How to Get a Larger Brain

aaMonet_WaterLiliesHow do you increase the volume of gray matter in your brain? Mindfulness-Based Stress Reduction (MBSR), one of the most widely used mindfulness training programs, may be the answer. MBSR is receiving increasing attention for the significant morphological changes that it appears to produce on brain structures. The most recent results come from a controlled longitudinal study completed at Massachusetts General Hospital and published in the January 2011 edition of Psychiatry Research. Researchers at MGH investigated pre–post changes in brain gray matter concentration in individuals who participated in an 8-week MBSR program. Changes in gray matter concentration, measured using voxel-based morphometry, showed increases in gray matter concentration within the left hippocampus, as compared with a control group of individuals who did not meditate and showed no such increase. Whole brain analysis also confirmed gray matter increases in the MBSR group only, which were located in regions of the brain involved in learning and memory processes, emotion regulation, self-referential processing, and perspective taking, such as the posterior cingulate cortex, the temporo-parietal junction, and the cerebellum.

Earlier studies conducted in the last five years at Yale and Harvard have shown that mindfulness meditation increases the thickness of gray matter between .004 and .008  inches (in proportion to the frequency of meditation) in parts of the brain that are responsible for attention and processing of sensory input. It also appears to slow down the brain deterioration which is a part of the natural aging process.

Yoga and tantric meditation, mantra or transcendental meditation, and mindfulness meditation are increasingly popular forms of stress management. The therapeutic value of meditation in producing positive effects on psychological well-being and ameliorating symptoms of a number of disorders has become widely accepted. Research on the neural mechanisms that underlie these beneficial effects and actual morphological changes produced by these practices offers encouraging new avenues of study that further validate their effectiveness.

Humor: The All-Natural Remedy Against Stress

GinettoA stress reaction to challenging people and situations may be expressed by anger, hostility, aggression or seething inward rage. These instinctive reactions have their obvious drawbacks, but are altogether too common. There are other, more adaptive and sublimated responses (see this post for a complete list) that can turn angry reactions into assertiveness, the ability to effectively stand up for one’s rights, to engage in a respectful and yet passionate discussion of opposing points of view, an energy-releasing all-out workout at the gym, or humor. There is an abundance of evidence that proves the therapeutic value of humor. When used appropriately, this 100% natural remedy against stress is an adaptive, cathartic release of tension, a safe outlet for hostility and anger, and an effective defense against depression. Moreover, humor not only indicates emotional intelligence but also causes healthy neurological, immunological and physical changes. The mere act of laughter immediately increases muscular and respiratory activity, elevates the heart rate and stimulates the production of anti-stress hormones.

What Psychologists Say About Humor

American psychologist and psychotherapist Gordon Allport, in his research The Nature of Prejudice reported that 94% of people he questioned said their sense of humor was either average or above average. Allport stated that “the neurotic who learns to laugh at himself may be on the way to self-management, perhaps to cure” (p. 280).

American existential psychologist and author Rollo May, in Existence, suggested that humor has the function of “preserving the sense of self. . . It is the healthy way of feeling a ‘distance’ between one’s self and the problem, a way of standing off and looking at one’s problem with perspective” (p. 54).

mans-search-for-meaning-viktor-franklAustrian neurologist, psychiatrist and Holocaust survivor Viktor Frankl, in his best-selling autobiographical Man’s Search for Meaning, shared as his learned experience that, “to detach oneself from even the worst conditions is a uniquely human capability.” He specified that this distancing of oneself from aversive situations derives “not only through heroism . . . but also through humor” (p. 16–17).

American physician and psychologist Raymond Moody (Glimpses of Eternity and Life After Loss: Conquering Grief and Finding Hope), noted for his well-researched studies on grief, loss and the possibility of an after-life, also pointed to the ability to detach oneself as intrinsic to humor: “A person with a ‘good sense of humor’ is one who can see himself and others in the world in a somewhat distant and detached way. He views life from an altered perspective in which he can laugh at, yet remain in contact with and emotionally involved with people and events in a positive way” (p. 4).

What Is Humor?

Humor is expressed in many ways: verbally (a funny story, joke, stand-up routine), visually (a mime’s movements, funny faces and gestures) or behaviorally (slapstick, pie-in-the-face comedy). It can be triggered by a book, hours-long stage or film productions or by just a few words, as in this very short story,

A passenger carried his own bomb onto a plane. When questioned by the TSA, he said that it was for his own safety, because the odds of there being two bombs on the same plane are virtually nil.

What makes this story humorous? The stress-relieving fun of it lies in the entirely natural and universal human need to seek safety and reassurance, which is however expressed by integrating two contradictory beliefs, no matter how absurd the result. In fact, it is the absurdity or incongruity of the synthesis that is the essence of humor.

Humor is therefore a mental capacity, the skill of discovering, expressing, or appreciating the ludicrous or absurdly incongruous. Its effectiveness, i.e. the difference between funny and inappropriate, depends on the incongruity between what we expect to happen or to be said and what we perceive with our senses. Not all incongruity is humorous: in addition to being there, the incongruous must also be meaningful or appropriate, and must be at least partially resolved.

Humor and Human Development

BabyLaughingIn developmental psychology, humor is a form of play expressed by the manipulation of images, symbols, and ideas. Humor can be detected in infants of about 18 months of age who have acquired the ability to manipulate symbols and objects. Some believe that humor may be present in infants as young as four months old if humor is defined as the ability to perceive incongruities in a playful way and accept them without distress.

From a very early age, humor serves a number of social functions. Beginning in early adolescence and into young adulthood, humor can be an effective coping strategy, can reinforce interpersonal connections, or can be used to test the status of relationships.

One of the most important signs of a healthy self-esteem and maturity is the ability to laugh at one’s own shortcomings and mistakes. Most prominently in adulthood, humor is often used to express forbidden feelings or attitudes in a socially acceptable way, a device at least as old as the Renaissance fool or court jester who was, up to a point, allowed to speak of unpleasant truths and openly mock those in positions of authority.

Humor and Mental Health

Flirt_DepressionIt is a recognized fact in mental health practice that the presence of humor in a person’s narrative is a healthy way of reducing anxiety and indicates the ability of reasserting mastery over a situation. Conversely, one of the clear signs of depression is the inability to appreciate or use humor in any situation.

A judicious use of humor ushers in the opportunity to detach from the most painful aspects of a situation, albeit briefly, and exercise some control over its impact by laughing at the seemingly inescapable predicament. This dynamic, psychological attempt at regaining control by interjecting an element of incongruity is concretized in this popular German witticism about two contrasting points of view, “In Berlin, the situation is serious but not hopeless; in Vienna, the same situation is hopeless but not serious.”

{tab=Humor and Pain}
pain-signA 2005 study by Zweyer and Velker conducted at the Department of Psychology, Section on Personality and Assessment of the University of Zurich, 56 female participants were assigned randomly to three groups, each having a different task to pursue while watching a funny film: (1) get into a cheerful mood without smiling or laughing, (2) smile and laugh extensively, and (3) produce a humorous commentary to the film. Their pain tolerance was measured using a cold presser device before, immediately after, and 20 minutes after the film. Results indicated that pain tolerance increased for participants from before to after watching the funny film and remained high for the 20 minutes. Participants low in trait seriousness had an overall higher pain tolerance. Subjects with a high score in group 1 showed an increase in pain tolerance after producing humor while watching the film whereas subjects with a low score showed a similar increase after smiling and laughter during the film.

{tab=Humor and Immunity}

ilovebacteriaThe functions of the immune system that are essential for good health are known to be strongly affected by psychological experiences. Stressful events often result in immunosuppression, which leaves the body highly vulnerable to illnesses. Dillon, Minchoff, and Baker (1985) hypothesized that if stress and negative emotions can cause immunosuppression, it may also be true that humor, a positive emotional state, may be a potential enhancer of the immune system. In testing their hypothesis, they found that laughter induced by a humorous video caused a measurable and significant increase in concentrations of salivary immunoglobulin A (S-IgA), which is often described as the first line of defense against upper respiratory infection. Later research by Dillon and Totten (1989) replicated and expanded on these findings. Working with a group of mothers who were breastfeeding their infants, they found a strong relationships between humor and S-IgA.

Further connections between humor and immune system functioning were established by Lefcourt, Davidson, and Kueneman  in 1990, who found that the presentation of humorous material resulted in increased concentrations of S-IgA. When the humorous material was universally rated by participants as being highly funny (they used the video “Bill Cosby Live” for this research), S-IgA concentrations of most participants increased. However, when the humorous material produced variation in funniness ratings (when they used Mel Brooks and Carl Reiner’s “2000-Year-Old Man” video), larger increases were found only among some of the participants.

Changes in immune system activity with laughter are not restricted solely to immunoglobulin A concentrations. Berk et al., in their 1988 study, reported that mirthful laughter while watching a humorous film was associated with increased spontaneous lymphocyte blastogenesis (production of white cells) and increased natural killer cell activity.

Because immunosuppression appears to commonly occur in stressful circumstances when negative emotions are triggered, these findings would suggest that humor reduces negative emotions and/or increases positive emotions, with a corresponding beneficial effects on the functions of the immune system.

{tab=Humor and Stress}
climate-change-bears
In addition to interacting with immune system functioning, humor has also been found to influence physiological responses associated with stress. In a landmark study, Berk et al. (1989) examined the effects of humor on neuroendocrine hormones that are involved in classical stress responses. The study participants were asked to watch a 60-minute humorous video during which blood samples were taken every 10 minutes. A control group of people who were not watching the funny video were asked to enjoy 60 minutes of “quiet time” during which they were exposed to neutral stimuli. Blood samples were tested for the presence of eight hormones which usually change during stressful experiences, such as corticotrophin (ACTH), cortisol, beta-endorphin, 3,4-dihydroxyphenylacetic acid (dopac, a metabolite of the neurotransmitter dopamine), epinephrine, norepinephrine, growth hormone, and prolactin. Five of the eight hormones were found to have measurably decreased among participants who watched the funny video, while they remained virtually unchanged in the control group.

The importance of humor in prolonged stress situations, and its effectiveness as a stress-reducer, can hardly be overemphasized. The ability to laugh, not only with others but also at oneself, is a vital skill of survival that promotes better adaptation to adversity. Former prisoners of war have claimed that single instances of a humorous circumstance made them feel better for weeks to months later. A remarkable example of how humor can serve as an emotion-focused coping response in highly stressful circumstances is the case of Brian Keenan, whose powerful book An Evil Cradling: The Five-Year Ordeal of a Hostage describes the way in which he and other hostages in Lebanon used humor to survive their incredible ordeals during five years of captivity.

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Why Hardiness Is Faster Than Competitiveness

aaBruegel_HuntersSnowDo you know someone who deals with stress by working harder and faster to produce more in a shorter time? These so-called type A personalities appear to have a stronger than average sense of urgency, can be more highly competitive, and may be frequently and more easily angered when things don’t go their way. Stress reduction and stress management is perhaps one of their most urgent needs, yet these individuals are perhaps the least likely to take the time to learn effective self-management techniques.

Unfortunately, as discussed in our recent post on the impact of stress on the heart, type A personalities suffer from a significantly higher rate of cardiovascular disease than type B personalities. The former may be more successful at getting things done faster. Type B’s may be slower and somewhat less effective, but they can play and relax without guilt, are much less hostile and unlikely to exhibit excessive competitiveness.

Hardiness Matters More Than Speed

The evidence for the difference in health outcomes between type A and type B originally came from groundbreaking research by S. C. Kobasa of the University of Chicago. Dr. Kobasa looked at personality as a conditioner of the effects of stressful life events on illness by studying two groups of middle- and upper-level 40- to 49-year-old executives. One group of 86 individuals suffered high stress without falling ill, whereas the other group of 75 individuals became sick after experiencing stressful life events.

The results of the study showed that, unlike the high stress/high illness executives, the type B group was characterized by more hardiness, a stronger commitment to self-care, an attitude of vigorousness toward the environment, a sense of meaningfulness, and an internal locus of control. These “slower-paced” individuals appear to view stressors as challenges and chances for new opportunities and personal growth rather than as threats. They report feeling in control of their life circumstances and perceive that they have the resources to make choices and influence events around them. They also have a sense of commitment to their homes, families, and work that makes it easier for them to be involved with other people and in other activities.

SH_Rcmds_smAccording to Herbert Benson and Eileen Steward, authors of Wellness Book: The Comprehensive Guide to Maintaining Health and Treating Stress-Related Illness, the incidence of illness is much lower in individuals who have these stress-hardy characteristics and who also have a good social support system, exercise regularly, and maintain a healthy diet.

[amtap book:isbn=0671797506]

This is a stress management book well worth reading, because it specifically targets hardiness and better stress management with type A personalities in mind. It is the Stresshacker Recommended selection for this month.

Disaster! 9 Critical Crisis Management Skills

aaCezanne_BendOfRiverDisaster strikes…an event with sufficient impact to produce significant emotional reactions, and one that can carry significant consequences. In the range of our ordinary experience, such an event may be extremely unusual. Perhaps it is the first time that we have been in a car wreck, an earthquake, a flood, lost our job, missed the mortgage payment, or discovered a very unpleasant and unexpected truth about a person or a situation. The first time, any of these events constitute a serious crisis, with wide-ranging impact. The second or third time, these events continue to be real crises but may be approached with enhanced skills and capability to cope with their aftermath.

Whenever and however often these critical and extremely stressful events may occur, a few outcomes can be predicted as very likely to be experienced by most people. First, there will be potential and actual traumatic reactions to the event or incident, either immediate or somewhat delayed. Expecting no reaction or minimal reaction is unlikely, and a severely restricted reaction or no reaction at all may be a sign of poor cooping skills, an attempt to deny the impact of the stressor, or to minimize its seriousness. Second, there will be acute manifestations of stress (some purely psychological, other physical, or a combination of both) that must be managed and mitigated. Third, the stressful event may have an impact on the individual’s ability to function in his/her usual occupation, school, or even in carrying out daily routines. Fourth, the stressor may be of such magnitude and effect that short-term psychological or medical treatment may be necessary. Fifth, the best mitigating effects are produced by family support, peer group support and continued interaction in the workplace; isolating is an instinctive reaction when in emotional pain, but it is proven to be counterproductive when dealing with a severe stressor.

In critical incidents or severe stress situations, the first 24-72 hours after the event are the most crucial. It is important to provide to others or seek out for oneself a reduction in the intense reactions to the traumatic event. While it is normal and expected to have a stress reaction, even severe, people should be facilitated in their return to their routine as quickly as feasible. In this respect, re-establishing access to one’s social network prevents isolation and reduces anxiety. In recognizing similarities to others, being understood and supported while in pain, and not being judged or criticized for their reaction, people often are better able to cope with the challenges of troubled times.

Here are 9 ways of managing acute stressors that have been proven to work:

  1. Reaction. Allowing ourselves to have an appropriate reaction that is physical (e.g., crying), psychological (feeling upset), and social (reaching out for help), without much concern for how our grief or sorrow may “damage” our image with others. An attempt to look strong and to show no emotion in the face of a significant stressor may work in the short term, but if the reaction to its impact is not allowed to take place, this may create a situation of chronic stress over time.
  2. First Aid. Psychological “first aid,” education and follow-up are important. Talking to trained peers, chaplains, and/or mental health professionals may be just what is needed in the critical first few days following the incident. Longer term counseling or medical help may be needed to manage any anxiety or mood disorders (such as depression) that could be triggered by the stressor.
  3. Comfort. The basic human needs to be comforted and consoled when in distress and being protected from further threat or distress, as far as is possible, are important. This may mean moving away from the scene of the incident at least for a time. It is not unusual to need and benefit from a few days out of town visiting welcoming family members or very close friends, following a disastrous event or a major personal crisis.
  4. Basic Needs. Immediate care is needed to address any physical necessities caused by the severe incident. In the case of a natural disaster, shelter, food and warmth become critically important and take precedence over psychological interventions.
  5. Reality Testing. Seeking goal orientation and support for specific reality-based tasks (“reinforcing the concrete world”) is important in mitigating the effects of a severe stressor that may make the individual feel like “the world is coming to an end” or “this is too much to even comprehend” and any severe symptoms of derealization or detachment.
  6. Relationships. It is important to facilitate the reunion with loved ones from whom the individual has been separated. If this disruption of relationship occurs, reuniting parent and child, or spouses, or siblings, is critically important. If an immediate reunion is not possible, providing good information as to the loved ones’ whereabouts and health is the next best thing.
  7. Talking. At the earliest opportunity, the telling of the “trauma story” and the expression of feelings as appropriate for the particular individual should be facilitated. Even though not everyone may be willing to go into details as to what happened, at least not right away, providing the earliest opportunity to say what happened and what it means to the person affected is critically important.
  8. Ongoing Support. If the individual seems to be “lost” in the magnitude of the event, linking the person to systems of support and sources of help that will be ongoing is never a bad idea. The key is the continuity of support. For some incidents or severe stressors such as the loss of a loved one, this support may need to continue for weeks and months to come.
  9. Regaining Mastery. Eventually, after all the critical “first aid” interventions have been taken care of, the goal becomes the restoration of some sense of mastery, a regaining of control over one’s life, a new beginning and the ability to deal effectively with the new situation created by the incident. The memory of what happened will most certainly never go away, but its traumatic impact on distress and functioning is meant to fade over time, when new ways of coping have been successfully put in place.

How To Deal With 6 Personalities Under Stress

Pisa%20-%20Piazza%20dei%20Miracoli%20-%202How does each personality style tend to handle a significant stressor? And, if we happen to be the spouse, significant other, sibling or friend of any of these, what is the best way to interact with them while they are under severe stress? To answer these questions, it is necessary to understand their most relevant characteristics, the most likely meaning of the stressor to each style, the most likely feelings or responses evoked among other people that interact with them, and tips on the management of this interaction.

The Dependent Personality Style

Relevant Characteristics Under Stress: May become needy, demanding, clingy. May be unable to reassure self and will seek reassurance from others.
Meaning Attributed to the Stressor: Threat of being abandoned and left all alone. 
Feelings Evoked: May make others feel powerful and needed. May also make them feel overwhelmed and annoyed.
Management Tips: Reassure within limits, mobilize other supports, reward personal efforts toward independence, avoid the temptation to withhold all help.

The Obsessive Personality Style

Relevant Characteristics Under Stress: Meticulous, orderly; likes to feel in control; very concerned with right/wrong approach.
Meaning Attributed to the Stressor: Dangerous loss of control over body, emotions, impulses.
Feelings Evoked: May elicit admiration for their attention to detail; may also provoke anger—a “battle of wills” due to their perfectionistic approach.
Management Tips: Provide choices to increase their sense of control, provide detailed information, focus on a collaborative approach that avoids the battle of wills.

The Histrionic Personality Style

Relevant Characteristics Under Stress: Entertaining, melodramatic.
Meaning Attributed to the Stressor: May fear loss of love or loss of attractiveness.
Feelings Evoked: May make others feel anxiety, impatience, off-putting dramatic gestures.
Management Tips: Try to strike a balance between warmth and formality, maintain clear boundaries, encourage them to discuss fears, avoid confronting them head-on.

The Masochistic Personality Style

Relevant Characteristics Under Stress: “Perpetual victim,” self-sacrificing martyr, may expect negative outcomes.
Meaning Attributed to the Stressor: May view the stressor as conscious or unconscious punishment.
Feelings Evoked: May provoke anger, hate, frustration, helplessness, self-doubt.
Management Tips: Avoid excessive encouragement, share their pessimism (albeit without agreeing).

The Paranoid Personality Style

Relevant Characteristics Under Stress: Guarded, distrustful, quick to blame or counterattack, sensitive to slights.
Meaning Attributed to the Stressor: Proof that the world is against them.
Feelings Evoked: Anger, feeling attacked or accused, defensiveness. 
Management Tips: Avoid assuming a defensive stance, acknowledge their feelings without disputing them, maintain interpersonal distance, do not confront irrational fears.

The Narcissistic Personality Style

Relevant Characteristics Under Stress: Arrogant, devaluing, vain, demanding.
Meaning Attributed to the Stressor: May view it as a threat to self-concept of perfection and invulnerability; may be shame evoking.
Feelings Evoked: May cause others to feel anger, a desire to counterattack, activate feelings of inferiority.
Management Tips: Resist the desire to challenge their sense of entitlement, provide opportunities for them to show off, offer appropriate advice if requested.

Christmas Stress Survival Kit

aaMantegna_1500_AdorazioneMagiThe holiday season is upon us — the cash tills are ringing — the car parks are chocka — the shops are heaving — and stress levels are rising. For all the perfectionists out there this time of year can be a real nightmare as The Need To Do Things Perfectly swings into overdrive.  Advertising induces huge pressure to roll out the perfect Christmas:  perfect gifts — perfect parties — how to cook the perfect turkey …   and so on. We put impossibly high expectations on ourselves and end up being unable to enjoy the celebrations.

So here are a few ideas to help ease the stress and allow you some space to enjoy the festive season.

► DELEGATE/ASK FOR HELP: If the majority of the work falls on your shoulders please don’t suffer alone.  If you do you’ll have an exhausting Christmas and probably end up feeling resentful.  Ask for help from those around you — partner, children, family, friends.  Preparing food or writing cards together feels very festive and will significantly ease the burden on you.

► BEWARE “SHOULDS”: Christmas is full of ‘shoulds’.  Be aware of the number of times you use this word.  It usually implies that you’re about to embark on something you don’t really want to do — but feel you ought to.  In other words, the impetus is stemming from external expectations.  The antidote is simply to supplant the word should with could. This instantly reintroduces the element of choice.  You DON’T have to brave the crowds to buy just one more gift … you could, but you might choose not to…

► TEMPER EXPECTATIONS … of others and, more importantly, of yourself.  Don’t sweat the small stuff. Please let go of the need to be perfect. If the turkey is a bit overcooked, or the Christmas tree lights go on the blink, or someone isn’t overjoyed with the gift you’ve bought them – how important is that in the great scheme of things?

► And finally … don’t forget to get out and do some exercise over the Christmas period.  We all eat and drink more than usual, so getting out for a walk and some fresh air always feels great and does you good.

Wishing you a happy, festive and stress-free Holiday Season.


fac_sutton_annabelThis guest post is courtesy of Annabel Sutton, a fully trained Life Coach and Author. In 2005 she was awarded the Professional Certified Coach credential. Her clients say that she inspires, energizes and motivates them towards success and she gets wonderful results. Email Annabel@annabelsutton.com or visit www.annabelsutton.com for more information or to sign up for Annabel’s free Coaching Tips.

Making Your Marriage Last and Thrive

SH_Rcmds_smWhat makes a good marriage last? According to the best evidence provided by thousands of studies and experimental research (most prominent that of Dr. John Gottman), marriages where the spouses provide a safe haven for each other and a secure base from which to face the world together provide the best chances of success. A key skill that all good partners acquire is that of arguing in a fair manner, which respects the other’s point of view (without necessarily agreeing with it), seeks to understand the reasons underneath each respective position, and negotiates a fair compromise.

If you are a couple, you most likely have arguments. Big or small, they can ruin a day and, even worse, a relationship. Dr. Sharon Morris May says, "It’s not how similar you are or even your level of conflict that determines your marital success but how you deal with your emotions, vulnerabilities, and dragons when you argue." In her book, How To Argue So Your Spouse Will Listen: 6 Principles for Turning Arguments into Conversations, Dr. Morris May presents conflict through the lens of attachment theory, helping couples understand why they argue, how they argue, and how to unravel arguments. The book also helps spouses identify what’s really going on in their brains and in their bodies when they argue, the cycle they get stuck in, the emotions fueling the cycle, and what can help them argue in more considerate and connecting ways.

[amtap book:isbn=0849918685]

How To Argue offers six practical principles that can help turn arguments into real conversations: Establish a Safe Haven, Comfort Each Other’s Dragons, Get Inside Each Other’s Emotions, Learn How to Complain, Learn How to Apologize, and Bookend It With Good Times.

Learning how to argue so your spouse will listen and in ways which will not lead to irreparable breaches is a fundamental skill that perhaps you did not learn in your prior relationships or from our own parents. The good news is that it is a skill that can be learned at any age and virtually at any point of your marriage: this book, the Stresshacker Recommended book for this week, can teach you how.

Best Omega-3 Against Depression

aaInness_1878_AutumnOaksThe polyunsaturated fatty acid omega-3 is an important weapon in combating inflammation, the principal cause of stress-related illness. However, when it comes to helping lift depression, not all types of omega-3 fatty acids are equal. According to a study presented at the 49th Annual Meeting of the American College of Neuropsychopharmacology which took place Dec. 5-9 in Florida, only eicosapentaenoic acid (EPA) has been shown to produce significant mood improvement in patients with depression. The other type of omega-3 fatty acid, docosahexaenoic acid (DHA), has no effect on depression.

The two omega-3 fatty acids EPA and DHA are found together in food (primarily fish and nuts) in a 1:1 ratio, but man-made supplements contain either EPA or DHA or a combination of both, in a ratio that may favor one vs. the other and may vary by manufacturer. In order to take advantage of omega-3’s antidepressant effects, it is therefore important to choose supplements that have an EPA-predominant formulation.

Among the many Omega-3 supplements that are rich in EPA for antidepressant effects, some of the highest rated are NutraSea Herring Oil (with a 3:1 EPA to DHA ratio), AST Bioactive Omega-3 EPA Amino Hybrid (with a 5:1 EPA to DHA ratio), and Pharmax High EPA Fish Oil.

Fake It ’til You Make It: Posture Lowers Stress

Is it possible, by deliberately assuming a simple two-minute high-power pose, to instantly become more powerful? In a study conducted conjointly at Harvard and Columbia universities, researchers have shown that humans and animals can increase the beneficial effects of power by deliberately assuming open, expansive postures for as little as two minutes, and suffer the effects of powerlessness by deliberately assuming closed, constrictive postures. The study results revealed that assuming certain postures almost immediately produces neuroendocrine and behavioral changes. High-power postures (widespread limbs, enlargement of occupied space, and spreading out) trigger a rise in testosterone, a decrease in cortisol, a perception of power and a willingness to take more risks. Assuming low-power postures (limbs touching the torso, minimizing occupied space, and collapsed inwardly) produces the opposite effects.

chinatown-jack-nicholson

By simply changing our physical posture, we can better prepare our body and our mind to take on stressful situations. Intentionally assuming certain postures can have the immediate effect of improving self-confidence in such situations, e.g., a public speech, a job interview, disagreeing with someone, preparing for a sports challenge or even taking a financial risk. As it turns out, “Fake it ‘til you make it” is not just a phrase:  even minimal postural changes, if sustained over time, can  improve our health and well-being, even if we may often feel quite powerless due to lack of resources, occupying a lower rank in an organization, or being part of a low-power social group.

How Does Posture Reduce Health Risks?

forrest-gump-p111Although short-term high cortisol levels are a normal reaction to stressors large and small, being in a position of lower power (at work, at home, in social groups) has been shown to cause a higher incidence of stress-related illnesses (Cohen et al., 2006). For people who hold positions of power or are able to exercise more power at work, at home or in social situations, the contrary is true. Their typical combination of high testosterone coupled with low cortisol is often associated with leadership capabilities and a higher resistance to disease. The stress-marking hormone cortisol is lower when we are in a position of power, indicating a lower level of reactivity to stress. The continuous state of alarm and elevated cortisol experienced by low-power individuals can produce negative health consequences such as inflammation, high emotional reactivity, a high allostatic load, stress-related illnesses (irritable bowel syndrome) and memory loss.

In short, arranging our body posture to indicate power (regardless of whether we feel powerful or not) causes specific advantages and adaptive psychological, physiological, and behavioral changes, with more positive subsequent behavioral choices. A simple two-minute pose can embody power and instantly make us more powerful. Who’d have thunk it?

When Stress Hurts: Curing Psychogenic Pain

villa-Era-Vigliano-Biella_Current treatments that effectively reduce or eliminate psychogenic pain is the subject of this, the sixth and last post in the series on the close association between psychological stress and psychogenic pain. Encouraging news for psychogenic pain sufferers from the pharmacist: A growing number of patients reports that by taking antidepressants they have experienced a significant reduction in the frequency and intensity of pain. More specifically, relief of psychogenic pain with antidepressants has now been thoroughly documented in the treatment of pain associated with bulimia (Faris et al., 1998), vulvodynia (Stolar & Stewart, 2002), chronic pain of undefined origin (Davis, 1990; Pilowsky & Barrow, 1990), migraine headaches (Kaniecki et al., 2006), chronic pain associated with depression (Bradley, Barkin, Jerome, DeYoung, & Dodge, 2003), functional bowel disorder (Drossman, Toner, & Whitehead, 2003), neuropathic pain (Fishbain, 2000; Saarto & Wiffen, 2005), and post-herpetic neuralgia (Max, 1994).

Non-pharmaceutical Treatments

As we have seen in a previous post, there is a strong emotional and affective component to pain of any origin, whereby pain always has a depressive effect on our mood. There is also ample evidence that pain is often the unwelcome companion of depression, anxiety, psychological trauma, anger and irritability. Even the mere expectation of pain, in the absence of any noxious stimuli, appears sufficient to produce it  and its perception, as has been documented in functional MRI (fMRI) changes to specific brain structures (Fields, 2000; Keltner et al., 2006). Conversely, diverting cognitive attention or causing distraction can mitigate pain, as shown in PET scans of cortical activation (Petrovic, Petersson, Ghatan, Stone-Elander, & Ingvar, 2000).

SH_Rcmds_sm UnlearnPain_BookHoward Schubiner, MD and Michael Betzold are the authors of Unlearn Your Pain, an excellent book that seeks to help reverse chronic pain by promoting a thorough understanding of its principal cause, learned nerve pathways (see Stresshacker’s explanation of the concept in this post). It offers a revolutionary step-by-step process that has been reported to work well by many psychogenic pain sufferers. It is Stresshacker’s recommended book resource.

Psychological Treatments That Can Eliminate Psychogenic Pain

The effectiveness of purely psychological interventions in the relief of chronic or acute pain is supported by the fact that pain and stress share many of the same biochemical processes, neural pathways and CNS structures (see this post for a full explanation).

Decreasing psychological stress through better stress management or counseling has been documented as effective in treating low back pain that is co-occurring with depression (Middleton & Pollard, 2005). There is also evidence that psychosocial interventions are efficacious for pain secondary to arthritis or cancer (Keefe, Abernethy, & Campbell, 2005). Multidisciplinary approaches, including relaxation therapy, biofeedback, behavior modification, hypnosis, desensitization and cognition therapy, have also been proven successful in treating chronic pain of unknown origin (Singh, 2005). Biofeedback therapy can be particularly successful in reducing colorectal pain (Jorge, Habr-Gama, & Wexner, 2003). Hypnotherapy, cognitive therapy, and brief psychodynamic psychotherapy appear to work well in patients suffering from irritable bowel syndrome (Blanchard & Scharff, 2002). Hypnosis has been proven effective in relieving oral pain (Golan, 1997), cognitive behavioral therapy for functional bowel disorder (Drossman et al., 2003), behavioral therapy for the treatment of headaches (Lake, 2001); and family therapy interventions have been associated with successful psychogenic pain treatment (Liebman, Honig, & Berger, 1976; Roy, 1987).

Previously in this series:

How Owning a Dog Extends Your Life

Puppy_1-21-09Human interactions have a biochemical signature that is most evident in what happens between a mother and her baby. A study presented at the 12th International Conference on Human-Animal Interactions that took place this summer in Stockholm offers convincing evidence that the same biochemical process plays a role in the bond between dogs and their owners. Researchers Linda Handlin and Kerstin Uvnäs-Moberg of Sweden’s Karolinska Institute believe oxytocin is the “bonding hormone” that is released in humans and in dogs during mutual interactions. To test their theory, blood samples were taken from dogs and their owners before and during a petting session. “We had a basal blood sample, and there was nothing, and then we had the sample taken at one minute and three minutes, and you could see this beautiful peak of oxytocin,” said Uvnäs-Moberg in an interview on PBS. “The fascinating thing is, actually, that the peak level of oxytocin is similar to the one we see in breastfeeding mothers.”

The hormone oxytocin has a powerful physiological effect. It can reduce blood pressure, increase tolerance to pain, and reduce anxiety. Research indicates that owning a dog could even extend your life. “If you have a dog, you are much less likely to have a heart attack, and if you have a heart attack, you are three to four times more likely to survive it if you have a dog than if you don’t,” added Uvnäs-Moberg.

Oxytocin: The Baby-love Puppy-love Hormone

Oxytocin is a polypeptide hormone that has long been known to stimulate the contraction of the uterine muscles and the release of milk during breast-feeding. It is now recognized as an important modulator of the stress response. Stored in and released from neurons in the posterior pituitary as well as in the brain, oxytocin is synthesized in cell bodies of the magnocellular neurons located principally in the paraventricular nucleus of the hypothalamus. However, oxytocin is more ubiquitous as it is also synthesized in neurons that are widely distributed within the central nervous system. Oxytocin facilitates mother–infant interactions and tends to facilitate behaviors that oppose classic fight-or-flight behavioral responses to stress.

The Study: Dogs Have Feelings of Love, Too

Mother and childHandlin and Uvnäs-Moberg sought to establish a correlation between levels of oxytocin and those of the stress hormone cortisol during interactions between dog owners and their dogs. Ten female dog owners were asked to evaluate the quality of their relationships with their dogs via a standardized questionnaire. They were also asked to interact with them, stroke them and talk to them for one hour. The owners’ oxytocin levels correlated significantly with questionnaire items indicating positive feelings and closeness to the dog, while cortisol levels were significantly correlated to items regarding negative feeling towards their dog. The dog’s oxytocin and cortisol levels also correlated significantly with the owners’ answers to items regarding their attitude toward the dog. The scientists concluded that hormones in both human and animal were related to the owners’ perception of their relationship with the dog. “A short-term sensory interaction between a dog and its owner [can] influence hormonal levels in both species,” says Uvnäs-Moberg. “The dogs’ oxytocin levels displayed a significant rise just three minutes after the start of the interaction. There was also a significant positive correlation between the dogs’ and the owners’ oxytocin levels after 15 minutes.”

Getting Better for Absolute Beginners

PalmIsland_EN-US349499969Getting better is the goal of every stress management program… and every other program, plan, treatment, intervention we may choose to undertake. But what does getting better mean? Are there some specific characteristics to recovery that would clearly indicate that we have succeeded? These important questions, for one reason or another, often are either not asked or not fully replied to, leaving us wondering where all that effort went and whether it was really worth our time and investment.

The Meaning of Not Doing Well

Before we attempt to define the specifics of getting better, let’s clarify the characteristics of not doing well.  In the case of chronic stress, two criteria can be used to reliably define its severity: subjective distress and level of functioning. The first, subjective distress, indicates how much we are bothered by the condition. Chronic stress can produce bothersome physical symptoms (gastrointestinal problems, fibromyalgia, skin rashes, headaches) and distressing psychological problems (irritability, anger, sleeplessness, poor concentration, memory loss). When these signs appear, it can be said that an individual’s subjective distress has risen to levels that go beyond just feeling pressured and have escalated to affecting multiple aspects of the mind and the body.

The second major indicator, level of functioning, can be gauged by examining personal productivity, balance between work and family life, quality of significant close relationships, and social connectivity. When problems appear in these areas, ranging from interpersonal difficulties to the inability to keep a consistent work schedule or to take care of tasks and chores that could be previously accomplished, one’s level of functioning is said to be impaired. Impairment of functioning can be somewhat of a subjective measure, and for this reason it is often helpful to compare our own perception of how well we are functioning under severe stress to the perception of those around us, as they may be able to give us a more balanced assessment.

Getting Better

As recently described by Dr. Marianne Farkas of the Center for Psychiatric Rehabilitation at Boston University at the Refocus on Recovery 2010 conference, getting better can generally be defined as, “the deeply personal and unique development of new meaning and purpose as one grows beyond the catastrophe… reclaiming a meaningful life… a long-term journey with many dimensions [which] include re-engaging in life, finding a niche or major role, developing secondary roles, reawakening hope, [and] developing a sense of purpose…”

In practical terms, this definition comes down to two essentials: the individual feels better (about meaning and purpose of life, hopefulness, and motivation) and functions better (by re-engaging in more meaningful and productive activities, and adding new roles and dimensions). Thus, the two hallmarks of feeling poorly, distress and impaired functioning, are both mitigated or reversed to fully express the reality that the person is indeed free of distress and capable of functioning at or near optimum levels.

Some indicators of having successfully overcome chronic stress:

  • A return to prior levels of happiness, enjoyment of life, and positive outlook
  • An increase in energy levels and the ability to apply energy toward productive activities
  • The ability to manage personal resources in a way that takes into account the need to replenish them before reaching exhaustion, e.g. better nutrition, more regular sleep patterns
  • A significant reduction or disappearance of the physical symptoms of stress, without the need for medication, alcohol, nicotine, or illegal substances
  • The restoration or improvement in the quality of interpersonal connections
  • A noticeable increase in self-esteem, feelings of well-being, a sense of empowerment

Using the two measures of well-being, distress and level of functioning, can be a quick and simple way of gauging different aspects of our life. Wherever distress is detected, or a stress reaction is taking place, there is an indication that something is not right and requires our attention. Likewise, detecting a reduced level of functioning at work, in leisure or in interpersonal relations should not be overlooked, as it indicates that our resources are dangerously depleted and must be restored.

Crying: Public, Political, and Private

BoehnerCryingDespite the popular (and clinical) consensus that emotional tears are beneficial, dating back to ancient history, the benefits of crying to one’s physical health and its effectiveness as stress reliever turn out to be unexpectedly controversial. Scientific evidence is inconsistent at best, owing in part to the difficulty in measuring the effects of crying on the body and on the psyche in a valid, reliable and reproducible way. Crying remains a poorly understood phenomenon whose physiology is not a mystery but whose product, human tears, appears to stir controversy when analyzed for composition and function.

It is some relief to weep; grief is satisfied and carried off by tears.- Ovid

Perhaps the best known and most controversial theory on the function of crying continues to be the 1985 research published by Dr. William Frey, who hypothesized that emotion-triggered tears may simply be an excretory process. Like other bodily waste, the primary function of emotional tears may be to remove ACTH, prolactin, endorphins, toxic substances and hormones that accumulate during emotional stress. Frey reported that emotional tears, at least those he studied in his laboratory, appeared to contain higher concentrations of some hormones. Frey also reported differences between the protein content of emotional and irritant tears. These results have proven difficult to interpret and duplicate, making it unclear whether this difference has any clinical relevance. Frey’s critics contend that the amount of tears shed by humans is generally so small that it is unreasonable to presume that this process would have any physiological benefit.

ClintonCryingA recently published book by Tom Lutz, Crying: A Natural and Cultural History of Tears offers plenty of insights into the history of public crying, but few scientific explanations for the phenomenon. Lutz, a professor of creative writing at UC Riverside offers interesting anecdotes about the political value of public tears. Says Lutz, “Men cried openly and often in the upper classes in the 18th century. Lincoln and Douglas both cried on the stump. And men cry more openly now than they did 50 years ago. Issues of ‘control’ are always in relation to these changing social norms. Bob Dole cried in public exactly twice before his 1996 campaign. But in the early 1990s, Bill Clinton had transformed the political meaning of crying; it tracked very well with women voters. All of a sudden Bob Dole couldn’t control his crying and did it often.”  As to the reasons for public crying, “We do so for a number of reasons,” he says. “For emphasis (this is so important I give myself permission to break the rules); for self-definition (I don’t care how I’m supposed to act; this is who I really am); to ward off criticism (he’s too upset for me to challenge him); to suggest intimacy (he feels so comfortable with me he will break the rules in front of me); and so on.”

The BBC lists the following as the ten most frequent reasons people cry in public:

  1. Making one’s parents proud. For men, this most often refers to Dad, as many movies having this theme can attest, e.g. Field of Dreams.
  2. The birth of a first child or grandchild.
  3. The suffering of a loved one.
  4. Letting a loved one down.
  5. Saying I’m sorry.
  6. Letting yourself down.
  7. Being dumped.
  8. Being beaten in a hard-fought game.
  9. Winning a hard-fought game. Most recently famous is Iker Casillas, the goalie of the Spanish soccer team who just couldn’t stop crying after winning the 2010 World Cup.
  10. These aren’t emotional tears. It’s just bits of dust.

ronaldo-cryingPsychologically, crying appears to perform a valuable interpersonal function. Tears can be a powerful way to get what we want.  And there is some evidence to suggest that a process of natural selection favors infants whose cries are most alarming.  This bit of psychology appears intuitively to make sense when we think about how babies get attention — they cry. And so do Bill Clinton, John Boehner, Hillary Clinton, TV preachers, and countless others on baseball, football, soccer fields and TV sets everywhere. And they get attention.

Beyond Reaction: An Intelligent Response to Stressors

aaAltdorfer_SusannaElternA stress reaction that gets “stuck” into alarm mode and never progresses toward a resolution of the stressor can develop into chronic stress or depression. The latter can be conceptualized as turning inward, shutting off the world and avoiding all but the most necessary contact with the stressor. It is a rather primitive and ultimately ineffective way of coping with stressful events and situations (for better ways of defending against stress see this post), but it is undeniable that it works at reducing the level of incoming inputs and the effort required to respond. When stress causes anxiety, what follows is a semi-permanent state of arousal (which can have dangerous health consequences). When the response is depression, what follows is a significant reduction in functioning—to the extent that the person is not anxious but apathetic, withdrawn, and unresponsive even to positive stimulation.

The Coping with Stressors Inventory

Adapted from the Coping Styles Questionnaire (CSQ) by Roger, Jarvis, & Najarian, (1993), this is a simple way to determine our instinctive and preferred ways of managing stressors as they appear in our lives. These are ways that are characteristic of our behavior and are most likely to be used under conditions of severe stress.

Instructions: Mark as many as apply, but make sure to choose only the ones that you are most likely to use or have definitely used in coping with severe stressors.

When I am confronted with a severe or continuing stressor:

1. I ignore my own needs and just work harder and faster.
2. I seek out friends for conversation and support.
3. I eat more than usual.
4. I engage in some type of physical exercise.
5. I get irritable and take it out on those around me.
6. I take a little time to relax, breathe, and unwind.
7. I smoke a cigarette or drink a caffeinated beverage.
8. I confront my source of stress and work to change it.
9. I withdraw emotionally and just go through the motions of my day.
10. I change my outlook on the problem and put it in a better perspective.
11. I sleep more than I really need to.
12. I take some time off and get away from my working life.
13. I go out shopping and buy something to make myself feel good.
14. I joke with my friends and use humor to take the edge off.
15. I drink more alcohol than usual.
16. I get involved in a hobby or interest that helps me unwind and enjoy myself.
17. I take medicine to help me relax or sleep better.
18. I maintain a healthy diet.
19. I just ignore the problem and hope it will go away.
20. I pray, meditate, or enhance my spiritual life.
21. I worry about the problem and am afraid to do something about it.
22. I try to focus on the things I can control and accept the things I can’t.

Results Evaluation: Even-numbered ways of coping are more constructive, while the odd-numbered ones are less constructive tactics for coping with severe or continuing stressors. Checking more even-numbered items indicates a better approach to stressors that takes into account the need for self-care, emphasizes the seeking of support, and confronts the stressor in effective ways. If more odd-numbered items are checked, this may indicate an attempt to cope with stressors by avoidance, smothering the stress reaction with chemical means, and generally retreating into tactics that may temporarily reduce the symptoms of stress but fail to address the causes.

A Woman’s Stress Relief: Tend-and-befriend

ElGreco on Stresshacker.com Reaching out vs. retreating appears to be what distinguishes the instinctual reaction to stress between men and women. For women, the choice between fight or flight in the presence of a stressor applies less frequently than tend-and-befriend.

Whereas the typical male is more likely to narrow his response to stress down to a decision whether to fight the stressor directly and aggressively or retreat from it by way of an emotional withdrawal, most women choose to turn to family and friends by tending to or cultivating connections. Forming a network of support appears to be an innate characteristic of females also among primates, intended as a form of protection for themselves and their offspring. Clearly, the assumption is that there is more safety in numbers than in trying to make it alone in potentially dangerous situations.

Most women naturally construct a more intimate and complex social network than men do, and when they are stressed, in danger, or in times of change, they can turn to this network for support. Thus, they are more likely to seek out the company of other women and less likely to flee the stressor by withdrawing or isolating or to fight it directly and single-handedly, as most men appear to do.

This natural response to the stress reaction, moderated by a support system such as tend-and-befriend, might help explain why women live an average of five years longer than men. Men are also capable of creating complex social networks (now enormously facilitated by technological connectivity), but male-created social networks may lack the necessary level of intimacy or remain underutilized as a coping mechanism.

The Science Behind Tend-and-befriend

Research being conducted at UCLA under a grant by the National Science Foundation on Biopsychosocial Bases of Social Responses to Threat indicates that, in times of danger, most people seek positive social relationships that may provide safety for themselves and their offspring.  This and prior research by Dr. Shelley Taylor at UCLA’s Social Neurosciences Lab suggests that the hormone oxytocin and other opioid peptides produced in the body stimulate these responses, most especially in women. Oxytocin in particular appears to function as a social thermostat that monitors the availability of social resources and prompts the seeking of additional connections when needed.