Author Archives: TimesAdmin

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).

Forrest Gump

by Dr. Alvin Burstein
with J. Nelson

It seems fair to say that Forest Gump has achieved the status of an American classic. Fans in an ABC poll voted the film the best of all Best Pictures over the last decades. The film manages to evoke laughter, heartache, and a sense of depth. This remarkable combination results from literary and cinematic devices that deserve our attention.

The story is book-ended by an image of a feather drifting, floating hither and yon as it slowly falls to the ground. It is ultimately picked up by Forest, who inserts it carefully into his childhood copy of Curious George, from which his mother early read to him. The emphasis accorded these images urges us to wonder about its meaning, a question to which we will return.

Aristotle taught us the comic protagonist is one that the reader or spectator feels superior to, so we chuckle at his social awkwardness and concrete thinking. But Gump not only has a name that makes us smile, he is intellectually disabled and, at the beginning of his story, crippled and wearing clumsy leg braces. His early classmates—except for Jenny—regard him as a target for bullying, evoking our sympathy.

In a classic comic move, this simple-minded man achieves extraordinary feats as a football and (don’t laugh) ping-pong player, and stumbles into remarkable acts of heroism in Viet Nam and financially successful ventures afterward. All in all, a classic Chaplinesque format. The character pulls us along in both delight and pain. “Tom Hanks may be the only actor who could have played the role,” said Roger Ebert, “The performance is a breathtaking balancing act between comedy and sadness.”

Forest Gump’s clearly fantastical history is literally woven into prominent historical events, the kinds that are deeply inscribed in our emotional memories: Gump is shown on in an actual newsreel on the occasion of the admission the first African American into the University of Alabama, he is photo-shopped into a real Medal of Honor award ceremony presided over by Lyndon Johnson, he is on the scene during the Watergate burglary that brought down the Nixon White House, he is photo-shopped into a newsreel of a reception given for an All Stars’ football team given by President Kennedy, etc.

This kind of interweaving of fiction and historical accounts has been explored and elaborated by the French philosopher, Paul Ricoeur, in his award-winning trilogy, Time and Narrative. Ricoeur sees this interplay between fiction and fact as facilitating fiction’s ability to help its audience experience alternative worlds, enriching the reader/viewer’s empathic abilities and psychological growth. Using this powerful tool, Forest Gump focuses our attention on the existential issue of the tension agency and chance, choosing and being externally controlled, in human affairs.

The story portrays Gump as having an enormous impact on others’ lives and of achievements that would ordinarily require and reflect extraordinary motivational focus. But Gump stumbles into them. He has no idea what was involved in volunteering for military duty in Viet Nam, nor, for that matter, what the nature of the conflict was, beyond walking in the jungle.

When his GI buddy, Bubba, proposes that Forest join him in a post-war career in shrimp fishing, Forest matter of factly says, “OK.” He sets off on a three year run, without a plan, without meaning to, and ends it on impulse, without knowing why. In short, he cites his mother’s mantra that life is like a box of chocolates, “…you never know what you are going to get.”

His readiness to accept all that happens to him, close brushes with death; involvement with world-shaking events, and tragic loss is, in its own way charming and appealing.

We are reminded of the Jungian archetype of the “Fool” who in one theoretical incarnation, embraces the serendipity and capriciousness of life by experiencing it on its own terms, accepting what comes without judgment, neither struggling to change it nor wailing to the heavens about it. This is strangely similar to the modern psychological emphasis on mindfulness. Forrest seems often blissfully free from and immune to social prejudice, competitive malice, or self-loathing. He is not burdened to intervene at every step, nor does he make the mistake so common for those in the American culture of perceiving control where he has none.

Forrest’s approach to life’s adversity is contrasted by the story lines for Lieutenant Dan, who angrily rejects the losses of his life, and Forrest’s beloved Jenny who is driven to escape her life.

Lieutenant Dan, who was supposed to die with honor on a field of battle, struggles through his hero’s journey after losing both legs and sinking into depression, a showdown with God, and then finally making peace with himself. He builds the shrimp business and makes Forrest a wealthy man investing the proceeds.

Jenny’s drive to escape is highlighted in the scene when, joined by Forest, she is trying to hide from her sexually abusive alcoholic father. “I wish I could be a bird and fly away!” she says. Her life is a series of self-destructive rebellions, in sharp contrast with Forest’s unplanned achievements.

Jenny asks Forrest if he was ever afraid in Viet Nam, and it is in this scene that we glimpse the depth of what supports this simple man. “Yes. Well, I… I don’t know. Sometimes it would stop raining long enough for the stars to come out … and then it was nice. It was like, just before the sun goes to bed down on the bayou, those million sparkles on the water. Like that mountain lake, it was so clear Jenny. It looked like there were two skies, one on top of the other. And then the desert, when the sun comes up, I couldn’t tell where heaven stopped and the earth began, it was so beautiful.” Forrest’s simple observations connect us with the universal, and we feel it gives some comfort to Jenny, and to us.

The emotional climax of the film is Forest’s discovery that Jenny had born his son, who is “normal,” and Jenny’s decision to, finally, accept Forest’s love for her, both of them knowing she is fatally ill. They marry but very quickly we see she is dying.

After Jenny’s death, Forrest devotes himself to parenting his son. The film ends with Forest junior boarding the school bus, mirroring the opening of the autobiography that constitutes the movie. As his son climbs onto the bus, Forest says, “I will be waiting for you,” and the son introduces himself to the driver in the same words that his father had used decades before.

The film leaves us teetering on the brink of unanswered questions: Will his son’s life continue to mirror the father’s? To what extent will agency and contingency play roles in the son’s life… play in ours? To what extent are we floating feathers or authors of ourselves? To what extent can we choose?

10 Stress-Free Minutes a Day Keeps the Doctor Away

It is true that most of us cannot avoid stress, especially if we want to continue to be an active participant in the world. Stress goes with the territory of juggling a career, a family, and a social life. Most of us understand only too well the dangers of continuing to schedule full days, of adding new projects to an already overlong list, and still trying to find some time for ourselves at the end of the day. We routinely overbook ourselves. Some of us have the grace to promise to do better next week and might even believe that we can make it up later. But, can we? Chronic stress is now linked to so many problems related to illness, chronic health problems, anxiety, loss of memory, and reduced longevity that it would take the rest of this column to simply list all the ways it affects our lives. We know, for example, that the things we think about and dwell on can have a direct effect on how much cortisol, or stress hormone, is produced in our body. Keeping the cortisol down has become a new goal for the health conscious.

Researchers from the University of California, Davis have just published findings from a long-term study, called the Shamatha Project, that studied how meditation influences the brain and mental health. The article published in the journal Health Psychology reports that meditation, and particularly mindfulness training, helps lower stress and cortisol levels, which in turn can help you lose excess weight and avoid developing “cortisol belly.”

Manage Your Stress…Not the Other Way Around

It’s time to draw a line in the sand and start reducing stress and cortisol. What I am proposing is not perfect, but it is a start that you can build on. If you keep waiting until you have the time, or until you can do it “right,” it could be too late. Stop letting your calendar manage you. Don’t “try” to do better. As Yoda says, “Do or Do Not!”

Begin Your 10 Stress-Free Minutes Today

You might think that 10 minutes a day is not much help. But it is. A few minutes goes a long way toward recharging your energy and breaking up your resistance to taking breaks. You can gradually add more mental “down time” and physical relaxation to each day. Get started by making yourself push away from your desk or daily routine for 10 minutes. Take this break with the intention of taking a brief mental holiday; give your mind a rest. Why not begin with 10 minutes of Mindfulness? Or, spend 10 minutes in focused breathing (with longer exhale). Add some music or put your feet up, close your eyes and direct your favorite piece of music. Remind yourself to do this daily by putting the reminder into your smart phone.

And, by the way, those of you who work with stressed-out clients, I have found that many seriously stressed patients are so overwhelmed that they cannot even begin to think about how they can reduce their stress. The above suggestion that they start with just 10 minutes a day has helped many people start adding relief to their day. Once they begin, the time can be gradually increased. Psychology tells us that making a conscious choice with commitment is a powerful tool. Do as I say AND as I do.

Watch for more tips and hints in the next 10 Stress-Free Minutes Column. Next, we look at how stress affects diet and weight loss.

Stress Solutions

by Susan Andrews, PhD

The Psychology Times, July 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).

12 Years a Slave

by Dr. Alvin Burstein

Aristotle taught that the power of epic tragedy lies in its ability to stir the audience to pity and fear—catharsis. The emotional impact of 12 Years a Slave earned it three Academy Awards, a Golden Globe Award and British Film Academy kudos. Watching it I felt more than fear. I felt horror. Yes, and pity.

And yet, and yet.

The story is that of Solomon Northrup, an African American man born free in New York State who, in 1841, is kidnapped and sold into slavery. It describes his scarifying experiences over the more than a decade in the cotton fields and mansions of south Louisiana, confined, beaten, lynched, and betrayed, all the while clinging to the flickering, fading hope of returning to his wife and two children and to his life as a free person.

During the opening credits an announcement that what follows is “based on a true story” scrolls across the screen. The unfolding story limns the evil of slavery, and its power to inflict agony and corrupt the spirit. But the characters in this drama verge on caricatures, seeming almost two-dimensional.

Consider the portrayals of Northrup, and Patsey, a young woman slave. They have an extraordinarily complicated and intense relationship. They are physically intimate and close enough that she pleads with him to kill her as an escape from the abuse and exploitation that dominate her life. Northrup not only refuses to help her die but is bullied by his master into mercilessly whipping her. Their relationship is fraught.

When Northrup is rescued by a friend from New York who had learned about his situation, Patsey bewails her desertion.

Northrup returns to New York, weeping at being reunited with his wife and two children and meeting his namesake, a new grandchild.

A happy ending.

But I found myself wondering how Northrup remembered Patsey. How her feelings about him, about how all of his experiences of being a slave for twelve years had marked and changed him. Had he to deal with survivor’s guilt? Did he feel shame at being an instrument of the sadistic erotism of the master that made him participate in Patsey’s beating?

Exploring these dynamisms, looking more deeply into Patsey, and, for that matter, into the dark and twisted ambivalence of Patsey’s master, would have transformed a deeply moving film into great art.

 

[Dr. Alvin Burstein is Professor Emeritus, University of Tennessee, Knoxville, and currently serves on the faculty of the New Orleans-Birmingham Psychoanalytic Center where he moderates their Film & Discussion Series.]

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