Benzodiazepines linked to Alzheimer’s Disease

Doctors prescribe benzodiazepines like Xanax (alprazolam) and Klonopin (clonazepam) as if they have no side effects or long-term risk, but a new study links the use of these “benzos” to the development of Alzheimer’s disease. Just a 3-month course of benzos was related to a 51 percent increase in the likelihood of a dementia diagnosis. That’s significant! The disclaimer is that this is not a causal link, and that benzos are often used to treat the symptoms of dementia, but… why take the risk.

I’ve said for years that Big Pharma and Big Medicine are using psychotropic medications to treat emotional problems with a chemical solution. Why not try therapy FIRST to address issues of anxiety or depression, rather than just slather some chemicals on the brain? Anxiety and depression are merely the body and mind’s use of emotions, such as the alarm/fear response, that has gone into over-drive.

Another disclaimer if you are currently taking benzos:  Do not abruptly stop using these drugs. Work with your doctor to slowly wean off of them. And get a therapist!

Karma of the Crowd

The February 2014 issue of National Geographic has an interesting article on the “Karma of the Crowd.” Laura Spinney reports on research by psychologist Stephen Reicher of the University of St. Andrews. He looked at the psychological and social effects on Indian Hindus who went on a pilgrimage to Allahabad for the Maha Kumbh Mela festival. Depending on the year, 30 to 70 million Hindus come to bathe and pray at the convergence of the Ganges and Yamuna rivers. The thought of those crowds in a space the size of half of Manhattan (with third-world toilet facilities) makes me want to run the other way. But many pilgrims actually came home healthier and happier than when they left for the Kumbh, despite bathing in heavily polluted water and enduring stress and misery on their travels.

What was going on? Reicher pre-tested and post-tested pilgrims and non-pilgrims on their mental and physical health. The pilgrims showed a 10 percent improvement in such things as pain, breathlessness, anxiety and energy levels. Before you poo-pooh this improvement, realize that many drug companies would be thrilled with this level of success for their pharmaceuticals.

What brings these benefits? Likely the effect of shared identity. “Belonging to a crowd… might thus benefit the individual in the same ways more personal social connections do,” the article says.

Rather than crowds being harmful (think mobs and looting), crowds are critical to society, Reicher is quoted as saying. “They help form our sense of who we are, they help form our relations to others, they even help determine our physical well-being.”

The trick, though, is it can’t be just any crowded subway car. The pilgrims felt tied together in the same purpose and felt a sense of belonging.

In “Pack Leader Psychology,” I proposed a similar concept — that we social humans absolutely need a sense of acceptance and belonging to feel emotional fulfilled. I proposed that modern Western society has so many social and emotional problems because of a lack of sense of belonging to a larger group and cause — a “pack.” This article confirms that theory, even linking the life expectancy in the United States to our lack of social connections and increased isolation.

So it may be time to reconsider. Maybe that sports game is more than just about cheering the home team. And sitting in church is not just about seeking salvation. We all need “a tribe” for a sense of belonging, and with that comes wonderful benefits to our health and wellbeing.

“Be In the Moment”: What Does It Really Mean?

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IMG_1879Meditation has become extremely popular and with good reason: The benefits for body, mind and spirit are well researched and well documented. Although I have practiced meditation since 1977, I recognize that phrases used in teaching meditation, such as “be in the moment,” can be difficult to understand.

Being in the moment is described as being fully mindful of our experiences as they happen, not focusing on the past or future with our thoughts.

I became much more skilled at living in the moment when I consciously made major changes to my personality and behaviors that I write about in my book “Pack Leader Psychology.”

While meditation can be helpful in developing this skill, I believe it is also important to thoughtfully choose to become aware of and eliminate certain habitual thoughts. Specifically, when I was struggling to improve my self-worth, I learned to become less judgmental of myself and others. I told myself consciously that these self-critical thoughts were not emotionally healthy and I chose to stop thinking them. This now allows me to truly engage in what I’m doing or who I’m with without an inner commentary that distracts me from that experience.

Most mindfulness practices, such as Buddhism, involve lessons on compassion for self and others. This is key to living in the moment.

As a psychotherapist I work with people who lack self-compassion. People with low self-worth often experience a constant stream of critical internal messages about themselves. It’s hard to live in the moment with those messages wafting through one’s brain.

People who are not self-compassionate also tend to look externally for approval, making them  fearful of judgment by others. This means they do not live in their own experience, but are overly worried about the other person’s experience. I recall spending a ton of emotional energy worrying about things like: “Do they like me? What does he want me to say? Am I wearing the right outfit? She is touching her hair a lot — maybe she’s telling me my hair is out of place.”

Clearly, I wasn’t really in the moment, experiencing the full person authentically. I wasn’t just being myself, but was more concerned about the other person’s opinion of me. This meant I was not emotionally or physically attuned to other person. Research shows that people can unconsciously sense this lack of attunement. Parts of our brains are used to sense the emotions of others. This helps us get along socially in a group and allows us to sense fear in others so we can react quickly to a physical threat.

I believe that when I was so distracted during a conversation it sent two signals to the other person. The first is a signal of fear. This made the other person anxious, which isn’t exactly a relationship builder. I also unintentionally sent a signal that I did not really like the other person. Because if I was fearful, could it be that I was fearful of her? She didn’t know the cause of my fear, she only sensed the emotion, so this would make her also tense up, even if she did not consciously understand the cause of her reaction.

The irony is that as a “Submissive” or pleaser type of person, I was trying desperately to get this person to like me. But, in reality, the exact opposite occurred. My not being in the moment probably felt cold, distant, fearful and inauthentic because I wasn’t fully present emotionally.

We all have a natural need to belong. But when our lack of self-acceptance and low self-worth lead us to be overly eager for approval, we may be triggered into a fear state and go overboard to seek acceptance. We may spend too much cognitive and emotional energy thinking of what the other person wants us to be, rather that just living in the moment and being authentic.

I now have much less concern for what others think of me and I am much less judgmental of myself or others. I have turned off those messages in my brain that worry about whether I am wearing the right outfit or saying the right thing. And the interesting thing is that by being authentic and in the moment I often relax, fearless, and say and do exactly the right thing at the right time.

 

Parents: You are Your Child’s Best Therapist

I had been seeing a pre-teen girl in therapy for a couple of months and recently saw the girl and her father for a review of the therapy goals. We discussed if her behaviors were improving, what was working about therapy, and what wasn’t. Although she and her father didn’t state it this way, I considered the underlying reason she was brought to therapy was for a lack of accountability. She did not claim to see the connection between not studying or doing homework and her poor grades. She had lots of excuses for why homework didn’t get done or didn’t need to be turned in. She had excuses for her bad grades on tests. She lied needlessly to present herself well. She had great difficulty being responsible for her choices and had difficulty apologizing.

These were all issues that bothered her father, who wanted her to learn to be responsible and honest — admirable parenting goals.

Accountability is a key character and behavior trait I identify in “Pack Leader Psychology” that distinguishes between emotionally healthy individuals (“Pack Leaders”) and unhealthy personalities of “Dominators,” “Submissives,” and “Avoiders.”

The good news with my client was things were getting better for her: her grades were improving, and the lying had gotten better. So I asked if there was anything that she wanted to work on regarding her relationship with her father, as they had a tendency to argue quite a bit. She quickly stated: “I want him to quit smoking.” Apparently he had agreed to quit smoking as a New Year’s resolution, but less than a month into the year he had relapsed.

Well, I was supportive of this healthy goal with the father and we talked neutrally about this for a minute. Then suddenly the father stood up, stated they were leaving and left. I was a bit stunned, as the conversation had been so positive to that point. Therapy for his daughter was going well, her behaviors were improving and I assumed he would be happy about that.

It took me a second to realize that the reason he left had nothing to do with his daughter. It had everything to do with HIS lack of accountability. He did not like being called out for his lack of ability to quit smoking. Just a short, supportive conversation about the very obvious health value of quitting was too much for him. He was hypersensitive to criticism and shame and reacted by bolting from the therapy room. I’m sure this behavior plays out in his life in many ways, but as he is not my identified patient, I do not have evidence of this.

This is where I part company with many child therapy theories. I believe therapy with children usually fails unless it addresses and changes the behaviors of the parents. How could I expect a child to learn to be accountable with 1 hour of therapy a week when 167 hours a week she lives with a parent who so clearly lacks the ability to step up and own his own choices and behaviors? His levels of self-criticism and shame were so high he could not handle any external criticism.

Parents: Get your own emotional and behavioral house in order. If not, don’t expect your children to grow up to make healthy emotional, behavioral or moral choices.

Fight or Flight Causes “Mental Illness”

“Fight-or-flight” is a concept I discuss in depth in “Pack Leader Psychology,” because I believe this primal fear response is key to understanding human behavior. This natural survival instinct is also a powerful driver of human emotions and interactions, yet psychiatrists and psychologists seem to have ignored this important fact when developing diagnostic and intervention theories.

I believe we in the profession and in the general public should talk more directly about the fear response. As a psychotherapist, I believe that if we more routinely label these behaviors people will not only begin to understand them, but the behaviors will be normalized. By calmly and clearly explaining a behavior, such as anxiety or depression, as a normal, primal response, perhaps some of the mystery about human behavior and psychology will be removed. It should not abrogate responsibility for these behaviors, especially the violent, abusive behavior that often accompanies the “fight” response, but at least it will increase awareness.

I believe the psychology profession has, for too long, used obscure, confusing terminology. What could be more primal and clear than “avoidance, freeze, flight and fight?” These are behaviors that every animal understands at the level of the survival instinct and to label these reactions as “mental illnesses” is incorrect, stigmatizing and may reduce the effectiveness of therapy.

I routinely explain the “fight-or-fight” response to clients in therapy and many have heard of it, but never applied it to their own behavior.

In “Pack Leader Psychology” I also add new layers of understanding to this concept, explaining why people today are so quick to flip into a fear response in today’s world and how to stop this behavior.