New Tool for Depression – Focus on Positive Future Expectations

For years, I’ve been teaching clients simple frameworks to manage the emotional mind. These frameworks have to be accessible within 1/3rd of a second, before the emotional mind hijacks the rational mind.

A powerful example of this is the framework developed by Phillip Zimbardo at Stanford regarding time perspectives and valence, which is a fancy way of saying that our attention can take you certain places – internal (e.g., monitoring your heart rate, your thoughts) or external (e.g., the room you are in, the people you are with); past, present or future; and/or positive or negative emphasis.

From Ken Pope’s excellent newsletter…

*CNS Neuroscience & Therapeutics* has scheduled an article for publication in a future issue: “Treating Major Depression by Creating Positive Expectations for the Future: A Pilot Study for the Effectiveness of Future-Directed Therapy (FDT) on Symptom Severity and Quality of Life.”

The authors are Jennice S. Vilhauer, Sabrina Young, Chanel Kealoha, Josefine Borrmann, Waguih W. IsHak, Mark H. Rapaport, Narineh Hartoonian, & Jim Mirocha.

Here’s the abstract:

[begin excerpt]

Introduction: This nonrandomized pilot study assesses the efficacy of a new future-oriented form of therapy, known as future-directed therapy (FDT), as a treatment for patients with Major Depressive Disorder (MDD) in a naturalistic hospital-based outpatient psychiatry clinic. The study measured symptom severity of depression and anxiety, in addition to quality of life pre- and posttreatment.

Aims: The study examined a new manualized treatment designed to help people anticipate a more positive future. The intervention consists of twenty 90-min group sessions administered twice a week over 10 weeks. The intervention was compared to depressed patients in the same clinic who enrolled in traditional cognitive-based group psychotherapy. Sixteen patients with MDD completed the FDT intervention as part of their outpatient treatment for depression. Seventeen patients with MDD participated in treatment as usual (TAU) cognitive-based group therapy. The Quick Inventory of Depressive Symptoms, the Beck Anxiety Inventory, and the Quality-of-Life Enjoyment and Satisfaction Questionnaire short form, self-report instruments were administered prior to and immediately after the completion of therapy.

Results: Patients treated with FDT demonstrated significant improvements in depression (P= 0.001), anxiety (P= 0.021) and quality of life (P= 0.035), and also reported high satisfaction with the therapy. Compared to the TAU group, patients treated with FDT showed greater improvements in depressive symptoms (P= 0.049).

Conclusions: FDT may have the potential of becoming an additional treatment option for patients with MDD.

[end excerpt]

On the Cedars-Sinai (where the research was conducted) web site there was the following additional information:

[begin Cedars-Sinai info]

Patients with major depression do better by learning to create a more positive outlook about the future, rather than by focusing on negative thoughts about their past experiences, researchers at Cedars-Sinai say after developing a new treatment that helps patients do this.

While Major Depressive Disorder patients traditionally undergo cognitive-behavior therapy care that seeks to alter their irrational, negative thoughts about past experiences, patients who were treated with the newly-developed Future-Directed Therapy(TM) demonstrated significant improvement in depression and anxiety, as well as improvement in overall reported quality of life, the researchers found.

Results were published recently in the peer-reviewed journal CNS Neuroscience & Therapeutics.

“Recent imaging studies show that depressed patients have reduced functioning in the regions of the brain responsible for optimism,” said Jennice Vilhauer, PhD, study author and clinical director of Adult Outpatient Programs for the Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences. “Also, people with depression tend to have fewer skills to help them develop a better future. They have less ability to set goals, problem solve or plan for future events.”

According to the U.S. Centers for Disease Control and Prevention, an estimated one in 10 American adults meet the diagnostic criteria for depression.

Anand Pandya, MD, interim chair of Cedars-Sinai’s Department of Psychiatry and Behavioral Neurosciences, said, “Future-Directed Therapy is designed to reduce depression by teaching people the skills they need to think more positively about the future and take the action required to create positive future experiences.  This is the first study that demonstrates this intervention intended to increase positive expectations about the future can reduce symptoms of Major Depressive Disorder.”

Depression in Men depressed guys

When people talk only about the negative aspects of their lives, it causes them to focus more attention on what makes them unhappy, Vilhauer said.

“Talking about what makes you unhappy in life doesn’t generate the necessary thinking patterns or action needed to promote a state of thriving and create a more positive future,” Vilhauer said.  “Future-Directed Therapy helps people shift their attention constructing visions of what they want more of in the future and it helps them develop the skills that they will need to eventually get there.”

In the study conducted at Cedars-Sinai, 16 adult patients diagnosed with Major Depressive Disorder attended future-directed group therapy sessions led by a licensed psychologist twice a week for 10 weeks.  Each week, patients read a chapter from a Future-Directed Therapy manual and completed worksheets aimed at improving certain skills, such as goal-setting.  Another group of 17 patients diagnosed with depression underwent standard cognitive group therapy. The study team measured the severity of depression and anxiety symptoms, and quality of life before and after treatment, using the Quick Inventory of Depressive Symptoms, the Beck Anxiety Inventory, and the Quality-of-Life Enjoyment and Satisfaction Questionnaire short form.

Results include:

Patients in the Future-Directed Therapy group experienced on average a 5.4 point reduction in their depressive symptoms on the Quick Inventory of Depressive Symptoms scale, compared to a two point reduction in the cognitive therapy group.

Patients in the Future-Directed Therapy group on average reported a 5.4 point reduction in anxiety symptoms on the Beck Anxiety Inventory, compared to a reduction of 1.7 points in the cognitive therapy group.

Patients in the Future-Directed Therapy group reported on average an 8.4 point improvement in their self-reported quality of life on the Quality of Life Enjoyment and Satisfaction scale, compared to a 1.2 point improvement in the cognitive therapy group.

[end Cedars-Sinai info]

The author note provides the following contact information: Jennice Vilhauer, Ph.D., Cedars-Sinai Medical Center, Department of Psychiatry and Behavioral Neurosciences, 8730 W. Alden Drive, Thalians W-101, Los Angeles, CA, USA. Tel.: +(310) 423-2620; Fax: +(310) 423-0114; E-mail:


Vulnerability – The Birth Place of Shame, Joy, Love and a Meaningful Life – Brene’ Brown

Brene’ Brown is my new hero(ine). You must check out this fantastic talk she did at TED in 2010.

I’m currently ordering numerous copies of her recent book, The Gifts of Imperfection, for all the mothers I know for Mother’s Day.

Emminently readable, vastly significant and life-changing.

If you’d like a FREE copy of my award-winning book, Guide to Self: The Beginner’s Guide to Managing Emotion and Thought, simply go to, click on the yellow book icon on the left side of the page and enter your name and email address.

Have a relaxing Mother’s Day!

To life, love and laughter,

John Schinnerer, Ph.D.
Founder Guide to Self, Inc.
Award-winning author and blogger
Anger management coach

Long-Term Users of Ecstasy and Thizz Risk Hardcore Brain Damage – New Study

I have a number of angry, male, teenage clients who use ecstasy, or thizz (which is a combination of ecstasy and PHP/cocaine/meth).  I’m always on the lookout for new studies that highlight the physical, cognitive and emotional effects drugs have on people. Yesterday, I found out about a brand new study from

Ecstasy MDMA Thizz in Danville CA

Ecstasy (Thizz, MDMA) Seems Prevalent in Danville, CA

‘ScienceDaily (Apr. 15, 2011) — Long term users of the popular recreational drug ecstasy (MDMA) risk structural brain damage, suggests preliminary research published online in the Journal of Neurology, Neurosurgery and Psychiatry.

Other research has suggested that people who use ecstasy develop significant memory problems, so the Dutch researchers wanted to find out if there was any clinical evidence of structural changes in the brain to back this up.

They focused on the hippocampus, which is the area of the brain responsible for long term memory.

They measured the volume of the hippocampus using MRI scans in 10 young men in their mid 20s who were long term users of ecstasy and seven of their healthy peers in their early 20s with no history of ecstasy use.

Although the ecstasy group had used more amphetamine and cocaine than their peers, both sets of young men had used similar amounts of recreational drugs, bar ecstasy, and drank alcohol regularly.

The ecstasy group had not been using on average for more than two months before the start of the study, but had taken an average of 281 ecstasy tablets over the preceding six and a half years.

The MRI scans showed that hippocampal volume in this group was 10.5% smaller than that of their peers, and the overall proportion of grey matter was on average 4.6% lower, after adjusting for total brain volume.

Ecstasy use on the rise

This indicates that the effects of ecstasy may not be restricted to the hippocampus alone, say the authors

“Taken together, these data provide preliminary evidence suggesting that ecstasy users may be prone to incurring hippocampal damage, following chronic use of this drug,” they write.

They add that their findings echo those of other researchers who have reported acute swelling and subsequent atrophy of hippocampal tissue in long term ecstasy users.

And they point out: “Hippocampal atrophy is a hallmark for diseases of progressive cognitive impairment in older patients, such as Alzheimer’s disease.”‘


It’s my deep-seated belief based on experience and a pretty good  (really, just pretty good, memory is NOT my strength!) understanding of the literature that most substance use is a means to escape the emotional mind – feelings such as ennui, embarrassment, anger, frustration, anxiety, depression, loneliness, alienation, excitement, disappointment, and heartache. One of the problems with ecstasy, or MDMA, is that it changes the way in which the brain perceives pleasure. Over time, the brain loses the ability to perceive pleasure without the addition of ecstasy. Without the ability to feel pleasure, chonic ex users lose the ability to ‘approach’ things they desire and increasingly ‘avoid discomfort.’

Anger in teenagers seems to be on the rise 2011 April

Lacking the ability to approach things they desire means that fulfilling activities are non-existent. So goal-setting and, more importantly, goal achievement, a major source of meaning and personal satisfaction, do not happen.

On the bright side, research has shown that the brain can recover rapidly, creating new neurons and new pathways. Changes in the brain occur every minute of every day. Your brain is always growing, developing, learning, and recreating itself!

My goal is to help you realize where you are, what you are missing (the hardest part), and to take small steps in a constructive, meaningful direction.

This is done through teaching tools such as self-forgiveness, mindfulness (sounds weak but is tremendously powerful), compassion, challenging catastrophic thinking, reframing, best possible self and more. By layering these tools one atop the other, there is a cumulative, additive effect wherby my clients become less filled with negative emotions (e.g., anger, guilt, anxiety, sadness) and more open to positive emotions (e.g., curiosity, awe, hope, courage, pride, and contentment).

All the best,
John Schinnerer, Ph.D.

Founder, Guide to Self, Inc.

If you are interested in finding out more, you can download a FREE copy of John’s award-winning book, Guide to Self: The Beginner’s Guide to Managing Emotion and Thought. It is awesome! Just visit, click on the picture of the yellow book on the left side of the screen and enter your name and email address in the required fields. This will also give you access to a bunch of free anger management online video classes. What could be better in this day and age of falling economies, changing breadwinner roles, and political correctness and incorrect polititicians?!

Also, be sure to check out John’s offering on the latest proven tools for anger management at

Mindfulness Shown to Reduce Pain Perception By 40%


Demystifying meditation — brain imaging illustrates how meditation reduces pain

April 6, 2011 by Editor
Researchers at Wake Forest Baptist Medical Center have shown that meditation produces a 40 percent reduction in pain intensity and a 57 percent reduction in pain unpleasantness.

Mindfulness - Positive psychology and pain management

Fifteen healthy volunteers (who had never meditated) attended four 20-minute classes to learn a meditation technique known as “focused attention.” This is a form of mindfulness meditation where people are taught to attend to the breath and let go of distracting thoughts and emotions.

Both before and after meditation training, study participants’ brain activity was examined using arterial spin labeling magnetic resonance imaging (ASL MRI) to capture longer duration brain processes. During these scans, a pain-inducing heat device was placed on each participant’s right leg. This device heated a small area of their skin to 120 degrees Fahrenheit, a temperature that most people find painful, over a 5-minute period.

Scans taken after meditation training showed that the pain ratings for every participant were reduced.

At the same time, meditation significantly reduced brain activity in the primary somatosensory cortex, an area that is crucially involved in creating the feeling of where and how intense a painful stimulus is.

The research also showed that meditation increased brain activity in areas including the anterior cingulate cortex, anterior insula and the orbito-frontal cortex, which shape how the brain builds an experience of pain from nerve signals from the body. The more these areas were activated by meditation, the more that pain was reduced.

The decreases ranged from 11 to 93 percent, which is a greater reduction in pain than with morphine or other pain-relieving drugs, says researcher Fadel Zeidan, Ph.D.
Zeidan and colleagues believe that meditation has great potential for clinical use because so little training was required to produce such dramatic pain-relieving effects. “This study shows that meditation produces real effects in the brain and can provide an effective way for people to substantially reduce their pain without medications,” he said.

Their work appears April 6 in The Journal of Neuroscience.

For a FREE PDF copy of John’s award-winning self-help book on proven exercises to turn down the volume on negative emotions and ways to turn up the volume on positive emotions, including mindfulness tips, visit Click on the yellow book icon and enter your name and email address for instant access!

For FREE online anger management courses, visit where you can have full access to 4 free anger management classes by anger management expert John Schinnerer, Ph.D. 

There is also a full 10 week course on Positive Psychology of Anger Management available at the same site for the ridiculously low price of $297.