Reasons Why Trump is Polling So Well - Part I

Donald Trump is a narcissist – diagnostically so. Narcissists tend to exude a sense of self-importance, show a lack of empathy, and have a profound need for admiration. (Trump cannot build anything without putting his name on it!)  A narcissist also typically believes they are special and unique and they tend to exude a sense of entitlement - the individual believes they deserve special treatment. They also frequently exhibit arrogant, haughty behaviors and attitudes. Another little known fact about narcissists is their capacity to show contempt. If someone disagrees with them (in other words, doesn’t show them the admiration they feel they deserve), they’ll show contempt by eviscerating the other person. People witnessed this during the Fox News debate when Trump criticized the female moderator after she asked a challenging question. Narcissists cannot help themselves and, even on national television, Trump could not either. Ironically, narcissists are popular at first. It’s only later that they get into difficulty interpersonally. And because of a narcissist’s high levels of grandiosity and superiority to others, they eventually have trouble with any type of long-term relationship. Individuals who are in relationship to a narcissist eventually feel exploited. (How many times has Trump been married?)

If Donald Trump were a certified narcissist, why would he be polling so well as a potential President of the United States? Why aren’t more people actually disturbed by his interpersonal dynamics? I’d like to address that question with a two-fold answer. I’ll provide a superficial answer first. Then, in Part 2, I’ll try and address the question from a deeper, analytic point of view.

A recent study done by Back et. al (2010) provides a possible answer as to why Trump is polling so well at the moment. In the study, 73 college freshmen that had never met each other took turns standing up in front of the room and introducing themselves. They were then asked how likable each speaker was and how much they’d like to get to know the speaker better. Interestingly enough, it was the most narcissistic students (they were tested and scored high on a questionnaire) that were better liked. And not only that but the type of narcissism that scored the highest on likeability was the most malignant kind, meaning the type of narcissist that actually enjoyed manipulating and exploiting people. It was the manipulators and exploiters who were the most popular when they introduced themselves!

Interesting right? But I bet you're still wondering how in the world can this be? It’s actually quite simple. The malignant narcissistic tend to exude four attractive characteristics when you first meet them. They have charming facial expressions, they dress well, they can be verbally witty and find unforgettable ways to introduce themselves, and their body language tends to be self-assured. They are also often very successful. Unconsciously, we humans feel naturally drawn to these characteristics when we first meet someone. When someone exudes an air of self confidence, is interesting to talk to, or seems successful, we naturally TEND to like them and feel drawn to them.

(To be Continued)

Metaphor, Empathy, and Intimacy - Will Technology Circumvent?

One of the things that make us uniquely human, Summers (2013) states, is our ability to use metaphor. Within the context of psychotherapy, particularly because of the deep exploration of self it provides, the use of metaphor is a frequent consequence. If this opening up of creativity and the use of metaphor is uniquely human, how might constant interfacing with technology and mobile devices disparage this process?

Summers states that psychotherapy is a process between two people who engage each other for the express purpose of transforming and expanding the subjectivity of one party. The patient begins to understand herself more deeply. Subsequently, one of the hopes we have as therapists is that the transformative power of this very dynamic generalizes to other relationships and situations for our patients. The insights one gains in psychotherapy can begin to change relationships OUTSIDE of therapy. But if our patients live in a world of tethered technology, of potential disconnected-ness, doesn’t this circumvent the very changes we’re hoping to effect?

When considering the developmental arc of growth in the human being, the child is helped to master negative feelings by parental responses to the pain and the offering of a different viewpoint. Simply put, when a child is comforted and soothed, rather than dismissed, a child is left feeling valued and healthy self worth grows. As a result, the optimal conditions for the child are both mutual and self-regulation. The child learns to regulate his own emotional responses to life challenges. Children need the responses of primary caregivers to learn how to master their own feelings in order to learn how to self regulate. But what happens when mobile devices become so embedded in and between human interactions? Will our absence with each other serve to circumvent our learning to self regulate, to feel comforted by another’s response?

Summers makes the statement that concentrating on the patient in psychotherapy, with all his/her complexities, is a mode of engaging human experience that makes psychotherapy inquiry unique and powerful. This singular focus on the experience of the other person, might it be thwarted by constant interaction with “others” that are only experienced through email, text, or Facebook?  Doesn’t communication, when it primarily occurs through technological means, inherently create a wall of intimacy whereby the participants cannot intimately engage with one another?

This might sound a bit simplistic. The longer I’ve been a psychologist, the more I feel like the main goal of psychotherapy is not only assisting clients in gaining insight about themselves, but helping them learn to tolerate their God-given feelings, and thereby growing in their ability for intimacy and vulnerability. This seems to occur the most powerfully in-between people and WITH each other. While technology is not inherently evil, my fear is that our world of tethered technology provides a ready made defensive and avoidance of the very conditions that help us feel like humans. Instead of conversation over dinner together, we feel tempted to check our mobile devices. Instead of noticing each other’s facial expressions, and thereby allowing for connectedness, we gradually become more and more distracted from each other. Instead of starting conversations with others in parks, coffee shops, gyms, or the grocery checkout line, we play games on our phones, listen to music with earphones, or check our Facebook page. In essence, we lose our ability for human relatedness.

What Happy People Do Differently

In an article in the August submission of Psychology Today, authors Kashdan and Biswas-Diener attempt to tackle the question of happiness. Interestingly enough, the question of happiness is not uniquely an American ideology. Psychologists Ed Diener of the University of Illinois at Urbana and Shigehiro Oishi of the University of Virginia studied more than 10,000 participants from 48 countries. They discovered that individuals from all over the world rated happiness as being more important than other personal outcomes, such as having meaning in life, becoming rich, and getting into heaven. The article mentions that true happiness is probably better described as a sense of peace or contentment. It also includes cognitive reflections, a state of mind, and as such, can be intentional and strategic. And not surprisingly, certain choices you make throughout the day can push you toward increased well-being – or not. Happy people, it turns out, engage in some counterintuitive habits that seem downright unhappy! So stay tuned for a collection of findings that researchers have found increase a sense of well-being!

Healthcare Reform - Implications for Mental Health Professionals

The best cure for mental illness

Dr. Jean Twenge and colleagues in the San Diego State University psychology department analyzed mental health records collected between 1938 and 2007 from more than 63,000 young adults. They discovered a dramatic and significant increase in psychological problems, particularly depression. In fact, they concluded that students today feel much more isolated, misunderstood and emotionally sensitive and unstable than in previous decades. Teens today are more likely to be narcissistic, have poor self-control and to endorse general overall dissatisfaction with life. Twenge and her colleagues concluded that consumerism is a major reason for the rise in mental illness. Twenge is quoted as saying “We have become a culture that focuses on material things and less on relationships” (Jethani, 2011). While one might have more questions about all the details of this study, it is certainly worth nothing that the rise in depression coincides with the rise in consumerism along with the individualistic nature of America’s society. Implicit in Twenge’s findings is the importance of relationship. A plethora of research confirms the importance of connectedness. Those who are embedded in communities, even if they suffer mental illness, will have a greater chance of healing and of shouldering their pain with dignity. Psychotherapy offers the opportunity to be known, fully known, and still accepted, which is something the human being seems to crave. It is in the context of deep vulnerability AND acceptance that we humans thrive, find meaning, and live life more fully.

Did Abe Lincoln Suffer from Bipolar?

Did Abe Lincoln Suffer from Bipolar?

No – at least according to award winning author, Doris Kearns Goodwin, in “Team of Rivals: the Political Genius of Abraham Lincoln.” However, it does appear that Lincoln experienced periods of depression and manifested a melancholy temperament. In January of 1841, in particular, Lincoln experienced a vortex of events, resulting in one of the lowest periods of his life. He had just experienced his broken engagement with Mary Todd, the woman who eventually became his wife. Two additional events caused Lincoln great pain – his political life seemed at a stalemate and his best friend moved away. What resulted was a period of Lincoln’s life that historians indicate included suicidal ideation and a marked withdrawal from his social life. Letters from that period even state that friends “had to remove razors from his room.” Interestingly enough, Lincoln sought treatment, consulting not only a Dr. Henry, but also Dr. Daniel Drake, a doctor at the medical college in Cincinnati. Lincoln eventually recovered from this very dark period of his life, in part, by monthly visits to see the best friend that had moved away. Author Goodwin goes on to delineate the difference between melancholy and depression. “To be sure, Lincoln was a melancholy man…this melancholy was stamped on him…it was part of his nature and could no more be shaken off than he could part with his brains.” Goodwin states that Lincoln’s melancholy partially indicated a withdrawal to the solitude of thought. As a child, he retreated from others to read. As an adult, he worked through a problem in private. It is Goodwin’s intimation that others frequently perceived this as evidence of melancholy. Also, the contours of Lincoln’s face, when relaxed, seemed to hint a sorrowful aspect. According to Goodwin’s thinking, there is a difference between depression and melancholy, the latter not having a specific cause. Rather, it is an aspect of temperament, of one’s nature. “Melancholy is a far richer and more complex ailment than simple depression. There is a generous amplitude of possibility, chances for productive behavior…” The melancholy that Lincoln seemed to exude “derived from an acute sensitivity to the pains and injustices he perceived in the world. He was uncommonly tenderhearted.” Goodwin argues that Lincoln possessed a profound capacity for empathy and for compassion, making him predisposed to sorrow but also profoundly capable of understanding his colleagues and the people he served as President. And another thing, Lincoln was “extraordinarily funny.“ “Lincoln himself recognized that humor was an essential aspect of his temperament. He laughed, he explained, so he did not weep.” His stories were intended to “whistle off sadness.” So did Lincoln manifest symptoms of bipolar? No, not as far as the history books seem to intimate. Did he experience a profound sensitivity to the events and people around him? Yes, and Goodwin seems to state it was what made him one of the best presidents our nation has ever known.

Pain is our friend

The physician who spent much of his life working with lepers in India was a gentleman by the name of Dr. Brand. He discovered that leprosy destroys the nerve endings in the body, leaving lepers unable to to feel. While this fact might seem like a blessing, it is ultimately a curse, resulting in the loss of limbs and even death. Without pain, lepers are unaware they have been injured. Dr. Brand is quoted as saying, "I thank God for pain, I cannot think of a greater gift I could give my leprosy patients." Symbolically speaking, the avoidance of pain can make us emotional lepers - we become incapable of experiencing the aches, pains, and fears of our existence, as well as the joys, the beauties, and freedoms of our lives. Although no one enjoys feeling pain or fear, these emotions play an important role in our existence. They help us stay alive!

What really counts when it comes to effective therapy

I frequently find myself thoughful about what's effective in psychotherapy. Is it particular things I say in response to my patients? Are there specific modalities that are more effective than others? Being the psychodynamic psychotherapist that I am, I possess a natural inclination toward understanding the deeper layers of the human psyche. Somehow, change and understanding the human being takes so much more than just a manualized approach to specific symptoms. For me, it's more about understanding the heart and soul of each person that walks in my door and treating each with as much dignity as I can muster. Each patient is more than just a list of symptoms. Each patient is more than just their pain. When I read the following article on research done in Sweden, I found myself feeling justified in how I've been trained: http://scottdmiller.com/icce/revolution-in-swedish-mental-health-practice-the-cognitive-behavioral-therapy-monopoly-gives-way/

Is psychotherapy effective?

As a practicing psychologist in Pasadena, I'm occasionally challenged by my patients to discuss the effectiveness of psychotherapy. "Will I get better? they often query. It's an honest and legitimate question - one I find myself pondering frequently. To my patients, they want to know whether the benefits of embarking on the strange journey toward self disclosure, vulnerability, and potential pain will be worth it. And will I be able to help them? Will paying for my services, my training, and my expertise be enough of a catalyst for healing? The answer is complex and multi-faceted. There's the issue of goodness-of-fit. Research shows that upwards of 80% of the effectiveness of psychotherapy has to do with the fit between patient and psychotherapist but how does one measure that? Other variables that influence the outcome of psychotherapy include such things as the level of participation of the patient, the level of motivation, and how accurately the empathy in the psychotherapist. With all this in mind, however, and the longer I'm privileged to do this work, the more I find that individuals who walk into my office really are seeking a deeper experience of authenticity and empathy and many are NOT looking for the quick fix. For a fascinating read on the effectiveness of longer term psychotherapy vs short term, see the following link: http://horan.asu.edu/cpy702readings/seligman/seligman.html

Treatment for Depression

As common as depression is, it is important to know how to address this mental health issue in the healthiest way possible. Treating depression is usually not a quick fix but if you’re willing to keep at it, you’d be surprised at the results. Treating depression usually includes a combination of elements, and no one element by itself works as well as all of them combined! There are many effective ways to deal with depression, including exercise, talk therapy, medication, natural supplements, and lifestyle changes. Learning about the treatment options will help you decide what measures are most likely to work best for your particular situation and needs. And another fact to keep in mind, research studies indicate that it is usually a combination of both talk therapy AND medication that brings the most effective results. And if you’re like most, the idea of talk therapy can feel intimidating and scary.  As understandable as that might be, don’t let it keep you from taking one of the most powerful steps toward change and healing.

Prevalence of PTSD

Just how frequently is PTSD diagnosed? The National Comorbidity Survey Replication (NCS-R), conducted between February 2001 and April 2003, comprised interviews of a nationally representative sample of 9,282 Americans aged 18 years and older. The NCS-R estimated the lifetime prevalence of PTSD among adult Americans to be 6.8%. The lifetime prevalence of PTSD among men was 3.6% and among women was 9.7%. Thus, the diagnosis is by no means uncommon. 

Benefits of Therapy

The research on the effects of therapy continually demonstrates that the relationship between patient and therapist is much more important than the "brand" of therapy, that the personal qualities of the therapist are far more relevant to the success of the treatment than his or her theoretical orientation. There also appears to be temperamental differences among patients that suit them more toward one kind of treatment than another. Analytic, depth therapies tend to be a good fit with people who are curious, who like to figure things out for themselves, who have some tolerance for ambiguity, who are comfortable with emotion, and who have some intuitive sense that there are unconscious processes within the human psyche.