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Monday, September 10, 2012

The Problem with Motivation

It has seemed to me in my practice that I am dealing with more and more persons, particularly over the age of 50 but sometimes far younger, who are having significant problems with a lack of motivation.  Sometimes these are people who have been quite active in the past and accomplished a lot.  Now they find themselves not being very active, and it bothers them.

The Problem

This blog is written mainly for people who have been motivated in the past to do things and who, due to age, depression, or some othe reason find themselves in a temporary state of not being motivated.  The techniques I discuss here are not likely to work in cases of what I might call "primary motivational problems" in which the brain was never very motivated (as in some cases of Autism Spectrum Disorder) or in which some fundamental change has occurred in brain function (as in frontal lobe dementia).  This blog is aimed at persons who have had motivation and find themselves doing less than they did in the past.  Their motivation may wax and wane. Some of these techniques are also likely to help persons with ADHD who have always had some problems with it but who at times can be highly motivated.

So first of all, a definition.  Motivation is the drive that comes from within us to do things, accomplish things, create things, impact our environment, and be active.  It is not simply the same as energy, but it is certainly linked to it.  If one has little energy, then there is likely to be less motivation.  If there is more energy, then it is easier for us to motivate ourselves.

Motivation is linked to the capacity to experience pleasure, but it is again not exactly the same.  If there is no pleasure from doing things, then there is less motivation.

But even without energy and without pleasure, persons who have been active in the past may still have a type of motivation.  They may at least "want to want to do something."  That is, they may be dissatisfied with doing very little and at least wish the situation were different.  They want to be more active and motivated but just don't know how to get there.  In conditions I referred to as "primary" motivational problems, the person no longer wants to be more motivated, and/or they may never have experienced the desire to do more.

Part of my fascination with motivation comes from watching my grandson, who is almost a year old. Motivation is never an issue with him. Never. He always wants to do something. He always wants to climb or explore, or pry the cover off an electrical socket. Ouch. So motivation is not a problem for him. But many of the clients I work with have been motivated in the past but have lost that some time during their lives.

Possible Causes for the Problem

Where does the problem come from?  Well, all emotion and behavior is rooted in the brain.  (We now know that there may be some exceptions to this, but they are not the point here.)  The brain is certainly the culprit for much of our lack of motivation.  Motivation can come from the serotonin system, the domamine system, and the frontal lobes.  For more information, see   .

There are undoubtedly psychological problems which interfere with out motivation.  I think that poor parenting can interfere with our motivation.  All children have to be told, "No, don't do that, don't touch that," etc.  But too much scolding, punishment, and cautioning of children creates excessive inhibition and guilt.  It is likely to carry into adulthood, creating a condition where we are more focussed on minding the rules than exploring and trying new things.

Clearly, for some if not most of my patients, depression has been a problem. It drains motivation. That is one of the symptoms of depression.

And then there is the role of natural aging.  A lowering of motivation appears to be part of the life cycle.  When I look around the assisted living center where my mother stays, most of these people are tired and seemingly not very motivated.  Clearly, there are physical changes in brain and body which have led to their inactivity.  Changes in the white matter of the frontal lobes of the brain may be partly responsible for low motivation in later years.  But on the other hand, we all know that some older people stay mentally and physically active and alert.  My mother reads a book a week.  At 86, she can hold her own in any discussion.  She is not as motivated as she used to be, but she is very inquisitive. 

It is not clear that we need to accept decreased motivation with aging.  Perhaps we do.  But I am of the same mind as the poet Dylan Thomas who wrote,  "Do not go gentle into that good night--rage, rage against the dying of the light."  I don't believe in dwindling away. We don't have to be rocket man over the grand canyon to stay active. (If you don't know what I'm talking about here, you really need to see the video on Youtube of the man flying  over the Grand Canyon. ).

But age undoubtedly has some effect on us.  Chuck Yeager, the famous test pilot is reputed to have said, "There are old pilots, and there are bold pilots, but there are no old, bold pilots."

Our Environment Changes Too

There is a scene in the movie Chariots of Fire where they are entering Cambridge, and there are a variety of activities the freshmen can join in  It's a scene that reminded me of my own high school and college years.   That type of cafeteria of available activites is usually not spread before us in later life.  And we don't have the energy to pursue all of those activities.

But maybe it would be nice if there was a "high school" or "college" for us to attend our whole lives long.  There would be plenty of people to meet and associate with and plenty of activities to engage in.  There might be less premature aging and fewer couch potatoes among us if we had more choices. Some large churches provide this type of atmosphere.  This kind of social setting can give us social and intellectual stimulation. There would always be clubs to join, and things to try out.

Then there is the issue of feeling like what we do matters.  When we work at a job, there is often an overall sense that no matter whether we like our job or not, it matters to somebody.  A customer's roof gets put on and protects against the weather, or it doesn't get put on and the customer suffers.  Somebody's clothes get cleaned or they don't have the clean clothes to wear.  A customer at a restaurant is served, or they don't get fed a meal.  Once we retire, we are mostly doing things for ourselves.  Our behaviors don't necessarily "attach to" or relate to the outside world.  As a result, there is no boss who is going to be pleased or displeased and there is no issue of whether we get a paycheck or not.  Who is going to care and who is going to be affected if we clean out the garage or just watch TV instead?

I sometimes wonder if the active, motivated state that we have during a regular work week somehow carries over to mowing or cleaning the house on weekends.  In other words, I think that it is good for our brains to have to do things and work hard; it is my belief that staying motivated and active through the work week keeps our brains "tuned up" so to speak, perhaps through greater use of the neurons and/or through greater blood flow.

The Negative Side of Habits.

As we will see, habits can be a positive effect on motivation; but just for a moment, let's admit that maybe there is a downside to certain habits.  I suspect that building up habit patterns over a life time may interfere with breaking out of ruts and trying new things.   For example, if our habit is to have breakfast with the guys at McDonalds on Saturday, get a haircut, mow the lawn, and then drink a beer Saturday evening, followed by church and watching NFL football on Sunday, could those habits interfere with acquiring new behaviors?  Possibly.  On the one hand, these are good things to do, and it helps us to be able to do them easily without really having to decide to do them.  However, some behavioral habit patterns may also prevent us from trying new things in life.

Some Techniques to Work on Motivation

Here are some possible ways of motivating yourself when you feel like you are not really doing as much as you want to in life.

1. Commit yourself to a goal or action in front of other people--Let other people know what you plan to do.  It motivates some people to follow through when they have made a public or semi-public commitment to a course of action.  ("I am going to build a new deck for my house; I am going to take a course in French. Etc.")

Or similarly, belong to a group that encourages you towards your goal and to whom you report your success. Psychologist M.E.P. Seligman writes about an online group to which he belongs. All the members encourage each other to stay on their exercise regimens through email.

2. Reinforce yourself--Give yourself something out of the ordinary for following through.  The trickiest part of this strategy is not rewarding yourself with the same reward at other times.  For example, if the reward for cleaning out the car is a Starbucks coffee, then it is important to not have Starbucks in the week or so leading up to the time to clean the car.

3. Creative procrastination.  If you just can't seem to set that dentist's appointment for next week, set it up for a few weeks out, or even a few months out.  It may seem easier.  Then when the time rolls around, just keep the appointment.

4. Do a little bit.  Sometimes doing just a little bit of something can be energizing.  After doing a little bit, one may find it easier to take the next few steps.  If not, then at least something has been done.  If necessary, do the simplest, most minimal amount just to get started.  If you need to have an appliance repairman come to the house, put the phone book on the desk in plain sight.  This may lead you to a chain of behaviors that eventually gets the appliance repaired.

5. Get your spouse to give you a nudge.  Tell him or her what you are trying to do, and get them to remind you or prompt you to do what you really want to do.  When they do remind you, don't take it out on them.  They are just doing what you told them to do.

6. Find a different time of day.  This blog on motivation has taken me a long time.  I find that I just don't have the motivation to work on this blog about motivation in the evening.  :)  But it has written itself in the morning.  Find the right time of day.

7. Build habits. While I wrote about the downside of habits above, the upside is probably greater than the downside. If appropriate, find something which is done every day at the same time, or perhaps every week at the same time. If you build a habit, you don't have to make a conscious decision to do it. It is my habit to get on the computer to pay bills, work on blogs, and balance my checkbook every morning. That is a good habit. I don't have to decide what to do; I just do it. And as a result, it gets done and without having to force myself to do it.

8. Become part of a group which has regular activities; this way you stay active without having to plan every single activity yourself.  And there will be people there expecting to see you.

9. Go places that would stimulate you to want to do more.  If you are an amateur astronomer, and there is a company that sells telescopes, go to their showroom.  If you are a sportsman, go to a Bass Pro Shop.  If you are an artist, visit an arts supply store.  See if this stimulates your interest.

10.  Use reminders.  Put up pictures to remind you of things you enjoy doing.  If you have a boat in storage and never use it, put up a picture of it in your office or home to remind you how much fun you have with it.

11.  One of my favorite strategies is taking lessons. But I will admit that it can be expensive. My piano and painting lessons are not too bad, but the flying lessons are killing me.  But not only am I motivated to do my homework and keep doing my hobbies, it makes me feel good that I am learning new things.

12.Schedule activities. Have regularly recurring activities. Again, this way, you don't really have to make a decision to do something. And you don't have to decide what to do; and you don't have to work as hard making arrangements for the activities.

13.  Clear away the negative thoughts that would interfere with trying things.  What kinds of negative thoughts?  Well, I don't know what yours would be, but here are some that people might encounter:
     I'm too old for this.
     I'll fail.
     I'll look stupid.
     I'll never stick with it.
     This is for young people, not for me.
Then there are other negative thoughts that may have some validity that you may need to find a way of solving:
      I don't have the money for this.
     I will pay for it tomorrow with aches and pains. 
     I'm not as mentally sharp as you used to be.
Some of these thoughts may have some validity.  But that doesn't mean that they have to totally dominate your decision making and prevent you from doing some of the things you want to do.  Just make the necessary adjustments to the activity so that maybe it will work for you.

Wednesday, June 06, 2012

How Tightly is Your Front Door Shut? The Preservation of Identity and Self-Esteem versus the Mature Need to be Known.

We all have a front door to our personality, and for some of us it is bolted shut.  For others of us, we open it up from time to time.  We can let others see in, or even come in for a visit.  And for still others of us, it swings open too easily. 

All counselors have had patients who seemed to use a high degree of defensiveness and denial.  This shows up on psychological tests as a high degree of defensiveness.  It can get in the way of counseling when people are overly defensive, and it can be very frustrating.  For example, I might administer a 175 question personality inventory and find that a patient has answered false on every single symptom question.  Even the healthiest of persons has some kind of symptom.  The patient is not identifying problems to work on, and they are not identifying any of their own coping mechanisms which need to be worked on.  Sessions in this case can be quite stilted, slow, and uncomfortable.  The patient may "throw a bone" to the therapist, some little problem to work on, but nothing significant.  Sometimes that changes later in the therapy process when the client is more comfortable to open up.

However, there can also be a problem when a person has an overly wide open front door.  Imagine the following scenario:  "Hello, my name is Ed.  What's your name?  I just got out of Griffin Memorial Hospital, but my schizophrenia is under control. I'm not suicidal anymore, and my medication is working just fine.  I'm going home for some pizza right now; would you like some?  It would not be wise for us to be totally transparent and let the world see everything about us; and it would not be wise for us to expose our "inner DNA"--our identity and self-esteem--for just anyone to influence or experiment with, since this is a precious commodity.

We all keep a front door closed so that the outside world does not see too much. Jung drew a distinction between the persona and the ego and the self. Normally we just let the world see our persona.

I try to be sympathetic with my patients and to realize that there is a reason whey they are the way they are, and to that end, I have come up with an explanation that makes sense to me of why some people are so defensive.

Traditionally, patient defensiveness in therapy would be seen as either a result of anxiety about opening up, or a result of low psychological mindedness.  These would remain possible reasons in my mind, and I won't discuss them here, but what also makes sense to me, is that  psychological defensiveness is protecting something very precious.

Think of a cell and its DNA.  There is one thing in a cell which it absolutely must protect.  It is right at the center.  It is the code, the DNA.  Without it, it dies.  People have a kind of DNA.  Cell DNA gives a map for the how the cell will function.  A person's identity and self esteem also tells them their path and how they will function.  Without identity a person would be lost and drifting.  Without a sense of identity it would be harder to have a sense of self-esteem.  And without self esteem the person might feel that there would no reason to even try to function.

Using this model, the resistance of some people to opening up in psychotherapy is at least somewhat logical.  The resistance to letting others see one's DNA is similar to not letting others try to change one's DNA.  The organism may be programmed to protect that core.  Just as the cell is programmed to protect its DNA core, the human being, especially after reaching the late teen years, is probably programmed to protect their identity core:  "I belong to the nation of A and the religion of B.  My clan is C.  And I will defend them to my death."  This is an identity core.  If I let you see into my core too closely, however, you may see my uncertainties, and then you may want to change me.  That threatens what I have been taught.  Moreover, if I did change my identity it would require a great deal of energy. 

Teenagers are often loathe to open up in counseling about their problems and about their identity.  They particularly don't seem to want to open up about their problems to adults, and again, I think this makes sense.  They have finally started to have a clear sense of identity, and they don't want to start over.  Of course, they are not necessarily thinking in these exact terms.  I suspect that what they are actually thinking is, "Why is this shrink talking nonsense?  I'll just go along with him to the extent I have to, to get him and my parents off my back."  But his organism and genetic code may be thinking (not really "thinking," but sort of), "I have to preserve the important formative experiences of my identity.  I've got the truth now about who I am, and even if I am not totally sure it all makes sense, I can't start over now."

Here is a second analogy.  Imagine a sci-fi thriller movie in which the crew is in hibernation.  They wake up and find reason to suspect that their computer guidance system software has become corrupted.  The spatial coordinates in the computer are not quite right.  But on the other hand, those coordinates are all they have.  They can't call home, especially if they don't know which direction to point the antenna.  Even though the information in the computer is not quite right, the crew would fight to preserve that flight computer and its coordinates, because it is all they have.  Now, in the same way, we are probably programmed to defend our inner identity because it is all we have.

It takes a very mature person to be able to select the right therapist, open up their front door just the right amount, and then allow dialogue with their therapist with the aim of changing their internal identity and sense of direction.  Then, after a correction, the front door has to be closed once again.  The therapist has to be told goodbye in a mature fashion (see my blog on saying goodbye to the therapist), and the person goes on with their new set of inertial coordinates, their slightly altered sense of identity and coping abilities.

Some people are never ever able to open the door and let see someone else see in. They are never able to open the window shades and let a therapist have a chance to help them alter their inner DNA so as to feel better, have a happier and more productive life and so on.

Finding the balance between adequate self-protectiveness and reasonable openness to correction is difficult.  It can be hard to find a balance between protecting our inner DNA code and being mature enough and strong enough that we can let someone else see in and help us with some of our internal issues. 

Tuesday, May 22, 2012

My One Hundredth Blog Post

Today, I publish my 100th blog post.

Why do I do it?  Well, for one thing it gives me great satisfaction.  Knowledge is not to be kept or hoarded.  Moreover, I enjoy helping my patients solve their problems.  I know that some people for one reason or another can't make it into therapy.  I would hope both to encourage people and to explain some concepts regarding psychology along the way.  I also enjoy the feeling of being connected to people.

Commercial publishing is not really an option.  I've gone that route (mostly dry academic books on depression), and those types of books don't get distributed out to people very well.  There might be some money to be made on popular books.  But the money is not important.  What really brings me satisfaction is knowing that people around the world can freely access this information.

Ideas don't belong to any one person.  I don't know where they come from.  Sometimes I think that I have a new idea, but I suspect that what really happens most of the time is that my mind takes information which I have encountered and puts a slightly different twist on it.  They are my ideas, and yet they are not.  And if I don't share them, someone else will.  So why not share them for free?  And it seems like the more I share my ideas, the more it stimulates me to think.

Each of us has something to contribute.  If we give it away, the world is a better place for it.  Now I don't blame people for making money off of blogs or books.  I made a few dollars off of my academic books.  But there is also a time to give things away.

I like the idea of Teilhard de Chardin about the noosphere.  He was a Catholic theologian banned from publishing by the Vatican.  (It always makes something more tantalizing somehow when it has been banned).  He talked about the noosphere [(Greek word for mind=nous)+sphere] (sorry, I don't know how to pronounce it).  Of all the spheres surrounding the Earth (atmosphere, biosphere), he theorized that this one was composed of thoughts.  Here is a link, summarized in Wikipedia:  and .  I like the idea of adding my own thoughts to the noosphere.

So, I hope there is something useful here for you.  I would encourage you to read a little about Teilhard de Chardin, a very interesting thinker.  And hopefully, you can add your own contribution to the noosphere in one way or another, too.

Thursday, May 10, 2012


I always like to find a good, new book which summarizes recent research.  I was very impressed with the book Willpower by Roy Baumeister and John Tierney.  There is so much useful information in this book that there is no way to cover it in this blog.  However, there are two major thrusts of the book which I would like to focus on: ego depletion over short periods of time and building willpower over long periods of time.

As the authors point out, the whole concept of willpower was considered quaint or even nonsensical in most of 20th century psychology.  When I went to graduate school, there was absolutely nothing about it in my courses.

The book makes many points, but there are two major ones.  First, there is evidence that in the short run, our willpower (or self-restraint, or whatever you want to call it) can become depleted.  The source of the temporary depletion appears to be remarkably simple--less available glucose to the frontal lobes.  And one momentary cure can sometimes be as simple as--sugar.  Yes, sugar, that "evil" substance which has been accused of so many offenses, from hyperactivity to diabetes.  I am not advocating a diet of sugar, either for ourselves or for our children.  But the authors point out that in a laboratory situation, a quick hit of glucose seems to reverse the effect of willpower depletion.  Ideally, we will all have appropriate diets involving protein, complex carbohydrates, and so on, which provide the body the energy it needs on an ongoing basis.  But in a pinch, there is nothing wrong with a Hershey's Kiss.  A small amount of sugar can assist the frontal lobes in their work of exercising willpower and restraint. 
Now you may be asking: With all of the sugar being consumed in our society, why isn't there more self-restraint?  The answer is that the sugar "hit" only works when there is a temporary state of ego depletion.  The person has to have been actively using willpower over, say, a 15-30 minute period of time or more, for depletion effects to start to show up.  The availability of glucose is a "necessary but not sufficient" condition for willpower to occur.  This leads to the second major point of the book, and I think, the more important point:  willpower can be trained.  When we practice any type of willpower on an ongoing basis, it tends to have a generalized effect, heightening willpower in other areas.

Willpower doesn't just emerge from the brain like a flower growing from the ground.  While I do suspect that some of it may be genetic, I also think that much of our willpower comes from social training.  And I would give our society an "F" on that point.  (With the possible exception of the Asian community.)

I do believe that there are other important virtues for our society to train in children besides willpower.  I would vote for creativity and love as being two of the most important.  But willpower (and a related concept of "grit") is right up there with them for me.  Learning how to do the hard thing is so very important in growing up and being a happy, productive member of society.

The concept of willpower being important had not only disappeared from psychology at one point, I think that it has begun to disappear in the thinking of our younger generations.  I once had an adolescent patient tell me that she saw no reason for having to do multiple math problems for homework when she already understood the concept.  I did not have a good comeback for her at the time.  I do now. 

First, here is what I would have said then if I had thought it over then.  When we practice something over and over, we overlearn it.  By overlearning, we are less likely to forget it, and we are more able to remember it, even when we are stressed.  Now, here is what I would tell her now.  It's not just about math.  Yes, the overlearning of math procedures is important.  But there is really more at stake.  When we learn how to do the hard thing in something specific, we are learning how to do the hard thing in general.  And that is all too often what life requires of us.  I don't always like to do the hard thing, but sometimes I do it anyway.  We need to teach our children to do the hard thing because they will be faced with it over and over again in life. 

Ancient Spartans knew how to teach their children how to do the hard thing.  There were many things wrong with Spartan society;  I could list several off the top of my head.  But when it came to fighting off the Persians at Thermopylae, it was the Spartans that the other Greek city states turned to.  Their soldiers had learned a steely will power.  But are we teaching determination and restraint to our children?  Are we helping them to learn it while they are young, so they will not try to escape the challenges of life when they are grown?

Baumeister's research suggests that even for those of us adults who may be lacking in it to some degree, it is not too late.  No, I am not suggesting eating sugar.  Read the book.  I think you will find it very interesting.

Tuesday, April 24, 2012

Four Ways to Be Positive with Your Spouse--Your Words, Your Prosody, Your Nonverbal Behavior, and Your Actins

I have written before about being positive with your spouse and establishing positive reciprocal behaviors (if you give out positives, you are more likely to get positives back from them.)

I have come to understand that our communication with other people is multichannel.  (Translation:  There are several ways that we can be positive with our spouse, and there are several ways that we can be negative with our spouse, simultaneously.) 

There are at least four channels on which we are communicating at any one time:

1.  What are we saying?  What is the verbal content?  If it was written down, would it be positive or negative?

2.  What is the tone in our voice?  This is our prosody.  Think of it as the melody in the voice.  It can be friendly or mean, inviting or critical.

3.  What is our facial expression saying, and what is our body language saying?  Are we smiling, grimacing, or frowning as we deliver our message?

4.  Finally, what are we actually doing?  Are we doing something nice for the person (e.g. preparing them food) or something mean (throwing something, slamming things, breaking things, hitting them)?  Do we follow through on the things we have promised?  Do we remember the special dates, birthdays, and anniversaries?

These four ways of responding to our significant others would seem to exhaust the multichannel communication.  But they don't.  We are also communicating with our pheromones.  These are "invisible scents."  We don't know that they are being emitted by our bodies, but they are.  And the other person does not know that their brain is receiving them, but they are.

And there is probably at least one other type of communication going on, although perhaps less established scientifically--our pupil size.  When we see something we like, our pupils get larger.  the other person's brain may be able to pick up on that, and in turn, the second person's pupils may adjust.  This can be another type of back and forth communication.

But let's stick with the first four because we can't control our pheromones and our pupil size.

As we attempt to reverse the flow of negative reciprocity in a relationship to positive reciprocity, something which can be difficult, words alone are unlikely to be able to do it.  Compliments and positive observations about our partner are a good place to start, but more is needed.

We need to remember that we are communicating with the nonverbal behaviors--the look in our face, out body posture (are we turned towards them or away from them when they are talking to us).  What is our body language saying?  Is it positive or negative?  Are we pointing a finger at them?  Are we avoiding eye contact?

Then there is our prosody (pronounced PRAW-suh-dee).  Prosody is defined by the online Merriam Webster dictionary as meaning "3. the rhythmic and intonational aspect of language."  I think that this is often overlooked in our marital communication.  Words can be positive but if they don't have a certain melodic sound, the full positive quality of a message can be tempered or totally lost.

I have to pay close attention to my prosody when I am going to the hospital to test a new patient.  They don't know me.  Why should they open up and trust me?  I have to use every aspect of communication when I introduce myself to convey that I am there to help them, through my words, my nonverbal behavior, and my tone of voice.  Unfortunately, I think that after years of marriage, people simply don't put out the energy to use a friendly, pleasant tone with their spouse.  Their voice with their spouse can become flat--or even grouchy.  Watching the words we use is a fairly obvious way of being positive.  But we communicate with more than words.  The lilt or melody of our voice is our prosody.  Sometimes I think that our tone may be even more important than the words we use.  If you watch a mother talking to a newborn, she uses very exaggerated prosody.  It is a friendly prosody.  The infant hardly needs to understand the words.  The tone says it all.  It is warm.  It is friendly.  It is loving.

Finally, what are our actions saying?  It is said that men often express affection by doing things for their wife--mowing the lawn, taking care of the house and car.  I often like it when my wife offers to bring me a cup of hot tea when I am at the computer.

So, when trying to create a positive atmosphere in a relationship, remember these four things--words, body language, tone, and actions.  Give your partner something which is really positive.

Sunday, April 08, 2012

The Symphony Orchestra--Finding Happiness

In his recent book, Flourish, Martin E. P. Seligman puts forward the idea that while happiness is one worthy goal in life, it cannot be the only goal  According to him, well being is constituted of five things, which can be put into the acronym of PERMA.

P--Positive emotion, happiness.  Seligman does list happiness as part of the goal of life and part of the measure of well lived life.  In his previous work, it was the capstone of life.  Now he lists it as one worthy aspect of living.

E--Engagement--This diverges from sheer positive emotion.  It is doing something which engages the person in life, whether it is operating a business, pursuing a creative activity, raising children, or something else.

R--Relationships--This speaks for itself.  Relationships are in themselves a worthwhile aspect of living.

M--Meaning--The finding of something which makes sense of life, which gives it a larger context than just doing something for the moment, and involves something more than just feeling good.

A--Achievement--Accomplishing something which has value or worth.

Now some of my definitions here may not be exactly what Seligman would approve of, but I think they come close enough.

I am not sure why he left out three other pursuits, although I guess he would say they are included in the above.  The three others which I would list are creativity, the shaping of the will, and altruistic love (referred to by Christians as agape).  Creativity might be subsumed under engagement, or even under achievement, but I would like to see it have its own acknowledged place.  The importance of the shaping of the will has been pointed out in the book Willpower by Baumeister.  I think it deserves its own place, too.  Seligman would most likely subsume agape under relationships.

However, one could probably keep coming up with more and more indispensable categories.

I don't know if the ultimate goal of life is happiness, PERMA, or altruistic love.  I suspect it is all of these.  But when I think of what constitutes a sense of life satisfaction for me, I realize that it is not just one thing.  It is the resonance created by a variety of things happening in my life.  It is like a symphony orchestra.  The musical score for my life doesn't have just violins, trumpets, and French horns.  It has a great variety of instruments and many people playing those instruments.  In a symphony, it is the diversity, unity in diversity, and overall resonance which produces such a pleasing and satisfying effect.  The total result is something above and beyond what any one instrument can produce by itself and beyond what any one musician can create by himself/herself.  It is a situation where the whole is greater than the sum of the parts.

On the other hand, while I am emphasizing here the importance of having a diversity of pursuits, I will admit that I have six goals listed above all others for myself.  I keep them on my Yahoo calendar "to do" list, so that I see them every time I log on to it.

I would encourage you to read both Flourish and Willpower.  Make up your own mind as to what is important in your life.  What are you aiming at?  Remember that according to Socrates (as quoted by Plato in his Dialogues, Apology), "The unexamined life is not worth living."  That may be a little harsh, but it is not far off the mark.  But I think that the point in this blog is a little different: if you have not examined your life to know what is likely to bring you the greatest satisfaction, then you are likely to accept lesser satisfactions or to use your time in less than optimal ways.

(Now I would like to point out that I do also believe in "goofing off."  But it does not bring me any deep satisfaction.)

Hopefully, you have a variety of aspects of your life that bring fulfillment, and hopefully you experience that sense of resonance which comes from pursuing not just one focus but several.  Now I don't want to be a snob here.  I know that there are many people in the world who cannot really get involved in a variety of activities because of financial reasons.  However, I think that at least in American society, there are almost always opportunities for relationships with others, hobbies, and educational advancement.  (These days one can practically get a college education online for free--not a degree but an education.) 

Now what about people who have singlemindedly pursued one major area: explorers, artists, athletes, and so on?  I suspect that even for these people, one area of pursuit isn't enough.  While they may initially channel all of their energy into one area, eventually most people seem to need a diversity in their experiences.

I asked an acquaintance of mine about how she felt about being retired.  She said it was wonderful; it was like being a third grader without parents telling you what to do.  This view of life has much to commend it.  There is so much to explore and learn about in the world.  I hope that you are successful in finding a sense of richness, well-being, and resonance in your life.

Wednesday, April 04, 2012

The Colors of Optimism

I was reading the most recent book by Martin E.P. Seligman, Flourishing, which I highly recommend.  There are many interesting aspects of the book.  He highlights the research on optimism and the multiplicity of positive effects which it has in peoples' lives.  One positive effect for example is lower rates of coronary vascular disease.  (I am not going to outline all of the benefits of optimism here.  Just Google "benefits of optimism") and you will find numerous sites providing a list of the current experimentally validated benefits of such a positive outlook.)

However, reading his book, I found myself wondering just how optimistic is it realistic to be?

You have of course heard the following definitions:
The normal optimist--sees the glass as half full.
The normal pessimist--sees the glass as half empty.

Here are some more:
The radical optimist--It is bound to rain and refill my glass.
The radical pessimist--The little bit of water that I have is going to evaporate eventually, and I will have nothing.
The pragmatist--Simply goes to the faucet and fills the glass up without thinking about it.

On a more serious note, I realized that there are many "flavors" or "colors" of optimism.

The pragmatic optimist--This person understands the reflexive aspects of optimism.  If I expect the best and act like it is going to happen, it is more likely to come true.  Being optimistic leads me to better health behaviors. The pessimist might think that they have little control over their health outcomes.  Then by not trying to exert a positive effect, they do not do what they are capable of doing--having checkups, exercising, and so on.  If I am positive and optimistic, I will try harder at tasks.  I won't feel that I am wasting my time.  I won't be putting in a half hearted effort.  If I am positive, then people will also likely respond to me more positively.   

Moreover, it is also pragmatic because it feels better to be optimistic.  If I am anticipating something negative will happen every day of my life, even if it never happens, I will be more likely to feel down and even depressed.  If the events I worry about never happen, in one sense they might as well have.  One elderly woman I tested in the hospital told me that she had been sure that she was terminally ill; she had believed this since her early 20's!  How awful this must have made her feel--emotionally and physically-- for all of those years.

The protective pessimist--Some people feel that it just hurts too much to be disappointed.  They believe that it would feel better to not expect the best and then not be disappointed rather than expect the best and be disappointed.  Moreover, they believe if they prepare for the worst, they will be better prepared.

The focused optimist.  I perhaps like this one the best.  I will start by assessing a situation for all of the possible positive and negative outcomes and preparing for the reasonable eventualities.  Then I will stay focused on the positive potential.  Better things are likely to happen if I am positively focused.

The tres chic philosophical pessimist--The undergraduate who has read too much Sartre.  This type of person believes that it is just too naive to be optimistic.  There is too much suffering in the world.  They believe that a truly sophisticated person must be more cynical and pessimistic.

The philosophical optimist, a la Alfred North Whitehead--the world is evolving and getting better.  My philosophy says so. Alfred North Whitehead and Bergson had very positive philosophical systems which stated that the world (universe) was constantly evolving into a better place.

The theological pessimist--This person almost literally believes that the world is going to hell.  There may be a belief that terrible things must soon happen in order to fulfill Biblical prophecy.

The theological optimist--This person focuses on Bible passages which says that God is in charge of the world and that He will win over chaos, evil, and despair.  There is more of a focus on heaven than on hell.

There is both personal optimism and global optimism.  In personal optimism, I believe that my life will flourish.  In global optimism, I believe that the world will continue to advance and overcome negative forces. 

One might have both of these (My life will do okay, and the world will do okay).  Or one might be a personal pessimist and global pessimist (My life is going down the drain, and so is the world).  It might be possible to have one and not the other (My life is going to do okay, but the world is falling apart; or My life is going down the tubes, but the rest of the world will do okay.)  I suspect that personal optimism and global pessimism are correlated, but I don't know that for sure.

Ultimately, we have to have something to base optimism on.  It cannot be just wishful thinking.  As a cognitive therapist, I counsel my patients to test out their negative thoughts.  If they have fortune telling thoughts, follow up on them, and see if they come true.  I continue to have negative, fortune telling thoughts (unfortunately), and I can tell you that most of mine never come true.  They are generally a waste of time and energy.  Try it out for yourself, and see if you aren't wasting time with most of your negative predictive thoughts.  If they do come true, consider the possibility that they are reflexive, that is that they are self-fulfilling prophecies. 

For the time being, I am going to choose to be a focused optimist.  I am also a theological optimist.  These two go together well for me.  In my personal life, I will consider all of the things which could happen, and I will prepare for most eventualities.  Then I will focus my energy on pursuing the positive outcomes which could happen and act as if I expect them to happen.

Wednesday, March 28, 2012

An Evening with Marie Osmond

Last night Marie Osmond spoke in the grand ballroom of the Skirvin Hotel in Oklahoma City about her post partum depression.  I was impressed with her honesty and authenticity as she shared the incredible depths of the depression she went through following the birth of one of her children.  As with so many women now, she had very little time in the hospital to recuperate.  But on top of it all, her producers were demanding that she back in slim, tip top shape in just a few weeks to return to her entertainment job.  This seemed to produce just the opposite effect of what they had wanted.  Instead of motivating her, it drove her deeper into depression.

She shared how she left her children with someone and then just drove to get away from it all.  Her mother eventually tracked her down.  After that point, she finally was able to start receiving help.  Her primary care doctor told her it was only "baby blues," which for her discounted her experience and only made her more depressed.  But she was eventually able to find a doctor who listened to her and helped her.  Her doctor chose a variety of treatments including nutrition, acupuncture, and antidepressants.

When there was an opportunity for questions, I asked her what coping skills she had taken away from her treatment--what worked for her.  Here's what she said:

1.  Her doctor telling her that she is not crazy.  Most depressed patients are not psychotic.  But depression and anxiety can make a person feel "crazy."

2.  Her doctor really listening to her.

3.  Her doctor telling her that they would work through it together and that she would get better.  I liked this statement by her doctor.  Although I think it every time I meet with a new patient--that we will work through this together, I probably don't say it enough.

3.  Developing better nutrition.  Here's something else which I probably don't do enough of.  The evidence is not clear that nutrition helps depression.  But it is my personal belief that there is a downward spiral of depression leading to poor nutrition, which leads to more depression.  And I also believe that oftentimes as people recover, an improved sense of well being leads them to take time for better meals, which leads to an overall improved sense of well being, and so on.

4.  Reading books on positive emotion.  She found a way of combining exercise and reading such books by downloading them to her iphone and listening to them as she walked.  She joked about her initial reaction when the doctor her told her to exercise--exercise at that point in her life was just being able to get herself up and walk down the hall!  But this combination of walking and listening to positive books makes a lot of sense to me.  Walking is not an impossible exercise for depressed persons, although they may need to start slowly and build up.  And listening to something positive and uplifting at the same time provides motivation to walk and something positive to feed the mind.

After her talk, I was struck by how she had been at the ultimate low point in life, when nothing, not even her own life seemed to matter anymore.  Now, she and her brother have been voted as having the top Vegas show.  The myth of the Phoenix bird rising from the ashes came to mind.  Now she is not only a star, she has done much to reach out and help others.  For example, she is co-founder of the Children's Miracle Network and an outspoken advocate for depressed people getting the help they need.  How many of us, I wondered, go through a time of rising from the ashes?  How many of us go through a period of feeling that things cannot get any better and feel devoid of hope?  If ever there was a story of someone recovering from an absolute low point and finding that life had more in store for them, this was it.

Friday, March 16, 2012

The Scientific and the Moralistic--Two Ways of Viewing Human Behavior

I like to tell my patients that there are essentially two ways of looking at any human behavior--the scientific and the moralistic.  These are two very different ways of viewing human behavior.  And these can lead to very different ways of feeling towards others and trying to influence others. 

I will tell you in advance that I subscribe to both of these views, although at times it seems impossible for me to reconcile them.  They each have their strengths and their weaknesses.

I will also say in advance that I know I am greatly oversimplifying a difficult subject in this blog post.  I apologize in advance.  A person could spend a very long time contemplating these issues and  still be confused.  The following oversimplifications are meant to be thought provoking--not necessarily totally accurate.  It is a very complex subject.  Fortunately, in my everyday life, I don't have to confront the full extent of the complexities and contradictions.  But when I try to put something down on paper, then every sentence seems to raise questions.

Two Views of Human Nature

Here are the two basic ways of viewing human behavior:

View 1--What I would call the older, more traditional view.   People have free will because there is something in us that is more than the sum total of our molecules.  We are more than physical beings.  There is a soul (or whatever you want to call it) in us that can make decisions.  We can choose to do right, or we can choose to do wrong.  

This view has been linked to and related to the idea that there is something in us that is not physical, sometimes called a soul.  This has been disparagingly referred to by academics as the "ghost in the machine" view.  Descartes, a philosopher, subscribed to this view, and so it has been termed Cartesian dualism (the "dual" part meaning a physical body and a non-physical one).

This leads us to view # 2.

View 2--I would call this the modern, scientific view.  I do not mean by this that it is right or wrong, just more in line with current academic modes of thought.  This view would say that people act the way that they do because of how their brains are constructed.  Their brains are made of neurons and glial cells.  These are made of molecules.  Molecules obey the laws of physics.  Molecules have no free will.  It is therefore illogical to blame someone for doing what their brain makes them do.  If an ADHD child is hyperactive, there is no sense in blaming them.  They haven't chosen to be this way. 

Now this may seem like an academic question--is there or is there not free will?  But the fact is that many people use blame in their everyday speech with their other family members, or with their students, or with others.  And blame generally makes the most sense if someone could have done something else.  If there were psychological or physical reasons that someone did what they did, blame is kind of beside the point.

Why Do I Care?

Why is this an issue for me?  Why do I really care?  It is important in two kinds of counseling situations that I see over and over: the depressed person who blames themselves for being "lazy" and unmotivated; and the ADHD kid who is getting blamed for his/her behavior.  In both cases, the blame is both misguided and harmful to the treatment of the person.  The depressed person tends to blame themselves.  The ADHD kid gets it from others.

Let's say that a sixth grader keeps getting into trouble for being out of their seat in class and talking too much.  The traditional approach has usually been to scold and to blame, with the idea that Johnny can control his behavior if he will only choose to do so.  However, many times it eventually turns out that Johnny has ADHD.  His prefrontal lobe executive functioning is inadequate for the demands of the classroom.  He doesn't know this.  He can't explain why he does what he does--either to himself or to others.  The scolding and blaming does not make things better.  It only makes him more depressed and more alienated from school.

Or perhaps I am working with a depressed person who just can't motivate themselves to clean house.  And they blame themselves for being lazy.  This only serves to deepen their depression.  It doesn't get the house cleaned, because the deeper depression only makes it harder for them to do their work.

The Real World: Dealing with Science and Morality At the Same Time

How in the world can these two different types of models of reality be reconciled?  I will leave that for philosophers.  All I can say is that sometimes I use one concept, sometimes another, and sometimes both.  Let me give some examples.

1.  Example one.  Let's go back to the sixth grader with ADHD.  He can't stay in his seat.  He gets in trouble for talking too much in class.  Here I use the scientific paradigm.  There is no sense trying to shame him or blame him.  We simply need to do what we can to help him behave more adaptively (medication, better structure in the classroom, use of positive reinforcement, education of the parents, etc.)

2.  Example two.  Or consider a person who inherits depression or bipolar disorder, etc..  Maybe they stay in bed sleeping much of the time.  They can't get out of bed.  Again, I use the scientific paradigm.  They are not to be blamed.  Blame will only make things worse.  It will make them more depressed, which will lead them to stay in bed more.

3.  Example three.  A person is speeding down an interstate, creating a hazardous situation for others.  Here I might be thinking on two levels.  Why is this person being impulsive?  Is there an explanation in scientific terms for their impulsivity (bipolar disorder, frontal lobe brain damage)?  On the other hand, I would definitely see this as making a bad choice.  Drug use could fall into this same category.  Their brain is developing a craving for the drug.  That is at the molecular level.  At the same time, what choices led to them using the drug in the first place?

Complications--the Buck Still Stops Here

I hope that clarified why I am against using the moralistic approach all of the time.  Now, here is where it gets even more complicated.  There are definite reasons for using the free will/responsibility approach to seeing the world at times.

Let's go back to Johnny.  Let's say that we have determined that it is not his fault that he is not staying in his seat.  Let's say that a full evaluation has been conducted on his ADHD and that he is receiving medicine and counseling.  Let's also say that his parents are in parent counseling as well.  Systems are set up to help him to remember to get his homework done, turn it in, and so on.  Ultimately, the success or failure of the systems set in place will depend on him.  He will need to cooperate to some degree for it to all work out.  This will become increasingly true as he goes into high school and then becomes an adult.  Even if someone is not to blame, the responsibility for change may still fall on their shoulders.

Or let's say that a person goes through cognitive behavioral counseling for depression and is prescribed medication.  Only the person themselves can decide whether they are going to do the homework assignments and use the coping mechanisms.  Only they can decide whether they are going to take their medication.

One other problem with the molecular view of people is that it may lead us to treat them as objects, rather than as people.  Perhaps we are more likely to think of people as numbers rather than real human beings.  I think it would be easier for a dictator to send people to concentration camps if they viewed people as only a collection of molecules.  It would be easier to mistreat people.  I believe that to think of people as real live agents with free will and feelings may make us more sympathetic and empathic.  I think that an over reliance on the molecular viewpoint would tend to make us less caring towards others.

What is the Takeaway Here?

Ultimately, I believe that if the concept of free will can be presented to people in the right way, in a way that can keep it separate from blame and shame.  It can be liberating.  It can emphasize that persons are not simply a product of their genes and environment, and that there may be a way out of their predicament.  In that way, it can also create even better self esteem.  When we make good choices, it enhances our feelings about being who we are.

On the other hand, if we misuse the concept of free will, ignoring the biological and scientific foundations of behavior, then  we may fall into the trap of blaming and shaming.  This in turn can unleash a variety of negative consequences--both for ourselves and for those around us.


It is conceivable that someone could have a non-free will (deterministic) belief about human nature and still choose to use blame as a means of trying influence or coerce others.  However, I believe this is wrong headed in two ways.  First, it makes no logical sense to blame others for things over which they have no control.  Secondly, I believe that the negative, boomerang effects of blame make it a very poor choice for trying to influence others.  Blaming someone is different from disciplining them. Positive and negative consequences can still be used in thoughtful, caring ways for healthy discipline.

Some philosophers would maintain that even though we are just molecules, we are still more than the sum of our parts and that the concept of making true choices still makes sense, even if we are ultimately just molecules. Thus, the idea that we are more than just the sum of our molecules has been judged by some philosophers to be consistent with modern physics. I don't agree. I believe that modern physics does not leave room for us to be more than the sum of our molecules. I think that a larger view of the nature of reality is needed to be consistent with the idea of free will and choice.

Thursday, March 08, 2012

Staying Mentally Flexible Throughout Our Lifetime

It has been said  that science does not progress by old scientists changing their minds.  It progresses by old scientists dying and new ones taking their place. Throughout the history of humankind we can see how this drama plays out.  Young rebels come up with new ideas, and then in the end they, too, become inflexible, holding onto the new scientific dogmas that they have created.  I was reminded of this recently when I read that the 2011 Nobel prize winner for Chemistry had earlier in his career been forced out of his research group for theorizing about quasi-crystals.  He had even been derided by the famous scientist Linus Pauling for his idea. 

When Einstein built on the work of Max Planck in coming up with quantum theory, Planck could not adjust to the new ideas at first. Einstein was the rebel; Planck was the old guard. However, after Einstein convinced the world of the basics of quantum theory, even he could not adapt to all of its unusual implications; he ironically became the "old guard" that the young new physicists had to fight against. If this process of revolutionary turned defender of the scientific faith occurred with Einstein, then I guess it would occur with just about anyone.

How is it that creative and brilliant persons sometimes become inflexible in later years?

This makes sense if we think about how the brain develops in early life and then how it ages in later life.  It begins with more neurons than it needs, and then as the child develops, unused neurons begin dying off.  The brain becomes committed to using certain pathways rather than others.  In our older years, there is shrinkage of frontal lobe neurons.  The brain shrinks 2% each decade.  There can be "hardening of the arteries" causing cell death; there can be changes in cell structure of neurons in the brain. One of the functions of the frontal lobes is to make it possible to shift in our ways of doing things. The baby's brain is almost totally flexible, but with the loss of function in the frontal lobes, we lose flexibility. 

Some people would argue that as we age it is our duty to resist change at times--to stick to our values and beliefs for the benefit of society.  This makes a certain amount of sense.  There are several changes occurring in our society that I do not like.  We need to hold on to certain ideas and conventions (think--Bill of Rights), for the benefit of future generations.

However, there are undoubtedly less altruistic motivations for holding on to the past as well.  Some might be economic, such as when people are part of an establishment group which benefits from the status quo.  Scientists may cling to old beliefs not only because they cannot conceptually conceive of the validity of new beliefs but also because their ego (and even their names) are often associated with old discoveries and theories.

But we can try to be open to new ideas, and when we see a good one, we can encourage it along. It may be our duty to resist and try to put a brake on to the wrong headed ones, but I don't think any of us wants to be known as the one who stood in the way of an improved life or vision for humanity.

If we need to be flexible at times and conservative at times, where do we draw the line?  Let's assume that some new ideas need to be resisted, either because they are not true, or because in the long run, they will be bad for society.  As a starting point, let's assume that 50% of the new ideas are good and useful, and 50% need to be resisted because of being destructive or wrong in some way.  This 50/50 ratio may not be the right proportion, but it is a place to start.  If we were to uncritically accept 100% of new social developments as good and logical, then that would probably just be wrong.  And if we were to resist 100% of new technological and social developments, then that would be irrationally inflexible.  So the farther we get from a 50/50 stance, the more we probably need to at least ask ourselves whether we are being flexible enough or whether we have a totally uncritical stance to change.

So, the bottom line would be, use your frontal lobes and try to remain flexible.  Try not to fall into the trap that many famous scientists and many of our forebears have fallen into.  Try to maintain a reasonable openness to new ideas and new ways of doing things, even as you try to maintain and conserve the best of the old.

Monday, March 05, 2012

Don't Give Up on the Steep Part of the Learning Curve

I started flying again yesterday.  I hadn't been up in the air for about 10 years (in a small plane), and I went up with an instructor to get my flight review.  It's been awhile, so it will take more than one review session.

Some things went smoothly and some were more difficult.  I've been here before--on the steep part of the learning curve. Actually, I'm on a re-learning curve, but it's just as steep as anything when I first learned to fly, because when I first learned, we took everything slowly.  Now, I'm trying to relearn everything about small plane flying in a few weeks. 

After my first hour back up in the air, I was both exhilarated and tired.  A part of me was asking, "Do I really want to do this?"  Fortunately, I recognize this steep part of the learning curve.  I've been there with my oil painting and with my jazz piano, and I know that the steepest part of the curve doesn't last.  The fun, easy parts are coming. 

Unfortunately, many of our children are not learning how to persevere.  We need to teach them that the steepest parts of the learning curve don't last, and that it is worth going through them to get to our goals.

This relates a little to another issue I was pondering last night.  I was watching my grandson with his first efforts at crawling.  My wife commented on how much energy he was putting into learning how to crawl.  Now, in my line of work, one of the main things on which I work with people is their motivation.  Clients often come in to my office with very little motivation to do things.  (Fortunately, they have enough motivation to get to my office--so that's a start!)  They may be depressed.  Or there may be some other issue which interferes with them accomplishing goals.  The thought struck me last night, as I was watching him struggle so mightily to crawl and to move himself around the carpet, "Don't all children start being motivated like this?  How and why does such tremendous motivation go away?  How do we become couch potatoes?"

Here are a few answers I came up with.

1. Depression
2. Dementia
3. Harsh parenting
4.  Lax parenting
5.  A culture that addicts us to TV and video games
6.  A general decline in physical energy
7.  Perhaps a programmed decline in mental motivation (that is, the natural life cycle of our brain)
8.  Negative learning experiences--experiences in life in which we "learn" or think that we learn that we are helpless and cannot influence our environment or achieve things.

Notice that I did not include laziness in my list.  Those who have read some of my past blogs will understand why.  I do not consider laziness to be a scientific explanation.  It is a moral explanation.  It does not really explain anything.  Consider my grandson for example.  Let's say that he becomes "lazy" by the time he is 14.  He does not look lazy now.  If he is acting "lazy" by then, there will have to be some kind of reason.  So enough of that word.  I don't like to use it.

So what other word can we use?  The word (or words) would be "lack of motivation."  It is a description without moralizing.  So let's look at the above list of reasons one more time.  (This list is in no particular order.  I just started with depression and dementia because I see a lot of them in my practice.)

1. Depression.  Depression can be inherited.  It can also be the result of severe stress.  Life sometimes wears us out by the stresses we face.  Clinical depression is more than just the blues, and it definitely results in a severe loss of motivation.  It is not clear just how much people truly recover from severe depression.  Not only may they be unmotivated during the depression, they may not return fully to their previous levels of interest and activity without some encouragement.

2. Dementia.  Dementia starts being a problem for some people in their '70s, and sometimes earlier.  In the early phases, people have less and less motivation to do new things.

3. Harsh parenting.  I think that harsh parenting may temporarily lead to more motivation of a sort.  People feel driven to do things out of anxiety and fear.  But I think it takes the joy out of life.  It removes the joy of exploring life and doing new things.  In the end, harsh parenting often leads to compulsive or passive-aggressive behavior, not to a joyous trying out new things. Harsh parenting often leads to low self-esteem and other types of negative thinking, such as pessimism; and these lead to low motivation.

4. Lax parenting.  Huh?  Am I not contradicting myself here?  Just because harsh parenting may lead to problems with motivation, that does not mean that lax parenting leads to good things.  (If I had to label the in-between type of parenting, I might call it something like "structured parenting.")  Lax parenting does not teach children how to persevere when they become discouraged.  We all feel like giving up on some new endeavor at times.  Parents who let us give up easily are not doing us any favor.  Parents who park us in front of a TV set or video game to keep us occupied all the time are not doing us a favor.  Which leads to #5.

5.  A culture of electronic media which are quite addicting.  I don't think that we have seen the end of this.  Future media will be more appealing and addictive--not less.  As  a culture we are going to have to find how to keep our children active mentally and physically in the face of more and more appealing electronic and virtual activities that will encourage passivity.

6. A general decline in physical energy.  Getting older takes our energy away eventually.  My grandson is motivated partly because he has so darn much energy--and he will have more and more for awhile.

7. Perhaps a programmed decline in mental motivation (programmed in our brain).  Our brains are probably programmed to be somewhat less exploratory as we get older.  This serves the purpose of conservation of mental and physical energy.

8. Negative learning experiences--experiences in life in which we "learn" or think that we learn that we are helpless and cannot influence our environment or achieve things.  The theory of "learned helplessness" and the research supporting the theory, show that if there are numerous enough--or severe enough--experiences where we do not have control, then a kind of depression results, and we just tend to give up.

I'm sure there are other reasons as well.  My point here is not to elucidate every single type of reason for people not being motivated.  I simply want the reader to ponder the following question:  "Am I motivated to keep trying new things in life or not?  And if not, why not?  What can I do to stay involved in life?"  Or if the reader has children or grandchildren, the question becomes, "What can I do to keep their motivation high and to encourage them to enjoy life, learn new things, and to persevere?"

Wednesday, February 15, 2012

Frodo, the Lord of the Rings, Robin Williams, and Harry's Law

At the end of Lord of the Rings (I'm thinking of the movie here, not the book), while Frodo, Sam, Pippin, and Merry are sitting around drinking ale at the pub, there is a bittersweet quality.  Why?  Because their quest is over, and because there is nothing in life which can compare from that point forward to what they have already been through.  I suspect that they would wish to be back in the action, fighting the Dark Lord.  Of course, when fighting dragons (literally and figuratively in the book/movie), they were terrified.  Back then they were terrified partly because they did not know how things would turn out.  If they had known how well everything ended, they probably would have enjoyed their whole quest it a lot more.  In that scene, they can only enjoy it retrospectively, and that's just not the same.

A lot of times what keeps us from enjoying life, is our worry that things will turn out badly.  And I have to admit, sometimes they do.  But a lot of times life turns out well, and we need to learn to live in the moment and enjoy it while we have it.  If we enjoy the moment, then in one sense, things have already turned out well.  And if we don't enjoy the moment, then in one sense, things have already turned out badly.

Remember the movie Dead Poets Society?  Robin Williams plays the role of a prep school teacher.  He talks to his students about previous students that have gone off to war and died:
John Keating: They're not that different from you, are they? Same haircuts. Full of hormones, just like you. Invincible, just like you feel. The world is their oyster. They believe they're destined for great things, just like many of you, their eyes are full of hope, just like you. Did they wait until it was too late to make from their lives even one iota of what they were capable? Because, you see gentlemen, these boys are now fertilizing daffodils. But if you listen real close, you can hear them whisper their legacy to you. Go on, lean in. Listen, you hear it? - - Carpe - - hear it? - - Carpe, carpe diem, seize the day boys, make your lives extraordinary.

This scene makes a similar point, whether things turn out well or turn out badly,we need to seize the moment and use it, feel it, experience it.

Here's another more recent quote from the Media, from the TV show Harry's Law:

Harry: (Tommy takes Harry by the arm and pulls her into his office) What? What are you doing?
Tommy: (pulls up a chair for her) OK. You need to listen to me. (closes his office door) You're not having fun. You need to be having fun here, Harry.
Harry: Fun? A man's life is on the line. If I lose he might be put to death.
Tommy: Even so.
Harry: Even? Tommy, what's wrong with you? You think is all cause for amusement?
Tommy: I think you're 62 years old, I'm in my 50's, and it won't be long until you're the woman who used to Harry Korn, and I'll be the guy that used to be Tommy Jefferson. You hear me, Harry? We're not far from our 'used to be' years. Right now, you're in the game. The world is watching. A man's life is in the balance and you're right smack in the middle of it. (sighs) This may be the most irrelevant 15 minutes you'll ever know and, trust me, you do not want to wake up 10 years from now and say 'My God, why didn't I savor it?' So, yeah, it's pressure. Yes, there's stress but savor the moment because tomorrow we could be yesterday. That's what I'm saying. (Harry nods)

Perhaps it is not a tragedy if things turn out badly and we didn't enjoy the path to getting there.  But it would be a tragedy if things turned out well, and we didn't enjoy our way there.

Carpe diem readers.

Thursday, February 02, 2012

Substituting One Feeling for Another

One interesting coping mechanism in stressful situations is learning how to substitute one feeling for another.  If done in one way, it is probably a very healthy mechanism.  In another way, not so healthy.

I first learned this lesson as a novice skier.  I was skiing for the first time and came to a small blue slope (blue being a slope of intermediate difficulty).  I fell down three times.  For the next two days, I avoided the slope.  Then on the last day, when it was time to leave, I decided that I hadn't had enough fun.  I wanted to ski the slope--for the fun of it.  I fell down three times--and laughed all the way down. 

What was different between the two times?  I fell down three times on each occasion.  My heart was beating just as fast.  I was breathing just as hard.  My adrenalin was probably at the same levels.  What was different?  Somehow I had side stepped from anxiety to excitement, from one emotion to another, and it was very adaptive.  It helped me take another step in skiing.

So anxiety and excitement are sometimes just a step away from each other. Sometimes when we are anxious, it is possible to think of it as excitement, and excitement is a whole lot more fun than anxiety. 

The physiological arousal symptoms of anxiety and excitement can be quite similar.  Two psychologists, Schachter and Singer, injected college students with adrenalin (with their permission) and found that the adrenalin by itself did not produce reliable emotional effects.  The emotions which the college students experienced depended on what they thought they should experience.  This in turn was manipulated by the experimenters using two other students who were confederates of the researchers.  They were able to show that the physiological state of sympathetic arousal on adrenalin can go along with anger, amusement, or euphoria.  It greatly depends on the context.

So next time you are anxious and your heart is pumping, and your breathing is getting more rapid, try the following. Imagine that you are not anxious but excited.  You are excited and eager to get on with whatever stress you are facing. It is making your blood pump and your heart race and your lungs breathe faster. But it is not a bad thing; it is good. It is exciting. See if you can do the sidestep, replacing one emotion for another--another emotion which is much more palatable.

Are there other emotions where this sidestep is possible?  Probably.  I will be giving this more thought.

Now I said that sometimes replacing one emotion with another is not healthy.  When is it not?  When it involves denial or reaction formation.  When we are not aware of what we are doing.  When we are being dishonest with ourselves somewhere deep within our mind, so that we don't even know that we are doing it.  "I'm not angry!" would be denial if it were not true and if we were being dishonest with ourselves.  And "I'm not sad, I'm actually very happy" would be reaction formation if it were not true.  So adaptive coping mechanisms would differ from unadaptive defense mechanisms in that the person knows what he/she is doing; it is being done intentionally, and the person is being honest with themselves.

Now, for some theoretical comments from non-psychology fields.  (Skip this if you like.  It is just some theoretical stuff I have been thinking about.)

I came to understand this principle of side stepping is not limited to psychology when my jazz piano teacher and my painting teacher taught me the same lesson in the same week.  In a general sense, this can be called chromatic substitution.

"Chroma" is the coloring of something.  Two things can be similar but have a different coloring.  Of course a "coloring" when listening to something means something different from the coloring in a painting.  And both of those are different from the "color" of a feeling.  But there is quite a bit of similarity, too.

In jazz piano, a tritone substitution can be used for a dominant seventh chord, or any diatonic chord.  A tritone substitute chord shares the major 3rd and minor 7th of the original (usually dominant 7th) chord.  They have just changed places.  Now the fifth and ninth become something different, causing what is in essence the altered version of the original chord.  Altered chords are very cool sounding in a jazzy sort of way.  They sound good, and they are similar to the original chord, but they are also different.  And to a jazz musician, they often sound better.  So chromatic substitution here means using a tritone instead of the original dominant seventh, or using the altered chord instead of the original simple dominant chord.  And the substitute can be used because it is different, but in some ways also the same.

In painting, it is possible (especially in impressionist painting), to add additional colors, replacing the original "realistic" colors.  The new hues might be only hinted at, or even absent, in the original "realistic" image.  These colors usually disappear entirely in photographs but can be glimpsed by an artistic eye in real life.  In impressionistic painting, they have to be added at the same value level as the original colors.  (The value level is the black/white darkness level.  If you "desaturate

There is one other type of sidestep in therapy, and that is reframing.  Family therapists discovered early on that it is often not clear exactly what motive a person has in a family interaction.  When families become angry and deadlocked, they tend to "frame" the motivation of another family  member in a very negative way.  A reframing can be quite helpful in family counseling.  For more on this, see .

Sunday, January 22, 2012

How Do You Spoil a Child?

I had an interesting conversation the other day with an acquaintance on the issue of spoiling children.  He was saying that we needed to watch out and not spoil our children--that it was important not to give them too many things.

I generally agree with that statement.  However, he was using the word "spoil" in one way, and I use it in a slightly different way.  I think we all need to keep clear on what it would mean to "spoil" a child.

In a larger sense, for something to spoil is for it to go bad.  So the essential issue for me in whether children have been "spoiled" is not whether they have been given too much (although this is one way for them to become "spoiled") but whether they have been treated in such a way as to harm their psychological development.  In my way of thinking, if a child is deprived of everything, they can be "spoiled" or made bad in a totally different way.  I know that this is not the way that "spoiled" is normally used, but it makes more sense to me.  A spoiled child in the larger sense is one whose development has been seriously harmed.

So the issue in my mind is not simply one of whether a child gets a lot of things.  For some children, that might not "spoil" them.  I think that spoiling might or might not occur when children have a lot of possessions.    Now having said that, I would generally agree that children getting too much too quickly is a real hazard to them emotionally.  Here is why.

1.  I think it creates problems for children to give them everything they want so quickly that they do not have to work for anything.  Working for something builds skills and psychological strengths. 

2.  It may create problems for children to give them so much that they cannot really appreciate any one thing because it is just one thing in a mountain of things.  If we do not appreciate what we have, we cannot appreciate the fact that we are blessed to have anything.  We also are not likely to appreciate the fact that others may have very little.

3.  I think that having too much too quickly also keeps us from learning patience.  The desire to have it now, or the feeling that we need it right now, has to be tempered by the ability to be patient for what we want.

So I do not believe that the essence of spoiling a child is simply in having many things, although that creates a hazard.  I think that the essential aspect of spoiling children (in this particular sense) is depriving them of the opportunities to learn to work for something, to learn patience, and to learn to appreciate each and every object they own.

So while I might quibble with my friend over some details, I do believe that if we do give our children too much, then it is hard, if not impossible, for them to appreciate each item.  And if we give our children too much too quickly then the acquisitions will come so fast that they cannot learn patience.  And if we give our children too much too quickly, then they will only have the opportunity to work for a small fraction of what they have.

But overall our emphasis in parenting needs to be helping our children grow up straight and healthy; it does not need to be keeping them in a state of semi-deprivation.  We need to focus on giving them the real gifts of life: patience, a work ethic, and appreciation for what they have. 

Tuesday, January 17, 2012

What Makes a Family Functional? Here's Two Thoughts

First, let me say that don't really think of families in all or nothing terms, either as functional or dysfunctional.  I don't think that I have ever known a fully functional family.  Families exist on a continuum between the two.

Secondly, to write about what makes a family functional in general would be a whole blog in itself.  Perhaps I will devote more space to this in the future.  But here I  just want to write about two processes or behaviors which I think are important for families as they struggle to be more fully functional.

1.  First of all, let's start with a relatively easy behavior--getting through the holidays without arguing.  It is my experience that when families cannot get through Thanksgiving or Christmas without arguing that it lowers the overall sense of family self-esteem.  It tends to create a sense of "what's wrong with us that we can't even get through Christmas (or Thanksgiving)"?

There are also other events besides holidays which I think are equally important to get through without family meltdowns.  Weddings would be one.  People going into the hospital with a health crisis would be another.  There are simply times that we have to put aside our desire to "stand our ground" or "be right" or "make a point," and we just need to "grin and bear it" in order not to detract from the well being and happiness of others.

If we are going to insist on making a point, winning an argument, or having a family showdown (and I am not sure that any of these are all that necessary), then at least they need to occur aside from one of these "exceptional" days. 

Funerals pose a particular problem for this rule, because many families do seem to have meltdowns soon after a patriarch or matriarch has passed away.  It is as if the "glue" of the family has been lost; at that point, the children's squabbles often break out in the open.  But again, my rule of thumb would be that if it is absolutely necessary to have a squabble or showdown, the day of the funeral is inappropriate.

2.  Shock absorbers versus shock amplifiers.  When one family member begins creating tension in a family (and all of us have our little meltdowns from time to time), then there are basically two options that any other family member has.  One is to react in a stronger fashion, adding negative energy to the family system, and the other option is to dampen down our reaction.  Members of the family have the choice of giving out less negative energy than they receive, which would tend to calm the situation, or they can choose to amplify the first person's upsetting statements, adding to the family tension.  When the latter happens, then there is escalation, and sometimes an explosion.  In chemical and nuclear explosions, energy is released from some trigger which then affects neighboring matter, releasing more energy than was received.  This process is repeated over and over, microsecond by microsecond in an explosion.

In thinking about how family members can react to each other in a knee-jerk fashion, I often think of the analogy of a rack of pool balls.  A little known fact about pool balls is that they are extremely elastic.  That is, they tend to transmit energy very, very well rather than absorbing energy.  Once the cue ball hits the rack, then there is an automatic, inevitable transmission of energy to the other balls.  They all react.  If we then imagine the balls to be family members and the cue ball as being one particular family member who stirs things up in the family system, then the cue ball hitting the rack is analogous to one person stirring things up in the family and everyone automatically reacting to that person.

Let's say a father walks in and says, "It's been a terrible day at work; and to top it off, somebody left their bicycle in the driveway, and I ran over it!"  In the pool ball example, all of the family members would automatically react to his upset feelings and statements and start saying equally upsetting things, such as "Well, why don't you pay more attention to your driving!" or "You're going to have to buy me another bicycle!" and so on.

An alternative possibility to the cue ball example, however, is to imagine little shock absorbers between each ball in the rack.  The cue ball hits it, and then the shock absorbers cause there to be a kind of thud, where some energy but not all energy is transmitted from one to another and to another.  Then the balls move but not with a perfect transmission of energy.  There is no automatic reaction carrying the energy around the family system.  And there is certainly no amplification of the energy.

On the other hand, imagine little battery packs inside each pool ball, and when one one is hit, then it actually moves with greater energy than the one that hit it.  Pretty soon all of the balls would be bumping into each other with greater and greater energy.  That is how some other family systems operate.  They amplify the negative energy coming in, and pretty soon everyone is in an uproar with very hurtful things being said or done.

I would want to live in a family with shock absorbers.  I am not suggesting that we don't react to negative events.  We're just human.  But if the family members tone down their reactions, then pretty soon all of the energy is dissipated, and life can return to normal.  Maybe it would take a few seconds or several minutes.  Or maybe a little longer.  But it would not turn into a nuclear explosion.  So my second choice of behaviors for a functional family (relatively speaking) would be for there to be the shock absorber effect.

How can this be put into action?  Well, one way to absorb the negative energy is to delay.  For example, if someone said, "Let's take a look at the bicycle and see if it can be fixed," then there is a delay.  The reaction is put on hold until there is more information and a better understanding of the problem.  Rather than jumping to conclusions, or imagining it being a mangled piece of irreparable steel, there could be time taken to simply take a look at it.  It is possible that minor repairs rather than major repairs might suffice. 

This leads to a third issue--not jumping to conclusions.  There are a variety of negative communication behaviors that can cause problems in families, and jumping to conclusions would be one.  But then that would require a whole other blog post.

Wednesday, January 11, 2012

Increasing Your Self-Control

There are always new concepts being explored by psychologists. And one fascinating one that I have just recently been reading about is the concept of willpower. It is the ability to restrain oneself from an activity, whether it is eating a dessert, or shoplifting, or sex that one might regret later.  This blog post is based on an article in the Monitor on Psychology, a publication of the American Psychological Association.  In a recent article, psychologist and researcher Roy F. Baumeister discussed his work regarding will power.  He has written a book entitled Willpower: Rediscovering the Greatest Human Strength.

Here are some of the areas which Baumeister lists as being helped by self-control and willpower:
domestic violence
sexually transmitted diseases
unwanted pregnancy
educational failure
under performance in school and work
lack of savings
failure to exercise

Looking at the above list, it makes one realize just how important willpower is.  With it, there is the capacity to form a civilization.  Without it, there is chaos and no civilization.

Now we may think of willpower as only something we have to use now and then, as when there is chocolate cake on the kitchen counter.  But in fact research has shown that people use willpower many times a day.  It is a capacity worth cultivating because we are going to use it over and over in life.

We all know that at certain times we have more or less will power than at other times. What people may not know, is that willpower can be temporarily "used up."'  Research shows that if people have to resist temptation in one situation, they are likely to have less power to resist in another situation which comes soon afterward.  If you successfully resist temptation for an hour to eat chocolate chip cookies you just baked, and then you try to do homework, you are likely to be less able to resist temptations that would take you away from homework.

One might expect that resisting temptation in hour one would be good exercise to resist temptation in hour two.  However, while it may help to exercise the self-control "muscle" for the future, it does not help immediately afterwards; instead it hurts or depletes one's immediate ability to exert self-control.  In some way, it uses it up for the moment.

So, just as with exercising a muscle, using it helps strengthen it for the long run but may use up its energy and power immediately afterwards.  Baumeister refers to this process as "ego depletion."  Not only does resisting temptation use up this resource, even making decisions depletes it to some degree.  And that makes total sense to me.  There have been times that I had to make so many decisions that I was just tired and didn't want to make another decision.  It also makes sense to me because I would view both activities as involving the prefrontal region of the brain, so what would affect one capacity could also affect the other.

The good news is that we can increase our willpower and self-control. It is not fixed and unchangeable.  Just like a muscle can be strengthened.  Unfortunately, I believe that our society is not training children well in this area today.  Moreover, I suspect that drug use works to undermine this ability in the brain.

Surprisingly, glucose (a form of sugar) aids in impulse control.  A simple glass of lemonade can improve self-control.

The main point that Baumeister makes in the article is that we do not need to fatalistically accept the idea that self-control is a limited resource.  It is not; it can be increased over time.  In the long run, practicing self-control leads to even more self-control.

Friday, January 06, 2012

The Vicious Cycles of Depression

There are plenty of theories about what causes depression.  And many of them overlap with each other in some of their concepts. But here is another theory, one that is often in my mind as I am treating patients.  It is not necessarily different from other existing theories, but it has a somewhat different emphasis.

It seems to me that depression is an illness involving numerous vicious cycles.  Event A leads to Event B, which leads back to more of Event A, which leads to more of Event B, and so on.  There are a variety of these cycles in depression.  If there was just one, it would be easier to treat.  But there are several, and each keeps perpetuating itself. 

The theory doesn't really address the issue of what starts depression in the first place.  But it does help explain how a mild depression can turn into a severe one.

Here are some of the vicious cycles which I see in the depressions my patients struggle with:

Cycle #1--Withdrawing from the World.  Depression increases passivity and decreases social interaction.   This in turn isolates the person and deprives them of interpersonal stimulation. They don't get the social support and distraction from negative thoughts which they would otherwise get from interpersonal relationships.  They are increasingly left alone to deal with negative thought distortions on their own without any corrective input from non-depressed persons.  This in turn increase depression.  Which increases social isolation.  And so on.

Cycle #2--Negative Thinking.  Depression increases negative thinking about self, world, and future. The increase in negative thinking increases the depression level. The more depression a person has, the more negative thoughts are generated in the brain.  This is the basis of cognitive therapy. The cycle of negative thinking to depression and back to negative thinking has to be interrupted.

Cycle # 3--Possible Negative Effects on Nutrition.  Depression often decreases the appetite, which in turn may be depriving the person of important nutrients relevant to mood, well being, and health, thus increasing depression, and so on.  The depressed person may opt for a high carbohydrate (high sugar), junk food diet because they don't want to eat, or don't feel up to cooking a more balanced diet.  They seek out foods that will medicate their immediate feelings, not foods that will provide good nutrition for their brain.  Lacking good nutrition, the brain may be more susceptible to depression.  The link between nutrition and depression has not been proven, but there are some studies suggesting that there may be a connection.

Cycle #4--Decreasing Assertiveness.  Depression  makes people less assertive and less likely to use good problem solving techniques.  When people are less assertive, they don't get their needs met.  Aggravations in their environment can continue unabated.  Problems pile up.  And depressed persons generally do not follow well thought out problem solving approaches that would be needed to deal with the stresses they face.  The ongoing presence of stresses keeps them depressed.  The lack of assertiveness and/or problem solving allows stresses to get worse (such as by building up finance charges on credit cards), which can make the person more depressed.  And so on.

Cycle #5--Downward Spiral of Physical Activity.  Depression makes people less active, which means that some of the benefits of exercise (e.g., brain derived neurotrophic hormone and so on) are not obtained.  (Neurogrowth hormone is a naturally occurring substance in the brain which helps nerve cells grow.)  Theoretically, nerve cell growth or regrowth in the brain may be necessary to recover from depression.

The lack of activity also means that the depressed person is deprived of positive environmental stimulation (lights, sounds, tastes, etc.)  Even though these stimuli may be less interesting and less pleasurable than when the person was non-depressed, they may still give some pleasure, and these may be almost totally absent as the person withdraws into their house and/or room.

Cycle #6--The Cortisol Loop.  Psychological stress causes increases in cortisol.  Cortisol has a negative impact on brain function, although we are not sure all of the different ways this may affect it.  The impact of cortisol on the brain (or of other stress related chemicals)  may then cause the brain to go into deeper depression.  Which causes more negative thinking, less energy, and so on.  And so on.

Cycle #7--A Lowering Availability of Mental and Physical Energy to Cope with Stressors.  Let's say a person goes into a mild depression. This reduces their energy and likely increases their negative thinking about how much they have to do. A molehill starts to seem like a hill; a hill starts to seem like a mountain; a small mountain starts to seem like a big mountain.  There is a perceived difference between what they have to do and overcome on the one hand, and how many resources they have for the task.  The person may get an overwhelming feeling of, "I just can't do it all." This is not just a thought process. It is visceral--felt in the gut. They see their tasks as overwhelming, but they also feel it to be overwhelming because they are so fatigued due to the depression.

These vicious cycles all have the capacity of deepening depression to moderate or even severe levels.  For that reason, intervention can be needed to help someone recover. 

In other cases, depressed persons may succeed in eliminating the external source of stress.  That is, if they are without a job, they may succeed in getting another suitable position.  In still other cases, time may cause the external stress to seem less important.  If we lose a job today, it may feel overwhelming, but in two years, it may seem much less important.

Whatever the reason, the vicious cycles of depression fortunately do not go on forever for most people.  If, on the other hand, a person's depression does seem to be going on and on without any let up, then it would be logical to bring in an outside influence such as a psychotherapist, to help break up the cycle.