Facebook's Fat Emoji

Big news in the emoticon world this past week: Facebook removed the emoticon for “feeling fat” following complaints that the emoticon and its description contribute to body image dissatisfaction.

This article in today’s NY Times describes research that explains why that is a good thing. The author,Renee Engeln, describes her research which showed that when subjects were around people who spoke negatively about their bodies, they were more likely say negative things about their own bodies and to feel worse about themselves. It’s not hard to understand: When you hear the person next to you (whose body may look perfectly fine to you) speak ill of himself or herself, you think about how much worse your body must be.

The term “feeling fat” is so much a part of our language that we often forget that we don’t really even know what it means. Usually it’s a catch-all term for “I don’t measure up to some standard I have for myself” or “I wish this were different” or “I hate some aspect of myself.”

Perhaps without fat talk, we will be encouraged to identify more clearly what we really mean and learn how to express it clearly and directly. As for the “feeling fat” emoticon itself, The Verge reports that Facebook merely re-labeled the “rosy-cheeked, bloated” emoticon as “feeling stuffed.” Only to be used on Thanksgiving.

Weight, Weight-Loss and Self-Acceptance

I recently read a moving memoir that taught me a lot about weight, weight-loss and self-acceptance.  In It was Me all Along, Andie Mitchell describes how food became such an integral part of her life and how she coped with her stressful family life. “That girl version of me learned that I shouldn’t experience discomfort. That whenever I start to feel even one inkling of boredom, doubt, anxiety, or anger, food would soothe me. At least temporarily.”  Food became the way for her to cope with the discomfort of an alcoholic father and a mother who worked so hard she was rarely present.  By 16, she weighed 210 pounds, had been on and off of many diets and was a practiced secretive eater.

When she finally lost weight, what helped her? After reaching a high weight of 268 at age 19, she began to consider its impact on her health in addition to her appearance. She started with the gym—thirty minutes on the elliptical—and went with a supportive friend. She focused on the present: “Can you exercise today, Andie? Not tomorrow, not the next day, not even a month from now. Today? Eat the best you can, work your plus-sized heart out….today?” She tried to eat healthfully, which was okay during the day, but torture at night, the time she had been used to eating to numb her feelings. Eventually, she moved to Weight Watchers and found the structure of the point system and the consistent self-monitoring to be motivating. She accepted that it would be hard: “Oh, it’s just going to suck for awhile.”

What else? She developed “an arsenal of ways to distract myself, if only to narrowly escape a binge.” Here are a few: writing in a journal when flagging, calling a friend and talking about something unrelated to weight, losing herself in movies (without snacks), spending more time in nature. A semester abroad in Italy helped her start to appreciate and savor food.

But while losing weight helped her feel better about the way she looked, she still felt like "the fat girl."  "I looked into the mirror and loved what I saw so completely that all I wanted was to snap a picture of the girl within the frame…Without that mirror, without any way of physically seeing my own form in plain sight, I still believed myself to be the fat girl. My mind and eyes were in opposition.” Moreover, she did not feel like the happy thin self she had expected she would become. Instead, she felt anxious, sad, isolated and preoccupied with food. Finally, she went to a nutritionist and a therapist who helped her learn to see how she had been using food for comfort and soothing. She also learned to be more accepting of her appetite and less fearful of losing control.

I’m summarizing the book and perhaps making her painful process sound too easy and linear.  It took a tremendous amount of work and commitment to make the changes that led to her weight loss. But beyond those behavioral changes, it took work and attention to her attitudes about food, her feelings about herself, and the role that food played in her life for her to feel that the way that she felt on the inside and the way she looked on the outside were in sync.

New Year's Resolutions: Focusing on What's Important

In the new year, people often think about self-improvement and new year’s resolutions — losing a few pounds, for example. But though people have the best of intentions, these goals can send them in the wrong direction.

In this past Sunday’s New York Times, Pico Iyer wrote a piece — “Healthy Body, Unhealthy Mind” — touching on this very issue. Iyer writes about his efforts starting in his fifties to wean himself off of Big Macs and start to exercise. He admits, however, that he was ignoring what he took in emotionally. While he wasn’t gorging on calories, he was “gobbling down” a junk-food mental diet of useless information and gossip.

Iyer labels himself an “externalist,” or someone, he says, who “will dwell at length on everything he can see, in order to distract himself from the fact that it’s everything he can’t see on which his well-being depends….He interprets health in terms of his body weight, wealth in terms of his bank account and success in terms of his business card.”

So many of us work hard not to define ourselves solely by these external markers. Indeed, many people find themselves in therapy when they feel they are not measuring up on these counts. Weight and bank balances fluctuate — it’s risky to rely on them as measures of self-esteem. Part of the work in therapy involves helping someone find value in less concrete areas. With weight in particular, it can be tempting to focus on a number — a calorie count, a carbohydrate gram, a scale number — but when the number doesn’t go your way, it can be devastating. It helps to widen one’s lens beyond the concrete.

Orthorexia--when Healthy Eating is Taken to an Extreme

My grandfather’s mantra was “everything in moderation.” He drank a small scotch at 5 o’clock six days a week and lived to be 95.

There’s a growing problem in the US with the concept of moderation when it comes to eating and drinking—but not in the way you might guess. This issue isn’t always with people eating too much of food deemed unhealthy, explains Sumathi Reddy in a recent issue of the Wall Street Journal; the problem is with people being overly restrictive in the foods they will eat. The condition she describes is orthorexia nervosa, an unofficial term for when the effort to eat healthy or “clean” becomes extreme and obsessive, affecting either physical health (through weight loss or malnutrition) or mental health (anxiety or avoidance).

What may start out as health-promoting—becoming a vegetarian, going gluten-free or avoiding processed foods—can devolve into something very unhealthy. The condition, says one professional familiar with it, is more akin to an obsessive-compulsive disorder than it is to anorexia nervosa, the eating disorder characterized by overly strict limits on any type of food.

How can you tell if you’ve gone too far? It can be difficult to distinguish between healthy planning and obsessional avoidance. One way is paying attention to how much anxiety you feel. A red flag is when someone's eating habits makes him or her avoid social engagements, according to Marjorie Nolan Cohn, a dietitian quoted in the article.

If you are sacrificing your social life because your need to maintain your diet seems more important, then it may be time to ease up. Similarly, look at how much time you are spending thinking about and preparing food. If other important interests and commitments are getting pushed aside, that may be a signal that you’ve gone overboard.

Saying No to Body Shaming

In a recent New Yorker piece, Lizzie Widdicombe writes about the plus-sized fashion industry, describing how plus-sized women (size 14 and up) have felt stigmatized and marginalized by the types of fashions available for them. Some women have circumvented this, and there are now companies out there producing fashionable clothes in larger sizes.

In the article, she writes that the views we typically hold about weight and fat are recent, developing since the industrial revolution. Around that time, clothing became mass produced, so people started needing to fit their clothes, rather than the other way around.

In addition, fat had previously signaled affluence. Once that ceased and thinness signaled affluence, we started to devalue fat and weight. The author quotes Madeline Jones, the editor of the online magazine Plus- Model: “People become plus size for all sorts of reasons, not all of which involve lifestyle choices. And it’s not clear that shaming people—or requiring them to wear muumuus—is an effective weight loss tool.”

This is certainly true: fat shaming is hardly conducive to weight-loss.  

From Drugs to Diet

To really change behavior is a very difficult task. I was reminded of this reading a story this week about increasing attention paid to diet and wellness within addiction programs.

Traditionally, programs designed to treat alcoholism and drug addiction have focused only on helping people withdraw from the problematic substance. Diet hasn't been a worry, as Abby Ellin explains in her New York Times piece. In fact, sweets and snacks are typically available to ease the adjustment.

The experience can be similar with people who are trying to stop smoking. When people give up the comfort of their tobacco habit, it's easy for them to seek relief by eating more. There are so many things we can use to soothe and comfort ourselves, and they all have their downsides, though to a varying degree.

For some people in addiction treatment, Ellin explains, the process leads to an overreliance on foods with high fat and high sugar content. Now, few people would argue that eating poorly is more damaging than cocaine addiction, but weight gain can still cause problems if it becomes an obstacle to maintaining abstinence. The issue also highlights the importance in addiction programs of addressing multiple aspects of a person’s life: self-care, life skills--a varied arsenal of strategies to manage distress.

Ending Fat Talk

A recent post on the Motherlode blog describes a summer camp’s effort to ban not only “fat talk,” but any talk about appearance. “Fat talk” refers to the almost automatic way people (often but not always women and girls) comment on their bodies. It’s a stream of “I know I shouldn’t eat this, but” “Does this make me look fat?” and “I hate my body part.” It also extends to comments on others’ bodies, as in “You look like you gained/lost weight.” It’s such a pervasive part of conversation that you almost don’t notice it.

For myself, I have tried to disengage from fat talk. I have heard enough from others about how uncomfortable it makes them to have their weight commented on, whether those comments are positive or negative. When it’s negative, it’s pretty straightforward why it’s troubling. When it’s positive, it can make you wonder what people have been thinking all those other times they didn’t say anything about how you look.

However, this camp is taking it a step further and trying to eliminate any commenting on any aspect of a person’s appearance. In place of saying, “You look nice,” they encourage “I feel happy to be around you.”

I imagine it feels a little forced for campers. At the same time, it brings a helpful focus on how much of our thoughts and conversation are tied up with weight and appearance.

It is almost reflexive to think about appearance. I think about it when I see babies. Research has shown that we are more likely to comment on a baby girl’s looks and a baby boy’s strength and ability. I always try to remember that and think of something else to comment on with a baby girl. It’s an extra cognitive step, because it is so ingrained to think about beauty.

I applaud this camp for at least trying to address this issue. It gives campers a summer to think about what else there is to notice about people other than the way they look. Perhaps they can carry it with them the rest of the year.

Letter to my Fat Son

In What I’d Say to My Fat Son, Joshua Max writes movingly about his experience as a fat kid.

He began as a chubby kid with a belly who didn’t hate himself or his body, and grew into a bulimic teenager and adult--a man who may have been of normal weight, but who was filled with shame and body hatred.

It took years--plus $5,000 worth of dental work to fix teeth damaged by stomach acid from repeated regurgitation--but Max has come to a place of peace and body acceptance. What helps him? Making peace with his body and with other people. Surrounding himself with supportive friends. Focusing on small ways to help others when he starts to feel badly about his appearance.

Max’s plan for his potential future son: encourage him to be active, teach him about healthy eating, and help him not to focus too much on his weight. Finally, Max hopes to help his son avoid making value judgments about weight. “If someone hurts his feelings about his size,” writes Max, “we’ll talk about how people are uncomfortable with fat people because they see them as lazy, stupid, incompetent and ugly, but that fat people are none of those things inherently and some skinny people are also those things.” These are wise words from which we all could learn.

Boys' Body Image Worries

Eating disorders are usually considered the realm of women and girls. Boys, however, make up a growing share of those with body image concerns and eating disorders.

A recent study of adolescent boys, described at The Atlantic, concludes that boys, in contrast to girls, are usually less worried about thinness and are more worried about being muscular, leading them to fell pressure to gain weight.

Boys are increasingly susceptible to media images of men’s bodies. Like girls, they increasingly seek to emulate unachievable body types; but instead of trying to look like a supermodel, they’re trying to look like a superhero. Their ideal is to be like the Batman or Superman toy from their childhood, but only 1 or 2 percent of men naturally have the body type that is typically represented in action figures, according to Raymond Lemberg, a psychologist specializing in male eating disorders.

So rather than focus on thinness, boys are more likely to try to bulk up with steroids and protein powders, and through overexercise. But just as parents and professionals should be on the alert for signs of eating disorders among girls, they need to do the same with boys—looking for overconcern about weight and shape, as well as high-risk behaviors such as using steroids.

This development among males is disappointing. When people hope for equality of the sexes, I don’t think that the phenomenon of boys and men grappling with unrealistic body image standards is what they have in mind. 

What You Lose When You're a Perfectionist

When people think about perfectionism, they usually do so in relation to psychology; they look at it as a personality trait and see it as a reflection of someone’s character. In contrast, “The Agony of Perfectionism,” an article recently posted on TheAtlantic.com, explores perfectionism through the lens of economics. But despite the different approach, the economic takeaways arrive at the same conclusions as the psychological ones.

Economists once believed in the existence of the rational consumer. In theory, when a person had to make a purchasing decision, he or she would collect all available information about that potential purchase, weigh all the options, and in the end make a reasoned, well-informed choice about what to buy.

Anyone who has tried to buy a camera on Amazon or book a hotel on TripAdvisor, however, knows this is not possible. You face a vast number of choices and a wide range of passionate opinions. At a certain point you have to cut off your research and make a decision.

So some economists have divided consumers into two groups. One comprises people who strive to make their decisions in a rational way, seeking out as much information as they can get before they make their pick. These folks, called “maximizers,” want to examine all possible choices and to feel that they have made the best choice. Maximizers, in other words, are economic perfectionists. In contrast, the other group of consumers, called “satisficers,” aren’t perfectionists; they tend to settle for something they consider “good enough.”

So who’s happier with their purchase? The people who exhaustively research their purchases to find the best possible choice? Or the ones who put much less thought before they pull the trigger and buy? The satisficers, oddly enough. Despite all their research, maximizers are more likely to be filled with regret. Because the amount of information they can collect is limitless, they are always left wondering whether they made a mistake by not looking for more information, or by paying attention to the wrong information. There is always room for them to wonder whether they could have made a better choice.

Maximizers are also more susceptible to looking at others’ Facebook and Instagram posts and feeling badly about themselves and their choices. In the past, you were limited by your imagination in thinking that others were doing all sorts of cool stuff that you weren’t doing. Now, however, you can see actual photos of what they’re up to. You can Google them, easily learn about their achievements, and fuel your dissatisfaction and feeling of not measuring up.

In summarizing the research, the author makes the sad point that the maximizers/perfectionists work harder and perform better, but are also more likely to feel depressed and regretful. Whether you look at them from the psychological or economic point of view, the article encapsulates the challenge of striving to achieve and make good choices without pushing yourself to the point of dissatisfaction with all your choices.

My Age of Anxiety: Fear, Hope, Dread and the Search for Peace of Mind

After reading this excerpt in The Atlantic, I had to read the book itself. My Age ofAnxiety: Fear, Hope, Dread and the Search for Peace of Mind, by Scott Stossel, is an exhaustive look at the author’s experience with debilitating anxiety. He is trying to understand why he is so anxious and also how best to treat it. He has every reason to be anxious: his genes, his parents, and his own temperament. He describes some harrowing early experiences with separation anxiety and the less–than-sensitive ways his parents dealt with it. But in another chapter, he describes how his own kids, despite a much different family environment, exhibit some of the same phobias. So after a thorough examination of the research, he sees his anxious self as a product of both nature and nurture.

The book seems more positive about treatment than the magazine article. Stossel has been treated by a bunch of different therapists and psychiatrists over the years. Some of the therapeutic choices seem questionable. For example, Stossel’s father, when he needed a therapist, started seeing his son’s longtime psychiatrist. (It’s nearly always a bad idea for people that close to one another to be separate clients of the same psychotherapist.) The author is most positive about his current therapist, a psychologist who has tried to help him understand the sources and meaning of his anxiety, to provide him with concrete skills to reduce and cope with his anxiety, and who is supportive of medication.  This doctor also makes a point of helping the author to look at his strengths and what he has overcome, rather than simply focusing on his deficits.

This book is filled with information about anxiety and its sufferers—I did not know that Charles Darwin suffered from so much anxiety or that Matt Lauer was phobic about vomiting. There is also much about the history of anxiety and how our definitions and diagnoses have shifted based on research and medication; some disorders, such as social phobia, were popularized after medications were developed. But the most interesting parts are the author’s descriptions of his own struggles. It was terrifying for him to feel so much fear at such a young age. It’s impressive that he has been able to accomplish so much despite it.

Surviving Anxiety: One Man's Story

This month’s Atlantic Magazine features its editor Scott Stossel’s brave discussion of his longstanding and crippling anxiety. What makes it brave? His willingness to graphically describe some of his most shame-filled moments, such as clogging the toilet (loose bowels being one unfortunate symptom of his anxiety) while at the Kennedy compound in Hyannisport researching a book on Sargent Shriver.  I was feeling his pain as he described the experience and his awkward efforts to deal with it.

Where did all this anxiety come from? The author describes himself as something of a perfect storm for anxiety and depression.  There’s a family history of anxiety on both sides of his family going as far back as great-grandparents --including a set of grandparents who fled the Nazis and hid their Jewishness after they were safely in the United States. More immediately, the author’s mother had a host of her own set of fears and phobias, stemming in part from two miscarriages and other difficulties getting pregnant before he was born. In addition, he had a hard-drinking father with little empathy for his son’s emotions. It’s not difficult to see how both the genetic links and the environmental effects might produce an anxious person.  

He describes a host of treatments beginning at age 10 for medication and 11 for therapy. According to the author, nothing has worked. The article certainly gives you a sense of the great variety of treatments for anxiety and also the complexity of helping someone with such a number of symptoms and issues. His article also has you hoping that there is a less dangerous solution out there for a fear of public speaking than Stossel’s own remedy of Xanax, Inderol and scotch and vodka. One thing that struck me in his treatment descriptions was that his therapists and psychiatrists seemed to be very either/or in their approaches—either therapy or medication—so it didn’t seem that there was too much coordination between them.  It seemed he almost needed to hide one from the other.

On a bright note, this man, despite his severe anxiety, has managed to marry and become the editor of the Atlantic. It’s impressive, given the struggles he describes. He describes himself as a duck: “To some people , I may seem calm. But if you could peer beneath the surface, you would see that I’m like a duck—paddling, paddling, paddling.” How brave to let others see how hard you have to paddle.

Fat Talk and Body Dissatisfaction

Have you ever said, “I really shouldn’t eat that dessert”? Have you ever deflected a compliment about your appearance by saying, “Oh, I’m nowhere near as thin as you”? This casual banter can be more harmful than you think.

That’s the conclusion of arecent paper, “Is Fat Talking a Causal Risk Factor for Body Dissatisfaction?” “Fat talking” is an expression used to describe the very common dialogue among women (and some men) about how their bodies compare to others, why they shouldn’t eat what they’re eating, and how fearful they are of gaining weight. For this article,  the authors looked at 23 years of studies that measured fat talking. They were trying to understand the link between fat talk and body dissatisfaction. Is it that people who are dissatisfied with their bodies are more likely to engage in fat talking? Or does engaging in fat talking increase the risk people will be dissatisfied with their body? In that case, if you decreased fat talking, you could decrease body dissatisfaction--a worthy goal, since body dissatisfaction is linked to problems such as eating disorders and low self-esteem.

So what did the results show? Fat talking was most strongly correlated with body dissatisfaction for adolescents and adults, as opposed to for younger children. There was some indication of a cause-and-effect relationship between fat talking and unhappiness with one’s own appearance--that fat talking precedes changes in body dissatisfaction. In the one study that directly assessed this, exposure to others’ fat talking led to an immediate increase in body dissatisfaction. In other words, the more you do things such as compare your eating and exercise habits to other people and the more you evaluate other people’s appearance, the more likely you are to be unhappy with your own body. Now, people might know this intuitively. But the article is still a good motivator to be mindful about fat talking and to be conscious of its possible impact on yourself and others.

Overweight and Underweight: What they have in Common

When people are obese, they are often told by their doctor to diet and lose weight. But when  treated for an eating disorder--whether it’s binge eating, anorexia or bulimia--patients are told not to diet. What is the overweight person who binge eats supposed to do? Abby Ellin writes about this conundrum and of the effort of professionals to incorporate knowledge about eating disorders into treatment for obesity. 

Whether they are underweight or overweight, both groups tend to go back and forth between severely restricting their food intake and overeating or bingeing. The treatment for binge eating is geared towards avoiding dieting, not focusing on weight, and on regularizing eating in order to break the restriction-binge cycle. At the same time, a common approach to obesity has been the diet--focus on calories, portion sizes, weight loss. This makes for mixed messages  for the overweight person who also binge eats. Recent changes in the upcoming Diagnostic and Statistical Manual of Mental Disorders includes the diagnosis of Binge Eating Disorder and will hopefully allow for more common ground in the treatment of eating disorders and obesity, according to Ellin’s article.

So where is the common ground? For both underweight and overweight people with eating disorders, low self esteem and body dissatisfaction is common. Both place excessive emphasis on appearance and body size, says one expert quoted in the article. Both groups also suffer from weight stigma and bias. Shifting the focus away from weight and dieting is helpful treatment for both groups.  “The focus should be on behaviors, not weight,” said Dianne Neumark-Sztainer in the article. She is a professor in the School of Public Health at the University of Minnesota. “We know from our research that talking about weight and diets is not effective, and for many leads to weight gain over time.” 

On a societal level, it would help to reduce weight stigma and to lessen cultural pressure to be thin. On an individual level, it helps to resist checking the number on the scale and to focus on changing individual behaviors:eating regularly, learning to respond to feelings of hunger and fullness, and coming up with non-food-related strategies to cope with troubling emotions will help.

The Allure of the Chip

I’m in the middle of reading Salt Sugar Fat, a book by Michael Moss that reveals how manufacturers of processed foods develop and market the products they sell. It’s shocking to read about the effort that goes into creating foods that will be enticing on multiple sensory levels. One of marketers’ goals, Moss explains, is to turn people into what they call “heavy users” of their product, whether it’s a drink like Coke or Pepsi or a snack like Cheetos or Lay’s potato chips. The reason? It’s cheaper for marketers to get heavy users to buy more of a product than it is to try and find many more occasional users.

 In this interview posted on The Atlantic's website,  Moss describes in detail the allure of the potato chip: the intial flavor burst of salt you taste, the “mouthfeel” of the fat, the sweetness that gets released when you bite it, the crunch, the meltiness in your mouth.  Just reading his description makes you want to eat some chips. The experience is  seductive, and it’s scientifically designed to draw you in and keep you eating without registering how much you consume.

As you read Salt Sugar Fat, you get a sense of what you, the individual eater, are up against when you want to enjoy food but eat healthfully and moderately. A huge industry is devoted to tempting you into eating processed foods -- not just to eat them, but to eat a lot of them, and to eat them mindlessly. Reading about it makes me not only more mindful about trying to fight this manipulation, but also more forgiving of myself and others when the fight is difficult.

What is Real Beauty?

A recent advertisement for the Dove brand of personal care products is sending mixed messages. The ad, centering around a three-minute video, documents an FBI-trained sketch artist making portraits of several different women he cannot see. He draws each subject -- none of whom, apparently, are models -- twice. One portrait is based on that woman’s description of herself, and the other is based on another person’s description of that same woman.

The result is striking. Drawings based on each woman’s description of herself always look worse than ones based on another person’s description. The ad highlights the way that women tend to see themselves, and then describe themselves, in terms of their physical flaws and what they don’t like about themselves. In this way, the video offers an empowering message to women, explicitly stated onscreen at the ad’s close: “You are more beautiful than you think.”

Despite this explicit encouragement, the ad has been criticized by some eating disorder professionals and other online commenters. They point out that though the women in the ad -- like other women in Dove’s Real Beauty campaign -- don’t appear to be fashion models, they are, objectively speaking, thin and attractive nonetheless. Absent from the ad are women with a face or body not considered typically attractive; perhaps the relatively unflattering portraits inspired by their self-descriptions would simply be an undistorted reflection of their appearance. What is being communicated to these women? Critics make a strong case that this ad promoting “real beauty” is simply another message that it’s fine to be happy with your body as long as it falls within a particular narrow range of acceptable weight or shape. The ad also accepts as a given that being looked at is intrinsic to a woman’s existence. Of course, though, an ad focused on what women’s bodies can do, rather than how they look, probably wouldn’t sell much soap.

Learning from Mistakes without Driving Yourself Crazy

Trying to learn from past actions is a challenging task for many people. How can you reflect on something you have done and think about how you could do it differently without devolving into destructive self-criticism? In Top Dog, a book about the science of winning and losing, authors Po Bronson and Ashley Merryman address this question. 

It turns out there is a term for these what-if thoughts--counterfactuals, called so because the behavior involves looking at something that did not actually happen. According to research at the University of Illinois, 3% of humans’ thoughts are directed at thinking about things that almost happened or could have happened. Another 6% is spent contrasting the present against the past, or the present against the future. Another 3% is devoted to comparing ourselves to others and to self-evaluation, either negative or positive. 

I’ll take the precision of these numbers with a grain of salt, but they do suggest that a significant portion of some people’s thoughts is spent thinking about “coulda, woulda, shoulda” as well as comparing oneself to others. So the question arises: How can you use these thoughts in a constructive way? If all you do is ruminate about what you should have done, you’ll never get anywhere. At the same time, if you refuse to reflect on your past behavior, you’ll never learn and change. 

The answer is found in researchers’ distinction between additive and subtractive counterfactuals. A subtractive counterfactual is pure regret, while an additive counterfactual involves looking back but at the same time generating some constructive ideas for the future. Researchers who have studied counterfactuals with sales pitches, negotiations and athletic performances have found that those who look back with additive counterfactuals tend to improve with practice, while performance declines for those who look back with subtractive counterfactuals. This makes intuitive sense, as with an additive counterfactual, you are including a thought about something you can do to improve your performance.

What’s the implication of this research for you? When you start thinking about the past, notice how you’re doing it. If it’s all regret without any actionable ideas, you are ruminating and you should try to stop or to redirect your thoughts. If your counterfactuals are additive, keep  up the good work.

Coping with Stress in High-Pressure Situations

Some people thrive under pressure; others buckle. What accounts for the difference? In this week’s New York Times Magazine, Po Bronson and Ashley Merryman write about differences in the ways that kids cope with stress, but the research has something for adults too.

They describe research that identifies variants of a gene known as COMT that distinguishes between “warriors,” who cope well with stress and “worriers,” who don’t. Kids with the “worrier” version of the gene do better with cognitive tasks under low pressure, but in high pressure situations, they don’t do as well. In contrast, kids with the “warrior” version do not perform as well on workaday tasks, but then will rally when the pressure is on.

One way of thinking about these results is to understand that the children are interpreting a particular situation as either a threat or a challenge.  “Worriers” are more likely to interpret the physical symptoms that they feel in a high-stakes situation  to mean that they are in a threatening situation, and that response ends up being detrimental to their performance. A “warrior,” on the other hand, might experience the same symptoms and view the experience as a challenge that he or she can rise to.

All is not lost for the worrier, though. Practice and experience can erase the difference. In a study with Air Force pilots, inexperienced warriors performed better than inexperienced worriers. But among more experienced pilots, the worriers outperformed the warriors. Acclimating to stressful situations through practice, in other words,  can help with performance. This repetition appears to help worriers relabel the scary situation into a challenging one.

Most people who have taken the SAT or a similar standardized test will have an idea of whether they fall on the warrior or worrier end of the spectrum. If you’re a warrior, lucky you. If you’re a worrier, don’t avoid stress; instead, try to experience it in manageable doses. Try to learn ways of reframing anxious situations and reminding yourself that the anxiety you feel may help you be more focused and alert and better able to meet a challenge.

Overcoming Anxiety

What makes a panic attack so scary? Well, first there comes the sudden onset of  debilitating symptoms--racing heartbeat, tightness in the chest, nausea, among others--that can be mistaken for a heart attack. Then, once you realize that you’re not dying comes the fear that this sudden anxiety will strike again.

This makes a recent New York Times article about professional golfer Charlie Beljan all the more remarkable. He had a panic attack (although he didn’t identify it as such while he was experiencing it)  before a practice round for a PGA tournament. He managed to play through his anxiety and complete the round. For some, the initial panic attack can lead to avoidance of similar situations (for example, avoiding driving after having a panic attack while driving). In this case, Beljan returned to the tournament the next day, after spending the night in the hospital getting a medical workup.And despite the residual effects of the previous day’s experience, he won the tournament.

It’s hard to imagine experiencing such anxiety and then performing so well under pressure. Golf has a well-deserved reputation as a nerve-wracking sport--one in which a player’s greatest enemy is the psychological turmoil inside. The history of professional golf is filled with episodes in which a golfer nears the end of a tournament leading by a wide margin, only to buckle under the pressure, start playing badly and lose the top spot. In this case, he attributed the anxiety not to the pressure from the tournament, but recent changes and stressors in his personal life, such as having a new baby. After the tournament, the article notes, he contacted a psychologist for treatment.

Beljan’s story shows how disruptive and frightening anxiety can be, but also shows that it is possible to overcome it. His story is truly impressive and inspirational.

Male Anorexia

“20% of Anorexics are Men” is the to-the-point title of an article in the September issue of GQ, which profiles male anorexics and highlights some of their difficulties. Some takeaways:

• The number of male anorexics is rising quickly. One contribution may be the increased focus on hard-to-attain physical attributes like the six-pack

• Risk factors include being overweight as a youth and getting teased for it; a family history of eating disorders or obesity; being gay; and having participated in a sport that emphasizes speed or weight control (distance running, wrestling, etc.).

• Anorexia has the highest mortality rate of any mental illness--between 5 and 10 percent--a result of both suicide and health complications. It lasts longer in men (8 years) than women, in part because men are likely to wait longer to get treated.

• Even with recovery, there are likely to be health complications which can affect life expectancy. The prolonged deprivation can weaken the heart muscles, the bones, and cause cognitive damage which may lead to medical issues long after treatment is completed.

The photos that accompany the article are arresting and disturbing, as are the sad stories of the suffering men profiled. Included are one man on the verge of death, so emaciated that the fat from the pads on his ear that seal his Eustachian tube is gone, leading him to hear a constant rushing of air; and a subclinical anorexic, whose weight is low but not dangerously so, but who tightly controls his exercise and food intake so as to maintain it. What is striking in all of these stories is the amount of focus and energy on food and exercise, and the isolation that accompanies it. Either because of the time and energy devoted to losing or maintaining weight or the need to hide the extent of restriction from others, the men profiled appear lonely, virtually friendless and withdrawn from others. It is truly a sad and moving article.