Dec 29

Interesting figures have recently been published by the British Home Office: statistics show that young men suffer just as much as women from ‘abuse’ by their partners – at least if forms of emotional violence like harassment or bullying are considered as forms of abuse as well.

Probably because men are usually feeling less self-confident at the beginning of a relationship, especially in the younger age group of 20-24 years a surplus of female violence (6.4% versus 5.4% male) can be found, while in higher age groups, both ratios are increasingly aligning. For 2007/2008, 2.2% of interviewed women of all ages reported about experiences of mild or severe physical violence by their partners, but for men, the value wasn’t much lower with 2.0%. However, the study also found that women are more commonly abused and have to experience more severe and repeated physical abuse. Looking at the quality of the data available to researchers, a report on violence against men of the German Federal Ministry for Family Affairs from 2004 and a study by the Criminology Research Institute of Niedersachsen (Germany) conducted similar results for Germany with both reporting that the available data on violence is hardly sufficient to allow reliable conclusions about gender-based violence since domestic violence perpetrated by female partners is still considered a taboo by women, but also men – and social workers.

'Smitten - Engaged - Battered'
Controversial poster that depicted fathers as potential perpetrators of violence, funded by the Austrian Ministry of Women in 2008

In general, there seems to be a growing awareness process regarding the issue of female violence (including domestic violence). In England, for instance, male-specific charities have already been criticizing for some years that while in England and Wales there are a total of nearly 500 women’s shelters to escape from domestic problems and to obtain advice, but only 7 comparable facilities for men. Organisations and research dealing with women’s specific concerns are equipped with significant financial and media resources, while the ones dealing with men’s issues often have to fight for their financial survival every year. The shame of many men to get help for domestic violence underscores the public image (but also the statistics of many counseling services, which are often managed by women) that the perpetrators are usually men, while women are the victims of psychological and physical violence.

Related links and articles:

(Blog entry first posted in German language (‘Weibliche Gewalt – Ein Tabuthema’) in 02/2009; last update: 12/2011)

Oct 31

Have you recently experienced someone acting completely out of line or losing control over themselves?

In Psychiatry, patterns of repetitive behavior during childhood and adolescence where the social norms or boundaries of others are violated are called ‘conduct disorder‘. I am not a particular fan of this term as it reminds me a bit of authoritarian teachers and governments. But what it actually describes if being used by psychiatrists and therapists, is a symptom range of over-aggressive behavior, bullying, lying, cruel behavior toward people and pets, destructive behavior, vandalism and stealing, that should give you an idea of what it actually means.

Often, affected children come from a difficult family background with abusive, aggressive or addicted parents. If the underlying problems aren’t resolved, these children might develop more serious personality disorders as adults: particularly antisocial personality disorder, bipolar disorders or psychopathy . All of these increase the risk to cause or experience physical injuries, to suffer from depression, addiction, incarceration or even homicide and suicide, as they often intimidate others or initiate physical fights.

Antisocial persons don’t feel much of an inhibition to use weapons, and they have a tendency to deceit, con, steal or destroy property. While their behavior might seem confident and decisive at the outside, they can in fact feel very alone, anxious and hopeless, which often leads to alcohol abuse, depression or other problems.

One cause of the aggressive behavior of antisocial persons can be that they developed a ‘proactive’ but in fact mostly inappropriate, extreme form of self protection or need it as a valve to get rid of the emotional tensions they feel, not only inside themselves but also towards others. Unfortunately, in the case of psychopathic personality traits, this particular kind of relief is often combined with a lack of empathy and sympathetic concern for others, which reduces the hurdles to impose emotional or physical force on others. Thus, it is usually a good idea to avoid any open conflict with such aggressors. They would be unable to empathize with their victim or keep the conflict on a verbal level, let alone resolve it in a constructive manner. The best approach is usually to let them cool off and give them space and to give it another try at another day.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2011; picture credit:www.corrupt.org)

Oct 26

Almost everyone has seen it or even have personal experiences with what is commonly called ‘addictive relationships’. These are the forms of relationships where everyone around a particular couple might raise their hands in disbelief over why both partners are still together.

There might be a strong and obvious imbalance between both of them, sometimes aggressiveness or jealousy of one partner towards the other or blackmailing, but still, for some reason, the ‘addicted’ partner can’t find a way to ultimately break up or might even excuse their loved one’s behavior. Others are highly indifferent to the unhealthy aspects of their relationship as they are hard to see, especially if one is in the middle of it.

I have helped numerous clients get rid of their addictions over the years, and in working with couples (another major field of my work), I couldn’t help but notice certain patterns in chronically difficult relationships that resemble problems of addicts that their partners or family members have to fight with.

An addictive relationship thus is unthinkable without one partner who is emotionally unstable and would in most cases require professional support to successfully deal with their problems for one. This person might also be very self-centered and look very independent and self-confident – or very needy on the other hand. But this since they are not ready to do that or because they are delusional, it needs someone who is ready to ‘support’, or in better words: invest their time, energy and often enough money to take the edge off the other’s imminent issues and to keep not only themselves, but also the relationship going, hoping for things to get better in the near future.
But often enough, it just keeps a vicious circle going – a circle the partner might actually already have experienced during their entire life, sometimes extreme behavior endured by helpful souls who took care for them along the way.

7 Signs of Addictive Relationships:

  • Dishonesty. Both partners don’t communicate openly about their real intentions, needs or worries.
  • Unrealistic expectations. Both partners hope for the other one to ‘fix’ their problems, be it their self-esteem, body image, family, or existential problems. They believe the ‘right relationship’ will make everything better. Yet, they’re in a disastrous addictive relationship.
  • Instant gratification. One of both expects the other one to be there for him whenever he needs her; he’s using her to make him feel good, and isn’t relating to her as a partner – well, because she’s like a drug.
  • Compulsive control. Imminent threats of one partner to leave if the other one doesn’t behave a certain way, and anxious worries of the other one if this idea comes up. Both might feel ‘stuck’ together – for good or for evil.
  • Lack of trust. Neither partner is 100% certain about being ‘truly’ loved by the other one as sometimes they can sense the feelings of hate or desperation their partner is experiencing.
  • Social isolation. Nobody else is invited into their relationship – not friends, family, or work acquaintances. People in addictive relationships want to be left alone and can react harshly if someone is asking about the status of their relationship.
  • Cycle of pain. Often, couples living in a relationship determined by addictive patterns regularly experience cycles of pleasure, pain, disillusionment, blaming, and (often emotionally or sexually  loaded) reconnection. The cycle repeats itself until both partners seek professional help or one partner breaks free of the addictive relationship.

Unfortunately, there is no simple ‘recipe’ on how to help such partners effectively, as the one who suffers most is often very resistant to all efforts aimed at helping them get back on their feet again. Often, someone with a neutral viewpoint as a counselor can help, but if both partners feel determined enough, have strong self-control and are able to accept mutual accountability they might also find back to a fulfilling, balanced relationship.

Strategies for Overcoming Addictive Relationships:

  • Make your ‘recovery’ the first priority in your life.
  • Courageously face your own problems and shortcomings.
  • Cultivate whatever needs to be developed in yourself, i.e., fill in gaps that have made you feel undeserving or bad about yourself and/or get rid of the problems that turned you into an addict in the first place.
  • Learn to stop managing and controlling others; focus more on your own needs for a while and improve your self-esteem to become more independent
  • Find out what brings you peace and serenity and commit some time to that endeavor on a daily basis.
  • Learn not to get ‘hooked’ into the games of relationships; avoid dangerous roles you tend to fall into, e.g., ‘rescuer’ (helper), ‘persecutor’ (blamer), ‘victim’ (helpless one).
  • Find a support group of friends who understand and share your experiences.
  • Consider getting professional help to speed up the recovery process.

Many of you will know firsthand how many times friends or acquaintances entangled in an addictive relationship end up emotionally damaged, financially weakened or even physically injured. What you as a fellow friend can do is to avoid getting sucked into the ‘black hole’ of such an relationship yourself and to push both of them to seek professional advice.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2011; Image source: bhaskar.com; Laurie Pawlik-Kienlen, Counselor; Hints on how to overcome AR based on Robin Norwood’s book ‘Women Who Love Too Much‘)

Sep 04

That psychotropic drugs and other psychoactive drugs often have negative effects on behavior, is well-known to most. That their use can cause aggression, is known with antidepressants such as Prozac and Ritalin. However, there haven’t been any systematic examinations of these drugs and drug groups for their impact on violent behavior.

Now, U.S. scientists from the Institute for Safe Medication Practices published a study in the open access journal PLoS One based on data provided by the Federal Drug Administration (FDA), in which for 31 of a total of 484 studied drugs they found an unusually strong coincidence with reports of violence against others. This does not mean that these drugs directly cause violence, but there could be a connection.

31 drugs of a total of 464 drugs evaluated were associated with 79 percent of cases of violence during a period of 69 months. This included 11 antidepressants, 3 drugs for the treatment of Attention Deficit Disorder/Hyperactivity Syndrome (ADD / ADHD), 5 sedatives and varenicline which is used during smoking cessation. Its active ingredient is sold under the name Champix and has numerous side effects, including suicidal behavior and aggression – therefore, the FDA has recently issued a warning for this substance. The use of varenicline has to be consiedered as highly questionable after this study and is at the top of the list of problematic drugs. One-fifth of the reports of violence were associated with this drug, the tendency to violence is 18 times higher with it than for the other drugs. Bupropion (in Germany acted as Elontril) which is also used for smoking cessation, has a smaller connection to violent behavior, but is primarily used as an antidepressant.

However, there are links to violence with all antidepressants: all ahead is fluoxetine (Prozac) with more than ten times likeliness of violent outbreaks, paroxetine is in third place. With all antidepressants, the connection to violence is 8.4 times more likely than for all other psychoactive drugs. There is also a high probability for amphetamines as Atomexitin (Strattera) and methylphenidate (Ritalin), which are used to treat ADHD and a 9 – and 3.4-fold higher risk of having connection to violence. Of the psychoactive drugs, there is the sleeping drug triazolam (Halcion) with a 8.7-fold and zolpidem with an 6.7-fold increased risk. Among the non-psychoactive drugs was mefloquine (Lariam), which is used for prophylaxis and treatment of malaria, with a 9.5-fold risk.

(Links to research papers and tables: “Medikamente und Gewalt” (German language; in: telepolis 12.01.2011)

Aug 05

“What can I do, it’s in my genes!” In recent years, this has become a standard explanation for many of the health problems we have to face in our lives. Indeed, there are few human diseases without scientific studies trying to pinpoint ‘genetical causes’ as the root. Consequently, there are efforts to find genetic roots of mental problems as well. But 150 years after Mendel (the ‘father of modern genetics’) had outlined his ‘Laws of Inheritance’, we have still to see significant therapies that could wipe out major human burdens like cancer, addictions, diabetes or violence by purely genetical means. This is not to say that genetic science doesn’t have potential; but all the other influential factors should not be forgotten.

One of the weirdest aspects of the notion that all things human are genetically predetermined is that it takes everyone completely out of the context of their environment. We might as well not put personal or societal energies into trying to improve ourselves or others, because it’s inevitable and unchangeable anyway… But in fact there is just a very small number of very rare diseases that are truly genetically determined. Most complex conditions like ADHD, schizophrenia, a tendency to violence or addiction might have a predisposition that has a genetic component, but a predisposition is not the same as a predetermination. Genes just seem to give us different ways of responding to our environment. Some of the childhood influences and the method of child rearing in turn also affect gene expression; they can actually turn on or off various genes to put us on a different developmental track which may suit the kind of world we’ve got to deal with.

For example, a study done in Montreal with suicide victims looked at autopsies of the brains of these people and it turned out that if a suicide victim had been abused as a child, the abuse actually caused a genetic change in the brain that was absent in the brains of people who had not been abused. That’s an epigenetic effect: an environmental impact that is capable to either activate or deactivate certain genes.

So, in adaptation to the famous quote of Shakespeare, “There are more things in heaven and earth than are dreamt of in our scientific world.” And there are more things we can do to change ourselves than we might imagine.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2011)

May 03

When blood pressure rises, neck veins swell – and the rational mind is suspended. Aggression ‘beams’ us back to an early stage of our development … but once the adrenaline rush is gone, we often feel repentance over the damage we’ve done in our rush of emotions (be verbally or physically).

There are basically two categories of aggression: Affective Aggression (revenge, hostility, the tendency toward impulsive and uncontrolled behavior) and Instrumental Aggression (hunting, goal-oriented, deliberate behavior,). Empirical studies show that most people who have a tendency to Affective Aggression also have a lower IQ than those who do not.

Aggression is not synonymous for violence – but it can trigger violence. And there are cultural differences in the ways aggression is expressed. Studies have shown that people from the Southern states of America turn to physical violence more often than those in the Northern states than the Japanese, which prefer verbal conflict resolution. The same applies to people living in Northern and Southern countries of Europe. The murder rate is higher in these regions as well, and there is also a link between the tendency to violence and socialization. People who grow up in families with a high potential for aggression (verbal, mental or physical abuse experiences), adjust their behavior accordingly and have a tendency to outbursts of aggression later in their lives as well.

The same applies for the social acceptance of violence, such as violence against specific ethnic groups: a dynamic that is probably responsible for the never-ending spiral of violence in the Middle East. Many people also react aggressively when they feel they are not understood or taken seriously, or when they can’t achieve their goals and hopes. From a psychological perspective, this is mostly rooted in low self-esteem.

Many relationships are burdened by inappropriate expressions of aggression. Studies show that men are more likely to express aggression physically and directly, while women do it more verbally and indirectly. Relationship criseses often lead to escalating patterns – starting with a verbal exchange of blows, and at some point one partner loses control of himself/herself and injures the other one either physically or psychologically. The more regularly such processes occur, the more difficult it may be to resolve the conflict patterns in couples therapy, which again proves that the earlier professional help is sought, the more promising the results!

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2011; Image src:allhealthsite.com)

Nov 18

Bipolar Disorder: Caught between depression and excitement

John always felt that his wife was ‘changeful’ – but it took both of them years to find out that she was in fact suffering from so-called ‘bipolar disorder’. People with what was formerly called ‘manic depressive disorder’ cycle between unusually intense emotional states that occur in distinct periods: ‘manic episodes’ are defined by overly joyful or overexcited states, and ‘depressive episodes’ by extremely sad or hopeless feelings. However, sometimes symptoms of one state may also occur during the other, depending on the variation of the disorder which has been estimated to afflict about one of every 45 adults, independent of sex, culture or ethnic group.

One of the most common problems of persons dealing with this disorder is that they have serious difficulty set ting and achieving goals and maintaining stable relationships in their lives. During their manic episodes, they often experience an increase in energy, set themselves highly ambitious goals and might break up their relationships with people they consider as inferior or slowing them down. They tend to self-medicate, often through substance abuse (particularly stimulants or depressants, alcohol, cocaine or sleeping pills). Some of them tend to gambling, others might become aggressive or violent or experience a break with reality. As soon as the depressive episode kicks in, almost nothing of that remains: now, feelings of sadness, anxiety and guilt are dominating, and the person might feel isolated and hopeless. The formerly high sexual drive now almost disappears, fatigue, apathy or even suicidal thoughts may occur: The rate of bipolar patients committing suicide at certain points in their lives is very high.

Today, we still know little about the causes for bipolar disorders, but studies have indicated a substantial genetic contribution, as well as environmental influence (like an unstable or traumatic childhood). It is also likely that certain triggers are required to cause an outbreak of the disorder in some people, particularly relationship issues, cultural or job-related stress or physical illness. The basis of treatment usually consists of medication (which especially for this kind of disorder should really only be prescribed by a psychiatrist!) and complimentary psychotherapy to work on environmental triggers and efficiently learn to deal with the symptoms. The prognosis for most individuals with bipolar disorder is a good one – provided that they were diagnosed accurately and received the correct treatment.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2010)

May 28

Violence is an ‘unforgettable’ valve. Already as a toddler, each of us learned that violence can at least provide short-term benefits – an experience which was stored deeply in the brain. From then on, whenever we don’t feel understood or not heard in a conflict, and in any situation that feels threatening, there will be at least a subconscious thought playing with the possibility of using psychological or physical violence to gain ground.

Education and maturation of our personality however allow us to learn other means of conflict resolution as well, which is the reason why very few adults are using physical violence. But then there are also people who find it harder than others to control their emotions. Their conflicts escalate much more easily: at first, mostly verbal, but sometimes they can end up in the form of physical attacks or reprisals.

The roots of the propensity to violence are almost always socially conditioned: the vast majority of perpetrators of violence grew up in economically poorer and atmospherically difficult families, often there are feelings of depression, a lack of perspective or a feeling of ‘not being able to achieve it.’

Unfortunately, the use of force almost always results in massive problems in partnerships, friends and society. Also, studies show that due to higher stress loads, the tendency to violence harms various organs and can make physically sick. Therefore, psychological and psychotherapeutic impulse control programs have been developed which can help affected people to learn regulate their emotions better and regain their ability to be ‘the boss of one’s body’.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2010)

May 22

Armed conflicts are hard to process. Subconsciously they remind us of our own mortality and trigger a strong impulse to sympathize with either the aggressor’s or the victim’s side. After that, the position taken will rarely be corrected. A headwind will often amplify this, sometimes by suppressing or distorting new perceptions and information. The Swiss psychoanalyst Arno Gruen analyzed the causes for human destructiveness in a remarkable way in his publications.

This momentum explains why so many individuals as well as international media and organizations had such obvious difficulties to name the violent aspects of the political protests that took place. An openly signaled sympathy for the proponents of democratic values by individual reporters would be justifiable – but having to read and hear terms like ‘defense’ or ‘justifiable anger’ even after arson and attacks against civilians took place, many of us were stunned by the noticeable partisanship and rationalization of the damage caused.

A dynamic we saw in the camp of UDD was just as disturbing. Many people inside the camp as well as many supporters outside were so emotionalized by the passionate speeches (which constantly alleged the government of having an intent to kill them), that when their leaders finally called to immediately stop the radicalization at the time of their arrest, it did not help anymore because the train was already at full speed. Not least because revolutionary movements often attract elements who join them not from political belief but rather for the pleasure of destruction and violence – a drive just waiting for the appropriate opportunity to unleash.

(This short article is part of a weekly series dealing with psychological expat problems and general mental health issues and was published in various newspapers and magazines in Thailand, 2010)

Tourists walking through one of the destroyed districts of Bangkok (Image: ZEIT Online)

Links:
Arno Gruen – books dealign with
Bangkok iReport CNN
This is no peasant’s revolt (The Nation)
Put an end to this rebellion (Bangkok Post)
The Shame of the UDD (Bangkok Post)
Two “protest leaders” – two interpretations of ‘peaceful opposition’
What would your government do about this (Bangkok Post guest comment)

Nov 09

by Robert Preidt

new article illustration

THURSDAY, Nov. 6 (HealthDay News) — For children and teens who suffer violence at the hands of peers, immediate one-on-one mentoring on how to safely avoid conflict and diffuse threats reduces their risk of becoming victims again, a new study says.

The study included 10- to 15-year-olds treated for assault injuries — including gunshot, knife and fist-fight wounds — at emergency rooms at Johns Hopkins Children’s Center in Baltimore and Children’s National Medical Center in Washington, D.C., between 2001 and 2004.

Half of the 113 victims were treated and then referred by an ER doctor for at least six sessions of one-on-one counseling and three parent-home visits. The other half of the victims were referred to community resources and received two follow-up phone calls.

The counseling sessions included advice on how to identify and avoid triggers of anger, and role playing about conflict resolution and getting out of dangerous situations in appropriate ways.

The participants who received personalized counseling and formed a mentoring relationship with their counselors reported 25 percent fewer fights and 42 percent fewer fight injuries six months later, compared to those who received referrals only, the researchers said.

In addition, participants who received mentoring reported less aggression and fewer misdemeanors and were more likely to “think about the consequences,” take steps to avoid fighting, and “take a time out” when faced with a conflict.

The findings, published in the November issue of the journal Pediatrics, suggest that the emergency room is a critical point for initiating this type of intervention, which gives at-risk children and teens behavioral options that can prevent violence, the researchers said.

“There can be a cycle of violence fueled by fear and retaliatory feelings,” study lead investigator Dr. Tina Cheng, head of general pediatrics and adolescent medicine at Hopkins Children’s, said in a Hopkins news release. “When we see youth with assault injuries in the ER, we have a golden window of opportunity to step in and interrupt this cycle, and our findings suggest that pairing teens with mentors who teach them problem-solving skills can help decrease the risk of future violence,” she added.

(This article: Copyright © 2008 ScoutNews, LLC. All rights reserved.)

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