By Janice Wood
A new study suggests that people who notice they are having memory problems often are diagnosed with clinical memory impairment later in life.

For the study, Erin Abner, an assistant professor at the University of Kentucky’s Sanders-Brown Center on Aging, asked 3,701 men aged 60 and older one question: “Have you noticed any change in your memory since you last came in?”

That question led to some interesting results, she noted.

“It seems that subjective memory complaint can be predictive of clinical memory impairment,” Abner said. “Other epidemiologists have seen similar results, which is encouraging, since it means we might really be on to something.”

The researcher explains that the results are meaningful because it might help identify people who are at risk of developing Alzheimer’s disease sooner.

“If the memory and thinking lapses people notice themselves could be early markers of risk for Alzheimer’s disease, we might eventually be able to intervene earlier in the aging process to postpone and/or reduce the effects of cognitive memory impairment,” she said.

Abner was quick to note that the new study shouldn’t worry everyone who’s ever forgotten where they left their keys.

“I don’t want to alarm people,” she said. “It’s important to distinguish between normal memory lapses and significant memory problems, which usually change over time and affect multiple aspects of daily life.”

Source: University of Kentucky

By Traci Pedersen

In people who develop the disease frontotemporal dementia, those with more demanding jobs may live about three years longer than those with less skilled jobs, according to a new study published in the journal Neurology.

Frontotemporal dementia, which often develops in people still under the age of 65, causes changes in personality or behavior and problems with language, but does not affect the memory.

“This study suggests that having a higher occupational level protects the brain from some of the effects of this disease, allowing people to live longer after developing the disease,” said study author Lauren Massimo, Ph.D., CRNP, of the University of Pennsylvania in Philadelphia, Pennsylvania State University in State College, and a member of the American Academy of Neurology.

The study findings support the theory of “cognitive reserve,” which asserts that factors such as longer education, challenging occupations, and mental activity build up connections in the brain that create a buffer against disease.

“People with frontotemporal dementia typically live six to 10 years after the symptoms emerge, but little has been known about what factors contribute to this range,” Massimo said.

For the study, researchers looked at the medical charts of 83 people who had an autopsy after death to confirm the diagnosis of frontotemporal dementia or Alzheimer’s disease. They compared this information to people’s primary occupation.

Jobs were ranked by U.S. Census categories, with careers such as factory workers and service workers in the lowest level; jobs such as tradesworkers and sales people in the next level; and professional and technical workers, such as lawyers and engineers, at the highest level.

Researchers looked at when the dementia symptoms began based on the earliest report from family members telling of persistently abnormal behavior. Survival was defined as from the time symptoms began until death.

According to the findings, the 34 people who had developed frontotemporal dementia had an average survival time of about seven years. Those with more challenging jobs were more likely to have longer survival times than those with less challenging jobs.

Frontotemporal dementia patients in the highest occupation level survived an average of 116 months, while people in the lower occupation group survived an average of 72 months, suggesting that people with more challenging jobs may live up to three years longer.

The findings showed that occupational level was not linked to a longer lifespan in those with Alzheimer’s disease dementia. The number of years of education a person had was not linked to a longer life in either type of dementia.

Source: American Academy of Neurology

By Traci Pedersen
Scientists have long wondered why people with anxiety often seem paralyzed when it comes to decision-making. A new study reveals that people with anxiety have decreased neural inhibition in their brain, a process in which one nerve cell suppresses activity in another.

For the study, researchers wanted to test the theory that neural inhibition in the brain plays a big role in decision-making. So they developed a computer model of the brain called a “neural network simulation.”

“We found that if we increased the amount of inhibition in this simulated brain, our system got much better at making hard choices,” said Hannah Snyder, a psychology graduate student who worked with the researchers on the study.

“If we decreased inhibition in the brain, then the simulation had much more trouble making choices.”

Using the model, the team analyzed the brain mechanisms involved when we choose words. They then tested the model’s predictions on humans by asking them to think of the first verb that comes to mind when they are given a noun.

“We know that making decisions, in this case choosing our words, taps into this left-front region of the brain, called the left ventrolateral prefrontal cortex,” University of Colorado at Boulder psychology Professor Yuko Munakata, lead author of the study, said.

“We wanted to figure out what is happening in that part of the brain that lets us make these choices. Our idea here, which we have shown through the word-choosing model, is that there’s a fight between neurons in this area of the brain that lets us choose our words,” said Munakata.

They also tested the model’s predictions by observing the effects of increased and decreased inhibition in people’s brains.

Researchers increased inhibition with a drug called midazolam and found that people got much better at making hard decisions. It didn’t influence other aspects of their thinking, but only the area of making choices.

“We found that the worse their anxiety was, the worse they were at making decisions, and the activity in their left ventrolateral prefrontal cortex was less typical,” Munakata said.

The results of the study shed light on the brain mechanisms associated with making decisions and could be helpful in improving treatments for the millions of people who suffer from anxiety.

According to Snyder, there are drugs that already increase neural inhibition and these medications are currently being used to treat the emotional symptoms in anxiety disorders; however, the findings show that these drugs might also lessen the difficulty many sufferers of anxiety have in selecting one option when there are too many choices.

“[A] more precise understanding of what aspects of cognition patients are struggling with could be extremely valuable in designing effective approaches to therapy for each patient,” she said.

“For example, if someone with an anxiety disorder has difficulty selecting among multiple options, he or she might benefit from learning how to structure their environment to avoid choice overload.”

Said Munakata, “A lot of the pieces have been there. What’s new in this work is bringing all of this together to say here’s how we can fit all of these pieces of information together in a coherent framework explaining why it’s especially hard for people with anxiety to make decisions and why it links to neural inhibitors.”

A paper on the findings titled “Neural inhibition enables selection during language processing” was published in the Aug. 30 Proceedings of the National Academy of Sciences. CU-Boulder professors Tim Curran, Marie Banich and Randall O’Reilly, and graduate students Hannah Snyder and Erika Nyhus and undergraduate honors thesis student Natalie Hutchison co-authored the paper.

Source: University of Colorado at Boulder

By Rick Nauert PhD

New research suggests that individual expectations appear to influence how prayer impacts mental health.

For example, when it comes to easing symptoms of anxiety-related disorders, prayer doesn’t have the same effect for everybody. Baylor University researchers found that what seemed to matter more was the type of attachment the praying individual felt toward God.

Those who prayed to a loving and supportive God whom they thought would be there to comfort and protect them in times of need were less likely to show symptoms of anxiety-related disorders — symptoms such as irrational worry, fear, self-consciousness, dread in social situations, and obsessive-compulsive behavior — than those who prayed but did not expect God to comfort or protect them.

The study is published in the journal Sociology of Religion.

“While previous research has shown that people who have a secure attachment to God are more satisfied with life and less depressed and lonely, little attention has been paid to psychiatric symptoms,” said researcher Matt Bradshaw, Ph.D.

“For many individuals, God is a major source of comfort and strength that makes the world seem less threatening and dangerous. Through prayer, individuals seek to develop an intimate relationship with God,” Bradshaw said.

“Those who achieve this goal, and believe that God will be there to protect and support them during times of need, develop a secure attachment to God.”

In this context, prayer appears to confer emotional comfort, which results in fewer symptoms of anxiety-related disorders.

“Other people, however, form avoidant or insecure attachments to God — meaning that they do not necessarily believe God will be there when they need Him,” he said.

“For these individuals, prayer may feel like an unsuccessful attempt to cultivate and maintain an intimate relationship with God. Rejected, unanswered, or otherwise unsuccessful experiences of prayer may be disturbing and debilitating — and may therefore lead to more frequent and severe symptoms of anxiety-related disorders.”

For the study, researchers analyzed data from 1,714 of the individuals who participated in the 2010 Baylor Religion Survey. The study focused on general anxiety, social anxiety, obsession, and compulsion.

Teachings of Christianity and some other faiths use the parent-child imagery to depict the relationship between God and an individual, with one researcher describing God as “the ultimate attachment figure.”

The Baylor study findings are consistent with a growing body of research indicating that a person’s perceived relationship with God can play an important role in shaping mental health.

In theory, people who pray regularly may be inclined to live out their religion more faithfully, which may lead to less stress, such as marriage and family conflicts, researchers wrote.

People who pray often may have more of a sense of purpose in life or have more supportive personal relations. And many people use prayer as a coping strategy.

When it comes to personal prayer outside of religious organizations, however, findings by previous researchers have been inconsistent — and puzzling.

Some studies indicate frequent praying has positive effects on mental health; others report no effect — or even that people who pray more often have poorer mental health than those who pray less frequently.

“At the present, we don’t know exactly why the findings have been so inconsistent,” Bradshaw said. “Prayer is complex.”

Some possible explanations for varying findings:

Individual expectations — Some scholars suggest that “if you expect prayer to matter, it just might,” Bradshaw said. In several studies of older adults, people who believe that only God knows when and how to respond to prayer fare well when it comes to mental health; those who think their prayers are not being answered do not.
Style of prayer — In general, meditative and colloquial prayers have been linked with desirable outcomes, including emotional well-being, while ritualistic prayer actually has been associated with poor mental health outcomes.
Perceived characteristics of God — such as loving, remote, or judgmental — affect the relationship between prayer and mental health. “Our previous work has found that prayer is associated with desirable mental health outcomes among individuals who believe that they are praying to a God who is close as opposed to remote, and the results from the current study are largely consistent with this finding,” Bradshaw said.
Differences in study design and sampling.
“These are all important considerations, but a comprehensive understanding of the connection between prayer and mental health remains elusive,” he said. “We still have a lot of work to do in this area.”

Source: Baylor University

By Rick Nauert PhD
A new study suggests our friends may know us better than we know ourselves, a finding that may seem counterintuitive.

“It’s a natural tendency to think we know ourselves better than others do,” said Washington University psychologist Dr. Simine Vazire.

A new article by Vazire and doctoral student Erika N. Carlson suggest getting another opinion is actually a wise option. “There are aspects of personality that others know about us that we don’t know ourselves, and vice-versa,” Vazire said.

“To get a complete picture of a personality, you need both perspectives.”

The paper is published in Current Directions in Psychological Science, a journal of the Association for Psychological Science.

The researchers said that while we are generally well-informed on ourselves, there may be blind spots where our wishes, fears and unconscious desires may obscure reality.

Often the blinders result from trying to maintain a better self-image. Even watching ourselves on videotape does not substantially alter our perceptions—whereas others observing the same tape easily point out traits we’re unaware of.

Not surprisingly, our significant others and those who spend the most time with us know us best.

But even strangers have myriad cues to who we are: clothes, musical preferences, or Facebook postings. At the same time, our nearest and dearest have reasons to distort their views.

“We used to collect ratings from parents – and we’ve mostly stopped, because they’re useless,” notes Vazire. Such data tends to show that everyone’s own child is brilliant, beautiful, and charming.

Interestingly, people don’t see the same things about themselves as others see. Anxiety-related traits, such as stage fright, are obvious to us, but not always to others.

On the other hand, creativity, intelligence, or rudeness is often best perceived by others. That’s not just because they manifest themselves publicly, but also because they carry a value judgment—something that tends to affect self-judgment.

Often, outside souces tend to give us higher marks for our strengths than we credit ourselves with. Nevertheless, people are complex, social cues are many, and perceptions of others are clouded by our own needs and biases.

Plus, the information isn’t easy to access. “It’s amazing how hard it is to get direct feedback,” Vazire noted, adding that she isn’t advocating brutal frankness at any cost. There are good reasons for reticence.

The challenge, then, is to use such knowledge for the good. “How can we give people feedback, and how can that be used to improve self-knowledge?” Vazire asked. “And how do we use self-knowledge to help people be happier and have better relationships?”

Bottom line, listen to others. They may know more than you do—even about yourself.

Source: Association for Psychological Science

By Traci Pedersen
People have better insight into how skilled they are at a particular task when it can be measured in an obvious way (such as speaking a foreign language), according to new research published in the journal Perspectives on Psychological Science.

On the other hand, during tasks in which self-evaluation is difficult, people are often unaware of poor performance, often because of false feedback from family and friends.

For example, a person may think he is good at his job or have a special talent, such as singing, because of the feedback he receives from those around him.

“Too often that feedback is vague and does not offer any suggestions for improvement,” said Zlatan Krizan, Ph.D., associate professor of psychology at Iowa State University. “It is easier to tell a person he is doing a good job instead of telling the truth and risking hurt feelings.”

“This is one reason why we have barriers to self-insight, because oftentimes, even if we get feedback, it’s not accurate,” Krizan said. “As a society we make the wrong trade-off by thinking that boosting self-esteem is going to boost performance, and that rarely happens. That empty praise of telling someone they’re great, or pretending there are not skill differences when there are, can really become a problem.”

Krizan and Ethan Zell, Ph.D., a professor at the University of North Carolina-Greensboro, conducted a meta-synthesis of previous research to see how self-insight relates to different abilities. They analyzed large sets of data that examined connections between actual abilities and beliefs about those abilities for more than 330,000 individuals.

“In tasks that are more difficult to self-evaluate, such as athletic ability or singing, insight may be more challenging. People will focus on areas in which they excel and downplay their weaknesses,” Krizan said.

That’s why “American Idol” contestants — who insist their friends always tell them they’re good singers — can’t figure out why the judges don’t agree. Krizan notes that he often sees this phenomenon with students who perform poorly on an exam.

“Your expectations going into a performance will influence your experience,” Krizan said. “Students will get their exams back and say, ‘but I felt so good after the test.’ Well, if you don’t understand the material, it’s hard for you to gauge whether you’re giving right or wrong answers on a test.”

Employees who are skilled at evaluating their own abilities perform better in the roles to which they are assigned. Team members who cannot complete their assigned work may need to re-assess their abilities.

That is why Krizan recommends setting specific measures for evaluation and feedback.

“This will lead people to consider the things they’ve done and the outcomes, which will be more closely connected to real performances versus broad ideas of competency,” Krizan said.

“If people are evaluating themselves in terms of very specific criteria, they’re going to have better self-insight because they are constrained by how to interpret the ability.”

Source: Iowa State University

By Traci Pedersen
People with borderline personality disorder (BPD) tend to suffer similar deterioration of their psychiatric and physical health as those with bipolar disorder, according to new research published in the British Journal of Psychiatry.

“Despite the clinical and public health significance of both of these disorders, it sometimes seems as if BPD lives in the shadow of bipolar disorder,” said researcher Mark Zimmerman, M.D., director of outpatient psychiatry at Rhode Island Hospital.

“Bipolar disorder is a widely researched, well-publicized, well-funded topic. By contrast, BPD is seldom discussed and it is not included in the Global Burden of Disease study, a comprehensive registry that quantifies diseases by cost, mortality, geography, risk, and other factors.”

About 1.6 percent of the U.S. population has been diagnosed with BPD, compared with 2.6 percent of those with bipolar disorder, according to the National Institute of Mental Health. The study is the largest comparison of patients who have been diagnosed with BPD or bipolar disorder.

“The level of psychosocial morbidity and suicidality associated with BPD is as great, or greater, than that experienced by patients with bipolar disorder,” said Zimmerman. “From a public health perspective, improving the detection and treatment of BPD is as imperative as diagnosing and treating bipolar disorders.”

People suffering from BPD have difficulty regulating emotions and thoughts, often tipping toward extremes. They engage in impulsive and reckless behavior, and their relationships with other people are typically unstable.

People with bipolar disorder often experience the same mood for weeks, while those with BPD deal with intense bouts of anger, depression and anxiety that are short in duration. According to the study, clinical experience suggests that BPD is just as debilitating as bipolar disorder. In fact, in psychiatric patient samples, BPD is as frequent as bipolar disorder.

Similar to patients with bipolar, those with BPD are more likely to suffer from depression, anxiety disorders, substance abuse, eating disorders, and suicidal behaviors. These other mental illnesses may have symptoms that overlap with BPD, making it difficult to recognize BPD in patients with these other mental illnesses.

This research was part of the MIDAS (Methods to Improve Diagnostic Assessment and Services) project, an ongoing clinical research study at Rhode Island Hospital. Their aim is to integrate research assessment methods into routine clinical practice.

By Janice Wood
Researchers have found that normal-weight teens who think they are fat are more likely to grow up to be fat.

“Perceiving themselves as fat even though they are not may actually cause normal-weight children to become overweight as adults,” said Koenraad Cuypers, a researcher at the Norwegian University of Science and Technology.

Cuypers and his colleagues at the Department of Public Health and General Practice in NTNU’s Faculty of Medicine examined the obesity problem from a new angle: Their research looked at the relationship between perceived weights and actual weights in a study of teenagers and young adults.

The researchers note there are many reasons why teens who think they are fat — even when they are not — become overweight as adults.

One explanation may be related to psychosocial stress, which can be associated with gaining weight around the waist, the researchers said.

“Another explanation may be that young people who see themselves as fat often change their eating habits by skipping meals, for example. Research has shown that dropping breakfast can lead to obesity,” Cuypers said, adding that following a diet that you cannot maintain over time also is counterproductive, since the body strives to maintain the weight you had before you started the diet.

The researchers used data from the health survey Young-HUNT1, which was conducted from 1995-1997 and included 1,196 normal-weight teenagers of both sexes. Participants were later followed up in the Young-HUNT3 study, from 2006-2008, when they were between 24 and 30 years old.

Half of the participants still had normal weights as adults. But among those who were overweight, the researchers found that 59 percent of the girls who had felt fat as a teen became overweight in adulthood, as measured using body mass index or BMI. If waist circumference was used as the measure of obesity, then the percentage of teens who initially perceived themselves as fat and later became overweight as adults was 78 percent.

In contrast, 31 percent of the girls who did not consider themselves fat during adolescence were found in the follow-upstudy to be overweight as measured using BMI. That number was 55 percent as measured by waist circumference.

Normal-weight teens who rated themselves as fat in the initial HUNT study had a BMI in the followup study that was on average 0.88 higher than those who did not. They were also on average 3.46 centimeters larger as measured around the waist.

The study also shows that normal-weight girls were more likely than boys to rate themselves as overweight: 22 percent of girls and 9 percent of the boys saw themselves as fat in the first HUNT survey.

One explanation for this gender difference may be that the media’s focus on looks increasingly targets girls rather than boys, the researchers claim.

“Girls thus experience more psychosocial stress to achieve the ideal body,” Cuypers said. “Society needs to move away from a focus on weight, and instead needs to emphasize healthy eating habits, such as eating regular and varied meals and eating breakfast. Good sleep habits are also an advantage. And by reducing the amount that teens are transported to and from school and recreational activities, teens might also be able to avoid getting a ‘commuter belly.’”

Cuypers said he believes that the relationship between a perception of being overweight and the development of overweight is something that school systems and society as a whole must address to reverse the trend and reduce problems associated with obesity.

“The weight norms for society must be changed so that young people have a more realistic view of what is normal,” he said. “In school you should talk to kids about what are normal body shapes, and show that all bodies are beautiful as they are. And, last but not least, the media must cease to emphasize the supermodel body as the perfect ideal, because it is not.”

Cuypers’ results were published in the Journal of Obesity.

Source: Norwegian University of Science and Technology

By Therese Borchard

According to renowned psychiatrist Peter Kramer, happiness isn’t the opposite of depression.

Resilience is.

I’ve always loved that reminder because the word “happiness” makes me uneasy.

It’s not that I want to be unhappy, or I don’t want to be happy. It’s that every time I make happiness my goal, I become very unhappy. Like that famous study about suppressing thoughts of white polar bears. When everyone was instructed to think about anything but a white polar bear, they all thought about a white polar bear.

To be completely honest, I even hate the “life is good” T-shirts.

I prefer the “life is crap” ones, such as the one with the cruise ship about to plow over the guy in the canoe. Whenever my husband wears that one, it puts me in a good mood.

I smiled at the discussion on my online depression community, Project Beyond Blue, called “The Pursuit of Happiness.” Maggie, a young mother of five kids and one of the group’s administrators, had just read Eat, Pray, Love — about author Elizabeth Gilbert’s quest to “leave behind all the trappings of modern American success (marriage, house in the country, career) and find, instead, what she truly wanted from life” (the Amazon description). Maggie was a tad frustrated by the entire concept. She wrote:

“It’s probably because I’m a cradle Catholic, but I found this whole journey of hers to be innately selfish and egocentric. I mean, we’re all human. Who wouldn’t be happy with no money worries for a year, doing whatever you wanted, with whomever you wanted, wherever you wanted? I think even a week of this lifestyle would be enough to make me feel ‘happy.’ But this year-long journey of self-discovery is totally unrealistic to me. It’s like looking at someone’s Facebook page that just loves to put up pictures of their latest vacations, or their brand new, custom-built home. Yes, there is some envy mixed in there. I fully admit that. But my fear is that too many people these days are buying into this whole notion of ‘do whatever makes you happy.’ ”

I laughed out loud at that because I remember exactly where I was when I picked up Eat, Pray, Love the first time. I had snuck out of my inpatient program at Johns Hopkins Hospital. That’s right, I broke out of the psychiatric ward to meet my husband and spend an afternoon with him. Just him. No kids. We hadn’t spent a few hours alone with each other in months, maybe years. So we strolled around the inner harbor of Baltimore and ambled to the Barnes & Noble right there, in front of the paddleboats.

I picked up the book because I had heard about it. However, as soon as I read the back cover, I got queasy, and quickly put it back down. I remember thinking to myself, “I am about as far away from her notion of happiness as Dr. Joel Fuhrman’s green diet is to fried Oreos.” It all seemed so unrealistic and, like Maggie said, self-absorbed. Who wouldn’t want a life without commitments? Who wouldn’t want a week of Saturdays? And even if I could pull it off — a life without commitments, a life of Saturdays — is that really what I should strive for? Where would the world be today if everyone strived for a life of Saturdays? Would we have benefited from the contributions of extraordinary people like Mohandas Gandhi, Nelson Mandela, and Mother Teresa? Their lives included lots and lots of Mondays, weeks full of just stressful, painful Monday mornings.

Happiness expert Gretchen Rubin tackles this indictment in her blog post, “Happiness Myth No. 10: The Biggest Myth — It’s Selfish and Self-Centered to Try to Be Happier.“ She writes:

“Myth No. 10 is the most pernicious myth about happiness. It comes in a few varieties. One holds that ‘In a world so full of suffering, you can be happy only if you’re callous and self-centered.’ Another one is ‘Happy people become wrapped up in their own pleasure; they’re complacent and uninterested in the world.’

Wrong. Studies show that, quite to the contrary, happier people are more likely to help other people, they’re more interested in social problems, they do more volunteer work, and they contribute more to charity. They’re less preoccupied with their personal problems. By contrast, less-happy people are more apt to be defensive, isolated, and self-absorbed, and unfortunately, their negative moods are catching (technical name: emotional contagion). Just as eating your dinner doesn’t help starving children in India, being blue yourself doesn’t help unhappy people become happier.”

Gretchen’s book The Happiness Project is packed full of impressive research why striving for happiness benefits everyone, and she backs it up with her personal experience. When she is feeling happy, she finds it easier to notice other people’s problems. She has more energy to take action, to tackle the sad or difficult issues. She is less consumed with herself. In working on her happiness project she came to an intellectual breakthrough that she calls her Second Splendid Truth: “One of the best ways to make yourself happy is to make other people happy. One of the best ways to make other people happy is to be happy yourself.”

I get that. And I have tons of respect for Gretchen.

But I think there’s a definite difference between what positive psychologists and happiness experts like Gretchen are saying, and the philosophy sold to us in Gilbert’s book, and evidenced in a new generation of noncommittal happiness searchers.

It comes down to meaning.

Holocaust survivor and late psychiatrist Viktor Frankl explains it best in his classic, Man’s Search for Meaning:

“To the European, it is a characteristic of the American culture that, again and again, one is commanded and ordered to ‘be happy.’ But happiness cannot be pursued; it must ensue. One must have a reason to ‘be happy.’ Once the reason is found, however, one becomes happy automatically. As we see, a human being is not one in pursuit of happiness but rather in search of a reason to become happy, last but not least, through actualizing the potential meaning inherent and dormant in a given situation.

This need for a reason is similar to another specifically human phenomenon — laughter. If you want anyone to laugh you have to provide him with a reason, e.g., you have to tell him a joke. In no way is it possible to evoke real laughter by urging him, or having him urge himself, to laugh. Doing so would be the same as urging people posed in front of a camera to say ‘cheese,’ only to find that in the finished photographs their faces are frozen in artificial smiles.”

Frankl’s laughing analogy is perfect.

In Gretchen’s experiment, happiness is a byproduct of the commitments she has made — to herself, to her family, and to her community. Her happiness is a direct result of very hard work, not a life of Saturdays.

I’m not even going to use the term happiness for me — again, because, when I do, the primal part of my brain fires up and I start twitching. But peace or resilience, as Kramer says, that is available to me as a result of investing myself into the world, by tackling all of my Mondays as best I know how, and by honoring my commitments day in and day out.

By Christine Hammond
If you have clients who are intentionally exploited by their spouses; endure regular insults and rejection, alternating with affirmation; and feel manipulated into doing or saying something out of character, then they might be experiencing abuse.

Abuse is not just physical. There are many other forms of abuse, such as sexual, financial, emotional, mental, and verbal. While some of the other forms of abuse are obvious, mental abuse by a narcissist can be difficult to spot.

It starts simply with a casual comment about anything: color of the wall, dishes in the sink, or the car needing maintenance. The remark is taken out of context by the narcissist to mean that their spouse disapproves of them in some way. She tries to explain that wasn’t her intention, but they are off on a tirade, which ends in your client feeling like she is losing her mind.

How did this happen? Here are several favorite narcissistic mental abuse tactics:

Rage – This is an intense, furious anger that comes out of nowhere, usually over nothing (remember the wire hanger scene from the movie “Mommie Dearest”). It startles and shocks the victim into compliance or silence.
Gaslighting – Narcissistic mental abusers lie about the past, making their victim doubt her memory, perception, and sanity. They claim and give evidence of her past wrong behavior further causing doubt. She might even begin to question what she said a minute ago.
The Stare – This is an intense stare with no feeling behind it. It is designed to scare a victim into submission, and is frequently mixed with the silent treatment.
Silent Treatment – Narcissists punish by ignoring. Then they lets their victim “off the hook” by demanding an apology even though she isn’t to blame. This is to modify her behavior. They also have a history of cutting others out of their life permanently over small things.
Projection – They dump their issues onto their victim as if she were the one doing it. For instance, narcissistic mental abusers may accuse their spouse of lying when they have lied. Or they make her feel guilty when he is really guilty. This creates confusion.
Twisting – When narcissistic spouses are confronted, they will twist it around to blame their victims for their actions. They will not accept responsibility for their behavior and insist that their victim apologize to them.
Manipulation – A favorite manipulation tactic is for the narcissist to make their spouse fear the worst, such as abandonment, infidelity, or rejection. Then they refute it and ask her for something she normally would reply with “No.” This is a control tactic to get her to agree to do something she wouldn’t.
Victim Card – When all else fails, the narcissist resorts to playing the victim card. This is designed to gain sympathy and further control behavior.
You can teach your clients to memorize these maneuvers, remain silent when they are being used, and end the conversation as soon as possible. This will keep them from being a victim of mental abuse.

There is hope for your exhaustion. Repairing, restoring, and rebuilding relationships takes time, energy and effort. If you need more help during this process, please call our offices at 407-647-7005 or send me a quick email at growwithchristine@gmail.com.

Finding Healing When You’re Broken By Sarah Newman, MA

We’ve all met one at some point. A man or woman who seems to believe they are the center of the universe. Arrogant, callous and manipulative, they force the world around them to accommodate this belief.

Self-important and conceited, the narcissist exaggerates accomplishments, requires endless praise, and has an uncanny ability to quash the achievements of others. They lack empathy and don’t seem aware that you are a whole person with your own needs. In fact, you’re only a useful tool, something to extract admiration from. The narcissist believes they’re entitled to everything, including your time, your emotions and your self-esteem.

The dramatic attempts to hold your attention make your life seem tragic and fraught with anxiety. Being perpetually cut down so that the narcissist can be “better than,” destroys self-confidence and eventually leads you down a spiral of gloom.

I remember when I realized I was dealing with a narcissist. I remember receiving a beautiful embossed card one December that simply read “Joy.” I put it on my mantle for a few days before I really thought about that word. I felt so disconnected from it. What’s joy? Then I found myself wondering:

When did I get so negative?
Why am I always so down on myself?
When are things going to seem good? Or at least okay? I feel like I’m always one minute from tragedy.
Why do I feel so guilty every time I feel the least bit happy?
Whether it’s your boyfriend, your mother, your best friend or your husband, you may find yourself living in their narcissistic delusion, subjugating your own needs and feeling downright terrible most of the time. While you want to live your truth, you feel like you can’t. There are a lot habits that narcissists teach us that make it seem almost impossible to break free.

Here are a few things that I had to realize before I could unhook myself from the narcissist in my life:

1. A narcissist won’t appreciate all you go through to accommodate or satisfy them.

When you’re dealing with an extremely selfish person, it’s often easier to let them get their way than to try to make them conform to average social norms. For instance, you agreed to get dinner at 7, but they’ll show up whenever they want. You may even wait hours without so much as an apology.

If the tables were turned and you were late to dinner, you’d be apologizing for it until the end of time. If you’re the kind of person who doesn’t put up with this hypocrisy, the narcissist wouldn’t associate with you anyway. But you don’t want to be petty and you don’t want to spoil your day with an argument, so the narcissist wins. You eat where they want to eat, you watch what they want to watch on TV, and so on.

We conform to the narcissist; that’s why they keep us around. However, these efforts will never be appreciated. No matter how thoughtful your attempt, no matter how much time or money you spent, no matter how many people were put out on the narcissist’s behalf, the narcissist will not thank you. You’re only giving them something they believe they are entitled to.

2. They will never remember all the things you did right, only what you did wrong.

If you’ve ever been close to a narcissist, you’ve probably felt like a perfectionist. Nothing you do is good enough and you’re always missing the mark. The narcissist loves having people like this in his or her entourage. Because their expectations are unrealistic and their standards are impossible, the narcissist is also a perfectionist.

As a narcissist, “perhaps, the only way for you to feel special is to command special treatment, to insist on unquestioning compliance with your wishes from others, to demand nothing less than perfection from others,” writes Pavel G. Somov, Ph.D.

In sum, they are intolerant of imperfection as they feel it reflects unfavorably on them. If they are perfect and everything around them is perfect, then others will respond to them as perfect, and then, and only then, will they buy into the perfect reflection in the social mirror and finally feel good about themselves, if only for a brief moment.

While the narcissist won’t pat you on the back for doing something right, they will keep a laundry list of everything you’ve done wrong. It helps them to keep you feeling low about yourself and inflate their own ego. So I ask, what’s the use in bending over backwards, if none of the things you do right are going to count?

There’s no use in conforming to the narcissist. Doing so may hurt you more than you think.

3. If you subjugate your needs long enough, you’ll begin to lose your sense of self.

When you’re making a decision, does your mind automatically wonder what the narcissist would say? Their critical eye and overly harsh judgment rattles around in your head even when they’re not around. You don’t try a particular diet because the narcissist said it’s a waste of time. You buy a particular car because they said it’s the best. You pass on things or buy into other things because the narcissist said so and if you did something contrary they would bully you.

But what about what you want? Do you even know what that is? If the narcissist wasn’t in your life, who would you have dated, what car would you have bought, what movie would you go see, and what neighborhood would you move into? Ask yourself what it is that you truly want, without the narcissist’s influence, and start putting those needs first.

When you accommodate their profound selfishness, you’re affirming that your needs don’t matter as much as the narcissist’s. It’s as if they’re saying, “I’m going to bury your self-esteem,” and we answer, “Great, let me help you with that.”

Setting healthy boundaries is the only way to meet your own needs. It’s hard if you’re a “live and let live” kind of person. We don’t like to think that we have to guard ourselves a little more with certain people and we don’t want to believe a narcissist is a lost cause. But if you put the effort into caring for yourself that you put into keeping the narcissist satisfied, you could become the confident person the narcissist pretends to be.

Stay involved, don’t take sides and other tips for handling a break-up in the family

When a family is disrupted by divorce, it’s common for children to experience feelings of anger, frustration and sadness. Some children, though, resort to blame in order to cope with the new family situation, and refuse to speak to one or both parents as a result. “When a child behaves this way, it’s often because they blame you for the divorce,” says Melody Brooke, a family therapist in Richardson, Texas. Parents can combat the blame game by fostering open communication with their children who are coping with divorce.

Stay Involved

Even though your children may be giving you the cold shoulder, it’s important to stay involved in their lives and continue to show them that you care about them. Attend school events, send cards and notes, continue to call even if they won’t speak to you, and include them in all family activities, says Brooke. “The only thing you can do is continue to love and support them and be there for them even when they don’t want you to be,” she says.

Validate Feelings

An angry child needs time and support to work through these feelings. A teen who understands the complexity of relationships may feel betrayed by one or both parents during a divorce. Encourage your child to talk through these feelings with you, a trusted friend or family member or even a professional counselor. Taking the steps necessary to open the lines of communication, even if it isn’t with you, shows that you view her feelings as valid.

Keep in Contact

Every boy and girl needs a mother and a father, so it’s imperative that both parents stay in close contact with children after a divorce, even if they refuse to speak to you. “Do not allow your child not to have contact with one parent,” says Dr. Fran Walfish, Beverly Hills, Calif.-based psychotherapist and author of “The Self-Aware Parent.” “It is destructive to the child to have zero contact with a parent.”If the child is resisting contact with one or both parents, Walfish recommends contact with reasonable boundaries or even supervised visits. “Both parents must give permission and enforce contact with both parents,” says Walfish. “The courts decide on custody, so the only time not to allow contact is in the case of child abuse, and in those situations, the court assigns a monitor to supervise visits.”

Resist Taking Sides

When the family split is fueled by negativity and hostility, children often shift the blame to one parent and sometimes try to cease contact. Even if your child doesn’t want to speak to your ex-spouse or even you, resist the urge to fuel the blame game.

“Often, the parent who is not rejected by the child knowingly, or unknowingly, colludes with the child by saying bad things about the rejected parent,” says Walfish. “The child feels an alliance and protectiveness toward the jilted parent.” This behavior only adds fuel to the fire and can disrupt the relationship he or she needs to have with one or both parents.