Impulsive Generosity

What if every time you had a generous impulse you followed it?

For many of us, generous impulses come up relatively frequently (“They said not to bring anything, but I’ll pick up a bottle of wine,” “I wonder if my mom’s still sick, I’ll call to see how she’s doing” “I could pick up the tab for both of us”). However, our generous thoughts are often immediately followed by reasons to not follow through, such as “I don’t have time” or “I can’t afford it” and sometimes by stingy reasons like “Well, what has she done for me lately?”

Last week I went to a talk by American Buddhist teacher Joseph Goldstein. One of his topics was the impact of generosity on personal happiness and quality of life. He told us that about a year ago, he decided on a new policy: every time he had a generous impulse followed by a non-generous reaction, he would simply watch the non-generous         thought--without judging the thought or himself--and then return to the original impulse and follow through. He said that, without question, this practice had substantially increased the joy and happiness in his life (and probably, the joy and happiness of others).

What would it be like to try this? 

In the past month, I had several generous impulses that I didn't follow through: “I should bring a baptism gift for my niece” followed by “She's two months old, she won't know the difference” and “I should offer to babysit for my friend's birthday so he can go out with his wife" followed by “If they need babysitter, they'll ask me.” When I look back at these instances, my reasons for not following through seem silly, untrue, or workable, and I regret my decision. 

In contrast, I can think of several instances when I did follow through on generous impulses: “I'll email my colleague to see how her PhD defence went" and "I could get my friend a copy of that book we were talking about” and it felt great. The urge to not follow through still came up ("I'm busy right now" "He'll probably order it online himself") but I did it anyway.

Think of the last time you had a generous impulse and followed through. How did it feel? What was the impact on the recipient of your generosity--and on you?

Unconditional Positive Regard

Unconditional positive regard is a term coined by influential American psychologist Carl Rogers. If you have unconditional positive regard (UPR) for someone, you support and accept that person regardless of his or her behaviour. It means that even when you don't respect or approve of what someone says or does, you maintain an overall attitude of acceptance and positive regard for him or her.

Rogers named UPR as one of three necessary and sufficient conditions for successful psychotherapy, along with therapist genuineness and accurate empathy. He believed that therapists who demonstrated UPR for their clients created a positive therapy environment conducive to client growth and development. According to Rogers, the demonstration of UPR allows clients to freely express thoughts, feelings, and actions without fear of offending or alienating the therapist. Therapists may still question clients' behaviour, but without condemning the client as a person.

What about outside therapy, though?

Unconditional positive regard can exist in parent-child or other family relationships, in close friendships, and in romantic relationships or marriages. It can't be assumed to be present but, if we're lucky, we have UPR in at least one of our relationships. Social psychologist David G. Myers referred to UPR in relationships as "an attitude of grace, an attitude that values us even when knowing our failings." He added "It is a profound relief to drop our pretenses, confess our worse feelings, and discover that we are still accepted... we are free to be spontaneous without fearing the loss of the others' esteem."

My experience is that that's exactly what it feels like. I can think of a handful of people who seem to have UPR for me, and the word relief accurately describes how it feels to spend time with them. I've told these UPR-extending individuals what I believe to be the most shameful and appalling truths about myself, and it didn't seem to change how they feel about me. I don't worry about my pride around them and even when I'm my worst self, it doesn't threaten the relationship.

I can also think of a handful of people for whom I have UPR. It's hard to imagine something they could say or do that would make me turn away from them permanently, or make me not try to understand their motivation. I love and/or respect them even when I dislike them.

Unconditional positive regard is lovely when it happens, but I think it's the exception rather than the rule. That is, I'd venture that most of our friends, and even many of our family members, could lose our esteem. There are usually only a select few loved ones for whom we really feel unconditional positive regard. It may be spontaneous or may develop over time.  

For whom do you have unconditional positive regard? Who has it for you? What does it      feel like?

The Pleasure Principle

In the upcoming season of excess, what can we do when faced with temptation? When tempted to eat a third piece of pie, drink a fourth glass of wine, or buy a fifth adorable gift for our adorable niece, how can we exercise restraint? If you're wondering how to face the overeating, overdrinking, overspending, and other overs that run rampant in December, here are some ideas:

One way to handle situations that require will power is to have a predetermined rule. As discussed in an earlier post, using a rule means not having to make decisions, thereby avoiding poor choices borne of decision fatigue and ego depletion. For example, if you have a non-negotiable rule that you go to the gym before work every Monday and Wednesday, you don't have to make a decision when your alarm goes off in the morning, you just hop out of bed. If you have a non-negotiable rule that you don't drink coffee after 2pm, there's no will power involved in turning down your colleague's offer to pick you up a latte, because afternoon coffee is simply not something you do. 

Rules are rigid, though, and it takes time for them to be integrated to the point that no will power is required. I have a friend who has a novel approach: My friend pretty much never eats dessert. When others are impressed by her will power or accuse her of denying herself pleasure, she replies that rather than denying pleasure, she's giving herself a different kind of pleasure--i.e., the gratification of feeling fit and liking how her body looks. This is a new angle and one that applies equally well to saving money, avoiding sweets, exercising, and other generally positive behaviours.

I like to call this the Pleasure Principle and I've adopted it for my own use in situations involving, for example, spending versus saving money and going to bed at a reasonable hour versus staying up late reading or playing around on social media. I could enjoy new boots or I could enjoy feeling confident about paying my bills at the end of the month. I could enjoy sending one more message or I could enjoy being pleasant and well rested tomorrow. If I decide to save my money or decide to turn off the computer and get in bed, I'm not denying myself the pleasures of new boots or Facebook--rather, I'm benefiting from an alternative pleasure.

How is the pleasure principle different from rules, will power, and doing your future self a favour? Rules imply rigidity, will power implies self-denial, and doing a favour for your future self implies doing something grudgingly, but for a greater or future good. The pleasure principle removes all of the negative implications, leaving you with pure pleasure--it's win/win.

This holiday season, keep the pleasure principle in mind when you're trying to resist the third piece of pie, fourth glass of wine, and fifth perfect gift for your niece. Let me know if it helps!

The Apple of my Eye

Why do people love Apple products so much? Sure, many of us also love our best pair of jeans, our favourite book, or our sharpest chef's knife, but I think it's fair to say that we have beyond-reasonable affection for our MacBooks, iPhones, iPods, and iPads--and that we don't feel the same way about our coffeemakers, alarm clocks, or the PCs we have to use at work.

What's this outsized love about?

Among others, two features of Apple products elicit affection:

1) Anthropomorphism is the attribution of human characteristics or motivations to animals (e.g., My cat knows when I'm sad and comes to purr on my lap), to non-living objects such as cell phones (e.g., My phone thinks I want to say 'spring' when I'm trying to say 'sprint'), or to phenomena like the weather (e.g., This snowstorm is trying to make me miss my bus). Apple products are deliberately anthropomorphic: they have ultra-responsive touch screens, which makes us feel like we're communicating with them; they're silver or white with a sleep light that throbs like a gentle heartbeat (e.g., MacBook), rather than black and machine-like with flashing red or green lights.

2) Not only do they breathe and respond to touch, but many Apple products are tiny, captializing on the cute response. The cute response is an evolutionary concept that refers to a variety of features (small, smooth, rounded) that, across species, make something look cute. Now think of Apple products: like babies and unlike boxy old computers, Apple products, including most of their icons and features, are characterized by a general absence of sharp corners and right angles. Add miniatureness, and we're in love. I mean, who hasn't cooed over an iPod nano or iPad mini?

Why do we anthropomorphize? Anthropomorphism is hypothesized to help humans make sense of our environments and feel greater control. That is, assigning human motivations to our cats, dogs, laptops, and iPods makes it easier for us to understand and interact with them. Further, anthropomorphism has been demonstrated to be more common in people who are socially isolated, where it fills a need for connection. Think of Tom Hanks and Wilson the volleyball in Castaway.

Why do we like things that are tiny and cute? Evolution science suggests that mammals are hardwired to respond quickly and lovingly to anything with big eyes, a high forehead, a small nose, and an undersize chin. These cute features signal extreme youth, harmlessness, and vulnerability; they trigger our caring instincts, which is key for evolution since the infants of most mammal species are pathetically helpless and would quickly die without parental intervention.

Apple products capitalize on anthropomorphism and the cute response, at least partially explaining our boundless affection for inanimate gadgets. These features are no coincidence, but rather a careful design and marketing strategy.

NB: The flip side is that when we anthropomorphize, we make non-human entities responsible for their actions, explaining why we feel confused--if not humiliated and betrayed--when our gadgets don't work (e.g., "I charge it every day! I always keep it in its little case! I didn't do anything, but it's suddenly dead! How could my phone do this to me??").

Confirmation Bias

Confirmation bias refers to our tendency to seek and favour information that confirms our pre-existing ideas, and to interpret ambiguous information as supportive of our beliefs. That is, we pay attention to and believe information that confirms what we already think, while ignoring contradictory information. So for example, if I believe that the city where I live has the best restaurants in the world, I'll notice and remember every delicious meal I eat in my city--ignoring any poor customer service or bad food experiences, and forgetting about delicacies consumed in other cities.

How does confirmation bias manifest in clinical psychology practice?

We all have automatic thoughts and core beliefs about ourselves, others, and the world. Some of our problematic thoughts and beliefs aren't quite accurate and, reinforced by confirmation bias, they can be quite resistant to change. Consider one of my patients--an undergraduate student who was depressed after a longterm relationship ended. She was very lonely after the break-up, and frequently had the thought that everyone in the world but her was in a relationship. This recurring thought meant that every time she attended a social event, she was hyper-aware of couples and failed to notice people who had arrived alone or with friends. In our sessions, my patient repeatedly compared herself to her two best friends, both of whom were in relationships, ignoring that her sister and her roommate were both single.

As her depression deepened, my patient's recurrent thought was reinforced by confirmation bias and consolidated into a biased belief: if she was the only single person in her peer group, she must be unlovable. The belief that she was unlovable was in turn reinforced by confirmation bias: when her friends organized a huge surprise birthday celebration, she reported they were just looking for an excuse to party. When her lab partner asked her out, she assumed it was only because he wanted to copy her notes.  Her confirmation bias prevented her from taking in any information that contradicted her belief that she was unlovable, maintaining both the belief and the depression. 

You don't have to be clinically depressed to experience the effects of confirmation bias. Think about the last time you woke up in a bad mood. You probably paid a lot of attention to the guy whose massive backpack took up an extra seat on the subway, or to the fact that the elevator at work was out of service again. You probably failed to notice the gorgeous weather, or the delicious lunch your loving partner packed you. Why? Because these things didn't fit in with your preconceived idea that day that the world was a lousy place.  

How can we challenge confirmation bias?

The trick is to realize when we're in the grip of confirmation bias, to identify the bias, and to be willing to test it. Example: I have a patient who has a high-powered job and young kids, but her life is more difficult than it needs to be because she believes that fundamentally, other people are incompetent. Not only does this belief create interpersonal conflict, but it means that she can never delegate responsibility for any task or chore to her colleagues, her husband, or her kids because they're liable to do it wrong.

After a bit of psychoeducation about CBT, and some work on cognitive distortions, she agreed to test her belief. Armed with the scientific hypothesis "Others are incompetent," she set out to complete the following assignment: for one week, record evidence that supported or contradicted her belief. Evidence that supported the belief included "My husband put my daughter's diaper on backwards" and "The construction on my street that was supposed to be completed two months ago still isn't done." Contradictory evidence included "The tech support guy at work fixed my printer," "The airline actually served me the gluten-free meal I ordered," and "My son did his homework while I was away."

Faced with clear evidence that others are not always incompetent, my patient was forced to reconsider her belief. She modified "Others are incompetent" to "Other people can be incompetent sometimes, but often get it right." My patient's new faith in her husband, children, and colleagues smoothed relationships and allowed her to delegate tasks, leaving her a bit of time to relax.

Challenging confirmation bias is tricky and requires an open mind. If there's a thought or belief that's making you depressed or anxious ("I never do anything right"), creating relationship problems  ("No one could ever really love me"), or generating stress ("Asking for help implies weakness"), try looking around for information you might be ignoring, and for possible reinterpretations of the information you've been using to justify your belief! 

NB: Sneaky confirmation bias occurs on sites like Facebook that use algorithms to feed us information. Example: If in following the US election, you clicked on and "liked" all your Obama-supporting friends' statuses and ignored all your Romney-supporting friends' posts, your Facebook news feed narrowed, showing you more news from your Democrat friends and fewer posts from your Republican friends. Through the Obama supporters' posted statuses and articles, you learned more about why the Democrats were the better party, and received little information that challenged this perspective--maintaining and strengthening your bias.

Ingratiation Investigation

I recently went to a friend's housewarming party. I knew she was thrilled with her new apartment and I exclaimed over the painting and decor as I came in and looked around. Her response: "Yeah thanks, it's great but the lighting is bad in the living room and I still need to paint the bathroom." Later that night, a friend and I were talking to an acquaintance who was excited to hear that my friend was planning to complete his first marathon this year. Instead of accepting congratulations on his upcoming achievement, my friend deflected it by pointing at me and saying "Yeah but she's run a ton of marathons." To which I responded: "Yeah but anyone could do it if they trained; I'm not a natural runner or anything." Still later that night, I overheard a friend dismissively refer to his innovative and successful start-up as "my non-profit thing."

What's going on here? Why are we all downplaying our pride and our achievements? Are we actually not proud? Do we not want others to be impressed?

My guess is that we're all just trying to ingratiate ourselves. In social psychology terms, ingratiation means using deliberate communication strategies in an effort to become more attractive or likeable to others. There are a few different strategies, including other-enhancement (complimenting others), conformity (agreeing with or making yourself seem similar to others), self-promotion (emphasizing your own attributes), and self-deprecation (observing something negative about yourself or belittling or undervaluing yourself or your achievements to avoid seeming arrogant and to help others identify with you).

Social norms dictate that bragging is obnoxious. Rather, we are supposed to be modest, and people who aren't modest violate our expectations. At the party described above, my friends and I were all engaging in social ingratiation via a combination of conformity and self-deprecation. By emphasizing the apartment's imperfections, deflecting congratulations and insisting that anyone can run a marathon, and dismissing business success, we were a) being careful not to brag, and b) making ourselves more similar to our listeners, who may not have run a marathon or launched a start-up, and who may also have home improvements they'd like to make.

Is it really necessary to downplay or outright dismiss achievements? Would I view my friends unfavourably if they confessed to being thrilled with a new apartment or to taking pride in a successful business venture? What are the advantages and disadvantages of this kind of ingratiation?

Advantages: Conformity allows you to avoid threatening or alienating others, something braggarts often do. Self-deprecation can be funny and can defuse awkward social situations (e.g., telling a story about your own gaffe to take the heat off someone else). Overall, using conformity and self-deprecation appropriately demonstrates good social intelligence.

Disadvantages: Too much self-deprecation will turn you into a person who can't take a compliment, which can be annoying. Further, if you deflect every compliment and deny every achievement or success by turning it into a self-deprecating story, people might eventually start questioning your self-esteem, your skills, and your honesty.

Moral of the story: Ingratiate often, don't brag, and use conformity and self-deprecation wisely.

Stress Reduction Mantras

In April 2011, I posted mental health mantras--phrases you can repeat to yourself during difficult times. Here are my 2012 mantras, designed specifically to help in those moments when you're amplifying your own stress unnecessarily:

1) You don't need to like everything. This is something you can tell yourself when you're having a tantrum (out loud or in your mind) because you don't like the new duvet cover your partner bought, or you're in the mood for sushi but your friends want to order pizza, or your secretary booked you on a 7am flight. If you're saying to yourself but I don't like beige, I don't like pizza, I don't like getting up early, consider that it's not necessary to like every single thing that happens, and that people deal with things they don't like all the time. Maybe your partner didn't like the paint colour you picked for the bathroom, or your friends didn't like the restaurant you picked for your birthday dinner. Remembering that no one gets to like everything can help you laugh at yourself a little and snap out of your huff.

2) I can do hard things. This is for when it's time to ask your intimidating boss for a raise, when you're packing to move for the fifth time in two years, or when you're living alone after the end of a long relationship, and all you can think about is how hard it's going to be. Certain things are hard and rather than telling yourself they won't be, try reminding yourself that hard is something you can do.

3) This is the fun part. This is for when you can't wait until your child is out of diapers, until you finish your degree, or until your new home is all painted and set up, and you're stressing yourself out trying to get there as quickly as you can. This is the fun part can help you slow down and connect with the excitement or pleasure of the process, making toilet training, earning a degree, and shopping and decorating less stressful and more fun. (For things that just plain aren't fun, see number four.)

4) This is part of it. This is for when you're excited to send your mom the perfect birthday gift you found but get stuck in an endless line at the post office, when you're going on a road trip but get caught in Friday afternoon traffic, or when you're registering for a course online using an absurdly non-user-friendly website. Dealing with waiting, traffic, and poorly designed Web systems become much more bearable if you can adjust your perception of them: rather than preventing you from sending the gift, getting out of town, and registering for your course, they're simply part of sending the gift, getting out of town, and registering. 

I hope these help--keep me posted!

Let's Talk Change

Setting goals is easy, meeting them is hard, and not achieving them is discouraging. What's the best way to set realistic objectives that we can feel confident about meeting?

I learned a trick that's been useful in helping clients set and achieve goals. Say a client sets the objective of meditating for ten minutes five times per week. I'll ask him "On a scale of 0-10, how confident are you that you can achieve this goal?"

How does this question help?

1) Eliciting change talk. Say my client replies that his confidence level is six out of ten. My next move is to say "Hmm, six out of ten. Why not zero? Why is your confidence level at six instead of at two or three or even zero?"

This question may seem counterintuitive, but if I say "Why not seven or eight?" my client will produce a list of reasons why he can't meet his goal: he's too busy; he's not sure he'll be able to fit it in; he's not sure that meditation is for him. Suddenly he's resisting his goal. If I say "Why not two, three, or even zero?" the client will produce what's called change talk: it's not that hard, it's only ten minutes per day; he's been wanting to try meditating for a long time; it seems like something that could help him with stress. Suddenly he's making declarations about why he chose this goal and why it's important to him, boosting his own motivation.

2) Evaluating realisticness. Say my client replies that his degree of confidence in meeting his goal is one out of ten. I could still go for "Why not zero?" but it's important to consider that if his confidence is so low, the goal may be unrealistic and need adjustment. If my client has three children and works full time, meditating five times per week may not be possible for him. If we adjust the goal (e.g., meditating twice per week) and his degree of confidence increases to five or six out of ten, we're on the right track. I can then ask "Why not zero?" and he'll produce change talk: it's only twice per week, the kids go to bed at 8pm, leaving time for meditation in the evening; it will help him unwind at the end of the day.

The 0-10 confidence scale technique comes from motivational interviewing (MI), a coaching/counselling approach designed to increase motivation for change by helping people explore ambivalence and other barriers to change. MI incorporates the stages of change model, recognizing that people who want to make behaviour change or meet new objectives aren't always completely ready to do so.

I like to use the 0-10 confidence scale on myself and often find that low confidence is a symptom of an unrealistic goal (e.g., not eating out at all this week). I try to adjust my objective (e.g., eating out no more more than twice this week) until my level of confidence is at least six or seven, and then ask myself "Why not zero?" until I hear myself saying things like: I have the time this week to shop and prepare lunches; I actually prefer eating at home most of the time; I can put the money I save aside for my upcoming vacation.

Try it out!

Allowing

Emotions can be inconvenient. Sometimes we experience intense and difficult feelings at work, during a social occasion, or at some other awkward moment. It's not a convenient time to explore the emotions in depth or to sit and have a good cry, so what's the best strategy? Ignoring feelings? Suppressing them?

Like thought suppression, emotion suppression doesn't usually work; paradoxically, it can make feelings more intense. The trick is simply accepting that the inconvenient emotions are happening and allowing them to be present. It doesn't make feelings go away, but allowing eliminates the struggle against the feelings, freeing up your energy and attention for other things.

Here are two strategies for allowing:

1) Replace but with and. Say you're at a a great social event that you really want to enjoy, and you can't stop worrying about something stressful you have to deal with the following day. You're saying to yourself I'm at this great party, but I'm really anxious. Replacing but with and means telling yourself I'm at this great party and I'm really anxious. Whereas the original phrasing implies that there's no way you can enjoy the party with anxiety present, replacing one small word creates a new sentence that implies that the two can co-exist: you're anxious and also, the party is great.

2) Draw a picture. A client told me this story recently: At work one morning, he received a personal email that provoked intense sadness, fear, and jealousy. He tried to ignore his emotions and turn his attention to his tasks, but the feelings got stronger and stronger. The client needed to focus on his work; remembering the concept of RAIN, he decided to switch strategies and try allowing his feelings to be present. He wrote sadness, fear, and jealousy on three respective post-it notes and stuck them to the side of his computer monitor, illustrating each word with an emoticon-style face.

What happened? Emotion post-its turned out to be a great way of simultaneously defusing from emotions and allowing them to be present. The feelings/notes remained present in the corner of the client's mind/computer monitor, but the struggle to get rid of them was over, allowing him to redirect his attention. The feelings/notes became less and less distracting and after half an hour, the client was absorbed in his work. When he returned to his desk after lunch and saw the post-its, he laughed.

Neither replacing but with and or drawing a picture involves ignoring, suppressing, or denying feelings, and both strategies can help manage intense emotions at inconvenient times. Let me know if you try either of these tricks!

Threat Perception Bias

Threat perception bias refers to the tendency to interpret ambiguous stimuli as threatening. This bias has been demonstrated to be stronger in people who are generally anxious. For example, in one study, a researcher read aloud a list of homophones to two groups--anxious people and a non-anxious control group--and participants in both groups were asked to write down the words. Participants in the anxiety group were more likely than were control participants to interpret the words in a threatening sense, writing down die, slay, and pain, rather than dye, sleigh, and pane.

How does threat perception bias manifest in the real world? Example: A man who suffers from social anxiety speaks to a friend on the phone, and notices that his friend seems aloof. He might automatically imagine that his friend is mad at him for some social gaffe, rather than assuming that his friend is upset or distracted by something unrelated to the friendship. The friend's coolness is the ambiguous stimulus and the anxious man shows a bias by making a personally threatening interpretation.

Threat perception bias is usually related to long-standing or trait anxiety, but two personal experiences have convinced me that it can be induced in the span of hours:

Last week, I was watching an extremely disturbing movie--a psychological thriller that involved, among other things, cabins in the woods and creepy cult members flashing lights through the trees at night. Partway through the movie, I got up to check my phone. When I reached into my purse, my hand felt something unfamiliar and came out holding a palm-sized piece of hardware that resembled a mini-canister. My immediate thought: Someone put a grenade or some kind of explosive in my bag! I felt a stab of true fear in my belly. One second later, I identified the foreign object as the light bulb holder for the paper lantern I had received as a gift earlier that evening.

Similarly: When I was 15, I flew on an airplane alone for the first time. It was a 50-minute flight on a 14-passenger plane, and there was severe turbulence. Air pockets caused the tiny plane to plunge dramatically over and over; food and books flew off tray tables and everyone screamed and clutched their companions. I was paralyzed in my seat, terrified; it was the only time in my life I've ever really thought I was going to die. Safe at home that night, I was reading on the sofa when I heard explosions in the sky. My immediate thought: We're being bombed. One second later, I realized it was a holiday and that the noise I was hearing was fireworks.

Both situations involved instant interpretations of an ambiguous stimulus as life-threatening. I don't usually go around making such wildly inaccurate and catastrophic interpretations, and I'm convinced that my threat interpretation was induced by the respective priming effects of the movie and the turbulent plane ride.

Has this ever happened to anyone else?

I'm Watching You

One of the best things I've learned in my clinical training is that everything is information. Everything a client does provides data, and I can use it to generate hypotheses, even before the first session. For example, it's telling when a client asks the receptionist four times how much longer he'll have to wait, even though I'm only ten minutes behind schedule. It's interesting and useful to notice that a middle-aged client is dressed like a teenager, or that a client keeps his coat and hat on when he sits down across from me. 

What can I hypothesize about these clients? The client who repeatedly checks with the receptionist might be anxious, entitled, or both. The middle-aged client dressed like an adolescent might be emotionally immature or fear aging. The client who keeps his coat and hat on might be emotionally guarded and unsure about seeing a psychologist. These are only possibilities, but they allow me to start generating a conceptualization of the client--one that will be reinforced or corrected during the interview.

Naturally, the habit of observation extends outside the therapy office. I notice if an acquaintance is usually on her phone when she enters a party, and I wonder if it's important to her to look busy or if she's socially anxious about greeting people. I notice if a colleague starts every sentence with an apology and try to guess if it's just a verbal tic or if he believes that his contributions to conversation have no value or that others aren't interested in his opinion.

You don't have to be a psychologist to notice behaviour and make hypotheses, and there are benefits to this kind of observation. Say a friend tells you that she's thrilled about her new job, but you notice that she's biting her nails and doesn't smile once during the conversation. You can gently point out that she seem more stressed out than thrilled, and give her a chance to reflect and to discuss her true feelings. If you notice that a friend often busies himself with drinks and hors d'oeuvres and spends most of his time in the kitchen during weekly games night, you can hypothesize that he's unsure of his place in the social group, and--without necessarily saying anything--make a particular effort to include him.

Next time a friend or stranger does something interesting or unusual, or you notice a pattern in a colleague's behaviour, make a hypothesis. You might learn something interesting!

Inside Out

You know how you sometimes look at other people and feel like they are smarter than you are, more together or more successful than you are, and have a more fulfilling life than you do? How it sometimes seems like you're always stressed or depressed or panicked or angry, whereas others are well-adjusted and high-functioning?

News from the front line: Other people look at you and think the same thing. 

Yesterday I attended a workshop on mindfulness in psychotherapy. During one exercise, we were invited to get in touch with the thing that we like the least about ourselves, the thing that makes us different from and inferior to everyone else. As we wrote down our shameful secrets, people sniffled, people wiped away tears, but not one person raised their hand to say "There's nothing wrong with me. I'm just as good as everyone else." Later, the workshop leader showed us images of cue cards on which former workshop participants had described their inferiority: I'm too selfish; I'm defective; I don't fit in anywhere; I'm not as smart as others; and I don't measure up.  

Wait--what? How can everyone be different and inferior? Why does everyone think they don't fit it and don't measure up? What makes us think that we are the only one who doesn't have it all under control?

I think I know the answer: It's the phenomemon of comparing your insides to other people's outsides. Consider that painful emotions and judgmental thoughts are invisible; so is the sinking belly feeling and the tight chest feeling. So while we're extremely aware when these processes occur in our own body and mind, we don't see or feel them happen in other people. All we see are their sleek exteriors, and when we compare them to our own rumpled interior, of course we come up short!

What the workshop exercise made clear is that everyone's interior is rumpled and everyone is comparing their insides to others' outsides. It's not a fair comparison, and it's one that's practically guaranteed to make you feel bad. It might help to remember this next time you're feeling inferior.

NB: Facebook is a great example of this phenomenon, which explains why reading your news feed can leave you feeling like everyone is more fulfilled/having more fun than you are. No one posts statuses like "I'm so jealous of my friend's new baby I can barely breathe," "Wracked with guilt for not calling my sick grandmother again today," and "I feel like an imposter in my new job" (rumpled interior). Rather, we post about our our triathlon success, our adorable new nephew, and what a great time we had in Costa Rica (sleek exterior).

The Suicide Question

The other day, a research participant questioned me about the usefulness of asking clients whether or not they feel suicidal. He was completing the Beck Depression Inventory (BDI), a popular research and clinical measure of depressive symptoms, including suicidal thoughts. Question 9 of the BDI requires the respondent to choose from the following:

a) I don't have any thoughts of killing myself,
b) I have thoughts of killing myself but I would not carry them out
c) I would like to kill myself
d) I would kill myself if I had the chance

My participant wanted to know, who would actually admit to wanting to kill himself or herself? Given all the stigma surrounding suicide, wouldn't most people just lie?

Good question: Is it effective to ask clients flat out whether or not they are considering suicide?

The answer is yes. Doctors, psychiatrists, and psychologists are trained to ask the suicide question, without hesitation and without euphemisms. We ask it in a sensitive but straightforward manner, and clients invariably respond honestly. They either express surprise and say "What? Oh, no, I'm not at that point," or admit that yes, they've thought about it, at which point we empathize with their suffering and follow up with questions to determine whether or not they have a plan or a timeline.

I've never witnessed or heard of a client who reacted to the suicide question with shock or anger, and I've never heard of a client who lied (i.e., said he/she wasn't suicidal and then committed suicide). Rather, clients are relieved to be able to address the issue candidly. When a health care professional asks about suicidal thoughts in the same tone of voice used to ask about sleep and appetite, it removes the stigma, allowing the client to bring the dark, scary secret out into the open. To this end, some psychologists have their depressed clients complete the BDI at every session, providing a weekly measure of suicidal ideation, as well as of mood, sleep, appetite, and activity level.

Frequently asked question: Won't asking about suicide plant the idea if the person wasn't already considering it? This is a common fear, especially for non-professionals who aren't sure whether or not to broach the suicide question with a loved one. The answer is no. If someone isn't contemplating suicide, he or she won't start considering it because you asked; and if someone is thinking about it, he or she will probably be relieved that you brought it up, even if it's uncomfortable.

If you think that someone you know is contemplating suicide, ask the question.

Decision and Will Power Fatigue

Subsequent to my post about will power and rules, my sister sent me an article about decision fatigue and will power fatigue. Apparently, decision-making and self-control take up energy, and if you have to make many decisions or exert continued will power, you end up in a state of ego depletion, a condition of low mental energy that can lead to poor self-control and bad decisions. In ego depletion, your brain is too tired to weigh advantages and disadvantages, and resorts instead to one of two strategies: you become reckless and obey impulses rather than thinking decisions through (e.g., yes, I should buy these shoes, eat this entire pie, take this shortcut through a deserted park at night), or you avoid making decisions by sticking to the status quo (e.g., I'll just get the same bottle of wine I always get; I'll just continue dating this person for now).

Decision fatigue occurs a) when you have to make decision after decision, and b) when your blood sugar is low. One of the studies cited in the article found that Israeli prison parole boards more often granted parole to prisoners whose cases were reviewed first thing in the morning or right after lunch. In contrast, prisoners whose cases were reviewed right before lunch or at the end of the day were less likely to be granted parole; suffering from low blood sugar and decision fatigue, the parole board couldn't undertake the mental work of evaluating cases and therefore opted to stick to the status quo (i.e., prisoners remain in prison).

Decision fatigue can happen in any situation that requires numerous or repeated decisions. Imagine sitting down with a decorator to outfit your new home. At the beginning, you and your partner eagerly contrast and debate the merits of various dimmer switches, cabinet knobs, and shades of hardwood; after a long day during which you choose from thousands of options for lighting, counter-tops, and flooring, when the decorator pulls out paint chips, you're liable to groan and say "Just paint the whole thing cream!" To avoid hasty or bad choices in decision-heavy situations (e.g., wedding planning), your best bet is to make your choices when you are well-fed, and in more than one session.

Will power fatigue occurs when you have to exert repeated or prolonged self-control. Will power fatigue explains why, when you're trying to cut back on drinking, you're able to turn down champagne  at a wedding the first few times it's offered, but by midnight, you're so depleted from saying no that you grab and chug three glasses. Will power fatigue also explains why, after months of resisting your gorgeous, flirtatious, available co-worker, one night you give in and cheat on your partner.  To avoid will power fatigue, your best bet is to get out of the situation that requires continued will power (e.g., tell the waiters at the wedding that you don't drink, so they won't keep offering to fill your glass; don't go to post-work cocktail hour when your co-worker is there).
 
Are some people more prone than others to ego depletion from will power or decision fatigue? According to one of the researchers interviewed for the article, self-control and good decision-making aren't personality traits; rather, the people with these skills are the ones who organize their lives to conserve will power and avoid decision fatigue. They don't go to all-you-can-eat buffets, browse online for items they can't afford, or schedule important meetings late in the afternoon. Further, they establish routines or habits that prevent them from having to make decisions or exercise will power.

Here's where my post about rules fits in. If you have a strict routine of going to the gym after work Monday through Thursday, or a rule that you never watch TV on weekends, you don't have to use will power or make decisions; it goes without saying that you're going to work out four times per week and you aren't going to stream the latest episode of House until Monday. If your firm rule is that you only eat dessert on special occasions, you don't have to decide and redecide every time you walk by the plate of cookies some demon left in the lunchroom at work.

In this way, rules, routines, and smart planning allow you to conserve will power and save your decision-making energy for important decisions or unexpected situations.

Will Power versus Rules

If you want to make a difficult behaviour change, forget about will power and try making a rule instead.

I just finished reading The End of Overeating: Taking Control of the Insatiable American Appetite by David A. Kessler, a book about the psychology and physiology of compulsive eating and the role of the food industry. In the 'self-help for overeaters' section, the author recommends that, rather than counting on will power, overeaters should implement strict and absolute rules to eliminate struggle when faced with foods that trigger overeating. According to Dr. Kessler, absolute rules eliminate the need for will power! Here's why: Will power is invoked in the moment. The second you're faced with a desired stimulus (let's say cake, but it could also be a desirable but unnecessary purchase, or reading your favourite news sites and blogs rather than starting to work in the morning), will power pits the force of your desire for the reward (food, purchase, Internet) against the force of your determination to resist, creating discomfort.

In contrast, a rule is a long-term principle created in advance and not in the presence of the desired/rewarding stimulus. A rule (e.g., "No dessert") is based on experience and on a rationale (e.g., that much sugar makes my heart race and gives me a sugar hangover the next day; I want to maintain my weight; I know if I have one piece, I'll end up having seconds and thirds) that allows you to inhibit your normal behaviour (see cake, eat cake), without struggle ("I want it--no, I shouldn't have any--but it's a party and I deserve it--but what about my weight--okay, maybe a small piece"). Having an absolute and completely integrated rule allows you to avoid the impossible task of remembering your rationale at the moment you're faced with the desired stimulus--the rule is so internalized that it's a given.

A budget rule is another example: say you and your partner decide that travel is one of your most important values, and that in order to save money to travel, your rule is to never eat out when you're in town. When you receive an invitation to go out for dinner, you don't debate or agonize or argue over it, because the decision is pre-made: you're not going. No struggle and no will power necessary!

The distinction between rules and will power caught my attention because this year, I stopped eating grains--no pasta, bread, rice, and no most desserts--and have been training (running) harder than ever before. Observing me decline brownies and skip social occasions to go for long training runs, a few people have commented on my will power. This comment makes me feel uncomfortable because it rings untrue: if I have so much will power, why don't I stop eating family-sized bags of Nibs in one sitting, repeatedly interrupting my work to check my email, and scratching mosquito bites until they become scars?

The concept of rules provides an explanation: I am following two completely integrated and internalized rules: 1) No grains; 2) The training schedule is law. These rules are congruent with the definition provided by Dr. Kessler: both were created in advance (in January and years ago, respectively), for rational personal reasons (related to physical and mental health) based on my experience and consistent with my long-term goals, and they allow me to inhibit my default behaviour (i.e., eat any and all available baked goods; sleep in/prioritize social life). So when I turn down a fresh cinnamon bun, it's not because I have will power (which implies that I struggled with the decision), it's that my rule dictates that cinnamon buns aren't even an option. Same with following my training schedule: I don't struggle over getting up early or skipping your party to run; it's not hard and it doesn't involve will power. (Think about vegetarians who used to enjoy meat. I don't think they struggle every time someone offers them a burger; they're just following their very integrated rule.)

I think what might take will power is the initial creation of the rule--making the rule and sticking to it until it becomes entirely integrated. The two rules above are the only ones I've succeeded in internalizing to the point that there's no struggle. Among myriad others, I've tried "11pm is bedtime," and "no email checking until lunchtime" without success.

NB: The use of absolute rules isn't entirely positive, and rules aren't for everyone. I think they may be more helpful for abstainers (people who are successful with a 'cold turkey' or all-or-nothing approach) than for moderators (people who can successfully indulge moderately or occasionally). (Read about this distinction here.) Further, the inherently rigid nature of rules can create problems (e.g., following your training schedule to the letter even when you're injured; following your no-dinners-out rule even when it's your best friend's milestone birthday party).

What are your rules? Do they work?

Intermittent Reinforcement

Some people (ahem) check their personal email an absurd number of times per day. Sitting in front of a computer all day, it’s hard to resist checking for new messages, even if you just checked five minutes ago. In fact, it’s almost impossible. Why?

I think I know, and I think I learned it in Intro to Psych in 1999.

In the 1950s, behavioural psychologists experimented with learning by rewarding caged rats with a food pellet every time the rats pressed a lever. Although the rats initially only pressed the lever randomly or by mistake, they quickly learned the relationship between behaviour and reward and responded with frantic lever-pressing. In psych terms, the food reinforced the lever-pressing behaviour, that is, made it more likely to be repeated. Real-life examples of this kind of conditioning include rewarding your child with a new toy when he makes his bed or your company rewarding every two years of service with a pay increase. Toys and pay raises increase bed-making and company loyalty, respectively.

What does this have to do with email checking? Well, once the rats had clearly learned the relationship between lever-pressing and food, researchers started experimenting with the timing and probability of the reward. They wanted to know what would happen if they gave a rat a food pellet every third time it pressed the lever rather than every single time. Or if they provided food every 60 seconds no matter how many times the rat pressed the lever in the past minute. Or if the reward was completely random, that is, independent of timing and frequency of the behaviour. These variations are called reinforcement schedules. To their surprise, the researchers found that the most successful reinforcement schedule was intermittent reinforcement, that is, random and inconsistent reinforcement. This finding has since been widely replicated, in animals and humans, across situations and types of reward. 

Let’s go back to email checking now. You arrive at work in the morning and check your personal email first thing. You have a bunch of new messages. When you check again 15 minutes later, you have two more new messages. The next three times you check, there’s nothing. After lunch, still nothing. But an hour later, in mid-afternoon, you sign in again and bingo–you’re rewarded with 3 new messages! Yessss!! You feel pleased and validated because all your hard email-checking work paid off. You read your messages, respond or delete, and return to work. But 15 minutes later you have the urge to check your email again. You're in the clutches of email's inherently intermittent reinforcement!

Question: Is it disturbing or reassuring to realize that your personal behaviour is governed by basic principles of learning theory that apply to all people? And, um, all rats.

Twilight Zone

Seasonal Affective Disorder (SAD) is a mood disorder in which people whose mental health is stable for most of the year experience depressive symptoms during the winter months. But what about the short-term anxiety, disorientation, or melancholy that you feel in the winter around 4pm when the light starts to change? At first I thought it was just me, but the fleeting depressive state that occurs at dusk is a legitimate phenomenon (although not included in the DSM) and it has a name. It's called Hesperian depression, after the moment when the Greek God Hesperus, the evening star, rises in the sky. 

I've discovered that the best way to combat Hesperian depression is to be doing something at that time other than staring out the window at the darkening sky. For me, the best thing is to go for a run, but a phone call to a friend, a coffee break, or some other quick and pleasant distraction will also do the trick. By the time you're done, darkness will have fallen completely, Hesperus' rise will be complete, and that uncomfortable twilight period will be over.