O'Grady Psychology Associates

Psychotherapy, Marriage Counseling, Neuropsychological Assessment

Archives for August 2012

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The fullest experience of the adventure of life: Eleanor Roosevelt, Blogging, and Mindfulness

I just returned from Rhinebeck, NY, where I took an intensive professional training course in Mindfulness-Based Cognitive Therapy (MBCT) for the Prevention of Depression Relapse. The five-day course was developed for health-care professionals who already have experience with mindfulness-based approaches.

Many years ago, I studied Mindfulness-Based Stress Reduction with its developer, Dr. Jon Kabat-Zinn. Since that time, research has continued to demonstrate the effectiveness of mindfulness training in treating many forms of emotional difficulties. Offspring treatments that involve mindfulness as a major component to their treatment protocol include Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and Mindfulness-Based Cognitive Therapy (MBCT).

Taking a course in MBCT  gave me the opportunity to study with one of the major researchers and writers in the field. It was given by Zindel Segal, PhD, and Susan Wood, MSW, LCSW. Dr. Segal is the author of Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse, 2002, The Guilford Press.

While the course was valuable and added to my skills in teaching this treatment approach, the highlight of the trip was my excursion to Val-Kill, the unpretentious, comfortable home of Eleanor Roosevelt. Just down the road in Hyde Park, NY, stands the opulent estate of her husband, Franklin Delano Roosevelt. Ms. Roosevelt created her separate home in a style that reflected her sensibilities, not those of her husband. Set among trees and brooks, the house contains simple furniture and cozy, intimate rooms.

I was fascinated to learn that Eleanor Roosevelt was a kind of pioneering blogger extraordinaire. She wrote a daily letter to Americans that came to be called “My Day,” one of the most popular syndicated columns of the time. She wrote her column six days a week, often dictated in any free moment she found. She published over five hundred words per column, at least six days a week for 26 years from 1936-1962. Personal as well as socially relevant, her work communicated her thoughts, joys, and intimate concerns.

As a beginning blogger, I have wondered about my urge to write. In a previous post, I talked about how this form of writing allows me to take my many years as a psychologist and put words to this experience that can go beyond the confines of my confidential private office. Social media has provided a means for anyone to make his or her thoughts and opinions public, taking journaling to a new level—but not an unprecedented one, as I saw by Eleanor’s example.

Pleasant and Unpleasant Events Calendar

I often suggest that my clients journal. Collecting thoughts and feelings by observing them and taking the extra step to write them down allows insights to emerge. In MBCT, one of the first homework exercises is to write a daily note about a pleasant and an unpleasant experience that occurred during the day. By noting the thoughts, feelings, and sensations associated with such experiences, we bring mindful awareness to daily life. This can allow us to experience and appreciate the moment simply as it is, without adding further elaboration in the form of wishing, dreading, or judging. It is often our mental elaboration that triggers rumination, a common symptom in depression. We can begin to realize that even unpleasant events can be tolerated. Bringing awareness to each situation, whether we label it good or bad, is an important step in learning to relate differently to them. This takes practice. And curiosity.

The Fullest Experience of the Adventure of Life

As Eleanor Roosevelt writes in You Learn by Living: Eleven Keys For a More Fulfilling Life, “There is no experience from which you can’t learn something. When you stop learning you stop living in any vital and meaningful sense. And the purpose of life, after all, is to live it, to taste experience to the utmost, to reach out eagerly and without fear for newer and richer experience. . . . The experience can have meaning only if you understand it. You can understand it only if you have arrived at some knowledge of yourself, a knowledge based on a deliberately and usually painfully acquired self-discipline, which teaches you to cast out fear and frees you for the fullest experience of the adventure of life.”

Being attentive to thoughts and writing them down takes discipline. When keeping a journal (or a thought record of daily events, or writing a blog) our life experience is enlarged and enriched. For people struggling with depression, being able to notice even slightly positive things during the day allows them to see that such events are already there for them. For some, it may be noticing the song of a bird, or the stars on a clear night—these simple experiences are always within reach, but for someone who struggles with depression, they go unattended. Writing is a vehicle of self-expression.

References:

Roosevelt, E. (2001). My Day: The best of Eleanor Roosevelt’s acclaimed newspaper columns, 1936-1962. D. Emblidge (Ed.) Cambridge, MA: Da Capo Press.

Roosevelt, E. (2011). You learn by living: Eleven keys for a more fulfilling life. New York: Harper Perennial.

Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford.

 

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The College Transition: Things to Talk About

 College is a rite of passage, a transition into adulthood. It’s a transition for parents, too, who can no longer sleep in the room down the hall with ears half-cocked and one eye open. It’s all the more important, then, for parents to have conversations with their kids about how to deal with the common, normal changes and stresses likely to arise in these early years of living away from home.

As high-school friendships shift and fade, college students must forge new social connections or risk social isolation. Kids who have poor coping and social skills before starting college might seek unhealthy solutions, like partying, playing computer games, or holing up in their dorm rooms with their laptops

If these solutions, healthy or unhealthy, don’t work, college kids often isolate, deny, pretend, and find all sorts of other ways to conceal their loneliness. To be lonely is shameful. Instead, many tend to brood over stressful experiences and feelings, a process called rumination. The lonely, anxious person ruminates on negative thoughts: reliving past injuries, flubs, or missed opportunities; feeling apprehension about social events, and anticipating distressing outcomes.

Anxiety, Rumination, and Depression in College

Rumination and anxiety create a cycle where each promotes and prolongs the other. The effect of this is that a stressful experience (such as, say, being snubbed at a party) does not end when the stressful situation ends, but can continue on in one’s thoughts and moods. So it is not only the exposure to the initial stress but also exposure to the recurring representation of that event in the mind that results in a depressed mood. Over time, this anxious rumination leads to negative self-esteem and depression.

Apart from such dangers, loneliness doesn’t just feel bad; lonely people are at greater risk for poor health. Social support mediates health: It is well known that when someone has close family and friends, they will be encouraged to seek medical attention when needed, and they will take better care of themselves in general.

One simple thing to look at when considering college students, loneliness, anxiety, and stress is the role of sleep. Good sleep is the cornerstone of mental health. Most of the clients I see—college students or otherwise—suffer from some form of sleep disturbance. Difficulties getting to sleep or staying asleep are common in both depression and anxiety. (Oversleeping, too, can be a problem when it’s used to avoid situations that may provoke difficult feelings.)

In the recent issue of Health Psychology, researchers examined the mechanisms that underlie the relationship found between depressed mood and poor sleep quality in college students. They found that found that rumination and anxiety are strongly connected to loneliness and depressed mood as well as poor sleep quality.  The authors conclude that psychotherapists and college counselors need to assess loneliness in kids at school.  It is not enough to look at depression and anxiety.  Parents, teachers, college counselors need to look at sleep quality and social isolation, in addition to symptoms of anxiety and depression.

(Zawadzki, M. J., Graham, J. E., & Gerin, W. (2012, July 23). Rumination and Anxiety Mediate the Effect of Loneliness on Depressed Mood and Sleep Quality in College Students. Health Psychology. )

Of course, the image of a college student pulling an all-nighter, or partying until dawn, is a common one, and it’s true that college-aged kids need less sleep than adults. For vulnerable kids, however, poor sleep can lead to severe psychological problems. And as we’ve seen, college can be a vulnerable experience in itself. Add to this that students trying to solve their sleep problems don’t always choose healthy options. Some college kids I’ve worked with use combinations of stimulants and caffeine to stay awake, and anti-anxiety medications to sleep. This leads to drug dependence, and in vulnerable kids, will cause emotional problems ranging from depression to delusional thinking.

Whether problems are caused by too much social media, partying, or are the result of depression and anxiety, we need to pay attention to how these activities are affecting emotional well-being.  Find time to talk with your college-bound kid about some of these issues.  Enjoy the fun of shopping for dorm room stuff, but don’t neglect the crucial conversations about what to expect during this first year away from home. Some basic topics to discuss could include: how to deal with being lonely, how to contact the college counseling center if they feel anxious or depressed, limiting social media, how to get sleep when distractions inevitably occur, and of course, “call us when you feel down.”

Originally published here.


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Updating Your Love Maps—Keeping Friendship in Your Marriage

“You like tomato and I like tomahto”

Know your partner well to keep friendship in marriage.
Cherry tomatoes, late summer harvest

Last night I made a salad for dinner.  I picked fresh lemon cucumbers and baby lettuces from the garden, topping it with a grilled chicken breast we had cooked the night before.  David added whole red cherry and yellow pear tomatoes still warm from the garden.At the end of the meal, the tomatoes were left uneaten, because while I love sliced cherry tomatoes, I don’t like them whole.  “Ah,” I jokingly told David, ”time  to update your love map!”

What is a love map, and why does it need updating?

When couples first get to know each other, they have deep, intense talks, learning everything they can about one another. As they’re courting (or going through the “mate selection process,” to use the sociological jargon) they learn each other’s history, concerns, preferences, and world views, while yet undistracted by jobs, maintaining a home, childrearing, or finances. They keep a cognitive map of the relationship and its history.

In his book The Seven Principles for Making Marriage Work, Dr. John Gottman calls these cognitive spaces “love maps.” Making cognitive room for the marriage involves remembering major events in each other’s history and updating this information—the love map—as the facts and feelings of your partner’s world changes. Partners with good love maps know each other intimately and are well-versed in each other’s likes and dislikes, personality quirks, hopes, and dreams.

Why it is Important to Know Your Partner Well —Friendship in Marriage Depends on Updating Love Maps

But couples don’t always update their love maps. All kinds of stresses, personal problems, and life events can intervene in a couple’s positive regard for each other, and even destroy the deep friendship that is the basis for a good marriage. Anger and resentment can create “negative sentiment override,” in which everything—every conversation, mistake, action—gets interpreted more and more negatively. By the time couples enter counseling, they have forgotten what they love about each other and have stopped keeping track of relevant information about each other, meaning their maps are out of date. When partners stop paying attention to what is important to one another and instead keep a mental scorecard of mistakes, slights, and offenses, the positive perspective turns sour.

Because love maps are so important, one of the first homework assignments I suggest in couples therapy is the Love Map Exercise. For anyone old enough to remember the TV show “The Newlywed Game,” it’s the same idea. The questions are simple and fun. For instance, “Name your partner’s two closest friends,” or “What is your partner’s favorite music?” It is usually an easy assignment.

Updating your love maps requires communication about your likes and dislikes, and this is true for both partners. Do you like your cherry tomatoes sliced or whole?  After all these years, my partner didn’t realize I don’t eat whole cherry tomatoes.  But it is my responsibility to tell him this. If I don’t, he’ll keep adding them to our salads without slicing them first, and I’ll keep leaving them behind.

It may sound simple, but any map needs updating to stay relevant—even if the new information is just tomatoes, tomahtoes.

Reference:

Gottman, John; Silver, Nan (1999). The Seven Principles for Making Marriage Work. New York, NY: Crown Publishers imprint (Three Rivers Press).

Originally published here.