Does Positive Thinking Work?

If you are suffering from low self-esteem, can you get yourself out of the doldrums by simply thinking positive thoughts? In 1952, Norman Vincent Peale’s book, “The Power of Positive Thinking,” gave a definite “Yes” to that question. Peale said you do not need to be defeated by anything. You can achieve peace of mind, health, and energy by, among other things, picturing and thinking about yourself succeeding, minimizing obstacles when you think about a challenge, thinking positive thoughts to inhibit negative thoughts, and regularly reminding yourself of the respect you hold for yourself. Similar ideas have been presented recently by Rhonda Byrnes, author of “The Greatest Secret.” Read her books and you will come to see how you can have, be, or do anything you want; you will discover who you really are and the self-actualization that life can give you.

Wow! Think your way to happiness, contentment, serenity, and stability. Ah, but if it were only that simple. Think about it. If positive thinking had that kind of power, all of us would be able to raise our self-esteem to comfortably high and healthy levels just by thinking positive thoughts; we could erase a lot of mental illness, not to mention the need for psychoactive drugs. Realistically, though, dealing with pathological or even everyday emotional conditions is much more complicated than merely imagining how we want to be, and getting what we want.

“But wait,” you protest, “surely positive thinking has psychological benefits.” Indeed, it does. Research has revealed that people high in self-esteem who engage in repetitive practice in making self-affirming and positive self-statements do show temporary increases in self-esteem. Optimistic thinking has also been shown to strengthen the immune system, making one less susceptible to colds. There is, however, no evidence that such an outlook can increase longevity or cure one from an already-contracted disease. There is also no evidence we can permanently change our self-esteem level by simply thinking positively. Furthermore, positive thinking has been shown to lower self-esteem in those already low in self-regard. Apparently, they don’t “buy into” the positive self-statements, saying, “Nope, sorry. Those positive thoughts are not who I am.” In short, the positive effects of optimistic thinking are quite limited.

So where does that leave us? Simple. Forget the focus on thoughts; after all, they only exist in your head; in a sense, they are not real, unless you translate the thoughts into actions.

You must focus on optimistic actions, not thoughts, because without accompanying actions, thoughts remain fantasy. Before you decide your level of insecurity about life and yourself, take a good long realistic look at your behavior, not at your thoughts. Thoughts are cheap; actions reveal your essence and show you the path to better coping with stress.

Then there is the “happiness” card. People generally buy into the power of positive thinking because they want to achieve happiness. Unfortunately, attaining happiness is a false goal. It is not something you find, but something that emerges from actions you perform. Ironically, even those actions do not bring you happiness; they bring you feelings of contentment, satisfaction, and an appreciation of something worthwhile that you accomplished. Along those same lines, some people base their perception of reality on how “happy” they are. Please remember that effective coping does not require that you achieve “happiness.” Good coping means developing a realistic and optimistic lifestyle – not a momentary state of being, but a repetitive pattern of actions that empower you, and give you a sense of autonomy, personal control, and fulfillment.

Grief: Cognitive and Emotional Challenges. By Michael Church

NOTE: This entry does not refer to any particular person or to any particular group, and the example is a composite from multiple cases.

Katrina’s 20-year-old son, Trevor, had been diagnosed with terminal cancer when he was 10.  By the time he was 18 he was also diagnosed with a drug addiction. By the time Trevor was 20, Katrina, married with a child younger than Trevor, had spent the past decade believing it was her job to keep him alive, even though – as early as 14 – he told her many times he did not want to live any longer. His actions were very self-sabotaging, and he was brought into the hospital many times very close to death, resulting from drug use, lack of exercise, poor eating habits, and refusal to adhere to medical recommendations. All led to a rapid decline in his physical and cognitive health, while his tolerance to drugs grew greatly over the years, as he increased dosages to get the “high” he craved. He told his mom that the only time he felt okay was when he was on drugs.

One night he overdosed and died just before his 21st birthday. It was never clear if the overdose was intentional. Katrina was plunged into guilt; she blamed herself for not being there with him when he died, and obsessed about how she could have saved him once again. Although she admitted feeling some relief that the family suffering was over, even this relief added to her guilt: “What kind of mother would be relieved by her child’s death?” she lamented. Her guilt grew into serious depression and she began psychotherapy.

Katrina had to face and accept several harsh realities, especially that her son did not value his life and there was nothing she could do to change that. His cancer and drug addiction were consequences of many factors that were beyond her control. She felt guilty she had not insisted on chemotherapy, even though doctors said that chemo would not work. It was a terrible decision to be confronted with, but Katrina and her husband did the best they could at the time. She needed to accept that she did what most parents would have done in similar circumstances.

Katrina was still mothering Trevor during his late teens, and he had not made any fundamental or positive changes to help himself. As a matter of fact, he deteriorated during these years even while many medical and mental health care providers and facilities did their best to improve the quality and quantity of his life. The bottom line was, he did not care. He believed his pathetic state of living could not change for the better, and his drug habit fostered a self-fulfilling prophecy. He had been telling his mom for years – in actions and words – that he was not afraid of death and did not want to live, and she somehow denied the significance of these statements. His mom became collateral damage even though he probably survived longer because of her heroic efforts.

Katrina entered therapy to help reinvent herself with renewed purpose and goals. She worked to close the gap between cognitive and emotional acceptance. As is commonplace, she accepted Trevor’s death rationally before emotionally. At first, she made the mistake of trying to control her feelings, even to the point of refusing to cry or talk about her loss. Unfortunately, these actions extend suffering and delay acceptance. With the help of her therapist, Katrina was able to learn how to use action to facilitate emotional acceptance. She stopped blaming herself and trying to control her feelings. Instead, she focused on controlling her actions and letting natural healing take its course. It takes a lot of time and effort to reach emotional acceptance of many harsh realities of life, and there is no timetable or road map to follow. Every situation is unique and must be handled creatively and courageously.

She progressed with letting go (acceptance) because she was willing to talk about and face her loss. She developed a legacy for her son, did not avoid going to his room, looked at his videos and pictures, visited his grave site regularly, talked about him with family and friends, and joined a support group for grieving parents. Most importantly, she let herself grieve in her own way.

 Katrina knows there will always be an emptiness in her heart for her son who is not at the table, but she is no longer mired in the stages of grief. She is living more fully and reveling in her role as grandparent and the success of her surviving child. Her relationship with her husband is healthy and stable, and they are looking forward to a future with renewed energy and meaning.

Katrina’s case reveals some important lessons about the need to synchronize emotional acceptance with rational acceptance, particularly when personal loss is involved. That is, you need to behave in ways congruent with facing the reality of a situation, and focus on living in the present. Life is for the living and that is what those you leave behind would want. In so many important areas of life, when it comes to enhancing your confidence and self-esteem to face challenges and overcome fears, there is no substitute for facing and acting in ways to better those psychological states.

Social Comparison Theory

(With co-author Michael Church)

I was chatting with an acquaintance recently. She was telling me about her 20-year old nephew who had recently returned home following 3 months in rehab for alcohol and drug problems. She said, “Unfortunately, his parents were soon enabling him again, and it wasn’t more than a couple of weeks that he was hanging out with his old buddies, the ones he always did drugs with. I figure he’ll be back in jail or rehab before you know it. He’s got three older brothers and they’re all rock solid. Good educations, good jobs, good judgment. But this kid, he just doesn’t measure up to them. I used to wonder why they weren’t a better influence, but sometimes I think he looks at his brothers’ success and gets down on himself because he just doesn’t have it.”

Social psychologists call it social comparison, a concept developed nearly 50 years ago. One aspect of people’s evaluation of themselves – “How am I doing?” – takes place when they watch and compare themselves to what others are doing. Take a look at your own behavior. Have you been positively influenced by observing a friend or family member? Have you used their example to track your own development? If you’re like a lot of people you can probably identify some role model who motivated you to improve your own life. Many young people are spurred to do better when they have positive examples in their life like parents, siblings, a teacher, or a coach. But the comparison can go wrong.

When can comparisons make you feel bad? Judging yourself against others is likely to make you feel bad if you regularly chose those who are shining examples of certain traits. There will always be those better than you, and those worse than you, so why restrict yourself to always choosing the former for comparison? For example, you might believe you have a less active social life than others, but you don’t realize you’re always comparing yourself only to the most social people you know. It’s also possible that your comparison itself is based on a faulty assumption. In the case we just described, for instance, was the woman’s nephew negatively affected by being around his successful brothers and comparing himself to them? Or, did he carry a faulty assumption with his comparison because he elevated his brothers’ success far beyond where it really was? Consider the case of a college freshman whose self-esteem and confidence were in the toilet. Seems he was convinced that all the other students in his classes – none of whom he knew – were geniuses and he was the one dummy in the class. His assumption was flawed.

In addition to family models, young people compare themselves against others they see – those in media sources, peers, and subcultures. What is the effect on our children and adolescents who witness on a recurring basis: over half of our population being obese; at least ten percent showing drug and alcohol abuse; a veritable epidemic of Type II diabetes; more recently, refusing to take preventive sickness measures like wear a face covering or get a vaccination; and, a precipitous increase in the daily use of medical marijuana? These influences can build up over time and diminish self-esteem and contribute to depression.

Fortunately, most people have the social skills and impulse control to keep their standards for social comparison appropriate; those who don’t – especially impressionable young people who spend too much time on social media – need to be helped to understand the dangers of social comparison, and how to focus on using the process to motivate themselves to improve, not bring themselves down. For instance, social comparison can reinforce self-esteem when people focus on reviewing their memories of good times with friends. In fact, this is one aspect of social media – sharing positive times and good memories – that contributes significantly to psychological well-being.

The coping lesson? Be realistic about your comparisons, and focus on those that motivate you to act better – with reality-based acceptance, purpose, values, and accountability.

Coping is Doomed When Self is the Center

I was corresponding with a colleague recently about how a simple act – putting on a mask – has become politicized, even weaponized. She also pointed out to me how this issue illustrates a trend in society that has metastasized in recent years into extreme levels of self-absorption. She said, “I find the general level of self-preoccupation in society today absolutely startling.” She’s correct, of course, and what’s sad about this obsessive fixation with self is that it is completely incompatible with being able to cope with the stressors in your life.

Followers of this blog see again and again how we emphasize a three-step coping model that requires acceptance of your emotions and core tendencies, accountability for who you are, and development of a coping plan that must include two essential elements: humility and empathy. A coping plan that revolves around you, to the exclusion of others, is destined to fail. You will never be sensitive to your true inner self if you cannot be sensitive to the needs of others.

I often wonder how we might view things if – when we correspond or speak with someone, or post something on social media – instead of using words like “Republican” or “Liberal,” we substituted the phrase “Those who agree with me,” or “Those who disagree with me.” For instance, suppose an extreme progressive posted on Facebook, “The country was falling apart over the past four years with the Republicans in office, but now that the liberals have taken over, we’re back on the road to recovery from madness.” Any staunch conservative would consider those “fightin’ words,” literally! But what if the post said, “The country was falling apart over the past four years with those who disagree with me in office, but now that those who agree with me have taken over, we’re back on the road to recovery from madness.” Hmm. Less emotionally inciting, perhaps? Less a condemnation of others? More an admission of your responsibility for the conflict, an admission of your self-preoccupation?

 If you resolved to use only the latter phrasing, – “Those who agree/disagree with me” –   would you begin to realize that you have been operating totally from a self-absorbed, egocentric point of view that encourages conflict? Would you begin to understand that you have created an artificial, but inevitable, dichotomy between “us” and “them” that is based on the uniqueness and superiority of “me”?  Might you begin to appreciate that saying “those who agree/disagree with me” puts “us” and “them” on an equal plane, where the opposing positions just might both be valid? Could you conclude, “I have an opinion, others have an opinion, and the resolution to the conflict just might be somewhere in the middle”?

Food for thought? Maybe. One thing for certain: When you see yourself and your allies as the only enlightened ones in the discussion, you will never successfully cope with your stressors because you are operating in emotional mode, not problem-solving mode. The emotional mode is inciting, inflaming, and provoking; you will eventually hemorrhage into depression and self-sabotaging actions. Why? Because reality dictates that you are not the center of it all, and reality has a way of popping up again, and again, and again.

Values are Essential for Effective Coping

NOTE: This entry does not refer to any particular person or to any particular group, and the examples are composites from multiple cases involving different topics.

Alice is 52 and appears to have withdrawn from life. Her youngest child just graduated from college and has gone off to another city to pursue her career. Alice feels like her usefulness in life has ended; for 30 years she has devoted her life to raising three children, running the household, and supporting her husband as he moved up the career ladder. But now, Alice thinks, “It’s gone, all gone. I’m not worth much anymore.” She begins seeing a psychologist “to try and get my life in order.” The counselor diagnoses her with persistent depressive disorder – dysthymia – and recommends she get a prescription for an antidepressant from her physician.

Many psychologists would say, “Hold on. Let’s not rush into medication. Alice’s problem is not depression. Depression is the symptom of being confronted with stressors in her life. Alice needs to confront these stressors and do realistic evaluations of how she might handle them.” From this perspective, the psychologist might help Alice develop a treatment plan that involves working toward a new sense of purpose in her life, and committing herself to actions that will help her face and work through her stress, not be immobilized by it. The goal will be to find actions that, when combined with motivation and purpose, will bring Alice to a greater sense of being worthwhile and productive. Note, the emphasis is not having Alice focus on changing the symptom – depression – or asking her to change her thoughts and fears, which are normal states of anxiety and sadness resulting from the “empty nest.” Instead, Alice needs to see that she can act in ways that will give her a renewed sense of purpose, and not rely on medication.

But first, Alice must examine her values. What things matter to her? “I like to help others,” she says. “It’s important to me to be a source of support and guidance to those who feel a little lost and looking for meaning in their lives. I always did that with my kids. I didn’t tell them what to do, but said to see what sorts of things are important to them, things that they value, and we’ll go from there.” Alice pauses. “Good lord, that’s where I am right now, isn’t it? I’m like one of my kids looking for guidance and help from others.” She chuckles. “How about that!”

Once Alice had a grasp on her issues, she worked with the psychologist on listing her values, and finding activities that would be a good substitute for her parenting, which was now minimized, at least on a daily basis. She focused on volunteer activities and came up with five programs that she felt would work for her: Big Brother/Big Sister; Be a Mentor, providing a role model for kids, just as she did with her own; Hospice volunteer, which required 12 hours of training, plus Alice liked the fact that she would be challenged by needs for those at the end of the road, not the beginning: JustServe community volunteer, where she could use her vast knowledge of her local community; Mentoring programs at local high schools, an activity that would also make her feel like a needed parent again. She contacted each one to determine which  would work best for her.

Laura is a recent high-school graduate who works at Walmart. She is unsure of what she wants to do with her future: College? Marriage and kids? Stay at Walmart? She admits that her uncertainty is affecting her self-esteem, and she gets a little depressed about it all. She found herself joining her friends and buying into all sorts of conspiracy theories about what was going on in the world. “I felt more secure living in a simple world.” When people outside of her circle of friends would challenge her about the conspiracy beliefs, she would justify those beliefs by criticizing them and ignoring their contradictory information.

At some level, Laura began to feel uncomfortable with so much denial, and she began to ask herself, “Is it really me and so many of my friends who are correct, and everyone else is wrong? Does feeling I’m a loser because I’m uncertain about my plans, does that make me a loser?” Laura began to dip her toes in the water of critical thinking. She will swim in those waters when she is able to say, “I am what I do. I am not defined by my thoughts, beliefs, and feelings. I won’t feel better by simply thinking or feeling my way out by following some of my friends’ beliefs. I must be guided by what I value.”

Maybe Laura will eventually realize a basic truth about coping and learning how to evaluate your life: “Your thoughts do not make you good or bad. They are natural for you and part of what makes you human. You do not have to feel guilty about your thoughts or feelings. Every person has some extreme, distorted, bizarre or self-centered thoughts from time to time. Your thoughts and feelings do not define you. Your freely-chosen actions define you. That is what you need to concentrate on – your actions, not your thoughts and feelings.” 

The Meaning of Acceptance

NOTE: Jessica is a composite from multiple cases.

Like everyone else, you have stress in your life, and you want to be able to deal with it. The first step is Acceptance. Many people hear that word and say, “You want me to quit? To give up? To admit I’ve been defeated?” A lot of people confuse acceptance with giving up, being passive, and resigned to the inevitability of stressful events swirling around them. Passivity and helplessness, however, are not at all what we mean by acceptance.

Think of acceptance as the opposite of avoidance, of running away from your problems. When you seek to avoid and escape your stressors, you get trapped by irrational thinking, denial, and passively accepting what others tell you. Acceptance, on the other hand, means empowering yourself, facing yourself and the reality around you. Sometimes those actions mean working through some pain and suffering, but that is often necessary if you are to grow. President Woodrow Wilson once told an assistant, “I have found that one can never get anything in life that is worthwhile without fighting for it.” (Cited from Woodrow Wilson by John Milton Cooper, Jr.)

When you hear that acceptance is the first step in coping with stress, do not think for a minute that it means you must tolerate things or give up. In a coping context, acceptance means facing the stark realities of life. For instance, you can rationally accept something like your mortality, or the passing of a loved one. However, in many circumstances, acceptance can take a lot of time and work because you must engage in emotional, behavioral, and thought acceptance. It’s not unusual to hear people say they accept something, but their behavior does not coincide with their verbalizations or with their emotional reactions. When those elements are out of sync, there’s coping trouble ahead!

Suppose you’re anxious and fearful about something going on in the world. Someone tells you, “Don’t worry, everything’s going to be fine. You’re worrying over nothing.” Does that comment make you feel better? It shouldn’t because it advises acceptance by denial – “Just deny what’s worrying you.” But you listen to this advice and say to yourself, “Yeh, you’re right, I shouldn’t be afraid. Everything will work out. I’ll just stay calm.” Do your words make you feel better? Probably not, and you continue to be bothered by troublesome emotions and thoughts in spite of your comforting words. This lack of synchronism is a warning to you that you are asking yourself to deny something, in this case, the part of you that is anxious and fearful. Denying yourself is a dangerous, self-defeating game that sabotages coping efforts and your mind senses it.

Jessica is a high-achieving college student. She says, “My parents always drilled in me the importance of doing things right. Sloppy work was just not an option. But I get so anxious and angry at myself when I fall short of perfection. Why am I like that? Why can’t I be like my brother who screws up but stays laid back, so cool, so in control? But me, I’m there biting my fingernails off!”

Do you see what’s happening here? Jessica refuses to accept her perfectionistic tendencies. That refusal makes her criticize herself; she is never satisfied with her work, even when it’s good, because in her mind it always falls short of perfection. She treats her traits like her enemy, and that treatment denies who she is.

What does acceptance mean for Jessica? She’s frustrated, anxious, and angry. How should she handle those emotions? How should she handle her perfectionistic thoughts that bring self-criticizing words upon her? Once she accepts that how she feels is a part of who she is, then she can think about her emotions a little differently. She’s mad at herself for being overly perfectionistic, but now – rather than deny her emotions by trying to eliminate them – she can pause and consider the positive aspects of her perfectionism: She is less likely to make foolish mistakes; she is showing others that she cares about the quality of her work; she is more likely to seek creative solutions to a task; she is less likely to depend on others for completing a task; she demonstrates how her actions are consistent with her values.

Jessica can disconnect her self-criticism by focusing on these points. She can also remind herself that her perfectionistic tendencies are consistent with how she was raised and taught by role models she respects. “I was always taught that I must act in ways that make me proud of the result. If I’m going to do something, do it right. That’s my value and it’s the principle I live by.”

As a general rule of coping, here’s what you can take from Jessica’s case: Instead of criticizing yourself for who you are, accept who you are and examine the benefits of your traits, even the ones you find troublesome. This analysis can increase your sense of control, personal empowerment, and autonomy, and allow you to adapt and synchronize those troublesome traits with accepting emotions and actions.

Are You “Hurt”? Or, Really “Injured”?

            Years ago, I remember a football coach say something like, “Many of our guys go on the field and play through pain and being hurt; but I won’t let anyone play injured.” Apparently, the coach was making a distinction between being hurt, and being injured. I figured by the former he meant something like a blister, a bruise, or a body ache that produced some discomfort, but that a real athlete was able to “play through.” This view would fit under the adage, “When the going gets tough, the tough get going.” On the other hand, the coach obviously saw being injured as more serious, like a pulled or torn muscle or ligament, or a bone fracture. In this case, playing would pose a real threat of further injury. (Of course, some might argue that the same could be said about playing hurt!)

            Could this distinction between being hurt vs. injured also be applied to mental anguish? For instance, you could be down in the dumps because the car repair is going to cost more than you thought, and it’s going to be a strain on this month’s budget. You’re bummed out, but certainly not clinically depressed. Would the stress about the car repair be analogous to being hurt? What if, on the other hand, your despondent mood persisted for months, disturbing your sleep and appetite, and giving you a general loss of interest and pleasure in life itself? Would this Major Depression, or even the less severe form, Persistent Depressive Disorder, be analogous to being injured? We might also ask, “Would awareness of this distinction be helpful when it comes to coping with stress?”

            Consider Carl, who recently completed his third tour of combat duty in Afghanistan, and is now home for good. He’s having a couple of beers in his friend’s backyard, and says, “You know, Dan, I had forgotten how much my kids expect from me. And now it’s worse than ever because they really don’t believe me when I say I’m home for good. They just demand my time and kind of cling to me. I’m not sure I can live up to what they want.” Is Carl “hurting,” and maybe in danger of more serious “injury”?

            Then there’s Haley, who just returned to the office after a full year of working from home. While having lunch with a co-worker she says, “Honestly, Gail, I forgot the stresses involving in getting to the office. I need to get up an hour earlier for the commute. And I have Fred around again. God, not having to put up with his distracting corny jokes during the day was a blessing. After that year of working from home, I really don’t look forward to work like I used to.” Is Haley “hurting,” and maybe in danger of more serious “injury”?

Carl and Haley are hypothetical composites of thousands of people in those situations. Simone Biles, however, is real. Following Simone’s withdrawal from gymnastics events during the Tokyo Olympics, USA Today columnist Nancy Armour cited an Instagram post from Simone 15 months earlier (April 2020) when the Olympic games were postponed for a year: “Mentally I was ready to go in three months and ready to be done. That’s what I was striving for. Now we have to take our foot off the gas. Not three months, now it’s going to be 15. For a lot of us athletes, that’s a big adjustment.”

            Simone’s post has a lot in common with the hypothetical comments proposed for Carl and Haley: All three are implying, “I’m mentally hurt and I’m not sure how long I can keep this up.” They’re not truly “injured” at this point, but sending out warning signals that the “hurt” they’re feeling has put them in a vulnerable spot, a susceptible condition that could eventually result in more serious mental anguish.

            We’ve all had experiences like this. You have surgery scheduled in two days and you get a call from the surgeon’s office: “The Dr. had a family emergency and we have to re-schedule for next week.” “Damn,” you think, “I was ready for this and now I have to psych myself up all over again next week.” Another example: You have a sleepless Thursday night anxious about your presentation to company executives on Friday, when you’re told Friday morning, “We have to move your presentation to Monday.” “Damn,” you think, “now I’ll have a sleepless weekend.” Anyone who has had experiences like these should know full well how Biles felt following the delay announcement in 2020.

            The lesson here for coping with stress should be pretty clear. When those relatively small setbacks – the hurt – bring you discomfort, don’t ignore the resulting distress and uneasiness, because those reactions are warning signals that without taking pre-emptive and proactive coping actions, the hurt could easily turn into more serious injury over time. “OK,” you ask, “what might some of those preventive actions be?” Depending on circumstances and the individual, there are potentially many. Here are four: Take some time off to give your mind a rest, and let it slowly and calmly process – on its own – the challenges ahead; talk about your concerns with others you trust, especially those who have had similar experiences and, like you, may be troubled; get outside yourself by immersing yourself in projects that serve others and bring you a sense of satisfaction and contentment. And through it all, maintain humility by remembering that it’s not all about you – you are not the primary ingredient in this recipe. These are examples of accepting, empowering, and emboldening steps for tending to “hurt,” – getting fit mentally and psychologically – and increasing your resistance to more serious “injury” down the road.

Placebo, Coping, and Counseling

There is no magic wand when it comes to stabilizing yourself psychologically and coping with life effectively. Are you one of those who believes that psychology provides such a “magic-wand moment,” when a counselor is able make you better with little effort on your part? The truth is, successful counseling depends on several conditions: You must trust the counselor, be willing to “open up” and answer questions honestly, and follow recommendations; you must be willing to take an active role in treatment and work hard to produce needed changes in your behavior; most importantly, you must truly believe the process will help you.

That last condition sounds like a placebo-effect. That is, you believe counseling will work, and that makes it more likely to work. However, successful counseling is more than just a placebo effect. Notice, for example, that if you believe there will be a positive outcome, then you will also be more willing to work hard, stay optimistic and confident, trust the counselor, and persevere when the going gets tough. It is those qualities and actions that result in successful counseling, not some sort of magical placebo effect. Counseling is not like taking an aspirin, lying down, and waiting for your headache to subside. Counseling requires you to take an active role in your treatment. If you sincerely believe that it can bring you positive benefits, you will be more likely to engage in actions that will bring those benefits.

There are other intriguing aspects of the placebo effect that can provide insight into improving your ability to cope with stress. Consider medical research using an “honest placebo.” Imagine you’re in a study to investigate a drug for back pain. One group receives the drug, one group gets no treatment and is told nothing, and a third group gets the honest placebo. This last group is told, straight up, that they will receive a placebo. No deception; no fake pill that leaves you wondering if it’s real or not; just complete honesty from the researcher – you’re in the placebo group! Of course, this honest placebo should have no effect on pain levels, right? After all, you know you’re taking a “fake” drug. Initial studies, however, have shown that the honest placebo significantly reduces pain compared to the no treatment group.

How can that be? If you know you’re taking a sugar pill, and not real medicine, why would your pain subside? Here’s a possible answer. You go to the physician with back pain; she gives you a bottle of pills and tells you they are placebos, fake inert compounds. You take the pills and bingo, your pain subsides. Some professionals theorize that what is going on here is pretty straightforward: Even though you know the pills are fake, you receive them in a larger context of treatment that includes a trained, caring, and attentive physician. These stimuli may very well activate memories associated with medical care throughout your life, care that has more often than not resulted in relief from what ails you. That global context may very well trigger brain systems that lessen your pain. Your body shows a conditioned response to the global stimuli of a physician attending to your problem.

The ultimate answer to honest placebos may be more complex, but let’s ask what this honest placebo finding can teach us about counseling and coping. If you enter counseling with a well-trained, competent, and supportive therapist, those characteristics increase your odds of success. Your success, however, will begin with the belief that you can improve, and an acceptance of the role you must play in producing that recovery: You are the agent of change; only you can control your thinking and actions; only you can decide to embolden yourself to develop and carry out an effective coping strategy. Notice how we are describing beliefs that empower you, require you to be accountable for the role you play in your therapy, and require you to work with your counselor, not passively wait for benefits to magically arise. So, the question of therapy being a placebo is irrelevant. What matters is that the counseling context spurs you into action, activating behaviors that embody the principles of effective coping – accepting the realities facing you, being accountable for what you do, and devising a coping plan that involves humility and empathy. Remember, it is not the magic of the counselor that brings you favorable outcomes; it is the consequences of appropriate actions on your part that produce coping benefits for you.

“Fake News” Means Psychological Denial

The phrase “fake news” is relatively new. Criticisms of the news media have been around for as long as there have been media summaries of events. Generally, however, criticisms focus on one of three things: distortions – “You have taken my comments out of context,” – selecting only portions of what one said – “You included only the first sentence of my comment,” – and blatant misquotations – “I did not say dire consequences ‘will result’ from your actions, but that dire consequences ‘could possibly result’ from your actions.” The “fake news” comment, however, is different because to most people it does not mean distorted, doctored, or inaccurate news. Rather, it seems to mean, “This is news contrary to what I believe and I don’t want to hear it. Therefore, what I am seeing and hearing is not real. It is fake.” In other words, they are saying their position is based on personal belief, is set in stone, and there is no point in even discussing contrary news because it is like counterfeit money – a fraud, bogus. In short, they simply deny the reality of “fake news” because it opposes their belief. This is not a healthy way to cope with adversity, or to solve disagreements with others.

When I was a young college professor, a local TV sports reporter asked me for an interview about the psychological effects of Little League participation. I readily agreed because I believe Little League provides important life lessons to kids and strengthens them psychologically. Having the chance to deliver that message on TV was a great opportunity.

At the beginning of the interview, I mentioned standards that Little League helped instill in participants: teamwork, sportsmanship, and respect for others; how to lose or win with dignity, honor, and integrity; respecting and understanding rules and following them honestly; being accountable for mistakes and working to correct those mistakes. And on I went in what I felt was fine professorial form. Then the interviewer asked, “What about the importance of winning? Can winning be overemphasized? Can playing the game for the sole purpose of winning give kids the wrong message?”

“Of course,” I said, and proceeded to note how an overemphasis on winning would undermine all the positive life lessons I had just mentioned. For example, a stress on winning does not prepare young people for failure, and ultimately produces low self-esteem.

Guess which part of the interview was broadcast? You got it! The second part. I watched the interview on TV and was horrified to see myself sound like someone who hated Little League, and believed it did severe psychological damage to kids. After a class the next day, a student came up to me and said, “My dad coaches Little League and he thinks you should shut up.” I described the entire interview to the student, and asked for his dad’s phone number so I could call him and explain my real position to him. (I did so and we had a great conversation about the importance of Little League values and principles.)

Was the TV broadcast fake news? Absolutely not! The tape was not doctored or counterfeit; what viewers saw and heard was precisely what I had said: in Little League there is the possibility of over-emphasizing winning, and doing so can be psychologically harmful. But, if not fake news, did the broadcast at least distort and misrepresent my views by not presenting my critical comments in the context of my original positive evaluation of Little League? You bet it did! And I guarantee you I called the TV station producer and the reporter the next day and told them what I thought about the reporter’s ethics.

OK, let’s see if there’s a coping lesson in all this. The phrase “Fake News” is simplistic and implies that life operates according to either/or rules: things are right or wrong, real or fake; what I believe is correct and real, what you believe is false and fake. This kind of juvenile thinking denies subtle distinctions that surround us every day. When it comes to evaluating information, there just aren’t too many incontrovertible absolutes. In my interview the segment that aired was accurate in conveying what I said; it was, however, unfair (to me, at least) because viewers had no chance to evaluate my criticism in an appropriate context.

“That’s Fake News!” is so easy to say, but the comment boils down to psychological denial. You rely on arguments that are simple, concrete, childlike, and easy for you to accept, so you can effortlessly deny the validity of others’ beliefs. “That’s Fake News! I am right, you are wrong, so get lost!” What is difficult, however, is rising above the “Fake News” phrase and trying to understand opinions different from your own. That effort requires an appreciation of nuance; a willingness to discuss opposing viewpoints; and empathy, a characteristic that a phrase like “Fake News” does not encourage. Like most things in life, choosing the difficult road may be worth the effort. That road leads to unity by finding commonalities in differences, resolving conflicts, and proposing compromise where everyone emerges a little bit unhappy, but also a little bit happy.

Don’t let a platform that uses the term “Fake News” be your guidance in your interpersonal relations. If you do, you will be encouraged to treat others with condescension, making it obvious you believe they are inferior to you because they are fake and you are real. No matter what the issue, if guided by “Fake News,” you will automatically take sides and overlook the complexities of the issue. Your world view will be simpleminded and naive, and you will generate emotional upheaval in your social interactions, allowing anxiety, frustration, and anger to dominate you. Solving conflicts – coping well with reality – requires a problem-based strategy, not an emotion-based one conveyed by the phrase, “Fake news.”

Emotional Dysregulation

Did you ever feel that your emotions and thoughts are out of control? Maybe you have unpredictable outbursts of anger that are not really appropriate to the situation, or experience flare-ups of anxiety, mood, or attitude. In short, do you occasionally show emotional fluctuations when it seems that your emotional life is poorly regulated and beyond your control? Many people would answer “yes” to these questions, and the fluctuations are pretty mild and temporary. But what if they are frequent – almost chronic – and extreme in their intensity? In this case, the instability in emotional expression is called emotional dysregulation. The condition can obviously be quite unsettling, and it may interfere with your relationships and general quality of life.

Emotional dysregulation can exhibit itself in a variety of emotions and thoughts: Anxiety; shame and anger; self-harm; substance abuse; perfectionism; conflict in interpersonal relationships; eating disorder; and even suicidal thoughts. The pattern seems to overlap considerably with borderline personality disorder, which affects the way you think and feel about yourself and others, and includes self-image issues, difficulty managing emotions and behavior, and a pattern of unstable relationships. People diagnosed with borderline personality disorder often experience emotional dysregulation with emotional sensitivity, reactivity, and difficulty finding an emotional level that feels stable.   

How might all this emotional lability develop? What sorts of experiences could cause emotional expressions to become so inconsistent, changeable, uncertain, turbulent, unsettled, and undependable?  Some psychologists say the condition develops out of a childhood characterized by caregiver abuse that involves deprivation of basic needs. The deprivation would show itself in failure to provide consistent and adequate supervision; lack of basic health care, clothing, education, and safe housing; an inability to meet emotional and social needs; and rejecting, ignoring, or harshly judging the child’s thoughts and feelings. In short, the child is raised in a roller coaster environment of uncertainty, ups and downs, and unpredictability that makes emotional stability difficult to develop and maintain.

Regardless of the cause, adults tormented with emotional dysregulation need professional help in learning how to regulate better their emotions, how to mitigate extreme reactions to emotional triggers and stimuli, and in general how to control more effectively their expression of thoughts and feelings. Effective techniques in therapy include helping the sufferer build new skills and actions that can be consistently applied in different situations. A professional mental health care provider can help sufferers learn and practice practical behaviors that can increase satisfaction, foster higher self-esteem, and give them a greater sense of control over their emotions. Examples could include things like taking a college course, learning a new skill, completing school, requesting new opportunities for advancement at work, or volunteering to help those in need.

Whatever the case, note the emphasis on actions, doing things. The best way to increase emotional consistency is not solely by positive thinking, but by consistently doing things that tend to bring you positive results, meaning feelings of contentment and satisfaction from taking on something new. When the situation is structured appropriately, self-esteem will increase; confidence will increase; and you will teach yourself the value of behaving in a predictable way. You will be able to say, “I gave it my all and did the best I could. I will look for ways to improve and do even better tomorrow.”

Rory came to therapy because he was suffering from panic attacks. He didn’t realize it, but these attacks were telling him he needed to make some important life changes. Like many cases, the source of panic attacks was actually anger, not anxiety. He viewed himself as a failure, which resulted in unpredictable waves of anxiety. He also had chaotic wake-sleep cycles with no consistent routine, and his social life was unstable as friends found him unreliable and disordered.

Rory had achieved his life-long career dream, but found his profession did not give him the glamour and luster he thought it would. He wanted to get married and have a family, but not with his present lifestyle. He knew he was young enough to pursue another career, but he was not moving in that direction. Thus, he was unconsciously angry at himself for not moving toward a more appropriate and productive goal. His agitation, panic, and tumultuous disorganized attacks were a signal that he needed to look seriously at making major life changes. Originally, Rory viewed his panic as the problem he had to confront, and he saw the attacks as a sign or weakness. But in fact, the attacks were providing valuable information: “Things are not right! You need to take corrective action.” Ultimately, he made the changes he needed to make. He investigated alternative careers, and he took courses at a local college to prepare himself for a career change. When he began to make specific alternative career plans and follow through with them, his panic attacks subsided.

Let’s be clear about Rory: his life changes were not easy to face. But the changes were productive, and they put him on a much smoother life road. Rory’s problem was not the panic attacks, but that he was lounging around stagnating, wasting away in a pool of frustration, confusion, and muddled non-productivity. Only by forcing himself to face challenges, could he produce satisfying outcomes resulting from personal autonomous efforts.