Feelings
Feelings are your algorithms and their make-up are like no one else's in the world. They are one of the many things that make you so unique. - Gordon Clay "Fine" is not a feeling. It's an acronym for multiple feelings. If a man says "Fine", it means he's furious, isolated, numb and empty. If a woman says "Fine", it means she's feeling freaked out, insecure, neurotic and emotional (Italian Job movie). - Gordon Clay
Related
issues: Suicide. I Wish
I Knew Now What I Knew Then Once upon a time, long, long ago, men knew how to express their true feelings. And, women did too. That was in an era when parents took time to be with us, as children, to hold us and carry us around, on their bodies. When we were upset, we expressed it and our parents understood. When we were hungry, they could tell, and responded. When we were rambunctious, our feelings were put up front over our parents' need for quiet, or for adult conversation. Along time ago, we knew how to express these true feelings. And others knew what those feelings meant. We were understood. As the centuries passed, the needs of the adults took priority. Adult activities, with other adults, got more attention. They invented things like cribs and strollers, and we children lost that human contact with our parents when we were very, very young. To get attention, we had to change our "true" feelings to ones that got us noticed. Expressing how we really felt, we quickly learned, was unacceptable. So we would try different tacks. If one didn't work, we tried another, until we found the one that brought attention. Not always positive attention, but at least it was some attention. If we were around adults who didn't respond in a healthy way to our true expressions, we had to learn different ones to feel safe, get attention, get what we need. And, if we were in a family with generations of violence in its past, we might have even learned that attention by getting hit was okay, too. It wasn't really okay, of course, but our need for attention became so great that we told ourselves that it was. After generations of violence, we may even have confused being hit with receiving love, since our deep, deep craving for physical touch was so great and violence was our only experience with that human contact. We kept telling ourselves, "I know they love me. Maybe if only I were a better child, they wouldn't hit me." The good news is that each of us were born with all of our true feelings intact. We knew then what our true feelings were. And, we naturally expressed them: discomfort when we were uncomfortable, anger when we weren't getting the attention we wanted, fear when we were afraid. We let the world know it. But, then the adult messages started coming in that told us that our natural, honest expressions of our feelings didn't, in fact, reflect the way we "really" felt, after all. Messages like "Stop crying. There's nothing to be afraid of." And, we came to believe, that we really couldn't trust our own feelings to be true. We decided we must learn, very early on, to stuff those "true" feelings, for the appropriate adult feelings. As we grew older as boys, we quickly got new messages around feelings. If we were afraid, instead of being allowed to show our fear and release it, we got the message to "Act like a man". If we hurt or were in pain, the message was "Be tough." That meant, stuff the feeling, and act like it's not there. And, if we were sad we were told, "Big boys don't cry" or we were shamed by being called a "cry baby." So, we quickly learned that it wasn't okay to express fear, hurt or sadness but it was okay to numb out or express anger ("Boys will be boys"). Numbness and getting mad were really our only two feeling options. After a while, we may have learned to explode in a very violent manner or to continue to maintain the deep hurt, sadness or pain. Some of us kept it long enough to allow it to eat away at us from the inside in the form of cancer, ulcers and many other diseases. Girls growing up got a different message. Don't ever get angry. If it wasn't the message that "nice girls don't get angry" it was the threat of violence in reaction to her anger. Some threats were physical, others emotional. The girl growing up soon learned that she could displace the "true" feelings of anger with sadness or fear, which often led to acting out in a passive-aggressive way or manifesting depression, migraines, menstrual cramps, or even anorexia. When these displaced feelings get acted out in a coupled relationship, you can see how confusing it can become. When her "true" -- deeply felt but unacknowledged -- feeling is anger but she expresses the "displaced" feeling of sadness and his "true" feeling is hurt or fear but he "displaces" it with anger, the road to intimacy becomes blocked. And that intimacy will remain blocked as long as the "true" feelings of anger, hurt and sadness are withheld or inappropriately expressed. This can manifest in a very unhealthy scenario. I'm sure you have heard someone say, "We had a big fight last night and the sex afterwards was really great!" What's going on here? The truth is, that's the only way this couple knows to get through the layers of anger. But in fact, it's not necessary to have a fight to have great sex, when you can take other steps to release the repressed anger, and get in touch with the "true" feelings that are going on. Many people are afraid, and say something like: "Getting in touch with my true feelings will change things and I won't know the outcome in relationship," or "I won't know what to expect," or "I might lose 'control'". All of these worries are founded in reality, and yet without experiencing our own "true" feelings, we're left in a very confusing world. Getting in touch with these feelings might be scary. For most people, the scariest feeling to look at is anger. "I might explode", "I might destroy everything around me", "Others might not like me", are some of the common fears. Society has placed anger on its Great List of Taboos, calling it dangerous and unhealthy. The confusion is that anger, like love, is a feeling, not a behavior. (This is a common misconception. Many confuse the feeling with the way people behave, when these are very different things. The expression "If you loved me, then you would...," refers to an expected behavior, not the feeling of love.) So, because we so connect the feeling of anger to the behavior of violence, we have learned many different ways to cope. Unfortunately, many otherwise healthy techniques for stress reduction are in fact very unhealthy when we use them for the wrong reason, namely, as a way of calming the anger within us. Some examples of this are: diverting the mind, numbing out, getting grounded, surrounding ourselves in white light, prayer, yoga and meditation, to name a few. Other things we've used to avoid expressing anger and other feelings include substance abuse, working harder and sexual addiction. And while there are definite benefits to yoga, meditation, grounding, prayer, when you apply them as a solution to release anger, they're just another way we try to trick the mind so we don't have to deal with this feeling. It remains locked in the body and the emotional system to come out even stronger, later, in a different, unrelated situation. So, you can see why anger needs to be expressed -- moved through the body and out of the energy system using appropriate behavior. There are many ways to appropriately express anger without going into some form of violent behavior. Dancing energetically while shaking (keeping fists open), lets anger move through you. Where appropriate, yelling or screaming at the same time is very valuable. Where that's not appropriate, screaming into a towel or pillow helps. Even in the office, a trip to the rest room and screaming while completely covering your mouth with your hands can remove the anger's presence from your body without stuffing it. Wringing a towel is also good if you don't see it as someone's neck, but hitting a racquetball, punching bag, pillow, bataka bat or any system that reminds and reinforces a violent message in the nervous system, is not appropriate, for two reasons. One, the fist is usually closed which doesn't allow the anger energy to escape through the hands, and second, with each hit comes the message of violence to the nervous system. We already have enough of these messages constantly bombarding us. Bringing them in in such a direct way is not healthy. If you still feel that it's okay to hit pillows or throw things against walls, look at the message you might still be carrying from childhood. The parent's message "This is going to hurt me more than it is you," was one that the child's subconscious mind often turned into "I'm sorry I'm hurting you when you have to punish me for being bad. I really want your love." And, with that message, transferring the adult to a pillow or punching bag and hitting it might seem perfectly okay as a subconscious way of receiving love. It may require taking a hard look at why it seems okay, so that you can really get clear on what the act of hitting tells your nervous system. What we found working with angry but non-violent people was that when they started hitting things to release the anger, it started feeling good and the distance between hitting and not hitting became compressed, the line thinner and easier to step over. As you can see, "true" feelings have been part of you and everyone that came before you, but over time got "displaced" and denied until none of us really know how we're feeling. So, how are you feeling right now? Fine? What does that mean, fine? Fine seems to work much better to describe the coarseness of sandpaper rather than feelings. When a woman says "Fine", I often see in her the energy that translates into, "I'm Frustrated, Irate, Nervous, and Empty." And from a man, the translation seems to say I'm Furious, Isolated, Numb and Empty." How often we all feel "empty", looking outside for something to fill us up, give us approval, make things better. Better to "fill" our experience with all of our feelings, however unfamiliar they may seem at first, so that we may enjoy fuller relationships throughout our lives. And, while the journey inside to "true" feelings might seem scary and filled with the unknown, it is one that we all must take, if we want to live in integrity in a healthy community and in fulfilling relationship. It is possible to know now, what you knew then. Good luck on your journey! Let's meet
at the crossroads. - Gordon Clay Study suggests
human only have four basic emotions As humans we tend to consider ourselves to be unique snowflakes, all with our own distinct feelings and emotions -- but a new study says we may not actually have that many emotions to choose from. The research from the University of Glasgow says that humans have just four basic emotions: that's down from the six humans were believed to have. Traditionally, those included happiness, surprise, fear, disgust, anger and sadness - but after observing reactions to faces exemplifying those emotions, researchers now say there's some overlap. To get to their findings, researchers had participants examine computer-generated facial-animations, then categorize them into one of the six emotions. What they found was anger and disgust, as well as fear and surprise, looked very similar to the participants at first glance - and it took a minute to discern the difference. So, what does that tell the researchers? According to a writer for The Atlantic, researchers surmised that humans only have four biologically-based facial signals, with additional nuances evolving in response to social cues. She quotes the study authors who wrote, "Our data re?ect that the six basic facial expressions of emotion, like languages, are likely to represent a more complex set of modern signals and categories evolved from a simpler system of communication in early man." According to the study, that leaves us with the four basic emotions of: 1) Happiness Their research was published in the
journal Current Biology. Study: Happiness
Spreads, Depression Doesn’t This was actually a stronger effect
than you see with antidepressants, and the study authors
also found that while “healthy moods” can spread,
depressed teens don’t seem to cause their friends to
become depressed. Is happiness really contagious? Negative
Emotions: Use Them or Lose Them All emotions, though, are innate signals for us to pay attention to something. Think about it: we don’t get angry for no reason. We get angry when someone violates our rights or intrudes on us, and the anger helps us to protect and assert ourselves. Our evolutionary ancestors relied on negative emotions to keep them alive. When a hungry-looking saber-toothed friend stalked past their cave, the high-alert signals motivated the actions needed to protect them. In our modern world, negative emotions aren't always a bad thing—they can help us focus on problems in front of us, boost our performance, and increase our compassion. But too much of a bad thing is, well, not fun at all. Many of us experience negative emotions to an extent that keeps us from functioning optimally. Here are 4 of the major categories of negative emotions and some tips for helping you to think through whether the feeling is a friend that can motivate you to do something—or whether it’s a foe that you should feel motivated to defeat. Fear Ranging from the nagging worry that you need to pay your bills this week to the heart-stopping adrenaline rush you get leaning over the edge of a canyon, fear is telling you that danger is ahead. When to Use It: A bit of worry can be productive, particularly when it motivates you to take a step to relieve it. If you’re nervous about an upcoming presentation, or worried about going on a blind date, allow the anxiety you feel to drive some extra preparation. In the long run this will boost your confidence. When to Lose It: If your fear or anxiety is strong enough to be preventing any meaningful movement forward, then it’s time to fight back. Calming and relaxing your body with exercise or meditation can be helpful. So can talking about your fears out loud with a trusted friend. Anger Whether you’re a mild irritation gal or a full-of-rage guy, anger comes when we feel we’ve been violated and encroached upon wrongly or unnecessarily. When to Use It: If someone did something that hurt you, like when your partner wasn’t focused on the good news you were excited to share, listen to your anger and get curious about what’s going on for you. In many cases, particularly with people close to you, it’s appropriate to communicate what you’re feeling in an assertive and controlled way. When to Lose It: Blaming the world for your problems is not a pathway to happiness. If your anger is widespread or if you don’t have any control over or influence over the situation that frustrated you—like the driver who cut you off to make the next exit ramp—it’s best to drop it. Try shifting gears by practicing kindness or empathy. Do something nice for someone who doesn’t expect it or imagine what would have motivated someone to act in the way they did that hurt you. Sadness A reflection that we’ve lost something we valued, we experience it when we lose a loved one and when we make a transition in our life leaving the past behind. When to Use It: When you’ve lost something that matters to you, sadness can be a cue to slow down and honor it. When it’s a person, a pet, a period of life, or a profession, listen to your solemn feelings and mark the occasion. Find meaning in what’s transpired and identify a way to carry that meaning forward into your future. When to Lose It: When sadness cripples you, you may be experiencing a bout of depression. While physical exercise and social contact can help, it may be difficult to get yourself going. Try taking a small step that feels manageable, and focus on what helps you feel better. If a deep sadness persists and is affecting your ability to manage daily tasks, consult a healthcare professional. Shame Often a painful emotion that hangs on, shame reflects an evaluation that something is fundamentally wrong with us and that we don’t measure up to other people. When to Use It: A smidge of guilt, when it’s warranted, is exactly the humble pie we need. It forces us to reevaluate our own actions, which may have hurt others, and to apologize and make amends. Take this as a sign that you care about the situation and do your best to fix it. When to Lose It: Feeling insecure, inadequate, or worse is the best way to crush a good mood. If you are questioning your own abilities or value, take stock that something in your life is truly bothering you, but this emotion isn’t helping. Focus on your strengths to build confidence. Do something you know you can accomplish to create positive momentum. Or try these tips for turning your insecurities into inspiration. For activities and games to help you
conquer negativity in your life, visit Happify.com or
download the iPhone or Android app. Imaging Technology
Finally Reveals How Emotions Manifest in Your Body
Every feeling you have affects some part of your body, and stress can wreak havoc on your physical health. Just because we don’t have the technology to visualize the mind-body connection doesn’t mean it’s not real In a recent experiment to map emotions, researchers asked volunteers to think about one of 14 predetermined emotions, and then paint the areas of a blank silhouette that felt stimulated by that particular emotion The experiment shows that emotions do tend to be felt in your body in ways that are generally consistent from one person to the next, irrespective of your age, sex, or nationality Previous studies have linked stress to lowered immune system function, increased blood pressure and cholesterol levels, and altered brain chemistry, blood sugar levels, and hormonal balance 
By Dr. Mercola I’ve often said that you cannot divorce your health from your emotions. Every feeling you have affects some part of your body, and stress can wreak havoc on your physical health—especially if you’re not exercising or eating right, as both of these can help keep stress in check in the first place. Still, even if you’re doing everything “right,” your emotions—both chronic and acute—can wield great power over your body. The classic definition of stress is “any real or imagined threat, and your body’s response to it.” Your body’s natural stress response can have a significant impact on your immune function, brain chemistry, blood sugar levels, hormonal balance, and much more. In recent years, there’s been an upwelling of mind-body therapies that take this interrelatedness between your emotions and physical health into account.1 The Emotional Freedom Technique (EFT) is, I believe, among the most effective. Many in the primarily left-brained field of science are still reluctant to embrace the mind-body paradigm however, and one of the factors holding them back is the fact that you cannot see or measure emotions inside your body. But just because we don’t have the technology to visualize the mind-body connection doesn’t mean it’s not real! Mapping How Emotions Manifest in Your Body The image below is a step in the direction of being able to visualize how your emotions manifest inside your body. Researchers in Finland asked 700 volunteers from Finland, Sweden, and Taiwan to think about one of 14 predetermined emotions, and then paint the areas of a blank silhouette that felt stimulated by that particular emotion. Using a second blank silhouette, they were asked to paint in the areas that felt “deactivated” during that emotion. To help them generate the appropriate emotion, they could read a short story or view a video. (If you want to try this experiment yourself, you can do so here. The online test is also available in Russian, French, and Italian.) The experiment shows that emotions do tend to be felt in your body in ways that are generally consistent from one person to the next, irrespective of your age, sex, or nationality. As reported by the featured article in The Atlantic:2 “The mapping exercise produced what you might expect: an angry hot-head... a depressed figurine that was literally blue (meaning they felt little sensation in their limbs). The Mind-Body Connection It’s interesting to note that certain emotions are known to be associated with pain in certain regions of your body, even though science cannot give an explanation for why. For example, those suffering from depression will often experience chest pains, even when there’s nothing physically wrong with their heart. Extreme grief (or any other extremely stressful event) can also have a devastating impact—not for nothing is the saying that someone “died from a broken heart.” In the days after losing a loved one, your risk of suffering a heart attack shoots up by 21 times! While the mechanics of these mind-body links are still being unraveled, what is known is that your brain, and consequently, your thoughts and emotions, do play a role in your experience of physical pain, and can play a significant role in the development of chronic disease. For example, previous studies have linked stress to lowered immune system function, increased blood pressure and cholesterol levels, and altered brain chemistry, blood sugar levels, and hormonal balance. It has also been found to increase the rate at which tumors grow.4 One of the reasons for this has to do with the way the biological stress response promotes inflammation in your body. When you're stressed, your body releases stress hormones like cortisol, which prepare your body to fight or flee the stressful event. Your heart rate increases, your lungs take in more oxygen, your blood flow increases, and parts of your immune system become temporarily suppressed, which reduces your inflammatory response to pathogens and other foreign invaders. When stress becomes chronic, your immune system becomes increasingly desensitized to cortisol, and since inflammation is partly regulated by this hormone, this decreased sensitivity heightens the inflammatory response and allows inflammation to run rampant. While it’s not possible to eliminate stress entirely, you can help your body to compensate for the bioelectrical short-circuiting caused by emotional stress. EFT Can Be Used to Counter Effects of Negative Emotions I’m a big fan of energy psychology and one of the most popular forms is Emotional Freedom Technique (EFT), which is a type of psychological acupressure. While it makes use of the same energy meridians known in traditional acupuncture, EFT does not involve needles. Instead, gentle tapping with your fingertips is used to transfer kinetic energy onto specific meridians on your head and chest while you think about your specific problem -- whether it is a traumatic event, an addiction, pain, anxiety, etc. -- and voice positive affirmations. This combination of tapping the energy meridians and voicing positive affirmation works to clear the "short-circuit"—the emotional block—from your body's bioenergy system, thus restoring your mind and body's balance, which is essential for optimal health and the healing of physical disease. Clinical trials have shown that EFT is able to rapidly reduce the emotional impact of memories and incidents that trigger emotional distress. Once the distress is reduced or removed, your body can often rebalance itself, and accelerate healing. In the videos below, EFT practitioner Julie Schiffman shows how to tap for stress and anger.
Total Video Length: 24:53 Stress Takes a Heavy Toll on Your Gut According to the authors in the featured study, “disgust” was the emotion that was most strongly felt in the gut. Fear, anxiety, and shame also generated a felt impact in this area. All four of these emotions are generally felt by those experiencing depression, and I’m not surprised to see a strong connection between these emotions and the gut. In recent years, the connection between your gut health and your mood and behavior has become increasingly clear—so much so that some scientists are starting to consider probiotics (beneficial bacteria) as a potential alternative to antidepressant medications. For instance, the probiotic known as Bifidobacterium longum NCC3001 has been shown to normalize anxiety-like behavior in mice.5 Research published in 20116 also demonstrated that probiotics can have a direct effect on brain chemistry, thereby improving feelings of anxiety or depression. There's also a wealth of evidence showing intestinal involvement in a variety of neurological diseases. In a very real sense, you have two brains, one inside your skull and one in your gut, and the greatest concentration of serotonin, which is involved in mood control, depression, and suppressing aggression, is actually found within your intestines, not your brain. The implications are particularly significant in our current era of rampant depression and emotional “malaise.” There’s compelling evidence suggesting that improving your gut health is a very important component, if not the key, to successfully addressing depression, anxiety, and other mood disorders. One of the easiest and most cost-effective ways to do this is to add traditionally fermented or cultured foods to your daily diet. To learn more about your gut-brain connection, and how probiotics may help you improve your mental health, please review my previous article, “Are Probiotics the New Prozac?” Make Stress Management Part of Your Lifestyle Besides EFT and tending to your gut, there are many other stress-management strategies. The following are, I believe, among the most important basics:
Syncing Your Body and Mind As stated in the beginning, just because we don’t yet have the technology to visually observe how the emotions affect the body doesn’t mean that the mind-body connection isn’t real. It is. You just have to observe the effects of your emotions to “see” how they might play a role in your health. After worrying about something for a period of time, do you then get a headache? Does the idea of going into a meeting set off a stomach ache? Another way to familiarize yourself with the connection between your body and mind is to feel which parts of your body are stimulated or shut down when you’re experiencing any particular emotion, as was done in the featured study. One thing is clear, your emotions matter, and they cannot be ignored in the big scheme of your overall health. So please, take your emotional health seriously. Sleep, exercise, eating properly, and addressing your stress are all part and parcel of a healthy lifestyle. If you’re struggling with difficult emotions, I really recommend giving EFT a try. There are also many other energy psychology tools out there that may offer similar benefits. The key is to find what works for you, and do it consistently to keep your equilibrium. Promoting
positive anger expression It is also a good idea to find ways to
channel this energy positively to ensure that it does not
have a destructive impact on yourself or others, for
instance, through increased aggression. Such productive ways
of channelling anger could include taking part in
high-intensity sports, such as swimming, martial arts or
basketball, or engaging in the arts. When It
Comes to Happiness, It's Contagious Usually when we're talking about something being contagious, it's a warning about germs. You don't want to pick up this season's flu or the hacking cough of the guy sitting next to you on the airplane, and anyone with school-aged children knows that any formal school communication containing the words "highly contagious" is most likely to be about lice, pinkeye, or some other virus du jour. Contagion is bad, right? Not always! It turns out that happiness is also contagious, in ways you may not have expected. What this means for those of us seeking to be happier is twofold. First, it means that---just as exposing yourself to communicable disease increases your chances of getting sick---you can "catch" happiness if you surround yourself with it; and second, it means that we have yet another great reason to work on our own good mood: it's actually a service to those around us, as it increases their chances of greater happiness, as well. Research on this very topic remains a hot area of interest, and new discoveries are being made all the time. Check out these happiness-contagion findings and see if any of them surprise you (I bet the last one will). Proximity matters Perhaps the most famous study in this area is the 20-year longitudinal one published in 2008, conducted by Nicholas Christakis and James Fowler, which concluded that happiness can spread through social circles in unexpected ways. While the researchers weren't surprised to learn that your friend's happiness increases the chances that you'll be happier, they were amazed to discover a ripple effect of happiness which persisted through even multiple degrees of separation---that is, you're also more likely to be happy if your friend's friend is happy, even if that's someone you don't personally know. This was the first study of its kind to suggest that the emotional "temperature" of a society or community as a whole may affect individuals more directly than previously believed. And while that study emphasized physical proximity (even going so far as to find correlations between distance from the other happier person and your likelihood of a mood boost, yourself), in 2014 a follow-up study by Christakis showed a similar effect taking place on Facebook, where physical distance becomes moot. "Joy transfer" could take place simply through witnessing another person's happiness on the screen, whether you know them personally or not. This confirmed that surrounding yourself with happier people---either physically or virtually---has a positive impact on your own mood. Smiles are significant Multiple studies have shown that a "forced smile" (one which you set out to create, rather than one which occurs spontaneously) can boost your wellbeing and decrease your stress. The mechanism of this phenomenon most likely has to do with the brain's interpretation of those muscle signals (but don't think about it too hard because the notion that your brain is relying on your facial expression to determine your mood can be a little disturbing). Regardless of how, exactly, it works, it does indeed work to make us feel better, whether it's a genuine smile or not. Armed with this information, of course it stands to reason that once we know how a facial expression can influence our mood, social researchers will want to determine if said expression tends to be contagious, itself. Swedish researcher Ulf Dimberg constructed a study wherein subjects were instructed to view pictures of various facial expressions and respond in various ways. Even when subjects were specifically instructed not to smile at pictures of people smiling, monitoring of activity within their facial muscles showed an involuntary smile response. Smiling is, indeed, contagious! Eau de happiness This may just be the weirdest one, but you can't argue with science: A group of researchers in the Netherlands have just released a study about "happiness sweat," and just like smiling, it turns out that this may be another avenue of happiness contagion, too. Don't worry; it doesn't make you sweaty. Actually, the sweat secreted while experiencing pleasant emotions somehow conveys that emotion via scent. We've long suspected that "fear sweat" smells different than "regular" sweat (and this would make evolutionary sense, for fellow members of the species to be able to discern danger via pheromones), but this may be the first study confirming that those smelling this "happiness sweat" may indeed end up feeling happier, themselves. What does all of this mean for you? It
means you're spreading happiness just by being happy, and
that you can go grab a boost off of happier people if you
need one. Happiness is contagious, and that's awesome! Negative Emotions: Use Them or Lose
Them All emotions, though, are innate signals for us to pay attention to something. Think about it: we don’t get angry for no reason. We get angry when someone violates our rights or intrudes on us, and the anger helps us to protect and assert ourselves. Our evolutionary ancestors relied on negative emotions to keep them alive. When a hungry-looking saber-toothed friend stalked past their cave, the high-alert signals motivated the actions needed to protect them. In our modern world, negative emotions aren't always a bad thing—they can help us focus on problems in front of us, boost our performance, and increase our compassion. But too much of a bad thing is, well, not fun at all. Many of us experience negative emotions to an extent that keeps us from functioning optimally. Here are 4 of the major categories of negative emotions and some tips for helping you to think through whether the feeling is a friend that can motivate you to do something—or whether it’s a foe that you should feel motivated to defeat. Fear Ranging from the nagging worry that you need to pay your bills this week to the heart-stopping adrenaline rush you get leaning over the edge of a canyon, fear is telling you that danger is ahead. When to Use It: A bit of worry can be productive, particularly when it motivates you to take a step to relieve it. If you’re nervous about an upcoming presentation, or worried about going on a blind date, allow the anxiety you feel to drive some extra preparation. In the long run this will boost your confidence. When to Lose It: If your fear or anxiety is strong enough to be preventing any meaningful movement forward, then it’s time to fight back. Calming and relaxing your body with exercise or meditation can be helpful. So can talking about your fears out loud with a trusted friend. Anger Whether you’re a mild irritation gal or a full-of-rage guy, anger comes when we feel we’ve been violated and encroached upon wrongly or unnecessarily. When to Use It: If someone did something that hurt you, like when your partner wasn’t focused on the good news you were excited to share, listen to your anger and get curious about what’s going on for you. In many cases, particularly with people close to you, it’s appropriate to communicate what you’re feeling in an assertive and controlled way. When to Lose It: Blaming the world for your problems is not a pathway to happiness. If your anger is widespread or if you don’t have any control over or influence over the situation that frustrated you—like the driver who cut you off to make the next exit ramp—it’s best to drop it. Try shifting gears by practicing kindness or empathy. Do something nice for someone who doesn’t expect it or imagine what would have motivated someone to act in the way they did that hurt you. Sadness A reflection that we’ve lost something we valued, we experience it when we lose a loved one and when we make a transition in our life leaving the past behind. When to Use It: When you’ve lost something that matters to you, sadness can be a cue to slow down and honor it. When it’s a person, a pet, a period of life, or a profession, listen to your solemn feelings and mark the occasion. Find meaning in what’s transpired and identify a way to carry that meaning forward into your future. When to Lose It: When sadness cripples you, you may be experiencing a bout of depression. While physical exercise and social contact can help, it may be difficult to get yourself going. Try taking a small step that feels manageable, and focus on what helps you feel better. If a deep sadness persists and is affecting your ability to manage daily tasks, consult a healthcare professional. Shame Often a painful emotion that hangs on, shame reflects an evaluation that something is fundamentally wrong with us and that we don’t measure up to other people. When to Use It: A smidge of guilt, when it’s warranted, is exactly the humble pie we need. It forces us to reevaluate our own actions, which may have hurt others, and to apologize and make amends. Take this as a sign that you care about the situation and do your best to fix it. When to Lose It: Feeling insecure, inadequate, or worse is the best way to crush a good mood. If you are questioning your own abilities or value, take stock that something in your life is truly bothering you, but this emotion isn’t helping. Focus on your strengths to build confidence. Do something you know you can accomplish to create positive momentum. Or try these tips for turning your insecurities into inspiration. For activities and games to help you
conquer negativity in your life, visit Happify.com or
download the iPhone or Android app. Do's
and Don't's of Dealing With Anger We all experience anger. Managed in healthy ways, anger can be a positive thing -- a red flag that something’s wrong, a catalyst for change, a good self-motivator. Handled poorly, anger can cause health and relationship problems. (See this article for more on the negative effects of anger.) For many, especially those who didn’t have positive role models for anger management while growing up, dealing with anger can be confusing; it’s hard to know what to do with such a powerful and potentially destructive emotion. Examining your anger and using other anger management techniques can positively impact your health, relationships and overall happiness. It's simple to do. Here are some proven anger management strategies. Understand Your Anger Dealing with anger is much easier when you know what you’re really angry about. Sometimes people may feel generally irritable because of stress, sleep deprivation, and other factors; more often, there’s a more specific reason for the anger. Either way, you can become more aware of what’s behind your anger if you keep an anger journal (a record of what makes you angry throughout the day) for a few weeks, then talk it over with a good friend, or even see a therapist to uncover underlying sources of anger, if you find yourself stumped. Once you are more aware of your sources of anger, you can take steps to deal with it. Express Yourself—Constructively Research shows that writing about anger and expressing it constructively can help reduce negative mood and even pain, particularly if the writing leads to ‘meaning-making,’ or speculation into the causes of the anger. This research, as well as other research on the benefits of journaling, supports the effectiveness of writing down your feelings and working through them on paper. The written expression of anger allows you to actively do something with your anger rather than just letting it make you feel bad. Take Action Your anger is telling you something. The first part of dealing with anger, as discussed, is examining it and listening to what it’s telling you about your life. The next part involves taking action. Knowing why you’re upset can go a long way, but eliminating your anger triggers and fixing problems that make you angry are equally important. You may not be able to eliminate everything in your life that causes you anger and frustration, but cutting out what you can should go a long way. Don’t Obsess Ruminating on your anger isn’t actually helpful. Studies show that, among other things, those who have a tendency to ruminate over situations that have made them angry in their past tend to experience higher blood pressure as a result, putting them at greater risk for organ damage and associated health problems. Trying to solve a problem is a good idea, but stewing in your anger is not. Don’t Over-talk It Discussing your anger is a tricky thing. Talking about your anger with a trusted friend can be an effective strategy for dealing with anger -- to a point. It can help you better understand your feelings, brainstorm problem-solving strategies, and strengthen your relationship. However, there’s also evidence that repeatedly discussing topics that make you angry with your friends can actually make you both feel worse, and increase stress hormones in your blood. If you’re dealing with anger by talking to friends about it, it’s best to talk about a situation only once, exploring solutions as well as your feelings. Most of us --especially the women -- have been involved in conversations that are basically complaint sessions or downward spirals of negative emotion; it’s best to change the subject to a happier topic before it gets that far. If you find yourself wanting to talk a lot about what is making you angry, it might be a good idea to schedule a few sessions with a therapist, who may have some effective ideas on dealing with anger. Sources: Byrd-Craven J, Geary DC, Rose AJ, Ponzi D. Co-ruminating increases stress hormone levels in women. Hormones and Behavior, March 2008. Gerin W, Davidson KW, Christenfeld NJ, Goyal T, Schwartz JE. The role of angry rumination and distraction in blood pressure recovery from emotional arousal. Psychosomatic Medicine, January-February 2006. Graham JE, Lobel M, Glass P, Lokshina I. Effects of written anger expression in chronic pain patients: making meaning from pain. Journal of Behavioral Medicine, March 6, 2008. This article:
stress.about.com/od/stresshealth/a/dealing_anger.htm
Feelings when someone
dies Shock: It may take you a long time to grasp what has happened. The shock can make you numb, and some people at first carry on as if nothing has happened. It is hard to believe that someone important is not coming back. Many people feel disorientated - as if they have lost their place and purpose in life or are living in a different world. Pain: Feelings of pain and distress following bereavement can be overwhelming and very frightening. Anger: Sometimes bereaved people can feel angry. This anger is a completely natural emotion, typical of the grieving process. Death can seem cruel and unfair, especially when you feel someone has died before their time or when you had plans for the future together. We may also feel angry towards the person who has died, or angry at ourselves for things we did or didn’t do or say to the person before their death. Guilt: Guilt is another common reaction. People who have been bereaved of someone close often say they feel directly or indirectly to blame for the person’s death. You may also feel guilt if you had a difficult or confusing relationship with the person who has died, or if you feel you didn’t do enough to help them when they were alive. Depression: Many bereaved people experience feelings of depression following the death of someone close. Life can feel like it no longer holds any meaning and some people say they too want to die. Longing: Thinking you are hearing or seeing someone who has died is a common experience and can happen when you least expect it. You may find that you can't stop thinking about the events leading up to the death. "Seeing" the person who has died and hearing their voice can happen because the brain is trying to process the death and acknowledge the finality of it. Other people's reactions: One of the hardest things to face when we are bereaved is the way other people react to us. They often do not know what to say or how to respond to our loss. Because they don't know what to say or are worried about saying the wrong thing, people can avoid those who have lost someone. This is hard for us because we may well want to talk about the person who has died. It can become especially hard as time goes on and other people's memories of the person who has died fade. Further help Our booklet Restoring Hope gives more detail on how you may feel following a bereavement. Other publications are available from our online shop. You can find out more about what you can do to help yourself, and how Cruse can help in our section on supporting yourself through grief. We also have information on coping with particularly traumatic deaths or homicides, those in military families and children and young people. Grief is a natural process, and most
people will cope with help and support from family and
friends. For those who need additional specialist help,
Cruse offers free confidential support for adults and
children, and this can be by telephone, email or
face-to-face. Satisfied Men
Live Longer In a study of more than 22,000 adults in Finland, investigators found that men who reported high levels of satisfaction with their lives were more likely to be alive 20 years later. There was no association between life satisfaction and mortality for women, however. "It seems to me that the coping abilities of women with distress and dissatisfaction may be better than in men," the study's lead author, Dr. Heli Koivumaa-Honkanen, from the University of Turku in Finland. For example, men who feel dissatisfied might cope with their feelings by abusing alcohol, smoking and not exercising while women might talk to friends or seek professional help, she added. Life satisfaction refers to a sense of general well-being and takes into account a person's interest in life and their feelings of happiness and loneliness, the authors explain. Dissatisfied men were more than twice as likely to die of all causes than those who were satisfied with life, and more than three times as likely to die of a disease, the report indicates. Men who drank heavily were at even higher risk. Marriage, exercise, high social class, not smoking and drinking moderate amounts of alcohol diminished the risks somewhat, but the association between feeling satisfied and living longer remained. "Perhaps the coping capacity ... is not adequate in those men who are less able to create a stable intimate partnership or earn their living," Koivumma-Honkanen suggested. She added that it is not clear if these men had risky health behaviors already or whether they developed these behaviors later in life. The team also found that men were less satisfied than women overall. And men were more likely to smoke and drink alcohol, according to the report published in the American Journal of Epidemiology. Koivumma-Honkanen said the study findings underscore the importance of feeling satisfied -- particularly for men. "It is not enough for a human being to earn money and be in physically good condition. One should respect mental health as well," she said. Source: American Journal of
Epidemiology 2000;Suzanne Rostler, 152:983-991. Internet Makes
Men Happy, Survey Says The "Happiness Index" study also demonstrates that, collectively, women's happiest activity is spending time with family, an opinion shared by just 45-percent of men. While we are certainly in no position to criticize these Aussie Web-lovers (we do run a blog, after all), we believe we'd be remiss not to criticize the apparently pitiful number of family men Down Under. Then again, we're not sure if the stats would be that much better here in the states... Is playing online games really more satisfying than spending time with your children? For all those kids out there that find
themselves in this sort of predicament, fear not. If you hip
your daddy to some of these new widgets, he might just be
grateful enough to play a game of catch sometime. Forgiveness
As Salve for Sin From South Africa to the White House, from the Vatican to the Diocese of Oakland, everyone seems to be talking about forgiveness. Tomorrow, Roman Catholic Bishop John Cummins of Oakland will lead priests and nuns in an unprecedented liturgy in which they will stand before the victims of priestly sex abuse and seek God's forgiveness for their sins of church leaders. That ceremony comes two weeks after Pope John Paul II presided over a historic prayer service in St. Peter's Basilica in Rome, where the pontiff apologized for almost 2,000 years of church wrongdoing against Jews, women and other groups. But this tidal wave of repentance goes far beyond the Catholic Church. Nearly everywhere you look -- in courtrooms, the corridors of political power and the halls of academia -- forgiveness is hot. "This decade we are entering is going to be an age of reconciliation,'" said psychologist Everett Worthington, executive director of the Campaign for Forgiveness Research. "Forgiveness," Worthington said, "can do more than save your soul. It can save your life. We know that feeling hostile over a long period of time can contribute to heart disease. Not forgiving is stressful, and our immune systems do not work as well when we are under stress.'" The campaign, financed primarily by the John Templeton Foundation, has handed out $6 million for 32 studies on the psychological, spiritual and physical benefits of forgiving. Two of its research projects are under way at Stanford University. Worthington, a professor of psychology at Virginia Commonwealth University, traces the academic and popular interest in forgiveness back to a 1984 book by theologian Lewis Smedes, Forgive and Forget. South Africa's Example: During the 1990s, the world watched the power of forgiveness working through the South African Truth and Reconciliation Commission, which examined injustices committed during that nation's apartheid era. Anglican Archbishop Desmond Tutu of South Africa, along with former President Jimmy Carter, are among the five co-chairs of the forgiveness campaign. Worthington said another U.S. president has helped put forgiveness in the public spotlight. "Bill Clinton has done more for forgiveness research than anyone else in America,'" he quipped. Forgiveness is also at the center of "Jubilee 2000,'" a broad interfaith campaign that includes calling on international bankers and wealthier nations to forgive the crushing debts of Third World countries. Meanwhile, legal scholars are looking at what effect forgiveness -- or the reluctance of people to apologize -- has on the mountain of civil lawsuits burying the courts. Worthington said a task force in Washington, D.C. is studying whether a doctor's apology could be excluded as inadmissible evidence in medical liability cases. "Doctors who make medical mistakes say they can't apologize because of liability problems," Worthington said. "But one study showed that two-thirds of patients said they wouldn't sue if doctors weren't so arrogant and would just apologize." Much of the research on forgiveness confirms what many of the world's religious traditions have been saying for centuries: Confession, forgiveness and repentance are good for the soul. St. Peter's Ceremony: Earlier this month, Pope John Paul II made headlines around the world with a mea culpa proclaimed at Sunday Mass at St. Peter's Basilica. Yesterday, during a visit to the Yad Vashem Holocaust memorial in Jerusalem, the pope said the Roman Catholic Church is "deeply saddened'" by Christian persecution of Jews throughout history. San Francisco Archbishop William Levada said the pope is leading a worldwide Catholic initiative that seeks "atonement for sins and of reparation for past faults . . . committed in the name of the church through these past two millennia of Christianity. Only by asking pardon for our own sins do we dare to beg pardon for another's," said Levada, writing in today's issue of the weekly Catholic San Francisco newspaper. Not everyone is happy with the papal confession or his regrets uttered yesterday at the Holocaust memorial. Many Jewish leaders had hoped the pope would have specifically apologized for the public silence of Pope Pius XII during the Nazi slaughter of 6 million Jews during World War II. In his column today, Levada said the critics "in the religious community and the media are trying to 'demonize' Pius XII. It would be interesting to apply the criteria which some now suggest in regard to Pius to the activities -- or 'silence' -- of American government officials and policies, or of Jewish agencies and leaders in the United States during the same period," the archbishop writes. Victims of Sexual Abuse: Another group that has sought a more specific apology from church leaders are the victims of sexual abuse by priests. They will get just that in an extraordinary reconciliation service to be held at 1 p.m. tomorrow at Leona Lodge, 4444 Mountain Blvd., in Oakland. Victims of sexual abuse are invited to attend the service, which will be presided over by Cummins, the spiritual leader of Catholics in Alameda and Contra Costa counties. "We, as a church, were often negligent and did not respond to victims of sexual abuse appropriately," Cummins said. "The Diocese of Oakland has resolved not to repeat the evils of the past." In recent years, the Archdiocese of San Francisco, the Diocese of Santa Rosa and other church jurisdictions around the world have been scandalized by continuing revelations about the sexual abuse of children and teenagers by Catholic clergy. Terri Light, West Coast director of SNAP, the Survivors Network for Those Abused by Priests, praised Cummins and Sister Barbara Flannery, the chancellor of the Oakland Diocese, for "taking care of victims and being sure perpetrators are held accountable. This will help us heal," Light said of tomorrow's service. The ceremony will include responsive readings. For example, victims of sexual abuse will read, "We were treated as if we were the ones who had brought shame and embarrassment on the church." Church leaders will respond, "We were ashamed and afraid to know the horrible truth.. . . Even though the signs were right there before us, we did not recognize them." East Bay's Leadership: Light said she hopes the church in San Francisco and Santa Rosa will learn a lesson from their East Bay brethren. "We have a huge contingent coming over from San Francisco and Santa Rosa," Light said. "There is particular sensitivity in the Oakland Diocese. In San Francisco, they feel so dark. The church needs to be guided by its mission, not by its lawyers and insurance agents." Levada will lead a penance service at
10 a.m. April 8 at St. Mary's Cathedral, timed to coincide
with a National Day of Atonement called by the National
Conference of Catholic Bishops. Two days earlier, the
archbishop will gather his clergy at the National Shrine of
St. Francis in North Beach and "pray for atonement for the
past sins of priests." Maurice Healy, spokesman for the San
Francisco Archdiocese, said people should not expect the
pope or the archbishop to make specific apologies. "People
are missing the point. This is a prayer, and its offered on
behalf of all the members of the church," Healy said. "We
don't want to get into an argument over why this is on the
list and why that's not on the list. It's not a recitation
of specific offenses, but that doesn't mean its any less
sincere." www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2000/
How Do I Not
Trust Thee: Jealousy A Suspicious Letter Diane left some letters on the kitchen counter for me to mail, as she always does, and as I walked down the steps I quickly looked through them, as I always do. Among the endless bills was a hand-addressed envelope to a man at an address I didn't recognize in another state. I thought for a second about asking Diane who he was, but I didn't want to appear, y'know, suspicious. So instead I went down to my office and acted suspicious, searching the name and address on the Internet. I finally found him on a government scientific Web site. And while I tried not to jump to any conclusions, I couldn't get my mind to stop considering the possibility... Is my wife cheating on me with an algae researcher? I wrote down the name and address on a Post-it (easier to eat if I had to destroy the evidence), mailed the mail, and went about my business. For the next two days I thought about how to bring this up to Diane. Then I got an e-mail. It was from the researcher. Oh my god. I clicked it open and there was just one sentence: "Did you get the swizzle sticks yet?" That mystery letter? A check Diane had written for something I forgot that I'd bought on eBay. Okay, I'm an idiot. I'm also a jealous guy. Always have been. Probably always will be. If nearly 20 years of marriage to a woman who loves and completes me hasn't cured me, nothing will. Jealousy is one of the few emotions that husbands have always been expected to express. Unfortunately, most of us express it really badly -- often for absolutely no good reason, and sometimes with disastrous consequences. It might be the only emotion that wives wish husbands would suppress. After the swizzle stick episode, I started asking my basketball buddies about jealousy -- what Shakespeare called "the green-eyed monster which doth mock the meat it feeds on." (I didn't mention Shakespeare specifically because I didn't want anyone to throw the ball at my head. It was bad enough I was asking them to admit they actually had feelings.) I was most interested to hear from one guy because I knew he and his wife had just entered a scenario rife with betrayal possibilities. After many years of being home with their kids, his wife took a job at a small company with a lot of younger single people. I was at a party recently where I saw her with some of her new male colleagues. They flocked around her, almost flirtatiously, I thought. It actually made me feel a little jealous on my buddy's behalf. So I was amused by the way my friend denied the role of jealousy in his marriage. "Not as big a deal now as it was 20 years ago," he said, "but I've always had more to be jealous about than my wife, because she is a first-class flirt." Then he added, a bit irritably, as if the facts were irrefutably in his favor: "Look, her coworkers are all much younger and/or gay. And the one person she is hanging out with lots is 10 years younger, with a pregnant wife." Oh, okay. Good thing you're not feeling threatened. And, of course, guys never cheat on their pregnant wives. Why I'm a Jealous Guy How he stays calm I don't know. I get jealous over much less. I'm not what experts call "morbidly jealous" -- I don't get aggressive or have much of a temper. But I do feel more jealous than any happily married man should. And it comes out in all kinds of little ways I'm embarrassed to admit. Besides occasionally checking out the mail (or, okay, the cell phone bill), I definitely do the "husbandly hover." I pay a little too much attention to whom Diane talks with at parties, remaining far enough away to be inconspicuous but close enough to stealthily intercede in any conversation that seems suspiciously long. Why do husbands do this kind of stuff? During our first few years together I believed my actions were well-founded responses to something real -- perhaps a carryover from fighting off other suitors to win Diane's hand. Like many husbands, I felt I had married someone way better than I deserved and needed to diligently protect myself against losing her. I still feel that way and can see how Diane attracts people: She's smart and disarmingly funny and, at 50, still turns heads (sometimes all the way around) in just a T-shirt and jeans. But I have also come to understand that most of my jealousy is unfounded and unprovoked -- something I brought into the marriage, like that ugly brown sleeper sofa. According to social scientists, husbands and wives are jealous in different ways: Supposedly, men care more about sexual fidelity and women care more about emotional fidelity. And, in a more important sociological indicator -- bad movie dialogue -- it is usually "did you sleep with him?" versus "do you love her?" Now, I've always been troubled by this notion that men care more about possessing women than loving them, treating them like toys that nobody else can play with, while women will overlook sexual indiscretions as long as he loves her best. So I'm glad to report that recent studies show jealousy is becoming a more equal-opportunity obsession. Men are now scoring as more emotionally jealous than ever before, and women as more sexually jealous. Our worst relationship fears have all begun to even out. This could mean men are learning to love more or that women have finally wised up about the old "I slept with her but it didn't mean anything" line, or both. As for us, I consider myself lucky that after 20 years together my wife is still kind of flattered by how possessive I can be. Even now Diane recalls as "funny and cute" how, during our courtship, I used to show up "coincidentally" at restaurants where she was dining with friends. ("Funny and cute?" a friend of ours gasped when she later heard about my extreme wooing. "He was a stalker!") When I recently fessed up to Diane about the algae researcher incident, she found it "hilariously touching." I guess that's because she appreciates the upside of jealousy in a marriage. And no matter how many times she has to deal with me waiting up for her like some '60s sitcom dad on the few nights she goes out with the girls, I can think of only one thing worse for our relationship. And that would be if I stopped being so jealous. Source: By Stephen Fried.
Originally published in Ladies' Home Journal,
September 2006. lifestyle.msn.com/Relationships/CouplesandMarriage/ArticleLHJ.aspx?cp-documentid=939560
Taming The
Jealous Mistress I have reflected on my life over the past 10 years since starting my career in Medicine. For the most part I have given up the luxury of weekends off and 9 hour work days. I cannot even count the times I left the house at 600 AM, only to return exhausted at 900 PM, for 6 days straight. I used to think medical school was rough-only to find Residency 30-grit rougher. Not only is Medicine the ultimate time monger, but our work also involves great personal sacrifice…caring for others in need. It is very difficult to place into words how mentally and emotionally draining this care can be…particularly in the Emergency Department. Day in and day out we work in a fast paced pressure cooker. Here, our patients do not care about the type of day we are having; a dying patient need not to know that you are having marital problems, or that your kid is failing school. Many physicians have to completely compartmentalize their life from their work-your normal life gets shoved to the dark recesses of your mind for 12 hours. When leaving work after a draining shift-the reality of medicine, and the stress of your day dissipates, only to be met by your life’s real problems. As many physicians with problems outside of work admit-whether it is marital, drug or alcohol abuse,” they just do not have the energy to deal with their real problems.” They either turn to something else, or dig in deeper to their career. Everything about her is seductive: the time, the pressure, the stress, and the commitment. I think this is where the notion that Medicine is like a jealous mistress begins…and ends. I have come to realize that I, or any other physician, cannot blame our career on our life’s troubles. Sure the job demands much more than the average, but it is our choices which ultimately determine our happiness. I am reminded of a quote by the late John Candy: “Like your work, Love your wife.” Amen. I recently have had many new aspiring physicians ask me “how do you balance work and home life?” It is not easy. But priorities are paramount. I vowed early on that my wife and children will always be paramount-they are my number one, and my job will never replace them. I tell newer colleagues if they want to be surgeons, if they want to do research, if they want to be leaders of their chosen profession, that is wonderful….but these aspirations will require great sacrifice. Just do not sacrifice what is truly important-the ones who love you. Very few, tread in these waters and maintain the harmony between work and family life they or their families expect. “Medicine can be like a jealous
mistress if you are not careful Sean.” He was right,
you do have to be careful, but we are in control of our own
destiny. We choose our own priorities, and these dictate the
life will lead. After a grueling 12 hour day in the
Emergency Room-after the stress, the chaos, the heartache,
and triumph-I know at the end of it all, my wife and child
are waiting. Everything else melts away. The mistress once
again gets the boot. Childhood
Fears
Toxic
Emotions 8 Things Your Brain
Does Wrong Every Day But we're often unaware of the myriad little -- and big -- ways that our thinking is irrational and biased. To become the highly-evolved, rational creatures we are today, our brains evolved with certain handy shortcuts (known in psychology as cognitive biases) to help us identify threats and make quick judgments. And even in the modern world, where we don't face threats to our survival every day, they're still very much present, and they shape the way we experience the world and ourselves. "Humans suffer... the consequences of living in a time and place we didn't evolve to live in," neuroscientist Dean Buonomano, author of Brain Bugs: How The Brain's Flaws Shape Our Lives, told NPR. "And by peering into the brain, we can learn a lot about why we are good at some things and why we are not very good at others." Here are eight common thinking errors and cognitive biases that you may not even be aware of -- but that shape the way you view yourself and the world. We can't help but focus on the negative. According to psychologist Rick Hanson, author of Hardwiring Happiness, our brains are wired to scout for the bad stuff -- as he puts it, the brain is like velcro for negative experience and teflon for positive ones. The brain is constantly scanning for threats -- which of course was in our favor as we evolved -- and when it finds one, it isolates and fixates on the threat, sometimes losing sight of the big picture. And even though we no longer deal with the threat of being eaten by wild animals in our daily lives, our brain hasn't let go of its sensitivity to perceived threats, even if they come in the form of an email from your boss. This threat-awareness creates a "negativity bias" which causes the brain to react very intensely to bad news in comparison to how it responds to good news. Because negative experiences affect us so much more powerfully, research has even shown that strong, long-lasting relationships require a five to one ratio of positive to negative interactions in order to thrive. "We've got this negativity bias that's a kind of bug in the stone-age brain in the 21st century," Hanson told The Huffington Post last year. "It makes it hard for us to learn from our positive experiences, even though learning from your positive experiences is the primary way to grow inner strength." We see patterns where there are none. One of the most basic thinking mistakes is called Type 1 Error, which is believing a false hypothesis to be true, often by mistaking correlation (or lack thereof) for causality. (This is one explanation for why we love coincidences so much.) While it does lead to thought errors, thinking this way may have given us an evolutionary advantage. "Causal thinking evolved because it allows people to understand and control their environment, i.e. to be able to predict that, for example, if you eat a red mushroom you will die," writes an Oxford University Press psychology textbook. "This causal thinking is adaptive but may sometimes lead to Type 1 errors –- where you believe something is true when it isn’t, for example you believe that tying your shoes laces twice causes luck." This tendency to seek out connections and patters in random information is what's known as apophenia. This inclination plays out in a number of different ways, from spotting coincidences to conspiracy theories to finding hidden codes or significance in numbers or text. And yet we don't see what's right in front of us. Think you're present and mindful to your environment? While it may be true to a certain extent, you're probably not as aware as you think. In a now-famous 1998 study, researchers from Harvard and Kent State University targeted college campus pedestrians to see how much they noticed about their immediate surroundings. In the experiment, an actor approached one of the pedestrians and asked for directions, and while the pedestrian was giving the directions, two men carrying a large wooden door walked between the actor and the pedestrian, completely blocking their view of one another for several seconds. During that time, the actor was replaced by an actor of different height and build, complete with a different outfit, haircut and voice. Roughly half of the participants did not notice the substitution. The experiment illustrates the phenomenon of "change blindness," which shows just how selective we are about what we take in from a visual scene. It seems that we rely on memory and pattern-recognition (going back to Type 1 Error) significantly more than we think we do, and that our visual perception may not be as reliable as we think. We're heavily biased towards things that agree with us. Our brains have quite a distaste for conflict and disagreement -- and they'll go to great lengths to avoid it. For this reason, we naturally gravitate towards things that we agree with or that reinforce our existing beliefs, and avoid those that oppose any of our beliefs. Cognitive dissonance -- a psychological term coined in the 1950s to refer to this innate distaste -- leads us to the brain's confirmation bias, a tendency to search only for information that confirms our hypothesis, while ignoring information that refutes or challenges it. This is often why we have such a hard time changing our mind about things -- it's mentally taxing and confusing for us to let go of what we think we know and start collecting evidence for a new hypothesis. But this bias can lead us into error in work, life and politics. "Paradoxically, the Internet has only made this tendency even worse," the blog io9 notes. And it's true: Whatever your political or religious beliefs (or your stance on anything, really) it's easy to find the information that tells you you're right -- and to simply tune out the rest. We put ourselves under a harsh spotlight. Did you ever have something mortifying happen to you in high school, after which your mother advised you to stop panicking, because "People don't notice the little things you do wrong because they're too busy worrying about themselves." Turns out, she was onto something. We do tend to magnify our mistakes and flaws, thinking that people are paying more attention to them than they really are. This is referred to in psychology as "Spotlight Effect" -- our tendency to think that other people notice things about us more than they actually do, a phenomenon that's been demonstrated time and again in social psychology experiments. The effect is basically the result of our naturally egocentric worldview, explains psychologist Nathan Heflick. "We all are the center of our own universes," Heflick wrote in Psychology Today. "This is not to say we are arrogant, or value ourselves more than others, but rather, that our entire existence is from our own experiences and perspective.... But other people not only lack the knowledge of, for instance, the stain that you have, but they are the center of their own universes too, and in turn, are focused on other things." Our choices are highly subject to a number of biases. In American consumer culture, we're faced with a feast of choices for even the most mundane decisions -- we can choose from 35 types of toothpaste at the drugstore, pick a shirt from the 50 hanging in our closet, select a movie to watch from the hundreds available on Netflix, and the options for what to tweet or share on Facebook are practically infinite. And despite the illusion of freedom, all of these choices may be skewing our decisions and leading our minds into error. Having too many options creates a sort of paralysis, according to psychologist Barry Schwartz. Sometimes, having too many options keeps us from making any decisions at all. And when we do settle on something, we're more likely to regret or be disappointed by it. "It's easy to imagine that you could have made a decision that would have been better," Schwartz said in a popular TED talk. "This regrets subtracts from the satisfaction that you would have gotten out of the decision you made, even if it was a good decision. The more options there are, the easier it is to regret anything at all that is disappointing." And what's more, Schwartz explains, the way we measure the value of things is by comparing them to other things. And when there are lots of things to compare something to, we tend to imagine the attractive features of those other things, diminishing the perceived value of the thing we have. It's a sort of grass-is-always-greener syndrome that keeps us from viewing our choices objectively. We can't trust our memories. Most of us would like to think that we recall past events with accuracy -- but we don't need psychologists to tell us that in reality, our memory is highly fallible and subject to a laundry list of biases and errors. Eyewitness testimonials are notoriously unreliable, as extensive research has found. One study even demonstrated that 25 percent of people could be induced to remember events that never even happened to them. One common error is allowing our view of the past to be colored by our emotions in the present. Just broke up with your boyfriend? Your entire relationship history may start to look pretty grim. Just got a promotion? That grueling, soul-sucking first job suddenly looks like a valuable stepping-stone to bigger and better things. As the band Oasis said, "Don't look back in anger" -- because your anger, or any other emotion you're experiencing, will change the way you think about the past. As Buonomano explained to NPR: "One type of memory error that we make -- a memory bug -- is really a product of the fact that in human memory, there's no distinction between storage and retrieval. So when a computer writes something down, it has one laser that's used to store the memory and another laser to retrieve the memory, and those are very distinct processes. In human memory, the distinction between storage and retrieval is not very clear, and this can have very dramatic consequences. ... The act of retrieving a memory can affect the storage." We're (too) partial to our own kind. Both historical events and everyday
experience demonstrate, again and again, our favoritism
towards members of our own social groups. Human beings have
a well-documented cognitive bias towards members of their
own clans (real or imagined), and this even goes beyond
ethnic, social or nationality groupings. Psychologists have
found in-group bias to exist even among randomly-assigned
groups. Favoritism of our own can sometimes, although not
necessarily, lead to judging, stereotyping and hostility
towards other groups. How
shame has evolved Shaming was a prominent part of the punishment process well after medieval times, said Peter Stearns, a historian at George Mason University. The best-known example comes from American fiction in the form of "The Scarlet Letter," penned by Nathaniel Hawthorne in 1850. But the history books are also replete with accounts of criminals being locked in stocks or pillories for public humiliation, and of kids being forced to wear dunce caps in school. By the end of the 19th century, stocks were banned as an instrument of punishment throughout the United States. Public shaming has also fallen out of favor as a childrearing strategy, at least in Western societies. "There's still lots of humiliation in schools, but there are no codified practices," Stearns told NBC News. Several reasons have been proposed for the decline of shaming: One is that modern Western communities are less cohesive than they were in past centuries — which dilutes the impact of humiliation. That's not to say that the shame game has ended. "The complexity is that over the past couple of decades, public shaming has made something of a comeback," Stearns said. For example, some defendants have been sentenced to hold up signs in public saying "I Stole Mail," or "I Am a Thief," or "I Stole From a 9-Year-Old on Her Birthday." Meanwhile, social media networks have provided new avenues for public shaming. Stearns pointed to the case of Nobel-winning biochemist Tim Hunt, who was pilloried last week for sexist remarks about "the trouble with women" in science labs. "This guy was shamed and degraded in two days," Stearns said. Does shame work? Amid all the ups and downs in public shaming, experts say there's been precious little research into the efficacy of the technique. One of the standout studies was conducted by a team led by psychologist June Tangney, a colleague of Stearns' at George Mason University. "Although shame is effective for punishing people, it's not clear that it helps them avoid doing harm in the future," Tangney told NBC News. She and her co-authors tested more than 400 prison inmates on their feelings of guilt ("I did a bad thing") vs. shame ("I'm a bad person") — and correlated the results with their likelihood to reoffend within a year. The researchers found that inmates who blamed others for their sense of shame were most likely to return to a life of crime. If the inmates accepted blame for their humiliation, they were less likely to get into trouble. Tangney said punishments that emphasize guilt and making things right appeared to be still more effective. "There are judges who are understandably trying to experiment with alternative punishments, because the current system isn't working very well," she said. "But I think public shaming is going down the wrong path. Community service sentences seem to be more likely to produce the desired result." Would Cersei repent her ways if she
were sentenced to community service? It's unlikely,
considering how things work in "Game of Thrones." But who
knows? George R.R. Martin still has time to write that plot
twist into his next book. Anxiety
Disorders and Anxiety Attacks It’s normal to feel anxious when facing a challenging situation, such as a job interview, a tough exam, or a blind date. But if your worries and fears are preventing you from living your life the way you’d like to, you may be suffering from an anxiety disorder. There are many different types of anxiety disorders—and many effective treatments and self-help strategies. Once you understand your anxiety disorder, there are steps you can take to reduce your symptoms and regain control of your life. When does anxiety become a disorder? Anxiety is the body’s natural response to danger, an automatic alarm that goes off when you feel threatened, under pressure, or are facing a stressful situation. In moderation, anxiety isn’t always a bad thing. In fact, anxiety can help you stay alert and focused, spur you to action, and motivate you to solve problems. But when anxiety is constant or overwhelming—when it interferes with your relationships and activities—that’s when you’ve crossed the line from normal anxiety into the territory of anxiety disorders. Do you have an anxiety disorder? If you identify with any of the following 7 signs and symptoms, and they just won’t go away, you may be suffering from an anxiety disorder:
Signs and symptoms of anxiety disorders Because anxiety disorders are a group of related conditions rather than a single disorder, they can look very different from person to person. One individual may suffer from intense anxiety attacks that strike without warning, while another gets panicky at the thought of mingling at a party. Someone else may struggle with a disabling fear of driving, or uncontrollable, intrusive thoughts. Yet another may live in a constant state of tension, worrying about anything and everything. But despite their different forms, all anxiety disorders share one major symptom: persistent or severe fear or worry in situations where most people wouldn’t feel threatened. Emotional symptoms of anxiety In addition to the primary anxiety symptoms of irrational and excessive fear and worry, other common emotional symptoms include:
Anxiety is more than just a feeling. As a product of the body’s fight-or-flight response, anxiety involves a wide range of physical symptoms. Because of the numerous physical symptoms, anxiety sufferers often mistake their disorder for a medical illness. They may visit many doctors and make numerous trips to the hospital before their anxiety disorder is discovered. Common physical symptoms of anxiety include:
Anxiety attacks and their symptoms Anxiety attacks, also known as panic attacks, are episodes of intense panic or fear. Anxiety attacks usually occur suddenly and without warning. Sometimes there’s an obvious trigger—getting stuck in an elevator, for example, or thinking about the big speech you have to give—but in other cases, the attacks come out of the blue. Anxiety attacks usually peak within 10 minutes, and they rarely last more than 30 minutes. But during that short time, the terror can be so severe that you feel as if you’re about to die or totally lose control. The physical symptoms of anxiety attacks are themselves so frightening that many people believe they’re having a heart attack. After an anxiety attack is over, you may be worried about having another one, particularly in a public place where help isn’t available or you can’t easily escape. Symptoms of an Anxiety Attack Surge of overwhelming panic Feeling of losing control or going crazy
It’s important to seek help if you’re starting to avoid certain situations or places because you’re afraid of having a panic attack. The good news is that panic attacks are highly treatable. In fact, many people are panic free within just 5 to 8 treatment sessions. Types of anxiety disorders There are six major types of anxiety disorders, each with their own distinct symptom profile: generalized anxiety disorder, anxiety attacks (panic disorder), obsessive-compulsive disorder, phobia, social anxiety disorder, and post-traumatic stress disorder. Generalized anxiety disorder If constant worries and fears distract you from your day-to-day activities, or you’re troubled by a persistent feeling that something bad is going to happen, you may be suffering from generalized anxiety disorder (GAD). People with GAD are chronic worrywarts who feel anxious nearly all of the time, though they may not even know why. Anxiety related to GAD often shows up as physical symptoms like insomnia, stomach upset, restlessness, and fatigue. Anxiety attacks (Panic disorder) Panic disorder is characterized by repeated, unexpected panic attacks, as well as fear of experiencing another episode. A panic disorder may also be accompanied by agoraphobia, which is the fear of being in places where escape or help would be difficult in the event of a panic attack. If you have agoraphobia, you are likely to avoid public places such as shopping malls, or confined spaces such as an airplane. Obsessive-compulsive disorder Obsessive-compulsive disorder (OCD) is characterized by unwanted thoughts or behaviors that seem impossible to stop or control. If you have OCD, you may be troubled by obsessions, such as a recurring worry that you forgot to turn off the oven or that you might hurt someone. You may also suffer from uncontrollable compulsions, such as washing your hands over and over. Phobias and irrational fears Phobia A phobia is an unrealistic or exaggerated fear of a specific object, activity, or situation that in reality presents little to no danger. Common phobias include fear of animals (such as snakes and spiders), fear of flying, and fear of heights. In the case of a severe phobia, you might go to extreme lengths to avoid the thing you fear. Unfortunately, avoidance only strengthens the phobia. Social anxiety disorder and social phobia Social anxiety disorder If you have a debilitating fear of being seen negatively by others and humiliated in public, you may have social anxiety disorder, also known as social phobia. Social anxiety disorder can be thought of as extreme shyness. In severe cases, social situations are avoided altogether. Performance anxiety (better known as stage fright) is the most common type of social phobia. Post-traumatic stress disorder Post-traumatic stress disorder (PTSD) is an extreme anxiety disorder that can occur in the aftermath of a traumatic or life-threatening event. PTSD can be thought of as a panic attack that rarely, if ever, lets up. Symptoms of PTSD include flashbacks or nightmares about what happened, hypervigilance, startling easily, withdrawing from others, and avoiding situations that remind you of the event. Self-help for anxiety Not everyone who worries a lot has an anxiety disorder. You may be anxious because of an overly demanding schedule, lack of exercise or sleep, pressure at home or work, or even from too much coffee. The bottom line is that if your lifestyle is unhealthy and stressful, you’re more likely to feel anxious—whether or not you actually have an anxiety disorder. So if you feel like you worry too much, take some time to evaluate how well you’re caring for yourself. Do you make time each day for relaxation and fun?
If your stress levels are through the roof, stress management can help. There may be responsibilities you can give up, turn down, or delegate to others. If you’re feeling isolated or unsupported, find someone you trust to confide in. Just talking about your worries can make them seem less frightening. Anxiety self-help tips
When to seek professional help for anxiety While self-help coping strategies for anxiety can be very effective, if your worries, fears, or anxiety attacks have become so great that they’re causing extreme distress or disrupting your daily routine, it is important to seek professional help. If you’re experiencing a lot of physical anxiety symptoms, you should start by getting a medical checkup. Your doctor can check to make sure that your anxiety isn’t caused by a medical condition, such as a thyroid problem, hypoglycemia, or asthma. Since certain drugs and supplements can cause anxiety, your doctor will also want to know about any prescriptions, over-the-counter medications, herbal remedies, and recreational drugs you’re taking. If your physician rules out a medical cause, the next step is to consult with a therapist who has experience treating anxiety disorders. The therapist will work with you to determine the cause and type of your anxiety disorder and devise a course of treatment. Treatment for anxiety disorders Anxiety disorders respond very well to therapy—and often in a relatively short amount of time. The specific treatment approach depends on the type of anxiety disorder and its severity. But in general, most anxiety disorders are treated with behavioral therapy, medication, or some combination of the two. Therapy for anxiety disorders The following types of therapy can help with issues such as panic attacks, generalized anxiety, and phobias. Cognitive-behavior therapy focuses on thoughts—or cognitions—in addition to behaviors. In anxiety treatment, cognitive-behavioral therapy helps you identify and challenge the negative thinking patterns and irrational beliefs that fuel your anxiety. Exposure therapy for anxiety disorder treatment encourages you to confront your fears in a safe, controlled environment. Through repeated exposures to the feared object or situation, either in your imagination or in reality, you gain a greater sense of control. As you face your fear without being harmed, your anxiety gradually diminishes. Cognitive-behavioral therapy and exposure therapy are types of behavioral therapy, meaning they focus on behavior rather than on underlying psychological conflicts or issues from the past. Medication for anxiety disorders If you have anxiety that’s severe enough to interfere with your ability to function, medication may help relieve your symptoms. However, anxiety medications can be habit forming and cause unwanted side effects, so be sure to research your options. Many people use anti-anxiety medication when therapy, exercise, or self-help strategies would work just as well or better—minus the side effects and safety concerns. It’s important to weigh the benefits and risks of anxiety medication so you can make an informed decision. More help for anxiety How to Stop Worrying: Self-Help Tips for Relieving Anxiety, Worry, and Fear Therapy for Anxiety Disorders: Treating Your Anxiety with CBT and Other Therapy Options Anxiety Medication: What You Need to Know About Anti-Anxiety Drugs Resources and references Support organizations for anxiety disorders National Alliance on Mental Illness Information Helpline – Trained volunteers can provide information, referrals, and support for those suffering from anxiety disorders in the U.S. Call 1 (800) 950-NAMI (6264), Monday through Friday, 10 am-6 pm, Eastern time. (NAMI) Find a Therapist – Search for anxiety disorder treatment providers in the U.S. and find advice on selecting the right doctor or therapist. (Anxiety Disorders Association of America) Support Groups – List of support groups in the U.S., Canada, Australia, and South Africa. (Anxiety and Depression Association of America) Anxiety UK – Information, support, and a dedicated helpline for UK sufferers and their families. (Anxiety UK) Sangath, India – Non-profit, non-government organization providing mental health services in Goa, India. (Sangath) Anxiety Disorders, Canada – Provides links to services in different Canadian provinces. (Anxiety Disorders Association of Canada) SANE Helpline – Provides information about symptoms, treatments, medications, and where to go for support in Australia. Call: 1800 18 7263. (SANE Australia). Signs and symptoms of anxiety attacks and anxiety disorders Anxiety Disorders – Guide to the different types of anxiety disorders, their symptoms, and how to get help. (National Institute of Mental Health) Treatment options Anxiety Treatment Options – Article looks at the many treatment options for anxiety, including exercise and breathing techniques. (Better Health Channel) Psychotherapy
and Other Treatments –
Overview of therapies and complementary treatments for
anxiety. (University of Maryland Medical Center) Handling
Special Occasions Consider Whether Usual Traditions May Be Comforting or Challenging Some people find comfort in keeping their usual traditions but adapting them in some way, while others cannot imagine carrying on with their usual traditions. There is no right or wrong here — just what works for you. It is okay to take a year off from your usual traditions and decide next year if you will resume them. Keep Traditions, or Start New Ones If holding to longstanding traditions proves too painful, consider developing new family traditions. For example, if you used to cook holiday meals, make dinner into a potluck instead. Anticipating the Event Can Be Harder than the Event Itself Know that worrying about the event in the time leading up to the event is often more difficult than the event itself. Feeling anxious about a coming event does not mean the event itself will be difficult. It may be helpful to let supportive people in your life know that you are concerned about how the day will be, so they can help you figure out what may be most helpful to you. Communicate Your Needs In Advance Friends and family often want to be helpful but may need to be told what they need to do to be supportive. If you find it comfortable to talk about your loved one, or would rather grieve in a private way, talk openly with them in advance so that everyone knows what to expect. Ask them to check in with you throughout the day, if needed, and to take care of tasks that will help to reduce your stress levels. Take a Break If Needed If the event proves to be too much, talk a short walk. Make sure you have a way to leave early if you need to. Sometimes having an exit strategy can make you feel more at ease, whether you need to use it or not. If you do, communicate it to someone supportive so they know that you are okay and just in need of a break. If you are not feeling okay, it may be better to find someone to talk with privately to decide whether leaving the event would be most helpful. You may also identify someone you can call from the event if you need to, and let them know in advance you may call them if you are having a hard time. Consider Traveling If you have friends or family living in a different city, consider visiting them – a change in scenery might be helpful. Some people find planning a trip or travel gives them something else to focus on than the date itself. Volunteering is a Great Way to Heal Look online for volunteering opportunities in your area. Many people find meaning in helping others, and it’s a great way to honor your loved one or to acknowledge an important date. Sometimes Special Occasions are Just Difficult Even without the loss of a loved one, occasions like holidays can be stressful. Do the best you can, and remember that healing takes time, and the experience is different for everyone. How you feel this year may not be how you feel in future years — take it one occasion at a time. Take Care of Yourself Get enough sleep, eat well, drink
plenty of water, refrain from or limit alcohol intake, and
practice healthy self-care. Getting a regular form of
exercise, or using activities like yoga and meditation, may
help to reduce your stress during this difficult time.
Engage in activities that feel restorative to you. Strees
and Coping - CDC Everyone reacts differently to stressful situations. How you respond to the outbreak can depend on your background, the things that make you different from other people, and the community you live in. People who may respond more strongly to the stress of a crisis include
Stress during an infectious disease outbreak can include
People with preexisting mental health conditions should continue with their treatment and be aware of new or worsening symptoms. Additional information can be found at the Substance Abuse and Mental Health Services Administration (SAMHS) website. Taking care of yourself, your friends, and your family can help you cope with stress. Helping others cope with their stress can also make your community stronger. Things you can do to support yourself
Call your healthcare provider if stress gets in the way of your daily activities for several days in a row. Reduce stress in yourself and others Sharing the facts about COVID-19 and understanding the actual risk to yourself and people you care about can make an outbreak less stressful.. When you share accurate information about COVID-19 you can help make people feel less stressed and allow you to connect with them. Learn more about taking care of your emotional health. For parents Children and teens react, in part, on what they see from the adults around them. When parents and caregivers deal with the COVID-19 calmly and confidently, they can provide the best support for their children. Parents can be more reassuring to others around them, especially children, if they are better prepared. Not all children and teens respond to stress in the same way. Some common changes to watch for include
There are many things you can do to support your child
Learn more about helping children cope. For responders Responding to COVID-19 can take an emotional toll on you. There are things you can do to reduce secondary traumatic stress (STS) reactions:
Learn more tips for taking care of yourself during emergency response. For people who have been released from quarantine Being separated from others if a healthcare provider thinks you may have been exposed to COVID-19 can be stressful, even if you do not get sick. Everyone feels differently after coming out of quarantine. Some feelings include :
Children may also feel upset or have other strong emotions if they, or someone they know, has been released from quarantine. You can help your child cope. Resources For Everyone Coping with a Disaster or Traumatic Event For Communities
For Families and Children
For First Responders Emergency Responders: Tips for taking care of yourself Disaster Technical Assistance Center (SAMHSA) Siurce: www.cdc.gov/coronavirus/2019-ncov/prepare/managing-stress-anxiety.html Managing
Grief During a Pandemic Grief can be messy. It’s not linear, as in, “when I get through this particular feeling, I’m done with that.” It is cyclical and lingers around important events, words not said, certain songs, and moments captured like photographs in our minds. It is a place we can choose to visit or ignore, though it resides in the background as if waiting for us to notice. If you are experiencing grief right now, here are some things you might remind yourself: 1. There are different ways to say goodbye. Unexpected endings tend to bring strong emotions, often anchored in both the present and the past, when we may have felt abandoned or left behind. There are different ways to say goodbye. Write a letter to your loved one, even if you end up being the only one who sees it. If your loved one has died or is in a place you can’t visit, hold an intention for them in your mind, and say it aloud as you think of them throughout the day. One of my favorites is, “May you feel my love for you and be surrounded by peace.” 2. The last sentence of the book doesn’t rewrite the entire story.” Years ago, following the loss of someone dear to me, a wise person shared these words with me. It reminded me that even though I was unable to be with my loved one when he died, I had a book full of lines to draw upon that were the story of our life together and of our relationship. Many of those lines were expressions of our love, moments we shared together, conversations and memories. Remembering these feelings and these moments is how we get a sense of who the individual was; who we were with them; and what the relationship was—all of which surpasses their final moments. Right now is a good time to reflect on those earlier, better memories as best as you can, to remind yourself of the full picture of their lives and your connection. 3. Connections can deepen over time, even after loss. My father died 14 years ago this week. In the early days and weeks following his death, all I could remember was the image of him sick, and the trauma I associated with that. As time passed, my memories of him unexpectedly became richer and more accessible than they were in those early days. The images of him being sick began to fade away. I can now more easily remember his laugh and his jokes, and recognize the similarity between my daughter’s eyes and his. I also feel more connected to how he must have felt as a parent, now that I am one, myself. These are newer, deeper connections to my father, ones I couldn’t have anticipated at the time he died. 4. You are not alone in your grief. Know that others are also experiencing grief right now, and that there is support available. Online grief support, and grief support provided by mental health professionals, hospice centers and faith groups are all accessible to you, many via telehealth and other virtual platforms. You can learn about options for grief support by connecting to your local mental health providers, faith organizations or hospice, or through one of the following national resources: National Suicide Prevention Lifeline: 1800 273-TALK (8255); Crisis Text Line: text SOS to 741741. If you are struggling with the loss of a loved one to suicide, even one that occurred prior to COVID-19, Please know, at this time, that others
who have traveled the roads of grief are here for you and
can serve as guides. Look to them for hope, healing and
comfort during this difficult time, and know that days are
ahead of you in which the intensity of your grief will be
lessened, and replaced by loving
memories. Therapists
Learn How To Help Farmers Cope With Stress Before It’s
Too Late - 6/25/24 The farmers’ co-op here is a center of hope every spring. It’s where farmers buy seed and fertilizer for the summer’s crops, and where they seek tips to maximize their harvest of corn and soybeans. But on a recent morning, a dozen mental health professionals gathered at the Key Cooperative Agronomy Center to discuss why so many farmers quietly struggle with untreated anxiety and depression. Studies have concluded that suicide is unusually common among farmers. Researchers believe it’s not just because many farmers have other risk factors, such as rural addresses and access to guns. The tragic trend has caught the attention of the U.S. Department of Agriculture, which sponsors training sessions like the one in Grinnell to help health care professionals learn how to talk to farmers about the pressures they face in wringing a living out of the land. “A lot of them are born to it. They don’t have any choice,” family therapist David Brown explained to the session’s participants. He noted many farms have been passed down for generations. Current owners feel that if they fail, they would be letting down their grandparents, parents, children, and grandchildren. Brown, who works for Iowa State University Extension and Outreach, led the training in Grinnell. He said farmers’ fate hinges on factors out of their control. Will the weather be favorable? Will world events cause prices to soar or crash? Will political conflicts spark changes in federal agricultural support programs? Will a farmer suffer an injury or illness that makes them unable to perform critical chores? Brown said surveys show many farmers are reluctant to seek mental health care, partly because they think therapists or doctors couldn’t understand their lives. Tina Recker, a mental health therapist in northeastern Iowa, attended the training session. She has lived on farms, and she has seen how the profession can become a person’s entire identity. “It’s just farm, farm, farm, farm,” she told the group. “If something goes wrong with it, that’s your whole world.” It’s difficult to estimate how much of farmers’ increased risk of suicide is due to their profession. Part of the reason for the elevated rate could be that many farmers are middle-aged or older men, who tend to be more at risk in general. “But it’s broader than that for sure,” said Edwin Lewis, a USDA administrator who helps oversee efforts to address the situation. The Grinnell training session was part of a federal program called the Farm and Ranch Stress Assistance Network. Lewis said the program, which also funds counseling hotlines and support groups, spends $10 million a year. Jason Haglund sees the issue from multiple angles. He’s a mental health advocate who farms part-time near the central Iowa town of Boone. He and his brother-in-law raise corn and soybeans on the 500-acre farm where Haglund grew up. His family has farmed in the area since the 1880s. His parents hung on despite going into bankruptcy during the 1980s farm crisis, and he embraces his role as caretaker of their legacy. Haglund is trained as an alcohol and drug addiction counselor, and he co-hosts an Iowa podcast about the need to improve mental health care. He said it can be stressful to run any kind of family business. But farmers have a particularly strong emotional tie to their heritage, which keeps many in the profession. “Let’s be honest: Farming at all these days isn’t necessarily a good financial decision,” he said. Farmers traditionally have valued self-sufficiency, he said. They try to solve their own problems, whether it’s a busted tractor or a debilitating bout of anxiety. “With the older generation, it’s still, ‘Suck it up and get over it,’” Haglund said. Many younger people seem more willing to talk about mental health, he said. But in rural areas, many lack access to mental health care. Farmers’ suicide risk is also heightened by many of them owning guns, which provide an immediate means to act on deadly impulses, Haglund said. Guns are an accepted part of rural life, in which they are seen as a useful tool to control pests, he said. “You can’t go into a rural community and say, ‘We’re going to take your guns away,’” he said. But a trusted therapist or friend might suggest that a depressed person temporarily hand over their guns to someone else who can safely store them. Haglund said health care professionals shouldn’t be the only ones learning how to address mental stresses. He encourages the public to look into “mental health first aid,” a national effort to spread knowledge about symptoms of struggle and how they can be countered. A 2023 review of studies on farmer suicides in multiple countries, including the U.S., cited cultural and economic stresses. “Farmers who died by suicide, particularly men, were described as hard-working, strong, private people who took great pride in being the stoic breadwinners of their families. They were often remembered as members of a unique and fading culture who were poorly understood by outsiders,” wrote the authors, from the University of Alberta in Canada. Rebecca Purc-Stephenson, a psychology professor who helped write the paper, said health professionals face two challenges: persuading farmers to seek help for mental stress, then encouraging them to keep coming back for therapy. Back at the training in Iowa, instructors urged mental health professionals to have flexible schedules, and to be understanding when farmers postpone appointments at the last minute. Maybe one of their animals is sick and needs attention. Maybe a machine broke and needs to be fixed immediately. Maybe the weather is perfect for planting or harvesting. “Time is money,” said Brown, the therapist leading the training. The session’s lessons included what to ask and not ask when meeting farmers. A big no-no is inquiring right away about how much land they are working. “If you ask them how many acres they’re farming, that’s like asking to see their bank account,” warned Rich Gassman, director of Iowa’s Center for Agricultural Safety and Health, who assisted with the lesson. It would be better to start by asking what they enjoy about farming, the instructors said. Many farmers also need to talk through emotional issues surrounding when, how, or even if the next generation will take over the family operation. Tim Christensen, a farm management specialist for Iowa State University Extension and Outreach, said some standard advice on how to deal with stress could backfire with farmers. For example, he said, a health care professional should never advise a farmer to relax by taking a couple of weeks off. Most of them can’t get away from their responsibilities for that long, he said. “There’s a common saying on the farm: No good vacation goes unpunished.” Warning Signs of Mental Struggle The American Foundation for Suicide Prevention lists these signs that a person might be considering suicide:
What
Do Farmers Need for Suicide Prevention: Considerations for a
Hard-to-Reach Population - 6/25/24 Purpose Farmers have suicide rates much higher than the general population, with elevated mental health symptoms and high stress levels. Farmers are a hard-to-reach population due to occupational demands and a culture where conversations about mental health are often stigmatizing. This study explored ways to tailor suicide prevention strategies to unique characteristics of farmers by speaking with groups close to farmers who were open to discussing stress and suicide prevention: women married to farmers and agricultural Extension agents. Methods Focus groups with women married to farmers (N=29) and interviews with agricultural agents from the university’s local Cooperative Extension offices (N=13) from rural Georgia counties explored effective ways outreach and education about suicide prevention, mental health, and coping could be provided to farmers. Using a thematic analysis approach, qualitative coding was completed by two researchers (Cohens kappa=0.86), with initial codes collapsed into common themes. Results Four themes were identified: 1) Barriers due to the nature of farming, including time demands of farming and cultural stigma in help-seeking; 2) Acceptable messaging, including framing conversations as part of general health; 3) Make information accessible by making it brief, clear, and omnipresent through multiple media; and 4) Elements of effective information and education, including emphasizing “you’re not alone” and connection, how to access supports and crisis services, educating people close to farmers, and motivating farmers by emphasizing that they could help another farmer with the information. Conclusion Due to farmers’ stoic identities and reluctance to admit mental health struggles, speaking with those close to farmers may help us better understand what is needed to tailor farmer suicide prevention strategies. The insights shared by participants suggest that culturally responsive outreach and education strategies, strengthening relationships through peer support, and gatekeeper training with specific trusted others are important ways to tailor suicide prevention strategies for this hard-to-reach group. Keywords: agricultural stress, agricultural suicide, rural suicide prevention, farmer culture, mental health stigma, rural mental health Introduction Farmers have a suicide rate much higher than the general population, with some estimates in the United States as high as three times the national average.1–3 This phenomenon is not limited to the United States but is a global phenomenon with varying, yet always elevated, rates in countries as disparate as India,4 Australia,5 and France.6 In addition to suicide rates, farmers have been shown to have higher levels of mental health symptomatology associated with suicide. The Hordaland Health Study, a large population-based study out of Norway, demonstrated that when compared to non-farmers, farmers had higher levels of depression, particularly in the male subpopulation. Additionally, farmers of both genders had higher anxiety levels when compared to non-farmers.7 A more recent Norwegian study used Trøndelag Health Study data containing one of the world’s most extensive longitudinal population surveys. Results demonstrated that farmers have high odds of having symptoms of depression when compared to other occupational classes and that farmers have higher odds of having symptoms of depression when compared to their siblings.8 The nature of farming, including economic and occupational hazards, isolated geography, and rural culture, presents unique risk factors for suicide, particularly elevated rates of chronic stress, a known risk factor for suicide.9 Farming is a highly stressful occupation, with elevated stress from factors such as extreme and damaging weather, high input costs, variable commodity prices, high potential for accidents, the need for loans and financial risks, and complex policies and programs, as noted in studies from both the US and Ireland.9–11 Carpenter-Song and Snell-Rood12 note that many rural communities have experienced rapidly declining wages in the past several years, partly due to a reduction in the agricultural sector. Farmers, frequently self-employed, are very vulnerable to fluctuations in market prices and economic downturns.13 Other studies have identified environmental factors that put farmers at elevated risk of suicide. Zanchi et al14 found that pesticide exposure may exacerbate depression, impulsivity, and suicidal ideation, with implications that exposure to pesticides may be a contributing factor to farmers’ poor mental health and thus increase the risk of suicide. Firearms, which are often involved in suicides, are common in farm environments. It is, therefore, not surprising that this environmental hazard is very frequently involved with suicides within the farming population.15,16 Agricultural values and culture are additional important considerations when exploring risk factors for suicide among farmers. Farmers often have great pride in their occupation, show a strong bond to their often multi-generational farms, and feel a sense of responsibility to their families to continue their work. The risk of farm failure, which means disappointing family and often losing the work of prior generations, looms large.3 Views commonly held by farmers complicate these risks and stressors. Farmers often do not accept the concept of mental health vulnerability.13 This perception leads to stigma toward mental health care and help-seeking behaviors and reinforces the presence of traditional masculine norms and self-reliance.16 Typically, these more traditional masculine beliefs include ideals of not showing emotion, putting on a façade of independence, and remaining strong in the presence of others,17 which can lead to worse health outcomes for men.18 While the number of women in farming is growing, representing 14% of principal operators and 37% of secondary operators on the farm, the majority of principal farmers are men. Given the higher proportion of farmers who are men, these norms are particularly potent.19 In addition to farmer culture and mental health stigma, the geographic challenges of rurality contribute to farmers’ risk of suicide. People residing in rural communities often live much further away from potential mental healthcare resources than they might in an urban location.20 Rural residents are disproportionately affected by behavioral health issues with this limited availability of mental health providers. These findings of disproportionality are global, with similar observations made in countries in Africa, Australia, and North America.21–23 In a study surveying farmers from Ontario, Canada, farmers indicated both geography and culture were significant barriers and felt that even when mental health practitioners were utilized, there was often a disconnect between providers and their understanding of the culture of farming, leading to a lack of “farm credibility.”24 Interventions to address farmer suicide risk and mental health are limited. While evidence suggests various programs are promising, rigorous evaluations are still needed.25 Preliminary research with pilot programs indicates that mental health literacy education and peer support may mitigate farmers’ poor mental health and bolster social support. Mental health literacy programs in both the US and Canada hold promise to improve help-seeking behaviors, attitudes, and knowledge in both farmers and those close to farmers and may serve as protective factors regarding farmer mental health.26–29 Farmers have high rates of suicide, increased mental health symptomatology, experience tremendous occupational stress, and have few options for mental health care—all embedded within a culture where mental healthcare and help-seeking are stigmatized. Due to the characteristics of farming and farm culture, activities and interventions designed to improve farmer mental health outcomes or prevent suicide must be carefully and precisely tailored to meet their unique characteristics and needs. Given farmers’ reluctance to seek help, discuss emotions, and lack of confidence in mental health providers, it is often difficult to discuss ideas for acceptable intervention strategies with farmers themselves. It may thus be particularly productive to explore the perceptions of those who are close to and trusted by this population. We, therefore, examined the ideas and views of two groups trusted by farmers—spouses and agricultural agents in local Extension offices who work closely with farmers30 —asking for their thoughts and opinions on effective suicide prevention, mental health, and coping with stress information and education strategies for farmers. This information is crucial to developing effective, acceptable, culturally responsive interventions for suicide prevention among farmers. Methods Participants Two sources of data were used for this study: one from focus groups with women married to a farmer and the second from interviews with agricultural agents from the university’s local Cooperative Extension offices (offices that “extend” the university’s agricultural research findings out to local farmers). These two groups were selected because they knew farmers well and were trusted by farmers.30 Additionally, based on researchers’ prior experiences, these two groups were open to discussing farmer mental health and stress. All data collection occurred in counties where Extension agents had begun local conversations about farmer suicide risk and stress. This was also done to increase the likelihood of participants being open to discussing these difficult topics. The focus group data were part of a larger study where women married to farmers were asked about a range of farm mental health and stress topics, including how they felt information about suicide prevention, mental health, and coping with stress could most effectively be shared with farmers. Six focus groups were conducted in six rural counties in Southwest Georgia. Three groups had six participants each, two groups had four participants, and one group had 3 participants. Counties were selected if their Extension Office had hosted conversations on farm stress in the prior year and if the Extension agent was able to and agreed to help with the study. Participants were recruited by sending invitational flyers and following up expressions of interest with a phone call. One of the authors then contacted interested participants and scheduled the focus groups. Participants were informed that all discussions were confidential, and all signed written consents to participate and consent for publication of anonymized responses. Additional criteria for participation in the focus groups were: 1) married to someone who farmed; 2) living on the farm currently; and 3) 18 years of age or older. In total, 29 women participated in these focus groups. The second data source came from interviews with 13 Extension agents working in a county where they had engaged in preliminary conversations on farmer stress and suicide risk. Interviews focused on agents’ thoughts on the impact of these conversations on the community and how they felt information about suicide prevention, mental health, and coping with stress could most effectively be shared with farmers. One of the researchers contacted the agents in these counties to invite them to participate in a confidential Zoom or phone interview. All contacted agents gave verbal consent to participate. Focus group participants (N=29) were all White women with an average age of 48.9 years (SD 14.4). Nearly 62% worked outside the home and farm, and over one-third of participants cared for children under 18 at home. On average, participants had been married to a farmer for over 26 years. Extension agent interviewees (N=13) were 69% men and 31% women, all White, 92% Non-Hispanic, and 8% Hispanic. The agents’ average age was 30.4 years (SD.8.01). This work was reviewed by the University of Georgia Institutional Review Board, Project #00005555, and also complies with the Declaration of Helsinki. Data Collection and Analysis The focus groups were led by one of two researchers with lived farming experience, with support from an additional researcher. Questions asked participants to discuss mental health, stress, and coping strategies in their farmers, their children, and themselves and what could be done to help by providing information and support on these topics. Focus groups lasted 60 to 90 minutes. All groups were recorded using a digital recorded and transcribed by an external service for analysis. The same researcher conducted Interviews with Extension agents for all 13 participants by Zoom or telephone. Participants were asked if they thought prior program conversations on farm stress had any impact on farmers and ways information about suicide prevention, mental health, and coping with stress could be most effectively shared with farmers. Interviews lasted 20 to 30 minutes and were recorded and transcribed for analysis. We completed a thematic analysis of both focus group and interview transcripts,31 with the sensitizing concept of effective communication with farmers on suicide prevention, mental health, and coping with stress. Our key research question was “What are effective ways to provide suicide prevention and coping with stress interventions and education to farmers?” We aimed to identify the essential elements of suicide prevention and coping with stress interventions needed to address the unique needs and characteristics of farmers. Our specific objectives were 1) to identify elements of effective suicide prevention and coping with stress interventions that are acceptable to farmers and 2) to understand potential barriers farmers might experience to receiving these interventions. Transcripts were independently line-by-line coded by two researchers, one of whom had co-facilitated the focus groups and completed all the interviews. Then, researchers consulted and generated a commonly agreed-upon set of 24 initial codes. These codes were used to recode the data, with excellent initial inter-rater reliability (Cohen’s kappa of 0.86). Researchers discussed code disagreement until a consensus was reached. Codes were then organized into broader themes, which are described below. Each participant’s transcript was given a unique alphanumeric code to protect anonymity; this code was used in quoting a participant when reporting results below. Results In both focus groups with women married to farmers and interviews with Extension agents, the same four themes emerged repeatedly regarding information and education for farmers regarding suicide prevention, mental health, and coping with stress. These were: 1) Barriers due to farmer identity; 2) Acceptable messaging; 3) Make information accessible; and 4) Elements of effective information and education. Barriers Due to Farmer Identity When discussing farmer stress and mental health, participants discussed two barriers that they felt were significant and closely linked with the role and identity of being a farmer—farmers’ reluctance to discuss emotions and admit a weakness or need for help and the considerable time demands of farming. They were adamant that any stress management or suicide prevention programming had to be crafted in such a way as to address these barriers, or they would not be successful. One participant emphasized that typical education strategies would not work with farmers, saying
Farmer’s reluctance to discuss emotions was stated repeatedly, echoing findings in the literature.3,13 A group of wife participants giggled when thinking about their spouses admitting a vulnerability, one stating, … a man is not going to sit at a table and say, Oh, I am stressed. I am so stressed. And then the one across from him will go, “Me too.” [laughter]. (Participant CS5) Another participant simply said I’m thinking my husband wouldn’t call [a help line] in a million years. (Participant CS3) An Extension agent echoed this sentiment, noting Pride was a very big issue. And I think that when a farmer admits that he’s under stress, in his mind, he feels weak, and he can’t let his peers or his family see that. (Participant SS2). Another Extension participant expressed frustration at farmers’ reluctance to seek help, reflecting, What they won’t do is go get help. They’ll talk about it [farm problems] all day, but they won’t go get help if they need it. Especially somebody that’s in really bad shape. (Participant LS1) In addition to a reluctance to discuss stress or to seek help for distress, participants noted that farming is sun-up to sundown (and beyond) work and that time is one of farmers’ most precious resources. Other tasks are put aside because of the urgent time demands of farming, particularly during planting and harvest; as one Extension participant said, And so I think a lot of times, they put those things on the back burner because ‘We don’t have time for that. We don’t have time for that. We got to get ready for the harvest season. We’ve got to do this. (Participant ES3) One wife described the constant demands by saying And our phone never stops ringing. It starts ringing at 6: 00 AM and it can ring to 10:00 PM, 11:00 PM. And I was very surprised by this when we first got married…I said, Matt? He said, Baby, this is the farm life. I mean, farmers don’t have hours. (Participant SS2) The intense time demands of farming result in farmers de-prioritizing their well-being. One Extension agent described it by saying They don’t have time. And that’s why they don’t get to the doctor like they should. And especially in areas like ours that don’t really have a-- I mean, you’ve got to drive an hour to go see a doctor. And so, they’re too busy taking care of their livestock’s health. I mean, they take better care of their cattle’s health than they do their own personal health. I mean, they take better care of the soil than they do their own health. We just need to-- if there’s a way to get them to prioritize their health, that’s what we need to do. And it’s easier said-- I mean, easier said than done, but if we could figure out a way, that’d be great. (Participant LS1) Acceptable Messaging Given the barriers to engaging with farmers regarding suicide prevention, mental health, and coping with stress, participants were insistent that messages needed to be framed in ways that were culturally acceptable to farmers and respected their needs and values. To address farmers’ reluctance to talk about stress and mental health, several participants recommended that the conversation be embedded within the larger concept of “health” in general. An Extension agent recommended linking mental health and physical health: I think something else that might be useful is to talk about how poor mental health can affect you physically, too. (Participant TS1) One wife specifically discussed the stigma around the term “mental health” and stated I feel like if you focus it more on health, it would be a better-- sometimes, mental health seems more taboo, and people are like, Oh, I’m fine. Because people don’t want to talk about that or share that, and I think that goes back to the manliness. No. I’m fine. I don’t need-- so gearing it more towards health, overall health, versus mental health. (Participant ES3) In addition to using language acceptable to farmers, participants discussed the importance of making discussions about suicide prevention, mental health, and coping with stress permissible by communicating through individuals trusted by farmers. One trusted group identified by participants was spouses. Participants who were wives described how their farmer spouse confided anxiety and frustration to them and how often they were the ones who were called on to be positive and emotionally “uplifting” (Participant CoS7) and help the farmer cope with stress. Extension agents stated that wives were a trusted group and farmers would listen to them; an agent strongly encouraged this idea, saying, I think if you focus on farmer’s wives probably more than the farmer, you’d probably get farther. (Participant BS1) A second trusted group that the participants felt could help move forward the conversation on suicide prevention, mental health, and coping with stress was other farmers. One participant described a leader in the farming community who was vocal in his support of mental health by saying And he has been a huge, huge help. And somebody that is a huge advocate for mental wellness and mental awareness and everything like that. And I think by him stepping in and kind of doing that, it makes them (farmers) feel like, okay, he’s doing it. He’s one of us. So maybe we can talk about it. (Participant CS1) An Extension agent talked about another community leader who is a farmer and is open to discussing mental health Yes, he’s excellent, and he’s a farmer. He can relate to farmers. So, finding more of those locally to our industries, or our regions of the state type thing, finding a few of those that are willing to share their story, on the video, having an actual farmer in the video helps relate to farmers. Farmers want to talk to farmers. They don’t want to talk to a therapist. They don’t want to talk to a doctor. They want to talk to a farmer. So, having a farmer relay those messages will definitely go a lot farther too. So, if you’re able to find any of those people that are willing to be that voice for us as well, it helps spread messages. (Participant MS1) Contrary to the agent quoted above, who said farmers did not want to talk to a doctor, several participants thought farmers might trust and listen to doctors on the topic of stress management and health. One wife noted, He does talk to his doctor… And doctors, they see so many (farmers). Yeah. I think that might be a really good thing to do, is to talk to physicians in the area (Participant KIS1) Some Extension agents believe that farmers might also trust and talk with them but noted that they would want additional information and training before trying to provide more than very general support. An agent stated, But I do think sometimes people may feel that they can confide in their agent. They’re asking them about other things, and so sometimes it gets to a more of a personal level…I’m just not sure what other resources (to give). (Participant SS1) Make Information Accessible Participants were adamant and articulate in emphasizing the importance of making information on suicide prevention, mental health, and coping with stress easily and quickly accessible to farmers. Having accessible information was seen as a way to respect farmers’ time. If messages could be infused across a range of events and locations frequented by farmers, it was also seen as a strategy to normalize discussions about suicide prevention, mental health, and coping with stress. The three strategies they suggested were multifaceted information placement, infusion, and brevity. When asked about the best ways to make information on suicide prevention, mental health, and coping with stress easily accessible, participants recommended that messages be located in multiple places where farmers are likely to be so that they would see posters, flyers, and cards at supply stores, agricultural equipment dealers, even the restaurants they frequent. One Extension agent described this as …in front of them constantly, so it was kind of directly in their face all the time. Could not really avoid it, almost. So more of those to place strategically would be useful (Participant TS1). Another agent listed a number of potential locations Yeah. And I think maybe at other places that they frequent, too, like the FSA (Farm Service Agency) office and the John Deere place in town…So different places like that that they walk into all the time, they have to be in. So at least they see it. (Participant TS1) Another way to make information readily accessible to farmers was through media, particularly media they already use. Participants suggested all sorts of media, including radio and television (particularly local shows on agriculture), podcasts, blogs, videos, phone texts, newsletters, agricultural magazines, email, and print material. One participant explained It would need to be kind of multifaceted, I think. I mean, definitely some social media. Something you can put out on Facebook every once in a while, just to kind of keep the message there. And also, we put out blogs or newsletters and things, maybe pop something in there every couple of months or something. (Participant LS1) Interestingly, participants reported seeing farmers use very different kinds of electronic media. Some reported that farmers they knew preferred written materials, others said they saw farmers online looking things up, and others reported farmers using various social media forms. When pressed about the connection between age and media preference, many participants disagreed and reported older farmers using social media and reading on their tablets. One specific medium all agreed would be valuable was to have information printed on a calendar for farmers. As one wife noted, Something else a farmer loves is a stick-on calendar for the inside of their truck, you know what I’m talking about? (Participant CS2) Participants believed it was important for media and written messages to be brief and concise. As one participant noted, Most farmers, if it’s a long thing, you’re going to lose them. So that’s why I think just little snippets and things along the way. (Participant MS2) while another warned, Farmers really don’t have a lot of extra time on their hands. And so you can bombard them to a point to where they’ll eventually turn you off. (Participant LS1) Participants felt that a concise and clear message would be most effective; one said that the calendar should simply have a crisis line number and say, ‘For help, call this number’, is what goes on the top, for help, for help Call this number for help Do not try to beat around the bush…Just be upfront and direct. (Participant CS5) Given that farmers are reluctant to talk about emotions and stress and that they have little available time, participants did not think that they would attend special programs specifically on coping with stress or suicide prevention. They strongly encouraged infusing suicide prevention, mental health, and stress management content into existing events for farmers. A wife suggested that The information can be disseminated through something that they’re already doing or a part of… Like the Extension production meeting (where a brief discussion on stress had been included in their counties), they didn’t have to go out of their way for that. It was already available. (Participant ES3) An Extension agent commented similarly and suggested Just being where they are, any of these association meetings, like the Pecan Growers Association, the Forestry Association. All of these associations have conferences. So being in front of them at those type places (Participant MS1) While another agent recommended considering the agricultural industry, noting that Retailers and consultants, they have meetings on the growers or they have contacted growers. So that’s just their avenue to get the word out. (Participant JeS1) Elements of Effective Information and Education In addition to discussing ways to make information about suicide prevention, mental health, and coping with stress acceptable and accessible to farmers, participants discussed at length what the actual content of the message should be. Several participants discussed the importance of conveying to farmers that others recognize that their profession is stressful and that when they experience stress, they are not alone. One wife stated, I think just recognizing that they have stress and communicating that to them helps them a lot. (Participant CoS6) Another Extension agent noted I know they internalize it and they think, “I’m the only one that’s feeling this amount of pressure. So, when someone stands in front of them and says, You’re not the only one. And probably the man to your left and the man to your right is feeling the same thing that you’re feeling,… another farmer’s going to understand and, If it’s not just me, then it’s not that I didn’t work hard enough.” That’s exactly it. It’s not [his] fault. (Participant CS1) A second part of the message you’re not alone that participants emphasized was the importance of staying connected with others. A wife articulated this by saying the message should include Don’t forget to stay connected. Don’t forget to talk to somebody about what’s going on. Don’t put everything on yourself. And when disaster does strike, know that there are avenues to take after that that will keep you afloat. (Participant CoS7) Both wives and Extension agents emphasized the importance of providing information on services and support, both informal and formal. A participant recommended that messaging include Here’s the people you could talk to. Talk to your friends. Talk to your pastor. Talk to your extension agent. Just talk to somebody. (Participant CS3) Others emphasized the importance of giving the 988 crisis line phone number or the number for the local mental health center. In addition to ways to find support, participants believed it would be helpful for messaging to include simple skills for coping with stress. One Extension agent asked for … a word, a map, or if there’s research, top five ways to help your body cope with stress, whether that’s getting enough sleep, or-- Whatever the research says is the best way to cope with it, if we could have the top three ways, or top five ways. (Participant GS1) Participants also talked about the importance of getting information to those who care about farmers, like spouses and Extension agents. One wife asked for information on Here’s what to look for, here’s what to do, here’s what not to do. Here’s what to say, here’s not what to say. Just very simple, something that people can remember. (Participant CS7) Similarly, several Extension agents asked for information about what to do if they had concerns about a farmer or if a farmer confided their distress to the agent. One summed it up by saying, …having some resources for the agents of, not only when they do come to us, where to go with that, but what do we ask if we can tell something’s off but we don’t know how to approach it? (Participant MS1) while another wanted guidance if his concerns about a farmer became serious It would be good to just have an established protocol…It would be good, yeah, to know just exactly what I need to say. If it’s something serious [who can] I call or something. (Participant BS1) Finally, participants talked about conveying information in ways that would motivate farmers to pay attention to stress management, mental health, and suicide prevention. As discussed above, participants believed that farmers would be reluctant to admit emotional distress and want to protect their privacy. However, both Extension agents and wives believed that if the message could be framed as something they needed to pay attention to for the good of others, that would be a strong motivator. Reminding farmers that their stress impacts their families, particularly their children, was seen as an excellent motivator. In addition, participants discussed how a farmer might not recognize or admit warning signs of stress in himself but could see it in others and be motivated to help them. A wife described this by saying And what’s going on is your husband is going, ”I don’t need that. I don’t need that.” But your farmer or your husband, he recognizes it in a friend or his son or son-in-law, and he realizes that they’re suffering. So, they may be trying to help them out, but sooner or later, that farmer may say something to the wife or something. Or he may walk into the FSA office and go take out his phone and take a picture of that number and send it to the wife or someone. He’s not going to recognize it in his own self, but in today’s time, he may recognize it, like I said, in his son or grandson or his neighbor… (Participant CS5) Discussion Farming is a difficult and stressful occupation, and farmers have significantly elevated rates of suicide compared with the general population. Effective suicide prevention strategies are needed to address this issue. However, for cultural and pragmatic reasons, farmers are a hard-to-reach population. Our study provides insight into the unique characteristics of farmers that must be considered when developing suicide prevention and coping interventions. Using information from two groups who are trusted by farmers and who know them well, we can begin to provide specific recommendations for how to build interventions to help farmers manage stress, learn the risks of high stress up to and including suicide, and suicide prevention. Study Limitations As with all studies, this study had several limitations. First, in order to obtain a meaningful volume of information, we chose to gather data from two groups trusted by farmers--women married to farmers and Extension agents who work closely with farmers-- rather than farmers themselves. It may be that farmers themselves would have different views and ideas on suicide prevention and stress coping skill information. Additional research is needed to engage farmers in these discussions. An additional study limitation was geography. We spoke with participants from one region in Georgia in the United States. These findings may be very different from the thoughts and views of those in another state or another country. Also, the counties in which we gathered data were ones where farm stress conversations were already beginning, so participants were sensitized to the concepts, which could potentially influence their discussion. Finally, while most researchers had lived experience with farming, they were not specifically from these farming communities and were thus “outsiders.” Participants may have been cautious or selective in their responses when talking with unknown researchers. Despite these limitations, our study is a valuable first step in considering how to design a culturally acceptable, accessible, and effective suicide prevention strategy for farmers. Implications for Suicide Prevention Programs In conceptualizing the implications of these findings for suicide prevention strategies designed specifically for farmers, we used a culturally responsive lens,32 the Centers for Disease Control and Prevention (CDC) suicide prevention strategies of teaching coping and problem-solving skills, promoting healthy connections, and identifying and supporting people at risk,33 and the Social-Ecological theory of suicide prevention, focusing on individual, relational, and community levels.34 Considerations for Individual-Level Interventions Farming is a unique culture, with strong values of self-sufficiency and strength and reluctance and stigma in admitting weakness or asking for help16 Given the information provided by participants, suicide prevention efforts must be tailored to farming culture and values. In addition, because of the considerable time demands of farming, interventions must be brief and convenient. Participants clearly indicated that farmers would be unlikely to attend specialized programming on coping and problem-solving skills. Therefore, at the individual level, mental health literacy education and skill building for coping and mental wellness should be framed as part of building health and strength. Given the stigma surrounding admitting stress or emotional distress, information on suicide risk, stress, and coping skills should be folded into events that farmers already attend, such as commodity growers’ conferences—both to normalize the concepts and to use farmers’ time effectively. All materials developed for training and information sharing should be brief, to the point, pragmatic, specific to farmers, and normalize (even valorize) building skills for coping and positive mental health. Messages in education and materials should provide information on supports and services and clearly state where to get help in a crisis. Considerations for Relational-Level Interventions Participants in our study repeatedly emphasized the importance of connecting with others for the well-being of farmers. Creating opportunities for farmers to connect with others and encouraging them to do so was seen as crucial to farmer well-being. Connection with others who understand their stress, where farmers feel “seen” and know that others are experiencing the same stresses, was seen as particularly important. This would normalize their experiences of stress and emotional distress, decrease shame (“It’s not just me, it’s not my fault”), and increase the likelihood that they would begin to talk about stress, coping, mental health, and suicide prevention. Agricultural communities are often close-knit, and farmers are more likely to connect with and trust those close to them in their communities—family, other farmers, and helpers who understand the realities of their occupation, such as Extension agents.30 These relationships provide valuable and protective social support; suicide prevention efforts should build on them.35 Peer support has been noted as a positive intervention for suicide prevention.32 Using this model to develop farmer-to-farmer peer support could be a powerful way to strengthen farmer social support networks. Education for families on coping with stress and supporting farmers during difficult times, through information and education in places spouses and children may frequent such as libraries and schools, could help strengthen farm families. Since spouses of farmers are their primary support and confidant, providing them with information and skills on how to recognize signs of high stress, how to intervene if they are concerned about suicidal ideation, and where to turn for help are particularly important interventions in farmer suicide prevention. In addition, interventions to support the mental health of wives themselves as they experience their own stresses on the farm will be an important aspect of farm family wellbeing. An additional aspect of relationships that should be considered in suicide prevention efforts is farmers’ willingness to help others. As noted by participants, farmers may not see or admit high levels of stress and suicide risk in themselves but would be motivated to listen to or take information about coping skills, mental health, or suicide risk for another farmer. The message “Learn to help a friend” could be influential in encouraging farmers to learn about suicide prevention and coping skills. Considerations for Community-Level Interventions At the community level, multi-component approaches to suicide prevention have shown effectiveness.36 For farmer suicide prevention efforts, our findings suggest that components should include community education campaigns, champion spokespersons, and gatekeeper training efforts to identify and support at-risk farmers. Broad education in agricultural communities is needed about the risk of farmer suicide, risk factors, protective coping strategies, and how to access help. Our participants emphasized the importance of getting this information out through multiple online and other media forms, particularly through avenues frequently used by farmers, such as agriculturally focused print, radio, and television, as well as locations where farmers often go, such as feed stores and equipment dealerships. In addition, identifying farmers who are willing to champion the issue of farmer mental health, coping, and suicide prevention could be a powerful strategy. As noted by several participants, having a farmer stand up and discuss the topic of mental health and suicide prevention is an impactful way to decrease the stigma of the topic and open the door to discussion and learning. In our study, we found that both women married to men who farm, and agricultural Extension agents were eager to learn more so they could help support farmers. Participants were particularly interested in learning more about warning signs of suicide, things to say or not to say if they suspected a farmer was at risk, and how to find support and help during a crisis. In addition to these caring individuals who could serve as gatekeepers, primary care physicians could serve in this role. Using a research-based gatekeeper training program such as Question, Persuade, Refer (QPR)37 to build a cadre of gatekeepers in rural communities who are aware of the specific risks farmers face could be an effective part of a prevention strategy. Conclusion Farmers have unique stressors, needs, beliefs, and values, which shape their risk of suicide and their openness to prevention strategies. Effective suicide prevention strategies must be tailored to these factors. Using the insights of those who know farmers well, this study was successful in answering our research question: What are effective ways to provide suicide prevention and coping with stress interventions and education to farmers? Farmer suicide prevention initiatives should include education, skill training, and materials integrated into events that farmers attend and use language they find acceptable, brief, and non-stigmatizing. 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Leave of Absence -- From Medicine or the Olympics -- Is Not
a Sign of Weakness - 8/12/24 In summer 2021, as Simone Biles bid farewell to competing alongside her peers in the team finals at the Tokyo Olympics, I found myself in a similar position, saying goodbye to my fellow medical students as they continued their education without me. Both Biles and I faced the daunting decision to take a leave of absence because our mental health had impacted our performance -- Biles in gymnastics and myself in medical school. This decision was not made lightly, and the stigma we faced from each of our communities was immense. We live in a world where taking a break is often equated with quitting, especially for Black and Brown women in the U.S. Both Biles (Black) and I (Brown), were labeled as "quitters" when we prioritized our mental health over our professional aspirations. The shame is compounded by the pressure to push through, despite the clear danger it poses to our well-being. For Biles, it was the risk of physical injury in her sport; for me, it was the risk of severely worsening mental health. I originally took my leave of absence because I was struggling to pass the practice exams during the dedicated Step 1 study period at the end of my second year of medical school. However, instead of first focusing on improving my mental health, I adamantly pushed myself to keep studying. This resulted in a failure on my Step 1 exam, and further delayed my return to medical school. As Biles explains in her Netflix documentary Simon Biles Risingopens in a new tab or window, she similarly pushed herself in the Tokyo Olympics, even after noticing that she was reaching her emotional limit. As a result, she ended up faltering on a vault routine and realized she could not complete the Olympics at her very best. In turn, she sat out from the rest of the competition; just as I sat out from medical school. Spectators around the world were in shock at her decision, in part because she didn't have a physical injury. This would have "justified" sitting out. But in contrast to physical injuries, mental health struggles are often invisible, making them harder for others to understand and accept. Biles' mental blocks and overthinking during her gymnastics routines mirrored my own struggles during standardized board exams. It became evident that pushing through these blocks was not only unproductive, but also threatened our well-being. The decision to step back is often not about quitting, but about individual survival and preventing a complete mental breakdown. The stigma around mental health is pervasive in both gymnastics and medicine. There is an unspoken expectation to endure grueling schedules and intense pressure without complaint. The pandemic only exacerbated these conditions, highlighting the unrealistic demands placed on both athletes and medical professionals. Betty Okino, a former Olympic gymnast, spoke in the documentary about how the system weaponizes the term "resilient," reducing individuals to mere performers of strength rather than acknowledging their humanity. This is an unfortunate reality that medical students and resident physicians also face while pushing through 24-hour shifts and 80-hour work weeks. During my leave, I felt out of control, much like Biles described feeling like a prisoner in her own mind and body. We both took time to heal from past traumas, which often resurface during periods of high stress. As a psychiatry resident and fellow trauma survivor, I understand how untreated trauma can manifest in both mental and physical health issues. Healing is a slow, deliberate process that cannot be rushed, and it's crucial to address this trauma during any leave of absence. Biles' journey back to gymnastics, getting "back to the basics," and rebuilding her confidence, mirrored my own return to studying for Step 1 after the failure my first time. I had to review content from my first 2 years, taking time to rebuild my foundation. Both of us found strength in our supportive communities -- Biles' teammates, and for me, a group of fellow medical students. We also leaned on our mental health therapists and our boyfriends or husbands, who saw us through our darkest days. People are often more understanding of visible injuries than of mental health issues. However, both can be equally debilitating. Biles' courage to prioritize her mental health on a global stage inspired me during my own leave of absence. Biles' return to the Olympics this year and my return to medical school for the third year -- culminating in my graduation and residency -- are testaments to our true resilience and determination. Professional sports players and doctors are often seen as superheroes, but we are human. In the documentary, Biles spoke about being the painter of her own story; similarly, I believe everyone in medicine has a unique journey that they create. Our experiences show that taking a step back is sometimes necessary to move forward. To anyone facing similar struggles,
know that taking time away from your dreams for your mental
health is not a sign of weakness. It is an act of courage.
Biles and I are not quitters. We are survivors, and our
leaves of absence were just chapters in our life
stories. Pain
is ‘dramatically’ different in men and
women Give someone an electric shock; bind a tourniquet tighter and tighter around their leg; submerge their hand in icy water; prick them with a pin: Researchers have done it all, and they’ve found — across years and hundreds of studies — that the same stimuli provoke greater pain responses in women. Women, in other words, are more sensitive to pain than men. They report feeling it more in just about every way: more intensely, more often, for a longer time. They grapple with more headaches, more painful gut conditions, more pain in their backs and pelvises and bones and, research suggests, virtually every other part of their bodies. Of the hundreds of millions of chronic pain patients around the world, they comprise roughly 70 percent. And underlying those striking disparities, studies are finding, is a still more extensive web of differences connected to both gender and biological sex that help shape how pain manifests, and how badly it hurts. Distinct types of cells appear to be involved in processing pain in each sex. Sex hormones have been shown to exacerbate or dampen it. Disparate stress levels, gender roles and even the ways men and women tend to think about their own pain all seem to influence how hard it hits. The list goes on — and likely keeps going on far beyond what research has so far uncovered. Though studies have long pointed toward sex and gender differences in pain, until recently most researchers devoted little attention to them, if not dismissing them entirely. That has at last started to change in the past decade, as new requirements from health agencies have driven a surge of new findings on the subject and, for the first time, brought it out of the narrow corner of the field to which it historically was relegated. But researchers may still just be scratching the surface of the disparities. “We’re not even remotely close to answering the question of how much is sex and how much is gender,” says Jeffrey Mogil, a psychology professor at McGill University. “We only know a fraction of the biological sex differences. I mean, they’re only starting to emerge now. And pain and gender is almost completely unstudied. There’s only a handful of papers that have ever been done.” Major differences in biology The sex differences researchers have found in pain biology, though they may only represent a “fraction” of all those that exist, are nonetheless extensive. “The biological processing of pain, regardless of how much pain is produced, is dramatically sex dependent. Different genes are being used in both sexes — different proteins, different cell types, dramatically different biology in each case,” summarizes Mogil, who has been studying the subject for decades. Dozens of genes and proteins have now been linked to pain in one sex but not the other. As of early this year, studies had tied at least 49 to chronic pain processing only in male rodents and 35 only in female rodents, according to a fact sheet compiled by Mogil and other researchers for the International Association for the Study of Pain. Some gene-level differences may contribute to disparities in pain tolerance. A variation in a gene that encodes one type of opioid receptor, for instance, has been connected to increased pain sensitivity in women, while variations in a gene that encodes another type have been linked to a higher threshold for thermal and muscle pressure pain in men. Hormones, too, have been found to influence pain sensitivity. Estrogen appears to play a role in suppressing pain at high concentrations, while lower levels of estrogen or higher ones of progesterone typically seem to amplify it. Prolactin, a hormone best known for its role in producing breast milk, increases “female-selective” sensitivity in the sensory receptors that initiate pain signals in the body, according to a study published earlier this year. The researchers found that a separate chemical messenger, orexin B, does the same in men and male mice. Testosterone, meanwhile, seems to inhibit pain in both sexes. And research indicates it could be critical in determining which cells and pathways in the immune system are involved in transmitting pain, or developing chronic pain. This is another aspect of pain processing that apparently varies markedly between sexes: A 2015 study led by McGill University researchers found that distinct types of immune cells act as key mediators of pain in male and female mice. Mounting evidence indicates those differences exist in both the central and peripheral immune systems, as well as in the brain. Brain imaging studies have also identified “significant sex differences” in both the structure of chronic patients’ brains and how they respond to pain. These differences are a result of more than just biology, researchers note. Natalie Osborne, a postdoctoral research fellow who uses neuroimaging to study chronic pain, emphasizes that brain scans reflect not only research subjects’ biological sex, but also the influence of gender and other aspects of their lives. “I’m bringing individuals in and scanning them in the MRI,” she says. “I’m not just scanning the biological differences, because this brain has also been socialized as one gender or another for years. So the differences that I see in the brain are a cumulative result of their XX, XY or whatever chromosomes, their hormone exposure over their life and how they were socialized.” Illustration / Courtney Jones; and Adobe Stock Gender’s role Research is showing that pain itself is “multifactorial,” says Diane Hoffmann, the director of the University of Maryland Law School’s law and health care program and co-author of a widely cited 2001 study examining sex and gender disparities in pain and its treatment. “You can’t just look at the biological and physiological,” Hoffmann says. “You have to look at that in combination with not just the psychological, but social and cultural impacts and how they affect a person’s experience of pain as well.” Stress, for instance, has been found to exacerbate pain, and childhood trauma to increase the risk of developing chronic pain later in life. Depression and anxiety have also been shown to worsen both chronic and acute pain. Women report suffering all four at notably higher rates than men. Researchers have linked gender roles to disparities in pain tolerance as well. People who identify as more stereotypically masculine display a higher threshold for pain, a 2012 meta-analysis found, as do those who consider themselves less sensitive to pain than the typical man or woman. Women and men appear to employ different mechanisms to cope with pain, too: Studies have found that women do more catastrophizing, or dwelling on their pain and making it out to be much worse than it actually is. That practice is associated with greater pain severity. Women are also more likely to seek help for pain than men are. But when they do, health care providers more often dismiss, psychologize and undertreat their pain, potentially worsening existing disparities. Pain researchers stress that a lot of work still has to be done to pick apart the tangle of biological and sociocultural factors that play a part in men and women’s disparate experiences of pain. Many pain studies don’t separate out data based on sex or gender, much less actively examine their potential influence, researchers point out. Vanishingly few incorporate any transgender or gender-diverse people. And only recently have a significant proportion begun to include female research subjects. An ‘exploding’ body of research When Mogil started studying sex differences in pain in the early 1990s, there were “just a small number of people doing it,” and other researchers were “resistant,” he says. “They would be like, ‘Yeah, OK, you found one. You found two. But it’s not really anything across the board,’” he recalls. He began studying the subject because of a quirk of the lab he started working in. While most preclinical researchers bought male rodents to conduct their pain studies with, his lab bred its own mice to save money, which naturally provided both male and female research subjects. And once female subjects are in the mix, he says, “the sex differences just stare people in the face.” For a long time, however, pain studies including female research subjects remained in the minority — despite increasing evidence that sex differences not only existed, but also posed major questions about findings based only on males. Mogil and other researchers contended in their 2015 study on the disparate immune cells and pathways involved in mediating pain that “this sexual dimorphism suggests that male mice cannot be used as proxies for females in pain research.” Two years later, researchers from the University of California, Los Angeles reached a similar conclusion in their review of sex-based differences in the brains of chronic pain patients. “Given those differences,” they wrote, “mixed-sex studies of chronic pain risk creating biased data or missing important information and single-sex studies have limited generalizability.” During the same time period, however, Mogil found that 80 percent of rodent studies published in 2015 in Pain, the leading journal in the field, included only male research subjects — roughly the same proportion as two decades earlier. That has at last begun to shift in the intervening years, after the National Institutes of Health (NIH) and its Canadian counterpart began requiring preclinical studies to consider sex as a variable: Mogil found that by 2019, the share of studies including female rodents had climbed to 50 percent. “And lo and behold,” he says, “the number of reported sex differences started exploding.” That 50 percent figure is still far higher than the “essentially zero” it should be, Mogil notes, and male bias persists even in the research that incorporates female subjects. Human studies, meanwhile, dedicate even less attention to the role of sex and gender, even though clinical research with NIH funding has been legally required to include women for more than three decades. “In animals, it seems well accepted that there are sex differences in pain physiology going from the cellular molecular level on up to the systems level,” says Elizabeth Reynolds Losin, the director of Pennsylvania State University’s Social and Cultural Neuroscience Lab. “In humans, I feel like it’s still kind of a controversial idea that there could be sex differences in pain.” Even as doubts and unanswered questions continue to loom, however, Roger Fillingim, the director of the University of Florida’s Pain Research and Intervention Center of Excellence, says he’s been “very encouraged by the increased attention, the increased number of publications.” “If you look at research on sex, gender and pain over the last 30 years, it is a dramatically upward slope,” he says, citing health agencies’ requirements as the driving force for the rise. “There’s a lot more attention to sex as a biological variable, to sex differences in pain, and now to the complexity and nuances of sex versus gender.” In the years to come, Fillingim predicts the growing focus on the topic could change not just the understanding of how pain is processed, but also the way it’s treated. “I think it’s
conceivable,” he says, “that within my lifetime,
we’ll see specific treatments that are developed for
women versus men.” Know Fear: What am I afraid to say I'm afraid of? - Gordon Clay The beauty of the soul shines out when a man bears with composure one heavy mischance after another, not because he does not feel them, but because he is a man of high and heroic temper. - Aristotle It is said that if you ask a man how he feels, he'll tell you what he thinks. Please honor that. What I think is important to me and often telling you that will teach me what I feel. Who Was That Masked Man Anyway? by Kenneth Byers If you're never scared or embarrassed or hurt, it means you never take any chances. Julia Sorel 1926- For every minute you are angry you lose sixty seconds of happiness. - Ralph Waldo Emerson Jealousy, that dragon which slays love under the pretence of keeping it alive. - Havelock Ellis Happiness is an illusion; only suffering is real. - Voltaire
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