Archive for July, 2009

Culture and Emotions

Wednesday, July 29th, 2009

Anxiety, depression, and other emotional problems are usually considered to be caused by a combination of genetic, biological, and psychological factors. However, culture may also raise the risk of certain emotional reactions. In our recent book Borderline Personality Disorder For Dummies, we discuss the emphasis on individualism, prevalent in most Western cultures as a possible contributor to a wide range of emotional and behavioral issues.

Multiple studies have looked at how increasing people’s focus on themselves causes negative feelings and lowers the ability to solve problems. In the West, people tend to celebrate the self, move from their families in order to accelerate their careers, and lavish attention on individual accomplishments. By contrast, many traditional, Eastern cultures place more emphasis on families, communities, and interdependence. Support for one another has a central place in these cultures.

Does this cultural difference matter to people’s mental health? Well, a considerable body of research supports the view that self-absorption, a tendency to focus attention on oneself, increases the chances of having the following:

  • Anger
  • Substance abuse
  • Anxiety
  • Depression
  • Eating disorders
  • Risky behaviors
  • Self harm
  • Virtually all psychopathology

People with Borderline Personality Disorder often have a number of such symptoms. We aren’t saying that people with emotional disorders are too self absorbed. Rather, we’re suggesting that any culture which overly emphasizes individualism and personal gain may be doing so at a steep emotional cost for much of its populace.

Therefore, we often recommend that clients with emotional problems find volunteer work and other activities that connect them with people. Such work often improves their adjustment. Connections and social support may have more value than merely trying to boost self esteem. Speaking of self esteem, don’t forget to check out our free gift offer celebrating the 8th anniversary of our book “Hollow Kids: Recapturing the Soul of a Generation Lost to the Self Esteem Myth.”

Self Esteem, Hollow Kids, and a Gift of Gratitude from Us to You

Saturday, July 25th, 2009

We are nearing the 8th anniversary of the publication of our book, Hollow Kids: Recapturing the Soul of a Generation Lost to the Self-Esteem Myth. We were especially pleased with this book. Although the book briefly received substantial attention from national media such as CNN; events around 9-11, the sale of the publisher, and other miscellaneous happenings quickly closed the door on such attention and sales. We are not bemoaning the book’s rapid demise into out of print status. But we do feel good that media such as Parent Magazine, Better Homes & Garden, the New York Post, and the Washington Times continued to write articles about it for several years after it was no longer available. And a colleague of ours recently wrote a review of the book that pleased us even more.

Even though we have a newly released book, Borderline Personality Disorder For Dummies, that we would dearly love to attract attention to, we wanted to do something special for the 8th anniversary of Hollow Kids. Does this mean we’re going to pitch an expensive copy to you? No. We feel grateful for the following we’ve had for our Anxiety and OCD Exposed blog and decided that we’d like to offer our readers a free pdf download of Hollow Kids from now until August 31st. It’s the complete book, not a condensed online version. No catch; no strings. We just want to express our gratitude for your interest and following. Of course, if you feel like checking out Borderline Personality Disorder For Dummies while you’re at it, that would be great too!

By the way, this book has been a bit controversial. We look forward to an honest, respectful debate about our ideas. Here’s the review by our colleague (presented with permission) recently published in the New Mexico Psychological Association’s newsletter. See what you think.

Adolescence: A Contributor to Anxiety, Depression, and Borderline Personality Disorder?

Tuesday, July 21st, 2009

In our recently released book about Borderline Personality Disorder, we discuss the possible cultural conditions that nourish the beginnings of BPD. Adolescence can also be a breeding ground for increases in anxiety and depression for similar reasons. In fact, studies demonstrate that rates of anxiety and depression have been increasing at alarming rates for several decades.
Here is an excerpt from our new book: Borderline Personality Disorder For Dummies (just now available through Amazon).

Adolescence is a relatively modern concept that refers to the transition period between childhood and adulthood. Adolescence emerged as a consequence of the Industrial Revolution as a way to keep children in school and out of sweatshops–not such a bad idea. However, as it has evolved, adolescence has become a tumultuous and treacherous time for many teens. Arguably, adolescence brings with it large chunks of free time, which means numerous opportunities for teens to engage in self-destructive behaviors. Pressures mount for teens to have more, be more, and be noticed.

Adolescence is a time when psychological disorders, including signs of personality disorders such as BPD, emerge. Problems with gangs, violence, drug use, sensation seeking, eating disorders, and risky sexual behavior have burgeoned among adolescents in the past four or five decades. Of course, we’re not saying that adolescence itself causes emotional disorders; after all, many adolescents mature into adulthood with no sign of any emotional disorders. However, from a historical perspective, BPD symptoms and behaviors have only been written about in the past century or so–which coincides with the emergence of adolescence as feature of modern culture. When kids were busy milking cows and gathering crops, much less adolescent angst existed among teens. Perhaps, if we can give teens more important tasks than texting, video gaming, and hanging out at the mall, they won’t be as easily seduced by self-destructive behaviors.

What do YOU think?

We’ll discuss other possible contributors to BPD, as well as other emotional disorders, in some future blogs–obviously “adolescence” isn’t the only one! BPD has many complex interacting causes that range from genetics to early learning experiences and cultural influences.

Wash Your Hands!

Monday, July 20th, 2009

How many times have you heard that admonition? Your parents no doubt warned you to wash your hands frequently; hospitals post signs everywhere to promote regular hand washing; and notices in restaurant restrooms urge employees and patrons alike to wash their hands. Furthermore, almost everyone knows that washing hands regularly is one of the most useful things you can do to avoid spreading germs and diseases.  

Perhaps it’s not surprising that worries about contamination represent one of the most common types of obsessive compulsive disorder (OCD). People with this problem dwell on the possibility of contacting germs and either becoming sick or even dying as a result. They often start washing their hands quite frequently to deal with this concern. Each time they wash, they feel better for a short while; then the obsession starts anew. Images of germs and contaminants flood their minds and the urge to wash increases. So they wash their hands again and again. Some people with this type of OCD spend many hours each day washing and rewashing their hands. And they point to the signs and warnings posted everywhere they turn as evidence that their behavior makes sense.

They problem of course is that hand washing conforms to the law of diminishing returns. Although a certain amount of washing makes great sense, the value of increased washing in terms of risk reduction quickly drops off at a certain point. Unfortunately, people with this kind of OCD don’t know where that point lies or how to find it.

As we’ve said in previous blogs, exposure and response prevention (ERP) is one of the best strategies for overcoming most types of OCD including contamination concerns. ERP involves having people touch or expose themselves to a wide variety dirt surfaces such as doorknobs, counters, greasy motor parts, tires, floors, shoes, or garbage cans while avoiding hand washing for as long as possible. Given what we’ve said about hand …

Taking a deeper look at impulsivity

Sunday, July 12th, 2009

Our last blog discussed impulse control disorders such as Tricotillomania and Kleptomania. We wrote a bit about how they can be compared and contrasted to compulsive disorders such as OCD. Both impulsions and compulsions can be considered urges to carry out some action either physical, like washing hands, pulling hair, or mental like counting, chanting, or yelling.

People with other mental disorders also have problems with impulsivity. For example, many people diagnosed with Attention Deficit Hyperactivity Disorder have this trouble. They tend to speak without thinking, interrupt others, or have difficulty waiting their turns. Impulsivity is a characteristic of Bipolar Disorders, as well as Borderline Personality Disorder and Antisocial Personality Disorder. People with substance abuse problems, kids with fetal alcohol syndrome, and those who suffer some types of brain damage also act impulsively.

Most of us think about impulsivity as acting (or speaking) without thinking. We all do that from time to time. But impulsivity appears to have four separate components and people with impulsivity don’t always have all four of these issues. The following examples will illustrate each type of impulsive factor:

1. Aaron likes to take risks. He enjoys rock climbing, hang gliding, and tends to drive too fast. He craves excitement and sometimes takes excessive risks. Aaron’s impulsivity is called sensation seeking.

2. Beth has dropped in and out of college. She gets excited about a career or area of study then finds herself losing interest. At home, she has difficulty finishing books, tasks; she lacks discipline and flits from one thing to another. Her impulsivity is called lack of perseverance.

3. Cathy is very bright and energetic. She has big ideas but rarely gets them off the ground. She has huge credit card debts, can’t seem to give up smoking, and fails to plan for the future. Her type of impulsivity involves lack of planning.

4. David’s relationships are constantly conflicted. He becomes excessively enthusiastic, and then quickly gets bored. He can’t seem to handle stress very well. His reactions are instantaneous and often rash. His type of impulsivity involves acting without thinking.

So, you can think about impulsivity as …

Uncontrollable Behaviors: Are they all OCD?

Thursday, July 9th, 2009

Many people exhibit various types of problems that occur repetitively, cause harm to the person, and seem virtually uncontrollable. Sometimes we’re asked if these problems are examples of obsessive compulsive disorder (OCD). Although these other disorders have similarities to OCD, they usually are not considered to be in the same category. What are we talking about here?

Specifically, we’re referring to the category of emotional disorders known as Impulse Control Disorders. The similarity to OCD is seen in the fact that they are all repetitive and very difficult for the person to bring under control. Furthermore, like OCD, they greatly disrupt and impair the sufferers’ lives.

Impulse Control Disorders also differ from OCD. Impulse Control Disorders, unlike OCD, often do not cause those afflicted great distress unless or until legal authorities are called in. Furthermore, anxiety and/or distress do not play a very large role in most Impulse Control Disorders. Finally, many of those with Impulse Control Disorders actually report feeling pleasure from their behaviors even though their lives are impaired by them.

Some of the major types of Impulse Control Disorders include:

  • Pyromania: People with this problem find themselves drawn to setting fires. They aren’t out to make money as some arsonists are; rather, they set fires for the excitement of it. Regardless, their behavior often brings attention from law enforcement agencies.
  • Pathological Gambling: Not just anyone qualifies as a pathological gambler and thus have an Impulse Control Disorder. Only those who gamble themselves into serious problems financially over and over again receive this label. These folks sometimes even steal or engage in other illegal behavior just to keep their habit going. They may “know” what they are doing is a problem, but report feeling unable to stop.
  • Kleptomania: These folks find themselves stealing repeatedly, yet they rarely need the things they steal. Rather, they feel tension prior to stealing and great pleasure and excitement when executing the theft. Later, they may feel remorse, but it never stops the behavior. As you can imagine, more than a few of these people eventually wind up in jail.
  • Intermittent Explosive Disorder: People with this problem report feeling unable to put the brakes on …

Obsessions and Compulsions in Bad Times

Monday, July 6th, 2009

Losing a job, worrying about holding on to a job, or fearing ever being able to find a job-these concerns are greater than ever in this economy. Lots of baby boomers look at dwindling retirement accounts and worry about how they will have enough to live on. Young people struggle to find their first jobs and layoffs affect almost every extended family. The shrinking economy has lots of people stressed out. Stress and OCD don’t mix very well. We know that obsessions and compulsions become more frequent and increase in severity when people with OCD experience stress and worry.

Furthermore, even if you have never had OCD, it’s possible for symptoms to appear when you’re tense and worried. Obsessions and compulsions can be ways of the brain to handle extreme fears or stress. For example:

Jan, a single mother, was laid off from work 6 months ago. She collected unemployment and cut expenses to the bone. For the first time she found herself shopping in resale shops when her kids outgrew their shoes. The family ate lots of rice and beans. She always kept a clean house, but lately Jan has been having worries about keeping her kids safe from germs. She spends her days cleaning and re-cleaning the house. She tells the kids that they can’t afford to get sick because her health insurance was cancelled. She starts to make them take showers when they come home from school and put their school clothes in the washing machine so that she can decontaminate them. Her oldest daughter, frightened by her mother’s strange behavior, phones her grandmother. “Grandma,” she whispers into the phone, “something’s wrong with mommy.”

Bill, a 67 year old retired autoworker understandably worries about the future of his health care benefits, pension, and retirement savings. These realistic concerns send him to his computer to check the daily news, stock market conditions, and the balances of his portfolio. The checking, rather than helping ease his tension, only increases his anxiety. He finds himself spending more time at the computer and less time with friends and family. Spending all day at the computer …

Dogs, Fireworks, Fear and the 4th of July

Friday, July 3rd, 2009

Happy 4th of July. Tonight, we’ll sit outside and watch the fireworks from our backyard. Our dogs will likely be close by; not terribly frightened, but a bit upset by the explosions. We’ll keep an eye on them-watching for signs of fear. Dogs often react strongly to the noise of fireworks. There have been frequent reports of dogs running away, digging out of yards, and even jumping through glass windows in response to fireworks.

If your dog (or cat) becomes frightened, what should you do; how should you respond? Well, try acting happy or for that matter, even bored or disinterested. Do not reassure or attempt to calm down your frightened animal. Why? Because if you give positive attention to your animal’s fear, then you are in effect saying, “Rover (or Spot), you’re absolutely right. Something is terribly wrong. Those noises are awful and you should be scared. I’m here to help you through it.”

And when you do that, your dog’s fear will likely increase. As the fears heighten, your dog will run to you for even more reassurance. And a vicious cycle begins. Alternatively, when you act either happy or disinterested; your dog receives a signal that conveys no concerns with what’s going on. You, the leader of the pack, are not worried. Thus, your dog becomes less anxious.

As with most good dog training principles, this one applies to people too. When someone you care about is frightened, it seems natural to offer reassurance. You want to be sympathetic and show that you understand. But, doing that grows and nourishes fear. Instead of helping, reassurance deepens anxiety.

Now, with people and kids who are anxious you don’t want to seem detached either. You can avoid that problem by carefully explaining that you are not going to give reassurance because it just makes things worse. In our book, Obsessive Compulsive Disorder For Dummies we suggest some phrases that you can tell your kids if they seek unproductive reassurance. Some of these include:

  • You know I can’t answer that question.
  • I understand you’re worried, but we agreed that I wouldn’t reassure you.
  • There’s always a chance something bad could happen.
  • I …

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Laura L. Smith, Ph.D. and Charles H. Elliott, Ph.D. are authors of many books, including Overcoming Anxiety for Dummies and Child Psychology & Development for Dummies.

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