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Why do people cheat?

7/30/2013

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Unfortunately it happens all the time: infidelity in relationships. No one enters a relationship with the intention to be unfaithful. So why do people cheat?

There is plenty of evidence that we are hardwired to stray, that the human species like most others is not naturally monogamous. With that said, let’s shelf the biology and focus on the psychology. In working with couples who have experienced infidelity, there usually is a process of deterioration in the relationship that culminates in cheating by one or both partners. Let’s take a closer look at that process:

Emotional dishonesty.  Emotional dishonesty is not being open with your partner about your feelings. If something is upsetting, then it is your responsibility (to yourself, partner, and relationship) to share your feelings. When you keep feelings to yourself, your partner will continue to be in the dark about how you feel, and an opportunity to be heard, validated, and comforted is lost.

Relational distance.  With enough emotional dishonesty, comes emotional distance. If you feel you can’t talk to your partner about your emotions, the distance between you and your partner will grow. The more you withhold your feelings, the more likely you are to feel confused, resentful, and alone.

This distance is exacerbated when the response to shared feelings is dismissive, critical, or lacking empathy. In session, couples regularly talk about how a major issue in their relationship is the mutual inability to accept how each other feel. The result is one or both individuals feel unheard, uncared for, and unloved.  

Sense of void.  Once the distance is large enough, it becomes a void. This usually occurs after months or years of relational dysfunction, and it’s one of the most challenging parts of couples therapy. Usually this void is accompanied by sadness, anger, and hopelessness. The individual shifts to self-preservation mode, fully believing that they are alone in the relationship.

Novel excitation.  Emotions are stirred by someone outside of the relationship. Happiness, excitement, and positive emotions are experienced that have been long absent in the current relationship. The "new" person highlights what is lacking in the current relationship. Usually those who are unfaithful describe the encounter as fulfilling what was perceived to be missing in life.

I’m guessing most have picked up on (maybe ad nauseam) of how emotions were mentioned in almost every sentence. That was for a reason. Emotions are the foundation of any relationship. I've never had a couple come into my office and say they are as happy as ever, but are having problems and need couples therapy.

Some may read this post and think I am condoning cheating. My aim here was to provide perspective on why someone might stray from a relationship. I will say that whenever a couple talks about infidelity, a part of therapy (with me, at least) is exploring the role each person played. The goal is for each person to better understand how each impacts the other.

Lastly, it’s important to check in with your partner regularly about your relationship. Don’t wait until it’s too late.  


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!

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Isaac Newton the psychologist? The physics of relationships: Part II

7/23/2013

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In last week’s Part I post, I presented a parallel between Newton’s first law of physics and interpersonal relationships: the idea that each social interaction has an impact on our emotional state, and how the emotional impact is a product of the person and the content/delivery of the message. If you missed last week’s post, you can read it HERE.  

In this week’s post, let’s focus on what happens after the emotional impact. That is, what you are thinking and feeling after an emotional experience. The emotional aftermath is usually lost on what happened to cause the aftermath. So think about what happens to you after your parent/boss expresses disappointment in your performance, or when your spouse/family member praises you, or when your favorite TV show is cancelled?

There is no right or wrong answer to any or all of these questions. They may seem rhetorical but it’s worth asking yourself, “How do I feel?” after a situation. It doesn’t have to be a traumatic or highly emotional experience, it can be any experience. Sometimes I encourage patients to emotionally “check-in” with themselves at random times during the day. Why do this?

Good question, well for a few reasons:

1)  You will actually learn about your emotional world. 
     What impacts you, how, and for how long.

2)  Recognizing and identifying your emotions will help in 
    understanding and empathizing with others’ emotions. 
    It’s difficult to empathize or even emotionally connect 
    with others if your own emotional world is unclear.

3)  Introspective questions (e.g., How do I feel?)                    increase self-awareness and help you gain personal          insight. This comes in very handy, especially in              relationships.

4)  Sometimes asking yourself a simple question like     
     “How do I feel?” or “What just happened?” can slow 
     things enough to calm yourself and keep your 
     composure in a stressful situation. Think of how 
     many times you've reacted in a situation and then 
     reflected and wished you had a moment to think 
     before doing or saying what you did.

Gaining insight and awareness into how experiences influence your emotions will allow you to better prepare for similar situations that arise in the future. For example, if you get defensive or flustered during stressful situations, you can practice relaxation techniques when you are entering a stressful period of your life. Increasing self-awareness will allow for you to manage your feelings in a healthy, pro-social manner. So if you are aware that you are feeling defensive or flustered, then you could utilize a strategy that helps you return to a more relaxed, calm state.

How an experience affects you is as important as the experience itself. Everyone is busy, but I encourage you to take time during the day and reflect on the high, low, and average experiences of your day. Tap in to your emotional world; you’ll be glad you did.

As usual, feel free to share via facebook, twitter, etc.

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Isaac Newton the psychologist? The physics of relationships: Part I

7/18/2013

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Isaac Newton’s first law states an object is at rest or moves at a constant velocity unless acted upon by a force. The images that come to mind are probably two objects that act toward or upon one another: a baseball and a bat, two cars colliding, swirling your drink with a straw. Here, I’ll lay out how several aspects of the law of motion also apply to interpersonal relationships. 

A relationship is fluid. It evolves, shifts, and changes based on the interactions of the individuals. Relationships can vacillate from strong and sound to weak and tenuous as a result of the actions of one or both individuals. Newton theorized outside factors can impact the relationship between two objects; the same applies to relationships between people.

Thinking about the bat hitting the ball, there are two factors regarding the impact (Force): specifically the size of the bat (mass) and the speed at which the bat is swung (acceleration). Hopefully the F = ma equation came to mind (thanks, Dad). Now applying that equation to a relationship, think of the F as the emotional impact, the m as the person, and the a as the content and delivery of a feeling. The Emotional Impact is the product of a Person and the Feeling Delivered by that person. Emotions are certainly much more complicated than these two variables, but for now let’s keep it simple. I’ll discuss other factors in future posts.

For an illustration of m (the person), think about how you would feel if a loved one praised you compared to someone you had just met. More than likely, the praise from the loved one will have a larger emotional impact. How strongly you feel something is linked to who is delivering the message. In many instances, two different people give the same advice, but you might listen to one and dismiss the other. Why is that? Reflect on that question. Parents are driven batty by teens who ignore a parental suggestion and then respond “Great idea!”, when a friend makes the same suggestion.

As for the delivery and content of the message, a, the analogy I always use is your birthday and receiving a present. If someone presents a nicely wrapped gift with a “happy birthday!”, your experience is going to be different than someone giving you the same gift wrapped in a plastic bag with a “here”. The difference is clear, but it’s not always clear in relationships. In therapy, especially couples and family therapy, a constant theme is how to gift wrap feelings, both negative and positive. Just because the feeling is anger, sadness, or frustration doesn't mean it has to be expressed in a hurtful way.

Newton’s first law of motion focuses on being acted upon; the second part is how the object is affected by the act. I’ll touch on the second part here, and say more in next week’s post.

In relationships, this second stage is largely ignored in everyday life and consequently is a significant part of therapy. How do you respond after an emotionally-charged experience? People are more focused on what happened than on what happened after. Part of a relationship is increasing your emotional awareness. 

A complexity arises as an experience in one relationship can impact (positively or negatively) how you perceive and engage in other relationships. This is very evident in couples and family therapy where you have multiple individuals acting upon one another. I’ll write more about this later, but for now think about the solar system and what would happen if one planet suddenly shifted.

This is what makes relationships fluid and why laws and principles can’t completely capture relationships like it can with the sciences and math. Maybe it was serendipity, but Newton was on to something in regards to interpersonal relationships. Ironically, some psychologists argue that Newton would have been diagnosed with Asperger’s disorder in present day.

As usual, feel free to share. Part II, next week!


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Medicating Children

7/9/2013

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The use of medication for children has been an ongoing debate for decades. Medication seems to be winning. Use among children and adolescents has increased by close to 1,000% in the last 25 years. Proponents say the technology and understanding of psychological disorders have improved so much so that we can better identify and treat disorders. Opponents say pharmaceutical companies have been effective in marketing their drugs via commercials, hospital and office visits, and "evidence-based" studies.  Here are a few stats (NIMH, SAMHSA, and DHHS):  

• One child in 5 (20%)has a mental, emotional, or   
  behavioral disorder severe enough to cause some level 
  of impairment. At least one child in ten (10%) has a 
  mental illness severe enough to cause extreme 
  functional impairment.
• In 2006, 4.7 million children (8%) were reported to have 
  a learning disability;10% of boys were identified as    
  having a learning disability, compared with 6% of girls.
• Four and a half million children 3–17 years of age (7%) 
  were reported to have Attention Deficit Hyperactivity   
  Disorder (ADHD). Boys are almost three times as likely   as girls to have ADHD (11% and 4%).
• Research indicates that depression is present in 1% of 
  children and 5% of adolescents at any given time.

These stats are alarming for most. Every parent I have worked with takes the idea of medicating their child very seriously. It's a decision that most struggle with and almost always make with a degree of skepticism, uncertainty, hope, and fear. 

However, there is cause for caution. The statistics by themselves are concerning: 10% of children have some sort of disorder. Kids are generally crazy, but in the "I love you but you probably decreased my life-span by approximately 1-20 years" way. Four major concerns:

1)  Psychotropic medications are developed for adults and happen to be effective at treating children with anxiety, depression, and other clinical issues. Drugs that have been developed to treat depression sometimes appear effective in the treatment of other disorders (bipolar, anxiety, OCD, etc.). Doesn't seem like an exact science. Very messy. 

2)  Our brains develop well into our late 20s. Science is gaining an understanding of the brain but there is still much to be learned. What is known is that our brains develop for the first 3 decades of life and one of the last areas to develop is the frontal lobe. The frontal lobe is involved in decision-making, critical thinking, and memory. Makes sense, right?  We look back at poor decisions we made during childhood and adolescence and shake our heads, "How could I be so stupid?" Well, maybe it was immaturity but maybe it was our brain still developing.  How does a psychotropic cocktail impact the developing brain? The science is still unclear.


3)  Side effects of many psychotropic drugs can be the exact symptom you want alleviated. Common side effects of antidepressant and anti-anxiety medications include nervousness, concentration difficulty, irritability, moodiness, and changes in appetite among a host of others. I like to refer to these side effects as "the teenage years". I would argue most of you can think back to your adolescence and diagnose yourself with a psychological disorder?   

4)  What happens when someone experiences serious side effects or even worse, adverse effects (worsening of symptoms or development of new issues)? Most professionals either try a different medication or add another medication. So initially it was one medication, now it's two, three, or even four or more. Many patients report trying numerous medications until one worked. Scary stuff. 

To be fair, empirical evidence suggests medication can be effective...in the short-term.  Long-term studies generally show a waning effect in drug efficacy. Furthermore, it is still unknown what effects, if any, these drugs have on us over the lifespan.  

So what then? Consult with a mental health professional. Get a better understanding of yourself and your psychological makeup. Develop strategies to manage life, implement them, and determine if it was useful. Rinse and repeat. If after some time (6-12 months) nothing is helping, then have a conversation with a mental health professional about alternative treatment which may or many not include medication. 

As usual, feel free to share.

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Q&A Series: Aggression in kids

7/3/2013

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I recently saw two young boys, one punched the other in the stomach and the other slapped the first across the face. Both of them are around the ages of 8-10. I know it may be "normal" for boys or even girls to behave aggressively with other children on occasion, what bothered me is both of their mothers ran to their own child’s defense and was convinced that only their child was wronged. No one focused on the act itself, they focused on defending and legitimizing what their child did.

What would be the best way to approach that kind of situation as a parent? Where you want to support your child but not legitimize what they did and hold them accountable even if it wasn't their fault. I want to feel prepared when we have kids at this age.

--Anonymous, May 2013

In that situation, I'd point out what each child did right and what each child did wrong. I would also emphasize that physical aggression should only be used in self-defense. Then I would go to the emotion, specifically empathy. Ask your child how the other child would feel to be slapped on the face. That may be too indirect, if so, then I would ask how it would feel to be punched or slapped in the face. When they express the emotion, take that moment to praise them for sharing that feeling. If they express an inappropriate feeling, instead of dismissing it, ask how they came to that feeling. It's also important to emphasize that bad behaviors or choices doesn't make your child a bad person.

In almost all physical alterations, there is a build up from calm to physical aggression. So you might initially have annoyance, then frustration, then anger, and finally physical aggression toward others. Learning how to express emotions can decrease frustration and even supplant physical aggression. Reviewing these steps with your child can also serve as an effective way of helping your child (and you) in becoming aware of their emotional state in a stressful situation.

In these situations, you have to be consistent. Here the children were obviously upset so I would talk about other ways to express anger other than hitting. Help your child find ways to express thoughts and feelings in a way that is heard and respected. Don't expect radical changes, as one talk isn't going to fix everything. However, the great (sometimes not so great) part of human nature is behavior repeats itself, so you’ll have plenty of opportunities to talk about the issue. Take each opportunity as a chance to educate and correct the behavior. 

One thing to watch for is make sure your child is in the correct mindset to have a conversation. If your child is yelling or throwing a tantrum, a talk won’t be effective. Also, make sure you are in the right mindset as well. Adults can throw tantrums too. Check to see if your child can summarize the conversation. This will assure that your child was listening and understood what you were saying.

The other issue is what your child is seeing at home. If the child has parents that blame one another or even worse, hit one another, then that is going to be your child’s frame of reference. Teach your children that it’s okay to make a mistake, to be imperfect. That if they make a mistake they aren't going to be harshly criticized. Parents have to model healthy behavior. This includes saying, “I’m sorry” and “Oops, I was wrong.” Kids tell me that they feel so relieved to know they have imperfect parents, like a weight has been lifted off their shoulders, that it’s okay to be imperfect.

It's normal to be thinking about these things, but honestly you can't really prepare for all that parenthood entails. No one is ever completely ready to be a parent. What's important is communicating with your partner about planned and unplanned situations. And trust me, you'll have many, many more unplanned situations than planned. That's when the gray hairs happen :)

If you found the post helpful, feel free to share!

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    Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN.

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