Want to break the cycle of anxiety Hop on your bike

Just came across an recent article from a small-town paper about a local resident who's using cycling as a tool to fight anxiety disorders. And I quote:

STRATHMORE resident Justin Sacr can't drive a car for fear he has knocked down someone every time he hits a bump.

The 33-year-old has lived with anxiety and obsessive compulsive disorder since age 14 and, because of the phobia, his bicycle has become a 'lifeline'.

"I cycle to work every day. It has been a blessing in disguise because exercise helps me a lot," he said.

"It releases chemicals in your brain, like antidepressants, but in a natural way. It helps with your thoughts. You might look normal on the outside, but on the inside you're going through hell."

From experience: This guy's spot on. Cycling can have a hugely positive impact on your quality of life if you deal with anxiety. It's an especially good way to battle the shrinking-of-your-world of agoraphobia. The lightheaded feeling and elevated heart rate? That's what's supposed to happen when you exercise. Just push yourself to go a bit farther out of your comfort zone each time out. You'll feel better about yourself, more able. Guaranteed.

Traumatizing Your Characters Part 2 Types of Trauma

Now that we've established that most people will experience some sort of traumatic event(s) in their lives, and that a huge number of novels focus on trauma and its aftermath, let's discuss different types of trauma!

Trauma isn't ONE THING. It's sometimes hard to define, but here's SAMHSA's definition (lots of resources on that website, by the way--if you're going to traumatize a character, do your research!):

Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual's functioning and physical, social, emotional, or spiritual well-being.

 You see here that you need an event that a person experiences in a certain way, but that also has lasting effects. That's the core of it, but this can take so many different shapes!

Single event:

• car accident
• physical injury or accident
• natural disaster
• terrorism
• physical or sexual assault

We'll talk about treatment in a later post, but professionals agree that single event trauma is often "simpler" to treat than other kinds of trauma, because the individual can focus on grieving and integrating one event. That doesn't mean this type of trauma is no big deal--it can be crippling. But man, are there some extremely effective treatments that work particularly well for individuals who've experienced it.

Books that deal with single incident trauma include Hate List by Jennifer Brown, Speak by Laurie Halse Anderson, and Willow by Julia Hoban. I would say that the majority of YA books dealing with trauma that I've read involve single event trauma.

Episodic:

• domestic violence
• physical and sexual abuse
• combat

With this type of trauma, there are periods of respite in between, and sometimes the surrounding environment isn't utterly toxic, but when things explode, they have a "snowball" or cumulative effect. The traumatic events aren't isolated--they wear a person down.

Books that deal with episodic trauma include The Things a Brother Knows by Dana Reinhardt and The Hunger Games series by Suzanne Collins (Catching Fire is where the author really begins to show the aftereffects of trauma, but she also deepens the trauma with additional traumatic events). Lela, the main character in Sanctum, has also experienced episodic trauma, though it could be argued that her background involves significant developmental trauma as well (see below).


Chronic:

• refugee/forced displacement/warzone
• child neglect and deprivation

Chronic trauma, and particularly early and ongoing child neglect and deprivation, is much more complicated to treat because of the frequency of negative events and the pervasive badness of the environment. Developmental trauma, sometimes referred to as "complex trauma," is also harder to diagnose, because sometimes there is no single event that could be identified as traumatic. Rather, sometimes the entire environment is the issue! This type of trauma gets a post all to itself. As a child psychologist, I think about, talk about, and deal with this type of trauma (in varying degrees of severity) A LOT.

Books that deal with chronic trauma include Living Dead Girl by Elizabeth Scott and Nobody But Us by Kristin Halbrook.

If you're writing about trauma, feel free to share the type of trauma your character has experienced, and how you're thinking about his/her reaction to it. Also, please feel to recommend excellent books that deal with different types of trauma in an authentic manner!

On Monday, we'll move on to a discussion of factors that make traumatic events more likely to cause PTSD symptoms in those who experience them.

Guest Post Are You Inadvertently Shaping Your Childs Future with Labels

Today’s guest post is by Rachel Cherry. She discusses how parents may inadvertently induce their children to create what I call a false self or persona - a recurrent theme of this blog - by verbally pinning labels on them. These labels or pet names are sometimes just meant to be "cute," but, depending on other things that parents may say or do and the entire social environment of the family, may take on added meanings for the child and set up behavioral expectations for them. When this occurs, it forces them to try and hide their true nature, preventing what experiential therapists refer to as self-actualization. 

Labeling people is quite common in the world we live in. While many of the names that we call each other have respectful undertones or are shrouded in warmth and concern for  the other person, others are used as digs at a person and are clearly derogatory. When it comes to parents and children, such names can affect childhood development when the actions of the parent reinforce any behavior of the child that is consistent with the label. While most parents do not intentionally try to mentally scar a child in such a fashion, their behavior in a variety of contexts has the potential to solidify certain beliefs children begin to form about themselves and about how they are supposed to behave in various social situations.

There are two parts to any given individual's personality: outward demeanor and inner nature. Your demeanor is how you act around others, and this can be contradictory to how you are truly feeling inside. The demeanor aspect of your self-image is usually centered around how you want people to view you, and it can sometimes completely overwhelm your true, private personality. Inner nature is how you truly think and feel inside. For instance, someone's demeanor may outwardly be cold and calculating - as seen in some company CEOs for example - but his or her nature could secretly be nurturing and caring towards friends and family. Many people feel vulnerable whenever they show their true nature.

Labels and name calling whether good or bad can, when reinforced by certain actions by the parent, alter children’s perception of what sort of demeanor they believe they are supposed to present to the outside world. The child's outward behavior then assumes the qualities inherent in whatever the name signifies to them. Instead of being proud of their own true nature, the child may believe that the outward perception of others is the most important indicator of their validity as a person - especially if the actions of the parent strengthen that belief.

Reinforcing Demeanors:  When someone calls a child a "little princess" or "little prince," he or she could take it as a sign of affection. After all, what child doesn't want to be a part of royalty? However, when parents reinforce negative aspects of that label with actions such as providing various lavish gifts and succumbing to every whim and demand of the child, the child could begin to form a mental correlation between being thought of as royalty by the parents and demanding everything he or she wants. This may easily create a sense of entitlement that children can easily take with them as they develop into adults and interact with outsiders.

Family Sarcasm: Creating an altered persona of the child can be unintentional when the parents think of a label they apply to their child as mere humor. This could inadvertently provide a framework by which a child internalizes the label in a negative way. If jokes go too far, the parents may simply be unaware of how much damage they are truly doing. Taking a jocular stance concerning a child's shortcomings is quite common, but it could create for the child a like-minded negative demeanor as he or she begins to live up to the expectations implied by the comment. For example, jokingly pointing out the failures of a child while sarcastically calling him or her a "loser" could not only make the child feel worse, but it could also create the idea in the child that he or she will always be a failure.

Ignoring Aspects of a Child’s Behavior That May be Related to a Label:  Interestingly, not addressing certain behaviors while using labels can be just as deleterious to the child’s self-image as the labeling itself. If a parent ignores certain of the child’s related behaviors, the child may assume that those behaviors are justified as being part of what the label suggests. While it may be cute to watch a young child plot and scheme in order to get his or her own way in regards to minor situations, if the parents starts to call the child an “evil genius,” the behavior could easily develop into a demeanor for the child that is not so cute in other contexts.

Tone of voice is also important. If the parent uses a positive tone while labeling a child as a "little genius," the child could assume that this behavior is not only acceptable but expected. It could turn into something more elaborate as he or she develops into an adult. Instead of that cute little evil genius plotting to get a cookie, you could end up with a child who winds up spending a great deal of time behind bars.

Labels are Not Always Negative:  Not all labels have to produce negativity in a child. For example, when you call your child a "tough cookie" when he or she doesn't cry or otherwise expresses emotions when injured, it could help the child develop a sense of inner strength. As we all know, despite your best efforts to prevent your child from being injured, accidents frequently happen with the young. Children take their cues on how to react to those situations from the parents’ behavior. Most young children will wait to see the parents' response to an injury before reacting themselves. If you treat the situation light-heartedly, so will the child. This "tough cookie" demeanor could be beneficial throughout the child's life as he or she learns the value of inner toughness and self-reliance.

Labels in and of themselves do not usually create a child's entire demeanor. It is the actions of the parents and others that reinforce their concept of how to behave in interpersonal situations. If this behavior continues to be reinforced by the parents, the child's demeanor could overwhelm his or her true nature and reduce the child’s capacity to discover his or her true inner-self. If the child is constantly putting on a show for everyone by trying to be whatever he or she thinks others want, then there is less of a chance for the child to develop his or her potential. Your behavior as a parent is key to your child's development, and it is wise to monitor yourself closely when applying any label to your child.

Rachael Cherry is a wife, mother, and writer who is passionate about helping connect families in need with high quality caregivers. She has taken that passion and put it to work through NannyPro, a respected online nanny referral service. Learn more by visiting @NannyPro on Twitter.

Really Unfortunate Logo Choices for Your New Restaurant Part 1

You got your meditation in my CBT!

I've talked about meditation.

I've talked about cognitive behavioral therapy (CBT).

From personal experience I can tell you both can be effective in relieving anxiety, depression, and whatnot. Together, it seems, meditation and CBT are two great tastes that taste great together. According to a recent study, the two are also notably effective when used in combination -- at least for depression:

People with severe and recurrent depression could benefit from a new form of therapy that combines ancient forms of meditation with modern cognitive behaviour therapy, early-stage research by Oxford University psychologists suggests.

The results of a small-scale randomised trial of the approach, called mindfulness-based cognitive therapy (MBCT), in currently depressed patients are published in the journal Behaviour Research and Therapy.

28 people currently suffering from depression, having also had previous episodes of depression and thoughts of suicide, were randomly assigned into two groups. One received MBCT in addition to treatment as usual, while the other just received treatment as usual. Treatment with MBCT reduced the number of patients with major depression, while it remained the same in the other group.

Can a website help you better manage your anxiety and panic

Maybe sometimes you get so scared you think you're going to die. Or maybe your head jitters with anxiety, or wondering whether life is worth living makes it hard to get out of bed.

What do you do? Steps taken by people with panic, anxiety, and/or depression include psychotherapy, cognitive-behavioral therapy, SSRIs, benzodiazepenes, exercise, meditation, and biofeedback -- and that's just the start of the list.

But do any of them actually work?

Typically, at PANIC!, we've addressed questions of treatment efficacy via discussion of information from "official" sources -- published research studies, for instance.

Sites like CureTogether and patientslikeme offer a new and exciting source of information about what ails you, from the type and severity of the symptoms that others report, to the popularity and perceived efficacy and side effects of a wide range of treatments.

By submitting information about yourself (anonymously), you can help strengthen the database of knowledge about health problems -- and maybe learn about a treatment that could work for you.

If nothing else, these sites remind us that we're not alone. (On one of the sites, I actually found an example of someone who's also panicked while meditating!)

Your Brain On MDMA--- 

source-asap science

How to enhance your creativity

Creativity is the product of creative thinking

A general notion is that creativity is the phenomenon whereby a person creates something new that is outstanding and that has some kind of value. In my view creativity is the product of creative thinking, a mental faculty which every person is endowed with.

Two types of thinking – directed and undirected

Creative thinking is otherwise called undirected thinking. Normally one is instructed to use directed thinking which is goal oriented and rational. Such thinking requires a clear, well defined goal. One must then find a path that leads to the goal, with the aim of doing so as directly as possible. In general, directed thinking avoids wandering aimlessly, exploring odd options, and looking for creative solutions. Just such aimless wandering might be necessary to arrive at highly novel solutions. This type of meandering thought is called undirected thinking. Sigmund Freud who founded the discipline of psychoanalysis identified dreaming and day dreaming as forms of undirected thoughts that are not trammeled by the ordinary constrains of reality. Undirected thinking takes us to destinations that are sometimes murky and sometimes insightful. It plays an important role in creativity and in the solutions to problems that are poorly defined.

Creative thinking and globalization

According to the noted psychologist Mark A.Runco,Psychology Department, California State University, creativity has recently started to receive the attention it deserves by researchers in cognitive psychology because of the fast and complex changes such as globalization and technology advancements, which characterize the environment in which we live and operate.

Productive thinking and reproductive thinking

The Gestalt psychologists of Germany during the early twentieth century distinguished between reproductive and productive thinking.  Reproductive thinking entails the application of tried-and-proved true paths to the solution of a problem.  The thinker reproduces a series of steps that are known to yield a workable answer by using long term memory. Productive thinking, on the other hand, requires insight and creativity.  In view of the Gestalt psychologists, the thinker must see a new way of organizing the problem, that is, a new way of structuring the elements of thought and perception.

Trial-and-error vs. insight

Thorndike's puzzle box

Kohler's experiment

In psychological experiments on learning the animals use trial-and-error method of problem solving. Trial and error can be regarded as one form of reproductive thinking. Edward LeeThorndike was a pioneer in the experiments on leaning of animals using puzzle boxes. On being placed in the box, a cat pawed randomly about the box, obviously irritated by the confinement. Once it discovered the escape lever, the cat learns to associate the lever with a way to escape. That means the cat learns by trial and error method. Wolfgang Kohler, a Gestalt psychologist, designed a problems such as the following: a chimpanzee  is in a large cage along with several crates. Hanging from the top of the cage, out of reach, is a banana. Kohler reported that in this setting the chimpanzee would appear to be lost in thought, and then suddenly the proverbial light bulb of insight would flash. The animal would then move the crates under the bananas, stacking them to form a ladder to reach the food. In another problem a chimpanzee insightfully learned to join together two sticks in order to reach a banana lying outside the cage. The chimpanzee produces a new way to solve the problem out of productive thinking. This is the phenomenon of creativity.

Application of creativity

Writing, musical composition, architectural design, computer programming, engineering design, painting, and sculpting are just a few examples of tasks that call from creativity.

Historical versus personal creativity

Historical refers to ideas that are novel within the context of the whole of human history. The creator produces a product—some visible symbol that embodies his or her idea—that may be judged by others.  Consider the works of art or equations of physical theory. The Sistine chapel, the Mona Lisa, the laws of thermodynamics, and the general and special theories of relativity are products that plainly creative in the historical or product sense. Cognitive psychologist John R Hayes in his noted book The Complete Problem Solver argued that three criteria must be met before a product of the human mind ought to be regarded as creative.

 First, it must be novel or unique. Certainly, this is implicit in our everyday discussions of creative acts as well as in the distinction we encountered earlier between reproductive thinking, on the one hand, and productive, insightful creative thinking, on the other. 

Second a product must be judged as useful in some context. Here, many artists, inventors, scientists, and philosophers have lost in their ideas for fame. Their creation may have been novel but were utterly useless. Only when a product somehow connects with the pasts or find it niche in a cultural context does it stand a chance of being regarded as creative. This may take time—more time than the creators have. Some have been acclaimed as creative in the historical sense only after their deaths.

Third, the products must have demanded some special ability or talent on the part of their creators Hayes’s criteria of novelty, usefulness, and talent give very different answers to the question what is creative, depending on one’s cultural point of view.

Stages of creativity

The early twentieth-century reformer Graham Walls got somewhat nearer the source of the creative process, which he outlines in his book, The Art of Thought. Summarizing his own and other people's work in this area, Wallas described four stages of creation.

1. Preparation. The person expecting to gain new insights must know his field of study and be well prepared. This seems to fit what we have experienced 0 people get inventive ideas mainly in their own fields - poets in poetry; scientists, in science.

2. Incubation - Wallas noticed many great ideas came only a period of time spent away from the problem. This was certainly the experience of Archimedes when he got his idea in the public bath. Many ideas come to us when we are away from the problem, usually after actively engaging with the problem.

3. Illumination. This is the "click" or "flash" of a new idea. It's a mysterious phase. Resting the mind by doing other activities was the only suggestion Wallas could offer about how creative ideas form.

4. Verification. In this final step, efforts are made to see if the "happy idea" actually solves the problem. Since "great" ideas don't always work out in actual practice, this final step is vitally important to the success of any project.

We know that invention comes only in a person's field of specialization. Wallas is right when he says there must first be a Preparation stage: people have to become knowledgeable in some field before they may expect ideas to "dawn" on them in that area.

The more we know, the more apt we are to get new ideas; novel ideas seem to come from a fortunate scrambling of information we already have. And yet, although a certain threshold level of knowledge seems necessary for creativity, creative breakthroughs are not always the product of the most expert thinkers in a discipline.

Creativity and intelligence

There has been debate in the psychological literature about whether intelligence and creativity are part of the same process (the conjoint hypothesis) or represent distinct mental processes (the disjoint hypothesis). Evidence from attempts to look at correlations between intelligence and creativity from the 1950s onwards, by researchers regularly suggested that correlations between these concepts were low enough to justify treating them as distinct faculties of mind.

How to enhance creativity?

Acquire sufficient knowledge in the subject you are interested and think flexibly.

Anxiety and depression bad for your brain

We've all heard that anxiety and depression can be harmful to your health. Now there's evidence that they might be harmful to your brain:

People who are often stressed out or depressed are far more likely to develop memory problems than those with sunnier dispositions, U.S. researchers said on Monday in a finding that sheds light on early predictors of Alzheimer’s disease.

They said those who most often are anxious or depressed were 40 times more likely to develop mild cognitive impairment, a form of memory loss that is often a transitional stage between normal aging and dementia.

“Not only are these individuals losing cognition, but they are showing many of the changes in the brain that are associated with Alzheimer’s disease,” said Robert Wilson of Rush University Medical Center in Chicago.

...The latest research suggests that chronic stress may harm parts of the brain responsible for responding to stress — an area that is also associated with memory...

All the more reason to take a stand against your anxiety and depression.

Mixed Messages in Your Family A Quiz You Can Take

I have been studying the families-of-origin of patients with borderline personality disorder (BPD) since the the late 1970’s. As readers of this blog already know, I discovered that the biggest and most common emotional conflict in the parents who produce offspring with the disorder is a conflict over the very act of becoming and being a parent.  As I described in a previous post, the parents think being great parents and taking care of children is the end all and be all of human existence, but secretly they wish, for a variety of different reasons, that they could be spending most of their time doing something else entirely.

Since they are conflicted about their parental roles, they constantly give off mixed messages to their children about what is expected from them. This leaves the children to try to figure out how to meet their parents’ contradictory needs to be both needed by their children and, simultaneously, for their children to just go away. The children solve this dilemma by adopting various versions of the spoiler role.

Children growing up with mixed messages from parents is, in fact, a hallmark of families producing children with any personality disorder.  The problematic mixed messages are often in regard to only certain behaviors or role functions – usually just one or two – while the parents respond to other roles and behaviors in a coherent, non-contradictory manner.

For those readers who are now adults, how does your family stack up in the continuing double messages department? My colleague Hillel Abramson and I designed an instrument to try to measure the amount and type of double messages adults perceived as receiving from their primary attachment figures, called the Family Interaction Scale or FIS.  While designed with only borderline personality disorder (BPD) in mind, it can be used more generally, and you can administer it to yourself to see what areas are problematic for your families.

But first, just a little background.

In order to see what is going on in families, one has to appreciate that conversations between family members have subtexts. A subtext is an underlying, implicit and often distinct theme in a conversation that is not perceivable if someone is only paying attention to the literal meanings of the sentences spoken. In order to understand a subtext, one also has to listen to an entire conversation before hidden meanings might become evident. Just a few sentences will not do. 

Furthermore, an understanding of the entire history of the relationship between the people having the conversation, not just the current interactions, is also required to tease out important latent themes.

Therefore, appreciating the subtexts of conversations between intimates involves thousands of variables that will be completely different for each dyad or group being evaluated. To think that subtexts of this complexity can be “measured” by standardized questions and answers on a psychological test is ludicrous. For this reasons, truly “empirical” studies are impossible.

But in today's world, one must try. Some people insist that observations of subtexts are just “anecdotal.”  They can therefore just dismiss it as an object of scientific study. To get around this just a wee bit, we chose 9 of the most common themes in the families of those with BPD that I had observed over the years, and asked four different groups to rate their parents’ ongoing, current communication in these 9 “domains.”

The four groups were patients with the disorder, those who were subthreshold for the disorder (that is, who met 3 or 4 of the criteria for BPD rather than the required 5), non-psychotic patients being treated in our clinic who did not have BPD, and normal controls who exibited no psychiatric disorders at all.

The domains are:

1.  Praise and criticism

2.  Comments to friends and relatives about the subject

3.  Reactions to advice given by the parents

4.  Blame for the parents’ problems

5.  Frequency of advice giving by the parents

6.  Degree of parent’s preoccupation with the subject

7.  Relationship of a parent’s mood to the subject’s mood

8.  Parental reactions to the subject’s work failures and successes

9.  Parental reactions to the subject’s romantic failures and successes

For each domain, we provided 6 to 7 options. Since no human relationships are completely consistent all the time, we wanted to avoid saying anything that implied that the parents were “always” one way or another.  So we asked subjects to please check only the one item in each domain rating that "came the closest to describing the parent's current behavior towards you most of the time."

For each domain, there was one response pattern that we deemed appropriate. Another response pattern we originally deemed “neglectful.”  However, in thinking about it as the results came in, it seemed to us that it would be more accurate to say that these items reflected the fact that the issue in the domain did not seem to matter at all to the parents.

There were two response patterns that we deemed polarized – the parent acted most of the time at one extreme or the other without much in between.  There were also two response patterns that were indicative of  the pattern in which we were most interested: double messages. The parents either were perceived as blatantly contradictory in their behavior, or they said one thing but seemed to mean something that was contradictory to what they said. 

In reading the items below, you should be able to easily figure out which item corresponds to which response pattern.

Subjects in the original research were asked to choose and rate up to three attachment figures from their childhoods who were still alive, still interacting with the subject in the present, and not senile.  “Still in contact" could mean in person, by phone, by letter, or even by word of mouth.

These figures had to have served in the parental role when the subjects were between the ages of 5 and 15.  We provided the following list:

1.  Natural Mother

2.  Natural Father

3.  Adoptive Father

4.  Adoptive Mother

5.  First Stepfather

6.  Second Stepfather

7.  First Stepmother

8.  Second Stepmother

9.  Father's Father (only if he lived with you)

10.  Father's Mother (only if she lived with you)

11.  Mother's Father (only if he lived with you)

12.  Mother's Mother (only if she lived with you)

13.  Brother at least 5 years older than you

14.  Sister at least 5 years older than you

15.  Other (Specify)

Here were the test items:

DOMAIN 1

1.  This person consistently praises me no matter what I decide about how I run my life

2.  This person consistently criticizes me no matter what I decide about how I run my life.

3.  This person consistently goes back and forth between praising and criticizing me for the same decisions.

4.  This  person is consistently fair in praising and criticizing me for my decisions.

5.  This person rarely  praises or criticizes my decisions about how I run my life.

6.  Regarding my decisions, this person consistently says one thing but really                  means another.

________________

DOMAIN 2

1.  This person consistently brags about me to their friends and relatives.

2.  This person consistently bad mouths me to their friends and relatives.

3.  This person says contradictory things about me to friends and relatives.

3.  This person is consistently fair in making remarks about me to friends and relatives.

5.  This person consistently does not talk about me with their friends and relatives.

6.  This person consistently says one thing about me to friends and relatives but really means another.

________________ 

DOMAIN 3

1.  This person acts happy only if I follow their advice.

2.  This person acts happy only if I ignore their advice.

3.  This person consistently acts unhappy with my reaction to their advice no matter if I follow or ignore it.

4.  This person accepts my reaction to their advice even if I disagree with it.

5.  This person consistently does not react to how I respond to their advice.

6.  Regarding my reactions to their advice, this person consistently acts one way but really feels another.

________________ 

DOMAIN 4

1.  This person consistently blames themself for their own problems even when they are not at fault.

2.  This person consistently blames me for their own problems even when I'm not at fault.

3.  This person consistently goes back and forth between blaming me and themself for their problems.

4.   This person is fair in assigning blame for their problems.

5.   This person consistently blames others rather than me or themselves for their problems.

6.    This person rarely blames anyone for their own problems.

7.     In assigning blame for their problems, this person consistently says one thing but means another.

_______________ 

DOMAIN 5

1.  This person almost never tells me what to do, even if I ask for their advice.

2.   This person almost always tells me what to do.

3.  This person consistently goes back and forth between telling me to make my own  decisions and telling me what to do.

4.    This person usually tells me to make my own independent decisions but will offer advice if asked.

5.   This person is unconcerned with who makes the decisions in my life.

6.    Regarding telling me what to do, this person consistently says one thing but really means another.

________________

DOMAIN 6

1.   This person  consistently expresses worries  about how I am doing even when they know I'm doing well.

2.    This person never expresses worries about me even when they know I'm in trouble.

3.     In expressing worries about how I'm doing, this person goes back and forth between expressing worries and saying nothing.

4.    This person is consistently reasonable when expressing concerns about how I'm doing.

5.    This person doesn't even bother to find out how I am doing.

6.    In regards to worrying about how I'm doing, this person consistently says one thing but really means another.

________________

DOMAIN 7

1.    This person only acts happy when I am happy.

2.     This person only acts happy when I am miserable.

3.     This person goes back and forth between acting happy when I'm happy and acting happy when I'm miserable.

4.     This  person shows sympathy with how I feel but their mood does not depend on how I am feeling.

5.     This person almost never reacts to how I am feeling.

6.      When I'm happy or unhappy, this person  consistently acts one way  but really feels another.

_________________ 

DOMAIN 8

1.     This  person does not act happy unless I am succeeding in my career.

2.     This person usually acts unhappy about my career accomplishments and relishes in my failures.

3.       This person goes back and forth between acting happy about my career successes and relishing in my failures.

4.      This person expresses satisfaction with my career successes and sympathizes with my career failures.

5.      This person almost never reacts to my career successes and failures.

6.      When reacting to my career successes and failures, this person consistently acts one way but really feels another.

_________________

DOMAIN 9

1.     This person does not act happy unless I am having a successful romantic relationship.

2.     This person usually acts unhappy about my successes in romantic relationships and relishes in my failures.

3.     This person goes back and forth between happy about my romantic successes and relishing in my failures.

4.     This person expresses satisfaction with my romantic successes and sympathizes with my romantic failures.

5.     This person consistently does not react to how I am doing in romantic relationships.

6.     When reacting to my love life, this person consistently acts one way but                   really feels another.

_________________

The results of the study were published in 2005 in the psychiatric journal Comprehensive Psychiatry, volume 46, pages 340-352, and were highly significant and in line with most of our predictions. The fact that they were so significant was even more impressive considering the fact that the number of subjects in each subgroup was relatively small. Discovering small differences usually requires larger samples, so this means that the differences were probably quite large.

We found there were significant differences between groups in regard to appropriate and contradictoryresponses for the first attachment figure rated. BPD patients endorsed fewer appropriate responses than did the patient controls (p=.001) and than did the normal controls (P=.011). There were no other significant differences among groups regarding appropriate responses for the first rated individual.

BPD patients reported significantly more contradictory responses than did patient controls (p=.004) and normal controls (p=.003). In addition, Subthreshold subjects reported more contradictory responses than did patient controls (p=.009) and normal controls (p=.005).

Contrary to prediction, there were no significant differences in the mean number of polarized responses among any of the groups. The polarized responses were indicative of something called splitting: the tendency of people to think of others as all good or all bad.  BPD patients are thought to be unable to see shades of grey, but they were no more likely to endorse polarized response patterns than anyone else. In other words, this was evidence that patients with BPD do not split, at least when thinking about these issues. This was also shown in another way described below.

There were also no significant differences in what we first called neglect responses among any of the groups. This was a bit of surprise since neglect is often present in the parenting styles of those with BPD.  However, even when prominent, it tends to oscillate with overinvolvement.  But if these items measured lack of interest rather than neglect per se as described earlier, the fact that the parents of subjects with BPD were not characterized as uninterested should have been no surprise. That is because-  clinically - even when parents of future BPD patients are neglectful, they tend to blame it on the child!

When chronic unhappiness (dysthymia) was controlled for in comparisons of subject groups, the pattern of significant effects remained the same.

The number of subjects rating two parental figures (N=59) was considerably smaller than the number of subjects who rated at least one (N=93). No significant overall effect between the groups on the way they responded to the FIS regarding person B was found – possibly because of the much smaller sample size. However, the trends were the same.

Normal controls reported significantly more appropriate responses than did BPDs (p=.002), Subthresholds (p=.004), and patient controls (p=.024). BPD patients reported significantly more contradictory responses than did normal controls (p=.002) and trending toward reporting more than did patient controls (p=.064), while subthreshold subjects reported significantly more than did normal controls (p=.038). There were no significant between group differences in polarized or neglect responses.

Every contradictory item on the questionnaire was endorsed for person A by at least two of the BPDs (5%) with a range of 5% to 32.5%. The most commonly endorsed contradictory item was, “This person consistently goes back and forth between praising and criticizing me for the same decisions.” 

When we examined the FIS by domains, the most commonly endorsed domain in which either contradictory response was endorsed by BPDs for person A was domain 1, with 40%. The corresponding percentages were domain 2, 27.5%; domain 3, 25%; domain 4, 20%; domain 5, 32.5%; domain 6, 22.5%; domain 7, 20%; domain 8, 27.5%; and domain 9, 20%.

The fact that the pattern in the various domains was all over the place within the BPD sample also indicates that each item was considered separately and there was no pattern of items being  rated globally in one consistent way. Such global ratings might be expected in "splitting" subjects who were unable to look simultaneously at both good and bad characteristics in an individual.

Furthermore, although the mean number of contradictory responses of BPD subjects within the varius domains was considerably higher than the mean for patient controls for person A, it was still quite small—only 2.24 (range 0 – 8 out of a possible 9). The mean for the normal controls, however, was only 0.46.  In other words, the normal controls perceived almost NO double messages from their parents. 

So readers, go ahead and use the FIS to rate your own families on how often they drive you to distraction with double messages. You don't have to share the results with anyone unless you want to. But please feel free to share your general reactions to the FIS items in the comments section.