Archive for October 29, 2009

Dancing and Sexual Attraction – What Women Look Out For

I was never particularly good at dancing as a young man. I was shy, clumsy and uncoordinated. Then the rave scene came along, and not being able to dance was a bonus, so my confidence improved. Now when I take to the dance floor, the young guns wince. I look more like their father than a contender.

Even as a teenager, there was something about dancing that I just didn’t get. The activity always struck me as being intrinsically absurd. Research published in the journal Personality and Individual Differences and reported in the New Scientist, however, suggests there may be a point to dancing after all.

In the study 40 males were asked to dance to the Robbie Williams song Let Me Entertain You. Each of the men was also rated for physical strength using a grip test. 25 women were then asked to rate the men on their attractiveness. A further 25 women were asked to rate the men on their assertiveness. The researchers found that there was a strong correlation between the strength of the man, and their perceived attractiveness and assertiveness.

From an evolutionary perspective perhaps the role of dancing was obvious all along, I just never realised it. It’s an opportunity for men to demonstrate to women their fitness as a sexual partner. If so the advice is look strong and assertive when you do dance … even if it is to a Robbie Williams number!

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More Positive Evidence On Mindfulness

Everything comes in fashions. Mental health research is no exception. As I have reported elsewhere in this blog, mindfulness is currently the flavour of the moment in mental health. By mindfulness, what most people mean is some form of meditative exercise performed by the patient most days.

Two recent studies have been published in the journal Behavioural and Cognitive Psychotherapy which indicates that it might be helpful and feasible to use mindfulness techniques in people who hear voices or experience paranoia. This is interesting because this is a population that anecdotally has been suggested are unsuitable for meditation in the past.

In the same issue of the journal was a further study exploring mindfulness as a treatment strategy in depression. The trouble with depression is that once a person has experienced one episode it makes it more likely they will experience a further episode. Each further episode in turn makes a relapse more likely. In this was, what is known as ‘rekindling’, makes depression likely to become a chronic long term health problem.

The research paper suggests that mindfulness can help people with depression by giving them a greater sense of control over their symptoms, a greater acceptance of their symptoms, an improvement in their relationships, and a factor the researchers named “struggle” which they said was “the dialectical tension between acceptance and change” (p. 418).

It is worth pointing out in this study that mindfulness strategies were part of a well established package known as Mindfulness-Based Cognitive Therapy, and it is unclear what proportion of the positive change was attributed to the mindfulness

component of the therapy, or to the package as a whole. Having said this it seems that the research evidence is starting to stack up that meditation is effective at tackling the chronicity in depression.

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Obesity, Shrinking Brains, And Why Diets Don’t Work

Like most middle aged men, I struggle to balance the delights of eating with the disappointment of my waist line. I hire a personal trainer three times a week; I eat loads of fruit and veg, and am on a low saturated fat diet (to curb my concerning cholesterol levels). Despite this I continue to buy trousers that are too tight for me on the assumption that ‘at some time in the near future’, the new me, no, the real me, will return, and I will be able to fit into them. The gold standard of a washboard stomach seems as unattainable now as it ever has been.

I am not obese by the way. Nor am I fat. My body mass index shows I am ‘normal’. My point is that keeping it at ‘normal’ is something that I have to prioritise and make time for. Exercise and good eating doesn’t happen by accident. They are hard won habits that have taken years to build.

I have a real sense of empathy for my clients whose goal it is to loose weight. My weight once spiralled out of control. It happened ‘by accident’ and when I ‘wasn’t paying attention’. Suddenly I was fat, and had no real awareness of it happening. I turned my attitude around quickly to address the problem, but it still took two years to get back in shape. Of course I had a choice at that point. I saw how all too easy it would have been to rationalise being overweight, and continue with the cosy, exercise free and chocolate rich lifestyle I had been enjoying.

Over the years I have noticed that many of my overweight clients have reached this tipping point and chose to continue eating. This is a painful option, of course, as it feeds into the man’s sense of guilt and shame, poor body image and low self worth. Eating then takes on a different symbolic meaning. It becomes the way one punishes oneself and perpetuates self loathing.

Paradoxically, it seems to me that the constant health warnings about being overweight just seem to embolden this self destructive cycle of eating as self abuse. The latest one is truly shocking. Brain regions that are important to thinking processes are 6% smaller in overweight people and 8% smaller in obese people. The reports author, Paul Thomson, cited in the New Scientist claims that the brains of obese people look 16 years older than lean controls (see New Scientist, 22 August, 2009).

But what is a person to do to combat obesity? This, of course, is a huge area of academic interest. As our populations are getting heavier and heavier, and obesity costing the economy more and more, the importance of finding answers to this question is becoming more pressing.

One finding that does seem to be coming through load and clear from the research is this: diets don’t work. I see this with the clients of my personal trainer. He puts them on a low calorie diet and vastly increases their expenditure of energy through exercise. Very often the strategy is successful in the short term. He often beams with pride as he tells me of a client who has lost 15 pounds or even 30 pounds. But in the medium term the weight simply piles back on. One person slimmed down only to put three stone back on while on a cruise.

The bottom line with weight loss is eat less and exercise more, but why is dieting so ineffective in the medium to long term? There are lots of reasons suggested for this, some physiological some psychological. My take on this is that the body can increase the number of fat cells in order to put on weight. The trouble is fat cells cannot be destroyed by the body. Weight therefore works like a ratchet system, always building the capacity to get bigger, but never smaller. The significance of this is that when you loose weight your body ‘feels’ like it is in starvation mode (as all your fat cells are now showing as ‘not full’) and this makes cravings for high calories foods more likely.

In short, once you have been overweight, in order to keep weight off you need to radically re-thing your approach to food and how you respond to cravings. This is not an easy process, and requires time and effort. Fortunately you don’t have to use a therapist to start along this process. Some of my clients have gained great benefit from an online course called Food Philosophy. It aims to educate you in food psychology so you are armed with the tools you need to change the way you think about food.

My approach to working with clients is similar. I start with understanding the person’s relationship to food. I don’t even like starting with a target weight loss. By changing the assumptions and habits of the person, I hope to bring about lasting and sustainable weight loss through subtle behavioural change. In an industry that thrives on quick fixes, my approach can seem long winded. I firmly believe, though, that sustainable weight loss in people with chronic obesity cannot be achieved without this kind of patient work.

 

Dr Phil Tyson is a Men’s Psychotherapist based in Manchester in the UK.  He offers counselling in Manchester, psychotherapy in Manchester, cognitive behavioural therapy in Manchester and telephone counselling nationally and internationally.

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Exercise Helps You Beat Depression

exerciseDepressed mood is one of the most common problems I see in my practice with men. Feeling low is not the only symptoms guys complain of. Often low mood is coupled with a lack of energy, sleep disruption, reduction of libido, anxiety and appetite changes. Sometimes men feel so bad they think life is not worth living and feel suicidal. Depression is a serious health problem that can lead to death and should never be ignored. The question is how should it be treated?

I recommend a three pronged attack to get your life back on track. Antidepressants, cbt (cognitive behavioural therapy), and exercise.

Antidepressant medication is helpful for many men particularly if your low mood is starting to interfere severely with your life, for example by taking a lot of time off work. Antidepressants, however, should never be the only answer. It is really important that you get to understand ‘the depressed mind’, and how to combat it.

Depression is notorious for ‘rekindling’, that is, coming back again and again and becoming a chronic health concern. If depression is only treated with antidepressants, and you don’t learn the strategy’s you need to stay well, then you risk chronicity becoming a problem.

In fact there is a lot of research around that shows that antidepressants and a talking therapy like cbt, have a cumulative effect upon each other. That is to say having cbt while being on an antidepressant produces a positive effect greater than either antidepressants or cbt on their own.

Is there anything else a man can do? Well I’ve long held the hunch that exercise is a key factor in men’s emotional health. I’m sure it plays a role in women’s emotional health too; I just think it’s even more important for men. In fact a 2007 study in Psychosomatic Medicine found it the equal of antidepressants in curing depression. For this reason I also recommend exercise for the men I se e who are depressed.

There is a problem with exercise in depressed people, in that they often feel too tired and lethargic to get going with an exercise program. I advocate starting with a small but regular exercise regimen: one that is easily achieved. Say a five minute walk to the shops and back, three times a week. Once the routine has bedded down, start increasing the duration and intensity of the exercise. Your ultimate target is three half hour sessions of vigorous, pulse raising, exercise a week. Like antidepressants, it can take several weeks before the benefits of exercise take hold, so stick with it.

I see the best results with men who adopt all three strategies: antidepressants, cbt and exercise. However not everybody’s depression is severe enough to warrant an antidepressant, and some men simply don’t want to take a drug. I can understand and respect this. For these men, knowing that exercise is as effective as an antidepressant in shifting mood is really helpful information. I suspect exercise coupled with cbt is the way to go for these men.

The worst thing you can do if depression has got a hold of your life, is ignore it. If you are feeling depressed at the moment, the time to do something about it is now.

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Social Anxiety Often Co-morbid With Premature Ejaculation

Premature ejaculation is a difficult subject for many men, and there are many approaches to helping sufferers. Medical solutions include prescribing antidepressant drugs with a known side effect of retarding ejaculation. Physical solutions include building core stability to enhance ejaculatory control. Psychological solutions involve retraining the mind to pay attention to the dick resulting in a more mindful understanding of the sexual arousal cycle.
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What I find interesting about most of the self help books on premature ejaculation, and indeed, therapy manuals for psychotherapists, is that they invariably presume the participation of a partner to help with the therapeutic process. Given that premature ejaculation often starts in the teenage years, what I find is that many of the men I see haven’t got partners. They avoid sex, and therefore relationships, because it is too painful to face the ‘humiliation’ of coming too soon.

What I find with single men with premature ejaculation, is there is not just a problem of ejaculatory control that needs to be addressed in therapy, but also the patterns of social behaviour, thoughts and feeling that the person has built up around their lack of ejaculatory control. For some men they even meet the diagnostic criteria for social phobia for sexual situations.

For these men, helping with ejaculatory control is just the start. We also need to unlearn a lifetime of anxiety and fear around sex. At the heart of social anxiety is a fear of social humiliation. In the case of premature ejaculators, it is the humiliation of coming too soon, and the feared negative appraisal of that event by the sexual partner. The trouble is, the self help books don’t tell you how to do that. The result is that a guy can have ‘the facts’ about solving his premature ejaculation, but is too scared to put them into practice.

If you are a premature ejaculator and this all makes sense to you, why not try reading up on social phobia and apply it to your history of sexual behaviour. I can recommend Overcoming Social Anxiety and Shyness: A Self-help Guide Using Cognitive Behavioural Techniques by Gillian Butler.

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