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2012年4月21日 星期六

The Psychology of Children


On the need to focus on childhood events along with the developmental theories for a comprehensive psychology of children

Child psychology is associated with the social and personal development of children and a child goes through several stages before stepping into the adult world. The psychology of children has been studied from various perspectives including issues of nature and nurture and whether the child is a product of genes and heredity or a product of society and environment as also different developmental stages of sensory discrimination and perception, emotional expression and learning through language and cognitive development, development of intelligence and the socialization process. The study of child sexuality and sexual and moral development are also very important especially from a psychoanalytic viewpoint.

Children are vulnerable and affected easily by all events in the immediate environment. Events which are only trivial or unimportant to adults, may leave deep scars or memories in a child's mind. A child's mind is extremely impressionable and changeable and before the child reaches adolescence, certain very insignificant events can have great personal significance in a child's life. So 'childhood memories' and 'childhood events' are primary factors in determining adult personality pattern. Some major factors which can affect a child's later development and have potential long term effects are:

1. Loss or gain of a friend or friends

2. Memorable physical/bodily sensations

3. Separation in the family or divorce of parents

4. Domestic abuse or violence

5. Sexual molestation or abuse

6. Learning experiences either at play or during study

7. Personal experiences/events that evoked strong emotions of fear, joy, sorrow etc.

8. Accidents or illnesses experienced or observed

9. Death of family members, neighbors or close ones

10. Change of residence or relocation

11. Emotional relationships with friends, teachers or family members

12. Personal success or failure in school

13. Influence of films, stories, books or news events

14. War, terrorism, conflicts, bomb attacks etc.

15. Natural calamities like earthquakes, flood, famine etc.

The factors here are very general and every child goes through certain very specific events that affect him or her individually although there are certain very general theories in psychology that have been established through research studies and these theories have highlighted links between success or failure in later life and childhood events. Some of the major theorists of child development are John Bowlby, Sigmund Freud, Jean Piaget, Lawrence Kohlberg and Lev Vygotsky. Whereas Bowlby emphasized on childhood relationships, Piaget focused on cognitive development of the child through various stages and Freud wrote extensively on sexual development of children. Kohlberg studied moral development of children whereas Vygotsky analyzed the socialization process of children through social contextualism. All these theories on different aspects of child development only prove the immense complexity and the varied number of factors that tend to play a role in the psychological development of children. There are many dimensions to the psychology of children from social, emotional to cognitive, sexual and moral. Here I will provide a brief account of all these different theories and finally provide a comprehensive analysis on how these theories could be used along with the general factors listed above in the study of the psychology of children.

John Bowlby, a British psychiatrist, developed the 'attachment theory' in which he emphasized the importance of a mother or primary caregiver in a child's life. He showed in his study that any infant should develop and maintain a warm and intimate relationship with the mother or mother substitute and all maternal deprivation can lead to serious mental health problems in the child later in life. Bowlby's theory is very true and a mother should develop a strong physical and emotional intimacy with the child by being physically close to the child at least until the child is 2 years old. Doctors around the world have recommended breast feeding and an important part of this is the physical closeness between the child and the mother which is extremely necessary once the child is out of the mother's womb. When the child is released from the mother's womb, the first emotion is fear and the mother's continued physical closeness instills confidence and a sense of security in the child. Orphaned children or children who are separated from their mothers at birth require a substitute or they can grow up as mentally ill or maladjusted individuals.

Freud on the other hand provided a complete psychosexual theory and emphasized on what many of us don't like to believe - the sexual pleasure of children. Freud overturned the concept of childhood innocence and suggested that we are born with our unrepressed basic instincts which are slowly tempered with social adaptation. Freud believed that the inherent pleasure seeking desires that we are born with focus on certain erogenous zones of the body and accordingly there are different stages of psychosexual development from oral and anal to phallic, latent and genital stages. In psychosexual development, the child's pleasure seeking behavior changes from the mouth as in sucking and biting to the anus through toilet training and then finally to the genitals. Thus the child according to psychoanalysis derives complete sexual pleasure by sucking, biting, playing with genitals and releasing waste by defecation. I do not necessarily endorse Freud's views on the sexual pleasure of children and the pleasure derived from bodily sensations could be explained in other ways as I will discuss in another article.

Jean Piaget, a French-Swiss philosopher established the theory of cognitive development in children and laid out four developmental stages - the sensorimotor period, the pre-operational stage, the concrete operational stage and the formal operational stage. The first stage is when the child develops spatial abilities and comes to terms with the world through the senses during the first two years of life. The second stage is about developing and using concepts when children understand meaning of things and this continues until the age of 7. From 7-11 years the child reaches higher cognitive development through concrete operational stage and can sort and classify objects and can use logic to solve problems. The formal operational stage that begins around 12 years of age helps children to understand abstract thoughts, hidden meanings etc. Kohlberg provided a theory of moral development of children through six stages of pre-conventional, conventional and post-conventional levels. These are related to concerns for punishment and self interest, as also inner need for conformity and striving for social order, as maintaining universal ethical principles. So moral development seems to move from a belief of 'what is right and what is wrong' and whether there is punishment for the wrong to what is universally ethical and acceptable social behavior. Another prominent psychologist Vygotsky highlighted the importance of socialization and interpersonal communication and child development according to this theory is seen as an internalization of social and cultural knowledge.

Of course, all these theories will have to be added up and a complete or comprehensive theory that would provide an insight into the child's mind and behavior will have components from all these theories. In addition childhood experiences and events which have been highlighted in psychoanalytic theories are also extremely important and not just from a sexual point of view. All the general factors that I have mentioned in the beginning of the essay should be considered as factors that underlie social, sexual, moral, emotional, physical and cognitive development of children. As learning experiences lead to cognitive development, personal emotional experiences lead to later emotional development and maturity. Sexual molestation, abuse or other types of bodily sensations in childhood affect later sexual development and divorce or separation in the family can affect moral development. Thus an individual who has been molested as a child may either develop a fear of sexual activity or may show complete lack of sexual restraint as an adult.

A child who has lived without a father may either become extremely irresponsible or can develop into an adult with a very strong sense of parental responsibility. Experiencing trauma in childhood through death or accidents of family members or living in times of war, natural calamities have deep impact on children and can leave a perennial sense of insecurity or a need for attachment in the children which continues through adulthood and even old age or on the other hand these events can make a child isolated, schizophrenic or simply detached in later life. For healthy life of children it is important to not just depend on psychological theories to understand how a child grows up and perceives the world, but it is also important to focus on events or experiences of the child and use these along with the theories for complete psychological understanding of children.

In contemporary child psychology the focus on events is mainly psychoanalytic and the impact of adverse events is considered especially significant. However it is important that all events, positive and negative are considered and this should then be used to complement psychological theories. To understand the child, it is important to understand the child's world and memories so an 'event-based' psychology of children should be balanced with a 'theory-based' psychology of children.




Reflections in Psychology - Part I - by Saberi Roy (2009)
http://www.lulu.com/content/5865445





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2012年2月5日 星期日

The Psychology of Food Cravings and Emotional Eating


Why Do We Have Food Cravings?

One important factor which may influence appetite control is the notion of food cravings. This overwhelming urge to consume a particular food appears strong in overweight dieters, and many theories has posited why this is so. The nutritional and homeostatic role of food cravings is described by physiological theories and explains why cravings might be more present in people who are deprived of food. The psychoactive abilities of certain foods to trigger cravings are likened to a self-medication behaviour and thought to relieve a central serotonin deficits. Psychological theories stress the role of negatives emotions (e.g. anger) as triggers for cravings and learning theories claim that cravings are a positive learnt response to cues (sensory, situational) and giving into a craving results in a pleasurable consequence. What is evident here is that food cravings are a multi-dimensional and complex occurrence, one which possibly involves aspects of all of the proposed theories.

Whatever the reason, it is suggested that food cravings frequently lead to consumption of the craved food and elevated Body Mass Index is associated with food intake and preference for high fat foods. Even in non-clinical samples, food craving has been found to be related to body weight, suggesting the significant role of craving in food consumption. Early identification of elevated body mass indexes (BMI), medical risks, and unhealthy eating and physical activity habits may be essential to the future prevention of obesity. One crucial question is the role food cravings may play in maintaining excessive eating patterns observed in other problems with eating behaviours: binge eating, bulimia, and obesity.

Food Cravings and Weight Gain: The Missing Link

There is thorough and outstanding evidence regarding the increase in worldwide rates of obesity and the projected outcomes if this is not addressed. Children in particular are noted as being especially at risk of future long term health problems. While dietary restraint, more nutritious eating habits and physical exercise have always been purported to be the answer to the obesity crisis in adults, adolescents and children, long term meta analysis and follow-up studies indicate that weight loss is not maintained (and indeed the more time that elapses between the end of a diet and the follow-up, the more weight is regained). Unfortunately, several other studies indicate that dieting is actually a consistent predictor of future weight gain.

A recent study conducted by Patricia Goodspeed Grant (2008) involved investigating the psychological, cultural and social contributions to overeating in obese people. She found that eating for comfort for the morbidly obese is rooted in using food to manage experiences of emotional pain and difficult family and social relationships. Her participants reported that what had been missing from all treatment programs they had tried was the "opportunity to work on the psychological issues concurrently with weight loss".

It appears that a missing link in the treatment of overweight and obesity is this concept and issue of addressing the psychological contributors or emotional drivers that are leading people to overeat. Relying on willpower and education is clearly not enough.

Motivation Issues

Humans are only motivated by feelings (i.e. sensations). There are basically three types of feelings; pleasant, neutral and unpleasant. The motivation we get from the unpleasant feeling is to move towards a feeling we do not have, but do want. We move away from the unpleasant feeling by replacing it with a different pleasant (or neutral) feeling.

Hunger, is an unpleasant sensation (for most people) and is relieved by the pleasant sensation (for most people) of eating and the taste of food. Like other basic functions, this is so that we can survive, individually and as a species. Most of us prefer pleasant sensations over unpleasant sensations. But pleasant sensations are not always matched with the outcome that they were designed for. Many people eat, not because they need nutrition, but because they feel an unpleasant emotion, like rejection, loneliness, distress, depression, fear, betrayal, worthlessness, defeat, helplessness or hopelessness. This emotional over-consumption of food often leads to fat-gain and other health problems. This can then create a vicious cycle of more emotional eating to manage the emotional consequences of becoming overweight and unhealthy.

For children, excessive eating and binging are often a consequence of boredom and habit behaviours. Food or drinks are used to relieve the monotony. They can also be used as a coping strategy to deal with problems arising from anxiety, depression, stress and conflicts. Although they may feel comforted after consuming an amount of food, the person has not dealt with the underlying cause of these problems. This sets up a reward cycle of using food to get a better feeling. Consequently, there is no reason why they will not reoccur in the future. This can become a vicious cycle.

If a parent deals with their own emotional issues by eating and or over eating it is highly probable that the child will also do so. This pattern for coping is being modelled. Parents often find it difficult to tolerate their child's disappointment or pain and are motivated to take this away. If food is used regularly as a means of doing this, for example, "Never mind not getting invited let's go get a chocolate sundae," a parent can be setting up a cycle of soothing uncomfortable feelings with the pleasure of food. This again can set up a pattern of eating to manage feelings. This is particularly a problem when there is no real discussion of the child's pain or disappointment and instead food is just offered.

Have a think right now: why is it that you want to stop emotionally eating? You might immediately know, or you might have to think for some time. Finish this sentence out loud:

When I stop eating in response to my emotions, I will...

Your answer/s will give you some insight into how you are motivated.

If you are motivated towards pleasurable outcomes, you might have said things like:

• When I stop eating in response to my emotions I will be able to buy clothes 'off the rack' in the shops

• When I stop eating in response to my emotions I will be happy

If you are motivated away from negative outcomes your answers may reflect:

• When I stop eating in response to my emotions I will not be uncomfortable in my clothes anymore

• When I stop eating in response to my emotions I will be able to throw away my 'fat' clothes

You have probably noticed the patterns here. Moving towards pleasurable outcomes or away from a negative one, affects how we think, feel and behave. You might find that you have a combination of moving towards some outcomes and away from others. This is fine too. More often than not, we are primarily subconsciously motivated in one direction.

Motivation has also been shown to exist either as an internal characteristic or as an external factor in people in general. Internal motivation is linked to neurological circuitry in the left prefrontal lobe; the feelings of accomplishment, passion for work, excitement in our day all link to the left prefrontal cortex. It is this area of the brain, which governs motivating behaviour. It discourages pessimistic feelings and encourages action. The reality is that some people naturally possess a high level of this internal motivation; those who focus on the internal feelings of satisfaction they will attain despite any difficulties they face along the way. However others require more than this.

External motivation is any external influence or stimuli to generate positive behaviour. These might include monetary rewards such as bonuses, tangible recognition or honour, prizes, or other incentives. The reality is, despite such rewards motivating behaviour in the short term, it has been shown that no amount of bonuses or acknowledgment will inspire people to use their fullest potential to keep moving towards their goals. So what does it take?

You might have already noticed with exercise that no matter how many personal trainers you hire, how many motivational exercise tapes you purchase or classes you attend, eventually you lose interest and go back to your old behaviour. This is because all of those things are forms of external motivation. There is nothing wrong with them - some people thrive on external motivation and do very well with it. However, sometimes your behaviour does drop off when you cease getting the drive from an external source. Let's face it, if you had a personal trainer at your door every single day for the rest of your life and a personal chef in the kitchen preparing nutritious balanced meals forever, then yes, you would be motivated to lose weight and become fitter. Such full time assistance is not a reality for most of us.

Sometimes people FIND the internal source of motivation they need to lose weight from an external source and this can help them get started. Here's Mercedes' story.

Mercedes had tried to lose weight for years. She was a clerk in the local library and thoroughly enjoyed her work and her food. She noticed over years of living a fairly sedentary lifestyle, with little exercise and a whole lot of reading in her spare time that the pounds had crept on. She was an accomplished cook and took pleasure in preparing meals for herself out of gourmet magazines from the library. She wasn't really worried about her weight but it was always in the back of her mind that she should do something about it. It wasn't until she noticed a regular visitor to the library every evening that she paid attention.

Jon was studying for his final exams in accountancy and because he still lived at home with his rowdy younger brothers and sisters, he began taking to the library every evening for the peace and quiet. He found Mercedes to be very knowledgeable and helpful with finding him necessary reference programs and they struck up a friendly rapport. Mercedes noticed that she started to look forward to her time every evening chatting to Jon and after the first compliment he made about her hair, she proceeded to take more time with her appearance. Jon was really the first man who had ever noticed her as a woman. Unbeknown to him, Mercedes began watching her meals and even started parking her car further from work to get some exercise each day, in the hope of slimming down.

Mercedes and Jon remained good friends and while nothing particularly romantic ever happened between them, Mercedes felt inspired to continue her grooming routine and eventually met her future husband while power walking on the weekend. He had lived two doors from her for years and they had never noticed each other!

Are you motivated toward a reward? Or away from a painful outcome?

Your subconscious mind is actually equipped to lead you towards something you want, rather than away from something you don't want.

The same happens when we need to achieve a goal such as weight loss - we need to look where we are going. When focusing on losing weight most people are focused on wanting to move away from what they don't want, or the negative situation. Rather than focus on wanting to loose weight to move away from your current position, focus on the positives of becoming slim, healthy or fitter. This is moving towards the positive rather than moving away from the negative.

Here is a simple exercise which will prove to you your subconscious is on the alert 24 hours a day: on the way home today, choose a make, model and colour of vehicle- anything will do. Start to think about it consciously. And then start to look around and see how many you can count on the way home. Really look hard - you will find them everywhere! How was it that on the way to work you didn't notice any? You were not tuned in, that's all.

What's Driving Your Eating?

Many people suffer from food cravings at times when they are having a strong feeling. Others report a history of feeling criticized and judged by important others for their choices or the way they look, eat or feel. Feelings of shame and guilt about eating behaviours, looks or perceived lack of control are also common for people. Others report anger and annoyance that to be the shape they want, they have to eat differently to others and feel deprived (victimized/ not normal). Many are afraid to change their shape because this has helped them hide or protected them from hurt or intimacy. Many have tried changing their body shape so many times they do not believe they can succeed, or feel undeserving of success because they have a deeper sense of unworthiness.

Emotional Eating

Emotional eating is the practice of consuming quantities of food -- usually "comfort" or junk foods -- in response to feelings instead of hunger. Experts estimate that 75% of overeating is caused by emotions. Many of us learn that food can bring comfort, at least in the short-term. As a result, we often turn to food to heal emotional problems or take away discomfort. Eating to self soothe becomes a habit preventing us from learning skills that can effectively resolve our emotional distress.

Depression, boredom, loneliness, chronic anger, anxiety, frustration, stress, problems with interpersonal relationships and poor self-esteem can result in overeating and unwanted weight gain. There are 2 types of emotional eating in which people engage:

1. Deprivation-sensitive binge eating: appears to be the result of weight loss diets or periods of restrictive eating (yoyo dieters)

2. Addictive or dissociative binge eating: process of self-medicating or self-soothing with food unrelated to prior restricting (have you ever eaten a whole packet of something, before you realised it was gone?)

By identifying what triggers our emotional eating, we can substitute more appropriate techniques to manage our emotional problems and take food and weight gain out of the equation. Situations and emotions that trigger us to eat fall into five main categories:

1. Social. Eating when around other people. For example, excessive eating can result from being encouraged by others to eat; eating to fit in; arguing; or feelings of inadequacy around other people.

2. Emotional. Eating in response to boredom, stress, fatigue, tension, depression, anger, anxiety, loneliness as a way to "fill the void" or in response to feelings arising from memories of past negative experiences.

3. Situational. Eating because the opportunity is there. For example, at a restaurant, seeing an advertisement for a particular food, passing by a bakery. Eating may also be associated with certain activities such as watching TV, going to the movies or a sporting event.

4. Thoughts. Eating as a result of negative self-worth or making excuses for eating. For example, scolding oneself for looks or a lack of will power.

5. Physiological. Eating in response to physical cues. For example, increased hunger due to skipping meals or eating to cure headaches or other pain.

Some useful questions to ask yourself that might help you find some of your beliefs or issues include:

• Do you remember any times you were ashamed about your body or had others say things about you that you felt ashamed of yourself?

• When was the last time you were at your goal weight/shape? What was happening at that time?

• What are your attitudes about overweight people? What were the attitudes of important others about overweight people?

• What patterns exist in your family about food? Was it used to show love or as a punishment?

• What statements do you say to yourself that are self defeating, hurtful and holding you back from getting what you want. Some examples include:

- It's in my genes,

- I've never been slim so I can't be

- I'll always be fat

- I'm the fat funny one

- If I let anyone get close to me they will hurt me

- My friends/family won't like me anymore

It is useful to ask yourself:

1. What are the benefits of staying overweight?

2. What do you have to give up to achieve your goal?

3. Do you use food as your main reward either for yourself or your children?

Read these questions out loud then sit quietly and listen to what you say to yourself. Write down your answers. Remember, the more honest you are with your thoughts and feelings, the more profound change you are able to achieve.

Recent Research Tackling Food Cravings!

A recent randomised clinical trial tested whether The Emotional Freedom Technique (EFT) could reduce food cravings in participants under laboratory-controlled conditions. Ninety-six overweight or obese adults who were allocated to the EFT treatment or 4-week waitlist condition. The waitlist condition received treatment after completion of the test period. Degree of food craving, perceived power of food, restraint capabilities and psychological symptoms were assessed pre- and post- a four week EFT treatment program, at 6- and 12-month follow-up. EFT was associated with a significantly greater improvement in food cravings, the subjective power of food and craving restraint than waitlist from pre- to immediately post-test. At 6-months, an improvement in food cravings and the subjective power of food after treatment was maintained and a delayed effect was seen for restraint. At 12-months an improvement in food cravings and the subjective power of food after treatment was maintained, and a significant reduction in Body Mass Index (BMI) occurred from pre- to 12-months.

EFT as a therapy belongs to a group of therapies termed 'energy psychology' (EP) and similar treatments would include Thought Field Therapy (TFT), EMDR, and Tapas Acupressure Technique (TAT). EFT was originally designed as a simplified version of TFT. Based on acupuncture principles, Callahan (2000) suggested that a brief tapping procedure may be successfully used to treat almost any emotional disorder. Specific problems have a tailored procedure and after diagnosis, the process involves tapping on specific meridian points on one's body while focusing the mind on the source of the distressing situation. The tapping is suggested to create energy.

It seems EFT can have an immediate effect on reducing food cravings, result in maintaining reduced cravings over time and impact upon BMI in overweight and obese individuals. This addition to weight loss/dietary programs may result in assisting people to achieve and maintain reduced food cravings and lose weight.

References:

Callahan, R. (2000). Tapping the healer within: Using thought field therapy to instantly conquer your fears, anxieties, and emotional distress. New York: McGraw-Hill.

Goodspeed Grant, P. (2008), Food for the Soul: Social and Emotional Origins of Comfort Eating in the Morbidly Obese in Psychological Responses to Eating Disorders and Obesity (pgs 121-138) Wiley and Sons, UK.

Dr Peta Stapleton

Terri Sheldon




Dr Peta Stapleton and Terri Sheldon are two well known Australian psychologists with 37 years of combined clinical experience. They have developed the SlimMinds Program that teaches the latest effective psychological techniques to break out of that YoYo failure cycle that so often occurs with traditional weight loss programs. See http://www.slimminds.com and http://www.foodcraving.com.au.





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