24
Sep 18

Inner Voices

As humans, it is natural to self-label. We are repeatedly labeled and evaluated by others and we tend to adopt others’ labels into our own self-concept. This is especially detrimental for individuals, who are trying to fit in or figuring out who they are. As a result of self-labeling, those individuals may come to experience internalized prejudice, which takes place when a person turns an unfavorable opinion directed towards them by others onto themselves. A major issue that may result from internalized prejudice are mental disorders.

Internalized prejudice may not only result from direct comments or opinions of oneself from others, but also from society’s standards and social media. For example, the LGBT community has a higher prevalence of mental disorders than heterosexuals. Social psychologist, llan Meyer describes this excess in prevalence of disorder in terms of minority stress, which explains how the stigma, prejudice, and discrimination that they endure, creates a hostile and stressful social environment that leads to mental health problems (2007). These high levels of stress can be caused by expectations of rejection, the need to conceal and hide who they are from others and lack of support from their loved ones and community. Not only are these individuals experiencing general stressors, but also the added stressors that come along with minority stress, therefore they may require more of an adaption effort.

It is important to recognize our internalized prejudices about ourselves and work to combat them. This will help to steer away from negative self-concept and promote positive self-concept. People with a negative self-concept may be sensitive to criticism and feel as though others view them in a negative light, which can lead to self-esteem issues and even depression. When it comes to making inferences about individuals, through social categorization we must be careful not to show prejudice and to promote diversity in our own lives, which can also help to combat internalized prejudice.

Lastly, as a society we need to draw light to the issue of minority stress and offer adaption strategies to help individuals cope with the added stressors in their lives. For young adolescents experiencing these feelings, before and after-school counseling sessions would be beneficial. I also think there should be more access to therapy for people with or without health insurance to encourage people to talk to someone when they have no one else to confide in.

References:

Meyer, I.A. (2007, November 9). Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence. National Library of Medicine National Institutes of Health. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2072932/


24
Sep 18

The Fear of a Therapist’s Misdiagnosis

Clinical psychology has played an important role in society. Mental health has taken a great turn in terms of advancement, attention, and legitimacy. Generally, it has made progress in the last century. With the discoveries of mental disorders came the discoveries of different treatment. Throughout time, researchers have tried to understand a disorder’s underlying causes, why it develops, it’s genetic attributions, and how to successfully treat them in order for those individuals who suffer from them to prosper in society. Furthermore, psychology is a field that takes all factors of an individual’s life into consideration. Unfortunately, clinical psychologists, like all humans, are prone make mistakes when diagnosing their patients.

The fear of misdiagnosis or a wrong treatment to a wrong problem is something that individuals think of when going to a therapist. Unfortunately, we have heard about the controversial issue that a lot of children are being misdiagnosed with Attention-Deficient Hyperactive Disorder (ADHD) when they are merely acting out or acting like children. These mistakes tend to bring up the subject as to why people are being misdiagnosed. Is there an underlying reason that puts the fault on the client or on the therapist? This question ultimately leads to the assumption that clinical therapists can make mistakes in their diagnosis. There are a couple of factors that can be taken into consideration. According to Kvarnstrom (2017), clinicians might be inclined to diagnose disorders that they feel familiar treating. Another factor could be the vast availability of medication. Lastly, clinicians may have an unaware bias towards individuals due to their cultural or racial backgrounds.

According to the Schneider, Gruman, and Coutts (2012), sometimes, preexisting information may cause bias on a patient. For example, if an individual is being transferred to a clinical therapist from a doctor, then the therapist would read the pre-existing information (diagnosis records) and might end up with the same assumption. As a result, clinicians are under the labeling effect (which is the effect of labeling on judgment of mental illness (Schneider, Gruman, & Coutts, 2012). Additionally, clinicians occasionally exhibit negative stereotypes and the existence of clinical bias is very indirect. Another example of clinical prejudice could be based on cultural labels. After a clinician meets with a new client, he/she may realize that the person is, for example, African American. As a result, the clinician may diagnose the patient with schizophrenia, whereas, he/she might not give the same diagnosis to another individual who is Caucasian. Lastly, gender may influence a clinical therapist to misdiagnosis. For example, clinicians may rate females as less competent and therefore, would need more therapy sessions in order to overcome their problem. On the other hand, they would find a man to be more psychologically competent than a woman and would require less work for their healing process.

In conclusion, the problem of misdiagnosis is a serious one. Understanding the nature of a problem is necessary to identify solutions to that problem. Therefore, clinical psychologists must have an important interest in understanding their client’s problems. When a proper diagnosis occurs, then the proper measures are to be taken for a treatment plan. This will undoubtedly benefit the client on their road to recovery. Clinicians, like all individuals of society, are prone to bias and thought misrepresentation. It is through their skilled and professional training that will allow them to rid themselves of these biases and, ultimately, take care of a patient in the best way possible.

References

Kvarnstrom, E. (2018, February 27). The Dangers of Mental Health Misdiagnosis: Why Accuracy Matters. Retrieved September 24, 2018, from https://www.bridgestorecovery.com/blog/the-dangers-of-mental-health-misdiagnosis-why-accuracy-matters/

Schneider, F. W., Gruman, J. A., and Coutts, L. M. (Eds.) (2012). Applied Social Psychology: Understanding and Addressing Social and Practical Problems (2nd ed.). Thousand Oaks, CA: Sage Publications.


24
Sep 18

Only the Lonely: An Exploration of How Your Figurative Heart and Physical Heart Share the Same Aches

“may came home with a smooth round stone
as small as a world and as large as alone.”
―e.e. cummings 

Only the Lonely:
An Exploration of How Your Figurative Heart and Physical Heart
Share the Same Aches

It probably isn’t a surprise to anyone that loneliness has natural implications in mental health. Loneliness means we are missingsomething, sadfor someone or for a situation other than the one we’re in. If sadness stays with us long enough and deeply enough, it may evolve into depression. But loneliness precipitates other changes in us as well. Beyond our lowered mood and possible peril to our mental health, loneliness spreads over all aspects of our well-being: mental, social, emotional, and physical.

The concept of loneliness isn’t as simple as it may seem.There is an automatic assumption that those who live alone would be lonely and those with people around them do not have an opportunity to become lonely. That isn’t necessarily so. For instance, when loneliness was studied across age groups, those with the highest reported loneliness were high school students—and age group who are usually around people all day, almost every day. This was true even when compared to the elderly group (the focus of most studies of loneliness) including those who lived alone (Schultz & Moore, 1988). So, what is it, then? What makes a person lonely? Or, more importantly, notlonely?

What is different about situations that allow some to become lonely and some not? For the high schoolers, the loneliness materializes due to an increase in the perceptions of social roles and the uneasiness of in the adjustment in attempting to meet them (Schultz & Moore, 1988). But the lower levels of loneliness in the elderly group is intriguing, especially when considering around a quarter of this age group lives alone (American Psychological Association [APA] (2016). This is where the substantial difference between being aloneand being lonely comes to light. Surprisingly, one is not significantly correlated to the other (Holt-Lunstad, et. al., 2015). Rather than physical proximity, the strength and stability of social networks became the best indicator in staving off loneliness—even moreso than physical and mental health.

“But loneliness can’t be that big a deal, right? Everyone feels lonely sometimes.” It is true that experiencing the emotion of loneliness can be healthy for us. It can help us clarify what it is we would like to feel instead and motivate us to seek the necessary changes to bring it about.  The problem comes when loneliness persists and becomes a living condition rather than a mood. Living in this particular condition can bring about dire health risks. Persistent loneliness has a strong comorbidity with high blood pressure, stroke, more visits to an emergency room (Theeke, 2010), cardiovascular disease, increased risk of mortality, slowed repair of blood vessel walls, poor sleep quality, immune deficiencies (Leigh-Hunt, Bagguley, Bash, Turner, Turnbull, Valtorta, & Caan, 2017; Zebhauser, Baumert, Emeny, Ronel, Peters, & Ladwig, 2014), and behaviors and choices harmful to health such as physical inactivity and smoking (Holt-Lunstad, et. al., 2015). The effects of loneliness reach deeper and wider than that of a passing mood. Much like the difference between feeling sad compared to experiencing depression, one naturally passes while the other becomes a condition all its own, spreading to other areas of our health, and often requiring professional help to work our way out of it.

This is one reason why there have been studies on the importance of integrating social rehabilitation into traditional therapies. While individual and group therapies along with medicines predominate mental interventions, there is a shift to acknowledge social health as an important component of overall mental health, as well. Elisha, Castle, and Hocking (2006) surveyed the social health of 3800 adults living with a psychotic mental illness. Of these, 58% had withdrawn from social activity, 39% lacked a close friend, and 45% desired friendship. Only 19% received social rehabilitation, however. In a more general survey of people with mental illness who attended social rehabilitation programs, 92% stated that they had done so at the referral of a health professional (Elisha, Castle, & Hocking, 2006). In other words, those who experience social isolation seem to be eager to accept help for rehabilitation when offered, but, as of right now, it isn’t often presented as an option in treatment.

“But what if isolation doesn’t cause mental illness, what if it’s mental illness that causes isolation?” It is true, these variables are both symptoms and causes of each other. Sometimes mental illness causes social withdrawal and loneliness. In order to help isolate and study loneliness as causal of mental illness, Rohde, D’Ambrosio, Tang, and Rao (2015) conducted a study of those with no prior or current mental illness who were forced to change geographic locations (due to work or school), effectively cutting them off from their social networks. The results showed a strong correlation between indicated feelings of loneliness to increased distress and a lowered overall mental health (Rohde, D’Ambrosio, Tang, and Rao, 2015). By removing the possibility of a pre-existing mental illness, this strengthens the causal power of loneliness.

“What does that mean for me?”The good news is that this is not merely a message of warning about the possible threats loneliness has on our health. Though loneliness creates deficits in our well-being, we are not in a fight to simply balance these damages to a neutral zero level. In as much as social isolation has negative effects on health, having and maintaining strong social connections actively benefits even those without loneliness or mental illness—pushing us further into the positive effects, adding to our well-being and increasing longevity (Holt-Lunstad, et. al., 2015). Some debate that healthy social networks only benefit us indirectly, by mitigating our day-to-day levels of stress and anxiety (Rohde, et. al., 2015). Whether this is true, the benefits are to our overall well-being, or the indirect effects are inseparable from the direct effects, the presence of positive effects is undeniable.

We would do well to listen to our thoughts and emotions when we experience loneliness. Some classify this as one of the most basic warning systems with which we are equipped, like thirst or hunger (Holt-Lunstad, et. al., 2015). Rather than suppressing this alert system, it would be better to examine what we might do to best restore our health, to take actions and move into behaviors which benefit our well-being, and to enlist the support of others as we also offer our support to them.

______________________

References

American Psychological Association (APA) (2016). By the numbers: Older adults living alone. (2016, May). Monitor on Psychology, 47(5), 9. Retrieved September 23, 2018, from http://www.apa.org/monitor/2016/05/numbers.aspx

Elisha, D., Castle, D., & Hocking, B. (2006). Reducing social isolation in people with mental illness: The role of the psychiatrist. Australasian Psychiatry, 14(3), 281-284. doi:10.1111/j.1440-1665.2006.02287.x

Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and Social Isolation as Risk Factors for Mortality. Perspectives on Psychological Science, 10(2), 227-237. doi:10.1177/1745691614568352

Leigh-Hunt, N., Bagguley, D., Bash, K., Turner, V., Turnbull, S., Valtorta, N., & Caan, W. (2017). An overview of systematic reviews on the public health consequences of social isolation and loneliness. Public Health, 152, 157-171. doi:10.1016/j.puhe.2017.07.035

Rohde, N., D’Ambrosio, C., Tang, K. K., & Rao, P. (2015). Estimating the Mental Health Effects of Social Isolation. Applied Research in Quality of Life, 11(3), 853-869. doi:10.1007/s11482-015-9401-3

Schultz, N. R., & Moore, D. (1988). Loneliness: Differences Across Three Age Levels. Journal of Social and Personal Relationships, 5(3), 275-284. doi:10.1177/0265407588053001

Theeke, L. A. (2010). Sociodemographic and Health-Related Risks for Loneliness and Outcome Differences by Loneliness Status in a Sample of U.S. Older Adults. Research in Gerontological Nursing, 3(2), 113-125. doi:10.3928/19404921-20091103-99

Zebhauser, A., Baumert, J., Emeny, R., Ronel, J., Peters, A., & Ladwig, K. (2014). What prevents old people living alone from feeling lonely? Findings from the KORA-Age-study. Aging & Mental Health, 19(9), 773-780. doi:10.1080/13607863.2014.977769


23
Sep 18

Diagnosing the Doctor

The TV series House, which aired its first episode in 2004, quickly became a hit not only for its intricate and thrilling storyline but also for of its protagonist, Dr. Gregory House. House, as he is called in the show, is a quick-witted, smart, and sarcastic doctor, who also happens to be hated by most. House’s selfish and aggressive personality, which remain almost intact throughout the show’s eight seasons, quickly become a characteristic trait of the character. Beneath the hard shell that he portrays to the world, there is a sense of deep remorse and sadness. House’s seemingly incomprehensible dissatisfaction, given his high medical position and gifted mind, becomes much more clear when looked through the lens of the hopelessness theory of depression (Abramson, Metalsky, & Alloy, 1989).

First coined in 1989, the hopelessness theory of depression (HTD) states that people are more likely to develop depression when the following two factors coexist simultaneously: the person is vulnerable, and there are negative environmental circumstances (Abramson et al., 1989). Though vulnerable may not be the first adjective a House fan would label its protagonist with, the theory actually proposes a different view of vulnerability. The term is used to describe a person who has a negative way of portraying and interpreting aversive life events (Abramson et al., 1989). This kind of pessimistic explanatory style is done through two kinds of attribution, stable, and global.

Stable attributions can be though in terms of permanency, where one’s pessimistic view of something remains unchanged. In the 2005 episode “Three Stories”, House states at one point that “everybody lies” for it is a “basic truth of the human condition”. The stable attribution is present here for if lying is part of the human condition, there is no way that people will ever be exempt from such deplorable trait. The term “everybody” and “human condition” also lead to the discussion of the second kind of attribution.

Global attribution can be thought of as a kind of generalization, where a pessimistic view is thought to affect many aspects of one’s life (Abramson et al., 1989). In House’s case, given that lying is present in everyone at all times, there is no way he can ever truly trust anyone. Such belief affects his relationship with his patients, coworkers, friends, and loved ones. Dr. House never lets anyone truly in because the idea of safety and comfort with another is not a possibility in his mind. Clinical observations have also found that the more widespread the attribution and hopelessness may be, the greater the depressive symptoms are as well as their persistency. (Schneider, Gruman, & Coutts, 2012).

The second factor of the theory requires there being negative environmental circumstances in the person’s life (Abramson et al., 1989). When Dr. House first appears in the “Pilot” episode, he already walks with the help of a cane. The viewers quickly learn that he had previously suffered an accident which left his leg debilitated and in chronic pain. Vicodin is his medicine of choice and one that leads him to addiction. Despite the medicine, Dr. House continues living in pain, at one point in the series even stating that “life is pain” (Attanasio et al., 2004). He proceeds to say that he gets up in pain, goes to work in pain and has many times considered giving up. Both the accident and the Vicodin, which eventually leads to an incontrollable addiction, are two major negative environmental circumstances that mark Dr. House’s life forever.

Though House’s tough and aggressive personality may at first appear to simply be that of a selfish man, theories such as the HTD help to explore in a deeper and more holistic way the underlying causes of such behaviors. They remind us of the complexity and sensitive nature of humans, one both universal and yet so unique. The way Dr. House attributes aversive events in his life along with the negative circumstances that have taken place, shape both his mindset and the way he presents himself to the world. The show does an amazing job of portraying the wide spectrum of human nature as well as the different ways people chose to confront their problems and move forward (or not) with their lives.

References

Abramson, L. Y., Metalsky, G. I., & Alloy, L. B. (1989). Hopelessness depression: A theory-based subtype of depression. Psychological Review, 96, 358–372.

Paul Attanasio, Katie Jacobs, David Shore, & Bryan Singer (producers). (2004). House [Television Series]. New York: NBCUniversal.

Schneider, F. W., Gruman, J. A., and Coutts, L. M. (2012). Applied Social Psychology: Understanding and Addressing Social and Practical Problems. Thousand Oaks, CA: Sage Publications.


23
Sep 18

Sorry, I’m Not Feeling Well

I can’t even attempt to count the number of time I have canceled plans with friends due to my crippling social anxiety. My friends have become accustomed to a text something like: “I’m so so sorry, but I really don’t feel up to going out tonight,” followed by some excuse involving being too sick, too tired, getting called into work, or having too much homework. But in reality, sometimes I just can’t bring myself to enter a situation where I have to interact with others—especially situations like parties where I will have too meet and interact with large groups of new people. While I do feel very alone in this experience at the time, social anxiety is something that many people live with on a daily basis. My experience and the experiences of others can be understood using self-presentation theory.

Even if I do get myself out the door to go to a party, I usually do one of 3 tactics in order to avoid interacting with others: First, if the person who threw the party has a pet, I will spend as much time as possible petting it and playing with it. Second, I will gravitate towards the snack table and stand there eating. Or third, I will stick to whoever I came to the party with like glue (not once in my life have I attended a party alone). Then, the real nightmare begins when someone I don’t know begins talking with me. I am smiling on the outside, but inside my chest is tight from pure terror. I stumble as I speak in conversation, stuttering and running my words together, because I am so lost in my head worrying about saying the wrong thing and making a bad impression. It’s not that I don’t like people—it’s that I’m afraid that people will not like me.

My experience with social anxiety perfectly aligns with self-presentation theory as outlined in our textbook. Self-presentation theory defines two factors which must be present for a person two experience social anxiety (Schneider 2012). The first factor is high self-presentational motivation. “Self-presentational motivation refers to the degree to which people are concerned with how others perceive them” (Schneider 2012). This concern with what others think definitely is relevant to myself. Since I was a child, I was always extremely concerned with what others thought of me—my friends, my teachers, new people that I met—I always feared that they wouldn’t like me. The second factor of self-presentation theory is low self-efficacy. “Social self-efficacy is defined as a person’s level of confidence in his or her ability to convey a particular image to another person” (Schneider 2012). If someone has low self-efficacy, it means that they have low self-confidence in their own ability to make a good impression—a quality that is very applicable to myself. I always describe myself as awkward, and by that I mean that I perceive myself not being very skilled in interacting socially, often causing my to embarrass myself.

When high self-presentational motivation and low self-efficacy are combined, these factors lead to high negative outcome expectancies. “Negative outcome expectancies are defined as anticipated aversive repercussions that are contingent on creating an undesirable impression”(Schneider 2012). From my experience, I always feel sure that I will embarrass myself before even stepping through the doors of a party. This can also be referred to as anticipatory embarrassment (Schneider 2012).  And when someone, including myself, feels sure that social interaction will lead to a negative outcome, this leads to the feeling of social anxiety.

References

Schneider, F.W., Gruman, J.A., Coutts, L.M. (2012). Applied Social Psychology: Understanding and Addressing Social and Practical Problems (2nd ed).  Thousand Oaks, CA: Sage.


23
Sep 18

Virtual reality in clinical psychology

Virtual reality is transforming clinical psychology and mental health treatment as we know it. Advancements in virtual reality technology have improved in treating very serious psychological and physical disabilities. Virtual reality is a computer-generated simulation of a three-dimensional image or environment in which interaction is seemingly real or physical by a person using special electronic equipment. Researchers are using this virtual reality technique to further understand how we perceive the world around us. Perception is defined as experiences resulting from the stimulation of the senses. Researchers are using virtual environments to augment brain functions by enhancing perception. This is prevalent in the medical field, training simulations, entertainment and gaming environments. The results of these studies have shown optimal outcomes. Virtual reality has also shown as a promising tool for studying and measuring human behavior and cognition. This technology has aided in the treatment of phobias, post-traumatic stress, substance abuse, and other debilitating disorders.

An essential aspect of creating an immersive experience within a virtual environment is in creating a sense of three-dimensionality so that one believes one can move about within the virtual world. Since a good majority of our sensory receptors are dedicated to vision, virtual reality can serve as a medium. Combining virtual reality with our visual senses the possibilities are endless. The use of this virtual reality technique is to evoke the same emotions that are experienced in the real world without leaving the safeguards of a controlled environment. This type of treatment eliminates obstacles to control previously faced by researchers with participants in their experiments. The interactive nature of virtual reality helps participants to slowly let down their guard with the intense emotions the environment creates thus helping psychologists get to the root of the mental disorder.

“We can manipulate a virtual world in ways that could never be done in a real environment…For example, we could take away visual aspects of the environment that you might use to navigate, such as street signs or distal mountains, to explore what that means for visual perception or spatial cognition” says Jeanine Stefanucci, PhD, an associate professor of cognition and health psychology at the University of Utah.(4)

“Whether we feel scared or pleased in an environment and how we explore it is down to our combined perception of space and of our bodies, according to new research conducted in a virtual reality environment. The study, published in the journal Heliyon, suggests that the brain uses the interplay of these factors to control our emotional experience and exploration of an environment.” (2)

An example of the use of virtual reality would be a person with acrophobia (fear of heights). This technique would be used as a form of exposure therapy, the person would experience a real-world situation, like being lifted up on a skyscraper, and experience the same reactions as if they were truly in that setting.

Virtual reality and virtual environments have increased dramatically over time. It allows for greater control over stimulus presentation and for a variety of responses. Virtual reality allows researchers to create environments that are either impossible or unfeasible within the real world as well as situations that would be too dangerous to test with other methods.

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Works Cited

  1. Goldstein, E. B. (2015). Cognitive psychology: Connecting mind, research, and everyday experience. Stamford: Cengage Learning.
  2. Martin Dobricki, Paul Pauli. Sensorimotor body-environment interaction serves to regulate emotional experience and exploratory behavior. Heliyon, 2016; 2 (10): e00173 DOI: 10.1016/j.heliyon.2016.e00173
  3. Virtual reality study finds our perception of our body and environment affects how we feel. (2016, October 13). Retrieved from http://www.sciencedaily.com/releases/2016/10/161013154825.htm
  4. Virtual Reality Expands Its Reach. (n.d.). Retrieved from http://www.apamonitor-digital.org/apamonitor/201802/MobilePagedArticle.action?articleId=1330117&app=false#articleId1330117
  5. , & Geoffrey, W. (2014, March 24). Using virtual reality to augment perception, enhance sensorimotor adaptation, and change our minds. Retrieved from https://www.frontiersin.org/articles/10.3389/fnsys.2014.00056/full
  6. How Virtual Reality Could Transform Mental Health Treatment. (n.d.). Retrieved from https://www.psychologytoday.com/us/blog/know-your-mind/201605/how-virtual-reality-could-transform-mental-health-treatment

23
Sep 18

You Could Say It Was A Mountain

Depression is like being at the bottom of a mountain and needing to climb it to get back to civilization. You might be thinking it’s like being at the bottom of Everest, except that might be easier. It’s more like being at the bottom of Mauna Kea, which in it’s entirety is a mile higher than Everest and extends 19,700 feet below the Pacific Ocean. Because Depression is being submerged by this invisible force (water) and not being able to breath properly without help ( Therapy or Oxygen tank).

Now that you’re submerged, it’s time to climb that mountain, that mountain starts to represent impossible tasks. Every day tasks you struggle to complete anything from getting out of bed, cooking food for yourself, going two minutes down the block to the store, or finally completing that blog post you were meant to write for that psychology class.

You know those tasks will take you five minutes at the least to complete  if not seconds, and maybe thirty minutes at most, that if you just do the task it will be over and done with. And yet you could say it was a mountain. The task seems daunting, you feel unprepared, and everyone around you is just telling you to do it and be done. But you just can’t seem to find your foot hold on that mountain. Every time you try to pull yourself up you slip back down. And so it goes until one day your foot finds purchase. And you’re moving up the mountain and everything is looking bright above the water level as you break surface until you realized that you don’t have the next foothold and a new task looms ahead and somehow you are right back at the bottom of that mountain.

References:

Chelsea Ritschel in New York. (2018, August 30). How the ‘impossible task’ is a commonly-overlooked symptom of depression. Retrieved from https://www.independent.co.uk/life-style/depression-impossible-task-symptoms-sadness-twitter-a8515436.html

Schneider, F.W., Gruman, J.A., & Coutts, L.A. (2012). Applied Social Psychology: Understanding and Addressing Social and Practical Problems (2nd ed). Thousand Oaks, CA: Sage.


22
Sep 18

Sweet, Sweet, Stress

We often use the phrase “chocolate face” around my house to remind ourselves not to get too stressed out due to temporary situations beyond anyone’s control. Sounds strange? Well, maybe there is a little psychology behind this abnormal expression.

What seemed like the start to an average Saturday morning last June, quickly changed when I found my mom dead on the balcony off of her bedroom. In immediately contacting the police, I told the 911 operator that it looked like she had chocolate covering her face. I even searched around her body to see if I could find a random candy wrapper, empty chocolate milk container, or anything that would make the situation more understandable in my moment of shock. Of course, it was actually blood that had escaped from her nose, but the idea of “chocolate face” became a reminder for my family to take a step back and realize that life is too short to let tense moments get the best of us. In discussing different psychological concepts concerning stress and our response to that feeling, my phrase of choice may not just be bizarre, but may actually be part of a pattern experienced by many who find themselves in stressful situations.

Psychologists Richard Lazarus and Susan Folkman hypothesize that stress is effectively an affair between and individual and their environment. During the tenure of this interaction, described as the transactional model of stress, four complimentary parts work together to identify the cause of anxiety, weigh the necessity for a reaction, learn how to respond, and how to evaluate the outcomes (Schneider, Gruman, and Coutts, 2012).

Stressors are understood to be the environmental factors involved in inducing stress in an individual. These elements could be specific settings, certain people, or isolated circumstances that cause tension (Schneider et al., 2012). In terms of my mom’s death, she was not the cause of my agony, but the actual event in which I discovered that she was deceased gave me reason to become stressed.

An appraisal is the decision by the individual’s mind to react to the stressor (Schneider et al., 2012). Does this situation call for a fearful response? Are these people worth worrying about? How much strain should I feel because an event has occurred? If the answer is “yes” to the evaluation, then one begins to respond with some level of anxiety. While I seemed relatively calm in initially calling the police and notifying family members of my mother’s death this was likely due to shock, and after that wore off, I was left in a state of affliction with my stressor.

Coping is the next step in the relationship with stress, and it can involve two different behaviors to help reduce the burden. Problem-focused coping involves a forthright approach in which an individual actively works to minimize mental pressures (Schneider et al., 2012). If one was to find themselves in a social event that causes them to feel anxiety, they could cope by physically exiting the situation. If a peer is creating an issue at work, they may approach them directly to find relief. If schoolwork causes tension, then they may evaluate which parts are to blame and address those individually.

The second option for reducing stress is emotion-focused coping.  This method relies less on forceful behavior to solve one’s problems, and instead, targets changing one’s emotional approach to a stressful situation (Schneider et al., 2012). If someone is upset that they have no discretionary income to go on vacation, they may tell themselves to just be thankful for the food and shelter they do have. If their fostered dog gets adopted by another family, instead of sadness, they can be happy that the dog found a new home. If your team loses a close football game, you can decide that you are not sad, but excited for the experience gained in a tough contest.

My decision to manage the stress of my mother’s death by launching the “chocolate face” initiative seems to be a prime example of emotion-focused coping. Because the circumstance was out of my control, and could not be altered with any direct approach, I chose to modify my stressful feelings by searching for a positive outcome (Schneider et al., 2012). She was 54-years old at the time of her passing, so trying to convince myself that she had lived a long, and fruitful life seemed asinine. I was then left to contemplate the fragile nature of one’s time here on Earth and how quickly that can change, leaving me to try and never let stress overtake any situation.

The last phase of the transactional model of stress addresses the impact of anxiety on one’s health. Research has suggested that those who find themselves in increasingly stressful situations, and without the appropriate methods for coping, may experience higher levels of illness (Schneider et al., 2012). Stress can cause a variety of ailments from high blood pressure to autoimmune diseases, which may then lead to other stressors based on a decline in one’s well-being(Schneider et al., 2012). After my mom died, I did experience various moments of depression and headaches, but have worked through the process by trying to stay emotionally balanced.

In studying the factors of stress and coping, it seems that individuals follow a similar design in their behavioral choices, regardless of how unique these decisions may be. Lazarus and Folkman’s transactional model deconstructs each phase of the stress process including identifying the stressors, appraising reactions, finding coping mechanisms, and discussing future health outcomes. When I became stressed in response to my mother’s death last year, I made the decision to use emotion-focused coping to reduce my anxiety. The phrase “chocolate face” became a mantra to translate the feelings from my mother’s sudden departure, to an outlook based on overcoming life’s obstacles. Though I have not experienced any serious health ailments caused from this stressful situation, I still must remain diligent in not allowing this traumatic event to dictate my well-being. This would be the “sweetest” gift I could receive.

References:

Schneider, F.W., Gruman, J.A., & Coutts, L.A. (2012). Applied Social Psychology: Understanding and Addressing Social and Practical Problems (2nd ed). Thousand Oaks, CA: Sage.

 


22
Sep 18

Stress and Tweens

Having two children in middle school, I see so many different changes that for me, appear to occur overnight.  As both try to figure out where they belong in the world while they deal with their own changes within themselves.  Peer pressure in middle school seems to be over the top as if you are not on the A or B team or in certain activities and/or have the coolest whatever was popular yesterday, can certainly put a damper on someone’s existence.    As we all know adolescence is a time of continued neural maturation, specifically within stress-sensitive limbic and cortical regions. (Romeo, 2013).  When puberty starts for some, it seems to be an instance of popularity as they look mature. They may look mature but they are still the same kids as they were a few months back.

Navigating through middle school, it seems to be a fine line between wanting to fit in but also what is the price to do so. And middle schoolers can be extremely mean to each other sometimes.   Just trying to fit in on a daily basis can be hard and very stressful. My son who is so easy going, very laid-back kind of guy, was getting anxious which I did not see much of until last year.  As he was getting a bit more anxious last year, I suggested he speak with one of the guidance counselors at his school.  Eventually, he did and during those “talk-therapy sessions, which thankfully, seemed for him to be able to resolve some of the issues that he was dealing with. The guidance counselor and he himself, not only talked through some of the issues but came up with some ideas for coping strategies. (2018) This did not solve everything, but it helped.

As 6th grade was coming to an end, my son was relieved but as the middle of August was approaching, I was starting to notice, he was not himself again and looking a bit more uneasy as September was approaching.  As school did start, I was noticing, during drop off in the morning as I look through my mirror in the back, my sons’ facial expressions were changing and seem to have that stressed and anxious look.  Each day, I would see this, but what I was observing was how he seemed to be preparing himself to cope with the challenges of his day’s events.  He seemed to shift in the back seat and have a few sighs of big breath’s as he looked out the window to scan and see who’s passing him by and to see if this would be a good spot to drop off or wait a few more seconds or two as certain kids go by.  “His adrenaline that liberates the energy source of his norepinephrine was rising as his epinephrine aroused his body to provide readiness to keep his energy and mental alertness while he enters through the doors of the middle school. (PSU WC L5, p. 2, 2018)    As an adult, I know stress happens to all of us, but as my son is an adolescence and this stage in his life represents a stage in development when both of these aspects of stress are in flux.” (2013) He is learning to cope with his own stress factors and figuring out the best way to do it.

As we are winding down September and entering into October, he seems not as nervous and anxious as he was at the beginning of school.  I can still see him scanning for kids but he now says nothing and doesn’t have that nervous, stressed look as he had at the beginning of September.  With all the conversations we have, he has expressed to me, the teachers are actually ok and some of the peers that were in his class last year are not there and with the new group of kids in his class are actually nice.  Not sure if some of the kids are maturing or he’s just staying away from the kids from last year, but I just know, he’s coming home not as tense as last year and actually happy. Or as happy as you can be as he navigates 7th grade. As of now, he only seems to be stressing and having concerns about, “mom, I have a big Math test!”  Eek.

 

 

 

References:

Pennsylvania State University, World Campus. (2018). PSCH424 Applied Social Psychology. Lesson 5: Health AND Clinical/Counseling: [online lecture notes] Retrieved September 20, 2018, from   https://psu.instructure.com/courses/1942493/modules/items/25002499

Romeo, R, (2013) Barnard College of Columbia University. The Teenage Brain: The Stress Response and the Adolescent Brain: [online] Retrieved September 20, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274618/

 

 


21
Sep 18

Paying A High Price For Health Care

What is one of the biggest issues facing the United State? The first issue that come to my mind is health care. This issue affects millions of American every year even with the so called “Affordable Care Act”. Some factors that contribute to poor health care are cost, unnecessary tests, and increasing paper work. The US needs to reevaluate how our health care is being processed and offered.

Health care has risen in price tremendously since 1960 and 2016. In 1960 an average cost for a person per year was $151 and in 2016 it rose to $10,320 per year. ( Agresti, J. D. & Bukovec, S 2018) The numbers are astonishing, that is a huge difference and looks like the price will continue to rise. A main reason health care is so expensive is because providers get paid by exam or test they perform on a patient. I strongly believe a medical facility should get paid by providing hire quality care. I have worked in the medical field for over 11 years and in my experience medical facilities are forced to see as many patients as possible in the 8 hours they are open. What do I mean by forced? Well for example, a medical facility that treats the under served population which is normally Medicaid and Medicare patients do not get paid very well. The only way for a medical facility to remain open and continue caring for patients is by seeing a lot of patients. This is a very common practice for solo practitioners.

Our health care system has focused on making it very difficult for facilities to operate at its fullest potential. Now there is something called meaningful use, this is a program for providers to gather data of the care that they are providing and at the end of the year the report to Centers for Medicare & Medicaid Services (CMS). ( L. 2017)  One of the biggest issues that I have seen with this is that if a provider does not meet the set requirement they are penalized by reducing a certain percentage of each payment they receive for the following year. I find this to be unnecessary and it seems like CMS is just trying to find a way not to pay the providers. Another example of unnecessary changes was the implementation of ICD 10 codes. ICD 10 increased the coding from 14,000 to 68,000 making it more difficult to code because everything had to be relearned by providers and staff which held claims and held payments. (L. 2017)

17.7 % of the economy is being spent on healthcare. (8 facts that explain what’s wrong with American health care) Pharmaceutical companies are not helping with the rise in cost either. For the medication Nexium here in the US it cost $215 but in places like Switzerland, Spain, England and Netherlands it varies between $23-$60. (8 facts that explain what’s wrong with American health care) How can a medication that cost over $200 dollars be bought in a different county at very reduced price compared to the US.

The health care we are receiving is very one sided. It is not catered to its citizens and the people are the ones feeling the effects of a flawed system. We need to reorganize the healthcare system and make it more affordable. We need to let the doctors treat patients without worrying about coding or meeting a number to keep the doors open.

 

8 facts that explain what’s wrong with American health care. (n.d.). Retrieved September 21, 2018, from http://www.pnhp.org/news/2014/september/8-facts-that-explain-what’s-wrong-with-american-health-care

Agresti, J. D. & Bukovec, S. (2018, September 21). Healthcare Facts. Just Facts. Retrieved September 21, 2018 from www.justfacts.com/healthcare.asp

L. (2017, January 10). The Top Healthcare Industry Challenges in 2017 – Healthcare in America. Retrieved September 21, 2018, from https://healthcareinamerica.us/the-top-healthcare-industry-challenges-in-2017-7b4799b8b540


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