Reflections On Medicine, Shame And Stigma

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As I was entering medical school, I found out that my mother had made a postpartum suicide attempt. I did not find out from her; it was shared with me in hushed tones by another family member who thought I should know, “now that I was going to be a doctor.” I was quite surprised by this information. And it made me sad to think that this wasn’t a topic she felt she could openly discuss.

Suicide is a challenging issue for all of us. Secrecy surrounds the topic, with shame as a common co-traveler. That’s why it’s an honor for me to be a small part of NAMI’s movement to make seeking help and support more acceptable. I’ve met many resilient people in the NAMI community who have overcome suicidal thoughts or actions. Often because there was a person who stood by them during a crisis or a new treatment approach that made a difference in their life. Some found sobriety for a co-occurring substance use disorder. Others found clozapine or lithium, which have been shown to reduce suicidal thinking. Some learned coping skills through a psychotherapy like cognitive behavioral therapy or dialectical behavioral therapy. Many found relief in the community of NAMI. Regardless of how, their suicidal thoughts or actions were talked about and changed.

My field sorely needs similar conversation and change. Doctors also have high rates of suicide and it’s a major issue that some of the doctors we turn to for care are often not taking care of themselves. We need to teach help-seeking behaviors in the medical and psychiatric fields. Doctors need the same support and encouragement to get help as their patients.

I lost a patient to suicide early in my psychiatric residency. This was a person with many strengths, who was also in tremendous psychological pain. I worried about him during off-hours and felt powerless to help at times. After I learned of his tragic outcome, I was upset, slept poorly and struggled at work for months. I was worried I had said the wrong thing or had failed in some way as an inexperienced psychiatrist. I seriously considered leaving the field and entering another specialty. I was lucky to receive support and empathy from my colleagues and supervisors as they encouraged me to seek therapy. I did my best to carry on, but I never forgot about this patient and his suffering.

Last year, at an American Psychiatric Association (APA) event, I was impressed that even doctors are wondering if they worry, struggle and stress too much. APA president Anita Everett reviewed the stresses that commonly consume doctors and announced that psychiatric wellness would be a core feature of her leadership. Dr. Everett’s thoughtfulness and openness on the stresses doctors face and her emphasis on help-seeking was powerful; her efforts have started many overdue conversations across the entire field of medicine. Unfortunately, the same shame that led to the secrecy around my mother’s postpartum suicide attempt is alive and well in the medical field.

Doctors don’t have all the answers for stress, mental illness and suicide—our most challenging aspects of being human. Medical culture needs to continually evolve and learn from the remarkable and resilient people like those I have met at NAMI. Facing your mental health challenges head-on and working to get help with a supportive community behind you is a key piece of NAMI culture. It’s a culture we can all learn from.

 

Ken Duckworth is medical director at NAMI.

https://www.nami.org/Blogs/NAMI-Blog/September-2018-(1)/Reflections-on-Medicine-Shame-and-Stigma

How To Have A Healthy Relationship With Social Media

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Social media has allowed society to become more connected than ever. Over three billion people around the world use social media to engage with others, access the news and share information. In the U.S. alone, seven out of ten people are active social media users.

Some would argue that social media is inherently bad for our health. Recent research explores the negative implications of social media, including sleep issues, an overall increase in stress and a rise in mental health conditions and addiction to technology. There are also concerns about cyberbullying and youth and teen safety online. Fortunately, tech companies are proactively addressing these types of concerns. For example, the recently released Parent’s Guide to Instagram helps parents who are “raising the first generation of digital natives, for whom the online world is just as important as the offline world.”

On the other hand, there are many benefits to social media. Young people today consider social media as platforms for sharing their voice and finding a community of like-minded peers. And users of all generations understand that with social media, you can celebrate milestones or reconnect with old friends and relatives.

Regardless of what type of impact we believe these digital platforms can have on us, we must be intentional in how we use social media. For example, as NAMI’s social media manager, I use social media as a tool to spread mental health awareness. Through my experience, I’ve learned several tips and tricks for having a healthy relationship with social media. Here are some you might find helpful.

Unfollow Unhealthy Accounts

It’s important to remember that, often, the images and stories on social media aren’t reflective of real life. Whether you follow friends, influencers, businesses or organizations, social media feeds are filled with carefully crafted, curated posts. Consider the following: Does your feed leave you feeling overwhelmed or less-than? Do you constantly compare your experiences with others? If yes—and you notice an overall decrease in your happiness, self-esteem and life satisfaction, it’s time to make a change. Put an end to the negativity by reviewing the accounts you follow—unfollow, block or delete accounts that don’t bring positivity, motivation or inspiration into your life.

Support And Connect With Others

There are many people you can connect with through social media, even if they’re on the other side of the planet. And that’s a good thing. However, if the interactions you’re having leave you feeling isolated or upset, you should reevaluate why you use social media. Do you want to engage with others who share your interests? If so, search for digital communities of people who you have something in common with. From there, you can be more selective with who you connect and engage with.

Take Note Of What You Share

These days, it can be challenging to determine reputable sources of news and information. That’s why it’s important to play a conscious role before sharing something you see online with your friends or followers. Think about whether the content—be it an article or video—is helpful or harmful to others. Also consider if it truly provides knowledge worth sharing. If it doesn’t contribute something positive to the digital world, it may not be worth sharing on your social media account.

Reduce Your Screen Time

Smartphones are quite everywhere these days. In any public setting, you’ve likely noticed others with their eyes glued to their phones. In fact, recent studies reveal that people spend an average of over two hours a day on social media. If you’re concerned you may be spending too much time social media, try adopting healthier habits. Start by tracking the time you spend on social media; if you’re on Facebook or Instagram, look out for the new tool that helps users manage time spent on their accounts. When you limit your screen time, you’re creating more time for enriching, real-world experiences.

Take A Break

Completely stepping back from social media can be hard, but it’s a good way to help you reconnect to reality. Log out from your accounts for a full day, a week or even a month. Have a friend change your password so you don’t feel tempted to log back in to your account. Then, take notice of how you spend your time. Perhaps you rediscover an old hobby or sport. Or maybe you’re able to schedule more quality time for your family or friends. Either way, it’s more exciting to live life as it’s happening, as opposed to “living” through a screen.

Rather than thinking of social media as something that only hurts our health, we should reevaluate when and how we use our accounts. Social media platforms can be used for good—it all depends on whether you choose to use it for good.

 

Ryann Tanap is manager of social media and digital assets at NAMI. 

https://www.nami.org/Blogs/NAMI-Blog/September-2018-(1)/How-to-Have-a-Healthy-Relationship-with-Social-Med

How To Reduce Screen Time In The Digital Age

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Smartphones have transformed modern life in more ways than anyone could have imagined. They enable 24/7 access to infinite information and tools that help us stay organized, track our fitness, express ourselves and be entertained. However, easy access to these digital devices and their habit-forming qualities has led to high screen time for both children and adults and emerging research suggests that such high screen use can have a negative impact on mental health.

Since the rise of the smartphone, indicators of mental “wellness” such as happiness, self-esteem and life satisfaction have decreased while serious mental health issues like anxiety, depression, loneliness and suicide have increased significantly, particularly among young people. A possible reason for this might be that more time on screens, particularly social media, leads to increased risks of stressors like social isolation, cyberbullying, social comparison, decreased life satisfaction, reduced productivity and distraction from personal values and goals.

Increased time on screens also means there’s less time available for positive real world experiences that promote mental health, like exercise, quiet reflection and quality, in-person social connection. With all of this in mind, it’s not surprising that research suggests that less time on social media leads to better well-being.

While more research is needed, it certainly appears that less screen time bodes well for mental health. So, consider the following tips to keep screen time in-check, leaving more room for healthy, positive real-world experiences.

Connect For Real

Despite opportunities for online “connection,” loneliness is at an all-time high. Indeed, quality face-to-face social connection is critical to mental wellness. So, make it a goal to have screen-free, in-person social connections with friends, co-workers and loved ones on a daily basis. Consider making it a standard to power down whenever there is an opportunity for conversation such as in the car, standing in line and during meals or social gatherings.

Commit To A Screen-Free Bedroom

Screen time within an hour of bedtime can negatively impact sleep, which can contribute to physical, mental and cognitive issues. However, the lure of a screen in a quiet bedroom is hard to resist. It’s difficult to ignore texts, resist a Netflix binge or mindlessly scroll through social media. Eliminate the temptation by keeping phones out of the bedroom entirely and reach for a book or magazine instead.

Avoid Multitasking

Put away your phone when you need to focus on a task, particularly related to school or work. Research on multitasking shows that it causes distraction, reduces productivity and increases errors. One study showed that subjects whose phones were in a different room performed better on a cognitive test compared to those whose phones were in front of them—and set on “Silent” mode. In addition to reduced productivity and cognitive impact, media multitasking also has been linked to lower wellbeing.

Notice Motives And Feelings

Ask yourself if being on your phone is what you really want to be doing at that moment. By using mindfulness, you can identify if you’re trying to avoid negative feelings or a necessary task, or whether you’re truly enjoying your digital experience. This exercise can help with getting in touch with your emotions and improve purposeful decision-making around screen use.

Pursue Healthy Interests And Activities

Making time for hobbies or activities that promote health, personal growth or connections with others can help to reduce screen use and provide a sense of meaning and purpose. Some examples are: reading books, hiking in nature, taking mindful walks, prayer or meditation, joining a club, practicing yoga, cooking, volunteering or learning to play an instrument.

Practice Reflection And Gratitude

A daily practice in quieting your mind and counting your blessings can boost positive emotion and improve psychological wellness. Research suggests that gratitude may protect against social comparison and envy—common experiences with social media. Reflect on what is good and right in your life. During quiet, screen-free time, write down five good things from each day. Savor simple pleasures like a sunny day, a good cup of coffee or a friendly exchange with someone.

Clarify Your Values

Take time to mindfully consider what you value most in life. What do you want your life to be about? Quality relationships? Physical and emotional health? Spiritual growth? Professional growth? Regularly consider whether screen use is moving you toward or away from your values. If you notice that your screen use is moving you in an unwanted direction, give yourself grace, hit the figurative “reset” button and get back on track.

 

Nina Schroder, MSW, LCSW is a mental health therapist at Virginia Commonwealth University in Richmond, VA. She specializes in the treatment of anxiety and depression and researches the effects of high screen use on mental health, emotional resilience, and overall wellness. Nina is passionate about helping others increase wellness and emotional resilience in the Digital Age and delivers lectures and workshops both locally and nationally. You can reach her at nina.schroder@yahoo.com.

An Important Conversation With My Mom

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July is Minority Mental Health Awareness Month, and I wanted to take this opportunity to explore a particularly difficult season in my life: the years my mom served time.

As a quick background, my mom has always been as much of a friend as a mother, and before this period we spoke every day. The years she spent incarcerated were intensified by my severe depression and overeating disorder, but we’ve never fully talked about how they impacted one another. I thought now would be the right time to have that conversation:

DeWanda: Let’s start with logistics because my memory is the worst. What were the dates of your incarceration?

Mom: I was sentenced on July 2, 2008 and went straight to first Howard County Detention Center. I was transferred to the MCIW (MD Correctional Institute for Women) on July 20 and was there until April 20, 2010.

D: It felt so much longer in my head. Do you remember your first day? How did you feel?

M: The very first day was when I went to court for the sentencing. I was told that I needed to be prepared that they might not allow me to return home that day. The lawyer was right because I was told I was being given seven years out of a 15-year maximum. At that moment, I was silent, I felt numb, nauseated and like I was going to faint. They took me out of the courtroom in handcuffs after the judge spoke and to a cold room with cement floors, a single steel commode and a sink. There was also a cot. I felt dizzy and like I had just lost a loved one to death so I lied on the cot in the fetal position, pulled a blanket over me and immediately cried myself to sleep.

D: I can’t believe I never asked you that before. I think I must have been somewhere doing the same. I was in-between living situations then, couch-hopping with my friends, but I never felt more alone in my life.What would you say was your main coping mechanism during your time at MCIM? I mentioned mine was food. (Spoiler alert: It did not make me feel better.)

M: My coping mechanism became an obsession with reading lots of books. I would isolate myself during times when I could’ve been out mingling and talking to other people in the recreation area. I instead would hide in my room and read. I read and slept all the time. The other ways to cope was that I volunteered to clean up the entire tier of our living quarters as many nights as I possibly could. I cleaned the hallways, the main area and the shower stalls. I was constantly cleaning my cell (which all my cellmates loved). That went on until one day I finally decided to volunteer to help in the Chaplains office in which I ended up directing the choir, teaching people how to sing properly in a choir and helping to teach the new believers classes.

I basically spent the first month feeling sorry for myself and tried to do nothing but sit there and read. When I got over that phase I substituted it with being constantly busy so I’d be too tired to do anything but sleep when I did lay down. It also made the time go so much faster being busy.

D: So, it seems safe to say that faith played a significant part of how you spent your time. Me too, I was attending Redeemer then, and praying with my Bible study group about everything. I also worked on that play, “In the Continuum” down in North Carolina. My character, Abigail, was a woman of great faith too. It was the first time you had ever missed a performance. What else do you feel like you missed out on during your time?

M: I was worried about you because I didn’t know if you had jobs enough to have sufficient income. I didn’t really feel like I was missing anything because life {outside} had become so hectic and stressful that I just needed to lay down somewhere. It probably helped me to get to the point where I don’t have to go places as much as I used to.

D: You’ve always been the glass-half-full type. Yeah, I was miraculously fine. I remember coming to get you for Great-Grandma’s funeral and making sure they released you. That was a little light in the midst of things. I still feel bad about getting married while you were away, but I guess I thought you wouldn’t want me to stop living.

M: I was in no way offended about you getting married cause look at what a great husband you got. We ain’t want Alano to get away.

D: You’re too funny! This conversation is good. I’m over here crying.

M: Don’t cry! It’s over now and I actually got to help others which also helped me get through it. I saw other people who had to be on depression medication all the time while I was there. I have never been diagnosed as depressed but I supposed OCD is a problem.

D: Statistics regarding incarcerated women and mental health are pretty staggering.

M: Oh, wow!

D: OCD is definitely a thing—under-eating makes people feel like they’re in control, even if the food is gross.

M: I never really knew what that was; I just know I have to do something when I’m stressed.

D: Any lasting thoughts you’d like to leave with the NAMI community?

M: Yes. Get up every day and write a list of all the good things and blessings that you have. It helps to create a more positive mood for the rest of the day. The more we focus on the good things and also remember that someone else may have a harder time than we are experiencing, it keeps it all in perspective. Also, don’t be afraid to tell others how you are really feeling the next time someone asks, “How are you?” It makes all the difference in the world if you have someone who you know genuinely cares. Try to be that person for someone else and see what a difference it will make in your life.

 

DeWanda Wise is an actress whose work includes roles on Fox event series, Shots Fired, and the critically acclaimed series, Underground. She resides in California with her husband and the best cat in the world, Rascal.

https://www.nami.org/Blogs/NAMI-Blog/July-2017/An-Important-Conversation-with-My-Mom

Opioids And Substance Abuse: What Can We Do?

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Opioids and other substances that alter how we feel, think and act have overtaken our culture, and have been declared a public health epidemic. We are losing our loved ones, friends, co-workers and neighbors to these substances. But we have yet to implement the solutions that will beat back this epidemic, as we have so many others, like HIV/AIDS, polio, smallpox and tobacco.

Substance use and abuse—of opioids, heroin, cannabis, stimulants, alcohol, etc.—is universal and the casualties of drug addiction affect all classes, races and regions of the U.S. These substances are too frequently used as an answer to pain, mental and physical, and have become a cure-all for people who’ve fallen on hard times. That’s why so many people use them and that’s why so many people become addicted.

Substance use disorders commonly co-occur with mental health conditions, especially serious mental illness like schizophrenia, bipolar disorder, depression, eating disorders, PTSD and other forms of trauma. People with mental illnesses often turn to drugs and alcohol to quiet their symptoms, and drugs and alcohol can adversely affect our nervous system and increase risk for mental illness.

The Solution

We are failing with this epidemic because of this country’s dogged attachment to policies and programs that have never worked for addiction. Vast sums of money continue to be wasted on campaigns of drug control and on public messages, especially for youth, that rely on scare tactics. We can and must do better. We can beat this epidemic with three public health approaches.

  1. Prevention. This includes school-based programs that provide youth with decision-making skills and methods of controlling their moods and impulses. One proven program is called the Life Skills Training. Prevention also extends to the family, such as “positive parenting,” or actively modeling and teaching children about positive behaviors. Big Brother/Big Sister programs—where an older youth of the same background takes on a younger, high-risk child—is also highly protective. These prevention programs work, and we have hardly started to apply them.
  1. Screening. Early identification of a problem means early intervention, before the substance use disorder becomes more firmly rooted. We have good screening instruments, (such as the Alcohol, Smoking and Substance Involvement Screening Test), and need to make them standard practice in schools, pediatric and family medicine offices.
  1. Treatment. Families and people affected by addiction should advocate for the strong, comprehensive treatment approach they need. Effective treatment means first detecting the presence of a co-occurring mental (or physical) condition and assuring it’s also treated. Treatment for a substance use disorder should then combine:
  • Cognitive therapy that focuses on reducing the triggers of relapse
  • 12-Step programs like Alcoholics Anonymous and Narcotics Anonymous
  • Family education and support
  • Medications

This public health epidemic that is seizing our country can be beaten. And by following these steps, we save lives, help families and restore communities.

 

Dr. Sederer is a psychiatrist, public health doctor and medical journalist. His new book is The Addiction Solution: Treating Our Dependence on Opioids and Other Drugs(Scribner, 2018). www.askdrlloyd.com.

https://www.nami.org/Blogs/NAMI-Blog/June-2018/Opioids-and-Substance-Abuse-What-Can-We-Do

You Can Be Prepared For Crises

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Each year, there are about 5 million visits to emergency departments due to mental illness. Five million people whose symptoms escalate to the point of crisis. Five million people who don’t understand what’s going on or what to do and rush to the ER.

However, this number doesn’t include the people who experience mental health crises without going to the ER—people who are scared and unsure if their situation is a “true emergency.” This number also doesn’t account for the caregivers and loved ones of those experiencing a mental health crisis, standing beside someone they care for, watching them struggle, unsure of how to help.

Mental illness is unpredictable by nature and crises can, do and will happen. Although these crises can’t always be prevented, it is possible to be prepared.

Learn As Much As You Can

The first step in being prepared is gathering any information, resources and support that is available. Start by fully understanding your loved one’s condition: What are the primary symptoms? How can you tell if symptoms are getting more severe? What can you do to support them? And the list goes on. It can be helpful to go with your loved one to see their mental health professional, so you can ask these questions and any others you may have.

Next, learn more about what a mental health crisis is and what to expect when one occurs. NAMI’s new guide: “Navigating a Mental Health Crisis: A NAMI Resource Guide for Those Experiencing a Mental Health Emergency” is a great resource. This free, downloadable guide offers practical strategies on how to deescalate a crisis, information about available resources, tips for advocating for a person in crisis and a sample crisis plan. Details like these are often critical in supporting your loved one during a crisis.

Make A Crisis Plan

Creating a crisis plan should be a collaboration between your loved one and you. The best time to develop this plan is when things are going well. Take the time to ask them questions that will help build a crisis plan, like: What would be most helpful for you? What would you like to do? Who would you like to call? Waiting to ask these important questions can make it difficult to make decisions during a crisis episode.

A crisis plan should include:

  • Your loved one’s general information (date of birth, social security number, insurance information, etc.)
  • Current medications and dosages
  • Current diagnoses
  • History of suicide attempts, drug use or psychosis
  • Addresses and contact information for nearby crisis centers or emergency rooms
  • Contact information for health care professionals
  • A determined behavior/symptom that would prompt going to the hospital or calling 911

Once you create a plane, share it with family members, mental health professionals or anyone else you think should have it. Make sure to update it whenever there is a change in diagnosis, medication, treatment or provider. A crisis plan can be a life-saving resource, so keep it up-to-date and in a safe place.

Notice Behavior Changes

A person with mental illness will typically experience changes in their behavior before a crisis occurs, such as sleeplessness, mood swings or paranoia. These changes are warning signs and shouldn’t be ignored. “Psychiatric illnesses, for the most part, evolve slowly, so there’s going to be a lot of warning,” says Dr. Daniel Lieberman to U.S. News and World Report.

If you notice warning signs, talk to your loved one and encourage them to visit their treating mental health care professional or doctor. “If somebody has a relationship with an outpatient psychiatrist, that’s the first place to go,” Lieberman says.In many cases, there might be enough time to get in contact with a provider before escalating symptoms become a crisis.

Mental health crises can be frightening for everyone involved. However, being prepared can take away some of the fear and uncertainty around what to do and how to help your loved one. Your preparation and support alone can help deescalate a crisis situation—just knowing you’re there, as a stable force, can be an enormous comfort.

By Laura Greenstein

https://www.nami.org/Blogs/NAMI-Blog/June-2018/You-Can-Be-Prepared-for-Crises

Why Do We Have The Feeling That We Are Not Enough?

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Mike believed he had a good life and felt lucky for all the things he had. He was married to a loving wife, had a good job, owned a nice house and had three healthy kids.

Despite all his good fortune, Mike could not shake the nagging feeling that he wasn’t enough: “I should be more successful. I should make more money. I should be where my boss is. I should have a graduate degree. I should have a bigger house. I should have more friends.” These were some of the “shoulds” that plagued him daily.

“Could I get you curious about this part of you that feels inadequate?” I asked Mike during our first meeting. “Let yourself travel back in time. How old were you when you first felt ‘not enough?’”

He paused to reflect. “It’s definitely been with me a long time,” he said. “Maybe six or eight years old?”

Mike’s father had become extremely successful when Mike was six years old. Because of his father’s new job, his family moved to an exotic country where no one spoke English. Mike was scared and felt like a stranger. Even though he attended an international school, he had no friends for a long time.

His parents pushed him; they meant well and were trying to encourage him. But feeling scared and overwhelmed by the many changes in his life, he misinterpreted their words as disappointment that he wasn’t enough—it was the familiar feeling he still had today.

Showing Self-Compassion

We are not born feeling inadequate. Life experiences and emotions create that sense within us in a variety of ways. For example, when we were little, and we felt afraid or anxious, our mind told us something was wrong with us, not our environment. A child’s mind, not yet rational, concludes, “There must be something wrong with me if I feel so bad.” That’s why children who were abused or neglected grow up to be adults who carry so much shame. They likely spent years telling themselves: “I must be bad if I’m being treated badly.”

As adults, armed with education on emotions and how childhood adversity affects the brain, we can understand that feeling “not enough” is a byproduct of an environment that was insufficient. We are in fact enough! Yet to feel more solid, we must work to transform that “not enough” feeling.

One way to transform old beliefs is to work with them as separate parts of ourselves. With some mental energy, we can externalize ailing parts of us and then relate to them in ways that heal old wounds.

For example, I asked Mike, “Can you imagine that the 6-year-old boy inside you, who feels ‘not enough,’ is sitting on my sofa over there so we can be with him and try to help him?”

With practice, Mike learned to connect, listen and communicate with that part of himself. Offering compassion to the child inside himself helped him feel much better, even though he had struggled with the concept initially.

Since emotions are physical sensations, another way to work with wounded parts is through the body. Mike learned to recognize how “not enough” physically felt. “It’s like an emptiness—like a hole inside. I know I’ve been successful at times, and I believe my family loves me. Emotionally, it doesn’t feel that way at all. Good stuff comes in, but it goes right through me like a bucket with a hole. I’m never filled.”

To help patch the hole in his bucket, I helped Mike develop his capacity to hold onto good feelings by noticing them. “If you recognize and validate your accomplishments, what does that feel like inside?”

“I feel taller,” said Mike.

“Can you stay with the feeling of being taller for just ten seconds?”

Like a form of training, he built his capacity to experience positive feelings. Going slowly, we practiced noticing sensations associated with pride, love, gratitude and joy—getting used to them a little at a time.

What Else Can We Do To Help The Parts Of Us That Feel “Not Enough?”

  • We can remind ourselves again and again that our feelings of “not enough” were learned. It’s not objective fact, even when it feels so instinctually true.
  • We can connect to the part of us that feels bad and offer it compassion, like we would for our child, partner, colleague, friend or pet.
  • We can practice deeply belly breathing, five or six times in a row, to calm our nervous system.
  • We can exercise to get adrenaline flowing and create a sense of empowerment.
  • We can remember this very helpful phrase: “Compare and Despair!” When you catch yourself making comparisons to others, STOP! It only hurts, by fueling feelings and thoughts of “not enough.”

In the long run, we heal the parts of us that feel inadequate by first becoming aware of them. Once aware, we can listen to them and try to fully understand the story of how they came to believe they were “not enough.” Over time, by naming, validating and processing the associated emotions both from the past and present, “not enough” can become enough.

(Patient details are always changed to protect privacy)

https://www.nami.org/Blogs/NAMI-Blog/June-2018/Why-Do-We-Have-the-Feeling-that-We-Are-Not-Enough

Hilary Jacobs Hendel, LCSW, is the author of  It’s Not Always Depression (Random House & Penguin UK), a book which teaches both the general public and psychotherapists about emotions and how to work with them to feel better. She received her BA in biochemistry from Wesleyan University and an MSW from Fordham University. She is a certified psychoanalyst and AEDP psychotherapist and supervisor. She has published articles in The New York Times and professional journals. Hendel was also the Mental Health Consultant on AMC’s Mad Men. She lives in New York City. For more information and free resources for mental health visit: https://www.hilaryjacobshendel.com/

The 7 Thought-Habits of Highly Self-Confident People

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Are there mental habits that will increase your self-confidence?  Most definitely. You’ll read about 7 such powerful thinking habits below.

My last blog revealed the very best mental habit I know for building self-confidence: “The Daily Success Review.” This short and simple 3-minute procedure nudges you to tune into the little things you do right every day instead of over-focusing on what you think you did wrong. I have nicknamed this daily technique, “The Small-Success Review,” to counter the destructive mindset of thinking that only huge and dramatic successes and accomplishments really “count” when it comes to bolstering self-esteem.

In addition to the Small-Successes method, there are other ways to increase your self-confidence just by altering your mindset slightly.  Of course, it is also important to practice behaviors that will increase your confidence and to learn to project self-confidence to others, and those will be the topics of upcoming blogs.  This blog will spotlight the thinking activities you can do right now to build a self-esteem mindset.  Below are 7 of my favorites:

1. Don’t worry if you don’t feel confident all the time.  It sounds counter-intuitive, doesn’t it? But Dr. Alice Boyes, in her useful new book, The Healthy Mind Toolkit, describes her realization that she needs both self-confidence and self-doubt to do her best work.  A little self-doubt can keep you humble enough to realize you may need to learn more or work harder at something.  It may even give you the dogged determination to keep going and “show people what you’re made of.” Doubt, according to Boyes, “causes us to question what we’re doing, mentally prepares us to accept change, propels us to work harder or differently, and can lead to us taking more cooperative approaches in dealing with people who disagree with us.”

I love this reminder that your feelings of confidence will ebb and flow during the course of a day–or a lifetime—and that this fluctuation is normal. Not to worry!

2. Show compassion toward your Future Self.  Caring for your Future Self could involve actions as small as filling up your gas tank this afternoon because you have a busy morning tomorrow and as far-sighted as exercising now for better health as you age.  “I may not want to exercise,” you could say to yourself, “But my Future Self sure would appreciate it.”  Inthis blog(link is external), habits guru Leo Babauta points out that people who don’t procrastinate are also likely to be people who want their Future Selves to be happy.   Can you decide to be one of them?

3. Practice compassionate and realistic self-talk.  Being able to realize when you are suffering, to comfort yourself, and to tell yourself that “tomorrow is another day,” will help you accept yourself even when you haven’t been able to handle yourself the way you would have preferred. Being supportive and kind to yourself when you have made mistakes will not only boost self-esteem; it will also boost your motivation and self-control, according to research cited by psychologist Kelly McGonigal in her book, The Willpower Instinct.

Some examples of compassionate self-talk:

  • “It’s true that you didn’t do as well as you wanted on the talk, but given that you didn’t feel well, you were a hero just to get through it.”
  • “Yes, you feel bad that you didn’t say NO to your friend’s request.  Think of what you could say next time and put it in your mental file.”
  • “You don’t have to be perfect.”
  • “Don’t let it get you down. This too shall pass.”

4. Relabel “failures” as setbacks, challenges, opportunities, or learning experiences.  Relabeling “failures” as “challenges,” for example, will immediately lower the level of stress hormones in your body.  How could you meet this latest “challenge?”  Changing one word can initiate a cascade of problem-solving thoughts. Analyzing past mistakes and setbacks may also improve your future performance, according to this research(link is external).  Strike the ugly f-word “failure” from your mental vocabulary list!  Practice enough, and you will develop a “growth mindset,” as psychologist Carol Dweck calls it.

"Idea." Image by Tumisu. Pixabay, CC0.
Source: “Idea.” Image by Tumisu. Pixabay, CC0.

5. Don’t assume that other people know what you know. Own your expertise! This reminder is also from The Healthy Mind Toolkit by Alice Boyes.  Do you know…the best places to find inexpensive clothing? Your city’s ordinances about trash, permits, and large-item pickups? The best restaurants for any occasion? Think about the times when people turn to you for information; your friends realize that you have numerous areas of expertise, both career-related and life-related.

6. Know your strengths.  Think back on compliments and positive feedback from others. Notice how much you enjoy or dislike certain kinds of tasks. Take in the way you contributed to a situation and made it better. When you’ve had a success, mentally replay it again and again.  Remembering and savoring positive feedback from others will help you internalize your strengths. Likewise, remembering other positive experiences will ingrain your special qualities into your brain. (Many readers have found this blog on “knowing yourself” a helpful way to focus on strengths.)

7. Remember your higher purpose and your meaningful values and goals.  Reminding yourself of your most important values, goals, and life mission can give you more willpower, persistence, and self-confidence, according to considerable research.  Your values keep you oriented to your “true north,” pointing to the core of who you are.

If nothing is working, and you feel prey to constant feelings of worthlessness or self-hatred, find a good therapist. Your therapist will help you challenge any deep-seated negative beliefs about yourself.  Yes, therapy involves time, money, and work, but it’s worth it to improve your self-confidence. There’s a lot of truth in this quote by Maxwell Maltz: “Low self-esteem is like driving through life with your hand-brake on.”

References

McGonigal, K. (2012). The Willpower Instinct. (NY: Avery), p. 148.

Boyes, A. (2018) The Healthy Mind Toolkit. (NY: Tarcher), p. 66, 205, 206.

Babauta, L. “Two Simple Habits of Non-Procrastinators.”

By Meg Selig

https://www.psychologytoday.com/us/blog/changepower/201805/the-7-thought-habits-highly-self-confident-people

Are You A Chronic Self-Abandoner?

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Self-abandonment is a strange concept. How can you abandon yourself when you are always with you? If you’re well-schooled in the world of self-development, you may have an educated guess at what self-abandonment is: It’s when you don’t support yourself, right? Kind of.

Essentially, self-abandonment is when you reject, suppress or ignore part of yourself in real-time. In other words, you have a need or desire you want to meet, and (often on the spot) you make the decision not to meet it.

Example A: Jen comes home from a long, exhausting work week and is looking forward to resting. A friend calls, asking if she can come over to vent about her difficult relationship. While Jen knows what she wants, she still reluctantly tells her friend to come over.

Example B: Kyle is interested in studying a particular style of art that has excited him for years. But his friends poke fun at him, saying it’s a waste of time. Kyle despondently never enrolls in art class, despite his genuine interest.

In both cases, these individuals value the needs and opinions of others more than they value their own. They have an initial trajectory they are fairly certain about, but they abandon it as soon as they are “pressured” by others.

In a self-abandoner’s mind, the belief that their needs and desires either cannot be met or should not be met is a strong one. This belief leads to a continuous process of detachment, as the self-abandoner repeatedly makes decisions to ignore, repress or condemn their personal needs. Over time, they might even forget or lose the ability to identify their own needs.

This is a tough pattern that can lead in many negative directions. It can take us so far away from who we are that we find ourselves in a pattern of people-pleasing, settling or neglecting ourselves. Before long, our personal identities might even feel hazy. So, how can we move out of this pattern?

At its core, self-abandonment typically arises from a lack of self-trust. So, the fundamental solution to self-abandonment is self-trust and making a commitment to yourself. Anything that involves self-care, self-exploration or asserting yourself is a step in the right direction. Another part might be learning to handle peer pressure (yes, just like in high school!).

Here are two questions you can apply to any situation to determine if you are operating from self-abandonment:

  1. “For what reason am I making this decision?” If the answer involves guilt, shame, fear, timidity or generally negative emotions, you might be in abandonment mode.
  2. “If I were the only person on earth, would I still want to do ___?” This removes other people’s influence from your decision-making and frees you up to determine how you actually feel.

Remember: There’s no quick-and-easy solution. We don’t become self-abandoners from one decision, so we won’t change after one positive experience. Eventually, you’ll create a reservoir of experiences in which you trusted yourself and things worked out. With those in mind, you won’t default to self-abandonment. With those in mind, self-trust will come more naturally.

 

A mental health counseling grad student, Brianna runs ExistBetter.co, a blog that explores the nitty gritty of mental illness and self-development.

https://www.nami.org/Blogs/NAMI-Blog/April-2018/Are-You-a-Chronic-Self-Abandoner

Is your stress changing my brain?

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Jaideep Bains, professor in the Department of Physiology and Pharmacology, and Toni-Lee Sterley, postdoctoral fellow in Bains’ lab and the study’s lead author.
Credit: Adrian Shellard, Hotchkiss Brain Institute.

In a new study in Nature Neuroscience, Jaideep Bains, PhD, and his team at the Cumming School of Medicine’s Hotchkiss Brain Institute (HBI), at the University of Calgary have discovered that stress transmitted from others can change the brain in the same way as a real stress does. The study, in mice, also shows that the effects of stress on the brain are reversed in female mice following a social interaction. This was not true for male mice.

“Brain changes associated with stress underpin many mental illnesses including PTSD, anxiety disorders and depression,” says Bains, professor in the Department of Physiology and Pharmacology and member of the HBI. “Recent studies indicate that stress and emotions can be ‘contagious’. Whether this has lasting consequences for the brain is not known.”

The Bains research team studied the effects of stress in pairs of male or female mice. They removed one mouse from each pair and exposed it to a mild stress before returning it to its partner. They then examined the responses of a specific population of cells, specifically CRH neurons which control the brain’s response to stress, in each mouse, which revealed that networks in the brains of both the stressed mouse and naïve partner were altered in the same way.

The study’s lead author, Toni-Lee Sterley, a postdoctoral associate in Bains’ lab said, “What was remarkable was that CRH neurons from the partners, who were not themselves exposed to an actual stress, showed changes that were identical to those we measured in the stressed mice.”

Next, the team used optogenetic approaches to engineer these neurons so that they could either turn them on or off with light. When the team silenced these neurons during stress, they prevented changes in the brain that would normally take place after stress. When they silenced the neurons in the partner during its interaction with a stressed individual, the stress did not transfer to the partner. Remarkably, when they activated these neurons using light in one mouse, even in the absence of stress, the brain of the mouse receiving light and that of the partner were changed just as they would be after a real stress.

The team discovered that the activation of these CRH neurons causes the release of a chemical signal, an ‘alarm pheromone’, from the mouse that alerts the partner. The partner who detects the signal can in turn alert additional members of the group. This propagation of stress signals reveals a key mechanism for transmission of information that may be critical in the formation of social networks in various species.

Another advantage of social networks is their ability to buffer the effects of adverse events. The Bains team also found evidence for buffering of stress, but this was selective. They noticed that in females the residual effects of stress on CRH neurons were cut almost in half following time with unstressed partners. The same was not true for males.

Bains suggests that these findings may also be present in humans. “We readily communicate our stress to others, sometimes without even knowing it. There is even evidence that some symptoms of stress can persist in family and loved ones of individuals who suffer from PTSD. On the flip side, the ability to sense another’s emotional state is a key part of creating and building social bonds.”

This research from the Bains lab indicates that stress and social interactions are intricately linked. The consequences of these interactions can be long-lasting and may influence behaviours at a later time.

Story Source:

Materials provided by University of Calgary. Note: Content may be edited for style and length.

Journal Reference:

  1. Toni-Lee Sterley, Dinara Baimoukhametova, Tamás Füzesi, Agnieszka A. Zurek, Nuria Daviu, Neilen P. Rasiah, David Rosenegger, Jaideep S. Bains. Social transmission and buffering of synaptic changes after stress. Nature Neuroscience, 2018; DOI: 10.1038/s41593-017-0044-6

https://www.sciencedaily.com/releases/2018/03/180308143212.htm