Dr. Villarreal, along with her colleague Dr. Frank Davis, was interviewed by journalist/blogger Zennie Abraham of www.zennie62.com regarding the Newtown Shootings.

[from article produced by Zennie Abraham] “In the wake of the Newton Shootings, many people have a lot of questions. But perhaps the most well-considered one concerns how do we spot a person who might commit such an act before they do it?

To get to that answer, I turned to Oakland and Berkeley-based clinical psychologists Christina Villarreal and Frank Davis, respectively for a talk.

The main reason for Adam Lanza’s murder of 26 people, 18 of them kids, was simple: “access to guns,” is the comment both Dr. Villarreal and Dr. Davis pointed to in our conversation. “There may have been some mental health issues,” speculated Davis. “We have to speculate that there were mental health issues, but as of this time no report has been made (explaining that), Villarreal said.

What To Do If You Think Someone Has A Problem

If you think you know someone who has a mental illness problem that could lead to gun violence, Christina Villarreal and Frank Davis recommend that you talk to the person and also talk to a mental health professional for advice, too.

What About Internet Threats?

Some post threats of life to others on the Internet, but does that count as a issue of concern? Dr. Davis says it does. “I would take the threat seriously,” he said. And Davis also explained that it’s better not to consider such an act as benign. Dr. Villarreal said that it’s also important to make sure parents of children know what they’re accessing online, in order to keep them both from threats and from the possibility that they may be issuing threats via the Internet.

The watchword is to watch. Watch people around you and what they do. Be ready to ask questions of the person you think has the problem.

I would add this: support gun control. We have too many guns in our society, and that has to end.

Stay tuned, Zennie Abraham

Here’s an excerpt:

4,329 films were submitted to the 2012 Cannes Film Festival. This blog had 20,000 views in 2012. If each view were a film, this blog would power 5 Film Festivals

Click here to see the complete report.

Did mental illness and/or a developmental disorder contribute to Adam Lanza’s violent behavior and callous disregard for human lives?

Adam Lanza’s brother, Ryan Lanza, told ABC news that Adam “is autistic, or has Asperger syndrome and a ‘personality disorder.’” Greater diagnostic clarity will likely emerge in the coming weeks as individuals familiar with Adam’s medical/mental health history come forward to aid law enforcement in their investigation. In the meantime, this article serves to clarify symptoms of the diagnoses that have been named in the case:

Personality Disorder: The Diagnostic and Statistical Manual (DSM-IV), psychiatry’s classification guide states “a personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture.” This pattern must appear inflexible and pervasive across a wide range of situations, and lead to clinically significant distress or impairment in important areas of functioning. While Adam Lanza’s particular diagnostic picture is currently unclear, some personality disorders appear to reflect symptoms consistent with Adam Lanza’s violent behavior and callous disregard for human life.

Antisocial Personality Disorder (ASPD): The DSM-IV‘s term for what is commonly known as psychopathy. Although there are behavioral similarities, ASPD and psychopathy are not synonymous. A diagnosis of ASPD using the DSM criteria is based on behavioral patterns, whereas psychopathy measurements also include more indirect personality characteristics. The psycho-diagnostic tool most commonly used to assess psychopathy is the Hare Psychopathy Checklist, which measures the following symptoms:

• Aggressive narcissism (which may include) glibness/superficial charm, grandiose sense of self-worth, pathological lying, manipulation of others, lack of remorse/guilt, shallow affect (genuine emotion is short-lived and egocentric), callousness/lack of empathy, failure to accept responsibility for own actions

• Socially deviant lifestyle (which may include) need for stimulation/proneness to boredom, parasitic lifestyle, poor behavioral control, lack of realistic long-term goals, impulsivity, irresponsibility, juvenile delinquency, early behavior problems, revocation of conditional release

Research studies report these symptoms are associated with reactive anger, impulsive and premeditated violence, and criminality. While the exact cause of personality disorders remains under debate, research studies point to both genetic and environmental contributions. Assessment and treatment of personality disorders are generally time consuming and challenging, and exacerbated by cutbacks in managed healthcare. Doctors and other health care professionals are seldom afforded adequate time to collect the detailed information necessary to diagnosis and treat someone with a personality disorder. Effective treatment includes long-term theraputic strategies that are firm yet fair, and teach individuals skills that can be used to live independently and productively within the rules and limits of society.

According to Dr. Janella Street, a clinical and forensic psychologist who works with individuals who’ve been accused of or convicted of criminal activity “One of the biggest challenges in providing preventive mental health care is overcoming the stigma attached to being diagnosed with a mental disorder. We have to make more effort to educate the public about various types of mental disorders, and remind them that only a very small percentage of individuals with a mental disorder act out violently.”

Schizoid Personality Disorder: These individuals avoid social intimacy, have little interest in relationships, and have limited emotional range – often manifest as blunted affect. Russ Hanoman, a friend of Lanza’s mother, earlier reported to CNN that Lanza was “very withdrawn emotionally.” Schizoid Personality Disorder is not the same as schizophrenia, although there is a familial association between the two. There is also a familial association between schizophrenia and insensitivity to pain, which Lanza reportedly experienced. Richard Novia served as an advisor to Newtown High School’s technology club, an organization to which Lanza belonged. Novia says he had meetings with Lanza’s mother, Nancy, and school administers about ensuring Lanza’s safety, considering his apparent inability to feel pain. “If that boy would’ve burned himself, he would not have known it or felt it physically.” It is currently still unknown if Adam Lanza was officially diagnosed with congenital insensitivity to pain, a rare neuropathic disorder that makes people unable to register painful stimuli and can lead to empathy problems.

Avoidant Personality Disorder: These individuals are socially inhibited, feel inadequate, avoid social interaction, and are hypersensitive to criticism. Many who’ve come forward to offer their accounts of Lanza in his youth describe him as socially withdrawn and awkward. Alan Diaz who reportedly knew Lanza several years ago said “He was a shy kid, quiet. He would sometimes stand in the corner. We knew he was socially awkward and we just accepted it. But he was never threatening.” Marsha Moskowitz, 52, drove Lanza to school for three years and said about Lanza “He didn’t sit with the other kids and didn’t seem to have any friends.”

Autism: Autism is a disorder characterized by difficulty with social interaction and communication, as well as repetitive and restrictive behaviors and interests. It is currently estimated to affect 1 in 88 children born in America. Diagnosis is usually made between ages 2 and 6. While children with severe autism can have violent outbursts, there is no known link between autism and premeditated violence. According to UCLA psychologist Elizabeth Laugeson, autism spectrum disorders can sometimes correspond with a reduced sensitivity to pain. Lanza’s classmates claim to have been told that he had Asperger’s.

Asperger’s Syndrome is considered a type of autism (with anticipated change in nomenclature in the DSM-V in 2013). In this disorder, individuals have difficulty with social interaction and judgement, lack non-verbal communication skills, demonstrate repetitive and restrictive behaviors. Odd speech patterns and physical clumisness can also be common traits. People with Asperger’s may lack interest in sharing experiences with others, or developing relationships. Asperger’s is also associated with an insensitivity to pain as well as social deficits such as impoverished ability for empathy. Individuals with Asperger’s tend to have a theoretical understanding of people’s emotions, but often struggle with acting socially appropriate in real-life situations. The cause of Asperger’s Syndrome appears to result from developmental factors that affect many or all functional brain systems. The mainstay of treatment for Asperger’s is behavioral therapy, focusing on specific deficits to address poor communication skills, obsessive or repetitive routines, and physical clumsiness. Most children improve as they mature to adulthood, but social and communication difficulties may persist.

News source CNN has been unable to independently confirm whether Lanza was diagnosed with autism or Asperger’s. Both are developmental disorders, not mental illnesses. The Autism Society has released the following statement “There is absolutely no evidence or any reliable research that suggests a linkage between autism and planned violence. To imply or suggest that some linkage exists is wrong and is harmful to more than 1.5 million law-abiding, nonviolent and wonderful individuals who live with autism each day.”

Judith Warner, a health journalist of Time Magazine writes “We don’t know that Lanza’s crime represents a failure of our “system” of mental health care in America, as has been said countless times this week, because we don’t know what, if any, mental health care he was receiving in recent years at all. We don’t know what the Lanzas’ attitude toward mental health care was. Did Nancy, who home schooled Adam for years, reject the mainstream beliefs of child psychiatry, as many in the home-schooling community do?”

In the aftermath of the New Haven, CT shooting, The Interdisciplinary Group on Preventing School and Community Violence has asked for “a renewed nationwide effort to address the problem of mass shootings that have occurred repeatedly in our schools and communities. Now is the time for our political leaders to take meaningful action to address the need for improved mental health services and protection from gun violence. At the same time, concerned citizens in every community should engage in comprehensive planning and coordination to prevent violence in our schools and communities. These plans should include access to mental health services for youth and adults who are showing signs of psychological distress, including depression, anxiety, withdrawal, anger, and aggression as well as assistance for the families that support them. The bottom line is that we must all work together toward the common goal of keeping our schools and communities safe.”

The complete position paper and a list of endorsing organizations is available at curry.virginia.edu/articles/sandyhookshooting.

Read more at: http://phys.org/news/2012-12-aftermath-newtown-meaningful-action.html#jCp

The complete position paper and a list of endorsing organizations is available at curry.virginia.edu/articles/sandyhookshooting.

Read more at: http://phys.org/news/2012-12-aftermath-newtown-meaningful-action.html#jCp

The complete position paper and a list of endorsing organizations is available at curry.virginia.edu/articles/sandyhookshooting.

Read more at: http://phys.org/news/2012-12-aftermath-newtown-meaningful-action.html#jCp

The complete position paper and a list of endorsing organizations is available at curry.virginia.edu/articles/sandyhookshooting.

Read more at: http://phys.org/news/2012-12-aftermath-newtown-meaningful-action.html#jCp

The complete position paper can be reached at http://curry.virginia.edu/articles/sandyhookshooting

Dr. Christina Villarreal is a clinical and forensic psychologist in private practice in Oakland, CA. Professional inquiries please direct to christina.villarreal@gmail.com

Since writing the article Fifty shades of grey: awakening women’s sexual identities many readers have asked me to elaborate on a variety of topics related to the best-selling book series Fifty Shades of Grey, by E.L. James.  One question that has repeatedly come up is ‘How can I promote change in my partner, the way Ana did in Fifty Shades?’  As a clinical psychologist in private practice, I often help people improve their romantic relationships by helping them build communication skills, gain insights to their own perceptions about dating and marriage, and develop existing social skills so that their relationships are more fulfilling and enjoyable.  It’s not uncommon for people to want their partners to change as a way to improve their relationship, much like the characters in the book Fifty Shades of Grey.  This article serves to offer professional advice from a clinical psychologist on how to get what you want from your partner, and improve your relationship for the better.

1. In order to get what you want out of a relationship, you have to ask for it. 

• It sounds simple, but a lot of women assume that their partner should know what they want.  Girls are often socially reinforced to be more socially subtle and indirect, while boys are often socially reinforced to be more direct and straightforward in their communication style.  So when women expect men to pick up on subtle clues about their needs in a relationship, and then get angry when their partner doesn’t “get it” this only leads to further miscommunication and fights—not change.  Ask for what you want, and explain your reasoning (using both logical and emotional sources).  Then give your partner a chance to share their perspective, and give them the attention/consideration you’d like to receive.

In Fifty Shades of Grey, Ana was initially reluctant to share with Christian her desire for a deeper emotional connection with him.  Like many women, she was afraid of wanting ‘more from the relationship’ than her partner, so she chose to wait for him to take these steps on his own.  She tried to engage in the relationship on Christian’s terms, in spite of her obvious discomfort with some of his sexual preferences/habits, and his inclination to keep her at arms length, emotionally.  Ana eventually came to realize she couldn’t be happy with what he was offering her, and chose to walk away when he struggled to meet her needs in their relationship.  When Ana finally made it clear what she needed from the relationship in order for it to work, Christian began the process of challenging himself to compromise and change himself in order to meet her needs. 

2.  Timing is everything (when it comes to communication!)

• When initiating some conversations, especially ones that are likely to be emotional in nature, timing is essential.  Men are generally more comfortable and willing to open up to the possibility of change when they don’t feel pressured and put on the spot.  A lot of guys need time to think and analyze the situation before they are ready to respond, let alone agree to change immediately.  By giving your partner time to think over your concern without pressure, you’re more likely to get a positive response.  It can also be helpful to raise certain topics during an activity, like a long walk, drive or other simple task, rather than saying “we need to talk” and then expecting them to engage in long, emotion-filled, face-to-face conversation.  While women are often accustomed to simply chatting with their girlfriends, men are often more comfortable having conversations with their friends while doing a mutually engaging activity.

In Fifty Shades of Grey, Christian demonstrates to Ana he needs time to absorb and consider the changes she needs in order for their relationship to work.  Initially, his reaction to her is “this is who I am, and I can’t change.”  Further, Ana and Christian attempt to resolve their conflicts when both of them are already emotionally and/or physically charged, which proves to be unsuccessful in several scenes.  Both of them often needed time to cool off after an argument, and re-assess where they were willing to make compromises for each other.  The author made a point of allowing their relationship to develop and overcome obstacles in small, realistic steps.   

 3.  Lead by example.

• It’s often very helpful to take initiative in a relationship, and lead by example.  Be willing to find out if there are things your partner would like to see you change, and take them into serious consideration.  Take the approach that you want the relationship to grow in a positive direction for BOTH of you.  If your partner sees that you are willing to meet his needs in a way that might be initially challenging for you, he will be much more willing to change for the sake of the relationship too.  Try to resist the urge to keep score.  No one wants to feel like they’re in a relationship with the relationship police!  As long as both people are working on change, this is positive growth.  It’s not a competition and there is no finish line.  Aim to use positive reinforcement and support, and express appreciation.  You’ll likely receive it in return.  Both men and women are naturally attracted to people with ‘good energy’ versus, nagging, critical energy.

Ana was willing to demonstrate to Christian that she could change her ideas of what sex ought to be like- instead of ‘vanilla sex’ she was willing to experiment with his preference for BDSM-style sex.  With time, Ana was also willing to accept Christian’s gifts and lavish lifestyle, in spite of her discomfort with wealth, and all that it represented to her.  I believe her willingness to change for the sake of the relationship and positive encouragement allowed Christian to open up to the idea of change in himself.  For example, he became increasingly willing to allow her to physically touch him in ways he’d never allowed himself to be touched before.  She was also sensitive to moving forward at a pace that was comfortable to him.  The author writes about this dynamic of their relationship very realistically, which is why I believe the book captivates such a large audience.

4.  Understand that a man shouldn’t be expected to ‘change for you’ he should ‘change for himself’. 

• A lot of men develop habits in their life because it suits them during certain phases in their life.  These habits aren’t necessarily indicative that he’s ‘not ready for a serious relationship’ it just means he hasn’t found reason to behave differently.  This does NOT mean however, that a man should be expected to ‘change for you’.  If a guy sees that certain behaviors aren’t going to fly with you, he’ll figure that out, and decide on his own to internally motivate and take a new direction if he believes he’ll be a happier version of himself as a result of what this change can offer him.  

In the past, Christian was involved with many women in various capacities.  However, he’d never been inspired to relinquish his rigid sexual and relationship preferences.  When Christian fell for Ana, he realized he wanted to experience more with her, both emotionally and physically.  The author captures the tremendous challenges he experiences as he attempts to hold onto a woman who wants things he’d never thought possible to give someone.  When Ana questions his ability to be fully satisfied with her (as someone who doesn’t share his affinity for strictly BDSM-style sex), he explains that he no longer needs to maintain that lifestyle because he is happier with her than he’d ever been before.

5.  Don’t fight your differences, appreciate them.

• We’ve all seen that great couple in action- they seem to compliment each other and because of that, their lives are happier, healthier and less stressed.  Each of us have strengths and weaknesses in our personalities.  As much as we’d like to think we’re pretty close to perfect, we can often benefit from partnering with people who help ease us out of our rigid habits.  People who are planners and highly organized can often benefit from being partnered with people who are spontaneous and make do with completing things ‘at the last minute’.  Just because two people think/behave differently, doesn’t mean they need to try to change the other person.  In fact, these differences actually result in a couple that is capable of both planning AND living with spontaneity and flexibility- all skills that are equally important for a well-balanced life. 

Ana and Christian’s relationship is a great example of how two people can benefit from their personality differences.  Christian successfully introduces Ana to a sexual lifestyle that is highly fulfilling to her, and one that she might not have ever enjoyed had she not become involved with him.  Ana successfully introduces Christian to emotional intimacy, and helps him to trust and let go of his rigid need to control others- skills he might not have developed without a relationship with Ana.  Together, their qualities create a relationship that captivates readers because it is so obviously fulfilling and enticing to them both physically and emotionally. 

6.  Learn to get your needs met in a variety of ways, rather than looking for your partner to ‘be everything’ for you.

• Everyone should aim to develop and utilize a variety of ‘self-care’ habits, tools, and social support as a way to cope with the stressors in their lives.  Our partners can’t possibly be held responsible for changing in every way we’d like them to, and even if they were willing to try, it wouldn’t be possible.  Be aware that when you are stressed, you become more irritable and more likely to focus your attention on the shortcomings of your partner.  Don’t let stress accumulate and destroy your mood, leading you to believe your relationship is inadequate at making you happy.  No relationship should be held responsible for your happiness.  Only YOU can put to use a variety of resources that are effective in helping you distress.  Then you can go back to enjoying your partner, who hopefully is also working hard to do the same.

In this example, Christian is the one in the relationship that has to grow to accept that Ana needs to maintain parts of her life separate from him (working and developing her career, spending time with old friends, etc.) and can’t be available to him all the time to meet his needs.  Ana helps him realize that they can remain close and intimate without sacrificing their respective need for independence.

7.  Recognize that some urges to ‘change others’ have origins in your past. 

• Each of us can benefit from looking at our familial upbringing and preconceived perceptions about intimate relationships as a way of better understanding what we expect from our relationships.  When necessary, be ready to seek the expertise of a mental health professional to help you gain insight, understanding, and coping strategies when your past is keeping you from enjoying your intimate relationship.  If you feel that your partner’s past seems to be getting in the way of his ability to enjoy the relationship, support and encourage him to figure out ways to work through these issues, and also consider seeking professional help when necessary.

Fifty Shades of Grey illuminates the various ways in which Christian’s dysfunctional childhood shaped his overall outlook on interpersonal relationships, limiting his ability to trust and connect with others.  In the past, Christian’s only way of engaging in physical intimacy was through domination and control.  While Christian is able to successfully engage with Ana in the creative fantasy world of BDSM, he is also forced to examine his upbringing as a root cause for his rigid need control others, lack of trust, and need to keep people at a safe distance.  Through the use of effective, ongoing psychotherapy and support from loved ones, Christian is able to challenge himself and change in ways that allow him to reap the benefits of a loving, romantic relationship.  

Dr. Christina Villarreal is a licensed clinical psychologist in private practice in Oakland, CA.  For professional inquiries contact her at christina.villarreal@gmail.com

“I think the first real change in women’s body image came when JLo turned it butt-style. That was the first time that having a large-scale situation in the back was part of mainstream American beauty. Girls wanted butts now. Men were free to admit that they had always enjoyed them. And then, what felt like moments later, boom—Beyoncé brought the leg meat. A back porch and thick muscular legs were now widely admired. All Beyonce and JLo have done is add to the laundry list of attributes women must have to qualify as beautiful. Now every girl is expected to have Caucasian blue eyes, full Spanish lips, a classic button nose, hairless Asian skin with a California tan, a Jamaican dance hall ass, long Swedish legs, small Japanese feet, the abs of a lesbian gym owner, the hips of a nine-year-old boy, the arms of Michelle Obama, and doll tits. The person closest to actually achieving this look is Kim Kardashian, who, as we know, was made by Russian scientists to sabotage our athletes”.

Are American women and men preoccupied with beauty?

Camille Anna Paglia American author, teacher, social critic, and self-described dissident feminist has noted “We should not have to apologize for reveling in beauty. Beauty is an eternal human value”. Scientific evolutionary research supports the idea that physical symmetry, science’s definition of beauty, is preferred by human and animals because it is equated with a strong immune system. Thus, beauty is indicative of more robust genes, improving the likelihood that an individual’s offspring will survive. This evolutionary theory is supported by research showing that standards of attractiveness are often similar across a wide range of human cultures. So while humans are intrinsically invested in seeking beauty in others and appearing beautiful, how do we strike a healthy balance in how much attention we give to our physical appearance?

At what point does our pursuit of beauty become pathological?

It’s not hard to name the litany of celebrities who’ve made both subtle and dramatic changes to their physical appearance to improve, enhance, preserve, and in some cases overhaul their looks. Celebrities have access and means to hire world-renowned physicians, trainers, dieticians and stylists who, for better or worse, create results that leave lasting impressions on us. Is there a healthy balance of appearance-driven behaviors? From basic hygienic habits, to hair extensions and facial injections, to lengthy daily exercise routines designed to give us celebrity-worthy physiques, how much is too much?

Generally speaking, mental health experts define a given pattern/set of behaviors as ‘pathological’ when those behaviors:

• deviate markedly from the expectations of the individual’s cultural surroundings
• are inflexible and pervasive across a broad range of settings/situations
• lead to clinically significant distress in a person’s life, i.e. financial, social, occupational or other important areas of functioning

At what point does someone meet the criteria for the psychological disorder, ‘Body Dysmorphic Disorder‘?

Mental health experts define Body Dysmorphic Disorder (BDD) as a

• preoccupation with an imagined defect in appearance
• If a slight physical anomaly is present, the person’s concern is markedly excessive
• This preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning, and is not better accounted for by another mental disorder (such as dissatisfaction with body size in Anorexia Nervosa).

What types of treatment work best for people displaying symptoms of BDD?

• Cognitive Behavioral Therapy (CBT)- The goal of this treatment is to reduce an individual’s negative thoughts (and associated feelings and behaviors) about their appearance. Patients with BDD hold deeply negative thoughts about their appearance. CBT (using exposure and response prevention) can also effectively treat compulsive rituals that people develop out of anxiety about their appearance. These rituals can include checking themselves in the mirror, seeking reassurance from others, camouflaging the area of concern with cosmetics, clothing or tanning, and planning for surgeries to correct areas of concern. The goal is to “teach clients to challenge the validity and importance of their distorted thoughts about their bodies,” said Tom Corboy, M.F.T., director of theOCD Center of Los Angeles. Patients learn to “restructure their negative thought patterns to be more realistic,” said Sari Fine Shepphird, Ph.D, a Los Angeles clinical psychologist who specializes in BDD and eating disorders.
• Medication- Research studies demonstrate SSRIs can be effective in helping people manage BDD. These antidepressants—which include Prozac, Paxil, Celexa, Lexapro, Zoloft, Anafranil and Luvox—are also commonly prescribed for depression, OCD and social anxiety disorder, all of which share similarities with BDD.

is another great resource for additional information on managing this disorUnderstanding Body Dysmorphic Disorder: An Essential Guide, Katharine Phillips, M.D., a leading expert on BDD and director of The Body Dysmorphic Disorder and Body Image Program at Butler Hospital in Providence, R.I. This is a great resource for additional information on managing this disorder.

This article was produced by Dr. Christina Villarreal, a licensed clinical psychologist in private practice in Oakland, CA. For professional inquiries, please visit her website at www.drchristinavillarreal.com

Since news broke that Katie Holmes filed for divorce from Tom Cruise, there has much speculation about why their highly publicized celebrity marriage ended.  People magazine reported that Holmes had become increasingly unhappy in her five-year marriage to Cruise and that “she no longer had the life she wanted, in terms of her career, her way of life, everything.”  While the media has widely cited Cruise’s beloved Scientology to be at the center of the split, Cruise’s attorney Bert Fields insists the Church of Scientology was not involved, stating “Let me be very clear about this. The Church of Scientology played absolutely NO ROLE in the divorce settlement talks at all…”  But could Cruise’s early history of family dysfunction, which likely played a large role in his adoption of the Scientology faith, be the root of his failed marriage?  Would seeking professional psychological treatment have been more effective at helping Cruise break his old patterns of family dysfunction?

There remains many unanswered questions about what led to the breakdown of Cruise’s marital union with Holmes.  While Holmes was raised in a stable Catholic family upbringing by loving parents with whom she currently remains close, Cruise has shared with the media that his own family upbringing was laden with chaotic family dysfunction dominated by an abusive father, whom his mother eventually divorced when Tom was just 12 years old.  Cruise has described his father as “a merchant of chaos“.  Cruise described him as a bully and coward: “He was the kind of person where, if something goes wrong, they kick you. It was a great lesson in my life—how he’d lull you in, make you feel safe and then, bang! For me, it was like, ‘There’s something wrong with this guy. Don’t trust him. Be careful around him.”

Further, Cruise’s education was highly fragmented- he was enrolled in a total of 15 schools during his 12 years of education.  Coupled with a diagnosis of the learning disorder dyslexia which at the time, was often misunderstood and mistreated by mental health experts, early life for Cruise was troubled and difficult.  Cruise admits “I was a functional illiterate” upon graduating high school.  Cruise states his mismanaged learning disorder was an ongoing source of great distress and an obstacle to many of his early goals in life.  This experience appears to be the origins of his widely known contempt and mistrust of the field of psychiatry, which was reinforced through his later involvement with Scientology.   Cruise attributes his eventual success with literacy to the L. Ron Hubbard Scientology Study Tech.  Scientology is publicly and often vehemently opposed to both psychology and psychiatry, and view psychiatry as a barbaric and corrupt profession and encourage alternative care based on spiritual healing.

Clinical research has shown that adults raised in dysfunctional families experience difficulty forming and maintaining healthy, trusting intimate relationships, struggle to maintain healthy self-esteem/depend on others approval to determine their self-worth, and often fear losing control and allowing themselves to experience genuine emotions.  These individuals are highly susceptible to falling into unhealthy co-dependent relationships not just with people, but in the case of Tom Cruise, with rigid lifestyle choices that can push loved ones away.

Our early childhood experiences can lead to lifelong patterns that continue to shape us for the rest of our lives. While patterns of dysfunction can be very difficult to break, it is possible learn healthier forms of functioning.  In my work as a clinical psychologist, I have effectively worked with people of all ages who’ve experienced various levels of family dysfunction.  Without professional psychological intervention, many individuals eventually fall into old patterns of dysfunction and relationship failure, in spite of their efforts to change.

What are the goals for professional psychological treatment with someone like Cruise, who experienced early childhood family dysfunction and other stressors?

• identify and challenge irrational patterns of thinking
• develop and heal intimate relationships
• learn to identify and express emotions in safe ways
• learn to effectively and respectfully communicate with others
• develop healthy self-esteem
• work towards identifying and reaching rewarding life goals
• balance work and personal demands
• develop healthy and pleasurable forms of self-care
• establish boundaries with others that feel both safe and supportive

The following quiz was adapted at Kansas State University in their counseling services dept., and may be helpful in determining if you are experiencing long-term effects of living in a dysfunctional family.  If you find yourself answering “Yes” to the majority of the questions, you might consider seeking professional psychological help.

1. Do you find yourself needing approval from others to feel good about yourself? Yes_____ No_____
2. Do you agree to do more for others than you can comfortably accomplish? Yes_____ No_____
3. Are you perfectionistic? Yes_____ No_____
4. Or do you tend to avoid or ignore responsibilities? Yes_____ No_____
5. Do you find it difficult to identify what you’re feeling? Yes_____ No_____
6. Do you find it difficult to express feelings? Yes_____ No_____
7. Do you tend to think in all-or-nothing terms? Yes_____ No_____
8. Do you often feel lonely even in the presence of others? Yes_____ No_____
9. Is it difficult for you to ask for what you need from others? Yes_____ No_____
10. Is it difficult for you to maintain intimate relationships? Yes_____ No_____
11. Do you find it difficult to trust others? Yes_____ No_____
12. Do you tend to hang on to hurtful or destructive relationships? Yes_____ No_____
13. Are you more aware of others’ needs and feelings than your own? Yes_____ No_____
14. Do you find it particularly difficult to deal with anger or criticism? Yes_____ No_____
15. Is it hard for you to relax and enjoy yourself? Yes_____ No_____
16. Do you find yourself feeling like a “fake” in your academic or professional life? Yes_____ No_____
17. Do you find yourself waiting for disaster to strike even when things are going well in your life?  Yes_____ No_____
18. Do you find yourself having difficulty with authority figures? Yes_____ No_____

Dr. Christina Villarreal is a licensed clinical psychologist in private practice in the Bay Area, California and may be reached at christina.villarreal@gmail.com

How technology is shaping doctors’ communication with their patients.

Is your doctor accessible to you via email? Texting?  Twitter? Facebook?  Skype? Increasingly, the answer may be yes.  Historically, health care professionals have shied away from technology due to the threat to patients’ privacy and their own liability.  But a new breed of doctors are relying on technology such as texts, emails, blog messages, Skype sessions, Facebook and Twitter to communicate with their patients as well as the general public.  Beyond basic emailing, some doctors are using technology to send healthcare messages to patients, schedule and change appointments,  track disease trends on Twitter, provide psychotherapy during patient travel via Skype, or help people determine when it’s time for professional intervention via Facebook pages or blog posts.  Doctors’ use of social media and virtual communication for patient care is expected to increase under the Accountable Care Act, which encourages electronic health records and the “electronic exchange” of health information.

Like many clinical psychologists in private practice today, I serve a patient population whose lives are brimming with work and family demands as well as after-work activities.  People’s increasingly busy lives are allowing for less and less time to fit in phone conversations that require fewer distractions and more privacy.  Ordinarily, doctors of the past would spend the end of their day responding to patient inquires via phone, only to end up playing phone tag over something relatively benign.  These days, doctors and their patients have found it increasingly more convenient and effective to use various forms of technology to communicate in addition to phone calls.  In my own practice, I may rely on technology for the following purposes:

• Use of blog articles posted on my professional websites and Facebook page to convey basic facts on clinical disorders and trends in healthcare
• emailing responses to new patient inquires for setting up an initial psychological evaluation appointment, and how to use healthcare insurance for mental health treatment
• texting with patients about changes in schedule for appointments, directions to office locations, and other general logistic information
• Skype sessions for occasional individual psychotherapy, such as when a patient is traveling out of town and prefers to continue weekly treatment

When it comes to treatment with a qualified healthcare expert, nothing can ever replace the value of engaging in a face-to-face appointment for evaluation and patient care.  Patients and their doctors should have detailed communication up front about how and when use of technology is appropriate (and when it isn’t) for communication.  Health care professionals should take precaution by educating themselves on the most recent safety guidelines for using technology in their professional practices, understand the limitations of their practice insurance, and employ the highest level of security measures for their electronic devices and internet services.  Further, it is up to health care professionals who choose to employ technology for communication with their patients to take responsibility for informing their patients of the risks to privacy that may occur as a result of their choices.

For further information on the guidelines to using technology in the field of mental health, visit Joint Task Force on the Development of Telepsychology Guidelines for Psychologists and other recommendations from the American Psychological Association on distance therapy.

Click here to view the post, and feel free to leave a comment here should you have questions or comments.

A UK Guardian review proposes that Fifty Shades of Grey thrusts erotica into mainstream media, transforming the way erotic fiction is consumed by the public.  According to the publisher’s data, “gleaned from Facebook, Google searches, and fan sites”, more than half the women reading the book are in their 20s and 30s, in spite of the prevailing stereotype that the largest consumer of this series are middle-aged suburban women, sexually frustrated Twilight fans, or conservatives foraying into adult fiction in search of more palatable sexual fantasy reading material.

Dr. Mehmet Oz  dedicated a recent show to exploring this book series with an audience of women and men who have read them.  EL James “has gotten people talking about sex in a way that no one else could get them to talk about it,” Dr. Oz said from the red carpet of a gala honoring Time magazine’s 100 most influential people in the world.  Dr. Oz included James with the likes of President Barack Obama and Rihanna stating “this book is about people having an honest conversation about what sex should be like, what makes it feel better, what are the timing issues, how do we make it an important issue in our life rather than an afterthought.”

As a clinical psychologist in private practice, a large segment of my psychotherapy patients are young women in their twenties and early thirties.  Like the protagonist in Fifty Shades of Grey, many are struggling to awaken and understand their sexuality  during a developmental time when the goal is often to find and secure a loving life partner.

In my professional opinion, one of the biggest challenges these women face is learning how to cultivate the necessary self-confidence to enjoy sex.  This is a generation that grew up watching Sex in the City, had a wealth of sexual content at their fingertips via the world wide web, and whose favorite musical artists and actors relied upon sexual exposure at younger ages and more heavily then ever before in American history.  Perhaps due to wide-spread sexual overexposure that continues to objectify women, this generation of women continues to struggle with identifying and indulging their sexual desires as did earlier, more sexually conservative generations.

During psychotherapy sessions I conduct with many women, I hear feelings of inadequacy based on pressure to be aesthetically perfect for their partners, or a focus on fulfilling partners’ desires without identifying or communicating their own- all of which which robs them of their ability to truly develop their own unique sexual identity, and discover one of life’s greatest pleasures.  As a clinical psychologist, I use a problem-solving cognitive-behavioral approach to help individuals become more comfortable with the process of awakening and fostering their sexual identity.

What are some treatment recommendations for developing one’s sexual identity?

• explore (with a mental health professional, peers or through journaling) how cultural, familial, gender and religious norms, values, experiences and biases may have shaped your views of sexual behavior in both positive and negative ways
• explore the expectations you place upon yourself and others when engaging in sexual behavior- do these these expectations allow for healthy self care? Reciprocity?  Are they realistic?
• Identify images, fantasies and forms of touch that awaken your desire- what kind of judgment do you place upon them?  How might you gradually increase your comfort level with them in order to fulfill your needs?
• Are there materials that can support your exploration of the above?  Explore adult novelty websites such as Adam & Eve, or local bay area stores such as Feelmore 510 or Good Vibrations.  Bookstores such as Amazon/Kindle and Barnes & Nobles/Nook are also well equipped with reading material which can be procured discretely.

This article was written by Dr. Christina Villarreal, Clinical Psychologist in private practice in Oakland, California.  For professional inquires contact her at christina.villarreal@gmail.com

An excerpt from the article:

Christina Villarreal, a cognitive-behavioral therapist in Oakland, Calif., says she has clients in the tech industry—young men mostly—who spend so much time and money amassing collections of music or games or gadgets that they withdraw from the real world. “They can’t pay their rent or buy food because they have to have this latest piece of equipment to support their habit,” says Dr. Villarreal. She notes that hoarding often starts out as a way to feel good or fill an emptiness in life, but it leaves sufferers even more isolated. She helps clients relearn basic social skills and find other enjoyable activities instead.

The field of psychology is still establishing healthy standards of functioning when it comes to the consumption of technology.  The Diagnostic and Statistical Manual for Mental Disorders IV (DSM-IV) does not currently recognize digital hoarding as a mental disorder however it is being considered for inclusion in the DSM-V‘s main manual or as an appendix for further research, which will be published in May 2013.  To better understand the basis of hoarding, review Do you have Chronic Disorganization, Clinical Hoarding, or are you just a ‘packrat’?

How do mental health experts currently determine when digital collecting becomes ‘digital hoarding’ and disfunctional in a person?

Psychologists like myself are likely to diagnose someone as dysfunctional when their digital collecting behavior begins to impact multiple areas of their functioning in the following ways:

• occupational and/or academic demands are no longer consistently met
• social relationships begin to suffer negative consequences
• social withdrawl and/or isolation patterns emerge with friends and/or family
• physical functioning/self care habits are show decline, such as neglecting regular exercise, poor dietary choices that result in significant weight gain or loss
• sleep deprivation
• poorly managed finances/debts as a result of  digital/technology driven spending habits
• difficulty stopping or reducing their growing mass of digital devices and/or media files that go largely unused
• noticeable changes in mental functioning that result in marked  symptoms of depression, anxiety or substance abuse
• poor insight regarding the negative consequences of their hoarding habits

What kind of treatment, if any, helps someone with digital hoarding problems?

Cognitive Behavioral Therapy (CBT) is an evidence-based form of psychotherapy that can help to alleviate negative symptoms and improve overall functioning.  A well planned treatment regimen may include:

• Systematic Desensitization also known as Graduated Exposure Therapy
• assessing the need for psychotropic medication to reduce symptoms of obsessive thoughts and behaviors, anxiety and/or depression
• identifying/increasing other enjoyable activities into daily life
• increasing social opportunities for support
• social skill building when necessary
• developing and maintaining healthy self-care for diet, exercise and sleep patterns
• support for debt management