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New Year’s Resolutions Get a “Bum Rap”!

New Year's Resolutions

New Year’s Resolutions

New Year’s Resolutions get a “bum rap.”  They’re often derided as deluded wishful thinking and as rarely successful.  But I think they provide us with a wonderful opportunity to reflect and reevaluate, to engage in self-forgiveness and acceptance, and to rekindle hope and commitment to important goals—and, if approached carefully, they can be very successful.

Resolutions often involve things we know are good to do, but which either get lost in the mire of our daily obligations—like spending more time with loved ones or dedicating time to charitable work, or which are downright unpleasant—like controlling overeating or spending responsibly.

New Year’s Resolutions can serve as a reminder about our values and priorities.  Each day is filled with obligations and stuff that has to get done.  A special date, like New Year’s Day, can remind us to step back and take a look at where we are and where we’d like to go in life. 

Even more importantly, resolutions provide us with a chance for a “fresh start.”  Renewed hope.  A chance for a “do-over.”  We stop to reflect on what we should be doing—and haven’t done.  We have an opportunity for self-forgiveness for our failings and acceptance of our selves, as we strive to do better.  We can be empowered and reenergized.

How to Make Them Successful

But we can’t just wish something to be and expect it to happen.  We must develop strategies to ensure that we can accomplish these goals. 

Having a significant marker—a clear and special start date—is a good start.  We share New Year’s as a culturally recognized “new beginning.”  Social psychology notes the importance of culturally prescribed “rites of passage”—as in weddings, Bar and Bat Mitzvahs, Confirmations, etc.—to help mark new beginnings and to solidify new roles.  New Year’s celebrations occur annually and are certainly not as profound as these other rites, but can provide a boost for starting a new journey. 

But the excitement that comes from renewed hope is likely to wane as the year progresses.  Identifying other motivators is important.  We need to identify exactly why we want to pursue this goal.  So family members will be happier?  Which ones?  So we’ll feel more connected to humanity?  In what ways?  So we’ll feel healthier and more comfortable?  How will we experience this?  It’s important to be as specific as possible in answering this question. 

And then we must visualize these positive outcomes—as clearly as if we were watching them occurring on a video.  Research on procrastination tells us that we relate to our “future self” as if it were someone else (Pychyl, 2013).  Eating the cheesecake brings us immediate pleasure—that unfortunate “other person” can deal with the consequences in the future.  So, it’s helpful to look for ways to make our future self salient in the present.  We must visualize ourselves as that fit person, published author, or runner in a marathon.

We must also identify reasonable, realistic, and concrete steps to achieving the goal.  If we wish to lose 20 pounds, write a book, prepare for a marathon, etc., we’ll need to identify the steps on the way to the goal, translated in behavioral terms.  What would one have to do to lose 20 pounds, for example?  On Week 1?  On Week 2?  Again, small steps, defined in terms of behaviors.

Of course we’ll lose track of our goal—“fall off the wagon”—from time to time.  So we also need to establish regular times to reevaluate and reconnect to the goal.  Maybe a weekly time, marked in our calendar, to see how we’ve been doing and the next steps to take.

The “20-second rule” (Acher, 2010) is also very helpful.  We need to create an environment where it will take no more than 20 seconds to begin doing the behavior.  If we want to go for a run every morning, we need to have our running clothes ready and set out so that we can get out of the door before getting distracted from (or talking ourselves out of) the activity.  If we want to be sure we eat more fruits and vegetables, we should have them all washed, prepared, and visible in the refrigerator. 

Finally, research tells us the positive impact of social support, both on well-being and on attaining goals.  We should declare our resolution to others.  Perhaps others can be supportive of our journey and maybe even join in.

You can find more on making even dreaded tasks work in Facing Dreaded Projects.

References

Acher, S. (2010). The happiness advantage. NY: Crown Business.

Pychyl, T. A. (2013). Solving the procrastination puzzle. LLC Gildan Media.

Why Can’t We Simply Choose Happiness?

 

Happiness

HappinessAs a psychologist and psychotherapist, I’ve spent the last 30 years listening to people struggle with anxieties, depression, and loneliness, in search of ways to alleviate unhappiness.  And as a professor, I’ve spent as many years researching ways to build resilience—hoping to find ways to prevent people from “succumbing” to unhappiness.  The more I explore these issues, however, the more I’m convinced that Freud was on the right track.  We are extraordinarily complex creatures who, by nature, are probably not headed toward tranquility or happiness.  If we wish to build a happy life, we’ll have a darned hard fight on our hands.

Brain Research On Neurophysiology of Experiences

I keep returning to a delightful article by Hiss (2014) on the human brain published in the Reader’s Digest a couple of years ago.  Hiss reviews fascinating research on the neurophysiology of such experiences as love, procrastination, reactions to criticism, and road rage, and the basis for many of our emotional struggles. 

We like to think that our intellectual abilities accorded to us by the magnificent cortex provide us with the tools needed to control unpleasant emotions and primitive urges.  But why, then, do we feel our blood pressure rise and rage take over when someone “waves” to us with a single finger from their car?  What just happened?

As Hiss notes, the cortex is a relative newcomer to the brain party.  It’s built on a more primitive mammalian, emotional part of the brain, which is built on an even more primitive reptilian part.  How peaceful—or cooperative—a party should we expect? 

Our Expectations On Handling Life And Emotions

She draws an analogy to a speed boat that’s been built on a row boat base.  We expect to zip through life’s rough waters with ease—something our rickety base may not be able to manage.  It’s amazing that our brains aren’t out of service more often!

So when I hear patients question what’s wrong with them that they can’t seem to manage their emotions or just “choose” to be happy, I remind them that they’re not a Golden Retriever.  And some days, their lizard is active.

References

Hiss, K. (Sept. 2014). The beautiful life of your brain. Reader’s Digest.

The Importance of Consultation Among Psychotherapists

 

Consultation for PsychotherapistsConsultation for Psychotherapists

 

 

 

 

 

I tell my graduate students that beyond all the academic exercises of reading, writing, and research, the two most important skills for a competent psychotherapist to master are the capacities for being alone and the tolerance of not knowing.

Ironically, even though a psychotherapist spends many hours listening and talking with patients about the most intimate details of their lives, the therapist is a virtual stranger who assumes a role that is temporary and transient. The therapist certainly is drawn into an intense emotional experience, but, ultimately, as a visitor.

When the sessions end, any residual effects must be contained or resolved so as not to contaminate his/her role for the next patient or to be brought home to one’s family and friends. Our commitment to confidentiality is also a commitment to a private and personal aloneness.

Very few occupations require a person to remain as silent about one’s life as does the psychotherapist, except perhaps, for the profession from which it is derived—the priesthood.  We do, however, have the option of seeking consultation and/or supervision where, under a similar cloak of privacy, we can admit to our confusion and find refuge from our isolation.

The education of a psychotherapist is continuous, yet no amount of reading or research is sufficient preparation for a suicidal adolescent, the abused child, or the dying elderly. In the aloneness of these challenges, the therapist faces the limits of one’s potency in the task of helping a fellow human survive. 

Connecting with a colleague is a service, I believe, that is owed by every member of this profession, to every member. The remarkable technology we have can allow us to form affiliations with relative ease and unlimited potentials.

I invite any mental health practitioner who reads this blog to consider reaching out and forming connections, starting study groups and peer supervision circles.

For more on the complexities of the therapeutic relationship, see Psychodynamics of the Therapeutic Relationship.

A Commentary on the State of Mental Illness in Contemporary Society

Psychiatric MedicationPsychiatric Medication

Television advertising for psychiatric medications seems to have become as regular as commercials for automobiles, miracle cookware, or cosmetics. We are shown beautiful young men and women enjoying their friends and family, as we are also told that they have major depressions, bipolar moods, insomnia, and other potentially debilitating conditions.

Certainly these ads help de-stigmatize mental illness by showing that anyone can suffer from psychiatric problems. They present an optimistic view of successful treatment, a healthy productive life, and the assurance of better living through chemistry. Appropriately, they provide the legal disclaimers that these medications might cause some side effects and are potentially life threatening, but the likelihood is probably small and the image of a potential cure is obviously seductive.

The Motivation Behind Psychiatric Medication Ads

But also consider what else may be motivating these ads. These are not products that anyone can go out and buy like a car, a non-stick pan, or anti-wrinkle cream. These are products carefully controlled by the FDA to be dispensed only by licensed medical providers with an expertise in psychiatric disorders.

The target audience is presumably people who are suffering from serious mental health complications and/or their family members. If the intent of the advertisers were to help people seek psychiatric care, they would be promoting clinics, counseling centers, healthy lifestyle choices, and sources of information, as seen in public service announcements. Instead, they are targeting a vulnerable population with an implied promise of a cure that is not really supported by scientific research.

This is not to say that psychiatric medications are not helpful–they clearly are.  But they are not curative. The ads promote the theory that psychiatric disorders have been proven to be medical illnesses, which is not exactly true. The ads further assert that the cause of these conditions is specifically known and that these medications will correct the imbalance or deficiency the person is plagued with—also not exactly true!

In my 30+ years as a clinical psychologist I have seem many patients benefit from the use of medications, but I have never seen a patient cured by medication.  The combination of medication, psychotherapy, and lifestyle change has the best likelihood of helping people survive and thrive, so why isn’t that being made more explicit?

What Are Psychiatric Medication Ads Really Promoting?

I believe that the subtext to psychiatric medication ads is the promoting of helplessness and dependency in the public. That is, the ads promote the position of the patient as defective, damaged, or victimized.

There is no question that people are biological creatures constituted by a remarkably complex physiology and neuroanatomy. People are also creative, imaginative, and intelligent creatures who experience life with a remarkable capacity for change and adaptation. Everything we do or think or feel is accompanied by changes in our physiology, biochemistry, and neuroanatomy, but that does not mean that these processes determine us. Rather, biological processes are descriptions of how we function.

An increase in neurotransmitter levels may enhance a mood, whether by ingesting a medication, or by engaging in meditative or pleasurable activities. The causal relationship between biochemistry and mental states goes in both directions. By taking active roles in improving their lives, people can foster a healing that extends to the deepest levels of their physical existence.

To equate the effects of a medication with the definition of a mental experience would be like saying that a headache is caused by an aspirin deficiency. The aspirin can help, but its absence is not the reason for the headache any more than lowered serotonin level is the reason for depression.  For those people who may have a genetic, or otherwise inborn tendency toward a depressive way of being, medications may prove to be a godsend. These people will also greatly benefit from being helped to reconsider how they manage their lives, relate to others, and pursue their dreams.

Our Potential In the World

Mental illness may be an inevitable consequence of the human endeavor to redesign nature into a world that is safe, fair, and rewarding. We cannot eliminate the reality of nature’s forces or its occasional cruelty and tragedy. As humans, we face the disappointments of elusive ideals and the limitations of our ability to control our destiny. We must also consider the extent to which the world we have created for ourselves may be responsible for eliciting what we call mental illness. We are not the world, only participants in it who have a potential to think, choose, and survive with the help of others.

Mindfulness meditation practices and psychotherapy provide alternatives that can improve well-being, without diverting attention from the individual’s role in defining his or her life’s journey.

To find online courses for continuing professional development in psychoanalysis and other areas of psychology, see our list of courses on promoting diversity, modern systems theory, psychodynamics, mindfulness, and more.

Are We Over Diagnosing Children With Mental Illnesses?

 

Over Diagnosing Children

Overdiagnosing ChildrenI once read an article by Jordan Smoller called, “The Etiology and Treatment of Childhood.”[1] It was a satirical article that described childhood as a mental disorder. He noted that childhood is congenital, is characterized by temporary dwarfism, is marked by emotional instability and immaturity, and that children have knowledge deficits and legume anorexia. Mercifully, most children recover from this condition over time.

While clearly the article was meant as a spoof on the Diagnostic and Statistical Manual of Mental Disorders (DSM), the standard reference guide for mental health providers in the U.S., the implications of this article are quite serious.  Children are being diagnosed with mental illnesses at an alarming rate and being medicated for those conditions with increasing regularity.

Over Diagnosing of Attention Deficit/Hyperactivity Disorder

Consider the case of Attention Deficit/Hyperactivity Disorder. This is a condition where a child is unable to constrain his/her behavior to the requirements of a given social context. We are not talking about criminal or psychopathic behavior, but rather the inability to sit still in a classroom, restaurant, doctor’s office, or other such environment where conformity is expected.

Fifty years ago this condition was called Minimal Brain Dysfunction (for extreme cases) and was thought to be the result of a mild form of brain compromise that was not explicitly evident but could be assumed. The term fell into disrepute when parents resisted having their children stigmatized as damaged goods.

Then, sometime in the 1980’s, the atmosphere changed and the former stigma became, for some parents, an embraced diagnosis of ADD (then called Attention Deficit Disorder, with hyperactivity as a sub-type).

Why the change? ADD was classified as a learning disability that entitled children to special accommodations in the classroom and on standardized tests. Not only were schools required by federal law to provide preferential seating in the classroom, but the students could also have less, or no, homework, extra time on exams, less rigorous exam standards, and counseling and tutoring services (also subsidized by federal funds).

I am not suggesting that all children and parents took unfair advantage of the system. Many children needed these services and greatly benefitted from them. Some students also received these services in order to give them a competitive advantage for college placements.

I am not faulting parents for trying to get what they can to make their child’s life better and their future more promising. In fact, as a psychologist, my profession has profited greatly from this boon, as have college guidance counselors, and educational therapists. No one has profited more, however, than the pharmaceutical industry, which supplies medications to enhance focus, concentration, and task performance.  In my view, the issue of ADHD is only the beginning of a much larger problem—the pathologizing of children.

Over the past few decades we have seen enormous rises in the diagnosis of autistic spectrum disorders, bipolar disorders, depression, and obsessive-compulsive disorders in children and adolescents. It is possible that the mental health of this population is deteriorating at an epidemic rate. It is also possible that children are being dangerously over-diagnosed. Note also, that the rates of diagnosis are unique to the U.S. and disproportionately represented in middle and upper-middle class families.[2]

What Can Parents Do If They Think Their Child’s Behavior Is Questioned?

So what can be done?

First, parents need to step back and question the basis for a child’s diagnosis. If a child’s behavior is being called “pathological,” what is the normal standard for a child of the same age and sex? Nowhere in the DSM is there a guide for determining at what point a child’s restlessness, for instance, exceeds normal standards. The diagnostic criteria instead say “often.” Not how often, or too often, just “often.”

Second, parents and doctors need to consider the context of the child’s life. If the parents are divorced and the child lives alternatively in either home, how might that stress affect concentration and attention? Or how interesting is the classroom for the child?  Maybe a different teacher or school would be a better fit for the child.

Third, how much sleep is the child getting each night? Half of the children I have assessed for “inattentiveness” were sleep deprived. The child may be going to bed at 8:00, but may be on a smartphone, iPad, or computer until late in the evening. Furthermore, a sleep-deprived child may be depressed or anxious, not necessarily “suffering” from ADHD.

Fourth, doctors, psychologists, and teachers often base their diagnosis on checklists. This can be a somewhat useful starting point, but is irresponsible as a stand-alone assessment. No checklist is a substitute for knowing the person of the child. Consider that chest pain could be a heart attack or it could be indigestion! A restless, inattentive child may be lonely, sad, afraid, etc. While these conflicts and challenges are difficult and distressing, they are not necessarily signs of mental illness.

Finally, if there is a reasonable suspicion of some mental health issue, a competent specialist should be involved to thoroughly assess the child, the family, and the surrounding circumstances.  What diagnoses have been explored, evaluated, and ruled out? A range of possible interventions should be considered, with priority given to those that are the safest, least invasive, and most likely to be helpful. A child’s mental health is not the place to shop for bargains or quick fixes.

 I constantly remind my graduate students that diagnosis is more about the person than the illness and that children are people, not disorders.

Professionals who want to learn more about psychoanalysis, developing an analytic mindset, and more topics for continuing education in mental health counseling, see a list of our online courses.

[1] Published in the book by G. Ellenbogen (1982), Oral Sadism and the Vegetarian Personality, a collection of satirical psychological articles.

[2] Hastings Center, Washington, D.C. (2008) found a 20% increase in prescriptions for behavioral drugs between 2000 and 2003 and a 73% increase in prescriptions for antipsychotic drugs between 2001 and 2005.

Are There Really No Psychological Accidents?

Psychological Determinism

Psychological Determinism
Slip of the tongue?

Perhaps the single most representative concept of psychoanalysis is that of psychological determinism.  By this I mean a fundamental belief that human behavior, consciousness, and experience are determined or explainable.  Freud followed in a scientific tradition that was dedicated to uncovering the laws and mysteries of life, hopefully to lead to a comprehensive theory of the mind.  

Is Action Accidental or Random?

Such an approach would never be satisfied with a conclusion that suggested that a certain action was “accidental” or “random” or that a thought occurred strictly from a spontaneous, meaningless neurochemical action.  Unlike radical behaviorism or even social learning theory, which propose to account for some behaviors as incidental contingencies or fortuitous accidents, psychoanalytic thinking would tend to view such explanations as naïve, simplistic, or superficial.  

What Does Psychoanalysis Tell Us About Action?

Psychoanalysis proposes to describe mind and behavior as meaningful and understandable.  Thus, our lives are the products of our being.  Our intentions, as well as our accidents, are worthy of understanding.  While critics may argue that psychoanalytic theories make too much out of too little, the supposed error is committed in the pursuit of knowledge, with an implicit expectation and respect for the complexity of life.  It should also be noted that such an attitude is reflective of an appreciation for the humanism of psychology, not its mechanization or reduction to biochemistry.

What is the Focus of Psychoanalytic Explanation?

Even if one could demonstrate, once and for all, that the universe and life are random, nonsensical phenomena, this would not contradict the view of determinism.  The focus of psychoanalytic explanation is on the human experience of life.  What is characteristically human is our mind’s proclivity for making sense out of nonsense.  We cannot tolerate being in a state of uncertainty or confusion.  Psychological determinism addresses this characteristic of being human by suggesting that all human knowledge, no matter how sophisticated, abstract, or profound, is always, ultimately, human.

Freud and Breuer’s Studies in Hysteria

Freud’s and Breuer’s Studies in Hysteria are classic examples of the humanity inherent in a view of psychological determinism.  In their investigation and treatment of hysteria, they stressed how patients’ peculiar behaviors stemmed from important but forgotten episodes of their lives.  Hysteria, understood in the context of a person’s life, represents a meaningful continuity of being, such that the mental life of the patient is respected as relevant and the patient is further accepted as exhibiting psychological processes common to humankind.  The “logic” of symptoms soon led to an appreciation for the logic of dreams, mistakes, jokes, and slips of the tongue.  With acceptance of determinism, we can never take life’s events for granted again!

For more on psychological determinism and other psychoanalytic concepts, see the course Classical Psychoanalytic Theory.  If you would like to receive a specialization Certificate in Psychoanalytic Psychotherapy and learn more about issues of interest, please see our home study psychology continuing education courses, available online.

Thinking Like a Psychologist

Psychotherapy and Epistemology: Learning How to Think

Psychotherapy and EpistemologyPsychotherapy and epistemology–what do they have to do with each other?  Philosophy refers to how knowing happens as epistemology.  I would argue that addressing the process of knowing is at least as important for training psychotherapists as considering what is known.  Let me explain…

When I supervise graduate students who are training to be psychotherapists, I find the most challenging task is to teach them to think like a psychologist.  How does a psychologist think?  Or, more accurately, how do I think a psychologist should think? 

To me, the purpose of clinical psychology is to help mitigate human suffering to whatever degree we can.  In order to pursue that purpose, the psychologist has to understand the uniqueness of each patient’s suffering.  The patient is a person with whom we have a therapeutic responsibility and a person whom we are obligated to know and respect.

Knowing someone, especially someone who is a virtual stranger, such as a psychotherapy patient, is a formidable task.  We do not know someone by getting a list of facts.  Name, birthdate, place of birth, occupation, history of illnesses—these are all lists of categorical data, but they are not knowing.  We can only know someone by relating to them over time in a relationship.

In a relationship, we know someone by how we feel with them, what fantasies they stimulate in us, or how they communicate beyond words.  Being with another person allows us to become part of their (and our) creative process.  The key here is process…an ongoing interaction.

We are much better served by using verbs to describe relationships than by using nouns.  In fact, I would assert that mental disorders and pathologies are best understood as verbs as well.

Suppose, for a moment, that you wanted to get to know Vincent Van Gough.  Since he is dead, you couldn’t set up an appointment.  But you could read books about him, see a movie about him, or sit with a few dozen of his paintings and relate to them for a while.  I would suggest that, as a psychologist, you could get to know him very well from sitting with the paintings.  In fact, I would suspect that the books and the movie would be dangerously misinforming.  One does not need to be a trained art historian or critic to understand Van Gough from his paintings.  One needs to be able to be transformed by the perceptions and sensations created by the colors, swirls, and patterns.  The question you might have is whether these transformations are true and valid.  My answer is that they are as true and valid as one ever gets.  There is no ultimate truth to Van Gough any more than there is to you or me.

What is true is what we negotiate from our experience with one another.  And these truths are transient and evolving.  The truths we learn about someone are the products of our relationship.

In part, what we know is made up. We invent knowledge from information that is generated by our biological processes.  But it is not as if we just make it all up; rather we create information at a basic biological level that then gets transformed by complexes or networks of other biological processes that produce still more variations of information.  At some point, the product of these processes becomes a mental phenomenon that we refer to as thinking.  We link our thoughts together in patterns that are self-supporting and that afford us a sense of certainty or knowing.

In fact, much of everyday anxiety is caused by a lack of certainty or doubt that interferes with knowing.  Ask an anxious person why they worry and they can often tell you that they know that it doesn’t make sense, but that they “can’t help it.” Why not?  The thinking disrupts the links in the patterns of knowing and disrupts the certainty.  The result is to question what is known or to be anxious.

“What if…,” we think?  There are no limits to what we can imagine, but there are limits to what can be true.  Just because it can be thought doesn’t mean that the thought is true, but try to convince a worrier of that!  The dominance of our basic subjective position, our narcissism, can lead us to feel compelled to account for any thought as important simply because we thought it.

I doubt that most of us ever consider the epistemology with which we know.  We might be aware of certain beliefs or values and we might be aware of political or scientific theories that seem more right to us than others, but I doubt that we regularly consider the extent to which our knowledge is the product of a system for knowing.  We are most likely to entertain a challenge to our knowledge only as a last resort.

Even the onset of mental illness is not sufficient to cause us to rethink what we know.  I tell my graduate students that a patient’s psychopathology is the person’s best effort at staying sane.  A person is apt to make themselves crazy before they will lose their sense of certainty.  In fact, psychotics are quite certain about their delusions and hallucinations; it is we neurotics who worry and fret about what is true.

What is true, in any meaningful way to a person’s life, is always a subjective truth—what we “know to be true.”  This is a truth rooted in our sense of self—our being.  Scientific facts, religious truths, or mathematical proofs are only true to us when they have been incorporated into our being and embraced as our own.

Obviously, we have gone through quite an array of truths over the course of human history that were all touted as the unequivocal truths of their time.  Where did the Greek and Roman gods go?  They died when they didn’t have people to believe in them.  Why do we know that the Earth revolves around the Sun and not the other way around?  Because the mathematics for the former is much more simple and elegant.  Why do people go mad?  Because of abusive childhoods, biochemical imbalances, predisposing genetics, or socio-political persecution?  We are still struggling with that one!

Science is an epistemology, but only one of many.  The key to survival in nature is adaptability and diversity; likewise, the key to psychological survival is in adaptive and diverse epistemologies to help us learn to appreciate and respect the complexity of nature.

I am not arguing against science or for any particular epistemology for that matter.  Instead, I am hoping to inspire the reader to consider the basis and presuppositions that comprise one’s system for knowing.

Having spent nearly my entire life in education, either as a student or as a teacher, I am quite aware that we are rarely, if ever, taught how to think, but rather what to think.  I am also just as aware that what people benefit from most readily in psychotherapy is being emancipated from truths that are pathogenic and paralyzing.  These “truths,” however they may have been derived, can be redefined, diminished, or discarded for the sake of a person’s future mental health, but not without considerable resistance from that person’s loyalty to the “known.”

I welcome your thoughts.

~ Michael J. Gerson, PhD

Resilience

 

Resilience

ResilienceResilience, the ability to bounce back and maintain strength in the face of stressors, is an important attribute for our patients as well as for ourselves.  Life is filled with tribulation and dangers, both those we experience first-hand and those we live through vicariously as we are instantly exposed to events through the media.  How can we maintain our strength?

A study conducted with young adults found a 2-step process to be particularly helpful (Gerson & Fernandez, 2013).  Undergraduates were taught in three 1-hour sessions first to confront situations that were upsetting to them by analyzing them in terms of the role their actions may have played in causing the situation.  For example, if they’d been been snubbed by a friend, rather than blaming something about themselves that they could not change (“I’m no good”) or blaming their friend (“He’s a jerk”), they were to consider what they could have done differently and so could change for the future (“Maybe I acted insensitively”).  The second step involved focusing on “letting go” when no further actions could be taken.  This 2-step process led to a sense of personal control and significantly lower depression scores than a comparable placebo control group.

So, for yourselves as well as your patients, it may be helpful to confront worries with problem-solving strategies, followed by exercises to gain “perspective” on the troubles, whether with meditation or by seeking out experiences that lead to a sense of awe. Let me know what works for you.

For more on the importance of “letting go” when no further actions are possible, see Mindfulness Training: Introduction, Attention, and the Present Moment.  For more on how to do it, see Mindfulness Training: Body Scan Meditation and Informal Mindfulness Practices.

Reference: Gerson, M. W., & Fernandez, N. (2013). PATH: a program to build resilience and thriving in undergraduates. Journal of Applied Social Psychology, 43, 2169-2184. doi: 10.1111/jasp.12168

Please contact Dr. Gerson at mgersonphd@psychstudies.net if you would like to receive a copy of the article.

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