For a long time now we have known that people need people.

In the 1930’s, Harry Harlow conducted studies with baby rhesus monkeys.  He made surrogate monkey mothers out of wire and wood and some he covered with cloth.  The babies had a preference for the soft covered monkeys, even if the wire monkeys held the bottle of food.  The babies clung to the cloth mother.  Babies raised with just a wire mother had troubles with digesting their food and frequently suffered diarrhoea.  Baby monkeys were braver in the presence of a surrogate and would huddle in fear without them. Harlow concluded that contact comfort was essential to the development of psychological and physical health and lack of contact can be psychologically distressing.

Another important researcher of this era was John Bowlby.  He studied maternal deprivation and sought to understand the problems experienced by infants and children raised in institutions.  Prior to this research, institutions were large and busy places where children were fed, but the atmosphere tended to be clinical rather than warm. He suggested that babies need physical contact and emotional attachments to others in order to survive and that they cry and cling to make and maintain important survival connections.  If an infant has regular, steady contact with a reliable and caring attachment figure, they are likely to develop a secure attachment.

If there was trouble with early attachment, the child grew up with a different attachment style – insecure in their attachments – either constantly anxious about attachments and needing to check or expect abandonment, or avoidant of attachments altogether.

Attachment theory is starting to make a re-emergence as a way of understanding human behaviour, especially in terms of how others are in interpersonal relationships and now how well people deal with trauma.  We usually seek attachments when we are unwell or tired or under threat.  The way we go about doing this and the success we have in feeling soothed by others may well be influenced by our early experiences.

Move ahead from psychology history to now, the early 2010s, and we find that contact with people is important not just in infancy, but throughout life.

Professor Richard Bryant is one of the world’s foremost researchers in Post Traumatic Stress Disorder. I was fortunate enough to hear him speak at a recent congress.   His group has studied trauma in laboratory settings and also in those people affected by many of Australia’s natural disasters.  Some of the information they use has come through from the terrible bushfires of 2009 and is providing important information about attachments styles and how well people recover from traumatic circumstances.

In the laboratory studies, the team have used the cold pressor test.  A test where people are asked to put their hand into icy cold water, a stressful situation, and they measure various stress responses in their body.  Some who did the test were asked to think about a person they really loved during the test and others were asked to think about something else.  The group that were primed to think about their loved ones, showed lower stress responses in the test.

However, when they assessed the participants for their attachment style, they found that those who were avoidant in their attachment style reacted differently.  When those with an avoidant attachment style were asked to think about their loved one, there was no protective effect of doing so during the cold pressor stress.  Individuals with secure attachment seemed to benefit from thinking about loved ones more than those who had a pattern of avoidant attachment.

Based on these studies, you can see why researchers are speculating that attachment can affect how we learn about and deal with fear.

Then, beyond the lab and in the real world, Richard Bryant’s team looked at distress following real world disaster.  The team have followed those who survived the Ash Wednesday bush fires.  They have done some follow up with those children who were separated from their families when the fire came through and those who were with their families.  It seems that those children who were separated during the fire experienced more long term distressing effects, avoidance, numbing and arousal.  So, it seems it does not have to be long term separation from an attachment figure (like in an institution or care facility) for there to be an impact on long term trauma.

After Black Saturday in 2009, the team followed up with survivors again and looked at their social maps.  Social maps indicate the connections and friendships that people have to each other – who is friends with whom.  When they looked closely at the maps it indicated that the social connections people had correlated with how much trauma they experienced.  The more connections people had to other people, the less trauma they had and the connections seemed especially healthy if they were reciprocal rather than just one way.

A large proportion of our population have an insecure attachment style and not all of these respond to trauma in distressing ways.  Clearly, there are lots of other strategies that people use to get by, but this research confirms the importance of our early attachment and our need for people.  Secure attachment is obviously a priority for many with their infant and children.   To me, this research also suggests that it is wise to ensure that children who are separated from parents during fearful events are reunited quickly and that communities that have experienced trauma get support to continue to network.  Also, it seems important that those who go through trauma alone are given chances to work on building and maintaining reciprocal relationships.

Worries are those thoughts we have where we predict the future – but not in a good way.  We predict that something bad is going to happen and because our brain is thinking about something bad or threatening, the rest of our body can get worked up, too.  So, we can start to feel quite ill and uptight as our body changes from a relaxed position, with all its parts working steadily in combination, to a position where it is ready for battle danger– tense, not digesting, breathing rapidly, heart beat rising and our brain not thinking clearly.

Indeed, some people do get “worried sick”.

Usually, worries take the form of “what if…..” thinking.  “What if”….then insert something pretty terrible here.  For parents, who worry about their children, the worries may be “what if they are abducted”, “what if they get in with a wrong crowd”, “what if I’m parenting wrong”, “what if all of that screen time is causing them brain damage?”…there are so many possible negative “what ifs” and some people can generate lots of them.

Despite how awful people feel when they worry, some people find it hard to stop worrying.  Worrying can become chronic and severely interfere with the lives of people making it hard for them to think at work or school, causing sleep problems and getting in the way of relationships.  When worry is clinically significant, psychologists and mental health professionals may refer to it a Generalised Anxiety Disorder or GAD.

People who regularly worry can find it very hard to still their minds.  Often, it can be very difficult to convince them to let go of their worries.  It can take concerned friends and family members, or even psychologists, a lot of effort to convince someone to work on reducing their worry.

Despite knowing that their worries are causing them excess distress, some people love their worries very much.

From my experience of working with those who worry, there are three good reasons why people can fall in love with their worry.

• Reason 1 – worry feels like problem solving.

Worry is about predicting the future in a negative way and it almost feels that to some people, if they just worry about a predicted problem, they may be able to sort it out.  However, worry is very different to problem solving.  Good problem solving is about identifying a problem, weighing up possible solutions and then carefully analysing the pros and cons of each solution until you pick the best solution and try it.  Worry tends not to be this organised and it rarely arrives at a satisfying outcome.  Often, people who worry think about a future problem and then get stuck in their thoughts at that most troubling point – kind of like watching a scary movie but getting it stuck in the most frightening part.  It means that the body is tense and the brain is not thinking as clearly as when it is relaxed and logical.  If you find yourself worrying about something you’d like to fix, stop the worry stream and grab a pen and paper.  Write the problem down clearly, generate a range of possible solutions and pick the best one to implement.

• Reason 2 – some people think that worry prepares them to outsmart danger

Some people believe that, if they worry, they will be able to predict all bad options and therefore be able to outsmart or out-think any danger – like worry is preparing us for dangers ahead.  Worry certainly does prepare the body for danger or threat, but usually this is well before our body needs to be in threat mode. Worry also has the ability to make us over-estimate the chances of a bad things happening in the future so we can get all het up about something that has a very low chance of ever happening.

In threat mode our body is prepared to run, fight or freeze.  When there is a threat our bodies will automatically kick into the fight and flight response.  The fight and flight response does not need to be kept in a “half on” position in order to work.  We can be totally relaxed, swinging in a hammock by a relaxing pool and our body will still take care of us by switching into fight and flight if a threat arrives at that moment.  Turning on fight and flight and getting ourselves upset ahead of time with worry, only helps to wear us out by getting out body prepared before we need to take any physical action or when we may never actually need to take action.  It’s like worry makes us travel forward in time like some sort of really awful time machine to visit only the troubling places and not the joyful ones.  It can help people who worry to try to practice strategies that help them stay “in the moment”, mindful and relaxed.

• Reason 3 – some people believe that by worrying about someone they are loving them

For some people, it feels that by worrying about someone, they might be putting a protective shield around them.  But worry does not allow us to have super-human abilities. To worry about someone is not the same as loving them. In fact, too much worry can make us uptight in the presence of others.  It can lead us to nag them and hassle them and it can definitely bring the mood down in a household.  If you love someone, isn’t it better to wish them joy and wonderment in life’s adventures rather than to constantly remind them of all the negative outcomes you anticipate for their future?  It’s better to just love your special people and share acts of love rather than to worry about them.

So, if you catch yourself worrying, perhaps ask yourself whether you are really having a good time and whether you really think it will change the outcomes for anyone that you love.

If you think you need some extra help to get out of the habit or pattern of chronic worry, your General Practitioner can refer you to a psychologist if she or he thinks that is the best path for you.

oh, and if you are noticing that someone little in your life is starting to worry, perhaps you could share “Worries are Like Clouds” with them.

How many psychologists does it take to change a light bulb?

One, but the light bulb has got to want to change!

How do we help someone change?  If a person wants to change, then the process can seem a bit easier.  But what happens when a person is reluctant to change a habit or behaviour that is unhealthy, dangerous, illegal or causes ongoing problems with their friendships or relationships.  For instance, what if we want them to change or give up drinking, smoking, eating the wrong foods, or gambling?

For a long time now, since the 1980’s psychologists have been using a model developed by Prochaska and DiClemente (1986) called the “Stages of Change” model.  This model was first discussed in relation to giving up substance addictions, but has since been applied to a wide range of behaviours that people may want to change.   Psychologists don’t use the model in a rigid way to pigeon-hole people, but more as a framework for helping people and assessing their willingness to participate in treatment.

In the “Stages of Change” model, there are five stages:

1. A pre-contemplative stage – usually, the person who is pre-contemplative is not even thinking about changing. A person who is pre-contemplative about change will not usually attend for treatment or help. They may be forced to undertake treatment because someone else makes them – as part of a deal within a relationship, because they “have to” do it to satisfy some requirement to move forward on work or study, or because they legally need to do it.

A lot of young people I see are pre-contemplative. They might have been brought to see me by their parents or because school has said they need to come or because they have had brushes with the Law and have been told to seek treatment by a Court.

2. A contemplative stage – in the contemplative stage, a person is thinking about change, but has not made any firm commitment. It might be that they “kind of” know they should make s change, but they haven’t gotten around to it.  They know that there’s something they need to change
3. A preparation stage – in the preparation stage, a person might be planning to take some action. They might be ready to try something or “give it a go”.
4. An action stage – during the action phase, the person is actually taking the steps to make change – they might be going for treatment, getting to the gym, or staying alcohol free – but they are working towards their goal of change
5. A maintenance stage – in this stage, a person has changed their behaviour and is in the process of sustaining that change.

At any of these stages, things can happen and the person finds they are back in the old habit.  We call this a “lapse”.  People can lapse at any stage and might return to any of the earlier stages.

The important thing about understanding where people are at with regard to their change is that different stages call for different strategies – each stage of change needs a bit of a different approach.

If someone is not even thinking about change (pre-contemplative), then we can demand change and police it – but that doesn’t always work or might not always be an option.  It can be more helpful, sometimes, to provide a person with information about the behaviour that requires change, but we have to be careful that we don’t load the information with too many “have to” messages.  If we want to bring about authentic motivation for change, it’s best that the person arrive at their own reasons to change – being too bossy or domineering can lock a person in to the “anti” or “opposite” position.

Rather than waste resources on telling them how to change if they are pre-contemplative, it can be more useful to focus on making sure they understand exactly what the risks of their behaviours might be.  We need to provide this information is a collaborative way.  Anger and scare tactics can rebound sometimes.  In the case of alcohol, for instance, rather than tell a pre-contemplative teen that should not drink,  we might give a person information about how much is a standard drink, the health and legal effects of alcohol, look at how much and how often they are drinking and let them arrive at their own conclusion.

If they are still not ready to change or they are not ready to even think about it, then it is important that we give them the information they need to stay safe.  We call this “harm minimisation” – if they are going to keep doing it, how can they do so safely?  For instance, if a teen is going to continue to drink alcohol after being presented with all of the risks about it (for them and others), then talking to them about, for example,  staying close to good friends, making sure they don’t take their car, or pre-arranging safe lifts home becomes really important.

If a person is contemplating a change, this can be a good time to have them weigh up the pros and cons of change – what are all the good things about changing, what are all the good things about not changing, and also what might be not so good about change and what might be not so good about no change.

If a person is preparing for action we can help them set their goals and introduce them to various strategies for change.  For a young person wanting to stay sober and not use alcohol, we might teach them refusal skills so they know how to say “no” to offers and deal with any anticipated ridicule that may occur if they say “no”.

There is some new research emerging from here in Queensland that is looking at the importance of helping people visualise their goals rather than just talking about them.  Functional Imagery Training helps people visualise their goals and incorporate lots of senses in their images – the sights, sounds, smells of achieving change – and then to share their vision with us.

If a person has a lapse while they are trying to make change, it’s really important that we help them reflect and learn about the things that happened that made it easy for them to fall back into old ways.  We don’t want them to give up, “throw the baby out with the bath water” and go back to their old ways.  We like to look closely at it so we can learn and make plans for next time.  Again, we can’t do this properly if we are being too police-y or judgemental.

There’s much more to be gained by working collaboratively with a person who needs to change than by just adding more judgement.

Maybe it’s time to change how you think about others making change??