Certificate of Appreciation

Dr. Saied Malihialzackerini’s Certificate of Appreciation from President of Psychology and Counseling Organization of I.R.Iran


Dear Dr.Saied MAlihialzackerini 
We hereby express our appreciation and thanks to your Excellencies for proposing, designing, implementing, and operating the new website , web based platforms of membership, licensing, and web-based administrative automation for Psychology and Counseling Organization of I.R.Iran (https://pcoiran.ir ), as well as for your persistent and continuous efforts in optimizing the organization's technological affairs. Almighty God, I wish you more and more success in serving the people and the society of psychologists and counselors of Our country.
Mohammad Hatami
President 
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What you need to know before choosing online therapy

Become an informed consumer of telepsychology services—learn factors to take into account when considering online therapy and explore additional resources.


With the click of a mouse or the tap of an app, you can have instant and inexpensive access to a therapist, or so make the claims of many new tools and technologies that want to take psychotherapy out of the therapist’s office and into whatever location you are connected to the Internet. Using the Web can be convenient for the many people who are comfortable using the Internet and looking for help.

But before you sign up, log in, and start chatting, there are points to consider about telepsychology.

Psychologists commonly refer to any therapy delivered by telecommunication tools or devices as telepsychology. You may hear it called Web therapy, phone therapy, text therapy or online therapy. Anytime you’re interacting with a psychologist using a website, a phone or a mobile app, you could be taking part in telepsychology services.

Technology can contribute to an evolution in how people receive psychotherapy or work with a psychologist. Researchers are taking great interest in telepsychology and telehealth, evaluating how well it works, especially compared to in-person, in-office psychotherapy sessions. But much like the technology, the research is still new, and there is a lot science doesn’t yet know.

There are a few points to consider before signing up for any services that are offered exclusively online or by telephone.

Why people like Web therapy
Web therapy has a lot of promise and offers benefits compared to in-person psychotherapy.

It can be convenient. Online therapy can take less time away from the office or your workday or worry about traffic. No need to travel miles to meet up with your psychologist. Dial a number or log in to a site, and the session can happen wherever you are comfortable.Compared to traditional in-person therapy, it can sometimes appear less expensive. Some apps will advertise pricing that provides unlimited use for a weekly or monthly fee. Or the online session may seem significantly lower than in-office visits. If you’re not interested in using health insurance for psychotherapy, this can be a benefit. More about insurance and online therapy is discussed in the next section.Online communication is very comfortable for many people, especially younger adults or those who use technology often. More people are using email, webinars and text messaging to communicate, and it can seem more comfortable or easier than talking to someone in person, especially when revealing personal or private information.It can provide access to those who can’t get to an office. In some rural communities, the nearest psychologist office may be an hour or two drive away. Some people with chronic illnesses or disabilities may not be able to drive or easily able to leave their home. In these situations, Web- or telephone-based therapy may be their only option for help.
What you need to think carefully about regarding Web-based therapy
Despite the potential benefits, psychologists caution that Web-therapy may not be the best option for everyone or every situation in need of professional support. Here are a few points to consider or ask before signing up:

Is this the right tool to help me? The research hasn’t yet shown that stand-alone therapy online or via texting is effective for everyone in every situation. Some sites advertise that they offer therapy, but those claims may be misleading or false. For example, the people behind the apps may not be licensed or qualified to provide therapy.Is the therapist licensed? Licensing protects you. Therapist and psychotherapist are not legally protected words in most states, meaning anyone can claim to be a therapist and offer services that may appear as therapy. It may not always be easy to know that you are receiving evidenced-based psychotherapy.

All psychologists and other professional health providers must be licensed by the state in which they practice. Licensure laws protect you by ensuring only those who are trained and qualified to practice receive a license. It also ensures that you have recourse if there are problems with your treatment. Before you sign up for any Web services, find out who you are working with, if he or she has a license, where that license is held and the license number. Most states offer an online, searchable directory of professionals licensed in their state.Is the psychologist licensed in the state you live? Licenses are granted by each state with their own laws and rules, much like each state determines what residents must know to earn a driver’s license. But unlike driver’s licenses, which allow you to legally operate a car in all states, a health care provider is limited to providing services in the state in which they are licensed. The provider must be licensed in the jurisdiction where you are located, and making that determination may be difficult to do if you don’t know where he or she is physically located.Is the site or app secure? Will the information I provide remain confidential? Psychotherapy works in part because psychologists ensure that clients have a safe, private space to share deeply personal and sometimes difficult stories, thoughts or emotions. What happens and is said in a therapy office stays there, with the exception of a few situations. The site or app you use should, at a minimum, be HIPAA-compliant and have the ability to verify your identity and your therapist’s identity.How will you pay for the service? Many insurance companies cover the treatment of mental health and substance abuse disorders—treatment that includes in-person psychotherapy. If you work with a psychologist in her office, your insurance could cover most or all of the fee, depending on whether you need to meet a deductible or have a co-pay. Psychologists will often provide an invoice that you can submit to your insurance company for reimbursement. But online therapy or web therapy services are often not covered or reimbursable by most insurance providers. If you plan to be reimbursed, check with your insurance company first. Otherwise, prepare to pay for the full cost yourself.
More psychologists are exploring online sites and apps just as more patients are interested in using them. Research does show that some technological tools can help when used in conjunction with in-office therapy.

Many psychologists and patients are finding text messages helpful for quick check-ins or reminders. Some apps can help track and log moods or thoughts. Web-conferencing and streaming in real time can offer continuity when a patient is on vacation or not able to make a regular session.

There are cases in which Web-conferencing or therapy via telephone does seem to be a viable option on its own for some people. But for now, with the current research and with the current technology, mobile apps and text messaging are best used as complementary to in-person psychotherapy.

reference: APA
Link:https://www.apa.org/topics/telehealth/online-therapy
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Traumas in children and adolescents can be treated effectively

Psychotherapeutic treatment based on trauma-focused therapy is highly effective for children and adolescents who have experienced repeated traumatic events such as sexual, physical or emotional abuse.


Around 25 percent of children and adolescents exposed to traumatic events develop post-traumatic stress disorder (PTSD). Repeated physical, sexual and emotional traumatization in childhood in particular carries a high risk of PTSD. The cases of sexual abuse in the Catholic church and the Russian war against Ukraine are two current examples that illustrate the scope of mass trauma events.

"PTDS is a serious, usually chronic, illness which creates severe functional impairment in everyday life of those affected," says Thole Hoppen who is the lead author of the study in collaboration with psychologists at the University of East Anglia (UK) and the University of Oslo (Norway).

There had previously been strong reservations in clinical practice as regards using trauma-focused psychotherapy to treat children and adolescents suffering PTSD from multiple traumas. This form of therapy aims at changing patients' patterns of thought and behavior that have arisen as a result of the trauma. The aim is to enable patients to confront the trauma they have experienced, under the supervision of a therapist, and thereby process the memories and their consequences.

"The widespread argument is that this therapy demands too much of patients, and that it is not very promising, inappropriate, or even dangerous," Hoppen comments. "Our analysis has enabled us to prove the opposite."

In a so-called meta-analysis, the researchers evaluated the results of all randomized controlled psychotherapy trials published so far relating to PTSD in children and adolescents. For the first time in a meta-analysis, the authors distinguished between individual and multiple trauma exposures in children and adolescents.

"Psychotherapy is highly effective for children and adolescents with PTSD—and not only after a single traumatisation," says Hoppen. "The evidence base shows that this is also the case for multiple traumas."

The results of the study are important not only for outpatient psychotherapy but also for inpatient treatment in psychiatric wards, as well as for the training of psychotherapists. The results provide hope and guidance for people affected, for their families and for those treating them.

link: https://medicalxpress.com/news/2023-03-traumas-children-adolescents-effectively.html
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Meta cognition for children

Active monitoring and modifying of thought processes help us for self-regulation, involving self-awareness, critical analysis skills, and the ability to problem-solve.


For students, having metacognitive skills means that they are able to recognise their own cognitive abilities, direct their own learning, evaluate their performance, understand what caused their successes or failures, and learn new strategies. It can also help them learn how to revise. This is because it optimises their basic cognitive processes, including memory, attention, activation of prior knowledge, and being able to solve or complete a task. It makes them learn more efficiently and more effectively, and so they are able to make more progress.
Why is Metacognition Beneficial in Student Learning?
The potential benefits of metacognition in learning are as follows:

Higher achievement levels for the students. Metacognitive practices can also compensate for any cognitive limitations that a student might have, according to research such as this.
Increased ability to learn independently. Being able to monitor their own progress lets them take control of their own learning, inside and outside the classroom.
Improved resilience. Identifying their successes and failures, and which strategies work best for them – or which have failed – increases students’ perseverance in getting better at their work.
It aids disadvantaged students. According to this report, and research by the EEF, teaching in a way that supports metacognition is beneficial for students who are at a disadvantage to their peers.
Cost-effectiveness. This method of teaching does not require specialist equipment, nor any other large purchases – it only requires teachers to be trained in the method effectively.
Transferable knowledge. Metacognition helps students to transmit their knowledge and understanding across tasks and contexts, including reading comprehension, writing, mathematics, memorising, reasoning, and problem-solving.
Effective for all ages of students. Research has looked at both primary and secondary students – and even those who have not yet started school – and found benefits in all cases.
Emotional and social growth. Gaining awareness of their own mental states allows students to think about how to be happy, respected, and confident in themselves. They are also better able to understand other people’s perspectives.

Link:https://www.highspeedtraining.co.uk/hub/metacognition-in-the-classroom/
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Metacognition in practice

A metacognition checklist

If you are new to meta-cognition, it will help to ask yourself the following questions about your teaching practice.


1. Have I included clear learning objectives?
Students need to understand what their learning objectives are so that they can plan how to achieve them. The process of planning should involve learners identifying which strategies they already know that could be applied in this new situation.

2. How am I going to encourage my students to monitor their learning?
Effective learners commonly use metacognitive strategies whenever they learn. However, they may fail to recognise which strategy is the most effective for a particular learning situation. Teachers can ask questions to prompt learners to monitor the strategies that they are using.

For example, before learners begin a task, prompt them to identify where the task might go wrong and how they could prevent this from happening. During the task encourage them to focus on the learning objectives and get them to think about how they can maintain that focus. This will encourage learners to think more actively about where they are now, where they are going and how to get there.

3. How can I create opportunities for learners to practise new strategies?
When you introduce your learners to a new strategy, give them the opportunity to use it both with support and independently. It is important to monitor your learners’ progress and provide them with feedback on the specific strategies they are using to help shape their learning process. (For further ideas for giving feedback and effective questioning, see Getting started with Assessment for Learning.)

4. How can I allow time for learner self-reflection?
Personal reflection enables learners to critically analyse their performance in relation to a particular task and consider what they might do differently to improve their performance in future tasks. It is important that teachers dedicate time for learners to reflect, and provide them with the tools to do so. One way of doing this is to use thinking journals as mentioned in the previous section.

5. Does the classroom environment support metacognitive practices?
Teachers are instrumental in shaping the culture of learning in a classroom. By establishing a supportive learning environment that fosters and anticipates metacognitive practices, these practices will become an integral part of the learning process. Check that you are modeling metacognitive practices effectively, giving your learners plenty of opportunity to work collaboratively with their peers, encouraging reflection and evaluating their progress.

Metacognitive Strategies

Having this skill is essential for improving your own productivity and effectiveness 


Self-Questioning
Self-questioning involves pausing throughout a task to consciously check your own actions.

Without self-questioning, we may lack humility and awareness of our own faults.

Most importantly, we would not be able to improve because we never took the time to ask ourselves important questions like:

Is this the best way to carry out this task?
Did I miss something? Maybe I should check again.
Did I follow the right procedure there?
How could I do better next time?
Am I looking at this task the right way?
How can I do a better job at thinking about what I’m doing?
Good students question their actions both while they’re completing the task and after finishing it (see also: ‘reflection’).

 Meditation
Meditation involves clearing your mind. We could consider it to be a metacognitive strategy because meditators aim to:

Clear out the chatter that goes on in our heads.
Reach a calm and focused state that can prime us for learning.
Be more aware of our own inner speech.
Meditation for children is becoming increasingly popular in schools because educators can see the value of this task for helping students achieve greater self-awareness in the classroom.

 Reflection
Reflection involves pausing to think about a task. It is usually a cyclical process where we reflect, think of ways to improve, try again then go back to reflection.

Reflection is metacognitive only if you consciously reflect on what your thought processes were and how to improve upon them next time.

There are many models of reflection with varying steps. Most reflective cycles have at least the following phases:

A task is planned.
You attempt the task.
You look at how you did the task.
You come up with things you did well and areas for improvement.
You plan the next task, with a focus on improving on your weaknesses.
You try again …
You reflect again …
And so on.
Once you become skilled at reflection, you may also reflect while doing a task so that you can make adjustments to your thinking processes as you go. We call this sort of reflection reflection in action (as opposed to reflection on action).

 Awareness Of Strengths And Weaknesses
Central to metacognition is a person’s capacity to see their own strengths and weaknesses. Only through looking at yourself and making a genuine assessment of your weaknesses can you achieve self-improvement.

One way to start looking at your strengths and weaknesses is to use a SWOT chart.
A SWOT chart is a chart with four sections:

Strengths: write down what you perceive to be your strengths as a learner.
Weaknesses: write down what you perceive to be your weaknesses as a learner.
Opportunities: identify opportunities you may have to improve your cognitive skills in the coming weeks or months.
Threats: identify potential threats that may prevent you from improving your cognitive skills in the coming weeks or months.

Writing Down Your Working
Most people will recall in high school math classes their teacher saying: “I want to see your working so I know how you got to your answer.”

This teacher is ensuring you are employing the right thinking processes and can show others how you went about thinking about the task.

When you become an expert at a topic you tend not to think about your thinking. We sometimes call this “unconscious competence”, which is the fourth stage of learning in the learner competence model.

 Thinking Aloud
Lev Vygotsky (a central figure in the sociocultural theory of education) argues beginner learners tend to think aloud before learning to think inside their heads.

The benefit of sociocultural theory‘s strategy of thinking aloud is that it makes you really think. You have to talk through what your brain is doing, making those thinking processes explicit.

Teachers will often ask students to speak out loud about what they’re thinking. It not only helps the student be more conscious of their cognitive processes, it also helps the teacher identify areas where the student is going astray.
Regulation Checklists
A regulation checklist can either be task-based or generalized.

A task-based regulation checklist is usually created before a task begins. It will:

List the thought processes required to succeed in the task.
List the observable outcomes of higher order thinking linked to the task.
List the checkpoints during the task where people should pause to reflect on their thinking.
A general regulation checklist provides regulation strategies that can be used across any normal task, such as:

Reminders to pause and reflect-in-practice at regular intervals.
Prompts to remind students to think about what strategies they are using and whether they are appropriate for the task.
Self-questioning prompts to remind students to question their choices.
Quick charts and questionnaires to help people focus on their developments such as KWL charts.
Planning Ahead
When we plan ahead, we often have to think about how we’ll go about a task. We might call it our “plan of attack”.

Planning ahead involves thinking about what we’re going to do in order to complete a task. During your planning phase, you might make decisions such as:

Deciding what strategies you’ll use when your task, competition or activity begins.
Tossing up a range of different thinking skills you might use when approaching a task.
Reminding yourself not to make the same mistakes you made last time.
Preparing some tools that will help you keep your thinking on track, such as preparing graphic organizers.

Link:https://helpfulprofessor.com/metacognitive-strategies/
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Metacognition: How Thinking About Thinking Can Help Kids

A powerful skill for building resilience

Metacognition is a big word for something most of us do every day without even noticing: Thinking about our own thoughts. Reflecting on our thoughts is a big part of understanding our feelings and learning new things.When kids hit challenges — a hard math test, a fight with a friend — it can be tempting for them to give up. But in order to thrive, kids need to be able to go from “I can’t” to “How can I?” Metacognition can help.


When kids hit difficult problems — the seemingly insurmountable English essay, a math test that takes on epic proportions, social struggles that leave them feeling frustrated — it can be tempting to give up and resort to four words no parent ever wants to hear: “I can’t do it.”

In order to thrive, kids need to be able to make the transition from the negative “I can’t” to the proactive  “How can I?”

To do that, they need to think about why they’re stuck, what’s frustrating them, what they would need to get unstuck. They need to think about their own thinking.

There’s a word for that, and it’s metacognition.

Metacognition is a big word for something most of us do every day without even noticing. Reflecting on our own thoughts is how we gain insight into our feelings, needs, and behaviors — and how we learn, manage, and adapt to new experiences, challenges, and emotional setbacks. It’s the running conversation we have in our heads, mentally sounding ourselves out and making plans. Training kids to use it proactively to overcome obstacles, it turns out, can be a powerful tool.

More and more studies are suggesting that kids who are taught to use metacognitive strategies early on are more resilient and more successful, both in and out of school.

“I view metacognition as a goal,” says Marc Gladstone, alearning specialist. “Getting into the habit of using metacognitive strategies early on helps kids become more independent learners and bolsters self-advocacy skills.”
What is metacognition and how does it work?
“Metacognitive thinking teaches us about ourselves,” says Tamara Rosier, a learning coach who specializes in metacognitive techniques. “Thinking about our thinking creates perspective — perspective that leaves room for change.”

She gives an example: “Instead of saying, ‘Math tests make me anxious,’ we’re asking ourselves, ‘What is it about math tests that makes me feel anxious and what can I do to change that?’ ”

Kids who are taught to think of themselves as being “good” or “bad” at a particular task can have a fixed mindset that makes them passive in approaching a challenge: either they can do it or they can’t, but they aren’t likely to think they can change that outcome.

Teaching kids to become more metacognitive helps them move from a mindset that leaves little room for change to a mindset which promotes self-awareness and resilience.

Help for kids with learning issues
Helping your child learn to work through difficult situations (or homework assignments, as the case may be) without becoming overwhelmed or giving up is especially valuable for kids with learning issues who may need to come up with different strategies than other students in the class.

For example:

A child with ADHD who struggles to stay on task is likely to feel frustrated and anxious when he’s assigned a long essay. If he’s unable to reflect on why the project upsets him he might think, “Everyone else is having an easy time. I’m just bad at writing.”
A kid who’s learned to reflect on his own learning process, on the other hand, could look at the situation and say, “I always feel like this when I have to work for a long time. Maybe if I take breaks every hour or so I’ll feel less stressed out.” By taking a metacognitive approach, he’s able to manage his frustration and find a better way to approach big assignments in the future.
Great for self-regulation
Metacognitive skills are not only excellent tools for kids who learn differently, and often find themselves struggling to keep up. They also enable kids to self-regulate when faced with challenges, especially unexpected ones.

“One of the most powerful byproducts of metacognitive thinking is increased self-regulation,” says Gladstone.

Being able to self-regulate helps kids manage experiences that might otherwise overwhelm them. For example, take two girls who have to audition for a school play, both of whom are struggling with unusually difficult material.

A girl who is regularly told how talented she is and is used to being praised for her performances is likely to get frustrated and overwhelmed at the sheer thought of performing badly.

But a girl who is praised for her ability to work hard and persevere when she’s faced with a challenge can draw on her metacognitive skills to help her manage her nerves and help her figure out a way of rehearsing that works better for her.

Quieting negative self-talk
Fallout from a fixed mindset often takes the form of self-criticism. The negative feelings kids experience when they feel frustrated easily turn into negative self-talk. “If I’m so smart, why did I fail the test? I’m not smart. I’m useless.”

“When you place your value on being ‘smart,’ anything that makes you feel less than smart is devastating,” says Rosier. “A lot of kids develop a negative inner voice, and they develop it in place of metacognition.”

This negative voice is sneaky, she explains, often masquerading as a coach. “You can mistake self-criticism for motivation. What we want to do is get rid of the negative inner voice and replace it with metacognitive thinking that helps your child find new ways to manage her challenges instead of beating herself up about them.”

How to encourage metacognition 
How do you help your child start becoming more meta?” Metacognitive questions, says Rosier, will help your child begin thinking in a more reflective way. Questions should be:

Open-ended. Give your child some space to reflect on his thinking: Can you tell me more about why you think that?
Non-blaming. It can be hard to stay open when kids are acting out, but asking them to think about their behavior can help them learn to manage difficult situations in a better way: Why do you think you got so upset when Dad changed the channel?
Solution-focused. Encourage him to think about how he can use his understanding to change things in the future: How could you handle that differently next time?
Process-oriented. Ask questions that help your child get a better idea of how his thought process works: How will you know when this drawing is finished?
Be patient
“When you teach kids to think about their behavior differently, they begin to behave differently,” says Rosier. But she warns that it’s important not to expect instant results. Learning to think metacognitively is a process, and parents may have to accept that a lot of the work is happening behind the scenes.

“Of course we want to see progress, but our children — especially teenagers — don’t always share their thinking with us and that’s okay.”

Just asking the questions gets the metacognitive work going internally, even if it’s not visible to the parental eye, Rosier explains. The benefits are the same, she says, even if all you get is a grunt in return.

Learning to learn
Asking questions at home will help kids begin to use metacognitive strategies in their schoolwork, too. For many kids — especially those with learning differences  — this can be harder than it sounds. It’s easy to get bogged down by poor study habits, procrastination, homework meltdowns, and test stress.

If your child is struggling to work through a long paper, ask questions that help him use his metacognitive skills to try a different approach.

What do you think is making it hard for you to work on this paper right now?
What are some strategies that have helped you do well on similar papers in the past?
Can you use those insights to help you with the work you’re doing now?
Asking metacognitive questions will help him clarify his process, manage his anxiety, and find a better way to approach his paper, but the benefits don’t end when the assignment is done.

The more your child is able to understand his learning process the easier it will be for him to figure out what strategies and supports work best for him — knowledge that will help him succeed — both now and as he grows up.

Link:https://childmind.org/article/how-metacognition-can-help-kids/
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Teaching for Effective Learning

Metacognition is the process of thinking about one’s own thinking and learning.


It involves knowing when you know, knowing when you don’t know, and knowing what to do when you don’t know. In other words, it involves self-monitoring and correcting your own learning processes. For example, you engage in metacognition if you notice that you are having more trouble learning concept A than concept B, or if you realize that your approach to solving a problem is not working, and you decide to try a different approach.

Metacognition also involves knowing yourself as a learner; that is, knowing your strengths and weaknesses as a learner. For example, if you can explain what your strengths are in academic writing, or exam taking, or other types of academic tasks, then you are metacognitively aware. Metacognitive processes can be applied to learning and thinking in all disciplines and contexts. It is an essential skill for life-long learning, and therefore, metacognitive skills need to be taught and discussed with students.
Metacognitive approach to supporting student learning involves promoting student metacognition – teaching students how to think about how they think and how they approach learning. Why is this important? It makes thinking and learning visible to students

Link:https://www.queensu.ca/teachingandlearning/modules/students/24_metacognition.html

Putting Metacognition into Practice

Apply basic research on clinical and educational setting


In “Promoting Student Metacognition,” Tanner (2012) offers a handful of specific activities for biology classes, but they can be adapted to any discipline. She first describes four assignments for explicit instruction (p. 116):

Preassessments—Encouraging Students to Examine Their Current Thinking: “What do I already know about this topic that could guide my learning?”
The Muddiest Point—Giving Students Practice in Identifying Confusions: “What was most confusing to me about the material explored in class today?”
Retrospective Postassessments—Pushing Students to Recognize Conceptual Change: “Before this course, I thought evolution was… Now I think that evolution is ….” or “How is my thinking changing (or not changing) over time?”
Reflective Journals—Providing a Forum in Which Students Monitor Their Own Thinking: “What about my exam preparation worked well that I should remember to do next time? What did not work so well that I should not do next time or that I should change?”
Next are recommendations for developing a “classroom culture grounded in metacognition” (p. 116-118):

Giving Students License to Identify Confusions within the Classroom Culture:  ask students what they find confusing, acknowledge the difficulties
Integrating Reflection into Credited Course Work: integrate short reflection (oral or written) that ask students what they found challenging or what questions arose during an assignment/exam/project
Metacognitive Modeling by the Instructor for Students: model the thinking processes involved in your field and sought in your course by being explicit about “how you start, how you decide what to do first and then next, how you check your work, how you know when you are done” (p. 118)
To facilitate these activities, she also offers three useful tables:

Questions for students to ask themselves as they plan, monitor, and evaluate their thinking within four learning contexts—in class, assignments, quizzes/exams, and the course as a whole (p. 115)
Prompts for integrating metacognition into discussions of pairs during clicker activities, assignments, and quiz or exam preparation (p. 117)
Questions to help faculty metacognitively assess their own teaching (p. 119)
Weimer’s “Deep Learning vs. Surface Learning: Getting Students to Understand the Difference” (2012) offers additional recommendations for developing students’ metacognitive awareness and improvement of their study skills:

“[I]t is terribly important that in explicit and concerted ways we make students aware of themselves as learners. We must regularly ask, not only ‘What are you learning?’ but ‘How are you learning?’ We must confront them with the effectiveness (more often ineffectiveness) of their approaches. We must offer alternatives and then challenge students to test the efficacy of those approaches.” (emphasis added)

She points to a tool developed by Stanger-Hall (2012, p. 297) for her students to identify their study strategies, which she divided into “cognitively passive” (“I previewed the reading before class,” “I came to class,” “I read the assigned text,” “I highlighted the text,” et al) and “cognitively active study behaviors” (“I asked myself: ‘How does it work?’ and ‘Why does it work this way?’” “I wrote my own study questions,” “I fit all the facts into a bigger picture,” “I closed my notes and tested how much I remembered,” et al).  The specific focus of Stanger-Hall’s study is tangential to this discussion,1 but imagine giving students lists like hers adapted to your course and then, after a major assignment, having students discuss which ones worked and which types of behaviors led to higher grades. Even further, follow Lovett’s advice (2013) by assigning “exam wrappers,” which include students reflecting on their previous exam-preparation strategies, assessing those strategies and then looking ahead to the next exam, and writing an action plan for a revised approach to studying. A common assignment in English composition courses is the self-assessment essay in which students apply course criteria to articulate their strengths and weaknesses within single papers or over the course of the semester. These activities can be adapted to assignments other than exams or essays, such as projects, speeches, discussions, and the like.

As these examples illustrate, for students to become more metacognitive, they must be taught the concept and its language explicitly (Pintrich, 2002; Tanner, 2012), though not in a content-delivery model (simply a reading or a lecture) and not in one lesson. Instead, the explicit instruction should be “designed according to a knowledge construction approach,” or students need to recognize, assess, and connect new skills to old ones, “and it needs to take place over an extended period of time” (Zohar & David, p. 187).  This kind of explicit instruction will help students expand or replace existing learning strategies with new and more effective ones, give students a way to talk about learning and thinking, compare strategies with their classmates’ and make more informed choices, and render learning “less opaque to students, rather than being something that happens mysteriously or that some students ‘get’ and learn and others struggle and don’t learn” (Pintrich, 2002, p. 223).

Metacognition instruction should also be embedded with the content and activities about which students are thinking.  Why?  Metacognition is “not generic” (Bransford, Brown, & Cocking, p. 19) but instead is most effective when it is adapted to reflect the specific learning contexts of a specific topic, course, or discipline (Zohar & David, 2009).  In explicitly connecting a learning context to its relevant processes, learners will be more able to adapt strategies to new contexts, rather than assume that learning is the same everywhere and every time.For instance, students’ abilities to read disciplinary texts in discipline-appropriate ways would also benefit from metacognitive practice.  A literature professor may read a passage of a novel aloud in class, while also talking about what she’s thinking as she reads: how she makes sense of specific words and phrases, what connections she makes, how she approaches difficult passages, etc.  This kind of modeling is a good practice in metacognition instruction, as suggested by Tanner above.  Concepción’s “Reading Philosophy with Background Knowledge and Metacognition” (2004) includes his detailed “How to Read Philosophy” handout (pp. 358-367), which includes the following components:

What to Expect (when reading philosophy)
The Ultimate Goal (of reading philosophy)
Basic Good Reading Behaviors
Important Background Information, or discipline- and course-specific reading practices, such as “reading for enlightenment” rather than information, and “problem-based classes” rather than historical or figure-based classes
A Three-Part Reading Process (pre-reading, understanding, and evaluating)
Flagging, or annotating the reading
Linear vs. Dialogical Writing (Philosophical writing is rarely straightforward but instead “a monologue that contains a dialogue” [p. 365].)
What would such a handout look like for your discipline?

Students can even be metacognitively prepared (and then prepare themselves) for the overarching learning experiences expected in specific contexts. Salvatori and Donahue’s The Elements (and Pleasures) of Difficulty (2004) encourages students to embrace difficult texts (and tasks) as part of deep learning, rather than an obstacle.  Their “difficulty paper” assignment helps students reflect on and articulate the nature of the difficulty and work through their responses to it (p. 9).  Similarly, in courses with sensitive subject matter, a different kind of learning occurs, one that involves complex emotional responses.  In “Learning from Their Own Learning: How Metacognitive and Meta-affective Reflections Enhance Learning in Race-Related Courses” (Chick, Karis, & Kernahan, 2009), students were informed about the common reactions to learning about racial inequality (Helms, 1995; Adams, Bell, & Griffin, 1997; see student handout, Chick, Karis, & Kernahan, p. 23-24) and then regularly wrote about their cognitive and affective responses to specific racialized situations.  The students with the most developed metacognitive and meta-affective practices at the end of the semester were able to “clear the obstacles and move away from” oversimplified thinking about race and racism ”to places of greater questioning, acknowledging the complexities of identity, and redefining the world in racial terms” (p. 14).

Ultimately, metacognition requires students to “externalize mental events” (Bransford, Brown, & Cocking, p. 67), such as what it means to learn, awareness of one’s strengths and weaknesses with specific skills or in a given learning context, plan what’s required to accomplish a specific learning goal or activity, identifying and correcting errors, and preparing ahead for learning processes.

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1 Students who were tested with short answer in addition to multiple-choice questions on their exams reported more cognitively active behaviors than those tested with just multiple-choice questions, and these active behaviors led to improved performance on the final exam.

Link: https://cft.vanderbilt.edu/guides-sub-pages/metacognition/

Metacognition

Thinking about One’s Thinking


Metacognition is, put simply, thinking about one’s thinking.  More precisely, it refers to the processes used to plan, monitor, and assess one’s understanding and performance. Metacognition includes a critical awareness of a) one’s thinking and learning and b) oneself as a thinker and learner.
Initially studied for its development in young children (Baker & Brown, 1984; Flavell, 1985), researchers soon began to look at how experts display metacognitive thinking and how, then, these thought processes can be taught to novices to improve their learning (Hatano & Inagaki, 1986).  In How People Learn, the National Academy of Sciences’ synthesis of decades of research on the science of learning, one of the three key findings of this work is the effectiveness of a “‘metacognitive’ approach to instruction” (Bransford, Brown, & Cocking, 2000, p. 18).

Metacognitive practices increase students’ abilities to transfer or adapt their learning to new contexts and tasks (Bransford, Brown, & Cocking, p. 12; Palincsar & Brown, 1984; Scardamalia et al., 1984; Schoenfeld, 1983, 1985, 1991).  They do this by gaining a level of awareness above the subject matter: they also think about the tasks and contexts of different learning situations and themselves as learners in these different contexts.  When Pintrich (2002) asserts that “Students who know about the different kinds of strategies for learning, thinking, and problem solving will be more likely to use them” (p. 222), notice the students must “know about” these strategies, not just practice them.  As Zohar and David (2009) explain, there must be a “conscious meta-strategic level of H[igher] O[rder] T[hinking]” (p. 179).

Metacognitive practices help students become aware of their strengths and weaknesses as learners, writers, readers, test-takers, group members, etc.  A key element is recognizing the limit of one’s knowledge or ability and then figuring out how to expand that knowledge or extend the ability. Those who know their strengths and weaknesses in these areas will be more likely to “actively monitor their learning strategies and resources and assess their readiness for particular tasks and performances” (Bransford, Brown, & Cocking, p. 67).

The absence of metacognition connects to the research by Dunning, Johnson, Ehrlinger, and Kruger on “Why People Fail to Recognize Their Own Incompetence” (2003).  They found that “people tend to be blissfully unaware of their incompetence,” lacking “insight about deficiencies in their intellectual and social skills.”  They identified this pattern across domains—from test-taking, writing grammatically, thinking logically, to recognizing humor, to hunters’ knowledge about firearms and medical lab technicians’ knowledge of medical terminology and problem-solving skills (p. 83-84).  In short, “if people lack the skills to produce correct answers, they are also cursed with an inability to know when their answers, or anyone else’s, are right or wrong” (p. 85).  This research suggests that increased metacognitive abilities—to learn specific (and correct) skills, how to recognize them, and how to practice them—is needed in many contexts.

Link:https://cft.vanderbilt.edu/guides-sub-pages/metacognition/

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How Metacognition, or Thinking About Thinking, Can Improve the Mental-Health Crisis

Researchers report metacognition therapies, or directing personal thoughts and emotions for the benefit of mental wellbeing, can have positive effects on the treatment of anxiety, depression, and addictions.


In these times of virtual meet-ups, negative news overload and widespread uncertainty, it’s fair to say it has been a tough time for our brains. If you’ve been feeling mentally subpar, you may be floating around the edges or caught in the middle of the cognition crisis. And don’t worry, you’re not alone.

Our world is facing a global mental health crisis, one that is unique to modern times. Neuroscientist and neurologist Adam Gazzaley calls this a problem of “ancient brains in a high-tech world.”

Our brains evolved for a very different environment, and our biological instincts are struggling to keep pace with a sea of information, artificial stimulation and smartphone pings. This has contributed to a worldwide surge in anxiety, depression, addiction and other cognitive issues.

As is often the case, technology comes first and society adapts second. We are learning that surviving and thriving in the modern world requires a better understanding of our mind. This need for “cognition about cognition” brings us to the science of metacognition.
The successes of metacognitive therapy
Computer simulations of cognition are a large focus of the Cognitive Modeling Lab at Carleton University where I work as a researcher while pursuing a PhD in cognitive science. The theme of my research is the use of computational modelling to clarify metacognition. Metacognitive strategies can be thought of as a kind of mental software that can help to improve our cognitive functioning.

From my experience, it is worth looking at the successes of metacognitive therapy. It is unique in the sense that it involves the development of beneficial metacognitive beliefs. In many cases, it has shown to be more effective than cognitive behavioural therapy, another dominant approach taken by therapists.

For example, it can be helpful for someone to believe “I can direct my thoughts and emotions, and it is beneficial for me.” Believing in this possibility is a necessary precursor to action. Metacognitive therapy focuses on building this foundation, and it’s from this firm grounding that people can reach for the specific tools of metacognition.

We are already aware of many of these tools. And yet our practical minds require evidence before committing to them. The improving of attention through mental training or meditation practice works. Likewise, the strategies offered by cognitive behavioural therapy are among the most effective for learning emotional regulation. Particularly useful is the practice of “detached mindfulness” for treating depression and anxiety. Memory strategies have also shown to be productive, including the famous mind palace technique.

It’s time we take care of our minds
Overcoming the cognition crisis partly depends on getting around our mind’s automatic pleasure-seeking. Internally, we can avoid falling into the trap of instant gratification by being mindful of the information and entertainment we consume. Externally, we can craft a physical environment that improves our efficiency and mental welfare. Distraction blocking software offers just one example of how to do this.

We exercise, control what we eat and buy ergonomic desk chairs to take care of our bodies — it’s long past time we take the same care of our minds. There are so many evidence-based actions we can take to design a personalized toolkit of mental habits and strategies. Doing so will allow us to be more deliberate with our thoughts, attention and emotions, which can then improve every aspect of our lives.

Just as human health depends on mastering our own physical systems, the future of cognition depends on understanding and controlling our own psychological states. Solving the cognition crisis requires we get smart about our own minds, and there’s never been a more vital time to do that.

Link:
https://neurosciencenews.com/metacognition-mental-health-19649/
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Metacognition: How Thinking About Thinking Can Help Kids

Metacognition is a big word for something most of us do every day without even noticing: Thinking about our own thoughts. Reflecting on our thoughts is a big part of understanding our feelings and learning new things.When kids hit challenges — a hard math test, a fight with a friend — it can be tempting for them to give up.


When kids hit difficult problems — the seemingly insurmountable English essay, a math test that takes on epic proportions, social struggles that leave them feeling frustrated — it can be tempting to give up and resort to four words no parent ever wants to hear: “I can’t do it.”

In order to thrive, kids need to be able to make the transition from the negative “I can’t” to the proactive  “How can I?”

To do that, they need to think about why they’re stuck, what’s frustrating them, what they would need to get unstuck. They need to think about their own thinking.

There’s a word for that, and it’s metacognition.

Metacognition is a big word for something most of us do every day without even noticing. Reflecting on our own thoughts is how we gain insight into our feelings, needs, and behaviors — and how we learn, manage, and adapt to new experiences, challenges, and emotional setbacks. It’s the running conversation we have in our heads, mentally sounding ourselves out and making plans. Training kids to use it proactively to overcome obstacles, it turns out, can be a powerful tool.

More and more studies are suggesting that kids who are taught to use metacognitive strategies early on are more resilient and more successful, both in and out of school.

“I view metacognition as a goal,” says Marc Gladstone, alearning specialist. “Getting into the habit of using metacognitive strategies early on helps kids become more independent learners and bolsters self-advocacy skills.”

What is metacognition and how does it work?
“Metacognitive thinking teaches us about ourselves,” says Tamara Rosier, a learning coach who specializes in metacognitive techniques. “Thinking about our thinking creates perspective — perspective that leaves room for change.”

She gives an example: “Instead of saying, ‘Math tests make me anxious,’ we’re asking ourselves, ‘What is it about math tests that makes me feel anxious and what can I do to change that?’ ”

Kids who are taught to think of themselves as being “good” or “bad” at a particular task can have a fixed mindset that makes them passive in approaching a challenge: either they can do it or they can’t, but they aren’t likely to think they can change that outcome.

Teaching kids to become more metacognitive helps them move from a mindset that leaves little room for change to a mindset which promotes self-awareness and resilience.

Help for kids with learning issues
Helping your child learn to work through difficult situations (or homework assignments, as the case may be) without becoming overwhelmed or giving up is especially valuable for kids with learning issues who may need to come up with different strategies than other students in the class.

For example:

A child with ADHD who struggles to stay on task is likely to feel frustrated and anxious when he’s assigned a long essay. If he’s unable to reflect on why the project upsets him he might think, “Everyone else is having an easy time. I’m just bad at writing.”
A kid who’s learned to reflect on his own learning process, on the other hand, could look at the situation and say, “I always feel like this when I have to work for a long time. Maybe if I take breaks every hour or so I’ll feel less stressed out.” By taking a metacognitive approach, he’s able to manage his frustration and find a better way to approach big assignments in the future.
Great for self-regulation
Metacognitive skills are not only excellent tools for kids who learn differently, and often find themselves struggling to keep up. They also enable kids to self-regulate when faced with challenges, especially unexpected ones.

“One of the most powerful byproducts of metacognitive thinking is increased self-regulation,” says Gladstone.

Being able to self-regulate helps kids manage experiences that might otherwise overwhelm them. For example, take two girls who have to audition for a school play, both of whom are struggling with unusually difficult material.

A girl who is regularly told how talented she is and is used to being praised for her performances is likely to get frustrated and overwhelmed at the sheer thought of performing badly.

But a girl who is praised for her ability to work hard and persevere when she’s faced with a challenge can draw on her metacognitive skills to help her manage her nerves and help her figure out a way of rehearsing that works better for her.

Quieting negative self-talk
Fallout from a fixed mindset often takes the form of self-criticism. The negative feelings kids experience when they feel frustrated easily turn into negative self-talk. “If I’m so smart, why did I fail the test? I’m not smart. I’m useless.”

“When you place your value on being ‘smart,’ anything that makes you feel less than smart is devastating,” says Rosier. “A lot of kids develop a negative inner voice, and they develop it in place of metacognition.”

This negative voice is sneaky, she explains, often masquerading as a coach. “You can mistake self-criticism for motivation. What we want to do is get rid of the negative inner voice and replace it with metacognitive thinking that helps your child find new ways to manage her challenges instead of beating herself up about them.”

How to encourage metacognition 
How do you help your child start becoming more meta?” Metacognitive questions, says Rosier, will help your child begin thinking in a more reflective way. Questions should be:

Open-ended. Give your child some space to reflect on his thinking: Can you tell me more about why you think that?
Non-blaming. It can be hard to stay open when kids are acting out, but asking them to think about their behavior can help them learn to manage difficult situations in a better way: Why do you think you got so upset when Dad changed the channel?
Solution-focused. Encourage him to think about how he can use his understanding to change things in the future: How could you handle that differently next time?
Process-oriented. Ask questions that help your child get a better idea of how his thought process works: How will you know when this drawing is finished?
Be patient
“When you teach kids to think about their behavior differently, they begin to behave differently,” says Rosier. But she warns that it’s important not to expect instant results. Learning to think metacognitively is a process, and parents may have to accept that a lot of the work is happening behind the scenes.

“Of course we want to see progress, but our children — especially teenagers — don’t always share their thinking with us and that’s okay.”

Just asking the questions gets the metacognitive work going internally, even if it’s not visible to the parental eye, Rosier explains. The benefits are the same, she says, even if all you get is a grunt in return.

Learning to learn
Asking questions at home will help kids begin to use metacognitive strategies in their schoolwork, too. For many kids — especially those with learning differences  — this can be harder than it sounds. It’s easy to get bogged down by poor study habits, procrastination, homework meltdowns, and test stress.

If your child is struggling to work through a long paper, ask questions that help him use his metacognitive skills to try a different approach.

What do you think is making it hard for you to work on this paper right now?
What are some strategies that have helped you do well on similar papers in the past?
Can you use those insights to help you with the work you’re doing now?
Asking metacognitive questions will help him clarify his process, manage his anxiety, and find a better way to approach his paper, but the benefits don’t end when the assignment is done.

The more your child is able to understand his learning process the easier it will be for him to figure out what strategies and supports work best for him — knowledge that will help him succeed — both now and as he grows up.

Link:
https://childmind.org/article/how-metacognition-can-help-kids/

3 Takeaways From the Latest Emotional Intelligence Study

A new review paper shows the secrets to success of having a high EQ.


You’ve undoubtedly heard of the concept of “emotional intelligence,” or “EQ.” It took hold in the 1990s and has only continued to attract the attention of both everyday people and academic psychology. Claims about its contribution to success in life, announced even before its heyday, still remain somewhat controversial, however. In part, this is because the concept has become so blurry and all-encompassing that some of the original subtleties in its definition have since become long lost.
To understand whether EQ really matters for life success, it’s necessary to dig down deep into its original meaning and then take a clear-headed look at the available research. Fortunately, this is now possible due to the publication (in press) of a new major review article that does just that.
What Is Emotional Intelligence?
According to this new paper headed up by UCLouvain’s Thomas Pirsoul and colleagues (2023), this blurring of definitional lines is a major problem in evaluating EQ’s role in promoting life success. In their words, the “plethora of definitions and conceptualizations” can be categorized into two main areas: EQ as a trait-like quality or ability (personal resources approach) and EQ as a behavioral disposition that helps people feel better about their ability to navigate emotional situations (self-efficacy approach).
From the standpoint of EQ’s role in promoting life success, the Belgian authors narrowed their search through the vast literature to studies specifically focused on career. If EQ helps promote career success, it would do so by “developing awareness of one’s emotions” (p. 3). Defined as a general form of adaptive functioning, EQ allows people to “identify, understand, express, regulate, and use one’s own and others’ emotions” (p. 2).
Think now about people you would consider high in EQ. Perhaps you know someone at work, or who works with someone you’re close to, whom you regard as not just friendly but also sensitive, kind, and willing to listen. You trust this individual to show consideration to you but also to make good choices in their own life. They seem confident but not conceited, and you’ve seen them progress through their career in ways that you admire. Importantly, they are liked both by coworkers and supervisors, meaning that their progress up their career ladder seems that it should be easier for them than is true for most people.
EQ and Job Success
The route from high EQ to career ladder progression, as the UCLouvain authors propose, is charted through the intermediary step of adaptability. As you no doubt know from your own life experiences, being adaptable means that you can anticipate problems and then cope with them once they arise. If you are high in EQ, you can use your emotions to guide yourself through these difficulties.
High self-efficacy can build upon the strengths gained through career adaptability by helping individuals feel more confident about their ability to navigate work-related decisions. If you can, as high EQ implies, listen to your “gut,” you’ll feel that you have a more accurate career compass.
Self-efficacy can also contribute to an individual’s confidence in their so-called “entrepreneurial” skills. The belief that you can sell yourself, which is part of this skill, can help you be a more effective communicator of your own personal strengths. You might also be better able to read people, making you a better negotiator. Finally, you could be better able to launch new ventures based on EQ’s role in helping you manage the stress associated with striking out on your own.
The ability to manage stress becomes its own contributor to occupational success for those high in EQ. There are many situations in work settings, from job interviews to performance evaluations, in which people have to exert effort as they try to keep their stress down to manageable levels.
In evaluating the contribution of all of these factors to career success, the authors contrasted two theoretical models. In the trait or resource model, EQ alone would be enough to predict the objective favorable career-related outcome of salary and the subjective outcomes of feelings of job and career satisfaction. If career adaptability and self-efficacy serve as the intermediary influences on these outcomes, then this would support a model in which factors involving these two components are statistically better predictors than EQ is on its own.
After extracting data from more than 150 samples representing nearly 51,000 participants, Pirsoul and his collaborators concluded that the behavioral, rather than the trait or resource model, proved to have the strongest relationship to measures of objective and subjective career success. Supporting what they call the “career self-management model,” these findings show that people high in EQ do well because they are higher in self-efficacy. Supporting the “career construction model,” the findings also showed that people high in EQ do well because they can adapt to their circumstances, and they can also make better career decisions.
One set of findings also provided intriguing support for the notion that people high in EQ are lower in career turnover intentions, meaning that they are less likely to decide to quit their jobs or abandon their careers. Their greater self-understanding means that they choose a pathway that will be consistent with their needs and interests. Their better emotional self-regulation could also make them less likely to have problems with their coworkers and supervisors, going back to the idea that people high in EQ are just nice to have around.
Supporting the idea that EQ can continue to grow in adulthood, as is evident from prior research, the effect sizes for EQ and career outcomes were stronger for older samples included in the meta-analysis. It is possible that as people gain greater self-understanding, their EQ growth is reflected in these career adaptability and self-efficacy dimensions.
3 Ways to Get EQ to Work for You
These three takeaways from this study suggest that IQ is more than just a popular idea without academic merit:
1.People high in EQ do well in their careers, not just because they possess an overall higher level of knowledge about themselves but also because they know how to make good decisions and can approach work-related challenges with expectations that they can succeed. They also have greater internal self-awareness, allowing them to have a better idea of what they want out of their work lives. They can also negotiate with others more effectively, meaning that they are both better collaborators and also better strategists.
2.The UCLouvain study focused on work and, therefore, wouldn’t have direct applicability to relationships or other areas of adult life. However, given the importance of satisfaction with and success in one’s work role, it would make sense that the EQ findings would have favorable implications for well-being in general. There is extensive evidence throughout the career–family literature showing that satisfaction at work is related positively to satisfaction with one’s home life.
3.The final important conclusion of this study was the view that EQ isn’t a “thing” that you have or don’t have. Although high EQ may help improve an individual’s adaptability and self-efficacy, these latter two components of the Belgian model are behavioral in nature and, therefore, can be acquired.
To sum up, if you’re not naturally high in EQ, the Pirsoul et al. findings suggest that by using the skills that high-EQ individuals seem to have cultivated, you can find fulfilling outcomes in your most important life pursuits.

reference:
psychology today

link:
https://www.psychologytoday.com/intl/blog/fulfillment-at-any-age/202305/4-takeaways-from-the-latest-emotional-intelligence-study
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Cerebellum Stimulation Boosts Older Adults’ Episodic Memory

New research shows how noninvasive neurostimulation of the right cerebellum improves episodic memory and may offset age-related cognitive decline.


For centuries, the cerebellum was considered a motor-function-only brain region that coordinated smooth and accurate muscle movements but didn't play a role in cognition. Most neuroscientists didn't think the cerebellum played a role in nonmotor brain functions or cognition until the late 1990s, after Jeremy Schmahmann identified and coined the term cerebellar cognitive affective syndrome in 1998.
Before 1998, damage to the cerebellum was primarily associated with motor syndromes like cerebellar ataxia and dysmetria.
Since the early 2000s, accumulating evidence suggests that different microzones within the left and right cerebellar hemispheres play a vital role in optimizing how the whole brain works in concert to facilitate higher executive functions like working memory, linguistic processing, spatial cognition, social mentalizing, and emotion regulation.
Much like the cerebellum coordinates smooth, fluid movements and promotes superfluid athletic performance, different parts of the cerebellum's left and right hemispheres help to coordinate thought processes and may facilitate superfluid thinking.
For years, we've known that damage or deterioration of certain cerebellar regions affects the whole brain's cognitive capacity and can result in what Schmahmann calls "dysmetria of thought." Now, new research suggests that stimulating the right cerebellum enhances the brain's ability to learn and remember.
Stimulating the Right Cerebellum Improves Episodic Memory
A new study (Almeida et al., 2023) into the cerebellum's role in cognitive functions found that stimulating the right cerebellar hemisphere with anodal transcranial direct current stimulation (tDCS) improves episodic memory in older adults over age 60. These findings were recently published in the peer-reviewed journal GeroScience.
"Here, we show that the cerebellum plays a causal role in episodic memory performance and aging-related [cognitive] decline and that age-related episodic memory decline can be reduced in a long-lasting way with neurostimulation to the right cerebellum," the authors explain.
For this 12-day study, first author Jorge Almeida and colleagues randomly assigned study participants to one of four groups. Only one group received anodal tDCS to the right cerebellum for 12 days. Another group received anodal tDCS to the left prefrontal cortex during this time. The remaining groups were used as controls and didn't receive actual tDCS neurostimulation but instead were put on a waitlist or received sham tDCS treatment.
The researchers tested participants' verbal episodic memory using the Free and Cued Selective Reminding Test (FCSRT) at three different time points: before the study began, one day after the 12-day study ended, and four months after the study concluded.
Notably, those who received anodal tDCS to the right cerebellum were the only participants with significantly better FCSRT scores immediately following 12 days of neurostimulation and four months later at a follow-up evaluation.
"Memory performance enhancement greatly outlasts the [12-day] stimulation period," the authors explain. "Moreover, all individuals in the right cerebellum anodal tDCS experimental group showed memory performance improvements at the follow-up evaluation time [four months later]."
Neurostimulation of the Right Cerebellum Enhances Memory-Related Connectivity
Interestingly, Almeida et al. found that subcortical anodal tDCS to the right cerebellum improved its structural and functional connectivity with the hippocampus and other cortical brain regions involved in episodic memory.
As the authors explain, "Immediate effects of tDCS to the right cerebellum on the functional connectivity of the hippocampus were observed over a series of regions that are majorly involved in many of the processes that are central to episodic memory, and thus are important to sustain enhancements of episodic memory performance."
The Main Takeaways From This Study
Stimulating the right cerebellum improves episodic memory in older adults for at least four months after a 12-day treatment. Noninvasive anodal tDCS to the "little brain" also changes the cerebellum's functional and structural connectivity with the hippocampus and other cortical regions in the episodic memory network.
The authors conclude that neuromodulation of the right cerebellum can improve long-term episodic memory. They also posit that these findings demonstrate a "causal role of the cerebellum in high-level cognitive processes—specifically in episodic memory."
In an April 2023 news release, Almeida summarizes the clinical implications of his team's latest findings: "[Our] work opens up the possibility of developing non-pharmacological interventions to ameliorate typical age-related cognitive frailty that induce long-lasting improvements that, at least, outlast the four months tested herein."
Optimizing Connectivity Between All Four Brain Hemispheres
For decades, I've been fascinated with how the right and left cerebellar hemispheres work in concert with the cerebrum's "left brain-right brain." As a young right-handed tennis player, my neuroscientist father taught me that the right cerebellum works with the left cerebral hemisphere to control the right side of the body.
During my years as a professional athlete, I was always intrigued by the crisscrossed connectivity between the cerebral and cerebellar hemispheres as it relates to superfluid coordination and peak performance. (See The Split-Brain: An Ever-Changing Hypothesis.)
In 2009, I drew a brain map (see illustration, left) using some highlighters and Sharpies that showed a birds-eye view of all four brain hemispheres squished down onto a two-dimensional plane. The yellow and green bidirectional arrows form a "Super 8," illustrating how structural and functional connectivity might flow between all four hemispheres in ways that help the whole brain function better.
Looking at this brain map through the lens of Almeida et al.'s latest (2023) research, it seems plausible that targeting the right cerebellum kickstarts a chain reaction that enhances structural connectivity between different hemispheres and, in doing so, helps to optimize whole-brain functionality.

reference:
psychology today

link:
https://www.psychologytoday.com/intl/blog/the-athletes-way/202305/cerebellum-stimulation-boosts-older-adults-episodic-memory
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False Memories and Memory Enhancement: Neuroscience Insights

Factors that contribute to memory errors, and steps to improve memory


Have you ever left your keys in a spot where you were sure you would remember, only to forget and have to retrace your steps? Or, have you ever vividly remembered an event that never actually happened? These everyday experiences highlight the fallibility and reconstructive nature of human memory. Fortunately, new neuroscience research is helping us understand the underlying mechanisms of memory formation and identify ways to enhance memory retention while avoiding the formation of false memories.
False Memory: What Is It?
Human memory is fallible, and people can easily remember events that never occurred or remember them differently from how they happened. A person can produce a false memory when a person to post-event information somewhat consistent with the original memory. For instance, showing a series of photos, participants who viewed a photograph of a stop sign may later falsely recall seeing a yield sign instead. The false memory was instigated when they were told that a yield sign was actually in the images.
Neural Mechanisms Involved in False Memory Formation
The hippocampus is a brain region critical for forming, consolidating, and retrieving memories. Recent research has shown that hippocampal activity can predict false memory formation. For example, St. Jacques, Wittmann, Singh, and Daselaar (2021) used functional magnetic resonance imaging (fMRI) to investigate how neural activity in the hippocampus relates to forming false memories. Participants viewed a series of images and were later given false information about the images. The study found that people with high levels of cross-stage neural pattern similarity in the hippocampus were more likely to form false memories based on inaccurate information.
Shao, Chen, et al.'s (2023) research on predicting false memory derived from post-event inaccurate information using fMRI data showed that the hippocampus plays a central role in forming false memories. Precisely, patterns of neural activity in the hippocampus can predict the likelihood of developing a false memory. Furthermore, this research shows that the hippocampus, a region critical to memory formation, is also a source of memory errors when exposed to post-event information.
Factors Contributing to Memory Distortion
Post-event information can interfere with the original memory and produce a false memory similar to, but not identical to, the event itself. Several factors can influence the extent to which post-event information affects memory. These include:
1.The time delay between the actual event and the post-event information.
2.The degree of similarity between the post-event information and the actual event.
3.Individual factors such as age, personality, and cognitive abilities.

The research provides valuable information on the factors contributing to memory distortion, with conclusions such as time delay and similarity between post-event information and the actual event essential factors influencing memory accuracy. Thus, these factors should be considered when thinking about memory recall and strategies to improve memory retention and retrieval.
Tips for Improving Memory Retention
While false memory can be a frustrating experience, there are several strategies you can use to enhance memory retention and accuracy:
1.Engage in physical exercises, as studies show that it may help improve cognitive abilities and memory functions.
2.Study in short sessions with frequent breaks rather than trying to learn everything in one go.
3.Use mnemonic devices, visualization, and other memory aids to help you remember information effectively.
4.Get adequate sleep each night, as sleep is critical to consolidating memories.
5.Stay focused on the event and give a detailed description of events right after it happened.
Conclusion
The studies above indicate that human memory is a complex and nuanced cognitive ability prone to errors and inaccuracies. The insights offered by these studies are critical to our understanding of how the brain functions and how we can enhance our memory performance, particularly in situations where memory accuracy is essential, such as eyewitness testimony in legal settings. By continuing to explore the neural mechanisms underlying memory formation and conducting further research into strategies for improving memory accuracy, we can better understand the complexities of human memory and develop effective interventions for individuals who suffer from memory deficits.

reference:
psychology today

link:
https://www.psychologytoday.com/intl/blog/love-your-life/202305/false-memories-and-memory-enhancement-neuroscience-insights
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How to Give Advice Your Children Will Listen to and Follow

Carefully consider what you say and how you say it.


As parents, you will advise your children throughout their lives, and you will likely feel that certain advice is especially critical for your children to hear. But how can you ensure that your child will listen to your messages? What follows is context for understanding some of the factors that can affect your children's receptivity to guidance, as well as some suggestions about ways you can communicate to promote their listening.
One quality that constitutes good counsel is presenting your children with possible actions they might implement that fit their character or personality. Most of us have had the opportunity to witness peers or colleagues handle situations in ways we admire but that feel foreign to us. When you present solutions to your children, consider the temperamental or maturational differences between you and them that might make your suggestions difficult to enact. While you want to stretch your children's capacity to try different problem-solving solutions, it’s important that the solutions you offer aren’t ones they will be unlikely to use.
You may also think there is one optimal way your children should respond in a given situation, especially if you believe that their responding any differently would encourage someone to mistreat them. Although you may be right, remember that you are in this for the long haul. You are not just trying to give the best advice in the moment, but cultivating in your children the necessary skills to make good decisions down the road when you might not be around to influence their actions. To encourage reasonable and healthy risk-taking, it is important to communicate that their minor missteps are not tragedies. Help them know that your goal for them is autonomous, thoughtful problem-solving that they reflect upon and revise accordingly.
How advice is delivered often determines the likelihood that it will be used. Because most of us don't want to hear what we're doing wrong, the manner in which our flaws are pointed out to us is critical. For many, hearing implications that there was no possibility of a positive outcome due to their actions leaves them feeling ashamed or put down. Even great advice will likely be ignored if it is delivered with overtones of shaming, contempt, or derision.
Some people are more sensitive than others to feedback when the delivery is perceived to be harsh. Think whether, in offering your children advice, you are intimating something fixed about their character that will shift their focus from the corrective action you want them to take and make them focus instead on what a disappointment they think they are to you. You don't want your child's attention divided between taking and implementing your present advice and defending their past actions.
Are you a parent who communicates your judgment of others openly? If so, your children will quickly learn the criteria for your praise and criticism. They will also grow to know what you think about their actions. It will not matter if you openly express your opinions or not. This is called vicarious learning, and parents frequently teach in this way, though often unknowingly. For example, if your children watch you dismiss or think little of people you believe are lazy, they will know, when you casually suggest that they don’t seem very goal-directed or as interested in doing well, that your words are code for “lazy” and that laziness disgusts you.
How best, then, to present your feedback? For starters, try to avoid words like “always” or “never” —they are extreme and absolute, and there are usually exceptions that make such statements untrue. As I have recommended in earlier posts, it’s helpful to begin with a soft start-up that does not place blame. Start with expressions like “You may not have realized it,” “I wonder if,” and “Do you think things would have turned out differently if…?”
Also, if you know reasons that would make your child less likely to take your advice, it’s a good idea to address those reasons from the outset. For example, if they fear you are undercutting their autonomy, then be clear that that is not your intention. This helps dispel any misperceptions about why you are offering your guidance.
If you would like your children to consider other options than the ones they seem inclined to pursue, consider gentle reflecting questions like these: “What's your goal?” “What are you hoping will happen?” “Is there something that you're hoping for in the other person’s response?” “Do you think they will be receptive?” “Have you thought of how you will feel if they're not receptive?” “Will it bother you?”
As your child gets older, you can be more explicit with them about your intentions and ask them directly about the best ways for you to offer advice. For example, “You know that my wish as a parent is to help you navigate tricky situations with more ease and success than I did. But I also realize that I may not always offer advice in ways you like. Can you give me an idea of what approach works best for you?” Any of these scripts are drafts that you can change to sound truer to your own voice. And just as I am suggesting that your children may not come up with the perfect solution for any given situation, you may not either in terms of how you offer them advice.
And remember to check in with your children later to see how things worked out. Besides asking them whether their strategy was successful, you can also ask if there is something more you could have done or said to be supportive. You, too, will get better at this with time.

reference:
psychology today

link:
https://www.psychologytoday.com/intl/blog/school-culture/202305/how-to-give-advice-your-children-will-listen-to-and-follow

How to Reset a Broken Relationship

Relationship rifts are unpleasant, but new research shows how to push reset.


Relationships inevitably involve disappointment and mistakes. In a close relationship, it is highly likely that, at some point or another, one partner will inadvertently offend the other, creating a rift that may seem unfixable. Even small lapses from good harmony can throw things off.
Perhaps you asked your partner to comment on the new prescription sunglasses you just bought, which are, by definition, not returnable. Instead of giving you the rave reviews you were hoping for, your partner comes up with a mocking critique that is unhelpful and insulting to your general level of taste and fashion. Deflated, you walk out the door and try to find a way to cheer yourself up, but the comment penetrates too deeply.
Even in relationships that are not necessarily “close,” there can be disappointments and failures. A healthcare provider fails to address your questions with respect and courtesy, or the customer support representative at the other end of the phone line gives you a snappy comeback to your request for service. You need what you’re trying to get from them, so how can you get over your feelings of betrayal?
The Nature of a Broken Relationship
A newly-published study by University of Toulouse’s Lars Meyer-Waarden and University Jean Moulin Lyon’s William Sabadie (2023) on service breakdowns in the hospitality industry provides an excellent model for understanding what goes on when some type of failure threatens a relationship. In the case of this industry, you can only imagine how many relationships can verge on the brink of destruction. Food is overcooked at restaurants, airline computer systems break down, and hotel rooms are untidy, just to name a few possibilities. Indeed, the authors noted, “because of the ‘people factor,’ service failures in the hospitality sector are inevitable.”
Thinking now about a “people failure” you’ve experienced, what could the company have done to bring you back into the fold? According to the French authors, it all depends on relationship quality (RQ) and strength. On the one hand, you may be more forgiving when you’re basically loyal to a given company or brand. However, countering this may be the greater sense of betrayal when a company you’ve supported for years or decades fails to deliver.
Bringing this back into the sphere of close interpersonal relationships, you can see where there can be useful parallels. It can be helpful to know what to ask for when your partner lets you down; just as useful is knowing what you can do when you’re the one who’s failed.
Testing a Model of Relationship Reparation
In their investigation of reparation efforts by hospitality companies, Meyer-Waarden and Sabadie contrasted offers of refunds vs. vouchers and apologies/offers delivered by phone or in writing. RQ served as the other predictive factor. These effects were contrasted with their impact on customer responses through a sense of perceived justice.
Drawing on past theory and research, the French researchers proposed that this sense of justice would be at the heart of a dismayed consumer’s feelings after being let down; in their words: “perceived justice explains how people react when faced with conflict-laden situations.” You expect, then, that people will treat you fairly, whether it’s your close partner or a service agent on the other end of the phone line. If a relationship is going to be repaired, that sense of justice must be restored.
RQ, in turn, was defined in this study in ways that are perfectly consistent with theories of close relationships; namely, that a relationship’s quality is higher when those involved in it feel satisfied, can trust each other, are committed, expect the relationship to continue, and are willing to invest in it. Like close relationships, too, individuals seek to express their needs and become attached to certain brands.
The authors tested their model by presenting online participants with a scenario in which they received poor service from a restaurant serving them on an important occasion. At “Chez Toni’s,” they had to wait for a table despite having a reservation, received cold meals, and were not treated well by their server. The experimental conditions varied by the length of the relationship (how many times they were told they had eaten there before), the amount of reparation, and the nature of the contact in which the restaurant manager offered the reparation.
To measure perceived justice, the research team asked participants to rate whether the restaurant's response was just, balanced, and appropriate. Measures of RQ included ratings of satisfaction, trust, and loyalty intention.
The findings supported the study's overall framework in that high RQ predicted the extent to which reparation efforts on the part of the restaurant worked to restore loyalty. Customers who valued their relationship with the restaurant, in general, were more forgiving. However, to ensure complete restoration of loyalty, they also had to perceive that the restaurant manager was willing to go through considerable effort to win them back. As the authors concluded, “It is only when complainants are treated with courtesy and respect through personal phone calls that distributive justice has a positive effect on justice perceptions.”
What’s Needed for Relationship Reparation to Work
From the French study, it is clear the sense of justice is fundamental to a good relationship. When your partner insults your taste, this violates your belief that your partner will treat you respectfully. As the findings suggest, whether you can get over this sense of violation depends on what your partner does next and whether it rises to the level of sufficiently recognizing the harm that’s been done. The apology, in other words, needs to fit the crime both in amount and intensity.
In the case of the sunglasses example, this may seem like a small offense in the larger scheme of things, and your partner may not even be aware of how much it’s hurt you. As the aggrieved party, it would therefore be important for you to communicate your feelings. After doing so, you might want to prepare yourself to accept the reparation your partner offers.
All of this can be reversed, as you might imagine, in case you caused the relationship rift. Being willing to listen to your partner’s feelings of injustice and then offering a sincere apology can help pave the way back to harmony.
To sum up, relationship rifts are unpleasant and inevitable, but they don’t have to be permanent. Knowing how to restore justice can help you leave those rifts behind and strengthen your relationship’s bonds of loyalty and commitment.

reference:
psycholory today

link:
https://www.psychologytoday.com/intl/blog/fulfillment-at-any-age/202304/how-to-reset-a-broken-relationship
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The effect of psychotherapy on functional medical disorders

You may need medication, physical therapy, surgery, and so on. Psychotherapy can be a vital part of holistic treatment for all patients with medical conditions.


Functional somatic disorders are common and costly, thereby driving the need for the development of effective brief treatment options. many studies showed that  psychotherapy is a valid treatment option for diverse functional somatic disorders conditions resulting in somatic symptom reductions that persist over time. So psychotherapy should be included in functional somatic disorders treatment guidelines.
"The need for innovations in mental health to improve access and quality of care is urgent," said lead author Dr. Paul Kurdyak, Director of Health Outcomes and Performance Evaluation in the Institute for Mental Health Policy Research at CAMH and lead of the Mental Health and Addictions Research Program at ICES. "But increasing the number of specialists who provide psychotherapy alone will not solve the existing problem of poor access to psychotherapy in a publicly-funded system."
Psychotherapy is an evidence-based treatment for conditions like depression and anxiety, two of the most common psychiatric disorders. Treatment guidelines suggest that structured, evidence-based therapies like Cognitive Behavioural Therapy (CBT) should be a front-line treatment option for patients with mild to moderate depression or anxiety.
"Evidence-based psychotherapy should be available to all patients suffering from the most prevalent mental disorders," said Dr. Kurdyak. 

These Feelings Predict Divorce 7 Years Later

New research examines the link between ambivalence and marital satisfaction.


Ambivalence refers to the presence of both positive and negative evaluations of a person or relationship. It is prevalent in close and intimate relationships (e.g., girlfriend/boyfriend, husband/wife).
Ambivalence is associated with significant stress. Why? Perhaps because feeling both love and hate toward a close other causes uncertainty about the stability and future of the relationship.
Could these feelings of doubt and anxiety predict breakup and separation? Yes, according to recent research published in the Journal of Social and Personal Relationships.
The study, by Surjadi et al. concluded that ambivalence is associated with significant marital conflict and is predictive of divorce seven years later.

Investigating Relationship Ambivalence as a Predictor of Divorce
Data used in this research came from a sample of couples with young adult children who had participated in the Iowa Midlife Transition Project (MTP).
These families were initially part of the Iowa Youth and Family Project (IYFP), which included 451 married couples with a child in the seventh grade.
The present investigation used data collected between 1994 (when the children were in the 12th grade) and 2001.
Sample: Three hundred seventy heterosexual couples and their families; mean age of 43 years old for wives and 45 years for husbands; all Caucasian; married for an average of 23 years.
Measures (sample items in parentheses)
Marital Ambivalence: Four items (How often does your spouse make you feel he/she really cares about you?).
Marital conflict: Assessed based on reports from the couples’ adult children (How often would you say your parents argue or disagree with each other?).
Marital satisfaction: Two items asking how happy and satisfied both romantic partners were with the marriage.
Marital instability: The five-item short form of the Marital Instability Index (Have you discussed divorce or separation with a close friend?).
Divorce: Whether the couple separated.

Ambivalence predicts marital conflict and divorce.
Analysis of the data showed:
Shared ambivalence “predicted divorce seven years later through its association with couples’ marital conflict.”
Compared to those who stayed together, “spouses who eventually divorced were more ambivalent toward each other and had greater marital conflict.”
The negative effects of ambivalence were present even in spouses who chose to stay together. Indeed, shared ambivalence correlated with “greater marital conflict and lower couple-level marital satisfaction.”
At the individual level, wives’ and husbands’ own ambivalence (rather than their partners’ or shared ambivalence) was associated with worse assessments of marriage, such as reduced happiness, lower marriage satisfaction, and a greater desire to end the relationship.
These findings agree with the socioemotional selectivity theory, which suggests that as we age, our goals change, and we become more selective.
Specifically, older people pursue:
*fewer future-focused goals (e.g., making new friends)
*more present-focused goals (e.g., meaningful interactions with one’s partner).
Such increased selectivity tends to require disengaging from romantic relationships that are ambivalent and associated with conflict and distress.

Takeaway
Feelings of ambivalence in marriage are predictive of relationship conflict and divorce, and in couples who do not separate, they are predictive of lower happiness and marital satisfaction.
Given these findings, it would be wise to screen married clients for ambivalence and, as necessary, provide interventions at the individual and couple levels:
At the individual level, therapists can teach husbands and wives how to identify their own ambivalent feelings and use effective strategies to manage them.
Therapists could address shared ambivalence at the couple level, helping couples become more confident in their shared decision-making.
This is important because there is significant interdependence between how ambivalent husbands and wives report feeling; this may result from spouses reinforcing each other’s views, feelings, and behaviors (e.g., the push-pull dynamic). For instance, one partner becoming ambivalent may push the other partner who was already ambivalent toward ending the relationship.
A third way therapists can help is by teaching couples effective conflict resolution skills since the ability to resolve marital conflicts (e.g., through engaging in positive and cooperative behaviors) predicts marital satisfaction.

reference:
psychology today

link:
https://www.psychologytoday.com/intl/blog/finding-a-new-home/202302/these-feelings-predict-divorce-7-years-later

How to Talk About Mistakes in a Romantic Relationship

Talking about errors can make a difference in how a couple feels.


When I teach my class on the psychology of close relationships, at some point I get around to talking about the “not so bright and shining” moments that partners have. You know, those moments when someone inevitably takes a wrong turn and does something that’s likely to feel upsetting to their partner. To be clear, even though not all misdeeds are inevitable, it’s a certainty that, generally speaking, an offense of some type or another will happen because we’re all human and everyone makes mistakes.
For instance, perhaps you promised to do your partner a favor and then lost sight of it. Maybe you’re regretting those inconsiderate words you uttered a couple of days ago. Or your partner might have been really opening up to you in a vulnerable way, but you closed up and weren’t listening. No matter whether we’re talking about a mistake that’s more significant or a smaller misstep, stumbles are going to happen in a couple's journey together and, as long as that couple chooses to remain together, it’s healthy and important to be able to repair hurts in an effective way.
This brings us to the question of how couples might be able to fruitfully repair interpersonal wounds. In a recently published study, a team of researchers examined this question as they created a new questionnaire with the idea of “co-rumination” in mind. Co-rumination is “the extended and or recurring discussion of issues in social relationships.” They drew upon past psychological research suggesting that how an individual person thinks about difficult experiences is linked with that person feeling better or worse. More specifically, they referred to two concepts that have been linked to the idea of rumination: Reflection and brooding. Reflection involves thinking about the problem to try and work it out, whereas brooding involves repeating the same types of thoughts about what’s wrong and how upset a person feels, and magnifying the problem.
As you can probably guess, the former is useful and gets you somewhere, and the latter can be harmful, even though it can seem compelling. Although these elements of rumination have been applied to relationships (that is, co-reflection and co-brooding being two sides of co-rumination), the research team pointed out that these ideas haven’t really been used to understand how romantic partners might talk in the wake of a misstep and whether co-reflection and co-brooding may be connected to how the conversation goes.
First, they created and studied a measure of co-rumination and found that it mapped onto three forms of communication: Co-reflection, co-brooding, and co-avoidance. Co-reflection involved trying to reach a shared understanding and address an issue, whereas co-brooding involved focusing on one’s own views and feelings and not making headway on an issue. Co-avoidance involved staying away from the issue altogether. Then, the research team looked at how these three elements were connected with how partners feel after discussions about relationship mistakes. Co-reflection was the only style that was linked with better experiences for partners, such as more dedication to the relationship, more goodwill, and a person’s ability to truly take responsibility and forgive themselves. For co-brooding and co-avoidance, these styles were connected to experiences such as less goodwill, more vindictiveness, less dedication, and less of a capacity to really take responsibility and pardon oneself.
Certainly, no study is perfect. The team correctly highlighted the need for more research with more diverse groups of people. Also, the investigators were right to state that their research doesn’t make it possible to say that co-reflection, co-brooding, or co-avoidance causes a particular outcome, and other studies should clarify the link between how partners talk about relationship errors and what emerges from their conversations. All the same, given that co-reflecting is connected with more beneficial experiences for partners, it’s probably not a bad idea to try it the next time you and your partner are addressing a stumble and hurt feelings.

What could this look like? Based on the team’s research and their questionnaire, here are some possible ideas:
1.Try to really acknowledge, accept, and support how your partner feels (for example, hurt, hopeful, scared, angry, sad, confused).
2.Try to set aside your own position for a moment. Instead, try to really listen to your partner and see if you can understand where they’re coming from.
3.Try to be open and receptive to your partner in the conversation.

reference:
psychology today

link:
https://www.psychologytoday.com/intl/blog/your-future-self/202304/how-to-talk-about-mistakes-in-a-romantic-relationship
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Geriatric Psychotherapy: A Growing Need

Therapists need to start focusing on elder mental health


Thanks to active lifestyles, healthier diets, exercise, and advances in medicine and healthcare, Americans are living longer. That trend, coupled with historically low birth rates, is transforming the United States into an older population. In fact, by 2030, it’s expected that every baby boomer will be at least 65 years old and that seniors will account for one out of every five US citizens.  
This growing population presents a great opportunity for those who practice geriatric psychotherapy to help an increasing number of seniors live their golden years to the fullest. Keep reading to learn more about the issues that affect the older generations, why therapists need to start focusing on elder mental health, and how geriatric psychotherapy can help your practice get to the next level. 
ELDER MENTAL HEALTH: WHAT ISSUES AFFECT OLDER FOLKS THE MOST? 
Just because they’ve been on the planet longer than most people doesn’t mean seniors have it all figured out. In fact, it’s not uncommon for mental health issues to manifest as individuals get older as they leave their jobs, their kids move away, and they find themselves with more time on their hands than they’re used to. With that in mind, let’s take a look at some of the common mental health issues that older folks struggle with. 
Insomnia 
Due to a confluence of factors — a lack of exercise, an uptick in medications, and a less-than-optimal diet, for example — many seniors have problems getting a good night’s sleep. In fact, research suggests that nearly half of the elder population experience insomnia at one point or another. Unfortunately, sleep issues can translate into a host of other problems — like irritability, exhaustion, and drug addiction. 
Drug addiction 
When you think of people addicted to drugs, the older population might not be the first group that pops into mind. Believe it or not, research suggests that 5.7 million seniors are suffering from drug addiction today. Moreover, 6 million seniors consume alcohol, 132,000 use marijuana, and 4,300 use cocaine on an average day. On top of this, there’s been an increase in opioid use among this age group in recent years. Add it all up, and drug addiction among seniors is a growing crisis. 
Depression 
As people age, it’s not uncommon for them to have more time to think about their lives and their place in this world. Someone might begin to dwell on a mistake they made two decades ago and ruminate on it obsessively because they have more time on their hands than they’re used to, for example. Another individual might wish they pursued a different career. Either situation is an example of someone worrying about something they have no control over. 
While some seniors have a natural propensity toward depression, others began developing the issue in the wake of the COVID-19 pandemic. The abrupt transformation of our lives — coupled with fear over the virus itself and profound social isolation — was particularly difficult for certain seniors to process, causing them to become depressed. 
Bereavement  
When you live long enough, you see a lot of people you care about die. Whether it’s an old colleague, a childhood friend, a family member, a spouse, or even a child, losing a loved one can be an incredibly difficult period for everyone, including our elders. Depending on how the individual experiences it, bereavement can ultimately turn into profound, almost crippling grief. 
Bereavement can also cause a slew of other thoughts and behaviors, including guilt, anger, and regret. For this reason, many seniors seek out professional help to process these feelings of loss and overcome bereavement-induced pain and sadness. 
Struggling with growing older 
As people age, many of them begin having problems with the process of aging itself. On one hand, an individual might develop mental health issues because they’re forced to deal with chronic pain and deteriorating health. On the other, someone might have self-esteem issues as they see themselves getting older and losing their place and influence in the world. Many of these folks choose to talk to therapists to improve their outlook and live happier lives. 
While this list is by no means exhaustive, it should give you a better idea of the variety of different mental health issues that impact seniors. 
WHY THERAPISTS NEED TO BE PREPARED TO CARE FOR ELDERS 
If you’re a therapist who hasn’t considered geriatric psychotherapy before, here are some reasons why you might want to rethink that and give it a try: 
•	The population isn’t getting any younger. With declining birth rates and an aging population, more and more Americans are skewing older. By preparing to treat this group of seniors, therapists can do their part to promote the health of older adults — much to the benefit of family, friends, communities, and the seniors themselves.
 
•	The stigma around mental health is disappearing. While Americans have traditionally kept quiet about the importance of talking to therapists to work through mental health issues, that’s all changing. As the stigma around mental health continues to dissipate, it follows that more and more seniors will be willing to give geriatric psychotherapy a try if for no other reason than it’s socially acceptable.
 
•	There aren’t many therapists specializing in this area. There’s a reason that as many as 90 percent of seniors don’t get the treatment they need to live their best lives: There is a dearth of therapists that treat older folks. To some extent, this is due to the misconception that you can’t teach the proverbial dog new tricks. This ageist outlook is simply untrue.  
Now that you have a better idea of some of the reasons why you should start sharpening your geriatric psychotherapy skills, let’s turn our attention to the business part of the equation: how treating older patients impacts your practice. 
HOW GERIATRIC PSYCHOTHERAPY CAN BENEFIT YOUR PRACTICE 
At a very basic level, offering geriatric psychotherapy services can benefit your practice by enabling you to target an entirely new slate of clients — and grow your bottom line because of it. After all, this is a traditionally underserved population. If there aren’t many therapists in your area who treat seniors, you may be able to become the only show in town — which could be particularly lucrative. 
On top of this, seniors can also help you grow your practice via word-of-mouth referrals. If an elderly client really enjoys your services, you can bet that they’ll tell their friends and loved ones about you. At the same time, you might even be able to get some of their friends or family members as clients, too, as you all work together to navigate the complex issues that come with aging — and how they impact the entire family.  
Depending on how your experience goes, you might even find out that geriatric psychotherapy is your true calling. This could make your work more engaging while helping you reach your full potential as a therapist. 
If you’re a GoodTherapy member who sees geriatric clients or is planning to give it a shot after reading these words, be sure that you have “Elders” selected as one of the ages you treat in your profile. That way, older folks will be able to find you more easily when they begin their search for a therapist. 


Link:
https://www.goodtherapy.org/blog/Geriatric-Psychotherapy-Growing-Need
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Taking Care of Children’s Mental Health

CHILDREN’S MENTAL HEALTH IS OFTEN NEGLECTED 


When most of us think about folks going to therapy for mental health, we think about adults — people struggling with substance abuse, domestic violence survivors, folks going through a divorce, and those who are dealing with the loss of a loved one, for example. 
Unfortunately, many in society tend to overlook a critical group that needs mental help therapy just as much as everyone else: the youth. 
Just because this younger segment of the population might not have mortgage payments and bank accounts to worry about doesn’t mean they’re immune from mental health problems. In fact, one recent report found that 27 percent of young people felt anxiety within the last week, while 15 percent felt depressed. 
Believe it or not, more than half of high-risk youth don’t have access to the therapy they need to ensure their mental, emotional, and physical well-being. In the next section, we’ll examine why that is. 
WHY CHILDREN’S MENTAL HEALTH IS OFTEN NEGLECTED 
One of the main reasons kids are an underserved population for mental health services is because society hasn’t necessarily prioritized the importance of mental health counseling for young people as much as it should.  
Case in point? According to the American School Counselor Association, each school should have one counselor per 250 students to ensure they’re getting the mental health support they need to live their best lives. Despite that, the average school district has just one counselor per 455 students. 
Right off the bat, we’re collectively setting the tone that says something like this: While student mental health services are important, they’re not incredibly important to the point we need to make them a top priority. 
Perhaps this is because many adults think that kids who are suffering through issues are “just going through a stage” — and that their problems aren’t anywhere as serious as an adult’s problems might be. This couldn’t be further from the truth — particularly for those who grow up in less-than-ideal circumstances (e.g., in poverty or with an abusive parent). 
The COVID-19 pandemic 
Since kids can struggle with mental health issues in the best of times, it comes as no surprise that these struggles only compounded in the wake of the pandemic.  
All of a sudden, life was flipped upside down for those in the younger generation. Their routines were completely changed overnight. They couldn’t go to school, they couldn’t see their friends, and they couldn’t leave their houses. 
Not every child was able to seamlessly transition into the new normal. In fact, many youngsters reported having a hard time coping with attending class over Zoom and being separated from other students. Kids were also scared about the virus itself. For these reasons, it comes as no surprise that the prevalence of depression and anxiety was even higher than normal among this group of kids when COVID-19 set in. 
The good news is that by giving children’s mental health the respect it deserves and taking a proactive stance with treatment, it’s possible to help kids navigate through their issues and end up in a much healthier state of mind because of it. 
HOW THERAPY CAN IMPROVE CHILDREN’S MENTAL HEALTH 
When parents prioritize their kids’ mental health and give them the support they need to get past the issues they’re facing, great things happen.  
When kids are in a solid place, they’re able to think clearly, learn new things, and improve their social skills. At the same time, parents’ mental health improves, too, since they benefit from a stronger relationship and can find joy in seeing their kids thrive. 
No matter what issues your child is struggling with, the right therapist can help them. For example, if you and your child aren’t getting along, you may benefit from parent-child interaction therapy (PCIT), which is designed to help kids and parents overcome concerns related to things like ADHD, anxiety disorder, autism, oppositional defiant disorder, and selective mutism, among other conditions. 
Essentially, both parties join forces in PCIT to work through issues together, and these learnings can help guide the relationship forward over the next several years. After somewhere between three and six months, the therapy sessions wrap up, and parents and kids build on their relationship from there. 
Similarly, if a child is working through physical or emotional trauma they’ve experienced, parents might want to look into whether trauma-focused cognitive behavioral therapy (TF-CBT) can help them overcome the obstacles they’re facing. 
At a basic level, TF-CBT is a cognitive behavioral treatment that helps children figure out how to overcome trauma, respond to stressful situations, and cope with difficult emotions. They’ll also grow more in tune with their emotions and more able to express their feelings in productive ways. 
By now, you have a better idea about how therapy can help improve children’s mental health. But what if you’re not a therapist — is there anything else you can do? 
KIDS AND DEPRESSION: WHAT PARENTS, TEACHERS, AND CAREGIVERS CAN DO 
While parents, teachers, and caregivers might not be able to give children professional mental health services, they can certainly help anxious kids work through their issues. Here are some ways they can do that. 
Maintain an open dialogue 
First things first: If you’re not talking to the children in your life on a regular basis, how can you possibly expect to know what they’re dealing with and what’s going through their minds?  
One of the easiest ways to help kids deal with mental health problems is by maintaining an open dialogue with them to understand the issues they’re working through. For example, as the pandemic first shut down schools, parents were in a unique position to talk to their kids about the virus and what the experts had to say about it. By being open and honest, parents can help assuage some of their children’s concerns — particularly compared to folks who didn’t have much to say to their kids about the issue. 
Bottom line? By engaging in conversation with your kids every day and knowing more about the issues they’re facing, you can begin to have healthy dialogues that can help kids overcome the challenges they face. 
Recognize the warning signs 
It’s one thing for a child to have a bad day. It’s quite another to have several bad days in a row, with no signs of anything improving anytime soon.  
While parents, teachers, and caregivers aren’t able to provide professional mental health services, they can become familiar with the warning signs that may indicate they are suffering from issues like depression or anxiety. Here are some of the indicators to be aware of: 
•	Lack of appetite 
•	Low motivation 
•	Withdrawal from activities 
•	Fatigue 
•	Worsened school performance 
•	Low self-esteem 
Seek help when it’s needed 
Once you’re familiar with the warning signs to look out for, you’ll know when it’s time to enlist the services of a mental health counselor to help your child or student live a happier, more fulfilling life. 

Link:
https://www.goodtherapy.org/blog/Taking-Care-Children-Mental-Health
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How Schizophrenia Impacts Cognitive Function

Cognitive deficits in schizophrenia interfere with real-world functioning.


Schizophrenia is a disorder with readily observable symptoms including hallucinations, delusions, social withdrawal, apathy, and disorganized thinking and behavior. It is also associated with substantial cognitive deficits, which interfere dramatically with everyday functioning. Robert McCutcheon, Richard Keefe, and Philip McGuire recently published an excellent review in the journal Molecular Psychiatry that summarizes current knowledge about cognitive impairment in persons with schizophrenia.
Cognitive deficits associated with schizophrenia include difficulties with attention, working memory, learning, and processing speed. These deficits interfere with real-world functioning. They are associated with increased hospitalization, longer hospital stays, and decreased compliance with treatment.
Cognitive impairment is also a major contributor to illness-related disability, defined as an inability to work productively and/or live independently. Psychiatric illnesses, including schizophrenia, are among the leading causes of disability across the human lifespan.
Although, in general, persons with schizophrenia perform poorly on cognitive tasks and average in the lowest 5 to 10 percent of the population when compared to those without schizophrenia, the degree of deficit varies greatly among individuals. It is possible that some individuals have cognitive deficits in one area while others have deficits in other cognitive domains. Sorting out various patterns of cognitive deficits among individuals will require further research.

Natural History
Cognitive deficits typically precede the onset of behavioral symptoms in individuals who eventually develop schizophrenia. These cognitive deficits are often present during childhood and increase during adolescence. This differs from the time course of cognitive changes in bipolar disorder where such changes occur largely after the onset of mood symptoms.
The cognitive deficits that develop during childhood in those with schizophrenia remain relatively stable through middle adulthood. As individuals become elderly, they are at higher risk for cognitive decline. However, such late-in-life deterioration might result from a variety of health factors that are common in individuals with schizophrenia and that contribute to premature death in these individuals.

Pathophysiology
Various brain circuits and neurotransmitters play a role in the development of cognitive deficits. Elucidating which neurotransmitter systems are involved in which brain systems will require much more research.

Treatment
It is well known that both older- and newer-generation antipsychotic drugs do not substantially alter the cognitive deficits associated with schizophrenia. Novel medications are being developed to treat schizophrenia, and increased attention is being directed toward developing drugs that help ameliorate cognitive deficits.
Knowing which specific cognitive deficits an individual with schizophrenia is experiencing can assist caregivers in tailoring psychosocial management. Neuropsychological testing can determine the type and degree of such deficits.
Advances in neuroscience will result in an improved understanding of the nature and causes of schizophrenia. This should lead to advances in novel drug development. Together with increased attention to psychosocial interventions, these advances should aid the development of integrated, personalized treatment approaches to improve the everyday functioning and life satisfaction of those suffering from this devastating psychiatric disorder.

reference:
psychology today

link:
https://www.psychologytoday.com/intl/blog/demystifying-psychiatry/202304/how-schizophrenia-impacts-cognitive-function
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What Does the Term Frenemy Really Mean?

Do you feel like someone might not have your best interests at heart?


A new study published in the Southern Communication Journal offers a succinct definition of a term that has become commonplace in pop culture over the past decade: What it means to be a ‘frenemy.’
“Despite the prevalence of frenemies in popular culture and the significant effect these relationships can have on our lives, frenemy scholarship is limited and contradictory,” says Dr. Jenna Abetz, the lead author of the study. “Developing an in-vivo definition of the frenemy relationship portrays the realities of these relationships as they are lived.”
To land on such a definition, Abetz and her team interviewed 29 adults between the ages of 19 and 62 to get a better sense of how individuals who have had a frenemy define and understand the term.
They found that many of the interviewees shared similar feelings about frenemy relationships, leading the researchers to land on the following definition: “Relationships, often negative, steeped in situational ties and shared social connections that outwardly appear friendly but are fraught with underlying competition, jealousy, or distrust.”
Unlike genuine friendships, the researchers found that frenemy relationships displayed three prominent characteristics:

1.Competitiveness (viewing the other more as a rival to outdo than a friend to support)
2.Jealousy (either in terms of social connections or material possessions)
3.Distrust (a lack of respect and care in the friendship)
The dynamic was described by some interviewees as ‘hot and cold,’ with the frenemy repeatedly giving mixed signals as they shifted between friend-like and foe-like mentalities.
While many of these relationships were found embedded in unavoidable social circles and networks like family, school, and work, some participants stated that frenemy relationships evolved from seemingly true friendships that became pressured due to external circumstances.
Interestingly, having a frenemy was more of a ‘felt’ experience than a verbally defined label. In other words, frenemy relationships have an element of ‘unspokenness’ in them.
This is not to say that frenemy relationships don’t come with their own silver linings. Some interviewees shared positive outcomes amidst the dark cloud of a frenemy relationship.
“For some, the outcome of having a frenemy was better awareness of what they wanted and deserved in a true friendship,” explains Abetz. “Others reflected on those teachable life lessons — and that having a frenemy highlighted future relational red flags for them."
Here are two thoughts shared by interviewees that highlight the positive side of their experience with frenemies:

* “I’m more cautious, I see how they treat others before I get close to them.”
* “You learn how people are and what signs to look out for in a friend. It helps you reconsider all the earlier signs.”
Experience with frenemies or frenemy-like relationships underscores the importance of learning what a good friendship looks and feels like by having experience with a wide range of social relationships. This is especially important for children and adolescents to understand as they learn how to navigate the social world. They need to know that while no friendship is perfect, frenemy dynamics are not genuine friendships and they should not feel compelled to maintain them if there is a clear undercurrent of distrust.
“It is important for parents and educators to be able to assist adolescents in identifying unhealthy relational patterns and how they manifest in friendships,” says Abetz. “While learning how to make and be a friend is one of the central developmental tasks of elementary school, as children age they still need guidance and support navigating challenging friendship dynamics.”
Abetz hopes that her research not only helps people define a somewhat indescribable relationship feeling but that it can be used to teach young adults how to seek out more positive relationships in their own lives.

reference:
psychology today

link:
https://www.psychologytoday.com/intl/blog/social-instincts/202304/what-does-the-term-frenemy-really-mean

The Troubling Truth About Drinking in Moderation

It appears that no amount of alcohol is good for you.


It turns out that drinking moderate amounts of alcohol daily does not—as previously thought—protect against heart disease or contribute to a longer life. Apologies if your alcohol consumption depends in part on this popular belief and (until now) useful rationalization.
For decades, scientific studies suggested moderate drinking was better for most people’s health than not drinking at all, and could even boost longevity. But, a new analysis of more than 40 years of research has concluded that many of those studies were flawed and that the opposite is true.
Just published in JAMA Network Open, this meta-analysis reviewed 107 observational studies that involved more than 4.8 million people. The massive study stressed that previous estimates of the benefits of moderate alcohol consumption on the risk of death by “all causes” — meaning anything, including heart disease, cancer, infections, and automobile accidents — were “significantly” biased by flaws in study design.
According to the researchers, earlier research did not adjust for numerous factors that could influence the outcome, for example, age, sex, economic status, and lifestyle behaviors such as exercise, smoking, and diet. Using statistical software, they essentially removed such bias, adjusting for various factors that could skew the research. After doing so, there were no significant declines in the risk of death by any cause among the moderate drinkers.[1]
While these previous observational studies could identify potential links or correlations, they could also be misleading and didn’t prove cause and effect. Moreover, they failed to recognize that many light and moderate drinkers had other healthy habits and advantages and that non-drinkers used as a comparison group often included people who had given up alcohol after developing health problems.
This represents the largest study to effectively call B.S. on the widely held belief that moderate drinking of wine or other alcoholic beverages is healthy. In contrast, it found that the risk of numerous health problems, as well as that of dying prematurely, increased significantly after less than two drinks per day for women and after three per day for men.
This data adds to that of another substantial meta-analysis from 2022 in which researchers in Britain examined genetic and medical data of nearly 400,000 people and concluded that alcohol consumption at all levels was associated with increased risk of cardiovascular disease.[2]
The modern-day belief that daily alcohol consumption promotes health emerged in the 1980s, when researchers identified the so-called “French paradox,” which suggested that low rates of cardiovascular disease among men in France was associated with daily wine consumption. Although later analyses found flaws in the research, the idea that moderate drinking improved health became broadly accepted. Wine—particularly red wine—developed a reputation for having health benefits after news stories highlighted its high concentration of resveratrol, a protective antioxidant also found in blueberries and cranberries.
However, the hypothesis that moderate alcohol use is health-enhancing has come under increasing scrutiny over the years as the alcohol industry’s role in funding research became clear, revealing that many of the studies that purport the alleged health effects of alcohol have been funded by that industry. A 2020 report found that 13,500 studies have been directly or indirectly paid for by the alcohol industry.[3] Concurrently, a range of other studies has found that even moderate consumption of alcohol—including red wine—may contribute to cancers of the breast, esophagus, head and neck, high blood pressure, and atrial fibrillation, a serious heart arrhythmia.
Dietary guidelines for Americans 2020-2025 recommend that adults limit alcohol intake to two drinks or fewer a day for men and one drink or less for women, adding “that drinking less is better for health than drinking more.” The guidelines also warn that even drinking within the recommended limits may increase the overall risk of death attributable to various causes, including some types of cancer and heart disease, even at levels of less than one drink per day.[4]
This past January, Canada issued new guidelines warning that no amount of alcohol consumption is healthy and urges people to reduce drinking as much as possible. Issued by the Canadian Centre on Substance Use and Addiction, the new guidance was a significant departure from its 2011 guidelines, which recommended women limit themselves to no more than 10 standard drinks a week and men no more than 15.[5]
Alcohol is the most used recreational drug, and unfortunately, for those who enjoy drinking for relaxation and recreation, this is unwelcome news. As comforting as it might be to think that it’s good for one’s health, increasingly the science simply does not support it. The extensive new research decimates the hope of many that moderate alcohol use is healthy and makes clear that people should not drink alcohol for the express purpose of improving their health. If maintaining and/or improving health is your priority, in terms of alcohol consumption, less is more.

reference:
psychology today

link:
https://www.psychologytoday.com/intl/blog/some-assembly-required/202304/alcohol-is-not-good-for-your-health-even-in-moderation
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Depression: Goodbye Serotonin, Hello Stress and Inflammation

New research on depression focuses on the immune system.


KEY POINTS
Inflammation plays a key role in the pathology of stress-related diseases.
Inflammation can contribute to the development and severity of depression.
Conventional mechanisms linking stress and disease have focused on the HPA axis and the sympathetic nervous system.

Accumulating evidence indicates that stress is a common risk factor for more than 75 percent of physical and mental diseases, increasing the morbidity and mortality of these diseases. Psychiatric disorders such as depression are the most common stress-related disease.

In the past, medical experts believed that depression was essentially a brain illness due to a deficit of serotonin that led to treating depression with drugs that increased the concentrations of serotonin in the brain. Depression may be much more complex than that.

New research shows that stress can induce inflammatory changes in the brain and the peripheral immune system. This results in the production of inflammation-enhancing cytokines that travel to the brain’s reward center and largely deactivate it, leading to anhedonia, or loss of interest and pleasure. Anhedonia is a prominent symptom of depression.

Stress, Inflammation, and Depression
For a long time, inflammation was considered an essential response to tissue injury or microbial invasion. Increasingly, it is viewed as being precipitated by stress and a significant contributor to psychiatric disorders, including depression. People with depression often have higher levels of inflammatory cytokines in their blood. Many studies have demonstrated that treating inflammation can improve depression.

Stressful events activate the sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis, which trigger the “fight or flight” response that floods the body with catecholamines, glucocorticoids, and other stress-related substances, which, in turn, activates certain cells of the immune system to produce cytokines.

Cytokines are a broad category of small proteins, such as interferon, interleukin, and others. There are pro-inflammatory cytokines, which promote inflammation, and anti-inflammatory cytokines, which fight inflammation. We are learning now that certain pro-inflammatory cytokines are involved in anxiety, chronic pain, and, by blocking the function of the brain’s reward center, the development of depression. The reward system comes to associate diverse stimuli (substances, situations, events, or activities) with a positive or desirable outcome (i.e., feeling good and happy). When it is down, a person finds no pleasure in anything. The depressed person isolates and feels sad.

Dr. Steve Cole, professor of medicine, psychiatry, and behavioral science at the UCLA School of Medicine, has pioneered research on the signal transduction pathways that give rise to psychological and social states in the context of gene regulation. Signal transduction pathways relay information from outside the cell, through the cell membrane into the interior of the cell, where it can then start a chain reaction that ultimately leads to turning on or turning off genes inside the nucleus.

In a recent paper, Cole reported on his study of Black mothers in racially segregated neighborhoods on the South Side of Chicago. The overwhelming feeling that a majority of the subjects expressed was one of “being trapped.” These women suffered increased mental distress in the form of posttraumatic stress disorder (PTSD), depressive symptoms, and glucocorticoid receptor gene regulation. Feeling trapped, living in a violent environment was associated with greater cortisol output from the HPA axis and consequent negative feedback inhibition of the glucocorticoid receptor (GR) mRNA levels.

Writing on the subject of biological determinants of discrimination, Cole found that discrimination was associated with alterations of brain networks related to emotion, cognition, and self-perception, and structural and functional changes in the gut microbiome. This study contributes toward our understanding of how social inequalities become a whole-body experience and how a common expression like “racism makes me sick to my stomach” actually makes scientific sense.

Intestinal bacteria, the microbiome, produce metabolites such as bile acids, choline, and short-chain fatty acids (SCFAs) that are essential for host health as well as myriad neuroactive compounds such as serotonin, dopamine, and other brain chemicals that regulate mood. Therefore, it is not surprising that psychiatric and neurological illnesses, including multiple sclerosis, autism, schizophrenia, and depression, are often present simultaneously with gastrointestinal disease. Recent research expands our understanding of how the microbiome communicates with the enteric nervous system (“The Thoughtful Bowel”), the immune system, and, by way of the vagus nerve, the brain.

There is now considerable evidence that loneliness is a risk factor for poor psychological and physical health. Loneliness typically refers to the feelings of distress and dysphoria resulting from a discrepancy between a person’s desired and achieved levels of social relations. Scientists from the University of California, San Diego, La Jolla, found that loneliness was associated with a lack of diversity in the gut microbiome and, consequently, reduced resistance and resilience to stress-related disruptions, leading to downstream physiological effects, such as systemic inflammation and depression.

It follows that many factors such as stress and inflammation, in addition to “a chemical imbalance,” read “serotonin deficit” as promulgated by Big Pharma, are responsible for the development of depression and other mental and physical diseases.

Stress Busting
Depending on a person’s microbiome, certain antidepressants may benefit some people but not others. No doubt, assessing an individual’s microbiome before commencing treatment will be an important lab test in the future.
Moreover, nonpharmacological treatments for major depression such as exercise may be mediated by anti-inflammatory actions. Omega-3 fatty acids have been identified as potential treatments for major depressive disorder–related inflammations.

Enhancing good gut microbes—whether with probiotics or by adding yogurt or other fermented foods to the diet—may be an answer to intractable depression, the kind conventional treatments can’t touch.

Steve Cole has written much on the subject of self-regulation. He holds, and I totally agree with him, that we are architects of our own lives more than we realize. Our subjective experience carries more power than our objective situation. If we feel good about ourselves, not only will our health improve but so will our relationships. There are many ways in which we can raise our self-esteem and become more optimistic.

Treatment approaches that target inflammation and the gut microbiome in conjunction with SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors) may be more effective than SSRIs or SNRIs alone.

Reference: Psychology Today

Link:
https://www.psychologytoday.com/us/blog/explorations-of-the-mind/202305/depression-good-bye-serotonin-hello-stress-inflammation
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6 Ways to Design for Social Connection and Community

How the built environment can help heal and prevent loneliness.


KEY POINTS
Where we live, work, play, and learn impacts our social health and how connected we are as a society.
As cities invest in infrastructure, paying attention to how they impact loneliness and community well-being can benefit everyone.
Design guidelines that can help you advocate for better design wherever you are include accessibility, nature, and a sense of place.

In a time of hyper-connection and communication, recent surveys find that approximately half of U.S. adults are experiencing loneliness and lacking connection. This can increase risks of premature illness and death at levels comparable to smoking 15 cigarettes a day.

For this reason, the U.S. Surgeon General, Vivek Murthy, recently issued a public advisory calling the American people to this “urgent public health issue.” Murthy lists “design the built environment to promote social connection” as a part of the first pillar of his advisory.

Julianne Holt-Lunstad was the scientific chair of Murthy’s report, "Our Epidemic of Loneliness and Isolation." Nearly two years ago, Holt-Lunstad and I published a piece, "Is Your Environment Making You Lonely?" In it, we explored ways to cultivate connection using the built environment, policies, and programming.

Today's post focuses on one of the central themes we discussed then–shared spaces, or what Ray Oldenburg called third places open to all people to gather, such as cafes, parks, and libraries. I discuss why shared space is so essential and offer six design guidelines to help any built environment feel more conducive to fostering social connection.

Six Design Guidelines for Social Health
When I think of design for connection, I often think of the Italian piazzas I visited with my mother after my first year of architecture school. They are open to all people (accessibility), an inviting hub of activity (activation), with warm natural clay bricks and stones, often ivy tracing the walls (nature), with the choice of whether you want to sit in the center by a fountain (choice) perhaps, or under an umbrella on the edges (human scale); and they have a history and sense of place unique to each one (sense of place), carved into the place itself.

Taken together, those make the six design guidelines for social health, below I discuss these in more detail:

Accessibility
Creating places that are inclusive, safe, and walkable (stroller-able, wheelchair friendly, etc.) for the people who will use it is the essential first ingredient. This includes creating libraries, pocket parks, and gathering spaces that are an easy-to-reach part of the local social fabric.

Nature
We are hardwired to be drawn to and soothed by nature, a phenomenon called biophilia. Nature, specifically urban green space, has been linked to reducing loneliness, increasing sociability, and improving mental health. Infusing nature, greenery, and park space into our neighborhoods are essential to getting people outside their homes, lingering with one another.

Activation
Ideal shared spaces are vibrant and have some type of activation. By placing seating, refreshments, and amenities in the path of natural travel and circulation, we can create liveliness through purposeful collisions.

Choice
We each have different set points for our need for simulation or mental rest, and these needs change throughout our days, and lives and based on our tasks or activities. We can customize our space to our needs by providing options and adaptability.

Human Scale
We evolved in community with others, using our space to keep ourselves and the collective safe, so we are naturally drawn to places that provide a sense of scale or fit with our bodies. This includes a preference for edge conditions, such that we’re drawn to booth seating or leaning against the wooden porch railing. This includes creating nodes or nooks within a larger space, such as a front porch, as a welcome place before entering a home or a small waiting area to ease you into your child’s daycare and allow you to bump into other parents.

Sense of Place
A sense of place helps remind us of who we are and what matters to us and fosters a feeling of belonging. This ties to the idea that a place can create a sense of “ambient belonging” about how the built environment signals to others whether or not they are welcome here. The place is imbued with values, culture, and meaning, and a sense of place recognizes that significance.

Reference: Psychology today
Link:
https://www.psychologytoday.com/us/blog/designed-for-happiness/202305/6-ways-to-design-for-social-connection-and-community

For Bilinguals, Identity Is Influenced by Language

A new book reviews influences of speaking more than one language.

Language plays a significant role in all aspects of human social and cognitive life. People communicate with each other in a language. The language they speak also structures a number of aspects of the way they think. These effects become even more complex when people speak more than one language. Bilingual (or multilingual) individuals are those who have excellent fluency in two (or more) languages.
A great new book by the cognitive scientist Viorica Marian called The Power of Language explores a number of influences of speaking multiple languages on the way people engage, think, and act. One of the more fascinating sections of the book examines how people think about themselves depending on the language they are using to think about themselves.
If you speak more than one language, chances are you use them in different circumstances. For example, you may have one language that you use at home with family and another that you use at work and in your interactions with people around where you live. You might have a language that you spoke growing up, but that you speak more rarely later in life. You might have a language you speak only in professional situations, but another language that you use in your daily interactions.
These differences in context influence what memories you call to mind when you are asked questions (or ask yourself questions) in the different languages you speak. For example, suppose you speak one language at home and another at work. If you are asked to think about something you have done recently that is fun, you might be more likely to think of an event with your family when asked in the language you speak at home, but an enjoyable interaction with colleagues when asked in the language you speak at work.
The language used to answer the question makes it easier to think of memories associated with using that language. The memories you retrieve in a situation affect what you are likely to do and even how you are likely to feel in that situation.
In addition, properties of the language itself can affect your decisions. In the book, Dr. Marian points out that some languages (like English) require you to use a different tense when talking about events in the present versus the future. For example, if you say “I am walking in the park,” you are talking about something happening right now, but you have to say “I will walk in the park,” to talk about a future walk you are going to take. Other languages (like German and Mandarin) do not require a different grammatical tense to talk about present and future events.
The evidence suggests that people who speak languages whose grammar requires a distinction between present and future are less likely to make choices that benefit their future selves (like saving for retirement) than people who speak languages that do not. Consequently, the actions you take when speaking different languages can have very different implications for your future.
How people think, act, and feel is a significant part of their identity. So, in a very psychologically real way, the language bilinguals are speaking affects their identity in that moment. They are going to be reminded of different experiences. They are going to have different emotional reactions to situations. They may even make very different kinds of decisions.
Interestingly, many of these effects of speaking more than one language can happen without the speaker being aware of them. In the moment, people are engaging with the world in one of the languages they speak. They have no clear way of knowing what they would have done had they been speaking their other language. So, they have no good way to compare their reaction to what they might have done otherwise.
That means that in important situations, bilinguals might want to try asking themselves questions in both of their languages before moving forward. This exercise might lead to insights about ways that their identity is somewhat different depending on the language they’re speaking—and that might lead to different (and hopefully better) outcomes than when they engage using only one language.

reference:
psychology today

link:
https://www.psychologytoday.com/intl/blog/ulterior-motives/202304/for-bilinguals-identity-is-influenced-by-language

10 Ways to Tell if Your Relationship Suffers From Burnout

New research suggests what may really be going on in a burned-out relationship.

The feeling that your relationship isn’t going the way you expected it to can make you feel emotionally depleted. A couple generally enters into an intimate partnership with the hope that it will grow and flourish over time. When this doesn’t happen, the resulting disappointment can make you question why you ever got involved with this person in the first place.
Certainly, romantic characterizations of relationships emphasize the idea that couples move into a “happily ever after” state once they’ve decided to commit to each other. Even though you may realize that the reality of a relationship is unlikely to live up to this fantasy, you may still be at least somewhat surprised when the reality deviates even farther from that idealistic scenario.

What Is Relationship Burnout?
You’ve undoubtedly heard of burnout in the context of occupational settings. Burned-out employees feel exhausted and unenthusiastic about their day-to-day job routines, but they may also be plagued by the question of why they entered that particular occupation in the first place. According to a new study by Kharazmi University’s Solaleh Zamani and colleagues (2023), the counterpart in relationships of “marital burnout” occurs when couples realize “the reality of their marriage is not what they expected” (p. 1).
For the sake of generalizing beyond marriage, the term “relationship burnout” will be used here instead. As defined by the Iranian authors, this is a condition reflecting a “myriad of factors” including “emotionally life lost function” in which an individual’s coping strategies have become overwhelmed. The individual suffering from this “profound emotional state” may experience a range of physical reactions such as lethargy and headaches, emotional reactions such as feelings of hopelessness, and a sense of frustration with one’s partner.
The 10-Item Couple Burnout Questionnaire
The Zamani et al. study was intended to examine predictors of relationship burnout, but before turning to its findings, you can first test yourself on your own experience of relationship burnout. Rate yourself on these 10 items (0=never, 7=always) from an earlier study by the late University of the Negev Ayala Malach Pines and colleagues (2011):

When you think about your marriage/intimate relationship overall, how often have you felt:
1.Tired
2.Disappointed with your spouse/intimate partner
3.Hopeless
4.Trapped
5.Helpless
6.Depressed
7.Weak/Sickly
8.Insecure/Like a failure
9.Difficulties sleeping
10.‘‘I’ve had it’’

Who Is Most Prone to Relationship Burnout?
If you’ve diagnosed yourself or your partner as showing signs of burnout (with scores higher than 5 per item), the next question becomes which “myriad” of factors is leading to this unfortunate condition. Zamani et al. propose that those high in the quality of alexithymia, or “without emotional words,” would be very likely candidates. People who show this particular trait find it difficult if not impossible to relate to their partners or even be responsive to them because their emotional life is so empty. Their “deactivating strategies” (p. 4) lead them to tune out instead of connecting when their partners need them the most.
In addition to being poor communication partners, those high in alexithymia may also be characterized, the Kharazmi U. researchers propose, by an insecure attachment style. The qualities of fearing emotional closeness (avoidant) or being afraid of abandonment (anxious) both can impede their ability to grow within their relationship and, as importantly, facilitate the growth of their partner.
A related deficiency, the inability to regulate one’s emotions, could further contribute to relationship burnout. People high in emotional dysregulation would describe themselves as easily getting out of control when they get upset, and they would also state that they are confused about labeling their feelings.
The 216 adults in the Zamani et al. study were recruited through a family psychiatric clinic on the basis of self-identifying as suffering from relationship burnout, and this was confirmed via their scores on the Couple Burnout Questionnaire. Most were over the age of 30 and the majority (71 percent) identified as female. The analyses were conducted on data gathered prior to their entry into an emotion-oriented couples therapy program.
By statistically modeling the predictors of alexithymia scores, the Iranian authors were able to show that, as expected, attachment styles were not the primary influence on this outcome, but had their effect only through the mediational contributions of emotion dysregulation. In other words, emotion regulation had the effect of reducing secure attachment's effects but increasing the effect of insecure attachment's effects on alexithymia.
If emotion dysregulation is the key factor that predicts the alexithymia underlying burnout, the next question becomes how to help couples strengthen their relationship by focusing on emotions. According to emotion-focused therapy, the framework adopted by the Iranian research team, it may be possible to do just that. In this approach, individuals learn to gain better understanding of their experienced emotions and strengthen their emotion regulation. Such a strategy could, Zamani et al. argue, turn insecure into secure attachment.

Rekindling the Burned-Out Romance in Your Relationship
Because attachment style is so often regarded as fixed in early childhood, it may seem difficult to understand how it could be “adjusted,” as Zamani and colleagues propose. Even more to the point, if alexithymia is a trait, is it reasonable to think that it could be changed through intervention? It may also seem like quite an impossible task to turn the burners back on in a relationship that has become depleting.
The Kharazmi U. research team and the therapy clinic with which it is associated provide hope that all of these positive changes are within reason. The steps toward achieving this goal include developing greater awareness and understanding of emotional experiences that occur in the lives of a couple. As they do so, their emotional resilience becomes strengthened.
Turning this into practical steps, the findings suggest that you begin by working with your partner to stop and examine your emotions as they evolve over the course of your daily experiences. Which deeply held insecurities and anxieties are tapped when you get into an argument? Which similarly deep positive emotions do you feel when you and your partner validate each other’s feelings? If one of you feels uncomfortable talking about your emotions, this can become even more of a reason to take on the challenge.
To sum up, although burnout may seem to be an inevitable result of a relationship that has endured over time, the Iranian study suggests that it can be remedied, if not prevented. As you work on identifying and gaining control over your emotions, you will be on the way toward finding fulfillment in enjoying each other’s inner lives.

reference:
psychology today
link:
https://www.psychologytoday.com/intl/blog/fulfillment-at-any-age/202304/10-ways-to-tell-if-your-relationship-suffers-from-burnout

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For parents, carers and adults looking to connect with their children in a way that is meaningful

It’s well known that our early years are important for good mental health in later life, but I’ve often been asked by parents why that is.


Positive connections between caregivers and their children support a child’s biochemistry and neurobiology for a lifetime. It’s scientifically evidenced  to be fundamental in laying the foundations for long-term psychological and physical wellbeing, fostering resilience[1].

Bonding experiences give children a sense of safety and security in the world. This directly links to the development of the autonomic nervous system which affects, levels of anxiety, depressive moods, stress disorders. It also facilitates the development of our social brain which supports loving, nurturing, healthy behaviours and generally help navigate life’s difficulties[2].

 

When does connection occur and what is it?
A connection occurs when a person is open and available for another. Establishing social connections and bonds with people can help us feel valued and seen.

A parent is like a fantastic teacher for all age groups conveying messages through facial expressions, tone of voice, movement and touch, that contribute to enriching experiences.

But it’s not always easy to establish good emotional connections and this can leave caregivers feeling not good enough which may leave them feeling guilt and shame. Children can be defensive and there may be many reasons they’re unable to connect.

No family is the same. The beauty and strength of parents and caregivers is their journey to know their children. There is no such thing as the perfect parent and children gain from repairing disruptions in their connection.

 

How can I make that connection?
When things aren’t too complicated there are a few ways how:

Make time and space to actively listen. Let your child know you can hold them in mind even when you’re busy.
Touch – even resting a hand on a wrist releases the love hormone oxytocin.
Creative and imaginative play is the simplest way to engage children. They can communicate what is happening for them in a way that feels safe and non-intrusive. Some caregivers really struggle with this, but children can teach you. Child-led play starts with really noticing what your child is interested in and then going along with it. Once you get an understanding of what they enjoy it gets easier. Then follow their lead and allow them the freedom to show you as long as it’s safe.
 

When parents find connecting too difficult Child Psychotherapy can help
Psychotherapy is a safe, confidential and non-judgemental place where large and difficult feelings can be explored with a therapist through talking, play and multi-arts. This is how sense-making can begin with children of all ages even when it seems as though you are facing significant challenges.

If you’re interested in exploring therapy for a young person you care for then you can find more information on the UKCP website, including how to find a qualified psychotherapist.

References

Martino, J., Pegg, J., & Frates, E. P. (2015). The Connection Prescription: Using the Power of Social Interactions and the Deep Desire for Connectedness to Empower Health and Wellness. American Journal of Lifestyle Medicine, 11(6), 466-475. https://doi.org/10.1177/1559827615608788. PMID: 30202372; PMCID: PMC6125010.
Gerhardt, S. (2015). Why Love Matters: How affection shapes a baby's brain. 2nd Edition.
Sunderland, M. (2008). The Science of Parenting.

link:https://www.psychotherapy.org.uk/news/for-parents-carers-and-adults-looking-to-connect-with-their-children-in-a-way-that-is-meaningful/
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Why kindness and connection are important to mental health

How can a psychotherapist help someone looking for connection?


One of the main reasons we’re all unfortunately hardwired to struggle as human beings is that two of our central needs often disconnect us from ourselves and others: our safety needs and our reward needs. Safety needs view everything and everyone with a problem-focus while reward needs can cause disconnecting comparisons, competitiveness and feelings of dissatisfaction and frustration. In fact, much of what people bring to therapy – including anxiety, depression, chronic anger, narcissism, addiction, procrastination and stress – can all be seen as both causing and caused by this disconnection. 

When we feel connected, on the other hand, we feel safe, rewarded, alive and fulfilled. Life has meaning and purpose. Whether it’s to ourselves, trusted others, pets, groups, communities, nature or the environment around us, establishing and maintaining connection - which includes the quality of kindness both as its cause and its result - is fundamental to maintaining good mental and physical health. 

 

How can a psychotherapist help someone looking for connection?
To add to our biological tendency to do so, many of us also often disconnect easily due to our childhood experiences in relationships. These can include adverse incidents that happened to us, as well as a lack of genuine love and connection during that time. Because it was relationships that led to these difficulties, if we’re going to be able to connect more later on, we have to experience the quality of relationship we initially needed. 

Good therapy holds the very real potential for such a reparative relationship. The experience of being truly heard and listened to, of trusting someone enough to be vulnerable and say the previously unsayable will help with connection in all areas of life.   

Connection often requires conscious and consistent effort before it becomes the norm and each of its facets can be looked at in therapy. We can focus on how to improve connection with ourselves - including our thoughts, values, beliefs, self-image, body, feelings and behaviours - and with others by exploring areas like boundaries, communication and how we express love and resolve conflict. Looking at the client/therapist relationship itself in real-time can also be valuable here. 

If you’re interested in exploring therapy, then visit our website for helpful advice for those looking for an accredited and registered therapist.

 

Don’t hold on to the wrong connections 
It’s important to remember that nurturing connection and kindness doesn’t mean having to remain connected with others to our detriment. For good reason, our safety needs will be sceptical about striving for connection and kindness with everyone at all times. We all know there are people who are better left untrusted. In fact, disconnecting from another might be the kindest thing we do for ourselves and therapy can be a great place to explore this too. 

Link: https://www.psychotherapy.org.uk/news/why-kindness-and-connection-are-important-to-mental-health/
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How to stay connected with a teenager

Maintaining positive connections with your teen can be difficult as they begin to find independence.


This can be a challenging time for parents and teens to stay connected. Adolescents can react with a heightened sense of emotion and be more impulsive with their decisions.

I often hear parents during this period ask why a child they’d previously felt so close to is now so distant, so the question here is why?  

Here are some reasons why this may is happening:

Scientists have established there are several key changes in brain development during adolescence. As braincells and brain pathways connect more rapidly they perform better; each area of growth and behaviour change can really challenge the teen/parent relationship. This biological change is necessary as it supports coordinated thought, actions, and behaviours for a teenager’s transition to adulthood.

Teens become more outward looking as they explore their identity, focused on establishing connections with others away from their carers. As they develop new interests and become more influenced by people their age, they can begin to copy those they admire. At this stage teens can also misread facial expressions or cues, which is why they’re so quick to argue. The more logical area of their brain is still being built.

 

How to stay connected in a positive way
Hold in mind change is fast for teenagers in all areas: physically, socially, and psychologically. Coping with fears about relationships, fitting in, self-worth, hoping for acceptance – these can all heighten anxiety. Being emotionally available and empathic even when you are being challenging is key so press pause and acknowledge how difficult this process is. It will allow you to be open and be compassionate with your teen and yourself.
Remember social connection is vital for a child’s wellbeing. A good laugh with friends can introduce all the feel-good chemicals that help low mood or depression.
Avoid stereotyping adolescents and being hyper-critical. Enjoy their company as a new and exciting social connection.
Don’t underestimate how much they value their friends. It’s safer to be curious and non-judgemental within reason. Teens are full of interesting new topics and fashions. If they’re interested in a music artist, get to know the sounds rather than dismissing it. You may gain a shared interest.
Expressing how you feel or showing how you manage under stress can help a teen talk about their large and difficult feelings.
If they’re shouting and being unreasonable, try not to escalate the situation by joining in. They’re probably too angry or hurt to hear. Communicate later when things are calm.
 

What to look out for unhealthy connections and choices
When facing identity insecurity, teens may follow a group who they think is exciting or offers a sense of belonging. Look out for signs of risk-taking or dangerous behaviour which can be exciting initially, but develop into more serious difficulties:

going under the radar, truanting, dropping out from college or university
self -harm
weight loss, slurred speech, unexplained bruises and cuts, scalds, burns
erratic behaviour, becoming withdrawn, abusive and violent.
 

When connection is too difficult, psychotherapy can help
Sometimes communication has broken down and it’s important to open the channels again. This can be possible in a safe, non-judgemental space where even the most challenging issues can be thought about. Some teens find talking much too challenging. Exploring their feelings through the safety of imagery and the arts is a useful alternative to talking. Getting help early on can safeguard against issues affecting long-term mental health.

Link:https://www.psychotherapy.org.uk/news/how-to-stay-connected-with-a-teenager/
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Adults with a history of childhood trauma can benefit from recommended depression treatments, contrary to current theory

emotional/physical/sexual abuse before the age of 18) is known to be a risk factor for the development of major depressive disorder in adulthood


Adults with major depressive disorder who have a history of childhood trauma experience symptom improvement after pharmacotherapy, psychotherapy, or combination treatment. The results of a new study, published in The Lancet Psychiatry, suggest that contrary to current theory, these common treatments for major depressive disorder are effective for patients with childhood trauma.
emotional/physical/sexual abuse before the age of 18) is known to be a risk factor for the development of major depressive disorder in adulthood, often producing symptoms that are earlier onset, longer lasting/more frequently recurring, and with increased risk of morbidity. Previous studies have suggested that adults and adolescents with depression and childhood trauma were around 1.5 times more likely to not respond or remit after pharmacotherapy, psychotherapy, or combination treatment, than those without childhood trauma.

"This study is the largest of its kind to look at the effectiveness of depression treatments for adults with childhood trauma and is also the first to compare the effect of active treatment with control condition (waitlist, placebo, or care-as-usual) for this population. Around 46% of adults with depression have a history of childhood trauma, and for chronic depression sufferers the prevalence is even higher. It is therefore important to determine whether current treatments offered for major depressive disorder are effective for patients with childhood trauma," says Ph.D. Candidate and first author of the study, Erika Kuzminskaite.

The researchers used data from 29 clinical trials of pharmacotherapy and psychotherapy treatments for major depressive disorder in adults, covering a maximum of 6,830 patients. Of the participants, 4,268 or 62.5% reported a history of childhood trauma. Most of the clinical trials (15, 51.7%) were conducted in Europe, followed by North America (9, 31%). Depression severity measures were determined using the Beck Depression Inventory (BDI) or Hamilton Rating Scale for Depression (HRSD).

The three research questions tested were: whether childhood trauma patients were more severely depressed prior to treatment, whether there were more unfavorable outcomes following active treatments for patients with childhood trauma, and whether childhood trauma patients were less likely to benefit from active treatment than control condition.

In line with the results of previous studies, patients with childhood trauma showed greater symptom severity at the start of treatment than patients without childhood trauma, highlighting the importance of taking symptom severity into account when calculating treatment effects.

Although childhood trauma patients reported more depressive symptoms at both the start and end of the treatment, they experienced similar symptom improvement compared to patients without childhood trauma history. Treatment dropout rates were also similar for patients with and without childhood trauma. The measured treatment efficacy did not vary by childhood trauma type, depression diagnosis, assessment method of childhood trauma, study quality, year, treatment type or length.

"Finding that patients with depression and childhood trauma experience similar treatment outcome when compared to patients without trauma can give hope to people who have experienced childhood trauma. Nevertheless, residual symptoms following treatment in patients with childhood trauma warrant more clinical attention as additional interventions may still be needed. To provide further meaningful progress and improve outcomes for individuals with childhood trauma, future research is necessary to examine long-term treatment outcomes and mechanisms through which childhood trauma exerts its long-lasting effects," says Erika Kuzminskaite.

The authors acknowledge some limitations with this study, including a high variety of results among the studies included in the meta-analysis, and all cases of childhood trauma being reported retrospectively. The meta-analysis focused on symptom decline during acute treatment phase, but people with depression and childhood trauma often show post-treatment residual symptoms and are characterized by a high risk of relapse, thus they may benefit from treatment significantly less than patients without childhood trauma in the long run. The study design also did not account for differences between genders.

Writing in a linked Comment, Antoine Yrondi, University of Toulouse, France (who was not involved in the research) said, "This meta-analysis could allow to deliver a hopeful message to patients with childhood trauma that evidence-based psychotherapy and pharmacotherapy could improve depressive symptoms. However, physicians should keep in mind that childhood trauma could be associated with clinical features which may make it more difficult to reach complete symptomatic remission, and therefore, have an impact on the daily functioning."


More information: Treatment efficacy and effectiveness in adults with major depressive disorder and childhood trauma history: a systematic review and meta-analysis, The Lancet Psychiatry (2022). www.thelancet.com/journals/lan … (22)00227-9/fulltext

Link: https://medicalxpress.com/news/2022-09-adults-history-childhood-trauma-benefit.html
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Timely treatment of depression could reduce the risk of dementia

the course of ineffectively treated depression carries significant medical risk.


Depression has long been associated with an increased risk of dementia, and now a new study provides evidence that timely treatment of depression could lower the risk of dementia in specific groups of patients.

Over 55 million people worldwide live with dementia, a disabling neurocognitive condition that mainly affects older adults. No effective treatment for dementia exists but identifying ways to help minimize or prevent dementia would help to lessen the burden of the disease.

The study, led by Jin-Tai Yu, MD, PhD, Huashan Hospital, Shanghai Medical College, Fudan University, and Wei Cheng, PhD, Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China, appears in Biological Psychiatry, published by Elsevier.

Professor Yu and Professor Cheng used data collected by the UK Biobank, a population-based cohort of over 500,000 participants. The current study included more than 350,000 participants, including 46,280 participants with depression. During the course of the study, 725 of the depressed patients developed dementia.

Previous studies examining whether depression therapies such as pharmacotherapy and psychotherapy could lower the risk for dementia produced mixed results, leaving the question unresolved. "Older individuals appear to experience different depression patterns over time," said Professor Yu. "Therefore, intra-individual variability in symptoms might confer different risk of dementia as well as heterogeneity in effectiveness of depression treatment in relation to dementia prevention."

To address that heterogeneity, the researchers then categorized participants into one of four courses of depression: increasing course, in which mild initial symptoms steadily increase; decreasing course, starting with moderate- or high-severity symptoms but subsequently decreasing; chronically high course of ongoing severe depressive symptoms; and chronically low course, where mild or moderate depressive symptoms are consistently maintained.

As expected, the study found that depression elevated the risk of dementia – by a striking 51% compared to non-depressed participants. However, the degree of risk depended on the course of depression; those with increasing, chronically high, or chronically low course depression were more vulnerable to dementia, whereas those with decreasing course faced no greater risk than participants without depression.

The researchers most wanted to know whether the increased risk for dementia could be lowered by receiving depression treatment. Overall, depressed participants who received treatment had reduced risk of dementia compared to untreated participants by about 30%. When the researchers separated the participants by depression course, they saw that those with increasing and chronically low courses of depression saw lower risk of dementia with treatment, but those with a chronically high course saw no benefit of treatment in terms of dementia risk.
He notes that, "in this case, symptomatic depression increases dementia risk by 51%, whereas treatment was associated with a significant reduction in this risk."

"This indicates that timely treatment of depression is needed among those with late-life depression," added Professor Cheng. "Providing depression treatment for those with late-life depression might not only remit affective symptoms but also postpone the onset of dementia."

"The new findings shed some light on previous work as well," said Professor Cheng. "The differences of effectiveness across depression courses might explain the discrepancy between previous studies."
Journal reference:
Yang, L., et al. (2022) Depression, Depression Treatments, and Risk of Incident Dementia: A Prospective Cohort Study of 354,313 Participants. Biological Psychiatry. doi.org/10.1016/j.biopsych.2022.08.026.
Link:
https://www.news-medical.net/news/20221017/Timely-treatment-of-depression-could-reduce-the-risk-of-dementia.aspx
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Digital interventions can help relieve depressive symptoms

data from smartphones and wearable devices might be used to identify people with symptoms of depression and anxiety.


With a shortage of therapists, help with mental health problems is being sought from digital interventions, where elements of psychological treatment are offered via computer programs or mobile applications. According to a study, smart devices can help identify people with symptoms of depression and anxiety.

Every year, 400 million people worldwide are affected by depression or anxiety, and the coronavirus pandemic has only increased the prevalence of mental health problems. At the same time, there is a shortage of psychotherapists. Digital interventions, where elements of psychological treatment are offered via computer programs or mobile applications, have been proposed as a solution.

In his doctoral thesis in the field of psychology, researcher Isaac Moshe investigated the effectiveness of digital interventions in treating mental health problems, with depressive symptoms in particular focus.

Tracking depression and anxiety with smart devices
One sub-study in the doctoral thesis examined whether symptoms of depression or anxiety can be identified from data collected by smartphones or wearable devices. A total of 60 adults who used an iPhone or an Oura Ring took part in the sub-study.

Based on the study, smartphone GPS data was predicted the user's depressive symptoms. Subjects who visited the same locations repeatedly had more depressive symptoms than those whose location had more variability. The data collected by smart rings indicated that the longer the person slept or spent time in bed on average, the more depressive symptoms they had. The ring data also revealed that the more frequently people woke up at night, the more symptoms of anxiety they had.
Digital interventions alleviate depressive symptoms
The most extensive sub-study of the doctoral thesis was an international collaboration that assessed the effectiveness of digital interventions in treating depression by conducting a meta-analysis of all previous studies. Digital interventions typically include videos, interactive exercises or text to deliver the core components of psychotherapy, which are then packaged into an online program or smartphone app.

The dataset was composed of 83 randomized controlled trials conducted between 1990 and 2020 involving 15,530 participants.
The findings indicate that digital interventions brought relief from depressive symptoms when they were offered in public or private healthcare settings. Digital interventions alleviated symptoms in people of all ages, regardless of depression severity or physical comorbidity.

Moshe points out that there are important caveats: in children and adolescents, digital interventions were less effective than in adults. Having human support alongside the digital interventions was also critical to people completing the programs and therefore getting the maximum benefits. Furthermore, the researchers felt that it was unclear whether digital interventions were indeed as effective as face-to-face psychotherapy, as so few comparative studies on the topic have so far been conducted.

Moshe believes that, overall, digital interventions could provide a valuable way to help meet the growing global demand for mental healthcare.

"They lower the barrier to accessing treatment, enabling anyone with a computer an internet connection to benefit from psychotherapy at a time and place that is convenient to them. Digital interventions also require much less time from therapists than traditional therapy, making it possible to shorten waiting lists and treat more people."
Source:
Helsingin yliopisto (University of Helsinki)
Link:
https://www.news-medical.net/news/20221220/Digital-interventions-can-help-relieve-depressive-symptoms.aspx
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Performing acts of kindness may help people suffering from depression or anxiety

Social connection is one of the ingredients of life most strongly associated with well-being. Performing acts of kindness seems to be one of the best ways to promote those connections.”


People suffering from symptoms of depression or anxiety may help heal themselves by doing good deeds for others, new research shows.

The study found that performing acts of kindness led to improvements not seen in two other therapeutic techniques used to treat depression or anxiety.

Most importantly, the acts of kindness technique was the only intervention tested that helped people feel more connected to others, said study co-author David Cregg, who led the work as part of his PhD dissertation in psychology at The Ohio State University.
Cregg conducted the research with Jennifer Cheavens, professor of psychology at Ohio State. Their study was published recently in The Journal of Positive Psychology.

The research also revealed why performing acts of kindness worked so well: It helped people take their minds off their own depression and anxiety symptoms.

This finding suggests that one intuition many people have about people with depression may be wrong, Cheavens said.

"We often think that people with depression have enough to deal with, so we don't want to burden them by asking them to help others. But these results run counter to that," she said.

"Doing nice things for people and focusing on the needs of others may actually help people with depression and anxiety feel better about themselves."

The study involved 122 people in central Ohio who had moderate to severe symptoms of depression, anxiety, and stress.

After an introductory session, the participants were split into three groups. Two of the groups were assigned to techniques often used in cognitive behavioral therapy (CBT) for depression: planning social activities or cognitive reappraisal.

The social activities group was instructed to plan social activities for two days a week. Another group was instructed in one of the staples of CBT: cognitive reappraisal. These participants kept records for at least two days each week that helped them identify negative thought patterns and revise their thoughts in a way that could reduce depression and anxiety.
Members of the third group were instructed to perform three acts of kindness a day for two days out of the week. Acts of kindness were defined as "big or small acts that benefit others or make others happy, typically at some cost to you in terms of time or resources."

Some of the acts of kindness that participants later said they did included baking cookies for friends, offering to give a friend a ride, and leaving sticky notes for roommates with words of encouragement.

Participants followed their instructions for five weeks, after which they were evaluated again. The researchers then checked with the participants after another five weeks to see if the interventions were still effective.

The findings showed that participants in all three groups showed an increase in life satisfaction and a reduction of depression and anxiety symptoms after the 10 weeks of the study.

"These results are encouraging because they suggest that all three study interventions are effective at reducing distress and improving satisfaction," Cregg said.

"But acts of kindness still showed an advantage over both social activities and cognitive reappraisal by making people feel more connected to other people, which is an important part of well-being," he said.

In addition, the acts of kindness group showed greater improvements than the cognitive reappraisal group for life satisfaction and symptoms of depression and anxiety, results showed.

Cheavens noted that just participating in social activities did not improve feelings of social connection in this study.

"There's something specific about performing acts of kindness that makes people feel connected to others. It's not enough to just be around other people, participating in social activities," she said.

Cregg said that while this study used techniques of CBT, it is not the same experience as going through CBT. Those who undergo the full treatment may have better results than those in this study.

But the findings also show that even the limited CBT exposure given in this study can be helpful, Cheavens said.

"Not everyone who could benefit from psychotherapy has the opportunity to get that treatment," she said. "But we found that a relatively simple, one-time training had real effects on reducing depression and anxiety symptoms."

And beyond traditional CBT, acts of kindness may have additional benefits in creating social connections, Cregg said.

"Something as simple as helping other people can go above and beyond other treatments in helping heal people with depression and anxiety," he said.

Reference:
Ohio State University

Journal reference:
Cregg, D.R., et al. (2022) Healing through helping: an experimental investigation of kindness, social activities, and reappraisal as well-being interventions. The Journal of Positive Psychology. doi.org/10.1080/17439760.2022.2154695.
Link:
https://www.news-medical.net/news/20230110/Performing-acts-of-kindness-may-help-people-suffering-from-depression-or-anxiety.aspx
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Schizophrenia and Brain Asymmetry: New Insights

New large-scale study shows alterations in language areas in schizophrenia.

Schizophrenia is a devastating mental health issue that affects about 1% of Americans. Its symptoms can be quite different from patient to patient. Common symptoms include hearing voices and other forms of hallucinations, delusions, paranoia, as well as problems with thinking, and incoherent speech. All these symptoms represent issues with brain functions such as speaking or thinking. Therefore, scientists have conducted many studies looking for changes in the structure of the brains of patients with schizophrenia compared to healthy volunteers, as this may be helpful in understanding the reasons for schizophrenia and potentially creating new ideas for better treatments.
One leading theory suggests that schizophrenia is related to a reduction of so-called hemispheric asymmetries in the language system. In almost all people, brain networks on the left side of the brain are controlling language. In schizophrenia, this leftward asymmetry may be reduced, which may be related to common language issues in patients, such as hearing voices that are not really there. While this is an intriguing theory, previous research studies have yielded very inconsistent results, possibly because the number of people tested in most studies was rather low.
A new study on brain asymmetries and schizophrenia
A new study by the ENIGMA consortium, now published in the journal PNAS, tackled this problem by conducting the largest-ever study on brain asymmetries in schizophrenia (Schijven et al., 2023). The international research team analyzed magnetic resonance imaging data from 5,080 patients with schizophrenia and 6,015 controls. Magnetic resonance imaging is a neuroimaging technique that uses magnets to create high-resolution pictures of the brain. It is commonly used in hospitals for diagnosing different disorders, such as tumors in the brain. In addition to that, it is commonly used in psychological and neuroscientific research in order to assess the brain structure of patients and healthy people.
The scientists compared asymmetries in the thickness of the cortex of the brain between patients with schizophrenia and controls. They found asymmetry differences between the two groups in two brain areas: the rostral anterior cingulate (a brain area related to emotion and cognitive control) and the middle temporal gyrus (a key area for language). Both effects were caused by a thinner cortex on the left side of the brain in patients with schizophrenia compared to controls. This finding is in line with idea that language lateralization is altered in schizophrenia as these changes in the structure of speech area may cause altered function of the speech network.
A further whole-brain analysis of asymmetries revealed that all together, 7% of the variation in brain asymmetries was associated with the status of the participants (schizophrenia patients or control). This suggests broader changes in asymmetries across the brain in schizophrenia that are not limited to language regions. Taken together, the findings of the study show how large-scale neuroscientific studies in patients with mental disorders can be very informative in understanding the potential reasons why patients experience certain symptoms. Further analyzing the brain regions identified in the study using modern neuroscientific and molecular methods may be helpful in understanding the mechanisms behind schizophrenia and finally creating better treatments for patients suffering from this agonizing disorder.

reference:
psychology today

link:
https://www.psychologytoday.com/intl/blog/the-asymmetric-brain/202304/schizophrenia-and-brain-asymmetry-new-insights
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6 Characteristics of a Healthy Family

To understand what is unhealthy, we first have to define what is healthy.


KEY POINTS
While each family is different, there are some common elements that can contribute to a healthy family environment.
Respecting opinions and personal needs, as well as showing respect, are all part of healthy family systems.
In isolation, one or more of these characteristics not being a part of your family is not in itself dysfunctional.
Whenever I conduct trainings or start working with clients who are beginning their journey in recovery from family trauma, I like to go over some basic characteristics of healthy families. If we do not know what is healthy, it's difficult to identify what was unhealthy.
These may sound easy to identify, but in truth, many of us are unaware of what makes a family healthy—or normal. Words like “healthy” or “unhealthy” have become so commonplace, but few of us could describe the characteristics required to use these words in relation to families. Thus, I focus on these six to give a foundational understanding to build from.

Here are six common characteristics of healthy families or social systems:

1. Respecting healthy emotional and physical boundaries: Children and other family members have privacy, and all members understand and respect that. In healthy families, parents do most of the emotional work with their children by modeling empathy, self-control, and appropriate behaviors in response to emotions or stress. The role of children is to learn.

2. Seeing each family member as an individual with an opinion: Everyone is allowed to have an opinion and all family members should respect and allow those opinions to be expressed as long as they are respectful, even if adults make the final decision. In families where there is little room for differing opinions, it is common for children to grow up into adults who do not know who they are. When you are always taught how and what to think, it is normal to not know how to do this for yourself.

3. Setting consistent, fair, and age-appropriate rules and expectations: All families have rules and it would be normal to find homes with different sets, but rules that are inconsistent or not age-appropriate create an environment of confusion and chaos. Children are still growing and learning, so a caregiver’s expectations of them should not be the same as their expectations of themselves or other adults.

4. Meeting each person’s needs appropriately: All members are concerned with the health and well-being of others, but in an age-appropriate way. Parents provide emotional care for the children; not the other way around. As best as they can, other members also seek to meet their other family members' needs.

5. All members of the family feel safe and secure: Children in a healthy family feel safe learning, growing, and making mistakes. They have a healthy understanding of mistakes and understand that they will not challenge or threaten their security or safety. Love is unconditional.

6. Expecting mistakes and forgiving them in a healthy way: The family members understand that we are all humans learning and growing. Conflict is handled in an appropriate and safe way, with adults modeling appropriate ways to manage disagreements and disputes. These families explore mistakes to understand and improve, instead of shaming people for them. Children understand that they will be punished for unacceptable behavior, but that they will also be forgiven for making mistakes, instead of having them held against them for years after.
Take a moment to think about your family history and if you remember any of the above characteristics. Often, people who experienced family-of-origin trauma will not have these experiences. This list can just give you an idea—if none of them took place in your home, that might be a sign that things were at least somewhat unhealthy.

In isolation, one or more of the above characteristics not being a part of your family of origin is not in itself dysfunctional. For example, different households might have different ideas about whether and how the children can express their opinions based on individual family dynamics, like culture, generation, and other factors. All of the above items do not have to exist together, either, for a family to be healthy.
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Alcohol Is Not Good for Your Health, Even in Moderation

New research confirms that even small amounts of alcohol have real health risks.


KEY POINTS
It turns out that drinking moderate amounts of alcohol daily does not—as previously thought—protect health or contribute to a longer life.
New research confirms increases in the risks of numerous health problems and dying prematurely, even with modest drinking.
A 2020 report found that the alcohol industry directly or indirectly paid for 13,500 studies linking alcohol use to health benefits.
As comforting as it might be to think that drinking is good for one’s health, increasingly, the science does not support it.
It turns out that drinking moderate amounts of alcohol daily does not—as previously thought—protect against heart disease or contribute to a longer life. Apologies if your alcohol consumption depends in part on this popular belief and (until now) useful rationalization.

For decades, scientific studies suggested moderate drinking was better for most people’s health than not drinking at all, and could even boost longevity. But, a new analysis of more than 40 years of research has concluded that many of those studies were flawed and that the opposite is true.

Just published in JAMA Network Open, this meta-analysis reviewed 107 observational studies that involved more than 4.8 million people. The massive study stressed that previous estimates of the benefits of moderate alcohol consumption on the risk of death by “all causes” — meaning anything, including heart disease, cancer, infections, and automobile accidents — were “significantly” biased by flaws in study design.

According to the researchers, earlier research did not adjust for numerous factors that could influence the outcome, for example, age, sex, economic status, and lifestyle behaviors such as exercise, smoking, and diet. Using statistical software, they essentially removed such bias, adjusting for various factors that could skew the research. After doing so, there were no significant declines in the risk of death by any cause among the moderate drinkers.[1]

While these previous observational studies could identify potential links or correlations, they could also be misleading and didn’t prove cause and effect. Moreover, they failed to recognize that many light and moderate drinkers had other healthy habits and advantages and that non-drinkers used as a comparison group often included people who had given up alcohol after developing health problems.

This represents the largest study to effectively call B.S. on the widely held belief that moderate drinking of wine or other alcoholic beverages is healthy. In contrast, it found that the risk of numerous health problems, as well as that of dying prematurely, increased significantly after less than two drinks per day for women and after three per day for men.

This data adds to that of another substantial meta-analysis from 2022 in which researchers in Britain examined genetic and medical data of nearly 400,000 people and concluded that alcohol consumption at all levels was associated with increased risk of cardiovascular disease.[2]

The modern-day belief that daily alcohol consumption promotes health emerged in the 1980s, when researchers identified the so-called “French paradox,” which suggested that low rates of cardiovascular disease among men in France was associated with daily wine consumption. Although later analyses found flaws in the research, the idea that moderate drinking improved health became broadly accepted. Wine—particularly red wine—developed a reputation for having health benefits after news stories highlighted its high concentration of resveratrol, a protective antioxidant also found in blueberries and cranberries.
However, the hypothesis that moderate alcohol use is health-enhancing has come under increasing scrutiny over the years as the alcohol industry’s role in funding research became clear, revealing that many of the studies that purport the alleged health effects of alcohol have been funded by that industry. A 2020 report found that 13,500 studies have been directly or indirectly paid for by the alcohol industry.[3] Concurrently, a range of other studies has found that even moderate consumption of alcohol—including red wine—may contribute to cancers of the breast, esophagus, head and neck, high blood pressure, and atrial fibrillation, a serious heart arrhythmia.

Dietary guidelines for Americans 2020-2025 recommend that adults limit alcohol intake to two drinks or fewer a day for men and one drink or less for women, adding “that drinking less is better for health than drinking more.” The guidelines also warn that even drinking within the recommended limits may increase the overall risk of death attributable to various causes, including some types of cancer and heart disease, even at levels of less than one drink per day.[4]

This past January, Canada issued new guidelines warning that no amount of alcohol consumption is healthy and urges people to reduce drinking as much as possible. Issued by the Canadian Centre on Substance Use and Addiction, the new guidance was a significant departure from its 2011 guidelines, which recommended women limit themselves to no more than 10 standard drinks a week and men no more than 15.[5]

Alcohol is the most used recreational drug, and unfortunately, for those who enjoy drinking for relaxation and recreation, this is unwelcome news. As comforting as it might be to think that it’s good for one’s health, increasingly the science simply does not support it. The extensive new research decimates the hope of many that moderate alcohol use is healthy and makes clear that people should not drink alcohol for the express purpose of improving their health. If maintaining and/or improving health is your priority, in terms of alcohol consumption, less is more.

Reference: Psychology today
Link:
https://www.psychologytoday.com/intl/blog/some-assembly-required/202304/alcohol-is-not-good-for-your-health-even-in-moderation
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Smiling to Death: The Hidden Dangers of Being ‘Nice’

We can learn to bring more awareness to our own emotions and needs.


KEY POINTS
Pushing down anger, prioritizing duty, and trying not to disappoint others are leading causes of chronic illness.
Ignoring or suppressing how we feel and what we need revs up our stress response, pushing our body toward inflammation.
Our need to maintain membership in our groups leads us to suppress our emotions in a tug-of-war between attachment and authenticity.

Being nice and pleasing others—while socially applauded and generally acknowledged as positive traits—actually can harm our health, says Gabor Maté.Decades of research point to the same conclusion: Pushing down our anger, prioritizing duty and the needs of others before our own, and trying not to disappoint others are leading causes of chronic illness, says the author of the New York Times bestseller, The Myth of Normal: Trauma, Illness and Healing in a Toxic Culture.

“Our physiology is inseparable from our social existence,” argues the Vancouver physician. Ignoring or suppressing how we feel and what we need—whether done consciously or unconsciously—revs up our stress response, pushing our body toward inflammation, at the cost of our immune system, he says.

“If we work our fingers to the bone, if we’re up all night serving our clients, if we’re always available, never taking time for ourselves, we’re rewarded financially and we’re rewarded with a lot of respect and admiration,” says Maté, “and we’re killing ourselves in the process.”

Personality Features of People With Chronic Illness
When Maté reviewed the research on the chronic illnesses he’d treated for more than 30 years, he discovered a pattern of personality features that most frequently present in people with chronic illness:

Automatic and compulsive concern for the emotional needs of others, while ignoring one’s own needs;
Rigid identification with social role, duty, and responsibility;
Overdriven, externally focused hyperresponsibility, based on the conviction that one must justify one’s existence by doing and giving;
Repression of healthy, self-protective anger; and
Harbouring and compulsively acting out two beliefs: I am responsible for how other people feel, and I must never disappoint anyone.
“Why these features and their striking prevalence in the personalities of chronically ill people are so often overlooked—or missed entirely,” is because they are among the “most normalized ways of being in this culture…largely by being regarded as admirable strengths rather than potential liabilities,” says Maté.
These characteristics have nothing to do with will or conscious choice, says Maté.
Coping Patterns
“No one wakes up in the morning and decides, ‘Today, I’ll put the needs of the whole world foremost, disregarding my own,’ or ‘I can’t wait to stuff down my anger and frustration and put on a happy face instead.’” Nor are we born with these traits—instead, they are coping patterns, adaptations to preserve our connection to others, sometimes at the expense of our very lives, he warns.

We develop these traits to be accepted, in what Maté describes as the tug-of-war between our competing needs for attachment and authenticity. We need attachment to survive, as we are a tribal species, wired for connection, conforming to the needs and rules of others to secure our membership in groups.

But we also need authenticity to keep us healthy. We’re designed to feel and act on emotions, especially the “negative” ones. It’s our alarm system to survive danger. Psychiatrist Randolph Nesse, founding director of the Centre for Evolution and Medicine at Arizona State University, explains that we’ve evolved to survive, not to be happy or calm.

Low mood, anger, shame, anxiety, guilt, grief—these are all helpful responses to help us meet the challenges of our specific environments. Having loud, sensitive protective functions like emotions that sound alarms when we’re threatened isn’t a design flaw. It’s a design success.

Our emotions act as smoke alarms to match the perceived threats around us, says Nesse. This seems most obvious with emotions, like fear, that scream out warnings of danger. But even more subtle emotional experiences help us navigate threats and rewards for survival. The discomfort of a low mood is signaling that there aren’t enough rewards in our environment to outweigh the risks of being there, motivating us to seek out circumstances that are more rewarding or conserve our energy in a safe place—like in bed bingeing Netflix—until the rewards return.
Anger, too, is a necessary response to fight inequities, violations, and having our needs blocked. It’s our most effective tool to mobilize action against injustice. The biggest obstacle to social justice is not heated opposition, but apathy. And, yet, society has socialized many of us to suppress anger. Even the vilified emotion of anger’s more subtle form, resentment, is helpful. When our body and brain pick up subtle cues that our boundaries are not being respected, the resentment alarm shouts out loud and clear to assert these boundaries before we even have time to reflect on the situation.

Suppressing Vital Emotions
Yet, the need to maintain membership in our groups has led us to suppress these vital emotional signals, disarming our ability to protect ourselves, says Maté. Even more problematic, says Maté, is that conscious suppression of emotions has been shown to heighten our stress response and lead to poor health outcomes. “We know that chronic stress, whatever its source, puts the nervous system on edge, distorts the hormonal apparatus, impairs immunity, promotes inflammation, and undermines physical and mental well-being,” says Maté. And numerous studies show that a body stuck in a chronic stress response stays in an inflamed state, Maté continues, the precursor of many chronic illnesses, such as heart disease, cancer, autoimmune diseases, Alzheimer’s, depression, and many others.

Maté is careful not to use this research to blame people for their own illnesses. “No person is their disease, and no one did it to themselves—not in any conscious, deliberate or culpable sense,” he says. “Disease is an outcome of generations of suffering, of social conditions, of cultural conditioning, of childhood trauma, of physiology bearing the brunt of peoples stresses and emotional histories, all interacting with the physical and psychological environment. It is often manifestations of ingrained personality traits, yes—but that personality is not who we are any more than are the illnesses to which it may predispose us.”

Our personality and coping styles reflect the needs of the larger social group in which we develop, says Maté. “The roles we are assigned or denied, how we fit into society or are excluded from it, and what the culture induces us to believe about ourselves, determine much about the health we enjoy or the diseases that plague us.” Illness and health are manifestations of our social macrocosm, he argues.

It’s no surprise, then, that the inequities of society deeply affect our health, with those more politically disempowered or economically disenfranchised being forced to shape and suppress their emotions and needs most gravely to survive, says Maté. This means systemic change to fight inequities and focus on social justice is the foundation of improving our health, a common thread in The Myth of Normal.

At the same time, we can work to unlearn these behaviour patterns by bringing more awareness to our own emotions, signals in our bodies, and our needs, rather than automatically ignoring them in the service of others.

“The personality is an adaptation,” says Maté. “What we call the personality is often a jumble of genuine traits and conditioned coping styles, including some that do not reflect our true self at all but rather the loss of it.”
Maté describes true healing as opening ourselves to the truths of our lives, past and present. “After enough noticing, actual opportunities for choice begin to appear before we betray our true wants and needs,” he says. “We might now find ourselves able to pause in the moment and say, ‘Hmm, I can tell I’m about to stuff down this feeling or thought—is that what I want to do? Is there another option?’

“The emergence of new choices in place of old, preprogrammed dynamics is a sure sign of our authentic selves coming back online.”
Reference :
Psychology today
Link:
https://www.psychologytoday.com/intl/blog/its-not-you-its-the-world/202304/smiling-to-death-the-hidden-dangers-of-being-nice
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The Surprising Role of Empathy in Traumatic Bonding

Research examines the relationship between traumatic abuse and bonding.


A recent study by Effiong et al. suggests empathy intensifies traumatic bonding—the formation of a strong bond between the victim and his/her abuser. Published in Journal of Social and Personal Relationships, the study is discussed below.
But first, a few definitions.
What is empathy?
Empathy is defined in a number of ways. Depending on the definition chosen, its meaning may overlap with similar concepts, such as empathic concern, emotional empathy, cognitive empathy, sympathy, care, and compassion.
According to a commonly used definition, empathy is composed of affective and cognitive empathy:
Affective/emotional empathy refers to the ability to generate an appropriate emotional response to another person’s emotions. Affective empathy overlaps with sympathy and compassion.
Cognitive/intellectual empathy refers to the ability to understand another person’s psychological state and point of view (to put oneself in another’s shoes). Cognitive empathy is related to theory of mind.
In the study by Effiong and colleagues, empathy was assessed using the Basic Empathy Scale, which measures both affective and cognitive empathy.
What is traumatic bonding?
Traumatic bonding refers to the formation of a powerful emotional attachment, due to repeated cycles of violence, between the victim and the abuser (whether a boyfriend/girlfriend, spouse, or complete stranger).
The fact that the abuse often comes in cycles—meaning that the violence is interspersed with positive reinforcement—also explains, in part, why victims find it difficult to leave their abusers.
For instance, after harming the victim, the abuser may (in an apparent reversal of power) apologize profusely, beg for forgiveness, or behave with great love and surprising tenderness.
Nevertheless, sooner or later, the next cycle of violence occurs, confusing the victim.
Another reason victims of abuse don’t leave has to do with their low self-worth. As the maltreatment continues, the victims—with their self-esteem eroded—find themselves in an increasingly powerless and dependent position.
In fact, they may no longer even believe that they deserve to be treated with kindness, dignity, and respect. This makes it much harder to stand up to the abuser and risk more rejection and humiliation.
The three dimensions of traumatic bonding
Traumatic bonding has three dimensions:
1. Core Stockholm syndrome: Associated with interpersonal trauma, cognitive distortions (e.g., rationalization, self-blame, seeing the abuser as a victim), unrealistic hope for things getting better on their own, believing love will prevent the abuser’s aggression, etc. Many of these behaviors are essentially (dysfunctional) coping mechanisms.
2. Psychological damage: Associated with depression, interpersonal difficulties, low self-esteem, the loss of sense of self, and many symptoms commonly seen in borderline personality disorder, like fear of abandonment or never finding a loving partner after leaving the abusive relationship.
3. Love dependency: Associated with assuming that one’s survival is dependent on the abusive partner’s love and protection, thinking the abuser’s love would be worth any pain, experiencing a loss of identity when alone, and believing that one would have nothing to live for without the partner.
Let us now turn to the new research on the link between empathy and traumatic bonding.
Investigating traumatic bonding in victims of intimate partner violence
Sample: 345 women from the Sexual Assault Referral Centre (n = 145) and the Lagos State Domestic and Sexual Violence Response Team (n = 200) in Nigeria; average age of 36 years old (18-61 range); married an average of 10 years.

Measures
1. Intimate partner violence: Measured with the short version of the Composite Abuse Scale (30 items). Participants were asked about the frequency of emotionally or physically abusive behavior by an intimate partner. Sample items: “Slapped me”; “Told me that I wasn’t good enough”; “Harassed me at work”; or “Tried to rape me.”
2. Empathy: Measured with the Basic Empathy Scale (20 items). For example: “After being with a friend who is sad about something, I usually feel sad,” and “I can often understand how people are feeling even before they tell me.”
3. Traumatic bonding: Assessed with the Stockholm Syndrome Scale (49 items). For instance: “Without my partner, I have nothing to live for”; “I cannot make decisions”; “When others ask me how I feel about something, I do not know”; “I both love and fear my partner”; and “If I give my partner enough love, he will stop getting so angry at me.”
Results
Analysis of the data showed empathy was a mediator of the relationship between intimate partner violence and traumatic bonding, including core Stockholm syndrome, psychological damage, and love dependency.
So, for all three aspects of traumatic bonding, empathy appears to be a path through which intimate partner violence is “translated and intensified” into traumatic bonding.
Takeaway
Empathy, particularly cognitive empathy—meaning the ability to understand another person’s psychological state—appears to be a pathway through which intimate partner violence intensifies traumatic bonding.
One way of explaining this finding is that victims use their empathic ability to rationalize the mistreatment they endure.
For instance, they may view the perpetrator as a victim, a victim who needs their help or one who cannot be held responsible for the aggression or abuse.
Such rationalizations are not surprising. After all, with their self-esteem and sense of self eroded by abuse, these women find it difficult to generate self-compassion and are instead prone to guilt, self-blame, and self-sacrifice.
Not only do victims of intimate partner violence tend to feel unworthy of respect, kindness, and love, but many also feel they will never find someone who treats them well.
Since victims additionally believe they cannot survive on their own (due to impaired autonomy), they find it extremely difficult to leave the toxic relationship, and as a result continue to suffer terribly. Unless, of course, they seek therapy and try to break this vicious cycle.

reference:
psychology today

link:
https://www.psychologytoday.com/intl/blog/finding-a-new-home/202207/the-surprising-role-of-empathy-in-traumatic-bonding