Monday, September 29, 2008

Stress: Overview

Stress is actually a survival mechanism built into your brain. When your brain detects what it perceives as dangerous, it releases stress hormones such as adrenaline. For example, these hormones cause your muscles to tense, your breathing increases and your mind starts to race. When the danger goes away, your muscles relax, your breathing slows down and your mind begins to calm.

If the stress trigger continues over a long period of time you then experience chronic stress. This causes your brain to release a new chemical called cortisol. Studies have shown that increased cortisol appears to be related to depression. Higher cortisol levels also affect many body functions such as higher blood pressure, hyperglycemia, and impaired immune functioning. This is just a sampling of what can go wrong in your body because of increased long-term stress.

Although it is helpful in short-term stress situations, the constant release of cortisol into your blood stream can be a major contributor of disease. In women, too much cortisol can decrease bone density. One study found that 40-year old women with high stress levels had similar bone density to 70-year old women.

Interestingly, when couples have arguments, women release more stress hormones than their partners. When men do experience stress, they tend to return to a more relaxed state quicker.
One of the most physically damaging aspects of stress is how it affects your immune system. The risk of an infectious disease increases the longer the stress hormones remain in your body. Some research shows that chronic stress levels and a diminished immune system can increase the likelihood that you might become infected with viruses linked to cancer. Another study found that when elderly people got flu shots, those with high stress levels received the least benefit from the vaccination.

What this all means is that stress has minimal affect on the bodies of people who practice stress relaxation exercises: Natural Breathing, Muscle Relaxation, and Mind Calming. People who do this are simply stronger in the face of problems! The most recent discovery is that all this takes place at the level of your genes. As you calm yourself, your DNA changes the genetic makeup in your body.

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Tuesday, September 23, 2008

Panic Attacks, Part 2

If you missed Part 1, you can see it here: Panic Attacks, Part 1

If you have been told by your physician that your panic attacks are not the result of a biological condition, then you can concentrate on learning the skills needed to minimize your panic attacks. When psychologists first began working with panic attacks, our goal was to help you totally eliminate panic attacks. We eventually found this goal unworkable and unnecessary. The problem was that too much pressure existed to "never ever again have another panic attack." This level of perfect expectations would often backfire.

If you believed that you could never have another panic attack, the elephant in the room (your mind) was the thought that you just might have one. This germ of an idea would eventually grow into a fatal prediction that you, indeed, would have one. As you now know, this prediction would then bring on the panic attack. Psychologists have a different goal today: we teach people how to get to the place where they don’t care if they have a panic attack or not. This new attitude is more reasonable. It is possible because once you have the tools, then any panic attack will be short lived and under your control. In other words, it will merely be an inconvenience, not a terrifying experience.

So what do you need to do to bring your panic attacks under control? The first is to learn to activate your brain’s parasympathetic nervous system. You can do this by learning, practicing and mastering three simple skills: Natural Breathing, Muscle Relaxation, Mind Calming.

First, learn how to breathe properly (see Monday, October 6, 2008 post). When you are panicking, your breathing is shallow, fast and continuous. Learn to belly breathe by pushing out your stomach as you inhale; pull your stomach back in when you exhale. Then slow your breathing down by continuing to inhale and exhale as you spell the word "relax" at the rate of one letter per second. Finally, pause (stop breathing) momentarily after you exhale and before you take the next breathe. I call this type of breathing, Natural Breathing. This name is appropriate because this is the way that babies breath when they are born.

You also want to get rid of all the muscle tension that accompanies panic attacks. Learn to relax about 15 different muscles in your body by tensing a muscle for about ten seconds and then quickly releasing the tension and observing it for another ten seconds before tensing another muscle. This entire exercise should take between fifteen and twenty minutes. Do this slowly and observe the difference in feeling between a tense muscle and a relaxed muscle. Sometimes, relaxing a group of muscles results in a warm or tingling sensation. This indicates you are relaxing the muscle properly. Traditionally, people start with relaxing their feet, legs, stomach, back, shoulders, neck, and facial areas.

When you are finished relaxing your entire body, you want to practice calming your mind. Think of a pleasant scene (most people pick a peaceful water scene) and try to experience this as much as you can. The trick is to deal effectively with a wondering mind. You can do this by merely coming back to your chosen scene every time your mind wanders. This is often discouraging to beginners because our mind is supposed to "wander." You want to train your mind to focus on one topic for an extended period of time. This may take several weeks or months to become effective. Don’t be disheartened if the learning is slow because you will eventually be proficient. You only need to stay with this scene for a few minutes each time you practice Mind Calming.

The major mistake most people make in learning these three skills is to expect these skills to work with only minimal practice. When I teach these skills to my clients, they must practice Natural Breathing five times every hour while awake until it becomes automatic and easy. This usually takes place within a few days. They are expected to practice Muscle Relaxation four times a day. Mind Calming needs to be practiced about eight times a day.

The other skill you need to develop for your Panic Attack toolbox is to learn how to switch from worry to concern. The skills above are designed to activate your relaxation response in your body. Eliminating worry eliminates the panic attack trigger. You can learn this skill by reading our blogs on worry (there will be more to come) for checking out our book, The Worry Free Life.

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Sunday, September 14, 2008


Everyone wants it. It is the end of the line. When people are asked why they want more money, better relationships, or a more satisfying job, their response is often, "because it will make me happy." When anyone in any country is asked what they want out of life, the common answer is they their children to be happy. But, no one says they want to be happy so that it will get them something else. There's nothing after happiness.

Recently, science has begun to study happiness in spite of the many doubters who believed it could not be studied scientifically. Since 1981 the World Values Survey has conducted polls that measured happiness in 90% of the world's population. Although happiness increased in some countries, declined in others, stayed the same in one country, the overall increase in world happiness was 6.8 percent in the last seventeen years.

It appears there are three basic factors that contribute to increasing personal happiness. At the most basic level, individuals are happier when they live in a society where basic needs are met. In this situation, happiness increases when people have access to more medical care, clothing, shelter, food, and a longer life. However, once these basic levels are reached, more of the same does not result in increased happiness.

When these needs are satisfied, another level for attaining happiness is available: freedom. Freedom always implies social and religious tolerance. A society that promotes equality tends to increase the happiness of their citizens. Unfortunately, our brains have changed slowly over thousands of years and is still plagued by what some people call a "tribal mentality." This type of worldview promotes fear of anyone who is different from us and our immediate social group. Being accepting of people different than us can easily be threatening.

Only in recent times has the world at large believed that tolerating differences is a good thing. The research now bears this out. It is good because it advances well-being and happiness in people living in places where tolerance is accepted. People in tolerant societies are more happy than people living in tyrannical or intolerant societies.

Even freedom and tolerance have their limits for increasing happiness. Once these conditions are in place, happiness is to be found in what an individual does. Most happiness researchers agree that happiness is not a goal but a process of doing something meaningful with your life. To experience happiness at this third level, you need to find out who you are and what you can do that allows you to participate in something bigger than yourself.

In The Worry Free Life we learn about two types of happiness. One is short lived and only temporarily fulfilling; it then needs to be constantly renewed. The other kind of happiness is longer lasting and becomes a part of your being. The first is called the little h, the second is called the Big H. To obtain lasting happiness, you need to master three skills: healthy thinking, managing your emotions, engaging in meaningful and purposeful behavior.

Which of the following statements are true:
1. Happiness is a result of my biology. People are born with the ability to be happy.
2. It would surely be easier to be happy if life were different: better mate, more money, decent job.
3. Winning the lottery would make me happier in the long run.

You can read more about happiness at this link

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Wednesday, September 10, 2008

Panic Attacks, Part 1

Have you ever had a panic attack? If you have to ask, "What is a panic attack?" then the answer is "No." Panic attacks are terrifying and many people end up going to the local emergency room because they think they are having a heart attack.

The list of panic attack symptoms is long. Heart palpitations and sweating are very common. Sometimes people tell me their heart is pounding so loud they can't think. Others have described visual distortions like the floor or the sidewalk they are on is moving or waving. Some people find that the inability to swallow makes it seem like they are choking. Physicians are often told about dizziness, nausea or chest pains. Embarrassment can also occur because trembling or shaking may be visible to others. Other symptoms include feelings of heat or cold or tingling sensations. These are just a few of the more common symptoms.

Anyone who begins to experience panic attacks must immediately get a complete physical because certain diseases or physical conditions can also cause the above symptoms. A physical exam will try to rule out heart problems, asthma, hormonal problems, neurological disorders, anemia, withdrawal from alcohol or drugs, medication side effects, excessive caffeine intake or even some type of head injury. There are an entire host of other physical issues that can also contribute to panic attack symptoms.

If the physical exam eliminates all potential physical problems, the likelihood of a "pure" panic attack is highly probably. It is important to understand why your body has panic attacks. To experience a panic attack, one must have two preconditions: one is genetic and one is learned.

Panic attacks tend to run in families. This may sometimes be difficult to determine because the diagnosis is fairly recent – within the last several decades. Panic attacks cannot occur without a genetic predisposition for them. This is why it is often seen in relatives. Emily told me that she had a parent, an uncle and a sibling who had panic attacks. As she thought more about her more distant relatives, she realized that perhaps her grandmother and a great aunt may also have had panic attacks. The family thought them a bit odd, because they often refused to attend family functions or take vacations too far from home.

However, a predisposition to have panic attacks can only be set off by a learned condition called "worry." Worry is something we have to learn to do. Babies don't worry because their brains are not developed enough to do so. Many people have been taught how to worry by others when they were children. I know of no one who has read a book on how to worry and be miserable. By adolescence, worry can become a habit (although I have worked with some younger children who have already developed the habit). There are many types of worry, but only a specific one is associated with worry.

Panic attacks are triggered by making predictions about the future. The prediction takes the form of, "Something bad is going to happen to me and it will be a catastrophe." As this prediction repeats itself in a person's head, that person is getting set up for a panic attack (if they have the required biology).

Once the panic hits, the associated behavior is to escape and leave whatever situation the person is in. When a person leaves the environment of the panic attack, the symptoms will often subside. This is why many people think that situations, places or people "cause" the panic attack. Here, in California, many of my clients are afraid to drive on freeways because that is where they had their first panic attack (no wonder, with all the time we spend in our cars). Like Pavlov's dog, the freeway becomes the trigger that sets off the panic attack.

The environmental trigger is not what really causes the panic attack. Rather, the trigger sets the mental prediction in motion which then sets off the adrenaline overload which is the mechanism for having a panic attack.

In our next blog we will cover the strategies that need to be learned in order to conquer panic attacks. Have you ever had a panic attack? Did it match this description? What have you tried to help manage the panic attacks?

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Thursday, September 4, 2008


Have you ever wondered how two different people can experience the same trauma and yet have such different results? Researchers are beginning to find that these differences are the result of something called resiliency. We now know some people have the ability to quickly recover from personal catastrophe while others have severe psychological problems as a result.

In fact, some people even thrive during periods of extreme stress. Young men and women in the military who go through U.S. Special Forces training experience some of the most extreme stress any human can face. Yet, those who complete the training have no lasting effects on their well-being. A study of these individuals sponsored by the Mount Sinai School of Medicine in New York City found, unsurprisingly, that Special Forces personnel display extreme resilience to intense stress.

Does this mean that some people are destined to crash under stress while others sail through it? Has God allowed some people to be hardwired one way or the other? The answer is, change is possible.

Another study looked at Vietnam veterans who were prisoners of war. These 750 POWs faced daily, ongoing stress. The researchers studied what factors were involved in those POWs who were able to withstand the torture and isolation. Ten critical elements were found that distinguished those who had high resilience from those who had low resilience.
  1. Optimism. There is a relationship between high optimism and high resilience. People who are more optimistic tend to be able to bounce back from high amounts of stress.
  2. Altruism. Coping with the trauma of being a prisoner of war was easier when people focused on others instead of always thinking about themselves. It seems that helping others was an effective way of maintaining high resiliency.
  3. Having a moral compass. Resiliency was strong for those POWs that had a set of beliefs that was not easily destroyed by threats or intimidation. Researchers have found the same results in Iraqi prisoners at Guantanamo. Those with the strongest faith have been the ones who been able to successfully resist interrogation.
  4. Faith and spirituality. For some POWs, prayer was a daily ritual. Those without a faith engaged other non-religious rituals to help them cope with the trauma.
  5. Humor. Comedians often call this "dark humor." We also know that people living in oppressed totalitarian countries tend to generate a lot of jokes about their predicament.
  6. Having a role model. This seems to keep one's mind off their own dire circumstances. Those who used this technique were able to tell themselves that "if that person can do it, so can I."
  7. Social supports. One of the most powerful pieces of high resilience is having someone in your life you can trust. This trust allows you to share some of your most deepest thoughts and emotions.
  8. Facing fear. Everyone has a personal comfort zone. High resilience makes it easier for people to leave their own safe place. This seems to go against our instinct but is nevertheless important for successfully managing trauma.
  9. Having a mission or meaning in life. Knowing that life is much greater than the trauma. Extreme pain tends to focus our mind on that one, current aspect of life. Knowing that you are destined for something better and more than just painful trauma allows you to cope more favorably.
  10. Training. This is the most hopeful aspect of managing trauma. Even though you may have a disposition towards low resiliency, we now know that you can learn to increase it. As a psychologist who has worked with people for several decades, I see firsthand that if I can enhance a person's view of his or her options in life, then resiliency can begin to increase and the effects of past trauma can begin to dissipate.
  • What have you tried to do for yourself to manage traumas in your life?
  • Have some tools been more successful than others?
  • Do you think there might be others personal techniques that improve your own resiliency?

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Tuesday, September 2, 2008

Is Worry Ever Justified

Is worry every justified? Many people would say yes because it is important to worry about important things that might go wrong. It is a way of preparing oneself to deal with adversity. Some people think that worry is necessary if you care about something or someone. To not worry is to not care.

A common misperception is to equate worry with concern. This is understandable because worry and concern have several things in common. They are both styles of thinking and perceiving. Both of them may take a lot of mental effort. Additionally, worry and concern can both focus on very important issues.

The similarity stops there. One of the first steps you can take to begin managing your thought life is to understand the vast difference between worry and concern. My position is that worry is never warranted and always misplaced and self-destructive. Worry is not only focused on the future, but can be related to the present and the past. Worry is often a mental habit. The habit may be so strong that a person may worry without even being aware that he or she is worrying.

Worry is destructive and unhealthy because it is a mental style of thinking that runs you in circles. It goes round and round and seems to go on forever. It’s like the gerbil in the caged wheel — a lot of effort but no forward movement. What really defines worry is the focusing on parts of life beyond your control. By worrying, you can find yourself in the strange predicament of trying to control things in life that you have no control over.

Concern, on the other hand, is more linear. It allows you to make forward movement in your life’s journey, It is often more deliberate and reflective. Concern can take you places that are unreachable by worry because you are able to make creative choices instead of retreading old ground.

For example, let’s say you have parked your car on the street in front your friend’s house at night. As the night begins to wear on, you begin to wonder if you locked your car because its visibility and availability is an invitation for thieves. If you were to worry about it, your joy of being with your friend would begin to ebb. It might even make you reluctant to go check your car because you might worry about looking like a fool in front of your friend. Concern would get you to take immediate action with very little pondering what others might think. You would still be able to enjoy the time with your friend.

Knowing the difference is merely the starting point. The goal here is not to stop worrying, Your mind has to continue to operate. You want to learn how to replace worry with concern. Making the switch from worry to concern is the hard part. We all know how difficult it is to change long-standing habits. In future posts we can begin to look at what this replacement process looks like.

Questions: Do think there really is a difference between worry and concern? What if you could replace worry with concern — what would your life be like? Do you believe that the work it would take to replace worry with concern would be worth the effort? Feel free to post your comments about this topic and its questions.
Did You Know? Recently, scientists have discovered, by using neuroimaging of the brain, that when you think about God’s thoughts or when you think of your own thoughts, the same area in your brain gets activated?

Monday, September 1, 2008

Six Unhealthy Emotions

How do you deal with painful emotions? Most people just want the emotional pain to go away. This is common sense. However, did you know that some type of painful emotions can be healthy while the others are unhealthy? Unhealthy emotional pain needs to be dealt with by learning specific strategies for minimizing the impact.

Fortunately, only six human emotions are unhealthy and destructive. They might be familiar to you: depression, clinical anxiety, guilt, irrational fear, helplessness, and resentment. Learning specicfic techniques is a must for anyone who wants to live a more joy-filled life. In future blogs we will talk some more about each of these six unhealthy emotions, why they are so destructive and where they come from.

Since we all have the capacity to experience dozens (hundreds?) of emotions, most painful emotions are healthy for us. Once you eliminate the nasty six, you will find that all other emotional pain can serve a purpose in your life. You have probably known someone who has stated they have become more mature because of past emotional difficulty. They were able to experience this because healthy emotional pain does not last as long as the unhealthy variety. We are able to learn because of the healthy type, while each of the six unhealthy ones just keep us running in circles -- for years or even decades.

Learning to accept healthy emotions is the technique for managing these types of emotions. This is not easy nor automatic. When our brains are screaming at us to shut the discomfort down, we often find ourselves resorting to self-defeating behaviors to deal with an emotion that we would be better off to accept.

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