Now, in addition to your original stressor, you’re under more pressure because you’re scrambling to find lost keys, dealing with hurt feelings or frantically reconstructing forgotten projects.

And on top of that, when stressed, our emotions are running rampant. That scramble for the keys is anything but calm and a remark from your mother about that missed phone call can send you deep into guilt.

It’s easy to attribute these lapses in memory and emotional intensity to simple overload. When we’re stressed it’s typically at least in part because we’ve got too much going on and we just don’t have the capacity to keep up with everything.

Scientists have known what common sense tells us — that stress has an impact on memory and emotion.  But it’s not just that we have a lot going on and aren’t paying attention. Stress actually has an impact on how the brain processes information and stores memories. And research over the last several decades has pinpointed changes in certain areas of the brain during times of stress.

Now new research, published in the Journal of Neuroscience builds on previous understanding of the brain. It suggests that dramatic changes that occur in the brain when under stress are linked to our emotions and scattered memory.

Chronic stress affects two important areas of the brain when it comes to memory: the hippocampus and the amygdala.

In this new research, electrical signals in the brain associated with the formation of factual memories weaken while areas in the brain associated with emotion strengthen.

So, according to these researchers, with increasing stress, our brains are wired to discount factual information and to rely heavily on emotional experiences.

“Our findings suggest that the growing dominance of amygdalar activity over the hippocampus during and even after chronic stress may contribute to the enhanced emotional symptoms, alongside impaired cognitive function, seen in stress-related psychiatric disorders,” the researchers suggest.

So when you’re under stress — like when you’ve forgotten that important work document and your boss makes a comment that causes you to turn to jelly inside — keep in mind that your brain is wired to highlight the emotional part of her message. The factual part of the message may be lost altogether, which can leave you both intensely emotional and failing to act on important facts.

In my 20 years living in the Boston area, I cheered on the runners on many occasions and now, even from far way, these events feel close to home.

Experiencing trauma can have a dramatic effect on our bodies and our minds.  And although it’s a different experience to witness a trauma on television, it still can affect us.

When you perceive a threat, the body activates the stress response. The stress response occurs in both your body and brain.

The body’s response to acute stress is a preparation for emergency.  Adrenaline and other hormones are released.  The body shuts down processes associated with long-term care.  When under immediate threat, digestion, reproduction, cell repair and other body tasks related to long-term functioning are unimportant.

Of immediate importance is survival.  Increased blood sugar can provide extra energy for muscles. Increases in cortisol counter pain and inflammation. Blood pressure increases. Blood is diverted from our extremities to our major muscles to provide us with extra strength. Increased endorphins can help us ignore physical pain.

You can see the effects of these changes to the body in many of the symptoms of stress, such as racing heart, dizziness, nausea, shortness of breath, shaking, feeling hot and flushed, and sweating.

But it is the impact of trauma on the mind that is often the most disturbing.  Traumatic events can leave us feeling unsafe.  They can disrupt our beliefs and assumptions about the world. Your sense of your ability to control your life may be shattered. You may question how much influence you have over your life and your life choices.

A trauma, such as the one the occurred at the Boston Marathon, can leave us distrustful of other people.  You may question your basic trust of other people in the world.  Trauma can affect your ability to be intimate with others and may impact your feelings of self-worth.  Those who survive the trauma often feel guilt and wonder why they lived when others were less fortunate.

As we grow, change and have varied experiences throughout life, our beliefs and assumptions typically evolve over time.  With trauma, those beliefs and assumptions that we use to make sense of the world around us change nearly instantaneously.

It’s common to experience a wide range of psychological symptoms, including intrusive thoughts, worry, difficulty sleeping, trouble focusing, bouts of crying, blame or self-judgment and lack of satisfaction.

The effects of trauma also can cause intense emotion, including extreme emotional fluctuations, unhappiness, anxiety, loneliness, anger, and irritability.

Multiple traumas or repeatedly being exposed to life-threatening events can have a further impact on your body and mind. Parts of the brain can become sensitized, causing you to be on high alert and to perceive threats all around, leaving you jumpy and anxious.

Other parts of the brain associated with memory can actually shrink, making it difficult to consolidate and form new memories.  Prolonged stress can effect the development of a number of health issues, including diabetes, obesity and hypertension. And repetitive stress affects our moods, brings on anxiety disorders, and affects our experience of chronic pain and our ability to control food intake.

But when horrible events occur, such as those that occurred at the 2013 Boston Marathon, we also see the generosity and caring that is a large part of human nature.

Countless individuals ran to help without a second thought.  First responders, medics, EMTs and even bystanders jumped into action to do what they could to save lives.  Runners crossed the finish line and kept on running straight to give blood.

As we deal with the impact of violence, we can also keep in our minds the heroes and the strength of the human spirit that brings us together when we are faced with senseless tragedy.

Image: Wikimedia Commons: Aaron “tango” Tang

So what is alternative treatment? You may already have some experience with the most popular, according to the Monitor on Psychology. Meditation, biofeedback, hypnosis and progressive muscle relaxation are all popular complementary or alternative psychological treatments. 

Although you may be familiar with the most popular, there are dozens of alternative and complementary treatments, which typically fall into four categories:  mind-body medicine, biologically-based practices, manipulative and body-based practices and energy medicine.

The Monitor article reports that, although these, and many other, alternative and complementary treatments have been around for thousands of years, the National Institute of Health (NIH) has been studying their usefulness, safety and role in improving health and health care for only a little more than a decade.

But many people embrace these treatments and are visiting alternative medicine practitioners more frequently than they visit their primary care doctors.  And these treatments are big business. A 2007 study found that $34 billion is spent each year on products and services for alternative and complementary medicines.

Continued research on the effectiveness of these treatments is ongoing and crucial.  However, current research suggests that many are effective for treating a wide range of problems, ailments and disorders.

There are too many to document in one post, but the following are the top 4 according to frequency of use, as reported in the Monitor.

1. Dietary Supplements.

Dietary supplements are used to promote general health, as well as to improve depression and anxiety and to decrease pain.  Common supplements reported in the Monitor include ginkgo biloba, St. John’s wort and vitamin supplements.  Although regulated by the FDA, they are held to very different quality standards than more conventional medicines.

• Caution: The FDA does not review the safety and effectiveness of any supplement before it is sold to consumers.  Supplements can vary widely from brand to brand and may interact with other medications. They should not be used without the knowledge of a physician.

2. Meditation.

Meditation is a process in which people learn to focus their attention in a particular way and on purpose.  It is used to treat a variety of symptoms, including high blood pressure, chronic pain, anxiety, depression, stress and insomnia.  It is also used to promote general health and well-being.

Meditation is integrated into many psychological treatments and practices with positive results; however, there are no formal qualifications necessary to practice it.  It is important that those who use this method receive appropriate training.

3. Chiropractic.

Chiropractic physicians use noninvasive treatments, such as spinal manipulations or chiropractic adjustments, with the aim of improving nerve and organ functioning by aligning spinal vertebrae.  These treatments are used to treat an array of ailments, from pain and headaches to stress and ADHD, among others.

Becoming a chiropractic physician requires several years of graduate work.  Most psychologists are unlikely to hold a chiropractic degree and, if they did, it would not be appropriate to serve as both a psychologist and chiropractor for the same client.

4. Aromatherapy.

Aromatherapy uses smells and aromas naturally extracted from plants to balance, harmonize and promote health of mind, body and spirit.  It is used clinically to relieve symptoms typically addressed in psychotherapy; holistically, to improve overall well-being; and aesthetically, in various oils and skin care products.

The Monitor cites recent research that indicates that aromatherapy can help treat pain, anxiety and agitation specific to dementia.  However, while certification is not required, it is recommended.  There are also risks related to toxicity, skin irritation and dosing regulations that require a competent professional to oversee, the article states.

Reference

Barnett, J.E., Shale, A.J.,(2013). Alternative Techniques.  Monitor on Psychology, 44(4).

If you’re experiencing some of the common symptoms of stress, such as irritability or anger, fatigue, feeling overwhelmed and changes in sleeping habits, then the physical and mental consequences of stress are all too clear.

And if you have made efforts to improve your stress levels, you’re not alone.  According to a new survey, Stress in America: Missing the Health Care Connection, which was conducted online by Harris Interactive, Americans think it’s important to improve their health and levels of stress.

Over the past five years, 60 percent of adults have tried to reduce their stress and more than half are still trying to meet this goal, according to the survey.

In fact, according to the survey’s findings, Americans are struggling to keep their stress at levels that they believe are healthy.  But how well do we do that?

Average reported stress levels have dropped in recent years, but they are still considered at unhealthy levels, according to those surveyed.  And although overall stress levels dropped, almost three-quarters of respondents say that their stress level has increased or stayed the same over the past five years and 80 percent say their stress level has increased or stayed the same in the past year.

But when it comes to making changes, many people are struggling.  People are reporting exercise as well as sedentary behaviors like listening to music, reading or watching television or movies as strategies for managing stress. 

However, we are are also spending time lying awake, overeating or eating unhealthy foods and skipping meals due to stress.

Despite their interest in making changes for a healthier life, many adults face barriers, such as lack of time, lack of willpower and lack of support, that prevent them from achieving their health and wellness goals.

Millennials (people ages 18 to 33) and people with chronic health conditions seem to be struggling the most when it comes to finding support for making healthy lifestyle changes to reduce stress. Millennials report higher stress levels than other Americans and nearly half report that they are not doing enough to manage their stress. Few report support from their health care provider for stress or behavior management.

And although stress increases your risk of becoming chronically ill and increases the risk that your defenses will be overwhelmed by disease, adults with chronic illness also lack support for managing their stress.  Stress is on the rise for those with chronic illness, but few are getting any support for managing that stress, which, in turn, could have devastating effects on the course of their illness.

So what can you do to better manage your stress? 

The answer is individual and has much to do with your lifestyle and personality.  However, a few tips from the good folks over at the American Psychological Association include: evaluating your lifestyle for stress, focusing on your own physical health and changing one habit at a time.

Need Help Changing Your Stress-Relief Habits?

Check out these articles:

• The Golden Rule of Habit Change

• Changing Our Routines and Habits

And women are feeling it more acutely than ever.  After decades of making progress in the work force, many women are feeling less valued than men, according to a recent APA survey on Stress in the Workplace.  They’re feeling they don’t receive adequate monetary compensation for their work and feel that employers offer them fewer opportunities for internal career advancement than men.

Why are women feeling less appreciated than men, when it comes to compensation and why are they stressed by lack of opportunity?

Possibly because they are.

Take a look at the healthcare industry as one example.  Healthcare as a whole is still an overwhelmingly female occupation: 80 percent of all workers in this field are female, according to a report on the healthcare industry by Georgetown University Center on Education and the Workforce.

But men are still earning more in many healthcare careers.  For example, female doctors earn less than their male counterparts and male nurses earn more than female nurses at every level of education, according to the Georgetown report.

And healthcare isn’t alone.  According to the results of the annual VIDA Women in the Literary Arts survey, male authors were featured 3 to 4 times more often than female authors in many major literary publications, such as The New York Review of Books and Harpers Magazine.

The reality is, in down economic times a wide range of people have good reason to feel stress at work.  Both men and women are often working during paid time off, typically checking email, but sometimes participating in conference calls or using days off to catch up on work.

And exacerbating the realities of the stressors in the job market, women may be more likely to internalize stress, according to a recent article in the Wall Street Journal.  They may hesitate to speak up for themselves or to challenge behavior that they see as unfair.  And, according to the APA survey, men are more likely than women to use flexible work arrangements, although both men and women report that job demands interfere with their ability to fulfill family or home responsibilities.

In the short term, stress isn’t always a bad thing.  It can motivate us to deal with a situation that poses some level of threat.  And the burst of adrenaline and other hormonal changes that occur during a stress response can heighten our senses and give us extra amounts of energy.

But chronically stressful situations that go unaddressed can lead to serious health problems.  Constant job stress can impact eating and exercise habits, which can contribute to high blood pressure, high cholesterol and weight gain.  Stress on the job can also accelerate the onset of heart disease and can lead to burnout, which is often associated with depression.

What can you do?

There are a number of strategies for dealing with workplace stress.  What will work for you may be entirely different than what will work for others.  Some interventions include:

• Learning relaxation and meditation techniques

• Assertiveness training
• Nutrition and exercise counseling
• Time management training
• Structuring breaks into your workday
• Emotion regulation training
• Identifying and setting reasonable standards

Your options for decreasing your stress levels include: making changes to yourself, how take care of yourself and how you think about and respond to stress, and making changing to your work environment by doing things such as asserting your needs and managing your time. 

It’s important to remember that sometimes, despite our best efforts, we are powerless to make changes to our environment.  Some work demands won’t change and sometimes we’re unable to change a hostile work environment.  When that is the case, to reduce your stress, you may have to evaluate your career options.

More than one third of U.S. adults currently are obese, according to the Centers for Disease Control and Prevention. Physicians and other health care professionals urge us to lose weight or risk becoming vulnerable to a host of diseases, including diabetes, high blood pressure and heart disease. Weight loss has become a national conversation.

On an individual basis, most of us either have tried to lose weight or are actively engaged in maintaining a healthy weight.  Why we struggle with weight and how best to lose weight are hotly debated topics.  The nation’s current weight struggles have been attributed to a range of biological, societal and personal problems such as unhealthy school lunches, media advertising, too much corn and corn syrup in our diets, sugar substitutes, lack of willpower, overreliance on fast and prepackaged foods and many more.

But what gets in the way of your ability to lose weight?

Is it lack of time to prepare healthy meals?  Lack of willpower to stick to a healthy eating and exercise routine?  The intense influence of advertisements urging you to eat unhealthy foods?  Lack of interest? Not knowing how to lose weight?

The answer, according to a new survey of psychologists suggests that when it comes to dieting, weight loss and weight gain, emotions play a central role and may be the primary obstacle to weight loss.

Have you ever felt guilty after eating a cookie and then decided to eat the whole box, since you’d already blown your diet? Have you felt low and skipped exercise? Then you’ve experienced emotions interfering with your weight loss.

If we were merely cognitive beings, we’d eat the cookie, evaluate how it affects our daily calorie intake, and make adjustments to get back on track.

But we’re not merely cognitive beings. According to the survey of more than 1,300 licensed psychologists, conducted by the Consumer Reports National Research Center, understanding and managing the behaviors and emotions related to weight management is essential to weight loss.

In fact, emotional eating was considered a barrier to 43 percent of people who wanted to better manage their weight.  And it’s not just emotional eating.  Emotions can interfere with maintaining a regular workout routine and making healthy food choices.

Getting Help for Weight Loss

So what can you do, if you’ve tried to eat healthy and exercise regularly and found that it’s just not working? 

More than 70 percent of the psychologists who provide weight loss treatment identified several key treatments and strategies for addressing the underlying emotional issues related to weight gain.  Those strategies considered “excellent” included:

• Cognitive therapy: a treatment that helps people identify and address negative thoughts and emotions that can lead to unhealthy behaviors
• Problem-solving:   Finding alternate solutions to setbacks, changes and obstacles
• Mindfulness:  Using strategies to allow thoughts and emotions to come and go without judging them, and instead concentrate on being aware of the moment

Also considered important in helping clients to lose weight and keep it off were the following:

• Motivational strategies
• Keeping behavioral records
• Goal-setting

Although weight problems may be caused by an array of biological, emotional, behavioral and environmental issues, it has become clear that stress and emotions play a central role in our ability to manage our weight.  Without strategies to recognize emotional triggers and respond to our emotions effectively, we are likely to continue to struggle with our weight and health.

According to the U.S. Department of Labor Statistics, 12.3 million workers were unemployed as of January 2013.  Among those who are employed, many — such as the 66 percent of mothers who work full- or part-time and struggle with the conflicting needs of work and family — continually strive to find careers that are the best fit for their families and their financial needs.

Good networking skills also can make a difference in whether you get hired.  One study found that people rated medical performance higher for medical residents they knew, suggesting that even the slightest of personal knowledge can give you an edge.

Other studies suggesting that even knowing a political candidate’s name can sway a voter, supporting the concept that having some connection with potential employers might give you a boost (Monitor on Psychology, July/August 2012).

So what can you do, to make that all important first connection?

The Monitor on Psychology had a few suggestions for psychology graduate students. But it’s good advice that can apply to any person pursuing any career (July/August 2012).

1. Attend an industry convention or networking meeting with a plan.Review the presenters ahead of time and map out who you’d like to meet.  Prepare a few sentences about their accomplishments or interests and why you want to meet them.
2. Ask questions.It can be intimidating to approach others, but most people like to talk about themselves.  Asking questions can prompt a genuine discussion.
3. Seek similarities.One study found improved rapport between strangers who self-disclose. The idea here is to find ways in which you are like the people you want to connect with. For example, you grew up in the same state, have a similar hobby or root for the same sports team.
4. Give yourself 50 percent of the spotlight.Sometimes when we’re looking for a job, we feel we need to sell ourselves and end up self-focused the whole time.  Try to keep the conversation balanced.  If you find you’re monopolizing the conversation, ask a question.
5. Take a note from dating research and balance friendliness with aloofness.Want to avoid an awkward dating situation?  Balance warmth with a focus on the other person.  The same can hold true for creating a quick impression with someone you’ve just met.  Avoid extremes of friendliness and detachment.  Think warm, but not overly eager.
6. Meet other people in the same situation as you.You might think you only want to meet people in a position to hire, but other people who are looking or who have jobs in the field you’re interested in often make recommendations.  They can also keep you informed of possible job openings and may have advice from their own experience.

Young business couple photo available from Shutterstock

In order to get chores done or get in a little extra leisure time, many cut corners on sleep.  We rationalize that a few hours here and there won’t make much difference.

But sleep deprivation can have effects on both your mental and physical health.

So what are these negative effects of not getting enough sleep?

Negative Effects of Not Getting Enough Sleep

1. Lower stress threshold. When you’re tired, routine activities, such as stopping at the grocery store on the way home from work, walking the dog or picking up the house can feel like overwhelming tasks.
2. Impaired memory.  Deep sleep fosters the formation of connections between cells, and REM sleep aids in memory formation.  Students considering pulling an all-nighter to study for that big exam might do better to get some sleep.
3. Trouble concentrating.  When you’re dragging yourself through the day, it’s hard to stay alert and focused.  This is why we don’t want our pilots and surgeons to lose too much sleep.  Sleep-deprived people have trouble focusing on tasks and overestimate their performance.
4. Decreased optimism and sociability.  Whether it’s the effort we have to put into staying awake or other factors, sleep deprivation makes us less hopeful and less friendly.
5. Impaired creativity and innovation. A growing body of research suggests that sleep deprivation may have a particular effect on cognitive processes that rely on our experience of emotions.
6. Increased resting blood pressure.  Several studies have found that sleep deprivation leads to increased blood pressure (Fujikawa et al., 2009) and even half a night of sleep loss has been reported to increase blood pressure in people with hypertension or pre-hypertension (Lusardi et al., 1996).
7. Increased food consumption and appetite.  Research indicates that acute sleep loss enhances pleasure response processing in the brain underlying the drive to consume food (Benedict et al., 2012).  The researchers raise the question of whether chronic sleep deprivation is linked to rising levels of obesity.
8. Increased risk of cardiac morbidity.  A number of factors can lead to an increased risk of heart attacks, and sleep deprivation is one of them.  During experimental sleep deprivation of healthy participants, increases in inflammation associated with the future development of cardiovascular disease occurred.

Why we experience all of these health problems related to sleep loss is not entirely known.  The strain of staying awake, alterations in hormone levels that the body releases during sleep, upsetting the strong circadian drive for sleep, loss of REM sleep and other factors may all play a role.

Although scientists may still debate the function that sleep provides us, it is clear that lack of sleep is associated with mental and physical dysfunction.

If you’re one of the chronically tired or if you view sleep as a waste of precious time, it might be time to change the way you think about sleep.  You  may not be aware of what your brain and body are doing during sleep, but that time is vital to your ability to function and potentially to your life.

Need help with getting to or staying asleep? Try these tips for shutting off your brain before bedtime.

References

Fujikawa T., Tochikubo O., Kura N., & Umemura S. (2009). Factors related to elevated 24-h blood pressure in young adults. Clinical and Experimental Hypertension, 31(8), 705-712.

Lusardi P., Mugellini A., Preti P., Zoppi A., Derosa G., Fogari R. Effects of a restricted sleep regimen on ambulatory blood pressure monitoring in normotensive subjects. Am J Hypertension. 1996;9:503–5.

Benedict C., Brooks S. J., O’Daly O. G., Almèn M. S., Morell A., Åberg K., … & Schiöth H. B. (2012). Acute sleep deprivation enhances the brain’s response to hedonic food stimuli: an fMRI study. Journal of Clinical Endocrinology & Metabolism, 97(3), E443-E447.

But electroconvulsive therapy (ECT) treatment has developed considerably since the days depicted in “One Flew Over the Cuckoo’s Nest.”  A current study at JAMA Psychiatry examines a treatment called transcranial Direct Current Stimulation (tDCS).

Could this fairly new form of electrical treatment for depression really be effective — and without the negative side effects of ECT?

This new treatment, which involves stimulating the brain with a weak electrical current, is starting to be considered as an alternative — and potentially effective — treatment for depression.  tDCS, unlike traditional ECT, passes only a weak electrical current into the front of the brain through electrodes on the scalp.

Patients receive the treatment once a day for 30 minutes and remain awake and alert during the entire procedure.

Why is New Treatment for Depression So Essential?

Depression in adulthood remains a common and often under-treated condition.

Depression can occur at any age, but it typically emerges in the mid-20s. Women experience depression twice as frequently as men, and symptoms can vary from mild to severe. Major depressive disorder, which may be diagnosed when depressive symptoms last for 2 weeks or more, is understood to occur in 15 to 17 percent of the population.

Symptoms of major depressive disorder can include a depressed mood, loss of interest and enjoyment, reduced energy, increased fatigue, diminished activity and reduced concentration and attention.

These and other symptoms, particularly when prolonged, impair a person’s ability to function in day-to-day life, making effective treatment essential.

Research continues to improve our knowledge about the impact of depression on our ability to process information and the underlying processes in the brain that are associated with depressive symptoms.

With increased information, psychologists and mental health professionals have made significant progress in identifying effective treatments.  A combination of cognitive behavioral therapy and medication has evolved the most effective treatment to date.

However, it is not fully understood exactly how and why antidepressants work. And despite significant advancements in medications, treating major depressive disorder remains a challenge. Although medication helps, it can be costly and produce troublesome side effects.

Recent Advances in Electrical Treatments

Noninvasive brain stimulation, such as tDCS, has been increasingly investigated for the treatment of major depression.

In previous research out of the University of New South Wales (UNSW) and the Black Dog Institute, 64 depressed participants who had not benefited from at least two other depression treatments received active or sham tDCS for 20 minutes every day for up to six weeks.

The study found up to half of depressed participants experienced substantial improvements after receiving the treatment.

In a recent clinical trial, Andre R. Brunoni, M.D., Ph.D., of the University of Sao Paulo, Brazil, and colleagues examined the safety and efficacy of electrical current therapy compared to treatment with sertraline hydrochloride for major depressive disorder (JAMA Psychiatry).

Participants included 120 patients with moderate to severe nonpsychotic unipolar major depressive disorder who were not taking antidepressant medications. A three-point change in a depressive rating scale at the six-week mark was considered clinically significant.

Participants were divided into groups to compare sertraline to tDCS or a combination of both.

In major depressive disorder “the combination of tDCS and sertraline increases the efficacy of each treatment. The efficacy and safety of tDCS and sertraline did not differ,” the study concludes.

According to the study reports as noted in JAMA Psychiatry, there was a significant difference in the depression rating scale score when comparing the combined treatment group (sertraline/active tDCS) vs. sertraline only (mean difference 8.5 points); tDCS only (mean difference, 5.9 points); and placebo/sham tDCS (mean difference 11.5 points).

Side effects of participants who received active tDCS treatment were fairly minimal, with skin redness at the treatment site and an increased potential for hypomania or mania episodes being the primary adverse effects.

More research is needed to confirm the results of this latest study. But increasingly, it looks like tDCS may offer people with depression another alternative to more traditional forms of treatment.

Reference

Andre R. Brunoni MD, PhD, Leandro Valiengo MD, Alessandra Baccaro BA, Tamires A. Zanão BS, Janaina F. de Oliveira BS, Alessandra Goulart MD, PhD, Paulo S. Boggio PhD, Paulo A. Lotufo MD, PhD, Isabela M. Benseñor MD, PhD, Felipe Fregni MD, PhD. The Sertraline vs Electrical Current Therapy for Treating Depression Clinical Study: Results From a Factorial, Randomized, Controlled Trial. (2013). Arch Gen Psychiatry, 70, 1-9. doi:10.1001/2013.jamapsychiatry.32

At school, teachers face varying forms of misbehavior: A child may wander around the classroom when he is supposed to be working at his desk, or talk out of turn when she is supposed to raise her hand. 

Parents often confront issues such as siblings squabbling at dinnertime, or children whining or throwing tantrums when they don’t get their way.

Parents, teachers and caregivers often respond to misbehavior by verbally correcting the child and doling out consequences. But some teachers are being taught a strategy called active ignoring. They overlook disruptive behavior and either focus on a child who is behaving, or wait until the misbehaving child exhibits a desirable behavior.  For example, a teacher may ignore a child calling out an answer and call on the student who is raising her hand.

These techniques are taught in a program called teacher-child interaction therapy (TCIT), which is based on a similar program for parents. Early studies suggest that these approaches, whether in the classroom or at home, improve children’s behavior.

Parent-child interaction therapy (PCIT) is designed for children with emotional and behavioral disorders.  Its aim is to change the quality of the relationship between parents and children by changing the way they interact.

When children misbehave or have more serious behavior problems, such as violent outbursts and tantrums, it is easy for parents and caregivers to react with anger and frustration or harsh limits.

The goal of PCIT is to help parents show greater warmth, responsiveness, and sensitivity to their child’s behaviors. Studies indicate a quality parent-child relationship helps children develop a secure sense of their relationships and more effective emotional and behavioral regulation. Contingency management is the underlying principle. Contingencies — two events that tend to occur together — can have a great effect on how children act.

PCIT and TCIT advocate altering the paired events.  Instead of pairing misbehavior and attention, these programs pair positive behavior and attention.  The assumption is that children want and need adult attention. That makes it a reinforcer — something that, when paired with an action, makes that action more likely.

For example, a parent might respond to a child when out running errands by saying “you stayed right by me in the store, and you talked nicely, so we’re going to stop and get an ice cream cone on the way out.” In this instance, the parent is pairing both positive attention and a reward (ice cream) with the positive behavior.

Pair attention with misbehavior and you get more misbehavior. 

But if you ignore the misbehavior and wait for a desired behavior, with time, you increase the desired behavior. While waiting can certainly be difficult, it may be worth it to learn a little extra patience to help your children grow.

More information about PCIT can be found here.

What makes for adversity is different for each person. For example, while one person might see the loss of a job as an opportunity, many (if not most) would find it stressful.

These life-changing situations often happen when we experience a death, job loss, serious illness or other traumatic events.

How you act when faced with setbacks and hardships can be as unique as you are.  But according to the American Psychological Association (APA), what you have in common with anyone else facing adversity is “a flood of strong emotions and a sense of uncertainty.”

So how do we overcome adversity?

With resilience — the ability to overcome obstacles and deal with difficult, life-changing events. It is the capacity to make realistic plans and carry them out. It may require you to solve difficult problems, experience painful emotions or take action when you’d rather step back. But in order to overcome adversity, it is necessary to foster resilience.

The good news is that resilience is not a trait.  This means it is not something we’re either born with or without. It’s a skill everyone can learn.

You can develop resilience by following these strategies:

• Focus on building relationships.Studies have shown that strong, supportive relationships are one of the primary factors in resilience.  Whether it’s family, friends or co-workers, having role models, encouragement, support, love and trust is important to the ability to overcome adversity.
• Accept change.When change happens, especially if it brings pain or hardship, it’s natural to wish that it hadn’t occurred.  But once it’s happened, continuing to fight the change only keeps you stuck in difficult emotions.  Instead, try acknowledging that this change is hard, painful and unwanted. Then ask yourself how you want to live and what type of person you want to be going forward.
• Try to learn about your strengths.Ask yourself how you’ve dealt with adversity in the past. In what ways are you strong?  Are you a decision-maker, able to reach out and help others? Are you optimistic by nature? Able to make others laugh? Persistent?  Take time to reflect and build upon your strengths, then use them to your best advantage.
• Act.Overcoming difficult circumstances can require us to take difficult action.  Even if it’s a very small step, it’s important to move forward.

It may feel as if the obstacles you face are tougher to overcome than those of others. The reality is that every day, ordinary people are required to rise above their circumstances, dust themselves off and continue on. You can do it too.

Students want to study when they want and how they want.  Distance learning makes education available to those who wouldn’t otherwise be able to get off of work, travel to class or spend hours in lectures.  

That same increase in convenience and availability could have a real impact for people seeking psychological treatment. Is distance treatment ready to take off?

People who must maintain jobs, care for children or aging parents, don’t have cars or access to public transportation or want to learn material that is not offered where they live can all benefit from distance learning. These are often the same reasons people struggle to access mental health services.

And there is a large body of research that suggests distance learning and traditional classroom learning provide the same quality of education. Distance learning is no longer considered a sub-standard educational option.

So, how can these benefits apply to receiving psychological treatment?

Treatment available online or at a distance could certainly help people with difficulties in getting to therapy sessions and incorporating treatment into a busy lifestyle. It would also enable people to access specific treatment modalities not otherwise available to them.

And, according to the American Psychological Association, psychologists have begun using electronic communication such as email, Skype and various forms of videoconferencing to augment treatment. But, while technology surges ahead, licensing laws and guidelines for providing safe and ethical distance treatment are still catching up.

A recent article reporting on the use of phone therapy in Monitor on Psychology suggests that talking on the phone with a therapist can provide the same, or even better, results for some.

In this study, conducted by University of Cambridge researchers, British adults with mild and moderate depression and anxiety disorders who received cognitive behavioral-based therapy via the phone benefited as much, if not more, than those who received face-to-face therapy. Those with severe symptoms did not see the same results.

This study also found that telephone therapy was less expensive than traditional therapy and was conducted as part of a national initiative in Britain aimed at increasing people’s access to therapy.

The telephone is only one of many options for providing distance treatment. The number of mental health tools available is rapidly increasing. And many in the field agree that it’s time for practitioners to embrace technology and what it has to offer in delivering interventions.

One-on-one treatment cannot be replaced.  Nor should it.  However, the need for treatment providers to meet the changing and growing mental health needs of the population has caused the ΑΡΑ Insurance Trust and the Association of State and Provincial Psychology Boards to launch a task force to develop guidelines for tele-psychology practice.

So what are some of the alternatives to one-on-one therapy?  According to a cover story in the APA Monitor they include the following:

• Behavioral intervention technologies, such as those that deliver care via the Internet or mobile phones
• Computer programs for depression and other disorders, which typically teach principles of cognitιve-behavioral therapy or some other evidence-based treatment

Although these treatment options are appealing and there is a growing body of research to suggest that many are effective, it is important to proceed with caution.  It is essential to ensure that individuals get the right treatment and that treatments offered have been studied and found effective.

During the holidays we are often surrounded with images of people who are happy, in love and enjoying the whirlwind of their lives.  In reality, however, this time of year can be difficult.  When our lives don’t match the images we see around us or live up to our own ideals of family and friendship, it can be painful. And spreading all that good cheer, creating traditions and memories can be tiring and can exacerbate daily pressures and hassles.

The following tips are designed to help you find relaxation during this often-emotional time and to improve how you are thinking or feeling about the moment and the season.

1.  Find meaning in the season.  Find or reconnect to a purpose, meaning or value during the season.  Contributing can give a sense of meaning and make you feel good about yourself. Give something to someone else, do volunteer work or do a surprising, thoughtful thing.
2. Anticipate obstacles to your sense of well-being.  Take a few moments and remind yourself of circumstances that intensified your stress in past years.  For example, looking back, you might notice you often feel lonely. Conversely, you may have a tendency to overschedule yourself. Or you might find a particular family gathering painful.  Once you know you have identified a few of the more stressful moments of the holidays, you can plan how to approach them, possibly using some of the strategies below to get through them with less stress and emotional pain.
3. Do only one thing in the moment.  Doing just one thing can give you time to settle down in the midst of a frantic or chaotic day or week. Focus your entire attention on what you are doing now.  Let go of the mental listmaking, worrying, and party planning.  Put your mind in the present and focus on physical sensations, such as walking. You can also do one thing in the moment right at home by focusing on tasks around the house, like washing dishes, listening to music or decorating.
4. If you’re feeling down, do something opposite to how you feel.  When your life isn’t perfect, the holidays can bring up sadness, regrets and other painful emotions.  Change your mood by engaging in activities that are opposite to how you’re feeling.  Read emotional books, listen to emotional music or go to emotional movies.  Act with kindness and compassion toward those people who irritate you.
5. Schedule some memorable activities into your holiday season.  Research indicates that happiness increases with experiences, rather than things.  Reconnect with a childhood tradition or make a new one.
6. Try muscle relaxation.  Whether you’ve had a day on your feet or sitting at your desk, extra stress can make your muscles tense and sore.  Try to relax your muscles by tensing and resting each large muscle group.   Start with your hands, clenching them into fists tightly for 10 to 15 seconds, then releasing the fist and allowing your hands to rest heavily on your lap for 30 seconds.  Repeat the exercise a second time and then move to other muscles in your body, such as your arms, the muscles in your face, your shoulders, and your legs.  When you’re done, take a moment to rest and notice a feeling of heaviness in your body.
7. Self-soothe with taste.  If you’re out and tempted to graze on appetizers or other fast food without really tasting anything, pause, and then choose one food, slow down and really taste it.  Or, if you’re at home, take time to prepare a good meal or favorite soothing drink, such as hot chocolate or warm apple cider.  Then sit, do nothing else and focus your attention on tasting and savoring the food or drink.
8. Try deep breathing.  Lie on your back, breathing evenly and gently. Focus your attention on your breath, coming in and out and the movement of your stomach.  As you breathe in, allow your stomach to rise.  Exhale fully, pushing all the air out of your lungs. Continue for 10 breaths.
9. Clean the house. The holidays often bring extra chores and cleaning.  Use them as an opportunity to self-soothe, rather than as an additional stress.  Divide your work into stages:  straightening things and putting them away, then scrubbing and cleaning.  Allow a good length of time for each task.  Move slowly (three times more slowly than usual) and focus your attention fully on each task.  Maintain awareness of your actions and your thoughts if they wander.  Bring them back to full attention on the task at hand.

This time of year can be tiring, lonely, overwhelming, financially difficult and can bring up painful conflicts and reminders of  painful circumstances and feelings.  Not all of these strategies will be right for you.  Choose two or three that you believe will help you and try them.  They just might help you get through the season with a little less stress and a few more moments of calm and peace.

Stressed shopper photo available from Shutterstock

It’s the holidays.  Magazines focus on our waistlines and ways to survive the season while keeping a slender figure. I’m all for good health, but we’re frequently sold an image, product or diet that does not always result in good mental or physical health, particularly for women.

What’s your ideal weight?  In one alarming study, adolescent girls described their ideal girl as 5 feet 7 inches tall and weighing a mere 100 pounds.

This ideal is — at best — unhealthy and, for many, anorexic. 

And while it’s unattainable for most girls, they still hold it.  In doing so, they are more likely to be dissatisfied with their bodies, no matter their shape or size. They may feel disgust and revulsion toward themselves and envy and bitterness toward others.  Carrying this skin-and-bones ideal is associated with low self-esteem and the development of eating disorders.

Males also can hold unhealthy, unrealistic body ideals and suffer from similar dissatisfaction and distress.  According to one study, when boys experience body dissatisfaction, it is more likely associated with large, muscular bodies than a thin and skinny image.

Body image is believed to be a less prevalent issue for boys, who tend to view their bodies as a tool, rather than as a means of attracting others, but it is also a much less studied topic.

So where does the desire to be skinny come from?  The answer is both complex and simple.  It can be transmitted through family, peers, schools, athletics, business, and health care professionals.

But advertising is the most aggressive source of the overly slender image, according to a study in the International Journal of Eating Disorders. Thinness is equated with goodness and self-control.  Slender images are used to sell diets, cosmetics and exercise programs.  The female body is portrayed as an object of desire and when girls and women feel they don’t live up to the ideal, they are more likely to feel shame and anxiety.

Some simple strategies to improve body image include:

Putting down the magazine. 

Make a choice not to subject yourself to ideals and images that will make you feel worse about yourself.

Seeking healthy role models. 

Role models can help girls and women focus on eating to sustain healthy, functional bodies, rather than on dieting to become skinny.

Refusing to talk about dieting. 

Peers have a huge influence on adolescent girls, but our friends affect our worldview at any age. Resist the urge to talk about dieting, especially non-nutrition-based fad diets, with friends.

Not isolating yourself. 

Encouraging adolescent girls to develop healthy relationships with peers may prevent them from developing body dissatisfaction, according to one study.

If you or someone you know is struggling with body image problems or with an eating disorder, you can get more information from the National Eating Disorder Association.

These events touched many families personally. For those of us not directly affected, they can still leave us with feelings of horror and wanting to hold our loved ones near.

As a nation and as individuals, we could not possibly have anticipated or planned to have to deal with the emotional consequences of such an event. And yet here we are… many of us saddened, enraged and overwhelmed.

In the midst of tragedy and crisis, it can feel as if life is spinning out of control.  An event like this can remind us of devastating events from the past, which in turn can trigger thoughts and emotions connected to our own personal misfortunes and heartbreak.

We can’t change what has happened, but we can use a few strategies can help get through intense painful feelings and do what needs to be done in our daily lives.

• Turn off the news. 

  Give yourself permission to take a break from the images, thoughts and emotions related to this tragic event.  As with a car accident, when something terrifying or tragic occurs, we can feel compelled to watch and gather information about the event.  But it’s important to your emotional well-being to get a break from it.

• Distract yourself. 

  If you’re plagued by persistent thoughts or painful emotions, try engaging in physical or mental activities that take your mind off of it.  You might try things such as going to a movie, exercising, doing a puzzle or playing a video game.

• Help others. 

  One of the most effective ways to feel better is to help others.  Whether it’s volunteering for a charity, watching a neighbors pet or saying kind words to someone else, helping others can improve how you are feeling.

• Do something opposite to how you’re feeling. 

  You may be feeling angry, sad or depressed.  Don’t take lightly the impact a pleasant experience can have on your mood and emotions.  Some things you might try include watching a funny TV show, talking to a light-hearted friend or listening to comforting holiday songs or upbeat music.

• Soothe yourself. 

  Often when we’re in the midst of painful emotions we neglect to do the things that can make us feel calm and relaxed. You might try lighting a scented candle, baking cookies, wearing soft clothing, putting on a special scented lotion or looking at pictures of loved ones or special times.

When you have good reason to feel bad, it can be hard to regain your equilibrium and get through normal daily activities.  A few simple coping strategies can make a bigger difference than you might expect.

If feelings triggered by the tragic events in Newtown Connecticut are interfering with your ability to function, it’s essential that you employ strategies that will help you bear the moment and get through this difficult time.  These strategies or seeking help from a professional are important.