I yearn for my work, because it always helps me make sense of things.  For never was a horror experienced without an angel stepping in from the opposite direction to witness it with me.

Rilke – Letter to Marianne von Goldschmidt Rothschild December 5, 1914.

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We are all so different…but so similar in some of our patterns. Especially the limiting  or negative ones.

Psychiatric personality diagnosis tries to provide some order, but sometimes alienates people. Who wants to have a “disorder”?  Must be something deeply wrong with me. But it’s easy to  think of our personality ‘issues’ (in olden days: “neuroses”) with much more compassion and understanding.

As young people growing up in the world of our family, our schools, neighbourhoods, with all their challenges, we face certain common, human problems. Like: how will I be accepted? How can I get recognition and love? How can I get attention for what I need? How can I belong? How can I assert my independence? What do I have to do to feel safe? Where can I express myself?

Depending on the world we are in, along with the basic temperament and body we’re born with, it can be pretty tough, but not solving these problems is not an option. So we do the best we can with our little bodies and developing minds. And it is not surprising that we come up with some similar solutions to these similar problems. We try out lots of things. We’ll be good –  OK, that didn’t work, we’ll be bad. Hmm, that didn’t work, we’ll be cute. No? Beautiful? How about smart?  Stoned? Funny? Needy? Withdrawn? Strong? Tough? Aha! Recognition. Success.  Partial solution to an otherwise insolvable problem. Now I can get the love/recognition/safety/freedom etc I need.

We try the solution out over and over. Eventually, we become it, we live it. It’s gone beyond being a strategy, now it’s a way of life, of thinking, perceiving things, of feeling. Who we are. We’ve figured out to go down a path others have followed too. So it starts to look like, even though we are unique, we share personality traits in common with others. It’s not too surprising that we came up with similar solutions to similar kinds of problems.

As we grow up, we may gradually, dimly realize that we pay a price for the early solutions. As a Nobel laureate commented (I forget the source), “what I really wanted was love, but I accepted a Nobel prize”. Work…worked. But it was only a partial solution. Or, in the case of addiction, Dr. Gabor Mate suggests addicts try to fill “a God-shaped hole in the heart of every man which cannot be filled by any created thing” (Blaise Pascal) with a substance. Leaving it unfilled is not an option, even at a huge price.

Our partial solutions were absolutely the best we could come up with at the time to solve an otherwise unsolvable set of problems.  Some would call this pathology, neurosis, personality disorder, “issues”. I prefer to see the glass half full. Let’s recognize what a challenge it is to grow up and be someone, and appreciate the struggles, and acknowledge the efforts made along the way to solve these crucial and otherwise unsolvable  problems.  Then we can gently and therapeutically begin to find more creative, fulfilling (and adult) alternatives.

Brian Grady, Ph.D. R.Psych

The new issue of *Archives of Pediatric & Adolescent Medicine* (vol.
163, #6, June) includes an article: "Peace of Mind and Sense of Purpose
as Core Existential Issues Among Parents of Children With Cancer."

The authors are Jennifer W. Mack, MD, MPH; Joanne Wolfe, MD, MPH; E.
Francis Cook, ScD; Holcombe E. Grier, MD; Paul D. Cleary, PhD; & Jane C.
Weeks, MD, MSc.

Here are parts of the abstract:

The objective was to evaluate issues experienced by parents of children with cancer and
factors related to parents' ability to find peace of mind.

One hundred ninety-four parents of children with cancer (response rate,
70%) in the first year of cancer treatment were involved.

The main Outcome Measure was the Functional Assessment of Chronic Illness Therapy-Spiritual Well-
being sense of meaning subscale. This taps peace of mind and sense of purpose.

Most parents had a strong sense of purpose, but lacked peace of mind 
representing the strongest sense of peace or purpose. Parents had higher 
peace of mind scores when they also reported that
they trusted the oncologist's judgment, that the oncologist had disclosed
detailed prognostic information, and that
the oncologist had provided high-quality information about the cancer.
Peace of mind was not associated with prognosis or time since diagnosis.

Conclusions  

Physicians may be able to facilitate formulation of peace of mind by
giving parents high-quality medical information, including prognostic
information, and facilitating parents' trust.

Courtesy of Ken Pope

“There is an idea current in the prevailing culture that writing about something that means you heal the pain.  I was not, when I began writing my life story, and I am not now, healed of my mother.  You do gain a small distance from anything by keeping it in suspension in your mind while you work at finding the words to fit it.  The process is so slow and incremental that you do not notice its effect, but the point is that it is a process.  I found out when I was a little girl that if you are crying uncontrollably and want to stop, the thing is to do something useful with your tears — water a plant, say.  They’ll dry up for themselves.  The same happens when you try to make sentences of painful material: the material lightens as it is put to work.”

Nualo O’Faolain in “Almost There”, pg. 36.

Tomorrow’s *Chicago Tribune* (Sunday, May 3) includes an interview with social psychologist David Myers:  “Money does buy happiness — but only temporarily” by Eve Hightower.

Here are some excerpts:

[begin excerpts]

Q  What should we know about happiness during times like these?

A  Economic growth has not led to happiness over time.  Growth and
downfalls can lead to short-term happiness, but we rebound to our normal
level of happiness after a while.

People who value high income, occupational success and prestige to
having very close friends and a close marriage are twice as likely to
describe themselves as “fairly” or “very” unhappy.

The need to belong runs deeper, it seems, than any need to be rich.

For all but the very poor, more money buys no more than a temporary
surge of happiness.

Q  What does predict happiness?

A  Perhaps the most important predictor is close, supportive
relationships.  We’re social animals.  Forty percent of married adults
say they’re happy, whereas 23 percent of never-married adults say
they’re happy.

But just being married doesn’t mean you’re happy.  You can be in an
unhappy marriage.

Q  There’s also a correlation between religion and happiness. Are
religious people happy or are happy people attracted to religion?

A  Causal traffic is two-way between happiness and marriage and could be
with religion too.   Happy people tend to be more social in general.

<snip>

QAnd unhappiness can be a good thing?

AWhen bad things happen in our lives, unhappiness alerts us to do
something about it.

[end excerpts]

The interview is online at:
<http://tinyurl.com/cavldx&gt;.

courtesy of Ken Pope

Three strategies for dealing with useless worry
– a cognitive therapy approach.

Some people find the following strategies helpful for reducing pointless and upsetting worry.

1. Thought Stopping

Thought stopping is designed to be used when you find yourself worrying about the same issue again and again. It should only be used if the worry is pointless. If your worrying is actually giving you solutions to the problem, then you might want to keep doing it.  The technique takes a fair bit of practice to learn. Here’s the sequence:

a) Pick a time when you can be undisturbed at home for a couple of hours.

b) Sit down and deliberately start worrying. This may be harder than you think. You should choose an issue that bothers you but not one that will send you into deep depression or make you think about harming yourself.

c) Once you begin to feel worried do three things: stand up, clap your hands once and shout “stop!” you will feel quite silly doing this but do it anyway. You should notice that the worry stops for a bit.

d) The moment you notice yourself worrying again (probably only a few seconds later) stand, clap and shout “stop!” again. Keep repeating this. Eventually you should notice that the worry takes longer and longer to come back. At this point clap and shout without standing.   After a while stop clapping; just shout.

e) Finally stop shouting. Instead picture a large stop sign in your head and imagine yourself shouting “STOP”. Now you can have other people around again. Over the next few weeks make a point of imagining the sign and the shout whenever you catch yourself worrying about the topic. If you like you can wear a rubber band around your wrist and snap it (gently) against the skin at the same time. Then shift your mind onto some other topic. With time you can become very effective at halting periods of pointless worry.

2. Worrying Time

Worrying time is designed to help you stop worrying about problems for most of the day by saving all of your worrying for a particular time. This can be easier than stopping the worrying altogether. As well you may have to think about some of your worries in order to decide what to do about them. Here’s the strategy;

a) Pick a time during the day or week when you will sit down and think about the things that have been worrying you. You probably don’t need to do this every day but more than once a week would be a good idea. Set aside a maximum of 30 minutes when you will not be distracted.

b) Carry a pen and paper (index cards work well) with you at all times. When you catch yourself worrying, make a note of the topic. Assure yourself that you will  think about the issue but not right now. Shift your mind onto something else.

c) When it is time to worry, take out your list of topics and consider each of them in turn. With some topics you may find that you can actually come up with a solution or a decision about how to handle them. Others you may just worry about.  This strategy may sound a bit odd but it is amazingly helpful if you are disciplined about carrying it out.

3 . Worry Inflation

We frequently try to minimize our fears. Worry inflation uses the opposite approach: making the problems as big as possible. Why? Because if you exaggerate many fears they eventually become ridiculous. You find that you can’t really believe that things will get that bad, and the problem shrinks down to realistic proportions. Here’s the strategy:

a) First identify the disturbing thought you want to deal with.

b) Next decide whether inflating the worry will make it seem silly or will only make it seem worse.

c) If it looks like a good topic for worry inflation, exaggerate the disturbing thought out of all proportion. Imagine the most extreme consequences possible. For example: “If I phone my old friend she won’t remember me. She will tell the police she has had a nuisance caller. They will trace the call and arrest me. I’ll spend the rest of my life in jail”. The more extreme the worry gets; the less you may believe in it and the less that thought will be able to bother you in the future.

Putting pen to paper is said to help the brain “regulate emotion” and reduces feelings of anxiety, fear and sadness.

Researchers claim the act of writing about personal experiences has a cathartic effect because it inhibits parts of the brain linked to emotional turmoil, and increases activity in the region to do with self-control.

Now they hope to develop therapies based on their findings that could be used to ease social fears and phobias.

Dr Matthew Lieberman, a neuroscientist at the University of California, outlined his findings at the American Association for the Advancement of Science in a lecture called Putting Feelings Into Words.

He said that expressing yourself in print was “a sort of unintentional emotion regulation”.

“It seems to regulate our distress,” he added. “I don’t think that people sit down in order to regulate their emotions but there is a benefit.

“I think it could play a role in why many people write diaries or write bad lyrics to songs – the kind that should never be played on the radio.”

Dr Lieberman proved the therapeutic power of writing by scanning the brains of 30 individuals while they described distressing pictures.

He found that the act tended to reduce activity in the amygala, a part of the brain connected with emotion and fear and increased activity in the pre-frontal cortex, the mind’s regulator.

This suggests that the mere action of writing about an emotion was a way of calming down the brain and re-establishing mental balance.

Often the author is unaware of the therapeutic effect of the task, it was claimed.

“If you ask people then they don’t think that it serves an emotion regulation but when you look at the brain that looks like what is going on,” he added.

“The more frontal activity we see, the less amydala response. There seems to be a see-saw affect.”

In another trial, writing was used in conjunction with exposure therapy for people who had a phobia of spiders.

It was discovered that writing about their fears actually boosted the effect of the therapy compared with people who did not put pen to paper.

“We do think that it has clinical applications,” Dr Lieberman said.

“People expressing negative emotional responses in words while being exposed gave them greater attenuation (reduction) of fear.”

Dr Lieberman said that the effect was negated if the writing was too vivid or descriptive because it led to people reliving their trauma. Also, typing was not as good as writing long-hand.

“You have to write about it in a detached way,” he said.

Asked why writers were often troubled souls, he said that the writing itself may be a reaction to severe emotional problems.

“I am sure that it is one of their motivators to write,” he said. “You have to ask yourself what they would be like without the writing.”