Thoughts / supporting someone with a mental illness

What the doctor might not mention ...

I fought against taking medications for mental illness for a long time and now I have been contentedly taking them every morning for a long time.

I had resisted them because I was a big believer in psychology. And the ability of cognitive techniques to get me through. I also felt there was something genuine and authentic about my strong emotions, even if they were tortured and despairing. I had always identified as someone who “thought too much” and approached the world very critically, so something about this sustained sadness felt very much like me.

I did wonder – and I still do – if by going on medication, I’d be denying a part of my true self. I thought that perhaps bouts of paralysing depression and anxiety were just part of the human condition, and something didn’t feel right about ‘curing’ it with medication.

But part of the human condition is also about having some sort of desire to keep living. And that’s what I got back when I went down the antidepressant path. My sleeping patterns changed and my motivation wakened. I got a bit of my spark back.

There’s a lot of misconceptions about antidepressants out there. And I held some of them.  Here’s some of the things that a doctor might not let you know.

The beginning part is really pretty shit.

Chances are, you’ll probably feel a lot worse initially.

I have been fortunate enough to have been in a hospital each time I have started on a new medication. Otherwise, I just don’t know if I would have had the patience to stick with it.

The initial period felt like I wasn’t even a part of the world – electric currents surging through the body, pounding headaches, nausea, crippling anxiety, dizziness and light headedness, total exhaustion. Not the most pleasant experience.

Depending on the type of antidepressant, it can take anywhere between two and eight weeks to feel the effects. Immediate results are not key here. Some medications, like Venlafaxine, can induce some bizarre sensations, like brain zaps or muscle spasms. You might experience nausea or headaches, so most medical professionals advise that you don't go on them during a period where you really can't afford to take time off.

The other key thing to note is that often with these medications they will start to relieve the physical symptoms of the psychological disorder before the mental or emotional symptoms. As such, we might start to begin to feel more motivated and energetic, but still be experiencing very negative self-talk, feelings of hopelessness and a depressed mood. This combination of factors can increase our suicide risk during the initial phase.

Trial and error is common.

And once you start one medication, you might find out that antidepressant is not the right one for you. And the process needs to start again.

I’ve been really lucky with the medications I’ve tried, but I think I’m an outlier.

There is still so much that we don’t know about mood disorders. Sure, we’re learning more about it every day, but as of right now, we don't have it down so well that we can hear a list of symptoms, prescribe the appropriate medication, and then let the drugs do CPR on our broken rainbow generators.

Certain types of depression require specific types of medication. Couple that with the fact that each person reacts to those chemicals differently, and you basically have to set up a dartboard, prescribe whatever you hit, and see what happens.

I’ve known people who have had to go through months and years of trial and error of medication games trying to find something that might “work”. It’s horrendous. The real trouble starts when the person gets frustrated, not understanding exactly how long it takes for these things to show any sign of working. Couple that with it taking up to six weeks to even know whether or not a medication will work or not. For some, this can be an enormous process that takes massive amounts of time and dedication, and often the person will feel much worse before they feel better.

The side-effects can range from harmless to hellish.

Antidepressants are pretty serious brain drugs. They can also have some pretty serious side effects.

Side effects generally depend on the type of antidepressant and the individual, but common side effects include weight gain or appetite changes and reduced sexual desire.

Most people are aware that antidepressants and anti-anxiety medication can cause impotence in men, but it can also have a severe effect on women's sex drive. Many people on this kind of medication have difficulty achieving orgasm, some only for a few months, and others for as long as they’re on it. I can’t personally comment on this, as I am gloriously single.

The most notable side effects I experience are drowsiness, increased night sweating and blunted emotions.

I’ve always loved to sleep, but now I seem to be somewhat affected by what Dr Matt calls the “Zoloft doze”. The afternoon nap, which is not really a nap, but a solid and very deep sleep and which doesn’t impact my ability to catch the zzz’s at night time.

Because of the drug's effect on REM sleep, there are numerous studies to suggest that they worsen the quality of sleep in depressed patients. Some are activating, while others are sedating, so it's important to know the right match for you. Currently, I could sleep for 12 hours and wake up and hit the snooze button. This is pretty common for individuals using SSRIs and SNRIs.

I sweat more during my sleep. Bit gross, but apparently normal. Up to 22 per cent of patients report excessive sweating after taking antidepressants. Many also encounter intense night sweating.

And my emotions are blunted. My highs aren’t as high as they were. And I don’t cry in Love Actually anymore. Or at funerals.

Withdrawing from them may be atrocious.

Antidepressants are not addictive medications – you don't get cravings for them or need to keep increasing the dose to get the same effect.

However, all psychiatric drugs change your brain and body chemistry, and if you have been taking them for a while, your body will have adjusted to them. This means that you may experience withdrawal symptoms when you stop taking them – especially if you've been taking them for a long time. Withdrawal or discontinuation syndromes from these medications, is something that has only been acknowledged as thing by the pharmaceutical companies in the past ten years or so.

For this reason, it's always advisable to reduce the dose slowly instead of just stopping taking them.

I always knew this, but one time I skipped a couple of doses. I think it was a public holiday and I couldn’t really be bothered finding the after-hours chemist and I thought a couple of days wouldn’t be noticeable. I was wrong.

Pretty quickly I had a runny nose and headache. I was dizzy and had trouble standing up straight and walking. And the ‘brain zaps’ – sort of like electric currents going through my brain – were unpredictable and just weird. Sleep was impossible. Disorientating, weird and awful.

Never again.

Some medications are renowned for causing particularly bad withdrawals, and others have barely any. It also depends on the person.

Your days of taking party drugs may be over. Or you will be.

I am sometimes gobsmacked that psychiatrists and doctors don’t make this clearer. Working in the drug and alcohol services, it never ceases to surprise me the number of people who I see who prescribed SSRIs and are also known to take party regularly, yet have no idea that this combination is potentially fatal.

Because SSRIs block or inhibit the reabsorption of serotonin back into the neurotransmitter it means that there is quite a bit of serotonin swimming around in the brain. This helps lift the cloud of depression. However, some licit and illicit drugs (e.g., MDMA, ecstasy, speed, methamphetamine) also act on the serotonin pathways in the brain causing even bigger amounts of serotonin to be swimming around in the brain. And it’s got nowhere to go – because the SSRI is blocking it’s path.

And here’s the thing, too much serotonin – serotonin toxicity – can be fatal.

They’re not a cure.

Unlike other things we might see doctors for – rashes, broken arms, infections – the prescriptions they give us for our brain, are not on their own enough. Relying solely on pills to treat or manage a mood disorder is usually a massive disappointment; although they do help relieve some of the anxiety and stress caused by depression, they don't address the underlying mental issues. They just help with some of the symptoms.

All the research shows, that psychological treatment (therapy of some sort) is needed in conjunction with the medication for some sort of effect to occur. There are often things outside the realm of a physical chemical imbalance that need to be addressed. Work is too stressful. You're intimidated by large crowds. You have nightmares about geese with guns. Those things need to be talked out and confronted. Pills can't do that for you.

There is stigma around taking them.

And despite these medications being not all that easy to take, they still come with a bit of stigma within the community – Aren’t you just treating the symptoms and not the cause? Have you tried natural remedies? How do you know what you’re like now without them?

The truth is, I don’t know the answer to these questions. And psychiatry hasn’t really figured out how anxiety and depression works. Or how antidepressant medications work. But like most things, my use of medication, is a personal choice that suits me really well right now, despite the allowances I make.

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When life goes doesn't go to plan

My dearest friend,

Doesn’t life throw us some curve balls? Sometimes these unexpected things are perfectly delightful – like finding an unused $20 note in a winter jacket – and some are just a mild inconvenience – like missing a flight or getting a flat tyre. Some have a bit more too them.

We may not think of it in quite such naive terms, but we usually start out – somewhere in the semi-conscious mind – with a script of how our lives might go. We’ll get some schooling and education, there will be some friendships and some moments of self-discovery, first loves and riotous fun.  We’ll then have some sort of career – maybe one that pays, but not merely done for money. Hopefully (this is dream land, remember) we’ll be competent, respectable and fairly honoured for the intensity of our efforts. At the same time we will develop a central relationship, maybe a marriage. A union that will last forever, be mutually satisfying and come with sincere friendship. There’ll be kids too, offering us a chance to nurture a grateful, adorable small person, the best of its two parents, whom we will watch grow into an admirable, motivated adult. With the current advances in science, we will go on to lead an active and pain-free life, mentally and physically healthy, into our early eighties. Our parents will themselves have died at an advanced age and when the time comes for us, the end will be swift and painless. Easy.

But life hasn’t got the script in your case. Or most cases. You’ve found yourself with an unexpected event with lifelong consequences. That doesn’t quite fit into the script that we’ve been handed by the advanced, secular, consumer society we live in.

I’m so super proud of how you have handled such an off-script and surprise event.

Research shows us that negative emotions, like fear and anger and frustration can actually cause our brain’s executive network (responsible for problem solving and higher order thinking) to constrict and work less effectively. But on the other hand, positive emotions help your brain generate more creative solutions to problems.

Sure, some negative emotions arose in relation to this unexpected event. But you didn’t react based just on these. And that’s way important. There’s a world of difference between a reaction and a response.

A reaction comes from an automatic part of the brain. Almost life a reflex. Reactions are very quick, especially if we feel threatened in some way. On the other hand, a response is something we consciously choose to do based on a more thoughtful assessment of a situation. For example, when someone cuts us off in traffic our automatic reaction can be to get angry and assume the driver is deliberately rude, thoughtless and incompetent. But by pausing and taking time to think, we give ourselves a window of opportunity to pick a better option. We might decide that retaliating is not in your best interest or we may realise that the driver wasn’t deliberately trying to be disrespectful, but was simply not paying attention.

You did a great job of pausing. You restrained a reaction long enough to ensure that you chose the best response for you given the situation. This takes wisdom. And self-knowledge. And grace.

And you didn’t judge this unexpected event.

For most of the things that happen to us, there's generally no way of knowing whether they will be a ‘bad’ thing or a ‘good’ thing—and which one an event turns out to be often has a lot to do with how we respond. If an intimate relationship ends and our response is to blame our self, become despondent, and never leave the house, we will increase the likelihood of not finding another relationship. However, if we accept that, for whatever reason, it was not the right relationship for us, maintain a positive attitude, believe that a better relationship is coming our way, and then get involved in fun activities, we significantly increase the likelihood of finding another great partner, possibly one who is an even better match.

You were able to see that this unexpected situation could have the potential to open other doors. We never know what will come of a situation, so rather than assuming a situation is bad, which only generates lots of unhelpful, negative emotions, you kept saying, "We shall see." You were looking ahead with hope.

And you’ve been planning since for everything to turn out well.

A lot of people don’t do this. Myself included. Many people hope for the best, but plan for the worst. The problem with this strategy is that we act on our expectations, yet our actions create our experiences. If we want a good outcome, we have to be plan for one because that is what leads to the actions that create good experiences.

An unexpected event is one you didn’t plan for, but you’ve shown that that doesn’t mean you can’t plan to create the best possible outcome from the situation. We all have the ability to shift our attention from an unexpected event that seems like a big problem and focus instead on finding the solution. The minute we ask what we can do to make something better, we have taken the first step in planning for events to go well.

It’s time now to trust in your ability that it will all be okay.

You’ve been through difficult things in life already. There’s been loads of challenges. And to date, you have survived them all. You’re strong. You’ve got the power to handle this. Trust yourself.

Because the truth is that the script we’ve been sold is not the truth. I haven’t come across anyone yet who gets through their allotted span without at least one (or five) major off-script event. Something, somewhere, will go catastrophically wrong. Not potentially, or incidentally, but necessarily. Because of our humanness.

We cannot know what it will be exactly; what is certain is that it will be something; an event committedly disastrous in nature that will stop us in our tracks, make us question every resilient assumption and break our hearts. The only thing we can do, is be aware that that the script was a bit of a false hold. The unexpected stuff is what makes us know we are human.  

Love me. xoxo

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The toughest gig going

I’m not a parent. But I spend quite a lot of time with people who are. My own, mostly. And being a parent has got to be – hands down – the hardest job in the world.  

Firstly, there is the way in which parenthood is sold to us all.

In general, society promotes deep enthusiasm about parenthood. The act of bringing a new person into the world as a cause of unalloyed joy and celebration. There is a lot of concentration on the high points, with the troubles acutely edited. In general, the script is that parents should accept with no guilt and good grace that, of course, being a parent is wonderful and difficult; rewarding and depleting; exciting and, at times, a bit tiring.

The problem is, that the evidence doesn't really back up this preconceived picture. Using data sets from Europe and America, numerous scholars have found some evidence that, on aggregate, parents often report statistically significantly lower levels of happiness (Alesina et al., 2004), life satisfaction (Di Tella et al., 2003), marital satisfaction (Twenge et al., 2003), and mental well-being (Clark & Oswald, 2002) compared with non-parents.

Regardless of whether we love being a parent or not, for some of us, society’s well-intentioned enthusiasm for parenthood can have unintended habit of triggering a very difficult consequence: it might become extremely hard to admit publicly to having problems around our new families. It might feel like a grave and serious failing of our own, a mark of a particularly deficient nature. We might feel unbearably guilty at certain thoughts we may have in the privacy of our hearts: that we’d rather not see our family for a few days; that we look very wistfully at the time before we had children; that we suspect we’re not naturally cut out to be a parent; that at certain points we resent our own child. Despite these feelings probably being particularly common.

Donald Winnicott, a mid-20th century psychologist who worked with parents and children, was particularly concerned by how many parents he observed in his consulting rooms who reported they were deeply disappointed with themselves. They reported feeling they were failing as parents and hated themselves deeply as a result. They stated they were ashamed of their occasional fights with their partners, their irritability, their times of boredom around their own child; their many mistakes; they were haunted by a range of anxious questions: are we too strict, too lenient, too protective, not protective enough? What struck Winnicott, however, was that these people were almost always not at all bad parents. They were not, by some fantasy ideal standard, perfect: but they were – as he came to put it, rather wonderfully – ‘good enough.’

And here’s the thing – good enough here is even better than perfect! Because EVERY SINGLE CHILD  will live the rest of their life in a very imperfect world. We cannot get on if we are dependent on those around us living up to the highest imaginable ideals. The good enough parent is at times irate, stupid, a bit unfair, a bit tired or a touch depressed. There will be delays, confusions, mistakes, outbursts of irritation – and always (or almost always, which is enough) a background of deep love and good intentions. The good enough parent is the perfect parent for the times half a century ago. And now.

And to add further complexity to the job of parenthood, there’s the component of just running the household with other people. The success of which pretty much determines more of our satisfaction from day-to-day than any other part of our lives.

Domestic life, properly understood, is the neglected locus of some of the most profound and noble challenges open to any of us.

The Romantic view of love forgets about this part of the love story. It is fascinated by, and deeply sympathetic to, the troubles and confusions surrounding the search for a life partner. It is deeply disturbing then, from the Romantic point of view, to find that a loving couple (people who are truly ‘right’ for one another, who overcame conflict and prejudice to be together) are liable to wind up spending a great deal of their lives – after they have finally found one another – bickering: over the TV remote control, the state of the kitchen work surfaces, whose turn it is for the nappy change  and who is meant to sweep the floor and when. Standard love stories rarely take us into these challenges. But these are the real challenges of love. And of life.

Because we don’t ever see these things as ‘challenges’ or haven’t formulated household labour as ‘real work’, we don’t ever really accept that household management and division are going to be hard and important. So, when it comes to looking at the buttload of domestic activities that exponentially pile up once children are involved– doing the laundry, keeping the fridge stocked, cleaning up after meals, making the beds, arranging a roster for picking up the kids, deciding what friends to see and when – these are things that we think should just happen in the background of real life. They never demand much thought. They are mere chores. No one could be meant to do them. It is simply a matter of everyone taking a fair turn at a boring, banal but sadly unavoidable drudgery.

And when we expect something to be easy and it turns out not to be, there’s a particular kind of struggle and bad mood that follows. Arguing about who should take out the rubbish, or whether to keep the bedroom window slightly open at night take on a distinctively painful form. Not only are we seriously angry, we can’t take our anger seriously. We fall into that pattern of behaviour typical when a problem hasn’t faced up to its own complexity. There might be nagging. There might be some passive avoidance. Or sulking. There might even be some door slamming. All of these are just symptoms of deeply serious issues that have fatally insisted on their own simplicity.

The true reality is that, this stuff is the hard stuff. The challenges of who gets up out of bed to turn the light off (and all other financial and practical responsibilities of sharing domestic life) is a sign that this is tough gig. Probably the toughest there is. Conflict in these areas is the logical consequence of the difficult tasks we have been accorded. If we admit that sharing a space and a life with other people is very difficult, we come to conflicts with a very different attitude. And it means that we’re doing it right.

Lastly, there’s reading all the ranting about parenthood available for parents on the Internet. By people who aren’t even parents. Exhibit A.  It has got to be the toughest job around.

 

This week is Perinatal Depression and Anxiety Awareness Week. We will be helping to spread some awareness to help you become PNDA Aware. You can also check out the PANDA website for more info.

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How charitable are we really?

It seems that we are all a bit impressed by the idea of charity. But often from a distance. Without looking at the idea too deeply.

We might watch something on the tele that moves us and makes us think a little bit more about someone else’s circumstances. Or we might put our loose change in one of the many buckets that litter the streets and supermarkets. But how many of us actually practice charity systematically?

Take me for example. The organisation I work for is a charity. I volunteer on Saturdays for a charity. My side project/business makes donations out of its profits to a charity. Do I practice charity regularly? I wish I did. I’d be a way nicer person.

At its most basic, charity means – giving someone something they need but can’t get for themselves. Normally that something is understood to be something material. We overwhelmingly associate charity with giving money.

At its core, charity goes well beyond the financial. But let’s begin there.

It’s quite lucky really that charity is more than just emptying our pockets, because unfortunately our higher income earners are much less financially charitable than the lower income earners. It's not news anymore, but it's still a surprise to more: the poor are more generous than the rich. For decades, surveys have shown that upper-income Americans ... are particularly undistinguished as givers when compared with the poor.... lower-income Americans give proportionally more of their incomes to charity than do upper-income Americans. (See, "The Charitable-Giving Divide" in Sunday's New York Times Magazine.)

Turns out its quite difficult for us to be financially charitable. Firstly, we are more willing to help a single individual than many.

Take this experiment -  one group was given general information about the need for donations, including statements like "Food shortages in Malawi are affecting more than 3 million children." A second group was shown the photo of a 7-year-old Malian girl named Rokia, and told that she is desperately poor, and that "her life will be changed for the better by your gift." People in the second group gave more. A lot more.

‘Futility thinking’ also plays a role. Giving money to help the ‘poor ‘is, we say, just drops in the ocean. We focus on those we cannot save rather than on those we can. People will give more to save 80 percent of 100 lives at risk than they will to save 20 percent of 1,000 lives at risk—in other words, more to save 80 lives rather than to save 200 lives.

We could easily make some subtle to overcome some of our psychological barriers to giving. Just as the psychological ‘bystander effect’ makes us less likely to help when others are around, knowing that others are giving makes us more likely to give. The more people talk about what they give, the more we can expect others to give or even pledge it online (for example, check the work at thelifeyoucansave.com).

Financial charity it tends to flow in one direction. The philanthropist may be very generous but they are habitually the giver rather than the recipient.

But in life as a whole, and especially in relationships, charity is unlikely ever to end up being one-sided: who is weak and who is powerful changes rapidly and frequently. You are likely to be, as it were, a patron in one area and a beggar in another.

Charity is much more than just about money. It’s more about recognising that a person needs help with something that they can’t do for themselves – and that their helplessness is not a sign of anything other than a part of the human condition.  We freely give because we appreciate how often we wouldn’t have made it if other people had not – at key points, in different contexts – cut us some slack.

It is in our relationships with others that charity can have the biggest impact. Here we don’t generally require the charity of money, clothing and free meals. What we can be short of is charity of interpretation: that is, a charitable perspective on our weaknesses, eccentricities, anxieties and follies – failings that we are unable to explain or win sympathy for, that we merely act out, with vulnerability and hurt.

It might be that our partner has made a big boo boo in their professional life. They made a significant decision at work that played out pretty badly. They may have been severely criticised; there was even talk of legal action. For months, they have been extremely agitated, and hard to live with. They couldn’t articulate their fears. They were sulky and annoying. They might have had to have stern meetings and altercations with senior management, clients and maybe even people on Twitter.

As their partner, we could make the conclusion that our partner is a bit inept, greedy and maybe even unprincipled. But, the charitable soul would do the work that their partner has not been able to do. They do the explaining for them. They understand enough about their past to have a picture of where their impatience and over-ambition came from. They hold in mind what happened with their parents and with the move to another country and with the brother who died too young. They lend a picture of who the ‘human’ is that is sufficiently generous and complex as to make them more than just the ‘fool’ or ‘weirdo’  they could so easily have been dismissed as.

The genuinely charitable person gives generously from a sense that they too stand in need of charity. Not right now, not over this, but in some other area. They know that self-righteousness is merely the result of a faulty memory, an inability to hold in mind – at moments when one is totally right – how often one has been deeply and definitively in the wrong.

This is the hardest form of charity, I reckon. So much more challenging than emptying our pockets. A much more gruelling and systematic task. To continually be generous and kind to each other in the spirit of humanness.

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Did you hear about ...?

Us humans talk an awful lot. We are the only species on the planet that exchanges information predominantly through speech. Some of our friends, like the dolphins or the primates, have their own languages, but they don’t rely on verbal communication like we do. Almost to the exclusion of other channels like us humans do.

And what is it we’re talking about. According to the research, most of us are just mostly talking about other people. In fact, a whopping two-thirds of our conversation consists of gossip. Of course, we discuss other incredibly important things like the meaning of life, world events, the performance of the Wallabies on the weekend and how funny Gogglebox was last week, but overwhelmingly it appears we talk about the affairs of others.

Before some of you take the moral high ground and plead that you are way too intelligent, sensible and way too compassionate for gossip, it might be worthwhile thinking a bit further on the topic.

The term “gossip” tends to have a negative connotation. It can be defined as ‘casual or unconstrained conversation or reports about other people, typically involving details which are not confirmed as true’.

Unsurprisingly, we do not like when they find that they are being gossiped about, and as such there is a moral stigma attached to the people who are gossiping too much. However, more often than not, the gossips are not entirely negative — they tend to be a mixture of both positive and negative things. We provide other people with our assessment of another person’s reputation as we see it, typically involving both the person’s strengths and weaknesses, and with only limited evidence to substantiate either. These assessments might still be viewed unfavourably by the subjects of gossips, even when the assessment is predominantly positive. Nonetheless, we accept positive assessments with pleasure, but tend to be annoyed by criticism.

And how many of us can actually walk away from a juicy story about one of our acquaintances and keep it to ourselves? It’s so very tough! Surely, each of us has had firsthand experience with the difficulty of keeping spectacular news about someone else a secret.

When we disparage gossip as a character flaw of those shallower than ourselves, we overlook the fact that it’s an essential part of what makes the social world tick. Unfortunately, the nasty side of gossip overshadows the more benign ways in which it functions.

In fact, gossip can actually be thought of not as a character flaw, but as a highly evolved social skill. Those who can’t do it well often have difficulty maintaining relationships, and can find themselves on the outside looking in.

As social creatures, we’re made to gossip

Like it or not, we are the descendants of busybodies. Evolutionary psychologists believe that our preoccupation with the lives of others is a by-product of a prehistoric brain.

According to scientists, because our prehistoric ancestors lived in relatively small groups, they knew one another intimately. In order to ward off enemies and survive in their harsh natural environment, our ancestors needed to cooperate with in-group members. But they also recognized that these same in-group members were their main competitors for mates and limited resources.

Living under such conditions, our ancestors faced a number of adaptive social problems: who’s reliable and trustworthy? Who’s a cheater? Who would make the best mate? How can friendships, alliances and family obligations be balanced?

In this sort of environment, an intense interest in the private dealings of other people would have certainly been handy – and strongly favoured by natural selection. People who were the best at harnessing their social intelligence to interpret, predict – and influence – the behaviour of others became more successful than those who were not.

And then these genes of those individuals were passed along from one generation to the next.

Avoiding gossip: a one-way ticket to no friends

Anthropologists believe that throughout human history, gossip has been a way for us to bond with others—and sometimes a tool to isolate those who aren’t supporting the group.

Some argue that, at least in the workplace, gossip serves a useful purpose. In the workplace, studies have shown that harmless gossiping with one’s colleagues can build group cohesiveness and boost morale.

Gossip also helps to socialize newcomers into groups by resolving ambiguity about group norms and values. In other words, listening to the judgments that people make about the behaviour of others helps the newbie figure out what’s acceptable and what isn’t. Northeastern University professor Dr. Jack Levin, says that gossip can be good for our emotional health. (He makes an exception for the weapons-grade rumour-mongering that destroys reputations.) In general, he believes, gossip is a force that ties together social and business networks. Others identify it as a way to see behind the curtain of employer pronouncements.

Today, good gossipers are influential and popular members of their social groups.

Sharing secrets is one way people bond, and sharing gossip with another person is a sign of deep trust: you’re signalling that you believe that the person will not use this sensitive information against you.

Therefore, someone skilful at gossip will have a good rapport with a large network of people. At the same time, they’ll be discreetly knowledgeable about what’s going on throughout the group.

On the other hand, someone who is not part of, say, the office gossip network is an outsider – someone neither trusted nor accepted by the group. Presenting yourself as a self-righteous soul who refuses to participate in gossip will ultimately end up being nothing more than a ticket to social isolation.

Fear of whispers keeps us in check

On the flip side, the awareness that others are likely talking about us can keep us in line.

Among a group of friends or colleagues, the threat of becoming the target of gossip can actually be a positive force: it can deter “free-riders” and cheaters who might be tempted to slack off or take advantage of others.

Biologist Robert Trivers has discussed the evolutionary importance of detecting gross cheaters (those who fail to reciprocate altruistic acts) and subtle cheaters (those who reciprocate but give much less than they get). Gossip can actually shame these ‘free riders’, reining them in.

Studies of California cattle ranchers, Maine lobster fishers and college rowing teams confirm that gossip is used in a variety of settings to hold individuals accountable. In each of these groups, individuals who violated expectations about sharing resources or meeting responsibilities became targets of gossip and ostracism. This, in turn, pressured them to become better members of the group.

For example, lobstermen who didn’t respect well-established group norms about when and how lobsters could be harvested were quickly exposed by their colleagues. Their fellow lobstermen temporarily shunned them and, for a while, refused to work with them.

Celebrity gossip actually helps us in myriad ways!

Firstly, it appears our brain can't help not getting excited by the headlines on the covers on the trashy magazines.

The part of the brain responsible for our social behavior is the prefrontal cortex. The prefrontal cortex is involved in social cognition and executive control. Social cognition refers to our ability to regulate our behavior and actions based on the real or assumed presence of other people. This is a trait that makes some want to conform to the norms and rules of society in which we live. Executive control channels our actual behavior and thoughts in the desirable direction. Studies with the use of functional MRI brain scans revealed the patterns of activation in the prefrontal cortex in response to positive and negative gossip about themselves, their best friends, and celebrities. A very interesting and revealing picture has emerged from these studies.

Two separate areas of the prefrontal cortex get activated in response to positive and negative gossip: positive gossip activates the orbital prefrontal cortex region, while negative gossip activates the superior medial prefrontal cortex. The intensity of responses was, however, very different depending on whether the gossip was about the subject of study or other people. Substantial activation of the superior medial prefrontal cortex was observed in both cases, regardless of the subject of the negative gossip. The orbital prefrontal cortex region was highly activated by positive gossip about the subjects themselves. However, this response was rather muted when the subjects listened to positive gossip about their friends or celebrities.

This study revealed volumes about the internal processes in our brain. It is quite clear that our ego makes us very attentive to any kind of information about ourselves passed around by other people. However, when it comes to information about others, we are biased to notice and register negative information preferentially. No wonder that the stories of scandals involving celebrities attract more attention than anything good these people do! Our own neuroanatomy makes celebrity magazines filled with the stories of scandals, cheating, and divorces, much more popular that magazines about happy family life.

There also could be a difference between strategy learning gossip and reputation gossip. A distinction noted by Belgian psychologist, Charlotte de Backer.

When gossip is about a particular individual, we’re usually interested in it only if we know that person. However, some gossip is interesting no matter whom it’s about. This sort of gossip can involve stories about life-or-death situations or remarkable feats. We pay attention to them because we may be able to learn strategies that we can apply to our own lives.

Indeed, de Backer discovered that our interest in celebrities may feed off of this thirst for learning life strategies. For better or for worse, we look to celebrities in the same way that our ancestors looked to role models within their tribes for guidance.

The bottom line is that we may need to rethink the role of gossip in everyday life; there’s no need to shy away from it or to be ashamed of it. Gossiping might just be a reflection of the curiosity that all of us humans possess.

If we gossip successfully and without intending harm on another, gossiping can assist in us being a good team player and sharing key information with others in ways that won’t be perceived as self-serving. It’s about knowing when it’s appropriate to talk, and when it’s probably best to keep your mouth shut.

It’s a fact of life: Where there are groups, there will be gossip. It’s how we’re wired. But like all things – there’s some skill to it.  

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The Big Three

When we talk about developing strong social connections, three words often come up – sympathy, empathy and compassion. Many of us use them interchangeably, and whilst they might be sort of related – second cousins maybe – they’re not synonymous with one another.

What they do have in common though, is that they are all a reaction to how someone else is feeling.

Let’s start with sympathy. If it was on a rating scale of degree of personal engagement with the reaction, sympathy would be at the lowest point of the three. Sympathy means you can understand what the other person is feeling and you experience care and concern for that person. What separates this emotion from the others though, is that while our facial expressions might convey caring and concern, we’re not sharing the other person’s distress. For example, we can probably sympathise with ladybugs or snails, but actually sharing their perspectives or emotions could be quite difficult.

If we take it up a notch on the scale of personal engagement, we get to empathy. Empathy can be defined as our ability to recognise and share the emotions of another person, fictional character, or sentient being. It involves, first, seeing someone else’s situation from their perspective, and, second, sharing their emotions.

In 1909, the psychologist Edward Titchener translated the German Einfühlung (‘feeling into’) into English as ‘empathy’. If we are to share in the perspective someone else, we need to do a lot more than merely put ourselves into their position. Instead, we need to imagine ourselves as them – with their personality, experiences, background - , and more than that, imagine ourselves as them in the particular situation in which they find themselves. To empathise we need to know this person AND we need to get creative with our imagination.

We may think of it as the business of escaping our normal egoism, of leaving the self – and putting ourselves imaginatively into someone else’s experience. But the trick for empathy might be slightly different. It isn’t so much about transcending ourselves as it is about practicing an unusual kind of introspection, which takes us into less familiar parts of our own minds.

Imagine if we were, for example, asked to empathise with someone who seems so far from our own personality, realm and experiences. Maybe an aristocratic, contemptuous, well-to-do gentleman from the late 1800s. Instead of giving up, we can try and draw on certain less obvious parts of our own experience. Insofar as each of us contains, in latent form, all of human life, there will inevitably be a small, currently recessive part of us that is in synch with the mindset we associate with a eighteenth century aristocrat.

We might remember one day being on a busy bus, totally annoyed by a group of obnoxious, perhaps drunk fellow passengers. The mood might not have lasted, but we might recognise for an instant in ourselves a potential to look rather sternly at others and suspect that in some ways, we might be rather better than other people. In trying to empathise with a lord, we’re seeking out and detecting an overlap of experience. We’re learning to recognise in a very different person an echo of our own intimate history.

It’s possible that the person who lacks empathy isn’t so much selfish as generally not fully alive to the darker, less familiar, more weird recesses of themselves: the parts that are a range of things that they aren’t quite most of the time. They might not be narrowly refusing the challenge of entering into the mind of another person, they may just be less aware of their own experiences or wary of treading with sufficient imagination into their own consciousness. Behind the reserve of the unempathetic is a fear of running into troubling emotions. The opposite of empathy isn’t just thinking of yourself; it’s thinking of yourself in limited ways.

Compassion kicks empathy and sympathy up a notch. When we are compassionate, we can feel the pain of another (i.e., empathy) or we can recognize that the person is in pain (i.e., sympathy), and then we take some action. We do something to try and alleviate the person’s suffering.

At its Latin roots, compassion means “to suffer with.” When you’re compassionate, you’re not running away from suffering, you’re not feeling overwhelmed by suffering, and you’re not pretending the suffering doesn’t exist. When you are practicing compassion, you can stay present with suffering.

Dr Thupten Jinpa, Ph.D., is the Dalai Lama’s principal English translator and a trainer in compassion cultivation. Jinpa posits that compassion is a four-step process:

  1. Awareness of suffering.
  2. Sympathetic concern related to being emotionally moved by suffering.
  3. Wish to see the relief of that suffering.
  4. Responsiveness or readiness to help relieve that suffering.

A compassionate response is something we do, not just something we think about. But at its core, compassion is also the acceptance of suffering. That doesn’t mean full detatchment, in which we stop giving a damn about anything (“hey, shit happens, move on”). Neither is it an intellectual acceptance of suffering that has us looking at someone’s personal tragedy through the haze of statistics (“well, you know, one in five these days). Rather, compassion is the acceptance that awful stuff can happen to any of us. But there are lots of things we can do to make that suffering way less shit.

For example, how good is it when someone really listens to us when we share a problem? The person listened without trying to fix our problem, and this person wasn’t relating it back to their own life. They listened without judgment. Simply listening with full presence can be one of the most compassionate acts we can offer.

An important distinction between empathy and compassion is how they can affect your overall well-being. If you are frequently feeling the pain of another, you may experience overwhelm or burnout.

Compassion, however, is a renewable resource. When you are able to feel empathy but then extend a hand to alleviate someone’s pain, you are less likely to burn out. Research indicates that compassion and empathy use different regions of the brain and that compassion can combat empathetic distress.

Don’t take it from me, though. The Dalai Lama famously said in the book The Art of Happiness, “If you want others to be happy, practice compassion. If you want to be happy, practice compassion.”

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Feeling skin and feeling safe

Let’s all just come out and admit it. There is nothing better than a good hug.

Our skin is our body's largest organ. It is also the fastest growing; it regenerates at an amazing rate—we sport a new coat of it every month. Skin acts as our body’s defense against the external world, as well as our brain’s collector of external data. The tips of our fingers, the soles of our feet, and our lips are designed to pick up the most precise pieces of sensory data, and have intense concentrations of nerve endings just for that purpose.

Even seemingly pure physiological reactions don’t happen in a vacuum—our affective antennae also gather information that informs our responses to circumstances charged with affective and cognitive complexity. The messages that nerve endings send take on another level of sophistication as the body responds at multiple points of activity.

A hug can offer an opportunity to provide a whole range of complex sensory responses that warm our heart and make us feel amazeballs.

The simple act of a hug isn't just felt on our arms. When we embrace someone, oxytocin is released in our brains, making us feel all warm and fuzzy inside. Oxytocin is also the neurochemical that has been linked to social bonding. It helps us build trust, it ‘dissolves’ short-term memory and it promotes feelings of bonding. It lays the biological structure for connecting to other people. And we can get it from a hug.

Researchers have also found that the presence of oxytocin can speed up the physical healing of wounds. Studies show that even a brief touch of the hand from someone who cares can start your oxytocin pumping. So when you offer a bear hug to someone in pain, or receive a big old bear hug when you are in pain, you not only begin the healing process, but you also allow your body to shut down memories of the painful stimulus. This is perhaps why the mother’s memories of labour are less disturbing when her newborn is placed in her arms and she is high on oxytocin. (Would there be any other reason women would go through that more than once?) Oxytocin encourages us to warm up to others and creates a sense of safety.

The hormones that are released in the body after a hug aren't just good for our happy-la-la feelings either. They can also help with our physical health. When someone touches us, the sensation on your skin activates pressure receptors called Pacinian corpuscles, which then send signals to the vagus nerve, an area of the brain that is responsible for (among many things) lowering blood pressure.

But the thing that I like most about the hug, is the message we can be sending each other when we engage in the act.

In our lives, the central time for hugging is early childhood. Up to about the age of four, a child may be frequently held, cradled, patted and carried. We accept that a little person can’t manage the trials of existence on their own and they will need a bigger person to take some of the strain. The young child can’t be helped by explanations and reasons; they respond to touch alone. 

But as we grow towards adulthood, independence and self-reliance become key and the sort of hugs we once knew recede. Yet to suggest that we continue to need the proper, older kind of hug is to insist that we go on being, at points, rather like the children we once were, that is, people who can’t cope alone.

To be in need of a hug is to admit – in shorthand – ‘I feel, at the moment, terrifyingly small – and need someone else to be, for a while, like a parent’.

It’s tricky to admit how normal and reasonable such tendencies are. BUT THEY ARE. Some of us might see them like an affront to our individualism and dignity, but there can be no genuine maturity without an accommodation with the childhood self. I am not ashamed to admit that I still go to sleep hugging a soft toy. Or two.

The capacity to regress and show we need some help, should belong within every good loving relationship: it’s a sign that someone feels safe enough with you (and you with them) to allow themselves to be seen in a vulnerable state.

A hug is a symbol of everything we tend to sorely miss in our hyper-individualistic achievement-centred culture: a chance safely to admit that right now we are feeling vulnerable, and the other person is helping to keep us safe.

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What does our narcissism mean for connection?

It has been argued that the modern world we are living in, makes social connection difficult, just by the nature of the way it is. And it doesn't help that we might all be turning into narcissists. Cue, horror and shock!

Over the past few decades we may have witnessed a societal shift from a commitment to the collective to a focus on the individual or the self. We witnessed the self-esteem movement – which had much value – but determined that self-esteem was the key to success in life. Educators and parents started telling their children how special and unique they are to make them feel more confident. Parents and educators tried to “confer” self-esteem upon their children, rather than letting them achieve it through hard work.

The rise of individualism (with its focus on the self and inner feelings) and decline in social norms that accompanied the modernisation of society also meant that the community and the family were no longer able to provide the same support for individuals as they once did. And as I’ve repeatedly pointed out (like here and here and here), research has shown that being embedded in social networks – for example, being actively engaged in your community and connected with friends and family – has major health benefits.

As we have watched our social fabric reduce, it's possible that it's just harder now for each of us to meet the basic need for meaningful connection. The question has shifted from what is best for other people and the family to what is best for me. The modernisation of society can be seen to prize fame, wealth, celebrity above all else. All this, combined with the breakdown in social ties has created an individual self, empty of social meaning. 

And then to complicate things further, we have had the rise of technology and the development of social networking, changing the way in which we spend our free time and communicate. Today, there are nearly 936 million active Facebook users each day worldwide. More than 80 million photographs uploaded to Instagram every day, more than 3.5 billion ‘likes’ every day, and some 1.4 billion people - 20% of the world’s population - publishing details of their lives on Facebook. Is social media turning a relatively modest species into a pack of publicity-hungry narcissists? Or were we already inherently self-absorbed? Internet addiction is a new area of study in mental health and recent cross-sectional research shows that addiction to Facebook is strongly linked to narcissistic behaviour and low self-esteem.

So, what exactly is narcissism?

For those of us, who are not totes up with our Greek mythology, let’s go back to where the word descends. Narcissus was a hunter from central Greece, the son of the river god Cephissus and the nymph Liriope. He had long flowing locks, deep blue eyes, unblemished skin and full enchanting lips. One day, as he walked past a quiet pool of water, he caught sight of his own reflection, failed to recognise himself and was entranced with the image. He had never seen anyone quite so enchanting – and could not stop falling profoundly in love with himself, the most admirable and bewitching being he had ever spotted.

Apparently this behaviour was so incredibly bizarre that it’s become both one f the great and tempting insults of our age and a diagnosable personality disorder in the DSM (the psychiatric bible).

Narcissism lies on a continuum from healthy to pathological. Healthy narcissism is part of normal human functioning. It can represent healthy self-love, self-compassion and confidence that is based on real achievement, the ability to overcome setbacks and derive the support needed from social ties.

But narcissism becomes a problem when the individual becomes preoccupied with the self, needing excessive admiration and approval from others, while showing disregard for other people’s sensitivities. If the a person with unhealthy narcissism does not receive the attention desired, then really big problems can develop.

People with unhealthy levels of narcissism often portray an image of grandiosity or overconfidence to the world, but this is only to cover up deep feelings of insecurity and a fragile self-esteem that is easily bruised by the slightest criticism. Because of these traits, they might find themselves in shallow relationships that only serve to satisfy their constant need for attention. When narcissism is unhealthy it means that we can struggle to relate because it inhabits our ability to empathise with others. Uh oh. 

When narcissistic traits become so pronounced that they lead to impairment this can indicate the presence of narcissistic personality disorder (NPD).

According to the DSM-5, individuals with NPD have most or all of the following symptoms, typically without commensurate qualities or accomplishments:

  • Grandiosity with expectations of superior treatment from others
  • Fixated on fantasies of power, success, intelligence, attractiveness, etc.
  • Self-perception of being unique, superior and associated with high-status people and institutions
  • Needing constant admiration from others
  • Sense of entitlement to special treatment and to obedience from others
  • Exploitative of others to achieve personal gain
  • Unwilling to empathize with others' feelings, wishes, or needs
  • Intensely envious of others and the belief that others are equally envious of them
  • Pompous and arrogant demeanor

Like all the personality disorders, it would not be that difficult for most of us to meet some of these criteria at some points in our lives. That’s part of being human. It is however, difficult, to meet criteria for this personality disorder over a long period of time. True Narcissistic Personality Disorder symptoms are pervasive, apparent in various situations, and rigid, remaining consistent over time. The symptoms must be severe enough that they significantly impair the individual's ability to develop meaningful relationships with others. Symptoms also generally impair an individual's ability to function at work, school, or in other important settings.

In the clinical setting, about 2% to 16% of people suffer from this disorder, while in the general population, less than 1% of people are affected. And whilst the disorder is much more common in men than women, we don’t know much else about it. Jose Romero-Urcelay, a forensic psychiatrist and the director of therapies at the Dangerous and Severe Personality Disorders unit at Broadmoor, West London Mental Health Trust, says:

“No one knows where it comes from, but it tends to present in the patient’s early twenties. There is no genetic predisposition to the disorder, nor are specific types of people more susceptible than others. It isn’t triggered by illness, injury or substance abuse. Some suspect it may be caused by an excess of love in infancy; others by childhood abuse or emotional trauma. Some point to a breakdown in the infant’s relationship with his or her mother.” 

It is certainly possible that NPD - or traits of narcissism - has the potential to thrive in our modern western societies. Increased materialism, the decline of community life and a fascination with image afford perfect conditions for its growth.

So what can we do about all this and how can we lead a happy and purposeful life? One of the largest studies on happiness was conducted by a group of Harvard researchers who followed a large cohort of people over a period of 75 years. What they discovered – unsurprisingly – was that fame and money were not the secrets to happiness. Rather, the most important thing in life and the greatest predictor of satisfaction was having strong and supportive relationships – that “the journey from immaturity to maturity is a sort of movement from narcissism to connection”.

So maybe it’s time to take a break from that smartphone, shut off your computer and meet up with a friend or two. Maybe, just maybe, you might feel a bit of collective joy, love and excitement. Sometimes it can be nice to experience these things with others. 

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Connecting to our phone

I’m pretty certain this will not be the first time you have heard or thought this, but quite possibly our biggest barrier to good social connection right now is our reliance on our phone.

The majority of us really, myself included, really love our phones.

It’s not a difficult stretch to say that most of us are dependent or ‘addicted’ to our smart device. We might not be injecting illegal substances or drowning ourselves in alcohol, but we are almost all dependent on this object in one way or another. ‘Addiction’ is (in essence) dependence on something that keeps our emotions at bay: it is (more broadly) any and every routine we deploy to avoid a fair and frank encounter with our own minds.

We use our phone a lot, yes. And we use them for a lot of things. Often we may find ourselves incapable of sitting alone in a room with our own thoughts floating freely in our own heads, daring to wander into the past and the future, allowing ourselves to feel pain, desire, regret and excitement. The phone offers us reprieve. Games, online shopping, social media. Distraction that fits neatly in the palm of our hand.

We are dependent on our phones not because we rely on them, but to the extent that we might use them as a coping mechanism for self-avoidance. They do not intent to hurt us. And they may not. But they probably will. They are so incredibly good at taking us away from ourselves. If there’s anywhere a lot of us don’t want to be, it’s with ourselves. And unless we can connect with ourselves and our own emotions for what they are, we’re really going to struggle truly connecting with others.

Secondly, the mere presence of a device can affect how we are relating to others. We don’t even need to be paying it any attention.

Przybylski and Weinstein asked pairs of strangers to discuss a moderately intimate topic (an interesting event that had occurred to them within the last month) for 10 minutes.  The strangers left their own belongings in a waiting area and proceeded to a private booth.  Within the booth, they found two chairs facing each other and, a few feet away, out of their direct line of vision, there was a desk that held a book and one other item.  Unbeknownst to the pair, the key difference in their interactions would be the second item on the desk.  Some pairs engaged in their discussion with a nondescript cell phone nearby, whereas other pairs conversed while a pocket notebook lay nearby.  After they finished the discussion, each of the strangers completed questionnaires about the relationship quality (connectedness) and feelings of closeness they had experienced.  The pairs who chatted in the presence of the cell phone reported lower relationship quality and less closeness.

Przybylski and Weinstein followed up with a new experiment to see, in which contexts, the presence of a cell phone matters the most.  This time, each pair of strangers was assigned a casual topic (their thoughts and feelings about plastic trees) or a meaningful topic (the most important events of the past year) to discuss — again, either with a cell phone or a notebook nearby.  After their 10-minute discussion, the strangers answered questions about relationship quality, their feelings of trust, and the empathy they had felt from their discussion partners.

The presence of the cell phone had no effect on relationship quality, trust, and empathy, but only if the pair discussed the casual topic.  In contrast, there were significant differences if the topic was meaningful. The pairs who conversed with a cell phone in the vicinity reported that their relationship quality was worse.  The pairs also reported feeling less trust and thought that their partners showed less empathy if there was a cell phone present.

Thus, interacting in a neutral environment, without a cell phone nearby, seems to help foster closeness, connectedness, interpersonal trust, and perceptions of empathy — the building-blocks of relationships. Past studies have suggested that because of the many social, instrumental, and entertainment options phones afford us, they often divert our attention from our current environment, whether we are speeding down a highway or sitting through a meeting.  The new research suggests that cell phones may serve as a reminder of the wider network to which we could connect, inhibiting our ability to connect with the people right next to us.  Cell phone usage may even reduce our social consciousness.

In principle, we want to have good relationships and social connections. We love family life and are very keen on and devoted to relationships. But, obviously, the reality is tricky. The wonderful things are mixed up with a lot that is awkward and frustrating. Our partner isn’t quite as sympathetic as we’d ideally like; our family is more conflicted and challenging than feels fair or reasonable.

Our phone, on the other hand, is docile, responsive to our touch, always ready to spring to life and willing to do whatever we want. Its malleability provides the perfect excuse for disengagement from the trickier aspects of other people. It’s almost not that rude to give it a quick check – just possibly we might actually need to keep track of how a news story is unfolding; a friend in another country may have just had a baby or someone we vaguely know might have bought a new pair of shoes in the last few minutes. It’s so tempting to press the screen when one’s partner launches into an account of their day or their play-by-play of today’s golf results. The details of their existence and their hopes for our shared domestic life cannot compete with how much the signed John Lennon print is going to go for on ebay or how many likes our last Instagram post received. Only the former will, in the long-run, be a lot more important – as we know.

Perhaps, the ongoing questions need to be – who am I in a relationship with right now? Who should I be connecting with? Is it myself? The person seated opposite me? Or is it my phone?

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Challenges for Connections


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