PLACEBO EFFECT

If you take a pill and expect it to reduce your headache pain, you have increased the odds that the pain will indeed subside. This effect can be so strong that even if the pill you take is simply an inert sugar pill, a placebo, and not a pain-killing medicine, your headache may still go away. This “placebo effect” shows how expectation can have powerful physical effects.

How about a psychological condition that is being treated by counseling? Can the placebo effect operate in this case?

Let’s create a hypothetical situation where two guys, Joe and Bill, live in parallel universes. They both suffer from social anxiety; put them in a room full of strangers and they fall apart, overwhelmed with insecurities, fear, and dread. They each have a friend who has a similar problem and is undergoing counseling for the problem.

In their respective universes, the friend says, “Why don’t you sign up for some sessions with my psychologist? She’s really helping me and might be able to help you.”

Joe says, “That sounds good. If it works for you I bet it’ll work for me. Give me her number. Thanks for the tip. I really feel good about this.”

Bill, in his parallel universe, says, “Just because she helps you doesn’t mean she will help me. But what the hell, just to get you off my back, give me her number and I’ll schedule an appointment. Believe me, though, it’s going to be a big waste of time.”

Note that right out of the gate Joe and Bill have different expectations about how well the counseling might help. Joe is optimistic, Bill is pessimistic.

In their separate universes, Joe and Bill go off to their respective sessions. Afterward, each is on a bus heading home and a stranger sits down in the next seat and starts reading his paper. Joe and Bill each think, “OK, the Dr. says I might try to give a casual greeting to a stranger, just to show myself I won’t drop dead from fear. Here goes.”

Optimist Joe turns to the guy reading the paper and says, “Really hot weather we’ve been having, isn’t it?” The guy turns to him and says, “Yep, sure is,” and goes back to his paper. Joe thinks, “Well I’ll be damned. I actually got a response. I started a conversation and got a reply. This counseling is really working!”

In pessimist Bill’s universe his action and result are identical. He turns to the guy reading the paper and says, “Really hot weather we’ve been having, isn’t it?” and the guy replies, “Yep, sure is,” and goes back to his paper. Bill, however, thinks, “Well I’ll be damned. I reached out and got a big three words from him. What a waste. I tried to start a conversation and basically was ignored. This counseling is nonsense!”

Joe and Bill have identical experiences, but their reactions are quite different. How come? Do we have a placebo effect here? Remember, Joe believed the counseling was going to work. Is it that belief that makes him give such a positive reaction to the three words the stranger gave him? By the same token, Bill never really did believe the counseling would work. Did his negativity dispose him to put the 3-word reply in such a negative light?

When it comes to increasing the likelihood of successful counseling, let’s note that several preconditions are important. First of all, the client must be willing to take an active role in counseling and work hard to produce needed changes in his/her behavior. The client must also trust the counselor and be willing to “open up” to the counselor, and follow recommendations made by the counselor. Perhaps most importantly, the effectiveness of counseling is helped enormously if the client truly believes it will be helpful.

Obviously, this last precondition brings us into placebo-effect territory; that is, believing counseling will work makes it more likely to work. However, I don’t mean to suggest that successful counseling is simply a placebo effect. Notice, for example, that if a client believes there will be a positive outcome, then the client will also be more willing to work hard, stay optimistic and confident, trust the counselor, and persevere when the going gets tough. It is those qualities and actions that result in successful counseling, not some sort of magical placebo effect.

The point here is simple: Counseling is not like taking an aspirin, lying down, and waiting for your headache to subside; counseling requires you to take an active role in your treatment. If you sincerely believe that it can bring you positive benefits, you will be more likely to engage in actions that will bring those benefits.

There is no magic wand when it comes to stabilizing yourself psychologically and coping with life more effectively. You are the agent of change; only you can control your thinking and actions; only you can decide to empower yourself and develop an effective coping strategy. Your success, however, will begin with the belief that you can change.

 

FINDING SATISFACTION

One reason happiness is so elusive is that people tend to center their search around “me.” What do I need to do to make myself happier? The problem here is that you’re being self-serving and looking for a recipe that is defined by your needs, your frustrations, your anxieties, your difficulties.

“But,” you ask, “how can I possibly help myself if I don’t center my plans and actions around myself?”

Here’s a thought: Instead of putting yourself as the main ingredient of the recipe, take yourself out of the recipe. Consider the possibility that, whatever your difficulty, using the emotions it generates within you will increase your sensitivity to others who suffer from trauma and conflicts similar to yours. This empathy will not only help others, but yourself as well. That’s right, taking yourself out of the formula will encourage you to reach out to others. The bonus? You will discover that reaching out will bring you ample helpings of personal satisfaction, and help you cope better with your problems.

Empathy. We usually think of it in terms of helping others. If you have been previously victimized or are presently dealing with emotional upheaval in similar ways as another, who can understand their plight more than you?

The true human beauty of empathy, however, is that both the giver (you) and the taker (the other) reap the psychological benefits. There is no more effective therapy than empathic service to others.

Whatever your plight, you are not alone in your difficulties. The best way to facilitate your ability to cope is to make sure that, as you travel the road to finding personal satisfaction, you leave no one behind. In that way you will find yourself participating in the richness of the human adventure.

 

SUPPORT GROUPS

When we’re faced with the aftermath of a traumatic event, one of the greatest obstacles to coping is when we look inward and attempt a self-analysis. This process can compromise good coping because, more often than not, we enter the world of self-doubt (“Do I have the courage and strength to recover?”), self-blame (“I should have done things differently; the whole event is my fault.”), and self-pity (“I need to let others know how I have been victimized because I deserve their sympathy.”).

These self-intrusions make successful coping with the trauma difficult because you become unable to look objectively and accurately at the event and the challenges facing you. One excellent way to resist these ventures into a self-centered mine field is to join a support group for those who have suffered the same, or very similar trauma. Such groups are plentiful, and can be located by contacting a local mental health association, crisis hotline, or even local law enforcement.

When in the company of victims like yourself, interesting psychological dynamics unfold. Consider the words of support-group members, and note how so many coping lessons that we discuss in this blog can be found in their words:

“Telling my story to others, and listening to their stories, helped me organize the basic facts, the objective reality of the event.”

“I felt less alone.”

“I discovered it was OK to be nervous; OK to feel ashamed thinking I was the Lone Ranger, all alone in my turmoil.”

“I found it was OK to laugh, and talk, and share. There was a lot of all of that in my group.”

“We shared our secrets, our darkest days. I felt a sense of belonging because there was a bond of trust, of privacy, an unspoken understanding that our secrets would never leave the group. It gave me a sense of identity beyond myself, and the security that brought me was unreal.”

“New people would show up. It was hard for me to listen to them because I was reliving my own experience. But the long-term effect was acceptance and a feeling of personal strength.”

“I knew I was reaching an inner peace and strength when it occurred to me that I had become as much a helper in my group as one who needed help. When I shared my story with newcomers I could see it in their faces. There is life afterwards; it goes on.”

“I discovered sympathy and empathy, I mean to the point that I realized it was not all about me. We asked the same questions, faced the same demons, and found lifelines. Since joining my group I have felt more human than ever before in my life.”

We should all be so lucky.

So, what are some of the important coping themes we see in these comments? Organizing a plan to deal with the reality of your issues; realizing you’re not alone; accepting emotions instead of denying them; sharing secrets and trusting.

Two cautions: your group leader should be a professional with experience; and, the purpose of the group should not be to embarrass, badger, or intimidate members.

CRISIS SELF-COMMUNICATION

Roy is 62 years old and is finishing up his annual physical. His physician says, “Roy, everything looks great. Your blood work, vitals, weight, lifestyle…everything is in normal and healthy ranges.”

Roy smiled and said, “That’s always good to hear!” The physician looked at him and added, “Of course you understand that I can’t guarantee you’ll live to 80 or even 70.”

Roy, still smiling, nods and says, “Sure I understand that. But trying to live a long life is not why I exercise, keep my weight down, and all that other healthy stuff. I just want to feel good today! Isn’t that about the best we can do?”

Even though the staying-healthy odds are in his favor, Roy could easily suffer a health crisis at any time, even the next day. And here’s the coping question I want to pose: If it happens, will he be prepared for the crisis?  An unexpected event brings drastic changes to his life and arouses intense emotions that threaten to overwhelm him. Will he be able to keep his head above water? Will he be prepared to have a “crisis conversation” with life?

How about you? Are you prepared to maintain your coping conversations with life in the face of crises? Here are some things to consider when faced with events so intense that you feel you could very easily spiral out of control.

To organize your crisis plan, ask yourself some basic “what if” questions. The idea is not to make up a precise list of steps to take, like a family might do to prepare for a flooding river, tornado, hurricane, or some other natural threat. No, the idea is to formulate a general conceptual plan of basic principles to follow when suddenly confronted with unexpected coping challenges, such as when a loved one dies, sickness occurs, or there is a vital threat to your financial security.

First of all, assess the crisis by determining what features are under your control. A crisis tends to bring out strong emotional reactions, which put you at risk for blindly reacting and trying to influence events that really are far out of your control.

Remind yourself to be proactive using your intellectual abilities and not relying solely on sudden emotional tendencies. Fear, frustration, jealousy, anger and other emotions will tell you to run, avoid, and hide, and such avoidance is a sure recipe for devastation. A more rational approach will focus on how you can use your emotions to your advantage, not on how you can deny the presence of your unwanted emotions.

Bring in your trusted friends, your social network, to help. Communication is essential here, but again, it must not be based on panic and fear. Rationality, objectivity, and a willingness to listen to proactive suggestions from others is essential if your communication is to be productive.

Do not blame others for your crisis. Doing so will distract you from the task at hand. Convincing yourself that evil others are responsible for your travails will only elicit derisive laughs from life. Even your social network will recoil from your displaced blame because you will sound defensive and unwilling to move forward.

All these suggestions are explicitly developed throughout this blog, and they shouldn’t surprise you. The point here, however, is that if you are psychologically and mentally prepared when a “what if” question becomes real, you will be better able to put our blog principles into practice.

 

 

 

 

 

A SELF-DESTRUCTIVE LIFESTYLE

Alice’s father drank heavily and used his belt on her often. She was obviously afraid of him. She describes her mom as psychologically abusive, an unstable woman who had a psychiatric history of her own. More than thirty years after these disturbing childhood experiences, Alice still has nightmares about school and her early home life. Thus, she shows symptoms of post-traumatic stress disorder (PTSD) along with unresolved anxieties caused by fear of abandonment. For a number of years, Alice has been a client in psychiatric counseling, including medications, although without much success.

Alice has a long history of abuse with alcohol and drugs. She says nothing in life gave her the relief and pleasure she received from alcohol. She knows drugs and alcohol do not mix well with psychiatric medication, so she tries to avoid taking medication as much as possible.

She has trouble sleeping, complains of issues in areas of anger, anxiety, and depression, and shows pessimism and marked sensitivity in relating to life and people. She cannot handle criticism from others, and takes it as a personal attack and sign that she is incompetent and worthless.

During adolescence and early adulthood, Alice developed a strong indifference to her health and survival. To put it bluntly, she didn’t care if she lived or died. Drugs and promiscuity became the major players in her life. Although she never went to jail, she was routinely involved in drunk and disorderly episodes. Remarkably, she avoided major setbacks for many years.

Although she never tried to kill herself, Alice is intensely ambivalent about living. She took many risks and rolled the dice many times in her life and never seemed to care what the outcome might be. She trusts no one. The built-in will to survive keeps her alive, barely, but overwhelmingly negative thoughts and emotions produce a risky, self-defeating, and self-destructive lifestyle.

Alice’s life shows unmistakable signs of subtle suicide, characterized by a steady descent into a black hole of self-sabotaging behavior. After thirty years of practicing this lifestyle, her prognosis is not good because her core conflicts are so well established.

In the past her counselors have tried to help her attack her alcohol and drug abuse, but those are just symptoms. Alice needs to confront her core conflicts: fear of abandonment; inability to trust others; anger and self-blame for the psychological abuse she suffered as a child; and internalizing criticism from others as symbolic parental attacks on her competence and worthiness.

Alice’s case is an excellent example of the importance of what she and her counselor need to attack. Too often, the treatment emphasis is on symptoms, which ignores the deep-rooted conflict that causes the symptoms. Unfortunately, with Alice this core has been ignored so long, her personality dynamics and action patterns designed to service the root conflict have become entrenched. Replacing them will not be easy.

MODIFY YOUR ACTIONS

Effective coping requires adjustment and adaptation to changing circumstances. You can often get into difficulty by constantly repeating behavior that has worked in the past while overlooking the fact that the situation has changed.

Kelly Therrion specializes in Organizational Behavior Management, and consults with clients in a business context to help them perform more efficiently at their workplace. Viewed in a broader perspective, however, her suggestions are relevant to coping with everyday life in a wide variety of situations. We make the same points many times in this blog, but what she has to say is worth repeating.

Imagine yourself during one of those frustrating, stressful times. You feel like you’re ready to explode at another person who is making your life miserable at this particular time. What do you do?

First, remember that you can’t control the other person’s behavior; you must focus on your own actions and thinking. Second, find a way to “vent” some steam. We don’t mean you need to lash out at someone, yell at them, or insult them. Such behavior would be counterproductive. As we noted in our June 29, 2016 blog, however, there are appropriate ways of venting. Take a timeout; talk things over with a friend who will listen; go to the gym for a vigorous workout or jog/walk for a mile or two; write down your frustrations in private (see blog from August 1, 2016).

Three, think about the specific aspects of your situation that seem to trigger your frustration and emotional upheaval. Once you make yourself aware of such situational causes, you can be on your guard in those situations and make yourself less vulnerable to disruptive emotional arousal (see blogs of September 16, 2016, and February 10, 2018).

Four, try and understand the other person’s perspective. When someone says something totally at odds with your opinion it is easy to forget that there are two sides to every story, and the truth is often in the middle. Also, as we noted in the October 14, 2018 blog, once you have achieved some empathetic understanding of others, the clarity, rationality, and effectiveness of your communication with them will be greatly enhanced.

Five, use your communication with others to help you adjust your thinking. You may need to modify your opinion in order to find new ways to be proactive in the situation. No matter what your situation, it is generally worthwhile to find a good “fit” between your beliefs and preferences, and the needs and opinions of those with whom you interact. Doing so may require some compromise on your part, but that’s a good thing. When confronted with conflict and challenges, the object is not to win by destroying your opponent; your goal should be to reach an appropriate resolution that makes everyone function better as a team.

 

FORGET THE NEW YEAR’S RESOLUTIONS

“My New Year’s resolution is going to be the same one I made a year ago: find a new job. This time I’m serious. Plus, the economy is good and employers are looking for workers; it’s a workers’ market. Wages are also up so I should be able to expect more pay in the new job. What do I need to do to be successful?”

These words, written to a newspaper columnist who specializes in advice for job seekers, illustrate how not to cope with a challenge. First of all, note the excuse for last year’s failure: “I wasn’t serious last year.” Secondly, note how the writer focuses on external factors like the economy and having no advisor to explain his earlier failure, rather than focus on what he may have done wrong.

When failure occurs, effective coping requires correcting mistakes, not focusing on external factors. The former is under your control; the latter is not. Any athletic coach understands this principle. After a loss, coaches say, “We’ve got to correct our mistakes, and that’s what we’ll be concentrating on in practice. We can execute better if we work hard.”

The coach does not say, “We need to petition the league for better refs, and make sure we don’t get that crew again! I’m also bringing in a new morale coach so we can be in a better frame of mind before our next game.”

We’ll never know, of course, but I would not bet the farm that our letter writer is not going to have more success this year than last. He’s got a lousy strategy based on chance factors and reliance on someone to take care of him.

One recent Christmas holiday an acquaintance was bemoaning the fact that her gym would soon see hordes of “resolutions nuts” descending upon her and other gym regulars. “These jokers don’t know the first thing about gym etiquette and they’re just a royal pain. The only good thing is that by the end of February most of them will be gone. They dump those resolutions in a hurry.”

Bingo! Resolutions don’t last. That just about says it all. The fact is, resolutions like those made for the new year are a lousy way to cope with things bothering you, whether it’s being too heavy, smoking, lack of exercise, being inattentive to family, etc., etc., etc.

Why don’t resolutions work? For one thing, the very fact that you pick a specific date to begin your transformation into a better person shows that you are procrastinating, and are really not motivated. Picking a date is artificial and just means you’re kicking the can down the road.

Another problem is that many folks use resolutions to motivate themselves. Well, that’s just putting the cart before the horse. Resolutions must be the result of motivation to do something, not the catalyst for generating motivation.

If that’s not enough, resolutions are also usually unrealistic. You make grandiose, unattainable resolutions (“be able to run a marathon by Spring,” “lose 30 lbs. by February,”) and you also believe that you’re going to be involved in reinventing yourself, creating a new you. That’s unrealistic thinking.

To have any chance of success, a resolution must involve specific goals involving specific actions: “I will eat a piece of fruit, an apple or a pear, for lunch instead of a sandwich.” “I will do a workout at the gym 3 days a week.” “I will walk my neighborhood (or my treadmill) for 30 minutes every day.” “Every Monday I will weigh less than, or at least the same as, the previous Monday.”

If you want to change something about yourself, don’t wait until some future date to begin; start now. It’s important to remember that there is often a huge disconnect between “will” and “want.” You may indeed “want” to change your behavior, but you can’t quite muster the “will” to make a step towards that new end. Many problems like smoking, weight loss, exercise, and getting in shape all fit this distinction.

So, how do you begin your attack on such actions? First of all, you must connect your resolution to a specific motivator: “Warm weather will be here soon and I want to be able to look decent at the pool”; “That wedding I’m in is only a few weeks away and I need to look sharp”; “The boss invited me to join in a jog last week and I nearly died of exhaustion. That’s no way to get a promotion. I have to be able to keep up.”

Second, your resolution must involve your values as well as your actions. Specifically, you must engage in values-oriented thinking and make your actions consistent with that thinking.

The following examples show the disconnect between values and actions that gets you into trouble: you put off investigating diets (an action) that may work for you even though you say, “I care about my health” (your value); you put off joining a gym (an action) even though you say, “I want to get in shape” (your value); you put off spending more time with your kids and spouse (an action), even though you say,  “I value family” (your value); you put off signing up for a course at the local community college (an action), even though you say, “I want to become more educated” (your value). Well, if you truly value those things, then you must admit to yourself that your actions are inconsistent with those values, and you must work to correct that problem.

A key to successful resolutions is to use them to connect actions and values. Identify those things that you really value, the things that are important to you. Then resolve to coordinate those things you value with specific actions that are compatible with those values.

Once you identify constructive actions and begin engaging in them, they will tend to become a part of your routine; they will become automatic and it won’t take much effort to maintain them, making your resolutions successful. And in the future, definitely resolve not to wait until January 1st to put them into action!