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Tag: depression

  • Six Signs of Resistance to Change
    and What To Do About Them

    manhattan_bridge_post_versionIt is hard seeing your client struggle through resistance to change. Facing a difficult emotional experience, and at the same time, wanting to escape it. Struggling in sobriety, mourning the loss of the addiction, a job, maybe even their family. They are thinking they are of little worth, while working on some of the hardest challenges they have ever faced. Yes, it is hard for the coach to keep pushing; it is just as hard for the client to keep showing up for the appointments and completing the homework assignments. But push we must and the following paragraphs explain why.

    I have a 35-year-old male client with 120 days clean. I can see this change is extremely hard for my client to move through. He has commented that it is like taking a college course, Change 101. He’d really rather go back and do what he has always done: escape, do drugs, it was easier, he knew how to do it, and at least, he limped along. This is what coaches call resistance to change.

    Expecting resistance and preparing how to deal with it is the most crucial part of developing a plan of change for your client.  In order to forecast any type of resistance, a coach needs to understand the most common reasons people object to change. Below are six examples of the reasons underlying a client’s resistance to change. Some will be artfully combined and the order of their prominence will frequently shift. What‘s imperative is that the coach anticipate each instance of resistance, having ready a response in their back pocket.

    1. Denial — I like to use consequences as the perfect wake-up call to denial. This is my classic change-resistance stand-by: When my client says, “I can’t see any reason to change,” my response is adapted from an AA slogan, “If you keep doing the same thing over and over, you’ll keep getting the same results over and over.”

    2. Anger — It’s remarkable how closely these stages of resistance mimic the five stages of grief. In the case of anger, I use the same response I would in replying to a client who is grieving the loss of a relationship. I mix with it a bit of empathy. Rationally, my client understands his live-in girlfriend, his job, or his family is not responsible for the onset of his addiction. I point this out. Emotionally, he may resent anyone for causing him pain or resent his family for placing shame or putting pressure on him. I suggest he may feel guilty for being angry, and this makes him even angrier. Teasing out these threads of anger helps eliminate the “blurred lines” standing in the way of progress.

    3. Fear and Confusion — One of the most common reasons for resistance is fear of the unknown. People will only take active steps toward the unknown if they genuinely believe — and perhaps more importantly, feel — that the risks of standing still are greater than the risks of moving forward in a new direction. Once again, I bring out my bag of slogans and request he use affirmations on a daily basis. One of my favorite quotes is by Eleanor Roosevelt: “Every time you meet a situation that you think is an impossibility, then you meet it and live through it, you find forever after you are freer than you were before.” Another is from Dr Susan Jeffers: “Pushing through fear is less frightening than living with the underlying fear that comes from the feeling of helplessness.” Or Winston Churchill’s quote:  “If you are in Hell, keep going.” The basic emotion of fear jumbles one’s thoughts, resulting in confusion. Using simple affirmations can break through the underlying emotion of fear and help redraw the line, nudging it forward toward change.

    4. Depression — Again, a classic symptom of grief as well as resistance to change. This phase may be eased by a few kind words. However, I have to battle for this particular change model, and fight against my client’s old thoughts of living an “easy life” in addiction. That old life seemed easier than all of this work. So first, I ensure my client is following his medication-assisted treatment protocols. Then, I pull out my depression-buster toolbox: Get some friends and talk about it — my client’s assignment is to have coffee after his next NA meeting and talk specifically about his depression as well as having to work on his relationships. Depression-buster tool number two is to read inspirational messages. My newest favorite book is National Geographic‘s Daily Joy — 365 Days of Inspiration, uniting inspiring words with lovely National Geographic images of the world. Tool number three? Distraction. When depressive thoughts come creeping back in, get out of that bed, no sleeping until noon. Walk, workout, mow the lawn, go to the grocery store and shop for some nutritious ingredients for this week’s meals. Write in your journal, call your coach, talk to your sponsor and best of all, hit your knees and ask your higher power to take from you these thoughts and feelings of depression.

    5. Crisis — No matter what, there will be a crisis during the period of time in which you are implementing change. So ready yourself for it. In this particular coaching situation, a crisis can be deadly, so I pre-empt any thought of my client ‘using’, head-on. I talk about how addiction will transform thoughts of escape or defiance into the thought of using. I urge my client to prepare for this with a Fire Drill:

    “What are you going to do if these thoughts enter your head? Write this down and use it just like a fire drill is used in a school or office. Thinking of using? A bell starts ringing! Call a friend, say the serenity prayer, call me, take a walk, take out the picture of your 5 year old daughter from your wallet, go to a meeting, hug your girlfriend, write in your journal, drink a glass of water and repeat! Continue to do these things until the thoughts pass.”

    I have my client write all of these actions of a fire drill down on a 3×5 card and carry it in his wallet. Defining and breaking down a crisis helps, too: Picking up a drug is the biggest crisis; a minor fender bender is not. Heading out to an old drug-dealing location is a crisis; bouncing a check is not. In all cases tell someone, call a sponsor, a NA friend or your coach.

    6. Acceptance — Sometimes it takes a crisis to move to acceptance, and hopefully a minor crisis like a fender bender or a bounced check is the crisis my client will experience to effect this change. He can see the experience of dealing with a crisis as a sober person works more effectively.  Of course, as his coach, I follow up by asking him about the eventual resolution of this minor crisis. I am confident he will see how his change of interaction and communication styles has helped improve the resolution of the crisis. Most importantly, he will have accepted this aspect of change because he has gained a new found confidence in being a sober person resolving a crisis in a orderly and humane way.

    And confidence is really the strength my client has needed all along.

     

  • I am Lonely, Part Two

    manhattan_bridgeThe Research on Loneliness

    Have you ever been all alone at a party? Are you perfectly content sitting home reading a book or watching Hulu? Even though you secretly hate sitting at home watching Hulu? Do you have a need to fill the hole in your heart with anybody, or any substance and to take away the feeling created by that empty place? Even if that body or substance is not good for you? Lonely adults consume more alcohol and get less exercise than those who are not lonely. Are you one of them?

    Loneliness is a complex mental phenomenon that has at its base a powerful emotion, the building of which begins in childhood, and is a survival mechanism linked to Bowlby’s attachment theory. Research completed by Robert S. Weiss (1973) defines loneliness as a social, as well as, an emotional phenomenon. All of us have experienced some degree of it, if only for a short time, and remember the painful feeling that goes along with it.

    Whenever we are reminded of this feeling or anticipate it, we get a twinge of distress that can be linked with a feeling of abandonment we perhaps experienced in our youth. This is what we experience as loneliness, but it is so much more. This feeling can occur at a party, in the classroom or even after making love. It can be pretty confusing and can pull you into a downward spiral, if you don’t know what’s going on.

    Research on loneliness is relatively new. John Bowlby did a lot of loneliness research when working on his attachment theory in the 1970s. Robert S. Weiss distinguished between social loneliness, (people who are considered introverts could be socially lonely) and emotional loneliness (people who are emotionally lonely may not have had a firm and reliable care-giving figure early in their childhood development).

    People who are socially lonely have certain personality traits that inhibit the formation of social relationships. These traits might take the form of an individual more self-focused or unable to pay a lot of attention to their partner. For women, these traits present as lonely ladies who do not disclose their intimate feelings to their female friends, and for men, these traits present as less participation in group activities like softball or even playing chess with a friend. Personality research has shown that depression, shyness, and low self-esteem are linked to loneliness.

    Another approach to loneliness is the perception that loneliness is not good. Being lonely is less satisfying than other feelings, like joy. It is perceived as never ending or a permanent state of being. You should not be lonely, no matter what. It is also perceived that there is an ideal social relationship and a not so ideal social interaction. The not so ideal social interactions create loneliness.

    There is research that suggests loneliness is hereditary. According to research by John Cacioppo, a University of Chicago psychologist and a top loneliness expert, loneliness is strongly connected to genetics.

    Nonetheless, whether social, emotional or perceived, loneliness can be measured. The most frequently used assessment is the 1996 UCLA Loneliness Scale created by Daniel W. Russell. Research based on those individuals taking this assessment is quite interesting.

    Lonely feelings are more prevalent in adolescents and young adults (16-25) and very old individuals (80 plus years of age). As a parent, I look back on my son’s constant retort, “I’m bored.” After reading this research, I wonder if he could possibly have been unable to articulate that he was lonely. Of course, numerous 80-year-old respondents were in retirement or assisted-living communities when participating in this research. And many of these oldest adults didn’t have the level of social interaction they had when they were young. Doesn’t it make you want to go bring Grandma home for Thanksgiving dinner?

    Overall, women report slightly greater feelings of loneliness than men. I wasn’t surprised by that finding. As researchers drill down into the demographics, they discovered non-married men are lonelier than non-married women. Marriage is well known as protection against loneliness, which is greater in those that are divorced or never married.  African Americans of both genders tend to be lonelier than Caucasians. Yet, African American women are less lonely than Latina or Caucasian women. Based on a university study, it was found that college-aged Asian students were more lonely than their peers. Following along the lines of educational success, it was determined that the attainment of a high school diploma protects the population against loneliness, possibly indicating the enhancing benefit of the higher social status and self-esteem associated with this accomplishment. Employment is another factor illuminating loneliness. Retirement and unemployment represent a loss of social contact, so both groups experience feelings of loneliness greater than those that are still employed. Participation in a religious organization has also been identified as yet another protection against loneliness.

    Let’s get back to Grandma in the nursing home. Negative health factors increase with a higher level of loneliness. Sensory impairment, such as hearing loss, significantly contributes as well, because it impairs an individual’s ability to participate in conversations. Impaired mobility (walking) is also a contributor to loneliness, limiting the access and the desire to venture out to seek social interaction. Once loneliness takes a foothold in the individual, it makes a mountain out of a molehill. Those who are lonely react more intensely to negative situations, and they experience fewer uplifting feelings from positive events. Even if there is success by a loved one or a friend in delivering nurturing support, a lonely 85-year-old woman may perceive any exchange as less fulfilling. Using fMRI scans of a lonely person’s brain show they derive less pleasure from pleasing social interactions. Not only do the lonely contribute to their own negativity, others view them as negative and begin to pull away as a way to avoid negative situations. All of this confirms to the lonely that their interpretation of a negative social interaction is true, that social interactions will be consistently threatening and that changing those interactions is beyond their control.

    Loneliness is an added stress to the individual’s life. Perceiving stress as a growth and motivational opportunity is a start. Responding to going out and engaging with business colleagues can be looked at optimistically instead of with pessimism and avoidance. Thinking that anything is better than watching Hulu again tonight is an optimistic view of having an interaction with colleagues. The lonelier someone is, the less successful they are in dealing with stressors. Oftentimes the lonely withdraw and often they quit trying altogether. Not a good reaction to completing a work deadline or when trying to advance in your career.

    The lonely have higher systolic blood pressure and a higher body mass index than non-lonely people, which affects their heart health. Older lonely people have more differences in the hormonal production of the hypothalamus, the pituitary and the adrenal glands than people their own age who are not lonely. This can negatively affect their autoimmune system. Research has shown that people with loneliness experience non-restorative sleep (sleep that is non-refreshing despite an 8-hour normal sleep time). The risk of Alzheimer’s disease is twice more likely to appear in a lonely person than in non-lonely individuals. Living with loneliness can increase the likeliness of an early death by 45%.

    So, what can a lonely person do, not to mention a friend or family member of a lonely person? More will be revealed in my next post.

    Research gathered for this blog post came from:

    Loneliness, a paper written by John T. Cacioppo and Louise C. Hawkley, from the Chicago Center of Cognitive and Social Neuroscience, at the University of Chicago. This research was supported by the National Institute on Aging and the Templeton Foundation.

    John Cacioppo is also the co-author of the book Loneliness: Human Nature and the Need for Social Connection.

    Further reference material was drawn from Robert S Weiss’s book Loneliness: The experience of emotional and social isolation, published in 1973 at MIT Press, in Cambridge MA, and the 1996 UCLA Loneliness Scale created by Daniel W Russell.

    The You Tube TED talk with John Cacioppo, is accessed at: https://www.youtube.com/watch?v=_0hxl03JoA0.

  • I am lonely

    manhattan_bridgeWhat Is Loneliness?

    Webster’s Dictionary defines loneliness as a state of solitude or being alone. But I believe loneliness to actually be a state of mind. It causes people to feel empty, alone and unwanted. People who are lonely crave human interaction, but their state of mind makes it difficult to socialize or make connections with others.

    Loneliness is not about being physically alone. Instead, loneliness is the perception of being alone. A new employee might feel lonely despite being surrounded by colleagues and bosses. A soldier might experience loneliness upon returning home after being deployed abroad. Or a new college student may perceive being alone, despite being in the keg line at a frat party.

    The state of loneliness is an emotional one, in which a person experiences a powerful feeling of emptiness and isolation. It is more than the feeling of needing company or wanting to do something with another person. Loneliness is a feeling of being cut off, disconnected and alienated from other people. The lonely person may find it difficult, or even impossible, to have any form of meaningful human contact. People who are lonely often experience a subjective sense of inner emptiness or hollowness, accompanied by those feelings of separation or isolation from the world.

    How did I get so lonely?

    People can experience loneliness for many reasons, and many life events are associated with it. The lack of friendships during childhood and adolescence, or the physical absence of meaningful people are causes for loneliness or the seeking of extreme degrees of isolation. At the same time, loneliness may be a symptom of another social or psychological problem, for example, chronic depression, for which professional help should be sought.

    Many individuals experience loneliness for the first time when they are left alone as an infant. It is also a very common consequence of divorce or the breakup of any important long-term relationship. In these cases, it may stem both from the loss of a specific person and the withdrawal from social circles caused by the event, as well as the associated sadness. Loneliness can also be attributed to low self-esteem. People who lack confidence in themselves often believe that they are unworthy of positive attention. This can lead to the aforementioned states of isolation and chronic loneliness.

    Grief also can lead to loneliness. Leaving home and going to college is an example of an event that will trigger a grief response, homesickness, both possibly resulting in loneliness. It may also occur after the birth of a child, when a spouse devotes all of his/her attention to the new baby while the other spouse grieves the loss of their adult companion. Loneliness can occur within marriages or close relationships where there is anger, resentment, or where love cannot be given or received. Other contributing factors include situational variables, such as actual physical isolation, say, after moving to a new location, and/or a divorce.

    According to the results of a study of 5,000 people, loneliness is contagious. It can spread much like the flu. Loneliness can spread through groups of people via negative social interactions. More will be discussed on this topic in my future posts.

    John Cacioppo, respected loneliness researcher, suggests that loneliness is becoming rampant in the United States. When polled as part of a 1984 questionnaire, respondents frequently reported having three close confidants. When the question was asked again in 2004, the most common response was zero confidants. Experts believe that it is not the quantity of social interaction that combats loneliness, but that it is the quality of such interactions. Having just three or four close friends is enough to ward off loneliness and reduce the negative health consequences associated with this state of mind, with the emphasis on close friends. This trend is unfortunate.

    Are we lonelier as an outcome of our computer-generated, social-networking circles, or video game dependence, with their resulting sacrifices of good friends for just peripheral acquaintances or online social relationships? I will expand on this in my next post.

    _________________________________________________________________

    Research gathered for this post came from:

    A blog hosted at About.com, featured in the education section entitled: Loneliness: Causes, Effects and Treatments for Loneliness by Kendra Cherry, accessible at http://psychology.about.com/od/psychotherapy/a/loneliness.htm.

    More information was received from the John Cacioppo, J.H. Fowler & N.A. Christakis book: Alone in the crowd: The structure and spread of loneliness in a large social network

    Journal of Personality and Social Psychology. As well as the Boston Globe interview with John Cacioppo by Daniel Askt, (2008, Sept. 21).

    A talk with John Cacioppo: A Chicago scientist suggests that loneliness is a threat to your health. The Boston Globe is found online at www.boston.com/bostonglobe/talk with John Cacioppo.

    And the You Tube video of a TED talk with John Cacioppo, accessed at: https://www.youtube.com/watch?v=_0hxl03JoA0.