26. October 2011 by John Schinnerer.

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.”

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:

<vilhauerj@cshs.org>.

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10. September 2011 by John Schinnerer.

I have spent nearly a lifetime trying to understand, manage and fix the human mind. The mind fascinates, torments, inspires, belittles, loves, and elevates. So it was with great interest that I read that the CDC came out with a new report on mental illness, including anxiety and depression.

The Center for Disease Control just released their report, Mental Illness Surveillance Among Adults in the United States (September 2, 2011), outlining  the tremendous reach that mental illness has into my life, your life and every other life in the United States of America.

Some highlights from the report…

In the United States, the economic impact of mental illness  is enormous, roughly $300 billion in 2002. No more recent numbers are available, but the cost is rising.

Approximately 25% of adults in the U.S. have a mental illness. That means one out of every four individuals are dealing with some form of mental illness (e.g., anxiety, depression, other mood disorders, psychosis, OCD, ADHD, personality disorders, etc.). The report defines mental illness as all diagnosable mental disorders. Effects of mental illness may involve chronic abnormal thoughts, moods, or behaviors associated with distress and impaired  functioning. The effects of mental illnesses include disruptions of daily function; incapacitating personal, social, and occupational impairment; and premature death. The most common ones are anxiety and mood disorders (e.g., depression and bipolar disorder).

Almost 50% of American adults will experience at least one mental illness in their lifetime.

Mental illness leads to more disability than any other group of illnesses. More than even heart disease and cancer!

The Mental Impacts the Physical and Vice-versa

Most mental illnesses are fundamentally intertwined with chronic medical disorders like heart disease, addiction and obesity. So the manner in which our mind works dramatically impacts how well your body works.

Mental illness is a massive public health problem. Check out these facts from the World Health Organization…

• ‘mental illness is associated with increased occurrence of chronic diseases such as cardiovascular disease, diabetes, obesity, asthma, epilepsy, and cancer;
• mental illness is associated with lower use of medical care, reduced adherence to treatment therapies for chronic diseases, and higher risks of poor health outcomes;
• mental illness is associated with use of cigarettes, chewing tobacco and abuse of alcohol;
• rates for both intentional (e.g., homicide, suicide) and unintentional (e.g., motor vehicle) injuries are 2 to 6 times higher among people with a mental illness than in the population overall;
• many mental illnesses can be managed successfully, and increasing access to and use of mental health treatment services could substantially reduce the associated death rate and
• many chronic illnesses are associated with mental illnesses, and it’s been shown that treatment of mental illnesses associated with chronic diseases can reduce the effects of both and support better outcomes.’

Interestingly, there are currently no efforts at the national or state level to track anxiety disorders. Yet, anxiety disorders occur just as frequently as depression.
What’s more, anxiety disorders are similar to depression in that they

1. negatively impact daily functioning as much as depression,
2. are closely tied to the stress response system in the body,
3. have similar negative effects on physical health, and
4. are frequently found to exist together with the same physical illnesses as those that exist in folks who suffer from depression.

In conclusion, it appears that we are lagging in monitoring the prevalence of anxiety and providing assistance for those who struggle with anxiety. Mental illness is just beginning to get adequate exposure so that we can continue to develop cutting-edge tools and technologies to help those who suffer from it. We can no longer afford to bury our heads in the sand and ignore the compounding costs of mental illness. It is time to bring mental illness into the light where it can be appropriately identified and treated without shame.

What are your thoughts on this CDC report?

How have you been affected by mental illness in your life?

Please leave a comment below to get the conversation started!

All the best,

John Schinnerer, Ph.D.

Founder, Guide to Self, Inc.

Award-winning author of Guide to Self: The Beginner’s Guide to Managing Emotion and Thought (for a free PDF version, visit http://www.GuidetoSelf.com and enter your name and email address)

Award-winning blogger on The Shrunken Mind - a top 3 blog on positive psychology

Free online anger management classes which incorporate humor and positive psychology at WebAngerManagement.com

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24. August 2011 by John Schinnerer.

In my private practice, I see a number of angry teenage boys. Intuitively, I knew that teaching them to turn down the volume on negative emotions such as anger, anxiety and depression, WHILE teaching them to turn UP the volume on positive emotions would have a powerful impact on their lives. The results in my practice have been astonishing - reduced drug use, less illegal activity, more compassion, improved academic performance and less anger in the home.

Today, I came across a study that just came out from UC Davis which supports this approach. Take a look and let me know your thoughts!

John Schinnerer, Ph.D.

Founder Guide to Self Inc.

A Positive Psychology Approach to Anger Management

Happiness Can Deter Crime, a New Study Finds

From ScienceDaily (Aug. 23, 2011) — Happy adolescents report less involvement in crime and drug use than other youth, a new UC Davis study finds.

The paper, “Get Happy! Positive Emotion, Depression and Juvenile Crime,” is co-authored by Bill McCarthy, a UC Davis sociology professor, and Teresa Casey, a postdoctoral researcher at UC Davis, and will be presented at 10:30 a.m. Aug. 22 at the American Sociological Association Annual Meeting in Las Vegas.

“Our results suggest that the emphasis placed on happiness and well-being by positive psychologists and others is warranted,” McCarthy said. “In addition to their other benefits, programs and policies that increase childhood and adolescent happiness may have a notable effect on deterring nonviolent crime and drug use.”

The authors used 1995 and 1996 data from nearly 15,000 seventh- to ninth-grade students in the federally funded National Longitudinal Study of Adolescent Health, the largest, most comprehensive survey of adolescents ever undertaken.

They found that about 29 percent of the youth surveyed reported having committed at least one criminal offense, and 18 percent said that they had used at least one illegal drug. The researchers then correlated these reports with self-assessments of emotional well-being.

Consequences of happiness are rarely examined by sociologists, and no previous studies have investigated its association with juvenile crime, the authors said.

Many explanations of adolescents’ decisions about crime focus either on reflective thought that discourages offending, or negative emotions — such as anger or rage — that contribute to it.

McCarthy and Casey argue that positive emotions also have a role. “We hypothesize that the benefits of happiness — from strong bonds with others, a positive self-image and the development of socially valued cognitive and behavioral skills — reinforce a decision-making approach that is informed by positive emotions,” they write in their study.

Their research finds that happier adolescents were less likely to report involvement in crime or drug use. Adolescents with minor, or nonclinical, depression had significantly higher odds of engaging in such activities.

The study also found that changes in emotions over time matter.

Adolescents who experienced a decrease in their level of happiness or an increase in the degree of their depression over a one-year period had higher odds of being involved in crime and of using drugs.

Most adolescents experience both happiness and depression, and the study finds that the relative intensity of these emotions is also important. The odds of drug use were notably lower for youth who reported that they were more often happy than depressed, and were substantially higher for those who indicated that they were more depressed than happy.

University of California - Davis (2011, August 23). Happiness can deter crime, a new study finds. ScienceDaily. Retrieved August 23, 2011, from http://www.sciencedaily.com¬ /releases/2011/08/110822091859.htm

For your free PDF copy of John’s award-winning self-help book, Guide to Self: The Beginner’s Guide to Managing Emotion and Thought, on the latest tools to turn down the volume on negative emotions (like anger) and techniques to turn UP the volume on positive emotions, visit http://www.GuidetoSelf.com and click on the yellow book icon. Just enter your name and email for instant access to your copy!

For more info on John’s revolutionary online course on the positive psychology of anger management, visit http://drjohnsblog.wordpress.com. There are

four free anger management videos you can check out right now!

Follow John on Twitter at http://twitter.com/johnschin.

Facebook: https://www.facebook.com/anger.management.expert

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28. June 2011 by John Schinnerer.

I just read a great blog post by Ben Hayden on Psychology Today. I tried leaving a comment but was enable to due to website difficulties. Instead I’ve reprinted the post here with my comment below. Click on the article title below to go to the original blog post on Psychology Today…

The Decision Tree

Decision-making from all perspectives.

by Ben Hayden, Ph.D., is an Assistant Professor of Brain and Cognitive Sciences at the University of Rochester.

Are you rational?

What do economists mean by rational and irrational?

Published on June 26, 2011 by Ben Y. Hayden, Ph.D. in The Decision Tree

My last post raised a lot of questions about rationality. Rather than reply to them individually, I decided to devote this column to the topic.

I talk to the public a lot about economic discoveries that violate assumptions of rationality. And one thing that always surprises me is just how pleased people are to hear about these violations of rationality. Gleeful even. Relieved to not be the only dummy out there.

It’s surprising that people are so excited because, when it comes to economics, violations of rationality are pretty darn recondite.

An economically rational individual is someone whose preferences obey certain formal rules that insulate them from economists’ bugbear: intransitive preferences. Intransitive preferences means I prefer an apple to an orange, an orange to a pear, and a pear to an apple. This pattern of preferences is distressing to economists because some opportunistic evildoer could come along and offer to trade me an apple for my orange plus a small fee, and then offer me a pear for that same apple plus an additional fee, and then offer me an orange for the pear plus another small fee. Then that evildoer winds up with a free lunch from me. And there’s nothing economists hate more than a free lunch. (Economists would say that this evildoer has turned me into a ‘money pump’).

Bottom of Form

But the real reason this bothers economists goes much deeper than their annoying perennial reminders about free lunches. In the early 20th century, economics struggled to establish itself as a formal and rigorous science. Economists craved respect. (Anyone who has heard economics called the dismal science knows it’s been an uphill battle). Many brilliant economists built the field a solid foundation that was axiomatic - based on a few simple and obvious rules - the same way Euclid did with geometry and Peano did with arithmetic. And to make these axioms, economists had to come up with an economist’s equivalent of mathematically true and false. And they chose the terms rational and irrational.

Aristotle and Plato Discussing Reason and Emotion

These words were not intended to describe what people do. Humans are not robots; most (but not all) economists know that. Even if we were, our brains are finite. We have to take mental shortcuts. We are approximately rational and even that only sometimes. We economic psychologists love the phase ‘bounded rationality’.

Economics 101 is one of the most popular undergraduate courses in the United States, and it often gives rationality a central place. But we all have money anxieties, so we are predisposed to hear personal judgment coming from our economics professors. Every year, a new crop of students thinks their teachers are criticizing them about how they manage their personal finances.

But that’s not it at all.

Violations of rationality are nothing to be ashamed of. They are like optical illusions in vision: they are universal and they provide clues to how the visual system works. We study irrationality because it gives us essential clues to help us learn how the brain makes economic decisions. And we do that because it leads us to solutions for the real irrationalities: depression, addiction, schizophrenia, and so on.

Invite your local economists to the bar, buy them a round of beer and ask them about it. They’ll admit (in my experience, cheerfully) that when they go to the store, they make the exact same mistakes as the rest of us do. Because we are all human. We are all irrational.

-          Ben

 ——————————————————-

Dear Ben:

Thanks for the insightful blog post! I have this difficulty with clients frequently - they want to believe the illusion that they are primarily, if not solely, rational individuals. This would be great if it were so, but as you point out, it’s not the case. And I find individuals vary on a spectrum as to how much of the time they spend being rational vs. emotional. My challenge, for years, has been to decipher how to become aware of and train the emotional mind.

Different emotions can increase or decrease our rationality, reasoning and focus. Anger, for example, makes us more focused and rational - to a point. Think of anger on a 1 through 10 scale with 1 being calm and 10 be enraged.  Anger can  be useful below a 5. Once you go above a 5, the emotional mind is in charge, rationality goes out the window and we become atavistic and primal.

Thank you for pointing out our ubiquitous illusion of rationality.

Best regards,

John L. Schinnerer, Ph.D.

Founder Guide to Self

Award-winning author, blogger and anger management coach

For a free copy of John’s award-winning book on reason and emotion, visit GuideToSelf.com, click on the yellow book icon and enter your name and email.

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8. May 2011 by John Schinnerer.

I’ve seen this phenomena for years in my private practice where I teach clients anger management tools - parents bring in their teenage son and want me to ’fix’ his anger problem. The adolescent often has ADHD (Attention-Deficit/Hyperactivity Disorder) and trouble managing his emotions (i.e., mainly anger, but also anxiety, shame, guilt and sadness). As I begin to work with the troubled teen, it becomes obvious that he is not the only person in the family with difficulty managing anger and other negative emotions.

Online Anger Management Class For Parents Plus Individual Anger Management Coaching for Teenager

Typically, I’ll suggest that the parents take my online anger management course, in conjunction with individual coaching for their teenager. This has been highly effective in creating families that are cooperative, peaceful, and respectful.

This study just came out today demonstrating that ADHD and difficulty managing strong negative emotions, such as anger, run in families. In my mind, it’s a genetic predisposition which is activated by an emotionally volatile environment.

You may be interested in a guide book to your mind if you are reading this. If so, I have just the thing, and it’s free! You can instantly get a complimentary PDF copy of my award-winning book (Guide to Self: The Beginner’s Guide to Managing Emotion and Thought). It teaches you concrete steps to turn down the volume on anger and other negative emotions (as well as proven methods to turn up the volume on positive emotions). All you have to do is visit my main website at www.GuideToSelf.com, click on the yellow book icon at the top left of the page and enter your name and email address.

For more information on my online anger management class, visit http://webangermanagement.com. There are even four free online anger management classes available there!

To life, love and laughter,

John Schinnerer, Ph.D.

Founder, Guide to Self, Inc.

Anger management coach

Proudly Serving San Ramon, Danville, Alamo and Walnut Creek CA since 2000

Here is the write up of the study from Science Daily…

Combination of ADHD and Poor Emotional Control Runs in Families, Study Suggests

ScienceDaily (May 5, 2011) — A subgroup of adults with attention-deficit hyperactivity disorder (ADHD) also exhibit excessive emotional reactions to everyday occurrences, and this combination of ADHD and emotional reactivity appears to run in families. A study from a Massachusetts General Hospital (MGH)-based research team finds that siblings of individuals with both ADHD and deficient emotional self-regulation (DESR) had a significantly greater risk of having both conditions than did siblings of those with ADHD alone.

The study, which will appear in the American Journal of Psychiatry, has received early online release.

“Our research offers strong evidence that heritable factors influence how we control our emotions,” says Craig Surman, MD, of the MGH Pediatric Psychopharmacology and Adult ADHD Program, the study’s lead author. “Emotion — like capacities such as the ability to pay attention or control physical movement — is probably under forms of brain control that we are just beginning to understand. Our findings also indicate that ADHD doesn’t just impact things like reading, listening and getting the bills paid on time; it also can impact how people regulate themselves more broadly, including their emotional expression.”

Along with the classic ADHD symptoms of trouble paying attention, excessive physical activity and poor impulse control, many individuals with ADHD display high levels of anger, frustration and impatience. In contrast to mood disorders, which are characterized by the persistence of specific emotions and behaviors, DESR involves emotional expressions that are brief and occur in reaction to situations that would be expected to produce similar but much less extreme responses in most individuals. For example, an individual who consistently reacts to minor disappointments by snapping at family members or co-workers or who displays great distress in response to small inconveniences may have DESR.

While some investigators have proposed that poor emotional control be included among the defining symptoms of ADHD, previous studies have not clarified whether the two conditions are separate conditions that appear together by chance or if they are related. Also previously unknown was whether DESR is transmitted among family members, something that is well known to be the case for ADHD.

The current study began with a group of 83 participants — 23 with ADHD alone, 27 with ADHD plus DESR, and 33 comparison participants with neither condition — and then enrolled one or more siblings of each of the original participants. Researchers conducted standardized diagnostic interviews with all participants to determine whether they met the criteria for ADHD and other mental health conditions. Diagnoses were confirmed by expert clinicians who were blinded to participants’ diagnoses or their sibling status. Participants also reported their current frequency of DESR-associated symptoms and were determined to have DESR if their control of emotional reactions was worse than that of 95 percent of a large group of individuals without ADHD, which included the comparison sample in this study.

As expected, ADHD was more common, in the siblings of original participants with ADHD than in the comparison group. However, co-occurrence of both ADHD and DESR was found almost exclusively among siblings of the original participants who reported both conditions.

“Other research that we and another group have conducted found that individuals with ADHD who also display emotional overreaction have a reduced quality of life and difficulties with personal relationships and social success,” Surman says. “Studies have shown that 4 percent of the adult population has ADHD, and this investigation is part of a larger study that found DESR in more than half of the enrolled adults with ADHD, suggesting that roughly 5 million adults in the U.S. may have the combination of ADHD and poor emotional control.”

He adds, “Increased recognition of emotional dysregulation, its frequency in adults with ADHD and the potential consequences of both conditions will help people get support for these challenges. Future research needs to examine both medication- and non-medication-based therapies and improve our understanding of who could benefit from these therapies.” Surman is an instructor in Psychiatry at Harvard Medical School.
Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Massachusetts General Hospital.
________________________________________
Journal Reference:
1. C. B. H. Surman, J. Biederman, T. Spencer, D. Yorks, C. A. Miller, C. R. Petty, S. V. Faraone. Deficient Emotional Self-Regulation and Adult Attention Deficit Hyperactivity Disorder: A Family Risk Analysis. American Journal of Psychiatry, 2011; DOI: 10.1176/appi.ajp.2010.10081172

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