By Margie Nichols, Ph.D. The Diagnostic and Statistical Manual of the American Psychiatric Association (Fourth Edition) is the “Bible” of mental illness. The DSM is being revised, and in a few years DSM 5 will come out. I think – along with a lot of others in the mental health field – that there is a diagnostic category we could use that might actually be useful but is being ignored because it is seen as indicative of a highly stigmatized disorder. One of the revisions that didn’t make it into DSM 5 was the recommendation to create a disorder called “Emotional Dysregulation Disorder.” Instead, people who suffer from the inability to control their own emotional reactions and moods are lumped in the category of “Borderline Personality Disorder,” now to be called “Borderline Type.” Borderline Personality Disorder – BPD – is stigmatized even by mental health professionals. Until a type of therapy called “Dialectical Behavior Therapy” came into existence twenty years ago or so, it was considered ‘untreatable’ and ‘incurable,’ and many if not most therapists still see it this way. There are ten symptoms, according to the DSM 5 proposal, of “Borderline Type.” A few of them are pretty extreme:… Read more »
Category: Expanding Mind: All About Mental Health and Personal Growth
A NEW SOLOMON’S DILEMMA? OBESITY VS. SMOKING IN KIDS
By Margie Nichols, Ph.D. There’s an interesting piece by Gina Kolata in the Times today about how funds used to combat smoking in teens is now diverting into obesity prevention in children. The question is: if you have to choose, which is more important to prevent? Obesity or smoking? Clearly we shouldn’t HAVE to choose….but if we did? The answer isn’t obvious. Kolata discusses some of the pros and cons. For example, anti-smoking campaigns aimed at teens appear to have been partially successful- teen smoking has gone down, although since rates of smoking have gone down in all age groups, it’s a little hard to attribute that purely to prevention efforts. And, the truth is that we know of nothing that prevents obesity. As Kolata says, “..no interventions, when tested in large studies, have caused a big difference in children’s or teenager’s weights.” So all the ‘common sense’ about preventing obesity – promoting healthier choices, more activity, soda taxes – might be about as effective as, say, the D.A.R.E. program was in keeping kids away from drugs (i.e., zero percent) My guess is that many of these measures may prevent obesity in a small percentage of what I call ‘accidentally’ obese kids –… Read more »
Help For Insomnia: Tips From The CBT Playbook
By Margie Nichols, Ph.D. Some people have insomnia because they have medical sleep disorders like sleep apnea. But for the millions whose sleeplessness is primarily driven by anxiety, stress, racing thoughts, etc. the treatment of choice is cognitive behavioral therapy. It may take two to four weeks before the techniques start to work, and many of them focus on helping people develop better ‘sleep hygiene’, or habits around sleep. TIP NUMBER ONE: use your bed for only two things- sleep and sex. You are attempting to condition yourself so that the bed is associated with sleep. No reading or watching TV in bed. And if you try to go to sleep and can’t, after 20 minutes you get up and do something else. TIP NUMBER TWO: it’s a little different for people whose problem is waking up too early. The first thing you should do if this happens is to try a relaxation exercise, visualization, or meditation. That may allow you to fall back to sleep. If you don’t fall asleep,remain in bed and rest quietly- this is nearly as rejuvenating as sleep. If you are too restless for that – get up and do something. TIP NUMBER THREE; try to go to sleep… Read more »
The Problem with the ‘Problems’ with the Millennials
By Margie Nichols, PH.D. The Millennials (aka Generation Y) are the generation of people born between 1982 and 2002. The oldest of them are in their late twenties, and for a while now there’s been a lot of bashing of these young folks as they have entered adulthood. Dubbed “Generation Me,” they’ve been characterized as entitled whiners whose parents heaped on way too much praise for way too little, and who were ‘awarded’ far too many prizes for insufficient amounts of achievement. As Judith Warner says in a piece in the Times called “The Why-Worry Generation” they’ve been assessed as psychological basket cases, narcissistic wimps. Apparently, the latest piece of news about them is that they are “unreasonably” optimistic in the face of the recession, that they don’t second-guess themselves and they’re sure that bright days are ahead. This is a problem? It’s called resiliency. I’m glad Warner has taken on those who sneer at this generation’s more laid-back values (they are turning down jobs that require them to work more than 40 hours a week, even this year). She points out that the young adult Millennials may be annoying to those of us raised on Woody Allen-style anxiety about the future and… Read more »
THE BRAIN KEEPS THE SCORE PART TWO (continued apologies to Bessel van der Kolk)
Let me start Part Two with a personal story that reflects how traumatic memories are stored differently than ‘regular’ memories and how they can be problematic. My story is more dramatic than many, but nevertheless an example of how all trauma works, whether it be chronic moderate abuse in childhood, or the loss of a loved one in a hurricane. I lost my daughter Jesse six years ago on June 2, 2004. She was born on June 6, 1994 and her memorial service was June 6, 2004. You don’t need to have lost a child to know that those anniversary dates are probably more painful than most other times of the year for me- we all intuitively understand the power of implicit, sensory memories. This year was the first year since Jesse died that the dates and days of the week coincide. I’ve found, somewhat to my surprise, that this congruence of date and day of the week lights the old limbic system memory circuits– and the emotional affect associated with them-with more intensity than they’ve been fired with in years. Some days I feel, in a small way, the same way I did back in 2004, when I was… Read more »
Recreational Meditation Part 2: How it Helps
By Margie Nichols, Ph.D. In Part 1 (posted 4/27), I described myths about meditation – that you have to do it for a pretty long time, that you should have a blank mind, and so on. Here’s why meditating – any form you want – helps you, and a little about which type helps with what issue: • Relaxation: Meditation is deeply relaxing, with a type of relaxation that often renews you afterwards. It slows down the chattering mind a bit as well as the body. It’s useful just for this. If your main purpose is relaxation, I recommend guided visualization audios, or even just lying down and focusing your attention on meditation music. It has also been shown that after even brief periods of meditation, the “relaxation response” tends to last for hours, fading gradually. This “inoculates” you against stress and emotional over-reaction. • Improving Concentration: most of the meditation being taught today is a variation of ‘one-pointed focus,’ it involves focusing your attention on a sensation – the sensation of the breath entering and leaving the body is classic, but it could be a visual point, a sound, tactile sensations, a mantra, a candle flame, or counting. You… Read more »
THE BRAIN KEEPS THE SCORE, OR, WHY YOU OVERREACT TO YOUR BOSS/PARTNER/KID/STRANGER IN THE NEXT CAR
By Margie Nichols, Ph.D. There is a Buddhist story about a man steering a boat on a river in the early dawn when the river is shrouded in mist. Another boat collides with him, and the driver of the first boat rails at the second boat and its driver, who is obscured by the fog. In a few moments, the mist dissipates….and the second boat is seen to be empty, adrift in the river alone. This story is used as a metaphor for human relationships. We rail at ghosts in the mists, ghosts of our own making. Every day I see the evidence in my office: a man describes his road rage, and slowly what emerges is that the rudeness of the other driver triggered the same fear and anger he experienced as a child being berated by a contemptuous father. A woman cowers when her husband scowls, because his facial expression mimics the look that was on her mother’s face just before mom used to terrorize her as a child. I’m not really analytic in my therapy approach- but I am a fan of neuroscience, which increasingly gives us explanations for our behavior based in biology, not theory. The… Read more »
By Margie Nichols, Ph.D. There’s a word for constant, unmitigated happiness about your life: denial. Barbara Ehrenreich skewers the positive psychology field in her new book “Bright Sided.“ It’s about time. First of all, it’s become a veritable industry, with top motivational speakers making tens of thousands of dollars and books on ‘happiness research’ flying off the shelves. The message of this research, some of which is quite solid and interesting, has become diluted down to: smile, be happy, and you’ll be healthier and have your dream life. But the research itself is more nuanced and ambiguous- for example, some ‘negative’ people are actually healthier than optimists. Let’s face it, at times pessimism is a more appropriate view of life. The skill is to learn to cope with life’s curve balls without melting down, not to look the other way in ignorance. More support for the nuanced view of ‘positive thinking’ comes from research reported in this month’s issue of Psychology Today (sorry folks, the actual paper magazine, not online yet). This study correlated scores on a test measuring trust in people with household income. Turns out there’s an optimal level of trust: too little and you miss opportunities because… Read more »
Really? We’re Still Discussing This?
By Margie Nichols, PH.D. Our colleague James Cantor, Ph.D., published a CNN article showing physiological evidence that gay men are not pedophiles. He pointed to differences in brain structure, and differences in “phallometric” response (that’s right, a ‘peter meter’). Gay men’s brains look like those of straight men; both differ from the pedophiles brain in some distinct ways. And straight and gay men alike have very little phallometric response to images of children, in contrast with child molesters. Cantor wrote this article at the request of CNN and of course because the Catholic Church is trying to blame gays for the horrible child abuse perpetrated by its priests. But what saddens me about this is that we still have to refute such claims. Images of sleazy men in raincoats lurking around school yards were what came to mind when you thought about homosexuality – in the 50’s. Sixty years later, we have science to argue against this belief, not just Cantor’s research but a ton of research documenting very clearly that are pedophiles aren’t gay and vice versa. I’m glad we have a mountain of research. I’m sorry we still need it.
OUR FIRST POST
By Margie Nichols, Ph.D. We’re off to a good start. I’ll be writing on “EXPANDING MIND” about general issues of psychology, mental health, or human nature, and other IPG people will be “Guest Authors.” Our resident Guru, Neil Selden, is posting his poetry, meditations and pearls of wisdom on ‘PIECES OF MY HEART’ The wise and funny Sue Menahem will blog on “THE L WORD” about….you’ll figure it out. And many of us will be writing on “ALTERNATIVE THOUGHTS”, focusing on issues of interest to the L/G/B/T, kink, and poly communities.