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On Loneliness and Valentine’s Weekend

The American Psychological Association recently declared that loneliness is a bigger health epidemic than obesity and smoking combined. Because it doesn’t just impact our emotions, it impacts our health in an extraordinarily negative way. Research shows that people struggling with chronic loneliness have up to a 14% higher chance of experiencing an early death and are more vulnerable to other health conditions.

Our emotional evolution makes us want to avoid pain. Loneliness hurts. Valentine’s weekend is a time when trying to avoid pain can lead to poor decisions and additional hurts from unmet expectations, unhealthy behaviors, and a sense of loss or grief. Most mental health professionals receive an uptick of phone calls from clients on V Day.

Strategies to use when the loneliness feels too much:
Connect with a close friend
The marketing of Valentine’s Day usually refers to a romantic connection, but it can also be viewed as a day to celebrate the “power of relationships of all kinds.” Ask yourself: who would I like to spend some time with today?

Social connection calms our physiology, so when we feel lonely, we are walking around in fight or flight mode, which can put tremendous strain on our hearts and immune system. Even a conversation with a friend over the phone or FaceTime has a calming effect

Be careful how you speak to yourself
Self esteem is like an emotional immune system that protects you from emotional pain and strengthens your emotional resilience. An effective way to increase self-esteem is to practice compassion for yourself. When you hear that inner voice telling you, you’re not worthy of friendship or a loving partner, or that you deserve to be treated without respect, imagine what you would say to a close friend who is feeling bad about themselves. Offer yourself that same encouragement.

Avoid Attaching a Story to Your Loneliness
Loneliness is a strong feeling, but we need to be careful not to attach a story to that emotion. “I am lonely because I am unlovable,” or “ I am not good at relationships,“ are examples of stories that are not accurate, but can become internalized if we repeat them to ourselves.

Engage in healthy distractions
When you’re caught up in negativity and can’t stop replaying painful scenes in your head, interrupt the negative self-talk with a task that requires concentration. Do a challenging crossword puzzle, lose yourself in a complicated recipe, play a video game, watching an engrossing movie, or take an online exercise class. Studies show that even two minutes of distraction can reduce the urge to focus on the negative.

Practice Self-Care
Be kind to yourself in a way that feels comforting. Treat yourself with a warm-scented bath, an uplifting movie, a special treat to eat, or a snuggly blanket. Also see The Tenderness Ritual for ideas.

Look for purpose in loss
Deriving purpose from loss can promote recovery from it. It may be challenging but try to imagine the changes you could make that will help you live a life more aligned with intention, values, and purpose.

Help others
When we volunteer or take time to help others, it helps to build our social connections and to make us healthier and happier. In one study, participants reported greater happiness if they spent money on someone else (as opposed to spending it on themselves). In another study, teenagers who volunteered for community service had lower levels of risk factors for heart disease than those who didn’t volunteer. Colleagues of mine have given out roses and candy at women’s shelters for Valentines, and described having a wonderful experience.

Plan a Zoom Date With Single Friends
If you have single friends, plan a party night for a Zoom date with them. Be sure to keep the evening upbeat. Activities that the group could do might include the following:

  • Play online games as a group
  • Watch a movie together
  • Cook the same meal or prepare the same cocktails together over Zoom

In addition to feeling less lonely, spending some quality time with your friends will keep your social skills strong and will provide you with feelings of love on this day.

Mental health benefits of having a companion animal

Living with a companion animal is certainly good for your mental health, sometimes in surprising ways. A brief survey of recent studies:

– Within five minutes of playing with a pet, our stress hormones, especially cortisol goes down. Our levels of the “feel good” hormones: serotonin, dopamine, and oxytocin go up. Companion animals increase happiness and decrease stress.

– In one study, a group of adult participants who scored high on stress measures, were told to pet a rabbit, a turtle, or a toy.  Touching the toy did not have any effect. However, stroking and playing with a rabbit or turtle reduced stress and anxiety. Interestingly, even people who said they did not like animals experienced the same benefits.

– The sensory act of stroking a pet lowers blood pressure, providing a health benefit in addition to mental health.

– Having a pet supports executive functioning development. Pets require planning, organizing, staying on schedule, prioritizing, immediate recall, sustaining effort, and task completion.

– Studies have shown that dogs can help calm hyperactive or aggressive children. In my own practice, both my dogs work with children with behavior disorders, and I have seen anecdotal evidence for this repeatedly.

– A large study by the CDC, in 2015, found that children who grew up with pets in the household had lower anxiety and stress levels. The study controlled for screen time, medical health, and physical activity. Having a pet is a protective mental health variable for children, extending through the teenage years.

– Individuals with companion animals are more mindful. Feeding, walking, veterinary care, schedules, are all prominent in the daily lives of pet owners.

– Our animals help us feel loved. One recent study asked teenagers to write about a time when they felt excluded or bullied. Then they were asked to do one of three things: write about their pet, write about their best friend, or draw a picture of their house or school. Writing about their pets was AS effective as writing about a close friend in reducing feelings of rejection.

-Companion animals support self care.  From getting up in the morning no matter what, to spending time outside in nature, to physical activity and exercise, to reminders of self-care: our animals require these things, and bring us along with them.

– Pets help people with chronic mental illness. A meta-analysis, which is also known as a synopsis of multiple studies, found significant evidence that having a pet benefits people with severe mental health conditions. One study was conducted at the University of Manchester in 2016 with patients who had been diagnosed with schizophrenia, bipolar disorder, and severe depression. 60% of the participants identified their pet as one of their strongest support systems. They reported that their animals distracted them from severe symptoms like suicidal thoughts, hallucinations, and ruminative worry.

The Mental Health Benefits of Random Acts of Kindness

I was recently interviewed for a popular mental health and wellness website about Random Acts of Kindness, and some of the psychological science behind them. Neuropsychological research shows that the act of giving appears to be as pleasurable as the act of receiving, if not more so. A brain-imaging study led by neuroscientists at the National Institutes of Health showed that the “pleasure centers” in the brain are fully activated when we engage in random acts of kindness (the parts of the brain that are also active when we experience other pleasures, including eating, hugging, and intimacy). Neurotransmitters- oxytocin, serotonin, and endorphins, are all released when we engage in random acts of kindness.

One of the interview questions asked me about creative ways people can show random acts of kindness in a time where they are more needed than ever, but also a time when people have financial and social limitations.

Some of my ideas:
Try babysitting for a parent who works from home, while their children are engaged in virtual learning. Being able to help the child, maybe making a snack, or even serve lunch can be tremendously helpful to a parent torn between meetings and childcare.

I work with some families who have very limited resources, and are attempting virtual learning using cell phones. If you have tech skills, helping families who lack reliable Wi-Fi or computer access set up their virtual learning, and answering questions about possible glitches and problems they may be experiencing can be tremendously helpful.

Befriending a senior who is stuck at home and becoming a phone pal on a weekly basis.

Set a socially distanced movie date every week with a friend or family member who may be lonely or isolated.

Help those who help others. A local restaurant owned by a friend in the DC area, literally serves 100s of delicious meals, delivered, to front line healthcare workers every week. Several patrons who come to the restaurant to buy food for their families have added very generous tips to their bill to help fund this pro bono meal service. Acts of kindness are contagious.

Community food service. A group of neighbors have started making trays of lasagna on weekends and delivering them to housebound folks in their neighborhood who have financial hardship or health issues that make it difficult to leave the home.

Practical donations. From coat and mitten drives in the cold winter months, to toiletries, thoughtful gestures matter. In my clinic, donated designer purses were stuffed with toiletries for women and were much appreciated by clients experiencing hardship.

Using your own personal talent online: random acts of kindness may include hosting a free art lesson, yoga class, writing class, tutoring, even stand up comedy. Many families have lost after school services and recreational opportunities and this can go a long way.


  • Plan a special surprise you would do for someone special in your life.
  • Hold the door for a stranger.
  • Send a hello email or text to a family member or friend you hardly ever see.
  • Give a compliment to someone every day.
  • Make a handmade card, or write a hand written letter.
  • Smile at everyone.
  • Say “I love you” to everyone you love.
  • Do a chore or errand for someone who needs help.
  • What are some other ideas? … please share in comments.
  • More to come.

What is narcissistic personality disorder?

I am frequently asked about narcissism, especially by clients who are living or working with a narcissist. Narcissistic Personality Disorder takes its name from a story in Greek mythology. Narcissus was a hunter who was the son of a god, and was very good looking. His good looks meant that many people fell in love with him, but he treated those people with contempt. This caused anguish for many who loved him. In order to exact justice on Narcissus, a goddess by the name of Nemesis lead Narcissus to a pool. On looking into the pool, Narcissus saw his own reflection and immediately fell in love with it. So fixated was he by his reflection that he was unable to leave it, and eventually wilted away.

What is the difference between narcissism and narcissistic personality disorder?
Narcissistic personality disorder (NPD) is a mental disorder in which people have an inflated sense of their own importance and a deep need for admiration. Those with narcissistic personality disorder believe that they’re superior to others and have little regard for other people’s feelings. But behind this mask of ultra-confidence lies a fragile self-esteem, vulnerable to the slightest criticism. They easily feel a deep sense of shame and humiliation and low self-esteem. This used to be known as a “narcissistic injury. “

These are people who do not function well. They alienate friends and family and often end up feeling socially isolated and depressed. This is very difficult for them because they do not want to think anything is wrong. Individuals with Narcissistic Personality Disorder are caught between thinking they are superior and feeling miserable, all at the same time.

There are also people who are narcissistic but who do not have a mental illness. They often feel superior to others and see nothing wrong with that. They have little or no empathy with the feelings, conditions, situations or plight of others. They also have no difficult exploiting others in order to get what they want. Importantly, they do not feel like they have a problem and do not experience the shame and pain of an individual with NPD.

What are narcissistic characteristics?
Lacking Empathy
The vast majority of us are able to understand how others are feeling. We will offer comfort or sympathy if others are sad. For the narcissist, though, empathy is alien. Even if you are having a terrible day, the narcissist is unlikely to sympathise, they may not even understand why you are sad at all.

The narcissist is also unlikely to feel bad about any of their own actions that may have caused upset to other people. Instead, they will continue as normal as though nothing has happened.

Lack of Reciprocal Communication or Conversation
Narcissists often want to dominate the conversation, and they value their own opinion above others. The narcissist does not like to be corrected in a conversation. They expect you to agree with them all the time, and they don’t like any suggestion of disagreement. Don’t agree with what they are saying and you can expect to be rebuked, corrected and even ignored.

Narcissists tend to feel as though they deserve special treatment. They expect others to treat them as if they are special, but see no reason why they should do the same in return. “My way or the highway,” could be their mantra.

Image Projection
The narcissist feels it is important to always give others the impression that they are highly successful. They feel the need to be seen in expensive cars and will often only consider living in the ‘right neighborhood’. Their clothes have to be brand name designs, they have to go to the best restaurants, and they have to let people know about it. They also try to surround themselves with others who appear successful, in order to enhance their own image.

Rule Breaking
Narcissists tend to think that they are above ‘normal’ people and this includes the rules that others are expected to adhere to.

A narcissist will have little problem in manipulating others’ thoughts and emotions to suit their needs, even people that are close to them. Spouses, siblings, parents and even children can be manipulated for self-serving gains.

When everything is going well, the narcissist is more than happy to take the plaudits. But they will look to blame what they can, or who they can, when things are not going well. This includes colleagues, family, and friends.

Narcissistic Personality Disorder Diagnosis
Clinical psychologists diagnose NPD when you have at least five of the following characteristics:

  • Overinflated sense of self-importance.
  • Constant thoughts about being more successful, powerful, smart, loved or attractive than others.
  • Feelings of superiority and desire to only associate with high-status people.
  • Need for excessive admiration.
  • Sense of entitlement.
  • Willingness to take advantage of others to achieve goals.
  • Lack of understanding and consideration for other people’s feelings and needs.
  • Arrogant or snobby behaviors and attitudes.

The exact cause of narcissistic personality disorder (NPD) is unknown. It is probably a mixture of genes, early childhood experiences, and life long psychological factors.

Early childhood risk factors include:

  • insensitive parenting
  • over-praising and excessive pampering – when parents focus intensely on a particular talent or the physical appearance of their child as a result of their own self-esteem issues
  • unpredictable or negligent care
  • excessive criticism
  • abuse
  • trauma
  • extremely high expectations

NPD can be treated in psychotherapy. Usually what brings individuals to treatment is estrangement from family, friends, or colleagues. They feel alone. Similarly, they may come for therapy when their partner or family makes it an ultimatum, or when they are experiencing significant difficulties in the workplace.

Friendships are good for your mental (and physical) health

In neuropsychology, co-regulation is when you are in a close relationship, friendship or intimate, where your nervous systems actually attune to each other in ways that are soothing. Research shows that it has the effect of reducing anxiety and depression.

Co-regulation is usually applied in the context of overall emotion/affect. That The emotions of each individual within a dyad are constantly in flux. If emotion co-regulation is in effect, the result will be a decrease in overall emotional distress. A working definition of emotion co-regulation has been offered as “a bidirectional linkage of oscillating emotional channels during interactions between two people, which contributes to emotional stability for both.”

Although most of the co-regulation literature is based on parent and child relationships, there is an emerging body of research on adult relationships. Primarily, co-regulation in adult relationships is defined by reciprocity between two individuals, such that the responsibility to regulate the other is more or less equally split. Of course, the split may not be constant, but the fluctuation evens out over time. Second, research on adult co-regulation is more likely to incorporate physiological measures. For example, there is an increase in oxytocin, which is the bonding and comfort hormone, there is a decrease in cortisol, the stress hormone. Most importantly,  co-regulation in caring adult relationships increases vagal tone.

The vagus nerve is one of the 12 pairs of cranial nerves within the sensory-somatic nervous system. The 10th cranial nerves called vagus are the main nerves of the parasympathetic nervous system originating at the brainstem in the medulla oblongata. They travel from behind your ears, down the sides of your neck, across the chest, and down through the abdomen. People who have low vagal tone often clench their jaw, have muscle aches and pains, and gastrointestinal distress.

This nerve is the sensory network that tells the brain what’s going on in our organs, most specially the digestive tract (stomach and intestines), lungs and heart, spleen, liver and kidneys, not to mention a range of other nerves that are involved in everything from talking to eye contact to facial expressions and even your ability to tune in to other people’s voices. It is made of thousands upon thousands of fibers, operating far below the level of our conscious mind. It plays a vital role in sustaining overall wellness. It is an essential part of the parasympathetic nervous system, which is responsible for calming organs after the stressed “fight-or-flight” adrenaline response to danger. People with higher vagal tone are able to soothe themselves more easily in situations of stress.

Love, laugh, hug. This seems a little “kumbaya” but if you hang out with people who fill you up with love, laughter, and kindness, it’s actually good for your mental and medical health.

Relationships matter.

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.

On the Psychology of Superheroes

Mr. Boseman embodied the idea that anyone can be a superhero, if they choose. He played King T’Challa, a superhero and leader of Wakanda, in the film Black Panther – which was praised as a cultural milestone for having a primarily black cast and portraying women as more than equal warriors, rulers, leaders, and scientists.

His character was seen as an inspiration for young black people in particular – as Black Panther was the first high-profile black Marvel superhero, and Wakanda was a strong and thriving country with the most advanced technology on Earth. Dozens of young clients I have worked with spoke of Black Panther as a very important influence in their life. Many a time, children came into my clinic wearing a black panther mask.

As tributes pour in for Boseman, who died of cancer at age 43, many are remembering the impact that his character had on them, and their families. In addition to the Black Panther, Mr. Boseman portrayed Jackie Robinson, Justice Thurgood Marshall, and legendary singer, James Brown. He had an exceptional range. Yesterday, we learned that he was a superhero in his personal life, who had been battling a virulent form of cancer, and was quietly and diligently working on his craft and movies between treatments for over four years.

In 1977, psychologist Albert Bandura developed the theory of social learning, proposing the idea that learning occurs within a social context through both observation and direct instruction. Developmental psychologists have stated that social learning theory has applications for the way in which children develop an understanding of morals and empathy. Most famously, Bandura tested his theory using the Bobo Doll experiment, in which adults modeled violent behavior towards a doll and were then punished, rewarded or provided no consequence. Children were then observed to determine if they would replicate the behavior that they observed. At a high level of significance, they modeled the behavior they saw.

It is quite common for superheroes to be presented with the option of whether to fight or not to fight – to use their moral compass, so to speak, before making big decisions. Importantly, these moral dilemmas occur so frequently within comics they give children the opportunity to observe how their favorite role model problem-solves through ethically laden situations. Super heroes ARE role models and facilitate learning. The regal presence and grace of King T’Challa has left an impact on an entire generation of children. And adults.

Now a proud provider for the Sukhi Project

Embolden Psychology is now an official provider for the Sukhi Network in the Washington metropolitan area, and by teletherapy for the country.

A bit about the The Sukhi Project:

Asian and Asian American communities are more at risk for anxiety and depression.  Stigma, culture, and a lack of access to culturally competent providers have exacerbated the issue and lead to low utilization rates of wellness services.

Sukhi is dedicated to reducing the stigma surrounding mental distress while increasing access to support services. Their network links together many resources for the Asian and Asian American communities where mental health may have been marginalized.

And now I have the privilege of being of part of this important project.






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.

Thank you for contacting us.