Smart solutions when productivity stalls- perspective is everything

You know that feeling when you’re stalled by something that needs to get done?  Even the most efficient people face roadblocks in their productivity from time to time.  This is especially frustrating for people who are used to completing challenging tasks with relative ease.  I recently met with an accomplished young gaming engineer for executive coaching to support his exploration of new work opportunities in Silicon Valley.  He revealed that he’d struggled for hours to complete a cover letter email, and this left him feeling baffled and weary about the whole process of interviewing for new employment.  We used the session to get to the root of what was creating this stall in productivity, and generated smart solutions based on his personal strengths.  Strategy and perspective makes all the difference.

Working with the Bay Area’s talented tech community has taught me this- the smartest people take it the hardest when their performance and results don’t meet their expectations!  Many have grown accustomed to things coming easily to them and have quickly advanced in their chosen career trajectory.  Early giftedness in STEM can sometimes lead to people develop an identity centered around being ‘brainy and capable’.  It may come as a shock when something as simple as creating a cover letter sidelines them and deflates their sense of efficacy.

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Why does this happen?  Over time, our strengths get reinforced as our primary means of solving problems because they get us from point A to point B quickly and easily.  Since these same strengths are also tied to our sense of identity and self worth, we become less willing to set them aside and use other methods of ‘solving’.  Tasks that force us to operate outside of our comfort zone trigger feelings of frustration because we aren’t as effective as we’re used to feeling, which stalls our productivity.  A guy who’s honed skills as a talented engineer, fluent in the most sought after programming languages will probably not be as adroit at English writing composition and will likely need to give himself more leeway in completing a thoughtfully composed cover letter.

Apply a smart solutions formula when your productivity stalls:
1. Conscious self-awareness.  Identify the evidence in your life (historically and currently) of how and when you have leveraged your personal strengths to achieve good outcomes.  How did your strengths allow you to perform optimally?  Result outcomes might be found in academic, career advancement, kinesthetic/athletic, social/interpersonal, emotional, musical, aesthetic, experiential, operational or other realms of functionality.

“I can recognize times in my life when my skills and abilities have allowed me to make progress, overcome obstacles, and reach important goals that have led me to where I am now.”

2. Balanced self-acceptance.  Scientific advancements in human cognition and intelligence reveal that all people possess strengths and weaknesses relative to their overall functioning.  To expect to function only by means of our strengths is unrealistic.  Sometimes we must be willing to step back from our most comfortable mode of operating and acknowledge certain tasks don’t call for our ideal skill set.

“This task calls for specific skills that I don’t practice as often (e.g. writing English composition).  I can’t rely on my core strengths to complete it.  I must be willing to feel uncomfortable if I’m to make progress.  So what?  That’s true for everyone sometimes.  If I let this slower pace of progress demoralize me it could stop me from getting from point A to point B.  Any pace will do, as long as I’m trying to move forward.”

3. Realistic expectations.  Plan to break down larger goals into chunks that are achievable and utilize breaks to regain energy.  Attempting to complete a difficult task in one fell swoop doesn’t lead to efficiency, it’s a set up for failure.  When you’re using your brain to work in less familiar ways, expect to take breaks before your mental energy begins to stall so your overall motivation remains strong.  This way you avoid feeling demoralized and progress remains steady.

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4. Shift perspective.  Pay attention to how you’re evaluating yourself- when we only measure our progress based on ‘results’ rather than ‘performance effort’ we can end up feeling ineffective or lose our sense of purpose.  Another coaching client of mine works in a highly specialized area of machine learning/artificial intelligence (AI).  While there has been genuine advances and exciting new applications here in Silicon Valley and other tech hubs around the world, the field remains experimental, and it still requires time-consuming, exploratory research.  Even the most brilliant minds working together face a sense of disappointment when big breakthroughs don’t happen, especially with constant media hype  fueling the AI frenzy.  If you are working on the cutting edge of new scientific discovery, it may be difficult to quantify progress and demonstrate measurable value compared to an ever-changing larger community.  While it’s natural to want to make comparisons, track and measure your contributions by ‘showing your work’ rather than evaluating yourself on outcome results alone.  By documenting your steps in the scientific process, generating strategic hypotheses, testing them critically through observations and experiments you are creating a useful path of ‘knowledge’ as you arrive at Type 1 or Type 2 errors, etc.  Find value in documenting how you’ve made progress to better direct your future paths of discovery.

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5. Prepare to use trial and error.  If one particular process of completing a task isn’t coming together, try a different plan of action.  Step away from a task and let your brain absorb the learning and develop new insights.  Go back with fresh eyes in regular intervals and adjust accordingly, and practice applying new insights.  According to the latest neuroscience,  researchers have discovered that moments of creativity take place when the mind is at rest rather than directly working on something.  Since creative approaches are so crucial to success, be sure to give yourself space from your work efforts.

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Bringing it all together:  Discover optimal productivity methods based on your personal strengths and challenges.  Practice applying a perspective that takes into account all the moving parts and your abilities before comparing your pace to others.  Remember that everyone hits roadblocks from time to time; taking this mindful approach and using smart solutions will help you overcome them as efficiently as possible.

5 winning strategies to improve your likability at work and why it matters

“Likability” has become the X factor that distinguishes people’s success at work as the American workforce grows increasingly competitive and diversified.  Demonstrating a high level of likability goes beyond popularity, and is often cited as one of the most influential reasons behind promotion selection and leadership  advancement within a company.  The ability to come across as likable can lead to why co-workers and managers align with some people but not others. Likable people are more apt to be hired, earn a high level of trust and support from colleagues, and have their mistakes forgiven without injuring their credibility and reputation.  A study of 133 managers at the University of Massachusetts found that if an employee is likable and gives a well-organized argument, managers tend to comply with their suggestions, even if they disagree and the employee lacks supporting evidence.

On the other hand, unlikable people are often unaware of how toxic they feel to others, seem to provoke a combative response in others, and over time, develop a reputation of  being ‘hard to work with, or hard to work for’ even if they consistently demonstrate a high level of technical skill in their work role.

The ability to manage your emotions and remain steadfast and positive in stressful situations has a direct impact not only on your performance, but how likable you are to others.  As tempting as it can be to find fault in others, taking on a non-confrontational problem-solving approach encourages people to work in tandem and collaborate with you rather than react in defensiveness and go into attack mode.  A wise, highly successful manager once said to me “it’s never effective to make people feel wrong, even if they ARE wrong.  Shaming people wastes time and energy and reduces morale- causing people to withdraw or retaliate rather than work to improve themselves.”

TalentSmart has conducted research with more than a million people, and found that 90% of high ranked performers are skilled at managing their emotions in times of conflict in order to remain calm and in control. One of the greatest talents of likable people is their ability to neutralize difficult, unlikable people. They use their well-honed interpersonal skills to help disgruntled people feel supported, valued and useful to a team’s success, motivating them to cooperate with others.  If left unchecked, poorly managed conflict and employee grid-lock will sink a company’s success rate fast.

There are various strategies that likable people use to win their co-worker’s trust, appreciation, and support at work.  “Likability isn’t something you are born with, like charisma. It’s something you can learn,” says Ben Decker, chief executive officer of Decker Communications, San Francisco, a training and consulting firm.  To establish lasting, positive connections with people (whether you like them or not), you’ll need an approach that feels authentic to your interpersonal style. Many clients in my executive coaching practice come in to elevate their emotional intelligence skills to complement their highly developed STEM technical skills.  In the beginning, taking a different approach to interacting with others can feel difficult or artificial, but over time becomes easier to employ once you see the positive impact it has on your work relationships.  Engaging in stable, positive interactions at work will always be easier to maintain than constantly navigating awkward or tense work relationships.

Actionable strategies to increase your likability at work:

  1. Aim to communicate empathically with others.  Negative, unlikable people can be draining when they exhibit hostile emotions without regard for how they’re affecting others.  They aren’t focused on solutions because they feel unheard, and want someone to pay attention to their complaints.  You can avoid coming across as insensitive or unconcerned by offering a few short, empathic statements to demonstrate you’ve listened.  Help them see they’ve made an impact on your understanding of the issues they’ve raised, and you value their opinion.  This form of active listening increases your likability because you’ve demonstrated an ability to tolerate other people’s emotional expressions without negating their experience.  Even if you do not agree with them in the slightest, you’ve helped them move away from seeing you as personally contrary or combative.  Their complaints are not being made to generate solutions at this moment in time, but rather to be heard by anyone who will listen.  Refrain from sharing differences in opinion, which will only trigger a combative response style.  Use phrases to help that person feel understood before ending the exchange amicably.
  • “This does sound like a big problem.  I imagine it won’t be easily solved without some planning.  I appreciate you sharing your thoughts on the situation, it’s helped me get some new perspectives.  I’ll spend some time thinking about how to get the ball rolling in the right direction.”
  • “I think this is a really important issue too.  I want to give it the time and attention it deserves.  Now that I’ve heard your take on it, I feel like I can see how it’s affecting people differently.”
  • “This problem has been hard for a lot of people, but especially you, based on what you’re saying.  It seems like you’re doing the best you can, given the circumstances.”

If ultimately it’s your job to generate actionable solutions to the problems they’ve shared with you, it’s better to give yourself time to strategize, gather information, resources and support to optimize your plan of action rather than to engage in a reactive dialogue that won’t generate lasting solutions, and likely only provoke negative responses.

2.  Make time for small talk.  Positive relationships are born from sharing benign personal details.  Showing genuine interest in others makes you likable.  As someone who’s naturally chatty (with a personality style well suited to being a highly interactive coach versus a traditionally unobtrusive psychotherapist) I always enjoy helping people learn and practice the art of small talk.  Likable people make time to exchange simple personal reflections on topics that most people can relate to- favorite past times or culinary tastes, seasonal or local happenings.  Small talk is a time to compare mutual commonalities with the intent of learning something new about a person.  Sharing parts of yourself through small talk helps people feel familiar and comfortable with you and develop a sense of who you are outside of your work role.  I believe there are a few basic rules of thumb to successfully initiate and respond to others during small talk conversations.  These mini exchanges (think 5 -1o minutes) build upon each other over time, and eventually can segue into more in-depth conversations that are mutually interesting and enjoyable.

  •  Be willing to initiate a circumstantially relevant conversation (for example seeing someone enjoy a cup of coffee/tea is a good time to ask what they prefer, then share some small personal details about your own caffeine habits, add some novel experiences if you can to keep it from being too mundane).  Pay attention to the amount that they share and aim to match it, then expand a bit more.  Find out if there’s anything you can learn from them based on what they share.
  • Be responsive to people when they make an effort to begin a small talk conversation with you, and be inclusive of others whenever possible.   Even if you’re having a hectic day, take time to convey you appreciate their conversational gesture and try to refrain from saying how busy/rushed you feel.  If you really are counting on every spare minute that day, let them know you want to come back to chat with them a bit later, and make a point to follow up in some small way the next time you see them.
  • Ask a few people who know you well (family members, room mates, close friends) how they’ve seen you engage in small talk and ask for candid feedback.  What have they observed in your conversational style that works well?  What might be misinterpreted?  Consider any reoccurring themes with the intention of ongoing improvement so that others have easy, enjoyable exchanges with you.

 

3.  Pay attention to what tends to lighten people’s mood, what puts a smile on people’s faces or brings people out of their shell.  A few seconds of generosity with your energy can instantly warm people and makes you endearing to others.  I’ve had clients tell me they struggle to connect with people they have very little in common with, especially across genders.  If  you’ve ever paid close attention to someone who’s incredibly likable, you’ll see their charm often comes from a willingness to admit to not knowing much about something that someone else has a talent for- they’ll make light of this difference and find a way to joke about being less fashion savvy, less gadget knowledgable or less organized than a fellow co-worker.  Complimentary teasing, when done subtly and with genuine appreciation for someone else’s strengths is a fun, positive way to connect to others and increase your likability.

4.  Keep close tabs on your mood, and get in the habit of making micro-adjustments to sustain your comfort, stamina, peace of mind, and sense of humor.  Top performers understand how even the smallest differences in our mood can shape our response style and influence our ability to be creative, proactive and solution focused, and patient with unlikable people and complex problems.  You’ll want to aspire beyond healthy eating and good sleep hygiene and understand what additional influences can tip your mood in the right or wrong direction.  I recently sat next to Silicon Vally venture capitalist Tim Draper during a fundraiser luncheon for non-profit organization BizWorld.org.  He shared with me a few secrets to his success, including the importance of understanding and managing what influences your mood and energy level, taking extra precaution before going into high stakes meetings, public performances, or making paramount decisions with long term consequences.  By learning what helps you sustain your best mood, you’ll not only increase your likability and performance level, but serve as an inspiration to others who see you gliding through life with more ease and less stress.

  • create a varied and personalized list of self-care strategies and implement them routinely into your daily schedule.  (The list should range by category, e.g. time required, ease of access, supplies needed)
  • learn when to pass on extra curricular activities, social events and spending time with people that drain your energy and mood during times you’ll need to rely on your best performance ability
  • invest in resources that help you streamline domestic tasks that take up precious time and energy- whenever possible and affordable outsource tedious household chores so you can invest your time and energy on making career gains and positive social developments.

5.  Keep your eyes on the big picture and don’t sweat the small stuff.  The most likable people find a way to not let minor annoyances become obstacles to their success, and train their brain to notice positivity, hope, generosity, kindness, improvement and teamwork.  They are comfortable using trial and error, steer clear of perfectionistic or overly-idealistic expectations, keep their goals realistic, recognize growth and gains in themselves and others, and manage to find the silver lining in the most challenging circumstances.  Practice.  Then practice some more.  These are all tactics that take time to develop and can become staples in helping you become more likable and effective in your life and work goals.

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Is Lightweight Stalking on Social Media a Relationship Killer? Stop in 3 Easy Steps.

How often do you keep tabs on the person you're dating online?
How often do you keep tabs on the person you’re dating online?

Have you ever wondered how much checking someone’s status updates/tweets/photo uploads is normal/harmless, and when does re-checking their online activity become problematic?  Most of us have caught ourselves clicking through someone’s social media activity because we have reason to be naturally curious  about them- maybe the person is someone we want to meet, or just started dating and want to know more about them.  Other times we might scroll through our partner’s online activity as a way to check their daily mood, as counterintuitive as that may sound (since you likely see them or at least communicate with them regularly in person).  Today’s prolific use of social media gives us an alternative glimpse into our partner’s emotional status and social exchanges that we may not otherwise pick up on.  Even if someone’s online persona is carefully constructed for public consumption, having access to their online activity gives us an opportunity to interpret the meaning of their coming and goings, even their level of intimacy with others.  If this person is an ex-romantic partner this may be all we have to go on- even if all we see is their profile picture and friend list, this information can still provide a rough approximation of their current situation. This dilemma recently became a topic of conversation in my coaching practice, where helping people improve their emotional intelligence is a common goal throughout the work that I do.  Victoria, a bright and accomplished 24 year-old woman shared with me that constantly checking her boyfriend’s social media activity and online communication with his ex is taking a hard toll on her mood and relationship functioning. Me: “Have you ever talked to your boyfriend about what you see on his social media sites?  That you’re concerned about who he’s interacting with online?” Her: “HELL NO! The last thing I want to do is come across as the person that I actually am- the type of person who stalks people online to see what they’re up to, and compare their successes to mine.” Checking people’s online activity, or ‘lightweight stalking‘ if you will, can run deep.  We start out taking a quick glimpse at our partner’s tweet/Instagram pic of the day, only to find their ex decided to comment suggestively.  It’s too easy to then check out our partner’s ex-boyfriend/girlfriend’s Twitter/Instagram/Facebook, etc (because dammit they have a public profile just begging to be explored).  So begins the comparisons.  Do they seem happier/sadder now? Does their taste in fashion/music/politics demonstrate that I’m a more tasteful/intelligent person?  Is he/she in better shape than me?  Our self-esteem may start to wane the more we compare ourselves to them.  We end up heading into an tailspin trying to interpret their ‘Vaguebooking‘ habit on Facebook.  We’re left wondering if they’re pining for their old relationship.  Do they want to rekindle things?  Will they/have they tried?  If trust hasn’t been well established in our relationship, we might become irrationally suspicious by mistrusting and/or questioning our partner for no substantial reason.  Suddenly we’re starting arguments that undermine the health of our relationship.

FML.

Dr. Tara C. Marshall, Ph.D., explores online post-breakup fixations in her research article Facebook Surveillance of Former Romantic Partners: Associations with PostBreakup Recovery and Personal Growth.  Results based on the responses of 464 participants revealed that one-half to two-thirds of people have made contact with an ex-romantic partner through Facebook, and that over half admit to having looked through an ex’s photos to find pictures of them with a new romantic partner.  Findings from this study suggest that keeping tabs on an ex through social media is associated with poorer emotional recovery and personal growth following a breakup. Therefore, avoiding exposure to ex-partners, both offline and online, may be the best remedy for healing a broken heart.

Solution:  Put Yourself on a Stalking Diet

  1. Do not allow yourself to stalk during the time of day when you know you are the most emotionally vulnerable and/or have unlimited time to comb through the internet for new postings.  For many people this is late at night.  Give yourself an 8 pm stalking curfew!!!  Most likely after 8 pm, you’ll engage in other things that will bring your mood back to a normal, and you’ll be in a less anxious place before you sleep.
  2. If you know you’re not ready to quit cold turkey, put some “stalking hours” in place, like office hours, if you will.  You’re only allowed to check on those you stalk between 2-4 pm, for example.  That way if you find yourself curious about your ex at midnight (especially likely if you’ve been out drinking), you can rest assured you’ll have a chance to stalk to your heart’s content, just postponed a little.  Chances are, you won’t have that same aching (likely misguided) curiosity during the logical hours of the next afternoon.
  3. Delete the social media app(s) that you use the most during your sleuthing for one week.  This will allow you to see how much you actually miss compulsively scrolling through that particular social media site.  You might discover that the cost of missing out (FOMO) is not creating as much emotional damage as stalking does.
  • And if all else fails…
If all else fails…

Gen-Y’s tech twist on engagement, weddings and parenthood

While Gen-Y is still getting married at much lower rates than previous generations, some millennials are finally beginning to grow up, entering the world of marital engagements, wedding planning, and parenthood. True to form, their choices reflect advancements that set them apart from Gen-Xers, who were the first to utilize technology to chronicle their love stories on websites like theknot.com, build wedding registries online, gift personalized CDs with digitally remastered music as wedding favors, show spliced video montages of the bride and groom’s childhood at wedding receptions, and research honeymoons on websites like tripadvisor.com. As a card carrying member of generation X, I can proudly say we thought we were so cutting edge! Our kids were the first to be born with smartphones and tablets in their hands, and we posted their baby pictures on our social media pages and texted them to their grandparents. But time nor technology stands still, and Gen-Y has begun to put their own tech twist on engagements, weddings and baby plans. As someone who works with a high volume of with millennials in the San Francisco Bay Area, I have taken note of the following trends:

Their romantic relationships have an online life of their own. As the saying goes, no one really knows what happens behind closed doors, but in the personal lives of millennials, we can certainly take a look at their online activity to see what they’d like us to believe about their relationship status and history. The internet has become their forum of choice for chronicling romantic highs and lows, functioning as a means to gain public support, air grievances, compete for attention, and display markers of success (not to mention deleting away failures.) From public playlists on Spotify, hashtags on Twitter and Instagram, Pinterest boards and Facebook’s ‘Relationship Status’ updates, Gen-Y leaves little to the imagination when it comes to sharing their stories of romance.

They crowd source their decisions when it comes to navigating relationships. Millennials are used to solving problems fast, arriving at optimal solutions with the least resistance possible. Millennials have been groomed to work in competency-based teams, and this concept is frequently used for managing their personal lives too. They prefer to avoid conflict, and are more comfortable than previous generations relying on others to help them make decisions. Jeff Snipes, CEO of Ninth House, a provider of online education, including optimizing team effectiveness, says a hierarchical, leader-oriented team was more appropriate for earlier generations: “Traditionally if you worked up the ranks for twenty years and all the employees were local then you could know all the functions of the workplace. Then you could lead by barking orders. But today everything moves too fast and the breadth of competency necessary to do something is too vast.” When faced with life-changing decisions about relationship commitment or endings, Gen-Y seeks the opinions of their team of friends, family and experts to help them navigate and solve problems. When problems are deemed too private to share, websites like popular sites like Whisper and Secret are put to use by millennials as a way to air their private thoughts, share their hidden behaviors and ask for advice completely anonymously, so there is no threat to their carefully constructed online image.

Their engagement stories, weddings and honeymoons reflect their brilliance and investment in personal branding. While previous generations aimed to establish their worth and reputation through self-improvement, author Dan Schawbel of Me 2.0: Build a Powerful Brand to Achieve Career Success points out that Gen-Y has discovered that in the dawn of the internet, admiration and success comes from self-packaging through a carefully concocted personal brand. From the days of Myspace to Tumblr, millennials have grown up managing their self image like celebrity publicists. Gen-Y has turned self-portraits into a way of life- ‘selfies’ have become one of the internet’s top forms of self-expression. Their overall online presence has been a way to uniquely distinguish themselves from everyone else, and they are highly invested in making their relationship milestones ideally memorable as part of their personal brand. Whether they capture and share these milestones via Snapchat’s Our Story, Instagram, Twitter, Facebook, or personal blogs, millennials are sure to control how the world sees their love stories unfold through brand management. One San Francisco Bay area millennial shared with me she got engaged via FaceTime, since her long-distance boyfriend was living in abroad and couldn’t wait to pop the question. To his credit, her (now fiance) also created an iMovie that he shared with her, depicting him staged in funny scenarios accompanied by a personalized musical score that specially captured their romantic history.

They’re comfortable resisting tradition, understanding that ‘following the rules’ doesn’t necessarily bring ‘happily ever after.’ Author Paul Hudson of Elite Daily, The Voice of Generation Y observes that millennials are far less likely than past generations to buy into the notion that marriage is the gateway to a future of stability and happiness. Harry Benson, research director at the Marriage Foundation, describes the strong link between parental divorce and a reluctance to get married. “If your parents split up then most people are more likely to be quite skeptical about the value of marriage,” he explains. “So as there’s rising divorce rates, you can imagine how when the next generation appears, people will be more dubious about marriage.” Bobby Duffy, leading market researcher on generational analysis, says there are also far more financial pressures on millennials than previous generations. They have more educational debt in a less stable economic climate, and face an incredibly buoyant housing market. According to CNNMoney, twenty-somethings are transitioning into adult life at a more gradual pace, opting to cohabitate and co-parent without traditional marriage at a much higher rate than previous generations.

They anticipate their babies’ future in a world where technological identity matters. One website says it all:awesomebabyname.com, a new online tool that allows parents to choose a name for their child based on website domain availability. Yes people, this is happening. I heard it first a few months ago when a pregnant patient of mine found out she was having a girl, the first thing she and her cohabiting boyfriend/expecting father-to-be did was buy website domains and establish email accounts in her name. Of course, now there’s an app for that! “It’s important to give your children a fighting chance of having good SEO (Search Engine Optimization) in the 21st century,” says Finnbar Taylor, who created this website together with Karen X. Cheng. “We use search engines all day long to answer our questions and find things, including people. Imagine being called John Smith and trying to get a ranking on Google search. It’s important to give your child a unique name so that people, like potential employers, will be able to find them easily in the future.”

Granted, millennials are still in their 20’s, a time when it’s still developmentally common to be preoccupied with self-image, and an idealized future that looks different than previous generations. The question is, as Gen-Y ages, which of these trends, if any, will change?

 

Hypochondria or not: Do you use the internet to self-diagnose your physical symptoms?

Most of us have had that “OH NO! I think I have that!” moment, after poking around online, trying to figure out the cause of our vague physical symptoms. A 2004 study by the Pew Internet and American Life Project found that 79 percent of Internet users — roughly 95 million Americans — have researched health information online. People now have access to incredibly complex medical information, with little ability to sift through it or interpret it accurately. The abundance of health information available online, valid or not, has contributed to what the media have coined ‘cyberchondria’ (researching diseases on the internet, and then worrying that you have the symptoms of that disease.) These people are often frustrated when their self-diagnosis does not prompt their doctor to order the tests and/or medications they feel necessary.

Yet after getting checked out by a doctor and getting a clean bill of health, most of us feel reassured, and are then ready to move on. For hypochondriacs however, relief does not come, and the fear of serious illness continues to fester. Hypochondria falls under the umbrella category of Somatoform Disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and is defined as a preoccupation with the belief that one has an illness, based on a misinterpretation of bodily symptoms. To qualify as hypochondria, this preoccupation must cause distress in the person’s daily life and persist for at least six months — despite medical evidence discounting the perceived illness. About 1 to 5 percent of the population suffers from hypochondria, and the disorder is believed to strike men and women equally.
In the professional world of mental health, “Somatization” is a term that describes the expression of psychological or mental difficulties through physical symptoms. Somatization can range from preoccupation with potential or genuine but mild physical problems (as previously described in Hypochondria), to the development of perceived or actual physical pain, or dysfunction. This article addresses some of the other major diagnoses that the DSM-IV-TR defines within the Somatoform Disorders category.
Somatization disorder is characterized by a history of multiple unexplained medical problems or physical complaints beginning prior to age 30. People with somatization disorder report symptoms affecting multiple organ systems or physical functions, including pain, gastrointestinal distress, sexual problems, and symptoms that mimic neurological disorders. Although medical explanations for their symptoms cannot be identified, individuals with somatization disorder experience genuine physical discomfort and distress. Review of their medical histories will usually reveal numerous visits to medical specialists, second and third opinions, and numerous medications prescribed by different doctors, often putting them at risk for drug interactions.
Conversion disorder is marked by unexplained sensory or motor symptoms that resemble those of a neurological or medical illness or injury. Common symptoms include paralysis, loss of sensation, double vision, seizures, inability to speak or swallow and problems with coordination and balance. Symptoms often reflect a naive understanding of the nervous system, and physicians often detect conversion disorder when symptoms do not make sense anatomically. The name conversion disorder reflects a theoretical understanding of the disorder as a symbolic ‘conversion’ of a psychological conflict into a concrete physical representation. Ironically, patients with conversion disorder may not always express the level of concern one would expect from someone with their described condition.
Pain Disorder is physical pain that causes significant distress or disability or leads an individual to seek medical attention. Pain may be medically unexplained, or it may be associated with an identifiable medical condition, but it is experienced as far more severe than the actual physical condition would warrant. Common symptoms include headache, backache and generalized pain in muscles and joints. Pain disorder can be severely disabling, causing immobility that prevents patients from working, fulfilling family responsibilities or engaging in social activities. Like patients with somatization disorder, people with pain disorder often have a long history of consultations with numerous physicians.
Body dysmorphic disorder is characterized by preoccupation with a defect in physical appearance. Often the defect of concern is not apparent to other observers, or if there is a genuine defect it is far less disfiguring than the patient imagines. Common preoccupations include concerns about the size or shape of the nose, skin blemishes or color, body or facial hair, hair loss, or “ugly” hands or feet. Individuals with body dysmorphic disorder may be extremely self-conscious, avoiding social situations because they fear others will notice their physical defects or even make fun of them. They may spend hours examining the imagined defect or avoid mirrors altogether. Time-consuming efforts to hide the defect, such as application of cosmetics or adjustments of clothing or hair, are common. Many people with body dysmorphic disorder undergo permanent procedures like plastic surgery or cosmetic dentistry, but are seldom satisfied with the results.
Note that Somatoform disorders should be distinguished from Factitious disorder, in which patients intentionally act physically or mentally ill without obvious benefits such as monetary gain. What motivates people with Factitious disorder is being able to play the role of a sick person. Further, the DSM-IV-TR distinguishes Factitious disorder from Malingering, a disorder which is defined as feigning illness when there is a clear motive—usually to economic gain, or to avoid legal trouble.
Causes. One longstanding theory about the cause of Somatoform disorders suggests that it is a way of avoiding psychological distress. Rather than experiencing depression or anxiety, some individuals will develop physical symptoms. According to this model, their preoccupation with the body allows them avoid the stigma of a mental health/psychiatric disorder. They end up getting the care and nurturing they need from doctors and other people in their lives who are responsive to their physical illnesses.

Treatment. Cognitive-behavioral therapy (CBT) is considered an effective treatment for Somatoform disorders, focusing on changing negative patterns of thoughts, feelings, and behavior that contribute to somatic symptoms. The cognitive component of the treatment focuses on helping patients identify dysfunctional thinking about physical sensations. With practice, patients learn to recognize catastrophic thinking and develop more rational explanations for their feelings. The behavioral component aims to increase activity and self-care. Many of these patients have reduced their activity levels as a result of discomfort or out of fear that activity will worsen their symptoms. Patients are instructed to increase activity gradually while avoiding overexertion that could reinforce fears. Other important types of treatment include relaxation training, sleep hygiene, and communication skills training. Preliminary findings suggest that CBT may help reduce distress and discomfort associated with somatic symptoms; however, it has not yet been systematically compared with other forms of therapy.

Resources
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th edition, text revised. Washington, DC: American Psychiatric Association,2000.

Phillips, Katherine A. The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder. New York: Oxford University Press, 1996.
Pilowsky, Issy. Abnormal Illness Behavior. Chichester, UK: John Wiley and Sons, 1997.

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