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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22. August 2011 by John Schinnerer.

The evidence is mounting…

evidence that positive emotions exist for a reason…

evidence that evolution has selected positive emotions for specific reasons that help our species - reasons that help you in every area of your life.

Positive emotions include feelings such as awe, curiosity, gratitude, compassion, calm, love, joy, interest, passion and happiness.

Evidence is mounting to support the importance of cultivating positive emotions for success in a variety of areas in your life.

A comfy nesting bed with egg pillows

At the beginning of every session with a new client, I make a point of sharing a short, humorous video clip. One of my personal favorites is the popular Mother’s Day video by Barats and Bereta (www.BaratsAndBereta.com)…

The reason for sharing a humorous video with new clients is three-fold.

First, the funny video unlocks any negative emotions the client may be holding onto such as anger, irritability, anxiety or sadness (Fredrickson, The Broaden-and-Build Theory of Positive Emotions, 2004, The Royal Society).

Second, those few, fleeting moments of laughter, mirth and smiling  reduce depressive symptoms and improve your well-being and  satisfaction with life (Sin & Lyubomirsky, Enhancing Well-Being and Alleviating Depressive Symptoms With Positive Psychology Interventions: Practice-Friendly Meta-Analysis, JOURNAL OF CLINICAL PSYCHOLOGY: IN SESSION, 2009).

Combination stairs and slide for young ones

Third, science has known for over a decade that chronic anger, anxiety and depression put you at an elevated risk for cardiovascular disease (Suls & Bunde, Anger, Anxiety, and Depression as Risk Factors for Cardiovascular Disease, Psychological Bulletin, 2005). Most people go through life with the sympathetic branch of the ANS stuck in the ‘on’ position. The sympathetic branch is similar to the gas pedal in a car. Negative emotions (along with stress, exhaustion, and lack of exercise) activate the sympathetic nervous system which leads to increased heart rate, pulse and higher levels of cortisol into the blood stream. The sympathetic nervous system is responsible for the ‘fight, flight or freeze’ response.

On the flip side, positive emotions activate the parasympathetic branch of the autonomic nervous system (ANS) which acts like the brakes on a car.  The parasympathetic nervous system (PNS) is in charge of calming the body, reducing heart rate and pulse, and bringing the body back to a resting state. The extent to which you can activate your PNS predicts your emotional and physical health. It is intimately related to how well you can self-regulate your own emotions.

Lower levels of PNS activity are related to higher levels of depression (Chambers and Allen, 2002), anxiety (Friedman and Thayer, 1993), aggression (Beauchaine and others, 2007), and hostility (Virtanen and others, 2003).

On the other side, higher levels of PNS activity are associated with better psychological flexibility, health and resiliency. Individuals with higher levels of PNS activity are related to more resiliency to stress (Britton and others, 2008) as well as greater mental health in children in the face of chronic conflict between parents at home.

How do you come up with such an idea? Start with passion and curiosity

Importantly, the frequency with which you experience positive emotions is related to a more active PNS. Individuals who were shown humorous video clips demonstrated faster heart rate recover after experiencing intense negative emotions (Fredrickson & Levenson, 1998). In addition, simply asking people to think about a time when they felt grateful activated the PNS.

Other ways to ‘turn on’ the PNS include exercise, laughter, mindfulness, massage, yoga, walking your dog and taking fish oil.

You’ve gotta’ be inspired to come up with a bedroom like this! 

The success I’ve experienced with clients in my private practice is directly related to how well I can make them laugh. With laughter comes opportunity…

opportunity to unlock stale old anger,

opportunity to teach critical new skills,

opportunity to think outside the box, and

opportunity to transform your life for the better.

How do you proceed from here?

Begin to become more aware of the percentage of time you spend in a positive emotional state as compared to a negative state. This simple realization, this basic level of awareness will begin to produce massive tectonic shifts in your life. And you will reap the benefits…on a number of levels…physical, relational, and emotional.

To life, love and laughter,

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 author of The Shrunken Mind - the blog on positive psychology

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

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19. May 2011 by John Schinnerer.

I was recently asked for a quote for www.Livestrong.com for an article on emotions and how they influence our attainment of goals around health and wellness (i.e., optimal human functioning). Here is my short email…

Guilt has a boomerang effect on you

Hi! I hope this note finds you smiling! My Ph.D. is in educational psychology out of UC Berkeley. I currently teach positive psychology (JFKU), coach individuals in anger management and the latest ways to use positive psychology.

I am a self-professed emotion ‘geek’. I have studied emotion
research for a decade now. I love discovering how emotions affect our behaviors, such as health and wellness goals (e.g., losing weight, building muscle, eating better, learning a sport, or building psychological resiliency).

For instance, a recent study showed that guilt has a boomerang effect where it first causes the guilty party to avoid the guilt-inducing situation. Then guilt causes one to approach the situation to make things better. This is the first emotion I am aware of that’s been scientifically shown to have both an approach and an avoidance component to it.

In terms of wellness goals then, a moderate level of guilt (think a 4-6 on a 10 point scale) may work effectively at meeting wellness goals. If you fall off the wagon and feel guilty about it, you are likely to re-approach your goal shortly with a renewed motivation.

Elevation is the positive emotion experienced when you watch another person perform an act of moral courage or high integrity, and was first ‘discovered’ by Jon Haidt. This emotion seems to act as a hidden reset button wiping out doubt, replacing it with feelings of inspiration, hope and optimism. Elevation creates a desire to become a better person and thus, is likely to lend itself to meeting wellness goals.

Please note: When I interviewed Jon Haidt several years ago, he was not ready at that time to label elevation an emotion. More research was needed. From what I understand, both Jon and Dacher Keltner at UC Berkeley are now looking into it. I hope that is helpful for your article!

To life, love, and laughter!

John Schinnerer, Ph.D.

Founder Guide to Self, Inc.

P.S. Want to find out more about your emotional landscape? Want to figure out HOW to turn down the volume on anger, anxiety or sadness? Need to know the latest in anger management tools? Would you like to learn how to cultivate more positive emotions in your daily life? Just visit www.GuideToSelf.com, and click on the yellow book icon. Enter your name and email address for a FREE PDF copy of John’s award-winning book, Guide to Self: The Beginner’s Guide to Managing Emotion and Thought, because when it comes to the emotional mind, we’re all beginners!

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7. May 2011 by John Schinnerer.

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 www.GuideToSelf.com, 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
http://webangermanagement.com

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