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PsychNotes May 2013
by Monica A. Frank, Ph.D.
Clinical and Sport Psychologist

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May 31, 2013


A parent's job is to protect and teach. In particular, children need to be prepared for adulthood so as to function effectively in the world. Consequences for children are not as much for the purpose of making children behave but more for the purpose of teaching children that there are consequences for behavior in the adult world.

Therefore, the more natural consequences are, the more effective they can be. For example, many parents have found about age 12, they have little control over their child's mouth (unless they want to escalate conflict). I found myself in this position and decided that I didn't want to be angry anymore and that applied consequences weren't working (grounding, etc).

So I asked myself, “What do I have control over?” The answer to that question was “Myself.” Even if I gave a consequence to my son, it didn't stop the disrespectful way he treated me. However, once I recognized that I had control over myself, I stopped responding with anger when he mouthed off. Instead, I just noted it in my head for that day (I started over each day).

Then, if he asked me for anything, I would say “no.” If he asked me to take him somewhere, buy him something, help him with something, my answer was “no.” My reasoning was that in the adult world, if you mistreat people, they won't want to do things for you. So this seemed an ideal natural consequence. I didn't explain any of what I was doing to my son (so it wasn't a threat) unless he asked. If he asked "Why?", I would only say calmly “I just don't like how you treated me today and I don't feel like doing anything for you.” After a time he stopped asking because it was the same answer.

Does this mean his behavior became perfect? No, but it did improve. But, I think, most importantly, I was no longer angry. I was no longer trying to control a 12-year-old (which in some cases can be impossible) but I was in control of myself.

May 30, 2013


The experience of stress as having a negative or positive impact can be based on your mindset. An example of mindset is how people think of riding on a roller-coaster. Some people are excited about riding a roller-coaster and some people are terrified. However, both have the same physiological reaction—they just interpret it differently (excitement vs. fear). As a result, they experience it positively or negatively.

Researchers have shown that under certain conditions people who have the mindset of “stress-is-enhancing” were more likely to have a decrease in cortisol (the stress hormone) if it was too high and an increase if the cortisol was too low (Crum et.al, 2013).

Generally, it is believed that lower levels of cortisol help to cope with stress but chronically high levels of cortisol can have harmful effects. This research indicates that those people who believe that stress focuses and motivates them may be protected from the harmful effects of stress and are less likely to experience the physical consequences of stress.

How can this help those who are experiencing stress negatively? Cognitive-behavioral therapy (CBT) focuses on changing thoughts so as to change the emotional response. In this case, recognizing that stress can be beneficial and improve performance can change the emotional reactivity related to the stress.

For assistance with stress, try Excel At Life's app Stress Test and CBT Self-Help.

Crum, A.J., Salovey, P. and Achor, S. (2013). Rethinking Stress: The Role of Mindsets in Determining the Stress Response. Journal of Personality and Social Psychology, 104, 716–733.

May 29, 2013

Introverts are Important, too!

Introverts have often been made to feel they are inferior to extraverts and that to be truly successful they must try to be more like extraverts. I have been frustrated as a clinical psychologist that much of the psychological research about introversion is focused on anxiety which implies that an introvert would be more extraverted if they were not socially anxious. Not only that, but frequently researchers refer to introversion and social anxiety as if they are the same.

As a specialist with anxiety disorders, I have been able to discern a difference between social anxiety and introversion. Not all introverts are socially anxious. In fact, I tend to wonder if we create social anxiety within introverts by acting as if something is wrong with that personality style. What if we valued the introverted style more?

Finally, however, the true nature of introversion and the understanding that it is a valuable personality style of its own is beginning to take shape. Being an introvert is a different approach to the world that can assist in achieving success in different ways than an extraverted approach. Author Susan Cain provides us with a better understanding of this in her book Quiet: The Power of Introverts in a World That Can't Stop Talking (2012).

May 28, 2013


Question: We have a volunteer who behaves like she's in charge. She sends out messages on behalf of the organization (of which she's not actually a full member). If given an opportunity she'll change decisions that have been made previously. She ingratiates herself with members so she can be defended. She incites anger and then sends wounded messages to certain people in the organization. People are complaining about her and I worry we'll lose real members if we cannot get rid of her.

Response: In response to this writer, I will make several assumptions: 1) the volunteer has made friends with people in the organization who protect her; 2) the anger she incites is among the staff running the organization, not the membership; and 3) the writer does not have the authority to fire her. (To the writer: If any of these assumptions are wrong, let me know).

The behavior described appears to be a passive-aggressive (PA) controlling style. The volunteer is able to maintain her position by controlling the responses of others. The best place to start with managing this volunteer is to not respond with anger. This may require some staff training so that everyone can provide a consistent response. The problem with confronting PA with anger is that the staff is now playing her game and she has won if she can run “wounded” to powerful others who then play the part of her defenders.

Instead, there needs to be a single person to whom the staff can turn who can directly confront each and every instance of inappropriate behavior. As I've indicated elsewhere PA people hate being confronted about their behavior. In this case, this volunteer has the agenda of achieving control in an indirect manner so that she can deny that she is doing anything wrong, and that instead, she is the victim.

Read Complete Response

May 27, 2013


If you want a disturbing, but scientifically rigorous, view of the problems with sleeping pills read the free eBook by Dr. Daniel Kripke at www.darksideofsleepingpills.com. Dr. Kripke insists that the misconception that we require 8 hours of sleep has been spread by the pharmaceutical companies to sell their products. His research with more than a million participants (2002) has shown that people who sleep 5-7 hours a night have longer lifespans than those sleeping more or less than that.

For those who truly have sleep problems, a systematic review of the medical literature in PubMed concluded that cognitive-behavioral therapy (CBT) is the treatment of choice for long-term insomnia (Kozasa, et.al 2010). Not only is CBT effective, it does not have side effects like medications for sleep.

Kozasa, E.H., Hachul, H., Monson, C., Pinto, Jr.L., Garcia, M.C., Mello, L.E., & Tufik, S. (2010). Mind-body interventions for the treatment of insomnia: a review. Revista Brasileira Psiquiatria, 32:437-43.

Kripke, D.F., Garfinkel, L., Wingard, D.L., Klauber, M.R., Marler, M.R. (2002). Mortality associated with sleep duration and insomnia. Archives of General Psychiatry, 59, 131-136.

May 26, 2013


Imagine engaging in an activity that costs nothing, feels good when you do it and can significantly improve your health. What is there not to like about that?

Researchers have found that even a minimal amount of guided imagery with music (GIM) can significantly improve mood and reduce fatigue. Most importantly, perhaps, is the impact on the stress hormone, cortisol, which has been implicated in health conditions such as heart disease. As little as six sessions of GIM two weeks apart can reduce cortisol levels which can be sustained for at least seven weeks beyond the final session (McKinney et.al, 1997). beach image

What does this mean? Practicing the method of guided imagery not only has immediate effects such as improving sleep and mood but through reducing cortisol overall health is improved. So, if a few sessions of GIM can improve your health significantly, imagine how much it can help if you made it a regular practice in your life!

Not only can you improve your overall health, but you will save money on healthcare and reduce the amount of time engaged in having to manage health issues. Excel At Life provides numerous audio downloads to help you learn this method.

McKinney, C.H., Antoni, M.H., Kumar, M., Tims, F.C. And McCabe, P.M. (1997). Effects of Guided Imagery and Music (GIM) Therapy on Mood and Cortisol in Healthy Adults. Health Psychology, 15, 390-400.

May 25, 2013 This audio is to assist those who have been emotionally abused as a child. It discusses the lies you were told as a child by the abuser which can continue to affect your adult life. Learn how to refute these lies.

Self-Esteem image If you have experienced these lies as a child, listening to this audio repeatedly can help you begin to change the impact of these lies in your life. The more you recognize that what you were told was a lie and learn to counter these lies, the more you can create a more fulfilling life.

Also, using Excel At Life's Self Esteem Blackboard app can help you to challenge the inaccurate beliefs that you have about yourself because of the lies that were told you as a child.

May 23, 2013


Generally, it has been believed that increasing positive emotions to aid in reducing depression can be achieved by having people with clinical depression recall positive memories. However, it may be a bit more complex than that. In fact, the focus on attaining positive memories could increase negative emotions in those who are depressed (Mauss et.al, 2011) perhaps due to the demand or pressure to be happy.

Researchers Kang and Gruber (2013) examined the difference in thinking about memories of controlled and uncontrolled positive emotions. Uncontrolled positive emotions is when an individual has a spontaneous, unrestrained reaction to an event whereas controlled positive emotions is when a person creates the emotions through how they think of the event or their ability to manage or master a situation.

Interestingly, they found that individuals with Major Depressive Disorder responded positively to recalling memories of uncontrolled positive emotions but not controlled positive emotions. Not only did they experience increased positive emotions when recalling spontaneous positive emotion, but they also exhibited greater relaxation while recalling the event.

What does this mean for those with depression? When recalling positive events to “harness happiness” it is best to choose events in which spontaneous, unrestrained positive emotion occurred. Think of times that elicited uncontrolled positive reactions. This can be as simple as laughing with a friend or it can be a major event such as the birth of a child.

Kang, Y. and Gruber, J. (2012). Harnessing Happiness? Uncontrollable Positive Emotion in Bipolar Disorder, Major Depression, and Healthy Adults, Emotion, 13, 290-301.

Mauss, I. B., Tamir, M., Anderson, C. L., & Savino, N. S. (2011). Can seeking happiness make people unhappy? Paradoxical effects of valuing happiness. Emotion, 11, 807–815.

May 19, 2013


Music can have a profound impact on people including reducing depressive and anxiety symptoms (Miranda et.al, 2012). In fact, lasting changes in EEG (brain wave activity) were observed with music therapy indicating that music affects the activity of the brain in depressed individuals through a reduction in anxiety (Fachner et.al, 2013).

However, is it possible that the music we listen to can contribute to depression and/or anxiety? A recent analysis of the last 50 years of American popular music has shown that music has become increasingly more sad-sounding (Schellenberg & von Scheve, 2012).

music Music has been shown to induce negative moods especially in susceptible individuals (Vuoskoski and Eerola, 2012). Therefore, it is reasonable to assume that increasing the sadness of the lyrics and sound of pop music can impact negative mood states in those who are predisposed to depression and anxiety.

What can be done about being negatively influenced by music? Typically, people tend to choose music that is emotionally congruent. In other words, happy people are more likely to choose energetic, uplifting music and depressed people are more likely to choose sad lyrics with slow tempo music (Thoma et.al, 2012). If you have problems with depression or anxiety, it may be important to be aware of the music you listen to and to deliberately choose music that will uplift the mood or motivate rather than music that is consistent with a negative mood.

Fachner, J., Gold, C. and Erkkila, J. (2013). Music therapy modulates fronto-temporal activity in rest-EEG in depressed clients. Brain Topography, 26, 338-354.

Miranda, D., Gaudreau, P., Debrosse, R., Morizot, J., Kirmayer, L.J., MacDonald, R.A.R., Kreutz, G. and Mitchell, L. (2012). Music listening and mental health: Variations on internalizing psychopathology. Music, Health, and Wellbeing, New York, NY: Oxford University Press, 513-529.

Schellenberg, E.G. and von Scheve, C. (2012). Emotional cues in American popular music: Five decades of the Top 40. Psychology of Aesthetics, Creativty, and the Arts, 6, 196-203.

Thoma, M., Ryf, S., Mohiyeddini, C., Ehlert, U. and Nater, U.M. (2012). Emotion regulation through listening to music in everyday situations. Cognition and Emotion, 26, 550-560.

Vuoskoski, J.K. and Eerola, T. (2012). Can Sad Music Really Make You Sad? Indirect Measures of Affective States Induced by Music and Autobiographical Memories. Psychology of Aesthetics, Creativity, and the Arts, 6, 204–213.

May 18, 2013



Very interesting preliminary research indicates that the normal bacteria in our stomachs could impact us emotionally and even alter personality type (Carpenter, 2012). The implications for understanding and treating emotional disorders are mind-boggling. For instance, could this explain why there is higher incidence of stomach disorders (irritable bowel, colitis) among those with anxiety or depression (Kurina et.al, 2001)? Those with stomach conditions have typically been told that stress or anxiety or depression has caused the stomach problems. However, could there be something else that is causing both? Such as the bacteria living in the stomach?

Bacteria is normal and natural in our systems and on our bodies. The "good" bacteria helps our systems to function correctly. That is why sometimes people have adverse affects when taking antibiotics or if they use too much anti-bacterial cleanser. In addition to contolling the "bad" bacteria, they are killing off the beneficial bacteria which we need for optimal functioning.

However, could the bacterial make-up of certain people predispose them to emotional disorders? Fascinating research by Bercik and colleagues (2012) showed that changing the type of bacteria in mice could change their personalities. Two strains of mice who had opposing personalities (outgoing and curious vs. timid and shy) were raised in sterile environments to prevent the development of the bacterial colonies in their stomachs. Then, bacteria was introduced from the opposite strain of mice. The results showed that the mice developed the personalities of the other strain. In other words, the timid and shy mice were now outgoing and curious!

What could this mean for treatment of stress, depression and anxiety in the future? Maybe these disorders could be treated with a change of the stomach bacteria. However, for the present, this research is helpful for those with these conditions to understand that they are NOT creating anxiety and depression due to personal weakness or inability to cope--that there are factors that are still beyond our full understanding.

Bercik, P., Denou, E., Collins, J., Jackson, W., Lu, J., Jury, J. Deng, Y., Blennerhassett, P., Macri, J, McCoy, K.D., Verdu, E.F. and Collins, S.M. (2011). The intestinal microbiota affect central levels of brain-derived neurotropic factor and behavior in mice. Gastroenterology, 141, 599-609.

Carpenter, S. (2012). That gut feeling. Monitor on Psychology, 2012, 43, 50-55.

Kurina, L.M., Goldacre, M.F., Yeates, D. and Gill, L.E. (2001). Depression and anxiety in people with inflammatory bowel disease. Journal of Epidemiological Commuity Health, 55, 716-720.

May 4, 2013


Don't read this if you want to remain comfortably in denial. Reading this may create cognitive dissonnance which is the uncomfortable recognition that what you want to believe about yourself and what is true about yourself may be in conflict.

I've always found it interesting that psychological tests measuring honesty ask “Have you ever told a lie?” and if you answer “no” you are probably dishonest (or a nun). Human nature is such that we protect our self-concept. And one aspect of self-concept is “I am a good person.” Which means that if we all lie or cheat or steal, then we have to develop ways to convince ourselves that we really haven't done anything wrong. This is called rationalization. Rather than changing behavior, we change the way we think about what we did.

We have developed many ways to rationalize our behavior:
1) Obedience. “I was following orders.” We displace responsibility for our actions on to someone else.
2) Conformity. “Everyone else did it.” We aren't responsible for what happened because we were only part of it.
3) Anonymity. “No body saw me.” We may believe that if no one knows who did it, then we didn't really do it.
4) Routine. “That's what we always do.” We focus on the daily details which distracts from the overall purpose of the behavior.
5) Moral Good. “That person is bad so I was right.” We use the “ends justifies the means” argument to convince ourselves that our behavior was actually moral.
6) Comparison. “What he did was much worse.” We justify minor transgressions by comparing to “true” evil.
7) Distorting Consequences. ”No one was really hurt.” We tend to believe that we didn't do anything wrong if there weren't serious consequences.
8) Blaming the Victim. “They are evil, so it is okay.” We justify our behavior based upon who the victim is. This has been used to justify violence against groups of people.
9) Fragmentation. “I just did my job. I didn't do anything wrong.” If we are only playing a small part in a larger scheme, such as a secretary for an unscrupulous mortgage broker, then we aren't doing anything wrong.

“Because of moral rationalization, large-scale evil and small breaches of morality are, on a certain level, qualitatively similar (Tsang, 2002).” In other words, if we can recognize that our small instances of cheating, lying, or stealing are no different from large-scale evil, our only way of reducing cognitive dissonance, then, is to change the behavior because we can no longer rationalize the behavior.

Tsang, J. (2002). Moral Rationalization and the Integration of Situational Factors and Psychological Processes in Immoral Behavior, Review of General Psychology, 6, 25-50.

May 2, 2013

“I want to feel good NOW!”

The contrast between European culture and the U.S. is striking when comparing the attitudes towards medication. When my son was traveling in Europe and had a cold, he couldn't find cold medicine anywhere. In fact, it wasn't even legal to ship cold medicine to him!

It occurred to me that our culture focuses on wanting to feel good immediately. The European attitude towards a cold is that it will pass. Our attitude is that we have things to do and the cold interferes with our plans.

We also take this approach to other problems. For instance, I frequently observe doctors prescribing anti-depressants for grief. We have the attitude that we should never feel bad and if we do, there is a pill for that.

Yet, this reliance on medication is likely to lead to more problems rather than solve problems. With grief, for example, you can temporarily medicate the feelings but the grief doesn't go away until you deal with it. Emotions help us to process painful events and heal from them. When we don't allow that process to occur, it is no different than drinking problems away—they don't really go away.

Not only that, but for more than a decade, there have been serious questions regarding the efficacy of anti-depressants especially as compared to cognitive-behavioral therapy (CBT). The issue is not that medication is ineffective, but whether the small effect it has with a high risk of side effects is worthwhile. In contrast, CBT has greater effects with little or no side effects and better long-term outcomes (Antonuccio et.al, 2002). However, CBT takes more effort than taking a pill.

Antonuccio, D.O., Burns, D.D. & Danton, W.G. (2002). Antidepressants: A Triumph of Marketing Over Science?, Prevention & Treatment, 5, 1-17.

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Dr. Monica Frank

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