From: On the future of Mental Health Interview Series
The following interview is part of a “future of mental health” interview series that will be running on Psychology Today for 100+ days. This series presents different points of view about what helps a person in distress.
Originally posted Psychology Today by Eric R. Maisel, Ph.D. - Mar 27th, 2016
I’ve aimed to be ecumenical and included many points of view different from my own. I hope you enjoy it. As with every service and resource in the mental health field, please do your due diligence. If you’d like to learn more about these philosophies, services, and organizations mentioned, follow the links provided.
Interview with Melanie Greenberg
EM: Your 2017 book is The Stress-Proof Brain. Can you tell us a little bit about it and its intentions?
MG: The Stress-Proof Brain is due out in January 2017 from New Harbinger. It is designed for both the public and (mental) health professionals. It helps you manage stress using psychological tools based on a scientific understanding of the brain’s stress response.
When you encounter stress, a part of your brain called the amygdala puts you into “fight or flight.” The hormones adrenalin and cortisol increase your heart rate, blood pressure, and glucose as they prepare your brain and body to ward off the threat. This response has been wired in over thousands of years. Problems arise because “fight or flight” is so rapid and powerful that it can cause you to overreact or react impulsively to everyday stresses and conflicts.
If the stress becomes chronic, adrenalin and cortisol pose a longer-term health risk. The book shows you how to use strategies like mindfulness, perceiving control, and emotional awareness to soothe the amygdala. It then shows you how to move forward in a deliberate, thoughtful way using your prefrontal cortex or executive center of the brain. Having a growth mindset, controlling negative thinking and worry, creating positive emotions like excitement, and being gritty are ways your prefrontal cortex can help you manage your stressor.
EM: One of your interests is “love addictions.” Can you tell us a bit about what they are and how you help people overcome them?
MG: “Love addictions” is a term I use to describe people (often women, but it can be men as well) who become hooked on destructive relationships. It is not a clinical diagnosis because it has not been established that it’s the same process as that involved in substance abuse.
Despite this, many clients relate to the term as it provides a kind of short-hand to describe a range of behaviors like confusing emotional intensity with intimacy, seeking the highs and lows, wanting immediate bonding and emotional intensity without taking time to get to know the person, and putting up with inconsistent or even abusive behavior by the partner.
So-called “love addicts” are often drawn to narcissists or people who are incapable of true love and intimacy. They experience cravings for the loved one when he pushes them away, or feelings of emptiness, self-loathing and depression (withdrawal) when they try to give up the relationship. There is often an underlying insecurity, and there can be a history of sexual trauma. Interestingly, there may be a brain basis to these withdrawal symptoms. Brain scans show that “passion” is experienced in reward areas of the brain involving the release of dopamine. Also, romantic rejection is experienced in brain areas that are also involved in experiencing physical pain.
EM: Another of your specialties is trauma. How do you work with people who have experienced trauma?
MG: I first do a thorough assessment of symptoms and take a trauma history to see if the client is suffering from post-traumatic stress disorder (PTSD). While some clients know they have PTSD, many do not and may present with other issues like addictions, eating disorders, chronic depression, difficulties in relationships, or borderline personality disorder.
I use EMDR (eye movement desensitization and reprocessing) to help reduce clients’ reactivity to their trauma memories. EMDR was developed by Dr. Francine Shapiro in the 1980’s and is a mind-body strategy. It involves having the personal recall the trauma memory in words, imagery, and bodily sensations while at the same time watching a wand (or finger) go back and forth.
The eye movements keep the client’s awareness in the safety of the therapy room at the same time as they remember the trauma. The theory behind EMDR is that unprocessed traumas are stored in a “raw” unintegrated sensory form in the brain along with false beliefs that the client uncritically accepts (e.g., “I am bad,” or “I am not safe”). Processing memories in this way helps reduce bodily reactivity to these memories and can help change the negative beliefs at a deep level in the brain. EMDR is endorsed by the American Psychological Association as a treatment for PTSD and is regarded as state of the art.
EM: You often use “Schema Therapy” with clients who have long-term relationship difficulties, insecurity, or personality issues. What is Schema Therapy?
MG: Schema Therapy is an integrative approach developed by Dr. Jeffrey Young. Dr. Young was the head researcher on a national study of the effects of Cognitive Therapy (CBT) for depression. He found that, for some people, the treatment didn’t work because they couldn’t readily change their automatic negative beliefs (e.g., “I’m going to fail”) even if they knew at a rational level that they weren’t true.
He developed a new form of therapy that combined CBT with some principles of gestalt and psychodynamic therapies. Schema Therapy helps diagnose people’s core negative beliefs (or schemas) that came about because their fundamental needs for safety, nurturance, empathy, guidance, autonomy, and so on were not met as children.
Some examples of schemas are Mistrust and Abuse in which the client has difficulty trusting self and others or Emotional Deprivation in which he feels that others are incapable of or unwilling to meet his genuine emotional needs. While some people succumb to their schemas (act as if they were true), others avoid the situation altogether, or overcompensate (go to the opposite extreme). Schemas lead to repetitive ways of thinking and behaving that prevent clients from advocating for themselves, speaking up authentically, acting in their own best interests or making healthy relationship choices. As a result, they are unable to get their genuine needs met as adults. Schema Therapy helps them understand and change these cycles.
Dr. Melanie Greenberg is a clinical psychologist and author in Marin County, California who specializes in stress, trauma, and relationships. She also writes The Mindful Self-Express blog for Psychology Today and is an expert for national media. Prior to going into private practice, she was a Psychology Professor for more than a decade. She has published articles in scientific journals. She also presents Continuing Education workshops for health professionals. Her new book The Stress-Proof Brain is due out in January 2017 from New Harbinger.
The Mindful Self-Express Blog
Eric Maisel, Ph.D., is the author of 40+ books, among them The Future of Mental Health, Rethinking Depression, Mastering Creative Anxiety, Life Purpose Boot Camp and The Van Gogh Blues. Visit Eric at http://www.ericmaisel.com, and learn more about the future of mental health movement at http://www.thefutureofmentalhealth.com