Emotion Regulation

Childhood Insecurity Can Impair Adult Emotional Regulation

/ Meg Duke / Leave a comment

-Rick Nauert, PhD

New research suggests early childhood experiences can influence the way individuals manage stressful situations in adulthood.

For example, imagine two candidates at a high stakes job interview. One of them handles the pressure with ease and sails through the interview. The other candidate, however, feels very nervous and under-performs.

Experts explain that the emotional bonds we develop with a parent or primary caregiver in early childhood are thought to be the basis of our ability to regulate our emotions as adults.

“We know from other studies that our history of attachment directly influences how we act in social situations;” explained Dr. Christine Heinisch, one of the authors of the study; “but what about reaction to a neutral stimulus under emotional conditions?”

A good example of this in daily life, says Dr. Heinisch, is when a car approaches a traffic light. Under neutral conditions, it is easy for the driver to follow the signal. But what happens under emotional conditions?

“Usually, people tend to make more errors, like stopping too late or even driving through when the traffic light is red. Sometimes they stop although the light is still green,” she explains.

However, not everyone’s actions are impacted by emotions to the same extent. Some of us had emotionally responsive caregivers or parents in childhood, while others didn’t.

Psychologist explain that the “attachment theory” suggests these early experiences influence the ability to regulate emotions as adults.

We expected those having problems with emotional regulation to make more errors in performing a task — and one significant variable influencing this is our attachment experience,” said Dr. Heinisch.

To test this theory, their group conducted a study on adult subjects with different childhood caregiver experiences. Subjects in the study performed a task of identifying a target letter from among a series of flashing letters.

This task was administered under conditions that evoked a positive, neutral, or negative emotional state. The researchers then assessed task performance and analyzed EEG recordings of brain function in their subjects.

The results were revealing.

Subjects who did not have emotionally responsive caregivers in childhood (insecure-attached) had more trouble performing under emotionally negative conditions than the others (secure-attached).

They also had lower brain activity in response to the target letter under negative conditions than secure-attached subjects.

The lower task performance correlated with inefficient strategies for emotional regulation seen in insecure-attached adults. This could mean that a greater share of cognitive resources was allocated for regulating emotions, and consequently, less was available for performing the task.

Researchers admit that the study has limitations. One potential drawback is that the target letters were unrelated to the emotional context cues provided, and therefore had little real-life relevance.

In future studies, the authors plan to use a person or an object with emotional significance as target, and socially relevant situations as the context of the task.

One thing seems clear though — childhood emotional experiences have long lasting consequences for your ability to perform a given task.

The study appears in the open access online journal, Frontiers in Human Neuroscience.

8 Behaviors Often Mistaken for Depression

/ Meg Duke / Leave a comment

Do you know someone who looks and appears depressed but denies it when confronted? Do you believe their rejection of your assessment of them? Could it be that they are”hiding,” covering their true emotions, or simply telling the truth? Even as a trained therapist I have seem my fair share of clients, primarily men and adolescent males, proclaim over and over that they are not depressed even when they appear that way. I ended up second guessing myself and desperately searching for a term, diagnosis, or phenomenon that could help me make sense out of what appeared to be depression. Little did I know, it was pretty simple.

We live in a nation that fervently seeks for answers for behaviors that we do not understand or that do not meet a certain set criteria. For example, mental health professionals will often engage families in learning about depression when a adolescent exhibits traits and behaviors that seem to be depression. Rarely, if ever, will a trained mental health professional ignore other reasons for behaviors that seem like depression. We are all susceptible to mistaking certain behaviors for something way more serious than it actually is.

This article will discuss “normal” behaviors, moods, and traits that can be mistaken for depression symptoms.

When I was beginning in my field in an inpatient child and adolescent residential facility of very troubled and ill youngsters, I began to feel very tired. Every other day I felt more and more tired. I loved the work I did and I felt honored/humbled to be as close to troubled, yet wonderful youths who were mistaken to be “tarnished.” There wasn’t a day that went by that I did not have crippling fatigue or migraine headaches. I found myself developing, because of mild burn-out symptoms, a pessimistic view of today’s youths and their future. This pessimistic view most likely caused others to question whether I was depressed or not.

Trying to identify differences between depressed mood and normal temperament can be a very big challenge, especially for family and friends. It is important to learn the signs of depression so that you can decipher what may or may not be clinical depression. Unfortunately, because depression can be so very similar to other disorders or difficult temperaments, it is important to understand what is and is not a symptom of depression. Some of the following “symptoms” may be more temperament than depression:

  1. Isolation: Believe it or not, some people prefer to be alone. Why? Well, a few reasons may be that they “rejuvenate” through isolation (introverts), they prefer thinking over socializing, or they are avoiding social settings because of a history of social ostracism, discrimination/racism, or bullying. Some people believe isolation is not a bad thing, especially if isolating will keep them from having to be disappointment and uncomfortable in the social arena.  Have you ever heard of the saying “the quietest people have the loudest minds.”
  2. Maturity or serious behavior(s): Some individuals grow up fast while others take a bit more time to become “real adults.” People who “act mature” are often regarded by their peer group as “depressed,” “old,” or “pessimistic.” Mature behaviors or serious thinking styles can cause others to regard the individual as depressed or sad. Many mental health professionals come across as more serious than others at times which can appear to be depression or pessimism. For example, while completing my counseling psychology program in graduate school I often had fellow-classmates make statements about me such as “why don’t you ever joke around in class” or “you do know that therapists can have fun…right?”
  3. Not easily amused or “moved” by things: Some people are simply calm about almost every single thing in their lives. Nothing moves them. “Laid-back” people are sometimes underwhelmed and may not react to certain things like others would. For example, a wedding announcement or baby-announcement may not move the “laid-back” person like it would someone who is more reactive. For me, I tend to be “laid-back” and will only naturally respond to events that truly moves me to respond. Individuals who tend to be underwhelmed may or may not be depressed. It is important to consider the natural mood of the individual before assuming they are depressed.
  4. Emotional or reactive behaviors: As stated above, some individuals are reticent and laid-back while others are not. Individuals who are reactive are often viewed by others as positive or optimistic. Individuals who are thoughtful and tend to react only when necessary, are often viewed as depressed or pessimistic. I’ve heard families of some of my laid-back teen client’s say “OMG. Just tell me already. Don’t you have any thoughts or feelings about this?”
  5. Irritability: One of the hallmark features of depression for men and adolescent males is irritability. For women, depression is often characterized by tearfulness, depressed mood, or mood lability (i.e., changeable moods). But some irritability is temperamental and not based on mood. Temperament is personality and an irritable personality or temperament is not depression.
  6. Substance abuse and use of alcohol: Self-medication with drugs and alcohol is often a “symptom” of depressed mood. But there are some individuals who will use drugs and alcohol for social purposes (i.e., engaging with others or interacting at parties) or because they are addicted/dependent. Substance abuse/dependency does not always = depression.
  7. Anhedonia or lack of motivation: As difficult as it may be to believe, some individuals are born unmotivated. Individuals who seem to “take things in stride” or “does not care” may not be depressed. Again, temperament is often a major influence of personality. It is important to understand that individuals who have a positive temperament will most likely lose motivation if depressed. An individual who has always been unmotivated does not have to be depressed.
  8. Interest in “dark” subjects such as death/dying, life challenges, tribulation, or sorrow: Individuals who like to listen to depressing or “dark” music (or read dark/depressing books/articles, etc.) does not have to be depressed. As you know, some people enjoy topics that speak about life challenges, death, or depressed moods/attitudes. This does not always insinuate a depressed mood. While many of us are drawn to things that “speak” to our challenges, primarily when struggling with some aspect of life, other individuals gravitate toward this kind of stuff all of the time.

-Tamara Hill, MS, LPC

Whatever You Do, Don’t Run: Your Panic Attack Survival Guide

/ Meg Duke / Leave a comment

Your heart was racing. You were dizzy and felt detached. You thought you were about to die. So, understandably, you tried to escape the last situation that caused you to panic.

I get it!

It is natural to try to flee when faced with an anxiety-provoking situation or object. Every part of our being instructs us to do so. But while this could be helpful if we’re faced with a predatory animal, it is the opposite of what we should be doing during a panic attack.

Our bodies are equipped with fight-or-flight responses that, when we’re faced with what feels like danger, help us decide whether to stay and fight or to run as quickly as our legs can carry us. These are absolutely phenomenal responses that our minds and bodies produce in an effort to protect us, so kudos to you, biology, for this life-saving mechanism you have equipped each of us with.

Here is the thing, though. Although this is a fantastic response to have when we are actually faced with a threatening stimulus, panic attacks in and of themselves are not physically harmful—even though they can make us feel as if we can’t breathe. Panic attacks, which are based on a spiral of fear, confuse the brain into thinking there is real danger. The more we run, the more our minds would have us believe there is something to be running from.

So, what to do about it?

Here is your panic attack survival kit, in a series of steps:

  1. Accept, accept, accept! Acceptance is a key ingredient in mitigating and disabling these frightening responses and faulty alarm systems. The more you accept and understand, the less you fear. Try greeting your panic attack with a one-liner such as, “Hello, anxiety!” Actually picture yourself opening the door and welcoming this unpleasant visitor inside your mind’s home.
  2. Stay absolutely still! Wherever you are, stay put—do not flee. While escaping may seem like a helpful short-term solution, it only creates more problems. Running deepens the fear-processing circuits in the brain. Therefore, you may be more likely to experience the same reactions and bodily sensations the next time you find yourself in a similar situation.
  3. Breathe from your belly! Diaphragmatic breathing activates your parasympathetic nervous system or calming response as quickly as a light switch, which disables your fight-or-flight response. Try this reverse breathing technique, or breathing in through your mouth while expanding your belly, and turning your tummy inward as you exhale.
  4. Your mantra: this, too, shall pass! Assuming you received a clean bill of health from your physician, just remind yourself that despite how frightening these symptoms can seem, they CANNOT harm you in any way, shape, or form.
  5. Self-empowerment and praise! Once you have successfully made it through the aforementioned steps, you have learned how to deactivate your fear response whenever you need to. So, congratulate yourself on this victory and start treating panic attacks as empowering experiences that give you an additional opportunity to master your reactions. With each step, you are rewiring your brain and training the way it responds to panic.

In addition to the aforementioned suggestions, if you or someone you care about is experiencing panic attacks, consider seeking therapy from a trained cognitive behavioral therapist who can help you start living and stop running.

-Masha Shapiro-Berkovich, MSEd, LMHC

Talking Out Military Sexual Trauma

/ Meg Duke / Leave a comment

Sexual abuse led one vet to a VA career counseling other MSA victims.

            Jennifer Sluga,  six-year veteran of the Wisconsin National Guard, originally participated in the VA’s new oral history program to help her caregivers understand her military sexual trauma, but her ordeal made her a strong advocate for others who had been assaulted.

“In the beginning, telling about my story helped me heal,” she told me recently. “But now I want everyone else who has ever experienced sexual trauma to know that they are not alone. By talking about it, we can get back the power that was taken from us.”

Now a psychotherapist at the Vet Center in Madison, Sluga estimates that 90 percent of her patient caseload also suffers from MST.

Sluga spent 17 months with the National Guard in Kosovo, but she told Thor Ringler, the “poet-in-residence” who runs the VA’s pilot “My Life, My Story” program in Madison, that her PTSD probably started well before her deployment from her military sexual trauma during her military training. (For more about the oral history program, see my previous blog, “An Oral History Program to Tell Veterans’ Stories.”)

“When he started that program, I told him it was the most amazing program ever,” she said. “Talking this trauma out of my system and using it to help others is just an amazing and powerful experience. It’s important for medical personnel to know that when I’m in those situations, I’m gonna be a little uptight, that I wonder whether I can trust that person, and that I’d prefer work with female doctor.”

Her ordeal started in boot camp when she and her “battle buddy” both reported to sick call. Her buddy was sent to the hospital, and that left her alone with the doctor.

“He had lot of rank on his chest and expected me do anything he said,” Sluga said. “He wanted me get undressed, then he began touching me and it became pretty obvious that this was nothing in the realm of anything medical.”

Sluga finally managed to push him away and ran to her barracks, only partially dressed.

“I ran to our barracks because I wanted to shower and cry, but another woman saw the marks on my body, asked about them, and then called the drill sergeant,” she said. “He ran over to sick call, and I thought he was going to kill the medic. It was really cool to be validated like that.”

But it didn’t stop there.

Several members of Sluga’s unit reported also sexual abuse during their deployment, and she began advocating for them.

Finally, the medic was charged with sexually assaulting his patients, and Sluga, her battle buddy and her drill sergeant were all required to testify at his court martial. “He finally admitted to sexually assaulting more than 70 soldiers and excused it by saying he had been raped as a child,” she said.

No wonder Sluga was severely traumatized. But she didn’t realize it until after she had left the National Guard and returned to college.

“I didn’t recognize that I wasn’t doing well until I went from an A student and I was failing all my classes, not attending classes, sleeping 20 hours a day,” she said. “I just wanted to go hide.”

Her breaking point came after she and her classmates got an exam back, and one of the girls was complaining about a bad grade.

“She said, ‘It really raped me,’” Sluga remembered.  “And I just wanted to jump over the chairs and scream at her: ‘Did it really rape you? Did it make you feel completely out of control?  Did it actually hurt you?’”

That led to counseling and therapy. It led to Ringler and the “My Life, My Story” program, which has now spread to six other VA facilities across the country. And it led Sluga to a career helping others as a psychotherapist.

More men than women are sexually assaulted in the military, she said.

“One of four women reports she has been sexually assaulted,” said Sluga. “The rate for men is one in ten, but since there are so many more men than women, the number of male victims is greater. Females are assaulted by men and other females, and males are assaulted by males and females as well.”

Rape and sexual assault are not about sexual gratification, she added. It’s all about power and control.

“In the military, you have no control over much of anything, so if you can find an area you can control, you take it,” Sluga explained. “A lot of people bully up and take advantage of other people—it’s almost like a sport.”

Now look at Sluga’s ordeal in light of our previous discussions on moral injury. She was betrayed by virtually everyone in her chain of command: the medical officer who sexually assaulted her, the officers who let such conduct go unchecked.  Those fellow soldiers who are supposed to save your life if necessary and have your back should be the last individuals anyone should need to protect themselves against.

VA psychologist Jonathan Shay argues that moral injury is present when there has been a betrayal of what is right by a person in a position of legitimate authority in a high-stakes situation. “Moral injury impairs the capacity for trust and elevates despair, suicidality and interpersonal violence,” he wrote in an article, “Moral Injury,” published last year in the journal of Psychoanalytic Psychology.

Sluga would agree that military sexual trauma can lead to PTSD.

When you lose your sense of self, especially from someone who’s supposed to be helping you, and they take your power and use it against you, to me that’s combat,” she said. And we all know that combat trauma leads to PTSD.

-Eric Newhouse

Top 10 Traits of an Empath

/ Meg Duke / Leave a comment

Discover if you’re a highly sensitive person.

The trademark of an empath is that they feel and absorb other people’s emotions and/or physical symptoms because of their high sensitivities. They filter the world through their intuition and have a difficult time intellectualizing their feelings.

As a psychiatrist and empath myself, I know the challenges of being a highly sensitive person. When overwhelmed with the impact of stressful emotions, empaths can have panic attacks, depression, chronic fatigue, food, sex and drug binges, and many physical symptoms that defy traditional medical diagnosis.

But an empath doesn’t have to feel too much and be overloaded once they learn how to center themselves. The first step is to acknowledge that you are an empath. Here are the top 10 traits of an empath from my book on how to achieve emotional freedom. See if you can relate to them.

10 Traits of an Empath

1. Empaths are highly sensitive
Empaths are naturally giving, spiritually open, and good listeners. If you want heart, empaths have got it. Through thick and thin, they’re there for you, world-class nurturers. But they can easily have their feelings hurt. Empaths are often told that they are “too sensitive” and need to toughen up.

2. Empaths absorb other people’s emotions
Empaths are highly attuned to other people’s moods, good and bad. They feel everything, sometimes to an extreme. They take on negativity such as anger or anxiety which is exhausting. If they are around peace and love, their bodies take these on and flourish.

3. Many empaths are introverted
Empaths become overwhelmed in crowds, which can amplify their empathy. They tend to be introverted and prefer one to one contact or small groups. Even if an empath is more extroverted they prefer limiting how much time they can be in a crowd or at a party.

4. Empaths are highly intuitive
Empaths experience the world through their intuition. It is important for them to develop their intuition and listen to their gut feelings about people. This will help empaths find positive relationships and avoid energy vampires. Read How to Develop Your Intuition to learn more.

5. Empaths need alone time
As super-responders, being around people can drain an empath so they periodically need alone time to recharge their batteries. Even a brief escape prevents emotionally overload. Empaths like to take their own cars when they go places so they can leave when they please.

6. Empaths can become overwhelmed in intimate relationships
Too much togetherness can be difficult for an empath so they may avoid intimate relationships. Deep down they are afraid of being engulfed and losing their identity. For empaths to be at ease in a relationship, the traditional paradigm for being a couple must be re-defined. For strategies see my article Secrets for Sensitive People: Why Empaths Stay Lonely.

7. Empaths are targets for energy vampires
An empath’s sensitivity makes them particularly easy marks for energy vampires, whose fear or rage can sap their energy and peace of mind. Vampires do more than drain an empath’s physical energy. The especially dangerous ones such as narcissists (they lack empathy and are only concerned with themselves) can make them believe they’re unworthy and unlovable. Other vampires include The Victim, The Chronic Talker, The Drama Queen and more. To help you deal with the drainers in your life read 4 Strategies to Survive Emotional Vampires.

8. Empaths become replenished in nature
The busyness of ever day life can be too much for an empath. The natural world nourishes and restores them. It helps them to release their burdens and they take refuge in the presence of green wild things, the ocean or other bodies of water.

9. Empaths have highly tuned senses
An empath’s nerves can get frayed by noise, smells, or excessive talking.

10. Empaths have huge hearts but sometimes give too much
Empaths are big-hearted people and try to relieve the pain of others. A homeless person holding a cardboard sign, “I’m hungry” at a busy intersection; a hurt child; a distraught friend. It’s natural to want to reach out to them, ease their pain. But empaths don’t stop there. Instead, they take it on. Suddenly they’re the one feeling drained or upset when they felt fine before.

As an empath myself, I use many strategies to protect my sensitivities such as fierce time management, setting limits and boundaries with draining people, meditation to calm and center myself, and going out into nature. Being an empath is a gift in my life but I had to learn to take care of myself. Empaths have special needs. It’s important to honor yours and communicate them to loved ones.

-Judith Orloff, MD

How to Make Peace With Something You Cannot Control

/ Meg Duke / Leave a comment

Feeling safe when you’re not in control is a valuable skill

ibreakstock/Shutterstock
Source: ibreakstock/Shutterstock

Being in control feels safe, you can feel safe when you’re not in control too. The world is unpredictable and your power is limited, so feeling safe without control is a valuable skill.

When the world disappoints your expectations, your brain releases cortisol and it feels like an emergency. You can re-wire your brain to feel safe when you’re not in control. That doesn’t mean being out of control or giving up. It means building a new neural pathway to replace that old cortisol circuit.

Your brain will build a new pathway if you repeat a new thought or behavior for forty-five days. So give up control of something for the next six weeks and you will like the results!

Notice your usual strategy for feeling “on top of things,” and do the opposite. 
For example, if you are a person who tries to bake the perfect soufflé, spend forty-five days cooking without recipes. Conversely, if you are a person who likes to just throw things into a pot, spend forty-five days following recipes.

If you are a person who likes everything neat, let junk pile up for six weeks. But if you are a person who hates order and loves chaos, put things away as soon as you use them for six weeks.

Color outside the lines if that’s new for you, but if you already pride yourself on that, courageously stay inside the lines. It might feel awful on Day One, but forty-four days later it will feel curiously safe.

Don’t quit your day job to beg with a rice bowl. Just stop checking the weather report, buying lottery tickets, and expecting the world to work according to your rules. You will not like the cortisol at first, but you will train your brain to know that it doesn’t kill you. You will learn to feel safe in the world despite your inability to control it.

Getting rid of the clock is a great way to experiment with control, because you can’t control time.
We all have habits for managing the harsh reality of time. For some it’s chronic lateness and for others it’s constant clock-checking. You may think you can’t change your relationship with time, but here are three great ways to ignore the clock and make friends with the passage of time:

  1. Start an activity without having an exact time you need to stop. Finish the activity without ever checking the clock the whole time. It’s over when you feel like it’s over.
  2. Set aside a time each day to spend with no plan.
  3. Designate a day you can wake up without looking at the clock and continue through your day with no time-checking.

No matter how busy you are, you can find a way to relax your efforts to control time. You may be surprised at the bad feelings that come up, despite your abiding wish to escape time pressure. The bad feelings won’t kill you, however, and accepting them helps you accept the harsh realities of time.

Your mammal brain feels good about things it can control. Some people break traffic laws to enjoy a sense of control, while others feel their power by scolding those who break traffic laws. Whatever gives you a sense of power won’t work all the time, however. You will end up feeling weak and unimportant some of the time. That triggers cortisol, but you can learn to feel safe when you are not in control.

-Loretta G. Bruening, PhD

The Conveyor Belt

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This is one of my favorite exercises to ease anxiety and start gaining control over emotions. Imagine a conveyor belt, and that your thoughts are coming down the belt. Name the thoughts and feelings to yourself as they come down the belt — “I am having a feeling of sadness. I am now having a feeling of fear that I will be alone. It’s a very intense feeling. Now I’m having a feeling of curiosity about what my brother said last night.” Recognize each thought as it comes down the belt, and then let it pass by and go on the next thought. Allow the thoughts and feelings to flow through you as you observe them.

You’ll do this for a few minutes at a time a couple of times a day to start with. Every day you’ll increase the amount of time you spend. For example, the first day try 3 minutes, the next day 5. I know this may sound strange, but it’s actually a lot more difficult than people realize. What will probably happen is as you’re trying to do the exercise, you will get distracted from it several times. When this happens, just gently turn your mind back to the exercise. It’s important to note that one of the things you’re trying to master here is being separate from your thoughts. You are observing your thoughts as they happen without judging them. So if the the thought “Why did he treat me that way?” comes into your mind, you observe it, make a note that it is painful and then go on to the next thought. This exercise is a powerful tool to start learning to control your attention rather than your attention controlling you.

-Alexa Thompson, LPC