Facebook’s impact on the world is undeniable. The ability to connect with someone on the other side of the planet with the click of a button is remarkable. Be careful though, because studies examining facebook show an inverse correlation between the amount of time you spend on facebook and psychological well-being. In essence, the more time you spend on facebook, the worse you feel about your life.

Now with that said, many people use facebook to stay connected with family, maintain friendships (by not directly talking to friends…that’s for another post), network, and find others with similar interests. These reasons can all be healthy and actually improve life satisfaction. When facebook is used to stay connected with others, it can be very rewarding and beneficial.

So what's the problem? People by nature compare themselves to others. There are a number of theories (e.g., Festinger’s social comparison theory) that suggest people get their self-worth and value based on comparing themselves to others. Again, that’s not unhealthy. It can actually be very beneficial to compare yourself to others. The problem arises when the comparisons are not based on completely accurate information.

Facebook allows for a filtered, biased representation of the individual. Profiles are full of pictures of home-made meals, exotic trips, and daily highlights (kudos to those who share daily lowlights). With enough facebook surfing, these snapshots can seem like the norm. You start comparing your "average" life to friends who just returned from a vacation, make meals from scratch, or always seem to be having success. That becomes your belief of what others around you are accomplishing. You start to question your value and negative thoughts creep in.

It’s important to keep an accurate perspective. For every picture of culinary masterpieces, there could be countless pictures of leftovers. For every picture of breathtaking views of the beach, there could be hundreds of pictures of a somber office cubicle. People tend to share the good and not the bad, especially on social media.

Facebook profiles are like reality TV. They're edited to show the eye-catching highlights as the mundane routine couldn't get the ratings. Keep that in mind.

In the 1900s it was don't judge a book by its cover. For the 2000s, maybe it should be don't judge a person or yourself by a facebook profile. Neither a book cover nor facebook tell the whole story.

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According to Seligman, Steen & Peterman (2005), the secret to happiness isn’t money, adventure, or love; it’s expression of gratitude. If you want to read the study or view a creative summary and twist to the study, check out this Upworthy.com video by clicking here.

If you don’t want to read or watch, I’ll do a quick summary. Basically, it was found that people are happier when they express gratitude, and even happier if they are able to express gratitude directly to the person. The largest increases in happiness were found in those who initially reported the lowest levels of happiness.

This makes sense, right? Expressing gratitude means that you are polite, thoughtful, and respectful. Anyone would think these are characteristics of a well-adjusted, happy person. The catch is that there were people who initially expressed low levels of happiness, but their happiness increased significantly after expressing gratitude verbally and directly to another. Why?

Well, I think the answer lies in the process of expressing gratitude. One of my mentors always said, “It’s the process, not the content,” during our supervision sessions. It took me a while to understand what he meant, and I think it applies here (Thanks, Jeff). I’ll write about “the process” more in the coming weeks.

The process of expressing gratitude is powerful and intimate, more so than most people realize. It’s one thing to say “thanks”, it’s another thing to expound on that “thanks” and express how someone has really helped you as a person. Expressing gratitude opens your emotional world to another. That can make anyone feel vulnerable.

Why would someone feel vulnerable?

Two reasons why someone might feel vulnerable are: 1) the possibility of being hurt/exploited/criticized and 2) the possibility of actually emotionally connecting with another person in a healthy way. The latter is what happens with gratitude. When you express gratitude, you are saying, “I really appreciate you and the positive impact you have had on my life.” It may feel uncomfortable, but it feels good to make another person feel good, at least according to this study.

Why does any of this matter?

Well it matters quite a bit, certainly in therapy. My standard approach to working with a depressed individual is maintaining and increasing positive experiences (click here to read more about my approach). However, “positive experiences” are usually defined by actions that bring you joy: a hobby, lunch with a friend, something that makes you feel good. This study adds the twist of making someone else feel good by expressing gratitude. It will certainly add to my approach and hopefully yours.

If you are having a down day (or even a great day), express gratitude to someone. Test the idea out. See what it's like to send an email versus a phone call. If you're really brave, share your gratitude in person. You might be pleasantly surprised by how good it feels.

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One billion dollars is spent every year on dieting. Billion. Think of what you could do with that type of money. Ok, I just lied. It’s not one billion, it’s 60 billion. Sixty billion dollars on dieting, books, dieting drugs, and surgeries.

Weight gain is a numbers game. If you consume more calories than you burn, you will gain weight. Weight gain is your body saying, “I have no idea what to do with these extra calories so I’m going to store it in this love handle.” Remember that previous post about your body constantly talking to you (read it here if you missed it)? The same concept applies to eating.

Diets give you a framework for how to lose and maintain weight. In the end, it doesn’t matter what diet fad you adhere to, what matters is you. What are you doing fundamentally to change the way you view your relationship with food? Why are the diets not working?

Be realistic. Have realistic goals. Don't set yourself up for failure. Instead of cutting out all unhealthy foods, start by removing one food from your diet. If you eat out for lunch 5 times a week, set a goal to eat out 4 times a week.

Slow down. Take your time when eating. The faster you eat, the more you eat. Your body hardly has time to send you the “I’m satisfied” signal before another bite. Remember when you were young and everyone said chew your food 20 times? Well, chew your food 20 times.

Be mindful. Don’t just eat. Notice the flavor, texture, and other features of what you are eating. Being mindful changes your eating experience and helps you determine when you are satisfied before you are stuffed.

Recognize if you are actually hungry. Many people eat because they are bored, stressed, upset, it’s the typical eating time, or the opportunity simply presents itself. Ask yourself, “Am I hungry or am I just eating to eat?”

It’s okay to make a mistake. No one is perfect. If you gain weight or “cheat” on your diet, it’s okay. Reflect on what happened and learn from it.

Drink water. Your body is 60% water. It needs water. Water flushes toxins, transports nutrients, and can speed up metabolism. Most professionals recommend 12 glasses of water for men and 9 for women (8oz glass).

Water is also an appetite suppressant. For babies, the more food they eat, the less milk they drink. The more milk a baby drinks, the less food they eat. So, the more water you drink (which you need anyway), the less food (and calories) you will consume.

Avoid temptations. Alcoholics are taught to stay away from places where alcohol is readily available. Stay away from snacks and foods that are your weakness. Don’t peruse the snack aisle at the grocery store, and keep certain foods out of your home.

Adhere to your guidelines and be patient. Give your dietary change a chance. Your body needs time to adjust. If you don’t see instant results, stay positive.

Support. Changing your food lifestyle is hard. If you need support, get it. Whether that means a support group, dieting partner, therapy, or whatever is helpful for you.

The statistics are there: 95% of folks regain the lost weight within 5 years. Over 100 million Americans are dieting. Diets are short-term and superficial. Instead, change how you think about food and eating at the core (no pun intended), and you can change your life.

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Bad things happen in life, they just do. If they keep happening, it might be worthwhile to ask yourself, “Why does this keep happening to me?” “What is my role?” It’s one thing to be dealt a bad hand or have bad luck, it’s another to actively play a part in your own demise.

Self-destructive behavior can be a conscious effort, but in many instances it’s driven by unconscious forces. Why would someone actively sabotage their life? Why would someone seek out unhealthy relationships? Why are you chronically late to work or short-tempered? There are actually quite a few explanations for self-sabotage.

Self-destructive behavior is seen as normal. For some people, self-destructive behavior has been happening for so long it feels normal. A common theme in therapy is assisting an individual in realizing how their way of living might be maladaptive. It’s not easy to change unhealthy behavioral or cognitive patterns, especially if there is some degree of benefit. Part of the therapeutic process is gaining awareness of the beneficial and/or harmful aspects of behavior. 

Self-destructive behavior is beneficial. This might be a head scratcher, but sometimes there is a benefit to self-destructive behavior. Whether it is to elicit compassion, pity, or sympathy, self-destructive behavior can serve as a way to gain attention from others or a connection to someone. For some, any attention (even negative) is better than no attention, and there are plenty of people who are drawn to the emotionally wounded.

The fear of change. Change is uncomfortable and scary. Even if your behavior is self-destructive and unhealthy, if it has been your standard behavior, it’s comfortable and predictable. Comfort and predictability are highly valued, and in many cases, well-being and quality of life are compromised for comfort and control. Many people in unhealthy relationships are caught in a common conundrum: stay in a harmful, yet predictable, relationship or leave and be left with the unknown.

The fear of success. Self-destructive behaviors are typically associated with maladaptive, unhealthy experiences. After enough time, individuals can embrace a self-view of being inadequate and worthless. When failure is perceived as inevitable, even the idea of being successful is anxiety provoking. Shifting from a negativistic to an optimistic mindset is a challenge. Part of that challenge is letting go of a current identity and opening yourself to a new way of living. It can be an intimidating proposition but it's certainly doable.

Self-destructive behavior is common. If you find yourself wondering why the same bad thing continues to happen to you, partake in self-reflection and see if you can recognize patterns in your behaviors, relationships, and experiences.

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In a previous post titled "Letting Go",  I briefly commented on grudges within the process of moving on from relationships. You can read that post here. In this post, I want to say more about the idea of a grudge and how it may speak more about your coping and communication style than anything someone has done or said to you.

What is a grudge? A grudge is the resentment of another for a past harm. Psychologically, a grudge is what remains when an emotional injury hasn't healed properly or completely; essentially, an emotional wound or scar.

A few weeks ago, I wrote about how your body sends your mind signals when you are feeling specific emotions (to review that article, click here.). A grudge is your mind sending the following signal to your consciousness:

I continue to have thoughts about that person because of what happened, and because I still have unresolved feelings about the person and experience.

If you find yourself preoccupied with resentful feelings toward another person, you are holding a grudge. You have three options: continue to hold the grudge, address your feelings with the appropriate person, or decide to actively move on with your life. You could also do some sort of combination of the three.

Option #1: Hold on to the grudge. The benefit of this is you get to focus all your anger and resentment at this person inside of your head. The downside is chronic angry and resentful feelings puts your mental and physical health at risk. The other downside is you learn (or continue) to suppress your feelings, which will feed the cycle of being hurt and not advocating for yourself.

Option #2: Address your feelings. The purpose of sharing your feelings with the appropriate person (the perpertrator) is not to get that apology or for the person to grovel for forgiveness (though that would be nice), the purpose is to find your voice, to advocate for yourself. This value is sometimes lost in the process. Advocating for yourself is taking ownership of your life, it's saying that I can't control what other people do but I have power over my actions and how the actions of others affect me.

Option #3: Move on with your life. Many choose this option, but be careful. At face value, moving on and even learning from your experience sounds like a healthy, well-adjusted way to live. This option may very well work, but be aware that for some, continuing to be the "bigger person" may result in emotional and relationship issues later in life.

Why do some experiences result in grudges while others are resolved and released? That's a great question to reflect on. Is it simply because you have fully expressed your feelings and have complete understanding of the situation or are there other factors?

Many hold grudges because of the fear of what may happen if their true feelings of anger, sadness, and resentment are expressed. Expressing your feelings in a healthy way usually won't result in the catastrophic damage you imagine. It will result in a personal sense of accomplishment and mastery of one's environment.

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If you are interested in being notified of future blog posts, you can “like” The Family Center of Knoxville facebook group by clicking here. Thanks for your support!

You might be confused by the title, especially if you are familiar with the terms “narcissist” or “narcissistic personality disorder”. These terms tend to carry a negative connotation and most imagine a narcissistic individual as self-centered, conceited, and even delusional in their own self-worth. Other characteristics of a narcissist can include lack of empathy, relational exploitation, and entitlement. With all this said, narcissism can be a good thing…as long as it is in moderation.

What is narcissism in moderation? Basically, taking the good narcissistic tendencies and rejecting the bad. Many psychologists refer to two types of narcissism: healthy and unhealthy. The fundamental difference between these two types is the person's sense of self. Unhealthy narcissists lack a stable, healthy self-esteem. To compensate for feelings of inadequacy, the unhealthy narcissist exaggerates self-worth and importance.

The healthy narcissist has a stable and sound self-esteem, so there is little need for grandiosity and power-grabbing. The healthy narcissist is still confident and ambitious, but these feelings are grounded in a realistic view of personal strengths and talents.

How do you cultivate healthy narcissism?

It comes back to moderation and hopefully it starts from an early age. You certainly want your children to be confident, ambitious, and successful. At the same time, kids should be kind, considerate, and thoughtful. Instead of teaching kids to “win at all costs”, the focus should be on giving a great effort. This doesn’t mean kids shouldn’t want to win, it means their self-esteem should include both the outcome and their effort. The same goes for academics. If your child tries their best, be happy with the effort regardless of the outcome.

As for adolescence into adulthood and beyond, reflect on your successes. Did you reach milestones on your own merit or through exploitation and deceit? Did you consider the feelings of others or only focus on what was important to you? There is no easy answer, but most people have a sense of whether their successes are their own, someone else's or a combination.  

What are everyday signs of unhealthy narcissism?

Unfortunately there are unhealthy narcissists everywhere. Here are a few signs that someone might be a narcissist:

Showing compassion for a friend, but taking pleasure at their failures/difficulties.

Someone who can't see their faults or take any responsibility for a mistake.

The inability to apologize; it's always the other person's fault.

Someone who only talks about themselves or takes your successes and makes them their own.

Taking someone's concern as criticism, and responding defensively and critically.

The inability to empathize; lacking the ability to see the world from a perspective different from their own.

These are just a few of the many types of interactions with unhealthy narcissists. For me, when I find myself wanting to roll my eyes during a conversation, that's a signal that someone might be a narcissist, the unhealthy type.

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If you are interested in being notified of future blog posts, you can “like” The Family Center of Knoxville facebook group by clicking here. Thanks for your support!

Suicide is a mostly avoided topic, but there is a good chance you will be impacted by a suicide in your lifetime. More than likely, you will personally know someone or know of someone who has taken their life. Here are some sobering statistics (courtesy of the National Center of Health Statistics, 2010):

Suicide represents 1.6% of all deaths in America.

Suicide is the 2nd leading cause of death among teens.

Suicide ranks 10th in causes of death in America. Homicide is 16th.

Men are 4 times more likely to carry out a successful attempt than women.

Women attempt suicide 3 times as much as men.

There are approximately 1 million suicide attempts/year.

So what do you do if feeling suicidal? It’s important to know that as lonely and hopeless as you feel, many people from all walks of life have suicidal thoughts. Feeling suicidal is scary, but it’s not uncommon. Suicidal thoughts are the result of being overwhelmed with feelings of sadness and pain. You feel like you can’t cope and there is no other option. What’s important to know is with time and healthy choices, suicidal feelings can pass and you can regain control of your life. Here are some things that help if feeling suicidal:

Talk to someone.  Don’t keep suicidal feelings to yourself. Talk to someone. Feeling understood will decrease the loneliness and hopelessness.

Avoid drugs and alcohol.  Some feel that drugs and alcohol numb the pain; however, drugs and alcohol can actually exacerbate suicidal thoughts and feelings.

Make your home safe. If you have thoughts or a specific plan of how to hurt yourself, remove household items, weapons, and/or medications from your home. If you can’t, then go to a safe place or have someone remove the items for you.

Exercise and get outside.  Try to exercise for 30 minutes. Go for a walk outside. Even 10 minutes of activity can result in an improvement in mood.

Keep yourself busy.  Staying busy keeps you from thinking about suicide and keeps you productive. It also gives you time to gain perspective on your situation.

Focus on what keeps you from attempting suicide.  You are alive and that is for a reason. Focus on what keeps you alive (faith, family, friend, hobby, anything that helps).

You may be thinking that everyone will be better off, or even happier, if you aren't around. That is never the case. A suicide leaves a path of pain and sadness behind for those left to deal with the aftermath.

If you are feeling suicidal, there is always someone to talk to. In the U.S., you can call:

The National Suicide Prevention Lifeline at 1-800-273-TALK (8255)

The National Hopeline Network at 1-800-SUICIDE (1-800-784-2433)

Outside the U.S., you can search for a resource in your country by visiting the website below:

http://www.befrienders.org/directory

If you know of someone who is suicidal, you can call 911 or take the person to the nearest emergency room.


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! 

A major part of therapy is increasing your awareness, not just of your surroundings and other people, but also of yourself. Self-awareness is a process centered on gaining insight into how your thoughts and feelings impact you, others, and relationships. In this post I want to take a tangible turn and focus on listening to your body, literally.

The idea of becoming more aware of your physical experience and signals is grounded in the mindfulness process. I’ll write more about that at a later time but if you are interested, just do a quick search of mindfulness.

It’s my belief that the majority of mental health issues come down to a combination of feeling depressed, anxious, or both and struggling with how to cope with these feelings. This is a gross simplification, but in the end most conditions have an anxious or depressed underpinning. I often ask patients how you know you are depressed, anxious, or both. How do you know? Most describe an event (or many) that explains a change in their emotions and behaviors. This is an appropriate response, but it usually doesn't include a description of how their body is reacting during times of duress.

About those body signals. I start with fairly easy, straightforward questions. How do you know you are hungry or thirsty? How do you know you are hot? The answers are obvious: stomach growls, throat is dry, you sweat or feel warm. The same rationale applies to depression and anxiety or any emotion for that matter. Your body almost always tells you when you are happy, sad, angry, etc.

Even when feeling depressed your body sends you signals. Common symptoms include but are not limited to lack of energy, somatic complaints (aches and pains), decreased appetite, and tears from eyes (also known as crying). As for cognitive issues, symptoms include poor concentration, negativistic thinking, and memory problems.

For anxiety, common cognitive symptoms include but are not limited to excessive worrying, difficulty concentrating, and attention issues. Physical symptoms include sweating, tremors and shakes, chest pain, fatigue, and nausea.

Increase your body awareness when in an emotional state. Specifically, ask yourself what is physically happening when you are happy, sad, etc. Making connections between bodily cues and emotions will lead to an improved quality of life. For example, if you know you have trouble paying attention when anxious, by identifying the anxiety you can then intervene with relaxation techniques before the anxiety impacts your thinking. If you have unhealthy conversations when feeling hurt, recognizing your emotions will assist you in coping with your hurt feelings until you are in a psychological state where you can have a healthy conversation.

A good exercise is to reflect on the lowest and highest moments of your day (or any memorable experience), how you felt, and what if anything was happening with your body. As you do this more often, you will become efficient in identifying the body-emotion connections. Soon you’ll be able to recognize how you feel during that emotional experience instead of afterwards. I’ll write much more about how to become more mindful of your body and experience in the coming weeks.

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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!

Glass half-full or half-empty?  Based on your response, your worldview could tend to be more optimistic or pessimistic.  We are all familiar with the expression.  So I chose to mention it for a couple of reasons: 1) it's familiar 2) I'd like to use a similar analogy to explain depression.

There are a number of theories that explain depression from a genetic cause to environmental factors to an imbalance in specific neurotransmitters.  There are a number of ways to conceptualize and work with depression.  I will describe one approach here, the glass of water approach.  I was first introduced to this approach by my supervisor during internship, a very skilled therapist.  Before I go further, I have to emphasize that depression is complex, not every depressed person fits into what I describe below.  Each person is unique.

Think of yourself as a glass of water, neither half-full nor half-empty.  Now let's take a moment and focus on the actual water in the glass.  The water is the accumulation of single drops of water.  Think of each drop of water as a life experience.  It doesn't have to be a major experience, it could be any experience.  Anything from your first day of school to what you had for lunch. Both positive and negative experiences, they all accumulate in the glass.  As you have more experiences, the water level rises, drop by drop. 

For someone struggling with depression, the water in their glass has more drops of negative experiences than positive ones, or the impact of the negative experiences is greater than the impact of the positive.  Sometimes that is actually the case and sometimes that is the perception.  Part of therapy is determining whether the individual's perception is accurate or distorted.  Let's assume accuracy, the depressed individual has more negative experiences than positive.  So what can be done?

My approach is not to sugarcoat what has happened. Bad things happen in life, there is no getting around that. It's a part of life.  For depressed individuals, It is often suggested to focus on the positive or to look at how the negative might be a positive.  Sometimes this approach is effective, many times it is not.  The glass of water approach acknowledges the negative experiences and focuses on how "drops" of positive experience can be added to the water in glass.  The belief is that your experiences are real, they have shaped who you are. The negative experiences were painful.  Let's focus on figuring out how positive experiences can be added to your glass.  

A new positive experience does not replace a negative experience, but it may neutralize the impact of the negative experience.  The more drops of positive experience into the glass of water, the less likely that the negative experience will have a profound, lasting impact. 

For example, if you have a bad morning followed by a bad afternoon, you'll probably be in a bad mood that night. However, if you have a bad morning followed by a pleasant afternoon, you will probably be in a better mood than the previous example.

What is a positive experience?  Simply, an experience that brings you happiness or joy.  A potential hurdle, especially with depressed individuals, is they can truly feel there is no positive or pleasurable aspect of life.  It's a huge challenge to even think about something positive.  
A positive experience may be a non-negative experience. In that case, simply providing support and care may be the main focus of therapy, with occasional analysis of the depressive episode.  One strategy is to explore what brought you pleasure before the depression arose (e.g., spending time with family and friends, alone time, exercising, music, reading, being outside, etc.). Talking about these experiences can ease the depression and bring about hope and some level of optimism.    

So if you are struggling with depression, ask yourself what brings you joy, what eases the pain.  If you are able to come up with a list or ideas, follow through with them.  

This has been a simple description to a complex issue.  For the sake of brevity, I kept this short.  I hope no one was offended or thought that overcoming depression is always easy.  That certainly was not my intent.


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!