Friday, December 11, 2015


While growing up, we are all taught about how others believe the mind works and how we are supposed to cope with emotions. Sometimes the rules are stated explicitly (“Don’t be afraid” or “Stop crying!” communicates that it is expected that you should not feel afraid or cry.). Sometimes the rules are communicated less directly (People might avoid you when you are crying or may laugh at you if you are afraid. These less direct ways of communication still let you know that it’s not okay to cry or be afraid.) We are taught that we should be able to control our thoughts, feelings, and emotions.
In American culture, public expression of many if not most emotions are negatively judged by others. This to a great degree reflects the influence of many immigrants from northern Europe, such as Great Britain (“the stiff upper lip”), Germany, and Scandinavia, where emotional expression is very reserved. Public expression of sadness or fear (or any strong, unpleasant emotion) is often to be considered a sign of weakness and/or mental instability. Public disapproval of emotional display may be direct (e.g., criticism) or indirect (e.g., shunning). However, in other cultures (e.g., southern European cultures) open expression of emotion is viewed as much more socially acceptable, if not celebrated.
However, in actuality many of our thoughts, particularly the automatic thoughts, are generated by a part of our brain over which we have no conscious control. All of our emotions are generated by a part of our brain over which we have no conscious control. The seat of emotions is centered in a part of the brain called the amygdala. However, the source of emotion is likely a lot more complicated and centered throughout perhaps many parts of the brain.
Also, another important “rule” of the brain is that the more a person tries to not feel a feeling or think a thought, the more the brain produces that feeling or thought. Have you ever tried to forget something? If you try to forget a word or an idea, the harder you try, actually the better you remember the word or idea. And the same with emotion. The harder you try not to feel an emotion, the more the brain pushes back and produces more of the emotion.
The primary purpose of the brain is to promote survival. Likewise, emotions and thoughts exist for the primary purpose of promoting survival. Emotions are often seen as something mystical or even almost magical and hard to understand. Really what emotions are, is pretty straightforward--a means of nonverbal communication. They tell us something about what our brain sees and the relationship the brain perceives between itself and someone or something in the environment. Each emotion communicates a different message that could be useful for survival. The two most basic emotions are closely tied to the most basic survival mechanism—the fight or flight instinct (which is noted further below).
Emotions are a natural product of the brain and the survival mechanisms that exist—not only in humans, but in fact in just about all living creatures. As we have discovered most animals experience emotion and there is even evidence that animals experience empathy—the ability to perceive and feel what other animals feel. Emotions are a part of being alive.
However, most of us were raised to believe that some emotions were “good.” These “good” emotions (e.g., happiness, love, joy, surprise) are almost always pleasant ones, which individuals are encouraged to pursue. Other emotions are labeled “bad”. These “bad” emotions (e.g., anger, fear, sadness) are almost always unpleasant ones, which individuals are encouraged to avoid or minimize.
However, it’s most helpful to view emotions as neither good or bad. Emotions are just what they are. Learning to accept emotions without a moral judgment helps one deal more effectively with them. Not judging emotions as morally good or bad also helps one refrain from not trying to avoid the emotions. As noted previously, when we try to avoid or control the emotions, the brain tends to generate more of that emotion and at a high intensity.
So what messages do emotions communicate? Below is a table of some of the most commonly troublesome and unpleasant emotions with which people struggle. (Pleasant emotions also convey messages, but are typically not the focus or cause of problems.)
The brain sends the message that:
Something is perceived as a threat or a danger to physical well-being and that the person needs to prepare to fight for survival.
Something is perceived as a threat or a danger to physical well-being and that the person needs to prepare to flee for survival.
Something or something important for survival has been or will be lost.
The person has done something wrong (or thinking about doing something that is wrong) and that punishment is a likely consequence for the transgression.
The person has done something wrong (or thinking about doing something that is wrong) and that punishment (i.e. disapproval by others) is a likely consequence for the transgression.
An important relationship is in jeopardy of being lost (affection lost to another).
Something needed for survival is not being received or available.
There is a lack of meaningful connection to others.
There is a vague or ambiguous (unspecified) sense of danger or threat.
The person is facing something that poses a threat to health (e.g., infection or contamination).
Someone else has a possession or material goods that one desires or needs for survival.
There is a lack of compatibility to others who are around (i.e., the person does not fit in with a particular or any available social group).

Thursday, June 28, 2012

The Fraud of Chronic Pain by Dr. Kachmann

From Amazon:
Rudy Kachmann, M.D is the founder of the Kachmann Mind Body Institute in Fort Wayne, Indiana, and has practiced neurosurgery for over 40 years. Dr. Kachmann received his medical training from Georgetown University where he was Chief Resident of Neurosurgery, and Indiana University where he received his B.S. and M.D.

Years of experience in medicine has shown Dr. Rudy Kachmann convincing evidence of the many health benefits on nurturing the connection between the mind, body and spirit. Dr. Rudy Kachmann is passionate in teaching how to eliminate unnecessary medical procedures, reducing the use of medications, and reducing health care and insurance costs.
  I would highly recommend his book, which can be purchased through

The Fraud of Chronic Pain

Monday, April 16, 2012

How to be your partner's best girlfriend

Over the years in my everyday practice with many men and women, I noticed a recurring theme entailing conflict between the two persons in the relationship.  I have observed that oftentimes, one or sometimes both persons (sometimes the man or the woman) take on a role in the relationship where they are the "protector" or the "fixer."  The protector from my experience is the one who feels a need to protect the other person from things that are thought to be perhaps unpleasant or upsetting to that person.  The fixer is the person who feels responsible for resolving the problems--theirs and those of their partner. I had originally likened the protector-fixer as the "White Knight" rescuing the "Damsel in Distress," but I have found that the White Knight role and the Damsel in Distress role to be filled by both men and women. Because of the limitations and the gender stereotypes associated with "Knights" and "Damsels," I've changed my description to being that of a protector-fixer. While possibly more men are raised to assume the protector-fixer role, many women also assume this role in their relationships.

A protector-fixer assumes that the other partner needs protection and therefore takes steps the other from things (information, feelings, or circumstances).  However, as I have repeatedly observed, this very frequently leads to conflicts in the relationship and involves at least several faulty assumptions:
  1.  Something needs to be fixed for the other person.
  2. The other person is incapable of fixing it for him or herself.
  3. All problems can be fixed.
 As I continue to write about the inherent problems when someone assumes the role of the protector, it will be clear how this so often is not workable in a healthy, mature relationship between two capable adults. These assumptions inherently will lead to conflict in the relationship nearly all the time. 

As a healthier, more workable role in a relationship, I have been working with my patients on considering being their partner's "Best Girlfriend."  Why?  A best girlfriend makes a different set of assumptions and takes on a different role in a relationship:
  1. Listen--not fix.
  2. Accept and validate--not judge.
  3. Empower--not rescue, protect, or fix.

Wednesday, March 2, 2011

What is "the human mind"?

As a psychologist, I have been studying and working with "the human mind" for years, yet through most of my study, the concept of what the mind is has not been directly addressed. I believe that most psychologists would agree that the human mind is very complex and at times very difficult to understand.

Humans have been struggling to understand and describe the human mind for thousands of years and yet only in about the last one hundred of years or so have we been scientifically trying to examine what the mind is and what it can do. While we have made many advances through neuroscience, psychology, and other related fields, there is still so much that we do not understand.

But what is the mind?

Is it our conscious awareness? If so, what about the parts of our cognitive life of which we are unaware?

Can we reduce the human mind to the physical existence of the brain? Or is there something more to our mind that include concepts such as the soul or spirit?

Far be it from me to be even able to answer any of these questions conclusively. I simply do not know for certain. Though, I do have some ideas, though, that help me in how I work with my own mind and the minds of my patients, who are suffering.

For the purposes of my writing here, I am going to define "the human mind" as the totality of our awareness, cognitive activity like thoughts (both in and outside of our awareness), and emotions (both in and outside of our awareness). This is a pretty broad definition, but it helps us get started in thinking about how our minds operate and what makes up "the human mind".

While our minds are always at work, we are often unaware of what are minds are doing. I'll write more another time about self-awareness and something others have called "Mindfulness."

Friday, January 28, 2011

Over-diagnosis of Bipolar Disorder: Why is it a problem?

It has struck me over the past few years that more and more individuals were being diagnosed, mainly by psychiatrists, as suffering from Bipolar Disorder. I haven’t seen any published surveys to support this observation, but other psychologists have also reported seeing the rise in how frequently this diagnosis is made. I have had more than a few occasions where patients have been, in my professional opinion, diagnosed with Bipolar Disorder, whey I believed that they instead suffered from other disorders, such as Major Depression, Borderline Personality Disorder, Post-traumatic Stress Disorder, or Obsessive-Compulsive Disorder. So what’s all the fuss about—it’s just a label, right?

Labels have consequences. Let me point out a few that you might want to consider:

1. Bipolar Disorder is a Major Mental Illness and is seen as truly a physical disease process in the brain. There has been very strong evidence published for at least over the past 20 years that it is strongly influenced by genetics—that is to say that you likely inherit the disorder or at least a tendency to develop the disorder. Studies have shown that if one parent has Bipolar Disorder, children from this parent may have about a 20% chance of also having the disorder. If there is a strong family history of Bipolar Disorder, that is to say if several blood relatives also have Bipolar Disorder, the chance for a child to have the disorder skyrockets. If the parent and several blood relatives have the disorder, the chance for a child to have the disorder may be near 70%. This raises some concern for parents who are considering having children and whether parents want to risk creating a child that has a high risk of a serious mental illness that is not curable and may cause severe disability in life. Now, with increased frequency of this disorder being made, sometimes inappropriately in my opinion, parents who are faced with a possible dilemma that is not actually present.

2. Bipolar Disorder is treated with several different powerful classes of drugs, including anti-seizure medications and anti-psychotic medications. Many of these medications are relatively new to the market, and as such, they are extremely expensive. Also, it is not uncommon for psychiatrists to prescribe more than one of these medications to a “bipolar” patient at the same time. The prices were derived from the website on 01/28/2011. See the example below:

LAMICTAL XR (brand) 100 MG TER (30 tab) $309.99
Trileptal (brand) 300mg (60 tab) $235.99
Seroquel XR (brand) 600 MG (60 tab) $617.00
Risperidone (generic) 3 mg (60 tab) $299.99
Risperdal (brand) 3 mg (60 tab) $756.00 (estimated from price of 30)
Zyprexa Zydis (brand) 10 mg (30 tab) $529.99
Invega 6 mg (100 tab) $1,372.99
Geodon 60 mg (60 tab) $574.97

Cheaper medications such as Lithium (which is cheaper) are still sometimes used, but not as frequently now as these newer classes of drugs.
Now while some individuals without the diagnosis of Bipolar Disorder may be prescribed the anti-psychotic and anti-seizure medications, many more are treated effectively with simply an anti-depressant medication.

Now also consider the cost of prescription anti-depressants:
Sertraline (generic) 100 mg (30 tabs) $15.99
Zoloft (Brand) 100 mg (30 tabs) $131.99
Fluoxetine (Generic) 40 mg (30 tabs) $40.99
Prozac (Brand) 40 mg (30 tabs) $398.49
Lexapro (Brand) 20mg (30 tabs) $109.99
Celexa (Brand) 20 mg (30 tabs) $120.49
Citalopram (generic) 20 mg (30 tabs) $39.99
Pristiq (brand) 50mg (30 tabs) $141.99

Also remember that Bipolar Disorder is a life-long condition that necessitates medication (most of the time) for a life-time. Many other disorders may require long-term medication, but not necessarily for the rest of a patient’s lifetime.

3. Labels have consequences: while any psychiatric diagnosis carries a stigma, some of which may be more stigmatized than Bipolar Disorder, applying the incorrect diagnosis might mean that the person faces discrimination based on that diagnosis that they might not otherwise face.

4. Finally, when a misdiagnosis of Bipolar disorder is made, the accurate diagnosis may be missed and specific treatments, such as psychotherapy, may be not considered, when they are very effective. Treatment may be focused on simply maintaining the patient and controlling symptoms (that is to say with ongoing medication), rather the ameliorating the mental health problem (helping the person function more effectively with or without medication).

Sunday, September 20, 2009


I think that most people have a personal sense of what I mean when I say "suffering." We all have experienced pain, discomfort, and distress at times as we have gone through life's many experiences. And our natural reaction, as living beings, is to avoid suffering. We spend much of the time and energy in our lives to avoid discomfort, yet most of the time we find that our suffering continues and often becomes more intense as we progress through life.

Is suffering unavoidable? Can we live life without suffering? I believe that suffering is necessary in life and actually necessary for life. Without suffering, life would not last long. Now I understand that this may sound a bit crazy.

Consider how we would live a life without any pain or discomfort. When we needed food or drink, we would not experience the discomfort of hunger or thirst. When we stepped on a nail or broke a bone, we would not even necessarily recognize our injury or seek medical care. When someone that we love had died, we would feel no loss or experience grief--all we might feel is indifference at most, if that is even a "feeling."

As you probably can see, life without pain or discomfort would threaten our survival and make life an extremely dull and uneventful experience. We would remain unmotivated to do much of anything.

Suffering, that is to say discomfort, pain and distress, is an important motivator in everyone's life. It helps us want to change. And when we react to suffering in adaptive ways, our lives can actually be improved. On the flip side, when we react to suffering in maladaptive ways, our lifes can be more difficult, and our suffering can and often does become more difficult and intense. Ironically, the most instinctive response to suffering, avoidance, can actually lead to more intense suffering in the long run.

The choices we make in how to respond to our suffering is the key factor here. Learning how to respond to suffering in healthy ways is key to surviving, growing, and thriving!

Monday, July 20, 2009


"What disturbs a person is not the situation, but the view the person takes of the situation."

This is not my conclusion, but my take of a conclusion drawn by the Greek, stoic philosopher, Epictetus, who lived nearly 2,000 years ago. Despite the millenia have passed, his wisdom appears to apply aptly to the decisions that people make in their everyday lives. Yet, many individuals have convinced themselves that they are indeed disturbed by situations and that they have few, if any choices, in how they deal with situations.

I have found through the years that many people believe that they have little to no choice in many matters of life. However, in reality, we almost always have more choices than we believe and oftentimes we have choices available that we have never considered.

One common situation is that we sometimes tell ourselves that we have no choice in a decision or situation because we have no options, or perhaps only one, which which we like or feel comfortable. However, the truth is we almost always have other options available, but have discounted them because of their undesirable consequences.

So what's the big deal about feeling we have no choice in a situation? When we view situations or circumstances as forced, we oftentimes will feel trapped, frightened, angry, resentful, or out of control of our life situation. By simply realizing that we have choices in every circumstance, we can oftentimes feel much less anxious, sad, angry, or frustrated. This is accomplished not by changing the situation, but by only changing our perspective of the situation.

The simply stated, though not always as simply executed idea, first proposed by Epictetus, is the foundation for many approaches psychologists use in helping people who get stuck in uncomfortable or troubling life situations. Understanding and applying this idea can provide realization of the choices and an improved sense of control and freedom.

Please feel free to send me comments or questions on this or any of my other blog postings.

---R. Timbrook, Ph.D.