Two recent articles discussing studies of animals in stressful situations shed light on some valuable lessons about the role of stress in people’s lives.
In today’s New York Times Magazine, Gretchen Reynolds writes about an experiment in which two groups of rats ended up reacting differently to the same unpleasant situation. One group of rats exercised regularly for several weeks; the other group didn’t exercise at all. When both types of rats were exposed to stress -- specifically, forced to swim in cold water -- the brains of the exercising rats weren’t affected as negatively as those of the active rats. A related study indicated that, after an injection with chemicals designed to increase their stress level, active rats were less anxious than the idle ones. The studies support the idea that the physical stress of exercise helps the brain better handle emotional stress. But the payoff isn’t immediate. For rats, when it comes to seeing the benefits of exercise, the magic number is apparently between three and six weeks.
Meanwhile, in The Atlantic, David Dobbs writes about the insights of Stephen Suomi, a prominent researcher who has studied the emotional development of rhesus monkeys. Suomi has shown that when monkeys who are genetically handicapped in their ability to process a chemical in their brain known as serotonin -- a risk factor for anxiety and depression -- are raised as babies in poor environments, they grow up to process serotonin less efficiently as adults and are more likely to end up anxious and depressed. But when these genetically-handicapped monkeys are raised in ideal environments, they don’t just grow up to process serotonin efficiently; they do it more efficiently than those monkeys without the initial deficit. Monkeys who thrive despite this genetic weakness may in fact be more likely to prosper than your average monkey.
What does this mean for humans? Suomi’s research with monkeys is relevant to the study of what are sometimes known as “orchid children” -- children who possess gene variants that increase their susceptibility to problems such as depression, anxiety, and attention-deficit hyperactivity disorder. Given a stressful or abusive childhood, these kids are more likely to suffer negative consequences (versus “dandelion kids” who can pretty much thrive anywhere). But the article suggests that if these orchid children are raised in a more favorable environment, then these genetic variants can contribute to enhanced functioning. In short, what has usually been seen only as a liability can, under the right circumstances, be a strength.
As for the stressed-out rat experiments, it adds to a growing body of research indicating that exercise helps not only our physical health, but our mental health as well. As is the case with the rats in these studies, these stress-reducing benefits aren’t immediate. But there’s one important difference between people and the lab rats: Unlike the rats, no scientists are forcing us to exercise. People, unlike rats, need their own motivation. To reap enrichment from an exercise routine, they have to overcome inertia and push themselves to do something they might find unpleasant initially. But if they can stay the course until they start enjoying the returns, it’s worth it.
Sunday, November 22, 2009
Monday, November 2, 2009
Positive Psychology Has Its Limits
Last week, I read the book Bright-Sided: How the Relentless Promotion of Positive Thinking has Undermined America, by Barbara Ehrenreich. What got me interested was hearing a radio interview in which the author, who was diagnosed with breast cancer several years ago, talked about her reaction to the breast cancer culture she encountered during her treatment. Cancer was a gift, people would say. It’s the best thing that ever happened to me.
Ehrenreich wasn’t soothed by the cheeriness that people had in reaction to their cancer, and that they expected from her. Rather, this relentless focus on maintaining a positive attitude felt stifling to her. And when she expressed anger about her diagnosis, about the effects of chemotherapy, and about the frustrations of dealing with her insurance company, people responded by suggesting that she was too angry. Run, don’t walk, someone told her, to some counseling.
Ehrenreich points out that certain assertions that are often accepted as truth -- such that a positive attitude lessens your chances of getting cancer and improves your chances of surviving it -- are actually simplifications of the relevant research. While stress can weaken your immune system, that doesn’t mean that if you’re stressed, you’re more likely to get cancer. Similarly, while therapy and support groups may be good for people's emotional health, therapy, or support groups won't extend their lives. The problem, Ehrenreich points out, is that sometimes this research trickles down in such a way that people end up blaming themselves unnecessarily for their illness or for their inability to prevent its spread.
Another part of the book addresses the spread of positive psychology, a relatively new area of psychology that focuses on the study of positive emotions, happiness, and resilience. In her view, this research, along with some other New Age ideas, is being misused to foster the belief that what happens to us is our fault. For example, rather than focus on systemic issues (such as income inequality or a crumbling economy) as reasons why you lost your job, these disciplines focus on attributing what happens to you on internal, individual characteristics, and essentially blame the victim for what happens to him or her.
It’s an interesting argument that relates to the tension in people's lives between denial of reality on the one hand and debilitating, excessive pessimism on the other. If you have breast cancer, being told that your anger and sadness about the cancer is going to make it worse would most likely fill you with both rage and guilt. At the same time, if all you can think about is what is out of your control, it will be difficult to work to change anything about your situation. Sometimes, it’s important not to minimize the bad, or sad things that happen to us, or that we feel. You can recognize them and acknowledge them in a way that enables you to move forward.
Ehrenreich wasn’t soothed by the cheeriness that people had in reaction to their cancer, and that they expected from her. Rather, this relentless focus on maintaining a positive attitude felt stifling to her. And when she expressed anger about her diagnosis, about the effects of chemotherapy, and about the frustrations of dealing with her insurance company, people responded by suggesting that she was too angry. Run, don’t walk, someone told her, to some counseling.
Ehrenreich points out that certain assertions that are often accepted as truth -- such that a positive attitude lessens your chances of getting cancer and improves your chances of surviving it -- are actually simplifications of the relevant research. While stress can weaken your immune system, that doesn’t mean that if you’re stressed, you’re more likely to get cancer. Similarly, while therapy and support groups may be good for people's emotional health, therapy, or support groups won't extend their lives. The problem, Ehrenreich points out, is that sometimes this research trickles down in such a way that people end up blaming themselves unnecessarily for their illness or for their inability to prevent its spread.
Another part of the book addresses the spread of positive psychology, a relatively new area of psychology that focuses on the study of positive emotions, happiness, and resilience. In her view, this research, along with some other New Age ideas, is being misused to foster the belief that what happens to us is our fault. For example, rather than focus on systemic issues (such as income inequality or a crumbling economy) as reasons why you lost your job, these disciplines focus on attributing what happens to you on internal, individual characteristics, and essentially blame the victim for what happens to him or her.
It’s an interesting argument that relates to the tension in people's lives between denial of reality on the one hand and debilitating, excessive pessimism on the other. If you have breast cancer, being told that your anger and sadness about the cancer is going to make it worse would most likely fill you with both rage and guilt. At the same time, if all you can think about is what is out of your control, it will be difficult to work to change anything about your situation. Sometimes, it’s important not to minimize the bad, or sad things that happen to us, or that we feel. You can recognize them and acknowledge them in a way that enables you to move forward.
Saturday, October 3, 2009
Anxiety Disorders Are Treatable
Are some people destined to suffer anxiety as adults? That’s one of the questions explored in an interesting article in the October 4 issue of The New York Times Magazine. The story focuses on the work of Jerome Kagan, a developmental psychologist who has studied how children adapt to new situations. In his work, he found that some babies had a particularly negative reaction to unfamiliar stimuli. These babies, it turned out, were more likely to develop into anxious or fearful children. As they reached adolescence and adulthood, their anxiety dropped somewhat and they functioned seemingly well -- making friends, for example, and getting good grades. But more so than other children, they reported a lot of anxiety and nerves.
These subjects are among the people that Kagan and other researchers have identified as responding intensely to new stimuli and stressful situations. They’re known as “high reactives.” Physically, this is reflected in MRI scans of their brains, as well as through a higher heart rate and faster breathing.
But being anxious by temperament does not always correlate how people function in the world. Someone who starts out as a “high reactive” may grow up in a family that helps him or her manage anxiety constructively. Someone else of similar temperament, however, may have experiences that reinforce a predisposition toward anxiety and may end up with an anxiety disorder.
In addition, being anxious by temperament may not always be such a bad thing. Too much anxiety can paralyze you, but having some anxiety can be helpful. It can motivate us to accomplish something that we need to do. It can help us to consider the consequences of a particular course of action that we think of taking.
The message of the Times article is that anxiety is complex, and not necessarily the life sentence that some people think it is. Sometimes people who start therapy will describe themselves as having a “chemical imbalance.” That’s often shorthand for believing that they are born with whatever symptom they are describing and that their temperament has nothing to do with the way they grew up or have learned to cope with their emotions. It’s also shorthand for believing that there is nothing that they can do about their problem other than take medication. But I am more hopeful about the possibility of change. There is a lot we can do to understand ourselves and the way we think, and to modify those ways of thinking so that they are not so debilitating.
These subjects are among the people that Kagan and other researchers have identified as responding intensely to new stimuli and stressful situations. They’re known as “high reactives.” Physically, this is reflected in MRI scans of their brains, as well as through a higher heart rate and faster breathing.
But being anxious by temperament does not always correlate how people function in the world. Someone who starts out as a “high reactive” may grow up in a family that helps him or her manage anxiety constructively. Someone else of similar temperament, however, may have experiences that reinforce a predisposition toward anxiety and may end up with an anxiety disorder.
In addition, being anxious by temperament may not always be such a bad thing. Too much anxiety can paralyze you, but having some anxiety can be helpful. It can motivate us to accomplish something that we need to do. It can help us to consider the consequences of a particular course of action that we think of taking.
The message of the Times article is that anxiety is complex, and not necessarily the life sentence that some people think it is. Sometimes people who start therapy will describe themselves as having a “chemical imbalance.” That’s often shorthand for believing that they are born with whatever symptom they are describing and that their temperament has nothing to do with the way they grew up or have learned to cope with their emotions. It’s also shorthand for believing that there is nothing that they can do about their problem other than take medication. But I am more hopeful about the possibility of change. There is a lot we can do to understand ourselves and the way we think, and to modify those ways of thinking so that they are not so debilitating.
Wednesday, June 17, 2009
An Unhelpful Attitude About Dieting
The New York Times this week ran a fascinating story related to food and eating, one that has provoked some strong opinions on the paper’s web site. The subject of the article is MeMe Roth, a Manhattan woman who has clashed with administrators at her children’s public elementary school. Ms. Roth, reports the Times, strongly objects to the sugary snacks and baked goods that her kids and others have been offered at school, such as the cupcakes that parents bring into class for birthday celebrations. “I thought I was sending my kid to P.S. 9, not Chuck E. Cheese,” the Times quotes her as saying.
It is true that it is tough for kids to make healthy choices when they are constantly exposed to sweets. It’s tough for adults, too, to make those healthy choices if their own refrigerator is packed with ice cream and cake. Reducing children’s exposure to junk food makes it easier for kids to avoid eating it.
But in trying to eradicate all traces of snacks and sweets from a child’s (or adult’s life), a person can go too far. By going to extremes in making a diet healthy for oneself or someone else, one can end up perpetuating an eating disorder that can be just as harmful as a steady diet of Tootsie Rolls.
One unhelpful approach is to categorize foods as good or bad. A cupcake by itself, for example, is not intrinsically evil. But if it is demonized and taboo--think of the tree in the Garden of Eden-- it becomes more seductive and desirable. In the likely event that a person eventually does yield to temptation and eat the forbidden fruit (or junk food), he or she ends up feeling terrible and guilt-ridden -- and, feeling defeated, keeps on eating. A key goal in working with people with eating disorders is to help them prevent one slip from turning into a binge. And one way to do that is to stop demonizing certain kinds of food.
Another unhelpful approach is to fast for long periods during the day. Often, people with eating disorders will eat little during the day -- letting themselves get extremely hungry -- and then binge at night. Feeling horrible and guilty, they decide to start dieting the next day -- and begin the cycle anew. So part of treating people with eating disorders is to help them get comfortable with eating regularly, to not let themselves get too hungry and to move away from dieting and deprivation.
For people with food and weight issues, it is not easy to navigate all the external cues and social pressures to eat. At the same time, outlawing fat and food are hardly the way to help.
It is true that it is tough for kids to make healthy choices when they are constantly exposed to sweets. It’s tough for adults, too, to make those healthy choices if their own refrigerator is packed with ice cream and cake. Reducing children’s exposure to junk food makes it easier for kids to avoid eating it.
But in trying to eradicate all traces of snacks and sweets from a child’s (or adult’s life), a person can go too far. By going to extremes in making a diet healthy for oneself or someone else, one can end up perpetuating an eating disorder that can be just as harmful as a steady diet of Tootsie Rolls.
One unhelpful approach is to categorize foods as good or bad. A cupcake by itself, for example, is not intrinsically evil. But if it is demonized and taboo--think of the tree in the Garden of Eden-- it becomes more seductive and desirable. In the likely event that a person eventually does yield to temptation and eat the forbidden fruit (or junk food), he or she ends up feeling terrible and guilt-ridden -- and, feeling defeated, keeps on eating. A key goal in working with people with eating disorders is to help them prevent one slip from turning into a binge. And one way to do that is to stop demonizing certain kinds of food.
Another unhelpful approach is to fast for long periods during the day. Often, people with eating disorders will eat little during the day -- letting themselves get extremely hungry -- and then binge at night. Feeling horrible and guilty, they decide to start dieting the next day -- and begin the cycle anew. So part of treating people with eating disorders is to help them get comfortable with eating regularly, to not let themselves get too hungry and to move away from dieting and deprivation.
For people with food and weight issues, it is not easy to navigate all the external cues and social pressures to eat. At the same time, outlawing fat and food are hardly the way to help.
Thursday, May 28, 2009
How Perfectionism Can Help or Hurt Your Life
When I was growing up, my father would often joke about how when he was a child and brought home a test from school on which he had scored a 98: His father, my father told me, would ask him, half-seriously, “What happened with the other two points?”
I didn’t think much of my father’s story, other than to associate it with my grandfather’s expectations of good grades and high achievement—expectations which he also had for his grandchildren. But in recent years, I have heard similar stories from many different patients—people from a variety of ethnic and socioeconomic backgrounds. When people tell me that they remember parents saying this to them about their schoolwork, it often turns out that these people have high standards and expectations for themselves as adults.
Despite being accomplished and successful, they frequently wish they’d done more in their career or feel disappointed with their achievements.
So I was interested to read a recent New York Times profile of Peter Orszag, the new White House budget director and, at 40, the youngest member of the President’s cabinet. In the article, he talked about his work ethic:
Orszag, who grew up in Lexington, Mass., has always worked himself punishingly hard—a legacy, he says, from a math-professor father who glanced at test scores of 98 and asked about the 2 other points. “It was always, ‘When I was your age, I was a tenured professor,’ ” he said.
For some people, extremely high expectations spur them on to high achievement. For others, it demoralizes them; no matter how well they do, they feel they have fallen short. Not everyone has been as successful in the workplace as Peter Orszag, and for most of us, there will always be someone out there who is doing more or doing better. The challenge is learning how to work hard and strive for goals—but rather than measuring yourself against perfection or superachievers, setting your own goals and learning how to take satisfaction from reaching them.
I didn’t think much of my father’s story, other than to associate it with my grandfather’s expectations of good grades and high achievement—expectations which he also had for his grandchildren. But in recent years, I have heard similar stories from many different patients—people from a variety of ethnic and socioeconomic backgrounds. When people tell me that they remember parents saying this to them about their schoolwork, it often turns out that these people have high standards and expectations for themselves as adults.
Despite being accomplished and successful, they frequently wish they’d done more in their career or feel disappointed with their achievements.
So I was interested to read a recent New York Times profile of Peter Orszag, the new White House budget director and, at 40, the youngest member of the President’s cabinet. In the article, he talked about his work ethic:
Orszag, who grew up in Lexington, Mass., has always worked himself punishingly hard—a legacy, he says, from a math-professor father who glanced at test scores of 98 and asked about the 2 other points. “It was always, ‘When I was your age, I was a tenured professor,’ ” he said.
For some people, extremely high expectations spur them on to high achievement. For others, it demoralizes them; no matter how well they do, they feel they have fallen short. Not everyone has been as successful in the workplace as Peter Orszag, and for most of us, there will always be someone out there who is doing more or doing better. The challenge is learning how to work hard and strive for goals—but rather than measuring yourself against perfection or superachievers, setting your own goals and learning how to take satisfaction from reaching them.
Thursday, May 14, 2009
Obesity Prejudice in the News
Recently, colleagues on an eating-disorder message board were discussing the value of using weight-loss drugs to help reduce people's weight. (The consensus: There is very little evidence that the drugs lead to meaningful, sustainable weight loss.)
The discussion raised the question of how we see weight. Is being overweight and having a high body-mass index immediately indicative of health problems? Or is a high BMI one of several indicators of poor health? Not everyone who is overweight is unhealthy, and not everyone who is of normal weight is healthy. As one person on the mailing list put it, when we automatically consider someone with a high BMI to be unhealthy, it's as if we are saying that tall people are at a greater risk of medical problems—and then jumping to the conclusion that tallness itself is the disease we need to treat.
Soon after this discussion, I came across the following article on The Daily Beast [http://www.thedailybeast.com/blogs-and-stories/2009-05-04/fat-judges-need-not-apply/] about the candidates for the Supreme Court replacement for David Souter. The article suggests that some Democrats—who want Obama's appointments to be on the court for as long as possible—are using weight and thinness as a proxy for health and longevity. In this case, they prefer thinner candidates, such as Diane Wood and Kim McLane Wardlaw over the heavier ones, Elena Kagan and Sonia Sotomayor. Their belief is that because Kagan and Sotomayor are heavier, they are less healthy and likely to die younger. (Although not slim, neither woman is obese.)
This is a widely held view—that thin equals good and healthy and that fat equals bad, unhealthy and likely to die an early death. Yes, it is true that, on average, obesity is associated with a higher risk of death. But that doesn't mean that any given thin person will outlive someone who is heavier.
What I actually see in this particular Supreme Court debate is a weight prejudice doctored up as a health concern. Underneath the seeming concern about longevity is the dismissal of two women who do not completely fit social expectations for appearance.
The discussion raised the question of how we see weight. Is being overweight and having a high body-mass index immediately indicative of health problems? Or is a high BMI one of several indicators of poor health? Not everyone who is overweight is unhealthy, and not everyone who is of normal weight is healthy. As one person on the mailing list put it, when we automatically consider someone with a high BMI to be unhealthy, it's as if we are saying that tall people are at a greater risk of medical problems—and then jumping to the conclusion that tallness itself is the disease we need to treat.
Soon after this discussion, I came across the following article on The Daily Beast [http://www.thedailybeast.com/blogs-and-stories/2009-05-04/fat-judges-need-not-apply/] about the candidates for the Supreme Court replacement for David Souter. The article suggests that some Democrats—who want Obama's appointments to be on the court for as long as possible—are using weight and thinness as a proxy for health and longevity. In this case, they prefer thinner candidates, such as Diane Wood and Kim McLane Wardlaw over the heavier ones, Elena Kagan and Sonia Sotomayor. Their belief is that because Kagan and Sotomayor are heavier, they are less healthy and likely to die younger. (Although not slim, neither woman is obese.)
This is a widely held view—that thin equals good and healthy and that fat equals bad, unhealthy and likely to die an early death. Yes, it is true that, on average, obesity is associated with a higher risk of death. But that doesn't mean that any given thin person will outlive someone who is heavier.
What I actually see in this particular Supreme Court debate is a weight prejudice doctored up as a health concern. Underneath the seeming concern about longevity is the dismissal of two women who do not completely fit social expectations for appearance.
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