Resilience - Bouncing Back from the Marathon Events

by Richard C. Raynard, Ph.D.
Licensed Clinical Psychologist


After the marathon bombings, what do we do with the emotions aroused?  Is there any direction we can take from such events?

The Marathon bombings captured all the major features of a real-life reality show, with all its danger, drama and uncertain outcome.  The lockdown of a major city was unprecedented. The convergence of internet informants, police, fire and rescue, FBI, homeland security, neighbors, and more was astounding and fearful, both at once. And to bring it home, there were the emotional interviews of survivors, relatives, onlookers and media talk hosts.

Grateful

But Showtime it wasn't for many of us who are sensitive, troubled and even shaken by such events. Where on earth do we put such an event in the flow of our workaday and family life?

Resilience is the ability to bounce back from stress or trauma. The evidence is that the resilient can both face up to the harsh reality and get on with what they care about more, at the same time. Bonanno et al (2007) show that the very depressed come back sooner by going back and forth between the tears of a terrible loss and engagement with what they love about life.  No contradiction - they take turns, since you can't do both at once.

The resilient stick to their routines and habits and find comfort in them. They help others, as well as ask for help, all of which keeps you connected to friends and family and to share your own troubles. The resilient actually play off these horrendous events to affirm what really matters in their lives and renew their relationships with family, friends, work and all else (Ong et al, 2006).

We see how easily our lives can be changed or lost, and feel grateful and abundant.

A survivor, not a victim.


About Dr. Raynard
Dr. Richard Raynard is a licensed clinical psychologist with 35 years experience resolving a broad range of emotional problems. As a cognitive-behavioral therapist who has specialized in anxiety and phobic disorders since 1980, he has spent the last 35 years fulfilling his life-long desire to explore and define the true purpose of emotions and how people can easily use emotions to create meaning and satisfaction in their lives. Dr. Raynard's series of books on emotions can be found on Amazon.com. His other books include Don't Panic, and Anxiety & Panic Medications.

The Bomb of Loneliness and Alienation

by Richard C. Raynard, Ph.D.
Licensed Clinical Psychologist

In the Marathon bombing, there were few things that we learned about the interior life of the 26 year old leader, married and a trained boxer. However, it slipped out in his own words that he had no close friend. Also, he felt he didn't fit in with the American culture.


 

Loneliness

 The first, no close friend, is an earmark of the emotion of loneliness, where no one accepts you for who you are and stands beside you in everything. The second is the emotion (for which we have no word) for the need to belong. In belonging, we find our role and place in the larger community, a role that both honors our own needs and that of the group.

Most of the news and commentary in the weekend after the bombing was about the Al Qaida connection, the Chechnya resistance, internet fanaticism, the global Jihad, Homeland Security, etc. These external influences were calls for alarm and opposition, not feeling.

 

Are you willing to plunge into the world of prolonged loneliness and alienation?

 

R. Laing (1959) has shown the  disastrous effects of prolonged loneliness: you have no one who recognizes your most valued experiences, or the most hurtful trauma, or your worst self-doubts. By becoming secretive, you live in fear of being found out, exposed and condemned for who you are. The lonely person learns to put on a face of ease and affability, or whatever, just to get by.  Over time he feels more and more phony and starts to believe others are phony, too. At the extreme, he is contemptuous of the fakeness and lack of meaning around him. Disillusioned, he comes to despise and hate others

 

Cacioppo and Patrick (2008) sum it up: in extreme loneliness, "we mimic others more intensely" and at the same time "betrayal and rejection is lurking around every corner".

 

Hoffer (1951) shows how those who don't belong - marginalized or out of the mainstream - have a loss of a sense of self-worth and blame and hate others for what they see as lack of respect.  If they fail at finding where they belong, they can feel life is over, or "spoiled". He believes they are vulnerable to joining a cause, an alienated group, or a sect that promises redemption, even self-sacrifice, to a glorious cause.

 

Attention to all the external influences does not address the needs of these emotions, and can make us feel overwhelmed by powerful forces. In contrast, looking at the emotions and motives of the person leads us to prevention, early detection and opening up the means of participation in community life. The emotions of loneliness and the need to belong are recognizable to all and lead to constructive change and fulfillment.

 

What do you think?

 

About Dr. Raynard
Dr. Richard Raynard is a licensed clinical psychologist with 35 years experience resolving a broad range of emotional problems. As a cognitive-behavioral therapist who has specialized in anxiety and phobic disorders since 1980, he has spent the last 35 years fulfilling his life-long desire to explore and define the true purpose of emotions and how people can easily use emotions to create meaning and satisfaction in their lives. Dr. Raynard's series of books on emotions can be found on Amazon.com. His other books include Don't Panic, and Anxiety & Panic Medications.

Spotting the Potential for School Shooting

by Richard C. Raynard, Ph.D.
Licensed Clinical Psychologist

What do we do now that Congress has tabled gun control, except for the possibility of financial support for related mental health resources?

Fuming kid

It's no secret that community health centers have been eliminated for over 30 years. Still, assuming the lawmakers mean to focus on the prevention of school shootings, those who teach and advise students have the opportunity to be first-detectors (not first responders!) for students at risk of school shootings.

Here are some facts to contend with that do not often appear in the media.

Half of all homes have guns, some 300 million guns; half of these do not lock away their guns from children. A handgun is 43 times more likely to be use for murder or suicide than for self-defense (Berkowitz, 1993; Sege & Licenziato, 2001). Murder is the 4th leading cause of death among children.  Between 1980 and 1997 there were 20,000 murders (Meichenbaum,2001).

Now for more encouraging facts. For those of school age, the basics of violence have been known for some time. Meichenbaum (2001) alone lists over 900 references to different studies. (Please, Congress, don't just vote for further studies!)  Even more encouraging, there are many studies of gender differences, early development, bullying, consistency of aggression, school behavior, conduct problems, effective parenting, early trauma, and more - all relating to school violence.

Here is a partial list of early warnings for the risk of school shooting, from several sources:

Individual Factors
Having a detailed plan, blaming others for problems, threats of violence, cruelty to animals, violent writings or drawings (and more).

Family Influence:
Lack of parental supervision, victim of abuse or neglect, lack of warm family relations

School Behaviors:  
Poor social skills, rejected by peers, picked on, socially isolated, intolerant, antisocial peer group

Situational Factors:
Access to firearms, fascination for weapons, preoccupation with violent media

Attack Focus:
Loss of status, sudden decline in functioning, talks of violent intentions, a recent loss of relationship, rejection by others, organizing for attack, menacing others

Many of these signs are seen in the classroom, together with the observations of counselors. Parents, too, can be alerted to these signs. Of course it takes the motivation to take time, notice, and put these warnings together, as well as the determination to get the attention of the school and parents. And the treatment methods are also well known and available to therapists and counselors.

Can prevention of school violence may be within our grasp? If we are willing to see all these varied manifestations of anger, we may find it common sense to alert those who can help. Common sense, too, is legislation that funds this training and alerting within our schools.

About Dr. Raynard
Dr. Richard Raynard is a licensed clinical psychologist with 35 years experience resolving a broad range of emotional problems. As a cognitive-behavioral therapist who has specialized in anxiety and phobic disorders since 1980, he has spent the last 35 years fulfilling his life-long desire to explore and define the true purpose of emotions and how people can easily use emotions to create meaning and satisfaction in their lives. Dr. Raynard's series of books on emotions can be found on Amazon.com. His other books include Don't Panic, and Anxiety & Panic Medications.

Caring vs Serotonin

by Richard C. Raynard, Ph.D.
Licensed Clinical Psychologist

Can the act of caring be as effective as medication in battling depression and anxiety? Research into selective serotonin reuptake inhibitors (SSRIs) may provide answers that surprise you.

SSRIs are one of the newer class of antidepressants that emerged in 1987 with Prozac (fluoxetine), an approved treatment for depression. Since then, SSRIs have proven effective in treating many anxiety-related illnesses including panic disorder (PD).


Choices



Cherry Picking SSRI Research

Turner and others in 2008 subpoenaed the FDA to release ALL of the studies on antidepressant effectiveness in their archives.  They found that reports of positive effects were 12 times more likely to be published than negative results. Overall, the impression of effectiveness was inflated by about 33%. Over the past century, only 50% of all drug studies were published, mostly positive outcomes (Dobbs, '06).

Small Advantage of SSRI's
Two large scale metanalyses of SSRI effectiveness showed that SSRI's are effective 56-60% of the time. However, between 42 and 47% respond to placebos ("sugar pills"), making the effectiveness of SSRI's only about 10 to 15% better than a placebo (Arrill, '05; Dobbs, '06).

Growing Placebo Power
Since 1985, the potency of placebos, the benchmark for measuring medication effectiveness, has nearly doubled, from about 30% to about 45%. So it is harder than ever to show the effectiveness of medications. In 2007, the FDA approved the fewest drugs of any year since 1983 (PN, '10). The advertising success of Big Pharm may have led to the public increasingly to  believe that any pill will work!

Whoops!
In a major study of depression by NIMH, comparing imipramine to a placebo, they found the most effective psychiatrist got better results with a placebo than the worst performing psychiatrist with antidepressants.  This was back door evidence for the importance of relationships of therapeutic effectiveness (McKay et al, '06).

Relationships are Central
In the big debate about which evidence-based psychotherapies will be reimbursed by insurance, a growing body of critics question the focus on method (LeBow,'10). A metanalysis by Wampol ('02) showed that success in treatment was accounted for mostly by relationship factors between therapist and client, and less by treatment methods. Good relations of caring, empathy and openness may be the most effective part of psychotherapy. Shouldn't we be studying the "placebo effect" rather than the "drug effect"?

Could this mean that love (caring) conquers all?  Well...yeah.

About Dr. Raynard
Dr. Richard Raynard is a licensed clinical psychologist with 35 years experience resolving a broad range of emotional problems. As a cognitive-behavioral therapist who has specialized in anxiety and phobic disorders since 1980, he has spent the last 35 years fulfilling his life-long desire to explore and define the true purpose of emotions and how people can easily use emotions to create meaning and satisfaction in their lives. Dr. Raynard's series of books on emotions can be found on Amazon.com. His other books include Don't Panic, and Anxiety & Panic Medications.

The Benefits of Mistakes and Flaws

Wrong again

by Richard C. Raynard, Ph.D.
Licensed Clinical Psychologist

Mistakes and flaws, generally, are an unavoidable part of life, our daily bread.  What are we to think of them, do with them? Our beliefs guide us. And our emotions exaggerate these beliefs. Before concluding you are a ruined human being, consider these propositions, and rate how much you agree with each, from 0 to 10.
Go ahead, messer-upper!

 __   Mistakes and flaws are the lot of everyone, no exception
  __  Humans make a great more mistakes than all other creatures
  __  No one has complete control over life's circumstances
  __  We tolerate natural disasters better then our own mistakes
  __  We learn fastest from our mistakes
  __  Mistakes don't lie; they tell the truth and are on our side
  __  Our mistakes and flaws reveal what needs to be done
  __  The more mistakes we make and admit to, the faster we learn
  __  Making mistakes early saves us later pain of bigger mistakes
  __  Mistakes help us be true to ourselves and our needs
  __  When expectations are highest, we make the biggest mistakes
  __  Whoever shows us our mistakes is helpful, intentionally or not
  __  By inviting criticism, we put the critic on our side
  __  Sharing our mistakes brings us closer together, through compassion
  __  Owning our mistakes makes us more forgiving of others (St. Thomas)
  __  Expecting some mistakes helps us see them and overcome them
  __  A good chuckle helps us accept disasters (Wizard of Oz)
  __  Mistakes and flaws are opportunities for growth and strength
  __  Mistakes and flaws teach us compassion for others
  __  We live in a world that is both messed-up and wonderful

This test has no score, no norms. It is simply taking stock of your fears of mistakes and criticism. The lesson is to honor your mistakes. Admit them as soon as you can. Learn from them. Forgive.

Now, fumblers and bumblers, join the rest of us!

About Dr. Raynard
Dr. Richard Raynard is a licensed clinical psychologist with 35 years experience resolving a broad range of emotional problems. As a cognitive-behavioral therapist who has specialized in anxiety and phobic disorders since 1980, he has spent the last 35 years fulfilling his life-long desire to explore and define the true purpose of emotions and how people can easily use emotions to create meaning and satisfaction in their lives. Dr. Raynard's series of books on emotions can be found on Amazon.com. His other books include Don't Panic, and Anxiety & Panic Medications.

The Emotional Frontier - A New Diagnosis?

by Richard C. Raynard, Ph.D.
Licensed Clinical Psychologist

Developmental trauma disorder - A new DSM V diagnosis?

Van der Kolk and many others see the post-traumatic stress diagnosis (PTSD) as way too narrow for adult problems in identity, relationships, emotional regulation and even physical health.  Adults can be, at times, "clinging, needy, impulsive, enraged, depressed, despairing or suicidal".  Their childhood often features prolonged abuse, neglect, violence and incest. After presenting 130 research papers representing over 100,000 children - and resubmitting 300 more research articles - the trauma task force led by Van der Kolk was turned down by the DSM V committee. "Developmental Trauma Disorder" was seen as too broad, not researched, overlapping with other diagnoses and not useful .Still, the DTD trials go on, using newer treatments like TARGET and ARC. An uphill fight for the recognition of emotions.

The heart of DTD 



Shared emotions

The heart of DTD may be "extreme disregulation of emotional states" (Ford). Cloitre found that a failure of parental attachment and attunement to the child was worse than physical abuse in its consequences. Van der Kolk says that you need a parent who can mirror the child's emotions, so that he can "connect with his own felt inner experience" to develop a sense of his authentic self, or else the "capacity to feel your inner realness is impaired". Damage to your personal identity and coherent sense of self distinguishes DTD from PTSD. Such is the importance of emotions.

A catalogue of childhood emotional trauma.

Young (1999) has found and developed 18 maladaptive beliefs and feelings about relationships that begin very early in life, resulting from "ongoing patterns of everyday noxious experiences" with their parents or caregivers. These "schemas" fall into 5 groups: disconnection/rejection; impaired autonomy/performance; impaired limits; other-directed-ness; and overvigilence/inhibition. He has convincingly related several of these early abuse patterns to the development of resistant personality disorders appearing later in life. In a forthcoming book, I have identified the primary emotions that show up in each personality disorder.

Emotions give us energy and direction from our earliest days.  Why is it so hard to give them their due?

About Dr. Raynard
Dr. Richard Raynard is a licensed clinical psychologist with 35 years experience resolving a broad range of emotional problems. As a cognitive-behavioral therapist who has specialized in anxiety and phobic disorders since 1980, he has spent the last 35 years fulfilling his life-long desire to explore and define the true purpose of emotions and how people can easily use emotions to create meaning and satisfaction in their lives. Dr. Raynard's series of books on emotions can be found on Amazon.com. His other books include Don't Panic, and Anxiety & Panic Medications.

The Wall of Extreme Shyness

by Richard C. Raynard, Ph.D
Licensed Clinical Psychologist

We have all had our moments of shyness. Imagine you have been invited to a brand new social group or business meeting. After saying a brief "Hello" you decide to look things over.  You see that others seem to know each other; some are in earnest conversation. You sit down on the sidelines and you see you don't get more than a few glances.  As you feel a growing distance, you think, "There's something odd about me". Then, as everyone gets into their stories, jokes, and small talk, you feel snubbed, like you don't belong here. At some point, you may feel frustrated and angry and start writing off the whole scene.  You leave early, with some satisfaction at rejecting the "dumb bunch".


I'm shy



The trend in shyness in adults is rising overall.  40% of college students say they are currently shy, with 4% shy all the time.  13% of adults have high social anxiety. Membership in all kinds of groups has dropped by about 50% in the last 40 years (Putnam, 2000).

Some extremely shy ones don't even open the door. Any imminent contact feels terrifying.  They avoid all social situations and spend weekends at home.  If they have to, a very shy person will keep to the edge of a group, or near the exits, and try to "disappear".

The extremely shy one needs to find motivation to make satisfying contacts.  There is nothing like some good experiences.  Here are some very beginning steps:

• Look at people. Take pleasure in "people-watching". Just sitting in a park bench or mall gives a shy person permission to look at, rather than looking away.
• Smile at strangers. By just putting on a welcoming face, a shy person feels better.
• Say "Hi" to anyone passing by, and say to yourself "Welcome!". As the shy see immediate good will, this habit can grow on a very shy person.
• Find a role as a greeter.  At the door of a wedding or family gathering, by meeting one after another, you get desensitized. Your anxiety drops as you see nothing terrible happens.
• Greet others quickly, before they do you.  Two things: there is much less time for your fears to develop and you feel more in control.
• Bring along an interesting diversion. A magazine, a cell phone. This will distract the very shy person when he/she falls into the pit of worrying and "catastrophising".

Yes, these are baby steps, but success in these small steps means that both attitudes and feelings can start to change. And the skills are not soon forgotten.  With practice, they become reliable habits.

Have you seen someone so stuck?  Did you know it could be so hard?

About Dr. Raynard
Dr. Richard Raynard is a licensed clinical psychologist with 35 years experience resolving a broad range of emotional problems. As a cognitive-behavioral therapist who has specialized in anxiety and phobic disorders since 1980, he has spent the last 35 years fulfilling his life-long desire to explore and define the true purpose of emotions and how people can easily use emotions to create meaning and satisfaction in their lives. Dr. Raynard's series of books on emotions can be found on Amazon.com. His other books include Don't Panic, and Anxiety & Panic Medications.

Education - Everything but Ourselves and Our Emotions

by Richard C. Raynard, Ph.D
Licensed Clinical Psychologist

Have you noticed that you learn about everybody else except yourself in school? In school, the main characters are in literature, history, sciences and other remote places. Even in high school, you may have home economics, the arts, sports, music - maybe - but little of yourself. Kids complain, too, that they see little of themselves in school. Their evaluations of teachers and how they are taught are quite consistent: they can recognize ineffective teaching and learn little about their own interests.


Learning about Self



Stephen Rollin EdD was dumbfounded that during discussions of the future of education at the National Research Council in 2003 there was no mention of psychology or mental health. Then, for 10 years his programs addressed the needs of teachers. The proposal of the APA for Teaching of High School Psychology concerns theory, science, biopsychology, development, cognition, sociocultural, some motivation, emotion, and personality and a bit on careers in psychology. This is a college curriculum. In the wake of 2013 shootings, the APA Council of Representatives voted to focus on the education of psychologists, advocacy to policy makers, communications, and more study.

Where do young people learn about their developing interests, emotions, relationships, friends, beliefs, how to study, mentoring, getting enough sleep, a healthy body, healthy foods, bullying, the world of work, addictions, careers, applying for college...?  TV is toxic or irrelevant; parents often don't have time; and friends can mislead.



Then again, some things work famously. Geller (2013) developed lesson plans for cooperation, courage, compassion and coaching in which high school students coach middle school kids. Just a conscious effort to observe and record bullying in 2 elementary schools reduced bullying by 50%. The documentary "Against All Odds" shows how character-building, mentoring, cooperative study, and a year-long course for entry into college (and more) led to over 90% admissions into college in 3 poor, deprived community high schools. And they were already 2-3 grades behind as freshmen.

Imagine the curiosity children have in their vital interests, their relationships, their friends, their emotions, their future? 

Beyond schools, I imagine a public service TV channel called "Personal growth" just for teens and pre-teens. Real life drama, biographies and learning sets about relationships, feelings, health, play, the world of work, studying, handling your money, finding your true interests, and much more. Parents would watch it, too, and find a bit of what they were missing!

Anyone up to it? There has to be someone, somewhere...

About Dr. Raynard
Dr. Richard Raynard is a licensed clinical psychologist with 35 years experience resolving a broad range of emotional problems. As a cognitive-behavioral therapist who has specialized in anxiety and phobic disorders since 1980, he has spent the last 35 years fulfilling his life-long desire to explore and define the true purpose of emotions and how people can easily use emotions to create meaning and satisfaction in their lives. Dr. Raynard's series of books on emotions can be found on Amazon.com. His other books include Don't Panic, and Anxiety & Panic Medications.