Wednesday, November 30, 2011

Book Update

The Need to be Liked is now available for sale around the world with a number of book sellers:


Tuesday, June 7, 2011

Shyness, Social Anxiety and Your Rank in the Social Hierarchy

Imagine this:

You arrive at a party where you know a few of the guests, but most are strangers. Your anxiety is elevated, with increases in breathing rate, heart rate, and perspiration. You seek the people you do know, which offers some sense of comfort. You feel unable to maintain eye contact with the people you don't know and feel a bit insecure. You work hard to appear cool and calm. You do not want to seem shy and insecure, but you fear that people can tell you are anxious.

Questions:

1. Why are you anxious?
2. Why are you seeking "shelter" in the form of people you know?
3. Why are you avoiding eye contact?
4. Why do strive to appear cool and calm - and fear appearing anxious?

To Standout and Fit In

The above scenario may be a familiar one to a number of readers. Whether you are someone with Social Phobia or perhaps a bit shy in new social settings, experiencing anxiety in this manner is common for many people.

I could probably fill a book outlining all of the psychological factors involved in reactions like these, but that would be unnecessary (there exist books that essentially do this already) and exhausting. Instead, I want to answer the four questions posed above by making reference to research on social rank and social affiliation.

When it comes to interpreting and understanding interpersonal interactions among people, it is useful to bear in mind two different systems of motivation - social rank and social affiliation. Both are rooted in evolutionary biology, and so using an example involving animals can help explain these concepts.

You may remember, from watching the Discovery channel or some film on animal societies in your high school humanities class, that many mammals live together in social groups which are hierarchically structured. This means that structure is imposed on the group by way of social ranking of members - some are at the top of the hierarchy (the alpha males), while other members are below this upper echelon. Usually, power and dominance determine the hierarchies' structure.

This type of social system serves a purpose, in that there are no useless battles and arguments over territory and food. The group can therefore operate as a functional unit. Those who are lower in the ranks simply follow the leader(s). In this context, anxiety serves an important group function - it forces subordinates to be aware of the dominant members and play their role. There is another motivation in knowing one's social rank - it prevents harm through attacks. In sum, subordinates in a social hierarchy show signs of submission to the superior members to prevent harm (through attacks) and to maintain the structured system.

In humans,there exists somewhat of a similar social ranking among people in societies around the world. For example, in North America, the social hierarchy in place would have those in positions of power and wealth at the top of the hierarchy - not so much because of aggressive dominance (political leaders and CEOs don't physically dominate people), but because they control the distribution of resources and other sources of reinforcement.

There are other factors that determine social hierarchy in humans, including socially valued attributes, such as attractiveness, intelligence, and sense of humour. These qualities have the potential to increase likeability and therefore increase the probability of being accepted by others. These also relate to social rank. However, they also relate to the second motivational system mentioned earlier - the affiliation system. By connecting with other people and being liked and accepted, we reduce the likelihood of harm from aggression and rejection, and increase the probability of safety and the acquisition of benefits (ex: finding job and being promoted).

Therefore, affiliation with others tends to lower anxiety. 

So, how does knowing about social rank and affiliation answer the above questions?

1. Why do you feel anxious?

The amount of social anxiety experienced in a given social situation is dependent in part on one's assessment of social rank and affiliation ability.

Social rank is something that is both global and contextual. It is global because one could estimate their rank in terms of general society (ex: being a NASA rocket scientist confers higher rank than an unemployed teenager - generally speaking). However, social settings can impact rank as well. At a high school party, it is possible for an unemployed teenager to be revered more than a rocket scientist.

Returning to the original example, if you feel insecure about your rank, both globally and in that context (ex: there are many successful and popular people there), then social anxiety is likely to be elevated.

In terms of affiliation, if you know few people at the party (which is the case in this example) and you predict that the likelihood is low of successfully affiliating with strangers, then anxiety is also going to be elevated.

2. Why are you seeking people you know as a source of shelter?

As mentioned earlier, affiliation tends to lower anxiety and therefore will be reinforcing in this context.

3. Why are you avoiding eye contact?

This relates to the social rank aspect of interpersonal relating. It is an act of submission that serves the purpose of avoiding negative attention, evaluation, and ultimately rejection (which can be painful).

4. Why try to avoid showing others that you feel anxious?

Anxiety symptoms themselves can be interpreted as signs of submission to others and indicators of being lower in social rank. Reduced eye contact, shaky limbs, quivering voice, indecisiveness, etc. are similar to responses one might observe with a subordinate around a dominant member of a group.

Most people are uncomfortable with the idea of being lower in social rank and subordinate to others. They might interpret their own anxiety symptoms as indicating to others that they are weak and insecure.

For many people, such symptoms and thoughts are disturbing and annoying. It can be particularly annoying if you are generally happy and successful in life with plenty of friends, yet feel anxious and uncomfortable in social settings. As such, they may try and fight these symptoms and thoughts. Unfortunately, fighting anxiety can oftentimes makes it worse.


What to Do?

If social anxiety, negative thoughts and problems with affiliation (including issues with social skills and/ or likeability) are compromising your ability to enjoy and function in social settings, consider seeking the services of a psychologist.

You may also consider reading The Need to be Liked, which deals with many of these issues.

Notable References

Weisman et al. (2011). Social rank and affiliation in social anxiety disorder. Behaviour Research and Therapy, 49, 399-405.

Trower & Gilbert (1989). New theoretical conceptions of social anxiety and social phobia. Clinical Psychology Review, 19-35.

Tuesday, May 31, 2011

Public Health Agency of Canada Offers Encouraging Response

As readers of this blog may be aware, I have trying to raise awareness of an inaccuracy in Canadian mental health statistics.

Many Canadians have probably heard or read that 1 in 5 Canadians will experience mental illness in their lifetime. This number appears in official government reports and exists on numerous health websites, including the Canadian Mental Health Association and Health Canada. Bell Canada also popularized this figure in their "Let's Talk" campaign.

The problem is that 1 in 5 is inaccurate. I will not reiterate the reasons why this is inaccurate here, but I encourage those unfamiliar with this issue to read previous articles here and here. To give an idea of just how "off" this statistic is, consider that the American rate of lifetime mental illness is approximately 50%(1).

The Public Health Agency of Canada (PHAC) has been one of the few organizations to take my concerns seriously (I have contacted multiple organizations and even some media).

I was fairly unimpressed with PHAC's original response, as outlined here.

However, I recently received a follow-up email from a representative within the organization, who wrote:

You raise a valid point and concern around the statement that (more than) 1 in 5 or 20% of Canadians will experience a mental illness in their lifetime. The Public Health Agency of Canada will be precise on the seven mental illnesses (i.e., major depression, bipolar disorder, panic disorder, agoraphobia, social phobia, alcohol dependence or illicit drug dependence) on which this estimate is based to ensure accurate interpretation of this statistic.

We will also continue to explore options for adding other mental illnesses to our surveillance system. Our website content is currently under review and we will use consistent language in communicating this measure.


I am pleased with this response, and the PHAC agent also invited me to further discuss additional concerns with a psychologist working in their Chronic Disease and Surveillance Monitoring Division.

While I am encouraged at PHAC's response, I have been discouraged by the rather apathetic response of other agencies and individuals. If cancer rates were underestimated by at least half the true prevalence, there would be a public outcry. Unfortunately, mental illness apparently does not warrant such concern or consideration.

True change in mental health initiatives must start with an accurate understanding of the extent of the problem.

It is not the case that 1 in 5 Canadians will have a mental illness in their lifetime. Canadian research actually shows that this number (20%) is actually the number of people who will have a mental illness within a 1 year period(2).

It is embarrassing for Canadian health institutions to present such clearly contradictory statistics to the general public.

(1) Kessler et al. (2005). Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593-602.

(2)A Report on Mental Illness in Canada



Monday, May 30, 2011

The Need to be Liked - Paperback

The Need to be Liked is now available in paperback at Amazon (click here to visit Amazon.com).

For those interested in downloading the e-book version, please visit here to learn how The Need to be Liked can be downloaded on various platforms (ex: iPad, Kindle, etc.)

If you have read my book, I would love to hear your feedback.

Sincerely,

Dr. Roger Covin (roger@drcovin.ca)



Thursday, April 28, 2011

Tylenol for Rejection? Reducing the Pain of Rejection With Acetaminophen


As readers of some of my previous blog posts (or book, “The Need to be Liked”) may remember, one of the very interesting findings from psychological research over the past decade has been the discovery of a strong association between physical and emotional pain responses.
For example, when we are injured in some way, an area of the brain that processes this pain information is the Anterior Cingulate Cortex (ACC). This same region of the brain becomes active following interpersonal rejection. The research evidence supporting the association between the two types of pain is remarkable, and beyond the scope of the present article. However, suffice to say that rejection from other people can actually ‘hurt.’
Well, some of the top researchers in the field of social psychology recently published some exciting follow-up work. They wanted to test the following hypothesis:
If acetaminophen (e.g., Tylenol) dulls physical pain, would it have the same effect on the emotional pain associated with rejection?
The researchers conducted two, well-designed experiments.
In the first experiment, research subjects were randomly assigned to one of two conditions: (1) acetaminophen or (2) placebo. The acetaminophen group took 1000 mg. of the drug everyday for 3 weeks. The placebo group took a placebo pill daily for the same length of time. All subjects were asked to keep track of the amount of social pain experienced in their daily lives (ex: whether their feelings were hurt that day).
Results from the first experiment showed that people in the acetaminophen group reported fewer amounts of pain from rejection relative to the placebo group. Presumably, both groups experiences a comparable amount of rejection and hurt feelings over the 3 week period, so the fact that the experimental group felt less pain indicates that the acetaminophen worked via the same processes that dull physical pain.
In the second experiment, subjects were again assigned to an acetaminophen or placebo group. However, in this experiment, the experimental group ingested 2000 mg. of the drug on a daily basis for 3 weeks. Afterwards, all subjects underwent an MRI evaluation of the brain – with a twist! Like previous experiments on rejection, subjects took part in a game where they were rejected. The researchers wanted to see what happened in the brain when the subjects felt hurt by the rejection.
Results showed that areas of the brain that typically “light up” during rejection (ex: ACC) were less active among the subjects that took acetaminophen relative to the placebo group. Again, the pain-relieving drug appeared to deactivate areas of the brain responsible for processing pain in general.
Conclusions?
First, these experiments add to the long list of research studies demonstrating that interpersonal pain (ex: from rejection) overlaps with physical pain in terms of neurological and biological processes.
Second, this research raises interesting clinical implications – namely, should psychologists start recommending that clients going through a divorce or break-up take Tylenol to ease the pain? As of now, I would say “no” this is not recommended for at least a few reasons.
First, there needs to be some follow-up research that confirms and validates these findings.
Second, this additional research will have to evaluate dosage and response in a more clear-cut manner, in order to facilitate decision making around the appropriate dosage and frequency. Ideally, after further research, an expert panel would make recommendations to professionals (i.e., clinical treatment guidelines, or something to that effect).
Third, there is an inherent risk in recommending to someone who could be depressed and even suicidal that taking Tylenol will ease their pain.
Finally, whenever professionals start recommending that a drug be used to take away pain, there is the potential for people to over-rely on such an approach, which can have consequences. This is similar to the issues that surround the overuse of prescription medication for depression and anxiety, where people lose the ability to cope with mild to moderate stress and pain.
I look forward to seeing where this research goes, and will be sure to provide updates through this site.

Monday, April 18, 2011

The Need to Be Liked - Ebook Now Available

After approximately 18 months of research, writing and editing, my new book "The Need to be Liked" is now available for sale on Amazon.com. It is currently available as an e-book, which can be downloaded and read using many devices, including a PC, Mac, iPad, iPhone, iPod Touch, or Kindle.

I am planning to make a hardcopy available for purchase in the near future.

For more information about the book and how to download it, please follow this link.



Thursday, March 10, 2011

Are Elecronic Devices Ruining Sleep for Americans?

One of my favourite sections of the newspaper is the Health section. I particularly enjoy reading articles about interesting scientific studies that reveal fruitful information about mental and physical well-being. Unfortunately, journalism and science are not always a match made in heaven, and it is not uncommon to read headlines and articles that are biased and poorly represent the practice of science. Hence, I was pretty disappointed by a recent article that made all the rounds in the media on Tuesday.

Monday, March 7, 2011

Underestimating Mental Illness in Canada: Response from PHAC Only Validates "Orphan" Status

As I wrote in an earlier post, it is common for health organizations in Canada (or even corporations involved in mental health awareness, such as Bell Canada), to use the statistic of "1 in 5" when describing lifetime prevalence of mental illness. I thought this estimate was too low because it is nowhere close to the U.S. data, and after a little reading, I presumed that the 20% figure originated from an error in interpreting a report from 2002. I subsequently contacted Bell Canada, the Canadian Mental Health Association, and Health Canada to seek information.

Thursday, March 3, 2011

Charlie Sheen's Behaviour: A Case of Cognitive Dissonance?

I am compelled to start this post by stating that I am not in the business of speculating on the mental health of strangers, nor am I interested in providing pseudo-psychological assessments of celebrities in the news. It is important to make this clear because I don't want readers fooled by the title of this post. Indeed, there are enough armchair psychologists in the media offering analysis of celebrities' behaviour. Rather, the recent attention that Mr. Sheen has garnered made me think of a psychological process that can significantly impact mental health, including substance abuse. Psychologists call it cognitive dissonance.

Friday, February 25, 2011

From Weight Loss to the Treatment of Depression: The Importance of Understanding "Rate of Change"

Of the many factors that influence change, one's expectation or understanding of how change occurs is significant among them. People can vary considerably in their understanding of how change occurs - specifically, rate of change. Rate of change can be defined as the speed and consistency of improvement when trying to eliminate a problem. For example, if you are trying to lose weight, there are different patterns of change. You might:

Wednesday, February 9, 2011

Bell's "Let's Talk Day": Right Idea - Wrong Estimates: Are Health Organizations in Canada Underestimating the Prevalence of Mental Illness?

Bell Canada is promoting mental health awareness today with their "Let's Talk Day." It's a great idea that will see Bell contribute 5 cents from every text and long distance call to support mental health programs. I also love Clara Hughes' involvement in the project - an act that is both courageous and generous.

However, I am quite certain that Bell has its "1 in 5 Canadians" figure wrong. You may have seen the advertisements on TV or the web where Bell cites a figure from the Canadian Institute of Health Research (CIHR) which states that 1 in 5 Canadians will experience mental illness in their lifetime. You will find a similar figure on both the Health Canada and Canadian Mental Health Association (CMHA) websites. Unfortunately, I suspect they are all incorrectly citing data from one study(1).

Friday, January 28, 2011

What Qualities Make A Person Likeable?

As a clinical psychologist I often work with clients with low self-confidence. This low self-confidence can sometimes be attributed to negative biases in thinking which causes the person to underestimate the number of positive qualities they have, and overestimate the number of negative ones. You could refer to this bias in thinking as reflecting a problem with accuracy - the person is not accurately evaluating themselves.

At other times, clients also exhibit another type of error in thinking. Instead of inaccurately evaluating themselves, they examine the wrong qualities. When I say the "wrong qualities," I am referring to those qualities that only play a limited role in determining how likeable someone is to others. For example, if someone believes that they are unlikeable almost solely because of their physical appearance, then they are misinformed about the factors that determine likeability.

So, I thought it would be a good idea to write about the actual factors that do determine likeability. Specifically, I'm going to report the findings from a great study that was published a few years back in the Journal of Social and Personal Relationships*. The authors sought to answer the following question:

When it comes to having a relationship with another person, what qualities do people want the other person to have?

Thursday, January 13, 2011

The Benefits of Stress and Adversity

Do stress and negative life events may us weaker or stronger?

A recent longitudinal study published in the Journal of Personality and Social Psychology* sheds light on this question. The researchers followed a large, representative sample of people over a period of several years. They asked participants to indicate how many negative life events they had experienced in their lives, out of a list of 37 events (ex: illness or injury; assault; financial problems). They also measured other psychological variables such as life satisfaction, distress, impairment in functioning (i.e., difficulty performing social/ work activities because of physical or emotional health problems), and the presence of post-traumatic stress symptoms (PTS).

Thursday, January 6, 2011

The Colour Red Makes Women More Attractive

While doing some research for my book, I came across a fun and interesting article* in the highly respected Journal of Personality and Social Psychology. I've been meaning to write about the results for a while, but kept forgetting. So here's the study in a nutshell...