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3 Steps to Treat Your Anxiety Using CBT

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If you’re someone who struggles with anxiety, the process of finding a therapist can feel overwhelming. Since therapists often specialize in treatment methods, finding the right type of therapy for you is the best way to get started. Cognitive Behavioral Therapy (CBT)is a popular and proven technique to treat anxiety disorders such as generalized anxiety and social anxiety. CBT is a short-term treatment aimed at developing skills to help you alter emotional responses that are harmful to your wellbeing. Your therapist will help you change the thoughts and behaviors that trigger or worsen your anxiety. Because thoughts come before feelings, and feelings lead to actions, changing your thoughts can reduce or eliminate your negative emotions and unhealthy behaviors. In other words: thought → feeling → behavior. If you can change your thinking, your feelings and actions will change as well. CBT does this by using a three-step process.

For an example of how the CBT process works, let’s use a thought someone with social anxiety might have: “I feel so awkward at parties. Everyone must think I’m a loser.” This thought may lead to feelings of sadness, shame, and fear. You’re ashamed of how you act at parties, sad that people think you’re a loser, and feel anxious at the thought of attending a party. These feelings then lead to behaviors like isolation and avoidance, which make you feel worse.

In CBT, a thought like that is called emotional reasoning: “I feel it so it must be true.” But feelings are not facts. Just because you feel awkward at parties doesn’t mean other people think you’re awkward.

Emotional reasoning is an example of a cognitive distortion. Cognitive distortions are irrational thought patterns that lead to an inaccurate perception of reality. It’s your mind convincing you that something is real when it isn’t. CBT is designed to treat the most commonly occurring cognitive distortions, including emotional reasoning.

A CBT-trained therapist will take you through three steps to reduce or eliminate the distortion:

Step 1: Identify the negative thought

In this case, the thought is, “I feel so awkward at parties. Everyone must think I’m a loser.” In a CBT session, it may take some time to uncover this thought. At first, you might talk to your therapist about your feelings toward going to parties, and how you feel when you attend one. Together, you’ll find the root thoughts behind your anxiety and tackle each one separately.

Step 2: Challenge the negative thought

Your therapist will help you question the evidence for your thought, analyze the belief behind it, and reality test it. For example, you might talk about the time in middle school someone called you a loser and how it has shaped your self-esteem. Then you’ll discuss why you feel awkward at parties. Finally, you’ll test your negative thought by separating your thoughts and feelings from reality. You may feel uncomfortable at parties and assume people dislike you, but they wouldn’t invite you if they thought you were a loser, and you get invites all the time! Your thoughts and feelings aren’t based on facts.

Step 3: Replace the negative thought with a realistic one

If you try to change your negative thought into its opposite extreme, the new thought won’t stick in your mind for long. “Everyone thinks I’m the coolest person in the world” also fails the reality test. It will quickly fall apart, which will send you hurtling back to the negative thought. Instead, you want to find a realistic thought that passes the reality test. For example: “Just because I feel awkward doesn’t mean other people see me that way.”

In CBT treatment, you’ll learn about more cognitive distortions and repeat this three-step exercise for other negative thoughts you have. When you practice challenging your negative thoughts and replacing them with realistic ones, it’ll become easier to identify distortions before they hurt you. With CBT, practice makes perfect and perfect is a life without debilitating anxiety. Finding a therapist who is familiar with CBT is a good place to start when looking for help with your anxiety.

Anxiety
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“I feel it so it must be true.” But feelings are not facts.
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Mindful Anger
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When you practice challenging your negative thoughts and replacing them with realistic ones, it’ll become easier to identify distortions before they hurt you.
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A Health Tech Revolution In Your Dentist's Office

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Innovations in health and medicine are commonplace.  From activity trackers to artificial intelligence, technology is playing a bigger and bigger role in many aspects of care.  But for some, these innovations are largely theoretical or impractical. The role of genetic analysis, for example, is common, yet its consumer applications are largely around ethnic heritage and esoteric traits such as wet or dry ear wax and flushing from alcohol consumption.  The future is coming, but not as fast as some may wish.

A trip to the dentist might change this perspective.  Dentistry is in the throes of a revolution that offers significant advances that read right out of the digital health playbook. From imagining to empowered consumers, technology can make you go wow.  Or in this case, ahhh!

Digital imaging.  X-ray has come out of the dark room to offer electronic imaging that provides both speed and simplicity.  And advances in cone beam tomography add another tech tool for today's dental office that enhances image quality as well as efficiency.  Images, combined with CAD (computer-aided design) are now part of the clinical plan that can be shared with patients in real-time and offer a comprehensive view of diagnoses, procedures, and potential outcomes.  

Material science.  Modern dental materials offer key advantages for today's patients. For example, nanoparticles provide unique feature combinations from strength to aesthetic qualities.  Advanced materials can also provide the basis for important clinical advantages including supporting bone growth and antimicrobial activity. 

Tissue regeneration.  Preservation and restoration of oral tissue are essential parts of care. Today's procedures and treatments can facilitate direct tissue regeneration.  Even the role of stem cells is being explored in dentistry.  Science suggests that these cells may regenerate dental pulp in damaged teeth and help avoid procedures such as root canals.

Virtual reality. VR isn't only about gaming.  Today's technology offers advanced and effective control of both pain and anxiety.  VR enables the patient to journey outside of the dental office to a virtual environment that is more soothing. The experience is improved for both patient and care provider and may even lead to better outcomes.

Robots! Yes, even robots have become part of the news in dental innovation.  More common in the traditional operating room, the role of robotic assistance and robots in oral surgery—filling the need for qualified humans--is a potential near-term reality.

Consumer empowerment.  Today, control is shifting to collaboration with patients playing a much more active role in care.  From activity trackers to genomic analysis, patients are driving decisions and action.  At-home tooth whitening kits and direct-to-consumer teeth-straightening procedures  are now commonplace and driving the progression from quantified steps to the quantified mouth!

Oral and systemic health.  From sleep apnea to systemic bacterial contamination to eating disorders, the dental chair is another important examination table that can help with the diagnosis of, and offer therapy for, conditions with oral and systemic implications.

Beyond innovation, the dental marketplace is significant. The annual spending in US dental care is projected to be over $200 billion by 2027.  Our aging population, growing awareness of aesthetics and cosmetic dentistry, and the expanding awareness of oral health, all come together to provide tremendous business opportunities for both companies and entrepreneurs.

Transformative innovations taking place in dentistry—from scientific research driving development of digital dentistry to next-generation, high-tech tools and procedures—are driving health innovation that will impact a patient’s whole health—beyond their teeth, gums and mouth. It’s our responsibility and privilege to harness that cutting-edge research, putting it in the hands of dentists across the country to help transform patient care.  Julie Charlestein, President and CEO of Premier Dental Products

The convergence of technology and dentistry is leading the charge in transforming medicine.  Often overlooked, the dental office and dental science in your own home are real-world examples of what health technology offers us today.  From functional applications such as teeth whitening and straightening to stem cell regeneration of teeth, the revolution is here.  And that's certainly a reason to smile.

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Advances in dental technology are giving people lots of reasons to smile.
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The Digital Self
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There's a health tech revolution happening right in your dentist's office!
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Embracing This Human Condition

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I've always had a problem with those who just see problems. To be more precise, perhaps it's the way we throw that word around now, how it drips with the subtext of inferiority.

The word's etymology actually is much kinder and more curious, denoting a question or riddle that is thrown before you or the barrier that interferes with forward movement. Those kind of problems I'm intrigued by and just fascinated with; they're the ones that generate creative momentum, that invite us to make our way together through the labyrinth.

Too often though, when I talk to people about my work, even others in the field, they say things like, "Boy, I didn't realize college students had so many problems!" as if they were stricken with a terminal condition. Or worse yet, dead on arrival.

It's not that I deny that problems exist. Nor am I naive enough to think we don't have to work through complexities and difficulties to get to the heart of the matter. It's just sometimes I question why it is we are so ready to pathologize in our problematizing.

So much of what's found in the catalog of disorders—the DSM—are sophisticated ways of problematizing the myriad ways in which the human hearts and minds "suffer the slings and arrows of outrageous fortune," the various ways we all attempt to find some meaning and equilibrium amidst the inevitable storms of life.

I often wonder why we don't begin to look at the symptoms of psychological disorders as Carl Jung did—as messengers, as opportunities for new growth and development. It goes without saying that this place will hurt, it will likely even sting, but that's completely normal. The creative wound is the place one is attempting to move out of, but the inevitable hope is that it will be repaired and something transformative will emerge. This doesn't happen without a fight.

The symptoms are part of the transitional phase, a signal of the place where the dissonance of the chords has not found their way to cadence back to the original key. This is where the creative work of therapy begins!

The taxonomy of problems found in the DSM is essential of course, and it has its wisdom. It differentiate those disorders which are greatly affected by nature-bipolar, schizophrenia, autism, to list just a few-and those which are more heavily impacted by nurture—certain kinds of PTSD for instance-- and many of which are some complex combinations of both—depression, anxiety, OCD, etc. However, it doesn't go far enough in providing the true origin, context, meaning, and possibilities of how these issues connect to being fully human.

In short, it, along with many practitioners and people in general in our culture, can easily forget that the human condition—in all its glory and tragedy—is the most important condition to consider at root.

It's healthy to accept the fact that we can't fully escape this human condition either. Coming from this vantage point takes off the extra burden of trying to be superhuman in trying surmount our challenges. This human condition may be terminal but it's also what makes our infinite complexity and beauty possible.

So the next time, someone says you've got problems or that you yourself think you do, consider the fact that we all have this human condition.

The interesting parts happen when, with support and guidance, we arrive at new forms and creative solutions, ones that transcend what we initially thought possible. We make something out of what appears to be nothing--or at least, nothing good.

When we arrive at this place, we can feel heartened that we are deepening ourselves, solving our unique riddles, and that, above all, we are not alone in our journey through this mysterious condition we all are attempting, each day, to truly possess.

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How to live beyond labels.
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Tired of problems and labels? Let's start embracing this human condition again.
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How to Love Being with Your Kids? Dive Deeper

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"When our mind is neither in the past or the future and we are completely present, our experience changes in a significant way. Suddenly life seems more spacious, and more peaceful."– Jan Marie Dorr

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Source: iStock/Used with Permission

We're on the home stretch of our Spring-Cleaning for Your Psyche series, in which we've focused on taming our inner critics and becoming more mindful. Why does this matter to our children? We all know that the negative voice in our heads makes us worse parents. Learning how to manage our minds and moods helps us respond in a way that calms, rather than escalates, any situation with our child.

True, our kid may still behave badly.  But now we have a choice about how to react. Your Child's Action + Your Reaction = the Outcome, which is the kind of child you're raising. 

The good news is that we can all learn ways to tame our inner critics and make our minds easier to live with. We’ve been talking about those strategies for the past few weeks.

The even better news is that there are ways to give our minds mini-vacations. Even a small amount of time with a quiet mind replenishes us, like water when we suddenly realize we’re parched. Our intuitive natures take over, allowing us to make wiser, more compassionate decisions. Scientists say that even a small daily break from our conscious minds can create physiological changes, enhancing our functioning and happiness all day long.

Today's strategy: Bypass your Inner Critic by Diving Deeper

Most of us find it tedious to make yet another snack, change yet another diaper, be patient one more time. Sometimes it feels like parenting traps us in a cycle of wearying repetitive tasks. Our mind starts gnawing away at us.

But there’s a secret to transforming tedium into joy: Dive deeper. Be fully present.

If we’re only half there, it often feels tedious to meet our child’s needs. If we’re thinking about everything we need to get done, worrying about whether our child is on the right track, or cataloging our own failings, then the caretaking tasks of parenting will always feel tedious.

What’s more, our kids will always be demanding more, more, more – because what they’re experiencing is that we aren’t all there.

And by staying in our minds, we leave the door open for our inner critic to make a mess of things by finding fault with everything we do, and everything our child does.

But being with kids doesn’t have to be boring. When we bring ourselves into each present moment of experience, we find it brimming with life. The creative possibilities are endless. It's our resistance that's the burden, not our kids.

Try an experiment: Turn off your cell phone. Show up 100% when you’re with your child. See how much more joy and delight you find in nurturing and guiding. See how much easier everything is. And notice that it’s a gift to yourself as well.

Want some specific ideas?

1. Find someplace you can watch the sunset with your kids. Really appreciate "the show" as the sky streaks red and the sun sinks below the horizon.  It will leave your inner critic speechless.

2. Now, bring some of that sunset-inspired awe into your next interaction with your child. Whether she's five months or five years, she's a miracle.  Watch the way she communicates.  Moves.  Learns.  Seeks your love. Really taking in the miracle of your child will fill you with love, and put all those things you worry about into perspective.

3. Hold your child on your lap. Just show up. Bring your full presence into your touch. Soak him in through your body.  Watch how much more fully you embrace him when you dive deeper into the moment. Feel how he sinks into you, how his nervous energy drains away into stillness.

4. Throw yourself into the “zone.” As you give your child a bath, read him a book, or help him clean up his toys, forget about everything except this one moment.  Watch how your child feels the juice of your full presence and responds with happiness and cooperation.

5. If your inner critic shows up while you're enjoying your kids, bypass it by diving deeper. Resist the lure of the to-do list; it will be there after the kids are in bed.  Remind yourself that you're engaged in the greatest possible creative act -- Helping your child blossom. Your presence is the sunshine she needs to flower. Just show up.

"Instead of focusing on how much you can accomplish, focus on how much you can absolutely love what you’re doing. Be there completely. While doing this, you’ll find that you naturally enjoy those seemingly tedious tasks much more (like washing the dishes). It’s amazing how much non-resistance and presence changes everything.”  —Zen Habits

Our Spring Cleaning for Your Psyche series:

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5 ideas on how to bypass your Inner critic by diving deeper.
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Psychological Nutrition for Caregivers

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Data show that family caregivers suffer from poorer health than non-caregivers. In one recent national survey, 22% of caregivers reported a decline in their health and 40% reported experiencing high emotional stress related to caregiving activities (National Alliance of Caregiving and AARP, 2015). Emotional stress is highest (46%) among those with higher-hour caregiving when compared to lower-hour caregivers (34%). Approximately 50% of those caring for family members with dementia experience emotional stress. Other studies have suggested that a substantial percentage of family caregivers may meet the criteria for clinical depression (Zarit, 2006). Caregivers who are elderly suffer from fatigue, health problems, and sleep disorder. Women (often a wife or the eldest daughter) tend to be the caregiver; women experience feeling more stressed in their caregiving responsibilities than men.

Generally, researchers identify two levels of caregiver stress distinguished as primary and secondary stressors (Pearlin et al., 1990).

Primary stressors. These stressors stem from the condition of the person to whom care is being provided. For example:

  • Can they take care of their basic hygiene needs?
  • Can they live independently?
  • Are they cognitively intact?
  • Are there wandering or behavioral issues? 
  • Are there financial issues and strains?

The more of these primary stressors, the greater the risk for the caregiver being emotionally overloaded.

Secondary stressors. These stressors come from the caregiver’s role; such as

  • Loss of a spousal relationship in the case of the person with dementia.
  • Being tasked with end-of-life decisions.
  • Overloaded by multiple responsibilities.
  • Conflicts in work, family, caregiving responsibilities.
  • Strain and worry from the “small” daily caregiver hassles, such as:
    • making calls to arrange transportation.
    • arranging and meeting healthcare appointments.
    • picking up prescriptions.

Researchers suggest that primary and secondary stressors can lead to “intrapsychic strain,” meaning that there may be a loss of self-esteem and emotional distress stemming from the caregiving role. That distress in turn may lead to a variety of social, familial, and work conflicts.

Tertiary stressors. We add a “tertiary” or third stressor—psychological malnutrition. The toll of caregiving exerts a chronic, harmful effect; that is, its effects slowly continue and add up—sometimes with the caregivers unaware of the severity of their emotional and mental depletion.  The issues that caregivers deal with present numerous psychological landmines:

  • Behavioral issues stemming from dementia or severe traumatic brain injury.
  • Sibling conflicts in caring for an elderly parent.
  • Health care decisions; such as, placing the family member in a care facility; making end-of-life decisions.
  • Financial issues such as those arising from testamentary capacity matters; costs for in-home help, skilled nursing facilities, and medications  .

Caregivers are at risk for psychological malnourishment when worry, anxiety, guilt, bitterness, and sadness dominate their emotional state. These emotions drain energy and psychological reserves through emotional self-deprivation. They leave little to no room for experiencing positive emotions, such as love, gratitude, and joy. It is at this point that the caregiver is emotionally running on “empty.”

It is easy to neglect your emotional health as a caregiver. The impulse is to place your focus primarily on what your impaired family member needs. You are then likely to try and meet the needs of:

  • your children or others;
  • work obligations;
  • addressing daily living issues; such as paying the bills, grocery shopping, cleaning the house. 

You are often last on the list of addressing your needs. You may not even realize that you are psychologically malnourished. If you find yourself often:

  • doubting your judgments and second guessing yourself,
  • experiencing a hurried/agitated internal state, or
  • feeling pessimistic, frustrated, or in conflictual or adversarial relationships with others

then you are psychologically malnourished.

In the zone of psychological malnutrition, caregivers risk compassion fatigue (Stamm, 2002). Psychologists suggest that our perceptions of the consequences of our actions lead us to feel a sense of self-efficacy (that what we are doing matters) and self-satisfaction or a lack of self-efficacy (what we are doing does not matter) and dissatisfaction. Conversely, if we do not believe we are helping others, we feel emotionally dissatisfied. In the zone of psychological malnutrition, it is impossible to feel a sense that what you are doing matters, you only feel overwhelmed. This in turn erodes self-efficacy, leading to more emotional fatigue, emptiness, and burn-out.  

Burn out is a disastrous situation for a family caregiver--much more so than for a professional caregiver. You can leave your job; but, (for the most part) you can’t leave your family member. Therefore, the caregiver has to continue to provide care while in a situation of running on “emotional empty.” The zone of emotional malnutrition has some red flags:

  • Chronically feeling underappreciated by others for what you do
  • Feeling that what you do does not matter,
  • Experiencing guilt-driven caregiving and/or self-deprivation.

The zone of emotional nutrition is characterized by the opposite: feeling good about your caregiving and feeling good about giving yourself breaks from caregiving. 

Caregiving is an emotionally multi-layered experience. Helping means that caregivers believe that they are alleviating their family member’s pain—physical and emotional. It is driven by a desire to feel needed, to be given the opportunity to express compassion. There may be deeper motives; such as, inner conflicts related to duty (e.g., the marital vow of “for better or worse” or cultural values of responsibility to care for elderly parents). Caregiving may be a journey of reparation rooted in guilt for having let down the family member at some earlier point.

This emotionally complex endeavor of caregiving is both heartwarming and heartbreaking. Consequently, those of us who are caregivers for loved ones need to be vigilant about the state of our psychological nutrition and strive to “feed” ourselves healthy emotions.

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In your efforts to care for others, don't neglect to care for yourself.
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Emotional Nourishment
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It is easy to neglect your emotional health as a caregiver, but running on empty puts you at risk for psychological malnutrition and burnout.
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Reference: 

National Alliance for Caregiving and AARP. (2015). Caregiving in the U.S. Retrieved from https://www.aarp.org/content/dam/aarp/ppi/2015/caregiving-in-the-united-states-2015-report-revised.pdf

Pearlin, L. I., Mullan, J. T., Semple, D. J., & Skaff, M. M. (1990). Caregiving and the stress process: An overview of concepts and their measures, Gerontologist, 30, 583–594. doi.10.1093/geront/30.5.583

Stamm, B. H. (2002). Measuring compassion satisfaction as well as fatigue: Developmental history of the Compassion Satisfaction and Fatigue Test. In C. R. Figley (Ed.), Psychosocial stress series, no. 24. Treating compassion fatigue (pp. 107-119). New York, NY,: Brunner-Routledge.

Zarit, S. H. (2006). Assessment of family caregivers: A research perspective. In Caregiver Assessment: Voices and Views from the Field. Report from a National Consensus Development Conference (Vol. II). (pp. 12- 37). San Francisco: Family Caregiver Alliance. Retrieved from https://www.caregiver.org/sites/fca.huang.radicaldesigns.org/files/pdfs/v2_consensus.pdf#page=18

From Filmmaking to the Philosophy of Science

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This is the third in a series of interviews on “Science and Philosophy" featuring influential scientists and philosophers of science. Click here for part 1 on the rise of fake news.

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Cailin O'Connor
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Cailin O'Connor is a philosopher of biology and behavioral sciences, philosopher of science, and evolutionary game theorist. She is Associate Professor in the Department of Logic and Philosophy of Science, and a member of the Institute for Mathematical Behavioral Science at UC Irvine.

Walter Veit: What was your path towards philosophy?

Cailin O'Connor: I took an extremely odd route.  As an undergraduate, I started as a biology major.  But after too many off-putting interactions with pre-meds and the annoyed biologists teaching them, I switched my major to filmmaking.  For several years I worked on documentary films, as a digital media director, and doing various odd jobs.  (Once I was Cyndi Lauper's stand-in for a music video.)  At some point I decided to go back to graduate school, planning to study the biology behind aesthetic preference.  My now-husband was studying philosophy of science, which sounded like a decent way to marry my interests in the sciences and humanities.  I hadn't ever studied philosophy, so I started hanging around his department sitting in on seminars until I could put together a grad school application.  

Walter Veit: What is the role of philosophy in science?

Cailin O'Connor: I don't think there should be a strict divide between philosophy and science.  Many scientists are interested in questions related to methodology, the way their work fits into a bigger picture, and the impacts of science on society.  At the same time, many philosophers use the best methods of science — modeling and experimentation — to answer traditional philosophical questions.  On this picture, there are all sorts of ways that philosophy can benefit the sciences, and science can benefit philosophy.  

Walter Veit: You are a philosopher who uses models to explore philosophical questions. Have you ever received criticism from within the philosophical community towards this particular style of doing philosophy?

Cailin O'Connor: There are, of course, philosophers out there who think that modeling work, or empirical work, can't be proper philosophy.  I've also had pushback about using models and mathematics to address feminist philosophy.  To me, it makes sense to use all the best epistemic tools available when doing research.  Many of these tools were developed in the sciences.  There is no good reason to do philosophy with one hand tied behind your back.

Stay tuned for part 4!

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An interview with philosopher, modeler, and feminist Cailin O'Connor.
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Empaths and Addiction: From Alcohol to Overeating

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Why are empaths so susceptible to alcohol, drug, sex, food, gambling, shopping, or other addictions?

Empaths can become overwhelmed and overstimulated due to their extreme sensitivity. When they “feel too much,” including their own or another’s pain, some empaths self-medicate. If they don’t know how to manage this sensory overload, they numb themselves to shut off their thoughts and feelings to diminish empathy, though not everyone is aware of this motivation.

You pay a high price for coping with your sensitivities through addictions. They wear down your body, mind, and spirit creating illness, depression, and more anxiety as you try to manage an over-stimulating world. At best, addictions only provide short term relief from sensory overload, but in the long term they stop working and will worsen your feeling of being overwhelmed.

Self–Evaluation and Getting Support

Though not all alcoholics or addicts absorb other people’s energy, I’ve observed that a large portion do. Unfortunately, many empaths remain undiagnosed and don’t realize how overstimulation and high sensitivity fuel their addictive behaviors. It’s therefore crucial to understand whether you’re coping with your sensitivities by engaging in addictions. How do you know? Ask yourself the following questions:

  • Have I ever thought, “Life would be so much better if I didn’t drink or overeat?”
  • Have I ever tried to stop overeating or using substances for a month but could only last a few days, despite my best intentions?
  • Am I self-medicating to ease social anxiety or the stress I take on from the world?

If you suspect you are using alcohol, drugs, overeating, or addictive behaviors to manage the sensory overload of being an empath, take some time to reflect on how you cope by evaluating the following statements.

I turn to substances or other addictions when ...

  • I’m overwhelmed by emotions (mine or another’s).
  • I’m in emotional pain and feel frustrated, anxious, or depressed.
  • My feelings are hurt.
  • I feel uncomfortable in my own skin.
  • I can’t sleep.
  • I feel emotionally unsafe in a situation.
  • I feel criticized, blamed, or rejected.
  • I feel shy, anxious, or don’t fit in socially.
  • I’m isolating at home and I need confidence to go out in public.
  • I’m tired and need an energy boost.
  • I feel drained by energy vampires.
  • I want to escape and shut out the world.

Here’s how to interpret this self-assessment:

  • Answering yes to even one statement indicates that you sometimes turn to an addiction to cope with your sensitivities.
  • Answering 2-5 yeses indicates you are moderately relying on an addiction to self-medicate feelings of sensory overload.  
  • Answering 6 or more yeses indicates you are largely coping with empathy by engaging in addictive behavior

Alternatives to Self-Medicating: Strategies and Solutions

Self-awareness is liberating. No shame. No blame. By being aware of your addictive tendencies, you’re gaining a larger appreciation of how you cope with your empathy. Then you can more productively deal with it. Here are some action steps from The Empath’s Survival Guide to help manage sensory overload.

First, it’s necessary to identify your addiction. Honestly assess: How much do I drink or take other substances weekly? How often do I overeat to cope with feeling overwhelmed? Do I turn to other addictions (such as sex, love, gambling, shopping, video games, the internet, or excessive work) to lower my anxiety level or shut off my sensitivities? Be compassionate with yourself. See if you find a pattern of self-medicating your feelings. Self-medicating even once a week or once a month indicates that you may have an issue with addictions.

Second, it’s crucial to realize that nothing on the outside--no substance, person, job, or amount of money--can make you feel comfortable with yourself and your sensitivities. Happiness is an inside job. You must learn to know, love, and accept yourself, a life-long process of discovery. The more you run from your sensitivities, the more uncomfortable you will get. As the Buddha said, “There is no external refuge.”

Third, for an ongoing plan to address your addiction, you might want to consider entering psychotherapy and/or attending Twelve-Step meetings for support. It’s important to find healing modalities to inspire you in having a healthy relationship with yourself and others. Then, as an empath, you won’t be at the mercy of the painful feeling of sensory overload and you will be able to center yourself to find a liberating sense of balance in your life.

Adapted from The Empath’s Survival Guide: Life Strategies for Sensitive People by Judith Orloff MD

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Why empaths so susceptible to addiction.
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The Neuro-Scientific Basis of Morality

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Review of Conscience: The Origins of Moral Intuition by Patricia S. Churchland. W.W. Norton & Company. 226 pp. $27.95.

In deriving foundational principles of morality, Immanuel Kant declared, “the ground of obligation must be looked for, not in the nature of man nor in the circumstances in the world in which he is placed, but solely a priori in the concepts of pure reason.”

Patricia Churchland, professor emerita of philosophy at the University of California, San Diego and author, among other books, of Neurophilosophy: Toward a Unified Science of the Mind-Brain, does not agree. Morality, Churchland claims, “does not and cannot emerge from pure logic alone.” Or from laws derived from religion.

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In Conscience, Churchland draws on recent scientific research to demonstrate that genetic predispositions combine with environmental stimuli to produce ethical systems. The path from biology to morality runs along these lines: Genes dispose us to be social animals. Evolution favors this development. Human beings bond with others with varying degrees of self-sacrifice. The circuitry supporting sociality, self-care, and social norms begets conscience.

Neurobiological data, Churchland acknowledges, does not tell us which ethical option should be preferred. Nor does it tell us precisely how neural networks regulate behavior. But the evidence does support the conclusion that wiring that is genetically ready at birth stimulates a disposition to care, which in turn produces a motivation to acquire the social practices – table manners, food sharing, respect for the flag, marriage, slaveholding – of the community.  “Once learned,” Churchland writes, “social norms become part of a developing extended neural network, in cortex as well as subcortical structures.” Of course, some individuals challenge social norms. And psychopaths do not abide by them. But these responses, Churchland suggests, can also be explained by differences in the brain.

Informative, accessible, and engaging, Conscience introduces readers to studies in genetics, evolution, psychology, anthropology, and philosophy that examine interactions between nature and nurture. Many of them will be of interest to readers of Psychology Today.  Rooted in the “rich connections” between the basal ganglia and the frontal cortex and hippocampus, reinforcement learning “is a marvel,” Churchland points out. In addition to Pavlovian conditioning, instrumental conditioning through reward and penalty prediction (in which toddlers, for example, get toys when they point at them and ask) link learning and deciding. Stress reduces self-control, constraint satisfaction, and prospective optimization; changes to the nervous systems enhance the attraction of immediate rewards and diminish the appeal of longer-term preferences. For heroin addicts, wanting and liking sometimes diverge. To tell us what to watch for, dopamine release follows positive outcomes; serotonin when a choice turns out badly; releases are calibrated to the size (actual or counterfactual) of the gain or loss.

Churchland also introduces us to cognitive pattern generation, the “breakthrough concept” devised by Ann Graybiel, a neuroscientist at MIT. A cluster of neurons in the basal ganglia, Graybiel discovered, is organized to enable us to perform multi-step, semi-habitual actions, previously performed successfully. Although we can – and do – customize to fit specific cases, the general form works well when we drive a car and often when a nurse triages patients in an emergency room. Internalizing norms is efficient and can reduce anxiety, but, Churchland acknowledges, rituals can also “become problematic habits.”

“The yearning for moral authority is altogether understandable,” Churchland concludes. “But certainty is the enemy of knowledge.” To be human, she implies, is to struggle to find the balance between respecting (internalized) social norms and recognizing the flaws in them:  between trusting our own conscience and acknowledging that, “even with the best of motives, we will sometimes err and our conscience will churn.”  We “can strive to continue learning from our social experience,” she maintains, and from the findings of brain scientists.

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Why Duff McKagan Still Does His Laundry in the Sink

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photo by Albert Sanchez
Duff McKagan
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“Everybody’s lyin’, I need some truth”

From “It’s Not Too Late” by Duff McKagan

Here’s a question for all of you music nerds out there: which rock musicians have had success not only in at least three prominent bands but also as a solo artist?

So far, my list includes Eric Clapton, Steve Winwood, Neil Young, Robert Plant and Chris Cornell. And, in my opinion, at least one more person belongs in that elite fraternity: Duff McKagan. While being a founding member of hard rock legends and Rock and Roll Hall of Fame inductees Guns and Roses, Velvet Revolver and, albeit briefly, Jane’s Addiction qualifies McKagan on the band criteria, I also dig his early work as a drummer for indie rock pioneers, Fastbacks, and Seattle hardcore bands, The Fartz and 10 Minute Warning - so pick your poison.  

And with his new album Tenderness and world tour, McKagan continues to make a strong case for himself as a solo artist. McKagan’s shift to a definitively softer and more subdued tone is being well received, with Rolling Stone calling the album,  “…full of beauty and heart,” and Louder saying “… the songs gleam like jewels in the desert sun.”

Having given us original music for 40 years, how has McKagan been so prolific for so long across different genres of music, different bands and even different instruments? As he tells the story, McKagan’s secret sauce is an ongoing commitment to pursuing a raw authenticity that has been consistent throughout his career: “three chords and the truth.”

McKagan traces his approach to his roots growing up in the Seattle punk rock and hardcore scene. Initially, he was lured in by the in-your-face intensity of the music, but he soon found himself drawn to truths about cultures and issues that went beyond his local scene.

“Punk rock … it was this whole new world … I saw the posters on the telephone poles … and I was so intrigued. I had just started playing music. And I saw these fliers for D.O.A. and The Lewd, The Mentors and I was like, ‘Hey, what is this stuff about?’ There were probably 120 people total in Seattle that were into this kind of music,” McKagan told me. “They turned me onto music by The Clash and by Stiff Little Fingers. Foreign bands were talking about foreign subjects. I didn’t know what a ‘Suspect Device’ was. It wasn’t until my mom walked into my room one day and I was listening to Stiff Little Fingers and she started crying. And I’m like, ‘Why are you crying?’ She said, ‘These poor boys, they are in The Troubles in Ireland.’ And I’m like what are The Troubles?’ And a suspect device is a bomb. I was like, ‘Whoa, I thought it was just a jam.’ So, it opened me up to this whole kind of international politics I guess and people going through different things than I was in Seattle.”

According to McKagan, the early era of hardcore wasn’t just about learning new information, but rather about a more general openness to alternative perspectives. “For me from ’78 to early ’82 it was very pure and good. So the hardcore ethic and this punk ethic has been this thing of openness – kind of chest out, head up telling the truth … When [Henry] Rollins came into Black Flag, hardcore was still a pure and open and inviting place. Anybody could come – weirdos, geeks, jocks – whatever, doesn’t matter,” McKagan described. “But it got kind of closed down, it became kind of a dress code. And some kids from suburban areas started coming in and they thought that slam dancing was fighting. And some things started to come in – like you started seeing some people doing the Hitler salute. It was like whoa, whoa, whoa whoa – wrong idea. This isn’t about that.”

“Three chords and the truth is really what it’s about.”

Part of what made punk rock, and particularly hardcore feel so open and inviting was that the bright line that had previously existed between “rock stars” and their audience had been erased, resulting in a more intimate relationship between artists and fans. “I’d just seen Led Zeppelin at the Kingdome. And I love Led Zeppelin to this day … But they were so unattainable. They were so far away … you’d never meet them. But here these bands were coming through town. I met The Clash and they said from the stage, ‘There’s no difference between you and us the band – we’re all in this together,’” McKagan recalled. “That has impacted me to this day … It might be the whole crowd. It might be one person you see in the front that you make eye contact. And you see there’s a deeper story … And I know there’s a deeper story because I’ve gone out and talked to those people.

“Because The Clash came and talked to me.”

As McKagan shifted from playing drums to bass and became a songwriter in his own right, he began to experiment with a more punk-infused hard rock style of music that became the trademark of Guns N’ Roses. And despite the fact that Guns N’ Roses was a definitively hard rock band, and that the other band members did not hail from the punk and hardcore scene, he found that they all shared the same raw punk rock honesty which came through in the music. McKagan commented particularly on singer Axl Rose’s authentic nature.

“You know Axl … his way was certainly truthful … I mean he was like Henry Rollins. When I first met him, he couldn’t lie if you held him over a fire … He wouldn’t. He didn’t go through the hardcore scene. He just had it naturally. And the guys in that band – all of them – had the edge,” McKagan explained. “And maybe it was because we moved to L.A. in the case of Axl, Izzy [Stradlin] and myself. When you move to a different city to do music, you know you’re going to be a lifer. Like this isn’t a hobby. And I was looking for other people where it wasn’t a f*cking hobby. We didn’t have anything to fall back on.”

McKagan described two challenges that emerged as time went on.  The first was that as Guns N’ Roses became more popular and, therefore, played in front of larger crowds, McKagan felt that he was losing his connection to his punk rock roots and to his audience.

“We connected with our audience because it was only three people at first. And it grew to seven and it grew to thirty and it grew to fifty and it grew and grew … We’re playing stadiums where the audience is 50 feet away from the stage. How do I get that same connection? They’re not sweating on me. They’re not spitting. They’re not singing the lyrics in my ear as I’m playing,” McKagan explained. “I did go through a little punk rock guilt I suppose … I talked to other people about it too, like Stone [Gossard] and Jeff [Ament] from Pearl Jam. They know what I’m talking about … In Guns N’ Roses I was doing nothing different than what I was doing with the Fastbacks, the Fartz … It was truthful and honest and we’re going out there, giving 110% and connecting with an audience. But when the band blows up … Our band got so big that naturally it turned into a machine at one point. And I lost my footing a little bit. That was a fast adjustment for a punk rock kid to make.

“It was a fast adjustment for us all to make.”

Another big change was that McKagan now had money – and punk rockers are not supposed to be in it for the money. “I think money was one thing. I wasn’t struggling. I didn’t know what money was. I had money in my bank but I didn’t know how to spend it. I didn’t want to spend it,” he said. “It’s simple – I’d never been introduced to the f*cking world of business or commerce. You’re selling things. So, you’re going to make money because you’re selling a lot of it. Okay, I’m not supposed to make money. That’s not what I got into this for. It’s an adjustment period.”

The other issue that pulled McKagan away from his connection to his authentic truth was his battle with alcohol and cocaine addiction. McKagan described how as he began the recovery process, he began to grapple with many issues that he had avoided, including his conflicted feelings regarding his new found fame and fortune.

“It wasn’t until I got sober and I was 30 years old that, literally in the hospital – I was in the hospital for a couple of weeks – and I started having my first sober thoughts. And there was a million of them coming at me, ‘What am I gonna do? Can I play music again? Is my life over? Is it not going to be fun anymore? Oh, I get to live, though. Maybe I can have a family. Maybe I can go to college now. I think I’ve got money now. Do I have money? Who’s taking money from me? I better find out about money,’” McKagan described. “And I got out of that hospital and I listened to the Ruts and I listened to things that brought me back to a simpler time in my life. And I road on my mountain bike and began to figure things out. Like, why did I have punk rock guilt? What was that guilt about? And I started to put things together. I’m not a kid anymore – I’m thirty. Which to me now still seems like a fucking kid. And I’m like f*ck yeah – knowledge is power … This is true power. It’s not money.”

Eventually, he came to realize that success was not the enemy of his truth or his connection with the audience. In fact, he reflected on how important music had been to him throughout his life and realized he was paying it forward.

“Music heals us … It heals a broken heart … Music’s gotten me through panic attacks. Music’s gotten me through touches of depression. You know if you hold on to one song – just listen to it over and over again – you’ll be safe, you can breathe,” McKagan said.

“People loved the band – that’s great… The band … It f*cking spoke to them. Your f*cking music’s helped people. Your music’s done stuff for people on a really huge scale. You should be thankful for that. Don’t have guilt about that.”

And so it was that McKagan began to reaffirm the core principles that drew him to punk rock and hardcore music in the first place. He harkened back to when he was learning about issues and cultures around the world through music and began to refocus his attention to the power of knowledge. Accordingly, McKagan eventually went to college and business school.

“And I began realizing what a great writer Blaine [Cook] from the Fartz was … He was smarter than me. I wasn’t paying attention to what he was saying. We were just going out and playing those songs. And I was like, ‘How’d you get smart?’ And I started reading books and I went to college,” McKagan explained. “And for a guy like me who went through what I went through it was so empowering. And I was reading books. Okay, Civil War – I want to know everything I can about the Civil War. I’m an extremist. And I’m a punker. And I’m thorough. I’m going to read twenty books from each side of the Civil War. Polar exploration – I want to know everything about it … And I met my wife at a certain point, and got into business school. And I wanted to know … What is a stock? What is a bond? I don’t know what any of this stuff means. Gaining knowledge of that was empowering.”

McKagan credits a great deal of his sustained recovery to his martial arts practice and the small behaviors that built a healthy and honest life. And interestingly, he noticed that one of the habits that grounded him, and he had been doing all along, was washing his own clothes when he was on the road.

“I didn’t go to therapy. I went to martial arts. Which in itself did more for me than maybe twelve therapists could have. It was Ukidokan. It was a system of martial arts where you took responsibility for your actions. And you treated others well and you treated yourself well. And you make amends to people that you’ve hurt. And I realized ten years later that’s what they do in AA. I started really sharpening up my life and taking responsibility … I returned every phone call I got. I made my bed. Small things. But I’d wake up in the morning and have nothing left undone,” McKagan said. “I’m always coming from the same place… I still do my laundry in the sink.  Even on the biggest f*cking tours where you could have someone doing your laundry, I still do my laundry in my sink. There are some habits I just can’t f*cking break. And in turn I’ve taught my wife and daughter to do that too when we’re on the road.”

As McKagan delved into his work with Velvet Revolver, he continued to prioritize his recovery and reaffirmed the songwriting process he felt that he learned from his early punk days.

“If you look at a Fartz record, it’s railing against the man, it’s railing against apathy. It’s about thinking for yourself,” McKagan described.  “And nothing’s really changed … I know there are songwriters who know how to write songs for other artists and stuff … that really know how to write songs for the masses. But that’s a whole different art – I have no idea what that’s about really. I’ve been in this world this whole time where you write songs that speak to you first … and then you go out and you play it and you hope other people connect with it. But you’ve got to write for yourself first,” he said. “And getting to Velvet Revolver … that was a time when we were forty, maybe being looked at as too old. And it was kind of that thing again – well it’s us against them. We’ll show them … and we wrote songs for ourselves.”

And so it was with that same mentality that McKagan approached Tenderness. “I’ve always wanted to do a musically sparse record. I’ve made little attempts at it in my past. I wanted to do a Johnny Thunders So Alone acoustic record … I’ve wanted to do a Mark Lanegan acoustic record since I heard Winding Sheet.

In this album, McKagan takes on more societal issues and what he sees in the world. One issue he takes on is the dangers of social media, which he sees as often antithetical to the commitment to the truth he seeks in his music.

“Social media is not a truth teller. It’s not the sage of all. I’ve had to raise my girls … We’ve had to wade them through this miasma of opinions – anonymous opinions … In 2004 we had a fan forum …  And I would go on there, and people would post, and rarely would they use their real names. And there was this guy, and he was posting about our band. And some of the stuff was right on – and I was reading it all. And then sometimes he would criticize us,” McKagan recalled. “And it was the Netherlands, we’re playing this gig, and I’m backstage at this concert. Kind of like a meet and greet of fans … And this kid comes up to me, he was 14. And he gave me his social media name – and he was the kid that I was living and breathing on every post he made. He was 14. And I stayed in touch with him, and he met his wife at a Loaded show.

“But that kind of taught me all I needed to know about social media.”

The themes in Tenderness are diverse, ranging from sexual assault to drug addiction to homelessness and war profiteering. There is perhaps an irony that as McKagan’s music became at first blush a far cry from punk and hardcore, it in fact went back to the roots of those genres in shedding light on important societal issues. “And these were stories I experienced when we were on the road. Things I took note of. And we’re really not talking about having an opinion … some of these things I’m not informed enough.  But I am on the opioids. I am about the drugs. I’m trying to discover about homelessness. I wrote about my fear… maybe that’s why we’re fearful, because we’re like two bad moves away from being there ourselves.”

And he harkens back to the openness and acceptance he learned from punk and hardcore in his approach to these issues. “It’s easy to have an opinion on everything. Sometimes those opinions are really uninformed. Sometimes when someone’s going through a disease like alcoholism or drug addiction, it’s easy for someone to be like, ‘f*ck that, pull yourself out of it.’ Or you see a homeless person, ‘Get a f*cking job,’” McKagan pondered. “You don’t know what happened to them. We don’t know about their abuse as a child and putting them in foster care and them getting abused in foster care and drugs and they had no way f*cking out ever. We don’t know. That could be the truth or not the truth about that homeless person you told to get a f*cking job.

“But we all do it. We all prejudge. I’m not perfect – I do it too. But maybe take a step back – especially in this day of social media and what not, take a step back … I’m sure we all posted something where we wish we had more information before we posted it. We have to have empathy for each other. The America I know, at our best, f*cking helped each other without question. We didn’t ask who we voted for, we didn’t ask how much money you made. After 9/11 we helped each other. After hurricanes we helped each other … fires … I could go on. That’s the America I know, we didn’t ask who we voted for, we were just there for each other … And that goes for the rest of the world. I’ve traveled and … we have so much more in common with each other than what separates us by far.” 

Interestingly, none other than Henry Rollins took note of the concept behind McKagan’s new solo album. And McKagan got some true validation that he had been sticking to his authentic hardcore roots all along.

“I’m doing a f*cking interview with f*cking Henry Rollins. He’s one of those guys. There’s Prince, there’s Henry Rollins and there’s Iggy. There are certain people in my life that are untouchable. I never really wanted to meet him because he’s Henry Rollins,” McKagan said. “All of a sudden it comes up that he’s going to interview me. He’s researched the album – he knows every song and every lyric. I’m like holy sh*t he’s going to tear me apart. But the first thing he said was, “This is the most punk rock record I’ve heard in the longest time.’

“I felt like if I got that from Henry Rollins, that I’ve achieved what I’ve tried to do which is three chords and the truth.”

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Cults of Personality and Where to Find Them

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A few years ago, then-presidential candidate Donald Trump infamously remarked, “I could stand in the middle of Fifth Avenue and shoot somebody and I wouldn’t lose any voters.” The statement provoked scoffs and eye-rolls, which, for some, papered over worries that it might be true. One could see Trump’s profession of his invulnerability in the eyes of his base as a claim to cult status, based on his personality.

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An event celebrating Tito in 1945
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A mention of ‘Cults of Personality’ calls to mind portraits hung on every available wall and thousands of simultaneous salutes—associations which impart a distinctly old-fashioned tinge to the concept. Insofar as cults of personality are relevant to contemporary politics, they exist at the margins: in North Korea or Turkmenistan, perhaps Iran. However, I think that cults of personality continue to influence politics in even the most democratic of nations, even if the aesthetics have evolved.

My idea stems from a theory called the "devoted actor" hypothesis, recently advanced by Scott Atran and several other researchers. On this view, people are willing to defend religious, political, or moral ideals at great cost, “when such values are embedded in or fused with group identity, becoming intrinsic to ‘Who I am’ and ‘Who We are,’” as Atran writes. Particular ideals are called "sacred values," oft-cited examples of which include the protection of human rights or the environment and control of holy sites. If offered a chance to compromise one of these values for monetary rewards (say, if a developer wanted to buy the Temple Mount), an actor truly devoted to that site would never even consider it.

Alongside objects of obvious import—holy sites and human rights—different groups treat many seemingly mundane things as sacred objects. Hairstyles and flags are sacred in some quarters, as are slogans and symbols. There’s the famous ladder on a ledge of the Church of the Holy Sepulchre in Jerusalem, unmoved for hundreds of years because of intrafaith disagreements, now an important symbol in itself. As a result of this diversity, sacred values are defined in terms of the behavioral patterns that emerge when people interact with sacred objects, not in terms of content, i.e. what types of objects are in themselves sacred. That is to say, anything can become a sacred value if a community is willing to defend it unconditionally.

If anything can become a sacred value, it follows that a politician or dictator could come to occupy that cognitive place for a group of people. When this occurs, I’d say that person has their very own cult of personality. It surely seems so if their followers are: (1) willing to defend them unconditionally and (2) motivated by allegiance to the individual above party or policies. This understanding could replace (or supplement) traditional historical definitions of the phenomena that emphasize intentional campaigns to elevate the leader of (usually) a single party state, involving governmental apparatuses and media. The psychological perspective can assess the behavioral effects of buying into a cult of personality on both a personal and societal level.

Leaders have employed a variety of methods to build up cults surrounding themselves, with various degrees of success. Trying to transfigure oneself into a sacred object is a difficult and uncertain task; indeed, absent the propagandistic drum-beating of authoritarian states, like the USSR or Yugoslavia, it can happen more or less by accident. Two of the more recent cults of personality that have arisen in America likely surprised even their subjects—Trump’s aforementioned following, but also those who formed a circle surrounding Bernie Sanders. Tellingly, both groups of people adopted semi-ironic monikers around which they could rally.

The “MAGA fans” and “Bernie bros” manifest the same patterns of behavior that Atran finds among those committed to sacred values. For one, they elevate their favored leader, both mentally and by voting and making financial contributions to their campaigns. They also denigrate opposing candidates (not to mention the supporters of those candidates). Secondly, their activity becomes more intense when their candidate’s success was threatened—witness the reaction of Sanders supporters to moves the Democratic party made in Hillary Clinton’s favor. Finally, both sets of supporters display a proclivity for ignoring negative stories, and eventually in Trump’s case, his failures to make good on promises to build a convincing wall or deliver quality healthcare. On a small and interpersonal level, this is the treatment that cult leaders strive for: no questions, no doubts, only unending commitment and respect. Politically, of course, large numbers of energetic and decidedly uncritical followers make life easier.

Importantly, it’s not only the personality who benefits from such a political cult. Their followers find a sense of purpose and belonging; to use Atran’s language, they find answers to the vital questions of ‘Who am I?’ and ‘Who are we?’ Through attending a rally together, or working on an election campaign together, people achieve a sense of working on a common project, of place. The need for these increasingly scarce experiences is not tied to any one political perspective. People can bond at a Trump rally, but so too at a Democratic Socialists of America meeting. Perhaps the crucial aspect of the devoted actor hypothesis is its recognition that people are only bound together in a community through their shared respect for sacred objects. Perhaps it shouldn’t be surprising, then, that politicians sometimes play this role.

There's something strange about idea of cults of personality within democracies. After all, aren’t we supposed to be voting for the candidate who makes the best arguments, who would serve the country best? The unconditional loyalty borne of treating a leader as a sacred object short-circuits the reasonable behavior implicit in idealized visions of democracy. Certainly, a callous politician can use his or her base of devotees to amass power and lessen the backlash from illegal or unethical actions. For this reason, reflexivity about even the leaders one loves the most is called for. At the same time, however, belonging to a community of partisans fulfills the very real need for a sense of belonging. Pursuing a cause greater than oneself brings with it positive emotions and a greater sense of self-worth. Balancing the desire to immerse oneself in a community of like-minded peers and an awareness of the potential for the abuse of collective devotion is a difficult task for even the most erudite politicos.

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Do You Smell That?

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You know those people who can always smell something?

  • Do you smell that?
  • That smells musty.
  • This chicken has a funny smell to it.
  • This thing smells like rotten milk.
  • Gross! You really can’t smell that!?!?

In a recent study conducted at Tulane University, researchers Zachary Airington, Marjorie Prokosch, and Damian Murray (2019) tried to illuminate the evolved psychology of these “super smellers.”

The Evolutionary Psychology of Disgust

Think about something that disgusts you. Feces on the sidewalk? Vomit? A creepy guy who smells vile and who won’t leave you alone in a social setting? Take your pick.

As is true of emotions writ large, disgust evolved to help us avoid stimuli that would have had adverse survival or reproductive-relevant consequences for humans under ancestral conditions (and, likely, now as well). Our ancestors who stopped eating when someone vomited at the dinner table were less like to ingest dangerous pathogens that might have made it onto their own food. An ancestral woman who made a point to effectively reject the advances of a disgusting, creepy guy would have been more likely to mate and bear offspring with someone of higher mate value. And so forth. Disgust is a part of our “behavioral immune system” and it evolved to facilitate survival and reproduction. Disgust acts as a class behavioral adaptation.

Disgust, Smell, and Evolution

In Airinger et al.’s research, they essentially argue that olfactory ability evolved to help us navigate a world that is partly peppered with disgusting stimuli—stimuli that could have adverse consequences pertaining to survival and reproduction.

The nature of our olfactory system, then, evolved for a function.

Individual Differences in Olfaction Abilities

As is true of many behavioral adaptations, olfaction ability is not completely uniform across people. Some people have a better sense of smell than others do. The team from Tulane set to figure out why this is the case.

Generally, these researchers predicted that increased olfactory acuity would tend to correspond to (a) markers of disgust sensitivity and (b) approach to sexual interactions. In short, they predicted that people with highly attuned olfaction abilities would be relatively sensitive to disgusting stimuli and that they would, generally speaking, show a preference for relatively long-term (monogamous) mating rather than short-term, promiscuous mating. In short, these researchers predicted that heightened olfaction ability serves a special function in some people: It allows them to be particularly sensitive to disgusting stimuli and it encourages them to utilize a relatively low-risk approach to intimate relationships.

In a sample of nearly 200 young adults, the researchers found general support for their basic predictions. They found that super smellers (a) showed more sexually specific disgust sensitivity and (b) showed a relatively low inclination toward short-term mating interest.

Super Smelling as Vigilance

At the NorthEastern Evolutionary Psychology Society conference, I was fortunate to have a conversation with the study’s lead author, Zachary Airington—who, by the way, won the NEEPS conference’s award for the Best Student Poster for this work: Congrats, Zachary! I suggested that a broader explanation for this set of results may be found in the psychology of hyper-vigilance (or being super-attuned to stimuli in one’s environment). Here, I spell out that reasoning:

Hypervigilance is characterized by someone being especially sensitive to stimuli that surround him or her. A pen drops across the room, and the hypervigilant person immediately stands up and orients toward that part of the room. Someone across a crowded room looks briefly in this person’s direction, and the hypervigilant person focuses keenly on this glance, immediately working to infer why that person just stared at him or her.

While hypervigilance has several causes, one well-known cause is found as a response to trauma, vis a vis this 2005 report of the National Collaborating Centre for Mental Health (UK). People who have experienced traumatic events have learned through such experiences that life can be dangerous and that people are not necessarily to be trusted. Hypervigilance, then, can be seen as a specific adaptation that follows from such experiences. If life is truly dangerous based on what has happened to you in the past, it likely pays to be hypervigilant at all times.

Being a super smeller may well be a psychophysiological facet of hypervigilance. Perhaps people who have had some experience with trauma have relatively highly attuned olfactory abilities. Perhaps they are more sensitive to disgusting stimuli because in their actual experiences, they have encountered survival-threatening disgusting stimuli. Perhaps they are wary of short-term, promiscuous mating situations because they have been interpersonally burned in the past and, thus, have their evolved psychological guard up.

Being wary of trusting others for short-term intimate relationships, having particularly highly attuned olfactory ability, and being easily disgusted, then, may be part of some broader adaptive response to adverse life experiences. (Looking for a research idea in the evolutionary behavioral sciences? I’d love to see someone design and carry out a study to predict the model that I propose herein!)

Bottom Line

Some people can literally smell various stimuli better than others can. Zachary Airington and his team from Tulane set to figure out why this is the case. Based on their data, it looks like super smellers have relatively high disgust sensitivity (particularly vis a vis sexual stimuli) and they tend to be hesitant to seek short-term mating opportunities.

Is this all, perhaps, part of some broader hypervigilance adaptation? Is it part of some unconscious strategy that serves to have those who have had highly adverse experiences be on the lookout for danger? Only future research will tell.

Evolutionary Psychology
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The evolutionary psychology of being a super smeller.
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Darwin's Subterranean World
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The ability to smell various scents and odors varies widely among people. An evolutionary perspective can help us understand why.
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Airington, Z., Prokosch, M. L., & Murray, D. R. (2019). Smells and sexual strategy: The relationship between olfactory acuity, disgust, and mating strategy. Poster presented at the annual meeting of the NorthEastern Evolutionary Psychology Society (NEEPS). June.

National Collaborating Centre for Mental Health (UK). Post-Traumatic Stress Disorder: The Management of PTSD in Adults and Children in Primary and Secondary Care. Leicester (UK): Gaskell; 2005. (NICE Clinical Guidelines, No. 26.) 2, Post-traumatic stress disorder. Available from: https://www.ncbi.nlm.nih.gov/books/NBK56506/

Are You a Morning Person, Night Person ... or Neither?

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George Shervashidze / Pexels
Source: George Shervashidze / Pexels

If you never felt you quite fit into the "morning person" or "evening person" mold, you may have been on to something. New research published in the academic journal Personality and Individual Differences identifies two new personality types to describe people's level of alertness throughout the day. New to this list is what researchers are calling the "napper" and "afternoon" chronotypes.

To come to this conclusion, a team of sleep experts from Russia and Belgium asked 1,305 people to take part in a short online survey. In the survey, participants were randomly shown different times of the day (e.g., 8 a.m., 11 p.m., 4 p.m., etc.) and were asked to predict their level of alertness/sleepiness at that time. In responding to these questions, participants were told to assume they had a normal night's sleep ending in "spontaneous waking or by a waking up signal at approximately 7:30 a.m." Furthermore, participants were asked a series of demographic and sleep-related questions, including questions that measured their habitual sleep times and the quality of their sleep.

Here's what the researchers found. First, they replicated the familiar "morning" and "evening" personality types. According to their analysis, morning people are most alert from 9 a.m. to 11 a.m. Their level of sleepiness gradually rises throughout the day and, by evening, they express significantly higher levels of sleepiness than the other three chronotypes. Evening types, on the other hand, are considerably more tired than morning types when they wake up (but not as tired as afternoon types). Evening types don't really get going until about 10 in the morning. Their level of alertness, however, stays consistently high throughout the day; sleepiness does not set in until after 10 p.m.

For the two new types identified in this research, "afternoon" types wake up with the highest levels of sleepiness out of all the groups. Sleepiness abates by about 11 a.m. and their alertness stays high until approximately 5 p.m. At that point, sleepiness begins to set in again and rises steadily into the late evening. Interestingly, "nappers" are the only group that shows a double-peaked sleepiness curve across hours of the day. Similar to morning types, nappers begin the day very alert and remain that way until about 11 a.m. Then, sleepiness starts to set in—peaking at around 3 p.m. After that, alertness returns until approximately 10 p.m., at which point sleepiness increases again (but less sharply than the other groups).

Interestingly, the researchers examined the extent to which various demographic and lifestyle differences might shape a person's chronotype. What they found, however, is that these differences have less to do with one's chronotype than might be expected. Their analysis, they write, "illustrates that such four patterns were identical for subsamples of either daytime or shift/night workers, either males or females, and of either younger than 25 years or older age."

And, while previous research has suggested there may be other chronotypes beyond just morning and evening types (for example, some have hypothesized the existence of a group that is hyper-alert throughout all hours of the day and another group that is generally more sleepy regardless of the time of day), the chronotypes discovered in this research are different from previous conceptualizations.

The authors conclude, "Evidence is gradually accumulating in favor of distinguishing at least four rather than two distinct chronotypes. [...] In post-industrial societies, the vast majority of the population might be classified into these four distinct chronotypes while only the minority of population might have intermediate (neither) chronotype."

Sleep
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New research adds two new "chronotypes" to the familiar morning/night dichotomy.
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Putilov, A. A., Marcoen, N., Neu, D., Pattyn, N., & Mairesse, O. (2019). There is more to chronotypes than evening and morning types: Results of a large-scale community survey provide evidence for high prevalence of two further types. Personality and Individual Differences, 148, 77-84.

Heritable Politics

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One June 1, Democratic presidential candidate Andrew Yang tweeted, "According to twins studies between one-third and one-half of political alignment is linked to genetics; that is most of us are born somewhat wired to be liberal or conservative. If this is the case we need to build bridges as much as possible. It’s not just info or culture." The first part of this statement is mostly true - twin studies (or comparisons between identical and fraternal twins) do show that identical twins tend to be more similar than fraternal twins on political attitudes. From this, we infer that genes play a role in the development of political opinions. But exactly what that role is, and how it might impact how we engage with one another, is still very much unknown.

Andrew Yang/Twitter
Source: Andrew Yang/Twitter

Political Attitudes are Partly Heritable

Political attitudes, both generally and specifically, appear to be partly heritable. But what does that mean? Heritability (as estimated from twin studies) means that people who are more genetically similar (that is, identical twins) are more similar in their behaviors compared to people who are less genetically similar (that is, fraternal twins). Politics is no different than any human behavior that scientists have studied using the twin method - everything seems to be at least a little bit heritable. This finding of non-zero heritability is so consistent across human individual differences that it's been called the First Law of Behavior Genetics. Heritability estimates are always about group averages in similarity, never about individuals. Although identical twins tend to be more similar in their politics than fraternal twins, that doesn't mean that all pairs of identical twins have the same political opinions, or that all fraternal twins differ substantially, or even that all pairs of identical twins are more similar than all pairs of fraternal twins.

But we also know that, like politics, no human behavior is entirely heritable. Human individual differences on average tend to be around 50% heritable, but there's a huge range. Even within political attitudes, the range in heritability goes from around 10% for 'sense of civic duty' to nearly 60% for 'political knowledge/sophistication' (Hatemi & McDermott, 2012, Figure 1). On the full spectrum of heritability, that makes political attitudes weakly to moderately heritable.

Gerd Altmann/Pixabay
Source: Gerd Altmann/Pixabay

Heritable Doesn't Mean Unchangeable

Actually interpreting what heritability "means" is a much bigger challenge than just estimating it by comparing twins. It doesn't mean that something won't change. For example, schizophrenia is strongly heritable, yet it changes over the lifespan and can be treated without genetic intervention. A heritability estimate is a simplified proxy for what we're really interested in, which is what causes the behavior. And heritability can arise from a lot of different potential causes. Even if we find specific genes that are correlated with political attitudes, it doesn't mean that those genes cause the attitudes.

Genes do not directly cause any human behavior - they code for proteins, which swirl around in the body, building structures and engaging in chemical reactions, on their own and in response to outside stimuli. Heritability can occur either because "genes cause the thing" (through a long long loooong chain of events from gene to behavior), or because genes cause something else that causes the thing, or because certain genes are correlated with having experiences that cause the thing (gene-environment correlation), or because genes change how a person responds to experiences (gene-environment interaction). Or all of the above simultaneously! Heritability estimates average across all of these complex processes, and more. So saying that political attitudes are partly heritable is true, but doesn't tell us what we need to do to build bridges between people who disagree.

Info and Culture Play a Big Role

Unlike the cluster of opinions that scientists label "political attitudes", political party affiliation shows very little evidence of genetic influence. Instead, party affiliation appears to be strongly (70%) due to influences that are shared between twins who are raised together (such as family, school, or cultural experiences). That is, twins who were raised together tend to have the same political party affiliation, regardless of whether they're identical or fraternal (Hatemi & McDermott, 2012, Figure 1). One thing we know from the history of public policy interventions is that even more strongly heritable behaviors can absolutely be influenced by changes in the culture. More education causes IQ scores to go up (for example, when governments provide public schools and increase the minimum required years of schooling), raising the minimum drinking age decreases teenage alcohol use, raising taxes on tobacco products decreases smoking. Politics is partly heritable, and resolving disagreements is important, but one does not inform the other.

Politics
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Do twin studies explain political disagreement?
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A US presidential candidate tweeted about twins and political bridge building. What does heritability tell us about why people have different opinions, or how to get to agreement?
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Hatemi, P. K., & McDermott, R. (2012). The genetics of politics: Discovery, challenges, and progress. Trends in Genetics, 28(10), 525-533. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.363.440&rep=rep1&type=pdf

Beware of the Big Bad, er, What, Exactly?

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Those of us who love dogs – and we are multitudes! – must never forget that alongside the happy times we spend with our canine companions, there are occasional problems too. Dogs are not nearly as dangerous as humans, but sometimes dogs do hurt people, and the people they most commonly harm are children. As the authors of a recent paper in the International Journal of Pediatric Otorhinolaryngology (that’s ear-nose-and-throat medicine to the rest of us) point out, wounds caused by dogs can be quite severe and require substantial reconstructive surgery. Garth Essig Jr and his colleagues at the Nationwide Children’s Hospital in Columbus, OH, and the University of Virginia School of Medicine looked at 43 published research studies containing data about dog bites, as well as bite reports from their own two hospitals. In total they had access to data on medical treatment for 26,000 dog bites – possibly the largest survey of its kind ever attempted.

Dr. Essig and his colleagues want to provide people with useful information about which breeds of dogs are most dangerous. This could be extremely valuable for families considering adding canine companionship to their human pack. Unfortunately, the authors of this study made two serious errors in their analysis.

U.S. Air Force photo/Airman 1st Class Anthony Sanchelli
Dog bites need to be taken seriously
Source: U.S. Air Force photo/Airman 1st Class Anthony Sanchelli

Their first mistake was to assume that people landing at an emergency room actually know what breed of dog bit them. In some cases, the victim will have been harmed by their own dog, a dog with a pedigree and papers and whose breed, therefore, is beyond suspicion. This is likely to be a pretty rare case, however. Fewer than 1% of the dogs in the United States are registered as pedigree pure-bred animals with the American Kennel Club. There may be a roughly equal number of pure-bred dogs not registered with the AKC (Verdon, 2010). The remaining 98% of the time, people are just guessing – and we have completed studies showing that even experts’ guesses about mixed-breed dogs are often wrong (Gunter et al. 2018). Consequently, for most of the 26,000 dog bites in this study, the breed identity is just a shot in the dark.

Essig and colleagues’ second error was to imagine that how often a dog breed appears in their hospital records of bites gives some clue as to how dangerous that dog is in the community at large.

@Wineke1968/pxhere
A beautiful German shepherd dog
Source: @Wineke1968/pxhere

To take one example: According to Essig and colleagues’ analysis, German shepherds are more dangerous than Rottweilers. They believe this because, of the bites they recorded, more were claimed to have been caused by German shepherds than by Rotties. Unfortunately, it does not follow that because the number of bites from shepherds is greater than the number of Rottweiler bites, shepherds are more dangerous than Rottweilers. This is because we don’t know how many German shepherds and how many Rottweilers are living in the communities from which these physicians collected their data. Perhaps more people were bitten by German shepherds just because there are more German shepherds around to bite people.

Unfortunately, in the United States, where dog registration is not consistently enforced, it is impossible to know how many dogs of different breeds live among us. An excellent study was carried out in the Netherlands, where dog registration is universal. That study found that, although nearly twice as many people were bitten by German shepherds as by Rottweilers, since the Netherlands contains nearly four times as many German shepherds as Rottweilers, the actual risk to a person of being bitten by a Rottweiler is nearly double the risk of being bitten by a German shepherd (Cornelissen & Hopster, 2010). Without that knowledge of the numbers of dogs of different breeds living in a community, information about bite numbers is quite useless.

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A cute Rottweiler puppy
Source: TeamK/PixaBay

Essig and colleagues have taken on an enormously important issue. Scientists and physicians need to understand why, how and when people get bitten by dogs. For dogs and people to live their best lives together, we need to not only accentuate the positive, but also reduce the negative. Tragically, however, their analysis only adds noise to an already complex and confusing situation.

The best practical advice is to look past whatever guesses may have been made about a dog’s breed makeup. Don’t leave small children alone around unfamiliar dogs of any breed and supervise interactions with the family dog. Whether the dog is yours or a stranger’s, dogs have teeth. Learn what a dog who has reached his limit looks like (which varies between dogs, just as it does with people). To live well together, individuals – whether of the same or different species – need to respect each other’s needs. Give dogs space to rest, to eat in peace, and freedom from stimulation that pushes them past their limits. At the present state of the science, that’s the best advice for peaceful coexistence.

Thanks to Lisa Gunter, Ph.D., for assistance in compiling this post.

Animal Behavior
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A new study tries, but fails, to clarify what breeds of dogs are most dangerous.
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Dogs and Their People
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People need to know how to be safe around dogs, but a recent article is barking up the wrong tree.
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Cornelissen, J. M. R., & Hopster, H. (2010). Dog bites in The Netherlands: A study of victims, injuries, circumstances and aggressors to support evaluation of breed specific legislation. The Veterinary Journal, 186(3), 292–298. https://doi.org/10.1016/j.tvjl.2009.10.001

Essig Jr, G. F., Sheehan, C., Rikhi, S., Elmaraghy, C. A., & Christophel, J. J. (2019). Dog bite injuries to the face: Is there risk with breed ownership? A systematic review with meta-analysis. International Journal of Pediatric Otorhinolaryngology, 117, 182–188.

Gunter, L. M., Barber, R. T., & Wynne, C. D. L. (2018). A canine identity crisis: Genetic breed heritage testing of shelter dogs. PLOS ONE, 13(8), e0202633. https://doi.org/10.1371/journal.pone.0202633

Verdon, D. R. (n.d.). AKC registrations continue to decline. Retrieved May 23, 2019, from dvm360.com website: http://veterinarynews.dvm360.com/akc-registrations-continue-decline

Is the American Dream Real or Purely Imaginary?

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“It’s time to restore the American Dream,” said US Rep. Eric Swalwell of California on May 31st as he joined the 2020 presidential race, the latest of a long line of politicians to use the American Dream to attract voter interest.

But is the American Dream real or, as the latter word suggests, purely imaginary?  Either way, it is impossible to ignore the enormous impact the American Dream has had on Americans and the nation as a whole since the idea was first conceived by historian James Truslow Adams in 1931.  Much like other powerful mythologies like religion, the American Dream is psychologically entrenched in everyday life, not just shaping the view of the world for those who choose to believe in it but the decisions one makes and the actions one takes.

On the bright side, it is this absorption of and immersion in the American Dream that accounts for the tremendous value it often adds to people’s emotional lives.  As a utopian ideal, the American Dream functions as a beacon of hope, something to strive for and keep one’s spirits up when times get tough.  As a common denominator, it helps bring Americans together, as it is one of the precious few things we can all relate to in an increasingly multicultural and, too often, divisive society.  For those new to the country, the American Dream serves as a user-friendly vehicle of assimilation, allowing one to express one’s Americanness while still retaining one’s ethnic identity.  Accommodating and tolerant of difference, the American Dream is, I believe, the nation at its best, not surprising given that its fundamental tenets were conceived by the Founding Fathers, refined by the likes of Emerson, Whitman, and Thoreau, and, finally, articulated by the most popular historian of his day.  The American Dream is, quite simply, a masterpiece, a work of art whose ideological beauty can arguably never be surpassed.  That many a politician, including Donald Trump, as well as Madison Avenue have embraced it should be expected, as the thing is an unequivocal “killer app” of salesmanship.

That said, like anything of great value, the America Dream has proven to be a wellspring of considerable trouble for many who have overly invested themselves in it.  Rather than view it as just an ideal, some of us have taken it as something of which most of us are entitled, like the opportunity to vote or social security benefits.  When what these folks mistake as a promise is broken by some economic event- a recession, corporate cutbacks, outsourcing, or another unfortunate but quite normal “correction”- their trust in the system is often crushed.

The sudden disappearance of the American Dream or, should I say, its maddening unreliability and undependability, is thus a source of great frustration for many Americans.  Constantly coming and going, the American Dream seems to almost always reside in the past or loom in the future, rarely ever existing in the here and now.  Although frequently on the horizon, just around the next corner, it is more often viewed as having once thrived, its (and thus our) best days behind us.  A Google search (of well over 1 billion results) reveals that the American Dream is, more often than not, “fading,” “withering,” “shrinking,” “sliding,” “unraveling,” “squeezed,” “threatened,” “broken,” “going backwards,” “in reverse,” and “dying,” when not already “dead.”

A look back at the remarkable cultural history of the American Dream suggests that we should not give up on it, however, even with all the major challenges we now face.  Despite its typical diagnosis as in critical condition or having kicked the bucket, the American Dream has always seemed to recover; our mythology has repeatedly proved to have more lives than the proverbial cat.  The hopefully continual flow of immigrants to this country has and will continue to serve as a breeding ground for the American Dream, for one thing, as their enthusiasm and energy to achieve great things rubs off on all of us.  New immigrants in fact tend to believe in the mythology most fervently, and politicians at all levels continue to employ the American Dream as the centerpiece of their campaign strategies.

There are other reasons to be bullish on the American Dream despite all of the major challenges the nation faces.  The country’s increasing diversity will help fuel the American Dream, as our different backgrounds, experiences, and perspectives are beneficial towards identifying opportunities and bringing them to life.  And although a cliché, Yankee ingenuity will still be a principal driver of the American Dream; our startup business climate proves that our hard-wired urge to build a better mousetrap is as alive as ever.  And if that’s not enough, the core values of the nation have not really budged an inch despite the incredible changes in society since 1931.  These will continue to serve the interests of the American Dream whether it be boom times or bust. 

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Either way, it's impossible to ignore its enormous impact on people's lives.
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7 Things Ultra- Successful People Do

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Kristin Meekhof
Author Kristin Meekhof with Dr. Deepak Chopra, New York City 2017
Source: Kristin Meekhof

   Over the past five years, I've had the joy and honor of spending time with and / or interviewing some of the most successful people on this planet. They range in their professions from Olympic athletes to C- Suite executives to best- selling authors to entrepreneurs.  Some of these individuals include:  my dear friend and mentor, Dr. Deepak Chopra, Olympian Meb Keflezighi,  best- selling author Amy Morin,  C- Suite automotive executive Michael Silvio,  Peabody Award winning journalist Katie Couric, and entrepreneur Lord Loomba, CBE.  These high performers earned overwhelming respect not only within their profession, but also garnered unprecedented media recognition.  In observing and interacting with these high achievers and others, I've noticed the ultra- successful do these seven things: 

1. The Ultra- Successful Are Consistent: They understand which daily practices enhance not only their daily performance, but lead to their reaching their goals, and they consistently engage in these habits. These habits can range from running to writing to reading to meditating. For the ultra- successful these habits are integrated into their daily routine as essential action items, not optional actions. 

2. The Ultra- Successful Are Clear About Their Goals: These individuals clearly defined their personal and / or professional goals and reasons for setting them. The reason may be a feeling they want to achieve, such as financial security or something tangible, like an award.  As a result of this clarity, they are able to employ strategies which help them in the completion of their goals. 

3. The Ultra- Successful Know How to Cope With Negative Emotions: The road to victory for the ultra - successful is filled with obstacles, but these blocks do not impede their vision. Instead, setbacks are met with a "can- do" attitude. While they recognize their disappointment, they do not ruminate in negativity. They override the pessimism with optimism and gratitude for the people who help them climb over the hurdles. 

4. The Ultra- Successful Embrace Change: The ultra- successful view change as an opportunity not an interference. They understand circumstances occur beyond their control happen; however, they optimize the change and leverage it to their advantage. For example, if it is raining on marathon day, they know it is raining for everyone and they are adept at tweaking their running pace. 

5. The Ultra- Successful Fully Understand What They Can and Can't Control: The ultra- successful do not waste time trying to control circumstances for which they have little impact over. They know doing this wastes their energy. Instead they conserve their energy for things they can control, such as devoting their time and efforts to things that matter to them. This means, they are able to mentally and / or physically let go of things and situations which no longer serve them. 

6. The Ultra- Successful Are Curious: If I had to give a middle name to each of the ultra- successful people I listed above it would be "Curious". They embody a curiosity about how things operate. And this lead them a process of exploration, and their deep dive isn't necessarily related to their professional work. Their curiosity lends itself to constant learning and openness to new growth opportunities. This approach enhances their overall personal and / or professional development. 

7. The Ultra- Successful Are Comfortable With Their Inner- and Outer- Self: The ultra- successful know others may question certain behaviors they practice, but they remain confident in their internal drive. They are well aware that appearances matter to some, but they aren't too concerned how others view them. The ultra- successful typically aren't using their financial capital to obtain the newest trendy garments or make purchases to create an impression. They remain centered on their goals and know how their inner- peace leads to outward achievements. 

The footprints of the ultra- successful are unique in the sense they create high impact and resolve. Their influence can be felt at multiple levels.  And it is these seven things the ultra- successful do which make their power and work sustainable. 

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Curious about how the ultra- successful people function? Here's 7 things they do
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A Widow's Guide to Healing
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Do You Have a Sense of Purpose in Life?

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Having a sense of purpose in life is associated with a lower risk of death, according to a recent study published on May 24, 2019 in JAMA Network Open.

The research, which sampled almost 7000 people, included a Psychological Well-Being evaluation, a 7-item questionnaire which assessed purpose in life (Alimujiang, et al, 2019).  The researchers concluded: “This study’s results indicated that stronger purpose in life was associated with decreased mortality.  Purposeful living may have health benefits” (2019, p. 2). 

These findings are striking – shifting the concept of purpose in life from simply a good idea to a critical factor contributing to physical and mental health as well as longevity.  This research joins an increasing number of studies (Cohen et al, 2016; McKnight & Kashdan, 2009) showing a connection between a sense of purpose, health benefits, and overall quality of life.

Moni Mckein from Pixabay
Source: Moni Mckein from Pixabay

Stanford University psychologist William Damon and colleagues (2003, p. 121) define purpose as “a stable and generalized intention to accomplish something that is at once meaningful to the self and of consequence to the world beyond the self.”  Their definition of purpose includes three components: (1) in contrast with simple day-to-day objectives, such as getting dinner on the table or driving to work, purpose is “more stable and far reaching” (p. 121); (2) has an external facet that involves reaching in some way beyond one’s self; and (3) involves achievement, progress, or completion.

Leaders in the growing, evidence-based field of positive psychology explain purpose and meaning as cornerstones of happiness, flow, optimal experience, and a life well-lived (Seligman, 2011; Csikszentmihalyi, 1990; Fredrickson, 2009). 

Purpose opens opportunities. This information can awaken us to define goals and ideals that are personally meaningful and reach beyond ourselves in some way to progressively define our existence.  Purpose does not have specific definitions or boundaries. Whether we experience a sense of purpose as a volunteer, receptionist, carpenter, teacher, maintenance worker, parent, or physician does not matter. It is having a sense of purpose that matters.

With baby-boomers, transitioning to retirement in record numbers, the pursuit of purpose becomes a topic of broad and compelling relevance.  Seeking purpose and meaning can open doors to cultivate well-being as we navigate the challenges and opportunities in the second half of life.  Perhaps these findings recommend a shift from a retirement of leisure to a retirement of meaning.

Having a purpose -- whether large or small, whether we reach the objective or continue to strive for it – informs our existence in very important ways that predict physical and mental health and overall well-being. 

** This post is for educational purposes and should not substitute for psychotherapy with a qualified professional.

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Recent study links strong life purpose and health.
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Alimujiang, A., Wiensch, A., Boss, J, Fleischer, N.L., Mondul, A.M., McLean, K., Mukherjee, B., & Pierce, C.L. (2019). Association between life purpose and mortality among US adults older than 50 years. JAMANetwork Open,2(5). https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2734064

Cohen, R., Bavishi, C, & Rosanski, A. (2015). Purpose in life and its relationship to all-cause mortality and cardiovascular events: a meta-analysis. Psychosomatic Medicine, 78(2), 122-133.

Csikszentmihalyi, M. (1990). Flow: The psychology of optimal experience. New York, NY: Harper & Row.

Damon, W., Menon, J. & Bronk, K.C. (2003). The development of purpose during adolescence. Applied Developmental Science, 7(3), 119-128.

Fredrickson, B. L. (2009). Positivity: Top-notch research reveals the upward spiral that will change your life. New York, NY: Three Rivers Press.

McKnight, P.E. & Kashdan T.B. (2009). Purpose in life as a system that creates and sustains health and well-being: An integrative, testable theory.  Review of General Psychology 13(3), 242-251.

Seligman, M.E.P. (2011). Flourish: A visionary new understanding of happiness and well-being. New York: NY: Atria Paperback.

Boundaries: A Guide to Making Essential Life Decisions

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“If you want to live an authentic, meaningful life, you need to master the art of disappointing and upsetting others, hurting feelings, and living with the reality that some people just won’t like you.” —Cheryl Richardson

Linda Esposito, used with permission
Source: Linda Esposito, used with permission

Establishing boundaries is one of the best ways to preserve your emotional energy and define who and what you allow in your life. Most importantly, you internalize the message that you teach people how to treat you.

What is a boundary?
A boundary is an invisible line you draw around yourself to identify what is acceptable behavior and what is unacceptable behavior. The beauty of boundaries is they are fluid and ever-evolving; for example, looser limits around extending yourself to others is easier when you’re younger and childless. As you age and gain insight, you'll get a quicker read on the energy vampires and the narcissists of this world.

Some people love boundaries because they represent structure, order, and rules. Others see limits as an unyielding set of laws where there are no gray areas, only black and white. A critical part of a healthy psyche is deciding on the right tension for your life. Psychological distress results from overly rigid or overly loose limits.

Boundaries come in many forms:

Physical boundaries relate to your personal space, privacy, and body. What is an acceptable distance between you and another person? Are you comfortable with affection, or are you more reserved? Do you shake hands upon meeting someone? What does your home decor reveal? Are you organized or prone to clutter?

Mental boundaries apply to your thoughts, values, and opinions. Are you capable of having an open mind and a flexible attitude? Signs of weak mental boundaries include reacting in an overly-emotional manner, being defensive, rigid and combative.

Emotional boundaries exist when you can withstand different opinions from yours. Healthy emotional boundaries suggest you don’t need to dispense advice or try and “fix” someone else’s problems. You also recognize that you’re not to blame when other people get upset. You don’t let guilt get in the way of your decisions because you recognize that you have a choice in every situation and relationship.

Financial boundaries include how you spend, save, give and budget money, and how and what you dole out on material goods and experiences.

Moral boundaries exist when you know what behaviors align with your core values. For example, not accepting intolerant attitudes from others, or refusing to put up with lying and cheating.

Sexual boundaries mean you understand your comfort level around physical touch, intimacy, and sexual behaviors.

Spiritual boundaries define your religious beliefs, whether this pertains to God, another deity, or a supernatural being.

If you were raised in a household where your parents and caretakers were overly harsh or overly permissive with discipline, chances are boundaries are a challenge. Exposure to childhood physical and psychological trauma is another cause for tolerating unhealthy behaviors from others. The good news is you're no longer that terrified five-year-old hiding in a corner when your parents fought, but an adult with agency over your life. In order to make the proper adjustments to your limit setting, it's important to understand where your boundaries template originated and typical signs of unhealthy behaviors.

Common Reasons for Unhealthy Boundaries:

Boundaries were not taught to you as a child. When your needs and wants were not respected by your parents/caretakers/family members, you may have internalized that you are not important.

You’re a people-pleaser or the ‘good girl’ or ‘good guy.’ You don’t want to offend anyone or appear that you’re not up to the task at hand, so you take on too much.

You were the care-taker or the parentified child. When your role growing up was to take care of the needs of others, your needs were put on hold. To do something for yourself meant you were "selfish."


3 Types of Boundary-Challenged Behaviors:

Emotional Vomiting. When every emotion is worn on your sleeve. You assume others are comfortable with the intimate details of your life, your sexual dalliances, and your inner-most thoughts, wishes, and failures. Social cues are often missed as self-awareness is lacking.

Immediate Intimacy. The assumption of closeness upon meeting someone for the first time. Think indiscriminate friendships and love interests. It’s about meeting your “soul mate” one week, and feeling bereft the next because you were abandoned, once again.

All or None Relationships. The act of being completely consumed with another person. For example, the college roommate who spent four years in one or more continuous relationships. It’s nearly impossible to make plans or to count on this person since they are joined at the hip with their love interest.

Getting firm on your boundaries takes time and practice, but it's well worth the effort. Resentment builds when you allow others to infiltrate your mind, your time and your physical space. You feel taken advantage of, and you rebel. Behaviorally, this could be a tantrum, a scream-fest, and saying and doing things you later regret.

A guilt hangover follows because constantly doubting yourself means you're stuck in a cycle of indecision, avoidance, analysis paralysis, rumination and compensating behaviors towards the recipients of your anger.

Boundary-building Techniques


Establish your limits. You have to know what you stand for and what you value in order to set solid boundaries.

Get comfortable with ‘no.’ If this is difficult, practice in the mirror until you get the hang of sounding confident and in control. You don’t need to yell or scowl. Think cool, calm and collected.

Be direct. You may have been taught that direct is synonymous with aggressive, insensitive or brusque. While cultural boundaries should always be respected, clear communication is key.

Say goodbye to fear and guilt and hello to safe and self-assured. Fear about what others say and think will keep you awake at night, and stuck in the cycle of self-doubt. Guilt sets you up for overextending yourself and being used.

Check in with your gut. If someone rubs you the wrong way, trust your instincts. If certain behaviors or individuals make you unhappy, it’s probably because they don’t respect you. Ask yourself “What am I going to do to make this situation favorable?”

Remember there’s always options in life. If a job, a relationship or an opportunity doesn’t work out, remind yourself that now is not the right time. Take the situation for the learning experience it was, and move on. You’ll never be stuck so long as you keep moving.

Befriend ‘reciprocal.’ Too many people with loose boundaries do way too much to maintain relationships. Ask yourself what you’re willing to give, and what you need to get in order to continue this partnership.

Beware of Passive-Aggressive Pat and Patricia. It may be habitual for you to pick up the slack in order to keep peace at home or at work. Unless there’s a gun to your head, you’re choosing to overcompensate, which leads to feelings of exhaustion and being taken advantage of. As a recourse, you may ‘forget’ to pick up your partner at the airport, or ‘accidentally’ burn the brownies for the PTA luncheon.

Be a role model for your children (or your inner-child if you don’t have kids). What behaviors are you modeling? What are you teaching about self-respect, independence, and problem-solving? When you take care of yourself, you model appropriate limits on mental and physical energy. And when you practice self-compassion, you’re mindfully present for others.

Don’t over-explain yourself. The key is to communicate with clarity, confidence, and brevity. Extra words, lengthy explanations, and backtracking are signs that you don’t really buy what you’re saying.

Think small. If this is difficult for you, take it slow. Practice boundary-setting incrementally and build up from there.

Know when you’re being sold to. Financial transactions are ripe for being taken advantage of. Just because the baby-faced mortgage broker flashes that megawatt smile, don’t be fooled by the bottom line. There’s nothing wrong with negotiating. Remember the person on the other end of the sales desk usually needs you more than you need them.

Wait on important decisions. We don’t make sound decisions when we’re under stress, tired, hungry and emotional.

Having clear boundaries is essential to a balanced life and healthy relationships. Here is a random list to get you started, or to reinforce your boundaries framework:

  • Drama is best left for the stage
  • Anxiety is not always a bad thing
  • Children have one shot at childhood
  • Nobody ever died from their feelings
  • The opposite of indecision is confidence
  • Sometimes fences make the best neighbors
  • When lost, remember you’re never far from home
  • “I don’t have time” is the cousin of “You’re not important”
  • Feeling sorry for people hijacks their ability to figure it out
  • A narcissist cannot invade your space unless you open the door
  • You create your reality through your thoughts, emotions, and behaviors
  • The simplest way to get a read on someone is to observe their behaviors
  • A good attitude is the easiest way to avoid unnecessary time on the couch
  • You have a finite amount of emotional energy every day and unused minutes do not roll over
  • Embracing vulnerability is difficult but essential for emotional growth and deeper relationships
  • “I’m not the cause, and I’m not the cure” is a great internal script when  dealing with mean people
  • Six-figure salaries and professional accolades don’t hold a candle to the job of raising emotionally healthy children
  • Belief in abundance over scarcity reassures that there’s enough money, romance, and opportunities and to go around

For more resources on supporting your mental health, check out my author bio page.

Copyright 2019 Linda Esposito, LCSW. All Rights Reserved. No part of this article may be reproduced or utilized in any form or by any means without permission in writing from the author.

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10 Statistics You Need to Know About Creativity at Work

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Creativity is the thinking that fuels innovation. Over the last decade, talk about the importance of creativity-related skills in business has skyrocketed. Whether you need a statistic about creativity to present to the hiring managers on your team or you just need a reminder of how important creativity is within your company or school, this post is for you. Below, we’ve collected some of the key statements and stats related to creativity at work so that you can cite them early and often. 

10 Statistics You Need to Know About Creativity at Work

1. “Creativity is the single most important skill in the world.” (LinkedIn Learning, January 2019)

2. 94% of hiring managers say it is important to consider creativity when hiring a job candidate. (Adobe, Hiring for the Future (2014))

3. In a search for “creativity in business,” Google returned 345,000,000 results.

4. 35% of workers are only given time to be creative at work a few times per year. (Gallup 2017 American Workplace Survey)

5. Creative problem solving sessions with groups that have even a minimal amount of training in creativity tools and principles generated 350% as many ideas than groups without training—and these ideas were 415% more original. (Puccio, et al)

6. CEOs say creativity is the #1 factor for future success. (IBM)

7. Recruiters rank creative problem solving as the second-most difficult skill to find among job applicants. (Bloomberg Businessweek)

8. 78% of college-educated workers over 25 wish they had more creative ability. (Adobe, Hiring for the Future (2014))

9. Countries with high PISA scores have lower confidence in entrepreneurial capabilities. (Yong Zhao)

10. Creativity is or is related to 9 of the top 10 skills that global executives say is essential for 2020 and beyond. (World Economic Forum)

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The Stigma of Addiction: We Can’t Keep Ignoring It

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When we published The Stigma of Addiction: An Essential Guide earlier this year, many were surprised to learn that it is one of the only books that focuses on stigma directed towards those with substance use disorders. Despite addiction’s ubiquitous impact and its prominence in the national dialogue, key aspects that surround addiction often go undiscussed. Our primary goal is to collect leading scholarly thought, providing both the clinician and the non-expert with a comprehensive understanding of the different aspects of addiction, addiction stigma, and the different arenas in which it arises.

What is stigma?

Although the word is widely used and readily understood, there is some variability in how it is defined. The classic definition, by Goffman (1963), has stigma referring to an “attribute that is deeply discrediting” and that reduces the bearer “from a whole and usual person to a tainted, discounted one.” Link and Phelan (2001) embrace Goffman’s definition but also add an element of power: “[S]tigma exists when elements of labeling, stereotyping, separation, status loss, and discrimination occur together in a power situation that allows them.” For the purposes of this blog, we will adopt a definition of stigma that functions as a common denominator of the above definitions. Addiction stigma refers to negative attitudes towards those suffering from substance use disorders that, one, arise on account of the substance use disorder itself and, two, are likely to impact physical, psychological, social, or professional well-being.

Consider a prototypical example of addiction stigma. A 25-year-old man named John visits the hospital emergency department multiple times over the course of a year for alcohol abuse. He eventually agrees to inpatient substance use treatment, after which he transitions to outpatient care. He does well. He has a multi-month period of sobriety. However, he relapses and, as he had many times over the prior year, presents in the emergency room. While he’s waiting to be treated, he overhears a physician remarking to a nurse, “Oh, that’s just John. We knew he’d be back again.” Rather than seeing John as a someone with an illness, the physician viewed him as someone with deficient character, as an incorrigible person.

But do such attitudes matter? They certainly do. Major and O’Brien (2005) found that stigma creates unique stressors and psychological distress, not least on account of the fact that stigma involves status loss—it threatens the stigmatized person’s standing among peers and in society (see Link and Phelan 2001). Moreover, the sheer need to cope with stigma may lead to unintended and unforeseen consequences, even ones that are unrelated to the stereotype (Smart and Wegner 1999). For instance, the cognitive effort required to defend against self-esteem loss precipitated by stigma could lead to a decrease in cognitive functioning in other areas, including in ones as mundane and important as budgeting one’s personal finances. Research in social psychology has documented a multitude of adverse outcomes stemming from stigma, including poor academic performance (Crocker et al. 1998). Over the past decade, stigma has increasingly been linked to adverse mental and physical health outcomes, especially among those who are likely to suffer multiple stigmas, such as African-Americans (Williams et al. 2003).

In 2017, the opioid crisis was declared a Public Health Emergency in the United States, bringing addiction even more into the spotlight. Substance use disorders incur a large toll on individuals and on the collective society. Successful treatment requires astute care by experienced professionals. Unfortunately, stigma against those with SUDs is rampant, permeating multiple professional fields and coloring both social and familial relationships.

In future blog posts, we will explore these and other issues relating to addiction. In particular, we will be looking at foundational philosophical issues undergirding substance use. What is addiction? Is it a disease? Is it strictly a matter of controllable decision making? We also will be looking at how addiction affects different populations. Do attorneys use substances at rates higher than the rest of the population? Do physicians? Why are there stereotypes that link certain substances to certain ethnic groups? Does addiction differ by country? Further, we will be exploring how different groups, especially professionals, respond to others who show signs of substance use. Do attorneys stigmatize their own clients? Do physicians stigmatize their own patients? And how does implicit bias impact such attitudes? Lastly, we will be addressing the way forward. What are some ways of educating individuals about addiction stigma? What interventions might be devised—and will any of them be successful?

While these issues and questions are just a sliver of what we’ll be covering, we hope they set the stage for what’s to come. We also hope that they bring issues and ideas to your mind. If there are any topics about which you’re interested, or any lines of thought that you would like to see pursued, please reach out to us and begin a conversation. We’re glad you’re reading, and we’re looking forward to exploring and unpacking addiction and addiction stigma with you.

This post was adapted from the introduction of The Stigma of Addiction: An Essential Guide.

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Reference: 

Avery, J. D. & Avery, J. J. (Eds.). (2019). The Stigma of Addiction: An Essential Guide. New York: Springer Publishing.

Crocker J., Major B., & Steele C. (1998). Social Stigma. In Gilbert D., Fiske S.T., Lindzey G. (Eds.), Handbook of social psychology (4th ed., pp. 504–553). Boston: McGraw-Hill.

Goffman, E. (1963). Stigma: Notes on the Management of Spoiled Identity. Englewood Cliffs, NJ: Prentice Hall.

Link, B., & Phelan, J. (2001). Conceptualizing Stigma. Annual Review of Sociology, 27, 363-385.

Major B., & O'Brien L.T. (2005). The Social Psychology of Stigma. Annual Review of Psychology, 56, 393–421.

Smart, L., & Wegner, D.M. (1999). Covering Up What Can’t Be Seen: Concealable Stigma and Mental Control. Journal of Personality and Social Psychology, 77, 474-86.

Williams D.R., Neighbors H.W., & Jackson J.S. (2003). Racial/Ethnic Discrimination and Health: Findings from Community Studies. American Journal of Public Health, 93, 200–208.

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