For many, the security of having a job is essential for their well-being. If you know anything about Maslow’s hierarchy of needs, safety and employment are in the second level, just above breathing — so it’s pretty important.

If you are facing the threat of redundancy then I imagine you’re going through many different emotions right now, but there are some things you can do to help you deal with these rumors more easily.

Take my friends, for instance. A few welcome the idea of redundancy and are actively seeking to be made redundant. Others are struggling with the idea, mainly because of their unhealthy thinking about redundancy and how it will ultimately affect them.

It’s important to learn to deal with unknown threats well, otherwise anxiety can become overwhelming. Once that happens, it’s very easy to cause ourselves even more emotional, cognitive, and behavioral problems.

So what can those facing redundancy do?

First, understand that this is a rumor and may not be true. Worrying about something that doesn’t exist or over which you have no control is a waste of time and effort.

Second, check that you are not causing yourself anxiety by creating unhealthy thoughts and putting yourself in a “loss-condition.” That’s when you focus so much on the potential loss that you magnify it and take it to a catastrophic conclusion. For example, a person in a loss-condition might start thinking, “What if I lose my job? I can’t lose my job, that would be awful. What if I don’t find another one and can’t afford to pay my rent? My children won’t be able to go to school and my wife will leave me. I’ll then be alone and homeless on the streets. Oh God, I can’t stand it. This must not happen!”

The problem with creating this loss scenario is that once you think it, your mind will create a visual story of that thought and react accordingly. Your brain will begin to believe that thought is true. The more you think that irrational belief, the quicker your brain will recall that devastating visual and it’ll react to the threat by creating even more anxiety symptoms. Before you know it, you won’t be able to think clearly and cope with the threat or the reality of redundancy.

Essentially, you’ve created a fictitious scenario that your brain believes to be true. You’ll be convinced that this will be your ultimate outcome. This thinking is very dangerous to your health.

Third, while you are focusing on the loss scenario, you are not focused on what you might be able to do to help yourself if the redundancy does become real and does affects you. While you’re becoming more anxious and spending more time thinking about how awful life will be, you could have gotten your resume updated, gotten an idea about the state of your finances, checked out insurance policies to see if you have unemployment payment protection, and so on. (There are many good sites that offer practical advice.)

It’s perfectly healthy to have concerns over being made redundant, because it’s not a small thing. It’s also healthy to be cautious and prepared for the possibility that you may be made redundant. But it’s too easy to let our healthy concerns turn into unhealthy anxiety.

With just a small change in thinking, while rationally assessing the situation, you will be putting yourself in a healthier position to react, and manage any potential loss situation in healthier, more productive ways.

In her book Crafting Calm: Projects and Practices for Creativity and Contemplation, Oman Shannon quotes the 20th-century Catholic priest Henri Nouwen, who said, “Through the spiritual life we gradually move from the house of fear to the house of love.”

Oman Shannon believes the same can be said about the creative life. Through creating, she writes, “we can enter the stillness that characterizes prayer and the ‘house of love.’ We can open ourselves and experience spaciousness.”

In Crafting Calm, Oman Shannon shares a variety of creative activities, stories and resources that help readers relax, comfort ourselves, get clarity and connect with others. Ultimately, connecting to our creativity can help us connect to our spirituality. In other words, crafting can become a spiritual practice.

Here are three exercises from her book to bring you calm and comfort and help you connect to your spirituality.

Prayer Garden

“Gardening is a wonderful practice for bringing one back to the present moment,” Oman Shannon writes. She suggests creating a prayer garden with plants that are meaningful to you.

If you follow a specific religion, you might pick the plants that are mentioned in your favorite passages of your holy book. For instance, the Old and New Testaments include lilies, papyrus and olive. Once you choose your plants, you can create labels that include those passages.

When creating your garden, Oman Shannon suggests pondering these additional questions: “What do particular scents – lavender, rose, peppermint – remind me of? What fragrances, or scents, do I need to surround myself with right now? What would calm me and why? What in my life feels sweet right now? Spicy? Energizing? Calming?”

According to Oman Shannon, whatever approach or shape your garden takes, there are important lessons to be learned. “Whether we create a simple prayer garden, consciously choose outdoor plants that remind us of the ancient wisdom in the Scriptures, or work with herbs in a windowsill, we will be rewarded with nourishment from nature and the lessons nature can teach us.”

Portable Shrine

A portable shrine can serve as a comforting tool, which soothes your mind and heart, Oman Shannon writes. You might not know it but you’re probably carrying around a portable shrine right now. Oman Shannon notes that a shrine could be anything from “a sacred symbol on a keychain” to “a collection of photographs of your beloveds on an iPhone.”

Cultures all over the world use shrines, and they do so in unique ways. In Central and South American countries, people use tiny matchboxes. Oman Shannon bought one with a “worry doll,” a clay angel pendant and a red seed. On the matchbox, it says, “There are moments in which you need a peaceful vibe, a touch of good luck, and someone to tell your worries to. Use this emergency kit to balance those tough moments! An angel for peaceful thoughts, a Lucky Bean and a Worry Doll.”

When creating your own portable shrine, Oman Shannon suggests considering what brings you the most comfort and what would symbolize that best.

Affirmation Blanket

All of us, Oman Shannon writes, have some sort of “blankie” that brings us comfort, whether it’s a sweatshirt or specific throw. Years ago, she bought a blanket for her young daughter that includes phrases such as “I am filled with unlimited possibilities,” “I am a true miracle” and “I am a bright light in the world.”

Her daughter not only sees these words (which serve as an important reminder), but she also feels them, “as they are in every way wrapped around her.”

Oman Shannon believes that our need for these words and blankets doesn’t dissipate as we get older. “…[I]f anything, we perhaps need them more as we navigate a world that doesn’t stop to communicate what a bright light we are in it.”

Depending on your expertise, you can create an affirmation quilt or embroider your affirmations into a pillowcase or other lightweight fabric. Or you can use fabric paint or pens on a fleece blanket.

When considering what words to pick, Oman Shannon suggests asking these questions: “What words will serve as your strength, your shield, at this time in your life? What words comfort you; what words do you need to wrap yourself up in right now – literally?”

Creativity offers a bounty of benefits. By using our hands to craft meaningful objects and environments, we can soothe ourselves and cultivate a spiritual practice.

“A young girl’s traumatic event may have triggered her inherited undiagnosed mental illness. The Turned Leaf follows one woman’s struggle with a mental illness, the effect it has on her and her loved ones. This drama is infused with modern dance , video elements, modern song and digs deep into the heart of the illness. ”

Below is a brief synopsis of how she came to write the play and what she hopes to accomplish with it.

Walking on eggshells is not just a phrase to me. It is a living, breathing entity where one false step can have catastrophic repercussions. I grew up with a mother who could literally turn on a dime and what set her off is, to this day, a mystery. I have spent my life trying to reconcile the fact that it is the illness which I hate and the mother’s heart which I love.

Those lines recently blurred when her blind rage attack sent my father to move in with me and my husband. This is what prompted me to write The Turned Leaf.

Growing up I never knew what was the truth or a made-up truth to cover the hurt but throughout the years a pattern prevailed. The Turned Leaf is based off of some moments of lucidity and by putting together pieces of a very abstract puzzle.

She is undiagnosed. She is untreated. She is miserable. And she is lonely.

The Turned Leaf is ultimately a love letter to my mother’s heart, and may help to shed an understanding light into mental illness, the demon within, and how it may have gotten there.

The Turned Leaf will be performed at the NewBridge Theatre Company in Hastings, Minn. May 16-18 and May 23-25, 2013.

Mental health and wellness is the state at which one feels, thinks, and behaves. Mental health can be viewed on a continuum, starting with an individual who is mentally well and free of any impairment in his or her daily life, while someone else might have mild concerns and distress, and another might have a severe mental illness.

Everyone has “stuff” that they keep contained in a tightly sealed plastic bag. There are some who occasionally can’t help but let the “stuff” leak, and there are those with the bag wide open.

However, in our society, we still tend to stigmatize those who let their “stuff” leak out instead of helping them, understanding them, or simply not judging them. Just as we all know someone with cancer, we all know someone with a mental health disorder.

Mental health is just as vital as physical health. In reality, the two coexist and should not be treated separately. There are many mental health disorders that exacerbate physical concerns or disorders, and vice versa.

For instance, someone who suffers from chronic migraines might also suffer from an anxiety disorder. Obesity contributes to the severity of symptoms of depression. Poor anger management is associated with high blood pressure. Behind every medical illness, it is possible to find a mental health concern as well.

It is also possible that a boost to mental health can alleviate symptoms of a medical condition. As an example, those who receive art therapy or pet therapy in hospitals are shown to have a speedier recovery than those without, as well as a decrease in severity of symptoms experienced.

A holistic approach for individuals needs to be the standard. Physicians, nurses, dentists, psychiatrists, psychologists, mental health counselors, and other mental health professionals need to collaborate to provide a complete treatment plan. A medical doctor who doles out prescriptions for irritable bowel syndrome also can refer the patient to a therapist for stress management. A dentist whose patient is suffering from extreme anxiety can have a mental health professional onsite or have one to whom to refer the patient. A psychologist can suggest that his patient see a specialist for any symptoms that can be contributing to his or her eating disorder.

As reported by the National Institute of Mental Health, more than 26 percent of the adult U.S. population has a mental health disorder, with over 22 percent of cases being considered “severe.” Mental health disorders include anxiety disorders, attention-deficit/hyperactivity disorder, autism, eating disorders, mood disorders, personality disorders, and schizophrenia.

Still, only 1 in 3 individuals will seek treatment for his or her disorder. It’s as if only 1 in 3 individuals who suffered from a high fever or a broken bone sought out a doctor.

We tend to view mental health as something that is an illusion, “all in one’s head,” or that certain disorders are overdiagnosed. Has anyone ever exclaimed that “cancer is overdiagnosed”? Yet, I have heard countless times that attention deficit hyperactivity disorder (ADHD) is being diagnosed too loosely in children and adolescents.

This month is to advocate for the awareness of mental health; however, it should be a consistent concern. Recent events have brought mental health awareness to the surface. We need to know what that means. This does not mean all catastrophic events are caused by those who are mentally ill and therefore we need better treatments. In fact, statistics show that those who are severely mentally ill are more likely to be victimized than to do harm.

It is easy to blame or stigmatize a certain group when events that cannot be understood occur and we grasp for any bit of reasoning we can. But it is neither accurate nor fair. This is the time that we educate ourselves and become properly informed, and develop compassion and understanding.

References

Brodie, S. J., Biley, F. C., & Shewring, M. (2002). An exploration of the potential risks associated with using pet therapy in healthcare settings. Journal of Clinical Nursing, 11(4), 444-456.

Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., Gasquet, I., Kovess, V., Lepine, J. P., … & Chatterji, S. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA: The Journal of the American Medical Association ,291(21), 2581.

Monti, D. A., Peterson, C., Kunkel, E. J. S., Hauck, W. W., Pequignot, E., Rhodes, L., & Brainard, G. C. (2006). A randomized, controlled trial of mindfulness‐based art therapy (MBAT) for women with cancer. Psycho‐Oncology, 15(5), 363-373.

Neuroaesthetics is the relatively recent study of questions such as “Why do we like the things we like?” and “Why do some people find one thing pleasing while others find it appalling?” It has focused on issues such as creativity, visual and motor processing in visual artists and the varying factors involved in creative domains.

Many of these studies have examined music and the neural activity that occurs when we listen to and evaluate what we hear.

Salimpoor and Zatorre (2013) reviewed a number of research studies examining the effects of music on brain activity; in particular activity that relates to the feeling of pleasure. The evidence was clear: not only does music boost our sense of pleasure but there is also a dopamine activity in anticipation to the music that “touches us.”

But that’s where the tricky part lies: this effect is noteworthy only when it is music that we choose, otherwise it does not apply. When the experimenter chose music he or she found to be emotion-inducing, the participants did not experience the desired feeling or the “chills” effect.

Then, the question remains: Why do people get emotional with some songs but not with others? The answer is not clear.

Cultural background, previously reinforced neural activity, subjective interpretations, exposure to certain sequences of sound and many more variables come into play. The notion of subjectivity in evaluating art is something that still requires a lot of exploration.

However, despite the uncertainty regarding why the pleasurable sensation of music is not an absolute and objective process, there is an important point we ought to highlight. The clear message that we can hold onto is that music arouses rewarding emotions, similar to those involved in addictive behaviors that get reinforced over time.

This information, though intuitive to some degree, may be more helpful when discussing the topic of coping skills for symptoms of depression, “emotional numbness” and recovery from chemical dependency.

One of the goals in developing a treatment plan for depressive disorders and substance abuse is to come up with a set of coping skills that can be easily accessed when feeling “as if nothing brings feelings of joy.” Chemically dependent individuals often report that the feeling of numbness and anhedonia can be quickly escaped by using drugs or other sources of immediate gratification.

Of course, the problem is that along with the sense of pleasure comes other unwanted consequences. This is where the findings from these neuroaesthetic studies come into play: When contemplating ways to respond to a decreased sense of pleasure, knowledge about how music can make us feel good comes in handy. Turning to this risk-free way of experiencing pleasure can be incorporated in treatment methodologies for conditions associated with decreased sense of emotional rewards.

Having said that, we have to be careful not to imply that the strong neurological and physical reaction to substances and other addictive behaviors can be reduced and compared to the effect of listening to a David Bowie or Shakira song. However, knowing that music is a highly rewarding experience is a useful reminder when discussing ways to replace destructive habits, or when developing a set of tools that help manage feelings of depression.

Reference

Salimpoor, V.N.; Zatorre, R.J. (2013). Neural interactions that give rise to musical pleasure. Psychology of Aesthetics, Creativity, and the Arts, 7, 62-75. doi:10.1037/a0031819

Suggestions abound about the necessity (not mere option) of striving toward certain pinnacles in life, be they health challenges to overcome or professional goals to better implement. The condition of being human in a complex world requires much life-energy spent on going after what’s really important and required of each of us, rather than in chasing distractions.

I like the addition to this philosophy, though, of an element I believe that’s equally required in the mix. It was well stated in a New York Times Career column editorial on Sept. 30, 2012, describing that mere work and dedication are not enough to reach one’s goals.

Real “audacity” must be paired with a balancing measure of “humility.”

Akin to gentle strength — a metaphorical pairing I really latched onto a decade ago (and symbolized for me by a picture of a Sioux woman carrying a heavy burden of wood through snow on her shoulders) — risk and humility go hand in hand. The latter does not temper the trajectory of the extension of the risk-taking — our liabilities do that. Humility simply properly balances the scale, accompanying our grand, significant striving motions that move us forward to what we deserve in our lives, our bodies, our work, our relationships.

You must believe in yourself, your ideas and needs, and go toward what is required and needed for wholeness with a measured sense of humble acknowledgement that our unique assets are indeed worth preserving, declaring, and cultivating.

Attaining something that changes the playing field might seem unreachable to an individual, group or company at any given time. With risk-taking, with the grit of unusual and unique dedication to topics normally resisted, they can be accomplished.

True change is risk paid off as ultimate reward for many — daring to utter the normally not-spoken, pursuing what needs to be addressed that everyone hides their head in the sand about, whether it be mental health or business or cultural issues, and going after the big players who do naught but ill in their work. But it also exposes and celebrates those who create good as individuals and for society.

Things that require over-the-top courage are the very things that will liberate and invigorate an individual as much as the larger whole.

Think in your life where bold steps paid off. Then reflect some more on future risk and reward and link your next steps, with the appropriate measure of humility in the mix — experiential learning, professional advancement, a focus on personal or organizational wellness. Whatever is required, take risks; strive for it. No greater reward will reveal itself than deep personal satisfaction with far-reaching impact.

Its narrow and inaccurate perception explains why many of us — women in particular — feel guilty about attending to our needs. It explains why many of us stumble around drained and depleted.

However, self-care offers a slew of benefits. And it feels good to nourish our needs.

Below, experts dispel seven of the most common myths surrounding self-care.

1. Myth: Self-care is all or nothing.

Fact: Many people believe that self-care means spending an entire day of pampering or “it’s not worth it,” said Anna Guest-Jelley, a body empowerment educator, yoga teacher and founder of Curvy Yoga. However, while pampering is a great way to nurture yourself, it doesn’t define self-care.

“I believe that self-care is really found in the small moments of life – when you choose to take a deep breath because you notice you’re feeling stressed, or when you give yourself three minutes before bed to sit quietly and reflect on your day.”

2. Myth: Self-care requires resources that you don’t have.

Fact: Self-care is often viewed as a luxury that many of us have neither the time nor the money to enjoy. “Self-care does not need to involve an expensive spa or tropical vacation, nor does it need to take hours of your day,” according to Joyce Marter, LCPC, a therapist and owner of the counseling practice Urban Balance.

For instance, self-care can be “10 minutes of mindfulness meditation a day or doing some stretching or taking an Epsom salt bath,” she said. These simple practices “can go a long way in rebooting your mind and body.”

3. Myth: Self-care is optional.

Fact: Running yourself ragged can lead to unhealthy habits, because our needs can’t go unmet for too long. “If you choose not to create room for self-nurture or rest, it will elbow its way in, often in forms that feel less than self-caring in the moment,” according to Ashley Eder, LPC, a psychotherapist in Boulder, Colo. These forms include compulsive behaviors such as overeating and even symptoms of depression, she said.

If you find yourself turning to these kinds of habits, explore the needs you’re meeting with them. And “offer yourself that choice directly instead of through these backdoor behaviors.”

4. Myth: Self-care is unfeminine.

Fact: The media perpetuates messages that femininity is “other-focused and self-denying,” Eder said. We typically see female protagonists focusing on everyone else’s needs, listening to others instead of speaking and playing a supporting role, she said. Care-taking is portrayed as a woman’s job.

“This only makes sense in real life if you want the star of the play to be a man. It does not work for a woman to play a supporting role in her own show.”

If you notice that your needs are going unmet, “try asking yourself who the main character in your life is right now, and whether you would like to stick with that or change it.”

5. Myth: Self-care is anything that soothes you.

Fact: Many people turn to alcohol, TV marathons, smart phone games and food to soothe their stress and unwind, Marter said. But these habits are the opposite of self-care. “Self-care practices need to support health and wellness and should not be addictive, compulsive or harmful to your mind, body or bank account,” she said.

6. Myth: We have to earn the right to practice self-care.

Fact: “Our lives are organized culturally with an emphasis in the first third of our lives on education, the second around career and family development, and the last third for leisure,” said Sarah McKelvey, MA, NCC, a psychotherapist with a private practice in Centennial, Colo.

This creates the notion that we can only take good care of ourselves after we’ve accomplished certain goals. Yet it is self-care that gives us the energy and nourishment we need to achieve great things.

7. Myth: Practicing self-care means making a choice between yourself and others.

Fact: “When we are not taking care of ourselves, we end up in a cycle of deprivation in which the activities of our day deplete our energetic and emotional reserves,” McKelvey said. We become frustrated, cranky and needy, she said. We look to others to nourish our needs and replenish those reserves.

“Ironically, all of our efforts of sacrifice make us vulnerable to actually ‘being selfish.’” Yet, when we’re meeting our needs, we have more energy to give to others. “There is nothing greater to offer the world than your inspired and well-nourished self.”

Self-care is an important part of our lives. It is the basis for our well-being.

But one aspect of getting divorced — or breaking up with your boyfriend or girlfriend — that can and probably will cause all kinds of problems is if you end up having sex with your ex. Oh yes, it happens. Hey, don’t look so shocked, you know you’ve done it.

Sometimes it’s not a planned thing. Sometimes it just ‘happened’ that one night when he came over to collect his Eminem CD’s, slanket, and favorite Big Bird mug. Or you may have a regular thing going on because your ex is ‘so damn hot’.

Whatever the circumstance, you might want to ask yourself, “Is this really a good idea?”

Whom you choose to have sex with is up to you. However, having sex with your ex could be setting yourself up for an ultimately unsatisfactory, long-drawn-out experience.

For both parties, the idea of losing a long-term relationship and being alone can be scary as hell. Often the attachment with your partner is still going to be strong in the early stages of divorce or separation, so letting go of that is going to be incredibly hard. You’ll have much shared history and familiarity. Thinking you can just turn your back on that and move on overnight is unlikely. Which is why, if your ex calls, it’s easy to give in and go running to the safety of someone who knows you.

The trouble is, sex probably isn’t going to solve past problems, especially if those problems were around communication, appreciation, emotional support or trust.

It’s amazing how the world looks like a better place after sex. That sense of happiness that intimacy brings is due to endorphins being released into the brain. Essentially, sex is crack for your brain. For that brief period after sex, anything will seem better. You’ll forget the midnight arguments, verbal abuse, and how sick you feel when they clip their toenails in front of the TV while you’re trying to watch “Castle.”

If you’ve got to a place in your relationship where divorce is the only solution to your differences, then there’s a good chance sex with your ex will only complicate matters. But if you still want to go ahead and do it, then do it. There is no right or wrong in this situation, only what you think is right for you.

However, here are a few things to think about before making a choice to get jiggy with your ex:

• Why did you get divorced or breakup in the first place? Did you have a good reason? Will sex make that right?
• Do you still have strong feelings of love for your partner, or do you just have fear of being alone?
• Are you or your partner using sex to try to keep the relationship going instead of facing the discomfort of ending?
• Will having sex muddy the waters? If you plan on moving on from your ex, being intimate with them means you’re not moving on.
• Is this an exclusive thing? Are you OK being a sex-buddy? Who else are they having sex with? Are you using protection?
• How will you feel if your partner tells you they’re seeing somebody else?

Remember, the reason to get divorced or to breakup is to dissolve the relationship — dissolve, as in make disappear.

Getting back with your ex for the occasional night of passion might seem fun, but it usually prolongs the inevitable ending, which can make it harder to forge new healthy relationships. An ending that you face and accept, no matter how uncomfortable in the short-term, will be better in the long run. Still, the choice is yours.

Some writers read a lot more into that statement than was actually there. Science 2.0 — a website that claims it houses “The world’s best scientists, the Internet’s smartest readers” — had this headline, “NIMH Delivers A Kill Shot To DSM-5.” Psychology Today made the claim, “The NIMH Withdraws Support for DSM-5.” (The DSM-5 is the new edition of the reference manual used to treatment mental disorders in the U.S.)

So is any of this true? In a word, no. This is “science” journalism at its worse.

NIMH’s Research Domain Criteria

For the past 18 months, the NIMH has been working on a different categorization system to classify mental disorders, to help further its research efforts (the NIMH is primarily a research-driven organization). It’s called the Research Domain Criteria project:

NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system.

The proposed classification system works under these assumptions:

• A diagnostic approach based on the biology as well as the symptoms must not be constrained by the current DSM categories,

• Mental disorders are biological disorders involving brain circuits that implicate specific domains of cognition, emotion, or behavior,
• Each level of analysis needs to be understood across a dimension of function,
• Mapping the cognitive, circuit, and genetic aspects of mental disorders will yield new and better targets for treatment.

In short, the NIMH is trying to find a new categorization system that takes into account more of the biology, genetics, brain circuitry and neurochemistry that we’ve discovered in the past three decades’ worth of research is becoming increasingly relevant to understanding mental disorders.

Does it Replace the DSM-5?

Will this replace the DSM-5? No, because as Dr. Insel notes, “This is a decade-long project that is just beginning.” If the NIMH effort ever replaces the DSM, it will be a long time from now.

Somehow, though, Science 2.0 and Psychology Today believe this letter suggests the NIMH has “withdrawn” support for the DSM-5, or has delivered a “kill shot” (whatever that is!). Are these kinds of characterizations accurate — or indeed, helpful?

We reached out to Bruce Cuthbert, Ph. D., the director of the Division of Adult Translational Research at the National Institute of Mental Health for clarification.

“As with most shifts in science, changes in research priorities require a transition,” said Dr. Cuthbert.

“Because almost all clinical researchers today grew up with the DSM system both clinically and in research, it will take some time to get a “feel” for the relationships between DSM disorders and various kinds of RDoC phenomena (both in terms of the types of symptoms, and in overall severity), learn how to write grant applications with the new criteria, and evolve new review criteria. So, there will be a period of some time while these crosswalks are worked out.

“I also should point out that these comments reflect [only] our translational research portfolios.

“Our Division of Services and Intervention Research mostly supports research conducted in clinical settings that is relevant to current clinical practice and services delivery. Thus, [...] grants in these areas will continue to be predominantly funded with DSM categories for some time.”

That’s a far cry from the entire NIMH withdrawing support for the DSM-5. The NIMH is simply saying (in my opinion), “Look, we’re unhappy with the validity of the DSM and its lack of support for biomedical markers for mental disorders. We’re working on a different schema, especially targeted at researchers. It may have greater relevance someday — that’s our hope and vision.”

Why a New Diagnostic System?

But then again, researchers in mental illness have been promising biomarkers for at least two decades as well — with little notable progress to show for their efforts.¹

Why is a new diagnostic system needed?

“For psychiatric disorders, we cannot effectively use very much of the knowledge we have gained about the brain and behavior over the last 30 years because of our symptom-based diagnostic system. In other words, the categories defined by symptoms simply do not map onto all the knowledge that we have gained about brain circuits, genetics, and behavior,” replied Dr. Cuthbert.

“We know that many different mechanisms are involved in any one DSM disorder (heterogeneity), while any one mechanism (fear, working memory, emotional regulation) is typically involved with many different disorders. [This] heterogeneity frustrates attempts to develop new treatments.”

Indeed, as John Horgan over at Scientific American wrote,

Ironically, some pharmaceutical companies that have enriched themselves by selling psychiatric drugs are now cutting back on further research on mental illness. The “withdrawal” of drug companies from psychiatry, Steven Hyman, a psychiatrist and neuroscientist at Harvard and former NIMH director, wrote last month, “reflects a widely shared view that the underlying science remains immature and that therapeutic development in psychiatry is simply too difficult and too risky.”

Pharmaceutical companies say that, on average, a marketed psychiatric drug is efficacious in approximately half of the patients who take it. Dr. Cuthbert from the NIMH suggests that, “One reason for this low response rate is the artificial grouping of heterogeneous syndromes with different pathophysiological mechanisms into one disorder.”

So the NIMH’s regrouping appears to be as much of an effort to spur new drug development as it is an effort to rethink the classification system of mental disorders. Which is a bit odd, if you think about it, since there is a rich research foundation showing that non-medication treatments — such as psychotherapy — work equally well (if not better) for the treatment of many mental disorders.

If these were pure medical diseases with clear and readily defined biomarkers, that shouldn’t be the case. After all, positive thinking can’t cure cancer.²

“Thus, mental disorders are an area where we must transcend the current symptom-based system if we are to advance,” concludes Dr. Cuthbert. “Among other things, if you have to wait until a full-blown set of symptoms is present before you can define a disorder (and there is no quantifiable data regarding risk states, as there is for, say blood pressure), then prevention is — by definition — impossible.”

This is simply untrue, in my opinion. There is a solid and growing research base already demonstrating that we can detect mental illness through a number of early screening and symptom measures and implement prevention measures. Other studies demonstrate significant correlations with certain characteristics — signs that can also be used to implement effective prevention.

“The research process will necessarily involve complex science to understand how we can relate more neuroscience-based measures to more specific and quantitatively-defined symptoms and clinical outcomes,” says Dr. Cuthbert from the NIMH. “This does not necessarily mean, however, that the diagnostic systems of the future will necessitate such a complex battery. As with biomarkers in other areas of medicine, a subsequent phase will be to find assessments that can be obtained feasibly in clinical settings (although this is unlikely to mean, as is the case now, that all disorders can be diagnosed simply sitting in a clinician’s office).”

Is It All About the Money?

Horgan suggests, perhaps, some ulterior motives for NIMH’s statement:

NIMH director Insel doesn’t mention it, but I bet his DSM decision is related to the big new Brain Initiative, to which Obama has pledged $100 million next year. Insel, I suspect, is hoping to form an alliance with neuroscience, which now seems to have more political clout than psychiatry. But as I pointed out in posts here and here on the Brain Initiative, neuroscience still lacks an overarching paradigm; it resembles genetics before the discovery of the double helix.

I’m not as skeptical as Horgan, but do believe the timing of Dr. Insel’s letter is a little curious — right before the launch of the DSM-5, and right after the public commitment of $100 million to brain research.

What is clear is that the NIMH is not withdrawing support for the use of the DSM-5 anytime soon. It is the reference manual all researchers and clinicians use today to speak the same language of mental illness. Without the same reference frame, research — and treatment — would become impossible.

Further Reading

Scientific American: Psychiatry in Crisis! Mental Health Director Rejects Psychiatric “Bible” and Replaces with… Nothing

Science 2.0′s article: NIMH Delivers A Kill Shot To DSM-5

1. David Kupfer, who chairs the DSM-5 Task Force, told Pharmalot: “The promise of the science of mental disorders is great. In the future, we hope to be able to identify disorders using biological and genetic markers that provide expreciseact diagnoses that can be delivered with complete reliability and validity. Yet this promise, which we have anticipated since the 1970s, remains disappointingly distant. We’ve been telling patients for several decades that we are waiting for biomarkers. We’re still waiting.”
2. Although, to be fair, positive thinking can definitely help in its overall treatment.

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.

Begin to think about some new channels of growth for yourself, as the time of year for sprouts and buds and new green shoots has begun here in the northern hemisphere.

Seedlings and fresh growth are just busting out now, reaching for the sun’s light and warmth. The approach we take to our challenges, to what has been negatively buried or merely incubating, should be the same. Especially in this time of tremendous new growth, it is good to reflect on our own striving for warmth, insight, nourishment and potential to expand.

So what kinds of questions could you ask yourself to help nurture this growth?

Some questions to think on as your fingers work in soil or you tread paths in spring woods:

• Anything keeping you down, not allowing you to grasp for new means of expanding your life professionally, personally, in relationship?
• Just what are you experiencing that is keeping you from peace and wholeness?
• How did you previously move beyond past limitations, and how have past problems been a force for change in your life?

Upon our reflection, while the earth is engaged in upheaval, the past insight we have gained over challenges and transitions will allow for our own enrichment. And some of the best revelations happen when we allow ourselves not to think directly on problems but instead immerse in other activity. New means of understanding ourselves, our lives, and our world surely will sprout as well. In fact, we as humans are called to grasp for more, reaching ever beyond our boundaries.

Explore a different path in the woods. Take one you are not accustomed to and which evokes a little anxiety, for whatever reason. Go to a new coffee shop and challenge yourself to talk to someone you do not know (at an appropriate time).

Take a course, perhaps one of the novel MOOCs (Massive Open Online Courses) really coming into fruition now. They are free and offered both by the most prestigious universities or more casual ones. You’d have no excuse of inconvenience or cost as these cater truly to the individual spirit clamoring for knowledge.

What you cultivate literally will lift you up and out into an evolving, perhaps entirely new, way of being.
Channels of growth occur after seeds are planted in anticipation. Not all seeds flower. Some become different looking (or tasting) than they were supposed to. Great surprises happen.

Spring is a great time to ready yourself for what is about to flower. We are not meant to stagnate (though so many of us do, continually or periodically). Think of your own growth and just what channels that might take.

What sort of flower might you grow into?

“Between a shaky world economy, increasing unemployment, and related issues, many today are being forced to come to the edge of uncertainty. Just like the baby sparrows, they find themselves leaning into the mystery that change brings, because they have no choice: It’s fly or die.”

For persons struggling with depression and anxiety — and for those of us who are highly sensitive — uncertainty is especially difficult. Forget about learning to fly. The uncertainty itself feels like death and can cripple our efforts to do anything during a time of transition.

I have been living in uncertainty, like many people, ever since December of 2008 when the economy plummeted and the creative fields — like architecture and publishing — took a hard blow, making it extremely difficult to feed a family. In that time, I think I have worked a total of 10 jobs — becoming everything from a defense contractor to a depression “expert.” I even thought about teaching high school morality. Now that’s desperate.

I don’t think I’ll ever be comfortable with uncertainty, but having lived in that terrain for almost five years now, I’m qualified to offer a few tips of how not to lose it when things are constantly changing.

1. Pay attention to your intention

I’m not a new-age guru. I don’t believe that you can visualize a check for $20,000 and find one in your mailbox the next day. Nor can you get on Oprah by believing you’ll be her next guest. (I tried both of those.) But I do recognize the wisdom in tuning into your intention because therein exists powerful energy that you can tap.

Awhile back I did Deepak Choprah’s exercise of recording my intentions and seeing how many of them actualized. I was surprised at the synchronicity between intention and events. Psychologist Elisha Goldstein writes in his book, The Now Effect: “Our intention is at the root of why we do anything and plays a fundamental role in helping us cultivate a life of happiness or unhappiness. If we set an intention for well-being and place it at the center of our life, we are more likely to be guided toward it.”

2. Tune into the body.

Psychologist Tamar Chansky, Ph.D. reminds us to listen to the body when we get anxious. If you understand why certain symptoms occur in the body – racing heart, dizziness, sweating, stomachaches – and repeat to yourself, “This is a false alarm,” you are less afraid, less panicked by the situation. Knowing that these symptoms are part of the sympathetic nervous system (SNS) trying to protect you from danger – part of the primitive regions of the brain mobilizing the “flight-or-fight” response –the reaction becomes less about the situation and more about talking to your body about why it’s freaking out so that you can use the parasympathetic nervous system (PNS) to restore the body to normalcy, which, in my case, is still pretty panicky.

3. Imagine the worst.

I’m not sure you will find a psychologist to agree with me on this exercise, but it has always worked for me every time I do it. I simply envision what it would look like if my worst nightmare happened. What if my husband and I could not get any architecture gigs or writing assignments? What if we can’t pay for health care insurance and my heart malfunctions (I have a heart disorder)? What if we both come to a bone fide professional dead end? Then I move to my actions. I think about selling our house, moving into a small apartment, and working as a waitress somewhere or maybe as a barista at Starbucks. (If you work more than 20 hours, you get health care insurance.) I research health care insurance options for persons who make minimum wage. Under ObamaCare, my kids, at least, would be covered. I invariably come to the conclusion that we will be okay. All is okay. A huge adjustment. Yes. But we are getting to be pros at that. This exercise makes me fret less about the things that I think I must have and get back to the essentials—literally a warm meal on the table, even if it’s one a day.

I am comforted by the words of Charles Caleb Colton: “Times of general calamity and confusion have ever been productive of the greatest minds. The purest ore is produced from the hottest fire.”

4. Describe, don’t judge.

In his book Get Out of Your Mind and Into Your Life, Steven Hayes, Ph.D. dedicates a few chapters to learning the language of your thoughts and feelings. Especially helpful to me is learning how to distinguish descriptions from evaluations.

Descriptions are “verbalizations linked to the directly observable aspects or features of objects or events.” Example: “I am feeling anxiety, and my heart is beating fast.” Descriptions are the primary attributes of an object or event. They don’t depend on a unique history. In other words, as Hayes, explain, they remain aspects of the event or object regardless of our interaction with them. Evaluations, on the other hand are secondary attributes that revolve around our interactions with objects, events, thoughts, feelings, and bodily sensations. They are our reactions to events or their aspects. Example: “This anxiety is unbearable.”

If we are feeling anxious about the uncertainty of our job, for example, we can tease apart the language of our thoughts and try to transform an evaluation, “I will be destroyed if I am fired,” to a description, “I am feeling anxious and my job is unstable.” By naming the emotion and the situation, we don’t necessarily have to assign an opinion. Without the opinion, we can process the object, event, etc. without hyperventilation.

5. Learn from fear.

Eleanor Roosevelt wrote, “You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face … You must do the thing you think you cannot do.” My body usually protests against that statement, but theoretically I concur with Eleanor. I sincerely believe the good stuff happens when we are afraid. If we go a lifetime without being scared, as Julia Sorel said, it means we aren’t taking enough chances.

Fear is rather benign in itself. It’s the emotions we attach to it that disable us. If we can confront our fear, or rather approach it as an important messenger, then we can benefit from its presence in our life. What is the fear saying to us? Why is it here? Did it bring roses or chocolate? According to Jones, this is an exercise of getting comfortable with being out of control, of learning to let go of the illusion of control — because we never really had it in the first place — and developing an inner knowing that everything will be okay.

As a psychotherapist, I can’t count how many times I have seen individuals and couples struggle with building healthy connections in their relationships.

The most common complaint has been that they feel unfulfilled, devalued or unappreciated in relationships with others. It is my professional experience that when we get caught up in what others can do to make us feel good about ourselves, we are likely to become angry and resentful.

So how do you avoid the resentment trap in your relationship?

Four Tips to Avoid the Resentment Trap

1. Ask yourself: Am I being realistic with my expectations?

Perhaps due to unmet needs, you project your disappointments onto people who are incapable of meeting your standards. No one person can meet all of your needs. If this describes you in relationships, you will ultimately set yourself up for feeling unfulfilled and empty. Friendships, work relationships, family and partners all participate in your life in meaningful ways. But in the end, it is up to you to love yourself the way you deserve to be loved.

One common theme of having unrealistic expectations is getting caught up in the fantasy of what a relationship is supposed to look like — for example, having expectations that your “Prince Charming” will sweep you off your feet and all of your troubles will slip magically away. Now if this isn’t a resentment waiting to happen, I’m not sure what is!

How many women have dreamed of having their lives turn out like the fairy tale endings of Cinderella and Sleeping Beauty? Realistically, how many women have had those fantasies fulfilled to their expectations?

2. Remind yourself: I am a valuable, lovable human being.

No one person can make you feel good all of the time. You can feel loved in another’s presence, but if you choose one person to define how you feel in a relationship, you will be setting yourself up for deep disappointment. If you don’t feel good about yourself, begin by acting as if you do by creating a loving mantra and reciting it each morning in front of the mirror before the day begins. Examples may include “I deserve love,” “I am lovable,” and “I am perfect just the way I am.” Recite a mantra often enough and you will begin to believe it!

3. Surround yourself with healthy people.

By healthy people, I mean people who accept you unconditionally. I am talking about people who don’t shame you or try to prevent you from making your own decisions. These are individuals who will support you with your day-to-day challenges, accept you for your “human-ness” and are okay with you making mistakes. Write a list of people you know who have these qualities and keep in contact with at least one of them on a daily basis. These are also individuals who you can give you a healthy reality check. If you struggle with an issue that keeps you feeling stuck, ask for their perspective.

4. Focus on self-care.

If you deplete yourself to the point of exhaustion, it is far more likely that you will be vulnerable to wanting your needs met by others. You may possibly go to a child-like place and demand that you get your needs met immediately. I see this sort of thing in my work with clients who are struggling in love-addicted or codependent relationships.

So what is the best remedy for healing the vulnerable child within? Replace your expectations with gentle guidance and nurture yourself through a walk, deep breathing, a yoga class, journaling or meditation. Get to know yourself better.

One exercise I recommend is making an inventory of your strengths and weaknesses. Think deeply about your interests and passions. How can you begin focusing more on the things that bring you joy? You deserve loving care — and who better than yourself to give it to you?

However, losing a mom has a powerful effect on young adult daughters. In her research, Bhatia found that a daughter’s sense of identity is especially shaken. “They don’t know what being a woman is all about.”

Daughters also doubt their own role as mothers. “Most motherless daughters are very insecure about how well they could mother without their mothers’ advice, support and reassurance.”

Cultural identity is affected, as well. As kids and teens, many daughters are too busy with school and other activities to focus on their traditions, Bhatia said. They assume they’ll be able to learn from their moms in the future. But once their mothers pass away, they “find they don’t have anyone to learn from.”

Many daughters feel like orphans, Bhatia said. Fathers may become “absent and withdrawn, and are unable to tend to their [children’s] emotional needs.” Moms typically form the foundation of the family. They “take care of everyone and keep the family together. If there is a conflict, mom is the mediator.” So when mothers pass away, the family can fall apart. To regain their family’s stability, daughters set aside their own grief and assume their mother’s role.

Motherless daughters also can experience a persistent grief for years, which peaks during milestones, like their own pregnancy and post-delivery. “When you become a mother yourself you want to be mothered,” Bhatia said.

Daughters who didn’t have good relationships with their moms still experience a profound grief. They grieve for what could’ve been. “They grieve for the opportunity to improve their relationship,” Bhatia said.

Motherless daughters may have problems with their other relationships. They tend to feel especially distant from their peers, because of both “jealousy and lack of commonality.”

“In intimate relationships, motherless daughters are far more needy because they’re trying to fill that void. They try to find in their intimate partners that nurturing that they used to get from their moms.” They’re also not able to give much back to their partners, which causes resentment.

To prevent this, Bhatia suggested motherless daughters gain insight into their behaviors and “utilize other resources to gain that nurturing, such as a friend or maternal figure.” Individual and couples counseling also can help.

Below, Bhatia shared other suggestions for motherless daughters to cope healthfully with their loss.

1. Carry on your mom’s traditions.

Instead of solely focusing on your loss, incorporate the traditions you grew up with into your own life, Bhatia said. If you’re a mother, this also is a great way to teach your kids about their grandmother, she said.

2. Participate in fundraising efforts.

Helping others who are in a similar situation can be a tribute to your mom, Bhatia said. For instance, if your mom passed away from cancer, you might participate in events sponsored by the American Cancer Society, or make a yearly financial contribution.

3. Create a collage.

A collage is a tangible tool for retaining your connection with your mom, according to Bhatia. It’s a way for you to see her every day and feel her presence, she said. “Instead of forcing yourself to disconnect and get over your loss, what’s more helpful is to hold onto your memories and keep those connections.”

4. Accept your different identity.

Again, a mother’s passing is a powerful loss, which can change your identity. Bhatia wants readers to know that this is OK. It’s OK if you’re different today. “Allow yourself the opportunity to explore different prospects without the approval of your mom.” If your mom wasn’t supportive of your career or life choices in the past, “understand that as time progresses, things change. [Your] mom’s opinions would’ve evolved, as well.” For many daughters, their image of mom stays static, she said, but people naturally change over time.

5. Participate in support groups.

Many motherless daughters feel like they don’t fit in and can’t relate to their peers, Bhatia said. Talking with women who’ve also lost their moms and share similar experiences reminds you that you’re not alone. It helps you connect with others, create a sense of belonging and build a support system.

6. Find a maternal figure.

For instance, you might become close with one of your mom’s friends, who are often very similar to your mom, Bhatia said. And you might learn more about your mom, she said. “When you’re not able to do that, seek out older females who might help to guide you – almost like a maternal surrogate.”

7. Seek individual or family therapy.

For the participants in Bhatia’s study, individual therapy was incredibly helpful in processing their mother’s passing. Family therapy also is helpful for daughters, dads and siblings to process their grief and be honest with each other in a supportive environment, Bhatia said.

Coping on Mother’s Day

Naturally, Mother’s Day can be especially hard for motherless daughters. “Many motherless moms don’t celebrate the day and deprive themselves of that opportunity,” Bhatia said. They may feel guilty for celebrating without their mothers.

Bhatia encouraged daughters to celebrate the day and enjoy the appreciation of their families. This “reflects the fruits of their own mothers’ labor and thus honors them, for they wouldn’t be the mothers they are without that strong primary attachment.”

Also, motherless daughters can continue to buy a card for their moms, she said. In it, they can express what they truly want to say to their moms and reconnect in a meaningful way.

As Bhatia said, “just because your mom is gone, it doesn’t mean you’ve lost your attachment or connection to her. Your mom will always be there to help you navigate through life.”

How great is that? Here’s a Roman general, top of the pile, a massive celebrity (like the Jay-Z of his day), and there’s this slave reminding him that he’s mortal and not to get too high above himself because he too can die.

Personally, I think we need more of that today — humility and the awareness to realize and accept that we are mortal, destined to die.

Death rarely is a fun topic to bring up, especially when you’re picking up a grande latte at Starbucks first thing in the morning. Not because it’s not an interesting subject, but more because people rarely acknowledge or want to think about their mortality.

So why is talk of death an unusual subject? It’s a shared experience every human on the planet will go through (hands up if you’re about to stop reading this article because it’s too heavy). Richard Dawkins put it most elegantly: “We are going to die, and that makes us the lucky ones. Most people are never going to die, because they are never going to be born.”

Isn’t that amazing? We are so lucky. We are here and now. We can feel emotions such as love and happiness. We can express joy and laughter. We can feel warmed by the sun, chilled by the wind, cooled by the rain. We can witness so much beauty in the world, gasp at nature’s creativity, do amazing intellectual feats to understand it all. Yet, we’re still unable to stop the inevitable degradation of our bodies and eventual death. Bummer.

The idea of death seems to go against our Western philosophy of being able to choose what we want. We can choose to buy that big 60″ HDTV with the surround sound home-cinema system, but we can’t choose not to die. Who decided that nonsense? No wonder most people will do anything they can to avoid the inevitable (myself included).

Have you ever seen the movie “Logan’s Run”? That film had a profound affect on me when I was younger. In the film, to control population, when people reach 30 years old they’re summoned to the carousel to be ‘renewed’ (killed), and I used to think that was a great idea — until I reached 30 and realized it’s a terrible idea!

So what is our problem with thinking and talking about death? In his Pulitzer-prize winning book Death Denial, Ernest Becker argues that most human action is taken to ignore or avoid the inevitability of death. But this type of thinking is totally irrational because death is inevitable, and this denial will only cause major complications in our lives.

I think many people are realistic enough to hold a healthy preference about their own death, “I’d really prefer not to die, but I also know that it will happen one day.”

However, there are many more people that hold a rigid demand about death, “I absolutely must not die, it is too terrible to comprehend. I can’t stand it.” Due to this unhealthy thinking, people often become overly busy, doing things to distract themselves from thinking about their mortality. Others strive for wealth and power as a way to shield themselves from the inevitable — “maybe if I’m rich, I can buy my way clear of death.”

Unfortunately, it doesn’t work that way. Just ask Steve Jobs, Joe Weider, or Jerry Buss. It doesn’t matter how much wealth or fame you have, or how busy you are, you can’t beat death.

The other way society avoids thinking about death is with this relentless drive for immortality. You’ve got to look young in society to be acceptable, so take your pills, exercise, stop drinking sugary soda, pray and you might live forever. But hasn’t this irrational goal held humanity back and caused irreparable divisions between people and cultures?

Let’s face it, death is a non-discriminatory experience. Our denial about something that is as natural as birth needs to be accepted and valued. Let’s bring our fear of death to the forefront of our awareness. Death denial will only lead to a life of fear and anxiety, and that’s not healthy.