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.

Writing for Mental Health

Joshua Smyth and his colleagues at the State University of New York – Stony Brook studied the effect of writing about personal traumas on physical and psychological health. In Smyth’s general procedure, people were asked to choose a personal trauma and write about it for a few minutes a day for several days. The most frequent topics were the breakup of a relationship, death of a loved one, or being in an accident. A control group of people was asked simply to write about their plans for the next day.

After the writing period, all participants were given physical and psychological tests. The physical tests assessed how well their immune system was functioning; the psychological tests evaluated how effectively they felt they were handling stress in their lives. On both measures, the group that wrote about personal issues scored better than the group that merely wrote about plans for the next day. Along the same lines, James Pennebaker of the University of Texas described a study done with unemployed engineers. Half were randomly chosen to write about how being laid off from their jobs made them feel; the other half did not. Over a period of weeks, measures of psychological well-being showed those who wrote about their feelings were happier, healthier, and more energetic in their job search.

What’s going on here? Does writing provide some sort of energy release – getting rid of negative thoughts and feelings – that is responsible for the benefits? The researchers didn’t think so. They concluded that writing helps people restructure their thinking about current stressful issues. That is, as they write about stressors, they are actually dealing with them at some intellectual and cognitive level; they are seeing things in a new perspective while thinking things through. In other words, the writing exercise helped the writers focus on their problems, not on their emotions and feeling sorry for themselves.

Many entries in this blog describe the dangers of being overly concerned with your emotions. Do you believe your emotions are the cause of your problems? Do you see those emotions as the reason you can’t fall in love, work with colleagues, or have a satisfying social life?  If so, you need to stop focusing on your emotions and focus instead on the fact that you are troubled because of actions you take: denial, social withdrawal, avoidance of responsibility, inappropriately confronting others, hanging on in an unsatisfying relationship like some masochist – these are actions that sabotage effective coping. You need to accept the reality that you are anxious, frustrated, jealous, ashamed, or angry because of actions you choose to perform to service these emotions. “I must become less anxious” is not a good coping strategy because you must deny a part of yourself; “I will learn to act in different ways when I am anxious” is a good strategy because you see that you have a problem to solve.

When you believe your emotions cause your difficulties, you will try to manage, control, and avoid those emotions. This approach won’t work because emotions are a normal part of you. If you try to suppress or deny them, you become obsessed with them, and they actually become more frequent and troublesome. You will become frustrated and self-critical, putting yourself down, complaining that “I can’t even control my emotions.” Such self-criticism can lead to feelings of helplessness, and depression is not far behind.

When psychologically troubled, you may not profit from writing about it. Always remember, when it comes to coping plans and strategies, once size does not fit all. Still, the studies on writing and mental well-being show the benefits of focusing on what you can do about your emotions, rather than preoccupying yourself with those emotions. Asking, “Why am I such an anxious person? How can I get rid of this anxiety?” takes you into a world of denial, avoidance, and instability. Writing about a problem and ways to solve that problem just might inspire you to recognize, “I’m an anxious person in these types of situations, so I need to prepare appropriate behaviors so the anxiety doesn’t overwhelm me.” Such a strategy will take you into a world of effective coping with confidence and personal empowerment.

An Olympic Lesson in Coping

NOTE: What follows is a discussion of the psychological dangers of self-medicating with psychoactive drugs when coping with stress. The discussion uses the Acceptance, Accountability, Action model of coping that we have discussed in this blog over the past 4 years. This entry deals with psychology, and there is no attempt to make a sociocultural statement about marijuana use and laws in the United States, the World Anti-Doping Agency, or the United States Olympic Committee.

Sha’Carri Richardson is an up-and-coming US sprinter who won the 100-meter dash at the US Olympic trials. She was a definite favorite for a gold medal at the Summer ’21 Olympics until she failed a drug test, testing positive for THC, the active ingredient in marijuana. THC is a banned substance under World Anti-Doping Agency rules, and Richardson was suspended for a month, which extended through the 100-meter event at the Olympics. The United States Olympic Committee also decided not to place Richardson on the team to possibly compete in other track events.

In an interview on NBC, Richardson, 21, said, “I want to take responsibility for my actions. I know what I did. I know what I’m supposed to do. I know what I’m allowed to do, and I still made that decision.” Good for her. She accepted responsibility for making a stupid decision. She embraced accountability, which is a cornerstone of the coping model we often repeat in this blog: Effective coping requires acceptance of reality, being accountable for your actions within that reality, and developing a realistic coping plan of action that includes humility and empathy.

But wait. Richardson went on to explain that she used the marijuana after being told that her biological mother had died, news, she said, that put her in a state of “emotional panic.” This comment raises a psychological red flag because it contradicted her earlier statement of responsibility for using the drug. Now she played the “entitlement card,” saying that the emotional burden of the news about her mother caused her to self-medicate. Psychologically, that’s an avoidance strategy that says, “It’s not on me.”

Applying our coping model, when Richardson brought in her burden-of-grief excuse she was avoiding accountability and not serving herself well, psychologically speaking. In general, when you’re all stressed out and emotionally overwhelmed, self-medicating with psychoactive drugs is a poor coping strategy. Counselors’ offices are filled with clients who have traveled the self-sabotaging road of alcohol, marijuana, hallucinogens, opioids, stimulants, and designer compounds. This road is paved with avoidance, denial, helplessness, dependence, and self-criticism, and it generally leads to the dead end of depression. In Richardson’s case, her action sacrificed something she values: winning an Olympic medal. Whenever you behave in ways that damage what you value, you’re in psychological trouble.

Richardson’s unfortunate action shows that being accountable for your behavior can be easier said than done. In last week’s post we described Grace, who was molested by a coach when she was 12. She also carried a heavy emotional burden, and for years she coped with it by adopting a sense of entitlement. Grace said, “The only way I could deal with it was to use it to gain sympathy from others. You know, ‘Treat me gently because I suffered abuse as a child. I deserve your sympathy and tenderness.’ That attitude of entitlement drove people away from me; my social and romantic life was a mess. Counseling helped me realize that I did not deserve to have the corners of my world padded just because I had a traumatic experience. It happened, and it raised a whole bunch of emotions that I let dominate me. It took me awhile, and I still process it, but the fact is I don’t deserve squat, and I have to be responsible for living my life now, not yesterday.”

Grief presents a special set of coping challenges, but Richardson could have met hers without seeking padded corners for her world. A world-class athlete like her could have discovered that her grief could be worked through by honoring her mother’s memory with hard training, and dedicating her Olympic performance to her mother. [See blog entry of December 24, 2020] When her suspension ends, she will have many opportunities and challenges ahead. I hope she finds an appropriate social and professional support network to help her realize that effective coping with those challenges must involve complete accountability, independence, confidence, humility, and self-esteem, none of which will be found in a drug.

Memories: “Ah, yes, I remember it well.”

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

How often do you reach back into your storehouse of memories to retrieve a memory of an event long past? This can be a tricky undertaking because your memories are not like photos in a scrapbook, unchanging replications of a past event. They are more like sand dunes on a beach, changing shape according to wind and tide fluctuations. For instance, in one experiment, just prior to taking a test, students were asked how anxious they were. About a week after taking the test, they were told they either did well, or did poorly, and then asked again how anxious they felt before taking the test the previous week. Those who were told they did well, remembered themselves as less anxious before the test than they actually were; conversely, students who were told they did poorly, remembered themselves as more anxious before the test than they actually were. In others words, when you reflect back on an event, your memory can be influenced by your current circumstances. If you’re presently depressed and are asked what sort of childhood you had, what are the odds you will remember it as Brady-Bunch delightful? You are more likely to remember your childhood as stressful and frustrating, and you can justify your depression by casting blame on your parents. In this case, the potentially-distorted memory retrieval can greatly complicate efforts to deal with your current depression.

Memories can also be an impediment to effective coping by trapping you in your past. You can become tormented by memories of long-ago events that may produce anger, shame, anxiety, or similar emotions that interfere with stable functioning in the present. You may need to learn to accept the past as something over which you have no control, and focus your coping efforts on the present. Grace, for instance, was physically molested by a coach when she was 12. “I never forgot that experience,” she says, “and it haunted me. The only way I could deal with it was to use it to gain sympathy from others. You know, ‘Treat me gently because I suffered abuse as a child. I deserve your sympathy and tenderness.’ That attitude of entitlement drove people away from me; my social and romantic life was a mess. Counseling helped me realize that I did not deserve to have the corners of my world padded just because I had a traumatic experience. It happened, and it raised a whole bunch of emotions that I let dominate me. It took me awhile, and I still process it, but the fact is I don’t deserve squat, and I have to be responsible for living my life now, not yesterday.”

            Another way memories can challenge your coping efforts is when you come to believe things that didn’t happen the way you remember. Elke Geraerts of Maastricht University, The Netherlands, and colleagues were interested in determining if presumed victims of sexual abuse when a child, could actually forget the event and then later recover it years later during therapy. The researchers conducted extensive interviews and testing with women in their 40s who claimed they had recovered forgotten memories of earlier sexual abuse, and recovered the memories during formal therapy. Geraerts also interviewed family members and friends, and found little objective confirmation of the recovered memories. That is, extensive interviewing and investigation with relatives and friends just did not verify the events these women said they suddenly began to remember during therapy sessions. Geraerts concluded that during therapy, the clients were slowly buying into suggestions from the therapist – “Maybe the source of your problems is that you were abused as a child. Have you ever considered that?” – and they incorporated imaginary experiences into their memories, experiences that never took place. Impossible? Actually, memory researchers have found that false memories from childhood can be “implanted” in highly suggestible people, memories like getting lost in a store for a few minutes when 3, or being taken to the hospital for a stomach ache when 4. Some people are quite capable of unconsciously manufacturing memories that never happened.

            There are some valuable coping lessons here. When trying to cope with stress, you would be wise not to rely on analyzing your past, especially if your memories of that past are all you have to go on, and you cannot confirm the reliability of your memories with reports of others. Also, remember that your memories can be greatly influenced by suggestions from others, and by your current circumstances and emotional state. Given these caveats, it’s safe to say that your coping efforts will be much more successful when you focus on what you can control and act on in the present, and not dwell on memories of past events.

Improving Self-esteem

Most psychologists agree that your self-concept gives you a sense of stability and allows you to see yourself as the same person from day to day. Yes, you act differently with different people and situations but, nevertheless, you maintain that continuity of “self.” The way you view yourself is called “self-esteem,” and the level of self-esteem that we carry around is important. For instance, if you have high self-esteem, you probably tend to see yourself as empowered and able to obtain high goals; you are not likely to act like a failure and give up when faced with challenges; you enjoy involvement with others, especially in a helping, empathetic context.

People low in self-esteem show quite a different pattern of behavior. Compared to those with high self-esteem, they are more prone to depression, anxiety, poor interpersonal relationships, underachievement, and health problems. They believe they are destined to these fates, helpless to change them, and deserving of unhappiness; they tend to avoid meaningful interactions with others, thinking they are inferior to others; they see failure, rejection, and loss as their fault; their negative self-perceptions sustain their self-doubts, low confidence, self-criticism, and other self-defeating thoughts.

In short, acting like a failure, giving up, immoral behavior, and poor health are inconsistent with having high self-esteem, but consistent with low self-esteem. High self-esteem protects people when negative events occur. They are resilient by reminding themselves that they are worthy; they ascribe setbacks to bad luck or the fault of others. Low self-esteem, however, does not afford these protections. These people have difficulty seeing aspects of their self-concept that are admirable; they blame themselves for adversity, and become self-critical, which makes them vulnerable to anxiety and depression.

How might one improve their level of self-esteem? Therapist Michael Church uses an exercise with low self-esteem clients to help them deal more realistically with who they are, and discover that many aspects of their lives are commendable, admirable, and worthwhile. He asks clients to draw a circle and divide it into pie-like slices that represent the main areas of their life. This task may take several efforts to include all relevant areas, and Church says many clients find that insightful. That is, they don’t usually think about how diverse and complex their self-concepts are.

Church says, “Clients eventually section off spaces relevant to job or school, friendship, extended family, girlfriend/boyfriend, intelligence, physical attractiveness, morality, and health. There are other areas that may or not be included such as citizenship, spirituality, emotional development, and maturity. I discuss their choices with them to make sure that they are comfortable that all pertinent aspects of self-concept in their life are included. Then, I ask them to shade the areas where they see themselves with at least a modicum of self-esteem. I have never had anyone fail to shade in at least a few areas, even those who claim to have ’no self-esteem.’ This part of the exercise helps them realize that contrary to what they believe, they do not have generically low-self-esteem that pervades all aspects of their life. Then, we work on the shaded areas of choice, consistent with their priorities and values. I encourage them to identify actions they can take, and work within productive and proactive goal-setting guidelines. [See blog entry April 30, 2021.]. This helps them define goals appropriately and realistically while also having the means to know objectively whether they are making progress or have reached their goals.”

Note how Church’s exercise stresses action. As he puts it, “The best way to increase self-esteem is not by positive thinking, but by doing things that bring about positive results. Thoughts and feelings can be discarded, but we cannot easily dismiss our efforts and results that are valid and obvious. Our behavior is factual; it either occurred or it did not. Our effort is under our control, unlike the reactions of others and life situations we did not create.” Church is saying that if you want to increase your self-esteem you must focus on what you can control, and in many cases that is personal effort. You may apply for a job and get an interview. You may prepare for the interview – that’s something you can control. But you can’t control the interviewer, and you may not get the job. If you focus on your effort, however, you can view the interview as a learning experience, accept the result, and move on better equipped for the next interview. There is nothing to be gained by hanging on to disappointments and setbacks. Learn from them, correct mistakes, and adapt your effort to the next situation. Self-esteem does not require constant success. It requires you to 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 next time.”

Weather and Mood

NOTE: Lynn’s case is hypothetical.

It’s June! It’s getting warm! Is your mood increasing too? If so, that’s not surprising because there a relationship between our moods and the weather. For example, researchers at the Virginia Institute for Psychiatric and Behavioral Genetics found that mood and thinking ability both improved with warmer temperatures, and sunny, pleasant weather. But, there’s a caveat: The researchers also found that when assigned to work on tasks outside on warm, sunny days, the mood of the research participants increased; for those assigned to complete the tasks inside, however, even when pleasant weather conditions prevailed outside, mood was lower. In other words, the positive effect of weather depended on where the person was working during those nice weather conditions. Working outside – certainly more stimulating to the senses than being inside – produced better performance than working inside.

Isn’t this exactly what happens every Spring (except for 2020, of course, when the pandemic took hold)? Warm April days come after weeks of cold weather that have driven you inside – at least in the North. And now, almost overnight, there is opportunity for outdoor activities. So, you get outside and do more and you feel great!

There’s a key word here: Activity. Is winter a “downer” for you? If so, is it possible that you might feel a little sad in the winter months because you change your routine and give in to the darkness? All those worries about the dangers imposed by bad-weather driving, flying home for the holidays, becoming snowbound, getting the flu, or a host of other concerns – all resulting from negative psychological responses to winter – just tie you up in knots. So, you retreat and curl up on the couch. You’re less likely to “mask-up” and go out to dinner and parties, host small social events at home, or engage in outdoor hobbies and recreation. You lower your activity level.

Every September Lynn gives her psychiatrist’s office a call and asks to refill her anti-depressant medication. She tells them she’s feeling fine and hasn’t taken any meds since last April. But winter is coming and she knows that come late October she will begin to feel “down” as those winter blues set in. She wants to get a running start and start the meds so they will have already “kicked in” by November, and she will cut off the depression at the pass, so to speak. Her strategy is like getting a flu shot before the flu season sets in.

If you tend to get down-in-the-dumps during winter and want to take antidepressants, that’s your choice. But in a few months, you might consider an alternative strategy. Perhaps the key to maintaining a good mood during winter is to maintain your activity outside the home. When winter 2021-22 begins to rear its ugly head, don’t let it drive you inside; rather, stay active. Schedule special events and activities that you’ll enjoy. Sure, you’ll have to adjust from November to April to take that walk, go to the gym, deliver meals to the needy, volunteer at the animal shelter, or visit with hospice guests, but doing so is better than sitting on your butt.        

Some physiologists speculate that winter depression results from altered brain biochemistry because of reduced sunlight. While certainly plausible – bathing in sunshine is uplifting for the spirit – a psychological hypothesis seems equally reasonable. As winter approaches and the days get shorter, maybe it’s not reduced sunlight that makes you feel miserable; maybe it’s what you do – or don’t do – during the reduced sunlight that brings on that glum mood. Yes, you can choose to take antidepressants during this time; but you can also resolve to approach winter as a challenging time to continue with activities that give you pleasure and a sense of control in your life, not as a time to hibernate! What you do is under your control; the weather is not! So, have a great summer, but when it’s over, find creative ways to extend your pleasurable warm-weather activities into the winter months. [For a lengthier, more detailed look at this topic, see our entry on November 12, 2017.]

Critical Thinking

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

The phrase “critical thinking” has been absorbed into a lot of current issues – think conspiracy theories, for instance. When someone expresses a conspiracy theory, it’s not long before someone else mentions the need for critical thinking. In this blog, we’re also interested in critical thinking, but in the context of coping with stress: Critical thinking is essential for effective coping. Being able to think critically about conflicts will help you immensely in resolving the stress involved.

Critical thinking means being able to evaluate, objectively, what a speaker says about an issue. The critical thinker will want the speaker to produce clear, impartial, independent evidence supporting their position, and to show how alternative explanations can be ruled out. In other words, the critical thinker wants something more than, “Because my Senator [or my dad] said so!”

Years ago, I had a college classroom discussion going about the psychological benefits of religious belief. At one point a young man ventured off focus and made a comment about Mormons: “They have more than one wife, you know.” I asked how he knew that, and he said, “My dad told me.” I said, “But where’s dad’s evidence? Where are all these extra wives? Are they hidden away?” “Must be,” he replied.

I told the class, “Hang on. Dr. Murphy in our department is an expert on Mormons. Let me go get her.” She was in her office and I asked her to come to the class and tell them what Mormons believe and practice. I didn’t tell the class she was Mormon; that was her business and she could tell them if she wanted. She didn’t. Instead, she treated the topic like any knowledgeable professor would: Here’s some history, some statistics and data, and current Mormon doctrine governing things like tithing, family, and ministry. At the end of class, as the students were filing out, I asked the kid who started it all, “What do you think?” He said, “I don’t care what she says, I’ll stick with my dad.” Critical thinking is a challenge because it may require you to discard ideas that bring you comfort and certainty, and this student was a long way from reaching that requirement.

Bart hears a speaker proclaim, “We are at the end of days. God has had it with humanity, filled with pedophiles, baby killers, and other assorted perverts, and the world will end within the year. Only my believers will be saved.” Bart is attracted to this notion because he also feels humans have screwed everything up. He doesn’t see much hope for the world, and he would love to have a pathway to salvation. “I should join this group,” Bart thinks.

But, wait, let’s have Bart do some critical thinking first. “Just because his words bring me comfort doesn’t make him correct. Since the dawn of time, the world has been filled with evildoers. Why hasn’t God ended it all long before this? Why would God single out this guy as His messenger? Does this guy have some private agenda? I know my buddy, Jim, is always telling me how much good there is in the world, if I just look around for it. Maybe he’s right, and not this guy. If I join this group, what will that mean for other parts of my life?” And on Bart could go, critically and objectively evaluating the claim that the world will end this year, and examining the guy’s motives in proclaiming that view. Bart must also examine his personal consequences of accepting or rejecting the world’s-end claim. The task requires him to detach himself emotionally from arguments on all sides and think about things rationally, logically, and realistically.

There’s one more thing involved, the most important thing, but it’s also the one thing that people never seem to realize: Critical thinking requires humility. Critical thinking requires you to admit that it’s not all about you, that you are not the center; you are not the indispensable ingredient in the recipe; you are not the one with the best judgment. Critical thinking – like effective coping itself – requires you to put aside such self-absorption and admit that you may be wrong! Unless you’re a narcissist, that admission shouldn’t be difficult. After all, it’s illogical to think that you are always correct, and those who disagree with you are always wrong. You say the government is evil and the source of all your troubles. Or, maybe it’s mom, dad, or any of several other authority figures in your life who are to blame. But you know your belief is true because you see yourself as superior to others in evaluating what’s around you.

But here’s the problem with such condescension: You are not superior; you just think you are. The truth is, you cannot accept uncomfortable truths about yourself; you are unable to hold yourself accountable for your actions and beliefs; you cannot devise your own independent, autonomous coping plan that includes the needs of others. In short, without humility, not only are you unable to think critically, but you’re also unable to cope with life as a rational, independent, self-sufficient human being.

Critical thinking and coping effectively and realistically with stress are tightly intertwined. Those whose self-concept is threatened by self-examination; those who see infidels under every rock and conspiracies around every corner; those who blindly follow and never question the wisdom of their own actions – they are self-absorbed and imprisoned by self-interests. They are incapable of handling stress because of denial, anger, fear, and self-blame – unchecked emotions and ego defenses that inevitably lead to self-sabotage.

[For more on critical thinking check out blog entries for May 14 and 21, 2021]

Oppositional Defiance in Adults

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

Oppositional Defiant Disorder (ODD) is a disorder of childhood. Children with ODD are uncooperative and hostile toward peers, parents, teachers, and other authority figures. The condition often begins when children are toddlers, and may reflect problems with becoming independent from a parent or caregiver – anyone to whom they are emotionally attached. Conflicted between independence and dependence, they become more and more resentful of rules and restrictions on their behavior.

Although not typically diagnosed in adults as a disorder, oppositional defiance can be expressed as a chronic adult behavior pattern. Habitual actions would include temper tantrums; arguing; refusing requests; preoccupation with self and pathological narcissism; questioning rules and refusing to follow them; purposely doing things to annoy or upset others; being easily annoyed by others; speaking harshly or unkindly; seeking revenge or being vindictive. Of course, at any given point in time, anyone could exhibit some of these behaviors, but many occur habitually, we can characterize the individual as being an oppositional defiant type.

The adult pattern could have its roots in childhood. For instance, the victim might have unresolved anger toward a parent. This anger would be released when conflict with other adults – particularly authority figures – occurs. The authority represents the parent. Unresolved anger from childhood could also be turned inward, and the victim blames him/herself for the childhood conflict. Such blame could lead to instability in interpersonal relationships, especially when dealing with a spouse, significant other, boss, or co-worker. Whatever the case, the ODD adult is not pleasant to be with.

Felicia is an extreme example of the ODD pattern, and her case shows the influence of unresolved childhood anger toward a parent. Felicia had a lot of emotional upheaval in childhood. Her parents divorced when she was six and she lived with her father to escape her alcoholic mother. Her father eventually remarried, and he was overly controlling and dictatorial toward both his wife and Felicia. She harbored anger toward her dad but was unable to express it, fearing retaliation. When she was 16, her boyfriend raped her. They were “making out” but he escalated the situation despite her pleas of, “No, stop! I don’t want to.” She kept the episode a secret, and was eventually able to end the relationship. The episode, however, intensified her mostly unconscious anger toward men, anger she didn’t know how to resolve.

Ironically, as she grew older, Felicia only felt comfortable with abusive, confrontational, angry men. They were a part of her “father comfort zone,” meaning she was used to confrontational interactions with men and felt a sense of predictability and control. On the other hand, when a man showered Felicia with warmth, support, consideration, and understanding, she experienced anxiety because she didn’t know how to handle those gestures. She didn’t know how to return affection and it’s no wonder her multiple marriages were a bust.

Felicia’s third husband, Kurt, was much like her, and their arguments were monumental; she was finally symbolically confronting her dad and releasing years of pent-up anger and frustration. Physical and emotional abuse from both Felicia and Kurt resulted in multiple calls to the police, and their home life was, at best, chaotic. At one point they tried marital counseling, and over several years one or both of them had therapy sessions. They tried psychiatrists and different medications; they tried psychologists and different types of treatment strategies. Soon they found that going to sessions together was a mistake because issues that came up would just provide fuel for arguing later. The counseling and medications did not really lessen their personal insecurities or their anger with one another – and for Felicia, her anger toward her dad. Neither she nor Kurt could be intimate with the other, nor refrain from lashing out at the other. Even on rare “pleasant” days, eventually something would come up that would cause stress and tension, and they would once again fight like two rams locked in battle. Will they stay together unhappily until death?  “You’ve heard of soul mates?” says Felicia. “I guess we’re devil mates!”

Do you know someone who fits the ODD pattern? A co-worker, partner, acquaintance, spouse? Obviously, their coping abilities are terrible; they do not solve problems, they create them. Their actions are designed to help them avoid the inner turmoil tormenting and terrifying them – the repressed, never-resolved emotional conflicts that require them to maintain a pathological character armor to protect them from having to face who they are, and sabotage their life in the process. They are perfect models of ineffective coping.