Therese: What are five clues you should be letting go of something?

Eileen:

1. You find yourself repeating the same complaint to different people.

We all get frustrated from time to time, but it’s not good for our mental or spiritual health to wallow in frustration. I remember once I got irritated with another mother at my kid’s nursery school after she did something that inconvenienced me. I complained to the first mother I ran into, and then the second. When I heard myself repeating the story for the third time, it hit me that I was making myself more agitated, not less. I was also putting poison in the community well. Someone had made an honest mistake, and I needed to get over it.

2. You’re churning over in your brain what you wish you (or someone else) had done.

You can’t change the past. Period. If you can’t stop thinking about something that has happened, reframe your internal conversation by asking what you have learned from the experience or what you want to do differently next time. Just replaying the same tape isn’t going to get you anywhere.

3. Your body is showing signs of anxiety.

Often our bodies give us clear messages about what is going on inside of us. For some people, anxiety manifests in not being able to sleep. For me, heartburn is a frequent symptom, as well as tight shoulder muscles. If you pay attention to how you feel when you are at peace as well as when you are anxious or angry, you can learn to use your body as a barometer. Awake at 2AM again? That may be your sign that you need to let go of something.

4. You are scheming how to make someone else do something.

Face it: you can’t force anyone else do anything, and the more you try, the more likely you are to push that person away. You can tell them what you want, but if you find yourself imagining ways to get them to do what you want, it’s time to back off and let go. (i.e. “Accidentally” dragging your boyfriend past the diamond store in the mall is not going to make him ready to get engaged, if that’s what you’re hoping.) Focus on making yourself happy, rather than trying to manipulate someone else.

5. You can’t appreciate the life you have because you keep focusing on what could be.

Every one has something to be grateful for, even if it’s just breathing. If it takes you more than several seconds to think of five things you are grateful for, you are probably focusing too much on a picture of how you wish things were. Counting your blessings is a time-tested way to let go of what you don’t have and focus on what you have.

Therese: And in reverse, what are five clues you should be making a change instead of giving up?

Eileen:

1. You can’t let go.

An inability to forget something may be a sign that you need to make a change. If you just can’t accept the fact that your boss doesn’t respect your work, maybe it’s time to polish your resume. If you are still grieving a lost friendship, maybe you need to write the person a letter to repair the relationship or get closure. Sometimes we need to take action before we can let go.

2. The problem will persist if you do nothing.

Forgiving someone for an honest mistake is one thing, but if someone continually does something that you find hurtful or annoying, you probably need to let the person know. Maybe if your neighbor knew that his music was bothering you, he would turn it down. Maybe not, but he won’t turn it down if you never tell him, and you are likely to get a better response if you mention it calmly when it is a minor annoyance, rather than waiting until you are exasperated.

3. You feel jealous of someone else’s accomplishments.

Jealousy can be toxic if we wallow in it, but it can also point us toward our unrealized goals. If you find yourself resentful of a friend who just published her first novel, maybe you should ask what creative venture you have put off. That could be the impetus to look for a writing class or take some other step toward what you want. 

4. People you trust believe you should make a change.

We have to be careful about following other people’s advice, but the truth is that sometimes other people see us more clearly than we see ourselves. Psychologists say that depression, for example, is often recognized by loved-ones before the depressed person can see it. Be open to the observations of people who have your best interests at heart, especially if they think you need some kind of help.

5. You angrily deny any problem.

If you get angry when someone suggests that you should be making a change, that’s all the more reason to take the person’s concern seriously. Anger is a typical symptom of denial. One way to break through denial is to look for objective evidence. One man I interviewed for The Wisdom to Know the Difference denied that he had a drinking problem until a counselor gave him a 20 question survey about drinking. When he answered yes to 18 of the 20 questions, he was jolted out of denial, giving him the boost he needed to join AA, a change that transformed his life.

To get to “Living the Serenity Prayer” by Eileen Flanagan, click here. Or visit her website at www.EileenFlanagan.com.

In the meantime, I present to you some of the best postings from our blogs in the past week:

The Fort Hood Massacre: A disturbed psychiatrist, a gun and the reality of war

(Depression On My Mind) - I will go to my therapist’s office this afternoon. I will sit in the waiting room and read an old magazine. Another client will walk from a hallway that leads to my therapist’s office, pass through the waiting room and leave. My therapist will poke her head out, smile and …

Reclaiming Sexual Intimacy in Your Relationship

(Healing Together for Couples) - It takes more than just showing up to reclaim or renew a good sexual relationship. Would you just show up on the dance floor to dance the tango together? Apart from the fact that you may have no interest in the tango – probably not. To really dance, you …

Exploring the Upside of Depression

(Mindfulness and Psychotherapy) - Sharon Begley, science editor for Newsweek and author of The Plastic Mind: New science reveals our extraordinary potential to transform ourselves, just wrote an interesting article titled The Upside of Depression. In this article she reviews some recent research that basically flies in the face of the “Happiness” surge and says …

Are We Exploiting Daniel Johnston?

(Celebrity Psychings) - Out of those of you who weren’t familiar with Daniel Johnston when I told you about his performance at the Austin City Limits Music Festival last month, I’m willing to bet more than a few of you found him interesting (even if you read only my brief introduction to him). …

More Thoughts on Hurtful Family Relationships

(Family Mental Health) - Hello dear Family Mental Health readers. Due to an inclusion in an Everyday Health newsletter, my blog post Can You Step Away From a Hurtful Family Relationship? post got a tremendous response. If you are now a new reader because you saw that post and have come back for more…

Beyond Mindfulness

(Anxiety and OCD Exposed) - My wife, Dr. Smith, and I are big fans of mindfulness approaches to therapy and we’ve included discussions of mindfulness in most of our self help books within the For Dummies series (including Borderline Personality Disorder For Dummies). In brief, Mindfulness is typically described as involving focused attention on experiences …

Bipolar Disorder Q & A: How Do I Tell My Doc, “This Isn’t Working?!”

(Bipolar Beat) - Garett Asks: “Five months ago, I was diagnosed as having bipolar disorder. First I was on Depakote and then I told my doctor I was still having major problems with my sleep. I was always up and about knowing it was 3 o’clock in the morning. I told her about the …”

7 Signs Your Body Image Is Bruised (and 5 Solutions)

(Weightless) - In this day and age, it seems like a positive body image is a rarity. Whether you fit today’s skinny standards or wish you did, most women have issues with their bodies. Some may argue that bickering with one’s body is as old as time. We frequently hear friends and family lament about their thick thighs or pudgy middle. Personally, whether I’m with family or friends, an hour doesn’t go by without someone saying that they shouldn’t be eating that much, must skip dessert…

Several mom friends of mine have lately come down with a bad case of “empty-nest depression” — moms who just dropped off their youngest offspring to college, or moms having difficulty keeping busy now that the youngest is in kindergarten all day.

I googled the term “empty-nest depression” to see what I could find on this topic. I was surprised to see the Beyond Blue post I wrote in 2007 at the top of the search results. But, after reading it, I can see why it was so popular. I merely asked a question, and all of you answered it. On the comment box of that post are written different kinds of compassionate and insightful responses to my question: How do you treat empty-nest depression?

Beyond Blue reader Barbara initiated the discussion with this practical piece of advice:

I am a mother of five children; the oldest 29, the youngest 20 in college. My children all went off on their own around the age of 18. Those in college worked their way through school so only returned home for a weekend occasionally; not for summer vacation. I was involved in all their lives, but I hope, not as a smother mother.

During a long period of their growing years, I was suffering from major depression. My therapist encouraged me to find some work outside the home. He was aware how much emphasis and identity I had tied up in motherhood, and how deeply depressed I was. I totally rebelled because raising my children was my first responsibility. But an opportunity came my way that would allow me to use my musical talent one day a week at a school. For some reason, I agreed to do it. Later it went to two days, then three. I finally decided to return to college and finish my degree while still teaching three days a week. By that time, only my son was still at home. He found he loved karate so my husband and I juggled our schedules so that he would never come home to an empty house.

Gradually, and as my children needed me to step back from hands-on mothering, I found myself gaining a lot of satisfaction in my new life as a teacher. My children were proud of me, and were a very boisterous cheering section at my graduation.

Now my husband is on the road for weeks at a time, so my nest is really empty. I am happy that I started building for the future before the nest started emptying. My vow had been to be a stay at home mom like mine had been. But I now see how important it was to anticipate the changes that were inevitably in my future.

My suggestion to any woman currently suffering separation depression and loss of identity, is to remember that you have years ahead of you that can be quite fulfilling. After menopause, the energy that our bodies put into reproduction each month is over, and we often gain a new burst of it. I went back to college at age 50 and thoroughly enjoyed the challenge and the sense of accomplishment that earning my degree gave me. Also remember, that while your children have moved away to develop their own identity, they will eventually move back toward you, albeit in a new relationship. They will live on their own, but have a new appreciation for you, as you will for them.

Look at the skills that you developed and practiced as a mother and pick the brains of your friends for ways to incorporate them into a new life. It seems scary to step outside your comfort zone, but it is something that everyone has to do if they are to grow and find satisfaction in life.

Change is daunting for almost everyone. We like things to be familiar and easy to understand. Sometimes all we need is a bit of reassurance that someone else has been in our shoes, and managed to walk in them.

How can you just delete an entire diagnosis and do away with a diagnostic label that hundreds of thousands of clinicians use everyday and millions identify with? If you’re the American Psychiatric Association, the folks behind the latest DSM revision, you can pretty much do anything you want.

Before I get to Asperger’s, I have to note what’s really cringe-worthy in this article — how it completely misrepresents how mental disorders are diagnosed in practice today. Take this explanation, for instance:

Another broad change is to better recognize that psychiatric patients often have many health problems affecting mind and body and that clinicians need to evaluate and treat the whole patient.

Historically, [Dr. Darrel A. Regier, research director at the American Psychiatric Association] said, the diagnostic manual was used to sort hospital patients based on what was judged to be their most serious problem. A patient with a primary diagnosis of major depression would not be evaluated for anxiety, for example, even though the two disorders often go hand in hand.

Similarly, a child with the autism label could not also have a diagnosis of attention deficit hyperactivity disorder, because attention problems are considered secondary to the autism. Thus, they might go untreated, or the treatment would not be covered by insurance.

I’m not sure if this is a bad translation of what Dr. Regier was trying to say or what, but the suggestion that a person is only diagnosed with a single diagnostic label (and can only be treated for a single disorder at a time) is simply untrue (and a ridiculous assertion). People are diagnosed — and treated — every day with more than one disorder. Indeed, there are thousands of children who carry both an ADHD diagnosis and an autism diagnosis — the two are not mutually exclusive (nor have they ever been). So while maybe back in the 1970s the DSM was used in the manner Dr. Regier describes, it hasn’t been used in that manner in modern practice for decades.

But getting back to the core reason why Asperger’s Syndrome, as a diagnosis, may be going away is because the new DSM is apparently going more toward a continuum approach for disorders. It actually already has this capability in the current edition, but it’s not a part of every diagnosis (for instance, you’ll find it for major depressive disorder, but not for things like ADHD). I believe the new DSM will ensure that every disorder is treated equally in this way — you can have mild ADHD, moderate ADHD, or severe ADHD.

In the same manner, you can have a mild form of autism and it’ll just be called “mild autism” — not Asperger’s.

I think the effort to make the diagnostic manual of mental disorders more internally consistent is a needed change. But doing away with well-used labels like “Asperger’s” is perhaps prematurely unnecessary; why couldn’t we use both labels to describe this form of mild autism? Certainly exceptions to the consistency can be made (and will have to be made anyway, since not every disorder will fit nicely into any classification system one could design).

While not ideal, allowances should be made during the transitional edition of this mainstay of mental disorder diagnoses to ensure that everybody embraces it — both patients and professionals alike. It could be as simple as including the phrase, “(also known as Asperger’s Syndrome)” next to the “mild autism” diagnostic criteria.

Read the full article: A Vanishing Diagnosis for Asperger’s Syndrome

According to government statistics, people with binge eating disorder are considered clinically obese, but plenty of people can engage in binge eating while maintaining an average or less-than-obese weight. Binge eating disorder probably affects 2 to 3 percent of all adults.
People with a binge eating problem often experience:

• Eating much more rapidly than usual.
• Eating until uncomfortably full.
• Eating large amounts of food, even when not physically hungry.
• Eating alone out of embarrassment at the quantity of food being eaten.
• Feelings of disgust, depression, or guilt after overeating.

Binge eating disorder is a serious mental health concern that, left unchecked, can ruin a person’s life with the feeling of being out of control. The resulting weight gain can also contribute to a person’s poor self-image and self-esteem.

Group therapy is one treatment method used to help people who have binge eating disorder. There are many different kinds of group therapy available, and recently researchers (Peterson et al., 2009) compared three different types of group therapy treatment to gauge their effectiveness in treating binge eating:

• A traditional therapist-led psychotherapy group
• A therapist-assisted group (where the therapist played a secondary role in the group)
• A self-help group

Here’s how the researchers described these three groups: “In the therapist-led CBT groups, a doctoral-level psychotherapist provided psychoeducation during the first half of each session and homework review and discussion during the second half. In the therapist-assisted CBT groups, participants watched a psychoeducational videotape (a specific tape was designed for each session) during the first half of each session, and during the second half a doctoral-level psychotherapist joined the group to review homework and lead a discussion. In the self-help groups, participants watched a psychoeducational videotape during the first half of each session and conducted their own homework review and discussion during the second half. Participants rotated as facilitators for this group.”

The researchers assigned 259 adults to one of these three groups (plus a fourth — a waiting list for treatment, used as a control group). They tested for the severity of binge eating using abstinent rates from binge eating, as well as a measure called the Eating Disorder Examination at the start of treatment, at the end of treatment, and then two more times at followups at 6 and 12 months. Ideally, we’re looking for treatments that would reduce the person’s rate at engaging in binge eating behavior — the higher the abstinent rate, the more effective the treatment. The most effective treatment would have someone no longer engaging in binge eating altogether.

Their findings? “At end of treatment, the therapist-led (51.7%) and the therapist-assisted (33.3%) conditions had higher binge eating abstinence rates than the self-help (17.9%) and waiting list (10.1%) conditions.”

So let’s put these numbers into some context. Getting help from a professional therapist resulted in the most effective treatment at this point — 5 out of 10 people got significantly better, and in the group therapy where a therapist assisted, 3 out of 10 people were helped. But even in the self-help condition, nearly 2 out of 10 people were helped, nearly double that of the control group. In that context, getting some help is better than none at all. And time alone does help some people get better on their own. Patients in the therapist-led group had the highest rate of abstinence and the fewest dropouts at end of treatment.

But here’s where things get really interesting. What about those abstinent rates measured 6 and 12 months after treatment was completed? After all, effective treatment needs to stick in order to prove it’s better than nothing at all. The researchers found no differences between the groups’ abstinent rates at these two followups.

Leave it to the researchers to the best possible light onto their findings:

Therapist-led group cognitive-behavioral treatment for binge eating disorder led to higher binge eating abstinence rates, greater reductions in binge eating frequency, and lower attrition compared to group self-help treatment. Although these findings indicate that therapist delivery of group treatment is associated with better short-term outcome and less attrition than self-help treatment, the lack of group differences at follow-up suggests that self-help group treatment may be a viable alternative to therapist-led interventions.

Well, that’s the kicker then, isn’t it? What use is a professional intervention if you can’t tell it apart from the self-help group (or worse yet, the control group) after treatment is over?

What this research really demonstrates quite well is how any targeted intervention is better than none at all. And that watching a psychoeducational video and then having a discussion about it with a group of other people may be just as effective as a professionally-led psychotherapy group, in the long run.

Reference:

Peterson, C.B., Mitchell, J.E., Crow, S.J., Crosby, R.D. & Wonderlich, S.A. (2009). The Efficacy of Self-Help Group Treatment and Therapist-Led Group Treatment for Binge Eating Disorder. Am J Psychiatry. DOI: 10.1176/appi.ajp.2009.09030345

So it is with great pleasure to bring you a new blog about just this very topic — body image, the skinny fad and learning how to attain freedom from the (weight) numbers and dieting. The blog is called Weightless:

As our new blogger, Margarita Tartakovsky, wrote in her introduction to her blog, “Weightless is about well-being, not weight; about fostering body image, regardless of your size. It’s about exposing women’s magazines, other mediums and so-called experts, when they’re touting unhealthy tips and promoting restrictive standards.

The goal of Weightless is to help women develop a better body image and work toward accepting themselves as they are, while being healthy and happy (fad diets and skinny-mini standards prohibited!); and to become sharp consumers, who can pick apart a commercial or magazine article and know which advice is helpful or harmful.”

Our Weightless blogger (who, I assure you, actually does weigh something) is a long-time writer for Psych Central, Margarita Tartakovsky. Her writing career began unofficially in second grade when she composed her first-ever essay on Cinderella (her mom still has it), several months after emigrating from Russia. Officially, Margarita began freelancing after graduating with an MS in clinical psychology from Texas A&M University.

This is going to be a great blog and I encourage you check it out if you have any interest in the topic of self-image, body image, and how to unshackle yourself from yo-yo dieting and being a slave to your scale.

Weightless: A Blog About Body Image

First of all, thank you for being honest. Because so many of us know exactly how you feel. I’m there a lot of the time myself. Less than I was the two years following my hospitalizations, but there too much of the time.

Doctor Smith would continually remind me during those first fragile years after my big breakdown that a slight setback in my recovery didn’t mean that I was plunging into a full-fledged depressive episode again, and that it wouldn’t take another 18 months to recover, like it did after my breakdown. These hiccups are normal, she reminded me. Recovery is never static, predictable, or symmetrical. On the contrary, it’s often messy, unpredictable, and annoyingly erratic.

I use a couple of cognitive reminders today when I’m panicking about relapsing.

1. My past doesn’t dictate my future.

They are totally separate. Just because I have been through an excruciating depression in my past doesn’t mean I will return to the same painful place every time my thoughts go south. Think of it this way: your brain is constantly forming. It’s part plastic. Which means, what was isn’t necessarily what is or what will be.

2. All things pass.

NOTHING is forever … which is a shame on the good days, but a lovely thing on the bad days. Moreover, this too shall pass. Everything does. Even the ice-cream truck in the summer. One minute it’s there, and then, bam! Gone to the next neighborhood. So much for the Klondike bars.

3. I will be okay.

Even if I do get sucked up right back into the Black Hole, I will survive it. I have before. I can rely on the reserves of strength and wisdom that got me out of there before (that is, in addition to some medication, in my case).

4. Have a plan.

Sometimes it helps to jot down some specific steps to take if you’ve just cried yourself through two boxes of Kleenex. A friend of mine knows it’s time to see her shrink when she doesn’t get out of bed for three days. My kids don’t really leave me that option, so my requirements are different: by the third day of crying incessantly I make an appointment to see Dr. Smith.

5. Be prepared.

You might not ever have a relapse. I hope you don’t. But if you suffer from chronic, and especially treatment-resistant depression, you can count on a few in your future. So be ready for the hurricane. For example, I always like to have at least two weeks worth of blogs uploaded in the blogging software that I can use in the event of a relapse. Some weeks I’m simply more productive than others, so I try to be like a communist country and even things out a little bit … taking the energy from the good weeks, and using them for the “my brain is a big fart” cycles.

What about you? How do you keep yourself from worrying about a relapse? Do you prepare yourself for one?

Key Benefits

• Parity for mental health and substance abuse services. As it is now, when you see a mental health provider, your insurance company will probably pay him or her less for your visit than they would pay your GP or specialist for a similar service. They might require a higher copay from you for a mental health service than a GP visit. They might limit your total annual or lifetime benefits for mental health services. For instance, I have many chronic depression clients who need year-round supportive therapy, but their annual benefits run out in August or September. Most patients have to pay me a $30 or $40 copay from their own pockets, rather than the $10 or $15 that their GP charges.

  With a reform bill, private insurers would have to end these practices. That will make it much more possible for patients to receive the care they need without added expense. It will also make it possible for patients who need medication to see a specialist, and not have to rely on the family doctor to prescribe medications he’s not really expert at. Eventually, it may lead to more practitioners entering mental health, a real benefit because credentialed providers are in short supply.

• No discrimination based on pre-existing conditions. The fact that insurers currently can, and do, refuse to insure you for pre-existing conditions is one of the major factors that keeps consumers tied to their jobs. It also forces them to contort themselves anxiously through COBRA plans and sensitive negotiations with their employers to stay on their old plan. And of course the old plan currently is still free to let you go, cap your benefits, or charge you a higher rate for those pre-existing conditions.

  This doesn’t hurt only mental health consumers, of course, but also those with cancer, heart disease, diabetes, or any other chronic or recurring illness. The current policy thus causes a great deal of stress for many, many consumers, which hopefully will be greatly eased by the new legislation.

• No rate changes based on health status. With reform, insurers will no longer be able to raise your rates because you develop a chronic or expensive condition. All subscribers in the same age group will pay the same rate.
• Greater availability of insurance, at lower cost. Though the details haven’t been worked out yet, a major goal of all the bills is greater availability of individual insurance plans to people who can’t afford health care now. Many people with mental health disorders such as long-term depression are not able to sustain themselves in challenging or stressful jobs, resulting in poverty or underemployment. The current economic collapse and the fact that insurance rates keep rising more than twice as much as the general cost of living has put health insurance out of reach for many. Reform is meant to make insurance much more available.
• Expansion of Medicaid. Medicaid is the government-run health care plan available to the poor. It’s a program that works well, and though there are some problems they are nothing like the problems with private insurance. The bill would basically expand the definition of the poor to include more working-class, low-income families. The fact that so many households have parents working two or three part-time jobs, none of them providing private insurance, means that Medicaid expansion and the greater availability of low-cost private plans will take a tremendous worry off of working people’s backs.

These are all great steps forward, especially for everyone who sees a therapist or takes an antidepressant or other psychiatric medication—or needs to. However, the devil is always in the details.

I’m still planning on talking about additional online interventions for other mental disorders, but am waiting for the conference folks to publish the presentations on their website because the abstract book doesn’t always contain the valuable bits of information I need to properly summarize a topic area.

In the meantime, I thought I’d mention Beacon. Beacon is a website that has gone to the trouble of indexing and rating over 70 different online interventions in the following categories:

• Alcohol (3/3)
• Bipolar disorder (3/0)
• Depression (24/11)
• Eating disorder (anorexia or bulimia) (6/5)
• Generalized anxiety disorder (4/1)
• Obsessive compulsive disorder (1/1)
• Pain (5/2)
• Panic disorder (8/6)
• Phobias (2/0)
• Post traumatic stress disorder (PTSD) (4/3)
• Social anxiety (3/3)
• Stress (7/3)
• Tinnitus (1/1)
• Weight and Obesity (2/2)

The first number listed is the total number of online interventions the online researchers have found. The second number listed is the number of interventions that have at least some research backing for them (some interventions have very good support, and are so duly noted at Beacon). So for example, there are 24 online interventions indexed by Beacon for depression, but only 11 of them have at least a little research support — 13 of them have no research backing.

As a person interested in pursuing your own self-help methods for a particular concern, this website allows you to quickly identify a program or two that might be of interest. You can avoid those websites that don’t have any research backing, saving yourself some time (and perhaps, wasted effort).

Beacon is provided by the same research team that was responsible for MoodGYM and BluePages, the tireless and dedicated researchers at the Centre for Mental Health Research at The Australian National University, headed by the charming and personable Prof. Helen Christensen, Ph.D.

There is one small downside to using Beacon. In order to access its database, a free registration is required. Ordinarily, that wouldn’t be a big deal, but this one also asks for basic demographic information and requires users to fill out a 35-question general mental health survey before giving you access to Beacon. They are using this data to see if there’s any correlation or pattern of behaviors between what people complain about through the survey and what they then search for on the website. I think that’s okay since they tell you that up-front, but you should be well aware of that requirement before deciding to register and check the site out.

Check out Beacon now.

They split the participants into two types of diet - those who ate a diet largely based on whole foods, which includes lots of fruit, vegetables and fish, and those who ate a mainly processed food diet, such as sweetened desserts, fried food, processed meat, refined grains and high-fat dairy products.

After accounting for factors such as gender, age, education, physical activity, smoking habits and chronic diseases, they found a significant difference in future depression risk with the different diets.

Those who ate the most whole foods had a 26% lower risk of future depression than those who at the least whole foods.

By contrast people with a diet high in processed food had a 58% higher risk of depression than those who ate very few processed foods.

There are three reasonable explanations for this finding. The one the researchers believe is that what you eat can directly impact your mood over the long run. Another explanation is that people who are more prone to depression live a kind of lifestyle where eating processed food is a normal part of it (think of a person who is harried and stressed out and doesn’t know how to manage stressors in their life very well). “Physical activity” and education don’t really rule out the possibility of the second explanation.

And the third explanation is that people with depression eat less healthily. That also seems like a reasonable explanation for this finding. The news article doesn’t say whether they assessed depression at the onset of the study (which seems like a pretty reasonable thing to have done).

Honestly, I’m not sure eating more healthy is going to directly impact your mood. It will, however, impact your overall general health, which does have an impact on your mood. So even if it’s not a direct relationship, it’s something to think about next time you find yourself stopping into McDonald’s for the 5th time this month (or week!).

Read the full article: Depression link to processed food

Therese: What are five ways a person can tackle perfectionism?

Michelle: Here they are …

1. Compare yourself to others.

I know, this probably sounds surprising when the prevailing wisdom says not to. But we perfectionists need frequent reality checks.

Think about whatever has you firing on all cylinders and what you’re hoping to achieve. A report with absolutely no errors? A living room fit to be featured in House Beautiful? A body like the cover model on that fitness magazine at the checkout stand?

Now notice how many people are doing quite well, thankyouverymuch, without raising the bar so high. People really do have satisfying relationships in non-model bodies, successful careers despite the occasional typo or misjudgment, and comfortable, happy homes with undusted mantelpieces. It’s good to look around and remind ourselves of this from time to time.

2. Use the 10-Year Question.

If you catch yourself ruminating about something you think you’ve done or might do less than perfectly, ask yourself, “Ten years from today, will I even remember this, let alone care about how well it was done or whether it was done at all?”

In the extremely rare cases where you answer “yes” and “yes,” go ahead and give the doing or fixing your best effort, and then move on. Most of the time, though, this little thought exercise will help dissolve your worry, or at least shrink it down to a more manageable size.

3. Take some time out.

Perfectionists overcommit–to others and to themselves. See if you can find a way out of an upcoming obligation (or two, or three) that you don’t really want to do but think you “should.” Also, look at your own to-do list and see what you can defer for now, or even take off your list entirely. To get my post on this, click here.

Now don’t just fill up this time with other stuff. There will always be more stuff. Allow it to be “white time” (analogous to white space) during which you have absolutely no agenda. Do whatever your body and spirit want–take a nap, go somewhere for a change of scenery, stretch, dance, meditate, walk on grass, finger-paint.

Perfectionism stems from an overly self-critical mind. Give your mind a break and let it rest. Nurture the other parts of you — they deserve it. Gradually, your mind will learn that the world doesn’t end if you leave it to itself for a little while.

4. Take one tiny but direct step.

It seems counterintuitive, but there’s a direct link between perfectionism and procrastination. You’d think perfectionists would want everything done neatly, thoroughly and on time, right? Instead, we often feel such pressure to do things perfectly that we overwhelm ourselves before we even start. Then we keep ourselves occupied with a million other things so that we always have a handy excuse for why we’re not doing Whatever It Is.

Try picking one very tiny thing and just doing it. Make the thing so small that it doesn’t intimidate you. But make sure it points directly toward something you want. Don’t browse the Internet for workout shoes–go outside and walk around the block. Just once. But do it. A single baby step is worth more than any amount of beating yourself up over not taking any action.

5. Ask yourself what you’d say to a friend.

I have a friend who calls me on this whenever she observes me going into overdrive. “If I were handling everything you are right now,” she asks me, “and I started criticizing you the way you’re criticizing yourself, would you stand there and take it? Or would you tell me to go fly a kite?” (pregnant pause) “Then why do you let you talk to yourself that way?”

It’s a good question, isn’t it?

Therese: What is your biggest obstacle in “practicing imperfection”? How do you get around it?

Michelle: I’m hyper-organized (is there a medical diagnosis for that? oh, yeah, OCD) and a diehard tweaker of systems. I can spend hours and hours searching for the “perfect” planner and then customizing it for every possible contingency, but then never actually using it.

I also seem to have this need to “clear the decks” before starting on major projects. So no, I can’t possibly track my finances until I have all my stray papers filed so I can find them, which means going through the box of papers in the corner, which means pruning my file cabinet of outdated material to make room for the new, which means getting some WD-40 to fix the drawer because it’s almost stuck shut, which means a trip to . . . etc., etc.

One of my newest mantras has become “Just start somewhere.” I’ve realized (verrrry grudgingly) that the inbox of my life will never be empty. Things will never coalesce into a perfect starting point with neatly squared corners and no loose ends. So I continue giving myself pep talks about this. And slowly, very slowly, I’m noticing how small steps really do have a cumulative effect over time. That not everything has to be exactly the way I’d like it for me to experience progress.

My blog is a great example. I’ve never done anything like it before, and I’m completely intimidated by the technical aspects of it. I also wanted to have something like 20 posts in the hopper before I even launched, because I was afraid of getting writer’s block. But in April of this year I enlisted the help of some friends to set up the site, and just started writing.

Does the website look and function exactly the way I want it to? Nope. Are there sections I need to complete, or even create? Absolutely. Can I afford a professional site design at this point? Hah! But I didn’t let any of that keep me from starting, and I’m learning as I go. I’ve made some great online friends and received helpful feedback and advice, none of which would have happened if I hadn’t plunged in the deep end and just started somewhere. And I’m having fun!

Excuse me? And what does that make me? Chopped liver?

You might be thinking, “Gee, Elvira, why would it scare you to be associated, even loosely, with a slutty, Vampira wannabe in a cheap wig?

[Yes. Before Elvira there was Vampira (circa 1953), the first ever late night horror film hostess. She was featured in that wonderfully campy Tim Burton film 'Ed Wood', with Johnny Depp as the cross dressing Mr. Wood.]

Anywho…

I don’t really mind that much…anymore…but once upon a time I dreaded hearing my name mispronounced and dis-respected. It hurt to hear people call me things like Velveeta cheese. God! Couldn’t my name at least sound like a classy cheese, l don’t know… Bree?

It doesn’t take a psychologist to figure out why I would get defensive, not to say persnickety, or snotty, but maybe those, too. Your name is your badge of honor, your coat of arms, your flag. I went through years and years, ever since I could talk, correcting people about how to say and spell my name. [Does Growing Up With a Difficult Name Build Character?] If you have a difficult name you know exactly what I’m talking about.

But I’m not touchy about my name any more. No, no, no! Having it mangled before my eyes is nothing to me now. Being mature and of a certain age has its perks, one of which is you don’t care as much. It’s nice, really. Many of my comrades in middle-age-dom like to say they are in their F*#k you, Fifties (or Forties, or Sixties) and proud of it! Maybe there’s something to that.

Could it be I’ve faced my fear of name abuse so many times and for so long that I’ve finally gotten to the other side of it? I don’t correct people as much as I used to or wince the way I used to either. I like to think I’ve grown up about it, gained some perspective.

Besides, as I said to a friend recently, it could be worse. At least Elvira/Vampira is hot in a ghoulish, Morticia Addams kind of way. Ah, Morticia! Now there’s a vampire with class!

Photo courtesy San Diego Shooter via Flickr

If you’re a parent and looking for some tips on how to handle Halloween this year in your house, look no further than this great article written by our own Dr. Hartwell-Walker two years ago:

Fast forward a decade or three and it’s not always so innocent or so much fun. Friends tell me of mobs of teens out terrorizing each other, shaking down the little kids, and demanding candy at the doors of those whose lights are on. Others tell me of carloads of kids being dropped off in their neighborhoods by parents who either think their own blocks are too dangerous or who want their kids to cash in on more free candy. Still others tell me of kids who can’t be bothered saying thank you when they collect their candy. They just want to be off to the next house to get more. It’s a sad comment on what the day has become and what kind of parenting is going on.

Keep in mind that Halloween is a fun time for kids to play a little make believe out in the real world. Let them enjoy the day (and night)! Happy Halloween to everyone!!

Read the full article: Halloween Safety Tips for Parents

Psychology researchers call it fluency while web developers call it usability, but they’re both basically talking about the same thing — how well something is designed can directly impact how much people use it. And not only the degree to which they use it, but also the amount of self-disclosure a person makes while using it.

Online researchers have repeatedly referred to the disinhibition effect of online behavior — people tend to disclose more about themselves or their personal details online than they do in similar face-to-face interactions. But why do people — especially teens — over-disclose on websites like Facebook or Twitter? What might be a contributing factor to encouraging people to disclose more than they ordinarily would?

Adam Alter from New York University and Daniel Oppenheimer (2009) from Princeton University set to answer this question in a recently published research study. Through the use of three laboratory experiments and one real-world experience with a live website, the researchers discovered that fluency (or usability) directly impacts people’s self-disclosure amounts.

Researchers manipulated fluency in the first three experiments by making the font harder to read on a number of exercises. In the first experiment, 33 undergraduates were asked to fill out a test that measured how strongly people “claim 18 virtuous but implausible attributes (e.g., “No matter who I’m talking to, I’m always a good listener”) and deny 15 common human frailties (e.g., “I like to gossip at times”). Lower scores on the scale indicate a willingness to disclose potentially self-incriminating flaws.” The study found that subjects tended to choose a greater percentage of socially desirable, non-disclosing responses when the test was printed in the difficult-to-read font. This experiment was replicated with another test just to make sure it wasn’t the test itself that was leading to the findings.

In the second experiment, subjects need to add a letter to an incomplete word in order to form a real word, the first one that popped into their head. According to the researchers, “eight of the [incomplete words] could be completed to form words associated with risk (e.g., “ris_” could be completed to form “risk” or “rise”), 5 could form words associated with self-presentational concerns (e.g., “_iked” could be made to form “liked” or “hiked”), and the remainder [could form] words associated with neither concept (e.g., “_og” could be made to form “dog”). Sixty-seven adults completed the study. Words show in the difficult-to-read font were more likely to be risk-related works.

In the third experiment, subjects were asked to complete a self-disclosure questionnaire in which they rated how comfortable they would be discussing their views on 30 self-relevant issues. The researchers found that “participants who found the font harder to read expressed greater discomfort and exhibited a diminished willingness to disclose their opinions on the 30 topics. However, this relationship between fluency and self-disclosure was mediated by the experience of negative emotions, [suggesting] that at least part of the reason why people prefer not to disclose self-relevant information when they experience disfluency is that disfluency enhances discomfort.”

The fourth and final experiment involved an existing confession-based website called grouphug.us that changed its design from gray text on a black background (harder to read and therefore less fluent) to black text on a white background (easier to read and therefore more fluent). Researchers had volunteers analyze the responses made on this website before and after the design change. They found that responses after the design change tended to disclose more embarrassing information.

The researchers summarized their results by noting that people self-disclosed more in high-fluency conditions — that is, when text was easier to read. When text was harder to read, subjects were more likely to hide their flaws and to think more about risk and concern. In the website experiment, people disclosed more revealing information about themselves when the website was easier to read.

The easier it is for us humans to process information means the more likely it is that we’ll engage in more of the behavior encouraging us to disclose. Alternatively, if we make it harder for people to read a website or fill out a form, a person is less likely to self-disclose.

This finding has many real-world implications, since self-disclosure is a big part of the psychotherapy relationship. Health (and mental health) professionals have many opportunities to induce greater fluency. The researchers suggest one example — by using simple words rather than long-winded alternatives, professionals can create more fluency (and more self-disclosure) from their patients. “Evidence from the negotiation literature similarly suggests that mutual disclosure benefits both negotiating parties, enabling them to identify their otherwise opaque mutual interests,” the researchers also noted.

Reference:

Alter, A.L. & Oppenheimer, D.M. (2009). Suppressing Secrecy Through Metacognitive Ease: Cognitive Fluency Encourages Self-Disclosure. Psychological Science. DOI: 10.1111/j.1467-9280.2009.02461.x.

“Do you put your picture on your website?” he asked.

When I told him that I did, he about fell out of his chair and went on a rant about how inappropriate this is, likening it to taking an ad out in the yellow pages of a phone book. Initially I felt deeply criticized and offended by what my father had said. But upon further reflection, I “got it.”

My dad comes from a very different time in the practice of psychotherapy — when therapists didn’t advertise at all, let alone display a personal photo.

My, how the landscape has changed for therapists since then! Some of us have websites (with pictures, Dad), some of us list ourselves in directories (again, with pictures), some of us use social networking platforms and some of us are writing and blogging. A few of us have figured out ways to create a passive income to supplement our therapy practices.

What does all of this mean? It means that therapists are more visible than we’ve ever been in the history of this field of work. However, the change in landscape has not occurred without controversy around issues of personal disclosure, therapist-client boundaries and the “digital footprint” left online, which cannot easily be removed.

Being that this is the age of information (albeit “information overload” at times), people want to know a little about who might become their therapist. I’m not suggesting therapists lay out their life stories on their personal websites but strike a balance between demystifying themselves and remaining in their ethical comfort zone.

The other night when my dad was over for dinner, he sidled up to me and said, “Hey Lis, I’d like to ask you a few questions about how to do a website.” This time it was me who cocked my head slightly and looked at him suspiciously. He enthusiastically explained that he wants his own website to put all of his articles in one place.

For a moment I flashed back five years to that day we sat on the patio and he berated my online endeavors. This memory was quickly followed by a surge of validation knowing he must have decided what I’ve been doing all this time has some merit. (Isn’t it true how much we want validation from our parents?)

“But,” he clarified. “No picture of me.”

In that moment, two psychotherapy eras came together — well, sort of.