To Sleep Perchance to Dream

(Ay, there's the rub.)

I have been spending the last few days thinking rather intensely about the rules of hyphenation and how the placement of a single comma can change the meaning of a sentence. Yes. Manuscript edits. If I seem a bit fuzzy, that's why.

So I thought this might be a good week to talk about dreams. Today I'll talk a bit about actual dreaming, and on Wednesday we can chat about dreams in stories and writing (and maybe a little about the meaning of dreams? Yes?).

There are a lot of myths about dreams. We all dream in black and white (nope). Our dreams only last a few seconds (some last over half an hour). Lots of people don't dream at all (there's some evidence that folks who have parietal lobe injuries lose the ability to dream, but apart from that ... we all do, even if we don't remember). If you die in a dream, you'll die for realzzz! (nah ... I'm living proof that one's untrue)

Another myth is that people only dream during the phase of sleep called REM (rapid eye movement). That's not true, either! There's plenty of evidence that we dream during non-REM sleep, too, but the nature of the dreams is different. During non-REM sleep, we tend to have more mundane, repetitive dreams, ones that are more grounded in everyday life. There's speculation (and research) that these non-REM dreams can help us rehearse or practice things we've learned so that we perform better when we're awake. In addition, there's some research to suggest these dreams involve a bit more positive and neutral emotion than REM dreams.

During REM sleep, dreams are more emotional and perceptual. These dreams can be bizarre or nightmarish. Some sleep researchers believe that while non-REM dreams are rehearsal and processing of the present or past, REM dreams are more speculative, like a safe way for the brain to experience future possibilities. Some studies have demonstrated that REM dreams can result in greater creativity in specific tasks/endeavors, but there are also studies that show that people with certain types of depression have a lot more REM sleep than non-depressed people--REM sleep involves activation of the amygdala, the processing center for intense negative emotions.

This is really just the tip of the iceberg when it comes to dreams. The research is getting more refined and more fascinating as the years go by. One thing they haven't quite figured out, though--how to really eavesdrop on people's dreams. You know how they do it? They have these sleep studies where they wait until the participant is in a particular phase of sleep, and then they wake him up and ... ask him what he was dreaming about.

So ... what are your dreams like? Do you have vivid, memorable dreams, or are you one of those folks who doesn't remember your dreams at all? Do you want to share a dream or two with us? Here, I'll start: I sometimes dream I can fly, except I can never do it very well, and so I spend most of the dream trying to will myself off the ground and hovering, like, a few inches off the pavement. At some point, something starts chasing me, and I'm simultaneously annoyed and panicked because I know this flying thing doesn't work so well for me, but it's all I've got, so usually I end up (sort of, clumsily, with lots of fits and starts) flying away just ahead of the menacing presence (which I can never see, by the way).

There.

Your turn.

And after you're done telling us about your dream life, please go visit Lydia for her Medical Monday post (leech therapy! Aaaah! Talk about nightmare fodder) and Laura for her Mental Health Monday post (about whether it's normal to have imaginary friends ... or not).

IS IT OKAY TO LET YOUR CHILD GO FOR SLEEP OVERS

We have been conducting seminars on parenting in various schools and one of the greatest concerns raised by parents has to do with sleepovers. Many parents wonder whether or not to allow their children to go for sleepovers or to host them. Their main concern is the safety of their children during such sleepovers. We decided to source for knowledge on the same and here is what we have to share with you.

According to Pattie Fitzgerald, founder of Safely Ever After, sleepovers are part of a wonderful childhood, and many parents would like their own kids to be able to enjoy the same. Yet, they can also be a slippery slope just by their very nature, and it’s certainly appropriate for parents to have legitimate concerns. There have been stories about children being molested while at a sleepover while in others, children enjoy without anything bad ever happening. The answer to whether or whether not to have a sleepover is both a ‘yes’ and a ‘no’. It all depends with YOU and what you are most comfortable with!

Sleepovers can provide a perpetrator easier access to a child than a typical play-date during the day. This is because once children are in their beds or sleeping bags, there is a quiet, vulnerable atmosphere when children can be caught off-guard if approached by another adult, or possibly even the older sibling of their friend. In such an environment, a child might be less likely to shout out for help, or even yell out a good, strong “STOP IT!”, for fear of waking the others. The child may feel “trapped” and not know how to get away from the perpetrator. Also, during a sleepover, there may be more of an opportunity for a molester to victimize a child, simply because they can wait until everyone else is asleep. For this reason, it is important to talk specifically with your child about sleepover issues, before you make your decision.

Is the solution "No Sleepovers- Ever?"

That’s one way to solve the problem and it’s certainly a parent’s right to ban sleepovers if you choose. But, some parents may feel differently based on their own experiences or parenting styles. They may want to allow occasional sleepovers depending on certain circumstances. That’s okay too, provided you arm your children with clear safety instructions before ever allowing them to spend the night at another home.

Safeguarding a Sleep Over- A Parents Role.

Before allowing your child to spend the night at any friend’s home, you will need to have specific conversations regarding “good touch/bad touch/confusing touch.” You’ll need to pose some “what if” questions, to be sure your child knows how to react to anything that feels uncomfortable or “yucky.” There are many variables which can determine if a household is safe for a sleepover. You might be comfortable letting your child spend the night at one friend’s home, yet another home may be completely out of the question.

Run through the check list below

This will help you evaluate if this sleepover is a “safe scenario” or not. Consider who else may be at that home… for example, other relatives or adult friends? Is the older sibling also having a friend sleep over, do the parents have the same feelings that you do regarding the use of alcohol or other substances – particularly when children are around?

1. Do you know everyone who lives at the home?
2. Does anyone at this home give you an uncomfortable or “uh-oh” feeling?
3. Will the parents be home or are they having a babysitter in for the night? (If so, who is the sitter and what do you know about them?)
4. Are other children going to spend the night as well?
5. Are the supervising parents having their own adult friends over?
6. Will the children be staying in all night or is there an outing or activity planned for earlier in the evening (such as dinner out, bowling, or a movie)?
7. Will your child need to take a bath there? If so, who will be helping them? (Note: the smartest choice is for the child to bathe at home before going).
8. Have you told your child that they can call you at anytime, no matter what, if they feel uncomfortable or scared and that you’ll pick them up right away? *Even in the middle of the night!
9. Are you able to discuss safety concerns with the supervising parent(s) without worrying about what they might think of you?
10. Do the other parents make you feel guilty for asking questions, or try to minimize your concerns by teasing you or not taking you seriously?
11. Is your child generally able to speak up for themselves when they feel uncomfortable or uneasy?
12. Have you taught your child to trust their instincts and to listen to their own “inner voice”?
13. Have you discussed what to do if someone tries to touch them in an uncomfortable or unsafe manner?

5 Safety tips for kids away from home

1. Assess your child's age

There's no magic age where kids stop being homesick. However, the personality and needs of your child should help you determine at what age kids are ready for a slumber party away from home. The most important thing to consider is your child's safety, so it's up to you to judge whether he or she is capable of making safe decisions under someone else's supervision.

2. Invite the friend over first

Daytime play dates will give you a chance to meet the kid your child wants to have a sleepover with before you send her off to spend the night. Watch and see how the children interact with one another prior to agreeing to any slumber party plans.

3. Meet the parents

Either during drop off, at the sports field during little league games or at a daytime play date, schedule some face time with the adults who are hosting the sleepover prior to the get together. This will give you a chance to catch any red flags or give you peace of mind about your child's nocturnal adventure.

4. Lay out the ground rules

Don't be shy -- let the hosting parents know your child safety rules and supervision requirements for your child. Remember to offer info on anything about your youngster that will pertain to the overnight plans, such as any fears of the dark or food allergies. Also remind your child of your family's rules before he or she heads off to have fun.

5. Create a code word

Develop a word that your kiddo can use as code if he or she becomes uncomfortable at a slumber party and wants to go home. Whether it's a child safety issue like domestic violence or a social issue like drinking or a video game that violates your family's rules, a no questions asked policy when this code word is used will help keep you and your child at ease.

Overall, slumber parties away from home are something that are good for children and parents alike, fostering independence for children and helping you to let go of the reigns as your child grows, as long as you are mindful of basic child safety standards. However, note that setting these sleepover safety guidelines early on will likely lead to less resistance by teens down the road, so start early and send your kiddo off for some overnight fun, If you both so please!

Warm regards from the Nairobi Parenting Clinic Team.

To Tell the Truth

A new internet-based survey of 2,020 patients who had received treatment for depression, conducted by a Dr. Sawada and presented at the Annual Congress of the European College of Neuropsychopharmacology, revealed something that I have known about for a very long time.  A lot of patients lie to their doctors. 

About 70% admitted lying at least once!  66% stretched the truth about daily activities such as work while almost 53% were untruthful about their symptoms - on purpose.

That patients can be less than honest should come as not surprise to anyone familiar with the literature on patient compliance with doctors' orders.

In the United States, according to some estimates 20-30% of prescriptions are never even filled at the pharmacy.  According to the World Health Organization, only 50% of people complete long-term therapy for chronic illnesses as they were prescribed. According to the US government's Office of the Inspector General, research indicates that 55 percent of the elderly do not follow the medication regimens prescribed by their physicians.

As described in my post of August 10, 2010, Don't Ask, Don't Tell, I  had an exchange with another psychiatrist that included the following:

Me: Family members will not usually volunteer the whole truth during a superficial visit with a doctor. Anyone who thinks that family members act the same way at home as they do in front of an authority figure, or that they will be totally honest about things like family violence or abuse, needs to get out more.

Other Psychiatrist : This broad statement essentially implies and equates pediatric mental disorders with the family abuse and neglect... The reasoning goes along the line "if child has problems, someone in the family caused them." And if the family does not offer any evidence of maltreatment,they are lying. A fundamental fallacy, in my opinion, that for decades prevented psychiatrists from understanding the nature of mental disorders... Suspecting family members of hiding "the whole truth" is a regrettable statement from a professional. 

It sounded to me like it is the writer who is saying that poor discipline or even child abuse is never an issue in any behavior or psychiatric problem at all! And apparently he believes patients never fib or hide information! And the statement about offering evidence of maltreatment?  First, that implies that this psychiatrist probably never even asks about it in the first place but waits for the parents to "offer" evidence. And since we were talking about children, if the parents had been abusive or neglectful, does anyone think that they would admit this to someone who was legally required to turn them in to the authorities?  REALLY?!?

I pointed out in that last post: Obviously this psychiatrist has never done any serious psychotherapy, or he would know that a patient may not reveal absolutely essential information about their situation until they have been seeing a therapist for months.



I've gotten into similar argument with folks who are against psychiatric meds and who demonize antidepressants and mild sedative/hypnotics by telling tales of people they talk to who claim to have had horrible and never-ending side effects from these drugs.  While some of the people such folks talk to undoubtedly did have very bad reactions to the drugs in question, many are also taking other illegal drugs and/or a concoction of several different prescribed psychiatric and/or somatic medications.

More importantly for purposes of this discussion, they may be scapegoating the drugs for personality and family problems that are the real cause of their "side effects." 

When I make the latter point, the usual response I get is something to the effect that "I've met plenty of people who have none of the additional issues you are talking about."  My answer: And you know this how? Do you think people just advertise all the things they are ashamed of and brag about family dysfunction?

Going back to survey that is the subject of this post, the reasons that the subjects gave for not being truthful to their doctors were very instructive.  Although males often withheld or altered the facts due to a fear that the doctor would recommend that they take sick leave or quit their job, the two most common reasons given for lying to the doctor were:

1. The patients found it difficult to talk to their doctor, particularly about things they were ashamed of or embarrassed about (49%).
2. They thought that the doctor would not take it seriously, even if they they told him or her (36%).  In particular, females said they could not trust their doctor or that "he looked busy."

Both of these reasons concern relationship issues between doctor and patient.  For want of a better term, they concern a doctor's bedside manner.  In therapy circles, these issues are referred to as the therapeutic relationship (or as transference and counter-transference, respectively, if the patient and doctor are reacting to one another subconsciously).



In my experience, A doctor - particularly a psychiatrist who must deal with a lot of skeletons in closets - who is not in a rush, who appears empathic and non-judgmental, and who does not seem uncomfortable with highly emotionally-charged or typically squirm-inducing subjects, is far more likely to get the truth out of a patient than one who lacks these qualities.

If the psychiatrist sees the patient frequently in psychotherapy and maintains these qualities, more of the truth will emerge from the patient.

Many of today's psychiatrists only see patients for a few minutes (thereby appearing to be "busy"), and are only interested in the patient's symptoms and not in the environmental and psychological context in which those symptoms take place).  One can safely assume that in many cases such doctors are getting a highly-distorted picture of the patient's clinical condition.

These problems are magnified in randomized controlled drug studies (RCT's).  In such studies, diagnostic interviews and self-report instruments focus only on symptoms and researchers do not even bother to take a psychosocial-relationship history from research subjects. 

Furthermore, researchers do very little to establish a trusting therapeutic relationship with their subjects.  Many do not know how to establish this type of relationship, but even if they did know how and really wanted to try, doing so would increase the placebo response rate and should therefore not be done in a so-called empirical study!

Since they are not based on lab tests, the data from these studies is almost all dependent on the truthfulness of the subjects, which as I have been arguing is highly questionable in many cases. When lab values are available, such as blood levels of such drugs as lithium, depakote, and tricyclic antidepressants, they are seldom checked frequently if at all. 

And even if they were, they are still subject to manipulation by the research subjects.  Most drug levels should be so-called trough levels - the lowest level that a medicine is present in the body over a 24 hour period.  Levels should generally be drawn 10-12 hours after the last dose of the medication taken and before the next dose is taken.  All a patient has to do to appear to be taking the drug more often than he or she actually is is to take a dose just prior to the blood draw.

This is another big reason why randomized controlled studies should NOT, by themselves, be the gold standard of so-called "evidence-based" psychiatry.

Waiting to get on the bus

So im on the bus now. Paid my £1.80 :) slightly anxious but im feeling good! Bring it on kind of mood. Its set off. Comforting it goes as fast as a car. Nice big space not claustraphobic at all. Bus driver also seemed really nice. Looking out of windows. Not many people on it either. Feeling fine. Breathing steadily in threw nose&out threw mouth. And there I am nearly at the stop I said Id meet my dad at :) better than i thought amd defonitely not what i expected. Negative thoughts really arnt reality. Completed my homework woohoo!!xxxx

Scarecrows The Only Way to Inspire Jealousy and Rank Fear in Ones Neighbors

Above: An extremely menacing and possibly predatory scarecrow terrorizes a neighborhood. It is joined by evil brethren from the local garden center.

I would like to tell you the secret for making your home shine like a diamond in a sea of mediocrity. And that secret is this: Scarecrows. The more scarecrows a property has, the more it will breed stirrings of fitful and vengeful jealousy in the neighbors; pride of ownership in you, the owner; and rank fear in the local squirrel, neighbor, and bird populations.

I have only three scarecrows, as I have recently learned the secret over the past weekend, and have been unable to get to the supermarket to buy scarecrow-making equipment due to the heavy snows. My scarecrows are named after familiar friends and companions of mine, so they are called Johnny-Laid-a-Turd, Repticilus Vaginicus, and She Who Chews Soup. I have placed them in menacing attitudes in various spots about my property.

As soon as I placed my first scarecrow I sighted my neighbor peering out of her upstairs window through her binoculars. I could tell right away by her shocked expression that the scarecrow had terrified her greatly—and her greatest terror lay in the fact that she, poor wretched thing, had not a single scarecrow gracing her property. My first scarecrow was wearing very little at all but a loincloth I had fashioned out of a bathtowel, and I had nailed him on a cross-like structure near the foot of the driveway. Soon after, my neighbor went out in her car, casting me dark looks of aspersion. I believe she went to the local Shop-Rite to purchase some stuffing and scarecrow-pelt material, and perhaps she was caught in the ensuing blizzard? Serves her right, the plagiarizing poseur that she is!

While she was out, I took the opportunity to set up my second scarecrow on the roof overlooking the driveway. Despite the cold weather (Christmas was rapidly approaching), I dressed this scarecrow in a cast-off Lilly Pulitzer dress that no longer fits me due to ingestion of strudel.

It is very important to dress one’s scarecrows appropriately. Outdated costumes that make your scarecrows look like “hayseeds” or “rubes” will only cause your neighbors to laugh at you, not foam at the mouth with jealously. It is difficult to get your scarecrows to look properly menacing while wearing cocktail attire, but it can be done. I suggest buying a pen of the Sharpie brand and drawing very dark eyebrows with a vigorous, up-and-down squiggling motion that makes the scarecrow look like it’s saying “Grr! Grrr!” This has always made my scarecrows look angry and fit to kill, even while holding pink paisley handbags.

I know I have only three scarecrows but I intend to get more very soon.

It is important that your scarecrows are homemade. Storebought scarecrows are often cheap and shoddily made, and their faces melt off in the first heavy rain. Plus, their costumes are not name brand, and that is a dreadful embarrassment. There is nothing more humiliating than seeing a squirrel fearlessly nibbling at the privates of your scarecrow—knowing the damned thing was false by the cut of its collar or the crease in its pant legs—while you are eagerly waiting for that same scarecrow to menace the underthings off your hoity-toity neighbor across the street.

A scarecrow that is not properly menacing should be eliminated from your property, before you become a laughingstock. I always choose compostable materials when constructing a scarecrow, so that I can toss my scarecrow in the compost heap without fear of damaging our Mother Earth. This is why my most recent scarecrow is made entirely out of congealed soup.

No one else on my block has a scarecrow. It is quite pitiable. Not only will their vegetables be snacked upon by all manner of avian pest, but they have to live with the fact that I have beat them to it as a trend-setter. If they were to all invest in scarecrows now, they would most certainly appear to be copying me. It is too late for them. They are doomed to sink in a sea of mediocrity. My neighbor is probably furiously stitching away at her new scarecrow, glaring at me through the window as she does so, but I shall still boldly stride through her property, snacking her vegetables as much as I like. It shall not deter me, although she is using Very Menacing rosemary spriggets for its eyebrows. Rosemary that she could have used in a stew but chose to employ against me, her sweet neighbor. Such is the nature of jealousy, my friends.

You who do not live on my block, however, can still adopt this trend and look smart and chic! I will not begrudge you, especially if you live far across the country where you and your derivative brethren will not bother me. This is why I am sharing the secret of making your property the Very Best It Can Be. With scarecrows!

Here are the best ten tips for building your scarecrows with the proper menace, and with nature-friendly and affordable materials:

1. Encourage your children, if you have any, to participate in the construction of the scarecrow. A child’s poor artistry and inability to construct arms of equal lengths will give your scarecrow a horrible, deformed quality that would never be achieved in those factory-made knockoffs. If you do not possess children of your own, you may borrow one of mine. They have unmedicated spatial inconsistencies that will give your scarecrows that je ne sais quoi.

2. It is best to patent your scarecrow with the U.S. patent office, especially if you have found a way to make him sentient and/or capable of perpetual motion without fresh ingestions of petrol.

3. When arranging your scarecrow in the most menacing attitude on your property, it is often advisable to rest its hands gently upon its privates. This will cause neighbors to wonder if it has molestation on the brain. Were it to become sentient, this would be unpleasant. This will cause them to lie awake at night thinking agitated thoughts, and limit their abilities to do better than you in any way.

4. Straw, chaff, wheat, spelt, and so on are poor choices for scarecrow stuffing. I prefer Gluten-free ingredients that are not liable to be pecked by wild turkeys and doves, causing my scarecrow to look decrepit and decayed. Gluten-free pasta, crackers, and breads are readily available at most health food stores, including Mrs. Greens and Whole Foods.

5. Try to make your scarecrows diverse, reflecting the breadth of our colorful, human tapestry. A sea of white scarecrows dangling from wooden staves and crosses will just make your home look like a rarified country club. This is not what We want to achieve.

6. A scarecrow’s handbag should always be of an appropriate seasonal hue. If a scarecrow is wearing a light, white summer frock, do not choose a heavy black handbag, for example. This sort of thing will result in rude talk amongst the very neighbors one is trying to menace.

7. Scarecrows can be made much more menacing by the application of odors, such as Go Away Evil ™, or by installing soundtracks that play artists such as Peter Cetera. A scarecrow that appears to be singing “I am a man who will fight for your honor” will disturb and agitate many passersby.

8. Accessorize, accessorize, accessorize! I mentioned handbags earlier. The handbags are much more menacing if they are filled with real grenades, loose bullets, or the carcasses of the scared-stiff animals that you have managed to trap by freezing them in the aural glare of a Peter Cetera marathon. Scarecrows also look nice with necklaces made of human teeth.

9. Remember that the goal is to keep people off your property and cause them to tremble in fear whenever your name is mentioned. Then, and only then, will perfect domination be achieved! If any scarecrow fails to fulfill this purpose, it should be terminated without remorse. It is best to terminate during a neighborhood Block Party, at the exact moment that the ice cream truck arrives. In winter, substitute with the arrival of the local Caroling group.


10. Local teens tend to think that scarecrows are a subject for hilarity, not mind-numbing terror. Teach them a lesson by air-dropping a batch of homemade beauties atop their homes during “Movie Night” or a sleepover. Make certain the scarecrows you choose to drop are the ones most likely to become sentient at the most surprising moments, or else the hollow thumping may simply remind the callow teens of turds striking the roof.
  
It is best not to overdo the scarecrows. I know that I earlier recommended “the more scarecrows the better,” but I have recently revised my view due to an article I read in The New York Times. I am a little bit scared now, as the one I made out of soup has dissolved into my yard in the heavy snows and, therefore, into our water table.  

I would rather not share the entirety of the article's content here, due to copyright restrictions, but suffice it to say that my prescient warnings about sentient scarecrows came true for one poor homeowner in Marietta, Georgia, who had covered every square foot of her property with a matching scarecrow in a gingham outfit with black button eyes (Pfah! Hardly menacing!), in an effort to control the local goose population. Not only were Ms. Scribb's geese not deterred, but her scarecrows turned on her in a gruesome bloodbath that is soon to be made into a motion picture. Let this be a lesson to you! Keep your scarecrows to a minimum. I suggest 15 at most. Good luck to you.

Panic focused psychodynamic psychotherapy hard to say but may make life easier

Having panic attacks? Looking for an alternative to talk therapy or cognitive-behavioral therapy (CBT)? You might consider panic-focused psychodynamic psychotherapy (PFPP), a 24-week course of therapy that's kind of a psychological exposure therapy, helping the patient explore and manage the hidden psychological conflicts that are contributing to their panic. From the link:

The treatment is divided into 3 phases. In the initial phase, the therapist focuses on identifying the meaning and content of panic symptoms, derived from exploring the circumstances, stressors, and feelings surrounding panic onset. Elucidation of a developmental history, including previous panic episodes, helps determine early life experiences and self and object representations that may play an active part in panic. The initial phase aims at relief of panic symptoms.

In the second phase, the therapist works with the patient to identify core conflicts underlying panic disorder. Conflicts surrounding anger and autonomy, as well as other contributing dynamics, are brought to the patient's attention. Defense mechanisms, including reaction formation, undoing, and denial, are addressed as efforts—often unconscious—to avoid facing emotional contributions to panic symptoms. Emergence of the transference allows for exploration of these conflicts and defenses in the relationship between therapist and patient. This phase focuses on addressing vulnerability to panic and relapse.

In the third (termination) phase, mixed feelings surrounding anger, autonomy, and separation are addressed as they emerge in ending the therapeutic relationship. The therapist helps the patient articulate feelings about the loss of the therapist, allowing for further recognition of conflicts and a reduced risk of panic recurrence. Increased assertiveness, encouraged by this patient-directed approach, and an increased sense of safety in being more able to tolerate mixed feelings, helps improve psychosocial function.

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The Joy of Self Esteem What Its Related to and What Its Not

First, for those of you who commented Wednesday, and for those of you who communicated with me over email, thank you for sharing your thoughts. I'm really honored to have these conversations with you.

Now. Self-esteem. The whole thing is kind of complicated. This won't be the only post I do on this topic. And before I get started, just a warning: If you look at my profile up there in the top righthand corner, it says "unapologetically empirical". That means I value good evidence over what-seems-like-it-should-be-true (most of the time, at least). Here's where I got my evidence for today's post: an article that reviews about 15,000 studies' worth of data on self-esteem.

Several decades ago, a few studies came out linking self-esteem to good outcomes for people. And some psychologists said, "America, self-esteem is where it's at."

Is anyone else vaguely creeped out by this?

We make people feel good about themselves and our problems are solved.  What's not to love about this idea?At least one state--California--spent tons o' money on initiatives meant to improve self-esteem. And then things got a little wild.  Folks started banning games of tag in school playgrounds and giving out prizes for nothing at all and tossing confetti at people.

And then researchers took a step back and ... did better research. And then a few others looked at all the studies together. Their findings?

Self-esteem is nice, but it ain't all that.


Sigh. These psychologists said, "Erm, America, we might have jumped the gun."

It turns out self-esteem is not strongly related to many outcomes. Not substance abuse. Not interpersonal success. For the things it is related to, there's no solid evidence that it CAUSES them. It's  related to depression but not considered a primary cause of it. It's also related to academic success ... but a close analysis suggests that success raises self-esteem, not the other way around. Interventions meant to increase student self-esteem haven't actually resulted in kids doing better in school.

High self-esteem does have its benefits. It's related to persistence in challenging tasks as well as happiness and emotional resilience. That's good stuff, and can really come in handy when you're a writer who's trying to make it to publication. People with high self-esteem rate themselves as prettier, smarter, more likeable, and generally shinier than others. It's not necessarily true, but it can keep you going, right? High self-esteem may be the fluffy buffer that protects some people from the slings and arrows of life (research results are actually mixed on this one).

Anyway, many of you said your self-esteem fluctuates depending on what's going on in your life--and depending on what part of your life we're talking about. Some of you are feeling discouraged, and you feel bad about yourselves. Some of you are really riding the rollercoaster right now, feeling different every day. Some of you are in a good place, and you're feeling fantastic about yourselves. Some of you are treading the middle path. Many of you tied that to your evaluations of your skill or success in one area or another. All that makes really good sense. What research seems to suggest is that events in our lives really have an affect on how we feel about ourselves, as much as or more than the reverse.

Self-esteem is a perception. It's not guaranteed, objective, verifiable reality. In fact, it sometimes veers sharply away from reality. You can be really good and still feel bad about yourself. You can suck and feel good. And feeling good feels GOOD. It's great, unless it holds you back from improving, which could be a huge problem for a writer. But if it lets you face the criticism, use it, and still be all right, that's the perfect place to be.

Like I said, there will be more on self-esteem and all its glorious complications. Next week, I'll be doing a post or two on bullying, and self-esteem's going to come up again.

Most of us have been taught about the importance of self-esteem from childhood, so do these results on self-esteem surprise you?

Stop relying on those struggling to speak first

(CW: talk of suicide.)

I’m a bit irritated. 

I used to blog a lot when I was irritated. I loved having fierce emotions and strong opinions but when my mental health started going up the spout, my fierce emotions became a misdirected mess and I had no opinions on anything because what’s the fucking point, am I right. 

But I’m irritated and tired at a particular part of the mental health conversation so I’m here and ready to bang my gavel.

It’s a repeated and basic point, but social media is both a blessing and a curse, especially when it comes to mental health. It allows a space for all to explore and be open, and it allows for trolls and bullies and thoughts and opinions from all angles. It’s liberating, but it’s exhausting. It’s progressive, but it’s dangerous. Ad infinitum. 

Thanks to social media, we also now know pretty quickly when someone - more often a celebrity/someone well known - takes their own life. There’s likely no warning. We refresh and suddenly know about the actions they took often no longer than 24 hours previously. Sometimes we don’t know them, sometimes we know of them, and sometimes we know them and like them and love them. It’s a hard thing to stomach. 

I try and stay out of the aftermath when this happens. I find it hard to read stories on suicide, especially when they’re so raw, and I know I can’t contribute to the conversation. I feel anything I say will be futile and so I step away, but not before I get probably irrationally angry at tweets and Facebook statuses and Instagram posts ordering those struggling with their mental health to talk. 

“Please tell someone if you’re feeling suicidal!!!”

“Don’t suffer in silence. Talk to someone. Say something.”

“I’m always here if you need a chat. xxx”

“I can’t believe someone could feel so lost that they’d commit suicide?!!” 

It’s not ‘commit suicide’, because suicide is no longer a crime. Say they took their own life, ‘completed’ suicide, or killed themselves. Do not say ‘commit’. Ok? Ok.

If I end up grating my teeth so hard just writing this post that I get sore and can’t eat dinner later then I’m gonna be so fucking angry. And I’m really trying to not be angry, and blunt, and sarcastic, because that’s not too healthy when talking about mental health, and especially suicide. I’m trying.

But, believe it or not, people who are struggling with their mental health likely know that they should talk. They know that there are people out there who would listen, whether it be their family, friends, teachers, colleagues, GP, a stranger on a helpline, strangers on social media. They know. They know that the biggest step can be admitting you’re struggling, starting that conversation.

They know. 

They don’t need an old school friend, who they’ve only still got on Facebook because they like keeping up with the dramatic oversharing, saying that their inbox is always open if you need to talk xoxoxoxoxox. They don’t need another thread on Twitter with thousands of numbers telling them to talk if they think suicide is their only option. They don’t need a whimsy Instagram quote on a beautiful background with an unncessary amount of hashtags telling them that they’re important and life is beautiful. 

It’s not enough. They know. People who struggle with their mental health may have irrational thoughts, but they still know they’re not ok, most of the time. They know about the importance of talking. They know who they can talk to. But they need more. They need:

1) The tools and skills to help them talk about how they’re feeling, and

2) Others to start the conversation for them

And 2) is what I’m encouraging here. That’s what I’m highlighting, what I’m shoving on a billboard, what I’m sticking up in neon lights with fireworks.

S T A R T T H E C O N V E R S A T I O N F O R T H E M.

Disclaimer: No, it’s not your responsibility to care for someone’s mental health. It’s not your responsibility to fix anything and provide answers. It’s not your responsibility to be responsible. But the art of conversation and learning and practising the skills to talk about mental health - your own and others’ - is important and underrated.

Please don’t get me wrong. I encourage the encouragement to get those struggling to speak up and not be afraid to talk about their mental health. Hell, I ran a fucking marathon (here she is, banging on about the marathon again) for Heads Together, whose message was just that. I encourage conversations and taking those first steps and going to see your GP. That’s great. It’s important. It’s not futile and pointless and basic. But it cannot stop there. You cannot rely on that. Everyone is different, their situations are different, and making it obvious that you can talk about your struggles is not enough.

A lot of people don’t know HOW to talk about their mental health, their thoughts, their emotions. We’re not taught it. Someone might WANT to speak up, but they don’t know where to bloody start. That’s something for another post. 

A lot of people are obviously unwell. They’re down or anxious. Their behaviours have changed. They’re erratic. They’re emotional. It’s noticeable. But those around them don’t know how to broach it. They feel embarrassed or like it’s not their place, so they wait for the person to admit it themselves. That’s also something for another post. Another another post.

A lot of people are secretly unwell. They’re good actors, they have coping mechanisms. They’re charmers. They’re jokers. They’re good at excuses, they’re extroverts. They’re high-functioning and they’re different people when they’re alone again. 

You’re not meant to be mind-readers, so what do you do then? 

The lesson here, to me, is to always be talking about mental health. You don’t have to struggle to talk about it. You don’t have to use technical language. You don’t need a psychology degree. You don’t have to talk about feeling bad, you can talk about feeling good. That’s still mental health. You can explore why you’re feeling certain ways with someone, and you can ask how that someone is too. 

You can drop them a text.

You can meet up for lunch.

You can go for a walk. 

You can ask them how things are going and how they’re doing. You can check in. You can talk about your own feelings to make it obvious you’re open. You can be invested in those around you, always. The more comfortable you make your relationships, the more likely someone will reach out should they need to. 

It shouldn’t take someone taking their own life for you to insist that you’re always there and your inbox is open. Mental health shouldn’t be a topic solely focused on when tragedy strikes. It’s not seasonal, it’s not topical at all. It should be an ongoing conversation, just part of your life, however you and your loved ones are doing and feeling. Always check in.
 

So when you feel compelled to tell people you’re always there for a chat or to urge those struggling to speak out, start talking yourself. Start talking now, go on. Send a text. Send a Snapchat with a rabbit filter, whatever. You’re not a mind reader and you can’t stop anyone from feeling mentally unwell, but maybe you’ll encourage someone to reach out. Maybe you’ll give them an opportunity instead of near-shaming them for not taking the step blindly themselves.

Don’t rely on those struggling to open up. Open up for them. Be aware. Be mindful. Be kind. That’s all.

What to Expect From Your Marriage

"In relationships, if you always do what you always did, you'll always get what you always got." ~ Amy Dickinson

A common complaint in letters to advice columns is that a spouse is chronically neglecting various needs of the complainer, or refuses to do something that the complainer fervently desires.  Sex may be the most common missing element described by people who write this type of letter – and women complain about the lack of it at least as often as do men – but it can be anything from refraining from cussing to refraining from describing embarrassing or quirky attributes of the complainer to outsiders.

To me, sexually frustrating one’s spouse seems to me to be the most strange of all such complaints, because it would be so easy and take so little effort to give the frustrated spouses what they say they want.  Do these spouses really care that little about keeping the other spouse happy?  That would seem really mean if not vicious.

After all, sex doesn’t take all that much effort, especially if you are not especially concerned about your own pleasure.  Why not make the other person happy occasionally even if you don’t enjoy it yourself?  A mere half hour every week or two might be just the ticket. 

You say it’s a chore?  So is going out and buying your spouse gifts on birthdays, Valentine's Day, and Christmas.  A lot of people seem willing to do those things.   How about meeting all of your other responsibilities at your job and at home?  Chores all, at least much of the time.  For most people, willing!

Even if the man is completely physically impotent and incurably so…and there's no G-rated way to say this... let’s just say his tongue probably works OK, doesn’t it?

Here is a typical example of a letter from a sex deprived wife, from the column Annie’s Mailbox from March 10, 2012.

"Dear Annie: "John" and I have been married for 15 years. He is a wonderful person and a great father...Our relationship is fine on the surface, but it's emotionally empty. There is little intimacy, which has been an issue throughout our marriage. It manifests itself periodically in arguments that never seem to get resolved… He wonders why I cannot "just be happy," because from his perspective, everything is fine. I have told him clearly that I need more attention and affection, but I have come to the realization that he is "just not that into me.

… Annie, I love my family. I am not asking for a magical romance. I don't think it's too much for a woman to need occasional loving physical gestures from her husband. I can't figure out why it's so hard for him to express his love if he cares for me as much as he says.


I don't want to leave, but things could be so much better if John would only put a little more effort into our marriage. Any suggestions on how to improve things? Or am I just destined to have an emotionless relationship?" 


The Annies answer: "There is a variety of reasons why a man may not show any interest in his wife: He could be gay, asexual, not attracted to you or having an affair. He could have low testosterone or other medical or emotional issues. The real problem is that he refuses to address it…"

Well those are all possibilities, but why would she have married someone like that in the first place if she craved affection so much?  It sounds from the letter like she just thinks hubby might just an A-hole, does it not?  I mean, she seems to think that he is someone who is depriving his dear wife of that which she craves, for no apparent reason.

But is that what is really happening?  Could be, but I have another, more likely explanation. The writer starts by saying that they have been married for fifteen years.  It doesn’t sound like this is a new problem, so what that probably means is that she has been putting up with this treatment for fifteen years.  And, after she mentions that, she praises the guy for being a “wonderful” person.  What, you may ask, is so wonderful about a guy who is more than willing to almost totally neglect your needs just because he can?

I find the husband’s response to be telling.   He asks her why she cannot "just be happy, because from his perspective, everything is fine.”  She also says that she has made it clear that the lack of intimacy bothers her a great deal.  So why would he think everything is just fine?  Why wouldn’t he already know the answer to the question of why she just “can’t be happy?”

Well, unless the guy has the IQ of a turnip, the only reasonable explanation for his apparent obtuseness and confusion is that he doesn’t believe her when she say she wants more intimacy.  Remember, she has been putting up with this for fifteen years.  In her letter she says he is wonderful and that she does not want to leave.   If we are hearing this in a letter she writes that may be up for public consumption, then the odds are extremely good that he has heard her say this stuff.  Many times.

The much less obvious explanation for this state of affairs – and so often the less obvious interpretation turns out to be the correct one for patients who I see in therapy - is that he takes her passive acquiescence of the state of affairs as a signal that she actually prefers it!  So, when she complains about it, he becomes confused and asks her why she is not happy, since he is doing exactly what he thinks she wants.  Maybe she really wants to avoid sex and affection, but also enjoys complaining!

He will never tell her about such thoughts because he knows that the thoughts will probably be greeted with great defensiveness, outright derision, or indignation from her that he is blaming her for his problem with intimacy.  That will get him exactly nothing but grief, so why bother?


More important, he is helping her to not face her issue with sex and affection, because he is volunteering to pretend to be the bad guy by denying her.

So could she really be covertly avoiding sex as much as he is?  And if so, why?  Well, the answer to the first question is a resounding, hell yes.  This does not mean that on some level she really does wish for more sex, but that for some reason she is more comfortable with the current state of affairs than with the “improved” version.  The answer as to why might be a one of many possible issues between her and her own family of origin, but she does not give us any clues in her letter about what those issues might be.

And what happened to his libido?  Again, we don’t know.  Maybe he has a whore/madonna conflict about his wife being a sexual being.  But it could also be many other things.

The point is, they are both avoiding sex, not just him. 

A different letter writer in the Dear Abby column of 3/15/12, says that she has been married for 32 years, and for all these years her husband has lied continually.  He fabricates the most outlandish stories, and the whole family knows it.  Furthermore, he is said to never own up to anything he has done wrong, but instead blames the letter writer for his actions. If she confronts or challenges him, he gets defensive and says she’s "always" belittling or challenging him in front of others. 

The probably translation, according to my scenario, is that she covertly thinks that he has a need for continuous humiliation - so she helps out by humiliating him -  and he thinks his wife needs to humiliate him - so he gives her plenty of opportunities.  After all, from the perspective of each, that is exactly what the other has always done.  For 32 years.


"In relationships, if you always do what you always did, you'll always get what you always got." 

Please I just want to go home sobs

"@simperman #ff @louisejones_x She's going to have a lively blog after last night's adventure."

So er you know I was bursting with a ridiculous amount of excitement Wednesday night and yesterday morning about seeing Ant & Dec? Well after the 10th hour at Pinewood Studios that excitement had receded and was replaced by a big fat feeling of anxious, closely followed by sheer panic and a lot of swearing...

My Mum, like me, believes that things happen for a reason and also believes bad things happen in threes. The morning started off okay, we were on time, organised and were dead excited about it all. Then the first bad thing happened. One of Mum's friends who was meant to come phoned and said she'd had a bad allergic reaction to something overnight and couldn't come, so that sucked. Then Mum tried diverting her work phone but apparently the function isn't on there, why it doesn't baffles me but there you go, so Mum was likely to get a ton of calls throughout the day, which is bad enough for her but worse for me as my Mum has a very loud 'phone voice' and her ringtone is awful. Oh and yes the third bad thing to happen in a hour, it started to rain...a lot...and our hair was perfect...fab. 'But that's three bad things to happen early' I hear you cry. Well yes that's the theory, but theory decided to ambush us with destruction in a number of ways, I even had my lucky bracelet on! Fat lot of good that was.

After an hour of faffing around deciding what to wear I was finally ready and me and Mum were on our way to the station to meet the other 6 who were already there. Got a great deal on train tickets, was only £1 for the kids (because we were obviously kids for transport and adults for the show, brilliant being 16 and noone can tell how old you actually are mwahaha) Jumped on a train to Liverpool Street, then the Metropolitan Line all the way to Uxbridge. Things were now going really well. Found taxis at Uxbridge who took us straight to Pinewood Studios and we were there at 2.30pm...3 hours early...right. Oh well better early than late. A man at reception came out and said "You're too early" Well yes I think we gathered that Mr 'you look a lot like my Physics teacher' man. "Well is there anywhere we can go?" "No." "Oh thank you so much for your help" #clearlynosarcasmintended. If it was up to us 'kids' we would have been quite happy sitting on a bench at Pinewood chatting and nomming on our Marks & Spencer's picnic, but oh no, "Let's go for a walk!" So we were dragged out of Pinewood by my Mum and her best friend to walk...with no purpose...and no sense of direction. Ronan had a Satnav thingy on his phone thank God which told us where we were going, and we found A PUB. Marvellous. So we sat in there for an hour talking, laughing at the sex toy machine in the toilets and trying our best to not get drooled on by Fang from Harry Potter, well Lacey the dog, that looked a lot like Fang from Harry Potter.

We found a shortcut on the way back, typical, and got back to the studios just in time to see other people arriving and starting to queue. Now this is where it gets tense. These tickets are first come first serve, you don't have seat numbers, and you can tell a tv recording regular (us) from a first timer by the way they queue and treat the others. Everyone is your enemy. You automatically dislike everyone. You stare everyone down. It's hilarious but so sad. As cars were coming in the ushers had to send them back out as the gate to the car park wasn't opening till 4.45pm, and it was only 4.15pm now, so naturally we laughed at them being sent away while we queued at the front happily. As 4.45pm came and the gates opened, it looked like the cavalry arrived as all the ushers in yellow jackets came out in a bundle, and all the 'public transport' lot gave each other sneaky looks, mostly at their feet, to see if they were gonna make a run for it through the gate. Well as soon as one posh snobby woman did it started a stampede, literally. Everyone clutching their tickets legged it towards the gates to the ticket people, and me being small managed to push past everyone to the front again, WIN. We were directed into another queue, only to be sent to another which was done for priorities, oh yeah, we were priority.

Then it rained. A LOT. Thankfully we had umbrellas but that precipitation still soaks you, not good. After half an hour of queuing Martin the SRO ticket person little gay man with a big voice I love arrived. I shouted "Martinnnnn! Nice to see you!" which started some glares my way as I was obviously tight with him. I'm not. But I pretended. When it was our turn to get wristbands he said "Oh just four of you? You have six tickets, where are the other two? Dead? Fuck em I didn't like em anyway. Now go to Ian and he'll tell you a story." Hahahaha oh I LOVE him. Well Ian, whoever he was, didn't tell us a story but a woman who looked remarkably like @salihughes gave me my wristband and said my hair looked gorgeous. Score, nice hair even in the rain, Ant & Dec wouldn't be able to resist me. We were directed into a marquee out of the rain where there were seats, so we sat waiting until the next leg of this event. By this time my feet were frozen and wet, so I ended up sticking them in the crease of my knee to warm them up, it worked. We were meant to be taken to the studio at 6.45pm but they were delayed and clearly not organised as us purple wristband people weren't called up till 7.15pm. Oh well it will still be over by 10pm right? *stares* Finally at 7.30pm we were all seated, in FAB seats, bang in the middle 5 rows up. Brilliant! Now we were getting SO excited. The set looked good and it was warrrrrrm, oh I've never appreciated warmth so much in my life. It took a long time getting seated but finally recording started at 8, Ant & Dec appeared in all their glory (minus Ant's shocking hairstyle) and we were clapping and cheering away. I'm not gonna tell you a lot about the actual show, you can see that for yourself next Saturday. But I will tell you that it could have been a LOT better with a lot more variety, and the families they chose were quite clearly from some sort of drama school, Ant & Dec got annoyed with them by the end never mind us, they were SO cocky. Minutes passed, more clapping past, more breaks passed, HOURS passed when Kiera looked at her watch and said it was 11pm. Oh SHIT. Now we were bored out our brains, tired and needed a wee BAD. This was meant to finish at 10pm, it was an hour wait and deep down I was scared we were gonna miss trains, but I always worry about things like that so let it pass. We left th..."Woah hold up Louise you haven't said anything about the warm up guy." Oh what Andy? I want to strangle him, slice him with a small grater and feed him to pigeons. There you go. (He's the warm up guy for Dancing on Ice too which I'm seeing on Sunday, someone will have to restrain me)

We were back at the main entrance at midnight, called for a taxi and I was now having visions of everything stopping and us having to walk the streets of London late at night, but that couldn't happen, could it? *stares harder* We were back at Uxbridge at 12.15am, and were welcomed by silence and one tube...stopping at Wembley. Oh shit x1000. But that was okay, they'll be trains from Wembley *gulp* We sat on that tube for 15mins before it started, and now Mum started to stress, causing me to stress, causing EVERYONE to stress. This was a time for Twitter. Mum didn't even bat an eyelid when I said I was gonna ask Twitter for help on my phone, an obvious sign of 'We need help NOW' The tube started moving at 12.25am and I was frantically asking for help from Twitter. Thankfully @simperman was on the case and found the last trains and buses from Wembley back to Stratford. We were utterly screwed. The last trains and buses were around 12.50am and there was no way we were gonna make that. As we pulled into Wembley we leaped off the train and scrambled to the exit to try and make last trains, it didn't work. Everywhere was eerily empty and the buses didn't go anywhere we wanted to go. One of the workers said there were no more connections anywhere now and then left us. 2 women with 6 kids and he left us stranded. Twat. We left the station and ended up walking up Olympic Way in the rain and dark, just in the hope of finding someone to help us or a bus to take us somewhere we knew. Nothing. It was like everyone had disappeared. It was 1.15am now, we were all shivering with cold, soaked through and scared shitless. We didn't know what to do. So we walked back to the station where a big group of workers were about to start work on the tracks. My Mum was close to tears now and ran up to these men literally begging for help. I have SO much respect for these workers now, they work all through the night and they are genuine lovely men who helped us out so much. One of them took my Mum to the office thing where a man was still monitoring the station, and bless his little heart tried so hard to help. He confirmed there were no more trains and the only buses we could take were ones going to Hainault, over 40 mins away from where we lived and would take two hours on the bus. We were all in tears now just not knowing what the hell to do. This man was absolutely lovely and even offered to put us all up in his hotel room till the first train at 5am (!), either that or we got our own room in Premier Inn next door. By now we were all in this office in the warm, all the works rushing around thinking up ways to get us home and telling us it was all gonna be alright. 1.30am it was now and Mum had rung my Dad to tell him what was happening. After a few phonecalls the lovely train man had managed to bag us a huge taxi to take us all the way home, for £100. Mum didn't know what to do, that was SO much money but we were all in such a state it was our last resort. I ended up breaking the silence through tears going to the man "Please I just want to go home" Which pushed him to get a deal for £90, it was cheaper at least.

The taxi was booked and we waited 20mins outside for it. On our own in the even more freezing and wet night, mysterious cars passing and staring at us, and pervy horrible men trying to talk to us, not to mention the van that skidded and did a 360 nearly crashing into all of us. It was AWFUL. I ended up singing 'Keep Holding On' from Glee to keep me calm. The taxi arrived and we bundled in, 8 of us in a 6 man taxi, three of us including me squeezed in the back, 3 in the middle, one on the floor and one in the front. Finally we were on our way home. After a few tweets and texts I crashed out in the corner of the taxi and woke up at 3am, just as we passed the 'Oakwood Avenue' sign, we were HOME. We shuffled into our house to my Dad who bless him had got up and was watching the Olympics, with money for the taxi man and hot drinks at the ready. I collapsed into his arms and vowed never to go to Pinewood or London late at night again. I will. But at that moment I just wanted to stay at home for the rest of my life. At 4am I finally got into bed after being ill from all the kerfuffle and sticking my feet under the shower, my toes had gone all wrinkly and white like when you're in the bath for too long.

I fell into bed with a hot water bottle and just fell asleep. Roll on Dancing on Ice, IN THE CAR. X