Friday, March 24, 2017

The Theory of Despair

The Theory of Despair

This Washington Post article does a good job of explaining why my psychology practice has an emphasis of working with older men and women who experience disappointment, anxiety and fear.

Monday, March 20, 2017

Worrying - How to Manage It

Worried? You’re Not Alone
By

New York Times
MAY 9, 2016 2:30 PM May 9, 2016 2:30 pm 45
I’m a worrier. Deadlines, my children, all the time they spend online — you name it, it’s on my list of worries. I even worry when I’m not worried. What am I forgetting to worry about?
Turns out I’m not alone. Two out of five Americans say they worry every day, according to a new white paper released by Liberty Mutual Insurance. Among the findings in the “Worry Less Report”: Millennials worry about money. Single people worry about housing (and money). Women generally worry more than men do and often about interpersonal relationships. The good news: Everyone worries less as they get older.
“People have a love-hate relationship with worry,” said Michelle Newman, a professor of psychology and psychiatry at Pennsylvania State University, who was not involved in the writing of the report. “They think at some level that it helps them.”
The belief that worrying somehow helps to prevent bad things from happening is more common than you might think. Researchers say the notion is reinforced by the fact that we tend to worry about rare events, like plane crashes, and are reassured when they don’t happen, but we worry less about common events, like car accidents.
But that doesn’t mean all worrying is futile. “Some worry is actually good for you,” said Simon A. Rego, the author of the new report and a cognitive behavioral psychologist who specializes in anxiety disorders and analyzed decades of research on worrying for the paper. “It’s what we call productive or instructive worry, that can help us take steps to solve a problem.”
One study published in 2002 recruited 57 young adults and asked them to list their worries in a diary for seven days and rate each worrying episode.
When the researchers analyzed the results, they determined that about 20 percent of the worries were about anticipating a negative outcome in the future. But nearly half of all the documented worries reflected a process of problem solving. While that can be constructive, people who worried a lot and couldn’t control their worrying were less likely to find a solution to their problem. The researchers, Marianna Szabo, now at the University of Sydney, and Peter F. Lovibond of the University of New South Wales in Australia, concluded that failing to come up with solutions may actually lead to more pathological worrying.
In 2007, the same researchers tried to correlate aspects of worrying with specific components of problem solving, like defining the problem, gathering information, generating solutions, evaluating and choosing a solution. Once again, they concluded about half the cognitive content of the worry episodes included attempts to solve a problem. Once people devise a solution, they quit worrying one-third of the time. But people found it hard to stop worrying if they weren’t satisfied with the solution they came up with.
People “get caught up in the worry itself,” Dr. Newman said. “It becomes so habitual, I call it ‘a process looking for content.’”
That kind of worrying can get out of hand. “Excessive worriers have multiple domains that they worry about, and if something triggers a worry in one domain, it can seep into other areas,” Dr. Rego said, “and things can move back and forth like wildfires — once one gets going, it can start other fires as well.”
Worrying, a cognitive process, should not be confused with anxiety, which generally refers to an emotional state of unease that also includes worry. While 38 percent of people worry every day, most of them do not have anxiety. Generalized anxiety disorder, the primary feature of which is excessive and uncontrollable worrying, affects only 2 to 5 percent of the population.
Liberty Mutual Insurance officials commissioned the report to better understand how Americans can “break the worry cycle,” since the insurance business is designed “around helping people live with less worry,” said Margaret Dillon, the company’s executive vice president and chief customer officer for the United States, adding that it could also help them develop the most appropriate products. The report noted, for example, that top worries for people ages 25 to 44 are about finances and housing, she said.
If you’re worried about your worrying, the report suggests some coping strategies, including:
Divide and conquer Try to come up with a solution to a worrisome problem by breaking it down into four parts: defining the problem, clarifying your goals, generating solutions and experimenting with solutions. Grab a pen and paper and brainstorm, the report suggests.Studies have shown this approach can help ease depression and anxiety.
Practice mindfulness Choose a routine activity or part of the day and try to experience it fully. Set aside concerns, and try to be “in the moment.”
Schedule a worry session Pick a designated time of day to mull your problems. If a worrying thought enters your mind outside of your scheduled worry session, jot it down so you can think about it during your scheduled worry time. Then get back to your day.
Practice accepting uncertainty Notice your thoughts and label them (as in, “there is the thought that I can’t manage”). Let go of tension in your body; soften your forehead, drop your shoulders and relax your grip.


Sunday, March 5, 2017

Retirement - Replacing `The Job' With Meaningful `Work.'

Photo
Dorothy W. Cantor, a psychotherapist from Westfield, N.J., says that the experiences of people in her family who had problems related to their own retirements taught her a great deal.


Link: The New York Times: March 4, 2017
Dorothy W. Cantor, a psychotherapist from Westfield, N.J., has an unusual practice. In addition to treating routine emotional problems, she helps her patients work through the special psychological difficulties that sometimes develop when they retire.
At age 79, Dr. Cantor, a member of Rutgers University’s Board of Governors and a former president of the American Psychological Association, is far from retirement herself. She is the author of six books in psychology.
“What Do You Want to Do When You Grow Up?: Starting the Next Chapter of Your Life,” a handbook for people considering retirement, was written with Andrea Thompson and published by Little Brown in 2001.
We spoke for nearly two hours recently. An edited and condensed version of the conversation follows.
How did you develop this specialized practice?ntinue reading the main story
Well, I got older. And as I got older, my patients got older, too. With time, I began seeing more and more people thinking about their retirement and all the many emotional issues surrounding it.
Earlier in my life, I had seen people in my own family go through problems related to their own retirements. Their experiences taught me a great deal. I was able to use what I’d learned from them and bring it to my patients.
What exactly did you witness with your family members?
A lot of dislocation rooted in their not having planned ahead for the day when their careers or their jobs would come to an end.
My husband’s father, for instance, owned a department store in Jersey City. When he retired at age 55, he declared: “I’ve always worked six days a week. Now, I’m going to play golf every day.” And off he went. Six months later, this poor man was depressed because looking forward to playing golf is one thing, but playing it all the time is another. At that point, my husband, a stockbroker himself, suggested that his father get a broker’s license. My father-in-law had always played the market and was good at it. He spent the rest of his life as a stockbroker on his own terms. That gave him purpose.
As for my mother, she’d been a schoolteacher. The year she retired, she said to me, “Don’t tell me what to do, Dorothy.” And I didn’t. But every time we talked, she was running to a different doctor about some new ailment. Eventually, she said, “Dorothy, I must do something with myself.” My mother lived in Greenwich Village and she signed up for a couple of courses at the New School. And that was all it took! The doctors’ visits stopped. Once she had something interesting and structured to do, she stopped focusing on her body. From then until she was 87, she took a course every semester.
What sort of issues do your patients present with?
Often they come when they are approaching retirement age or when they must leave jobs because they’ve been downsized, kicked out, handed a package, whatever. They come to me with their fears. “What am I going to do with myself now?” If they’ve retired without a game plan, they might be depressed. Others are just bored. Another word for boredom is depression.
So my No. 1 question to them is this: “What did work give you, besides money?” People, I find, do things habitually, and they often aren’t aware of what nonmonetary benefits they get from their job or their profession. What I help them do is identify how it had anchored them. Once they’ve done that, they are positioned to make a change.
So what do your patients tell you about what work gave them?
They say, “Work gives me someplace where I can go every day.” Sometimes, they say: “I have friends and colleagues at work. It provides me with a connection.” Often they’ll say, “Working makes me feel like I’ve accomplished something.”
When we’ve identified what their job did for them, we find a creative way to replace the missing piece. That might mean working part time. Or volunteering for a charity. Or, as with my father-in-law, retraining for something new.
In most cases, they’re probably not going to be able to go back to what they did before. But there are ways they can use their skills and experience productively.
Like what?
I have a friend, not a patient, who was an executive at a major corporation. He’s begun volunteering a couple of days a week advising new entrepreneurs on getting their businesses started. He enjoys using his contacts and expertise that way. The rest of the time he plays golf and tennis.
I have a client who was a high-level administrator, and she was forced out of her job in her early 60s. She doesn’t want to retire yet. So she’s been contacting consulting firms to see if she can get jobs on a per diem basis. If that doesn’t work out, she’s thinking of volunteering her administrative skills to her diocese.
Retirement can be the time when you’re finally free enough to try something you always wanted to do. I know a retired psychologist who writes and publishes novels. He told me, “I don’t know if anyone reads my novels, but it gives me enormous pleasure to write them.”
Is this why you called your book, “What Do You Want to Be When You Grow Up?”
Yes. Many people spend their lives in professions that others have chosen for them. Retirement, if you have an adequate income, can be a chance to do things your way. One question I frequently ask is, “When you were a child, what did you dream of doing?”
I recently had a patient who dreaded her coming retirement. I asked her, “What did you want to be when you started out?” She answered, “An artist, but my parents thought it was silly.” Then, she said: “You know, I could start taking art classes. I could take up where I left off.”
We all had dreams when we were younger.
Do people think of retirement as a kind of huge extended vacation?
Yes. They think of it as the prize for having worked hard for many years. But vacations are generally a relaxing restorative break from work. When it’s all you have to do, it can become empty, tedious, purposeless and boring.
That’s why it’s so important to plan for how you’re going to replace your work. As a society, we’ve done a wonderful job teaching older people how to save and invest for retirement. There are financial planners everywhere. Yet, we don’t teach people how to plan for their emotional well-being. A person nearing retirement should be asking, “How do I want to spend my time?” They shouldn’t just let retirement happen to them.
One of the things I try to do is encourage people to use trial and error to find out. It’s what little kids do. They’ll play games, fall down, and they don’t care. As we get older, we get fearful of new things. My patients frequently ask me, “How do I know I’ll be good at doing something different?”
Well, by planning ahead, you can try on different things for size till you hit what’s right for you. Do you like children? Volunteer at a neighborhood school one day a week and see if that fulfills you. Have you been thinking of going for a late-life law degree? Why not take a class?
Aren’t there many people who find retirement a relief?
Sure. There’s a segment of the population that looks forward to retirement. This is particularly true of people who’ve done physically strenuous work. If you’re a laborer or a builder, if you’ve done heavy lifting or repetitious work, you may well want to stop.
It’s also a matter of temperament and situation. I meet professionals who’ve never loved their work and who are thrilled to be done with it. For them, retirement — if they have enough money — can sometimes be a reset button, a second chance.
What about you? You still work. Have you ever considered retirement?
Happily, I can do this for a long time. I intend to work until the patients stop calling.