Teenagers, Depression and Suicide

Teenagers and Depression and Suicide

Most of us remember our teenage years as being very difficult. I have heard many adults, friends, family members, clients, and others unequivocally state that they would never want to revisit those days. Among the many problems adolescents face are feeling accepted by peers, believing that they are attractive, getting along with parents and siblings. Then there is also coping with school and adjusting to the rapid physical changes brought on by hormones, rapid growth in height, powerful sexual urges, and dealing with the pressure to use drugs and alcohol. It is not surprising that many of these teenagers feel anxiety and depression.

Adolescence is when young people join social groups of males and females. There are parties and the first experience of dating and sexual play. The Covid pandemic has brought these experiences to a halt. Many schools are closed, and most people wear masks to prevent the spread of the virus. These factors are not conducive to socialization. Perhaps, with the pandemic declining, everyone will resume their everyday lives.

Today, adolescents have the added pressure of social media. At least some teens are the targets of these insults and rumors who experience terrible feelings of despair. Sadly, it is easy for bullies of either gender to beat up each other by posting horrible things about youngsters they dislike. The result is shocking reports of suicides committed by these unfortunate youngsters.

During the past two years, teens have struggled with the Covid pandemic. Isolated at home and enduring internet learning, more young people, commit suicide. The quote is from the Baylor College of Medicine:

“During the COVID pandemic, I, along with most pediatricians, have seen an exponential rise in teenagers admitted to the hospital with suicidal thoughts and attempts. Some had been lonely and contemplating suicide for a while. Some made rash decisions and cried of regret when recounting their actions.”

“When a child tries to commit suicide by firearm, they are likely to succeed.”

“The pandemic uniquely affected adolescents. Social isolation, constant uncertainty, stress, and fear have plagued their lives. According to the CDC, teenage emergency room visits for suicide attempts increased significantly during the pandemic, with a 50% rise in cases in females and an almost 4% increase in males. Suicidality among teens in Texas was on the rise before the pandemic. However, most suicidal attempts are not fatal except for guns.”

“In Texas, guns are the second leading cause of death among children and adolescents. Suicide is also the second leading cause of death among American youth.”

Teenagers depend upon parental cooperation for psychotherapy. For example, they need to be driven to appointments and be provided with money to pay for sessions. Because of their age, parental involvement is essential for the therapeutic process to succeed. Parental involvement means that there will be joint sessions with the therapist and separate meetings with parents. Many parents are reluctant to get involved because they fear blaming their child’s problems.

 Experience with teenagers shows that parental attitude and cooperation make a big difference in whether the treatment is successful.

There are several ways parents can sabotage psychotherapy:

1. Failure to make the car available to the teen or drive them to the appointment.

 2. Failure to pay for sessions.

 3. Refusal to attend family sessions.

 4. Defensiveness for fear of being blamed.

 5. hostility blaming the teenager for everything.

 6. Rejecting depression as a real medical problem and blaming the teenager.

 7. Attempting to hide a history of child abuse.

All parents must know the importance of teenage depression and the need for psychotherapy. Multiple factors can cause our teens to become depressed, and many of them have nothing to do with the family. Today, children are growing up in a complex, dangerous, and uncertain world. In addition, they’re learning to cope with the opposite sex can become complicated. Breaking up with a boy or girlfriend can cause grief and depression. It is a mistake not to take this seriously.

Dr. Schwartz is available for consultation. He is available at dransphd@aol.com

Resentment, Like Holding Onto a Hot Coal

“Holding on to anger is like grasping a hot coal with the intent of throwing it at someone else; you are the one who gets burned.” ~Buddha

Resentment is an extremely bitter diet and eventually poisonous. I have no desire to make my toxins. ~Neil Kinnock

According to the Oxford American Dictionary, “resentment is defined as

bitter indignation at having been treated unfairly.” The definition includes the fact that people can harbor resentments going back many years.”

Resentment has also been called the experience of negative emotion, such as anger or hatred, felt because of a real or imagined wrong done to them.

A perfect example was given to me by a couple who complained about their younger son, now 38 years old, continuing to yell at them about his childhood. Despite being quite successful in his career, he loudly blames them for all of his troubles. The son is not occasionally yelling at his parents. Still, he does this every time he talks to them over the telephone. It has gotten so bad that his father will no longer speak to him. The son heaps the greatest on his father. His son is not bothered by this break in communication. Instead, his mother has to hear about all the past injustices.

A female patient bitterly complained about her husband. The latter eventually moved out of their apartment because he could no longer tolerate her. She blamed her father for never having time for her while growing up. Then, she blamed her therapist for not finishing her therapy and charging too much money. While she completed her treatment, she left these complaints intact, although her life quality dramatically improved since starting therapy. She was no longer depressed, completed her undergraduate degrees, had a professional career since graduation, and had a vastly improved relationship with her son and daughter. 

However, she held onto her resentments. Perhaps that enabled her to end her therapy successfully. She remained blind to how her complaining harmed other people. I never heard from her again, but sometimes I wonder how she got along afterward.

Parents are the most common object of resentment. As with the couple cited above, they are the people who are frequently the target of blame. These patients blame their parents for all failings and failures alike. 

I have heard patients blame their addiction on their parents. I have heard patients blame their parents for everything from poor school grades to work failures to failed relationships. Many young patients have complained to me they “Would not be depressed except by the way they were treated by mom or dad.”

What is so interesting is that, in blaming parents or others for one’s misfortunes, there is a failure to take responsibility for what has happened. The 38-year-old son never looks at his behavior to understand the role he plays in his present-day successes and failures.

None of this suggests that parents are innocent or that they never did wrong. We know that parents abuse, neglect, and reject their children. There are those parents who are overprotective authoritarians. Some are addicted to drugs and alcohol. In all cases, even the best parents are imperfect, make mistakes, and sometimes be unjust.

An essential step for all adults is acknowledging that what happened in the past cannot be undone. We can build better lives for ourselves in the present and future. To do this is to take responsibility for one’s behaviors and choices in the present. Many patients have told me that they want their parents to admit their wrongdoing. When asked how that would help them, most gave vague answers. Of course, there is nothing to be gained from asking a parent to admit guilt, even if they did so.

Resentment is malignant. There is no better way to hold on to the bitter past than to relive horrible events that happened then. There is no better way to relive the awful past than to continue to blame others, whether parents or anyone else. 

Remember Buddha’s quote that anger and resentment are like grasping hot coal that can only burn yourself.

Pandemic, The Economy, War and Life and Death

Along with American citizens and people worldwide, I am extremely upset about the Pandemic, Ukraine, Russia, and the economy. 

 Many friends, family, and clients say that they believed the Pandemic was over. However, Russia invaded Ukraine, and anxiety rose once anxiety and worry rose again. If these events aren’t bad enough, we have been plagued by rising prices for everything from gasoline, building materials, and food, among many other essential items.

I was born in 1942, in the middle of WW 11. My grandfather’s youngest brother, Uncle Sam, served in and earned the Purple Heart in the first World War. My three uncles served in World War 2. Then, there was the war to establish the State of Israel. Next was the invasion of Israel, the Korean War, Vietnam, invasion of Iraq, Gulf War, and Afghanistan, and more minor wars were between these. And, evermore, nations are gaining nuclear weapons and missiles. In these wars, including the current war in Ukraine, all of us witness acts of destruction. The destruction includes human lives, cities, buildings, and all the things people take for granted in their daily lives.

The great psychoanalyst, Sigmund Freud, wrote about the issues surrounding war, life, and death after World War 1. 

Freud’s Theories of Life and Death Instincts

Sigmund Freud’s theory of drives developed throughout his life and work. He initially described a class of drives known as life instincts. He believed these drives handled much of our behavior.

Eventually, he believed that life instincts alone could not explain all human behavior. With his book Beyond the Pleasure Principle in 1920, Freud concluded all instincts fall into two major classes: life drives or death drives.

The Life Drive (Eros)

Sometimes referred to as sexual instincts, the life drives deal with basic survival, pleasure, and reproduction. These instincts or drives are essential for sustaining the individual’s life and the continuation of the species.

While we think of life instincts regarding sexual procreation, these drives include thirst, hunger, and pain avoidance. The energy created by the life instincts is known as libido.

Freud proposed Eros was opposed by ego forces (the organized, realistic part of a person’s psyche that mediates between desires). In this latter view, he maintained that life instincts were opposed by the self-destructive death instincts, known as Thanatos.

Behaviors commonly associated with life instincts include love, cooperation, and other social actions. The life drives focus on preserving life, both the individual and the species. This drive compels people to engage in actions that sustain their own lives, such as looking after their health and safety. It also exerts itself through sexual drives, motivating people to create and nurture new life. 

Positive emotions such as love, affection, and social cooperation are also associated with life drives. These behaviors support both individual well-being and the harmonious existence of a cooperative and healthy society.

The Death Drive (Thanatos)

Freud first introduced the concept of the death drive in his essay Beyond the Pleasure Principle. He theorized that the death drive is the drive toward death and destruction, famously declaring that “the aim of all life is death.”

Freud believed that people typically channel their death drive outwards and manifest as aggression toward others. However, this drive can also be directed inwards, which can cause self-harm or suicide.

Freud based this theory on various clinical observations. For instance, Freud noted that people who experience a traumatic event would often reenact that experience. While studying soldiers returning from World War I, Freud observed they had a tendency to repeat the traumatic experiences that took them back to the combat scene.

He noted similar behavior in his 18-month-old grandson, Ernst, who played a game called Fort/Da whenever his mother was away. To deal with his anxiety, his grandson would repeatedly toss away and retrieve a wooden reel with a piece of string tied around it. Freud wondered how “repetition of this distressing experience as a game fit in with the pleasure principle?”

Freud concluded people hold an unconscious desire to die, but life instincts largely temper this wish.

According to Freud, the death drive stands in stark contrast to the drive to survive, procreate, and satisfy desires. In Freud’s view, all living organisms have an instinct” toward death.” in Freud’s view. The compulsion to repeat was “something that would seem more primitive, more elementary, more instinctual than the pleasure principle it overrides.” He further proposed that the death drive extended that compulsion.

As yet another war presents the danger of spreading into a wider conflict. Could Ukraine become the starting point of a third world war? I could not help but ask myself if Freud was correct. Does humanity have a drive towards self-destruction and extinction? What do you believe? I am available for exchanging ideas at

dransphd@aol.com

Trauma and Gaslighting

Gaslighting Quotes That Capture This Emotional Manipulation

  1. “Gaslighting is mind control to make victims doubt their reality.” — Tracy Malone.
  2. “Gaslighting is a subtle form of emotional manipulation that often results in the recipient doubting their own perception of reality and their sanity. In addition, gaslighting is a method of manipulation by toxic people to gain power over you. The worst part about gaslighting is that it undermines your self-worth to the point where you’re second-guessing everything.” — Dana Arcuri.
  3. “It frightens me because I feel vulnerable to attacks, an easy target for gaslighting. Phrases like ‘No, I didn’t say that!’, ‘You don’t remember,’ and ‘You must have forgotten,’ start rattling my brain and making me jittery.” — Ankita Sahani

There are many times of childhood trauma, where family members state it happened a long time ago, and it’s time to get over it. The same people who say that engage in gaslighting the survivor of childhood trauma.

What is meant by gaslighting?

Gaslighting refers to the act of undermining another person’s reality by denying facts, the surrounding environment, or their feelings and memories. Ultimately, the target of gaslighting may doubt their sanity.

The trauma of childhood abuse can have long-lasting repercussions that affect your understanding of yourself and the world around you. For many, the effects of abuse show up in dysfunctional interpersonal relationships resulting from attachment disruptions at pivotal points of childhood development. By examining the impact of childhood abuse on interpersonal relationships and the role of therapy in healing, people can better understand their experiences and the possibilities for recovery.

One result of childhood trauma can be dissociative disorders:

Dissociative disorders involve the inability to distinguish between thoughts, memories, surroundings, actions, and identity. People with dissociative disorders escape reality in involuntary and unhealthy ways and cause problems with functioning in everyday life. In one case, a patient dissociated when she had to move from her apartment after many years. Any stress can set off this disorder. 

The Impact of Childhood Abuse on Interpersonal Relationships

In the absence of secure attachments, survivors of childhood abuse often develop dysfunctional attachment styles that disrupt your ability to interact with others in healthy ways. Emotional abuse, neglect, and sexual abuse are more strongly associated with interpersonal distress in adulthood than physical abuse. However, it is essential to remember that any abuse survivor can experience profound interpersonal difficulties, including:

  • An inability to trust: The ability to trust others is a critical part of forming and maintaining healthy relationships. However, when someone has experienced childhood abuse, that ability is often diminished or even removed altogether. As a result, you may be reluctant to engage in honest and open relationships for fear that you will be betrayed or harmed. Staying closed off, guarded, or hypervigilant can make it difficult for others to feel close to you, and you deny yourself the opportunity to form healthy and meaningful bonds. The lack of trust also affects all insecure attachment styles.
  • Avoidant attachment: Some people who do not experience the benefit of secure attachment in childhood must avoid attachment to others altogether. Avoidant people are unable to trust others. It also arises due to extreme self-reliance. Many abuse survivors learned that they could not rely on others to meet their attachment needs early. Those with an avoidant attachment may decide to ignore those needs or attempt to meet them yourself. In adulthood, this typically translates to social avoidance or the formation of emotionally distant relationships in which you remain unresponsive to the needs of others.
  • Ambivalent attachment: Survivors of childhood abuse develop a weak attachment style. People with an ambivalent attachment style desire intimacy. However, they are ever watchful of change in the relationship, sometimes to the point of paranoia, “frustrated and resentful, particularly if you feel misunderstood or vulnerable.
  • Disorganized attachment: People who experience this style are deeply fearful of relationships. However, they crave emotional closeness. You are at once afraid of intimacy and of being alone. As a result, you may lash out if you feel ignored or unloved while being reluctant to show affection for others. These patterns create significant barriers to forming and maintaining healthy relationships. 

People who experience childhood abuse are vulnerable to developing mental health disorders that compromise emotional and behavioral stability, including depression, anxiety, PTSD, and borderline personality disorder. These illnesses present additional challenges to engaging in healthy interpersonal relationships, leading to re-traumatization that creates further emotional damage.

Contact Dr. Schwartz at

dransphd@aol.com

Einstein and a Hidden Universal Force: Love

In the late 1980s, Lieserl, the daughter of the famous genius, donated 1,400 letters, written by Einstein, to the Hebrew University, with orders not to publish their contents until two decades after his death. This is one of them, for Lieserl Einstein.…”

When I proposed the theory of relativity, very few understood me, and what I will reveal now to transmit to mankind will also collide with the misunderstanding and prejudice in the world.I ask you to guard the letters as long as necessary, years, decades, until society is advanced enough to accept what I will explain below.

There is an extremely powerful force that, so far, science has not found a formal explanation to. It is a force that includes and governs all others, and is even behind any phenomenon operating in the universe and has not yet been identified by us.This universal force is LOVE.

When scientists looked for a unified theory of the universe they forgot the most powerful unseen force.Love is Light, that enlightens those who give and receive it.

Love is gravity, because it makes some people feel attracted to others.Love is power, because it multiplies the best we have, and allows humanity not to be extinguished in their blind selfishness.

Love unfolds and reveals.

For love we live and die.

Love is God and God is Love.

This force explains everything and gives meaning to life. This is the variable that we have ignored for too long, maybe because we are afraid of love because it is the only energy in the universe that man has not learned to drive at will.

To give visibility to love, I made a simple substitution in my most famous equation.If instead of E = mc2, we accept that the energy to heal the world can be obtained through love multiplied by the speed of light squared, we arrive at the conclusion that love is the most powerful force there is, because it has no limits.

After the failure of humanity in the use and control of the other forces of the universe that have turned against us, it is urgent that we nourish ourselves with another kind of energy…If we want our species to survive, if we are to find meaning in life, if we want to save the world and every sentient being that inhabits it, love is the one and only answer.

Perhaps we are not yet ready to make a bomb of love, a device powerful enough to entirely destroy the hate, selfishness and greed that devastate the planet.However, each individual carries within them a small but powerful generator of love whose energy is waiting to be released.

When we learn to give and receive this universal energy, dear Lieserl, we will have affirmed that love conquers all, is able to transcend everything and anything, because love is the quintessence of life.I deeply regret not having been able to express what is in my heart, which has quietly beaten for you all my life. Maybe it’s too late to apologize, but as time is relative, I need to tell you that I love you and thanks to you I have reached the ultimate answer! “.

Your father Albert Einstein

Of Music and Life

“Music should strike fire from the heart of man, and bring tears from the eyes of woman.” Ludwig van Beethoven

“Without music, life would be a mistake. Friedrich Nietzsche.”

“When I hear music, I fear no danger. I am invulnerable. I see no foe. I am related to the earliest of times, and to the latest.” Henry David Thoreau.

“Music Hath Charms to Soothe the Savage Breast.”

This famous quotation from William Congreve (1670-1629) evidently has a lot more truth to it than he ever realized four hundred years ago.

To complete the quote: 

“Music hath charms to soothe the savage breast. To soften rocks or bend the knotted oak.”

According to Dr. Michael Miller, Director of the Center for Preventive Cardiology at the University of Maryland Medical Center, music can make you feel good. Therefore, possibly and possibly prevent a heart attack.

According to Dr. Miller, earlier studies showed that music affects heart rate and blood pressure. In addition, he states that laughter and prayer improve cardiac performance.

Dr. Miller’s research group selected a group of healthy participants to study the effects of music on the cardiovascular system. Subjects chose a joyful type of music that made them feel good and the second type of music that made them feel anxious. Using a blood pressure cuff, the researchers discovered that the people who listened to joyful music increased blood flow of the brachial artery, a very healthy response. However, the artery flow decreased when the subjects listened to anxiety-producing music.

What is very significant is that the increased artery flow was equal to what people experience after aerobic exercise.

So, what this means is that for you to remain heart healthy, it is essential to do such things as 

a) be careful about what you eat, 

b) maintain a healthy weight, 

c) exercise regularly 

d) provide yourself with the opportunities to laugh as much as possible, and, finally 

e) listen to music that you find joyful and is not anxiety-producing. 

Regularly performing these activities might allow you to prevent a future heart attack or stroke. At least, that is what the findings seem to suggest.

How it works:

Stress is a killer. Stress pumps lots of adrenaline into our system, resulting in the release of much bad stuff that clogs our arteries. However, the activities discussed above reduce and even reverse the impact of stress. Music, laughter, exercise, and others help release endorphins that create a wonderful, relaxed, and euphoric feeling. That is just the opposite of what work and other problems do to us. So, keeping your heart and mind healthy is very much a “laughing matter.”

Let yourself laugh and listen to happy music. “Soothe that savage breast” and live longer and more joyful.

What is Love

What Is Love?

“Love is friendship that has caught fire. It is quiet understanding, mutual confidence, sharing, and forgiving. Through good and bad times, it is loyalty. It settles for less than perfection and makes allowances for human weaknesses.” Ann Landers.

“Whatever our souls are made of, his and mine are the same.” Emily Bronte.

“Love is composed of a single soul inhabiting two bodies.” Aristotle.

Webster Dictionary Definition of Love:

1. strong affection for another arising out of kinship or personal ties. Maternal love for a child.

2. attraction based on sexual desire: affection and tenderness felt by lovers after all these years are still very much in love.

3. affection based on admiration, benevolence, or common interests love for his old schoolmates

4 .warm attachment, enthusiasm, or love of the sea.

Love:  

After several years of marriage, we take our spouses for granted.

I recently had a case of a married couple who had been together for 18 years. The husband, an amiable and sensitive man, forgot to send his wife some kind of gift for Valentine’s day. She felt hurt and disappointed. We discussed it in couples’ therapy. Clearly, he had no intention of hurting his beloved wife. While he intended to send her a gift, he forgot as he played video games with friends on the Internet. She was very hurt. As his therapist, I joked with him he had better have a good life insurance policy because she retaliated in a deadly way. 

He understood the joke and felt terrible about overlooking the import of expressing his affection, especially on Valentine’s day. 

We take a lot of things for granted, both husbands and wives. Yet, it is essential to express affection and love for our romantic partner. It’s just a reminder that we care. And it means a lot to our spouses. 

There are many ways for couples to express their love for one another. For example, ordering flowers, sending a loving card, cooking dinner for that evening, possibly ending in a sexual episode of lovemaking. These things mean a lot to people. There is more to love and romance and simply sex. People want to know that their partner is highly valued and appreciated. 

Love is a set of emotions and behaviors characterized by intimacy, passion, and commitment. It involves care, closeness, protectiveness, attraction, affection, and trust. Love can vary in intensity and can change. It is associated with a range of positive emotions, including happiness, excitement, life satisfaction, and euphoria. Still, it can also result in negative emotions such as jealousy and stress.1

It is said by many that love is one of the most important human emotions. Yet, despite being one of the most studied behaviors, it is still the least understood. 

Types of Love

Not all forms of love are the same, and psychologists have identified several types of love that people may experience.

These types of love include:

Friendship: This type of love involves liking someone and sharing a certain intimacy.

Infatuation: This is a love that involves feelings of attraction without a sense of commitment; it usually takes place early in a relationship and may deepen into more lasting love.

Passionate love: This type of love is marked by feelings of longing and attraction; it often involves an idealization of the other person and a need to maintain constant physical closeness.

Compassionate love: This form of love is marked by trust, affection, intimacy, and commitment.

Unrequited love: This form of love happens when one loves another who does not return those feelings.

The Many Meanings of a Smile

A Smile Can Hide More Than it Reveals

1. “smile though your heart is breaking, smile even though it’s breaking….” Nat King Cole song.

2. “Because of your smile, you make life more beautiful.”

Thich Nhat Hanh

3. “Anyone who has a continuous smile on his face conceals a toughness that is almost frightening.”

Greta Garbo

4. People also smile when they’re lying, a fact not lost on Shakespeare: Hamlet marvels at how “one may smile, and smile, and be a villain.” Shakespeare: Hamlet marvels at how “one may smile, and smile, and be a villain.”

5. Finally there is The Mona Lisa with her enigmatic smile.

Have you ever been told, “Hey, what’s the matter? Smile, smile!” How can there be such varied quotations about smiling? Much like Thich Nhat Hanh states, aren’t we told that a smile lights up the world, reflects happiness, and gives love to everyone?

In actuality, smiling, like all human nonverbal communication, is highly complex and open to many interpretations. 

A notorious police mug shot of Jared Lee Loughner, the mass murderer and shooter who killed several people and wounded a congresswoman in Arizona is grinning. Revisit the picture on the Internet, and you will observe how wicked that smile is. Yet, his defense attorneys are trying to ban the mug shot because it reflects poorly upon him. “But he’s smiling, isn’t he?” 

Studies show that smiles express many more emotions than happiness or contentment. The basis of a smile can be conceit, embarrassment, shame, deceit, grief, tension, and uneasiness. How often have you smiled when you are with someone who has said or done something that makes you feel outraged? In this type of circumstance, well known to most of us, there is a need to smile to cover the anger. Perhaps we are not comfortable discussing our natural reaction? There can be a multitude of motivations but, the smile is not friendly.

Then, there are cultural variables regarding the smile. I was startled to learn from Russian friends of mine that in places like Moscow and other big cities, a smile is viewed with distrust unless it is personal and meaningful. Americans might smile out of politeness, but that will leave a Russian suspicious. While Americans might smile while walking down the street, the Russians do not. That is why some Russians view American smiling as false.

In Japan, people restrain their smiles. The Japanese control their emotions. When they view a person smiling, they focus on the upper part of the face, especially the eyes, to understand the true meaning of what the person is conveying. Americans focus on the lower part of the face, particularly the mouth. The reason is that, while the mouth is flexible and can take many shapes, including a smile, this is far less true of the eyes. In addition, unlike the Russians, the Japanese smile to convey politeness.

It’s essential not to come to conclusions too quickly when you meet someone smiling. Yes, mainly that person is conveying a happy state of mind. But listen to your instincts when they tell you that something is wrong or doesn’t fit. On one occasion, I asked a friend or family what was wrong, even when smiling. There is something not quite right about the smile. The mouth has the correct shape, but the eyes, eyebrows, and tone of voice suggest something other than all is well.

Finally, are you confident that your smile reveals or expresses what you feel? Perhaps it would be better for you if it did. If you are distressed, why not say so instead of hiding your emotions by smiling? In reverse, are you sure you are smiling when you feel good? Feeling good can also be covered up.

What are your experiences with smiling persons, be they children, friends, family, or people at work? 

Address comments to Dr. Schwartz at dransphd@aol.com

The Fear of Emotional Intimacy

It is Interesting two people can be married and live together for years yet, not be emotionally intimate. In that situation, both people have committed to each other, but that is quite different from intimacy.

What is emotional intimacy?

Intimacy is the ability to share the most profound feelings with one’s partner. That includes sharing love, passion, creativity, laughter, and joy. It means allowing one’s partner to know the deepest secrets and the most hidden parts of oneself on a deep level. Emotional intimacy is such that one no longer feels lonely. Yet, there are countless numbers of people who feel lonely and unhappy despite marriage. Two people may live together for many years but feel like total strangers. 

One of the prime reasons for this is the fear of intimacy. In other words, commitment is the decision two people make to stay together. Still, intimacy is the ability and willingness to be open and honest. It is a closeness that is both sexual and emotional. But, of course, some individuals fear and avoid intimacy to the extent that they avoid commitment.

How do you know if either you or your partner fear intimacy? I get many email questions that represent problems with emotional intimacy. For example, people write to me complaining that their partner, during an argument or disagreement, gives the “silent treatment.” The silent treatment is the refusal to acknowledge or communicate with one’s spouse. Another complaint is that the spouse reacts to any disagreement by leaving the room. In this, there is a refusal to argue, disagree or talk about much of anything. 

There is nothing more frustrating than to be with a person who refuses to deal with an interpersonal conflict. Keeping secrets is another example of a lack of intimacy in a relationship. Secrecy is the opposite of openness and honesty with one’s spouse. Often, those who keep secrets do not view their partner as their best friend. Finally, real intimacy means that two people can empathize with the feelings and stresses their partner is going through.

People avoid intimacy for various reasons that usually lie in their past experiences. The first and most potent relationship experience begins during childhood. Children who grow up with physical and emotional abuse emerge into adulthood with problems of trust in others. Many of them may avoid commitment and intimacy for fear of being abused and hurt again. 

Then, too, parents who were too controlling and intrusive produce children who learn that getting too close to others may be too oppressive. So, again, there is a fear of being controlled and engulfed.

The absence of one or both people’s ability to show empathy and understanding for their partner is a sign of intimacy problems. A symptom of a problem is a chronic wish to be right all the time rather than learning. Relationships rest on a foundation of willingness to compromise, understand what the other is feeling, and an ability to be flexible and change for the sake of the other.

It’s Enough to Make You Pull Your Hair Out

Do you remember a time when you were reading or studying for a school exam or writing a term paper and were quite unconsciously twirling, twisting, and pulling your hair until the strands fell out?

I have worked with people with Trichotillomania. They are also known as “trichsters,” but nothing is humorous about this disorder. It is a disorder also known as hair-pulling. “Trichotillomania is repetitive twisting and twirling of the hair. The hair loss is usually in a well-defined area with shortened, broken-off hairs and early regrowth of hair. The scalp is the most commonly involved site, but eyelashes and eyebrows may also be involved. The hair loss can also be patchy and poorly defined.”*

Some 2.5 million Americans experience this disorder. Hair pulling often begins during childhood or adolescence. For example, studies show that boys who pull out their hair start around the age of 8, while girls begin around twelve years of age or with the onset of puberty. By far, the highest percentages of people with this disorder are women, and they are 4 times more likely than males to engage in hair-pulling.

The ancient origins of the word, Trichotillomania come from Greek root terms meaning “hair,” “pulling,” and “mania,” or madness. Actually, there is nothing mad or crazy about this little-understood disorder. Today, psychiatry and medicine define it as an impulse control disorder. The implications are that it is medical in nature and specifically neurological in origin.

*Symptoms:

  • Constant tugging, pulling, or twisting of hair
  • An increasing sense of tension is present before the hair pulling
  • Sense of relief, pleasure, or gratification is reported after the hair pulling
  • Hair pulling leads to an uneven appearance
  • Bare patches or diffuse (all across) loss of hair
  • Hair regrowth in the bare spots feels like stubble
  • Some individuals may develop a bowel obstruction if they eat the hair they pull out
  • Other self-injury behaviors may be present
  • People suffering from this disorder often deny pulling out their hair

*(Information is from U.S. National Library of Medicine)

Many mental health specialists define this disorder as impulse control because those with this disorder cannot resist the urge to pull their hair. The impulse to tear one’s hair is so overpowering that it cannot be controlled. Once the habit has reached those dimensions, there is no way to resist the urge. The result is that bald spots emerge on the scalp. 

The presence of these bald spots becomes a source of great distress, particularly for teenage girls when they are at the height of concern about their appearance. In fact, the impact on one’s appearance and its social consequences have the most significant impact on the social and emotional adjustment of people with this disorder.

One of the most essential facts for sufferers and their loved ones to know about this behavioral disorder is that it is not a bad habit. People can learn to control or alter patterns with little difficulty. The overwhelming urge to pull hair places it outside of the category of a learned and bad habit.

It is said that there are two types of Trichotillomania: one in which the individual is aware that they want to pull their hair and another: in which the person is so involved and absorbed in an activity that they are unaware of what they are doing.

Among those who know they want to pull their hair, there is a feeling of extreme distress, depression, and anxiety, leading them to pull their hair out. The result is a feeling of relief or an end to the emotional numbness experienced by these individuals. However, there is no awareness that they have started to pull their hair for other people. Among the second group, the process of hair-pulling seems to be much less open to attention much of the time, until sometime after it has started. In all cases, once the person attempts to stop the behavior, the worse it becomes.

Reports about the prognosis of this disorder are that most children will outgrow it within a year. However, if this does not happen, it can and does last into adulthood.

There is no one accepted and proven treatment for this disorder. The commonly tried treatments are medication for depression, psychodynamic psychotherapy, cognitive-behavioral therapy, and behavior modification. One form of behavior modification is referred to as reverse habit conditioning. The patient is made aware of the behavior and when it will happen and then explores alternative coping mechanisms to the hair-pulling.