Monthly Archives: May 2016

Breathe and Focus: How Practicing Mindfulness Improves Mental Health as We Age

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By Flora Ma (Clinical Psychology PhD student, Palo Alto University) and Rowena Gomez, PhD (Associate Professor, Palo Alto University)

 

As we age, it’s natural to worry about possible declines in our mental and brain health. Many older adults are concerned about things like memory loss and poorer attention, forgetting names, and taking longer to learn new things. As a result, as we get older we may feel more distress, sadness, and/ or anxiety that can decrease our quality of life. However, we can do something to address these concerns. The answer is mindfulness. Research shows that it can improve brain functioning, resulting in thinking and feeling better as we get older (e.g., Chambers et al., 2007; Chiesa et al., 2010; Prakash, 2014).

 

What is mindfulness?

Mindfulness is an Eastern meditation practice that originates from Buddhism (Baer, 2003). It involves directing our attention to the present moment. Mindfulness can help block irrelevant information and enhance emotional control which in turn can improve the mental health of older adults. For instance, mindfulness could be sitting quietly and not letting your mind wonder, but instead focusing on your breathing. You would breathe in slowly from your nose and breathe out slowly from your mouth.

 

Mindfulness helps cognitive health 

Practicing mindfulness improves functioning in certain brain areas associated with paying attention and keeping focus. It can help us become less distracted and increase our focus on what we want to pay attention to (Prakash, 2014). Research on mindfulness demonstrated improvements in concentration, attention, and even memory (Chambers et al., 2007; Chiesa et al., 2010; Prakash, 2014).

 

Mindfulness helps emotional health 

In addition, mindfulness can benefit our emotional health as we age. It promotes an increase in self-awareness that allows for better control of our feelings. We can use mindfulness to focus on positive feelings, and less so on the negative feelings. Research (Brown & Ryan, 2003; Chambers et al., 2007; Ostafin et al., 2006) has shown that mindfulness can:

  • Decrease depressive symptoms;
  • Reduce focus on negativity;
  • Reduce focus on distress; and
  • Increase self-control.

 

Mindfulness benefits us in the short term and long term

In research studies, short-term practice of mindfulness (i.e., practicing mindfulness for 10 days) has helped to improve attention and focus by reducing the effects of distraction (Chambers et al., 2007; Ostafin et al., 2006). Long-term mindfulness training shows greater effects in being able to maintain focused attention which leads to better thinking and mood. So, as with most things, “more” is “better”. The more we practice mindfulness consistently, the better our mental health will be as we age!

 

For more information, check out this essential guide to mindfulness for older adults and these 6 mindfulness exercises!

 

Biographies:

Flora Ma is a Clinical Psychology PhD student at Palo Alto University. She graduated from the University of British Columbia in 2014, with a major in Cognitive Systems.  She has particular research and clinical interests in aging, neuropsychology and life span studies. She is also a student member of the American Psychological Association.

Dr. Rowena Gomez is Director of Clinical Training for the PhD Clinical Psychology Program and Associate Professor at Palo Alto University. Dr. Gomez’s research focus has been in geropsychology, neuropsychology, and depression.

 

References:

Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice. http://doi.org/10.1093/clipsy/bpg015

Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848. http://doi.org/10.1037/0022-3514.84.4.822

Chambers, R., Lo, B. C. Y., & Allen, N. B. (2008). The impact of intensive mindfulness training on attentional control, cognitive style, and affect. Cognitive Therapy and Research, 32(3), 303–322. http://doi.org/10.1007/s10608-007-9119-0

Chiesa, A., Calati, R., & Serretti, A. (2011). Does mindfulness training improve cognitive abilities? A systematic review of neuropsychological findings. Clinical Psychology Review. http://doi.org/10.1016/j.cpr.2010.11.003

Ostafin, B. D., Chawla, N., Bowen, S., Dillworth, T. M., Witkiewitz, K., & Marlatt, G. A. (2006). Intensive Mindfulness Training and the Reduction of Psychological Distress: A Preliminary Study. Cognitive and Behavioral Practice, 13(3), 191–197. http://doi.org/10.1016/j.cbpra.2005.12.001

Prakash, R. S., De Leon, A. A., Patterson, B., Schirda, B. L., & Janssen, A. L. (2014). Mindfulness and the aging brain: A proposed paradigm shift. Frontiers in Aging Neuroscience. http://doi.org/10.3389/fnagi.2014.00120


Filed under: Aging, Health and Wellness Tagged: aging, cognitive health, emotional health, meditation, mental health, mindfulness, older adults

Are You a Boy or Girl? No: Living Outside the Gender Binary

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By Emmie Matsuno (Counseling Psychology doctoral student, University of California, Santa Barbara)

Transgender people are 25 times more likely to make a suicide attempt than the general population. Despite the high risk for a number of negative mental health outcomes, less than 30% of psychologists and psychology graduate students report familiarity with issues that transgender people experience. It’s likely that even fewer are familiar with non-binary gender identities.

Without knowledge about this vulnerable population and the best ways to support them, mental health providers may unintentionally mistreat gender non-binary people, who may perceive a lack of competence and resist treatment as a result. This article provides tips to mental health providers for working with gender non-binary clients. Even if a counselor has no experience working with any of these populations in the past, they can still be successful by avoiding assumptions and taking the role of a learner.

Gender non-binary is an umbrella term for many different gender identities, including identifying as both a man and a woman (bigender), neither a man nor a woman (agender), or another gender entirely (genderqueer). Although non-binary genders are not yet recognized in the U.S., other indigenous cultures around the world including India, Australia, and Germany are more accepting that there are more than two genders. In fact, currently 7 countries have legal gender markers outside traditional “female” and “male” categories.

Cultural competence for working with non-binary clients is important because:

  • 30-40% of the transgender community identifies outside of the gender binary. That’s nearly a quarter of a million people in the U.S. (the equivalent of the entire population of Orlando, Florida).
  • Some evidence indicates that gender non-binary people may be at the highest risk for mental health concerns within the transgender community.
  • Gender non-binary people experience different kinds of stigma and discrimination compared to transgender people who identify as men or women (e.g., people thinking they are confused or that their experience is invalid).

So while gender non-binary people are a large portion of the transgender community and are at potentially even greater mental health risk than other transgender folks, little research has been conducted on gender non-binary individuals, and practical implications specific to this population remain unaddressed.

As a gender nonconforming counseling psychology PhD student, my research focuses on transgender mental health, and I work closely with the transgender community in clinical and community settings. Here are things I’ve found really useful to do in my work with this population.

  • Avoid gender binary assumptions. Gender identity is not based on outward appearance. You can’t tell anyone’s gender by looking at him or her or them. If a client expresses that they are questioning their gender, avoid assuming that means they will want to transition into the other binary gender (e.g. “So you think you are actually a man?”).
  • Understand there is no right way to “transition.” While many transgender people including gender non-binary clients do want to go through various medical procedures such as hormone therapy or surgery, some transgender people do not want a medical transition and don’t need one to feel satisfied in their bodies. 
  • Practice using “they”/“them” as a singular pronoun. Always follow the client’s lead in terms of what pronouns to use. For example, many non-binary clients use they/them pronouns. The singular “they” was announced word of the year by the American Dialectic Society in 2015. It is here to stay. So while it may be difficult to get used to, it is important to respect the pronouns that your client uses. Practice, practice, practice.
  • Identify yourself as an ally. Transgender clients will often be on the look out to see whether they we be accepted and supported by the therapist. Having stickers, signs, or brochures that identify you as a transgender ally can go a long way in building trust with clients.
  • Create inclusive forms. Intake forms can have a large impact on whether or not non-binary clients trust the therapist and/or agency. Forms can be inclusive of all transgender identities by having a write-in option for gender and by including a pronoun section. This simple step can go a long way.

These small steps can make a huge impact for gender non-binary people who experience severe anxiety from unaffirming environments and are desperately searching for a safe space to be themselves.

Biography:

Emmie Matsuno is a third year PhD student in counseling psychology at University of California, Santa Barbara (UCSB). She works with Dr. Tania Israel and project RISE conducting research on LGBT mental health and well being. Her personal research focuses on creating inclusive and supportive environments for transgender people. In addition to research, Emmie is currently an intern at Pacific Pride Foundation and volunteers for other organizations including the Santa Barbara Transgender Advocacy Network (SBTAN), Just Communities, and the Trans Task Force at UCSB.

Image source: iStockPhoto.com


 


Filed under: LGBT Issues Tagged: agender, bigender, cultural competence, gender identity, gender non-binary, mental health, transgender, transgender identity, transgender mental health

Are You a Boy or Girl? No: Living Outside the Gender Binary

gnbpost1

By Emmie Matsuno (Counseling Psychology doctoral student, University of California, Santa Barbara)

Transgender people are 25 times more likely to make a suicide attempt than the general population. Despite the high risk for a number of negative mental health outcomes, less than 30% of psychologists and psychology graduate students report familiarity with issues that transgender people experience. It’s likely that even fewer are familiar with non-binary gender identities.

Without knowledge about this vulnerable population and the best ways to support them, mental health providers may unintentionally mistreat gender non-binary people, who may perceive a lack of competence and resist treatment as a result. This article provides tips to mental health providers for working with gender non-binary clients. Even if a counselor has no experience working with any of these populations in the past, they can still be successful by avoiding assumptions and taking the role of a learner.

Gender non-binary is an umbrella term for many different gender identities, including identifying as both a man and a woman (bigender), neither a man nor a woman (agender), or another gender entirely (genderqueer). Although non-binary genders are not yet recognized in the U.S., other indigenous cultures around the world including India, Australia, and Germany are more accepting that there are more than two genders. In fact, currently 7 countries have legal gender markers outside traditional “female” and “male” categories.

Cultural competence for working with non-binary clients is important because:

  • 30-40% of the transgender community identifies outside of the gender binary. That’s nearly a quarter of a million people in the U.S. (the equivalent of the entire population of Orlando, Florida).
  • Some evidence indicates that gender non-binary people may be at the highest risk for mental health concerns within the transgender community.
  • Gender non-binary people experience different kinds of stigma and discrimination compared to transgender people who identify as men or women (e.g., people thinking they are confused or that their experience is invalid).

So while gender non-binary people are a large portion of the transgender community and are at potentially even greater mental health risk than other transgender folks, little research has been conducted on gender non-binary individuals, and practical implications specific to this population remain unaddressed.

As a gender nonconforming counseling psychology PhD student, my research focuses on transgender mental health, and I work closely with the transgender community in clinical and community settings. Here are things I’ve found really useful to do in my work with this population.

  • Avoid gender binary assumptions. Gender identity is not based on outward appearance. You can’t tell anyone’s gender by looking at him or her or them. If a client expresses that they are questioning their gender, avoid assuming that means they will want to transition into the other binary gender (e.g. “So you think you are actually a man?”).
  • Understand there is no right way to “transition.” While many transgender people including gender non-binary clients do want to go through various medical procedures such as hormone therapy or surgery, some transgender people do not want a medical transition and don’t need one to feel satisfied in their bodies. 
  • Practice using “they”/“them” as a singular pronoun. Always follow the client’s lead in terms of what pronouns to use. For example, many non-binary clients use they/them pronouns. The singular “they” was announced word of the year by the American Dialectic Society in 2015. It is here to stay. So while it may be difficult to get used to, it is important to respect the pronouns that your client uses. Practice, practice, practice.
  • Identify yourself as an ally. Transgender clients will often be on the look out to see whether they we be accepted and supported by the therapist. Having stickers, signs, or brochures that identify you as a transgender ally can go a long way in building trust with clients.
  • Create inclusive forms. Intake forms can have a large impact on whether or not non-binary clients trust the therapist and/or agency. Forms can be inclusive of all transgender identities by having a write-in option for gender and by including a pronoun section. This simple step can go a long way.

These small steps can make a huge impact for gender non-binary people who experience severe anxiety from unaffirming environments and are desperately searching for a safe space to be themselves.

Biography:

Emmie Matsuno is a third year PhD student in counseling psychology at University of California, Santa Barbara (UCSB). She works with Dr. Tania Israel and project RISE conducting research on LGBT mental health and well being. Her personal research focuses on creating inclusive and supportive environments for transgender people. In addition to research, Emmie is currently an intern at Pacific Pride Foundation and volunteers for other organizations including the Santa Barbara Transgender Advocacy Network (SBTAN), Just Communities, and the Trans Task Force at UCSB.

Image source: iStockPhoto.com


 


Filed under: LGBT Issues Tagged: agender, bigender, cultural competence, gender identity, gender non-binary, mental health, transgender, transgender identity, transgender mental health

We Get Happier as We Get Older (As Long as We Stay Fit)

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You can build a better old age with exercise

By Kimberlee Bethany Bonura, PhD

Ponce de Leon was wrong: We’re not looking for the Fountain of Youth.

Life gets better as we get older. Gallup research shows that Americans over the age of 55 have higher levels of life satisfaction than younger adults.

In fact, happiness follows a U-shaped curve. In middle age, the demands of building careers and raising children put a damper on our moods; around the world, people in their mid-40s are the least happy people. Around 50, a combination of wisdom, perspective, and accomplishment come together and happiness begins a steady rise.

People over the age of 85 have more life satisfaction and less negative affect (in other words, less stress, anxiety, and depression) than people in midlife – as long as physical health and functioning are considered. According to the AARP Attitudes of Aging Study, health is the greatest predictor of life satisfaction for older adults – older adults who rate their health as good are twice as satisfied with life (84%) as older adults who rate their health as poor (44%). As Hamlet would say – “Aye, there’s the rub.” Life gets better as we get older – as long as we stay fit and healthy.

We are fine with getting older. Getting older brings stability, connection, and increased satisfaction with life. What we want is to stay healthy, fit, and functionally independent as we get older. Maybe what Ponce de Leon should have been searching for is the Fountain of Good Health.

Fortunately for all of us, we can tap the fountain of good health with some relatively simple tweaks to our lives. The most important thing we can do is to take good care of ourselves. A formula for good self-care includes:

  • sufficient sleep,
  • a healthy diet,
  • appropriate stress management,
  • regular exercise.

First, you need enough sleep. Research consistently shows that people who skimp on sleep are more likely to get sick. Being sleep-deprived increases your vulnerability to colds and flus, and increases your risk for major and chronic conditions, including diabetes and heart disease. Learn more about why sleep matters and how to improve your sleep.

Once you are rested, you will have enough energy to exercise – and exercise may be the best thing you can do for your health and well-being as you get older. New research shows that people with the best cardiovascular health have the best cognitive abilities in older age. Unfortunately, according to the Centers for Disease Control and Prevention, only 21% of American adults meet minimum standards for physical activity.

Let’s set a goal, together, to get exercise and stay healthy as we get older. The minimum amount of exercise you need to promote health and well-being is moderate and manageable. The basic requirements, according to the CDC:

  1. 150 minutes of moderate intensity aerobic exercise every week.
  2. Muscle-strengthening activities that work all the major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms) at least twice per week.

Your plan starts with finding exercise you enjoy. If you don’t enjoy it, you won’t keep doing it. It’s that simple. You can only guilt and force yourself to exercise because you “should” for so long before your willpower runs out. So, the first and more important part of building an exercise plan is to find an activity you enjoy. Make exercise fun – make it something you love – make it time for you to enjoy life.

Consider these options and suggestions:

150 minutes of moderate intensity aerobic activity every week.

  • Timing: It can be 30 minutes, five days per week. It can be about 20 minutes, seven days per week. It can even be 15 ten-minute blocks per week. It doesn’t matter how you get the time, as long as you get the time.
  • Options: walk the dog, walk the kids, walk with a friend, walk with your spouse. Ballroom dance, line dance, salsa dance, square dance, try cardio dance aerobics. Jump rope, ride a bike, ride a scooter. Go swimming, go hiking, go for a run. Just pick something you enjoy – or even better, a bunch of different things you enjoy – and then do it, consistently, so that your heart beats fast and you feel a little bit out of breath. It’s good for your heart, your lungs, your brain, and your entire body.

Muscle-strengthening activities that work all the major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms) at least twice per week.

  • Timing: At least twice a week.
  • Options: Get a personal trainer and try weights. Find a yoga or Pilates teacher and try a body-weight resistance program. Get stretchy bands and exercise balls and an at-home resistance DVD. Work in your garden with manual tools and dig, pull, and carry. Clean your own house and push the vacuum, move the furniture, lift and tote. Try a ballet class and learn pliés and abdominal control.

While you’re building an exercise plan to stay healthy with age, add two more things:

  1. Pelvic floor exercises: because incontinence limits your quality of life. More than 50% of older adults living independently have experienced an incidence of incontinence. Strengthening the pelvic floor muscles through exercise can help you maintain control. Learn more about how to do pelvic floor exercises.
  2. Mindfulness exercises: to help you relax and improve your ability to manage stress. Mindfulness practice can you help you to reduce stress and anxiety, reduce depression, and improve overall wellbeing. Learn more about the benefits of mindfulness, then, try a simple (free) mindfulness meditation practice.

We are, ultimately, like wine: we just keep getting better with age. I look forward to toasting that on my 85th birthday, and every year after that!

Biography:

Dr. Kimberlee Bethany Bonura is the Division 47 (Sport, Exercise, and Performance Psychology) representative to APA’s Committee on Aging (CONA). Dr. Bonura is a fitness and wellness educator; her work focuses on the benefits of exercise for health and wellness promotion. She is a contributing faculty member in the Walden University College of Social and Behavioral Sciences and a Professor for The Great Courses. Learn more at www.drkimberleebonura.com and contact Dr. Bonura at [email protected].

 


Filed under: Aging, Health and Wellness Tagged: aging, exercise, fitness, healthy aging, healthy diet, healthy eating, older adults, Older Americans Month

Man Up… Whatever That Means

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By Andrew Smiler, PhD

Man up… whatever that means.

Telling a guy to “man up” or “be a man about it” or “not act like such a girl” can be an amazingly powerful insult. When used in just the right away, especially by a powerful or popular male, the guy on the receiving end of that jibe might find himself doing things he wouldn’t otherwise do. As psychologists, it’s time to take a critical look at the concept of masculinity.

The Power of Masculinity

The insult’s power is derived from what seems like a fairly simple source: Most guys believe it’s important to be “masculine,” or “man enough.” Masculinity is generally understood to be an achieved status that needs to be proved. Historically, and across many nations, “manhood” can be proven by completing the culture’s coming of age ritual or earned through the 3 P’s: providing, protecting or procreating. In these cultures, manhood delineates a shift in status from juvenile to adult.

In current day America and other post-industrial nations, masculinity is not delineated by adulthood and there is no enduring standard by which masculinity can be proved once and for all. Instead, masculinity is inherently “precarious” (PDF, 101KB) and must be proved repeatedly; challenges to a guy’s masculinity should be answered immediately. Even 73-year-old Jack Palance felt the need to prove his masculinity by doing pushups on stage when he received an Academy Award (for playing iconic tough guy Curly in “City Slickers”).

The Pieces of Masculinity

In order to prove — or defend — his masculinity, a guy needs to act in ways that will readily be recognized as masculine. But “readily recognized” is often enacted by conforming to stereotypes of masculinity, particularly aspects of masculinity such as violence (i.e., fighting), risk taking (e.g., excessive alcohol consumption) and some forms of hooking up and promiscuous sexuality (e.g., who can find the ugliest partner), and hiding one’s feeling (except anger). Talk with friends that is sexist, misogynist,or homophobic can also serve this purpose; these aspects of masculinity, sometimes labelled “hypermasculinity” or “hostile masculinity” in the literature, typically receive low levels of endorsement (PDF, 55KB) on the scales designed to measure them.

Masculinity can also be defined in positive ways that highlight leadership, decisiveness, intelligence, perseverance and problem-solving. Measures that assess these aspects of masculinity reveal a pattern of ever increasing scores among both male and female undergraduates from the 1970s through the 1990s.

Yet what it means to be a man varies with ethnicity, nationality, age, and generational cohort, as we as life stage. Within the U.S., African-American males often identify responsibility and accountability, autonomy, respect and spirituality as important components of masculinity. Latino-Americans include concepts such as familismo, personalismo, simpatia and respeto. Similar themes were identified in a multinational study, with participants identifying the primary components of masculinity as being a man of honor, being in control of one’s own life, having the respect of friends, having a good job and coping with problems on your own.

Asian-American men report challenges proving their masculinity due to stereotypes that describe them as socially awkward and nerdy. Yet in a study that included men from five Asian nations, the primary attributes of masculinity were identified as having a good job, being seen as a man of honor, being in control of one’s own life, being a family man and having lots of money, while being promiscuous was rated among the least important behaviors.

Age, generational cohort and lifestage also influence the ways in which individuals define masculinity. Compared to older generations of men (Baby Boomers and their predecessorts), younger generations of men indicate they are somewhat more emotionally expressive and are less homophobic. Lifestage also plays a role; men who are parents, including teen fathers, typically emphasize breadwinning and financial providing in ways that (presumably childless) undergraduates and other young men do not.

Sexual orientation may also play a role. Many people, especially those from older cohorts, believe masculinity is inherently heterosexual and thus gay men are “gender inverted” and want to be women (thanks Freud). Some current researchers also rely on the notion that masculinity is heterosexual and label other forms of masculinity as “queer.”

The Plural of Masculinity

Jibes like “man up” imply there is only one way to be masculine. Yet the previously mentioned variations indicate that many definitions exist. This led to the notion that there are multiple “masculinities.” Originally used to contrast the “hegemonic” version of masculinity that forms the center of our cultural definition and reaps the most benefits from patriarchal power structures with other versions of masculinity that either support or challenge the status quo, the term “masculinities” has also come to incorporate a breadth of forms that overlap and intersect with demographically based identities (e.g., ethnic, sexual orientation). Others have argued that social identities such as jock, player and nerd represent different masculinities.

So how might a psychologist respond when a client talks about manning up? It depends, of course. But psychologists should have the ability to examine the power dynamics inherent in those words, educate their clients about the potential meaning of masculinity, and expand their clients’ understanding of masculinity.

Biography:

Andrew P. Smiler, PhD, LPA, is a therapist and author who resides in Winston-Salem, North Carolina. He is a past-president of APA Div. 51, the Society for the Psychological Study of Men and Masculinity. Smiler is the author of “Challenging Casanova: Beyond the Stereotype of the Promiscuous Young Male” and co-author, with Chris Kilmartin, of the best-selling Men’s Studies textbook “The Masculine Self (5th ed.)”.

Image source: iStockPhoto.com

This article originally appeared in the April 2016 issue of APA’s “In the Public Interest” newsletter.


Filed under: Men and Masculinity Tagged: boys and men, gender, identity, manhood, masculinity, mental health, sexual orientation