psychology

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The Woman Who Couldn’t Stop Buying Self-Help Books

(Great Beyond/Flickr via Compfight)

(Great Beyond/Flickr via Compfight)

Jean Fain is a Harvard Medical School-affiliated psychotherapist and the author of “The Self-Compassion Diet.” So why is the author of a self-help book criticizing self-help books? Read on… 

By Jean Fain
Guest contributor

At first, I couldn’t understand why this new psychotherapy client had settled on my couch. Sure, Kaye (not her real name) was unhappy with her weight, and yet, she enjoyed an enviably healthy diet. With the aid of self-help books, she had not only taught herself to cook delicious, nutritious dishes, she’d also learned to meditate and eat mindfully. This unusually self-motivated working mother of two not only read each book from cover to cover, she practiced what the most helpful authors preached.

As time went on, I came to understand that as much as self-help books helped Kaye eat more healthfully, they were effectively hindering her happiness. You see, she used self-help books the same way she used food – to stuff her feelings. For good reason. Binge eating and reading brought her enormous comfort, which she desperately needed to deal with a high-stress job and a low-achieving child. Only problem: as Kaye’s self-help library expanded, so did her waistline.

Therapist and author Jean Fain (Courtesy)

Therapist and author Jean Fain (Courtesy)

As we delved into the problem of turning to the dinner plate and the printed page for comfort, the solution became abundantly clear. If she was serious about finding true happiness, she’d have to stop buying self-help books and start asking for a little help from her friends and family.

Yes, I’m a self-help author myself, but since writing “The Self-Compassion Diet,” I’ve learned the limitations of the genre. Self-help outsells every other category because it gives people what they desperately need: hope. Which, on a good day, is enough to jumpstart change. But it’s rarely enough to sustain it. (Mostly, it sustains the publishing industry to the tune of $549 million per year, according to the market research firm Marketdata Enterprises.) So if you’ve been blaming yourself for failing to stick to the latest plan, you can stop. It’s not you, it’s the genre.

 I can’t tell you how many clients gained belly fat and weight trying to stick to the “Wheat Belly” diet.

Which isn’t to say self-help books have no benefit. In fact, self-help has become the world’s best-selling genre because most readers start reaping the benefits even before they crack the books. Of the many benefits, consider the top three:

Quick: The simple act of buying self-help books makes people feel better. Whatever you’re struggling with – losing weight, gaining employment, finding true love, getting a divorce, aging gracefully, dying with dignity – just knowing that simple answers to life’s complex problems are within reach gives book buyers an immediate sense of relief.

Cheap: Time- and money-wise, self-help costs a fraction of the cost of individual counseling. Virtually nothing, if you have access to free downloads or a public library. Continue reading

Coerced Sex Common For Teen Boys And Young Men, Study Finds

A few nights ago, unable to wind down, I was searching for something to watch and stumbled across the film “Adore.” It’s about a pair of lifelong friends (grown women) who end up having affairs with each other’s young, hunky, 19- or 20-year-old sons. My first reaction was the same as one Netflix commenter:

“…if this had been two pals and each other’s teen daughter; well, you get the point. The movie would not have been made, or if so, it would have had an entirely different hue-to say the least. DOUBLE STANDARDS.”

Or, as A.O Scott wrote in his New York Times review:

“It is worth noting that the same movie about a couple of dads sleeping with each other’s 20-year-old daughters would need, at a minimum, to confront the ickiness of the situation. Really, such a movie would be unlikely to make it into theaters, in spite of the commonness of real-life relationships between older men and younger women.”

(Dustin Hoffman, Anne Bancoft in "The Graduate"; Movie-Fan/flickr)

(Dustin Hoffman, Anne Bancoft in “The Graduate”; Movie-Fan/flickr)

The film isn’t about sexually coercion; but it is about boundary breaking, and I thought of it again reading this new study on the pervasive, but largely unexamined problem of sexual coercion among boys and young men.

The study, published in the journal Psychology of Men and Masculinity, found that coerced sex is fairly common for teenage boys and college-age men and can lead to psychological distress and risky behavior, such as sexual risk-taking and alcohol use.

From the American Psychological Association news release:

A total of 43 percent of high school boys and young college men reported they had an unwanted sexual experience and of those, 95 percent said a female acquaintance was the aggressor…

“Sexual victimization continues to be a pervasive problem in the United States, but the victimization of men is rarely explored,” said lead author Bryana H. French, PhD, of the University of Missouri. “Our findings can help lead to better prevention by identifying the various types of coercion that men face and by acknowledging women as perpetrators against men.” Continue reading

Might Personality Tests Of Patients Improve Preventive Health Care?

Myers-Briggs personality types (Wikimedia Commons)

Myers-Briggs personality types (Wikimedia Commons)

By Veronica Thomas
Guest contributor

Before entering my freshman year of college, I was asked to complete a Myers-Briggs Type Indicator personality test so the school could match me to a compatible roommate. She and I ended up living together all four years.

In fact, the Myers-Briggs tool, which classifies each individual as one of 16 personality types, is considered such a powerful tool that most college career centers and Fortune 500 companies use it to help people determine their appropriate course in the work world.

Soon, doctors, too, may conduct personality tests with patients to help tailor their care. A recent study, published in the Journal of Personality and Social Psychology, found that personality might play a key role in preventive health care among young-adult patients — the sort of patients now likelier to be covered by Obamacare and actually come in for check-ups.

Instead of 16 personality types, researchers from Duke University examined the “Big Five” personality traits, which provide the foundation for most personality assessments. They include conscientiousness, extraversion, agreeableness, neuroticism and openness to experience.

It’s probably not surprising that conscientious 26-year-olds had better health outcomes at age 38. But the effect size is impressive: 45 percent of the least conscientious individuals developed multiple health problems by age 38, compared to 18 percent of the most conscientious group.

Conscientious people generally may be healthier due to diligent behaviors outside of the physician’s office, such as exercising and eating nutritiously, rather than because of their health care, the study notes.

What might be surprising is that neurotic young adults did not have declining physical health later in life (though they perceived their health as worse than non-neurotic adults.) This contradicts many theories linking traits of neuroticism, such as anxiety, to worse health. Continue reading

Storytelling For Health: Doctor Promotes Intimate Patient Narratives

Marie Colantoni Pechet discussing her stage IV rectal cancer

Marie Colantoni Pechet talks about living with stage IV rectal cancer

By Dr. Annie Brewster
Guest contributor

My experience in the health care system — both as a physician and as a patient living with multiple sclerosis — has convinced me that the current practice of medicine squeezes out what is a most essential element of healing: the stories of peoples’ lives.

In response to this void, I started collecting patient’s stories in 2010, and these pieces have been featured here on CommonHealth, as part of the Listening to Patients series.

Through these deep connections, I’ve seen firsthand that there is tremendous healing power in stories — for both the storyteller and for those listening. Research supports this claim.

Last year, I launched Health Story Collaborative, Inc. a nonprofit dedicated to harnessing the healing power of stories through collecting, honoring and sharing these narratives. The goal is simple: to keep patients’ voices alive.

Last week, as part of the nonprofit, we launched a new program called Healing Story Sessions, live gatherings where patients share their narratives. I like to think of them as part “Moth” radio hour, part AA meeting (though of course, this isn’t about addiction: it’s all about standing up and sharing in a safe and supportive environment). The goal of these sessions – designed in collaboration with Jonathan Adler, Ph.D, an assistant professor of psychology at Olin College of Engineering in Needham, Mass., whose research focuses on the psychological function of our stories and their relationship with health — is to empower patients and build community.

Each session features two patient storytellers and about 15 of their invited “guests.” Prior to the event, storytellers work to craft a written narrative using Health Story Collaborative’s narrative guide, which provides some structure for eliciting these challenging stories. They also work with Adler and with me to shape what they’ve written. Then, when the time comes, they speak their narratives out loud for the selected audience.

The belief is that this public sharing is meaningful and therapeutic.

Last Wednesday, 30 of us gathered in a cozy room to hear the stories of Marie Colantoni Pechet, who has written about her cancer for CommonHealth, and Lara (who asked that her last name not be used). Marie is a 51-year-old mother with Stage 4 colorectal cancer who has been living with her disease for over six years. She is on a maintenance chemotherapy regimen and continues to thrive, surprising even her most optimistic doctors.

Lara, a 47-year-old mother of four children, has a fairly new diagnosis of Stage 2 breast cancer. She is now in the midst of chemotherapy treatment and awaiting surgery in May. Her mother died of this disease 15 years ago. Continue reading

Marriage Revisited: On Soulmates, Paramours And Avoiding Suffocation

Marriage, and how to improve it, is a bottomless pit kind of discussion.

So it’s not terribly surprising that CommonHealth’s recent post on a new, “all or nothing” model of marriage, in which researchers questioned whether we’re asking too much of our spouses, went viral.

Like sex, child-rearing and religion — everyone’s got an opinion to share.

(Wikimedia Commons)

(Wikimedia Commons)

Some commenters say they’ve had to readjust their expectations of finding the fantasy soulmate:

Deborah Rebisz wrote: “After a series of broken engagements, I went on an eight-year dating hiatus. My goal was to learn to rely upon myself for my own happiness…Expecting someone else to fill that spiritual, psychological, or emotional gap in my life was unrealistic, not to mention there was little chance of finding someone who could do all that.” Continue reading

On Gender Nightmares: Men Dream Of Floods, Women Of Relationships

A post last month on Slate about gender differences and nightmares got me thinking, yet again, about the profound, fundamental divide between men and women. We communicate differently, we eat differently and now, it turns out, we dream differently.

This particular story focused on research out of Canada that found men’s nightmares tend to be about natural disasters like floods and earthquakes, while women’s are about relationships. Here’s more from Katy Waldman’s post:

Analyzing themes and emotional content, the researchers found that men were more likely to report having nightmares about natural disasters (floods, earthquakes, fires, volcanoes), chase or pursuit, and insects. Women’s nightmare records more often featured interpersonal conflicts, such as an argument with a spouse and more frequently involved feelings of humiliation, frustration, or inadequacy.

Why might this be? My first thought was that, while women may not mind admitting to researchers that an ex-boyfriend still haunts them, men were only reporting the more cataclysmic plots. (Tsunami!) On the other hand, “dream content is tied into waking concerns,” [researcher Antonio] Zadra explained over the phone.

Last night I attended a forum where women discussed how they cope with serious illness (more on this later). All of the guests were women and the takeaway, for me, was about how vitally important — even therapeutic — the act of sharing, connecting and reaching out to our “village” is when we are sick and under intense, hair-raising stress. For men, it’s all about fixing the problem; for women, it’s all about being heard and understood. Not a newsflash, I know, but often, a reality.

So, in that vein, here’s my current favorite battle-of-the-sexes commentary: “It’s Not About The Nail.” Even my husband doubled over with laughter:

(Hat tip to Kayla, a wise 22-year-old who passed this along.)

Doll Dangers: Girls Imagine Fewer Career Options After Playing With Barbies

Charles (dollstuff.net)/flickr

Charles (dollstuff.net)/flickr

I grew up in the era of Marlo Thomas’ Free To Be You And Me, with gender-liberated lyrics like this: “Some mommies are ranchers or poetry makers, or doctors or teachers or cleaners or bakers, some mommies drive taxis or sing on TV, yeah, mommies can be almost anything they want to be.”

Indeed, Barbie dolls — with their overly sexualized, crazy-making-body-image implications — had no place in our little Brooklyn apartment.

Apparently, that was a smart move.

A small, but novel new study exploring gender roles and how kids imagine their future careers found something disturbing: little girls who were asked about 10 different jobs told researchers that boys could take on “significantly more occupations” than they could themselves. What’s more, according to the study, girls who played with Barbie dolls before being interviewed indicated fewer career options compared to boys, while girls who played with the far less sexy Mrs. Potato Head reported a smaller difference between future job options as compared to boys. The jobs mentioned to the kids were: teacher, librarian, day care worker, flight attendant, nurse, construction worker, firefighter, pilot, doctor, and police officer

allieosmar/flickr

allieosmar/flickr

The study (which I’m now calling “Mrs. Potato Head Rules” but is actually titled “Boys Can Be Anything”: Effect of Barbie Play on Girls’ Career Cognitions,”) involved 37 girls, ages 4-7. The research, led by Aurora M. Sherman, an associate professor in the School of Psychological Science Oregon State University with Sherman and Eileen L. Zurbriggen of the University of California, Santa Cruz, was published in the journal Sex Roles.

I asked Sherman via email how the project originated. She said that while there have been studies on what girls thought about fashion dolls like Barbie, there’d been “no actual experiments that could test whether playing with one kind of doll or another kind caused a difference in kids’ thinking.”

Sherman continued:

“I thought it would be interesting to test ideas girls have about careers as the outcome because there is a lot of emphasis on the 130+ careers Barbie has been dressed for, so it was logical to ask whether a Barbie costumed as a career professional (Dr. Barbie) would give girls a “boost” in their ideas about careers. However, that boost did not appear in my study…The lack of difference between Dr. Barbie and Fashion Barbie surprised me the most; it seems from our data that just a professional title and costume isn’t enough to expand the career horizons of girls when they play with Barbie.”

And while Sherman says she was interested in Barbie dolls as a child, “my parents didn’t allow them in my house. I didn’t have very many dolls of any kind as a kid, actually — my parents were more into providing games and books.” Continue reading

Gasping Through Marriage: Are We Asking Too Much?

(Katsunojiri/flickr)

(Katsunojiri/flickr)

Marriage — as anyone who has watched “House of Cards,” or actually experienced the giddy highs and devastating lows of a real, ’til-death-part-us union, knows — is complicated.

And, with the divorce rate hovering around 50 percent, it’s reasonable to once again ask the question: What’s the secret to a successful marriage? Or, put another way, how can couples get enough relationship “oxygen” while climbing the mountain of marriage to avoid suffocating?

In a recent study, psychologists from Northwestern University present a new model of marriage in the U.S. that’s all about avoiding suffocation. (The full title of the paper is: “The Suffocation of Marriage: Climbing Mount Maslow Without Enough Oxygen.”) In the report, researchers say that Americans today are increasingly — and perhaps unrealistically — asking their marriages to fulfill higher-level psychological needs, such as those related to personal growth and self-realization. So, it’s not so much that we’re asking too much of our spouses, we may just be asking for the wrong things.

Speaking at the American Association for the Advancement of Science annual meeting earlier this month, the study’s lead author, Eli Finkel, a Northwestern psychologist whose research areas include “initial romantic attraction” and “conflict-resolution in established relationships,” said that married couples who support each others’ deep psychic, self-growth needs are pretty darn lucky.

“The level of satisfaction from having a spouse help you achieve your understanding of your core essence or your ability to come closer to the person you ideally want to be — that’s an immensely satisfying experience,” he said.

But, sadly, for many couples, such satisfaction is elusive. “Although some spouses are investing sufficient resources — and reaping the marital and psychological benefits of doing so — most are not,” the researchers report.

It wasn’t always this way. Marital expectations have evolved over time from subsistence needs — food, shelter, safety, sex and procreation — to higher-level psychological needs. But couples today often lack the time and energy needed to meet these expanding needs, which is contributing to a declining level of marital quality and well being, said the authors.

“Higher expectations can lead to greater disappointments, Continue reading

Pet Study: Cute, Furry And (Possibly) A Catalyst For Better Adolescent Behavior

Pets, if you haven’t already noticed, are no longer simply pets. They are political (ban the puppy mills!); they are personal therapists; they are leading blog protagonists (see: My House Rabbit) and for some, they are prized surrogate children.

Now, it turns out, pets may have yet another dimension: they might contribute to more positive adolescent behavior (and you thought that was impossible). Indeed, a new study led by Tufts researchers finds that young adults caring for animals may develop deeper social connections and other positive traits such as empathy.

Here’s more from the Cummings School of Veterinary Medicine at Tufts news release:

girlanddogs

Young adults who care for an animal may have stronger social relationships and connection to their communities, according to a paper published online in Applied Developmental Science.

While there is mounting evidence of the effects of animals on children in therapeutic settings, not much is known about if and how everyday interactions with animals can impact positive youth development more broadly.

“Our findings suggest that it may not be whether an animal is present in an individual’s life that is most significant but rather the quality of that relationship,” said the paper’s author, Megan Mueller, Ph.D., a developmental psychologist and research assistant professor at the Cummings School of Veterinary Medicine at Tufts University. “The young adults in the study who had strong attachment to pets reported feeling more connected to their communities and relationships.”

Mueller surveyed more than 500 participants, aged 18-26 and predominately female, about their attitudes and interaction with animals. Those responses were indexed against responses the same participants had given on a range of questions that measure positive youth development characteristics such as competence, caring, confidence, connection, and character, as well as feelings of depression, as part of a national longitudinal study, the 4-H Study of Positive Youth Development, which was led by Tufts Professor of Child Development Richard Lerner, Ph.D., and funded by the National 4-H Council.

Young adults who cared for animals reported engaging in more “contribution” activities, such as providing service to their community, helping friends or family and demonstrating leadership, than those who did not. The more actively they participated in the pet’s care, the higher the contribution scores. The study also found that high levels of attachment to an animal in late adolescence and young adulthood were positively associated with feeling connected with other people, having empathy and feeling confident. Continue reading

Heroism At Home: An Intimate Look At Growing Ranks Of Caregivers

Screen shot 2014-01-31 at 10.38.03 AM

If you’re an adult living in the U.S., it’s a good bet that you (or your neighbor or close friend or colleague) are caring for an elderly family member. Indeed, more than 43 million Americans — about 18 percent of adults — care for a family member or friend 50 or older, according to the Family Caregiver Alliance; 15 million of these caregivers tend someone who has Alzheimer’s disease or some form of dementia.

Currently, family (read: unpaid) caregivers are the largest source of long-term care in the U.S. and health scholars expect that by 2050 the demand for such care will nearly double — and that family caregivers will have to continue meeting the greatest part of that need.

But the statistics don’t reveal the intimacy of such caregiving relationships: the terror of a mind slipping away, the humiliation and messiness of chronic illness, the often violent and shocking ways that bodies unravel. In her new book “The Caregivers: A Support Group’s Stories of Slow Loss, Courage And Love,” journalist Nell Lake details her two years observing a caregivers support group that includes a 50-year-old botanist who moved in with her aging mother to care for her, and a survivor of Nazi Germany who devotedly tends to his ailing wife, and others in the group (some of whom are dealing with serious health problems of their own). While documenting their lives, Lake offers views into the complexities of caregiving: the profound stress, the upheaval of family roles, the slow, often excruciating grief, as well as the graceful humanity of it all.

Here, lightly edited, is my Q & A with Lake, who lives with her family in Northampton, Mass.

RZ: You begin your book on a personal note, with a memory of your grandmother. Can you tell us a bit about her and how her story moved you to write about the larger issue of caregiving in America?

Journalist and author Nell Lake (photo: Sarah Prall)

Journalist and author Nell Lake (Courtesy Sarah Prall)

NL: My grandmother was a poised woman who lived her life with great energy. She had raised three children, kept a beautiful home, was active physically and also politically—involved in environmental causes and in the nuclear freeze movement in her community. She prized her independence and physical vitality, and, as she aged, she expressed a fear of ending up frail and in a nursing home. She kept materials from the Hemlock Society in a kitchen drawer.

In the summer of 1984, when I was 18, she found out from a doctor that she might have cancer. That night, she went to her garage, sat in her car, and turned it on. A neighbor found her the next day.

While my grandmother’s suicide didn’t directly spur me to pursue a story about long-term care and family caregiving, once I was sitting in on the caregivers support group, it was clear to me that I was immersing myself in the stage of life, an experience, that my grandmother had feared and successfully avoided. It became especially moving, then, for me to follow others who were making their way through the “shadow part of life,” as I put it in the book.

My memories of her shaped my lens: I wondered, Can we find ways to embrace this part of life, to meet it with less fear? Can we also try to make it better for everyone?

How did you connect with the hospital caregiver support group?

In late 2009, I went to a dinner party, a birthday celebration for a friend. I ended up seated next to a man whom I call Ben in the book. He told me that he was the lead behavioral health counselor at our local hospital, and that he also facilitated a weekly support group there for family caregivers. I told him I was a journalist interested in healthcare and mental health issues. He suggested I might want to sit in on the group, and later he asked the group members’ permissions. Before long I was listening to their stories.

Is there any particular quality you discovered about these caregivers that you didn’t expect?

It may sound surprising, but spending two years with the support group gave me a new and better sense for what constitutes heroism. I saw heroism in Penny, who had taken her forgetful mother, Mary, into her home. Caring for Mary was not easy, but Penny met Mary’s needs as best she could, sought to provide her mother with as much comfort, care, and happiness as seemed possible. I saw heroism, too, in Daniel, a caregiver who was himself quite frail, and whose wife was bipolar and in pain. Daniel also bravely did his best to meet his wife’s needs.

Their heroism, to me, was a willingness to keep returning to difficult circumstances, to persevere and act compassionately, to try to ease others’ suffering.

This idea of heroism is similar to the notion that bravery is not the quality of being free from fear; rather, bravery is a willingness to act in spite of fear.

Some (many?) caregivers are reluctant to take on so much responsibility, but feel they have no choice. Is this true for most informal caregivers these days and how does our modern notion of caregiving differ from past generations?

In the most important sense, there was less choice a century ago. The word “caregiver” didn’t exist; the words “daughter” or “wife” or “sister” sufficed to describe a caregiving role. Continue reading