Inessa Manevich,Ph.D., Clinical Psychologist
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Mental Illness--Do We Pass It On?

7/30/2012

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A great NYT magazine article explains the interplay of genetics and  environmental factors on inheritance of mental illness, specifically depression. This piece is written in first person by a mother who has struggles with depression throughout her entire life, and examines what effect, if any, her episodic hospitalizations for depression might have had on her daughter's mental health. http://www.nytimes.com/2012/07/29/opinion/sunday/is-depression-inherited.html?pagewanted=all

In the age of genetic exploration, one often hears the concern of parents and non-parents alike that whatever mental health issues the individual may be struggling with
(particularly with the more acute illnesses) will be invariably passed on to the offspring. As the article points out, for some people this is enough of a reason to foreclose on the idea of having children entirely. This concern  is understandable particularly given the preponderance of studies that link genetics to a large number of illness and even personality characteristics. It is important to note, however, that the majority of these studies speak to a genetic predisposition, or the underlying risk of developing a certain disorder, and not the inevitability of getting the disorder. Various environmental factors, such as parenting skills, the nature of the parental relationship and resource availability, just to name a few,  play a huge role on whether or not an individual will develop a disorder, even when they may have a genetic predisposition for the disorder. 

Additionally, the way that a parent handles his or her own mental health problems, or any adverse event for that matter, can be invaluable on how the child views themselves and the world. Witnessing resiliency, determination and self-care in their parents may be a great protective factor, and lesson for the child struggling with adversity. While an individual's personality and subsequent functioning appear to be the result of a mixture of both genetic and environmental factors, it is important to remember that parents are the child's first guides to this world, and the way that they choose to present the various positive and negative aspects of this world, will have an indelible impact on the child interpretation and perspective of the world at large.


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Couples Therapy with Asperger's Syndrome

7/24/2012

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It can be difficult enough to maintain a healthy satisfying romantic relationship with another person over time, but what if your partner has difficulty in either processing, noticing and/or exhibiting emotion? Some people may attribute their partner's emotional unavailability to a lack of commitment, care or passion, or they may believe that this seeming emotional withholding may be intentional. However, these hurtful interpretations may not be necessarily applicable when their is a realization that one of the partners may have Asperger's Syndrome.

There is surprisingly little literature and services out there that present a balanced, integrated approach to helping couples with AS understand each other's thinking and being in the world. In my experience working with these couples, it is not enough to help one of the partners be more like the other, but a true compromise, negotiation and acceptance is needed in order for both partners to feel fulfilled and understood in their relationship.

Dr. Cindy Ariel has recently written a wonderful book, titled "Loving Someone with Asperger's Syndrome"  that works toward helping these couples in their struggle to relate to each in a more balanced and informed way. "http://www.wrongplanet.net/article431.html

While having one of the partners in a relationship diagnosed or living with Asperger's Syndrome presents a specific set of hurdles, a recent NYT article depicts a relationship between two young people both of whom have been diagnosed with Asperger Syndrome. This article provides a glimpse into the lives of these two individuals and what it is like to be in a relationship with someone who has very specific sensory processing issues, special interests, and many other idiosyncratic behaviors and habits, that may or may not be similar to the other partner's own idiosyncratic ways of being.

http://www.nytimes.com/2011/12/26/us/navigating-love-and-autism.html?pag... 
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Fear of Failure

7/16/2012

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I just recently reread a 2010 NYT article by Jonah Lehrer titled The New Neuroscience of Chocking, in which Mr. Lehrer describes why sometimes, particularly the times that matter most, even the most successful and accomplished professionals simply fail to perform to their usual and expected level--they simply choke under pressure.

http://www.newyorker.com/online/blogs/frontal-cortex/2012/06/the-new-neuroscience-of-choking.html 

The author suggests, in part,  that  these individuals may be succumbing to the psychological phenomenon called loss aversion, the concept that "losses make us feel bad more than gains make us feel good". What this means is that the pain of losing something is greater than the joy of wining something.  Could this at least partially explain why an individual with social anxiety may fear the possibility of rejection much more acutely when approaching a person at a party  than the excitement he or she would feel at the possibility of actually getting a date? Could loss aversion also help explain why certain individuals who so badly want to be in a relationship, often do the very things that make those relationships fail? Could this phenomenon also explain why some people are often so reluctant to change certain things about themselves and their relationships, even when they know those things to be damaging, simply because the idea of losing what they already know and have is much more painful than the idea of gaining something new?

Is the devil you know really better than the devil you don't? Or are we so afraid of losing what we already know  that we are holding ourselves back from creating the kind of life and experiences that we truly want? Perhaps there is something to the Buddhist teachings that "in order to gain anything, you must first lose everything". Maybe we do not need to lose everything in the physical sense, but perhaps holding on to expectations, behaviors, beliefs and maladaptive patterns simply because of  habit, previous conditioning and the perceived safety of predictability is holding us back from truly experiencing all that life has to offer, and reaching our full potential in all of our endeavors.
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Glamorizing Anorexia 

7/10/2012

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A recent post on what appears to be a pro-anorexia site accused Kate Upton--a  relatively-healthy weight swimsuit model, of being thick and "about 30 lbs overweight". After a preliminary search of this model's actual weight, it appears that at 5'10'' she weights 130lbs, just barely making the normal range on the Body Mass Index.
http://jezebel.com/5924622/kate-upton-is-now-considered-fat/

Not only does this site appear to regularly attack celebrities for looking overweight, but they offer what appears to be "starvation tips of the day" to its readers. Needless to say, sites like these are such a tremendous disservice to young women, who grow up hating themselves and their bodies, in part, for not being able to live up to the standards that they might see in the media. 

Some recent studies have suggested that people with certain eating disorders may have perceptual errors when regarding their own bodies--meaning that they literally see their bodies differently than they really appear. Is it possible that these perceptual errors spread to these individuals' view of other people's bodies as well? Or is the attachment to these destructive behaviors and perhaps the sense of control that they may provide so strong that these poor folks will do anything to propagate them?

It is a real shame that just when the media is beginning to depict relatively-healthier looking bodies, by publicizing pictures that are not airbrushed and choosing healthier looking models, we see this backlash of eating disordered women demonizing healthy eating behaviors and shaming individuals with relatively-healthy bodies.
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Humor and Psychology of Men

7/9/2012

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One can not argue, that even when our society appears to encourage men to talk about their feelings, some men are still less likely then women to talk through their emotions and simply vent for the sake of venting. Surely these individuals discharge their frustrations, but the subject of such heightened emotional discharge is often channeled into safe, neutral, and culturally-approved subjects such as the performance of sports teams, politics, musical preferences, competitive exercise and of course, humor. Such sublimation is not a bad thing for even Freud would argue that any type of safe emotional discharge can be cathartic for the soul. 

However, when arguing politics or fighting it out on a court is not sufficient, how can something as overtly "touchy-feely" as psychotherapy be made more appealing to these folks?

A campaign in Colorado is using the concept of humor to reach men between the ages of 25 and 64 by creating a website where a fictional humorous therapist, "Dr. Rich Mahogany, an affable, mustachioed, middle-aged man whose personality might be described as Dr. Phil meets Ron Burgundy, Will Ferrell’s fictional anchorman", administers a questionnaire that assesses the respondents mental state in hopes of preventing suicide.
 http://www.nytimes.com/2012/07/09/business/media/a-humorous-approach-to-grim-issue-of-suicide-prevention.html

While this is a somewhat unorthodox approach to suicide prevention, reaching even one individual who would otherwise not receive any services is a huge success!

Similarly, I often find that humor in general can be such a great conduit to moments of great insight, particularly those moments where one is able to recognize the absurdity of one's behavior, the origins of which may have so little to do with objective reality. Perhaps there is something to the old adage, that laughter is the best medicine, so go ahead, laugh yourself to mental health!
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Distorted Perception of Threat

7/5/2012

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A fascinating article in the New Yorker described a study where a group of zealous baseball fans (Yankees)  perceived their rival city's stadium (Red Sox) as being closer than the stadium of a team that was "neutral" (Orioles), even though the neutral team was in fact physically closer. 

http://www.newyorker.com/talk/2012/06/25/120625ta_talk_mcgrath

Could this finding mean that once we identify a threat in the environment we zero in on it to such an extent that we actually misjudge the proximity of this threat?  This may certainly help to explain the behavior of certain individuals who identify a certain group of people as their "enemies" and then view all incoming information as confirming evidence that this "rival" group's dominance is imminently upon them? This finding could also help explain the thinking process of the socially anxious--the steadfast fear and belief that critical judgment by others is omnipresent, even when given empirical evidence as proof of the opposite. 

Such distorted perception certainly makes evolutionary sense. Given an actual physical threat to one's life, a human would certainly benefit from "seeing" this threat as actually being physically closer, in order to make sure that the human has enough time and resources to ensure its survival.

However, one cannot help but wonder if this once-advantageous perceptual distortion could be leading human beings into distorting their perceptions of reality and hence creating a more divisive, fearful and polarized society.

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    Dr. Inessa Manevich

    *Information in this blog is for educational purposes only and should NOT be used as a substitute for professional therapy*

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