Category Archives: General

Eye Contact and Nonverbal Communication

Human eyes are somewhat distinctive in the animal kingdom in that the sclera is very plainly visible whenever the eye is open. This is not just due to the white color of the human sclera, which many other species share, but also to the fact that the human iris is relatively small and comprises a significantly smaller portion of the exposed eye surface compared to other animals. It is theorized that this adaptation evolved because of our social nature as the eye became a useful communication tool.

The conspicuous sclera of the human eye makes it easier for one individual to infer where another individual is looking, increasing the efficacy of this important form of nonverbal communication. In fact, when I am doing psychological examinations, I comment on eye contact as a behavioral observation. Animal behavior researchers have also found that, in the course of their domestication, dogs have also developed the ability to pick up visual cues from the eyes of humans, making them one of only two species known to seek visual cues from another individual’s eyes. Dogs do not seem to use this form of communication with one another and only look for visual information from the eyes of humans.

Indigenous Americans, youth, and mental health.

Indigenous/tribal communities face significant behavioral health challenges and disparities. For Indigenous Americans, multiple factors influence health outcomes, including historical trauma and a range of social, policy, and economic conditions such as poverty, under-employment, lack of access to health care, lower educational attainment, housing problems, and violence.

These disparities have important consequences. Suicide is the second leading cause of death among Native American youth ages 8 to 24. Also, while there is general awareness that Native Americans experience higher rates of alcohol and substance use, the scope of these behavioral health problems is not fully understood.

With 564 federally recognized American Indian and Alaska Native (AI/AN, is the designation currently used by the Census Bureau) tribes, 100 state recognized tribes, and over 200 languages, there is a great need for the development of mental health programs aimed at AI/ANs that center culture as a dominant aspect of treatment. The deficit in culturally relevant treatment programs aimed at Indigenous Americans people living with mental illness is glaring. These communities cope with intergenerational trauma which has a historical context, occurring when exposure to trauma takes place in an earlier generation and continues to affect subsequent generations. The stress of intergenerational trauma contributes to the erosion of family structure, tribal structure and even spiritual ties. It can affect one’s identity, relationship skills, personal behavior, transmission of traditions and values, and attitudes and beliefs about the future. The stress of these traumas combined with the complex and ongoing mistreatment of AI/AN citizens contributes to the rates of mental illness in AI/AN communities and can manifest in a high rate of substance abuse disorder, PTSD, anxiety and depression.

Additional stressors such as a lack of access to health insurance, pervasive poverty and unemployment, and higher suicide rates exacerbate these issues.

I have compiled this list of resources for indigenous clients. Please note that the hours of availability may have changed, but they are all in service at the present time.

Mental Health Resources For Native And Indigenous Communities:
–  Indigenous Story Studio creates illustrations, posters, videos, and comic books on health and social issues for youth.

–  Suicide prevention.
–  National Alliance on Mental Illness.
–  One Sky Center: The American Indian/Alaska Native National Resource Center for Health, Education, and Research; mission is to improve prevention and treatment of mental health and substance use problems and services among Native people.
–  WeRNative: a comprehensive health resource for Native youth by Native youth, promoting holistic health and positive growth in local communities.
–  Ask Auntie: similar to an advice column – type in your question and it will pull up similar ones; if none answer what you’re asking, Auntie Amanda will write up an answer and notify you when it is posted.
–  StrongHearts Native Helpline: The StrongHearts Native Helpline (1-844-762-8483) is a confidential and anonymous culturally-appropriate domestic violence and dating violence helpline for Native Americans, available every day from 7 a.m. to 10 p.m. CT.

Nine reasons why cross cultural friendships are great for your brain

Nine reasons why cross cultural friendships are great for your brain:
1. MULTICULTURALISM
This is the ability to adapt and mix with people of different cultural background, religions, and races. You get to experience a rich selection of experiences that help create and support mental flexibility.
2. INCREASED KNOWLEDGE BASE
Not only does it promote cultural diversity, but it also increases your knowledge of different cultures. This leads to a much larger foundation of consolidated information: History, geography, theology, cultural traditions, literature, and so much more.
3. DIVERSITY IN LANGUAGES
The award-winning writer, Jhumpa Lahiri, was born in London to Indian parents. Her first language was Bengali, followed by Hindi and English. As an adult, she learned Italian, and wrote an entire book in this language. Creating neural pathways through language is a huge gift to your brain.
4. OPEN-MINDEDNESS
Making friends from different cultures also opens your mind to possibilities and new ideologies, such as seeing different approaches to solving problems. Broadening worldviews feeds frontal lobe functioning.
5. TRAVEL AND EXPOSURE
If for no other reason, the opportunity to travel and see the world should be enough to get you to enjoy cultural diversity. Travel doesn’t just give you insight but gives you the opportunity to have real experiences with different people. Being out of your familiar mental set promotes planning, organization, attention, and metacognition (the ability to think about your own thinking).
6. TOLERANCE
Ethnic and religious tolerance can be promoted by making friends from different cultures. The ability to be a part of someone else’s life and their journey can be a lesson in empathy. Empathy or EQ, has been equated with higher social, career, and interpersonal functioning., see below.
7. EMOTIONAL INTELLIGENCE
Meeting people of the different classes, races and ethnicity teach you to treat people accordingly and respect them individually. Empathy skills require practice, and have a myriad of positive outcomes, such as stronger mental health, positive relationships, and even job success. 
8. INCREDIBLE FOOD
Definitely important is the ability to exercise your taste buds with a wide variety of meals and feed your brain. The deliciousness may be a feast for the senses, but can also create better nutrition habits by learning from people around the world.
9. SELF EXAMINATION.
Diverse friendships encourage a greater ability to reflect on one’s own culture, with an observing eye. The result of this practice is that we go back to our roots. Due to this, we not only draw the positive points about our lives and thereby learn to appreciate them more, but we also think about certain negative practices or drawbacks of our culture that could use improvement. 

How to beat the Monday morning blues

1. Be with loved ones. Set aside some time over the weekend to enjoy your social connections. That could be hanging out with your family, watching a movie with a loved one, going for a walk with a friend, or meeting your bestie for a picnic or brunch. The trick is to do something that is socially oriented, and carving some time in the day to accomplish that. This creates good feelings, that spill over into Monday.

2. Sweat. Even 10 minutes of high interval intensity training will give you the energy you need. You can also go for a hike, or a nice brisk walk. A dose of nature or fresh air is relaxing to body and spirit.

3. Do not sleep in. Sleeping late one day, and having to get up early the next day is very dysregulating to our biorhythms. Sleeping in sounds great, especially on a lazy Sunday morning. Don’t be tempted to sleep in for more than an extra hour, otherwise you will get up feeling rushed and anxious with everything rolling around in your mind about what errands need to be done, on top of family and work obligations. The last thing you want or need is an extra undesirable shot or two of the stress hormone cortisol beyond what is needed to get you truly motivated to accomplish the things you need to do. Getting up at pretty much the same time seven days a week actually helps your body run better.

4. Set intentions for the week. An intention could be any particular phrase or mantra that can help to quite your mind. It can be something like ‘I will have a peaceful day ahead of me,’ ‘ I can get this done,’ or ‘I am grateful for my friends and family’.

5. Meditate. Even for ten minutes every morning before you start your day. Research benefits demonstrate positive changes in the brain even up to 2 to 5 minutes of meditation a day, done on a consistent basis. Learning how to breathe properly can help you feel calmer, center your mind, and maintain a sense of focus.

6. Work. If you must work, aim to set between 1-2 hours over the weekend to organize your emails, respond to only urgent work related matters, and write a list of your work/personal goals for the week ahead with a detailed plan of how you will tackle them. This does not have to be all in one shot. Breaking the time up will be quite easier. Designating some work time will prevent you from feeling more blue, or anxious later on in the day on Sunday, so you can truly relax. That sense of control can be quite powerful, and uplifting.

7. Read. Read something that is not work oriented, preferably before bed, or early in the morning if you are one of the first to wake up in your household. It is a healthy escape to indulge in, and might subconsciously help you relax as an alternative to screen time.

8. Meal prep on Saturday/Sunday. This makes planning your meals throughout the week a lot more manageable, less time consuming and more economical as well. Even something as chopping up many vegetables to be sautéed, or added to any side dish to a weeknight meal will be quite helpful for your meal planning strategies throughout the week.

9. Organize for the week ahead. Finish laundry, do online shopping, pay bills, clean the house. That way those things will not be in the back of your mind as the week starts.

10. Explore. At least once or twice a month, plan something that is out of the ordinary. Getting out of your mental set, going somewhere new, trying new food, hiking somewhere novel, going to an art show. Try activities that you don’t normally do. It recharges the brain.
(Art: G. Benson)

Friends are relatives you make for yourself

Friends are relatives you make for yourself. ― Eustache Deschamps

Famed anthropologist Margaret Mead was once asked, what do consider to be a sign of advanced civilization, over the course of your research? Instead of mentioning development of certain tools or other advances, she described the finding of a fossilized skeleton with a shattered femur that had healed. She reported that it was the type of severe injury such that no one could have made it to the safety and shelter of the cave where it was found, without being carried or dragged by another person. Such injuries were fatal. She defined looking out for the best interest of another person as her definition of advanced civilization.

Today: Friendships seem to be especially helpful for the heart, metaphorically and literally.

According to an increasing body of medical research, close friendships are good for your health. A three-year Swedish study of more than 13,600 men and women found that having few or no close friends increased the risk of having a first-time heart attack by about 50 percent. A two-year study of more than 500 women with suspected coronary artery disease showed similar results. Women who reported the lowest levels of social support were twice as likely to die during the study. The women who enjoyed close support were not only more likely to be alive after two years, they also had lower rates of high blood pressure and diabetes and were less likely to have excessive abdominal fat, which is related to a host of medical problems.

As first reported in the Journal of the National Medical Association in 2009, friendships and other types of social support can help relieve stress, a well-known contributor to heart disease. Among other things, stress can encourage inflammation in arteries, a first step toward atherosclerosis (clogged arteries). Some studies have found that people who enjoy close support from friends and family actually have fewer inflammatory chemicals in their blood. The link between social ties and inflammation seems to be especially marked in older people.

When stress does appear, friends can encourage healthy reactions. People who lack strong social support tend to have highly anxious reactions to scary or worrisome situations. Their hearts pound and their blood pressure may soars. But friends can help keep the heart on a more even keel. A study published in the Annals of Behavioral Medicine found that young men and women discussing rough patches in their lives had a lower pulse and blood pressure when they had a supportive friend at their side.

Literally having a friend next to you is good for your mental and physical health.

Ruth Bader Ginsburg and mental health

She was a champion for the most vulnerable. Thanks to Justice Ginsburg, the 1999 U.S. Supreme Court decision in Olmstead v. L.C. stated that mental illness was a disability and covered under the Americans with Disabilities Act. All governmental agencies, not just the state hospitals, were be required thereafter to make “reasonable accommodations” to move people with mental illness into community-based treatment to end unnecessary institutionalization.

This court decision limited the ability of state facilities to confine people in hospitals against their will by preserving the rights of people with severe mental illness to be treated in the least restrictive settings. In the case, two women with mental disabilities were ordered to remain in a psychiatric facility involuntarily even though some medical professionals believed they could live healthy lives in a community-based program.

Ginsburg wrote:
States are required to place persons with mental disabilities in community settings rather than in institutions when the State’s treatment professionals have determined that community placement is appropriate, the transfer from institutional care to a less restrictive setting is not opposed by the affected individual, and the placement can be reasonably accommodated.

The neuropsychology of binge watching

According to the American Psychological Association, there has been a significant uptick in anxiety disorders over the past five years. There has also been a steady increase in binge watching, including increased rates of subscription to Netflix, Hulu, Amazon Prime streaming, and Disney+. Binge watching and brain functioning go hand-in-hand.

Dopamine high
Watching episode after episode of a show can feel so good. When engaged in an activity that’s enjoyable such as binge watching, your brain produces dopamine. This chemical gives the body a natural, internal reward of pleasure that reinforces continued engagement in that activity. When binge watching your favorite show, your brain is continually producing a cascade of dopamine, over an extended period of time, creating feelings of relaxation and pleasure. Just like any other dopamine high, we want to keep the good feelings going, so we might stay up a little too late.

Memory coding
Our brains code all experiences, fictional, visual, IRL. When we remember storylines of shows, they are actually stored as memories not dissimilar from our own experiences. This way, we can become immersed with characters, plots, and events that occur on the screen. We may identify with characters or themes in our favorite shows. One young client tells me, “it feels like it’s happening to me, but it’s on the show”.

Modeling
Many of our favorite shows may have characters that we admire. These role models or aspirational goals may keep us hooked on who we would like to be. Sometimes, they can motivate our goals; in other instances, they may produce feelings of dissatisfaction or low self-esteem, if we feel we cannot measure up.

Distraction
Distraction is a tool that’s frequently used for stress management, and an anxiety reducing strategy taught by therapists. When we are immersed in binge watching our favorite episodes or shows, we temporarily forget our worries and stressors. Briefly, we can turn off our brains. Clients frequently tell me that they are particularly drawn to binge watching when their mind is full of worrisome thoughts.

Association
Binge watching can also be associated with other pleasurable activities. Many people cuddle with their companion animal or partner, wrap themselves in a blanket, watch from their favorite couch or in bed, text with friends, and eat favorite snacks while watching. Our brains create associations between all of these pleasurable activities, adding to the cascade of dopamine. This creates or enhances neural pathways.

Community
We may have friends and family who enjoy the same shows. Discussing episodes and storylines often creates a sense of connection, communication, and shared experience.

Ease of access
Streaming content can be easily accessed from your phone, tablet, laptop, television, anywhere. Part of the binge worthiness of our favorite shows is not having to drive anywhere to go see them, stand in lines, or deal with crowds, as well as being able to pick up where you left off, anytime. This adds to our relaxation and sense of ease while watching.

Note: According to pre-COVID stats from Netflix, 65% of Americans watch between two and six shows in a single sitting. Hulu reported between three and six shows.
(Photo credit: FFX and Hulu).

Some thoughts for Labor Day on Emotional Labor

Happy Labor Day
Emotional labor is the capacity to assist others in times of emotional difficulty. It’s when somebody in your life says I am having a sh*t day. And your willingness to say, I am here.

I am here. There are three no more powerful words in this world.

Asking for consent for emotional labor, even from people with whom you have a long-standing relationship should be common practice. Just like intimate activity, it’s not OK to text, DM, call, email someone with your stuff, without their consent. I have actually worked out rules of timing with my closest circle as to when it’s OK to call, text, email, and when it’s not. This is crucial.

Ask: May I ask you something. Do you have a moment. When can we talk. Is this a good time for you.

Emotional labor applies when, say, a restaurant server is told by their manager to “put on a smile” to serve a rude customer. As you may know, I teach mental health seminars for the restaurant and bar industry. The customer is not always right. You don’t ever have to be taken advantage of.

Whether it’s a close friend, family member, employee, employer, client, or customer, emotional labor is the work that we choose to do to help someone else. It’s work. Emotionally and psychologically. It requires consent and willingness. It’s a labor of love.

Happy Labor Day y’all.

What is social anxiety disorder?

My patient is sobbing in the office, stating she could not order her meal in a restaurant, and felt tongue-tied. She was on a date, which also took immense courage. Social anxiety disorder (also called social phobia) is a mental health condition. It is an intense, persistent fear of being watched and judged by others. Being embarrassed, or feeling foolish becomes a pervasive fear. This fear can affect work, school, and your other day-to-day activities. It can even make it hard to make and keep friends.

Social anxiety disorder is a common type of anxiety disorder. A person with social anxiety disorder feels symptoms of anxiety or fear in social situations, such as meeting new people, dating, being on a job interview, answering a question in class, or having to talk to a cashier in a store. Doing everyday things in front of people—such as eating or drinking in front of others or using a public restroom—also causes anxiety or fear. The person is afraid that he or she will be humiliated, judged, and rejected.

The fear that people with social anxiety disorder have in social situations is so strong that they feel it is beyond their ability to control. As a result, it sometimes gets in the way of going to work, attending school, or doing everyday things. People with social anxiety disorder may worry about these and other things for weeks before they happen. Sometimes, they end up staying away from places or events where they think they might have to do something that will embarrass them. Avoidance creates comfort, but keeps the person from learning the skills to manage the situation.

Social anxiety disorder is not uncommon; research suggests that about 7 to 10 percent of Americans are affected. Without treatment, social anxiety disorder can last for many years or a lifetime and prevent a person from reaching his or her full potential.

What are the signs and symptoms of social anxiety disorder?
When having to perform in front of or be around others, people with social anxiety disorder tend to:

  • Blush, sweat, tremble, feel a rapid heart rate, or feel their “mind going blank”
  • Feel nauseous or sick to their stomach
  • Show a rigid body posture, make little eye contact, or speak with an overly soft voice
  • Find it scary and difficult to be with other people, especially those they don’t already know, and have a hard time talking to them even though they sometimes wish they could.
  • Be very self-conscious in front of other people and feel embarrassed and awkward
  • Be very afraid that other people will judge them
  • Stay away from places where there are other people

Patients often ask me what causes social anxiety. Social anxiety disorder sometimes runs in families, but no one knows for sure why some family members have it while others don’t. Researchers have found that several parts of the brain are involved in fear and anxiety. Some researchers think that misreading of others’ behavior may play a role in causing or worsening social anxiety. For example, you may think that people are staring or frowning at you when they truly are not. Underdeveloped social skills are another possible contributor to social anxiety. For example, if you have underdeveloped social skills, you may feel discouraged after talking with people and may worry about doing it in the future. By learning more about fear and anxiety in the brain, mental health professionals can treat symptoms and help build strategies. 

Social anxiety disorder is generally treated with psychotherapy (sometimes called “talk” therapy), medication, or both. A type of psychotherapy called cognitive behavioral therapy (CBT) is especially useful for treating social anxiety disorder. CBT teaches you different ways of thinking, behaving, and reacting to situations that help you feel less anxious and fearful. It can also help you learn and practice social skills. CBT delivered in a group format can also be helpful. Don’t give up on treatment too quickly. Both psychotherapy and medication can take some time to work. A healthy lifestyle and self care can also help combat anxiety. Make sure to get enough sleep and exercise, eat a healthy diet, and turn to family and friends who you trust for support.

8 Ways to Support Others During Tough Times

Life is vulnerable; uncertainty is the only certainty. Pema Chodron has written a great book about this, the places that scare you, that I highly recommend. At one time or another, we will all go through a difficult time, whether we deal with financial hardship, health problems, death of a loved one, catastrophe, crisis, or relational breakdown. In psychology, we have a list of psychosocial stressors that include bereavement, breakups, housing problems or transitions, health problems, financial troubles, loss of work identity, and domestic or other abuse. Often people may experience more than one area of hardship simultaneously.

In those times, we need each other more than ever, but it’s not just enough to be surrounded by people. We, as supporters, need to be educated in the best way to love our friends and family through tough times.

How do we reach out to others? In tough times, circling the wagons and looking out for yourself and your immediate family becomes instinctual for many people. However, more than ever, we actually need each other. Often people don’t know what to do. They may even cause great harm by saying do not cry or just get over it.

1. Silence speaks louder than words misspoken.
Don’t ignore them. Plain and simple. If you don’t know what to say, don’t avoid them. Say something. Ninety nine percent of what you could say is better than saying nothing at all. I tell my clients to speak as close to the truth as possible. Which means sharing process. You could say, I don’t know what to say, but I really love you and I just want you to know that.

2. Don’t make them ask you for help.
Do they need help? Absolutely. Do they want to ask? Absolutely not. There is nothing more humbling than having to admit that you don’t have your life under control, and for all the people pleasers out there, asking people for something as simple as meals or free babysitting is something we’d rather avoid. We’d rather tough it out than beg.
Instead, offer your help, and offer specific ways that you would like to help.

3. Don’t rush them through their pain.
Saying things like “I know exactly how you feel” or telling me a story of your cousin’s boyfriend’s aunt’s struggle and how she made it through. While we may say things with good intentions, it can also serve to minimize their issues and urge them to stifle their pain. Yes, what they are going through has probably been faced before. Yes, people do survive. Yes, things might get better. Yes, to all the things. People need to know that the pain they feel is real and they need to move through it. They need to get a little messy and be a little more honest and feel a little more, because if they move through it too quickly or try to avoid their feelings, they might not heal just the right way.

A doctor doesn’t just give a sling with no cast to someone who has severely broken their arm. The doctor gives a cast. The doctor prescribes time for healing, because they know that if the healing is rushed, the bone may also not heal properly. In the same way, we need to give time for others to move through their pain rather than rush them. Instead, sit with them. Listen. Let them be honest when life is hard. Let them be angry. Let them be whatever they need to be, and resist the urge to fix them, heal them, or placate them. Just be with them.

4. Don’t give unsolicited advice.
Even if you have been in the situation before, support, but don’t preach. This includes all cliche and trite phrases and platitudes. You may have heard them said before, but that doesn’t mean they are helpful. Instead, listen, love, give. Give time, energy, resources… give yourself. Just don’t give advice when they haven’t asked.

5. Don’t give them magic formulas.
If they stand on their head, count to 30, twice and backwards, confess everything they have ever done, change their past mistakes, then this tough situation would no longer be happening to them. There is no magic formula. Life is hard and messy and it doesn’t negate the goodness in this world, but it does assign blame and guilt to the situation, one of the last things that someone who is suffering needs is to be shamed. Instead, let them know you are thinking of them, praying for them, loving them, and cheering them on.

6. Don’t make it about yourself.
Essentially, don’t complain about how your friend’s tough time makes you feel. If you are close, you will be affected, but if they are closer to the problem than you, then they are not the person to whom you should vent. Instead, you should offer them support. Check on them. Love them. Let someone else support you to stay on track.

7. Don’t forget the person.
With all of the above tips, don’t just follow them in a rote fashion. The beauty in each of us is that we are unique individuals with different backgrounds, personalities, experiences, and circumstances. Instead, consider the recipient. Some people want hugs. Some people aren’t touchy-feely. Some people want company. Some people prefer to sit alone. Some people want you to do things without asking, some people want you to run it past them first. Some people want someone to cry with and talk to, some people reserve that trust for a select few. Consider who they are before you act, and support them accordingly.

8. There is no timeline for grief and loss.
People may return to a place where loss feels fresh again. It’s not linear. Let people have whatever time they need. There’s no time limits or quotas.

Say a little less. Love a little more.
Life is messy, but with love, we can help each other survive even the toughest times.
#SpiralUp

Embolden Psychology
Embolden

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.

Thank you for contacting us.