Recession and Sense of Self

Self doubt. Diminished sense of self. Fear and diminished expectations. Depression. Anxiety. Lack of sleep. These are some of the symptoms being predicted as a result of the upcoming (if not arrived) recession. Washington and Lee University (quote from Shrink Wrap) warn of the following:

What’s really interesting is that this compromised sense of self becomes hardens and is better described as a permanent scar rather than a blemish. Even when people become employed again, the adverse impact of unemployment on psychological well-being lingers.

At the New York Times, David Brooks takes a broader sociological view, but comes to some of the same conclusions. He notes a cynicism from the 70s that never really went away. He notes:

Recessions breed pessimism. That’s why birthrates tend to drop and suicide rates tend to rise.

or

But recessions are about more than material deprivation. They’re also about fear and diminished expectations. The cultural consequences of recessions are rarely uplifting.

 

 

Discriminating Among Anxiety Disorders

An automatically generated link led me to a very nice old post at We Worry: A Blog for the Anxious about discriminating between anxiety disorders. Apparently weworry.com received some accolades last year (see the website), so you might want to check it out, particularly if you have questions about anxiety. For instance, If you click back to their homepage there’s another nice post titled, “Feel the Fear.” The post mentioned earlier, titled “What’s in a Diagnosis?” starts like this:

One of the most commonly heard questions on internet anxiety-support forums is some variation of: “Is this Generalized Anxiety or Panic Disorder?” Much discussion revolves around the diagnoses and their symptoms, yet the most important thing you will ever learn about your diagnosis is this: it’s largely irrelevant. Aside from the insurance companies and the FDA’s medication standards, your diagnosis has little bearing on your recovery.

The anxiety disorders fall on a spectrum and there is rarely an individual who shows signs of one without showing signs of another. Many people ultimately diagnosed with Generalized Anxiety Disorder (GAD) typically show signs of Obsessive-Compulsive Disorder (OCD). For example, many GADers experience chronic, nagging fears about their health (mental or physical); this is sometimes referred to as hypochondriasis or “health anxiety.” You may not realize it, but your constant thinking and analyzing of physical or mental symptoms is actually a ritual. So is your constant need for reassurance. If you find new symptoms and then rigorously search for relief from Dr. Google, then you’re performing a ritual. We often know this ritual won’t help much, but we can’t help it, we just have to know about the disease we fear so much.

Check out the rest of the post here. Again, the site seems like a good place to start if you’re interested in anxiety.

What Does A Panic Attack Feel Like?

Well, at PANIC!, there’s an excellent first-person account titled: “My first panic attack”. The piece does a nice job of describing how a mundane moment is exploded by total panic. In fact, if you’re interested in the subjective experience of panic disorder, you’ll find post after post of well written descriptions of and musings on panic disorder and how it has affected one person’s life. The writer, Eric Wilinski, is writing a book, and “has been dealing with panic disorder for 20 years”. An excerpt:

And then it happened. What is this feeling? I wondered briefly. In the next instant, my focus zeroed in on my chest, where, suddenly and without warning, my heart had started flapping and fluttering like a bird with clipped wings trying to escape its cage.

Well worth the read at PANIC!

Media’s Chemical Imbalance Theory of Depression

Yet more on the SSRI theory of depression. Here’s the full headline of a thought provoking press release from Florida State University: Media Perpetuates Unsubstantiated Chemical Imbalance Theory of Depression. The piece focuses on a few often overlooked facts: (1) That depression is caused by a “chemical imbalance” remains unproven and (2) That SSRIs are increasingly being found to be about as effective as placebo. Also (3) the media is largely misinformed about these facts. Here is an excerpt, the italics are mine:

Jeffrey Lacasse, an FSU doctoral candidate and visiting lecturer in the College of Social Work, and Jonathan Leo, a neuroanatomy professor at Lincoln Memorial University in Tennessee, found that reporters who included statements in news articles about depression being caused by a chemical imbalance, or a lack of serotonin in the brain, were unable to provide scientific evidence to support those statements.

Lacasse and Leo spent about a year in late 2006 and 2007 monitoring the daily news for articles that included statements about chemical imbalances and contacting the authors to request evidence that supported their statements. Several reporters, psychiatrists and a drug company responded to the researchers’ requests, but Lacasse and Leo said they did not provide documentation that supported the chemical imbalance theory. Their findings were published in the journal Society.

Obsessive Compulsive? High Achieving?

The scourge of perfectionism.
We call it perfectionism. Nice article in the New York Times today about the way the culture encourages both obsessive attention to detail and compulsive behavior. Much of what therapists do is dealing with the damaging results of people stuck in the mindset of “black-and-white thinking”, a sad by-product of perfectionism (either it’s perfect or not).

What it looks like.
Perfection’s a good credo for knife throwers but quickly become unmanageable in day-to-day life, leading to paralysis — a tremendous inefficiency in completing tasks, and a tremendous indecisiveness for fear of less-than-optimal outcome. Moreover, there’s the depression that so often results when one doesn’t measure up to exacting standards. (As one joke has it: Is there a hyphen in obsessive compulsive?) When one’s identity is wrapped up in perfection it’s a sure recipe for misery.

Panic Attacks: Did I Just Have One?

Like a heart attack.
When someone comes into an emergency room complaining of a heart attack, they are treated as though they are having one. But they may be having a panic attack. The symptoms — difficulty breathing, cold sweat, chest pain, rapid heart beat — are identical. Panic attacks occur unpredictably, and are not associated with any particular situations, unlike social phobias. Basically the body has gone into fight-or-flight reaction, dumping large amounts of adrenaline into the bloodstream.

What causes panic attacks?
A panic attack, or something that appears to be a panic attack, could be associated with a medical condition such as hypoglycemia or hyperthyroidism. It could be the result of extreme stress or anxiety. Stress may be related to current stressors. Anxiety may also be due to situational stress, but also may have deeper roots in upbringing or even trauma.

On Praising Children

How much praise is too much?
Recently there have been some articles on the negative effects of praising children. One trend in these articles is to confuse self-esteem with narcissism. It is a healthy, realistic view of one’s self and abilities. But self-esteem is a phrase with a lot of baggage. The rampant lack of self-esteem, and people’s hunger to repair it, creates a large audience for the self-help industry. John Norcross, Ph.D. states that this industry publishes about 3000 books a year. It is big business. Norcross notes that if these books really worked, they would not have to publish so many. Parenting books are a subset of the self-help industry.

Does praise lead to narcissism?
Narcissism, from the lay person’s point of view, is an abundance of self-love, self-concern, often associated with arrogance and self-absorption. A person that is narcissistic appears to be very confident, “high on himself.” What psychologists find underneath the facade, very often, are people that are actually very insecure, unhappy, unfulfilled, and have difficulty maintaining relationships. It does not matter whether these people are accomplished or not, their true self-regard is that they are worthless and incompetent. Therapists are in a unique position to see the harmful results of narcissism, and the experiences that shape it.

Damaging effects of false praise.
In preschools sensitive to the developmental needs of children, the kids are praised for their efforts, not the quality of their work. Why? The reason for this is that children that are praised for their efforts develop a sense of efficacy, a can-do attitude that translates into other areas. Praising efforts has more chance to be authentic. It is not about the child’s talents. When a parent or a caregiver tells a child that a painting she is unhappy with is “great!” the child learns to distrust that person and her own abilities. Children are hungry for acknowledgment, but they will spot false praise a mile off. A story in the Wall Street Journal addresses the destructiveness of false praise.

Fear of being a disappointment.
Children told that everything they do is fantastic are faced with a different dilemma. If the expectation is that what I do is fantastic, then if I fail I will be a disappointment. Depending on the level of hype, this may result in the child shying away from new activities where they might perform at a less-than-fabulous level. Thus, such a child attempts fewer things, self-limits her experiences, has less opportunities for growth. Deep down, children want their parents’ approval.

A recent study on efforts-based praise versus achievement-based praise.
Children that are praised for their efforts develop the attitude that even with difficult tasks they can do the work. In a study that compared the two approaches, praising production versus praising efforts in schools, it was found that the children whose efforts were praised scored better on tests. Here is an article that mentions the effects of different kinds of praise on testing.

Effects in college years.
There’s another factor in overpraising kids. Kids that have been told that everything they do is of superior quality are in for a rude awakening when they go college, or even high school for that matter. If they went to a school where they were told spelling was not important, just to express themselves, they may find that they are demoralized to find that spelling is important, that it effects how people perceive your competence, and that it may even effect your grades. The anything goes philosophy is more likely to be found in schools that call themselves “progressive” — though some of these schools are excellent.

Kalea Chapman, Psy.D.

Getting Curious About Psychotherapy?

Making that first call is tough. There are so many reasons we are told not to: “I should stand on my own two feet.” Or “Therapy is for crazy people.” Here are a handful of reasons you might want to consider seeking help:

• You are depressed but are not sure why.
• You are anxious but are not sure why.
• You are confused about where your life is going.
• Your current relationship seems to be going the same way as your previous relationship — and it’s not good.
• Your family is so in one another’s business that it is hard to know where one person begins and another ends.
• Your family is detached, and you have many unresolved questions about how you grew up.

Kalea Chapman, Psy.D.

Why People Seek Help: Five Common Reasons

Here are some common reasons people come in for therapy:

1. Trouble in relationships. marriage, friendships, coworkers.
2. Life transitions. Adolescence, marriage, change of career, divorce, empty nest, retirement — each of these phases poses unique challenges.
3. Anxiety. Many life transitions are tough on the nerves.
4. Depression. Sometimes we don’t even realize we are depressed. If you are suffering from apathy, difficulty with sleep or sleeping too much, feeling blue, irritable, or lack of motivation that lasts for more than a few days you may be suffering from depression.
5. Lack of direction. Sometimes people find that they are unhappy about where they are in their lives, confused how they got where they are. Psychotherapy is excellent at addressing such questions in a thoughtful, respectful manner that offers an opportunity for growth.

Kalea Chapman, Psy.D.