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On This Day … 12 February [2023]

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People (Births)

  • 1861 – Lou Andreas-Salomé, Russian-German psychoanalyst and author (d. 1937)
  • 1918 – Norman Farberow, American psychologist and academic (d. 2015)

Lou Andreas-Salome

Lou Andreas-Salomé (born either Louise von Salomé or Luíza Gustavovna Salomé or Lioulia von Salomé, Russian: Луиза Густавовна Саломе; 12 February 1861 to 05 February 1937) was a Russian-born psychoanalyst and a well-travelled author, narrator, and essayist from a French Huguenot-German family. Her diverse intellectual interests led to friendships with a broad array of distinguished thinkers, including Friedrich Nietzsche, Sigmund Freud, Paul Rée, and Rainer Maria Rilke.

Norman Farberow

Norman Louis Farberow (12 February 1918 to 10 September 2015) was an American psychologist, and one of the founding fathers of modern suicidology. He was among the three founders in 1958 of the Los Angeles Suicide Prevention Centre, which became a base of research into the causes and prevention of suicide.

On This Day … 11 February [2023]

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People (Births)

  • 1925 – Virginia E. Johnson, American psychologist and academic (d. 2013)

People (Deaths)

  • 1958 – Ernest Jones, Welsh neurologist and psychoanalyst (b. 1879)

Virginia E. Johnson

Virginia E. Johnson (born Mary Virginia Eshelman; 11 February 1925 to 24 July 2013) was an American sexologist and a member of the Masters and Johnson sexuality research team. Along with her partner, William H. Masters, she pioneered research into the nature of human sexual response and the diagnosis and treatment of sexual dysfunctions and disorders from 1957 until the 1990s.

Ernest Jones

Alfred Ernest Jones FRCP MRCS (01 January 1879 to 11 February 1958) was a Welsh neurologist and psychoanalyst. A lifelong friend and colleague of Sigmund Freud from their first meeting in 1908, he became his official biographer. Jones was the first English-speaking practitioner of psychoanalysis and became its leading exponent in the English-speaking world. As President of both the International Psychoanalytical Association and the British Psycho-Analytical Society in the 1920s and 1930s, Jones exercised a formative influence in the establishment of their organisations, institutions and publications.

What is Co-Dependents Anonymous?

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Introduction

Co-Dependents Anonymous (CoDA) is a twelve-step programme for people who share a common desire to develop functional and healthy relationships.

Refer to Codependency.

Outline

Co-Dependents Anonymous was founded by Ken and Mary Richardson and the first CoDA meeting attended by 30 people was held October 22, 1986 in Phoenix, Arizona.

Within four weeks there were 100 people and before the year was up there were 120 groups.

CoDA held its first National Service Conference the next year with 29 representatives from seven states.

CoDA has stabilised at about a thousand meetings in the US, and with meetings active in 60 other countries and dozens online that can be reached at http://www.coda.org.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Co-Dependents_Anonymous >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What is Codependency?

Published on by Andrew Marshall1 Comment

Introduction

In sociology, codependency is a theory that attempts to explain imbalanced relationships where one person enables another person’s self-destructive behaviour such as addiction, poor mental health, immaturity, irresponsibility, or under-achievement.

Definitions of codependency vary, but typically include high self-sacrifice, a focus on others’ needs, suppression of one’s own emotions, and attempts to control or fix other people’s problems. People who self-identify as codependent exhibit low self-esteem, but it is unclear whether this is a cause or an effect of characteristics associated with codependency. Codependency is not limited to married, partnered, or romantic relationships, as co-workers, friends, and family members can be codependent as well.

Refer to Co-Dependents Anonymous.

Brief History

The term “codependency” most likely developed in Minnesota in the late 1970s from “co-alcoholic”, when alcoholism and other drug dependencies were grouped together as “chemical dependency.” The term is most often identified with Alcoholics Anonymous and the realisation that the alcoholism was not solely about the addict but also about the family and friends who constitute a network for the alcoholic.

The term “codependent” was first used to describe how family members and friends might interfere with the recovery of a person affected by a substance use disorder by “overhelping”. Application of the concept of codependency was driven by the self-help community.

In 1986, Psychiatrist Timmen Cermak wrote Diagnosing and Treating Co-Dependence: A Guide for Professionals. In that book and an article published in the Journal of Psychoactive Drugs, Cermak argued unsuccessfully for the inclusion of codependency as a separate personality disorder in the Diagnostic and Statistical Manual of Mental Disorders, DSM-III-R. He found that the condition could affect people close to people with any mental disorder, not just addiction.

Melody Beattie popularised the concept of codependency in 1986 with the book Codependent No More which sold eight million copies, with updated editions released in 1992 and 2022. Drawing on her personal experience with substance abuse and caring for someone with it, she also interviewed people helped by Al-Anon. Beattie’s work formed the underpinning of a twelve-step organisation called Co-Dependents Anonymous, founded in 1986, although the group does not endorse any definition of or diagnostic criteria for codependency.

Definition

Codependency has no established definition or diagnostic criteria within the mental health community. It has not been included as a condition in any edition of the DSM or ICD.

Codependency carries three potential levels of meaning. First, it can describe a didactic tool that, once explained to families, helps them normalise the feelings that they are experiencing and allows them to shift their focus from the dependent person to their own dysfunctional behaviour patterns. Second, it can describe a psychological concept, a shorthand means of describing and explaining human behaviour. Third, it can describe a psychological disorder, implying that there is a consistent pattern of traits or behaviours across individuals that can create significant dysfunction.

Discussion of codependency tends to focus on the disease model of the term, although there is no agreement that codependency is a disorder at all, or how such a disease entity might be defined or diagnosed.  In an early attempt to define codependency as a diagnosable disorder, Timmen Cermak wrote:

“Co-dependence is a recognisable pattern of personality traits, predictably found within most members of chemically dependent families, which are capable of creating sufficient dysfunction to warrant the diagnosis of Mixed Personality Disorder as outlined in DSM III.”

Timmen proceeded to list the traits he identified in self-suppressing supporting partners of people with chemical dependence or disordered personalities, and to provide a DSM-style set of diagnostic criteria.

In her self-help book, Melody Beattie proposes that, “The obvious definition [of codependency] would be: being a partner in dependency. This definition is close to the truth but still unclear.” Beattie elaborates, “A codependent person is one who has let another person’s behaviour affect him or her, and who is obsessed with controlling that person’s behaviour.” Another self-help author, Darlene Lancer, asserts that “A codependent is a person who can’t function from his or her innate self and instead organizes thinking and behavior around a substance, process, or other person(s).” Lancer includes all addicts in her definition. She believes a “lost self” is the core of codependency.

Co-Dependents Anonymous, a self-help organization for people who seek to develop healthy and functional relationships, “offer[s] no definition or diagnostic criteria for codependence”, but provides a list of “patterns and characteristics of codependence” that can be used by laypeople for self-evaluation. The organisation identifies patterns that may occur in codependency.

The Medical Subject Heading utilised by the United States National Library of Medicine describes codependency as “A relational pattern in which a person attempts to derive a sense of purpose through relationships with others.”

Theories

Under theories of codependency as a psychological disorder, the codependent partner in a relationship is often described as displaying self-perception, attitudes and behaviours that serve to increase problems within the relationship instead of decreasing them. It is often suggested that people who are codependent were raised in dysfunctional families or with early exposure to addiction behaviour, resulting in their allowance of similar patterns of behaviour by their partner.

Relationships

Codependent relationships are often described as being marked by intimacy problems, dependency, control (including caretaking), denial, dysfunctional communication and boundaries, and high reactivity. There may be imbalance within the relationship, where one person is abusive or in control or supports or enables another person’s addiction, poor mental health, immaturity, irresponsibility, or under-achievement.

Under this conception of codependency, the codependent person’s sense of purpose within a relationship is based on making extreme sacrifices to satisfy their partner’s needs. Codependent relationships signify a degree of unhealthy “clinginess” and needy behaviour, where one person does not have self-sufficiency or autonomy. One or both parties depend on their loved one for fulfilment. The mood and emotions of the codependent are often determined by how they think other individuals perceive them (especially loved ones). This perception is self-inflicted and often leads to clingy, needy behaviour which can hurt the health of the relationship.

Personality Disorders

Codependency may occur within the context of relationships with people with diagnosable personality disorders.

  • Borderline personality disorder: There is a tendency for loved ones of people with borderline personality disorder (BPD) to slip into “caretaker” roles, giving priority and focus to problems in the life of the person with BPD rather than to issues in their own lives. The codependent partner may gain a sense of worth by being perceived as “the sane one” or “the responsible one”.
  • Narcissistic personality disorder: Narcissists, with their ability to get others to “buy into their vision” and help them make it a reality, seek and attract partners who will put others’ needs before their own. A codependent person can provide the narcissist with an obedient and attentive audience. Among the reciprocally interlocking interactions of the pair are the narcissist’s overpowering need to feel important and special and the codependent person’s strong need to help others feel that way.

Family Dynamics

In the dysfunctional family the child learns to become attuned to the parent’s needs and feelings instead of the other way around. Parenting is a role that requires a certain amount of self-sacrifice and giving a child’s needs a high priority. A parent can be codependent toward their own child. Generally, a parent who takes care of their own needs (emotional and physical) in a healthy way will be a better caretaker, whereas a codependent parent may be less effective, or may even do harm to a child. Codependent relationships often manifest through enabling behaviours, especially between parents and their children. Another way to look at it is that the needs of an infant are necessary but temporary, whereas the needs of the codependent are constant. Children of codependent parents who ignore or negate their own feelings may become codependent.

Recovery and Prognosis

With no consensus as to how codependency should be defined, and with no recognised diagnostic criteria, mental health professionals hold a range of opinions about the diagnosis and treatment of codependency. Caring for an individual with a physical addiction is not necessarily treating a pathology. The caregiver may only require assertiveness skills and the ability to place responsibility for the addiction on the other. There are various recovery paths for individuals who struggle with codependency. For example, some may choose cognitive-behavioural psychotherapy, sometimes accompanied by chemical therapy for accompanying depression. There also exist support groups for codependency, such as Co-Dependents Anonymous (CoDA), Al-Anon/Alateen, Nar-Anon, and Adult Children of Alcoholics (ACoA), which are based on the twelve-step programme model of Alcoholics Anonymous, Celebrate Recovery and Life Recovery a Christian 12 step Bible-based group. Many self-help guides have been written on the subject of codependency.

It has been proposed that, in attempts to recover from codependency, people may go from being overly passive or overly giving to being overly aggressive or excessively selfish. Therapists may seek to help a client develop a balance through healthy assertiveness, which leaves room for being a caring person and also engaging in healthy caring behaviour, while minimising selfishness, bully, or behaviours that might reflect conflict addiction. Developing a permanent stance of being a victim (having a victim mentality) does not constitute recovery from codependency. A victim mentality could also be seen as a part of one’s original state of codependency (lack of empowerment causing one to feel like the “subject” of events rather than being an empowered actor). Someone truly recovered from codependency would feel empowered and like an author of their life and actions rather than being at the mercy of outside forces. A victim mentality may also occur in combination with passive-aggressive control issues. From the perspective of moving beyond victim-hood, the capacity to forgive and let go (with exception of cases of very severe abuse) could also be signs of real recovery from codependency, but the willingness to endure further abuse would not.

It is theorized that unresolved patterns of codependency may lead to more serious problems like alcoholism, drug addiction, eating disorders, sex addiction, psychosomatic illnesses, and other self-destructive or self-defeating behaviours. People with codependency may be more likely to attract further abuse from aggressive individuals (such as those with BPD or NPD), more likely to stay in stressful jobs or relationships, less likely to seek medical attention when needed and are also less likely to get promotions and tend to earn less money than those without codependency patterns. For some people, the social insecurity caused by codependency may progress into full-blown social anxiety disorders like social phobia, avoidant personality disorder or painful shyness. Other stress-related disorders like panic disorder, depression or PTSD may also be present.

Controversy

Codependency is not a diagnosable mental health condition, there is no medical consensus as to its definition, and there is no evidence that codependency is caused by a disease process. Without clinical definition, the term is easily applicable to many behaviours and has been overused by some self-help authors and support communities. In an article in Psychology Today, clinician Kristi Pikiewicz suggested that the term codependency has been overused to the point of becoming a cliché, and labelling a patient as codependent can shift the focus on how their traumas shaped their current relationships.

Some scholars and treatment providers assert that codependency should be understood as a positive impulse gone awry, and challenge the idea that interpersonal behaviours should be conceptualised as addictions or diseases, as well as the pathologising of personality characteristics associated with women. A study of the characteristics associated with codependency found that non-codependency was associated with masculine character traits, while codependency was associated with negative feminine traits, such as being self-denying, self-sacrificing, or displaying low self-esteem.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Codependency >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

On This Day … 08 February [2023]

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People (Deaths)

  • 1964 – Ernst Kretschmer, German psychiatrist and author (b. 1888)
  • 2007 – Ian Stevenson, Canadian-American psychiatrist and academic (b. 1918)

Ernst Kretschmer

Ernst Kretschmer (08 October 1888 to 08 February 1964) was a German psychiatrist who researched the human constitution and established a typology.

In 1926 he became the director of the psychiatric clinic at Marburg University.

Kretschmer was a founding member of the International General Medical Society for Psychotherapy (AÄGP) which was founded on 12 January 1927. He was the president of AÄGP from 1929. In 1933 he resigned from the AÄGP for political reasons.

After he resigned from the AÄGP, he started to support the SS and signed the “Vow of allegiance of the professors of the German universities and high-schools to Adolf Hitler and the National Socialistic state.” (German: “Bekenntnis der Professoren an den deutschen Universitäten und Hochschulen zu Adolf Hitler und dem nationalsozialistischen Staat”).

From 1946 until 1959, Kretschmer was the director of the psychiatric clinic of the University of Tübingen. He died, aged 75, in Tübingen.

Ian Stevenson

Ian Pretyman Stevenson (31 October 1918 to 08 February 2007) was a Canadian-born American psychiatrist, the founder and director of the Division of Perceptual Studies at the University of Virginia School of Medicine.

He was a professor at the University of Virginia School of Medicine for fifty years. He was chair of their department of psychiatry from 1957 to 1967, Carlson Professor of Psychiatry from 1967 to 2001, and Research Professor of Psychiatry from 2002 until his death in 2007.

As founder and director of the University of Virginia School of Medicine’s Division of Perceptual Studies (originally named “Division of Personality Studies”), which investigates the paranormal, Stevenson became known for his research into cases he considered suggestive of reincarnation – the idea that emotions, memories, and even physical bodily features can be passed on from one incarnation to another. In the course of his forty years doing international fieldwork, he researched three thousand cases of children who claimed to remember past lives. His position was that certain phobias, philias, unusual abilities and illnesses could not be fully explained by genetics or the environment. He believed that, in addition to genetics and the environment, reincarnation might possibly provide a third, contributing factor.

Stevenson helped to found the Society for Scientific Exploration in 1982,[8] and was the author of around three hundred papers and fourteen books on reincarnation, including Twenty Cases Suggestive of Reincarnation (1966), Cases of the Reincarnation Type (four volumes, 1975-1983) and European Cases of the Reincarnation Type (2003). His 1997 work Reincarnation and Biology: A Contribution to the Etiology of Birthmarks and Birth Defects reported two hundred cases in which birthmarks and birth defects seemed to correspond in some way to a wound on the deceased person whose life the child recalled. He wrote a shorter version of the same research for the general reader, Where Reincarnation and Biology Intersect (1997).

Reaction to his work was mixed. In an obituary for Stevenson in The New York Times, Margalit Fox wrote that Stevenson’s supporters saw him as a misunderstood genius, that his detractors regarded him as earnest but gullible, but that most scientists had simply ignored his research. His life and work became the subject of the supportive books Old Souls: The Scientific Search for Proof of Past Lives (1999) by Tom Shroder (a Washington Post journalist), Life Before Life (2005) by Jim B. Tucker (a psychiatrist and colleague at the University of Virginia who now heads the division Stevenson founded), and Science, the Self, and Survival after Death (2012), by Emily Williams Kelly. Critics, particularly the philosophers C.T.K. Chari (1909-1993) and Paul Edwards (1923-2004), raised a number of issues, including instances where the children or parents interviewed by Stevenson had deceived him, instances of Stevenson asking leading questions in his interviews, and problems with working through translators who credulously believed what the interviewees were saying at face value. Stevenson’s critics contend that ultimately his conclusions are undermined by confirmation bias, where cases not supportive of his hypothesis were not presented as counting against it, and motivated reasoning since Stevenson had always maintained a personal belief in reincarnation as a fact of reality rather than also considering the possibility that it may not happen at all.

What is Emotional Eating?

Published on by Andrew Marshall2 Comments

Introduction

Emotional eating, also known as stress eating and emotional overeating, is defined as the “propensity to eat in response to positive and negative emotions”. While the term often refers to eating as a means of coping with negative emotions, it also includes eating for positive emotions, such as eating foods when celebrating an event or eating to enhance an already good mood. In these situations, emotions are still driving the eating but not in a negative way.

Background

Emotional eating includes eating in response to any emotion, whether that be positive or negative. Most frequently, people refer to emotional eating as “eating to cope with negative emotions.” In these situations, emotional eating can be considered a form of disordered eating, which is defined as “an increase in food intake in response to negative emotions” and can be considered a maladaptive strategy. More specifically, emotional eating in order to relieve negative emotions would qualify as a form of emotion-focused coping, which attempts to minimise, regulate, and prevent emotional distress.

One study found that emotional eating sometimes does not reduce emotional distress, but instead it enhances emotional distress by sparking feelings of intense guilt after an emotional eating session. Those who eat as a coping strategy are at an especially high risk of developing binge-eating disorder, and those with eating disorders are at a higher risk to engage in emotional eating as a means to cope. In a clinical setting, emotional eating can be assessed by the Dutch Eating Behaviour Questionnaire, which contains a scale for restrained, emotional, and external eating. Other questionnaires, such as the Palatable Eating Motives Scale, can determine reasons why a person eats tasty foods when they are not hungry; sub-scales include eating for reward enhancement, coping, social, and conformity.

Characteristics

Emotional eating usually occurs when one is attempting to satisfy his or her hedonic drive, or the drive to eat palatable food to obtain pleasure in the absence of an energy deficit but can also occur when one is seeking food as a reward, eating for social reasons (such as eating at a party), or eating to conform (which involves eating because friends or family wants the individual to). When one is engaging in emotional eating, they are usually seeking out palatable foods (such as sweets) rather than just food in general. In some cases, emotional eating can lead to something called “mindless eating” during which the individual is eating without being mindful of what or how much they are consuming; this can occur during both positive and negative settings.

Emotional hunger does not originate from the stomach, such as with a rumbling or growling stomach, but tends to start when a person thinks about a craving or wants something specific to eat. Emotional responses are also different. Giving in to a craving or eating because of stress can cause feelings of regret, shame, or guilt, and these responses tend to be associated with emotional hunger. On the other hand, satisfying a physical hunger is giving the body the nutrients or calories it needs to function and is not associated with negative feelings.

Major Theories behind Eating to Cope

Current research suggests that certain individual factors may increase one’s likelihood of using emotional eating as a coping strategy. The inadequate affect regulation theory posits that individuals engage in emotional eating because they believe overeating alleviates negative feelings. Escape theory builds upon inadequate affect regulation theory by suggesting that people not only overeat to cope with negative emotions, but they find that overeating diverts their attention away from a stimulus that is threatening self-esteem to focus on a pleasurable stimulus like food. Restraint theory suggests that overeating as a result of negative emotions occurs among individuals who already restrain their eating. While these individuals typically limit what they eat, when they are faced with negative emotions they cope by engaging in emotional eating. Restraint theory supports the idea that individuals with other eating disorders are more likely to engage in emotional eating. Together these three theories suggest that an individual’s aversion to negative emotions, particularly negative feelings that arise in response to a threat to the ego or intense self-awareness, increase the propensity for the individual to utilise emotional eating as a means of coping with this aversion.

The biological stress response may also contribute to the development of emotional eating tendencies. In a crisis, corticotropin-releasing hormone (CRH) is secreted by the hypothalamus, suppressing appetite and triggering the release of glucocorticoids from the adrenal gland. These steroid hormones increase appetite and, unlike CRH, remain in the bloodstream for a prolonged period of time, often resulting in hyperphagia. Those who experience this biologically instigated increase in appetite during times of stress are therefore primed to rely on emotional eating as a coping mechanism.

Contributing Factors

Negative Affect

Overall, high levels of the negative affect trait are related to emotional eating. Negative affectivity is a personality trait involving negative emotions and poor self-concept. Negative emotions experienced within negative affect include anger, guilt, and nervousness. It has been found that certain negative affect regulation scales predicted emotional eating. An inability to articulate and identify one’s emotions made the individual feel inadequate at regulating negative affect and thus more likely to engage in emotional eating as a means for coping with those negative emotions. Further scientific studies regarding the relationship between negative affect and eating find that, after experiencing a stressful event, food consumption is associated with reduced feelings of negative affect (i.e. feeling less bad) for those enduring high levels of chronic stress. This relationship between eating and feeling better suggests a self-reinforcing cyclical pattern between high levels of chronic stress and consumption of highly palatable foods as a coping mechanism. Contrarily, a study conducted by Spoor et al. found that negative affect is not significantly related to emotional eating, but the two are indirectly associated through emotion-focused coping and avoidance-distraction behaviours. While the scientific results differed somewhat, they both suggest that negative affect does play a role in emotional eating but it may be accounted for by other variables.

Childhood Development

For some people, emotional eating is a learned behaviour. During childhood, their parents give them treats to help them deal with a tough day or situation, or as a reward for something good. Over time, the child who reaches for a cookie after getting a bad grade on a test may become an adult who grabs a box of cookies after a rough day at work. In an example such as this, the roots of emotional eating are deep, which can make breaking the habit extremely challenging. In some cases, individuals may eat in order to conform; for example, individuals may be told “you have to finish your plate” and the individual may eat past the point in which they feel satisfied.

Related Disorders

Emotional eating as a means to cope may be a precursor to developing eating disorders such as binge eating or bulimia nervosa. The relationship between emotional eating and other disorders is largely due to the fact that emotional eating and these disorders share key characteristics. More specifically, they are both related to emotion focused coping, maladaptive coping strategies, and a strong aversion to negative feelings and stimuli. It is important to note that the causal direction has not been definitively established, meaning that while emotional eating is considered a precursor to these eating disorders, it also may be the consequence of these disorders. The latter hypothesis that emotional eating happens in response to another eating disorder is supported by research that has shown emotional eating to be more common among individuals already suffering from bulimia nervosa.

Biological and Environmental Factors

Stress affects food preferences. Numerous studies – granted, many of them in animals – have shown that physical or emotional distress increases the intake of food high in fat, sugar, or both, even in the absence of caloric deficits. Once ingested, fat- and sugar-filled foods seem to have a feedback effect that damps stress-related responses and emotions, as these foods trigger dopamine and opioid releases, which protect against the negative consequences of stress. These foods really are “comfort” foods in that they seem to counteract stress, but rat studies demonstrate that intermittent access to and consumption of these highly palatable foods creates symptoms that resemble opioid withdrawal, suggesting that high-fat and high-sugar foods can become neurologically addictive. A few examples from the American diet would include: hamburgers, pizza, French fries, sausages and savoury pasties. The most common food preferences are in decreasing order from: sweet energy-dense food, non-sweet energy-dense food then, fruits and vegetables. This may contribute to people’s stress-induced craving for those foods.

The stress response is a highly-individualised reaction and personal differences in physiological reactivity may also contribute to the development of emotional eating habits. Women are more likely than men to resort to eating as a coping mechanism for stress, as are obese individuals and those with histories of dietary restraint. In one study, women were exposed to an hour-long social stressor task or a neutral control condition. The women were exposed to each condition on different days. After the tasks, the women were invited to a buffet with both healthy and unhealthy snacks. Those who had high chronic stress levels and a low cortisol reactivity to the acute stress task consumed significantly more calories from chocolate cake than women with low chronic stress levels after both control and stress conditions. High cortisol levels, in combination with high insulin levels, may be responsible for stress-induced eating, as research shows high cortisol reactivity is associated with hyperphagia, an abnormally increased appetite for food, during stress. Furthermore, since glucocorticoids trigger hunger and specifically increase one’s appetite for high-fat and high-sugar foods, those whose adrenal glands naturally secrete larger quantities of glucocorticoids in response to a stressor are more inclined toward hyperphagia. Additionally, those whose bodies require more time to clear the bloodstream of excess glucocorticoids are similarly predisposed.

These biological factors can interact with environmental elements to further trigger hyperphagia. Frequent intermittent stressors trigger repeated, sporadic releases of glucocorticoids in intervals too short to allow for a complete return to baseline levels, leading to sustained and elevated levels of appetite. Therefore, those whose lifestyles or careers entail frequent intermittent stressors over prolonged periods of time thus have greater biological incentive to develop patterns of emotional eating, which puts them at risk for long-term adverse health consequences such as weight gain or cardiovascular disease.

Macht (2008) described a five-way model to explain the reasoning behind stressful eating:

  1. Emotional control of food choice;
  2. Emotional suppression of food intake;
  3. Impairment of cognitive eating controls;
  4. Eating to regulate emotions; and
  5. Emotion-congruent modulation of eating.

These break down into subgroups of: Coping, reward enhancement, social and conformity motive. Thus, providing an individual with are stronger understanding of personal emotional eating.

Positive Affect

Geliebter and Aversa (2003) conducted a study comparing individuals of three weight groups: underweight, normal weight and overweight. Both positive and negative emotions were evaluated. When individuals were experiencing positive emotional states or situations, the underweight group reporting eating more than the other two groups. As an explanation, the typical nature of underweight individuals is to eat less and during times of stress to eat even less. However, when positive emotional states or situations arise, individuals are more likely to indulge themselves with food.

Impact

Emotional eating may qualify as avoidant coping and/or emotion-focused coping. As coping methods that fall under these broad categories focus on temporary reprieve rather than practical resolution of stressors, they can initiate a vicious cycle of maladaptive behaviour reinforced by fleeting relief from stress. Additionally, in the presence of high insulin levels characteristic of the recovery phase of the stress-response, glucocorticoids trigger the creation of an enzyme that stores away the nutrients circulating in the bloodstream after an episode of emotional eating as visceral fat, or fat located in the abdominal area. Therefore, those who struggle with emotional eating are at greater risk for abdominal obesity, which is in turn linked to a greater risk for metabolic and cardiovascular disease.

Treatment

There are numerous ways in which individuals can reduce emotional distress without engaging in emotional eating as a means to cope. The most salient choice is to minimise maladaptive coping strategies and to maximise adaptive strategies. A study conducted by Corstorphine et al. in 2007 investigated the relationship between distress tolerance and disordered eating. These researchers specifically focused on how different coping strategies impact distress tolerance and disordered eating. They found that individuals who engage in disordered eating often employ emotional avoidance strategies. If an individual is faced with strong negative emotions, they may choose to avoid the situation by distracting themselves through overeating. Discouraging emotional avoidance is thus an important facet to emotional eating treatment. The most obvious way to limit emotional avoidance is to confront the issue through techniques like problem solving. Corstorphine et al. showed that individuals who engaged in problem solving strategies enhance one’s ability to tolerate emotional distress. Since emotional distress is correlated to emotional eating, the ability to better manage one’s negative affect should allow an individual to cope with a situation without resorting to overeating.

One way to combat emotional eating is to employ mindfulness techniques. For example, approaching cravings with a non-judgemental inquisitiveness can help differentiate between hunger and emotionally-driven cravings. An individual may ask his or herself if the craving developed rapidly, as emotional eating tends to be triggered spontaneously. An individual may also take the time to note his or her bodily sensations, such as hunger pangs, and coinciding emotions, like guilt or shame, in order to make conscious decisions to avoid emotional eating.

Emotional eating can also be improved by evaluating physical facets like hormone balance. Female hormones, in particular, can alter cravings and even self-perception of one’s body. Additionally, emotional eating can be exacerbated by social pressure to be thin. The focus on thinness and dieting in our culture can make young girls, especially, vulnerable to falling into food restriction and subsequent emotional eating behaviour.

Emotional eating disorder predisposes individuals to more serious eating disorders and physiological complications. Therefore, combatting disordered eating before such progression takes place has become the focus of many clinical psychologists.

Stress Fasting

In a lesser percentage of individuals, emotional eating may conversely consist of reduced food intake, or stress fasting. This is believed to result from the fight-or-flight response. In some individuals, depression and other psychological disorders can also lead to emotional fasting or starvation.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Emotional_eating >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What are Personal Boundaries?

Published on by Andrew Marshall1 Comment

Introduction

Personal boundaries or the act of setting boundaries is a life skill that has been popularised by self help authors and support groups since the mid 1980s.

It is the practice of openly communicating and asserting personal values as way to preserve and protect against having them compromised or violated. The term “boundary” is a metaphor – with in-bounds meaning acceptable and out-of-bounds meaning unacceptable. Without values and boundaries our identities become diffused and often controlled by the definitions offered by others. The concept of boundaries has been widely adopted by the counselling profession.

Usage and Application

This life skill is particularly applicable in environments with controlling people or people not taking responsibility for their own life.

Co-Dependents Anonymous recommends setting limits on what members will do to and for people and on what members will allow people to do to and for them, as part of their efforts to establish autonomy from being controlled by other people’s thoughts, feelings and problems.

The National Alliance on Mental Illness (NAMI) tells its members that establishing and maintaining values and boundaries will improve the sense of security, stability, predictability and order, in a family even when some members of the family resist. NAMI contends that boundaries encourage a more relaxed, non-judgemental atmosphere and that the presence of boundaries need not conflict with the need for maintaining an understanding atmosphere.

Overview

The three critical aspects of managing personal boundaries are:

AspectOutline
Defining ValuesA healthy relationship is an “inter-dependent” relationship of two “independent” people. Healthy individuals should establish values that they honour and defend regardless of the nature of a relationship (core or independent values). Healthy individuals should also have values that they negotiate and adapt in an effort to bond with and collaborate with others (inter-dependent values).
Asserting BoundariesIn this model, individuals use verbal and nonverbal communications to assert intentions, preferences and define what is inbounds and out-of-bounds with respect to their core or independent values. When asserting values and boundaries, communications should be present, appropriate, clear, firm, protective, flexible, receptive, and collaborative.
Honouring and DefendingMaking decision consistent with the personal values when presented with life choices or confronted or challenged by controlling people or people not taking responsibility for their own life.

Having healthy values and boundaries is a lifestyle, not a quick fix to an relationship dispute.

Values are constructed from a mix of conclusions, beliefs, opinions, attitudes, past experiences and social learning. Jacques Lacan considers values to be layered in a hierarchy, reflecting “all the successive envelopes of the biological and social status of the person” from the most primitive to the most advanced.

Personal values and boundaries operate in two directions, affecting both the incoming and outgoing interactions between people. These are sometimes referred to as the ‘protection’ and ‘containment’ functions.

Scope

The three most commonly mentioned categories of values and boundaries are:

  • Physical: Personal space and touch considerations; physical intimacy.
  • Mental: Thoughts and opinions.
  • Emotional: Feelings; emotional intimacy.

Some authors have expanded this list with additional or specialised categories such as spirituality, truth, and time/punctuality.

Assertiveness Levels

Nina Brown proposed four boundary types:

Boundary TypeOutline
SoftA person with soft boundaries merges with other people’s boundaries. Someone with a soft boundary is easily a victim of psychological manipulation.
SpongyA person with spongy boundaries is like a combination of having soft and rigid boundaries. They permit less emotional contagion than soft boundaries but more than those with rigid. People with spongy boundaries are unsure of what to let in and what to keep out.
RigidA person with rigid boundaries is closed or walled off so nobody can get close either physically or emotionally. This is often the case if someone has been the victim of physical, emotional, psychological, or sexual abuse. Rigid boundaries can be selective which depend on time, place or circumstances and are usually based on a bad previous experience in a similar situation.
FlexibleSimilar to spongy rigid boundaries but the person exercises more control. The person decides what to let in and what to keep out, is resistant to emotional contagion and psychological manipulation, and is difficult to exploit.

Unilateral vs Collaborative

There are also two main ways that boundaries are constructed:

  • Unilateral boundaries: One person decides to impose a standard on the relationship, regardless of whether others support it. For example, one person may decide to never mention an unwanted subject and to make a habit of leaving the room, ending phone calls, or deleting messages without replying if the subject is mentioned by others.
  • Collaborative boundaries: Everyone in the relationship group agrees, either tacitly or explicitly, that a particular standard should be upheld. For example, the group may decide not to discuss an unwanted subject, and then all members individually avoid mentioning it and work together to change the subject if someone mentions it.

Setting boundaries does not always require telling anyone what the boundary is or what the consequences are for transgressing it. For example, if a person decides to leave a discussion, that person may give an unrelated excuse, such as claiming that it’s time to do something else, rather than saying that the subject must not be mentioned.

Situations that can Challenge Personal Boundaries

Communal Influences

Freud described the loss of conscious boundaries that may occur when an individual is in a unified, fast-moving crowd.

Almost a century later, Steven Pinker took up the theme of the loss of personal boundaries in a communal experience, noting that such occurrences could be triggered by intense shared ordeals like hunger, fear or pain, and that such methods were traditionally used to create liminal conditions in initiation rites. Jung had described this as the absorption of identity into the collective unconscious.

Rave culture has also been said to involve a dissolution of personal boundaries, and a merger into a binding sense of communality.

Unequal Power Relationships

Also unequal relations of political and social power influence the possibilities for marking cultural boundaries and more generally the quality of life of individuals. Unequal power in personal relationships, including abusive relationships, can make it difficult for individuals to mark boundaries.

Dysfunctional Families

Overly Demanding ParentsIn the dysfunctional family the child learns to become attuned to the parent’s needs and feelings instead of the other way around.
Overly Demanding ChildrenParenting is a role that requires a certain amount of self-sacrifice and giving a child’s needs a high priority. A parent can, nevertheless, be codependent towards a child if the caretaking or parental sacrifice reaches unhealthy or destructive levels.
Codependent RelationshipsCodependency often involves placing a lower priority on one’s own needs, while being excessively preoccupied with the needs of others. Codependency can occur in any type of relationship, including family, work, friendship, and also romantic, peer or community relationships.
While a healthy relationship depends on the emotional space provided by personal boundaries, codependent personalities have difficulties in setting such limits, so that defining and protecting boundaries efficiently may be for them a vital part of regaining mental health.
In a codependent relationship, the codependent’s sense of purpose is based on making extreme sacrifices to satisfy their partner’s needs. Codependent relationships signify a degree of unhealthy clinginess, where one person does not have self-sufficiency or autonomy. One or both parties depend on the other for fulfilment. There is usually an unconscious reason for continuing to put another person’s life first - often the mistaken notion that self-worth comes from other people.
Mental Illness in the FamilyPeople with certain mental conditions are predisposed to controlling behaviour including those with obsessive compulsive disorder, paranoid personality disorder, borderline personality disorder, and narcissistic personality disorder, attention deficit disorder, and the manic state of bipolar disorder.
Borderline personality disorder (BPD): There is a tendency for loved ones of people with BPD to slip into caretaker roles, giving priority and focus to problems in the life of the person with BPD rather than to issues in their own lives. Too often in these relationships, the codependent will gain a sense of worth by being “the sane one” or “the responsible one”. Often, this shows up prominently in families with strong Asian cultures because of beliefs tied to the cultures.
Narcissistic personality disorder (NPD): For those involved with a person with NPD, values and boundaries are often challenged as narcissists have a poor sense of self and often do not recognise that others are fully separate and not extensions of themselves. Those who meet their needs and those who provide gratification may be treated as if they are part of the narcissist and expected to live up to their expectations.


Anger

Anger is a normal emotion that involves a strong uncomfortable and emotional response to a perceived provocation. Often, it indicates when one’s personal boundaries are violated. Anger may be utilised effectively by setting boundaries or escaping from dangerous situations.

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Who was Thomas Forrest Main?

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Introduction

Thomas Forrest Main (1911-1990) was a psychiatrist and psychoanalyst who coined the term ‘therapeutic community’. He is particularly remembered for his often cited paper, The Ailment (1957).

Refer to British Journal of Medical Psychology for The Ailment.

Life

Thomas Main was born on 25 February 1911 in Johannesburg, where his father was a mine manager who had emigrated there from England. At the start of World War I his mother returned to England with Thomas and his two sisters Isabella and Mary, while his father joined the South African Army. Main was educated at the Royal Grammar School, Newcastle-upon-Tyne before studying medicine at Durham University, graduating in 1933 and becoming a doctor in 1938. Specialising in psychiatry, he gained a Diploma in Psychological Medicine from Dublin in 1936. In 1937 he married Agnes Mary (Molly) McHaffie who also graduated in medicine at Durham University and who also became a psychoanalyst. They had three daughters and a son, Jennifer (Johns), Deborah (Hutchinson), Ursula (Kretzschmar) and Andrew.

Main worked as superintendent at Gateshead Mental Hospital. During the Second World War he joined the Royal Army Medical Corps as an adviser in psychiatry, attaining the rank of lieutenant colonel and working at the Northfield Army Hospital (aka Hollymoor Hospital) for the treatment of war neuroses. The work conducted at Northfield is considered by many psychiatrists to have been the first example of an intentional therapeutic community. The principles developed at Northfield were also developed and adapted at Civil Resettlement Units established at the end of the war to help returning prisoners of war to adapt back to civilian society and for civilians to adapt to having these men back amongst them.

The term “therapeutic community” was coined by Main in his 1946 paper, “The hospital as a therapeutic institution”, and subsequently developed by others including Maxwell Jones, R.D. Laing at the Philadelphia Association, David Cooper, and by Joshua Bierer.

After the war Main joined the Cassel Hospital, as medical director in 1946 and continued working there for the next thirty years.

Training as a psychoanalyst under Michael Balint, he was supervised by Anna Freud, Melanie Klein and Paula Heimann. In 1974 he co-founded with Michael Balint the charitable Institute of Psychosexual Medicine in London. He served as its Life President. He also served as vice-president of the Royal College of Psychiatrists, and was a co-editor of the British Journal of Medical Psychology. He died in Barnes, London on 29 May 1990, aged 79.

His papers are held in the Archive of the British Psychoanalytic Society, whose member he was for many years.

Works

  • The hospital as a therapeutic institution.
  • The Ailment and other Psycho-Analytical Essays, ed. Jennifer Johns, London: Free Association Books, 1989. ISBN 1-85343-105-2. The noted essay, The Ailment, is a report of Main’s detailed study of the feelings aroused in a team of nurses caring for a group of psychiatric patients with low potential for recovery. He found that a sedative would be used in the management of a patient “only at the moment when the nurse had reached the limit of her human resources and was no longer able to stand the patient’s problems without anxiety, impatience, guilt, anger or despair”.
  • Mothers with children on a psychiatric unit.
  • A fragment on mothering.
  • Meanings of madness: psychiatry comes of age.

Reference

Main, T.F. (1957) The Ailment. British Journal of Medical Psychology. 30(3), pp.129-145. https://bpspsychub.onlinelibrary.wiley.com/doi/10.1111/j.2044-8341.1957.tb01193.x.

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On This Day … 07 February [2023]

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People (Births)

People (Deaths)

  • 2015 – Marshall Rosenberg, American psychologist and author (b. 1934)

Alfred Adler

Alfred Adler (07 February 1870 to 28 May 1937) was an Austrian medical doctor, psychotherapist, and founder of the school of individual psychology. His emphasis on the importance of feelings of belonging, family constellation and birth order set him apart from Freud and other members of the Vienna Circle. He proposed that contributing to others (Social Interest or Gemeinschaftsgefuhl) was how the individual feels a sense of worth and belonging in the family and society. His earlier work focused on inferiority, the inferiority complex, an isolating element which plays a key role in personality development. Alfred Adler considered a human being as an individual whole, and therefore he called his psychology “Individual Psychology” (Orgler 1976).

Adler was the first to emphasize the importance of the social element in the re-adjustment process of the individual and to carry psychiatry into the community. A Review of General Psychology survey, published in 2002, ranked Adler as the 67th most eminent psychologist of the 20th century.

Marshall Rosenberg

Marshall Bertram Rosenberg (06 October 1934 to 07 February 2015) was an American psychologist, mediator, author and teacher. Starting in the early 1960s, he developed nonviolent communication, a process for supporting partnership and resolving conflict within people, in relationships, and in society. He worked worldwide as a peacemaker and in 1984, founded the Centre for Nonviolent Communication, an international non-profit organisation for which he served as Director of Educational Services.

According to his biographer, Marjorie C. Witty, “He has a fierce face – even when he smiles and laughs. The overall impression I received was of intellectual and emotional intensity. He possesses a charismatic presence.”

A Brief Overview of Hollymoor Hospital

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Introduction

Hollymoor Hospital was a psychiatric hospital located at Tessall Lane, Northfield in Birmingham, England, and is famous primarily for the work on group psychotherapy that took place there in the years of the Second World War. It closed in 1994.

Refer to Group Analysis.

History

Construction and Expansion

The hospital, which was designed by William Martin and Frederick Martin using a Compact Arrow layout, was built as an annexe to Rubery Lunatic Asylum by Birmingham Corporation and opened 06 May 1905. During the First World War, Hollymoor was commandeered and became known as the 2nd Birmingham War Hospital.

The Northfield Experiments

During the Second World War, the hospital was again converted to a military hospital in 1940. In April 1942 it became a military psychiatric hospital and became known as Northfield Military Hospital. In 1942, while Northfield was serving as a military hospital, psychoanalysts Wilfred Bion and John Rickman set up the first Northfield experiment. Bion and Rickman were in charge of the training and rehabilitation wing of Northfield, and ran the unit along the principles of group dynamics. Their aim was to improve morale by creating a “good group spirit” (esprit de corps). Though he sounded like a traditional army officer Bion’s means were very unconventional. He was in charge of around one hundred men. He told them that they had to do an hour’s exercise every day and that each had to join a group: “handicrafts, Army courses, carpentry, map-reading, sand-tabling etc…. or form a fresh group if he wanted to do so”. While this may have looked like traditional occupational therapy, the real therapy was the struggle to manage the interpersonal strain of organising things together, rather than simply weaving baskets. Those unable to join a group would have to go to the rest-room, where a nursing orderly would supervise a quiet regime of “reading, writing or games such as draughts… any men who felt unfit for any activity whatever could lie down”. The focus of every day was a meeting of all the men, referred to as a parade.

“.. a parade would be held every day at 12.10 p.m. for making announcements and conducting other business of the training wing. Unknown to the patients, it was intended that this meeting, strictly limited to 30 minutes, should provide an occasion for the men to step outside their framework and look upon its working with the detachment of spectators. In short it was intended to be the first step towards the elaboration of therapeutic seminars. For the first few days little happened; but it was evident that amongst patients a great deal of discussion and thinking was taking place”

The experiment had to close after six weeks as the military authorities did not approve of it and ordered the transfer of Bion and Rickman (who were members of the Royal Army Medical Corps). The second Northfield experiment, which was based on the ideas of Bion and Rickman and used group psychotherapy, was started the following year by Siegmund Foulkes, who was more successful at gaining the support of the military authorities. One of the military psychiatrists involved in the project was Lieutenant Colonel T.F. Main, who coined the term therapeutic community, and saw the potential of the experiments in the development of future therapeutic communities.

Northfield Military Hospital was the setting for Sheila Llewellyn’s novel Walking Wounded, published in 2018.

Decline and Closure

Poet Vernon Scannell was a patient at the hospital in 1947. By 1949 Hollymoor Hospital was recognisably distinct from Rubery Hill Hospital. It held 590 patients, falling slowly to 490 by 1984, and then dropping rapidly to 139 by 1994. After the introduction of Care in the Community in the early 1980s, the hospital went into a period of decline and closed in July 1994. It was subsequently largely demolished.

This page is based on the copyrighted Wikipedia article < https://en.wikipedia.org/wiki/Hollymoor_Hospital >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.