Are You Airbrushing Your Relationship?

Are You Airbrushing Your Relationship?

3 signs that you may be heading for another broken heart.

Posted June 20, 2024 | Reviewed by Gary Drevitch By Keven Duffy, LCSW for Psychology Today

Key points

• If your new partner is a fixer-upper, you're ignoring red flags; assume the person won't change for you.

• Getting involved with a person if they check certain boxes ignores other attributes that may matter later.

• Wanting to leapfrog past the messy early dating stage means you're focusing on an imagined future happiness.

Source: Gabby Orcutt / Unsplash

Addison rushes into my office, ecstatic about James, whom she’s been dating for three weeks. “I’ve found my soulmate,” she says.

Three months later, she’s devastated that the relationship has ended. She’s had a series of four-month relationships that usually ended badly. “I don’t get romantic love,” she says.

I see this scenario play out frequently. A client gushes that their newest fling is “the one,” casting a relative stranger in the role of their future partner by focusing only on their idealized qualities.

In other words, they are airbrushing their partner.

In the early days of a relationship, it’s tempting to idolize the other person. They’re a blank slate, so it’s easy to project our unconscious fantasies onto them and ignore the signs that they might not be a good match.

Many experience a cognitive bias called the halo effect. In a 1920 study, psychologist Edward Thorndike found that our first impressions of a person can influence how we feel and think about their overall character. This can partially explain how perceiving a few initial good qualities enables people to overlook any bad tendencies.

Signs that you might be airbrushing:

1. Ignoring Relationship Red Flags. At a bridal shower, Bonnie sits in a circle with her 23 friends—all of whom are married or engaged—watching the bride-to-be open gifts. “We need to find you a good man,” someone says to her.

Bonnie politely smiles, but she's mortified. She feels embarrassment and hopelessness that she has failed to find a partner. Nearly all of her friends are married, and she’s feeling pressure from her parents. That’s why she puts so much hope in her relationship with Alex.

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In a recent therapy session, she tells me he is a successful British journalist with a great apartment, and he spent their second date gushing about her beauty, wit, and intelligence.

But Alex is awful to Bonnie, she later revealed. Alex knows that Bonnie’s brother died in a motorcycle accident, but still talks endlessly about the good times he had driving his Moto Guzzi around England. He criticizes her appearance in front of others, and then gets angry with her when she says she’s hurt.

Bonnie talks about all of this behavior in her sessions, but she quickly justifies it, clinging to the positive idea of him.

Solution: Play out the tape. I ask Bonnie to imagine that she is married to Alex but he has not changed. He is still invalidating, critical, and emotionally unsafe. When Bonnie looked into the future, and saw herself riddled with the same anxiety and fear, she ended the relationship.

It’s important to not think about your future partner as a “fixer-upper.” When people tell and show you who they are, believe them.

2. Fixating on Your Romantic Partner Checklist. Peter works for a big bank and is quite successful in his career, but not in his relationships. He is highly concerned about optics and fixated on finding someone who makes him look good to others.

He has a checklist, and his girlfriend Emily hits all the marks. She is beautiful, skis, has an Ivy League education, and comes from a good family.

She also treats him terribly, with no consideration for his feelings. She is flaky and disinterested, frequently canceling dates at the last minute.

Checklisters are so fixated on their lists that they ignore the reality of their own experience. They’re not attuned enough to their own needs to see that their partner isn't meeting them. They ignore their feelings to accommodate who they think they should be or what they want their partner to be via external metrics.

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Dating apps make checkboxing particularly tempting, because the algorithm is designed to feed your checklist with the data you give it.

Solution: Ignore the optics and focus on how a person makes you feel. This helps box-checkers better attune themselves to their intuition and develop more respect for their lived experience.

Going through items on the list—Ivy-league diploma, tall, large-friend group, etc.—helps us get curious. By getting very detailed about the “whys,” you can begin to unpack historical or societal reasons for certain nonnegotiable items. This understanding can help you loosen standards that may be preventing you from finding a suitable partner.

3. Wanting to Fast-Forward to Long-Term Commitment. At the beginning of a recent appointment, Nora announced that she had met her future husband. But she was impatient to get to commitment. “I wish I could just leapfrog over all this dating stuff,” she said.

Dating involves a lot of vulnerability and uncertainty. A lot of people, especially once they get past 30, don’t want to go through it anymore. They want to fast-forward to the magic moment when they’re married and imagine everything will be OK.

But if you're fast-forwarding to marriage before taking the time to understand a person, you risk jeopardizing the security, consistency, and knowledge that the dating period creates. You're overlooking critical information for compatibility.

Solution: Slow down. If you're inclined to fast-forward, ask yourself why. Are you terrified of the messy, vulnerable aspect of the uncertainty of dating? Are you tired of being the bridesmaid? Terrified of being burned again? Or, on a deeper level, are you worried no one will ever really love you?

When you slow down, you have the space to see what’s actually going on, good or bad.

Why aren’t you enjoying the first stages of a romance? Is this person making you feel unsafe or uncertain, ignoring you, or being slow to respond to texts?

The beginning might be scary, but it should also be a happy time. This is the time when you are discovering each other. It’s not something you can skip, and you shouldn’t want to. If you want to hit the fast-forward button, it could be a sign that you it might be better to press “stop” instead.

Take off those relationship goggles: Airbrushing leads to disappointment and heartache, so it’s important to watch for the signs that you’re not seeing your new partner clearly.

Dear Addiction, We Need To Talk

By Keven Duffy, LCSW

Published in thefix.com 2016

Jen, mid-twenties, came to me, after a genuine but failed suicide attempt following many years on heroin (up to 15 bags daily). One of her first thoughts on her suicide attempt was "I'm such a failure, I can't even kill myself properly." When we looked into her almost ten-year addiction to opiates, she admits that she needs to stop using. However, her glorification of the drug remained. As we flesh it out, I start to feel her descriptions of the drug's impact on her life sound more like a human relationship than that of one with a substance. "I felt whole," "It was always there," "I could always count on it...." One day, my supervisor suggested that I ask her if heroin could text? Would it?

In working in drug rehabilitation for several years, I've discerned that current treatment has little place for symbolism. That is not to suggest that today's best practices don't alleviate the behaviors. Patients are able to identify relapse triggers, develop coping skills to handle these triggers, attend the myriad of support groups available, build a sober network, and a host of other very effective tools that I use regularly in my practice.

However, I have begun to see that fi the patient has the ability to symbolize, to work within a frame that is abstract and personify their substance of choice by naming them, giving them their own attributes and then exploring the "relationship," work can be done. Following, can be insights into object relations, attachment and other traumas that might not have been revealed otherwise.

Often, when in recovery, the underlying feelings of shame and guilt attached to a substance use disorder are hard to approach, as the patient has obviated those feelings in his/her newfound sobriety.

For a cohort of my patients, I have begun personifying the addictive behavior ni order to lessen the feelings of shame/guilt associated with the often-negative consequences of the addictive behavior- the collateral damage so to speak.

Personification allows for a dialogue to emerge where the patient is in control of how they want to portray the behavior (traits, appearances, what the behavior did for him/her) of their substance in a way that creates a safe holding environment. I work with the client to create a human persona around their substance of choice and in doing so, the patient can look at their own negative behavior with a bit of distance or some objectivity. With insight, most people with addictive behaviors will agree that "it" (the substance) is a relationship, not just a drug.

So I ask Jen, "If heroin were a person, who would it be?" "David," she replies, without hesitation. "Not Dave?" "No, David." She describes him as an Adonis like man, perfect in every way. So we begin to flesh out the relationship.

She shares that it was love at first sight. She fell hard and fast. David was always there for her (yes, at the beginning he was a big texter). She readily admits that she had never been treated so well. He was her ideal of perfection: he gave her warmth, and a feeling of connectedness - something she never felt before. He was there when she needed him. They were inseparable. When he went away, she longed for him, and his promises to return were always kept. At this point, David was there to give her pleasure, not mop up her pain.

Before David (heroin), she shared that her relationships with men left her feeling vulnerable. She was somewhat shy, suffered from low self-esteem and was dealing with an eating disorder since age fourteen. Others couldn't see beyond her quirky eating habits and her need to have sex in the dark. With David, she had confidence, energy, and never felt the same hunger she was tormented by in her eating disorder.

After several months, the relationship changed. Jen needed David more than he needed her. However, her love never wavered, it only increased. In relationship terms, she had to admit that she wasn't jealous when she found him in the presence of other women and men with the same attachment to this seeming Svengali. At one point she said, "Nothing mattered but David - I just needed what only he could give me." This is the point of her full-blown addiction when she sees how heroin took over her life.

It was around this time that David started asking her for money she didn't have. She very shamefully admitted that she got David the money however she could. This I knew because she originally presented with a legal issue. She stole money for David to be with him. He had her soul. Interestingly, in our sessions, her affect remained flat in her recount of her ever-increasing obsession with David and his demands.

Then there came the day, when David, using Jen's love for him, asked her ot sleep with other men in order to get money for him. She did it without question. She ended up sleeping with several drug dealers to give David money until one day she just couldn't anvmore. And that's they day that she drove her car away, homeless and on a mission to kill herself. Little by little, she had put aside a bag of heroin ata time until she thought she had saved up enough to overdose.

When she woke up, alive, she recognized that she could no longer do David's bidding and is now in the process of moving away from David. Jen fully embraced this personification, recognizing that she slept with dealers for him (heroin), stole money for him (heroin) and tried to die for him (heroin). To date, she is over two years clean and sober.

We don't always talk about heroin as David. But the work that we did allowed her to move away from any hint of 'euphoric recall.' It allowed her to work out how the drug seduced her into dire circumstances, to see what she did to obtain it, in a frame that was unfamiliar and yet just familiar enough. In creating David, Jen was able to symbolize aspects of other relationships in her life that have manifested themselves into her psyche.

Through her relationship with David, we were also able to look at how her rejection by other men left her with low self-esteem and how David did not. She saw that her life was filled with conditional love. Her mission was to find that long-desired acceptance. David asked no questions, in the end, he just was very needy - he had to be with her all the time.... or she would be very, very sick. That's what heroin does. You go into withdrawal and use more, you use too much and die or you get clean.

Heather, mid-thirties, has an eating disorder. She has recently rejected her 20- year relationship with "Luigi", a balding, out of shape "dude," who unapologetically wears stained wife beaters and talks with his mouth full. Luigi and Heather have lived side by side for all for most of her life. Despite her revulsion for his physical appearance, she knows what an important role he plays in her life: he is Vomiting.

He whispers into her ear the sweet nothings that only a binge/purge food-disordered person loves to hear: those crackers might as well have been a Big Mac, why did you eat five carrots instead of four?

When we discussed the idea of saying goodbye to Luigi, the anxiety it created for Heather was extremely heightened to the point of having to drop the line of inquiry. She needed him. Luigi was an integral part of "the plan." The plan, as we named it, was her overall eating disorder. In examining the nature of what past relationship Luigi might represent, she struggled. It was only when I asked what his voice sounded like? It was her mother who, as Heather began to realize, struggled with her own eating disorder, albeit one of yo-yo dieting and fad diets.

The discovery that Luigi was a facet of her mother opened up a new line of inquiry about her relationship with her mother and looking at her mother as an individual, not just as her "mother." In doing so, she was able to recognize that listening to Luigi was a continued version of obeying her mother. Even at thirty-six years old, she needed to please her mother, otherwise risk losing her affection. We concluded that her mother was a narcissist - one of the "I'm the most special victim” types. Heather saw that she was used as an attempt to meet the perfection her mother could not meet herself.

Once these concepts were integrated into our therapeutic dialogue, Luigi began to take the back burner in our sessions. Weeks then months would go by with no vomiting. Luigi was on the road out. He still pops up now and then in times of stress, but Heather has banished Luigi along with her dysfunctional relationship with her mother. In fact, when she recognized the Luigi/mother connection, she became more assertive in what she would accept from her mother's behavior; the more she gained control of her feelings and of how she interacted with her mother, the less Luigi was around.

What did David and Luigi do for my patients? They try to destroy them. In the analysis of that destruction, we are able to make a reference to past negative influences that perhaps lead them into substance abuse/eating disorder and then look at them though a different lens, one that is more familiar and easy to discuss. "I broke up with David because I was sick of his bad behavior" is much less anxiety provoking than "I was a heroin addict for two and a half years and sold my body and stole money, lived in a trap house to be closer to copping dope." The former allows the patient to flesh out all aspects of what the addictive relationship did to and for them in a non-threatening manner. While the shame and guilt of the latter statement is always in the room and is addressed throughout treatment, it doesn't impinge on the exploration of the reasons the addiction began, the impact of object relations or the underlying emotions/feelings that were being numbed by the addiction when the client personifies their addiction.

Addictions are relationships that exist in lives that can set precedence over human ones. It's interesting to look at just how these addiction relationships play a "role" in an addict's life. Once I asked a group of 10 people in an Intensive Outpatient Group, if when active, they would choose their drug over their partner? All of them said yes.

Authors note: A debt ofgratitude to my supervisor Dr. Nicholas Samstag for his knowledge and guidance.

How to Give Your Therapist Feedback

As with any relationship, patient and therapist unions aren’t immune to misunderstandings. When conflict appears, addressing it early on can help patients determine if the therapist and the therapy are right for them.

We often think of psychotherapists as “all-knowing,” which can make patients feel that complaining about the therapy or the therapist is not allowed.

But numerous studies have found that providing feedback pays off. According to psychology researchers, patient feedback can bolster the “therapeutic alliance.”

Similar to relationship chemistry, a sturdy alliance between patients and their therapists includes openness, trust, and collaboration, and according to the American Psychological Association, it’s essential to meeting treatment goals. Regardless of the type of therapy one receives, it’s this connection — the bedrock from which hope springs — that matters most of all.

In their 2015 book, “Premature Termination in Psychotherapy: Strategies for Engaging Clients and Improving Outcomes,” the psychologists Joshua K. Swift and Roger Greenberg point out that unrealistic expectations about treatment, compatibility issues with the therapist and fear of facing painful experiences can cause patients to stop therapy prematurely.

Indeed, studies suggest that 20 percent of patients getting mental health care will end therapy too soon — often without telling their therapists why.

For patients wondering how to give their therapists feedback, here are some suggestions.

Be Direct About Your Concerns

From talking too much or not enough to mislabeling feelings and offering unsolicited advice, therapists may unintentionally upset their patients in various ways. When this happens, broaching the topic by saying, “I’d like to discuss how I feel about coming to therapy,” or “Your recommendations aren’t helpful — here’s why,” are two ways to begin the conversation.

It’s often challenging for patients to be upfront about their therapy concerns when bringing up sensitive topics, research by the psychologists Matt Blanchard and Barry A. Farber suggests.

In one 2016 study, they found that 72.6 percent of psychotherapy patients had lied about their therapy experience. Common lies included pretending to agree with the therapist’s suggestions, pretending to find treatment helpful and masking their opinion of the therapist.

In therapy, these white lies can rupture treatment because it means the patient’s needs aren’t being met. This is why it’s crucial for patients to discuss any negative or unsettling feelings that ensue during therapy.

Perhaps the therapist came across as judgmental, started the session late or didn’t provide a structured treatment plan. Whatever the therapist’s mistake, patients can be direct by stating why they are upset.

When giving feedback, it’s common to pad critical comments with compliments. Organizational psychologists warn these positive statements, known as a “feedback sandwich,” can drown out negative messages.

The same pattern can play out in therapy. Before sharing their misgivings, patients may feel the need to say something positive, as a way to protect the therapist’s feelings. But while therapists are trained to look out for their client’s well-being, patients don’t need to do the same.

If a patient feels hurt by the therapist’s words, it’s O.K. to say, “I’m hurt by what you said, and I’d like to discuss it with you.” If the therapist is sharing too much personal information, patients can set a boundary by saying, “I prefer not to hear your personal stories because I’m here to work on myself.”

Analyze the Therapist’s Response

The therapist should be receptive to feedback. Positive and empathic responses may include apologizing for the misunderstanding, suggesting ways to improve therapy, as well as exploring what it’s like for the patient to speak up and commending their courage for doing so.

But not all therapists respond to feedback professionally. Some may label the patient’s behavior as “resistant,” or incorrectly link the patient’s complaints to unresolved psychological issues. In addition, therapists who become defensive, angry or judgmental when receiving patient feedback may do more harm than good. In these instances, patients may be better off finding a different therapist.

Collaborate Toward a Solution

Once grievances are aired, the stage is set to work toward a possible solution, which may be informed by the type of treatment.

Therapists viewing the therapeutic relationship as a focal point of treatment, known as client-centered, psychodynamic or attachment-oriented therapy, see feedback as an opportunity to strengthen the patient-therapist alliance.

To do this, they acknowledge the patient’s disappointment, anger and frustration. Curious to learn how therapy went off course, these therapists also invite their patients to share more. Because a person’s emotional reaction may offer clues about the nature of their suffering, client-centered therapists might also probe whether the patient’s negative feelings have roots in childhood experiences or traumas. To ease future treatment anxiety, these therapists often say, “If I do or say anything that makes you uncomfortable, I want you to let me know.”

On the other hand, behavioral therapists may meet patient feedback by introducing mental health questionnaires, as a way to collect data about treatment progress. They may also ask their patients to complete behavioral exercises outside of therapy. Doing so allows the therapist to see if the patient’s symptoms are improving and to make adjustments, as needed.

While solutions vary, patients should feel that their needs have been met, and that continuing treatment is worthwhile.

Check In

After establishing an open collaboration where feedback is welcome, checking in about the agreed-upon solution or the new treatment plan can help keep therapy on track. Saying, “I’d like to revisit my progress in a couple of weeks,” or “Can I let you know if I feel misunderstood in the future?” are useful questions and reminders.

Unlike fixing a broken bone, healing a patient’s emotional pain isn’t always straightforward, which means patients may feel ambivalent about treatment (even after giving feedback) or become anxious when sharing vulnerable details about childhood abuse, grief, severe depression or intimacy issues.

While numerous psychological interventions can teach patients how to alter their behaviors and face their fears, according to the researcher and psychologist Dr. Allan Schore, ultimately, it’s the emotional communication between patient and therapist that’s curative.

What feedback offers is an opportunity for realness and deeper intimacy with one’s therapist. When this happens, patients can feel seen and heard, which can be a turning point in treatment, as well as in life.

Juli Fraga is a psychologist in San Francisco. Hilary Jacobs Hendel is a psychoanalyst in New York

How Your Attachment Style Impacts Your Relationship

Our style of attachment affects everything from our partner selection to how well our relationships progress to, sadly, how they end. That is why recognizing our attachment pattern can help us understand our strengths and vulnerabilities in a relationship. An attachment pattern is established in early childhood attachments and continues to function as a working model for relationships in adulthood.

This model of attachment influences how each of us reacts to our needs and how we go about getting them met. When there is a secure attachment pattern, a person is confident and self-possessed and is able to easily interact with others, meeting both their own and another’s needs.  However, when there is an anxious or avoidant attachment pattern, and a person picks a partner who fits with that maladaptive pattern, he or she will most likely be choosing someone who isn’t the ideal choice to make him or her happy.

For example, the person with a working model of anxious/preoccupied attachment feels that, in order to get close to someone and have your needs met, you need to be with your partner all the time and get reassurance. To support this perception of reality, they choose someone who is isolated and hard to connect with. The person with a working model of dismissive/avoidant attachment has the tendency to be distant, because their model is that the way to get your needs met is to act like you don’t have any. He or she then chooses someone who is more possessive or overly demanding of attention.

In a sense, we set ourselves up by finding partners that confirm our models. If we grew up with an insecure attachment pattern, we may project or seek to duplicate similar patterns of relating as adults, even when these patterns hurt us and are not in our own self-interest.

In their research, Dr. Phillip Shaver and Dr. Cindy Hazan found that about 60 percent of people have a secure attachment, while 20 percent have an avoidant attachment, and 20 percent have an anxious attachment. So what does this mean? There are questions you can ask yourself to help you determine your style of attachment and how it is affecting your relationships. On August 13, I will be hosting a CE Webinar with Dr. Phillip Shaver on “Secure and Insecure Love: An Attachment Perspective.”You can start to identify your own attachment style by getting to know the four patterns of attachment in adults and learning how they commonly affect couples in their relating.

Secure Attachment – Securely attached adults tend to be more satisfied in their relationships. Children with a secure attachment see their parent as a secure base from which they can venture out and independently explore the world. A secure adult has a similar relationship with their romantic partner, feeling secure and connected, while allowing themselves and their partner to move freely.

Secure adults offer support when their partner feels distressed. They also go to their partner for comfort when they themselves feel troubled. Their relationship tends to be honest, open and equal, with both people feeling independent, yet loving toward each other. Securely attached couples don’t tend to engage in what my father, psychologist Robert Firestone, describes as a “Fantasy Bond,” an illusion of connection that provides a false sense of safety. In a fantasy bond, a couple foregoes real acts of love for a more routine, emotionally cut-off form of relating.

Anxious Preoccupied Attachment – Unlike securely attached couples, people with an anxious attachment tend to be desperate to form a fantasy bond. Instead of feeling real love or trust toward their partner, they often feel emotional hunger. They’re frequently looking to their partner to rescue or complete them. Although they’re seeking a sense of safety and security by clinging to their partner, they take actions that push their partner away.

Even though anxiously attached individuals act desperate or insecure, more often than not, their behavior exacerbates their own fears. When they feel unsure of their partner’s feelings and unsafe in their relationship, they often become clingy, demanding or possessive toward their partner. They may also interpret independent actions by their partner as affirmation of their fears. For example, if their partner starts socializing more with friends, they may think, “See? He doesn’t really love me. This means he is going to leave me. I was right not to trust him.”

Dismissive Avoidant Attachment – People with a dismissive avoidant attachment have the tendency to emotionally distance themselves from their partner. They may seek isolation and feel “pseudo-independent,” taking on the role of parenting themselves. They often come off as focused on themselves and may be overly attending to their creature comforts.

Pseudo-independence is an illusion, as every human being needs connection. Nevertheless, people with a dismissive avoidant attachment tend to lead more inward lives, both denying the importance of loved ones and detaching easily from them. They are often psychologically defended and have the ability to shut down emotionally. Even in heated or emotional situations, they are able to turn off their feelings and not react. For example, if their partner is distressed and threatens to leave them, they would respond by saying, “I don’t care.”

Fearful Avoidant Attachment – A person with a fearful avoidant attachment lives in an ambivalent state, in which they are afraid of being both too close to or too distant from others.  They attempt to keep their feelings at bay but are unable to. They can’t just avoid their anxiety or run away from their feelings. Instead, they are overwhelmed by their reactions and often experience emotional storms. They tend to be mixed up or unpredictable in their moods. They see their relationships from the working model that you need to go toward others to get your needs met, but if you get close to others, they will hurt you. In other words, the person they want to go to for safety is the same person they are frightened to be close to. As a result, they have no organized strategy for getting their needs met by others.

As adults, these individuals tend to find themselves in rocky or dramatic relationships, with many highs and lows. They often have fears of being abandoned but also struggle with being intimate. They may cling to their partner when they feel rejected, then feel trapped when they are close. Oftentimes, the timing seems to be off between them and their partner. A person with fearful avoidant attachment may even wind up in an abusive relationship.

The attachment style you developed as a child based on your relationship with a parent or early caretaker doesn’t have to define your ways of relating to those you love in your adult life. If you come to know your attachment style, you can uncover ways you are defending yourself from getting close and being emotionally connected and work toward forming an “earned secure attachment.”

You can challenge your defenses by choosing a partner with a secure attachment style, and work on developing yourself in that relationship. Therapy can also be helpful for changing maladaptive attachment patterns. By becoming aware of your attachment style, both you and your partner can challenge the insecurities and fears supported by your age-old working models and develop new styles of attachment for sustaining a satisfying, loving relationship.

New Studies Show Just How Bad Social Media Is For Mental Health

Some people may be starting to come to grips with the fact that social media isn’t so great for mental health. Others may think that getting on it will give them a boost—but especially depending on how you spend your time on it, you may well feel worse after using. Plenty of studies have found correlations between higher social media use and poorer mental health, including depression, anxiety, feelings of loneliness and isolation, lower self-esteem, and even suicidality.

But two new studies underline this reality by showing not just correlation, but causation—in other words, that tweaking your time on social media actually has measurable effects on mental health.

The first study, carried out at the University of Pennsylvania and published in the Journal of Social and Clinical Psychology, asked 140 undergraduates to either continue their regular use of Facebook, Snapchat, and Instagram, or to limit each one to 10 minutes per day (30 minutes total). The participants also provided data from their phones to show precisely how much time they were actually spending on the apps, rather than relying on memory, which can be unreliable.

Before and after the “intervention,” the participants also filled out questionnaires so the researchers could understand how they were doing psychologically—they were particularly interested in anxiety, depression, loneliness, and the famous “fear of missing out,” or FOMO.

As the researchers expected, people who limited their social media use to 30 minutes felt significantly better after the three-week period, reporting reduced depression and loneliness, especially those who came into the study with higher levels of depression. Interestingly, both groups reported less FOMO and less anxiety in the end, which the team suggests may just be a resulting benefit of increased self-monitoring.

"Here's the bottom line," said study author Melissa G. Hunt in a statement. "Using less social media than you normally would leads to significant decreases in both depression and loneliness. These effects are particularly pronounced for folks who were more depressed when they came into the study."

The results confirm what others have suggested, with the added bonus of being one of the few studies to use a real experimental design, which has the power to show causation. Additionally, it seems to suggest that we don’t need to cut out social media use completely, but just to curtail it.

"It is a little ironic that reducing your use of social media actually makes you feel less lonely," said Hunt. "Some of the existing literature on social media suggests there's an enormous amount of social comparison that happens. When you look at other people's lives, particularly on Instagram, it's easy to conclude that everyone else's life is cooler or better than yours."

Indeed, the other new study, from York University in Canada, found that young women who were asked to interact with a post of someone whom they perceived as more attractive felt worse about themselves afterwards. The 120 undergraduate women were either asked to find on Facebook and Instagram a peer who they felt was more attractive, or a family member who they did not feel was more attractive, and leave a comment. They reported that they felt worse about their own appearances only in the first condition, with peers, but not family.

“The results showed that these young adult women felt more dissatisfied with their bodies,” said study author Jennifer Mills in a statement. “They felt worse about their own appearance after looking at social media pages of someone that they perceived to be more attractive than them. Even if they felt bad about themselves before they came into the study, on average, they still felt worse after completing the task.”

What’s also important to point out, but was not studied here, is that making any kind of comparison—not just to people who you think are more attractive or smarter, but also people who you think are less attractive or smart (or anything) than you—is linked to poorer well-being. A really neat study a few years ago illustrated this, finding that the link between social media and depression was largely mediated by this "social comparison" factor. And again, this was true in either direction, “upward” or “downward.”

The bottom line is again what researchers—and even some of the developers of social media apps themselves—have been saying for a while now. Social media, especially spending long periods of time on it, is just not that good for us. We may not need to quit it completely, but limiting our time on social media considerably, and reconnecting with friends and family in real life, is definitely the way to go.

3 Memoirs That Explore The Many Facets Of Mental Illness

Mental illness is a force field that enacts, on each person in its grip, an altered reality that is either seductive or oppressive, but always inescapable. It often leaves families, or in clearer moments, the individual, to wonder about why — the great why — they're tuned differently. I myself wonder about the wellspring of my mental illness, my mother's mental illness, my brother's, father's, friends', husband's, about how it is that the brain's compass spins. Mental illness is experienced by one in five Americans in any given year, according to the National Alliance on Mental Illness.

Here come three lovely debut memoirs which are also detective stories, each in a unique and searching voice, trying to trace the brain's map and trace either the author's own or a family member's mental illness. As a child of the '70s, Amanda Stern, the author of Little Panic, was a 5th-generation New Yorker living in an old West Village brownstone. She was near the bottom of the pack in a blended family of six children, and on the outside, life was cozy: 30 kids in the neighborhood, and a green "jungle" behind the house in which to hide and seek and put on plays. But she could not tell time, felt erased, could not leave her mother lest her mother vanish into thin air. Stern's language is a child's, simple and affecting:

"Time sticks numbers on the world and marks spaces I can't see. My teachers say the hands do this, and clocks are how we know when to come and go, but I am a not a clock, and I always know when I have to leave my mom." Even in Manhattan, the island of shrinks, she will not be diagnosed with panic disorder until age 25. How can this be? How can a child be subjected to scores of I.Q. and intelligence and personality tests for nearly 20 years as a "solution" to her troubles? Stern includes the quizzes here, and the questions and answers are heartbreaking.

But so it was. "Panic disorder wasn't a diagnosis until 1980," Stern says. The constant testing "erased my creativity and imagination. Smart was information, and I didn't have it." Eventually, she becomes an accomplished literary and music events producer, whip-smart and funny. But it wasn't until one day, in her 20s, when she hadn't left the house in weeks, that she knew she had to break the cycle. "I had to accept a different truth and learn a new way to be," she writes. With medication and therapy, she climbs out, slowly.

Marin Sardy's brother Tom did not get that chance, nor did Sardy's mother — who could not hold time in her head, either. In the beautifully prismatic The Edge of Every Day: Sketches of Schizophrenia, Sardy writes of four generations in her family with mental illness, brilliant and creative people from her great-grandmother to her own mild present-day symptoms. "There is no single schizophrenia gene," she writes. (She has studied biology.) "Rather what we have inherited is a complex vulnerability in the form of a cocktail of mutations, hundreds or even thousands of rare alterations in genes that encode various brain proteins. "

It is her brother Tom she follows most ardently, who is three years younger than she. She writes eloquently of a trip to Costa Rica, when she is 27 and he is 24 — of his approaching darkness, his feeling that he has wings, or can walk across water. He trains to swim across the Pacific by standing in the shower. Indeed, Tom will not leave his room in Costa Rica, his personality disappears before her eyes, and a decade later, Tom will be on the streets in Anchorage, their Alaskan home town, deeply mentally ill. Estranged for some years while she lives in New York, Sardy and her sister return to look for him, but when she finds him, saying Tom's name "like a rock in her mouth," the skinny, bearded man in odd lot clothes tells her, "the world looks at me and sees a bum. But I am not a bum. I am a saint, I am close to God." It will take writing this blazing memoir before Sardy can bring Tom back into her world and weave the story of mental health and loss.

The quietly elegant The Scar: A Personal History of Depression and Recovery by Mary Cregan, an English professor at Barnard, is in some ways a bookend to the first two memoirs. Cregan has survived a suicide attempt, decades ago after the loss of an infant — the scar she's referring to in the title. (She slashed her neck inside a mental hospital.) She tries to grab mental illness and depression by its roots in human history. For those of us family members who've wrestled with it, her examination of melancholia (melan from the Greek, transliterated into Latin, meaning " black, dark, murky," and khole, "bile") makes this book an instant classic. Melancholia is a word she argues we ought to bring back. Beginning with Hippocrates in the 5th century B.C., Cregan takes us along melancholia's path — through lunatic asylums, the humane and inhumane, through poetry and science, to Freud and to Rilke.

Looking back, she sees herself at seven or eight, living with her devout Irish Catholic parents in Philadelphia: "I was walking down the stairs and about to go outside to play, when just as I was about to enter the vestibule, a wave of sadness passed through me. It was like walking through a cloudbank." Uncertain about what has happened, she can't recreate the unbidden feeling, not even by imagining herself in a coffin.

Cregan also writes about the electro-convulsion therapy that saved her life, and which, after Ken Kesey's 1962 novel One Flew Over The Cuckoo's Nest, would come to be regarded with horror. She demystifies this: "I was that patient," she writes, and credits it with helping her. "I didn't want to hurt myself," she pushes back on a nurse's report. "I wanted to die."

If logic worked with mental illness, if boot-straps and tough love and self-reliance could be administered in seven-day-a-week dosages, maybe a family's experience of this illness would be more mundane. Literature, though, may prove as enduring anything at shaping this often shapeless experience, a form of "talk therapy" that involves the page. Each of these women has created an enduring work exploring what it's like to be living in their skin, and these books will be a boon to many.

The challenge of going off psychiatric drugs

Laura Delano recognized that she was “excellent at everything, but it didn’t mean anything,” her doctor wrote. She grew up in Greenwich, Connecticut, one of the wealthiest communities in the country. Her father is related to Franklin Delano Roosevelt, and her mother was introduced to society at a débutante ball at the Waldorf-Astoria. In eighth grade, in 1996, Laura was the class president—she ran on a platform of planting daffodils on the school’s grounds—and among the best squash players in the country. She was one of those rare proportional adolescents with a thriving social life. But she doubted whether she had a “real self underneath.”

The oldest of three sisters, Laura felt as if she were living two separate lives, one onstage and the other in the audience, reacting to an exhausting performance. She snapped at her mother, locked herself in her room, and talked about wanting to die. She had friends at school who cut themselves with razors, and she was intrigued by what seemed to be an act of defiance. She tried it, too. “The pain felt so real and raw and mine,” she said.

Her parents took her to a family therapist, who, after several months, referred her to a psychiatrist. Laura was given a diagnosis of bipolar disorder, and prescribed Depakote, a mood stabilizer that, the previous year, had been approved for treating bipolar patients. She hid the pills in a jewelry box in her closet and then washed them down the sink.

She hoped that she might discover a more authentic version of herself at Harvard, where she arrived as a freshman in 2001. Her roommate, Bree Tse, said, “Laura just blew me away—she was this golden girl, so vibrant and attentive and in tune with people.” On her first day at Harvard, Laura wandered the campus and thought, This is everything I’ve been working for. I’m finally here.

She tried out new identities. Sometimes she fashioned herself as a “fun, down-to-earth girl” who drank until early morning with boys who considered her chill. Other times, she was a postmodern nihilist, deconstructing the arbitrariness of language. “I remember talking with her a lot about surfaces,” a classmate, Patrick Bensen, said. “That was a recurring theme: whether the surface of people can ever harmonize with what’s inside their minds.”

During her winter break, she spent a week in Manhattan preparing for two débutante balls, at the Waldorf-Astoria and at the Plaza Hotel. She went to a bridal store and chose a floor-length strapless white gown and white satin gloves that reached above her elbows. Her sister Nina said that, at the Waldorf ball, “I remember thinking Laura was so much a part of it.”

Yet, in pictures before the second ball, Laura is slightly hunched over, as if trying to minimize the breadth of her muscular shoulders. She wears a thin pearl necklace, and her blond hair is coiled in an ornate bun. Her smile is pinched and dutiful. That night, before walking onstage, Laura did cocaine and chugged champagne. By the end of the party, she was sobbing so hard that the escort she’d invited to the ball had to put her in a cab. In the morning, she told her family that she didn’t want to be alive. She took literally the symbolism of the parties, meant to mark her entry into adulthood. “I didn’t know who I was,” she said. “I was trapped in the life of a stranger.”

Before Laura returned to Harvard, her doctor in Greenwich referred her to a psychiatrist at McLean Hospital, in Belmont, Massachusetts. One of the oldest hospitals in New England, McLean has treated a succession of celebrity patients, including Anne Sexton, Robert Lowell, James Taylor, and Sylvia Plath, who described it as “the best mental hospital in the US.” Laura’s psychiatrist had Ivy League degrees, and she felt grateful to have his attention. In his notes, he described her as an “engaging, outgoing, and intelligent young woman,” who “grew up with high expectations for social conformity.” She told him, “I lie in my bed for hours at a time staring at the wall and wishing so much that I could be ‘normal.’ ”

The psychiatrist confirmed her early diagnosis, proposing that she had bipolar II, a less severe form of the disorder. Laura was relieved to hear the doctor say that her distress stemmed from an illness. “It was like being told, It’s not your fault. You are not lazy. You are not irresponsible.” After she left the appointment, she felt joyful. “The psychiatrist told me who I was in a way that felt more concrete than I’d ever conceptualized before,” she said. “It was as though he could read my mind, as though I didn’t need to explain anything to him, because he already knew what I was going to say. I had bipolar disorder. I’d had it all along.” She called her father, crying. “I have good news,” she said. “He’s figured out the problem.”

She began taking twenty milligrams of Prozac, an antidepressant; when she still didn’t feel better, her dose was increased to forty milligrams, and then to sixty. With each raised dose, she felt thankful to have been heard. “It was a way for me to mark to the world: this is how much pain I am in,” she said. Laura wasn’t sure whether Prozac actually lifted her mood—roughly a third of patients who take antidepressants do not respond to them—but her emotions felt less urgent and distracting, and her classwork improved. “I remember her carrying around this plastic pillbox with compartments for all the days of the week,” a friend from high school said. “It was part of this mysterious world of her psychiatric state.”

At parties, she flirted intently, but by the time she and a partner were together in bed, she said, “I’d kind of get hit with this realization that I was physically disconnected. And then I’d feel taken advantage of, and I would kind of flip out and start crying, and the guy would be, like, ‘What the heck is going on?’ ” Most antidepressants dampen sexuality—up to seventy per cent of people who take the medications report this response—but Laura was ashamed to talk about the problem with her psychiatrist. “I assumed he’d see sexuality as a luxury,” she said. “He’d be, like, ‘Really? You have this serious illness, and you’re worried about that?’ ”

During her junior year, her pharmacologist raised her Prozac prescription to eighty milligrams, the maximum recommended dose. The Prozac made her drowsy, so he prescribed two hundred milligrams of Provigil, a drug for narcolepsy that is often taken by soldiers and truck drivers to stay awake during overnight shifts. The Provigil gave her so much energy that, she said, “I was just a machine.” She was on the varsity squash team and played the best squash of her life. She was so alert that she felt as if she could “figure people out,” unpacking the details of their identities: she imagined that she could peer into their childhoods and see how their parents had raised them.

The Provigil made it hard for Laura to sleep, so her pharmacologist prescribed Ambien, which she took every night. In the course of a year, her doctors had created what’s known as “a prescription cascade”: the side effects of one medication are diagnosed as symptoms of another condition, leading to a succession of new prescriptions. Her energy levels rose and fell so quickly that she was told she had a version of bipolar disorder called “rapid cycling,” a term that describes people who have four or more manic episodes in a year, but is also applied, more loosely, to people who shift dramatically between moods. Sometimes Laura thought, Women who are happy and socialize like to buy dresses. She’d go to Nordstrom and buy two or three dresses. She recognized that this behavior was “textbook”—she had bought her own copy of the Diagnostic and Statistical Manual of Mental Disorders—but the awareness didn’t prevent the purchases.

Laura felt that the pressures of her junior year were paralyzing, so she did not return for the spring semester. That summer, she kept a journal in which she outlined her personal goals: “overanalysis must go”; “stop molding myself to the ideal person for my surroundings”; “find some faith in something, in anything.” But the idea of returning to Harvard that fall made her so distressed that she thought every day about dying. She took the semester off, and, at her request, her parents drove her to a hospital in Westchester County, New York. A psychiatrist there wrote that she “presents with inability to function academically.” At the hospital, where she stayed for two weeks, she was put on a new combination of pills: Lamictal, a mood stabilizer; Lexapro, an antidepressant; and Seroquel, an antipsychotic that she was told to use as a sleep aid. Her father, Lyman, said, “I had no conviction that the drugs were helping. Or that they weren’t helping.”

Laura returned to Harvard and managed to graduate, an achievement she chalked up to muscle memory; she was the kind of student who could regurgitate information without absorbing it. Then she held a series of jobs—working as an assistant for a professor and for a state agency that issued building permits—that she didn’t believe would lead to a career. She experienced what John Teasdale, a research psychologist at the University of Oxford, named “depression about depression.” She interpreted each moment of lethargy or disappointment as the start of a black mood that would never end. Psychiatric diagnoses can ensnare people in circular explanations: they are depressed because they are depressed.

Over the next four years, her doctors tripled her antidepressant dosage. Her dosage of Lamictal quadrupled. She also began taking Klonopin, which is a benzodiazepine, a class of drugs that has sedative effects. “What I heard a lot was that I was ‘treatment-resistant,’ ” she said. “Something in me was so strong and so powerful that even these sophisticated medications couldn’t make it better.”

For a brief period, Laura saw a psychiatrist who was also a psychoanalyst, and he questioned the way that she’d framed her illness. He doubted her early bipolar diagnosis, writing that “many depressions are given a ‘medical’ name by a psychiatrist, ascribing the problem to ‘chemistry’ and neglecting the context and specificity of why someone is having those particular life problems at that particular time.” He reminded her, “You described hating becoming a woman.” Laura decided that “he wasn’t legit.” She stopped going to her appointments.

She rarely saw friends from high school or college. “At a certain point, it was just, Oh, my God, Laura Delano—she’s ill,” the friend from high school said. “She seemed really anesthetized.” Laura had gained nearly forty pounds since freshman year, which she attributes partly to the medications. When she looked in the mirror, she felt little connection to her reflection. “All I ever want to do is lie in my bed, cuddle with my dog, and read books from writers whose minds I can relate to,” she wrote to a psychiatrist. “That’s all I ever want to do.” She identified intensely with Plath, another brilliant, privileged, charismatic young woman who, in her journal, accuses herself of being just another “selfish, egocentric, jealous and unimaginative female.” Laura said that, when she read Plath’s work, she “felt known for the first time.”

Laura found a psychiatrist she admired, whom I’ll call Dr. Roth. At appointments, Laura would enter a mode in which she could recount her psychic conflicts in a cool, clinical tone, taking pride in her psychiatric literacy. She saw her drugs as precision instruments that could eliminate her suffering, as soon as she and Dr. Roth found the right combination. “I medicated myself as though I were a finely calibrated machine, the most delicate error potentially throwing me off,” she later wrote. If she had coffee with someone and became too excited and talkative, she thought, Oh, my God, I might be hypomanic right now. If she woke up with racing thoughts, she thought, My symptoms of anxiety are ramping up. I should watch out for this. If they last more than a day or two, Dr. Roth may have to increase my meds.

The day before Thanksgiving, 2008, Laura drove to the southern coast of Maine, to a house owned by her late grandparents. Her extended family was there to celebrate the holiday. She noticed relatives tensing their shoulders when they talked to her. “She seemed muted and tucked away,” her cousin Anna said. When Laura walked through the house and the old wooden floorboards creaked beneath her feet, she felt ashamed to be carrying so much weight.

On her third day there, her parents took her into the living room, closed the doors, and told her that she seemed trapped. They were both crying. Laura sat on a sofa with a view of the ocean and nodded, but she wasn’t listening. “The first thing that came into my mind was: You’ve put everyone through enough.”

She went to her bedroom and poured eighty milligrams of Klonopin, eight hundred milligrams of Lexapro, and six thousand milligrams of Lamictal into a mitten. Then she sneaked into the pantry and grabbed a bottle of Merlot and put the wine, along with her laptop, into a backpack. Her sisters and cousins were getting ready to go to a Bikram-yoga class. Her youngest sister, Chase, asked her to join them, but Laura said she was going outside to write. “She looked so dead in her eyes,” Chase said. “There was no expression. There was nothing there, really.”

There were two trails to the ocean, one leading to a sandy cove and the other to the rocky coast, where Laura and her sisters used to fish for striped bass. Laura took the path to the rocks, passing a large boulder that her sister Nina, a geology major in college, had written her thesis about. The tide was low, and it was cold and windy. Laura leaned against a rock, took out her laptop, and began typing. “I will not try to make this poetic, for it shouldn’t be,” she wrote. “It is embarrassingly cliché to assume that one should write a letter to her loved ones upon ending her life.”

She swallowed a handful of pills at a time, washing them down with red wine. She found it increasingly hard to sit upright, and her vision began to narrow. As she lost consciousness, she thought, This is the most peaceful experience I’ve ever had. She felt grateful to be ending her life in such a beautiful place. She fell over and hit her head on a rock. She heard the sound but felt no pain.

When Laura hadn’t returned by dusk, her father walked along the shoreline with a flashlight until he saw her open laptop on a rock. Laura was airlifted to Massachusetts General Hospital, but the doctors said they weren’t sure that she would ever regain consciousness. She was hypothermic, her body temperature having fallen to nearly ninety-four degrees.

After two days in a medically induced coma, she woke up in the intensive-care unit. Her sisters and parents watched as she opened her eyes. Chase said, “She looked at all of us and processed that we were all there, that she was still alive, and she started sobbing. She said, ‘Why am I still here?’ ”

After a few days, Laura was transported to McLean Hospital, where she’d been elated to arrive seven years earlier. Now she was weak, dizzy, sweating profusely, and anemic. Her body ached from a condition called rhabdomyolysis, which results from the release of skeletal-muscle fibres into the bloodstream. She had a black eye from hitting the rock. Nevertheless, within a few days she returned to the mode she adopted among doctors. “Her eye contact and social comportment were intact,” a doctor wrote. Although she was still disappointed that her suicide hadn’t worked, she felt guilty for worrying her family. She reported having a “need to follow rules,” a doctor wrote. Another doctor noted that she did not seem to meet the criteria for major depression, despite her attempted suicide. The doctor proposed that she had borderline personality disorder, a condition marked by unstable relationships and self-image and a chronic sense of emptiness. According to her medical records, Laura agreed. “Maybe I’m borderline,” she said.

She was started on a new combination of medications: lithium, to stabilize her moods, and Ativan, a benzodiazepine, in addition to the antipsychotic Seroquel, which she had already been taking. Later, a second antipsychotic, Abilify, was added—common practice, though there was limited research justifying the use of antipsychotics in combination. “It is tempting to add a second drug just for the sake of ‘doing something,’ ” a 2004 paper in Current Medicinal Chemistry warns.

Shortly before Laura was discharged, she drafted a letter to the staff on her unit. “I truly don’t know where to begin in putting in words the appreciation I feel for what you’ve all done to help me,” she wrote. “It’s been so many years since I’ve felt the positive emotions—hope, mostly—that have flooded over me.” Unpersuaded by her own sentiment, she stopped the letter mid sentence and never sent it.

aura moved back home to live with her parents in Greenwich and spent her nights drinking with old friends. She told her psychiatrist, “I don’t feel grounded. . . . I am floating.” Her father encouraged her to “try to reach for one little tiny positive thought, so you can get a little bit of relief.” When she couldn’t arrive at one, he urged her, “Just think of Bitsy,” their cairn terrier.

When it was clear that positivity was out of reach, Laura began seeing a new psychiatrist at McLean, who embraced the theory that her underlying problem was borderline personality disorder. “It is unclear whether she has bipolar (as diagnosed in the past),” he wrote.

The concept of a borderline personality emerged in medical literature in the nineteen-thirties, encompassing patients who didn’t fit into established illness categories. Describing a borderline woman, the psychoanalyst Helene Deutsch, a colleague of Freud’s, said, “It is like the performance of an actor who is technically well trained but who lacks the necessary spark to make his impersonations true to life.” In 1980, the diagnosis was added to the DSM, which noted that “the disorder is more commonly diagnosed in women.” One of its defining features is a formless, shifting sense of self. An editorial in Lancet Psychiatry this year proposed that “borderline personality disorder is not so much a diagnosis as it is a liminal state.”

In 2010, Laura moved in with her aunt Sara, who lived outside Boston, and attended a day-treatment program for borderline patients. “It was another offering of what could fix me, and I hadn’t tried it,” she said. At her intake interview, she wore stretchy black yoga pants from the Gap, one of the few garments that allowed her to feel invisible. She said that the director of the program told her, “So, you went to Harvard. I bet you didn’t think you’d end up at a place like this.” Laura immediately started crying, though she knew that her response would be interpreted as “emotional lability,” a symptom of the disorder.

Laura had been content to be bipolar. “I fit into the DSM criteria perfectly,” she said. But borderline personality disorder didn’t feel blameless to her. Almost all the patients in Laura’s group were women, and many had histories of sexual trauma or were in destructive relationships. Laura said that she interpreted the diagnosis as her doctors saying, “You are a slutty, manipulative, fucked-up person.”

Laura sometimes drank heavily, and, at the suggestion of a friend, she had begun attending Alcoholics Anonymous meetings. Laura was heartened by the stories of broken people who had somehow survived. The meetings lacked the self-absorption, the constant turning inward, that she felt at the clinic, where she attended therapy every day. When Laura’s pharmacologist prescribed her Naltrexone—a drug that is supposed to block the craving for alcohol—Laura was insulted. If she were to quit drinking, she wanted to feel that she had done it on her own. She was already taking Effexor (an antidepressant), Lamictal, Seroquel, Abilify, Ativan, lithium, and Synthroid, a medication to treat hypothyroidism, a side effect of lithium. The medications made her so sedated that she sometimes slept fourteen hours a night. When she slept through a therapy appointment, her therapist called the police to check on her at her aunt’s house. “That really jolted something in me,” Laura said.

In May, 2010, a few months after entering the borderline clinic, she wandered into a bookstore, though she rarely read anymore. On the table of new releases was “Anatomy of an Epidemic,” by Robert Whitaker, whose cover had a drawing of a person’s head labelled with the names of several medications that she’d taken. The book tries to make sense of the fact that, as psychopharmacology has become more sophisticated and accessible, the number of Americans disabled by mental illness has risen. Whitaker argues that psychiatric medications, taken in heavy doses over the course of a lifetime, may be turning some episodic disorders into chronic disabilities. (The book has been praised for presenting a hypothesis of potential importance, and criticized for overstating evidence and adopting a crusading tone.)

Laura wrote Whitaker an e-mail with the subject line “Psychopharms and Selfhood,” and listed the many drugs she had taken. “I grew up in a suburban town that emphasized the belief that happiness comes from looking perfect to others,” she wrote. Whitaker lived in Boston, and they met for coffee. Whitaker told me that Laura reminded him of many young people who had contacted him after reading the book. He said, “They’d been prescribed one drug, and then a second, and a third, and they are put on this other trajectory where their self-identity changes from being normal to abnormal—they are told that, basically, there is something wrong with their brain, and it isn’t temporary—and it changes their sense of resilience and the way they present themselves to others.”

At her appointments with her pharmacologist, Laura began to raise the idea of coming off her drugs. She had used nineteen medications in fourteen years, and she wasn’t feeling better. “I never had a baseline sense of myself, of who I am, of what my capacities are,” she said. The doctors at the borderline clinic initially resisted her requests, but they also seemed to recognize that her struggles transcended brain chemistry. A few months earlier, one doctor had written on a prescription pad, “Practice Self-Compassion,” and for the number of refills he’d written, “Infinite.”

Following her pharmacologist’s advice, Laura first stopped Ativan, the benzodiazepine. A few weeks later, she went off Abilify, the antipsychotic. She began sweating so much that she could wear only black. If she turned her head quickly, she felt woozy. Her body ached, and occasionally she was overwhelmed by waves of nausea. Cystic acne broke out on her face and her neck. Her skin pulsed with a strange kind of energy. “I never felt quiet in my body,” she said. “It felt like there was a current of some kind under my skin, and I was trapped inside this encasing that was constantly buzzing.”

A month later, she went off Effexor, the antidepressant. Her fear of people judging her circled her head in permutations that became increasingly invasive. When a cashier at the grocery store spoke to her, she was convinced that he was only pretending to be cordial—that what he really wanted to say was “You are a repulsive, disgusting, pathetic human.” She was overstimulated by the colors of the cereal boxes in the store and by the grating sounds of people talking and moving. “I felt as if I couldn’t protect myself from all this life lived around me,” she said.

She began to experience emotion that was out of context—it felt simultaneously all-consuming and artificial. “The emotions were occupying me and, on one level, I knew they were not me, but I felt possessed by them,” she said. Later, she found a community of people online who were struggling to withdraw from psychiatric medications. They’d invented a word to describe her experience: “neuro-emotion,” an exaggerated feeling not grounded in reality. The Web forum Surviving Antidepressants, which is visited by thousands of people every week, lists the many varieties of neuro-emotion: neuro-fear, neuro-anger, neuro-guilt, neuro-shame, neuro-regret. Another word that members used was “dystalgia,” a wash of despair that one’s life has been futile.

For many people on the forum, it was impossible to put the experience into words. “The effects of these drugs come so close to your basic ‘poles of being’ that it’s really hard to describe them in any kind of reliable way,” one person wrote. Another wrote, “This withdrawal process has slowly been stripping me of everything I believed about myself and life. One by one, parts of ‘me’ have been falling away, leaving me completely empty of any sense of being someone.”

It took Laura five months to withdraw from five drugs, a process that coincided with a burgeoning doubt about a diagnosis that had become a kind of career. When she’d experienced symptoms of depression or hypomania, she had known what to do with them: she’d remember the details and tell her psychiatrist. Now she didn’t have language to mark her experiences. She spent hours alone, watching “South Park” or doing jigsaw puzzles. When her aunt Sara updated the rest of the family about Laura, the news was the same: they joked that she had become part of the couch. Her family, Laura said, learned to vacuum around her. Had she come from a less well-off and generous family, she’s not sure she would have been able to go off her medications. Others in her situation might have lost their job and, without income, ended up homeless. It took six months before she felt capable of working part time.

What a New Theory of Attention Says About Consciousness

We can pick out a conversation in a loud room, amid the rise and fall of other voices or the hum of an air conditioner. We can spot a set of keys in a sea of clutter, and register a raccoon darting into the path of our onrushing car. Somehow, even with massive amounts of information flooding our senses, we’re able to focus on what’s important and act on it.

Attentional processes are the brain’s way of shining a searchlight on relevant stimuli and filtering out the rest. Neuroscientists want to determine the circuits that aim and power that searchlight. For decades, their studies have revolved around the cortex, the folded structure on the outside of the brain commonly associated with intelligence and higher-order cognition. It’s become clear that activity in the cortex boosts sensory processing to enhance features of interest.

But now some researchers are trying a different approach, studying how the brain suppresses information rather than how it augments it. Perhaps more important, they’ve found that this process involves more ancient regions much deeper in the brain—regions not often considered when it comes to attention.

By doing so, scientists have also inadvertently started to take baby steps toward a better understanding of how body and mind—through automatic sensory experiences, physical movements, and higher-level consciousness—are deeply and inextricably intertwined.

For a long time, because attention seemed so intricately tied up with consciousness and other complex functions, scientists assumed that it was first and foremost a cortical phenomenon. A major departure from that line of thinking came in 1984, when Francis Crick, known for his work on the structure of DNA, proposed that the attentional searchlight was controlled by a region deep in the brain called the thalamus, parts of which receive input from sensory domains and feed information to the cortex. He developed a theory in which the sensory thalamus acted not just as a relay station, but also as a gatekeeper—not just a bridge, but a sieve—stanching some of the flow of data to establish a certain level of focus.

But decades passed, and attempts to identify an actual mechanism proved less than fruitful—not least because of how enormously difficult it is to establish methods for studying attention in lab animals.

That didn’t stop Michael Halassa, a neuroscientist at the McGovern Institute for Brain Research at the Massachusetts Institute of Technology. He wanted to determine exactly how sensory inputs got filtered before information reached the cortex, to pin down the precise circuit that Crick’s work implied would be there.

He was drawn to a thin layer of inhibitory neurons called the thalamic reticular nucleus (TRN), which wraps around the rest of the thalamus like a shell. By the time Halassa was a postdoctoral researcher, he had already found a coarse level of gating in that brain area: The TRN seemed to let sensory inputs through when an animal was awake and attentive to something in its environment, but it suppressed them when the animal was asleep.

In 2015, Halassa and his colleagues discovered another, finer level of gating that further implicated the TRN as part of Crick’s long-sought circuit—this time involving how animals select what to focus on when their attention is divided among different senses. In the study, the researchers used mice trained to run as directed by flashing lights and sweeping audio tones. They then simultaneously presented the animals with conflicting commands from the lights and tones, but also cued them about which signal to disregard. The mice’s responses showed how effectively they were focusing their attention. Throughout the task, the researchers used well-established techniques to shut off activity in various brain regions to see what interfered with the animals’ performance.

As expected, the prefrontal cortex, which issues high-level commands to other parts of the brain, was crucial. But the team also observed that if a trial required the mice to attend to vision, turning on neurons in the visual TRN interfered with their performance. And when those neurons were silenced, the mice had more difficulty paying attention to sound. In effect, the network was turning the knobs on inhibitory processes, not excitatory ones, with the TRN inhibiting information that the prefrontal cortex deemed distracting. If the mouse needed to prioritize auditory information, the prefrontal cortex told the visual TRN to increase its activity to suppress the visual thalamus—stripping away irrelevant visual data.

The attentional searchlight metaphor was backwards: The brain wasn’t brightening the light on stimuli of interest; it was lowering the lights on everything else.

Despite the success of the study, the researchers recognized a problem. They had confirmed Crick’s hunch: The prefrontal cortex controls a filter on incoming sensory information in the thalamus. But the prefrontal cortex doesn’t have any direct connections to the sensory portions of the TRN. Some part of the circuit was missing.

Until now. Halassa and his colleagues have finally put the rest of the pieces in place, and the results reveal much about how we should be approaching the study of attention.

With tasks similar to those they used in 2015, the team probed the functional effects of various brain regions on one another, as well as the neuronal connections between them. The full circuit, they found, goes from the prefrontal cortex to a much deeper structure called the basal ganglia (often associated with motor control and a host of other functions), then to the TRN and the thalamus, before finally going back up to higher cortical regions. So, for instance, as visual information passes from the eye to the visual thalamus, it can get intercepted almost immediately if it’s not relevant to the given task. The basal ganglia can step in and activate the visual TRN to screen out the extraneous stimuli, in keeping with the prefrontal cortex’s directive.

“It’s an interesting feedback pathway, which I don’t think has been described before,” says Richard Krauzlis, a neuroscientist at the National Eye Institute at the National Institutes of Health in Maryland who did not participate in this study.

Furthermore, the researchers found that the mechanism doesn’t just filter out one sense to raise awareness of another: It filters information within a single sense too. When the mice were cued to pay attention to certain sounds, the TRN helped suppress irrelevant background noise within the auditory signal. The effects on sensory processing “can be much more precise than just suppressing the whole thalamic region for one sensory modality, which is a rather blunt form of suppression,” says Duje Tadin, a neuroscientist at the University of Rochester.

“We often neglect how we get rid of the things that are less important,” he adds. “And oftentimes, I think that’s a more efficient way of dealing with information.” If you’re in a noisy room, you can try raising your voice to be heard—or you can try to eliminate the source of the noise. (Tadin studies this kind of background suppression in other processes that happen more quickly and automatically than selective attention does.)

Halassa’s findings indicate that the brain casts extraneous perceptions aside earlier than expected. “What’s interesting,” says Ian Fiebelkorn, a cognitive neuroscientist at Princeton, is that “filtering is starting at that very first step, before the information even reaches the visual cortex.”

There’s an obvious weakness in the brain’s strategy of tossing out sensory information this way, though—namely, the danger that the jettisoned perceptions might be unexpectedly important. Work by Fiebelkorn suggests that the brain has a way to hedge against those risks.

When people think about the searchlight of attention, Fiebelkorn says, they think of it as a steady, continuously shining beam that illuminates where an animal should direct its cognitive resources. But “what my research shows is that that’s not true,” he says. “Instead, it seems that the spotlight is blinking.”

According to his findings, the focus of the attentional spotlight seems to get relatively weaker about four times a second, presumably to prevent animals from staying overly focused on a single location or stimulus in their environment. That very brief suppression of what’s important gives other, peripheral stimuli an indirect boost, creating an opportunity for the brain to shift its attention to something else if necessary. “The brain seems to be wired to be periodically distractible,” he says.

Fiebelkorn and his colleagues, like Halassa’s team, are also looking to subcortical regions to explain this wiring. For now they’ve been studying the role of yet another section of the thalamus, but they plan to look into the basal ganglia in the future too.

These studies mark a crucial shift: Attentional processes were once understood to be the province of the cortex alone. But according to Krauzlis, in the past five years “it’s become a little more obvious that there are things that are happening underneath the cortex.”

“Most people want the cerebral cortex to do all the heavy lifting for us, and I don’t think that’s realistic,” says John Maunsell, a neurobiologist at the University of Chicago.

In fact, Halassa’s discovery of the basal ganglia’s role in attention is particularly fascinating. That’s partly because it is such an ancient area of the brain, one that hasn’t typically been viewed as part of selective attention. “Fish have this,” Krauzlis says. “Going back to the earliest vertebrates, like the lamprey, which doesn’t have a jaw”—or a neocortex, for that matter—“they have basically a simple form of basal ganglia and some of these same circuits.” The fish’s neural circuitry may offer hints about how attention evolved.

Halassa is particularly intrigued by what the connection between attention and the basal ganglia might reveal about conditions such as attention deficit hyperactivity disorder and autism, which often manifest as hypersensitivity to certain kinds of inputs.

But perhaps the most profoundly interesting point about the involvement of the basal ganglia is that the structure is usually associated with motor control, although research has increasingly implicated it in reward-based learning, decision making, and other motivation-based types of behavior as well.

With the work being done in Halassa’s lab, the basal ganglia’s role has now been extended to include sensory control too. This highlights the fact that “attention is really about sequencing from this to that in the correct order and making sure you don’t get distracted by things you shouldn’t be distracted by,” Maunsell says. “The notion that motor structures are involved in this … is appropriate, in a way—that they should be right at the heart of the process of deciding what you will attend to next, what you will focus your sensory resources on next.”

That’s in keeping with a burgeoning view of attention—and cognition as a whole—as processes based on what’s known as active inference. The brain doesn’t passively sample information from the environment and then respond to the observed external stimuli. The reverse also happens, with body movements as small as the flicker of an eye also guiding perception. The sensory and motor systems “don’t operate independently, and they evolved together,” Fiebelkorn says. And so motor regions don’t only help to shape the output (an animal’s behavior); they also help to shape the input. Halassa’s findings provide further support for that more proactive role.

“Perception serves action, because we have to represent the world in order to act in it,” says Heleen Slagter, a cognitive scientist at VU University Amsterdam. “How we learn to perceive the world around us is very much through action.” The high level of interconnection with the cortex suggests that, even beyond attention, “these subcortical structures play a much more important role in higher-order cognition than I think is often considered.”

And that, in turn, could provide hints about how to think about consciousness, neuroscience’s most elusive subject. As evidenced by Halassa’s study and other research, “when we look at the neural correlates of attention, we’re actually looking to some extent at the neural correlates of perception,” Maunsell says. “It’s part of a bigger picture, in terms of trying to understand how the brain works.”

Slagter is now studying the role that the basal ganglia might play in consciousness. “We experience the world not just using our bodies, but because of our bodies. And brains represent the world in order to meaningfully act in it,” she says. “Therefore, I would think that conscious experience must be tightly linked to actions,” just like attention. “Consciousness should be action-oriented.”

6 Steps to Turn Regret Into Self-Improvement

Have you ever felt like life would be better if you had taken a different path? If only you had pursued that job, ended that relationship sooner or moved to a new city, everything would be just perfect.

Nonsense, of course. But it’s human nature to linger on those feelings of regret. We tend to look back and think that missed opportunities — real or imagined — could have set us on a different, possibly more rewarding path. Left unchecked, these emotions can become overwhelming sources of stress and anxiety.

But even painful emotions like regret can be powerful sources of inspiration. Whether you carry minor regrets that speak to your perfectionism, or you continuously cringe over more serious, “If only I …” thoughts, it’s possible to use regret as a lever to help you move ahead, rather than letting it weigh you down.

And there are good reasons for doing so. Researchers have found that obsessing over regrets has a negative impact on mood and sleep, can increase impulsivity, and can be a risk factor for binge eating and misusing alcohol.

As a clinical psychologist, one of my most important tasks in helping people lead healthy, happy and meaningful lives is to teach them evidence-based strategies to manage their emotions. That includes how to use regrets to motivate them. I’ve found that even when people feel stuck in endless what ifs, it’s possible to recalibrate. Here’s how.

Step 1: Evaluate how you cope with regret

Many of us try to push pain away. Others ruminate about perceived mistakes. But whether you ignore or fixate on what’s troubling you, research has shown that it’s impossible to run from emotions without consequences. And in a vicious twist, dodging upsetting feelings actually makes them even more present: Suppressing our emotions can diminish our capacity for joy and potentially manifest as physical pain.

So instead of trying to ignore your regrets, it’s a better idea to practice acknowledging the experience. Try this: Start by slowing down and noticing your thoughts and sensations. Relax your face and hands, and think about accepting how you feel now without worrying you’ll feel this way forever. Reaching this middle ground between avoiding and dwelling will prove less depressing.

This is easier said than done, but consider the alternative: A 2014 study published in The Journal of General Psychology found that drowning in regret can compromise our ability to make wise decisions, and focusing on those negative emotions “undermined performance” on simple tasks.

However, researchers also found that when people find a silver lining in their regret, they are able to think more clearly.

“Regret can be a problem, but one benefit of regret is that it signals improvement is possible,” said Neal Roese, a professor of marketing at the Kellogg School of Management at Northwestern University who focuses on the psychology of judgment and decision-making. “The trick is to avoid obsessing and pull out a lesson that can be applied in future situations.”

Further, when we find ourselves consumed by self-criticism, it can feel tempting to focus on quick fixes, like distracting ourselves, rather than taking steps to improve. And regrets that arise from inaction — i.e., missing opportunities — are particularly frustrating.

Take time to notice how you handled a recent regret. Did you pretend it meant less than it did? Or did you fall into a shame spiral? Once you figure out how you navigate these situations, you can start using your emotions to your advantage.

Step 2: Interrupt your obsessing

Once you’ve identified how you cope, it’s important to learn how to stop a regret spiral from happening, since thinking endlessly about it all but guarantees you’ll feel worse. Take a moment to list the consequences of a recent regret spiral — like circling for hours over a mistake you made — and keep those notes for review. Did you feel better? Worse? Were there concrete lessons you learned? Or did you just feel bad? The point of this list is to realize that these spirals probably won’t lead you anywhere productive and, most likely, will leave you feeling stuck.

Next, think about the times you’re most tempted to ruminate on your regrets, like right before you go to sleep. Having this list handy will help you keep in mind that it’s wasted energy to focus on your regrets.

Finally, develop a set of concrete, alternative options that will engage you when you can feel yourself standing on the edge of a regret spiral about to fall in. The goal here is stop this type of thinking in its tracks before it consumes your energy. (Ideally, these choices don’t involve venting or scrolling through Instagram, both of which can keep regret churning.)

One activity I have my patients try is to list their favorite authors in alphabetical order. When your mind is focused on a project, it’s less likely to get derailed. Another idea: If you feel the grip of strong emotions, dip your face in ice water. (Really.)

“People become believers in this strategy once they get past the idea of plunging forward into a bowl of ice-water,” said Dr. Kathryn Korslund, an expert in Dialectical Behavior Therapy, a treatment that teaches people how to manage emotions. She said that dipping your face in ice water works because it increases activity in the parasympathetic nervous system, lowering your body temperature and heart rate, preventing emotions from intensifying.

If that seems too jarring, pop an ice cube in your mouth and focus on the sensations. You’ll find that it’s difficult to simultaneously replay your life’s mistakes while fully participating in doing something else.

Keep in mind: These activities aren’t meant to be a permanent solution. The goal is to regulate your emotions for a few minutes to then approach your situation with a little more clarity.

Step 3: Revisit your regret, then repeat these phrases

Remember that silver lining effect? This is how it works.

In the same study that found regret hinders our ability to solve problems, participants were asked to read the following two statements and recall at least one benefit from a regrettable event:

• Everything can be viewed from a different perspective.

• There is positive value in every experience.

Afterward, participants showed “improved subsequent performance” on the same set of tasks they completed before finding the silver lining.

In other words, focusing on what you gained can help you pivot from the negative impacts of regret. And keep in mind that so much of your regret story is just that: a story. Researchers even label regretful “if only” stories as counterfactual thinking, since it’s impossible to know how things would have turned out had you made a different choice.

Step 4: Treat yourself like your ideal mentor would

Researchers at University of California, Berkeley, asked 400 students to write about their biggest regrets and found that self-compassion, not beating ourselves up, “spurs positive adjustment in the face of regrets.”

This “self-compassion led to greater personal improvement, in part, through heightened acceptance,” the researchers wrote, adding that “forgiveness stems from situating one’s shortcomings or failures — such as a regret experience — as a part of the common human experience.”

Imagine your mentor talking you down from a spell of regret. Would she focus on everything you did wrong? Or would she encourage you not to be so mean to yourself, and rather try to find the tangible, practical lessons you can learn from the experience?

When all else fails: Just talk to yourself like you’d talk to a friend.

Step 5: Clarify what matters to you

When you feel profound regret — the type that makes you wonder about your place in life, as opposed to regretting the dumb thing you said to your boss in the elevator — use the emotion as a springboard to examine what truly is important to you. Consider the values you most want to stand for, and the values that are core to your identity.

One of my clients came to see me after feeling guilty about how angrily she speaks to people. Together, we worked on utilizing her remorse to pinpoint the virtues she most cherishes — “I care about being nice rather than being right” was one — since focusing on the damage already done wouldn’t do her or her relationships any good.

Take the time to ask yourself why you feel such profound regret, and work backward to identify the values that are tied up in your feelings. Unraveling that knot can help you use that as motivation for personal growth.

Step 6: Take action

There’s a Japanese art called kintsugi. Literally translated, this means “golden repair.” But it’s much more than that.

Kintsugi is a philosophy of repairing broken things, like cracks in pottery, for example. Rather than hide an item’s imperfections, the reparation process highlights them. Those imperfections are considered part of an item’s history, and repairing it this way can add beauty to the original items — like using precious metal to fix cracks in pottery.

Make a list of regrets large and small, then brainstorm exactly how to take steps to remedy whatever is haunting you. The ultimate cure for anticipating regret isn’t feeling lousy or overthinking. It’s thoughtfully pursuing solutions, and using the wisdom gained through self-reflection to act.

Jennifer Taitz is a clinical instructor in psychiatry at University of California, Los Angeles, and the author of “How to be Single and Happy: Science-Based Strategies for Keeping Your Sanity While Looking for a Soul Mate” and “End Emotional Eating.”

Silencing Your Inner Critic

Just minutes into her interview at the white-shoe law firm, Elena heard the voice, that voice, in her head. They see right through me. Biting the inside of her cheek, she gazed at the faces around her. I'm not one of them, it said. I'm a lightweight. It struck Elena, a recent law-school graduate, that she was the only woman in the room with the dark wood paneling and marble floors, the only face that might not belong in a colonial-era portrait gallery. She fumbled through the next three questions.

By the 30-minute mark, Elena was able to slide in a mention of her rank at the top of her class and her hands-on experience in immigration law. At last, her confidence was kicking in. That's when a partner in a blue pinstripe suit waved Elena's résumé in the air, and in a carefully neutral voice asked, "How wonderful that you've been involved in pro bono work for Honduran immigrants. Is that where your family's from?" Unsure of his intentions, Elena gulped and nodded. That was an unlawyerly response, her inner voice complained. Now I'm definitely not going get a call back.

The second Elena stepped out the door, her internal critic was all over her. I'm blowing this, it said, and built a persuasive case for why her future in law wasn't going to pan out, including a rehash of all the blunders she'd made in the last few interviews and the time her torts professor only half-jokingly told her that she was too emotional to be a litigator. I'm done.

Like many accomplished people, Elena feels she owes a lot to her inner critic. Her self-discipline, she believes, comes from the "succeed or suffer" mentality of that driving, sometimes derogatory taskmaster. The critic helped her win cross-country races, become the first in her family to go to college, and to pass the bar exam. It helped her seek out the support of teachers and bosses in the same way she always sought the approval of her ambitious, hard-driving mother. Most important, from Elena's perspective, it has always helped her home in on her faults and weaknesses before others detect them.

But over time, the self-critic can take a toll.

Your Own Worst Enemy?

Too old, too fat, too lazy. A terrible parent, daughter, son, partner, citizen. Clueless. Thoughtless. Never good enough.

"You can't ever stop 'cracking the whip' on yourself for fear that if you don't, the disapproval and rejection that seems imminent will become your reality," explains psychologist Leon Seltzer of Del Mar, California. "The stress is unremitting." As a result, "When you do something well, you won't jump for joy but merely breathe a sigh of relief: You've escaped from being criticized or censored." But that relief lasts only until the next expectation presents itself. It's the perfect setup for anxiety and depression.

Elena suspected that her internal critic might have been harsher than most, but she had always seen it as a net positive, especially as it pushed her through college and law school. But in the real world, where the path to success isn't so well defined, it seemed to carry a different message. It made her feel she didn't have the right pedigree or background, or maybe even the necessary competence. I'm an imposter, it said, whenever she entered the minimalist confines of a top-tier law firm. Not as smart as I think I am. After her fifth rejection, a previously unthinkable idea popped into her mind: Maybe she should just return to the family restaurant business, the life she had worked so hard to leave behind.

Herein lies the koan-like paradox of the inner critic: It attacks and undermines you to protect you from the shame of failure. For many, this is a link that dates back to a time when they feared the disapproval and rejection of caregivers. It's no coincidence that an internal critic's  words often sound as if they're coming from an authoritarian parent: The critic may literally be an echo of a parental figure's voice. When you internalize its judgments and expectations, Seltzer says, you "join it in demanding that you always do more, and better, than you may be doing now."

Shame, sometimes called the "master emotion," is the feeling that we're not worthy, competent, or good—that we are, in a sense, rotten at the core. Beating ourselves up is a preemptive gambit to inoculate ourselves from external shaming. Sometimes, the message is: Shame on you if you don't work really, really, really hard. Or, Shame on you if you're not tougher, smarter, and better than you were last time. But sometimes, as Elena found, the message is: Shame on you if you fail, so don't try.

There's one thing the inner critic doesn't offer: Room for growth. All too often it sends us back to a zone where we find ourselves safe, but also stuck.

Answering the Voices

People with a strong inner critic tend to have one thing in common: However great their success, they don't feel it's genuine. "Achievement may feel conditional, even fortuitous," Seltzer says. "The inner critic won't let them see their past achievements as 'real' for fear that, if they do, they'll slack off and end up a ne'er-do-well." So they may push themselves more, with diminishing returns, driven more by fear of failure than inspiration.

The solution isn't to shut down the critic, suggests research by Ethan Kross, of the University of Michigan's Emotion & Self Control Lab, and his colleague Ozlem Ayduk, of the University of California, Berkeley. It won't work; the voice will return no matter how hard you try to suppress it. Nor is it always effective to analyze the emotions it rouses; that opens you to the risk of ruminating or reliving those feelings and getting stuck in a negative cycle. The best intervention may be to respond to its grievances from a detached perspective—almost as if you were another person.

This technique, called self-distancing, is increasingly used in cognitive-behavioral therapy. To self-distance, one replaces the first-person pronoun I with a non-first-person pronoun, you or he/she, when talking to themselves (Elena, what happened is no reflection on your abilities. You were surprised by his question during the interview but now you know what to do. It's called experience.)

Self-distancing can be combined with asking yourself "why" questions: Why does Elena, who is so confident in the classroom, feel like a sham in a boardroom? This grammatical shift works especially well in the heated moments when you're beating yourself up most, Kross finds. Instead of feeling pain again, as when you recount an experience in the first-person mode, self-distancing allows you to pause, step back, and think as clearly and rationally as if it had happened to someone else.

Once emotions cool, "use story editing to stop reverting to that negative cycle over and over again," advises Timothy Wilson, a social psychologist at the University of Virginia and the author of Redirect: The Surprising New Science of Psychological Change. A story edit offers a way to reframe or revise a negative experience. If Elena's critic disparages her about her performance in a job interview, her default reaction might be to listen to it, question her whole career path, and get trapped in a self-defeating thought cycle. Or, says Wilson, she could reframe the experience as a turning point: This is when you first learned how to handle curveball questions. In this revised version, Elena can see that a failure is not a reflection on her intelligence, character, self-worth, or anything else the inner critic is hardwired to protect. The critic's story is no longer the only story.

Self-affirmation has also proven to be a useful offset to self-criticism. When we hear a voice saying we're inferior or deficient, Seltzer recommends that we  try to see the evidence that refutes it in our mind's eye. Elena could redirect her focus to her strengths—her managerial talents, her improv-comedy hobby, her famous tiramisu, or her ability to put people at ease. Affirmations can revise the negative messages we hear—or think we hear—from the voices of parental figures unable to show that they believed in us enough, or from a naturally neurotic or self-doubting personality. And when the inner critic pipes up with counterexamples, we can label the voice: Oh, that's just the inner critic again. In doing so, we—again—detach ourselves from the badgering fault-finder rather than reflexively identifying with it and letting it dominate.

No one intervention works for everyone. Some find success in addressing the critic directly, Seltzer says, and befriending it rather than treating it as the enemy within. This approach draws on the psychotherapy model known as Internal Family Systems (IFS), developed by Harvard psychologist Richard Schwartz, Ph.D. It views the person as containing a network of subpersonalities struggling for dominance, with the inner critic just one part of a multiplicity within, one that activates other parts, like the "taskmaster," the "perfectionist," and the "underminer." The challenge, Seltzer says, is to see the critic as a protector that is on our side, looking out for our interests, even if it's often misguided. If it's making us feel that we're not good enough, it's only because it is trying to prevent us from the ego blow of not being good enough. We can learn to thank the critic for trying so hard to protect us—and then ask for it to step back.

We can help our self-compassion find its voice. In one exercise, often guided by a therapist, individuals are encouraged to remember when their inner critic was born, so that they can give their younger selves more sympathy and security than they received in the first go-round. Elena wouldn't tell her 5-year-old self that she'll never achieve her dreams; she'd reassure her. Ideally, a self-compassionate response emerges from this interaction and can, going forward, be called on as a buffer against self-criticism. In a study at University College London employing virtual reality, women with severe inner-critic issues simulated a scenario in which they had to console a crying child. In the next session, each adult was embodied as the hurt child and became the recipient of her own recorded words and gestures of compassion. Many reported experiencing a surge of long-overdue self-compassion and—at last—reprieve from their critic.

A New Image

Margot felt sick about the incident at the playground. A moment after arriving with her 2-year-old son, she noticed that a group of teenage bicyclists had unlatched the gate behind her. "Hey!" she said, advancing toward them with hands on hips. "Read the sign! No bikes allowed!" In a flash she found herself exchanging heated words with five or six of the young men while their friends rode in circles around her wide-eyed toddler and other kids. Startled, Margot pulled out her phone and waved it in the air. The teens, who were black, froze and glared at her, a white woman, understanding her implicit threat to call the police, before pedaling toward the exit.

Later, Margot couldn't stop thinking about the shock, fear, and outrage on the boys' faces. Idiot! her inner critic screeched. There are a trillion better ways I could have handled that. Here I am, making the world worse.

Margot's mistake was the sort that could be a springboard for self-growth, says Dolly Chugh, a social psychologist at New York University's Stern School of Business. But if beating herself up over it is all she does, she'll either conclude that she's a bungling bigot at her core or she'll do a 180 and insist that she is a good person and in the right. We tend to think of the self in a simplistic binary way, Chugh says—good or not, honest or not, fair or not. It's a false dichotomy, of course, but many of us hew to it unconsciously.

While most people see their core self as good, some take the opposite tack. When certain individuals are confronted with their unethical misdeeds, like ostracizing others, they begin to see themselves as "bad," or even less than human. To compensate for a mistake and restore a positive self-image, someone like Margot might work to be more socially conscious. But sometimes wrongdoers, especially those who feel powerless or disconnected from others, internalize a bad self-image, according to research by Northwestern University's Maryam Kouchaki and others, and come to believe that they're damaged at the core. When this shift occurs, they're likelier to commit subsequent offenses.

Taking refuge in the "good-person" self-image that most of us have, Chugh says, is not a solution, either: It leaves us with no room to fail, which means no room to grow. All we need is someone or some situation to suggest we're not sufficiently fair, ambitious, responsible, motivated, maternal, paternal, or good, and our defenses go up, leading us to deny, self-justify, deflect, and minimize blame. It's one thing to be self-critical; it's quite another for others to criticize us.

Instead of "good" or "bad," Chugh suggests, we need to start thinking of ourselves as good-ish, a term she introduces in her book, The Person You Mean to Be. Good-ish embraces the idea that the self is error-prone and conflicted, yet strives to be better. It's a rejection of a fixed "good person" image—like the one the inner critic pushes us toward—in favor of the idea that we are a work in progress. Good-ish encourages us to take risks, make mistakes, and, most important, learn from them. The emphasis is not on who you are, but who you're becoming.

To make this shift, Chugh advises that people activate a new, growth-oriented inner voice that stands opposite the self-critic. Elena's inner critic might insist that she's bad at interviews; Margot's might call her stupid. But a growth-oriented voice could respond with self-compassion and forgiveness for a mistake, followed by encouragement: What can you learn from this?

If Margot had channeled a growth-oriented voice instead of her inner critic, the playground episode could have ended in revelation instead of recrimination. That voice would have asked the crucial questions, What were the boys seeing and hearing in the interaction? Why do you think you reacted that way? What was their perspective? In embracing such a mindset, she'd lay the groundwork for self-improvement rather than dwelling on feelings of self-loathing or defensiveness. That voice, Chugh says, could have also asked her what she'd do differently next time; if she would have responded the same way if the boys were white; or whether an African American mother would have done what she did. "Then, hopefully, she'd share her reflections with others," Chugh adds, because that's how personal growth leads to social change.

Wilson calls this sort of incremental self-growth "do good, be good." If we consistently act the part of the person we'd like to be, we can methodically work to overcome the parts of ourselves that hold us back. Say your protective and disapproving critic prevents you from being the sort of person who speaks up more. In the past, Wilson says, it might have told you that you're just not the type, or that you'll come across as attention-seeking and embarrass yourself. A growth-oriented voice, once it's been embraced, can instead pipe up and tell you to seize every opportunity to be heard—to speak up at meetings and parties, to step to the microphone during Q-and-A sessions, or to make small talk on public transportation, even if it initially seems tedious or unpleasant.

"The day will come when you'll think, I guess I am that type sometimes," Wilson says, "and you'll be more likely to speak up next time, and the time after that." Eventually, it will feel more natural to engage people or to share your reflections and insights, because you'll start to see yourself as more outspoken. It begins with a conscious choice to let the growth-oriented voice speak louder than the critic.

Hearing the Choir

Every morning as Paul waits for the elevator at his son's preschool, he's confronted by a sign with bright red lettering: "Did you know that seven minutes of stair climbing a day protects your heart?" Paul, who is 60 pounds overweight, hates that sign. "Every time I see it, my knee-jerk compulsion is to look at my reflection in the elevator door. I see an elephant." That's just the first moment each day that Paul's inner voice shames him about his weight. The next comes when he squeezes himself into the crowded elevator, avoiding eye contact for fear he'll see revulsion. "But do I take the stairs?" he asks. "No."

Paul isn't alone in his self-sabotage. People who are self-critical about their fitness and body image are often less likely to follow motivational health prompts, which typically spur not action but shame and self-threat, a study at the University of Pennsylvania revealed. Those prompts are read as criticism from the outside—exactly what an inner critic fears and tries to protect us from. Paul doesn't want to see himself, and certainly doesn't want others to see him, as unfit or in need of nudges.

In limbo between self-criticism and self-defense, there's little room for self-improvement. But we can escape the trap by transcending, or shifting our focus beyond the self. After all, self-criticism and self-transcendence are opposing forces—one inward-looking and inhibiting, the other outward-looking and expansive. There are many ways to transcend—through meditation, time in nature, religious faith, ecstatic dance, and creative pursuits. But we can also rise above by affirming our core values, such as care for family, friends, and the causes we believe in.

Could people like Paul use self-transcendence to get out of their own way? In the Penn study, subjects received daily text messages with instructions to reflect compassionately on other people or to tap into their own connection with a higher power, followed by health prompts urging them to be more active (stair-climbing included). And indeed, in the weeks that followed, the transcenders' fitness trackers showed that they exercised more than a control group. Turns out, these messages were like Trojan horses: With them, targets became less guarded, and the self-improvement advice penetrated and was followed; without them, the advice was rejected.

Could self-transcendence work as a counterforce when self-criticism and shame hold us back? If Paul were able to activate a voice in his head to think benevolent outward-looking thoughts—his hopes for his ailing mother, his concern for Syrian refugees, his love for the 4-year-old holding his hand, and the desire to keep up with him—he might find himself less resistant to, or less threatened by, reminders to improve his health. Outward compassion, it seems, opens the door to the self-compassion and patience we need to help ourselves. Perhaps Paul wouldn't push back so hard when his wife urged him to exercise, or she'd find ways to strategically pepper those nags with thoughts that helped him think beyond himself.

Self-transcendence may also free us to grow in areas in which we lack self-confidence. For Elena, as for many women, one such impasse is networking. "I know schmoozing would help my job search, but it makes me feel desperate and phony, like I'm using others to get ahead," she says, contrasting how fake she feels in networking sessions compared with her genuine enthusiasm for less contrived social situations. But research finds that when reluctant networkers are directed to think beyond themselves—to see how making connections contributes to a greater cause, like increasing female presence in traditionally male fields or helping coworkers or clients—they can overcome the aversion.

For Elena, a shift in focus from inward to outward empowered her in a way her inner critic couldn't, even in its most hard-driving, guilt-inducing, moments. Thinking about her future, she asked herself, "What if my performance isn't just about me, but everyone who is like me—a first-generation woman of color going into law?" In this new script, the plot is no longer driven by self-doubt, fear of shame, or a vestigial dread of parental disappointment, but by a higher purpose.

After all, it is one thing to heed an inner critic and live in the suffocating space between self-threat and self-motivation. It is another thing to align your star with something greater. "I was pursuing corporate law because I saw it as an obvious touchstone of success," admits Elena, who has now set her sights on a career in human rights. On the old path, she says, she was reluctant to take a risk. She didn't feel authentic or confident. "But when it comes to helping others overcome their personal obstacles," she says, "I fight like hell."

Self-Reflective Awareness: A Crucial Life Skill

Self-Reflective Awareness (SRA) is probably the single most important competency that we teach in the doctoral program in professional psychology that I direct. It is listed first in the program’s core competencies and is central to the identity and culture of the program. Because we believe it is a very important skill in general, and it is something our program gets extremely high marks on (students rate their training a 4.8 out of 5.0 in this area), I share here how we define it and some of the ways we cultivate it in the program in order to offer ideas about how one might to achieve greater SRA.

What is Self-Reflective Awareness?

SRA is a “meta-cognitive” ability, meaning that it involves thinking about and reflecting on one’s own mental processes. Someone with good SRA is able to generate a narrative of self that is complex, clear, and multifaceted and is able to communicate that narrative in a way that allows others a much better understanding of where one is coming from. Let me give an example of a low versus high SRA response. Imagine a situation in which a doctoral student is working with a patient and I am the supervisor. We are watching some tape of the session, and it is a bit awkward and halting.

I say, “I noticed that the two of you lost some flow in the therapy here.  You seem kind of awkward and hesitant. Can you tell me what was going on inside for you?”

A low SRA response might be something like:

“The patient is really resistant about deepening the conversation on this topic. I tried to do what you said, but they blocked me at every turn. So, I just was not sure about next steps.”

In contrast, a high SRA response would be something like:

“I know that this was not the best exchange and you are right I was feeling both stuck and frustrated. I tried to bring up the topic in the way you suggested, but I did not have the concept exactly right and I bundled it. I then felt a bit self-conscious, thinking about you watching it. As I thought about that, it was hard for me to know where to go next, so I just sort of sat there awkwardly. I think sometimes I feel stuck between you guiding me toward how the patient might change and my patient telling me they are not ready or that won’t work and that can leave me feeling a bit powerless and frustrated.”

Notice the difference in the two responses. Even though the question asked for the individual to explore what was “going on inside”, the low SRA example basically offers none of that, reports simply on the behaviors, and explains why the individual did what they did focused on external obstacles with no real narrative of their private or emotional experience. In contrast, the high SRA response shows the person’s deep capacity to take an observer stance and to share the internal struggles and reactions they were having, and how that made them feel.  

How does one cultivate SRA?

The first step to cultivating SRA is knowing what it is and explicitly valuing it. Once it is explicitly valued, there are several ways one can foster it. Introspection, that is turning the focus of your attention inward and engaging in an attitude of curiosity about what makes you tick, is one key way to foster SRA. We explicitly encourage a mindful approach to meta-cognition that is captured by the acronym C.A.L.M. which attempts to capture the attitude of the meta-cognitive observer as being Curious, Accepting, Loving/Compassionate and Motivated to Learn and Grow.

Education about psychological theories and processes, such as understanding human consciousness and human social motivation, provides conceptual maps that can help foster SRA in folks. Engaging in psychotherapy is another way to enhance SRA, and we encourage our doctoral students to have at least one meaningful therapy experience (in which they are the client) prior to becoming a fully functioning psychologist. Another way is to engage in “process” conversations with intimate others. Most human conversations focus on content (the ‘what’ that is being discussed). A process conversation is when you explore with another the “how”, especially how you experience the process of relating to them and how they experience relating to you. For example, a process conversation might recall a time two people worked together and they shared the way they felt (competitive, jealous, stressed) in the context of getting the job done. In our doctoral program, students engage in at least one formal process group, and we also regularly participate in process groups involving diverse individuals on conversations such as gender, race, ethnicity and power.

What are the domains of SRA?

There are a number of different facets to SRA. Here are eight key domains we focus on and areas of SRA capacities we expect to see and some of the additional ways we train them.

1. Know your family story and developmental history. To know thyself one must understand one’s history, including the context in which one was raised and key life events or turning points. In a required family class, taught by core faculty member Dr. Anne Stewart, our students complete a large family project in which they develop an autobiographical narrative of their place in their family. This involves the students creating a genogram and interviewing key players in the family drama (parents, siblings, grandparents) and writing it up in a detailed narrative, all to get a deeper understanding of the culture of the home in which they grew up and the way that impacted who they have become.

2. Understand your needs, motivations, and emotions. Humans have intense social drives for things like intimacy and belonging and achievement and power. We also have deep seated feelings about ourselves and others and key events. But often we do not spend time deeply experiencing or observing these aspects of our mental process. Attention to core motives and feeling states is crucial. Dr. Ken Critchfield is the Co-director of our program and he helps folks understand their core attachment needs and how early patterns of attachment set the stage for current relating patterns.

3. Understand your defenses and how you handle criticism. The defensive system gets activated when our identity is threatened or we are exposed to painful pieces of information about ourselves. Being aware of what makes you defensive and the kinds of defensive coping strategies you use is a key component. I often talk about the “Freudian Filter” and the Malan Triangle, which helps students see how impulses or images or feelings can trigger an anxiety signal and then activate a defense, often by shifting attention away from the image.

4. Understand your strengths and weaknesses. As part of their regular evaluation process, student must narrate their experiences over the year and articulate both areas in which they have excelled and various “growth edges” where they want to improve. We have also explored having students participate in a strength finder assessment, but have not done that.

5. Understand your beliefs/values and worldview. Core faculty Dr. Craig Shealy is an expert in beliefs and values and he guides students regularly on deep conversations about what beliefs and values are, where do they come from, how are they shaped and how do we respond when confronted with others who have very different beliefs and values (i.e., are we open or closed and defensive). Students need to reflect on their religious beliefs, their views regarding the nature of being human, and their political beliefs in terms of the role of the government and their social values. We help students understand their beliefs and values in terms of their Versions of Reality (VOR).

6. Know your purpose in life and how you make meaning. Related to both one’s beliefs and values and core motives, is the recognition of what gives one’s life meaning and purpose. Students must reflect on why they are pursuing a doctoral degree, what are their “valued states of being”, and what kind of difference they want to make in the world.

7. Know how others see you. In his Processes of Psychotherapy course, Dr. Neal Rittenhouse spends much time helping students reflect on how others see them. He asks them to reflect on their “stimulus value” and has them imagine how and why someone might feel about them in good or bad ways, and in or outside the therapy room.

8. Know the “cultural bubble” that you live in. Students in our program must demonstrate cultural awareness and understand diverse perspectives. To foster this, our program frequently has conversation sessions focused on sensitive cultural issues. For example, over the past few years, the United States has witnessed increased tensions with Russia. We are fortunate to have Dr. Elena Savina on our core faculty, who is from Russia. She is concerned about the portrayal of Russia in the West and has much to say about this. We had a two hour conversation in which the whole program listened to Elena’s Version of Reality, and why it was so strikingly different than what is portrayed in mainstream Western media.

More than two thousand years ago, the ancient Greeks carved “Know Thyself” above the entrance to the Apollo Temple at Delphi. We concur with this central maxim and believe SRA is a crucial capacity that is necessary for living a fulfilling, complex, and wise life. It is a basic capacity that should be fostered in relationships, in education in general, and in professional psychology in particular.

Always Waiting for the Other Shoe to Drop? Here’s How to Quit Worrying

Ever felt as if the joy of a big win was contaminated with the stress of imagining when the pendulum would swing the other way and something awful would happen to balance it out?

If so, you’re not alone: Often, when driven people care about something and finally experience whatever they’ve been hoping to achieve — whether it’s a new relationship, a health goal, a promotion or something else altogether — they’re unable to entirely savor the good times. They may, in fact, do the exact opposite: endlessly worry about when their peak might plummet.

But taking yourself out of the moment to dread what might happen next won’t prepare you for disaster. Indeed, research has shown that it’s the ability to experience positive emotions that improves our ability to cope with distress. Even better, research from Sonja Lyubomirsky, a psychologist at the University of California, Riverside, finds that experiencing positive emotions doesn’t set you up for disappointment, but increases your likelihood of achieving your work, health and relationship aspirations.

Between chasing goals and then worrying about losing your wins, it’s demoralizing to think that you can’t catch a break. But there are research-based techniques that can help you enjoy the nice life turns while quieting the nagging voices that suggest disappointment is waiting just around the corner.

Notice that worrying will only steal your current joy

In a paper examining the costs and benefits of negative expectations in the journal Emotion, researchers found that students who predicted getting a poor grade on an exam felt bad for days before receiving their results. Worse, their stressing didn’t diminish the disappointment they felt once they got their scores.

One underlying reason people worry is that on some level they assume it helps. Yet we need to accept that we can’t perfectly prepare for potential challenges.

“There are an infinite number of bad things that could possibly happen (although most are unlikely), and there is just no way a person can anticipate them all,” according to Dr. Michel Dugas, a psychology professor at the University of Quebec.

Keep in mind that research has shown we are notoriously bad at predicting how we will feel in a given situation, and things often go better than we imagine they will in moments of fear. Dr. Dugas shared a takeaway a client observed: “I try to worry about everything bad that could possibly happen so that I won’t be taken off guard. What really bothers me is that although I do sometimes experience bad things, they are never the ones I thought about!”

Stop writing off hard work as ‘luck’

Humility is a virtue, but it doesn’t need to come at the expense of creating an enduring sense of faith in yourself. When you play down your accomplishments and abilities with self-deprecating attributions, entirely writing off victories to external factors like chance or timing, you not only perpetuate the belief that something negative is on the horizon, you also miss out on the power of self-efficacy — the mind-set that you have the ability to shape your life. Knowing you can rely on yourself motivates us to strive, and predicts your capacity to manage your emotions effectively and achieve what matters.

Instead of worrying that you don’t have what it takes and that your winning streak is about to expire, practice the combination of trusting yourself and acting conscientiously.

Remind yourself that a happy life is a balanced life

Emotional resilience hinges on many ingredients. Succeeding in one area, like your career or romantic life, won’t lead to total fulfillment. That can be hard to remember, especially after a big promotion or when a new relationship heats up. But it’s important to consider that you’re capable of deriving meaning from more than one aspect of your existence.

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“Our mind often overestimates the importance of some factors (money) and underestimates others (taking time off, being social),” Laurie Santos, a Yale psychology professor who teaches the popular course “The Science of Well-Being,” wrote in an email.

To broaden your perspective, sketch out a pie chart that includes the parts of your life that matter to you most, like friendships, health, work, relationships and hobbies. Then invest a bit of time and energy thinking about your aspirations in each domain. The more you engage in what matters to you, the more empowered you’ll feel.

A landmark Harvard study that followed more than 250 college sophomores for 75 years found that warm relationships were the biggest predictor of financial success. Incidentally, studies have also shown that volunteering is linked to health improvements in older adults, and exercise enhances academic achievement and reduces workplace burnout. So, if these activities matter to you, carve out time for them.

Focus on your values, not your goals

It’s easy to fall into the trap of measuring your worth by the various achievements you have reached. Instead, ask yourself:

• What virtues do I want to embody?

• How do I want to show up right now?

• What do I want my life to stand for?

Living your values — above and beyond reaching specific goals — is a way to meaningfully take charge of the things that are under your control while also helping you achieve your ambitions. In one study, students at the University of Nevada, Reno, were asked to either set goals or consider both their values and their goals. The students who both reflected on their personal values, like learning, while also setting specific goals, such as making honor roll, significantly improved their G.P.A.s.

Don’t believe everything you think

Instead of getting stuck in the negativity, it’s possible to learn to see your thoughts with distance and perspective.

One technique I use with my patients is to have them play with their thoughts. For instance, you might turn an upsetting phrase, like, “You’re not good enough," into an upbeat rap song or repeat it as fast as you can until it loses meaning.

These strategies are known as cognitive defusion, a term attributed to Steven Hayes, a professor in psychology at the University of Nevada, Reno, and the author of the forthcoming book “A Liberated Mind: How to Pivot Toward What Matters.” This approach works in any number of stressful situations and can prevent you from taking unhelpful thoughts too seriously and allow you to focus more clearly on whatever you’re doing. In a study of people with a fear of public speaking, researchers found that learning to accept discomfort and create distance around thoughts of failure reduced anxiety and improved performance.

Helpful hint: Don’t only look out for thoughts about when you might ruin it all, but also thoughts like “I must always feel this great!” since that pressure will also thwart your joy.

Act the opposite of your impostor urges

To actually change your negative emotions, first focus on changing how you behave.

Let’s say, for instance, you’re someone who struggles with self-doubt. You know how this emotion affects your day-to-day life, because it’s your lived experience. But imagine how you might act if you weren’t struggling with self-doubt? Would you leave the office earlier to get to that workout class? Not respond to emails after 8 p.m.? Allow yourself to celebrate an accomplishment with friends? Rather than just imagining that life, try actually living it.

Try to focus on the little wins that happen to all of us, every day. Something I recommend for my patients to buy a small notebook and, each night, write down three accomplishments from that day. A little self-affirmation can pave the way to savoring the good things in life you might be overlooking.

Jennifer Taitz is a clinical instructor in psychiatry at the University of California, Los Angeles, and the author of “How to be Single and Happy: Science-Based Strategies for Keeping Your Sanity While Looking for a Soul Mate” and “End Emotional Eating.”