Author Archives: TimesAdmin

Gone Girl

by Alvin G. Burstein

[Editor’s note: The following review contains direct quotes from movie dialogue that could be offensive to some readers.]

All happy families are alike; each unhappy family is unhappy in its own way.
– Leo Tolstoy, Anna Karenina

The movie Gone Girl is about an unhappy marriage, one that is unhappy in a way that is not only unique but morbidly fascinating.

Amy Elliot and Nick Dunne get involved in a steamily erotic relationship that leads to marriage. Amy is the daughter of a psychologist couple that has written an immensely popular series of children’s books about an incredibly wonderful child, Amazing Amy. Their daughter, despite her Ivy League education and Manhattan chic, feels diminished in comparison. Nick, a middle-western low brow (he guesses that quinoa might be a fish and is addicted to video games) works as a hack writer.

These opposites attract and their marriage begins ideally. Although Nick chafes at the literary soirées and pre-nuptial arrangements that are required, he is clearly delighted by his conquest; she is intrigued and delighted by his lack of pretension and off-beat humor.

Nick’s mother becomes fatally ill, and the couple is required to move from New York, back to Nick’s hometown in Missouri. There the relationship begins to fray. Amy is bored by the small town tedium and with Nick’s involvement with old buddies and his twin sister, “Go.” Nick is increasingly restive about Amy’s efforts to buff up his appearance, and resentful when she unilaterally decides to lend her parents, who have run into financial difficulty, most of the million dollar trust fund they had endowed her with.

Although they maintain the public fiction of the perfect marriage, the private relations go sour. Nick gets involved in an affair and struggles to find the courage to tell Amy he wants a divorce; Amy, humiliated by her inability to compete with her fictional namesake and her parents’ expectations, decides to disappear, leaving behind an apparent homicide scene that she hopes will result in Nick’s conviction for murder—and Missouri has the death penalty.

Nick ultimately is arrested. While he is awaiting trial, Amy, disguised and on the run, is robbed by a pair of red neck psychopaths. Stripped of resources, she re-kindles her relationship with a previous wealthy suitor, Desi. Trapped in his luxe villa, Amy watches an interview Nick gives to a talk show host admitting to his faults and begging for his wife’s forgiveness and return. Moved by his reformed sinner persona, she decides to do so—covering her previous manipulation by stage managing another scene—being victimized and raped by Desi, stabbing him to death in quasi self defense.

Literally covered in blood, she returns to a vindicated Nick. He knows that she has murdered Desi and conspired to get her husband sentenced to death; she knows he knows but insists that they need and deserve each other, especially because she is pregnant with his child.

A telling final exchange goes like this:

Nick: “You fucking cunt!”

Amy: “I’m the cunt you married. The only time you liked yourself was when you were trying to be someone this cunt might like. I’m not a quitter, I’m that cunt. I killed for you; who else can say that? You think you’d be happy with a nice Midwestern girl? No way, baby!
I’m it.”

Nick: “Fuck. You’re delusional. I mean, you’re insane, why would you even want this? Yes, I loved you and then all we did was resent each other, try to control each other. We caused each other pain.”

Amy: “That’s marriage.”

The movie closes with reprise of an opening clip in which Nick is stroking Amy’s hair, reflecting, What are you thinking? How are you feeling? What have we done to each other? What will we do?

Conscienceless and amoral, Amy is more than a classic psychopath. She is Lillith, the female demon that lures men caught in her arachnoid web to their destruction. The perverse attraction that draws Nick to her is more than the attraction of opposites. It is the dangerous excitement that attends risking death.

Amy’s demonic appeal and Nick’s seeming paralysis is counterbalanced by two eminently sane characters who serve to reassure us. Boner, the policewoman, and Tanner, Nick’s attorney, are like a Greek chorus, observing the Gothic excesses without getting involved. They are realistic, tolerant, forgiving, soothing tonics permitting us to leave the theater with some hope for ourselves.

Still not Finding Time to De-Stress?

Are you still not finding the time each day to reduce your stress? If so, which of these reasons best fits you?

  • I don’t believe in the value of relaxing or de-stressing at least once a day.
  • I just forget to do it even though I agree it is important.
  • The day gets by me and I still haven’t stopped what I am doing to take a break.
  • I know it is important but tomorrow is another day.


If your main reason is that you forget or just cannot find the time to take a de-stress break, then let’s talk seriously about how to fix that. Here are a few hints.

  • Set an alarm on your smart phone to remind you to take a 5- minute break at least once a day.
  • Set it for that time in the day that you are usually getting tired. • 5 minutes can be enough, if you do it daily and more than once a day (if you can).
  • Like any habit, it takes practice and repetition for a couple of weeks to set it up so that it becomes more automatic.


What are the best ways to spend that one or two 5-minute rest breaks? There are always a few things that happen in a normal day that are empty time. By empty, I mean what you are doing in that period of time is usually waiting for something or doing something that does not require much of your attention. Several things immediately jump to mind for working people.

  • Usually when you turn on your computer (particularly if you are a PC type), there is a several-minute wait as it boots up and then installs things it thought about during the rest break.
  • We all have to use the bathroom a couple of times a day. This is a good time to stay an extra couple of minutes (behind closed doors) and do some focused breathing. Empty your mind, kind of like when you push in the clutch and let the car coast.
  • Relax with the Rainbow Shower where after a few breaths, you imagine a rainbow over your head and imagine the rainbow passing through your body from the head to the feet – first with red light, then orange, yellow, green, blue, lapis, violet, and white.
  • Not your thing? Then, sit and close your eyes and listen with your mind’s ear or sing or hum a little tune.
  • If you can do a little stretching after the mindful breathing, that would be even better.


I know you do not have to be a rocket scientist to come up with this stuff. But, those Rocket Scientist guys are some of the biggest offenders. They can die young from stress-related illness. We are all busy. And, the busiest people are usually the ones who can find or make the time to take better care of their mind and body. Short breaks during a workday are the best way to keep the stress down. Remember, the key to de-stressing is to disengage your mind; stop thinking for a few minutes, feel a positive emotion – smile to yourself. You did it!

Stress Solutions

by Susan Andrews, PhD

The Psychology Times, May 2015

Dr. Susan Andrews, Clinical Neuropsychologist, is currently Clinical Assistant Professor, LSU Health Sciences Center, Department of Medicine and Psychiatry, engaged in a Phase III study on HBOT and Persistent PostConcussion Syndrome. In addition to private clinical practice, Dr. Andrews is an award-winning author of Stress Solutions for Pregnant Moms (2013).

Interstellar-A Race Against Time

by Dr. Alvin Burstein

Interstellar is a corker of a film. The Director, Christopher Nolan, has assembled proven ingredients—a spunky young girl, Murph, an echo of Scout in To Kill a Mockingbird; a wise mentor, Professor Brand, reminiscent of Star Wars’ Obi Wan; a laconic (space) cowboy, Cooper, like his namesake in High Noon; and a computer, TARS, as programmable and likeable as Star Trek’s android Data. Nolan then adds a host of supporting characters, and puts them in a heart-pounding race against time. A race against time in more ways than one.

The movie opens in a not too distant future when the wonders of technology have sputtered out. The world, beset by environmental and ecological disasters, is a dust bowl. The financial resources for NASA have eroded badly and space exploration has ended. Food resources are drying up too, and the world is threatened with starvation. Cooper, a widowed astronaut whose vocation has become irrelevant, now lives a hard-scrabble farming life in a dusty, weather-beaten farmhouse along his father in law, and Coop’s two children, son Tom and the spunky daughter, Murph.

Murph tells Coop about a ghost in bookshelves of her bedroom that is scattering books, and drawing patterns in the dust on the floor of her room. Coop deciphers the markings as the coordinates of a nearby location where Murph and her father stumble into a secret NASA laboratory. Coop’s former mentor, Brand, is leading a last ditch effort to save the world from its death spiral by transporting humans to a new world in space. Brand’s plan A depends on his solving the puzzle of how to use gravity to propel earth’s doomed population to a new home in our galaxy; his plan B is to send an new expedition beyond our galaxy through a worm hole with embryos that can populate a planet there.

Brand persuades Coop, along with Brand’s brilliant, beautiful daughter, Amelia, to lead the plan B, assuring them that he will surely solve the gravity problem, saving the world’s current dwellers before the plan B expedition’s return. There are two races against time. The first is finding a home for earth dwellers before they starve to death. The second race is conditioned by the difference in time rates for earth time and for those on the space expedition. Can Coop, whose time is slow relative to earth time, keep a promise to return to his daughter Murph, aging at a rate much faster than her father’s in space?

Director Nolan treats us to a short course in physics, where we learn about the difference between dark holes in space and worm holes there, about the mystery of gravity, and about how relative time is. He hints that any other intelligent beings in the universe might be our human successors reaching back in time to us.

He also takes us on a psychological journey that highlights the power of love, driving Coop to persevere in efforts to keep his promise to his daughter. The film proposes love as a power that rivals gravity in its potency and mystery.

The movie documents, too, the agony that attends betrayals of trust by parental figures. Murph’s pain and bitter anger at what she perceives as her father’s willingness to sacrifice her to save humanity is re-iterated in Coop’s and Amelia’s shock when they discover that Brand had deliberately misled them. As Kohut’s self-psychology argues, such betrayals tear at the very structure of the self.

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Guest Columnist, Dr. Alvin Burstein, a psychologist and psychoanalyst, is a professor emeritus at the University of Tennessee and a former faculty member of the New Orleans-Birmingham Psychoanalytic Center with numerous scholarly works to his credit.

Despite the suspenseful catastrophes that propel the film and the psychological traumata that deepen it, there is something disappointing in its “happily ever after” ending, more fairy tale than myth. Amelia is successful at populating a new planet with the embryos. Murph helps to create a haven for current earthlings in our galaxy. Coop makes it home just in time to keep his promise to an aged Murph, and then journeys back into space to rejoin Amelia in that galaxy far away. Happy endings. A grimly realistic Freud would ask, “Are happy endings possible? Don’t we always hurt the ones we love? Are not love and loss necessarily bound together?”

Meditation: It IS What You Think

Years ago when first learning to meditate, I saw a T-shirt I liked with this logo on it. That slogan says it all. As psychologists, we know the importance of monitoring our thoughts and how interrelated thinking and feeling really are. A major cause of stress and one of the most important stress solutions has to do with our thoughts and our thinking. Turns out that Stress IS what you think, too. So here we have a Zen moment; both a stressed state of mind and a calm focused state of mind are related to our thinking.

The mind is an amazing thing. To a large extent, the negative consequences of stress are directly due to a busy mind. You do not have to be physically busy to have a busy mind. Most professionals would say they spend the day thinking and they might agree that thinking all day – without lifting a single shovel – is fatiguing.

If you are almost always thinking and worrying over a problem or you continue to dwell on the events of the day even after they are over, that is a chronic issue and your cortisol levels are likely to remain high. Cortisol levels do not drop until your mind calms and becomes quiet or still. So the longer you remain mentally active, even if you are lying in bed or sitting in an easy chair, the longer your high levels of cortisol will remain. And, that leads to an exhausting list of bad things, physically, mentally and emotionally. Let’s just say it does not lead to longevity and happiness.

Meditation, on the other hand, is a great antidote to stress caused by too busy a mind. In the past, meditation seemed more strange or alien to the Western mind. But, with the gradual advance of information about different forms of meditation and the acceptance of meditation as having value, it has actually become easier to learn and to include in your daily practice. Sanskrit words and chanting are no longer required. The rapid spread of Mindfulness is an excellent example. This technique takes minutes to learn and very little more to perfect. It is so simple that it is recommended for children and found helpful with children who are having problems with attention and/or with behavior. The book, Sitting Still Like A Frog: Mindfulness Exercises for Kids (and their parents) by Eline Snell, (2013) was featured at a 2014 LPA workshop by Dr. Michelle Moore. This book comes with a CD that has a number of great 5-minute Mindfulness exercises. I have recommended this book to many of my patients, old and young. It is inexpensive and easy to use. I recommend it for everyone who needs to learn this simple meditation technique.

Mindfulness is growing in popularity across the country. It is recommended for so many different reasons:

  • stress relief and pain relief
  • taking mental breaks during a busy day • assistance falling asleep
  • combat depression and/or anxiety


Do yourself a favor: Give Mindfulness a try.

Stress Solutions

by Susan Andrews, PhD

The Psychology Times, April 2015

Dr. Susan Andrews, Clinical Neuropsychologist, is currently Clinical Assistant Professor, LSU Health Sciences Center, Department of Medicine and Psychiatry, engaged in a Phase III study on HBOT and Persistent PostConcussion Syndrome. In addition to private clinical practice, Dr. Andrews is an award-winning author of Stress Solutions for Pregnant Moms (2013).

American Sniper: Celebrating a Hero

by: Alvin Burstein

As the American general, Curtis LeMay, reminded us, “War is about killing people. When you have killed enough, the other side gives up.” In the context of war, killing is a virtue. Thus it is that wars produce, not just fatalities, but heroes. And from a psychological point of view, having heroes is important, helping to define our self-concept and to shape our behavior.

Jung tells us of the hero archetype, the warrior slayer of dragons; the self psychologist Heinz Kohut describes the important role of the idealized parent imago, omnipotent and omniscient, in structuring the self. The first World War produced a hero, Sgt. Alvin York; the second World War produced Audie Murphy; in the Iraq war, a third hero, the American sniper, Chris Kyle, emerged.

The biopic American Sniper is a celebration adding Kyle to the pantheon of American military heroes. Early in the film flash backs about young Kyle and his father occur. In the first the boy is praised for killing his first deer; in the second, the father tells his children that there are three kinds of people: sheep, wolves that prey on them and sheep dogs that protect them. He enjoins them to be sheep dogs, laying the foundation for Kyle’s devotion to a career of slaying the wolves of al Qaeda during his four tours of duty in Iraq—over 160 confirmed kills.

The film is engaging on many levels. The acting is convincing, Kyle’s skills are literally awesome, the action provides a sobering look at the hell of war, there is an attempt to contextualize Kyle’s killings, “I don’t think about the people I’ve killed, but about my boys’ lives I’ve saved.”

Although American Sniper is a moving celebration of Kyle as a hero, it glosses over any sense of conflict in him, not over killing those threatening his boys, but his failure to respond to his wife Taya’s entreaties to come home. She repeatedly entreats him to come home to help her and be a father to their children; he chooses more sniping. He is unconflicted in choosing dragon slaying over being a husband and father. This theme, Kyle’s views of the soldiers he is guarding as his children, and his role as their protector is emphasized by his post-discharge efforts to help crippled veterans to recover—by taking them to a shooting range. This depiction hints at a powerful issue, little developed in the film.

There is a focus on injured veterans as amputees, a gesture of their feeling impotent, castrated by their injuries, and the role of gunplay in reducing the shame of lost potency. One of them says, in the course of his firing on the range, “I feel like I got my balls back.”

The link between gun play and male potency comes up at another point in the film. Kyle is out of the service and playing with his two young children. The play consists of his brandishing a revolver, happily unloaded. His wife, Taya is in the kitchen, and Kyle, holding the gun, turns toward her. She asks, “What can I do for you?” “Drop your drawers, ma’am,” he replies, and they laugh as he leaves to take another veteran to a session on the shooting range. In a tragic irony, Kyle will be shot to death in that session. That irony is unexplored in the film. To me it hints at a connection between the manner of his death and the implicit cultural links between masculinity, sexual potency and gun usage that constrain our society’s response to gun violence.

I found myself wondering how that omission might relate to director Clint Eastwood’s acting career: Rawhide’s Rowdy Yates, Dirty Harry and a spate of spaghetti westerns.

Chris Kyle may endure as a symbolic hero figure. The biopic celebrates him. Although it gave me a lot to think about, its dramatic superficialities leave it short of greatness.

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Guest Columnist Alvin Burstein, a psychologist and psychoanalyst, is a professor emeritus at the University of Tennessee and a former faculty member of the New Orleans-Birmingham Psychoanalytic Center with numerous scholarly works to his credit.


Children Suffer from Stress, Too

Just like all adults, children suffer from stress, too. Often it happens that the stresses experienced by children seem insignificant to adults. Or, worse, the parent may completely miss the fact that the child is stressed. Childhood stress can be caused by any situation that requires the child to adapt or change to a new situation. Change often produces anxiety because we don’t always know what to expect in the changed situation. You don’t have to be grown up to fear the unknown.

Stress can even be caused by positive changes, such as starting a new activity, but it is most commonly linked with negative changes such as divorce, illness or death in the family. But, because children have few previous experiences from which to learn, even situations that require small changes can have an enormous impact on a child’s feelings of safety and security.

Some parenting styles and parent expectations can be very stressful. Children want to please their parents. I know that seems like a “no- brainer.” However, those among you who treat children might now think that that everyone knows that. I have heard parents complain about their children in terms that make it sound like they believe the child is going out of his or her way to upset or defy them. And, before you object, of course some children can reach a point where they become oppositional. Usually that happens only after the child becomes resistant to being over-controlled.

Children with learning problems are often seriously stressed. They know they are not meeting their parents’ or teachers’ expectations for school success. They feel stupid and like a failure. Unfortunately, the main “job” that our children have is to succeed in school. Children learn how to respond to stress by what they have seen and experienced in the past. If the adults in their social environment are not good at dealing with stress, they are not likely to be either. Another major factor to consider is that a poor ability to deal with stress can be passed from the mother to the child during the prenatal months if the mother is very anxious or chronically stressed (Andrews, 2012).

Children probably will not recognize that they are stressed. Parents may suspect stress if the child has experienced a stressful situation and begins to have physical or emotional symptoms, or both. Some behaviors or symptoms to look for can include, changes in eating habits, new onset of headaches, changes in sleep pattern (nightmares, bedwetting, middle of the night awakening, resistance to going to sleep), upset stomach or vague stomach symptoms, anxiety, worries, inability to relax, fears that are either new or return (of being alone, of the dark, of strangers or new situations), clinging to you, and easy tears. Aggressive, stubborn or oppositional behaviors are also possible signs of stress in children.

Stress Solutions

by Susan Andrews, PhD

The Psychology Times, March 2015

Dr. Susan Andrews, Clinical Neuropsychologist, is currently Clinical Assistant Professor, LSU Health Sciences Center, Department of Medicine and Psychiatry, engaged in a Phase III study on HBOT and Persistent PostConcussion Syndrome. In addition to private clinical practice, Dr. Andrews is an award-winning author of Stress Solutions for Pregnant Moms (2013).

The Great Dictator

by Alvin G. Burstein

The jihadist massacre of Charlie Hebdo staff in response to their publication of a cartoon of Muhammad and the putative hacking by North Korea of Sony Pictures in response to a movie, The Interview, highlight searing questions about a complex of issues including ridicule, freedom of expression, hate speech, et al.

In that context, I decided to see and review the 2014 Sony film. That decision triggered memories of another film, one I had seen as a child, Chaplin’s The Great Dictator; because my memories of that film were dim, I watched it again, as well.

What the two movies have in common is their involving caricatures of foreign dictators, Hitler and Mussolini in the Chaplin film, North Korean Kim Jong-un in the Sony film. Both are comedies in that they ridicule their targets, making them the object of our laughter, encouraging us, not to fear them or to hate them, but to look down on them.

There are, however, striking differences between the two. Chaplin not only mocks Hitler and his cohorts, but dramatizes the injustice of anti-Semitism, or more bluntly, Jew hating. The movie centers on three characters, Adeniod Hynkel (caricaturing Hitler), played by Chaplin; Benzeno Napaloni (charicaturing Mussolini), played by Jack Oakie, and a little Jewish barber, a ghetto dweller, who is Hynkel’s look-alike, also played by Chaplin.

The movie ends with the little Jewish barber, managing to masquerade as Hynkel, giving speech in which the pseudo dictator eschews hate and pleads for tolerance and love for all. The Great Dictator is a propaganda piece urging us to be better.

There is none of that in The Interview. For those who haven’t seen it, the story is that of Dave Skylark, a Jerry Springer type of TV interviewer who wangles an invitation to meet with the North Korean dictator, is recruited by the CIA to assassinate the leader, finds himself drawn to Kim as his soul mate, but ultimately becomes disillusioned and kills him.

That film is remarkable for its scatological turn; the audience is lavished with crude references to every level of sexuality: oral, anal and genital. Some might be amused, others repelled, some bored by the excess.

I found myself taken with the psychoanalytic aspects of David and Kim’s mutual attraction. There is a mutual recognition of their having failed to earn their fathers’ approbation, and feeling driven to undo that lack with public adulation.

Kim seduces David with two gifts; an idealized bust of the TV celebrity and, later a puppy to replace a pet David had lost as a child, reminding me of a sign in my veterinarian’s office—I would like to be the kind of person my dog thinks I am.

Kim recognizes that David shares his aching need to be admired. Self psychologists argue that one of the anchors of self are self objects who are images of us. The powerful attraction that the two feel for each other lies in their recognition that they mirror each other.

On the other hand, David and his producer Aaron are bound together, but in a different way. They explicitly see each other in Tolkeinian terms. David describes himself as Frodo, and Aaron as his needed Samwise. We are not surprised when Aaron loses a finger protecting David; in Oedipal struggles, someone has to be castrated.

I do not see The Interview as a propaganda film. Unlike The Great Dictator, there is no positive message, little to admire and no one to love. Chaplin’s comedic art that invited us to look down on the little barber, but also to find him, like a puppy, someone loveable. And to listen to his plea for goodness.

What is Your Sleep IQ?

Not only is a good night’s sleep one of the most valuable things you can do for your health and longevity, but also getting a good night’s sleep is paramount to erasing the day’s accumulated stress. Sleep IQ can refer to a measure of how well you rest and includes the number of hours of restful sleep versus the number of hours of restless sleep or time out of bed each night. This definition of Sleep IQ also includes how long it takes you to fall asleep, your average heart rate and your average number of breaths per minute.

A different definition of Sleep IQ refers to how much you know about how to get a good night’s sleep. Many clinicians make a point of asking clients about their sleep and ability to rest. Some psychologists actually work with their clients on sleep hygiene. The following Sleep IQ Quiz is offered to refresh us all on some of the important misconceptions about sleep and how to get the best night’s sleep.

True or False?

  1. Sleep deprivation can make you fat.
  2. You can compensate for a night of bad sleep by hitting the snooze button and sleeping a little late in the morning.
  3. We can make up for lost sleep by going to bed extra early another night.
  4. Most people don’t need a full 8 hours of sleep each night.
  5. Sleeping pills mask sleep problems and do not resolve the underlying cause of insomnia.
  6. A typical cause of trouble falling asleep is when your mind just won’t stop talking.
  7. A little alcohol can help you fall asleep and sleep well.
  8. If you can’t fall asleep within 30-45 minutes, stick it out a little longer.
  9. Often just thinking about sleep affects your ability to fall asleep.
  10. Sleeping just one hour less a night can prevent you from learning or functioning normally.

[Answers: 1-T, 2-F, 3-F, 4-F, 5-T, 6-T, 7-F, 8-F, 9-T, 10-T]

If you scored 9 or 10 out of 10, you are a “sleep genius.” Congratulations and don’t forget to get your full 8 hours of sleep.

Stress Solutions

by Susan Andrews, PhD

The Psychology Times, February 2015

Dr. Susan Andrews, Clinical Neuropsychologist, is currently Clinical Assistant Professor, LSU Health Sciences Center, Department of Medicine and Psychiatry, engaged in a Phase III study on HBOT and Persistent PostConcussion Syndrome. In addition to private clinical practice, Dr. Andrews is an award-winning author of Stress Solutions for Pregnant Moms (2013).

Passing Stress on to the Next Generation

“Pass the salt. Pass the rolls. But, please don’t pass the stress.”

As a clinician, you will surely have the opportunity from time to time to counsel young women who are pregnant or who are hoping to get pregnant. Or, you may be a young psychologist looking to start or increase your own family. In the first case, you can offer information to your client about how chronic stress can harm their developing baby. Or, you can profit from knowing the value of managing stress – especially during pregnancy.

Last month we reviewed new research on how chronic stress can cause premature aging and illness because the constant overproduction of cortisol reduces the supply of the body’s telomerase and that prevents the cell from reversing the effects of stress on telomere length. This is the mechanism by which chronic stress can harm your DNA. However, there is more; another pathway by which stress impacts the body at the cellular level happens in the developing baby of a chronically stressed mom. Thus, the “transgenerational transmission of risks” has to be taken into account in planning ways to improve public health.

Dr. Sonja Entringer and colleagues published a study showing the higher the mom’s anxiety during the prenatal period, the shorter the baby’s telomere length. Now a great deal of research has been published on prenatal stress and anxiety and how it affects the child for the rest of his or her life. Stress Solutions for Pregnant Moms (Andrews, 2012) reviews the most important studies. The effects are not simply on health (such as premature birth and low birth weight, asthma and digestive problems). Serious consequences include the child’s reduced ability to cope with stress. The developing child of a chronically stressed mother is also more likely to have problems with attention and behavior (ADD/ADHD). Other related problems include learning problems, lower IQ, higher incidence of anxiety and depression, and even an increased risk of autism.

Not only are the newborn’s telomeres affected by the mom’s stress, but also the mom’s chronically high levels of cortisol may trigger changes in the developing fetal brain. The cortisol levels in the mother’s blood are noted by the fetus’s brain. The brain of the fetus begins to consider the higher cortisol levels as “normal.” According to this theory, the brain then decides that it does not need as many stress-hormone receptors in the developing hippocampus. The end result is that more cortisol will remain in the child’s blood whenever stressed and the child’s H-P-A axis has been changed or dysregulated.

The bottom line is that we are living in a world of ever increasing stress because of the constant change in which we live. Our world is changing daily and we are so aware of it because of the nearly instant TV, cell phone and internet coverage for major events. Everyone or nearly everyone has access to multiple sources of information. People now accept this level of stress as “normal.” Certainly, we all have the right to decide for ourselves how much stress for which we are willing take the consequences. But, now that we see the consequences are being passed to future generations, I believe it is critical to start implementing known strategies and solutions to manage stress better. And, in our role as clinicians, we need to get the word out.

Stress Solutions

by Susan Andrews, PhD

The Psychology Times, January 2015

Dr. Susan Andrews, Clinical Neuropsychologist, is currently Clinical Assistant Professor, LSU Health Sciences Center, Department of Medicine and Psychiatry, engaged in a Phase III study on HBOT and Persistent PostConcussion Syndrome. In addition to private clinical practice, Dr. Andrews is an award-winning author of Stress Solutions for Pregnant Moms (2013).

Chronic Stress Can Harm Your DNA

Most everyone over 30 is concerned with aging and age-related illnesses, like cancer and heart disease. The role of stress and cortisol in aging and chronic illness is now well established. But how increased cortisol is linked to early aging has not been clear…until very recently. Scientists at the U. of California, San Francisco have been working for a decade on the links in this chain. And, the answer is: short telomeres.

Telomeres function like a cap whose job it is to protect the end of the chromosome where the genes lie. Each time the cell divides, a bit of the telomere is cut off (instead of the gene). Dr. Elizabeth Blackburn, a molecular biologist now at UCSF, won the Nobel Prize in 2009 for her discovery of how chromosomes and genes are protected. Over time, with repeated reproduction, the telomere gets shorter. As the telomere becomes shorter, the organism begins to age and irregularities creep into the reproduction process. Some cancers may be due to these irregularities. Dr. Blackburn’s discovery was that the telomeres are actually replenished by an enzyme, telomerase reverse transcriptase.

The bad news, however, is that stress and excess cortisol damage the body’s supply of telomerase. So chronic stress can cause premature aging and illness because the constant overproduction of cortisol reduces the supply of telomerase and that prevents the cell from reversing the effects of stress. Telomere length (TL) can now be measured. However, if you are the President of the US, one does not need fancy tests to measure your TL. Stress is not the only way that telomeres become short too soon. Some people have the bad luck to be born with shorter telomeres. Others earn shorter telomeres in advance of their years by their life style choices. And, some have been exposed to early life adversities, which lead to shorter TLs over time.

The same scientists that discovered telomerase have been working on finding solutions to the harmful effects of chronic stress on DNA. In 2010, Dr. Puterman and colleagues demonstrated that moderate to vigorous physical exercise can buffer the effect of chronic stress on TL. Subjects took the Perceived Stress Scale and were divided into sedentary (not exercising) versus the active group (those getting the CDC recommended amount of daily exercise). The likelihood of having short versus long telomeres was calculated as a function of stress and exercise group, covarying age, BMI, and education. There was a significant moderating effect of exercise. Non- exercisers with even a one unit increase on the Perceived Stress Scale showed a 15-fold increase in the odds of having short telomeres, whereas for the exercisers, perceived stress was unrelated to telomere length. The conclusion is that “vigorous physical activity” (increased HR, sweating, +/or rapid breathing) appears to protect people experiencing high stress.

The USDA recommends that adults (18 to 64) do at least 2 hours, 30 minutes each week of moderate physical activity (brisk walking, dancing) OR 1 hour, 15 minutes each week of aerobic physical activity at a vigorous level (running, walking fast uphill, cycling). Being active 5 hours or more a week can provide even more health benefits. It is recommended that the physical activity be spread out over at least 3 days a week and that each activity should last at least 10 minutes at a time. Strengthening exercises are also recommended, like sit ups, weights, at least 2 days a week to maintain memory.

In sum, as you age, it is essential to protect your telomere length by a minimum of 25 minutes at least 3 days a week of vigorous exercise. Next month we will look at how the damage of chronic stress to DNA can be inherited or transferred to the next generation.

Stress Solutions

by Susan Andrews, PhD

The Psychology Times, December 2014

Dr. Susan Andrews, Clinical Neuropsychologist, is currently Clinical Assistant Professor, LSU Health Sciences Center, Department of Medicine and Psychiatry, engaged in a Phase III study on HBOT and Persistent PostConcussion Syndrome. In addition to private clinical practice, Dr. Andrews is an award-winning author of Stress Solutions for Pregnant Moms (2013).

Let’s Review…

To date, The Psychology Times has published 4 Stress Solutions columns. Let’s review where we have been.

In July 2014, the topic was “10 Stress-Free Minutes a Day Keeps the Doctor Away.” The main theme was that chronic stress is clearly linked to many health problems like obesity, emotional issues like anxiety, and cognitive changes such as memory problems. Even though as psychologists we know this, tell our patients about stress, and offer many suggestions to help them reduce stress, oddly enough, we do a poor job of following our own advice. July’s article suggested that we should all “draw a line in the sand” and start reducing our excess cortisol by doing something at least 10 minutes every day to reduce the effects of stress on our own bodies. I suggested the Mindfulness training and/or some focused breathing with music each day.

August 2014 was titled, “Is Your Treadmill Keeping You From Losing Weight?” Even exercise can produce more cortisol when we stress our systems by overexercising. The increased cortisol can then keep us from losing weight. Short bursts of high intensity exercise is recommended to use up the body’s glycogen stores without over- releasing cortisol. The benefit of regular exercise is that your body’s response to exercise improves with regular practice and that over time, regular exercisers deal better with social stress and emotional situations.

September’s column, “What do Obesity, Chronic High Stress, Heart Disease, Diabetes, Hypertension, and Depression have in common?,” addressed sleep deprivation and how sleep deprivation can keep you from losing weight. Sleep deprivation is a major stressor on the body and is related to reduced alertness, concentration, and memory efficiency. Good sleep is related to normalized blood pressure, lower morning blood glucose levels, and normal physical reactions to stress and activity. Many psychologists are focusing on sleep habits in their treatment sessions.

Last month’s topic was “Salmon and Sardines for Stress Reduction.” Eating fish rich in Omega-3 poly-unsaturated fatty acids has been shown to counteract the detrimental effects of mental stress on your heart. 9 grams of fish and/or fish oil supplements a day is recommended. Oily fish are species of fish that contain significant amounts of oil throughout their body tissues and in their belly cavity. Examples of oily fish include salmon, trout, sardines, kipper, eel, and herring. The benefits of eating such fish during pregnancy have been shown to carry over to the offspring in the form of reduced behavioral and attention problems.

Hopefully this mini-review will remind us all to get good sleep nightly, set up a regular exercise regimen, make ourselves take at least 10 minutes a day to reduce the body’s load of cortisol, and to eat oily fish at least twice a week or take Omega 3 supplements to reduce the effects of stress on our hearts. Coming up we will examine the effects of stress on our memory.

Stress Solutions

by Susan Andrews, PhD

The Psychology Times, November 2014

Dr. Susan Andrews, Clinical Neuropsychologist, is currently Clinical Assistant Professor, LSU Health Sciences Center, Department of Medicine and Psychiatry, engaged in a Phase III study on HBOT and Persistent PostConcussion Syndrome. In addition to private clinical practice, Dr. Andrews is an award-winning author of Stress Solutions for Pregnant Moms (2013).

My White Plume

A review of Cyrano de Bergerac
by Dr. Alvin Burstein

The French poet, Edmond Rostand, published a play, Cyrano de Bergerac, in 1897. Rostand’s hero had a real life counterpart who railed against the church and state -a gallant soldier, a duelist, a poet and a political dissident.

The protagonist in the play is a super-hero who is all of these things, but the fictional person is even larger than life, especially around the nose. And he is in love with a woman from whom, because of his grotesque appearance, he not only hides his love but whose relationship to another person he facilitates: a variation on the Beauty and the Beast theme. Very much a product of its romantic context, the plot has a strong appeal evidenced in its re-creation in a dozen films, as well as in plays and operas.

Another example of its appeal is Anna Freud’s mention of it as one of her favorites, saying that at one time she had memorized the script. She regarded Cyrano’s behavior as a special kind of altruism, one that reflects identification with another. Seeking that person’s gratification brings gratification to the altruist. Perhaps the kind of selfless love that Anna felt for her father.

My favorite movie version of Rostand’s play is the 1950 film starring José Ferrar. It follows Rostand’s script closely, with two related plot lines. The first highlights Cyrano’s proud independence—his refusal to be patronized or to curry favor. “Would you have me make friends everywhere as a dog makes friends? I observe the manner of the canine courtesies, and I despise them.”

The second develops Cyrano’s love for his beautiful cousin, Roxanne. His hopes are dashed when, at the moment he believes she might declare return his love, he finds she is infatuated with Christian, a handsome young guardsman in Cyrano’s company of musketeers. She asks Cyrano to be her lover’s protector. Not only does he agree to do that, but he goes on to help Christian to court Roxanne in a selfless effort to fulfill her romantic desires.

When Christian is killed on the battlefield, and Roxanne is mourning her lost love, Cyrano still cannot bring himself to disillusion Roxanne by revealing that a letter to her found on Christian’s body had, in fact been written by Cyrano. Roxanne consigns herself to a convent, where for the next fifteen years, Cyrano visits her regularly, never revealing his passionate attachment, playing the role of the clever courtier bringing a cloistered friend the news of royal goings-on.

When Cyrano is badly injured in a scurrilous attack, he insists keeping his regular commitment to visit Roxanne. Knowing that he is at death’s door, Cyrano asks Roxanne if she would permit him to read what she believes to be Christian’s last letter to her. As the shadows fall in the courtyard, Cyrano reads the letter, which speaks of the writer’s love for Roxanne, aloud.

Roxanne realizes that it is too dark for him to be reading—that he must be the writer and that Cyrano has always loved her, and, more, that the Christian that she thought she loved was Cyrano’s creation. As she confronts him with her realization, Cyrano begins to hallucinate, and struggles to his feet to do battle with death and all his old enemies.

His final words are the climax of the play and of the movie, “You have riven away my laurels and my roses, but there is one thing that I take with me, one thing, in spite of all my own, and that is (as he falls into Roxanne’s arms)…my white plume.”

Deciphering the symbolism of the white plume is critical. When I first saw the film, I took it to represent Cyrano’s fierce independence. But when I read the French version of the play, the final words were “…mon panache.” “Panache” in French has many meanings: a white plume on a hat, style, masquerade, pose. That suggested an alternative to me.

There is an important focus on acting in Rostand’s play and in Ferrer’s movie. The play begins with Cyrano’s vendetta against a bad actor, Montfleury, a ham actor. Christian, who complains that he does not know how to woo a woman, cannot read the lines that Cyrano composes for him well.

Cyrano, on the other hand, never abandons his pose of being, not a lover, but a loyal friend. That is the role he chooses to play.

Is that choice, his adherence to it, a form of integrity that he owns and cannot be deprived of? Is his insistence on choosing that role a flaw in his altruism, or is it is a final gift to Roxanne?

Salmon and Sardines for Stress Reduction

Benefits attributed to eating oily fish are mounting. Eating fish is now credited with combating depression, reducing the symptoms of arthritis, reducing the risk of heart disease, protecting vision, and most recently with reducing stress and improving working memory. Of course, this is due to oily fish, like salmon and mackerel, being very rich in omega-3 poly-unsaturated fatty acids and protein. White fish have fatty acids too but not as much.

A study published in the American Journal of Physiology – Regulatory, Integrative, and Comparative Physiology shows that fatty fish oils can “counteract the detrimental effects of mental stress (read that: the fight or flight reaction) on your heart.” The study, led by Jason Carter of Michigan Technological University, revealed that people who took 9 grams of fish oil supplements a day for over a month experienced less mental stress in measurements of cardiovascular health, including heart rate and muscle sympathetic nerve activity (MSNA) compared to those who took 9 grams a day of olive oil instead.

Oily fish are species of fish that contain significant amounts of oil throughout their body tissues and in their belly cavity. In contrast, whitefish only contain oil in their liver – and much less of it than oily fish. Other examples of oily fish include trout, sardines, kipper, eel, and herring.

The American Heart Association recommends that people eat at least two servings of fish every week. The National Health Service of the United Kingdom also advises people to eat at least two portions of fish a week, including one of oily fish.

It has been known since the famous Avon, England study of all the pregnant women in that city during one year in the 90’s that women who do not eat fish during pregnancy are more likely to experience high levels of anxiety at that time. The University of Bristol longitudinal study suggested that eating fish during pregnancy could help reduce stress levels, which – in turn – has the effect of reducing behavioral and attention problems in the offspring of oily fish eating mums.

My favorite study involved London cabbies, a stressed group who can always use some working memory improvement. The BBC reported on a small group of 10 cabbies who agreed to eat 4 portions of oily fish a week for 12 weeks. They were tested before and after the 12 weeks to see what affect the increased intake of oily fish had on their stress levels and memory.

At the end of the 12 weeks it was found that cabbies were better able to deal with stressful situations and their visualization-based memory had also improved significantly, something Omega 3 is believed to help with. As a group, their stress hormone as a whole was down by 22% and their anti-stress hormone up by 12%.

Since the study included only ten participants and had no control group the results are only suggestive. However, the cabbies could be heard to exclaim: “So long and thanks for all the fish…”

Stress Solutions

by Susan Andrews, PhD

The Psychology Times, October 2014

Dr. Susan Andrews, Clinical Neuropsychologist, is currently Clinical Assistant Professor, LSU Health Sciences Center, Department of Medicine and Psychiatry, engaged in a Phase III study on HBOT and Persistent PostConcussion Syndrome. In addition to private clinical practice, Dr. Andrews is an award-winning author of Stress Solutions for Pregnant Moms (2013).

What do Obesity, Chronic High Stress, Heart Disease, Diabetes, Hypertension, and Depression have in common?

If you guessed Sleep Deprivation, my hat’s off to you.

While there is no “magic number” of hours that we should sleep, it is now firmly established that you cannot lose weight if you do not sleep a solid 7-8 hours a night. Research says the average American misses 200-300 hours of needed sleep each year. This is known as a sleep debt.

Studies suggest that healthy adults have a basal sleep need of seven to
eight hours every night. Where things get complicated is the interaction between the basal need and sleep debt. For instance, you might meet your basal sleep need on any single night or a few nights in a row, but still have an unresolved sleep debt that may make you feel more sleepy and less alert at times, particularly in conjunction with circadian dips, those times in the 24-hour cycle when we are biologically programmed to be more sleepy and less alert, such as overnight hours and mid-afternoon.

Cortisol is not the only factor that inhibits weight loss but it is a big one. Some physicians are willing to flatly state that you cannot lose weight if you do not get to bed early and get a solid 7 or 8 hours.

What getting a good night’s sleep can do for you:

  • A good night’s sleep has a positive effect on your blood pressure, meaning that for most of us it goes down at night. If your hours of sleep are interrupted or too short, your blood pressure may never fall low enough.
  • Insulin resistance is reduced by good sleep. Dr. Michael Breus, a psychologist and sleep specialist, emphasizes the fact that even short- term sleep loss (being awake for approximately 36 hours) can cause blood glucose levels to be higher than normal.
  • A routine schedule for sleeping will help your body keep its internal biological clock running smoothly. You will be more alert, with good reaction time and physical ability, in other words, less accident- prone.

How psychologists can help

Many psychologists are focusing on sleep habits in the patients they are treating. A study in the Journal of Clinical Sleep Medicine, looking at adults with insomnia, found that more than 85% of the study sample who completed 3 or more sleep-focused treatment sessions were able to nod off faster and stay asleep longer. A 6- month follow-up revealed that those patients who had 3 or more sessions spent significantly less money on health care and had fewer doctor visits – compared to the 6 months before their therapy sessions focused on sleep habits. The weekly therapy sessions included relaxation exercises and education on topics such as activities to avoid doing 2 hours before bedtime (like exercise, heavy meals, and smoking). The APA magazine, Good Practice, (Spring/Summer 2014) offers an informative short article on tips to Getting a Good Night’s Sleep.

Stress Solutions

by Susan Andrews, PhD

The Psychology Times, September 2014

Dr. Susan Andrews, Clinical Neuropsychologist, is currently Clinical Assistant Professor, LSU Health Sciences Center, Department of Medicine and Psychiatry, engaged in a Phase III study on HBOT and Persistent PostConcussion Syndrome. In addition to private clinical practice, Dr. Andrews is an award-winning author of Stress Solutions for Pregnant Moms (2013).

Is Your Treadmill Keeping You From Losing Weight?

That’s right! Your treadmill could be contributing to your trouble losing weight. Of course, many factors can be blamed for failure to lose weight; however, until recently your treadmill was not one of them. Exercise was always considered essential to weight loss. That is still true but the type and length of exercise may need to be revised.

The reason your treadmill is getting bad press relates to stress and the overproduction of cortisol. New research has discovered that long jogs or exercise sessions on the treadmill can actually increase cortisol. And, increased cortisol works against weight loss. Excess cortisol stops your body from burning fat for energy. Without a good way of burning fat for energy, losing weight becomes an uphill battle.

Working long hours without taking breaks, sleeping less time than you personally need, and thinking and worrying all the time are major causes of the overproduction of cortisol. The last thing most of us want is to exercise 20 or 30 minutes on our treadmill thinking we are helping ourselves to lose weight only to find out that we have burned relatively few calories and that we have produced more cortisol.

Actually, the relationships between exercise and cortisol and weight loss are tricky. There is not one simple answer for all. Cortisol is released in response to stress. If you are not in shape and just beginning an exercise program, even walking at a 20- minutes-per-mile pace can cause you to release extra cortisol. However, as your exercise training progresses, that 20-minutes- per-mile pace may not be as stressful and thus, you will not release as much cortisol. But, if you exercise until you use up your body’s glycogen stores, then you will cause an added release of cortisol to use as fuel. More is not always better. Short bursts of intense exercise may be better for weight loss without adding cortisol.

More Good News About the Benefits of Exercise

The training effect of exercise is not limited to improving your body’s physical reaction to stress. People who are active and exercise on a regular basis show a significantly lower cortisol response to an emotional crisis when compared to sedentary controls. Dr. Rimmele and colleagues at the University of Zurich in Switzerland have published a number of recent studies on how exercise training reduces salivary cortisol and cardiac stress indicators, such as heart rate. The surprising finding of Dr. Rimmele’s study – and a good take-home message for psychologists working with clients who are easily upset and/or who have some social anxiety – is that physical exercise also reduces salivary cortisol when a person is stressed in social or emotional situations. So don’t give away that treadmill after all, just use it wisely.

In the next Stress Solutions Column, we look at how important sleep is in losing weight.

Stress Solutions

by Susan Andrews, PhD

The Psychology Times, August 2014

Dr. Susan Andrews, Clinical Neuropsychologist, is currently Clinical Assistant Professor, LSU Health Sciences Center, Department of Medicine and Psychiatry, engaged in a Phase III study on HBOT and Persistent PostConcussion Syndrome. In addition to private clinical practice, Dr. Andrews is an award-winning author of Stress Solutions for Pregnant Moms (2013).