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An Emotionally Sensitive Person is one who experiences more intense emotions than most other people do. When someone is emotionally sensitive, they often hear statements like “Stop overreacting,” or “You’re so dramatic.” Many are labeled as being “too sensitive” because their emotional reactions are quicker, last longer, and are stronger than other people expect.
The Emotionally Sensitive Person
By Karyn Hall, PhD
An Emotionally Sensitive Person is one who experiences more intense emotions than most other people do. When someone is emotionally sensitive, they often hear statements like “Stop overreacting,” or “You’re so dramatic.” Many are labeled as being “too sensitive” because their emotional reactions are quicker, last longer, and are stronger than other people expect.
Life is so complicated that we typically try to simplify it, often by putting people and events into black and white categories. But like much of what we tend to simplify in that way, being an emotionally sensitive person is not a you-are or you-are-not kind of descriptor.
Despite the emphasis our culture has on logic and self-control, the emotional part of everyone’s brain is pretty powerful, particularly given the right circumstances. Jonathan Haidt, in The Happiness Hypothesis, talks about the brain being like an elephant with a rider. Picture a huge six-ton elephant, with a rider on top. This represents the two basic systems in our brains.
Haidt says the rider is the logical, rational part of the brain that is reflective, it’s the part of you that deliberates and analyzes and plans for the future. The elephant represents the emotional system, the one that is instinctive, that feels pleasure and pain and wants gratification right now. But the rider is so small relative to the elephant, anytime the six-ton elephant and the rider disagree about which direction to go, the rider is going to lose. And that happens more than you might realize.
Anyone who has eaten a bag of potato chips when they said they would only have twelve, or who has compulsively called an ex when they vowed they wouldn’t, or who has said angry words they later wished they hadn’t, understands the power of emotion. And that’s just for everyday issues, not for the really big, this-matters-to-the-core kind of situations. For people who are emotionally sensitive, the elephant (the emotional part of the brain) is even more skittish and more difficult to manage.
Some individuals may have a focused sensitivity. This means they are noticeably more emotional than most people about a certain issue, like their weight or their children, or that they may be emotionally sensitive at certain times. Some may have always been emotionally sensitive and some may have experienced events that have led to or added to their sensitivity. Continue reading The Emotionally Sensitive Person (ESP) →
Your emotional state has powerful control over your body — and Kim Bullock, MD, knows just how strong that hold can be. The Stanford psychiatrist works with patients who experience seizures that aren’t generated from the electrical brain storms of epilepsy, but instead are driven by their own psychological turmoil.
From neurology to psychiatry: Bullock probes mysterious seizures
January 9th, 2012 in Psychology & Psychiatry
Your emotional state has powerful control over your body — and Kim Bullock, MD, knows just how strong that hold can be. The Stanford psychiatrist works with patients who experience seizures that aren’t generated from the electrical brain storms of epilepsy, but instead are driven by their own psychological turmoil.
As a medical student in the early 1990s in Washington, D.C., Bullock volunteered to help the mentally ill homeless population. “It was the best education of my life,” she said. “I saw how much suffering they experienced and yet how much support and community they also provided each other.” But it wasn’t until she was about to interview for a neurology residency at Stanford in 1995 that she realized her true passion was psychiatry.
“When I was in medical school I really thought I was going to be a neurologist, but in the middle of my interviews, I changed my mind,” she said. She realized she wouldn’t be able to interact with the sort of people she was fascinated with in D.C. or use the wisdom she had gained in those years if she went into neurology. So she quickly changed her application at the last minute and interviewed for a position in psychiatry. “It just felt like the right thing to do and things fell into place,” she said. “That must be evidence of the unconscious, that at the last minute I changed my mind. Another part of me knew the right direction.”
Bullock, now a clinical associate professor of psychiatry, also had deeper, personal motivations for wanting to study psychiatric disease. She grew up in the Bay Area in a family troubled by addictions. “I didn’t understand why my own family would behave in certain ways and would make such foolish choices, and that made me curious about mental illness,” said Bullock. “I wanted to understand it and have some keys for possibly fixing this kind of behavior.”
Bullock now studies another type of involuntary behavior called psychogenic non-epileptic seizures. The condition resembles epilepsy, but is not accompanied by the electrical brain wave abnormalities measured in epileptic patients. Instead, the seizures are an involuntary response to physical, emotional or social distress. The mysterious nature of these seizures and their “orphan” position between neurology and psychiatry appealed to Bullock.
The problem can manifest itself in convulsions, loss of consciousness or paralysis of a limb. It’s a disabling affliction, and patients, the majority of whom are female, are often unable to work or even drive. Although these seizures affect as many as one in 100,000 people — a rate as high as multiple sclerosis — there’s a lack of awareness in the public and the medical community, little knowledge of the physical pathways that cause them, and no standardized treatment.
Bullock had her first significant exposure to the disorder as a psychiatry resident at Stanford Hospital, where she assisted with several studies led by John Barry, MD, a professor of psychiatry and behavioral sciences. Bullock and Barry looked at the frequency of past trauma among people with psychogenic non-epileptic seizures and whether group therapy could be an effective treatment.
But as her career was taking off, Bullock grappled with a tough question. Could she take time off from her psychiatry residency to have kids? The answer, it turned out, was yes. In fact, she took two breaks from her residency to raise her two now-teenage children. “It was kind of scary because you assume most programs won’t let you back in,” said Bullock, but she added that if you ask for things, they often work out. Now, back in the clinic, Bullock continues to look for ways to treat psychogenic seizures.
Patients diagnosed with psychogenic non-epileptic seizures often receive incorrect diagnoses and treatment, said Bullock. It takes an average of seven years before patients are properly diagnosed. Typically, Bullock said, people suffering from the psychogenic seizures are first sent to neurologists who specialize in epileptic seizures. About one third of patients in epilepsy monitoring units at Stanford and hospitals across the country will eventually be diagnosed with non-epileptic seizures, but some patients take ineffective epilepsy medication for years.
Many of these patients have problems with their emotions, which can be either too extreme or too blunted. “Some patients are so shut down they don’t display emotions, are unaware of them, or have emotions all over the map that they can’t control,” said Bullock, “so we teach them skills for handling both problems.” Basic interpersonal skills such as how to appropriately ask for things or say no to requests can also be difficult for these patients, who face obstacles due to their disability, gender or other personal circumstances.
Often, psychogenic seizure patients feel they have no voice. “For example, a woman in an unhappy marriage may display these symptoms as a way to indicate that something is wrong,” said Bullock. “It can be as if their true feelings are expressed through their bodies instead of through their emotions,” she said. “In a sense the body is speaking for them.”
Other patients don’t know how to regulate their emotions, so “when they get really mad they have seizures and their bodies just go offline,” said Bullock. Still others need to address deeply buried effects of childhood trauma to end the debilitating seizures.
“Our hypothesis is that there’s something in the limbic system that is dysregulated,” Bullock said. The limbic system comprises the functionally and anatomically connected brain structures that regulate responses like emotion and behavior. There may be a biological vulnerability and a stressful environment that come together in a perfect storm, creating mental turbulence.
Figuring out the exact physical cause of the disease will be difficult because of such heterogeneity. Continue reading From neurology to psychiatry →
ANNE* ALWAYS felt she was different from everybody else and, having had a difficult early childhood, by the time she was a teenager she did not think she belonged in this world.
A therapy that helps to rebuild broken lives
SHEILA WAYMAN
Tue, Dec 27, 2011
ANNE* ALWAYS felt she was different from everybody else and, having had a difficult early childhood, by the time she was a teenager she did not think she belonged in this world.
“I believed I was invisible – I didn’t think people saw me,” she says. “I was insecure and very mixed up about my own identity; I did not know who I was, or how to fit in to life.”
From her mid-teens on, she attended a succession of psychiatrists and counsellors and was prescribed various medications for her “mood”. However, becoming a wife and mother gave her a new, positive feeling of belonging, and she moved on to become a mature student, followed by short-term work placements and voluntary work.
But when, in her 40s, life threw up challenges over which she had no control, her thoughts and emotions began to change rapidly.
Old fears of being abandoned returned; she became angry and impulsive. She started to self-harm and contemplate suicide; she misused alcohol and became dependent on prescribed medication.
It was only then that she was diagnosed with borderline personality disorder (BPD) and she began to understand the impact it had on her.
BPD is a broad category of mental health problems, often defined by “really powerful emotional distress and sometimes a lot of problems in relationships”, says Jim Lyng, a counselling psychologist with Cluain Mhuire, a community-based adult mental health service in the southeast of Dublin.
Affecting an estimated 1-2 per cent of the population, the disorder is characterised by impulsive and often life-threatening, self-destructive behaviour. Problems tend to start to show before a person reaches adulthood, as they begin to cope with their emotions in extreme ways.
“In a heightened state, people start to make desperate choices,” he explains. Talking of deliberate self-harm or attempts at suicide as “cries for help” misses the point, he suggests. “They are desperate attempts to cope.”
Luckily for Anne, she is living in one of the few areas of Ireland where the successful, evidence-based treatment programme of dialectical behaviour therapy (DBT) is available. Within weeks of diagnosis, she started DBT at Cluain Mhuire.
DBT was developed by Dr Marsha Linehan from the University of Washington to help people with a history of repeated self-harm and suicidal behaviour, many of whom would be classified as having borderline personality disorder.
And it was only this year Linehan disclosed that she has struggled with the disorder herself – so first-hand experience informs the therapy. Continue reading A therapy that helps to rebuild broken lives- DBT →
On the BPD Cafe page on Face Book, the owner of the page posted a link to downloadable versions of various CBT worksheets, including some from REBT and DBT. These are really nice to have. There are a lot of them, so I joined the SugarSynch page that allows me to download them en masse. One note about that: if you do that, you’re going to have to “un-select” one of the documents, which appears to be stuck in “synching” mode. The document that is stuck is called PsychosisSelfHelp.pdf. Also, if you want ALL the documents, you have to scroll down to the bottom of the list to make them all load.
Anyway, I was reviewing a document about the general principles of CBT (called SelfHelpCourse.pdf), and it outlines an important point about events, thoughts and emotions. I have pointed out in several articles and in my book about the behavioral chain:
Event -> Thought -> Emotion -> Action Impulse -> Behavior
The document says this about the different reactions a person may have to an event:
For instance, if someone you know passes you in the street without acknowledging you, you can interpret it several ways. You might think they don’t want to know you because no-one likes you (which may lead you to feel depressed), your thought may be that you hope they don’t stop to talk to you, because you won’t know what to say and they’ll think you’re boring and stupid (anxiety), you may think they’re being deliberately snotty (leading to anger). A healthier response might be that they just didn’t see you.
An ATSTP List member explains the difference between lying and bullshitting as being about intent:
I think the distinction between lying and bullshitting is an attempt
to clarify the intent of the person engaged in the act.
According to my interpretation Harry Frankfurt’s essay, “On
Bullshit” (http://athens.indymedia.org/local/webcast/uploads/
frankfurt__harry_-_on_bullshit.pdf), lying is a conscious effort to
misrepresent reality, whereas bullshitting is a conscious effort to
misrepresent the person doing the bullshitting. So the purpose of
bullshitting is to make the bullshitter seem like a different sort of
person than they actually are, or to misrepresent their own mental
state. Lying, in contrast, has as its primary goal to deceive another
person about reality.
So, if I am bullshitting you, my goal is to make you see me
differently. If I lie to you, my goal is to make you see reality
differently. Continue reading The important difference between lying and bullshitting →
In DBT, in the distress tolerance module, there is a concept of willingness versus willfulness. I find this concept particularly important and akin to the being right (willfulness) vs being effective (willingness) concept. Here is some information about willingness versus willfulness:
WILLINGNESS
- Cultivate a WILLING response to each situation
- Willingness is doing just what is effective in each situation, in an unpretentious way.
- Willingness is listening very carefully to your WISE MIND, acting from your inner self and your deepest core values.
- Willingness is becoming aware of your connection to the universe and to the person you are interacting with.
- Willingness engenders listening and mentalizing.
- Ask yourself, in 5 years from now, will the situation that causes the distress matter?
WILLFULNESS
- Willfulness is like sitting on your hands when action is needed, refusing to make changes that are needed.
- Willfulness is about the desire to be right in a situation, regardless of what is needed to get through effectively.
- Willfulness causes you to fight any suggestions that will improve the distress and thus make it more tolerable.
- Willfulness is being rigid and inflexible.
- It is the opposite of doing what works, of being effective. Willfulness is trying to fix every situation or refusing to tolerate the distressful moment.
That last example in willfulness is particularly important to read and consider. Often, I find the loved ones of borderlines to be “fixers” and try to solve each problem for the borderline. Being willing to listen, and really hear what the other person is feeling and going through is usually more effective, despite the distress it may cause, than telling the other person what to do or giving advice.
Adapted from dbtselfhelp.com, with edits and additions by Bon
 The Holidays can be a time of stress The holidays are often thought of as a time of warmth and happiness, family gathered around the table creating wonderful family memories. But for many of us, it can also be a time of angst and anxiety. (link to the article)
There are many reasons you may feel stress. Perhaps you are a student struggling with school and are afraid of criticism from your family. You may be unemployed and don’t want to face questions about your job search or finances. Maybe you’ve put on or lost “too much” weight this year and are feeling self conscious. If you have been struggling with depression, mood swings or anxiety, you may be more emotionally vulnerable. This time of year could remind you of someone who has become ill, passed away or moved.
There are as many reasons for holiday stress as there are individuals. All of them are what we at Silver Hill call “triggers” – they can bring about or literally “trigger” feelings of anxiety, loss and frustration.
The holiday season and family events can be enjoyable and help build meaningful connections with the people in your life, but if triggers set you off, you may instead find yourself caught in a riptide of emotion.
In the Silver Hill Dialectical Behavior Therapy (DBT) Program, we teach our patients strategies to deal with triggers like these. Three of the strategies are Radical Acceptance, Coping Ahead and Wise Mind.
Radical Acceptance
People usually do not change much from year to year. Personality traits you find irksome will still be there. Your snarky nephew will continue to be snarky. The self-obsessed sister will still be self-obsessed. Your mother-in-law will continue to make comments about your appearance or weight.
Expecting them to be kinder and gentler will only lead you to disappointment. Remember, unrealistic expectations are disappointments waiting to happen. Making matters more interesting, people tend to regress when they are around family. You may too. So if your brother really was a “brat,” don’t be shocked if he becomes a grown-up version of his former self. Accepting this fact, and dealing with the people as they are, will reduce your stress.
But Radical Acceptance works to your advantage because the flip side is also true: People who were good will most likely still be good. Your ever warm and wonderful grandmother will continue to be that way. The cousin with the infectious laugh will not let you down, and your always helpful brother-in-law will be his old self too.
Find a way to accept your own personal cast of characters, the good and the bad. It will help you with the next strategy called “Cope Ahead.” Continue reading Family Dynamics Around the Holiday Table →
One of my twitter followers posted the original Daily Star article about Amy Winehouse and Borderline Personality Disorder (BPD). Of course, I’d had Amy on my Celebrities with Possible BPD list for many years. If you want to read all of my articles about Amy Winehouse click here. I have no idea why the title includes ‘Mental Illness’ in quotes. Maybe it was because they were quoting the relative or maybe it brings up the question as to whether BPD is an actual mental illness. Here is the text of the article (and my comments below):
TRAGIC AMY WINEHOUSE HAD ‘MENTAL ILLNESS’
TROUBLED Amy Winehouse suffered from an undiagnosed mental illness, a relative has revealed.
The talented soul singer could have been struck down by the little-known Borderline Personality Disorder.
Sufferers have feelings of anger, emptiness, shame and guilt and become emotionally volatile.
And it can also push them into substance abuse and eating disorders, both of which Amy succumbed to.
Yesterday a member of the Back To Black star’s family said: “It was never diagnosed, because unfortunately she would never agree to a proper diagnosis.
“I’m not an expert, but from what I’ve read on Borderline Personality Disorder it kind of fitted with her.”
Meanwhile Amy’s dad Mitch, 61, said he wished his daughter, who died in July aged 27, had sought counselling.
He said: “She never stopped trying.
“She hated the way she was when she was drunk and when she was ill.
“And you know, the way I look at it, she died trying.
“She didn’t give up. She died trying to make her- self better.”
This article, although short, points out several interesting things about people with BPD. Since there’s no guarantee she had it, I’m going to generalize a bit. First of all, it is tragic that BPD is “little known” because it is much more prevalent than bipolar disorder. The article says: “Sufferers have feelings of anger, emptiness, shame and guilt and become emotionally volatile. And it can also push them into substance abuse and eating disorders, both of which Amy succumbed to.” This is very true. A person in extreme emotional pain will do anything to stop the pain. The article ends with “She died trying to make her- self better.” I’d like to amend that statement to “She died trying to make feel her-self better.” That’s the nature of the disorder and that’s what many non-BPDs do not understand. It’s all about his/her feelings (IAAHF) and not about controlling, manipulating or calling for attention.
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Children’s temper tantrums are widely seen as many things: the cause of profound helplessness among parents; a source of dread for airline passengers stuck next to a young family; a nightmare for teachers. But until recently, they had not been considered a legitimate subject for science.
Now research suggests that, beneath all the screams and kicking and shouting, lies a phenomenon that is entirely amenable to scientific dissection. Tantrums turn out to have a pattern and rhythm to them. Once understood, researchers say, this pattern can help parents, teachers and even hapless bystanders respond more effectively to temper tantrums — and help clinicians tell the difference between ordinary tantrums, which are a normal part of a child’s development, and those that may be warning signals of an underlying disorder.
Read the entire story or hear the audio
What I found illustrative of this story was the first comment… An excerpt:
This was the worst piece of parenting psycho-babble I’ve ever heard. Explain to me what the child has learned from this besides how to manipulate his or her parents into getting his or her own way? It’s all well and good to study and understand the dynamics of a temper tantrum, but as parents, our responsibility is to help our children become civilized human beings. In our household, tantrums were an automatic “no” for whatever the child was asking for and, if one of my kids had slammed a chair against a wall, that child would have been in his room. Amazingly, my children had very few tantrums and none of them escalated to this level. Not only did they learn that this behavior is unacceptable, they also learned how to ask for what they wanted in a respectful and polite manner and how to negotiate if they really, really wanted something.
I’m sure it’s wonderful to have judgmental atttitudes about others’ kids behavior, but what it illustrates to me is that most people, especially parents, don’t understand the basic mechanics of emotions. And don’t know how to properly react to emotional outbursts. To me, this comment just describes an “invalidating environment”. Kids are not trying to manipulate the parents during a truly emotional outburst. No, their reacting just like their emotions inform them (anger/sadness) and behaving in a perfectly natural way. If you deal with the emotions properly, this behavior will not occur.
The healthcare guidance body NICE has today published a new clinical guideline on the longer-term care of adults, children and young people who self-harm.
New guidance for management of self-harm issued
23 Nov 2011
The healthcare guidance body NICE has today published a new clinical guideline on the longer-term care of adults, children and young people who self-harm. The guideline development group was chaired by Professor Navneet Kapur in The University of Manchester’s Centre for Suicide Prevention.
This new guideline follows on from the NICE guideline on the short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care (NICE clinical guideline 16). The new recommendations focus on the longer-term psychological treatment and management of self-harm.
Dr Fergus Macbeth, Director of the Centre for Clinical Practice at NICE, said: “Self-harm is a very broad term for a behaviour that can be expressed by those affected in very individual ways, which is why it is so important that each person receives the right care plan for them. The previous NICE guideline on the short-term treatment of self-harm focused on the first 48 hours of an episode and the care they received in the Emergency Department. This new guideline aims to help healthcare professionals support, in the longer term, people who are known to self-harm in reducing and then stopping the behaviour.”
Professor Kapur, Professor of Psychiatry and Population Health in the University’s School of Community-Based Medicine, said: “People may keep self-harm a secret which means it is difficult to know how widespread it is. Many cases are unreported unless medical treatment is required. However, it is thought to be common, especially amongst young people, with one UK study finding that 1 in 10 girls aged 15-16 had self-harmed in the previous year. This new guideline is an important step in improving health professionals’ understanding of self-harm and thereby helping to ensure people receive the treatment and support they need.” Continue reading New guidance for management of self-harm issued →
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