Stephanie Livingston–Psychologist

Archive for January, 2013

High Blood Pressure–Are you working yourself to death?

by on Jan.19, 2013, under ARTICLES


Hypertension is a chronic medical condition that is characterized by an elevation in arterial blood pressure. Blood pressure is measured by systolic (top number) when the heart muscle is contracting or diastolic (bottom number) when the heart muscle is relaxed between heart beats. A reading of 120/80 is typically thought of as normal blood pressure, but can range between 100-140mmHg systolic, over 60-90mmHg diastolic. If a person’s reading is consistently at or greater than 140/90 hypertension exists. Most people have primary or also known as essential hypertension, with no underlying medical cause. Less than 10% of the population have secondary hypertension, which is caused by some other medical condition. Essential hypertension, can be the result of many factors such as age, weight, eating and exercise habits, genetic predisposition, and stress. Stress can influence blood pressure because the chemicals that are released during the stress/fight or flight response results in a constriction of the blood vessels, which raises blood pressure. Over time, the daily hassles of life can add up and cause prolonged elevations in blood pressure, which can result in hypertension and many other associated medical problems, such as stroke and kidney failure.
My dissertation research at The University of Chicago Hospitals revealed some interesting things with respect to hypertension and psychosocial factors in black women. Specifically I looked at a concept proposed by Sherman James called, John Henryism, an active coping mechanism used to deal with exposure to prolonged stressors, such as social discrimination. As the legend goes, John Henry was a slave, who could reportedly out- perform the mechanical steam drill, but at the expense of dying from over exertion. James, an epidemiologist, during his data collection for his research, interviewed a man named John Henry Martin, who had characteristics similar to the legendary John Henry. John Henry Martin was a black man who freed himself from the sharecropper system to successfully farm 75 acres of his own land through hard work and determination by age 40, but at the cost of serious health problems by age 50, including hypertension, arthritis, and peptic ulcer. James developed the John Henryism Scale to measure the degree to which a person relies on hard work and determination to achieve their goals. My research findings using female subjects were consistent with James’ research with males, which revealed that those women who scored high on John Henryism tended to have higher blood pressures than those who scored lower.
I have learned over the years as a psychologist that sometimes trying too hard can be detrimental in the long run. For instance, relaxation techniques, which are meant to calm the body and mind and counteract the effects of stress, require a person to give up control. Trying too hard to relax, like trying too hard to go to sleep just doesn’t work. It is not until the person gives up control that sleep comes. Pushing too hard can elicit a stress response which counteracts the relaxation response. There are times when taking control in an active way is beneficial, like when trying to complete a task or playing a sport. It is important to know the difference when you need to take control or give up control.
Many studies have shown the benefits of relaxation techniques (e.g., biofeedback, meditation, diaphragmatic breathing, imagery) in reducing blood pressure. I have used a self-regulation strategy called heart rate variability (HRV), which involves using computer software that is able to measure a person’s heart rate (HR) and HRV—what happens between heart beats. This activity occurring between heartbeats can be affected by negative emotions such as anxiety, stress, anger, and frustration. A clip is attached to the individual’s ear lobe, where the HR and HRV are transmitted through a wire into the computer and the software transforms this information into a graphic that gives feedback as to the level of these physical activities. The trainee uses breathing and imagery techniques to learn to control their HR and HRV. Oftentimes imagery techniques involve thinking of something relaxing and your body responds by becoming more relaxed. In the case of HRV training, the trainee is taught to think of images of love and appreciation, because studies show that it tends to have a more positive effect. My patients who have used these techniques have been very encouraged in learning to control their blood pressure.
At our clinic, BioSynergy, this process involves taking the blood pressure first to get a baseline. Next, the trainee goes through a round of HRV, and then takes their blood pressure again. A training session of HRV involves playing games on the computer where the trainee is able to achieve a goal, like having images on the screen do certain things like having a rainbow go into a pot and fill up with coins or keeping a balloon afloat, as a result of making the HRV go up or down. The goal is to obtain coherence, meaning a smooth HRV pattern. High coherence guarantees success in playing the games. As mentioned previously negative emotions can have an adverse impact on coherence, making the HRV patterns more erratic. Low coherence can result in a stress response being elicited and all the things that go along with this response, such as release of stress hormones, which can in turn increase HR, HRV and a host of other physiological responses.
Most people are not aware that the heart has a brain of its own that sends signals to the rest of the body, just like the brain in your head sends messages down to the body. Therefore, by controlling the heart, one can learn to control other systems in the body voluntarily. You can try this for yourself at home, by taking your pulse or blood pressure, try thinking of something relaxing or a situation where you felt loved or appreciated for ten minutes, and take your measurements again and see if there is a difference. Keep in mind that you are doing this without the benefit of technology. Imagine what you could do, if you had a little help. The mind is a powerful tool, the body is a highly efficient machine, and computers are intelligent devices. Learning to control the interaction of these three entities, create a dynamic force that can take your mind and body to new levels.
These techniques are not meant to be used in replacement of medication or other medical advice. Consult your doctor before considering using these strategies to manage your blood pressure. DO NOT STOP TAKING YOUR MEDICATION WITHOUT YOUR DOCTORS CONSENT. Contact us today for an appointment. We have offices in Illinois and Indiana and take most insurances.

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Stereotype Threat

by on Jan.19, 2013, under performance anxiety treatment

Stereotype Threat—does being a minority affect your performance

Have you ever been the only girl in a math class of all boys and felt intimidated; or a black student in a predominately white college or university, or a white male competing in a basketball camp of mostly black males? If you have felt intimidated in any of these situations, you may have been a victim of “stereotype threat”, A concept developed by Claude Steele, a social psychologist at Stanford University. He found that stereotype threat, feeling pressure to perform in a given situation because you feel that you have been type cast, negatively affects performance. The girl in a math class of mostly boys may have learned to believe over the years that boys are better than girls in math. Or the black student may have internalized the belief that whites are smarter or are at least preoccupied with the idea that white students may view them in that way. And the white basketball player, like the movie title “White Men Can’t Jump” may feel intimidated by black basketball players who tend to dominate in this sport. In Steele’s ongoing research, he found that the individual who may be a victim of stereotype threat may not even be consciously aware that they are experiencing it. The problem with stereotyping in this case, is that it tends to have a negative effect on performance. The part of the brain needed to perform the task at hand, whether it is doing well on a math test or shooting a basketball gets drained by the focus on the effects of the stereotype; thereby hindering performance. You can imagine how stereotype threat can be manifested in everyday life in most areas such as business, education, sports and entertainment, and health.
What is the solution to stereotype threat, you might ask. Something as simple as writing a narrative about one’s values and why one hold’s these values prior to going into the stereotype situation, like taking a test, can improve performance significantly. Or, reminding yourself of your accomplishments or credentials prior to your performance, can also be helpful. Steele found that black students who had to check the race box prior to taking a test was enough to trigger stereotype threat. However, when students were allowed to do the narrative exercise before the test, they were able to counteract the effects of stereotype threat.
At our clinic, we help people counteract the effects of stereotype threat by: evaluating the individual to determine if they are experiencing stereotype threat and the type of stereotype threat. Different types of threat require different approaches. We will also rule out any mental disorders that may play a role (e.g., stress, anxiety disorders, depression) in underperformance. Subjective and objective measures, (eg, clinical interview, testing, stereotype threat scales, physiological measures) both pre and post treatment will be used. The goal is to Devise an individualized program to address the specific needs of each client.
Treatment protocols include a combination of (behavioral skills training, relaxation techniques, mental skills techniques, cognitive-behavioral therapy, biofeedback). The goal is to generalize these strategies to improve performance by applying these strategies to real world settings.
Contact us today for an appointment, if you want to improve your performance in work, school, health, business, sports, or entertainment. We have locations in Illinois and Indiana.
Taken from, Whistling Vivaldi, (Steele, PhD, Claude, 2010, W.W. Norton & Co, Inc.)

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