Vicarious Trauma

 

Vicarious Trauma

Ed Geraty LCSW-C

INSITEintegrative.com

 

The darkest parts of reality continue to unfold with wars and disasters — millions face pain, suffering, separation, fear, loss, hunger, thirst, disease, and desperation. It’s beyond devastating.

Bearing witness to these experiences is nothing like being on the ground, but can be unrelenting in its own right. And, never has there been so much coverage of terror and horror on social media. The pictures. The details. The heinous acts. The constant exposure. The accompanying slurs.

It can evoke deep sadness, significant stress, and vicarious trauma that is far-reaching and potentially long-lasting.

What is vicarious trauma?

Events can negatively affect people a world away from the scene, especially when this involves witnessing fear, pain, grief, and terror that others have experienced. This is the “cost of caring”:  We empathize with victims and this can cause us to  “feel their pain.” We may also feel directly threatened, especially when we relate in some way to those most impacted—“this could be me” or “this will be me.” 

We feel helpless to do anything.

Our attitudes and worldviews shift after exposure to distressing images of these events. This is vicarious trauma—the psychological impact of second-hand exposure to traumatic events. If left unrecognized and, in some cases, untreated, it can lead to depression, anxiety, PTSD, social withdrawal, substance abuse, or suicidal thoughts.

Prevalence varies because of variation in how vicarious trauma is measured and where it’s been studied. But, perhaps most importantly, the extent of suffering depends on the dose of exposure and socio-demographic predisposing factors.

Dose: Media exposure matters

Widespread media coverage of war, and particularly terrorism, has harmful effects on mental and physical health. And the more you interact with social media and television, the worse its impact. We’ve seen this over and over in the literature from other events:  In a 2014 Israeli study, the higher the media exposure during terror attacks, the higher the distress and post-traumatic stress symptoms levels. After 9/11, those who watched 4+ hours of TV coverage daily were more likely to experience acute stress. After 9/11, frequent early exposure to 9/11-related television predicted posttraumatic stress symptoms and physical health problems two to three years later.

After the Boston Marathon bombings, repeated bombing-related media was associated with higher stress than direct exposure. Acute stress steadily increased with additional hours of media exposure.

Unfortunately, most research has focused on television exposure.. Of course, the information landscape has changed. Social media is not unfiltered, mis/disinformation is rampant, and exposure can be unexpected (for example, encountering gruesome photos while scrolling through feeds of pets).

 

Some recent studies have tried to fill the space. One simulation study found community PTSD prevalence almost doubled after social media video sharing of a terror attack compared to television.

Socio-demographic predictors

Everyone can experience vicarious trauma, but certain socio-demographic groups are  at higher risk: Shared social identity with victims. For example, a study on the Pulse nightclub terror attack, which occurred on Latin night, found Hispanics and LGBTQ individuals were more likely to develop acute stress through media exposure than other demographics.

. Pre-event traumatic exposure and/or traumatic loss. Your experience before an event significantly impacts how you experience a current event. One study found direct exposure to 9/11 or Sandy Hook was more likely to cause acute stress after the Boston Marathon bombing.

What can we do?

Of course, social media use can be a positive force too, like increasing social connectedness. One study found that social media was protective against vicarious trauma when the content was focused on heroic acts and viewing information about the conflict itself (rather than the suffering).  There are a number of things we can do to reduce vicarious trauma while remaining up-to-date on news:

Turn off auto-play videos on social media.

Walk away from social media after a time. Put on a timer.

Pay attention to how you’re feelings. If you’re feeling overwhelmed, do activities that make you feel calm or relaxed.

Seek social support. Being around other people who care about you is one of the best ways to reduce stress.

Talk to someone you trust. This can be a family member, a friend, clergy, or a therapist.

Find ways to feel useful. This can include donating to causes that help address the needs of those suffering or even just reaching out to a neighbor or friend who is struggling.

If you have children, monitor what they’re seeing or hearing. As overwhelming as the media exposure is for adults, it can be even more confusing and stressful for kids. The National Child Traumatic Stress Network is a helpful resource for discussing war with kids.

Bottom line

Being witness to terrorist attacks and war can set off a cascade of collective trauma that results in physical, mental, and emotional impairment for thousands; far more extensive and for far longer than we may think. If you’re hurting, overwhelmed, and exhausted, you’re not alone.

 

Info gathered from ptsduk.org

Limerence vs Love

 

Limerence vs Love

Ed Geraty LCSW-C

INSITEintegrative.com

What is Limerence?

Limerence means having an intense longing for another person even when they don’t fully reciprocate. The limerent person struggles to think about anything else but their “crush” and neglects their social life, work, and other responsibilities as a result.

The term was first coined by psychologist Dorothy Tenov in the 1970s when she conducted a series of interviews and noticed some people’s experiences of love were particularly intense. She found that this intense feeling can affect anybody regardless of gender, age, culture, background, or any other trait.

Because it can cause such significant problems in someone’s life, the interest in finding a way to treat limerence is growing among researchers and psychologists. But to find ways to overcome it, we first have to understand what it is and how it develops. Therefore, this article will discuss:

The symptoms of limerence

The difference between love and limerence

Phases or stages of limerence

Causes of limerence

How to overcome limerence

The Symptoms of Limerence

Limerence describes the experience of having an uncontrollable desire for someone – an obsession that consumes the limerent person’s thoughts, feelings, and behaviors. It usually involves two people: the person who desires the other (the limerent) and the desired person (the limerence object or LO).

Essentially, limerance is  a state of being stuck between uncertainty and hope: will they or won’t they return the sentiment? For instance, perhaps this person hasn’t rejected them entirely, but they haven’t confessed their love either.

This state of irresolution causes the limerent to become preoccupied with the LO, closely analyzing their behavior and body language to look for signs of reciprocation. They may also ruminate about past encounters with the LO and fantasize about what might happen between them in the future. The key feature of limerence is that these thoughts and yearnings are uncontrollable and all-consuming.

Other symptoms and characteristics of limerence:

Consistent and intrusive thoughts about the LO

Idealization of the LO e.g. “they are perfect.”

Constantly being reminded of the LO by places, people, objects, and situations

Intense fear of being rejected by the LO

Fluctuations of mood depending on whether the LO seems to reciprocate feelings or not e.g. feeling happy when they call and devastated when they don’t

Overwhelming emotions ranging from euphoria to distress and guilt

Being awkward, shy, and clumsy around LO

Spending excessive amounts of time grooming or beautifying yourself to impress the LO

Another focal aspect of limerance is that these symptoms or feelings are experienced for one person. Furthermore, this obsession significantly imapcts other areas of life, such as work, social life, and hobbies.

What Are the Positive and Negative Effects of Limerence?

Although limerence can be problematic, there are some positive aspects. The intense emotional high associated with limerance, like experiencing joy, elation, and excitement, can be good initially. Moreover, to impress their LO, the limerent may invest a lot of time in self-improvement, such as their physical appearance and social skills. They may also explore new hobbies and interests if these could bring them closer to their LO.

Yet the emotional high comes with an inevitable low, so, if the LO does not reciprocate, the limerent experiences extreme uncertainty, anxiety, and depression. This despair can also lead to being unable to eat or sleep, feelings of hopelessness, and potentially even suicidal thoughts or intentions.

Limerance can also be problematic because it stops the limerent person from living their life to its fullest as they may withdraw socially. Furthermore, antisocial behavior like stalking and violence have also been associated with limerence (but please note that not every limerent person is a stalker or violent).

Limerence vs Love: What’s the Difference?

Fundamental to understanding limerence is recognizing that limerence and love are different. Love is a feeling of attachment and wanting to commit to another person. It’s a chemical reaction in the brain and body that makes us want to unite with someone – emotionally and physically.  Love is selfless and involves true concern for the well-being and feelings of others; wanting the other to be happy regardless of whether they are with us or not and respecting their wants, feelings, and wishes.

In contrast, limerence is an unhealthy, obsessional mixture of emotions. On the surface, it may look like love, and we may have come to liken it to love because limerent behavior is often featured in movies and love songs. But limerant behaviours typically only serve the limerent’s own needs and come from a place of anxiety, rather than wanting the best for the other person. 

What’s more, limerance puts an expectation on the other through the belief that these feelings should be reciprocated. As a result of this expectation, the limerent often becomes jealous of any other relationships the LO might have. If they are rejected, they might become angry and vengeful, disrespecting the wishes and needs of the other person. Therefore, limerance can be harmful to both people involved and is filled with anxiety, uncertainty, and discomfort. Although the limerent experiences emotional highs, this is dependent on the LO’s reciprocation and therefore isn’t sustainable

The Phases of Limerence

Limerence moves through different phases or stages. It’s characterized by the limerent person hoping to find someone to love, becoming infatuated with them, and fluctuating between hope for reciprocation and fear of being rejected. According to Dorothy Tenov, there are five stages of limerence, which are described in more detail below:

Pre-Limerence

During this phase, the limerent individual doesn’t have a particular love interest but longs to fall in love and be loved in return. If, during their search, another person seems to be showing signs of reciprocation, they become their object of limerence (LO). Typically, a limerent person doesn’t choose their partners carefully but instead seeks anyone who will love them completely and passionately.

Pre-Reciprocity

Pre-Reciprocity is the phase wherein the limerent develops a strong desire for another person, the LO. Although the attraction might be physical initially, limerence isn’t actually about sex alone; it’s the desire for more than sex. For limerence to happen, the limerent must perceive the other (LO) to have some kind of interest in them but without clear reciprocation.

Without a clear return of interest, the limerent looks for any signs that the other person likes them. If they perceive a sign, they experience joy and excitement, which increases their longing for that person. But continued uncertainty creates an intense fear of rejection and self-doubt creeps in – “do they like me or not?”

Reciprocity

If the other person entirely rejects the limerent, this is usually the end of that limerent episode – although the rejection can be emotionally devastating to the limerent. If the LO reciprocates the limerent’s feelings, a passionate and obsessive love tends to unfold between both. As the relationship progresses, limerence either becomes less intense because the uncertainty has naturally decreased (as a result of commitment). Or limerence persists throughout the relationship if the uncertainty about commitment and love continues.

Gradual Dissolution

In most cases, limerence naturally reduces and eventually ceases to exist. This can be difficult for both people involved as they may question why the intensity of their love has vanished. They might yearn for things to go back to the way they were, or fear that the other person no longer loves them. Dissolution can lead to arguments, blame, and even the breaking up of the relationship. On the other hand, if both individuals realize that limerence was a natural phase in their relationship, there is space for the couple to transition to a healthier type of love.

Post-Limerence

After limerence, some relationships can become strong and healthy with open communication and collaboration. However, as mentioned, the loss of limerence can be devastating for many and can lead to the couple breaking up. In many cases, the limerent person then returns to the pre-limerence stage and yearns to fall in love and be loved by another person.

 

 

What Causes Limerence?

Limerence is still a relatively unexplored concept, but research suggests that it stems from a mixture of personality traits, biological predispositions, and attachment styles.

Some psychologists believe that we’re all born with an innate drive towards limerence. Possible evidence for this comes from teenagers. For instance, young adults often experience relationships that are characteristic of limerence – obsessional infatuation with extreme mood swings depending on the behavior of the other person. They may also often experience rejection or the end of a relationship as heart-shattering and as though their entire world has come to an end.

However, while many people will remember this kind of love from their teens and/or adult years, others have never experienced limerence. This may be because a particular gene becomes active only under certain environmental conditions, which then gives rise to a tendency for limerence. One such environmental condition can be the person’s upbringing and the relationship they have with their caregivers – their attachment style.

Attachment Style and Limerence

Insecure attachment, specifically anxious attachment, shares many similarities with limerence. Anxious attachment results from inconsistent caregiving during childhood, which gives the child (and later the adult) an unbalanced sense of security in relationships.

In relationships, someone with an anxious attachment style experiences preoccupation with the relationship and their partner, is emotionally dependent, and has low self-esteem. They base their self-esteem on the approval and acceptance of others, which creates a strong fear of rejection and failure to please their partner. This is very similar to the profile of limerence and, thus, in many cases, it’s likely that limerence stems from an anxious attachment style.

In this view, limerence is not caused by the LO (because they’re particularly desirable or their “soulmate”) but rather it’s the result of certain needs not being met during childhood.

Is Limerence a Mental Disorder?

Limerence is a distinctive state of mind, but it has been compared to obsessive-compulsive disorder (OCD) and substance use disorder (SUD or addiction). For the most part, due to how all of these conditions share the characteristics of compulsion, obsession, and lack of control. Although their causes are not entirely clear, these conditions are often a result of trauma, stress, and difficulties in childhood, combined with certain predispositions and environments.

As with OCD, limerence is experienced with an undercurrent of anxiety (in this case, anxiety about rejection). It also features obsessive and intrusive thoughts, which the limerent might try to reduce through certain behaviors, for example, repeating words in their head, counting, or arranging things. Lastly, as with OCD, the obsession takes over their life and becomes all-consuming.

Limerence and addiction are similar in that, although the person might know their behavior is harmful, they continue to do it. That’s because they both trigger a strong physiological response: a rush of feel-good chemicals. Like a substance user, a limerent builds up a tolerance and needs more and more emotional reciprocation from the LO to feel happy. They spend their time thinking and obsessing about the other person and experience their desire as uncontrollable. As with addiction, limerence causes the person distress and impacts their ability to function normally.

However, limerence isn’t addiction or OCD – it’s a unique condition that shares similarities with certain disorders. Although some psychologists and researchers believe severe cases of limerence could be considered a mental disorder, it’s currently not considered to be one. Nevertheless, similar to OCD and addiction, limerence may develop as a result of trauma, insecure attachment, and stressful life events.

How to Overcome Limerence

Limerence can range from severe to mild. So, the extent to which it’s affecting your ability to live your life will determine how best to intervene. If you’re struggling at work, with other relationships, have lost friends, been estranged from family, or become socially isolated, it might be helpful to seek the support of a therapist or psychologist.

Remember that limerence isn’t about the other person (the LO); it’s a symptom of a deeper psychological yearning or wound within you. This might be your first time being in a state of limerence, or perhaps it happens to you frequently, but regardless, it’s important to be introspective to find out what’s going on. The first important step is to get into the right frame of mind and commit to the process of healing. Approach it from a place of compassion and understanding with the aim of finding solutions, rather than dwelling on the problem. Here is some advice for overcoming limerence.

Practice Self-awareness/Mindfulness

Noticing our patterns of thoughts and behaviors is the first step toward positive change. When we’re aware of what’s happening within us, we can learn what our triggers are and intervene more effectively.

If you notice intrusive and obsessive thoughts about a person, observe them with interest – as though they’re someone else’s thoughts. Be curious about the content of your thoughts; try not to judge yourself but rather find understanding and acceptance. When you’re self-aware in this way, it’s easier to eventually let go of these thoughts and behaviors and replace them with more helpful ones.

Work on Attachment Insecurities

As mentioned above, limerence and attachment anxiety seem to be closely related – in fact, limerence may be a result of an anxious attachment style. So it might be helpful to find out what your attachment style is, how it affects you and your relationships, and how to develop a more secure attachment style.

Try Cognitive Restructuring

Cognitive restructuring refers to transforming your unhelpful thoughts, beliefs, and traits into constructive, healthy ones. Limerence comes from having certain unhelpful beliefs, like believing you need another person to feel happy and complete. Sometimes these beliefs can be subconscious so it takes a bit of work to uncover them. Once you’ve identified them, it’ll be easier to replace them with more helpful beliefs about yourself. This is best done with a trained professional, such as a cognitive-behavioral therapist, but you can also try a few things yourself, for example:

Journaling

write about thoughts and experiences as a way to self-reflect and identify patterns of thought and behavior.

Affirmations

identify unhelpful thoughts, turn them around, and create an affirmation. For example: if you believe, “no one will love me,” turn that into “I am a loveable person” and repeat it daily.

Exposure

try doing something that makes you feel uncomfortable or afraid. This will help you to work through any fears you might have and build your resilience and confidence. For example, if spending time alone makes you feel anxious, do exactly that. Be by yourself, without your phone, and do an enjoyable activity like drawing or listening to music instead.

Relaxation

breathing exercises and progressive muscle relaxation calm down the nervous system and will help you to think more clearly

Improve Self-worth

Limerence is partly caused by low self-esteem; a limerent person bases their self-esteem on the approval and acceptance (and love) of others. We may feel incomplete or empty if another person isn’t there to love us and this causes despair, loneliness, and sadness. Naturally, this would lead us to think that if we found someone who loves us completely and passionately, our loneliness and sadness would disappear.

But basing your worth on external factors makes it fragile and unstable. Letting go of the need for others’ approval means realizing that your worth doesn’t depend on external love and attention. Your value as a human being is unchanging, it doesn’t fluctuate. Try doing something new, use positive affirmations, make a list of all of your strengths and the things you like about yourself, and treat yourself as though you were a beloved friend.

Focus on Self-care and Self-love

Focusing all of your attention on another person can be a strategy to avoid facing your problems and fears. Perhaps you pour all of your time and energy into someone else so you don’t have to think about yourself. Instead of this, why not treat yourself as though you’re the LO? Put yourself first and build a healthy and sustainable self-care routine; pour your love, time, and energy into your own well-being and happiness.

Final Thoughts on Limerence

Limerence is an obsessive and anxiety-provoking kind of desire. Although it can feel amazing, it comes with extreme lows, despair, and self-doubt. But if you experience limerence, it shows you have the ability to love intensely. Turn that love towards yourself as a way to heal your past wounds and insecurity and overcome limerence. Learn how to be there for yourself, how to spend time with yourself, and how to be kind to yourself – in other words, be your own best friend.

Emotional Regulation

 

Emotional Regulation Skills

Emotions are helpful and important. They communicate information to us about our environment and our experience. Goals of Emotional Regulation include: naming and understanding our own emotions, decrease the frequency of unpleasant emotions, decrease our vulnerability to emotions, and decrease emotional suffering.

STOP

When you feel that your emotions seem to be in control, stop! Don’t react. Don’t move a muscle. Just freeze especially those muscles around the mouth. Freezing for a moment helps prevent you from doing what your emotions want you to do (which is to act without thinking). Stay in control. Remember, you are the boss of your emotions. Name the emotion – put a label on it.

Take A Step Back

When you are faced with a difficult situation, it may be hard to think about how to deal with it on the spot. Give yourself some time to calm down and think. Take a step back from the situation. Get unstuck from what is going on. Take a deep breath and continue breathing deeply as long as you need and until you are in control. Do not let your emotions control what you do. It is the rare incident, indeed, wherein we need to make a split-second decision about anything. Hence, it is okay to take our time to decide how to respond.

Proceed Mindfully

Ask yourself, “What do I want from this situation?” or “What are my goals?” or “What choice might make this situation better or worse?” or “What act will allow for success?” Stay calm, stay in control, and when you have some information and how that may impact your goals, you will be better prepared to deal with the situation effectively. Remember your brain needs time to think all of this through.

Opposite Action

All emotions activate us to respond and the type of activation is biologically wired. The Opposite Action Skill allows us to choose to respond opposite from what our biological response would activate us to do. They get us ready to act. Here are some examples:

Thirst: tells us that we need to hydrate. It activates us to drink water.

Hunger: tells us that we need to give our body fuel. It activates us to eat.

Fatigue: tells us that we need rest. It activates us to sleep.

Switch it Up

The 3 emotions listed above are helpful for our survival; but those that follow require thought before we act and opposite action may be helpful.

Anger gets us ready to attack/ It activates us to attack or defend.

Opposite show kindness/concern or walk away.

 

Shame gets us ready to hide. It activates us isolate.

Opposite raise your head up, give eye contact, shoulders back.

 

Fear gets us ready to run or hide. It activates us to escape danger.

Opposite go towards, stay involved in it, build courage.

 

Depression gets us ready to be inactive. It activates us to avoid contact.

Opposite get active.

 

Disgust gets us ready to reject or distance ourselves. It activates us to avoid.

Opposite push through and get through situation.

 

Guilt gets us ready to repair violations. It activates us to seek forgiveness.

Opposite apologize and mean what we say.

 

Remember:

1 If we want an emotion to stick around or increase, continue to do the action as above.

2 If we want an emotion to go away or become less uncomfortable, do the opposite action.

3If we want this skill to work, we must use opposite action all the way and believe that it will work.

 

ABC Please

ABC Please Skill

The ABC PLEASE skill is about taking good care of ourselves so that we can take care of others. Also, an important component of DBT is to reduce our vulnerability. When we take good care of ourselves, we are less likely to be vulnerable to disease and emotional crisis.

ABC

A Accumulate positive emotions by doing things that are pleasant.

B Build mastery by doing things we enjoy. Whether it is reading, cooking, cleaning, fixing a car, working a cross word puzzle, or playing a musical instrument. Practice these things to build master and in time we feel competent.

C Cope Ahead by rehearsing a plan ahead of time so that we can be prepared to cope skillfully.

PLEASE

Treat Physical Illness and take medications as prescribed.

Balance eating in order to avoid mood swings.

Avoid mood-Altering substances and have mood control.

Maintain good sleep so you can enjoy your life.

Get exercise to maintain high spirits.

Build Mastery

You can build mastery by doing things you enjoy. Whether it is reading, cooking, cleaning, fixing a car, working a cross word puzzle, or playing a musical instrument. Learn as much as you can about the subject in order to be well versed. Discuss what you have learned and write about what you have learned. Practice these things to build mastery and in time, feel competent.

Try Something New

Anyone can master a new recipe and with practice, it can become a family favorite. Finding a recipe for a dish that the family will enjoy is the first part of the challenge. Understanding the components of the recipe and how to follow the steps is next. If you are unsure, ask others who enjoy cooking or google the answer. Collect the ingredients and give the recipe a whirl. Expect mistakes, because mistakes help us to learn. Seek help when you are not sure about how to proceed.

Practice

Washing the dishes and doing the laundry are thankless jobs, yet when they are complete and are done well, we can feel good that the task is complete. Reading a book to a young child and finding joy in sharing that time, is also considered building mastery in relationship building. Playing a board game with friends, or frisbee, or any other sport, can also be part of building a relationship which involves mastery.

Give Yourself Credit

An important ingredient in this skill building is to remember to give ourselves credit for building mastery. We often let the day go as if we accomplished nothing at all. Give yourself credit for all that you accomplished at days end. Watch the video to see how someone developed mastery.

Cope Ahead

Cope Ahead Skill

The Cope Ahead skill is intended to have us consider how we might be prepared in some way to help us reduce stress ahead of the time. When we are asked to do some task, it is helpful to think through to the completion of the task. All of us at one time or another have had to give a presentation. Before the presentation, we likely wrote up some notes or did some research on the subject. We do this in order to increase our chances of communicating a message to others successfully. This is an example of coping ahead of time.

rehearse a plan ahead of time so that you are prepared to cope skillfully with emotional situations.

1 Describe the situation that is likely to prompt uncomfortable emotions. Check the facts. Be specific in describing the situation. Name the emotions and actions likely to interfere with using your skills.

2 Decide what coping or problem-solving skills you want to use in the situation. Be specific. Write out in detail how you will cope with the situation and with your emotions and action urges.

3 Imagine the situation in your mind as vividly as possible. Imagine yourself in the situation now, not watching the situation.

4 Rehearse in your mind coping effectively. Rehearse in your mind exactly what you can do to cope effectively. Rehearse your actions, your thoughts, what you say, and how to say it. Rehearse coping effectively with new problems that come up. Rehearse coping effectively with your most feared catastrophe.

5 Practice relaxation after rehearsing.

Examples:

Ken sent his resume and cover letter to a company for a position and was offered an interview. He used the Cope Ahead Skill to prepare for the interview.

Ken reviewed his resume and the job description and listed the skills he had already mastered. He also researched the company and prepared a list of questions to ask about the company. He realized he would likely feel anxiety and thought about how he had faced tougher situations than this in the past. He imagined how he would calm himself so that he would do well in the interview.

Positive Self Talk

Positive Self-Talk Skill

Sometimes all we have is the power of our own self-talk. There are hundreds of stories of people in dire situations who believed they had no more energy to carry on, yet they survived. Examples of this include Victor Frankl who survived a concentration camp. Another example is Donald Driver, who was raised in economically depressed city, was tempted by the street life, but became one of the best Green Bay Packer receivers ever and is now a best-selling author. Oprah Winfrey is another great example. She endured both physical and sexual abuse, she worked hard to overcome the burdens, and she became very successful. Those people who are successful, very often did not come by things easily. Malcolm Gladwell discusses this particular topic in detail in his book entitled, “David and Goliath.” In fact, the struggles these people endured made them stronger and it gave them an advantage over others.

The Backwards Brain

Emotions occur in the response to some trigger. Triggers can be a sight, a sound, a smell, or a thought. Triggers lead to emotions/thoughts. Once the emotion occurs, we are activated to take action. Many unpleasant emotions  occur due to our automatic negative thoughts (ANTs) that we developed as children. These ANTs are based on our perception of ourselves and our world as children before we were seven years old. These are not helpful and we need to change them to thoughts that are based on our adult understanding of the world.

Remember, we practice our ANTs (Automatic Negative Thoughts) since the time we were 7. Hence, it is helpful to identify the few repeating ANTs that occur most often and change those quickly to something we prefer to believe

What are emotions?

Triggers lead to...

Emotions

...lead to Action

Rejection Sensitivity and Relationships

 

Rejection Sensitivity in Relationships

 

Signs of Rejection Sensitivity

Individuals with high rejection sensitivity constantly look for signs that they’re about to be rejected. They tend to respond dramatically to any hint that someone doesn’t want to be with them.

Because of their fears and expectations, people with rejection sensitivity tend to misinterpret, distort, and overreact to what other people say and do. They may even respond with hurt and anger. Here are the factors that influence these overreactions.

Facial Expressions

People with rejection sensitivity often misinterpret or overreact to various facial expressions. For instance, one study found that individuals higher in rejection sensitivity showed changes in brain activity when they saw a face that looked like it may reject them.

Using functional magnetic resonance imaging (fMRI), the researchers found that individuals higher in rejection sensitivity showed different brain activity when viewing faces that showed disapproval.

Subjects of the study did not show the same results when looking at individuals who showed anger or disgust. This observation was in line with individuals who do not experience rejection sensitivity.

Heightened Physiologic Activity

When people with rejection sensitivity fear they may be rejected, they experience heightened physiologic activity—more than individuals without sensitivity to rejection.4 They also remain alert for more cues that they’re about to be rejected. And, they may even exhibit fight-or-flight behavior.

Misinterpreted Behavior

Hypersensitivity to rejection will often cause individuals to distort and misinterpret the actions of others. For example, when friends don't respond to a text message right away, a rejection-sensitive individual might think, “They no longer want to be friends with me.” Whereas someone without rejection sensitivity might be more likely to assume the friend is just too busy to reply.

Attention Bias

Additionally, individuals who rank high in rejection sensitivity often pay more attention to rejection or signs that they were rejected. This is known as attention bias.

For example, if someone high in rejection sensitivity asked 10 people on a date and nine accepted and one declined, they would focus the most on that one rejection. They might even refer to their dating attempts as a “total disaster” and start to believe no one likes them.

Conversely, someone who ranks low in rejection sensitivity might view the same circumstances as a great success. That person may focus on the nine positive interactions and pay little attention to the one rejection.

Interpersonal Sensitivity

Individuals with high interpersonal sensitivity are preoccupied with all types of rejection—both perceived rejections and actual rejections.6 They’re also vigilant in observing and monitoring the moods and behaviors of others and are overly sensitive to interpersonal problems.

Someone with rejection sensitivity may constantly look for proof that other people are rejecting them. So, despite a friend or partner’s reassurance that they’re welcome, loved, and good enough, they may still feel rejected.

They also crave close relationships. Yet, their fear of rejection can leave them feeling lonely and isolated. However, it's important to note that while someone might experience rejection sensitivity in social scenarios, they may not experience it in other circumstances.

For example, an individual who is terrified of social rejection may not mind getting turned down for an online job. When a situation doesn’t have social repercussions, they may be able to handle those rejections differently.

Causes of Rejection Sensitivity

Rejection sensitivity isn’t caused by one single factor. Instead, there may be many factors at play. Some possible causes include childhood experiences like critical parents and bullying, along with biological factors and genetics. Here is a closer look at the factors that may lead to rejection sensitivity.

Childhood Experiences

Early experiences of rejection, neglect, and abuse may contribute to rejection sensitivity.7 For example, being exposed to physical or emotional rejection by a parent may increase the likelihood that someone will develop rejection sensitivity. However, the rejection doesn’t always need to be direct to have an impact.

Growing up with a parent who is emotionally unavailable or highly critical can also cause someone to develop a strong fear of rejection in other relationships.

Rejection-sensitive children also are more likely to behave aggressively. According to a study published in Child Development, children who were highly sensitive to rejection were more likely to angrily expect rejection.8 They showed heightened distress following an ambiguous social interaction with a peer.

Likewise, children who feel bullied or ostracized also may grow up to fear rejection more than others. Any type of prior exposure to painful rejection can cause someone to go to great lengths to avoid experiencing that pain again.

Biological Vulnerability

It’s also thought that some people may have a biological vulnerability to rejection sensitivity. There may be a genetic predisposition or certain personality traits that increase the likelihood that someone will be sensitive to rejection. Some researchers have even linked rejection sensitivity with low self-esteem, neuroticism, social anxiety, and an insecure attachment style.

 Are Personality Traits Caused by Genes or Environment?

Impact of Rejection Sensitivity

Individuals who experience high levels of rejection sensitivity experience higher degrees of psychological distress when they’re rejected, including emotional pain, anger, and sadness. In an attempt to deal with that discomfort, they're also at a higher risk of engaging in aggressiveness, social isolation, and self-injury.

Additionally, there are two primary factors at play in people with rejection sensitivity: the constant need to be liked and the challenges they face in forming meaningful connections with other people. Here is a closer look at those two factors.

Constant Need to be Liked

People who are rejection-sensitive may feel the need to be liked by everyone. And, if they are rejected, they may work extra hard to try to win that person's favor again. This reaction to rejection can lead to people-pleasing behavior as well as extensive ingratiating behaviors.

In fact, a study published in the Journal of Personality and Social Psychology found that men who are high in rejection sensitivity are likely to respond by trying to become more likable.9

They also discovered that these men were willing to pay more money to be part of a group that rejected them. If a woman evaluated them negatively on a mock dating site, they spent more money on her during the date in an attempt to get her to like them.

Female participants exhibited similar behavior only when they were rejected by a potential romantic match with whom they had already shared personal information.

Rejection-sensitive people respond to life in a way that is meant to protect them from pain. Unfortunately, their behaviors often backfire.

Difficulty Making Connections

A rejection-sensitive person's fear of being rejected causes them to struggle to form new connections and to undermine their existing relationships.10 For example, someone who is high in rejection sensitivity may constantly accuse a partner of cheating—which may contribute to the other person ending the relationship.

Furthermore, a rejection-sensitive individual may become angry and hostile whenever a friend doesn’t respond to their invitations in a timely fashion. Ultimately, that may cause the friend to retreat even more, which increases the sense of rejection.

Meanwhile, others with rejection sensitivity may avoid all situations and relationships where they might be rejected. Consequently, they may feel extremely isolated and lonely—which essentially leads to their biggest fears coming true.

Romantic Relationship Problems

People who struggle with rejection sensitivity often interpret rejection as proof that they are unacceptable in some way. To them, rejection is a judgment of their worth and value as a person. And, in relationships, this belief system can be disastrous.

When someone is expecting rejection, it's hard to feel safe in relationships. Even if they aren't being rejected at the moment, they're always watching for it, expecting it to happen at any time.

Consequently, minor missteps are seen as a total lack of caring or as cruel judgments on their worth as a person. In the end, the rejection-sensitive person may grow distressed and angry as soon as they perceive a potential rejection. Here's a closer look at how rejection sensitivity can impact relationships.

Effects on Adolescents

Rejection sensitivity may start as early as the teenage years. Adolescent girls who rank high in rejection sensitivity may behave in ways that put them at a higher risk for victimization, according to a study published in Children Maltreatment.

Researchers found that rejection-sensitive girls also were more likely to go to extremes to maintain a relationship when they felt insecure about a boyfriend’s commitment.

Even when the girls knew there may be negative consequences for their actions, they still modified their behavior in an effort to preserve the relationship. They also were more likely to engage in relationships that involved physical aggression and nonphysical hostility during conflicts—and they tolerated unhealthy behaviors in an attempt to stay together.

Effects on Adults

Adults with rejection sensitivity who are in romantic relationships will likely experience ongoing relationship problems. They often misinterpret events and reactions because they’re hyper-vigilant about being rejected.

These behaviors may lead to irrational jealousy because the individual is terrified of being abandoned or rejected. They also might interpret other behaviors, such as a partner being preoccupied with work, as proof that the other person is no longer in love with them.

For men with rejection sensitivity, being in a committed relationship may be more helpful to them than it is to women. One study found that men are lonelier and more rejection sensitive when they’re not in a romantic relationship.

But women who rank high in rejection sensitivity aren’t likely to experience relief from being in a relationship. They may continue to feel just as lonely and fearful of rejection when in a relationship as compared to when they are alone.

Still, both men and women who fear rejection may struggle to establish close romantic relationships. Their efforts are frequently directed toward avoiding conflict and rejection rather than establishing intimacy and growth.

 How to Deal With Rejection

Rejection is a direct threat to an individual’s sense of belonging and can have serious consequences for mental health. Even if someone isn’t actually being rejected all the time, if they perceive that they are an outcast or if they believe that they are being rejected, their mental health is still likely to decline.

However, rejection sensitivity isn’t a mental health diagnosis on its own, but it is associated with several different mental illnesses. For instance, rejection sensitivity is a risk factor for developing depression and can worsen existing symptoms.

One study found that breakups—and the rejection associated with them—may be more likely to trigger depression in women.

For instance, college-aged women with high rejection sensitivity demonstrated increased depressive symptoms after a partner-initiated breakup compared to individuals who were low in rejection sensitivity.

Other studies have found that individuals who are high in rejection sensitivity are also at a higher risk of:

Anxiety

Body dysmorphic disorder

Borderline personality disorder

Loneliness

Extreme sensitivity to rejection is also part of the defining criteria for avoidant personality disorder15 and social phobia. Furthermore, researchers discovered a link between rejection sensitivity and suicidal thoughts in psychiatric patients.

The researchers found that individuals with suicidal ideation were more likely to feel like they didn’t belong, and they often felt as though they were a burden to others—things that people with rejection sensitivity often experience.

If you or a loved one are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Coping Strategies

If you suspect that you're sensitive to rejection, recognizing the symptoms—and the problems rejection sensitivity causes—can be the first step in creating change. Getting help could not only reduce your vulnerability to mental illness, but with appropriate help and intervention, also could improve your relationships.

In fact, research suggests that self-regulation, which involves monitoring and controlling one's emotional and behavioral responses, may be the key to coping with rejection sensitivity. For instance, when you perceive a potential sign of rejection, it may help to stop and reflect on the situation rather than responding immediately.

 

One way to do this is to look for alternative explanations for the behavior instead of assuming the worst. If you're unable to make these changes on your own, you may need to enlist the help of a counselor.

Start by talking to your physician, who can assist you with determining the appropriate next steps. Many times, cognitive behavioral therapy can help you deal with the thoughts, feelings, and behaviors that fuel the fear of rejection. And if you're already in a relationship, couples therapy could help both of you work to establish a healthier, more secure relationship.

It can be scary to take steps to grow closer to someone, because the deeper the relationship grows, the more being rejected could hurt. But learning how to build deeper, healthier connections is key to reducing loneliness and isolation.

Summary

Rejection sensitivity is not something you should ignore. In fact, symptoms often worsen over time if they're left untreated.

Consequently, if you're prone to overwhelming emotional reactions including intense anger, anxiety, and sadness when you feel criticized or rejected, talk to your doctor or a mental health professional. Learning to address your sensitivity and respond more appropriately to rejection is the key to improving your overall quality of life.

Codependency and Anxious Attachment

 

Codependency and Anxious Attachment

Codependency often has you funneling your energy into supporting the people in your life without making space for — or even considering — what you need for yourself

The signs of codependency typically include putting your own needs on the back burner to prioritize somebody else.

The main sign of codependency is consistently elevating the needs of others above your own. Other signs include controlling behaviors, self-sacrifice, and fear of rejection. But these aren’t the only ones.

Understanding what codependency really is and recognizing the signs of codependency in your behavior is an important first step toward building healthy boundaries and honoring your own needs.

What is codependency?

Codependency is a way of behaving in relationships where you persistently prioritize someone else over you, and you assess your mood based on how they behave.

The more you focus on providing the support you believe others need, the more heavily they may begin to lean on you. Over time, it becomes increasingly difficult to disentangle yourself.

Codependent traits can eventually:

lead to a disconnect from your own needs and desires

promote unhealthy relationship dynamics

affect self-worth and overall well-being

Experts originally introduced the term “codependency” in the 1940s to help describe specific behavior patterns they noticed in partners and family members of people living with alcohol use disorder.

By this original definition, “codependent” might describe loved ones who “enabled” alcohol use, and the signs included:

making excuses

hiding the alcohol use

protecting the person from any fallout or consequences of their actions

However, today experts agree that codependency has a more nuanced and complex meaning — and can show up in many situations, not just ones involving substance use.

“Codependency refers to any enmeshed relationship in which one person loses their sense of independence and believes they need to tend to someone else,” Botnick explains.

According to a 2018 research review, patterns of codependent behavior generally involve four main themes:

self-sacrifice

a tendency to focus on others

a need for control, which may fuel conflict

difficulty recognizing and expressing emotions

These themes can show up across various types of relationships — and even in the way you relate to yourself.

How to know someone is codependent: Main signs

Codependency isn’t considered a mental health condition, and experts have yet to outline specific diagnostic criteria for it. There is, however, some general agreement on what codependency usually involves.

Common signs of codependency include:

a deep-seated need for approval from others

self-worth that depends on what others think about you

a habit of taking on more work than you can realistically handle, both to earn praise or lighten a loved one’s burden

a tendency to apologize or take on blame in order to keep the peace

a pattern of avoiding conflict

a tendency to minimize or ignore your own desires

excessive concern about a loved one’s habits or behaviors

a habit of making decisions for others or trying to “manage” loved ones

a mood that reflects how others feel, rather than your own emotions

guilt or anxiety when doing something for yourself

doing things you don’t really want to do, simply to make others happy

idealizing partners or other loved ones, often to the point of maintaining relationships that leave you unfulfilled

overwhelming fears of rejection or abandonment

With codependency, the need to support others goes beyond what’s generally considered healthy.

If you behave in codependent ways, you don’t just offer support temporarily, such as when a loved one faces a setback. Instead, you tend to focus on caretaking and caring for others to the point that you begin to define yourself in relation to their needs.

Codependency vs. dependency

Some level of dependency is healthy in relationships. It may be tough to make it through life alone, and most people thrive with companionship and social support.

 

Interdependent relationships work better for both people involved. In other words, partners depend on each other. This means you don’t just focus on their needs or draw your value from self-sacrifice, but you’re available to support them when needed.

A healthy, supportive relationship involves listening, striving to understand, and keeping in mind the concerns of another person. Codependency is when that caring behavior crosses the line into trying to direct or control them.

Occasionally depending on others — and allowing them to depend on you — for help and support is perfectly valid. You can depend on someone for some things while still maintaining your own identity and sense of self.

Healthy dependence also means you:

state your own needs and desires

ask for support when you find yourself struggling

feel safe and comfortable expressing your own needs

let others know when they’re asking too much of you without worrying they’ll reject you

In short, you support others — but not at the expense of your own needs.

All of us learned how to form attachments to friends, family, and loved ones growing up — but not all of us learned equally healthy ways of relating to people.

The family systems we grew up in demonstrated to us how to form bonds.

While some people learned how to have healthy attachments to people in our lives, others learned codependency based on how they were treated and cared for or neglected. This is what psychologists refer to as attachment theory.

If caregivers were absent, dismissed your emotions, or taught you that you needed to act a specific way to earn love and approval, there’s a good chance you may be codependent in your relationships.

“Children who grow up to be codependent tend to grow up in families where they did get a certain amount of good loving contact: hugging, kissing, rocking, and holding from a parent. However, at other times, the parent was not emotionally available to them,” Gabrielle Usatynski, MA, LPC, a psychotherapist, explains.

“In other words, the child would feel emotionally abandoned by the parent at times. This naturally produces a lot of anxiety around a fear of abandonment when this child becomes an adult.”

Therefore, codependent people learn to put the needs of others ahead of their own and will sacrifice their needs and principles in order to maintain relationships.

People who are codependent feel a strong pull toward validation and self-worth from others.

Therapists who spoke to Healthline agree that the best kind of relationship to aim for is interdependency, which is where both partners value the emotional bond and benefits of the relationship but can maintain a separate sense of self and personal happiness.

Simply learning how to be more independent is not as simple as deciding to change the kinds of relationships you have.

Codependency can be hinged on attachment trauma. This can lead a person to question if they’re loved and worthy, if others are and can be available and responsive to them, and if the world is safe for them.

Using your partner as a way to have an identity is an unhealthy form of dependency,” Judy Ho, PhD, clinical and forensic neuropsychologist, tells Healthline. “If your partner is thriving, so are you. If your partner fails, then you do too.

You do everything to try to keep your partner happy. You keep saving them from self-destructive acts or clean up all their messes to try to get them to stay in the relationship.

This self-sacrificing nature is typical of codependency and can lead to significant relational issues.

“You are so afraid of losing your partner that you would put up with terrible, even abusive, behaviors from them just to keep them in your life,” Ho explains.

That’s where attachment trauma comes in. Here’s how it may be showing up for you:

Attachment style	How you show up	Examples
Dismissive-avoidant	You tend to be distant from others in order to hide your true feelings and avoid rejection.	burying yourself in your work to create distance between yourself and others; withdrawing from your relationships when conflict arises
Anxious-preoccupied	You tend to feel more insecure in relationships, fearful of being alone.	becoming “clingy” when things are difficult with a partner; assuming the worst, like a loved one might be sick or is likely to leave
Anxious-avoidant	You crave closeness with others, but withdraw when things become serious or intimate.	pushing people away when they try to take care of you, testing their loyalty; being overly critical of partners to justify leaving

Experiencing codependency and unhealthy attachment styles doesn’t mean you’re a lost cause.

You actually can unlearn these patterns. It starts with building your self-concept outside of and apart from others. For some of us (especially those with dismissive-avoidant traits), this also means detangling our sense of self-worth from our careers, too.

To be able to have healthy, mutually loving relationships, we need to be able to put the parts of our brain seeking safety at ease by cultivating that security within ourselves, rather than externally.

“Doing self-reflection and getting to know yourself better by developing hobbies and doing things independently is really helpful for that,” says Ho.

Once you know yourself better, you can learn to be present with yourself and to trust yourself to nurture and take care of your own needs.