30 Rock & Psychology

By Ted Cascio


The following dialogue takes place right after Liz barges in on a visibly disconcerted Jenna dramatically singing the chorus to Alphaville’s late-eighty’s hit “Forever Young” while applying tape to the sagging and wrinkled regions of her aged face:

Jenna: (singing) Forever young, I wanna be forever young.

Liz: Jenna, stop it. Look it, you claim that you want to be happy, but that’s never going to happen until you are honest about who you are.

Jenna: That’s easy for you to say. I’ve built my career on a certain image, and you have no idea what I go through to maintain it. The work-outs, the lotions, pretending I wasn’t fourth runner-up at the Miss Teen Bicentennial Pageant. And you don’t understand the fear I live with…the fear of people ever seeing the real me.

(Black Light Attack Season 4, Episode 10)

At first, this sounds like sound advice from Liz, and Jenna sounds like her usual absurd self. A typical case of the histrionic, delusional celebrity gone berserk. But I’m going to play devil’s advocate here and argue that Jenna’s problem is actually pretty common, even if we can’t understand her bizarre and peurile coping strategy. In Jenna’s defense, who would seriously claim that manipulating external perceptions is not a job requirement for celebrities, and indeed people from all walks of life? For many (maybe most) people the positivity of their public persona matters much more than its accuracy.

Moreover, on close inspection, the specific meaning of Liz’s advice appears vague. In particular, Liz fails to identify who the target of this honesty should be. Honest about who you are to whom? Others? Or yourself?

In recognition of the difficulties inherent in providing insight that is both entirely lucid and extemporaneous, we’ll give Liz (if not the show’s writers) a break here. Regardless of that, research indicates that this distinction she seems to ignore really matters, so we’ll go ahead and try correcting the situation if indeed it needs correcting. We can, with the aid of hindsight, improve on her ill-defined guidance and in the process test whether Jenna’s strategy has something to recommend it after all.

When it comes to “being honest about who you are” (or not) social scientists typically distinguish between self-deception and impression management. A great deal of research has shown that it is common for people to sincerely believe false things about themselves, and as you might expect these bogus beliefs almost always tend toward the enhancement side of the ledger. For example, most people believe that they are above average on a number of positive personal qualities such as intelligence, but of course, it’s impossible for most people to be above average. This is considered evidence for widespread self-deception, though this better-than-average-effect represents but one example of the many documented forms of deceptive self-enhancement, or what we’ll call self-deception for short. (If you’re inclined to doubt the ubiquity of self-deception, please read Taylor and Brown’s 1988 article entitled “Illusion and well-being: A social psychological perspective on mental health.”)

Impression management is a little bit different and perhaps less complicated. It is simply the tendency to describe oneself favorably to others, or to otherwise favorably bias people’s perceptions of oneself. Unlike self-deception, this sort of activity may not involve delusion of any kind. In its most innocent form, one simply attempts to put his or her “best foot forward.” The full spectrum of impression management includes emphasizing, exaggerating, or inventing positive qualities or actions, plus minimizing, concealing, or denying negative qualities or actions. But even at its most deceitful, we can do impression management while maintaining accurate beliefs about ourselves.

At the very least, Jenna was engaging in impression management, and possibly self-deception as well. Let’s now examine Liz’s guidance in light of these two possibilities.

As far as self-deception is concerned, the facts are to a certain extent hostile to Liz. Self-deceit is not only pervasive but, contrary to common sense, healthy. It appears that self-deception is positively associated with many good things, among them higher self-esteem, greater work engagement and productivity, positive mood, enhanced social relationships, and better and faster coping with adverse events. All of these outcomes are regarded as hallmarks of mental health and major contributors to life-long happiness. And, truth be told, there is clear evidence that depressed people, rather than holding overly negative self-views, in fact view themselves with a much higher degree of accuracy than those who are mentally healthy.

Yet, this topic continues to be vigorously debated in the psychological literature. Frankly, my opinion is that the side attempting to make the case against self-deception has set forth less rigorous and less abundant evidence in its favor. However, there is at least one important qualification on the self-deception as mentally healthy perspective that helps to vindicate Liz, if only in part. There are thankfully natural limits on how much self-deception you can practice before it begins to become disadvantageous; detrimental to all the positive outcomes it can, when practiced in moderation, sustain. A little bit of self-deception is good, but a lot is bad. This is what we in the scientific community refer to as theoptimal margin of illusion, an idiom introduced by the inimitable Baumeister (1989).

Clearly, Jenna is hardly if ever operating within this best possible margin. Granting that, Liz’s advice does indeed reclaim some validity. But she may have thought to include in her recommendation that in becoming more honest about whom she is, Jenna should not necessarily become completely honest. However implausible it seems, research clearly suggests that adopting totally unbiased self-perceptions is neither a good idea for Jenna, nor for people in the real world.

Alright, so what about impression management? If Liz was not referring to self-deception, but instead suggesting that Jenna should merely stop trying so hard to manage other people’s perceptions of her, that’s a horse of a different color. One important consideration here is that impression management requires effort to sustain, especially if you are attempting to forge an image that departs in great measure from your natural disposition. Effort spent in this pursuit is effort that could be used to pursue other, potentially more worthy goals. From this perspective, Liz’s advice should get your approving nod. Then again, the effort associated with impression management could be worth it after all, depending on how well (i.e., how seamlessly) it is practiced. Let’s face it, people who try to seem likeable often succeed in actually being more likeable. To the extent that impression management, practiced in moderation and in good faith, helps to improve one’s social relationships, it can be considered adaptive, even if its undertaking requires lots of effort.

All-in-all, the conclusion here is similar to the one we reached for self-deception. The advisability of impression management hinges on the degree of departure between our normal disposition and the persona we are attempting to convey outwardly. The greater the degree of departure, the more effort required to maintain the pretense, and the more likely our janissary maneuvers are to be detected. So, just as there appears to be an optimal margin of illusion, we can imagine that there is also an optimal margin of management. Do too much, and you’ll compromise worthy goals and/or potentially earn the unsavory label “phony.” Do it moderately and do it well, and you stand to reap maximum social rewards while expending minimal effort.

Once again, Jenna exceeds the optimal margin, so in that sense Liz’s advice could be the right advice so long as it doesn’t prompt Jenna to wander too far off the impression management reservation. Everything considered the ideal corrective measure for Jenna (or anyone else acting similarly) would be to temper, rather than completely eliminate her self-deceptive tendencies along with her impression-obsession.

Source Psychology Today

Why the Recession May Trigger More Depression Among Men

By ALICE PARK


It’s a well-established fact that women are at higher risk for depression than men, but that may soon change, says a psychiatrist at Emory University.

When Dr. Boadie Dunlop began recruiting subjects for a depression study, he enlisted the help of local sports radio shows, and was surprised by the tremendous response he received — from men. “We were really impressed with the number of men coming in with depression related to employment or marital conflict,” says Dunlop.

That led to discussions about the many social and cultural changes occurring in gender roles that may put men at increasingly higher risk of developing depression, which Dunlop outlines in an editorial in the British Journal of Psychiatry.

The most recent recession brought some of those issues to a head, he says, as downsizing and higher unemployment highlighted the death of manufacturing and labor-intensive jobs, which have traditionally been held by men. About 75% of the jobs lost in the downturn belonged to men. Innovations in technology, as well as outsourcing to countries where manual labor is less expensive, are shrinking this sector, forcing more men than women out of work. With men culturally shouldering the role of primary breadwinner for their families, unemployment hits men particularly hard, as their self-esteem, an important factor in depression risk, is often contingent on their role as provider.

At the same time, on a more psychological level, societal norms about the male image are changing, shifting away from males as the stoic breadwinner to a more realistic model of a member of a family who is just as prone to emotional and psychological stress as any other member. This change is making it easier, albeit only slightly, for men to talk about conditions such as depression, and may lead to a bump in incidence as more men start to feel comfortable talking openly about the mental illness.

Traditionally, women have had up to twice the risk of developing depression over their lifetime as men, and the reasons are both biological and social. Biologically, differences between genders in hormone metabolism account for some of the susceptibility to depression; culturally, the higher rates of childhood abuse among girls is also a factor in enhancing rates of depression among women. As adults, women have also been confronted with societal barriers to professional self-fulfillment that have had a negative impact on their self-image and self-esteem. But as more men either share or relinquish their role as primary earner in households, they may feel the same threat to their sense of self as women historically have. In addition, as more men take on child-rearing responsibilities, they may feel inadequate and overwhelmed, fertile ground for depression.

“Men are going to be taking on these roles, some by choice and some will have it forced on them,” says Dunlop. “How well will they be able to adapt, and how well we are able to help them if they have troubles with those roles?”

Socially, he says, despite many high profile cases of men admitting to depression, such as Mike Wallace and John Cleese, it’s still difficult for most men to acknowledge feeling overwhelmed and out of control. “To be depressed, to feel overwhelmed and not motivated to do things, are signs that have had the stigma attached to them of mental weakness,” says Dunlop. “And men traditionally have felt that they should just overcome them and snap out of it.”

Acknowledging that men are facing some profound economic and societal changes that could negatively affect their self-esteem is the first step that could help more health-care providers address the issue, he says. For family practitioners or other non-mental health specialists, simply asking about how their male patients are coping with the economic downturn, and whether the financial crisis has caused any changes in his family, is a good start. “A general inquiry about how you are getting by can open the door to how his role has changed, and whether he is finding things tough going,” says Dunlop.

Being aware of the cultural and economic shifts that may make men vulnerable to depression may also end up addressing an important question in mental health circles — how much of the greater vulnerability among women is due to biology, and how much to the sociocultural environment in which they live? If men and women continue to show divergent rates of depression even as gender roles become equalized — as more women become providers and more men take child-rearing responsibility — then it’s likely that nature may trump nurture with respect to depression. But if the rates start to match up, then, says Dunlop, it could suggest that our environment plays a more dominant role in triggering the mental illness. And that, in turn, suggests that there may be things we can do to address it. “If men are taking on different roles, they may need help in learning how to do it,” he says. Providing that help could lead to lowering their rates of depression.

Source Healthland

Therapeutic Lifestyle Changes Offer Many Mental Health Benefits

By Roger Walsh, PhD, M.D.


Lifestyle changes – such as getting more exercise, time in nature, or helping others – can be as effective as drugs or counseling to treat an array of mental illnesses, according to a new paper published by the American Psychological Association.

Multiple mental health conditions, including depression and anxiety, can be treated with certain lifestyle changes as successfully as diseases such as diabetes and obesity, according to Roger Walsh, M.D., PhD. of the University of California, Irvine’s College of Medicine. Walsh reviewed research on the effects of what he calls “therapeutic lifestyle changes,” or TLCs, including exercise, nutrition and diet, relationships, recreation, relaxation and stress management, religious or spiritual involvement, spending time in nature, and service to others. His paper was published in American Psychologist, APA’s flagship journal.

Walsh reviewed research on TLCs’ effectiveness and advantages, as well as the psychological costs of spending too much time in front of the TV or computer screen, not getting outdoors enough, and becoming socially isolated. He concludes that “Lifestyle changes can offer significant therapeutic advantages for patients, therapists, and societies, yet are insufficiently appreciated, taught or utilized,” The paper describes TLCs as effective, inexpensive and often enjoyable, with fewer side effects and complications than medications. “In the 21st century, therapeutic lifestyles may need to be a central focus of mental, medical and public health,” Walsh said.

According to research reviewed in the paper, the many often unrecognized TLC benefits include:

  • Exercise not only helps people feel better by reducing anxiety and depression. It can help children do better in school, improve cognitive performance in adults, reduce age-related memory loss in the elderly, and increase new neuron formation in the brain.
  • Diets rich in vegetables, fruits and fish may help school performance in children, maintain cognitive functions in adults, as well as reduce symptoms in affective and schizophrenic disorders.
  • Spending time in nature can promote cognitive functions and overall well-being.
  • Good relationships can reduce health risks ranging from the common cold to strokes as well as multiple mental illnesses, and can enhance psychological well-being dramatically.
  • Recreation and fun can reduce defensiveness and foster social skills.
  • Relaxation and stress management can treat a variety of anxiety, insomnia, and panic disorders.
  • Meditation has many benefits. It can improve empathy, sensitivity and emotional stability, reduce stress and burnout, and enhance cognitive function and even brain size.
  • Religious and spiritual involvement that focuses on love and forgiveness can reduce anxiety, depression and substance abuse, and foster well-being.
  • Contribution and service, or altruism, can enhance joy and generosity by producing a “helper’s high.” Altruism also benefits both physical and mental health, and perhaps even extends lifespan. A major exception the paper notes is “caretaker burnout experienced by overwhelmed family members caring for a demented spouse or parent.”

Difficulties associated with using TLCs are the sustained effort they require, and “a passive expectation that healing comes from an outside authority or a pill,” according to Walsh. He also noted that people today must contend with a daily barrage of psychologically sophisticated advertisements promoting unhealthy lifestyle behaviors such as smoking, drinking alcohol, and eating fast food. “You can never get enough of what you don’t really want, but you can certainly ruin your life and health trying” lamented Walsh.

For therapists, the study recommends learning more about the benefits of TLCs, and devoting more time to foster patients’ TLCs.

The paper recognizes that encouraging widespread adoption of therapeutic lifestyles by the public is likely to require wide-scale measures encompassing educational, mental, and public health systems, as well as political leadership.

Source Medical News Today

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Getting Someone to Psychiatric Treatment Can Be Difficult and Inconclusive

By A. G. SULZBERGER and BENEDICT CAREY


That question is as difficult to answer today as it was in the years and months and days leading up to the shooting here that left 6 dead and 13 wounded.

Millions of Americans have wondered about a troubled loved one, friend or co-worker, fearing not so much an act of violence, but — far more likely — self-inflicted harm, landing in the streets, in jail or on suicide watch. But those in a position to help often struggle with how to distinguish ominous behavior from the merely odd, the red flags from the red herrings.

In Mr. Loughner’s case there is no evidence that he ever received a formal diagnosis of mental illness, let alone treatment. Yet many psychiatrists say that the warning sings of a descent into psychosis were there for months, and perhaps far longer.

Moving a person who is resistant into treatment is an emotional, sometimes exhausting process that in the end may not lead to real changes in behavior. Mental health resources are scarce in most states, laws make it difficult to commit an adult involuntarily, and even after receiving treatment, patients frequently stop taking their medication or seeing a therapist, believing that they are no longer ill.

The Virginia Tech gunman was committed involuntarily before killing 32 people in a 2007 rampage.

With Mr. Loughner, dozens of people apparently saw warning signs: the classmates who listened as his dogmatic language grew more detached from reality. The police officers who nervously advised that he could not return to college without a medical note stating that he was not dangerous. His father, who chased him into the desert hours before the attack as Mr. Loughner carried a black bag full of ammunition.

“This isn’t an isolated incident,” said Daniel J. Ranieri, president of La Frontera Center, a nonprofit group that provides mental health services. “There are lots of people who are operating on the fringes who I would describe as pretty combustible. And most of them aren’t known to the mental health system.”

Dr. Jack McClellan, an adult and child psychiatrist at the University of Washington, said he advises people who are worried that someone is struggling with a mental disorder to watch for three things — a sudden change in personality, in thought processes, or in daily living. “This is not about whether someone is acting bizarrely; many people, especially young people, experiment with all sorts of strange beliefs and counterculture ideas,” Dr. McLellan said. “We’re talking about a real change. Is this the same person you knew three months ago?”

Those who have watched the mental unraveling of a loved one say that recognizing the signs is only the first step in an emotional, often confusing, process. About half of people with mental illnesses do not receive treatment, experts estimate, in part because many of them do not recognize that they even have an illness.

Pushing such a person into treatment is legally difficult in most states, especially when he or she is an adult — and the attempt itself can shatter the trust between a troubled soul and the one who is most desperate to help. Others, though, later express gratitude.

“If the reason is love, don’t worry if they’ll be mad at you,” said Robbie Alvarez, 28, who received a diagnosis of schizophrenia after being involuntarily committed when his increasingly erratic behavior led to a suicide attempt. At the time, he said, he was living in Phoenix with his parents, who he was convinced were trying to kill him. In Arizona it is easier to obtain an involuntary commitment than in many states because anyone can request an evaluation if they observe behavior that suggests a person may present a danger or is severely disabled (often state laws require some evidence of imminent danger to self or others).

But there are also questions about whether the system can accommodate an influx of new patients. Arizona’s mental health system has been badly strained by recent budget cuts that left those without Medicaid stripped of most of their services, including counseling and residential treatment, though eligibility remains for emergency services like involuntary commitment. And the state is trying to change eligibility requirements for Medicaid, which would potentially reduce financing further and leave more with limited services.

Still, people who have been through the experience argue that it is better to act sooner rather than later. “It’s not easy to know when we could or should intervene but I would rather err on the side of safety than not,” said H. Clarke Romans, executive director of the local chapter of the National Alliance on Mental Illness, an advocacy group, who had a son with schizophrenia.

The collective failure to move Mr. Loughner into treatment, either voluntarily or not, will never be fully understood, because those who knew the young man presumably wrestled separately and privately about whether to take action. But the inaction has certainly provoked second-guessing. Sheriff Clarence Dupnik of Pima County told CNN last Wednesday that Mr. Loughner’s parents were as shocked as everyone else. “It’s been very, very devastating for them,” he said. “They had absolutely no way to predict this kind of behavior.”

Linda Rosenberg, president of the National Council for Community Behavioral Healthcare, said, “The failure here is that we ignored someone for a long time who was clearly in tremendous distress.” Ms. Rosenberg, whose group is a nonprofit agency leading a campaign to teach people how to recognize and respond to signs of mental illness, added, “He wasn’t someone who could ask for help because his thinking was affected, and as a community no one said, let’s stop and make sure he gets help.”

At the University of Arizona, where a nursing student killed three instructors on campus eight years ago before killing himself, feelings of sadness and anger initially mixed with some guilt as the university examined the missed warning signs.

The overhauled process for addressing concerns is now more responsive, even if there are sometimes false alarms, said Melissa M. Vito, vice president for student affairs. “I guess I’d rather explain why I called someone’s parents than why I didn’t do something,” she said.

Many others feel the same way.

Four years ago Susan Junck watched her 18-year-old son return from community college to their Phoenix home one afternoon and, after preparing a snack, repeatedly call the police to accuse his mother of poisoning him. She assumed it was an isolated outburst, maybe connected to his marijuana use. In the coming months, though, her son’s behavior grew more alarming, culminating in an arrest for assaulting his girlfriend, who was at the center of a number of his conspiracy theories.

“I knew something was wrong but I literally just did not understand what,” Ms. Junck, 49, said in a recent interview. “It probably took a year before I realized my son has a mental illness. This isn’t drug related, this isn’t bad behavior, this isn’t teenage stuff. This is a serious mental illness.”

Fearful and desperate, she brought her son to an urgent psychiatric center and — after a five-hour wait — agreed to sign paperwork to have him involuntarily committed as a danger to himself or others. Her son screamed for her help as he was carried off. He was diagnosed with paranoid schizophrenia and remains in a residential treatment facility.

This week Erin Adams Goldman, a suicide prevention specialist with a mental health nonprofit organization in Tucson, is teaching the first local installment of a course that is being promoted around the country called mental health first aid, which instructs participants how to recognize and respond to the signs of mental illness.

A central tenet is that if a person has suspicions about mental illness it is better to open the conversation, either by approaching the individual directly, someone else who knows the person well or by asking for a professional evaluation.

“There is so much fear and mystery around mental illness that people are not even aware of how to recognize it and what to do about it,” Ms. Goldman said. “But we get a feeling when something is not right. And what we teach is to follow your gut and take some action.”

Web Source: http://www.nytimes.com/2011/01/19/us/19mental.html?pagewanted=1&_r=1&partner=rss&emc=rss