Author Archives: Lori Edelman

Is extreme racism a form of mental disorder?

This question was recently sent to me via one of my psychology blogs:

Is extreme racism a form of mental disorder? 

My answer:
The American Psychological Association has never officially recognized extreme racism as a mental health problem, although the issue was raised more than 30 years ago. After several racist killings in the civil rights era, a group of black psychiatrists sought to have extreme bigotry classified as a mental disorder. At that time, the question was posed to the American Psychiatric Association, a related medical association that is separate from mental health counseling/psychology.

This professional association rejected the recommendation, arguing ‘that because so many Americans are racist, even extreme racism in this country is normative; a cultural problem rather than an indication of psychopathology’.

The psychiatric profession’s primary index for diagnosing psychiatric symptoms, the Diagnostic and Statistical Manual of Mental Disorders (DSM), does not include racism, prejudice, or bigotry in its text or index.

Therefore, there is currently no statistical support for including extreme racism under any diagnostic category. This leads psychiatrists to think that it cannot and should not be treated in their patients.

Others in the profession have argued that to continue perceiving extreme racism as normative and not pathologic is to lend it legitimacy. Clearly, anyone who scapegoats whole groups of people and seeks to eliminate them to potentially resolve internal conflicts meets criteria for a delusional disorder, a major psychiatric symptom of illness.

Extreme racists’ violence could be examined in the context of behavior described by clinical psychologist Gordon Allport in the classic text, The Nature of Prejudice.

Allport’s 5-point scale categorizes increasingly dangerous acts: It begins with verbal expression of antagonism, progresses to avoidance of members of disliked groups, then to active discrimination including segregation, financial, and, social; to physical attack, and finally to extermination (lynchings, massacres, genocide).

Based on these theories, using the DSM’s structure of diagnostic criteria for a diagnosis of delusional disorder, the following subtype of delusional disorder has been suggested:

Delusional Disorder, Prejudice type: A delusion whose theme is that a group of individuals, who share a defining characteristic have a particular and unusual significance to the (psychiatric) patient. These delusions are usually of a negative or pejorative nature, but also may be grandiose in content. When these delusions are extreme, the person may act out by attempting to harm, and even murder, members of the despised group(s). Based on our Allport’s work, individuals suffering delusions usually also have overall serious social dysfunction that impairs their ability to work with others, have healthy interpersonal relationships, and maintain employment.

While psychiatric classification may be a useful tool, other researchers believe behaviors stemming from prejudice/hatred may not necessarily be pathological, and these acts are certainly not generic. Where is the line between societal ‘normal,’ and not? If racism has normative foundations, is it a disease, or an internalization of expectations? Is racism part of intergenerational trauma, as suggested by James Baldwin?

In my forensic work, intent, perceived goals, ability to understand right and wrong, cognitive ability, overall comprehension, and consequences, are all considered when somebody is deemed mentally incompetent. If somebody is aware of all of these factors and fully cognizant of their behavior, is it a mental illness?

We have a lot to study. And we must.

Dr. King and Mental Health

“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” – Dr. Martin Luther King, Jr.

As an adult, Dr. King experienced bouts of severe depression. From childhood, he experienced highs and lows. A brilliant student and writer, he skipped his freshman and senior years of high school before enrolling at Morehouse College at the age of 15. During this same period, following the death of his beloved grandmother, he also attempted suicide twice. The stigma against individuals with mental illness, still very much alive today, was even more pronounced in the 1950s and 1960s. Concerned that people opposed to the Civil Rights Movement would use it as a way to try to discredit him, his incidents of depression remained a closely held secret among family, friends, and his inner circle during his lifetime.

Dr. King was jailed 29 times for peaceful civil disobedience or protests (one charge was for walking on the grass). He spent the last 13 years of his life under constant threat of physical harm. He survived an assassination attempt in 1958, where a stabbing narrowly missed his aorta. He constantly worried about the health and safety of his children and wife. If he were seen by a mental health professional today, it is most likely he would have been diagnosed with PTSD, in addition to long-standing clinical depression.

The stigma that forced Dr. King to keep secret his experience with depression still negatively affects millions of people throughout the United States. An increasing body of research in neuropsychology and clinical psychology is demonstrating PTSD like symptoms from a young age for black youth exposed to microaggressions, vicarious traumatization, and systemic discrimination. [see also, Minority Mental Health: Everyday Traumas and Microaggressions.

Additionally, while rates of behavioral health disorders may not significantly differ from the general population, Black Americans have substantially lower access to mental health and substance-use treatment services. (Graph, SAMSHA, 2020).

Part of the legacy of Dr. King is: Mental Health is for All.

Turning poison into medicine: Psychology and Buddhism

What’s the worst problem you have right now?

Many people are struggling with where to work, live, be; loss of home, job, business, and livelihood. Dreams. They may have watched savings diminish, prospects wither, doors close. They may be forced to address serious health problems and illness, of self and beloved others. Even without the sociopolitical landscape, it has been rightly described as an exhausting, daunting, and never ending year for most.

From the Buddhist perspective, all people are endowed with the innate ability to create value out of any situation, no matter how awful or tragic. Unlike the naive adage or idea that every cloud has a silver lining—that something positive can always be found in everything negative—the principle of changing poison into medicine explains that we can transform even the most unsettling tragedy into something that leaves us with more resources and tools. It acknowledges, integrates, and requires a face down with pain and grief.

What is your poison?
We tend to label any event “bad” that makes us suffer, feel lingering loss, and seems unsolvable. It feels like it leaves a demarcation or brand on our soul skin. It hurts.

Two concepts:
The significance of any event changes depending on the circumstances surrounding it.
The significance of any event changes depending on what we decide to do next.
The process of changing poison into medicine begins when we approach difficult experiences as an opportunity to reflect on ourselves and to strengthen and develop our courage and compassion. This does not at all invalidate or minimize the deep pain that we have experienced.

Instead, it’s an impetus for change.

How to make poison into medicine
Stages of Grieving
The five stages of grief aren’t restricted to the loss of loved ones. These stages, in general, are ones we ALL go through when attempting to process something deeply painful.

The stages are:
When something bad first happens, we may be unable to process what is going on, and it can feel unreal or impossible to believe. You need time to unpack it. And there is no statute of limitations on that time.

The pain of being in your situation and sense of injustice/unfairness may take over.

You might get lost in “what if” and “if only” statements.

You start to realize that there’s no easy way out of this, which may make you feel sad, heartbroken, and hopeless.

You begin to understand the situation, and accept that it’s happened/happening to you.

Other ways to transform poison into medicine
You learn to forgive
Bad situations can be eye-openers when it comes to forgiveness. You realize: You forgive other people for what they’ve done. Moreover, you understand that they are complex individuals and that there are two sides to every story. You forgive yourself for “allowing” this to happen. Plus, you either realize it isn’t your fault, or you find the parts that are your fault and learn from them.

You become your own best friend. 
In some cases, the worst situation means feeling totally on your own. It’s a terrible feeling, but it can still teach you new things and change your life.

When you only have yourself to rely on, you have two choices. You can continue to be cruel to yourself, thus removing your only form of support. Or you can be kind to yourself, bolstering your support, so you thrive. Becoming your own best friend, and treating yourself the way you’d treat someone you care about, is a hugely positive step forward in personal development. It means that, even when you’re totally alone, you’ll be fine, because you still have yourself. [Also see: The Power of the Self Hug].

With this clarity, you can better see:
The support of your friends or family
The evidence of your strength
The fact that you can learn from this bad situation

You find out what you cannot control. And what you can.

There are many things in life you cannot control, and these may be the things that led to these “worst” situations. But what about the things that you can control?

The concept of taking control over certain life events and circumstances is known as self-efficacy, and it can prevent things from spiraling out of your grasp altogether.
So take control of the small things.

You can start by:
Rearranging the furniture in your home
Personalizing your work and leisure space
Taking up a new hobby
Changing your usual routine
Reaching out to friends. And making new ones.
Trying a new style: Fashion, social, work mode, aesthetic.

You realize that you can overcome stuff
If there’s one thing a bad situation can do, it’s to show you your inner strength. Think about all the terrible circumstances you’ve gotten through and how you’ve managed to emerge unscathed.
I have patients make a list of everything accomplished, not just the ubiquitous to do list. They are often astounded at what they’ve managed to do.

You learn to ask for help
You can’t do everything on your own. Or, if you can, it may not be the healthiest or most positive way to go about it. It’s okay to need help, and it’s okay to ask for help. Other people can provide you with different perspectives that you may not be able to see.

Here are some ways you can ask for help:
Reach out to a friend, mentor, or family member
Seek help from a therapist or counselor
Find support groups, whether online or in-person
Talk to someone you trust for advice
Ask for a deadline extension from a teacher, boss, or client, if needed
Learning to ask for help can dramatically change your life. This doesn’t mean you stop being self-reliant. It means you become secure enough in yourself that you’re comfortable seeking assistance when you need it. You learn to practice positive coping mechanisms, in the face of difficult events.

A few examples of positive coping mechanisms are:
Exercise (even simple, gentle kinds)
Expressions through art, like writing, painting, dance, or singing
Watching movies or shows
Reading books
Pampering yourself with a self-care day
Time spent in nature
We are natural alchemists, and life is our Laboratory.
Taking the poison and making it into medicine = gold.

How to ask for help without feeling weird

‘I Have Your Back’

Reaching out for support is a skill we’re somehow expected to know, yet it’s never taught and rarely modeled for us. When you need help -no matter the kind of help you need, or the person you need it from -to simply state “Can you help me?” can be fraught with tension.

A seemingly simple request for help can bring huge implications with it. You may have been raised in a family where asking for help, or letting others know that you need support, was considered a sign of weakness and was frowned upon for suggesting a lack of privacy regarding personal difficulties.

Asking family members, colleagues, friends, community, and partners for help may reflect a larger cultural dynamic of communication and give-and-take.

Saying, “Can you help me?” speaks powerfully to an instinctive desire to be of service to other people and to receive reciprocal attention. But “Can you help me?” also makes you vulnerable.

What I say to patients: please practice asking for help.
For many, it’s a new activity, and it feels rusty, like anything novel.  Yet, so many people have recently lost their livelihood, had physical health problems, financial hardship, and even loss of home and identity. More than ever, asking for help is an art form that we need. As a society, we don’t always have the experience to ask for help. In my belief, that needs to change, but requires self compassion and practice.

Where to start:
1. Make a list of what you need help with: particular errands, chores, some cooking, walking the dog, getting food or groceries, yard work, job recommendations, assistance with letter or email writing, changing filters, moving furniture, tech support, maybe even a shoulder to cry on.

2. Write down the names of friends, colleagues, and relatives who have offered to help in the past.

3. Match people with tasks based on their interests, their strengths, their time flexibility and your comfort level with them, given the intimacy of the particular task. One friend may really enjoy cooking, another may check in on you via regular texts, another might upgrade your computer, or walk your dog.

4. Pick just one thing off the list and contact the person you’ve chosen. Be direct. See the next few points, below.

5. I always talk about timing and dosage. If you’re not sure whether or not it is a good time, just ask. You can say, “I’ve love to ask for your help with something. Is there a time that’s good for you to talk?”

6. Don’t be defensive. Instead, say what you can’t do.
Instead of saying, “I need to add a few graphic elements for a major key point power point presentation, say, “I’m concerned a few of my slides for my seminar look terrible.” You don’t have to emphasize how ‘important’ you are. Just ask for the help that you need.

7. Show respect. Without actually saying it, you’ve already said, “You know more than I do.” You’ve said, “You can do what I can’t.” You’ve said, “You have experience (or talent or knowledge) that I don’t have.”

Learning is not diminishing yourself.

8. Show trust. You’re vulnerable. You admitted to a weakness.And you’ve shown the other person that you trust them with that knowledge. You’ve already said, “I trust you.”

9. Show you’re willing to listen. Instead of saying exactly how the other person should help you, you give them the freedom to decide.

By showing you respect and trust other people and by giving them the latitude to freely share their expertise or knowledge, you don’t just get the help you think you want. You get more.

10. Be grateful. Acknowledge the help you received. Even though you might feel embarrassed that you needed help, don’t pretend like it never happened. Directly acknowledge that you appreciate what the other person did for you.

11. Be sincere. When someone is helping you, it’s okay to be a little bit vulnerable. The other person might appreciate knowing that they are genuinely helping you during a difficult time.

12. Gain credibility by helping others. People will be more likely to agree to help you if you have been known to help others. Build a reputation as a helpful person. You will draw others to you who share that same sentiment.

The importance of vulnerability

Vulnerability is the driving force of connection. It’s brave. It’s tender. It’s hard to connect without it. But we’ve turned it into a weakness. Toughing it out, chin up buttercup, has become a standard. It defines strength to many people.

For others, hearing the refrain, ‘you’re so strong’, may leave them feeling that sad, tender, messy, scared, and even dark feelings are wrong. When exposed to this message, people learn to curtail and edit aspects of their own being.

What I have found, in my individual and couples work with patients is that without mutual vulnerability, relationships struggle. Vulnerability is, ‘Here I am – my frayed edges, my secrets, my fears, my unabashed affection.’ In return, it invites, ‘Oh, I see you there. It’s okay, you’re safe. And here – here’s me.’ It builds trust, closeness, and a sense of belonging. Relationships: friendships, romantic relationships, family relationships, will not thrive without it.

Vulnerability is openness to experience, people and uncertainty. It’s terrifying at times, and tremendously courageous, always. We will get hurt. Relationship pain is an unavoidable part of being human.

Dr. Brene Brown is a research professor from the University of Houston and an expert in the field of vulnerability. She’s looked at those who have a strong sense of connection and belonging and those who don’t. Her research found that a primary difference between the two groups was that those who had a strong sense of love and belonging believed they were worthy of it. People who believed they were worthy of connection experienced greater connectedness.

When people believe themselves worthy of connection, they’re more likely to move towards others. They’ll be the first to say ‘I love you’. They’ll be quick to say, ‘I miss you’. They’ll ask for help and they’ll be open to the love, affection, knowledge, and efforts of others. They’ll be grateful. They’ll be connected. They will appreciate learning and the give-and-take of reciprocal communication.

This doesn’t mean they’ll always get what they want. What it means is that they are more willing to be open and vulnerable in relationships because their potential for shame is less. If the connection falls short – if the ‘I love you’ is left hanging, the ‘I miss you’ isn’t returned, the request for help is declined, people who believe they are worthy of connection are less likely to blame themselves and their own ‘unworthiness’ for the disconnection.

They are often the people who will not give up on others. They will try again. And again. They will not let the pain of disappointing relationships sour them for future ones. They are open to love, connection, attachment. And the underbelly- disappointment, loss, grief, a broken heart.

Vulnerability, the understated superpower.

Signs that a family member, colleague, partner, or friend might be having trouble

When to check in:

– They have socially withdrawn.
That includes avoiding social media, not responding to phone calls, emails, or texts, and a lack of overall participation in activities.

-They are going through a difficult life event.
This may include unemployment, bereavement, break up of a relationship, health problems, financial hardship.

-They are behaving recklessly.
When they are making seemingly bad choices as a pattern, engaging in self-destructive behavior, or seeming to be oblivious to consequences.

-They are acting out of character.
They may be snapping or becoming easily irritated, having bouts of rage, or crying spells that seem to be out of nowhere.

-They frequently mention having sleep difficulties.

-They may be neglecting grooming and hygiene.

-They have extreme fluctuations in appetite, from forgetting to eat to binge eating.

-They seem to be emotionally distant.
They may brush off caring gestures or attempts to connect.

-They talk about the future in a hopeless or helpless way.
They may state that ‘everything sucks’ and is not going to get better.

-They become upset easily over little things.

-They want to be left alone the majority of the time.

-They are restless and uncomfortable.
They may not be able to sit still, focus, or even relax.

-They may be experiencing frequent physical (somatic) symptoms.
They may complain of having headaches, stomach aches, gastrointestinal problems, bodily aches and pains, or chronic physical distress.

-They frequently state they are overwhelmed by their life.
They may describe work, child care, life activities, and overall responsibilities as tiring and hard to keep up with.

-They frequently engage in mindless activities.
They may spend the majority of their time scrolling through social media, playing video games, binge watching YouTube’s and shows, or shopping online for items that are not needed.

-They appear disengaged in conversation.
They may not want to talk to people they care about or discuss topics that they usually find engaging. One sign that I look for is frequently saying “I don’t know.”

– They appear fatigued, or say that they are tired more days than not.

– They may avoid eye contact or reciprocal conversations.

Least Helpful Things to Say to Someone With Depression

Sackler Gallery, Washington DC, 2019

Lighten Up!
Why can’t you just act happy. You’ll feel better.
Things are not that bad.
You become what you think.
You do not need to take those pills. You’ll just get addicted to them.
Just chill, bruh.
Just have gratitude.
A hot bath always helps.
Get a job. It will keep you busy.
Smile and the world smiles with you.
Your face looks like you’re upset all the time.
You don’t look depressed.
You have gained weight.
You have lost weight.
You always think about yourself.
Your life is so easy.
You are being selfish.
Everyone goes through depression, it is not a big deal.
You are an attention-seeker.
Everyone goes through a rough patch, so that is normal.
Depression is not a disorder, it’s in your head. 
A person of your age should be having fun right now.
You know, you become what you think.
You brought this on yourself.
Stop acting like a child.
Think about others who are really suffering.
This bad attitude won’t help.
Stop thinking about it.
Just stay busy.
Get a life.
Your face is so sad that it makes me depressed.
You need to give yourself time.
Have you prayed on it?

Emergency Hotline

The Science of Compassion

In my doctoral studies, I had the honor of working on a research study on conjugal bereavement with Dr. Dacher Keltner. Dr. Keltner, in addition to prolific work in a wide range of areas, has developed the science of compassion and empathy into a multidisciplinary field. In short, the study I co-authored found that in a study of individuals who had lost a long-term partner, and who ultimately showed greater psychological health over a five-year span after the loss, were those who received ongoing empathy and social support in response to their vulnerability, as the primary variable related to mental health and adjustment.

(Bonanno, G. A., Siddique, H. I., Keltner, D., & Horowitz, M. J. (1996). Correlates and consequences of dispositional repression and self-deception following the loss of a spouse. The Catholic University of America, Washington, DC).

Dr. Keltner runs a compassion-based research studies program at UC Berkeley. He writes prolifically about the importance of compassion for psychological health, social justice, and even the survival of our species.

Compassion literally means “to suffer together.” Among emotion researchers, it is defined as the feeling that arises when you are confronted with another’s suffering and feel motivated to relieve that suffering.

Compassion is not the same as empathy or altruism, though the concepts are related. While empathy refers more generally to our ability to take the perspective of and feel the emotions of another person, compassion is when those feelings and thoughts include the desire to help. Altruism, in turn, is the kind, selfless behavior often prompted by feelings of compassion, though one can feel compassion without acting on it, and altruism isn’t always motivated by compassion.

While cynics may dismiss compassion as touchy-feely or new age-y, neuropsychologists have started to map the biological basis of compassion, suggesting a deeper evolutionary purpose. This research has shown that when we feel compassion, our heart rate slows down, we secrete the “bonding hormone” oxytocin, and regions of the brain linked to empathy, caregiving, and feelings of pleasure light up, which often results in our wanting to care for other people.

Compassion makes us feel good: Compassionate action activates pleasure circuits in the brain, and compassion training programs, even very brief ones, strengthen brain circuits for pleasure and reward and lead to lasting increases in self-reported happiness.

Being compassionate—tuning in to other people in a kind and loving manner—can reduce risk of heart disease by boosting the positive effects of the Vagus Nerve, which helps to slow our heart rate. A recent study found that people who have a greater level of empathy live 9 to 10 years longer than others, controlling for other factors. 

One compassion training program at Stanford has found that it makes people more resilient to stress; it lowers stress hormones in the blood and saliva and strengthens the immune response. Compassion training may also help us worry less and be more open to our own and others’ negative emotions. In short, people who are more compassionate tend to be less avoidant of the range of emotions.

Compassion could improve our mental health: One research review found that practicing compassion meditation improved participants’ emotional life, positive thinking, relationships, and empathy. Brain scans during loving-kindness meditation, which directs compassion toward suffering, suggest that, on average, compassionate people are happier.

Practicing compassion could make us more altruistic. In turn, it may also help us overcome empathic distress and become more resilient in the face of others’ suffering. Too often, we hear people say, I can’t watch the news because it’s just too much for me. Instead, the practice of compassion makes people more able to tolerate the pain of others, and yet provide support.

Compassion helps make caring parents: Brain scans show that when people experience compassion, their brains activate in neural systems known to support parental nurturance and other caregiving behaviors.

Compassion helps us be better friends and partners: Compassionate people are more optimistic, forgiving, and supportive when communicating with others.

Compassion helps make better doctors: Medical students who train in compassion feel less depressed and lonely, and avoid the typical declines in compassion that sometimes happen during medical school.

Employees who receive more compassion in their workplace see themselves, their co-workers, and their organization in a more positive light, report feeling more positive emotions like joy and contentment, and are more committed to their jobs. A compassionate workplace culture is linked to less burnout, greater teamwork, and higher job satisfaction.

Compassionate people are more socially adept, making them less vulnerable to loneliness; loneliness has been shown to cause stress and harm the immune system.

Compassion is contagious. According to Dr. Keltner’s “the greater good project”, based out of UC Berkeley, compassionate behavior rubs off on other people.

Adult Symptoms of Trauma – A Quiet Epidemic

The psychoanalyst Alice Miller wrote: “the true opposite of depression is neither gaiety nor absence of pain, but vitality—the freedom to experience spontaneous feelings. It is part of the kaleidoscope of life that these feelings are not only happy, beautiful, or good but can reflect the entire range of human experience, including envy, jealousy, rage, disgust, greed, despair, and grief. But this freedom cannot be achieved if its childhood roots are cut off.”

The SAMHSA’s National Child Traumatic Stress Initiative (NCSTI) reports that by the age of 16, two-thirds of children report experiencing at least one traumatic event. TWO THIRDS. The substance abuse and mental health services administration (SAMHSA) is the agency within the US department of health and human services that leads public health efforts to advance mental health in the country. 

According to the American Psychological Association (APA), a traumatic event is one that threatens injury, death, or the physical integrity of self or others and also causes feelings of horror, terror, or helplessness at the time it occurs. This can encompass many different situations and may even be different for each person who experiences a specific event.

Potentially traumatic events can include:

  • Physical, emotional, and sexual abuse
  • Neglect
  • Community or school violence
  • Racism and microaggressions
  • Sexual exploitation
  • Sudden or violent death of a loved one
  • Witnessing or experiencing domestic violence
  • Natural disasters or terrorism
  • Refugees or war experiences
  • Assault
  • Serious accidents
  • Life-threatening illness; Chronic illness or multiple surgeries

If untreated, childhood trauma can have long-lasting effects. Trauma can affect children’s mood, development, and their ability to regulate their emotions at the neural level. Consequently, as an adult, they are two times times more likely to develop major depression and three times more likely to develop clinical anxiety.

Symptoms of Trauma in Adults

There are a number of different ways in which symptoms can manifest for adults living with childhood trauma. Unfortunately, there is no clear-cut recipe to follow when diagnosing an adult with lingering signs of trauma, however, there may be some common physical, emotional, and behavioral symptoms. Listed below are just a few symptoms of someone living with trauma. It’s important to know that these are not static, nor linear.

  • Anger
  • Hypervigilance
  • Unresponsiveness
  • Anxiety
  • Emotional outbursts
  • Depression
  • Panic Attacks
  • Physical Pain
  • Poor Concentration
  • Shakiness
  • Night Terrors
  • Lack of Energy
  • Physical Illness
  • Sleep Disturbances
  • Intrusive Thoughts
  • Compulsive behaviors
  • Eating Disorders
  • Impulsiveness
  • Isolation
  • Numbness or Seeming Callousness
  • General disorientation/Confusion

Based on my clinical work, these are just a few of the LESSER known experiences of adult trauma survivors:

-You feel no one understands you, and perhaps no one will. Adult trauma survivors sometimes say, “I don’t fit or belong anywhere or with anyone”.

-You may minimize. Adult survivors say to me, after describing extremely painful experiences, “but, doesn’t everybody go through that? “
One meme that was shared with me by an adult survivor said:
Get up. No one‘s coming to help you. This is a trauma response

-You overperform. Meanwhile, you’re silently dreading the mountain of tasks you’ve signed up for — a list that only seems to get longer as the week wears on.

-You’ve got a love/hate relationship with work or being helpful, and no matter how many times you try to break up with the word “yes,” saying “no” just doesn’t come naturally to you. Extra hours to work on the weekend? You’re the first one in line.

-You may spew emotions seemingly out of nowhere. To others, who are not part of your trauma history, it might seem random or unfair. I have found that people described as “drama queens “ often have unspoken histories that are very painful.

-You might be unloading feelings onto distant strangers. For example, you might be able to talk to your deepest feelings to a server, bartender, or someone you just met at a party, but not to friends or family who have known you for a while. This might seem paradoxical, but it’s not. You do not want to be seen as a burden to those closest to you, which means you’re reluctant to open up when you’re struggling, so you only do so when you’re on the brink of totally breaking down, because you’ve held it all in for far too long.

Similarly, social distance may make it easier to express feelings.
Hello, Social Media: Sure, I’ll tell you all about my trauma. That way, if someone bails on us for being messy or “too much,” it stings less, and the stakes don’t feel as high.

-You feel guilty when you’re angry at other people. You might get angry, only to feel like a terrible person for having feelings at all five minutes later. You might even feel like you’re not “allowed” to be upset with other people. One adult symptom of this is constantly apologizing. In my experience, adult survivors of trauma are apologizing for their very existence. So even minor infractions may send them into a flurry of apologizing. 

-You feel responsible for other people’s reactions. Whenever you recommend a restaurant, a movie, or a book to someone, there’s a moment or two of intense panic. “What if they hate it?” Sometimes you just let other people make decisions on where we go and what to do, because if something goes awry, it won’t be because they failed” to make a good choice.

-You find yourself compromising your personal choices. This can be difficult to notice at first. You might think of yourself as being chill, good at compromise, easy to get along with. But if you pay attention to the conversations you’re having, you might notice you’re a little too agreeable. Sometimes it’s seemingly benign things, like saying you don’t have a preference for what you want to eat for dinner when you actually do. Other times, it may include validating a perspective or behavior that you don’t agree with. It’s not speaking up when you have an opinion, or something is upsetting.

-You sometimes dissociate in social situations. This is where you disconnect emotionally. This can show up as daydreaming, spacing out, withdrawing, or even “going blank”. I’ve heard many adult survivors say that they have been accused by partners, colleagues, and family members of not paying attention or not caring.

-You may feel numb, even cauterized. During the pandemic, I have heard numerous trauma survivors say that they do not feel any significant fear or concern. They may actually function more calmly than others who have not experienced a history of trauma.

Overall, this limited list of behaviors I have observed over the years in clinical work has one thing in common: an inability to fully experience the range of feelings that make us human. Restricted experiences have consequences for our interpersonal relationships, choices, lifestyles, and longterm mental health.

Is Crying Healthy?

Client: please teach me how not to cry.
Me: what would happen if you did?
Him: it’s not acceptable. 

Crying is a natural response humans have to a range of emotions, including sadness, grief, joy, anger, and frustration. It is not unusual to cry, and both sexes cry more than many people may assume. In the United States, women reportedly cry an average of 3.5 times per month and men cry an average of 1.9 times a month. This is likely to be under reported. According to neuropsychology, there are a number of benefits to being able to shed tears.

It can have a soothing effect
Self-soothing is when people regulate their own emotions, calm themselves, and learn to reduce their own distress. A 2014 study found that crying may have a direct, self-soothing effect- crying activates the parasympathetic nervous system (PNS), which helps people relax. Crying doesn’t only happen in response to something sad. Sometimes people cry when they are moved, happy, scared, angry, or stressed. It may help to restore emotional homeostasis- your body’s way to recover from experiencing strong emotion.

It helps ameliorate pain
Crying for long periods of time actually releases oxytocin and endorphins. These natural feel-good chemicals can help ease both physical and emotional pain. Oxytocin can give you a sense of calm or well-being. It’s another example of how crying is a self-soothing action.

It may help people receive support from others
As well as helping people self-soothe, crying can help people get support from others around them. When I was an undergraduate, I did developmental psychology research at a pediatric ward, observing the behaviors of premature babies. The actual crying of the babies elicited a caring and attachment based response in most caregivers. 

Enhances mood
Crying may help lift people’s spirits and make them feel better. As well as relieving pain, oxytocin and endorphins can help improve mood. This is why they are often known as “feel good” chemicals.

Releases toxins and relieves stress
When humans cry in response to stress, their tears contain a number of stress hormones and other chemicals. Research indicates that crying could reduce the levels of these chemicals in the body, such as cortisol, which could, in turn, reduce stress.

Crying aids sleep
A preliminary study in 2015 found that crying can help babies sleep better. Whether crying has the same sleep-enhancing effect on adults is yet to be comprehensively researched. There might be something to the old adage of crying yourself to sleep. 

Fights bacteria
Crying helps to kill bacteria and keep the eyes clean as tears contain a fluid called lysozyme, that is a natural cleanser. A 2011 study found that lysozyme in tears has significant antimicrobial properties.

Improves vision
Basal tears, which are released every time a person blinks, help to keep the eyes moist and prevent mucous membranes from drying out. The lubricating effect of basal tears helps people to see more clearly. When the membranes dry out, vision can become blurry. Crying actually helps with clarity. 

Embolden Psychology

Embolden offers the ADOS-2, the gold standard assessment for kids on the spectrum.

Combined with psychoeducational testing, it helps provide comprehensive information and recommendations to help children and teens six and up.

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