3 Good Ways of Responding To a Panic Attack

OBriensTower_EN-US194301618A panic attack ambushes the mind, the body, and the soul. Its targets are self-esteem, a balanced self-assessment and the ability to analyze situations and expected outcomes. When panic strikes, the present becomes a bleak landscape of dangers and the future includes a (seemingly) real possibility of annihilation. In the presence of a real (or perceived) significant stressor, one’s abilities to respond to the challenging situation becomes severely impaired. For the span of the panic attack, chest pains, shortness of breath, shaking, sweating, and even nausea and vomiting can give the sensations of impeding death. Can something be done to prepare for a panic attack with any degree of success?

One: Know Thyself

A first important tool is the ability to anticipate one’s own reactions, by getting to know them well enough so that they do not become stressors in themselves. Knowing the likelihood (and thus anticipating the possibility) of the physical sensations that go with feelings of panic (chest constriction, shortness of breath, increased heart rate, and sweating) may help avoid the distress that these symptoms can cause. The very fact of knowing that these physiological reactions will take place, and allowing them to happen as a natural and understandable reaction to a threat to our well-being, can be beneficial.

Two: Know About Panic

Panic attacks are about as close to feeling imminent death as one can get, as anyone who has experienced them in all their severity will attest. A panic attack occurs without anyone else’s intervention (usually no one else is present). It can be extremely frightening even when no real physical danger exists (it can strike a person comfortably seated in his or her favorite recliner). A panic attack, by definition, occurs without any clinical danger of death and cannot by itself cause death or serious injury. A the most, when it reaches a certain level, a panic attack may trigger a loss of consciousness through hyperventilation (prolonged shallow breathing). This usually resolves the physical symptoms by momentarily taking the brain out of the picture, whereby the body can returns to homeostasis. When the person comes to, usually the panic attack is gone just as suddenly as it came. Exhaustion is not infrequent at this stage, as a panic attack can be a real workout for the heart and muscles.

Three: Manage Your Response

BearAttackA useful tool in preventing the recurrence of panic attack is stress management. Allowing the body to react, in concert with the mind, to a situation that may objectively warrant fear, sadness or worry is not only strategically sound, it is also physiologically healthier. Just as courage is not the absence of fear but simply good fear management, allowing a naturally-occurring biopsychic reaction to a stressor is simply good stress management.

Thus, the key to successful panic attack management is not in denying or attempting to prevent the stress reaction, but in what to do next (our chosen response). After the initial physical reaction ebbs and subsides and the heart rate naturally returns to near-normal levels, the real stress management response has a chance to begin. This response should first and foremost consist of addressing the stressor that is causing the panic attack to occur.

3 Good Ways of Addressing Serious Stressors

Three options usually exists in addressing significant stressors:

  1. Eliminating the stressor that caused the panic attack to occur.
  2. Removing oneself from the stressful situation, if option 1 is not available.
  3. Reducing the impact of the stressor through relaxation techniques or good coping mechanisms, when options 1 and 2 are not available.

New Therapy for Fibromyalgia Is Not New at All

Sunset at Sea, 1882Fibromyalgia, the stress and trauma-related disorder that affects millions of people, is characterized by widespread pain in the muscles, ligaments and tendons, fatigue, multiple tender points, difficulties with sleep, impaired functioning, and depression. There are a few treatments that show at least some efficacy in relieving fibromyalgia’s often severe symptoms. These include pain medication, psychotherapy, and physical therapy. Now, the ancient Chinese practice of tai chi has been added as an effective treatment option.

Compared to wellness education and stretching, 60 minutes of classic Yang-style tai chi twice a week for 12 weeks can significantly improve even the most severe fibromyalgia symptoms. These are the results of a study conducted by a team of researchers at Tufts University’s Division of Rheumatology on 66 randomly chosen patients. Half of the participants were assigned to a control group that was treated with education about stretching exercises and how to best deal with the disease, while the other half was treated with a regimen of tai chi. Compared to baseline results and to the control group, tai chi-treated patients showed a significantly greater improvement in their symptoms and quality of life. A follow-up test after 24 weeks showed that these gains were maintained. No adverse side effects were observed.

The results of this important new study were published in the New England Journal of Medicine on August 19, 2010.

Business of Stress: Self-efficacy Predicts Success

StradaCampoImperatore In the demands-control model of occupational stress a situation is created whereby high demands are placed on the individual with little opportunity to exercise control over the work environment or the task design. This is the most common type of workplace stressor and it has been shown to have an impact on cardiovascular health. But is the problem simply a matter of demands/control stress diathesis? Why isn’t everyone succumbing to heart disease? Indeed, many individuals seem to thrive even in work environments where personal control is minimal and job demands are chronically high. How?

At least a partial explanation can be found in self-efficacy. Self-efficacy is the perception that personal resources are adequate to meet life’s demands. Even in situations of low control/high demands, adequate self-efficacy can act as an important protective factor.

When personal resources are perceived as lower than perceived job demands, low self-efficacy results. Task demands are felt to exceed coping abilities, which often creates emotional and physiological overload. Prolonged exposure to occupational stress with low self-efficacy increases vulnerability to burnout, which is characterized by physical and emotional exhaustion, interpersonal difficulties, apathy toward personal accomplishment, and occupational disengagement through cynicism about the importance or worth of one’s work contribution.

Individuals with adequate self-efficacy believe that their available personal resources are sufficient and may even exceed what is required by their workloads. In day-to-day work activities, this belief in one’s adequate resources accompanies the process of assessing tasks and personal capabilities: in most instances, the perceived balance is in favor of having more than what it takes and the task is undertaken with vigor and confidence. Read more

Stress, As Seen Through the Eye of Science

Bazille at Stresshacker.comWhen science looks at stress, the focus is on the body/mind interaction or, more precisely, on its psychophysiological mechanisms. Traveling back in time from our present condition to conception, we can see that our genes and the environment in which we grow up (in which our genes are expressed) determine how we respond to stress as adults. Our genetic and environmental differences (the nature or nurture of who we are) help explain how individuals exposed to the same stressful situation can have an entirely different reaction. Some can adapt successfully to the stressor (albeit not without discomfort), while others experience more severe immediate trauma and long-term emotional problems, such as PTSD.

During specific developmental periods, such as infancy, puberty, adolescence, adulthood, or maturity, certain stressors are almost certain to occur and are understood to be typical and appropriate to the process of maturation and change. The earliest such stressor is the effect of caregiving styles, which stems from the parents’ psychological state. An attentive and nurturing style produces vastly different effects on the child’s later adaptation to stress than a harsh, unforgiving or neglectful one. In adolescence, patterns of behavior and emotional reactivity—including the stress reaction—begin to crystallize and become fully set in early adulthood.

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The 4 Sources of Stress

Sources of stressStress, the reaction that mobilizes our resources against a potential danger (real or perceived), can be produced by an almost infinite variety of single triggers.  This variety is produced by the many different situations that can cause stress, in addition to the individual differences among individuals in their perceptions of these triggers.  It is not uncommon to see a threat where someone else may see an opportunity or a challenge, and vice versa.  For ease of understanding, stress triggers may be classified into four major sources, which in turn can be further combined into two categories.  The principal categories are: physical stressors and psychological stressors.

Physical stressors impinge upon the five senses and pertain to the domain of the tangible and concrete. These are stress triggers that we can see, hear, touch, smell or taste.  A car coming straight at us on the sidewalk is a real, tangible and imminent physical threat, which must and does trigger an immediate stress reaction.  We respond to this physical threat by stepping out of the way, instinctively and without giving it much thought.  Included in the physical stressors is pain, which is the body’s reaction to a noxious agent that attacks its structure.  Thus, illness, which frequently produces pain, is considered primarily as a physical stressor, rather than psychological.  However, and it’s a big caveat, it would be a mistake to consider illness a purely physical stressor, as illness (especially if accompanied by pain) has a way of affecting the mind by producing negative thinking, negative self-appraisal, hopelessness, mental fatigue and other effects on the person’s spirit, attitude and worldview.

Psychological stressors are the most complex and perhaps the most frequent type of stressors we encounter in our daily lives.  To understand psychological stressors it is important to remember that they can fall into two distinct categories: real or perceived. Real psychological stressors are produced by the perception of an emotional danger or threat, in other words by a concern over something that is based on reality and does or may objectively occur. An example of this may be an impending relationship breakup.  Perceived psychological stressors are produced by the same mechanism, and are a concern over events or situations that are often based on reality but may be exaggerated or may in fact never occur. An example of the latter may be a worry or concern over an unnamed threat that may keep us from being able to take an elevator, or ride in an aircraft.

To summarize, the four principal sources of stress may be grouped as follows:

  1. Environmental
    • Includes physical stressors that impinge upon the five senses, such as weather, traffic, noise, pollution, disturbing images.
  2. Social
    • Includes psychological stressors triggered when demands are made on our time, attention and skills, such as in job interviews, public speaking, work presentations, interpersonal conflict, competing priorities, financial problems, and loss of relationships and loved ones.
  3. Physiological
    • Includes physical stressors that are produced at various stages in our life, such as during growth spurts in adolescence, menopause, lack of exercise, poor nutrition  insufficient sleep, illness, injuries, and aging.
    • Included in this category is also the physical stress produced by psychological stressors, which produce muscle tension, headaches, stomach upsets, anxiety attacks, and bouts of depression.
  4. Cognitive-emotional
    • The principal source of this type of stress is our own thoughts. Our brain interprets changes in our environment and body and conducts an automatic “threat assessment” to decide whether a danger is present and thus mobilize the body’s defenses.  The good functioning, or poor functioning of our threat assessment mechanism determines whether we become alarmed appropriately or inappropriately, and whether to remain stressed or relax.

In all cases, the stress reaction and the response that follows begins with our ability to correctly assess the situation and to estimate danger. Stress researchers Lazarus and Folkman (1984) were the first to point out that stress begins with our appraisal of a situation. Instinctively, we first ask ourselves how dangerous or difficult a situation is and what resources we have at our disposal to cope with it.  Self-confident individuals are more likely to conclude that, although the situation may be serious, they have what it takes to face it.  Less confident individuals tend to conclude that the same situation requires resources that they either do not have or that they have in insufficient measure.

The stress response of fight, flight or freeze is directly correlated to our ability to interpret the danger correctly, and to select the best course of action that produces the wanted results.  In some case, we will be able to eliminate the stressor (turn the source of noise off), in others we may simply need to distance ourselves from the stressor (flight response), and in some other cases it will be appropriate to do nothing and let the situation resolve itself (the freeze response).  What we choose to do largely depends on our assessment of available resources: making the correct appraisal of what we are capable of can be the difference between the right response and the wrong one.

Stress and Breast Cancer

Chenonceau Castle at Stresshacker.com Learning how to better cope with stress had a significant positive impact on the lifespan and quality of life of a group of women with recurrent breast cancer. Researchers at Ohio State University’s department of psychology reported the results in the latest issue of Clinical Cancer Research Journal, published by the American Association for Cancer Research.

"Patients [who learned how to reduce stress] evidenced significant emotional improvement and more favorable immune responses in the year following recurrence diagnosis. In contrast, stress remained unabated and immunity significantly declined in the assessment-only group," said Dr. Barbara L. Andersen, principal researcher at the Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute.

Analysis of the data of the 11-year-long study showed that of 227 women in the study group, the women who had received stress management training had a 59 per cent lower risk of dying of breast cancer.

This excellent news, reported by Medical News Today, is further confirmation that treating the symptoms of the stress reaction through cognitive (psychoeducational) and behavioral interventions can have a powerful effect on health. It is especially beneficial to learn how to directly manage the stressor that is causing the reaction, how to reduce its impact by a combination of stress-reducing techniques of relaxation, appropriate nutrition, adequate sleep, and the affirmation of positive statements about one’s ability to cope and overcome the challenge.

Ultimate Stressors: A Complete Upheaval

minamisanrikuThe unexpected convergence of catastrophic events that generated widespread damage, loss and destruction in Japan readily meets the dictionary’s definition of disaster. The common characteristics underlying natural disasters such as earthquakes, tsunamis, hurricanes, and man-made ones such as terrorist attacks or nuclear accidents are the virtually total lack of anticipation, limited preventive planning and, subsequently, the drama of human vulnerability.

A few typical phases of disaster are readily discernible, regardless of the type of disaster or its location: an initial impact characterized by shock, fear, and anxiety; an heroic phase, characterized by survivors reaching out in concerted effort to prevent further loss of life and property; a honeymoon phase, within 2 weeks to 2 months after the disaster, when survivors are buoyed up by an outpouring of support, services and supplies. Later, a disillusionment phase may follow, when hopeful expectations give way to resentment as promises of substantial help are broken or snarled by red tape. Finally, a reconstruction phase, which may last several years, characterized by the affected communities’ efforts to rebuild and by individuals coming to grips with their personal losses.

japan-nuclear-reactor-meltdownThe goal of stress reduction and trauma management programs is to help survivors achieve their pre-disaster level of functioning. The majority of individuals exposed to a mass disaster will experience acute stress that may be short-lived and does not develop into a clinically diagnosable disorder, especially if rescue is rapid and effective (as in the recent case of the trapped Chilean miners) and reconstruction or restoration can happen in a relatively short time. However, a substantial portion of individuals exposed to traumatic events will experience clinically significant stress and subsequent mental health problems. These include Acute Stress Disorder, Posttraumatic Stress Disorder (PTSD), depression, chemical abuse and dependence, and anxiety disorders. In the Japanese situation, the rebuilding of families, homes and businesses may turn out to be painfully slow due to the obliteration of entire communities by the tsunami, which increases the likelihood of significant mental health consequences. On the other hand, the Banda Aceh, Indonesia experience shows that even after a near-total erasure of structures by the tsunami of 2004, a community will begin to come back to life—albeit after many years of continuous and painstaking reconstruction.

bandaAcehSome of the most frequently observed behaviors that occur following a disaster include intrusive reactions (efforts to process traumatic events), avoidance reactions (efforts to minimize distressing memories), and physical arousal reactions (efforts to keep the body prepared to survive additional threats). Intrusive reactions occur through recurring dreams about the event, persistent thoughts and images, and the experience of a continued sense of fear and danger. Avoidance reactions manifest as the survivor’s reluctance and resistance to discuss the event, to think about the event, or to revisit any reminders associated with the event. Physical arousal reactions include increased anxiety, hypervigilance, psychomotor agitation, difficulty sleeping, and concentration problems. All these post trauma reactions following a disaster of large magnitude should not be considered abnormal or necessarily indicative of mental health problems or of the need for continued treatment.

katrina_goes12In the best cases, first aid psychological support during major disasters takes place immediately after the event and may last up to one week. In the first critical days, rescuers engage survivors in conversations to determine whether they may be at greater risk for ongoing problems. An effort may also be made to identify survivors that are more likely to be at risk for further mental health problems, such as individuals with pre-existing personality and psychiatric disorders, those who exhibit the severest symptoms, those who lack social support, those who have a history of interpersonal difficulties, and those who have been previously exposed to trauma. Psychological first aid consists of a set of procedures that facilitate a survivor’s adaptive coping, and is based on the premise that safety, calm, self-efficacy, connectedness and hope must be promoted. In the initial, critical phase it is vital to provide survivors with human contact and engagement, physical and emotional safety and comfort, environmental stabilization, information, practical assistance, connections with social supports, information on available help, and linkage with collaborative services.

9-11In the second phase, after the first week and up to one month after the disaster, the primary goal of psychological aid is to promote anxiety management, further reduce stress, and begin the process of restoring normal functioning. This is accomplished through the development of targeted services such as psychoeducation, psychotherapy, skills enhancement, cognitive restructuring, and relaxation training. Care givers also remain alert to any signs of the development of mental health issues, such as derealization (a belief that the world has become strange or unreal), depersonalization (an unnatural feeling of detachment from one’s body), and flashbacks. In the final phase of recovery, taking place within 1 month and 3 months after the event, psychological care is provided to those in need—often for years afterwards.

The convergence of multiple disasters onto a finite geographic region at the expenses of the a limited number of individuals may appear as capable of affecting a specific locale only. In reality, as Chernobyl, Katrina, 9/11 and Banda Aceh have demonstrated, the repercussions quickly have a planetary impact. Stress is no longer a local phenomenon.

Japan-QuakeThanks to instantaneous communication and the transmission of color images via multiple media channels, the experience is quickly shared by the entire planet. This also means that stress is radiated from the epicenter of the disaster outward to all who view and hear it, thus creating intrusive, avoidance, and arousal reactions on a global scale. Moreover, the economic and political consequences of disaster are immediately felt by the financial markets, at the fuel pump, and even in the supermarket aisle.

The world of stress has never been so small.

Business of Stress: Organizational Change

Kandinsky_YellowRedBlue In the turbulence created by organizational change, there is a virtual certainty that employees and managers will come under significant stress and strain.

Putting operating processes in place for people to carry out their work together may prevent or at least mitigate unhealthy levels of stress. These processes can act as safeguard that will allow the task to be achieved in a way that is as efficient and as effective as possible.

Both participation in all of the processes of the work group and the development of a collaborative approach are at the heart of effective group work. Because of the tradition of autocratic leadership, neither participation nor collaboration are natural or automatic processes. Both require some learning and practice.

Glaser, R., & Glaser, C. Team effectiveness profile. King of Prussia, PA: Organizational Design and Development, Inc.

Without appropriate operating processes in place, it is not uncommon to experience negative outcomes in the functioning of a team:

  1. Pressures and priorities can push people into silo mentality and away from the team.
  2. Individual stress can rise to unhealthy levels.
  3. There is a tendency to focus more on the task than on people processes.
  4. Tensions, conflict, and stress can lead to insufficient focus on task accomplishment.
  5. Increases in stress and mistrust can occur if a coercive leadership style is overused in an attempt to correct imbalances.
What team changes are needed to better manage change?

Putting in place sound team operating processes can act like a lubricant, enabling healthy team functioning to resume. High levels of trust within a team are the bedrock for coping with conflict.

Typical trust-building areas that the leader must promote and the  team needs to address by discussing and agreeing include:

  1. Frequency, timing and agenda of meetings.
  2. Problem-solving and decision-making methodologies.
  3. Ground rules.
  4. Procedures for dealing with conflict when it occurs.
  5. Reward mechanisms for individuals contributing to team goals.
  6. Type and style of the review process.

Research News: Stress and IVF

Klimt_1895_Love Researchers at the University of Aarhus in Denmark have uncovered preliminary evidence that appears to suggest a link between stress and the chances of success with in-vitro fertilization (IVF). Unlike other studies that focused on stress caused by infertility and the IVF treatment itself, this study[i] analyzed non-fertility-related, naturally occurring life stressors. Specifically, this research explored the association between IVF outcome and stressful life events during the previous 12 months. Read the study methods and results after the jump. Read more

Sympathetic Muscle Tension and Stress

One of the well-known phenomena that accompany the stress response is the spontaneous and uncontrollable action of the sympathetic nervous system on the musculoskeletal structures of the body. Stress, muscular tension and pain often go hand in hand.

The Alarm or Stress Response of the Sympathetic Nervous System

bungee-jumpingWhen the sympathetic nervous system is suddenly stimulated by a stressor, there is an almost immediate increase in the body’s ability to carry out unusually vigorous muscle activity, even in individuals who would ordinarily not be capable of it.This almost prodigious increase in strength is facilitated by a cascade of physiological changes that is precipitated by stressful situations.

These changes, which take place in a matter of mere seconds, include:

  1. Increased arterial blood pressure.
  2. Increased blood flow to the muscles along with a corresponding decrease in blood supply to the gastrointestinal tract and the kidneys, which are not needed in mounting the body’s rapid response to the threat.
  3. Increased rates of cellular metabolism, which speed up the body’s rate of functioning.
  4. Increased blood glucose concentration, which provides increased levels of energy.
  5. Increased glycolysis in the liver and in the muscle, also a factor in energy supply.
  6. Increased muscle tension and preparedness to work, which increase tone and strength.
  7. Increased mental activity, which provides acuity, alertness and greater focus on the threat.
  8. Increased rate of blood coagulation, which protects the body from significant blood loss if it should sustain minor cuts and puncture.

The combined effects of the mobilization of virtually all principal organs is what enables the body to perform significantly more strenuous physical activity than it is ordinarily possible. Stress of any kind, physical, emotional or mental, excites the sympathetic system, whose purpose is to provide above-normal activation of the body’s resources. Because of this stimulation, the stress response is often referred to as the sympathetic stress response.

Emotional vs. Physical Stress

The sympathetic system is activated during physical danger, but it is also and more frequently activated by many real or perceived emotional stressors. Guyton-Hall cite the example of anger or rage,

…which is elicited to a great extent by stimulating the hypothalamus, signals are transmitted downward through the reticular formation of the brain stem and into the spinal cord to cause massive sympathetic discharge; most aforementioned sympathetic events ensue immediately. This is called the sympathetic alarm reaction. It is also called the fight or flight reaction because an animal in this state decides almost instantly whether to stand and fight or to run. In either event, the sympathetic alarm reaction makes the animal’s subsequent activities vigorous.
–Textbook of medical physiology by Arthur C. Guyton & John E. Hall, 11th ed.

Chronic Stress

The same exact response can be elicited even daily in individuals exposed to multiple or repeating stressors, such as a negative environment, a dysfunctional relationship, poor working conditions, or difficult socio-economic challenges. In this case, the muscle tension and sympathetic stimulation can be so great and so frequent that the body cannot return to a normal state of relaxation, in which case a chronic stress condition can ensue.

People Who Lie Under Stress And How to Tell If They Are

tborig17pe People who make public statements are generally expected to tell the truth, and most of the time that’s the case. Severe stress, however, can override ethical obligations. People in public positions, such as CEOs, political figures, athletes, entertainers who are under media or legal scrutiny may and do lie about facts and circumstances. How to tell if and when someone is not telling the truth? Conducted by a team of researchers at the Rock Center for Corporate Governance at Stanford University, a detailed analysis of over 29,000 public statements by CEOs made between 2003 and 2007 which turned out to be false or deceptive sheds some light on the process.

Results of the study show that, in general, public figures who are not telling the truth use more references to general knowledge (“as you know”), fewer non-extreme positive emotions words (great, good), and fewer references to ethical values and value creation.  Deceivers use significantly fewer self-references (“I believe,” “I think”), preferring to use more third person plural and impersonal pronouns (“it is believed,” “many people think”), fewer extreme negative emotions words (terrible, disastrous), more extreme positive emotions words (fantastic, terrific), fewer certainty words (“to be specific,” “as a matter of fact”), and fewer hesitations.

This and earlier studies on the language of deception suggest that the use of “I” statements implies an individual’s taking ownership of a statement, whereas covert liars try to dissociate themselves from their words by using general attributions (everyone, everybody, anyone, nobody). Dissociation is also evidenced by a greater use of group references rather than self-references, as for example in saying “we, as a company, believe…” Not surprisingly, liars are less forthcoming with their own opinion than truth-tellers and refer to themselves less often in their stories. In extreme cases, people using deceptive statements may choose to omit references to themselves entirely.

The Liar Unmasked

Behind the words chosen by public figures to deceive their audience, say the researchers, are severe stress, a cognitive effort to misrepresent the facts, an attempt to control the audience’s perception of the liar, and a desire to distance themselves from the situation.

The severe stress experienced by deceivers is a consequence of the guilt they feel and the anxiety of being caught in their deceptive act. The high stress level is manifested not only in their negative comments but also in their negative emotional state, which they may or may not be able to hide from the audience. Because of their guilty feelings and their desire to dissociate themselves from the lie, deceivers are also likely to use general terms and not to refer explicitly to themselves. As a result of this dissociation, their statements are often short, indirect, and evasive.

A cognitive effort is necessary to misrepresent the facts because fabricating a “good” lie is inherently difficult. Especially when a liar has little or no opportunity to prepare or rehearse, his or her verbal statements are likely to lack specific detail and include more general terms. Thus, a liar may sound implausible, vague and non-immediate, telling a story that avoids mentioning any personal experiences.

roger-clemens-congress The attempt to control the audience’s perception of the liars themselves induces them to avoid making any statements that are self-incriminating. As a result, the content of deceptive statements is tightly controlled so that listeners would not easily perceive it to be a lie. To achieve this deception, deceptive statements contain more general, non-specific language, fewer self-references, short statements with little detail, and more irrelevant information as a substitute for information that the deceiver does not want to provide. For example, a liar will speak with greater caution, using a greater number of unique words to restate the same information. In contrast, truth-tellers often just repeat the information they have provided, using the exact same words.

The attempt to control may also lead to a very smooth speech when a narrative is prepared and rehearsed in advance, whereas truth-tellers often forget (or adapt) what they have said previously. In contrast to the cognitive effort perspective, the attempted control implies that the deceiver’s well-prepared answers are likely to contain fewer hesitations, more specific statements, and a reduced number of general claims.

In their desire to distance themselves from the situation, liars often appear to lack conviction because they feel uncomfortable when they lie, or because they have not personally experienced the supposed claims. This implies that liars use more general terms, fewer self-references, and shorter answers.

Stressful Patterns: How Your Attachment Style Can Help or Wreck Your Important Relationships

When it comes to relationships, your attachment style can mean the difference between bliss and torment. But what is your attachment style? Where does it come from? How does it work? To understand the concept of attachment, we must go back to the cradle and to the world which the infant first inhabits. It is a world where primary needs (food, shelter, warmth, cleanliness, security, and human contact) reign paramount. Anytime the infant must experience hunger, disconnect, isolation and pain, a little trauma is the result. When those needs are frequently left unattended, a “primal panic” can be the result, depending on the length and severity of the deprivation. Of these primary needs, the need for closeness with other human beings is the most deeply felt by the child’s mind and spirit and it can be, at times, at least as important if not more important than physical needs. It is not unusual for couples in counseling to express their intolerable distress and deep sorrow about their disconnect from their partner. For example, Jennifer says, “I just can’t seem to reach him. That is why I get so mad. I feel so alone all the time. I can’t bear it.” Or Jeff may say, “She doesn’t even seem interested in talking to me anymore, let alone have sex. All she cares about is the kids. I really don’t have a wife.” These are adult manifestations of the same longing, a cry for help in the face of a painful deprivation of emotional needs for closeness and security.

A secure attachment style results from infancy, childhood and adolescence characterized by positive, attentive, and nurturing care. A secure attachment produces individuals who are well-adjusted, who can form and sustain long-term relationships, and who are not easily defeated by any difficulties that may arise between them and significant others. Far from being overly dependent on others, they can give and take from their relationships with balance and fairness, while remaining strong, confident, and truly themselves. In this sense, a relationship that provides secure attachment can become a safe haven, a secure shelter from life’s storms of anxiety and stress. It also provides a secure base from which to explore, change, play, learn, and grow. Amy says, “Whenever my fear that I may lose my job rears up, I don’t just get angry or overwhelmed. I know that I can always can go to him and get a hug. He is there for me. I can count on him.” A partner’s emotional availability and responsiveness is at the core of establishing secure attachments.

When the infant has the misfortune to experience a caregiver who is frequently absent or unavailable, this intermittent pattern of caring and not caring is traumatic, and produces an insecure attachment style. In time, this translates into a message of rejection, devaluation, scarce importance, as if the caregiver were saying, “Your needs do not matter to me, you are not deserving of my attention, and there is only a fragile connection between us.” When children experience this type of caregiving, their reaction follows a predictable pattern. First, there is distress, crying, and emotional pain, which are the only means available to the infant to get attention. In couples, this would have Marie say, “I cry, even poke him, and poke him again. I know I nag him. Anything to get a rise out of him.” When the frantic attempts to get attention fail, the symptoms of separation distress begin to appear: angry protests, dashed hopes, desperate disappointment, negative cycles of demand and distancing. In children, this can result in acting out behaviors, physical violence toward inanimate objects, highly physical “games” in which the anger of feeling neglected can find its expression. In adult relationships, this insecure attachment may produce angry demands for attention, or the starting of trivial arguments as a way of connecting with the other even if only in a negative way. In time, these cycles of angry pursuit and defensive withdrawal become almost infallible predictors of separation and divorce. Evidence-based research by Gottman has shown that the happiest couples know how to ask for what they need from their partner in a softer, more vulnerable way and they can stay emotionally engaged even when the other partner is temporarily unavailable or distressed. On the other hand, the stonewalling that signals a complete lack of emotional response between the partners almost invariably leads to anger, contempt and then to complete withdrawal.

What can be done to remedy this toxic situation? An understanding of attachment theory and the styles exhibited by each partner is the necessary first step. Understanding alone, however, is not sufficient. Explaining, offering advice and problem solving can only go so far in soothing a partner’s emotional needs. A more indirect approach that offers emotional recognition and contact, one that says, “I am here and I get you. I have your back. Do not be afraid,” is much more likely to be effective. I have heard many spouses complain that their partner is very quick to come up with a fix, when all they want is a loving and caring emotional presence.

Within the two basic attachment styles (secure or insecure), attachment theory further identifies three sub-types of insecure attachment: anxious, avoidant, and fearful/avoidant. In the anxious variant of insecure attachment, individuals become anxiously attached and are constantly worried about the relationship. They are flooded with anxiety and alternate between angry demands and the frantic pursuit of reassurance, which often has the effect of driving their partner farther away. In avoidant attachment, individuals learn (as a defense mechanism) to minimize their emotional needs, to numb their emotions and to focus on others matters, such as work or children. With their partner, they seldom acknowledge their needs and generally do not ask for emotional connection, which often produce anxiety and deprivation in the other partner. Lastly, some individuals exhibit a mixed pattern of behavior that combines anxious pursuit and fearful avoidance of closeness. While this can give a very confusing message to their spouses, “I need you desperately—don’t get near me,” it is quite often evidence of severe childhood, adolescence or adult trauma that was experienced in relationships with significant people. Often, these are individuals who were abused or violated by attachment figures and who are now caught in the painful dilemma of seeking comfort from someone whom they also fear as a dreaded source of danger.

In couples counseling, as well as individual counseling, an exploration of each partner’s attachment style can yield surprisingly accurate results and can help explain relationship difficulties, as well as offer a way forward toward healing and emotional fulfillment.