Category: Dr. Holland’s Mental Health Tips

Pain and Gratitude

Blogging with Dr. Jenny Holland, PsyD

The Dubious Connection between Physical Pain and Depression 

As a psychologist I understand that pain and depression are closely related. Pain can be a two-edged sword, and studies have shown that depression can cause pain just as pain can cause depression. Sometimes this kind of cycle of pain and depression or feeling low, can wear us down, create added stress and interfere with our lives and disturb sleeping patterns. To get symptoms of pain and depression under control, it’s important to take proactive steps to keep yourself on an even keel.

My Own Experience

Though I don’t often talk about it, I live with physical pain every day. When the weather is cold and damp, life becomes even more challenging. This past month has been particularly intense in this way. As such, I notice my own thoughts automatically drifting toward the negative. The mental list of things that are difficult or ‘wrong’ tabulate in my mind without effort. And I understand that the weather will probably be getting worse for the next couple of weeks, at least. As a way to tackle my own discomfort and to lift myself out of the cycle of pain and depression I thought I would blog about gratitude and how this practice has helped me.

The Study of Gratitude

In recent years, the study of how a simple action such as practicing gratitude can boost happiness and alleviate depression has gained attention and momentum among psychologists and mental health professionals all over the world. Scientists say that these techniques shift our thinking from negative ruminations to positive outcomes. Gratitude practice has been shown to produce a surge of feel-good hormones like dopamine, serotonin and oxytocin, and helps to build enduring personal connections.

Count Your Blessings

Many people find putting pen to paper to compile a gratitude list, or to start a gratitude journal provides a sort of ritual experience that lets us focus on the positive events of the day. As we journal, we can write more detail about the events that make us feel appreciative. When I put some energy into focusing on my own situation and turning my thoughts toward what is right about my life, I can begin to build a list of items that I appreciate such as:

  • I am grateful for my children and my husband. Adam and I have been together almost 25 years! That’s almost half of my life now.
  • I am grateful I am healthy and that those that I love are healthy.
  • I am grateful to have a few lifelong friends that support me, always.
  • I am grateful for my Jewish Communities.
  • I am grateful to have a job that allows me to be with people in meaningful and hopefully, in helpful ways

Expanding Gratitude into Work

Showing up and doing what I can do to help make a difference has a strong impact on my experience of pain and helps me to maintain an active, rather than a passive focus. About a year ago, I took a big leap and launched a private pay practice. Today it is thriving, and I am re-invigorated. In addition to seeing individuals, I have started a professional consultation group that is going well.  I also currently run a grief group, and I am starting groups for people with disabilities and their families. I will be traveling a bit in the next few months to spread the word about a book that is coming out in March in which I am a contributor. Fury: Women’s Lived Experiences of the Trump Era. I also started a book club this year that is feisty and fun. And on my favorite weeks, I get to do a little singing with my friends at Ner Shalom.

Gratitude is an Effort Worth Making

To count our blessings or to focus on the positive when dealing with pain, depression and/or anxiety is challenging for everyone and it takes a conscious effort. However, when we adopt the practice of gratitude as a daily habit it can become an important routine and step towards self-empowerment.

Get Started with Your Own Gratitude Practice

Journaling is probably the easiest gratitude enhancing practice we can undertake. Creating a gratitude journal can be as simple as buying a blank notebook and writing down a few things you’re grateful for each night before going to bed. You can enhance your journaling experience by turning it into a ritual such as first lighting a candle, making yourself a cup of tea, sitting quietly for five minutes before you begin, etc. Whatever you choose as a ritual, do it consistently. It strengthens the ability to turn what you’re doing into a positive habit. Anything fun and relaxing, will give you motivation to form a new habit.

 

Parental coaching can help kids navigate peer rejection, bullying and conflict

Parents can offer support and advice to youth as they navigate social challenges

During early adolescence, especially the transition to middle school, kids face a number of challenges both socially and academically. Peer rejection, bullying, and conflict with friends are common social stressors. These challenges can affect adolescents' ability to form positive peer relationships, a key developmental task for this age group. Parents can act as social "coaches," offering support and advice to youth as they navigate these challenges by offering specific suggestions for facing challenges head-on or by encouraging kids' autonomy, to "figure it out" on their own. University of Illinois researchers are finding that not all kids benefit from the same types of parental coaching because kids respond to stress differently.

In a recent study, published in the Journal of Applied Developmental Psychology, researchers report on the connection between how mothers advise their children to respond to specific peer stress scenarios and youth stress responses during conversations about real peer experiences. They also identify what mothers do or say that is particularly helpful in facilitating youth adjustment and well-being in the face of these stressors. "As we're thinking about the transition to middle school, we're looking at the extent to which mothers are encouraging their child to use active, engaged coping strategies, such as problem solving, help-seeking, or reframing or thinking about the situation in less threatening or negative ways," says Kelly Tu, assistant professor of human development and family studies at U of I.

The study also looks at how mothers may recognize that their children are transitioning into adolescence and looking for more autonomy and independence. "We wanted to examine the extent to which mothers are taking a step back, saying, 'I'm going to let you handle this in your own way -- what you think is best or what works for you,'" Tu says. Mothers and youth in the study participated during the transition from fifth grade to sixth grade. Mothers were given hypothetical peer stress scenarios such as peer exclusion, peer victimization or bullying, and anxiety about meeting new peers, as well as a variety of coping suggestions. Mothers were asked to report on how they would typically advise their child to respond.

Researchers also observed conversations between youth and their mothers about real peer stress situations. Common topics that were discussed included being around kids who are rude, having problems with a friend, and being bullied, teased, or hassled by other kids. During the conversations, researchers measured skin conductance level -- the electrical activity happening in the skin as part of the physiological "fight or flight" stress response system -- from youth's hands. "We assessed youths' physiological arousal during these problem-solving discussions to examine how the different levels of reactivity may indicate different needs of the adolescent," Tu explains.

For instance, greater reactivity during the conversations may reflect youths' higher levels of physiological arousal or anxiety in recalling that stressful experience and talking it through with the mother. Whereas less reactivity during the problem-solving conversation might serve as an indicator of youths' insensitivity to the stressful experience. And these different response patterns may require different parenting approaches. "We found that mothers' active, engaged coping suggestions were more beneficial for low reactive youth. Low reactive youth may not be attending to cues in these conversations about stressful or challenging peer experiences, and so they may behave in ways that are unexpected, non-normative, or inappropriate. But when parents give them specific advice for how to manage challenging peer situations, this appears to be helpful," Tu says. However, the same active, engaged approached predicted worse adjustment for kids exhibiting higher arousal. "Instead, self-reliant suggestions actually predicted better adjustment for these kids," Tu explains.

"These findings are interesting because this suggests that a multi-step process might work best for kids who are exhibiting high physiological arousal related to peer problems. If you're anxious or stressed, and your parent is telling you to face the problem head on, that might actually create more anxiety. But when a parent gives a highly aroused youth more autonomy about how to cope with the peer stressor, this seems to be more beneficial because parents are giving them more space and time to work through the situation in their own way," Tu says. Thus, parents may want to consider the match of their coping suggestions with adolescents' stress reactivity.


This article provided by Science Daily: University of Illinois College of Agricultural, Consumer and Environmental Sciences. "Parental coaching adolescents through peer stress."ScienceDaily, 18 December 2019. www.sciencedaily.com/releases/2019/12/191218153402.htm.


Dr. Jenny HollandThere are situations that arise for every child - spanning infancy to adolescence, that benefit from a parents’ ability to acknowledge the worthiness of the child's feelings. To be the loving, compassionate and unflappable parent requires the ability to manage your own feelings and frustrations. Over the years studies have pointed out that the best-adjusted children are nurtured by parents who find a way to combine warmth and sensitivity with clear behavioral expectations.

Dr. Holland has been in private practice for more than 17 years, helping patients to reach new levels of self-understanding and emotional well-being.  Dr. Holland will customize treatment to meet your specific needs. Contact Dr. Holland to learn more and to schedule an appointment, or call 707-479-2946.

 

Caregiver study focuses on the challenges of caring for a partner

Caregivers need to consider their own health as important as their spouse

Study participants had levels of depression symptoms serious enough to suggest a need for treatment

When they said their wedding vows, many of them promised to stand by one another in sickness and in health. But a new study suggests that as married couples age and develop chronic conditions, the daily demands of coping with their own health demands and those of their spouse may take a mental toll.

Depression symptoms increased over time among married men and women who themselves had two or more chronic conditions that need different types of self-care -- such as a special diet and medications for heart disease or diabetes along with pain-reducing therapy for arthritis. When husbands and wives both had chronic health conditions, and needed different kinds of self-care from their partners, husbands fared worse. Their depression symptoms were significantly higher, but this effect was not found for wives.

The new findings, made by a team from the University of Michigan using data from a long-term study of more than 1,110 older opposite-sex married couples from 2006 to 2014, are published in Journals of Gerontology Series B: Psychological Sciences and Social Sciences. While less than 10% of the women and less than 7% of the men in the study had levels of depression symptoms serious enough to suggest a need for treatment, lower-level depression is important for older people, clinicians, caregivers and adult children to understand, says Courtney Polenick, Ph.D., who led the study.

In both husbands and wives, the rise of depressive symptoms didn't begin until a few years after the first assessment of their health and well-being. "Our results suggest that there's a window where, if one or both of you are managing complex conditions that don't have similar self-management goals, it may be possible to intervene and prevent the development or worsening of depression," says Polenick, who is part of the U-M Department of Psychiatry and Institute for Social Research. "This might be the time for couples, and those who care for them, to emphasize broadly beneficial lifestyle behaviors that help to maintain both mental and physical health."

For instance, a woman coping with both high blood pressure and arthritis needs to make changes to her exercise routine, but her husband without such conditions could commit to making those changes along with her. Or a wife with diabetes who does most of the cooking and has a husband with prostate cancer could adopt a healthier menu for both of them. Polenick and her colleagues from U-M's Institute for Healthcare Policy and Innovation looked at data from the Health and Retirement Study, which repeatedly interviews and surveys thousands of American adults in their 50s and beyond over time.
They focused on conditions that have similar treatment goals focused on reducing cardiovascular risk -- diabetes, heart disease, hypertension and stoke -- and those with treatment goals and needs that are different from each of the other conditions- cancer, arthritis and lung disease.

When one person in the couple had at least one condition with different treatment goals and needs, they're considered to have "discordant" conditions. When one member of a couple had at least one condition that has different treatment goals and needs from the other partner, the couple is considered to have discordant conditions. "Research has focused on how individuals with multiple conditions, also called multimorbidity, manage their chronic health needs," says Polenick. "But most people in later life are partnered, with similar health-related habits, and we need to understand how changing health affects the couple dynamic." The fact that both wives and husbands experienced significant increases in depressive symptoms as the years passed, when they were coping with discordant conditions in themselves, is by itself important to understand, Polenick notes. But the fact that wives whose husbands' health needs differed from their own didn't experience an even greater rise in depression is a bit surprising, she adds.

Meanwhile, husbands whose conditions had self-care needs that were different from their wives' conditions did experience an additional rise in depression symptoms. Among individuals who are baby boomers or older, wives may be more used to taking the lead in caring for the health and emotional well-being of both themselves and their husbands, she says. But when husbands have wives who are coping with different health demands than their own, the husbands may experience less of this support than usual, worsening their stress and mental health.

Polenick and her colleagues continue to explore these intra-couple dynamics, and their consequences for mental and physical health. They also hope to expand the range of chronic health conditions they examine, and to look at shorter time frames in conditions that can be managed with lifestyle changes. But in the meantime, she notes that middle-aged and older couples may want to do more now to understand the factors that they can control as they age, and those they cannot, and talk about how they feel as a result.

"This is a reminder to step back and look at what your partner is coping with, to learn about their health conditions, to be conscious of it on a daily basis, and for grown children and clinicians to do the same," she says. "Having that awareness, and helping one another manage health problems while watching for signs of depression, may help both members of a couple over time."


Story Source: Content provided by Science Daily and Michigan Medicine - University of Michigan. "In sickness and in health: Study looks at how married couples face chronic conditions." ScienceDaily. ScienceDaily, 3 December 2019. www.sciencedaily.com/releases/2019/12/191203104756.htm.


Dr. Jenny Holland
Dr. Holland

Caregivers often report feelings of exhaustion and overwhelm. While caring for a loved one can be very rewarding, it also comes with distinct elements of stress. When dealing with a long-term challenge it's extremely important to also provide for your own emotional and physical well-being. When the challenges associated with care giving are not taken into consideration the caregiver's physical health, relationships and mental health can deteriorate over time — eventually leading to burnout and exhaustion. And when it reaches that point, both the caregiver and the person being cared for suffer. Caring for yourself is equally if not more important as making sure your family member gets to their doctor’s appointment or takes their medication on time.

Focused Therapy for Caregivers

If you are having trouble with accepting or adjusting to life's challenges, Dr. Holland can help you find healthy ways of coping. The simple act of expressing what you’re going through can be very cathartic. Dr. Holland will tailor treatment to meet your specific needs. Contact Dr. Holland to learn more and to schedule an appointment or call 707-479-2946.

New study says narcissism diminishes as a person matures

Level of narcissistic trait development depends on early career and relationship choices

The belief that one is smarter, better looking, more successful and more deserving than others -- a personality trait known as narcissism -- tends to wane as a person matures, a new study confirms. But not for everyone, and not to the same extent.

The study, reported in the Journal of Personality and Social Psychology, finds that the magnitude of the decline in narcissism between young adulthood and middle age is related to the specific career and personal relationship choices a person makes.

The research tracked participants across two time points. The first occurred when they were 18 and just starting out as freshmen at the University of California, Berkeley. The second was 23 years later, when participants were 41 years old. Of the original 486 participants, 237 completed a new round of evaluations.

Participants at both time points answered questions from a survey designed to assess their narcissistic traits. For the follow-up study, researchers also asked about relationship and employment history, job satisfaction, and health and well-being.

"We looked at the different facets of narcissism in adults at age 18 and again at 41," said Eunike Wetzel, a professor of psychology at Otto-von-Guericke University in Magdeburg, Germany, who led the research with University of Illinois psychology professor Brent Roberts; Emily Grijalva, an organizational behavior professor at Washington University in St. Louis; and Richard Robins, a psychology professor at the University of California, Davis. "We focused on participants' vanity, the belief in their own leadership qualities and their tendency to feel entitled."

Each facet of narcissism was associated with several negative -- and in a few cases, positive -- outcomes for the individual, the researchers found. Those who had higher levels of vanity at age 18 were prone to unstable relationships and marriages, and were more likely to be divorced by middle age. But they also reported better health at age 41. In contrast, those who felt the most entitled as young adults reported more negative life events and tended to have lower well-being and life satisfaction at middle age.

"We originally hypothesized that the leadership facet of narcissism would increase," Roberts said. "In fairness to my co-authors, that hypothesis was mine, and it turns out I was wrong."

Leadership is associated with goal persistence, extraversion, self-esteem and a desire to lead. It is considered one of the least pathological elements of narcissism, Roberts said.

"We know from past research that another component of personality, assertiveness, tends to increase during this time of life," he said. "So, I thought it was reasonable to hypothesize a similar increase in the leadership facet. This either means the past research is wrong, or our read of the leadership component of narcissism is wrong -- it may actually be more negative than we thought. We have to figure this out in future research."

Vanity appeared to be most strongly linked to life events, the researchers found. For example, vanity declined more in those who entered into serious romantic relationships and those with children. But vanity declined significantly less in middle-aged adults who had experienced more negative life events than their peers.

"We also found that narcissistic young adults were more likely to end up in supervisory jobs 23 years later, suggesting that selfish, arrogant individuals are rewarded with more powerful organizational roles," Grijalva said. "Further, individuals who supervised others decreased less in narcissism from young adulthood to middle age -- meaning that supervisory roles helped maintain prior levels of narcissism."

Despite the differences between individuals, most of the participants who responded to researchers' questions again at age 41 saw a decline in narcissism as they matured, the researchers found.

"Very few people, only 3% of participants, actually increased in overall narcissism between the ages of 18 and 41," Wetzel said. "And some remained just as narcissistic at age 41 as they had been when they were 18 years old."

"The findings should bring comfort to those who are concerned that young people are problematically narcissistic," Roberts said. "With time, it seems most people turn away from their earlier narcissistic tendencies."


Read this article on Science Daily: Materials provided by University of Illinois at Urbana-Champaign, News Bureau. Note: Content may be edited for style and length. University of Illinois at Urbana-Champaign, News Bureau. "Narcissism tracked from young adulthood to middle age." ScienceDaily. ScienceDaily, 11 September 2019. www.sciencedaily.com/releases/2019/09/190911113019.htm.


Tips From the Expert: Staying Grounded

Tips for Staying Grounded

In a crazy world, it can be difficult to know how to keep grounded. Here are a few suggestions that I hope might be helpful.

LIMIT your exposure to social media and news coverage. Once you learn about a devastating event, ask yourself if it is helpful to see the same graphic images and listen to the same sound bites again and again. Set a timer if you need to.

KEEP moving! Physical activity boosts our mood, gives us energy and a sense of agency and empowerment.

GET support from trusted allies, friends, colleagues and organizations. Isolation can heighten our painful emotions making them harder to manage.

SUPPORT and help others who may be struggling. Generously is a powerful response to suffering. This can be as simple as lending an ear or helping organize a community event or sending a donation if you are able.

BREATHE consciously -- When we are stressed, when we are tired and overwhelmed, it’s easy to hold our breath without even knowing it. And when we do that, we deprive ourselves of oxygen, which, in turn, limits our ability to think clearly in the moment and do things like problem-solving and affect-regulation. Which means, it’s harder for us to calm ourselves down. And we want to calm ourselves down right? So, JUST BREATHE And make it a habit to check in with your breath as often as you can. You might be surprised at how much calmer and clearer you immediately feel by taking a minute to catch your breath.

TAKE ACTION! Doing something to create change can be mobilizing and help ease depression and feelings of helplessness and anxiety that can coincide with loss and overwhelm.

Contact your Representatives at State and Federal Levels.

Educate yourself about the issues that concern you most.

Talk to others and attend marches, rallies and protests