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

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.

Here are some insights from their book.

What can understanding failure teach both seasoned and aspiring leaders that they can’t learn only by modeling success?

While studying success provides valuable lessons during good times, often these lessons aren’t applicable in hard times. The road isn’t always smooth and the sky isn’t always blue. When challenges present themselves, lessons gleaned from previous failures can help leaders avoid making the same mistake twice or making the wrong decisions.

Making mistakes — or failing — are part of taking healthy risk. They provide us with new ways of thinking and give us new insights into how we can improve as leaders.

Real failure doesn’t come from making mistakes; it comes from avoiding errors at all possible costs, from fear to take risks, and from the inability to grow. Being mistake-free does not lead to success.

Learning from our mistakes, however, is not always possible. Yes, every great leader makes mistakes they can learn from. But there are only a limited number of mistakes you can make before proving yourself an unworthy leader — you can only fall off the corporate ladder so many times before your climb is finished. And the higher up the ladder you get, the more severe the fall. The failure paradox is that in order to succeed we need to know failure — yet we live in an environment where we can’t afford to make mistakes. The solution? To study and learn from the mistakes of others in order to proactively avoid the predictable pitfalls that await every leader.

What are the specific benefits of learning from failure?

The benefits of learning from failure can be seen at both the individual level and the organizational level. We found strong statistical evidence between the ability to embrace mistakes and improved individual performance. Specifically we found that leaders who learn from mistakes are more proactive in deflecting potential problems, have a higher level of confidence when taking actions and making decisions, more accurately understand their environments, think more strategically, and are more creative.

These traits and capabilities also translated to the organizational level. Specifically we found that companies that are more accepting of mistakes have significantly better financial performance in terms of both top-line revenue growth, as well as bottom-line profit. We live in a culture that values perfections and hides failure. Companies pay their employees to succeed, not to fail.

However, the more we talk about the valuable lessons that come from mistakes and honor discussions about failure, the less likely it will be such a taboo subject.

For The Wisdom of Failure you conducted almost 1,000 interviews with managers and leaders. What about those interviews most surprised you?

We were surprised by how reluctant some leaders were to be associated with the topic of failure. Several times, we had leaders open up to us about key mistakes they had learned from in their own careers, only to call us back the next day to say they didn’t want us to use any material from their interviews in our book. Having their names associated with failure was too risky. Of course, we honored their request.

This reluctance to discuss failure emphasizes not only how difficult it is for leaders to talk about mistakes, but also the costly consequences leaders believe will follow if they do.

There’s something strangely comforting in looking at these lists and hoping that our life problems can be boiled down into five simple steps. I read them hoping for the answers, because I too want the secret to life, the universe, and everything.

However, I think the reality is this: As much as some lists offer interesting ideas, the majority mislead people about change. They offer false hope instead of facts. They generally encourage people to think their lives can be simpler if only they do those five secret things that may have worked for another person.

Come on, really? Life is so complex and the reasons why we feel and do what we do also are complex.

Take depression, for example. The reality is nobody really knows why people feel depressed; and nobody really knows what will cure each individual’s depression. When talking about cause and effect, there are so many factors to take into account: cognitive, environmental, social, biological.

What we do have is good empirical evidence that some therapies can help some people overcome depression. But that doesn’t mean everyone will overcome it through therapy. I’ve worked with many people and, for whatever reason, they remain depressed and sometimes become even more depressed. When that happens, the focus of therapy changes to learning to live with being depressed. No list is going to change that.

We know that medication can help. But it doesn’t help everyone. More often than not, medication is guesswork — an art more than a science. What works for one person can make another person sick. I’ve seen some people recover in a matter of weeks, and others poisoned to the point of hospitalization. Where’s the five-point list on that one?

Advances in neuroscience are helping us understand the brain and how it works. Yet, even super-intelligent scientists with the most sophisticated technology don’t fully understand what is causing depression. So, can a five-point list really tell us how to overcome it?

It’s clearly frustrating not knowing the secret to being well. As a therapist and coach, it’s my job to help somebody get well, so it’s easy to hope a list will provide me with the secrets that’ll help me and the person I’m working with.

But many lists just don’t cut it. I was reading a list on procrastination the other week and the first thing on the list was something like ‘just do it.’ I can imagine all the people who procrastinate reading that and thinking, “Wow, that’s amazing. Why didn’t I think of that?”

OK, I’m knocking these lists, so I must know all the answers, right? Nope. I wish I did but unfortunately I don’t (please don’t tell my wife I said that). With that being said, I will now counter everything I’ve just written and offer you my own secret five-point list to life, the universe and everything.

1. You are personally responsible for all that you think, do, and (mostly) feel.
2. Accept reality: Life doesn’t owe you a thing.
3. You are you. Nobody can ever know what it means to be you, so be kind to yourself and others.
4. Life is meaningless, except for the meaning that you give it — so use that power wisely.
5. Nobody has all the answers. We’re all just making stuff up as we go along, hoping for the best.

With social media a major part of teens’ lives, it’s important they have a healthy relationship with the Internet. What does this look like?

According to Udall-Weiner, it resembles any healthy relationship: It has boundaries.

It also shouldn’t have to meet all their needs, including emotional, social, intellectual and spiritual, she said. For instance, sites like Facebook, Twitter and Pinterest should never replace face-to-face interactions, she said. Instead, they should supplement them. That’s because online interactions lack the emotional depth and support of real-time relationships. “…[I]t’s hard to know whether someone is trustworthy, loyal, and invested in your well-being.”

The Internet also lets people keep a comfortable distance from others. Udall-Weiner cited MIT professor Sherry Turkle, who believes the Internet provides “the illusion of companionship, without the demands of friendship,” and “people are comforted by being in touch with a lot of people, whom they also keep at bay.”

Fortunately, parents can teach their kids to use the Internet in healthy ways. Below, Udall-Weiner shared five strategies.

What Parents Can Do

In Udall-Weiner’s experience, parents approach Internet use with extremes: “they either prohibit it, or they pretend it doesn’t exist, since they’re quite terrified to find out what their child is really doing online.” Instead, she suggested communicating with your kids and teaching them to be more aware of how they use the Internet.

1. Talk to your teen about their time online.

Talking to your kids about how they use social media and technology helps them break out of autopilot and become more mindful of their actions and reactions, Udall-Weiner said. “[This] is an important skill when it comes to developing emotional competence.” It’s important for teens to understand how being online affects them (such as their mood).

She suggested asking your kids these questions: “Which websites do you often visit?  How do you feel emotionally, both during and after using these sites? Have you ever had any uncomfortable experiences online, or seen anything upsetting? Do you believe that there are any downsides to viewing the sites you regularly visit, or to using the Internet in general?”

2. Teach your teen to be media literate.

A mistake parents often make, according to Udall-Weiner, is that they don’t teach their kids about media literacy. But it’s vital for kids to understand that what they see isn’t what they get online. For instance, “Parents need to actively remind their children that images are not reality—that no one is as thin, perfectly-muscled, unwrinkled, or flawless as that person in the ad.” She suggested visiting Media Smarts for more information.

3. Set time limits on Internet use.

Teens are still developing their executive functions, which include monitoring behavior, organizing information and setting goals, she said. Plus, spending too much time on sites like Facebook can make teens feel worse. “My clients regularly tell me that they become very upset after looking at Facebook, since everyone looks happier, thinner, or more popular than they feel.” So parents might need to set restrictions on Internet use.

4. Surrender all phones before bedtime.

“This is a way to ensure that kids aren’t up late texting or surfing the web, rather than getting precious sleep,” Udall-Weiner said. This rule also applies to parents’ phones, “since kids emulate what they see.”

5. Know the research about Internet use.

Research has suggested that looking at images of thin models — which are splashed all over the Internet — may be associated with various negative consequences. “After seeing these images, people report things like decreased self-esteem, poor body image, depression, guilt, shame, stress, and an urge to engage in eating-disordered behavior, such as restricting food intake,” said Udall-Weiner. She also specializes in body image and eating disorders and founded ED Educate, a website with resources for parents.

Research also has suggested that the Internet makes us feel more disconnected from others, she said. “It’s important for teens to know the research on Internet use.” Talk to your kids about these findings.

Udall-Weiner shares more information and tips on supervising your child’s Internet use in this video.

Over time, pent-up anger and resentment causes tiny problems to become big ones. Anger can become displaced or is expressed in a way that becomes problematic. Many people feel more upset when they realize that they overreact or explode with anger, especially if it causes hurt for themselves or someone else. Thus, it creates the terrible cycle of struggling with anger.

But there is help for anger that doesn’t require you to dig up your past, explore your thoughts, or send letters to a dead loved one. It’s called biofeedback, and it offers individuals readily-learned techniques that are safe and effective (based upon decades’ worth of research).

Unhealthy, inappropriate anger looks like this: You get home from a bad day at work, where everything seems to be going wrong. The house is a mess, and the kids are running around screaming. Your spouse is yelling to you from the kitchen to help.

You explode with a nasty remark about how you were busy working all day, and you do not have time to help. You say something hurtful in regard to your spouse not being a good parent. The kids hear you yell, and your spouse yells back or begins to cry. You then kick one of the toys on the floor and leave the house to go to a bar for a drink to unwind, leaving your family in disarray.

On the other hand, people also can internalize anger and it will manifest in different ways. Internalized anger can cause migraines, stomach problems, high blood pressure, depression, anxiety, and so on. The body expresses anger in maladaptive ways when people do not express it constructively.

Biofeedback and neurofeedback techniques offer individuals skills in how to effectively manage anger.

People can monitor their physiological responses and thus learn how to gain control over them. Neurofeedback also helps create a stronger connection between the emotional and executive areas of the brain, allowing people to gain a proper “checking” system. Anger is then expressed in a rational, appropriate, and conducive manner. Communication becomes clearer, and others are more likely to respond to your needs.

Children also can internalize anger and carry it with them, or express it with aggressive and problematic behaviors. Biofeedback, with the use of a video game program, helps build a stronger connection between the midbrain (emotional center) and forebrain (executive control center).

Here’s how it works. The child has sensors placed on certain areas of the head to read brain waves such as delta, beta, and hibeta waves. The video game will not advance if he or she is not keeping active and focused (increasing beta waves). If he or she becomes anxious or distracted (hibeta waves), or begins to feel tired or daydream (delta waves), the game will stop.

The child then learns to find the medium where he or she feels a calm focus and is in control of his or her brain functioning. A study conducted at Boston Children’s Hospital showed that the children who received biofeedback therapy had better control over their reactions to daily frustrations than they had prior to receiving the treatment.

“The connections between the brain’s executive control centers and emotional centers are weak in people with severe anger problems,” explains Joseph Gonzalez-Heydrich, chief of psychopharmacology at Boston Children’s and senior investigator of a recent biofeedback study conducted there.

Building a strong connection and balance between the midbrain and forebrain allows a child or adult to gain better control over their emotional responses and behaviors. Aggression and anger are then diffused in a healthy and appropriate manner.

Biofeedback also teaches breathing correctly as a relaxation technique. Breathing deeply through the diaphragm and focusing on each inhale and exhale will clear the mind and allow the frontal brain to keep the midbrain and emotional centers in check. It gives the mind a chance to step back from the situation and view it objectively instead of impulsively reacting off of intense emotions.

Biofeedback is a time- and research-tested technique to help people learn to better control responses that many believe are automatic or uncontrollable. If you or someone you love is having trouble with anger, consider biofeedback as one potential treatment to help with this concern.

Reference

Boston Children’s Hospital. (2012, October 24). Video game with biofeedback teaches children to curb their anger. ScienceDaily. Retrieved from http://www.sciencedaily.com/releases/2012/10/121024164731.htm

Therefore, the use of art and crafts in psychiatric settings has played a significant role in OT from the beginning. Furthermore, a core idea in the development of OT is that “occupation, or doing with the hands, can be seen as an integral part of experiencing a meaningful life” (Harris, 2008, p. 133).

Crafts have many potential therapeutic applications: motor control, sensory and perceptual stimulation, cognitive challenges, and enhanced self-esteem and sense of efficacy (Drake, 1999; Harris, 2008).

Crafts, too, are also often used to assess cognitive functioning: “Crafts were selected because they can be standardized to present new information that is meaningful to the disabled most of the time” (Allen, Reyner, Earhart, 2008 p. 3).

However, in recent OT literature the term “craft” appears to have acquired less worthy connotations. In addition, the emergence of art therapy as a psychoanalytic tool, as well as the use of arts and crafts in recreational therapy, questions the role of the arts in current OT practice with psychiatric patients.

In a study assessing the perspective of inpatient psychiatric clients on occupational therapy, it was found that arts and crafts were the most popular of sixteen activity groups offered. However, only a third of the participants in the arts and crafts group indicated that they found the activity to be helpful and beneficial (Lim, Morris, & Craik, 2007).

An earlier study revealed only a slightly higher than neutral rating of craft groups among psychiatric patients randomly assigned to various activities (Kremer, Nelson, & Duncombe, 1984).

In the course of my investigation of the use of art in occupational therapy in inpatient psychiatric settings, a recurring complaint in several articles was the lack of research on both subtopics: the current role of arts and crafts in OT, and the current role of OT with psychiatric patients.

Although the studies quoted offer only moderate support to the hypothesis that arts and crafts are beneficial to psychiatric patients, they are only two studies. Furthermore, rather than refute the use of arts and crafts altogether, they reinforce the doctrine common to occupational therapy that any treatment must be specifically tailored to fit the interests and needs of the client.

References

Allen, C. K., Reyner, A. & Earhart, C. A. (ed) (2008). How to Start Using the Allen Diagnostic Module: A Guide to Introducing Allen’s Theories Into Your Practice (9th ed.). Colchester, CT: S&S Worldwide.

Drake, M. (1999). Crafts in Therapy and Rehabilitation (2nd ed.). Thorofare, NJ: Slack Incorporated.

Harris, E. (2008). The meanings of craft to an occupational therapist. Australian Occupational Therapy Journal (55), 133-142.

Hussey, S. M., Sabonis-Chafee, B., & O’Brien, J. C. (2007). Introduction to Occupational Therapy (3rd ed.). St. Louis, MO: Mosby.

Kremer, E. R. H., Nelson, D. L., & Duncombe, L. W. (1984). Effects of selected activities on affective meaning in psychiatric patients. The American Journal of Occupational Therapy, 38(8), 522-528.

Lim, K. H., Morris, J., & Craik, C. (2007). Inpatients’ perspectives of occupational therapy in acute mental health. Australian Occupational Therapy Journal (54), 22–32.

This is one of those studies that take a moment to get your mind around.

Imagine you are an itinerant individual living in absolute penury in a third-world country. You survive by going through other people’s garbage and extracting your food for the day as well as other essentials like clothing and footwear. You live your life hand to mouth and what your hand finds are the things others have discarded. You recycle what you can for money, and this considerable effort earns you about $3 a day.

By downward social comparison, almost anyone seeing a person living in these conditions would assume the individuals engaged in this activity would resent their life circumstance and view their life as anything but happy.

But this study shows this is a false assumption.

Not only are these people not depressed, they are optimistic, have good relationships, and many of them play sports and read. The majority of them are happy with their lives.

Extreme poverty is considered to have a negative effect on happiness. In those instances, when poor people are happy, it is attributed either to their having very low future expectations or having adapted to their circumstances. But this study showed something different. Overall these rubbish collectors’ attitude is better about their future than their present. They believe their tomorrow will be better than today.

Research has shown that being a consumer of material goods does not in and of itself make us happy. What does increase our well-being and happiness is more leisure time and activities, support and connection with family, and being involved in good relationships. We are social creatures first and foremost. The desire to belong and identify with others is woven into our wiring as human beings. Everything from our health to our happiness improves when our social relations improve.

This is also true when we are involved in meaningful work — particularly work where we have an opportunity to develop our abilities, work toward objectives, have supervisory support, feel safe, and get status from the work we do. But these are hardly the conditions for rubbish collectors. Trash pickers are exposed to health problems, violence, and severe social stigmatization. This is despite the fact that the work they do provides a benefit to society. Recycling problems around the world are ubiquitous and trash pickers render a service that is both environmentally useful and economically practical. Still, this group is typically marginalized by society.

Yet the trash collectors of León are a resilient group and this study sheds some light on the relationship between income and happiness. Rather than any connection to income, the research found that the key to feeling happy is having a positive expectation for the future. Of those who rated themselves as happy, more than twice as many trash collectors could see brighter futures for themselves than their less optimistic counterparts. Additionally, men were happier than women, as were those who lived with fewer people.

But what about having enough food?

The pioneering work of Abraham Maslow and his hierarchy of needs proposed that we must have lower needs satisfied before having higher needs met. He argued we need to have our physiological needs met (things like food, water and sleep) before concerning ourselves with safety and security needs — and that these have to be satisfied before we move toward our need to be loved, esteemed, and eventually self-actualized.

The current research shows that having enough food is, indeed, a significant factor in whether an individual ranks himself as happy. Almost 90 percent of the trash collectors who rated themselves as happy had enough food to eat during the last month. This was a statistically significant finding in the study and would seem to be an indication that Maslow was right.

But in the article Vazquez points out an interesting fact: While not statistically significant, more than 70 percent of those who did not have enough to eat still rated themselves as happy. These individuals did not have the most basic ability to find enough food to feed themselves properly the month prior to the rating. This means that in spite of hunger, optimism and relationship may be more satisfying than knowing where our next meal is coming from. Socrates could have been talking about the trash collectors of León when he said: “Worthless people live only to eat and drink; people of worth eat and drink only to live.”

What can we learn from the stigmatized, impoverished, yet resilient trash pickers of León? We discover that optimism about tomorrow is important to us today; that good relationships are better than money in the bank; and that Maslow’s hierarchy of needs may not always be true.

In the words of Vazquez we come to find: “… the majority of the collectors are happy, and are convinced that they can achieve a better quality of life in the future with hard work and perseverance.”

In other words — like many of us.

Reference

Vázquez, J.J. (2013) Happiness among the garbage: Differences in overall happiness among trash pickers in León (Nicaragua), The Journal of Positive Psychology, Vol. 8, No. 1, 1–11. http://dx.doi.org/10.1080/17439760.2012.743574

And now, there are even designer babies: Parents are able to choose their children’s hair and eye color (though according to Wired, the Los Angeles clinic offering these services was recently shut down amid public outcry).

The potential for humans to modulate their emotions via technology is just as radical.

To an extent, we do this already with psychiatric medication. Many people are tempted to view those who use these drugs — even under the guidance of mental health professionals — as some kind of “cheating,” as a way of not truly dealing with the emotions themselves. Perhaps this is the case for some. It is, however, relatively clear that this tendency of yearning to gain control over our emotional experience did not spring forth at the advent of Prozac.

It might be said that nearly all of our choices are molded by how we feel now, how we have felt before, and how we want to feel in the future. If we have burned ourselves on the stove, we run for cold water. If we have been hurt in a romantic relationship before, we may take precautions in our involvement next time. If we have felt acceptance and excitement at a new job, we may throw ourselves into our work.

In the future, might it be possible to feel however we want, whenever we want?

Biotechnology, nanotechnology, and neurology at least point to the possibility of this being the case. In fact, initial “tinkering” with emotion is nearly 60 years old. In 1954, Peter Milner and James Olds implanted an electrode into the pleasure center of rats’ brains. Hooking the electrode up to a “pleasure button,” the scientists found that the rats would repeatedly press the button as much as possible — giving up food, water, and sex until they eventually died, frantically pursuing direct and intense pleasure.

Even given the avoidance of these very obvious dangers of diminishing returns on brain chemicals, tinkering with humans’ affective experience is a very slippery slope. Having an ability to feel “better,” or more energetic seems like a good idea for increasing our productivity. If we can overcome a common cold or a troubling situation at home with a kind of harmless emotional boost, is this wrong in itself?

The danger is not just negative side effects to the brain itself (which we might become smart enough to overcome), but a more insidious dependence on this boost. If we disregard food and sex for this boost, we may end up like the aforementioned rats.

Haven’t we all wished to control our sleeping patterns? Some people wish to overcome sleep altogether, while nearly all of us wish we could go to sleep or wake up on command. An implant that allows us to shut off and turn on consciousness as we please could seem like an initially harmless enhancement. Would it not just be one tiny step further to be able to control our feelings of hunger, or our sense of time (being able to fast-forward through a particularly boring wait in the bank line, or high school reunion)? This too might prove treacherous.

With the continual advancements in science, it seems as though psychology will eventually converge with, and help guide, other developing fields.

Technological progress alone — even with a much deeper understanding of neurology — is not complete without an understanding of the mind, its balance, its function, and the upkeep of its well-being that psychology can contribute. Mental health professionals someday may find themselves not only treating and helping individuals — or even striving for changes in policy — but as a guiding force and contributor to the enhancement of human experience.

Barbara Fredrickson’s new book, Love 2.0, is a powerful new perspective on what love, a renewable resource, means to our body. She walks us through a biochemical and behavioral labyrinth that is fascinating and gives us pause for thought. (To read a recent review of this leading researcher’s book check here.)

The key to understanding what happens to us during the time there is mutual caring is called “positivity resonance” for Fredrickson. It is a type of alignment of three features where there is a release of the neuropeptide oxytocin (sometime dubbed the love hormone because it is released in large quantities during orgasm); an enhanced vagal tone (the association of heart rate to breathing rate); and our brain syncing with another person during something called, appropriately enough, “brain coupling”. It is the sharing of positive emotions that generates what Fredrickson calls ‘micro-moments’. The moments are “virtually identical” whether they occur between parent and child, friends, lovers, or total strangers.

Wait a minute.

Let’s break this down: If your son brings home his report card and is proud to show you the “A” he received and you hug him that certainly would seem to qualify. If you are sitting across from your best friend and share a laugh over a joke he has told you, this is a micro-moment. If you are making love and are lost in your lover’s eyes this is certainly on the list. But what if you are on line at Starbucks and you and a stranger notice a little girl with her lips pressed against the glass counter trying to kiss the goodies on the other side. You and the stranger smile and nod slightly toward each other. Both of you would know this was a shared positive emotion – that it was a unique experience for the two of you. Certainly it is a micro-moment. But is this love?

Barbara Fredrickson would say yes.

She doesn’t think we need to limit our definition of love to one person or even to a small group of intimates. She believes we should look for and savor these micro-moments as they can happen all around us – even with strangers.

Her book offers several suggestions for ‘priming the pump’ so to speak for increasing the likelihood of these experiences. Here are a couple from the book—and you can go online at positivityresonance.com under the ‘tools’ section and register free to keep track of your progress in building positive emotions.

The first one is the social connections reflection. In this experience pick the three longest social connections you’ve had during the day and review them at the end of the day. Then see how true these two statements are:

• During these social connections I felt “in tune” with the person/s around me.

• During these social connections I felt close to the person/s.

Rate the truth of these statements on a scale from 1-7 where 1 is not true at all and 7 is very true.

This simple reflection on daily social encounters showed that over time it increases upward spirals of positivity and, even more surprisingly, increase vagal tone. It literally makes your heart better.

The next practice is a Loving Kindness Meditation (LKM). The goal here is to rouse tender, loving feelings as you visualize someone you love. There are many versions of this and the links below will take you to more complete meditations, but the essence of the practice is to imagine someone you love, allow warm feeling for them arise, and as you do recite these phrases to yourself.

• May (this person) feel safe.

• May (this person) feel happy.
• May (this person) feel healthy.
• May (this person) live his or her life with ease.

Dr. Fredrickson has kindly (of course) created a beautiful collection of meditations on her site, including one for LKM. You should check it out and try them all.

The quality of her research on LKM was so impressive on improving vagal tone that the Dalai Lama invited her to talk with him. Fredrickson was able to determine that those who had the largest increases in vagal tone had the most frequent positivity resonance experiences with others. Why was her research so important? Before her studies vagal tone was thought to be as stable and as unchangeable as one’s height. You either had good tone or not.

We could all use a little more love in our life, yes? Then keep your eyes wide as you wait in line for that latte. You may find it comes with a little extra sweetness.

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).

Unfortunately that advice wouldn’t have been able to stop me from praying rosary after rosary when I was in fourth grade to avert going to hell, nor does it quiet the annoying noise and chatter inside my brain today in any given hour. But the fact that a great leader battled the worry war does provide me some consolation.

It doesn’t matter whether you are a chronic worrier without an official diagnosis or battling severe obsessive-compulsive disorder (OCD), a neurobehavioral disorder that involves repetitive unwanted thoughts and rituals. The steps to overcome faulty beliefs and develop healthy patterns of thinking are the same.

Worrying about facing the inferno as a 10-year-old and fretting about whether or not I’ll provide enough income to keep my kids in private school stems from the same brain abnormality that Jeffrey M. Schwartz, M.D. describes in his book, Brain Lock.

When we worry, the use of energy is consistently higher than normal in the orbital cortex, the underside of the front of the brain. It’s working overtime, heating up, which is exactly what is the PET scans show. Too many “what if’s” and your orbital cortex as shown in a PET scan will light up in beautiful neon colors, like the walls of my daughter’s bedroom. However, with repeated cognitive-behavioral exercises, you can cool it down and return your PET scan to the boring black and white.

In their book, The OCD Workbook, Bruce M. Hyman, Ph.D., and Cherry Pedrick, RN, explain the ABCDs of faulty beliefs. It’s a four-step cycle of insanity:

A = Activity Event and Intrusive Thought, Image or Urge. (What if I didn’t lock the door? What if I upset her? I know I upset her.)

B = Faulty Belief About the Intrusive Thought. (If I don’t say the rosary, I’m going to hell. If I made a mistake in my presentation, I will get fired.)

C = Emotional Consequences: Anxiety, Doubt, and Worry. (I am a horrible person for upsetting her. I keep making mistakes … I will never be able to keep a job. I hate myself.)

D = Neutralizing Ritual or Avoidance. (I need to say the rosary to insure I’m not going to hell. I should avoid my friend who I upset and my boss so that he can’t tell me I’m fired.)

Those might seem extreme for the casual worrier, but the small seed of anxiety doesn’t stay small for long in a person with an overactive orbital cortex.

Hyman and Pedrick also catalog some typical cognitive errors of worriers and persons with OCD:

• Overestimating risk, harm, and danger
• Overcontrol and perfectionism
• Catastrophizing
• Black-and-white or all-or-nothing thinking
• Persistent doubting
• Magical thinking
• Superstitious thinking
• Intolerance of uncertainty
• Over-responsibility
• Pessimistic bias
• What-if thinking
• Intolerance of anxiety
• Extraordinary cause and effect

One of the best approaches to manage a case of the worries and/or OCD is the four-step self-treatment method by Schwartz, explained in Brain Lock,

Step 1: Relabel.

In this step you squeeze a bit of distance between the thought and you. By relabeling the bugger as “MOT” (my obsessive thought) or something like that, you take back control and prevent yourself from being tricked by the message. Because I’ve always suffered from OCD, I remind myself that the illogical thought about which I’m fretting is my illness talking, that I’m not actually going insane.

Step 2: Reattribute.

Here is where you remember the PET scan that would look like your brain. By considering that colorful picture, you take the problem from your emotional center to your physiological being. This helps me immensely because I feel less attached to it and less a failure for being able to tame and keep it under control. Just like arthritis that is flaring up, I consider my poor, overworked orbital cortex, and I put some ice on it and remember to be gentle with myself.

Step 3: Refocus.

If it’s at all possible, turn your attention to some other activity that can distract you from the anxiety. Schwartz says: “By refusing to take the obsessions and compulsions at face value—by keeping in mind that they are not what they say they are, that they are false messages—you can learn to ignore or to work around them by refocusing your attention on another behavior and doing something useful and positive.”

Step 4: Revalue.

This involves calling out the unwanted thoughts and giving yourself a pep talk on why you want to do everything you can to free yourself from the prison of obsessive thinking. You are basically devaluing the worrying as soon as it tries to intrude.

The mental health charity Mind UK recently highlighted their concern that there is a serious need for a range of therapies to be made available to depression sufferers.

According to the best psychological working practices, medication is now considered to be only one option for effectively treating the illness.

Talk therapies — otherwise known as psychotherapy — such as cognitive behavioral therapy (CBT) have proven effective at alleviating melancholic symptoms in hundreds of research studies conducted around the world. In Australia, the Australian Psychological Society has identified a serious need for psychotherapeutic interventions in the lives of people with depression.

Cognitive behavioral therapy (CBT) is a form of psychotherapy. Participants work with a specially trained psychologist to make positive steps in changing their thoughts and feelings. Committing to CBT means accepting that your actions affect your emotions and reasoning. Therapists help you to learn skills and strategies for changing negative thinking. This helps many people to learn to cope with depressive illness.

A recent study in the UK, carried out over a period of 12 months, looked at the benefits of CBT for managing depression. Participants were allocated a one-hour CBT session each week for the period of the trial.

After six months, 46 percent of the group who had been previously resistant to medication reported a reduction in depressive symptoms. The study concluded that CBT can improve quality of life by reducing depression’s severity.

A 2012 study published in the Australian and New Zealand Journal of Psychiatry involved a review of Australian National Health data. Researchers became interested in the period between 2001 and 2006, when better access to psychological treatment was made available in Australia.

The study showed from 2001 to 2008, following health care reform, there was a drop in the use of antidepressant and anti-anxiety medications. CBT is currently recognized in Australia as being a viable and effective way of treating mental illnesses like depression.

It is important to note that CBT is not intended to be a substitute for medication. In many cases it will serve to complement any medicine from the family doctor or psychiatrist. However, in those for whom medication has failed, CBT offers an alternative while new medicines are being developed. Of course, not everything — whether medication or talk therapy — will work for everyone.

In Australia, there is still a shortage of psychiatrists. The right of psychologists to prescribe medication is now a subject for debate. If this becomes reality, the therapist will then be able to evaluate each patient’s needs, and only prescribe drugs when necessary.

In the meantime, although it may not be the best option, family physicians are able to prescribe psychiatric medications if they believe it warranted.

In fact, in a talk posted on YouTube, Gladwell goes even further, saying, “In absolutely every system in which hockey is played, a hugely disproportionate number of hockey players are born in the first half of the year.” He says this in the context of a talk about society not taking advantage of opportunities to improve human potential.

“Logic tells us there should be as many great hockey players born in the second half of the year,” suggests Gladwell, “as born in the first half. But what we can see here, there’s almost no one born it the end of the year, everyone’s from the beginning.”

But is this actually true — are more elite hockey players born in the first half versus the second half of the year?

I was listening to this talk and couldn’t help but wonder, “This seems like a really perhaps-too-neat result. Is this actually true? Does the relative age effect impact your likelihood to be a great hockey player?”

So first I went over to Wikipedia and found this list, List of 100 greatest hockey players by The Hockey News from 1998. This is a quick and dirty way of testing the hypothesis at face value — are the hockey greats of the world more likely to have been born in the first half of the year?

Only 39 of the hockey players on the list have Wikipedia entries, so they were the easiest to verify their date of birth. Of those 39 players, 20 were born in the first half of the year, and 19 were born in the second half. Hmmm… that doesn’t really seem to jive with Gladwell’s claims.¹

So finding some support that perhaps the issue isn’t as clear-cut and dried as Gladwell suggests, I turned to PsycINFO, the psychological research database. It didn’t take long to find a study that had the same questions I did — does the relative age effect (RAE) actually predict excellence in sports?

Gibbs, Jarvis & Dufur (2012) suggest that the answer is no. In a far more systematic approach than my quick and dirty review of a top 100 list, the researchers examined the distribution of birth months for the first round draft picks of Canadian players in the NHL for the years 2007-2010. Then they looked at 1,109 players who played on major league rosters from 2000-2009.

Last, they examined All-Star and Olympic hockey rosters from 2002-2010. These are the elite players of hockey — the cream of the crop.

So what did they find?

In our analyses, we found a strong relative age effect that eventually fades, then reverses across levels of hockey play among Canadian-born players.

In our first data, early birth-month advantage is apparent in the Medicine Hat Tigers championship roster of 2007
(56%) and for their opponents the Vancouver Giants (44%), but it is less true of the same teams three years later (33% and 39% respectively). [These were the teams Gladwell highlighted in his book chapter.]

The effect is also apparent among Canadian-born first round draft picks, with 40 percent, 41 percent, 47 percent, and 33 percent born in the first quarters of 2007, 2008, 2009, and 2010 respectively.

But for the average player in the NHL, the effect seems to fade. Although the first round draft picks confirm Gladwell’s law (33–47 percent across 2007–2010) — a reflection of their Major Junior Hockey performance — the percent of all Canadian hockey players in the NHL born in the first three months is a modest 28 percent.

But it gets worse. Among the most elite hockey players, the effect completely reverses — it’s better to be born later in the year if you want to become one of the great hockey players: “The combined average of the All-stars and Olympic rosters [born in the first three months of the year] is 17 percent.” Compare this to the 28 percent noted above and you see that it actually hurts your chances to be born earlier in the year if you want to play in the Olympics or on an All-Star team.

Last, the researchers found one more perhaps-not-so-surprising result — players born earlier in the year have shorter hockey careers — an average of a year less than those born in the last three months of the year (Gibbs, Jarvis & Dufur, 2012).

The incongruous findings come from Gladwell confusing simply playing on a team with being an elite player in that sport. He defined success in hockey as simply making the team — a way most people who play sports probably wouldn’t agree with. The researchers sum it up nicely:

Our findings illustrate how critical it is to define hockey success. When hockey success is defined as playing Major Junior Hockey, the effect is strong, as Gladwell reported in the popular press.

But the effect diminishes when success is defined as making the NHL, and fades when performance and skill are considered.

When hockey success is defined as the most elite levels of play, the relative age effect reverses.

Who Will Tell YouTubers?

Now here’s the real problem — these YouTube talks and videos don’t get updated or removed. Nobody is going to come along and point out that the things Gladwell says in this talk aren’t necessarily true based upon our latest understanding of the research.²

Remember his line, “Logic tells us there should be as many great hockey players born in the second half of the year.” Well, actually the data suggests that this is, in fact, true after all.

And that’s the challenge of disseminating pop-psychology tidbits on video and in books — their conclusions will remain forever etched³, while the science and research data continue to march forward.

Finally, it’s a reminder that psychology and sociology data rarely results in neat, clean conclusions. While initial research might draw such conclusions, later more-nuanced, rigorous research often demonstrates the problems with those first studies.

Watch the Gladwell YouTube talk: Malcolm Gladwell Explains Why Human Potential Is Being Squandered

Read Ben Gibbs’ blog entry on his research: Relative Age Effect Reversal Found At Elite Level of Canadian Hockey

References

Barnsley, RH, Thompson AH and Barnsley PE. (1985). Hockey success and birthdate: The relative age effect. Canadian Association of Health, Physical Education and Recreation (CAHPER) Journal 51: 23–28.

Gibbs, B.G., Jarvis, J.A., & Dufur, M.J. (2012). The rise of the underdog? The relative age effect reversal among Canadian-born NHL hockey players: A reply to Nolan and Howell. International Review for the Sociology of Sport, 47, 644-649.

Gladwell, M. (2008). Outliers: The Story of Success. New York: Little, Brown.

1. Yes, I realize this isn’t robust research — it’s an arbitrary list and only 39 out of 100 datapoints were examined, but there’s no reason to suspect that those 39 datapoints were not fairly random.
2. Gladwell’s talk was apparently conducted in 2008, prior to the new research being published.
3. Unless someone goes back and edits these things, which is rarely done.