Tag Archives: People

MBTI and Personality Enlightenment

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Before I tell you what the Myers-Briggs Type Indicator (MBTI) is about, let me show you why I’m fan and why I think everyone can benefit from it.

When I found out I was an ISTJ, the duty fulfiller or the inspector, I had a light-bulb moment. I used to think there was something wrong with me because I had a combination of traits that made me different to most people I knew. To name some of them: I’m an introvert, I love studying and doing assignments, I enjoy hard work and painstaking, meticulous work that other people shudder at, I love deadlines and submit everything early, and I’m an organized freak who is incredibly structured and plans everything.

Now, being the introspective, metacognitive person I am, I knew all this about myself, but I thought I shouldn’t be all these things because other people thought my traits were odd.

That was all until I discovered MBTI and that I was an ISTJ. The profile fit me to a T and it was like I was reading myself on a page. It was amazing! It showed me that there was nothing wrong with me; I just had a particular personality caused by the way I saw the world, processed information and made decisions, which is something I don’t do consciously but could now understand.

I was worried when I told a friend my life motto was, life is about things to do and getting them done, because she just laughed and told me I was a workaholic. You’d think I would have worked that out for myself but I missed that fact. The motto isn’t what I thought life should be about; it was just how I saw life. I couldn’t help it and I thought I should get a new motto. But it reassured me when I found the name of the ISTJ is duty fulfiller. That sums it up right there and from then on I was okay with my hard-working nature and my tendency to state facts rather than inspiring idealisms.

Being an ISTJ, I got all the, what I call “hard” traits; so I’m a justice over mercy type person who likes rules. It’s why I love structure and don’t have a spontaneous bone in my body. I work well with details and facts because I take in things via the five senses so I excel in those areas, but even though I adore thinking about concepts and big-picture things, I don’t work well with those things. I would get frustrated when I had to work with big-picture things and didn’t know why before I knew I was an ISTJ, and now that I know, so much frustration is avoided.

Now, that’s only the tip of the iceberg in what I learnt about myself and how it helped me practically. I’ll give one more example of how it helped, and I use this one to show how knowing your personality is valuable because you can mould and manage it when you understand it.

As I said, I got all the “hard” traits. This was something I didn’t particularly like about myself, because I knew the importance of caring about people and not just doing things the way I liked them with rules, structure and cold hard facts. I knew there were also things called feelings and intuition, and I worked to develop my softer side.

That’s one of the great things about being an ISTJ: once we see the value of something, we wholeheartedly run with it. We’re not stubborn and don’t cling to our own ways when we see the validity of something new or different. So now I can be a mercy over justice person, not because that’s what I naturally go towards, but because I’m aware of other factors that might override justice, things that have become important to me since learning about my personality.

And now I can come out as an ISFJ with my feeling trait more developed. The profile doesn’t fit me as well as the ISTJ one and I will always naturally tend towards thinking over feeling, but because I’m aware of this, I can override it and use my feeling side. So you see, without knowing I was an ISTJ, I wouldn’t know that I lacked this feeling trait or that I was a thinker, so I wouldn’t have known how to do anything about it. All I had was this vague idea that I was a hard person who wanted to care more but couldn’t bring myself to do so because I didn’t know how I worked.

Now let me qualify this by saying, there’s nothing wrong with being a justice over mercy person and if that’s the way you want to stay, go for it. There are many other traits I have that I’m perfectly fine with and even though others might look down on them, I won’t change them because I’m cool with it.

The key is that MBTI can help you accept all of your traits and you can either love them or change the ones you’re not so keen about. I’m not sure I believe you can change your underlying preferences, but I do think you can override them if you understand them and work to develop the other preferences.

I will rave about MBTI because it helped me understand how I see and do things and  I’ve benefited so much from it in so many practical ways. Have you ever had a light-bulb moment from understanding something about your personality? Maybe you’ll get one when you do the test. Here it is: MBTI

In my next post I’ll give an overview of the MBTI so you’ll have a better idea of what I mean when I talk about traits, preferences, etc.

Thinking About Shyness

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I was a painfully shy kid. One of the earliest examples I can give comes from a kinder experience. We were rehearsing for a Christmas play for the first time and I was allocated to the red group. There was a frog, fairy, yellow and red group. I, of course, wanted to be a fairy being the girly-girl I am but plain, boring red it was for me; at least it was better than yellow, which is my least favourite colour.

The second time we rehearsed the play, my teacher asked me if I was in the red or yellow group. I didn’t say anything because of my shyness; I rarely spoke up to people who weren’t my family. I knew full well that I was in the red group and that I wanted to be in the red group, but I feigned that I didn’t remember and the teacher put me in the yellow group. I wasn’t very happy about this but this just shows the level of shyness I had as a kid. I didn’t speak up when I knew the answer to a question, and I didn’t even speak up when it would mean I’d get something I wanted.

It’s a common symptom of not speaking up: not getting what you want. When I ask people what they want, it frustrates me when they’re all polite and won’t say what they really want. If I ask what you want, I really want to know what you want. But I can’t blame them when I still fall into silence at times and don’t let people know what I really want.

I’m a lot better at speaking up for myself as an adult, and I think part of the reason is because I know what it’s like to be on the receiving end of a person who won’t speak up. You feel for the person but at the same time you almost want to shake them to make them speak up; you want them to speak up for their own good. Seriously, so much self-torture can be avoided if you just speak up.

If it matters to you, speak up. If someone is asking because they care about you, they will want to know your answer and do what they can to help you get what you want.

Perhaps the best example of my shyness as a kid comes from my visits to the milk bar down the street with my dad. Tony, the milk bar owner was a friendly guy and he’d say hello to us. Dad would always tell me to say hello to him but I never did; I was too shy to open my mouth. It would always frustrate my dad and one day he was so angry about it that he said I couldn’t have the packet of jelly beans he’d bought me at the milk bar until I said the word hello.

Now, any normal kid would just say hello but not me. I went to bed that night stressing over how I would get those jelly beans. I resolved that the next morning I’d say hello by simply saying it to dad when I saw him as though it wasn’t a calculated plan but a simple greeting.

So the next morning I put my plan into action except it didn’t work. I couldn’t bring myself to say the word hello and I ended up yelling “Hi.” I made up for my lack of hello by yelling hi to each family member and finishing with a, “Hi everyone!” They must have all thought I was nuts. I did!

Eventually, dad just told me to say hello and he’d give me the jelly beans, and so I grudgingly said hello and got my prize.

Now when I think back on this, I wonder why I was so shy. Was it actually shyness? Because I knew in my head there was nothing wrong with saying hello or speaking up in general. What I hated, though, was what my family would think of me if I spoke up. I don’t get it. They thought poorly of me when I didn’t speak up and I knew they’d think better of me if I did speak up; so why did I never speak up? What was my problem?

I’m still not sure to this day, and there are occasions even now when I won’t speak up for fear of what people will think of me. And in these types of situations, I’m never worried what the person receiving my words will think; it’s the people watching me, expecting me to say something, that has me worried. I didn’t care what Tony thought; I cared what my dad thought. But what am I afraid of? That they’ll think I’m a well-spoken person? That I’m normal and speak just like anyone else does? It doesn’t make sense, does it?

One of the areas I struggled in besides saying hello and good-bye to people was being served at a restaurant. If I sat with my family, I would always feel so uncomfortable when the waiter asked for our orders and gave us our food and drinks. I could never say, “Thank-you.” Mum would tell me it’s polite to say thank-you and expect me to say it. I rarely did and the times I did, it was so very awkward and I wanted to crawl in a hole and never come out.

Now why was that so hard for me to do for years? I’m very conscious of it even now when I go to a restaurant. I always say thank-you now and can do it with friends easily, but when I’m with family, it still feels awkward. It’s like all I can think about is what my family is thinking of me. They’re probably not even giving it a second thought since who makes a point of noticing when someone says thank-you to a waiter? But for me, I am incredibly conscious of it.

This is one area I don’t quite understand about myself. It doesn’t seem logical at all. I’d love to know an explanation for my strange thoughts and behaviour. All I can work out is that it has something to do with the expectation. If my family didn’t expect me to say hello, good-bye and thank-you, maybe I would have just done it because there was nothing attached to it, no pressure.

I’m not sure if this fully explains it, though, because usually I live up to expectations. Usually I’m so busy trying to find out what’s expected of me so I know how to behave and if I get no cues, I feel lost. So why then did I not live up to expectations in the case of hello’s, good-byes and thank-you’s? Why did I struggle with it so much?

The Difference A Smile Can Make

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A smile makes people seem so much more confident, beautiful and approachable. Why doesn’t everyone smile then? Just because you don’t feel it doesn’t mean you can’t do it. Studies have shown that smiling changes your mood. You may be feeling negative and think a smile will only come when your thoughts are positive, but it actually works the other way round too. Put a smile on your dial and your thoughts will change.

Now since I’ve written this post, it clearly means I’m aware of the power and payoff of the smile. I’m not used to the idea of behaviour changing the mind, but I know it’s true. I’ve not only read about it but I’ve experienced it for myself, not only when I smile, but when others smile. Some people can look downright scary when they’re not smiling and you just want to duck under a table when they walk past. But when they smile, their whole face lights up with warmth and it makes you want to be around them so you can bask in the glow of their smile. Because you can just tell by their smile, that at this moment, they are full of something you want – the beauty, joy, and peace in their own skin the smile reveals. And in those moments when I smile like they do, I feel like I have the same beauty, joy, and peace in my own skin too.

Sometimes I look at people who seem so unhappy all the time. I can sense their lack of confidence and their thoughts that people are judging them. I picture a smile on their face and I can just see people flocking to them because they’ve got something they want. People don’t tend to gravitate towards unhappy people; but all the unhappy person wants is for people to accept them and to connect with them. But that’s never going to happen if they have a negative outlook with an unapproachable frown on their face all the time—the frown that says, “I want you to like me but if I let you see me, I fear you won’t like me so I’m going to keep you away.” Then they wonder why no-one comes near them.

I want to tell them: Smile.

When you smile, people think you have something to offer and they won’t care what you look like, or what job you have or what past you’ve had. All these things you think people notice and will judge you by, won’t even be given a second thought, because they don’t matter. It’s only when you make them a big deal and draw attention to these things that others will see them as the barrier you put up. You may think it’s these things that stop people from connecting with you, but it’s actually your perspective about them and the resulting demeanour you have that makes you seem unapproachable. If they aren’t an issue for you, then they don’t become (or never were issues in the first place) for other people. But if you’re already expecting people not to like you before you meet them, you can make it hard to give people the chance to like you because you’ve already shut them out.

You got to give people more credit. See all those thoughts you have are reflected in the way you present yourself. Give people the chance to see you. Give them a chance to like you. No matter who you are, people are more likely to give you a chance if you give them a chance. And sometimes all a person needs to know they’ve been given a chance is a smile.

So you don’t have to have it all together, you don’t have to look the way everyone else does and you don’t have to be like everyone else for people to accept you. If you smile, people won’t care and they’ll want to know you. Because you know what I realized: A smile isn’t really about the person smiling, it’s about the people who receives the smile. As much as a smile can be for our own good and our own mood, a smile always gives something to others. There is a selflessness in smiling.

Sometimes we don’t smile, because we can’t be bothered. Because we’re too caught up in our own world and don’t feel we have anything to offer. But we all have something to offer, whether we feel like it or not. Believe it, and smile because it’s one gift we can all give to each other.

And just because I love TED Talks, here’s a video about how behaviour can change our thoughts.

What is Your Most Important Question?

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When I was in high school, I learned a new concept about how students can approach an assignment. I found the concept could be applied more broadly to how people approach life. As with any principle it can be taken too far, but I find the generalizations helpful.

It’s based on the idea that when faced with an assignment, students will ask one of three questions first: what, why or how.

  • ‘What’ people ask, “What do I need to do for this assignment?”
  • ‘Why’ people ask, “Why do I need to do this assignment?
  • ‘How’ people ask, “How do I need to do this assignment?”

The idea is that students will eventually ask all three questions but one will be more important to them than the others. They will then ask the second most important question followed by the least important. The degree of importance may vary between people so two questions may be very important to one person while to another only one question really matters.

This of course can be applied to many things in life, not just assignments.

I’m a ‘what’ person

Back in high school I identified myself as a ‘what’ person. If I was to get an assignment the first thing I would ask is, “What is it about?” not “Why do I have to it?” or “How do get it done?” This matches up with how I am in general as I’ll ask questions like, “What are you talking about?” and “What are you trying to say?” I also have a bit of a motto: “Just tell me what to do and I’ll do it.”
Clearly I’m a ‘what’ person. In my mind you need to know what you’re dealing with before you can make a decision about it. Only when I know what will I care about asking why or how because if there’s no ‘what’, why and how don’t matter.

Having said this, ‘why’ is very important to me. Even if I know the ‘what,’ if I don’t have a sufficient ‘why,’ I won’t do it or care about it. In this way, ‘why’ becomes more important than the ‘what.’

‘How’ doesn’t register very highly with me at all so much so that it seems foreign to me. The closest way I could get to understanding it was to think of a ‘how’ person. I think of ‘how’ people as fix-it types. They enjoy taking things apart and putting them back together to see how things work.

Know your question

Once you know which category you belong to, I think you can avoid frustration that comes from not having enough information to satisfy the question you ask first.
For example, the first thing I did when I started my new job as a children’s coordinator was gather information about what was working and what needed improvement. The first question a ‘how’ person might ask is, “How should I lead my team?” or “How do I implement a new program?’ A ‘why’ person might first ask, “Why was I brought into this position?” or “Why did I accept this job?” Each person will eventually ask all of these questions but not until our most important question is answered.

There isn’t a wrong approach; all the questions are important, people just work differently. If I was getting a lot of answers about how to lead before I knew what I was dealing with, I would feel exasperated. Even though I know the information is valuable, I wouldn’t be able take it in until I’ve answered my most important question- I’m not going to know how to lead unless I know what I’m leading. Yet a ‘how’ person will think- it doesn’t matter what I’m leading if I don’t know how to lead it.

Regardless of what questions are important to us, we all ask questions.

I believe you should know the way you work and then work with it. Go out and find the answers to your most important question then you will be free to ask the next question.

What is your most important question?

Intentional Acts of Kindness

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I believe it’s important to let people know they are loved and valued. Even if you don’t know them, I think we should always let people know they matter. I believe in using what you’ve been given to love others. We can all use our time, energy, creativity, gifts, talents and money to love people. What gifts and resources do you have that you can use to give to others? Maybe you can cook a meal for a single parent, read a book to a child, write someone a poem or a song, mow a neighbour’s lawn, or start a conversation with a stranger.

I created a list of ways that I can show people love and that they matter. These are ways that resonate with my interests and abilities, but there are many more ways to express love. Some people call these “random acts of kindness.” They are random in the sense that no-one has to do anything to receive them; they just have to be. Most of the time we only show love or acknowledgment when someone has done something for us, but everyone deserves to be appreciated. These acts can also be random in the sense that they are done occasionally, at the spur of the moment, almost flippantly.

I’d prefer “intentional acts of kindness” because I believe thought should go into appreciating people and the acts of kindness should be done regularly. Create your own list of ways to intentionally show people they matter and that they are loved, valued and appreciated. Here is my list and the ones I’ve done so far (I’ll hopefully share these experiences later):

  • Pay for another table’s meal at a restaurant or café (done)
  • Write a letter or card (hand-make a card) and send it to someone (done)
  • Take it on yourself to be a photographer at a party or event then send the photos to people who were there – you can even frame the photos or do a scrapbook album (done)
  • Post an encouraging note about someone on the internet, either privately or for all to see (E.g. Facebook, blog) (done)
  • Pay an amount for the person next in line at the supermarket checkout, the service station or cinemas
  • Get people to write encouraging messages to someone on pieces of paper then collate them all and give them to the lucky person (done)
  • Buy a voucher or tickets and post them to someone
  • Take someone out for a coffee, meal or movie and pay for them (done)
  • Take note of things people say they would like then buy it for them (done)
  • Let someone know how they’ve made an impression in your life – could be a teacher, a person you met once, a family member or friend (done)
  • Buy a box of chocolates, flowers or another gift to say thank-you to someone for the work they do (E.g. A crossing lady, a retail assistant, a receptionist, the postie)
  • Make someone a hamper
  • Put some money in an envelope and send it to someone or drop it in a stranger’s letterbox
  • Make gifts from photos (E.g. Calendar, book, mug, T-shirt, magnets, coasters) (done)
  • When someone comments on how much they like something you own, remember it and give it to them later

What would be on your list? Have you done any of these? Share your experiences.

What Is Your Word?

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In the book Eat, Pray Love, the author Elizabeth Gilbert, writes about people and places having a word that defines them and drives them. In the book, she lived in Rome for a time, and Rome was said to have the word SEX. Elizabeth loved Rome, but she knew it wasn’t where she would live forever; it wasn’t her city because she didn’t feel like it belonged to her—SEX was not her word.

She had a think about what her word would be. She thought about the word for her family when she was growing up—FRUGAL, IRRERVANT—and the word for her own city she lived in—ACHIEVE.

I thought this was an interesting concept and think you can apply it to many things: school, friendship groups, workplaces, etc.

I tried to think of my word when I was growing up: INNOCENT? SHELTERED?

I tried to think of my word at school and in my town: WORK? MONEY? POSSESSIONS? APPEARANCE? I think it’s STATUS.

I tried to think of my word for me all my life: RESPONSIBILTY, DUTY, RIGHT, PERFECT. I’m not saying these are words that I am, but they words that drove me.

At the moment, the word everyone else seems to give me is: TEACHER or WISDOM.

Then I tried to think of the word I wanted to be: PEACE? FREEDOM? PASSION? MEANING? PURPOSE? I’m still working on it.

I guess the idea is to find out what your word is and see if it matches up with the word you want to be. Take a hard, honest look at yourself and find out what really drives you. Now, hold onto that honesty and find out what word you want to be. When you’re word matches up with what you want to be defined and driven by, I guess that’s the equivalent of the inner life matching the outer life.

And once you know your word, I guess the idea is to find people and places who have the same word as you. There’s your match, where you belong. I’m not saying you shouldn’t branch out and only stay with your those who match your word, but when you’ve found those people and those places who match your word, you’ll always have a home to go back to.

Do you know your word? Does it match the word you want to be?

Our Darkness Isn’t a Reason to Hide Our Light

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You don’t have to be perfect, and you don’t have to know it all, or have it all together to be loved and accepted. You don’t have to hide your insecurities, your fears, flaws and faults. You don’t have to be strong, in control or confident to be of worth. You are worthy just the way you are. I will not run from you or think less of you if you show me your weaknesses and let me see your dark side. No, as long as you aren’t proud of the darkness and are always wanting the light to take over, I will respect and admire you for being brave enough to be vulnerable and honest. I won’t reject you, because I know the darkness in you is the same darkness in me. We may have different shades of dark but we all have darkness in us.

The darkness isn’t a reason to hide. The darkness doesn’t mean we are dark, but we are aware of a darkness in us. It may come in the form of an anger problem, a greed tendency, a selfish streak, a suicidal past, a criminal record, or any number of other sources of shame and fear. They can make us think no-one can know about them or else people will look down on us. They can make us hide ourselves so we feel we can never be honest or loved. They can make us feel like we have nothing to offer and that we shouldn’t be listened to. But these are lies. We all have something to offer the world; we all have ourselves to offer.

I believe we all have a light and we are all meant to be seen. I believe we all have darkness in us but that isn’t a reason to hide our light. Don’t let your weaknesses stop you from using your strengths. Don’t let your insecurities stop you from being sure of what you do have to offer. Don’t let your darkness grow darker and darker by hiding it for longer and longer. Always hope for and work towards turning your darkness into light. Show both your darkness and your light with humility. Share your light as though it is a gift for someone else. I believe we can all accept each other and what we have to offer even with our darkness. I will accept you with your darkness; I hope you will accept me with mine.

What’s Inside Your Heart?

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I want to really know people. I want to know everything about them. I believe everyone has a story; everyone is interesting and worth knowing.

I want to know what makes you happy, sad, angry and scared. I want to know what you love and what you hate. I want to know your regrets. I want to know your dreams and your greatest desires. I want to know the events and people who have had the biggest impact in your life. I want to know how you became the person you are. I want to know how you think and how you work. I want to know everything about you.

I wish I could get inside your mind and see things the way you see them because I’m so interested in who you are and how your minds works. Unfortunately, my mind is the only one I have twenty-four access to, which means I examine and analyse myself a lot; but I just find people, their stories and their minds are so fascinating.

I want all people to be seen, valued, loved and known. I want all people to know who they are and to share who they are and what they love with the world. Tell me your dreams because I want to help you get there.

I wish I could skip all the small talk and the get-to know-you stage so I can delve right in and find out who people really are. You can’t exactly go up to people, though, and ask them to tell you their life story and their deepest secrets. But when a person reveals a part of themselves to me, I feel so privileged, like I’ve been given a gift.

Sometimes I feel so desperate to connect—to be inspired, challenged and learn from people. It is one of my greatest desires to really know people at a deep level. That’s what’s inside my heart. I want to see what’s inside yours.

Some people – Go figure

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Some People — Go Figure!

Posted: August 18, 2013 in DialogProse

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8 August 2012

Today at the park, the congregation included Serge, Shakes, Hippo, Shawn ‘Sausage Fingers’, Little Jake, Danny, Outcast, Chester, Joy, Scarface and his dog Dillinger.The first person to approach me was Joy. I hardly recognized her. Gone was her do rag, her hair color had changed from black to blond and was professionally cut and styled. She was wearing a loose cotton, black on white print blouse with gray stretch pants.

“Joy,” I said, “you look beautiful!”

“Thanks, I thought I needed to pamper myself for a change. Were you on vacation?”

“Yes, I was at the lake for a week. It was great, except for Saturday. I was working on the roof of my cabin and got a case of heat stroke. I had to be wrapped in cold, wet towels. I’d been drinking lots of water.”

Outcast said, “It was brutal here, one hundred and four degrees Fahrenheit. The rain we had just increased the humidity, but didn’t lower the temperature. I used up one of my inhalers. I have to go to the pharmacy today to get a new one.”

Joy said, “I still don’t have my health card, so I borrowed Albert’s inhaler. That probably isn’t a good idea, but it’s all I could do. I was hardly here at all last week. It was just too hot.”

I said to Joy, “I was so sorry to hear that Magdalene’s baby died.”

“I didn’t know that. What happened?”

“I don’t know any details. I spoke to her yesterday morning. I asked, ‘How is your baby?’ She said, ‘He died two days ago.’ I asked how Alphonse was taking it. She said, ‘I don’t know.’ Perhaps they aren’t together any more.

“I mentioned it to Trudy. She had seen Alphonse earlier that day, but he wasn’t talking to anyone.”

Joy said, “Trudy was by earlier, but she didn’t stay. She was acting funny. She probably knows something that she doesn’t want to talk about.”

Outcast said, “It sounds like Sudden Infant Death Syndrome. A baby can turn over in bed and suffocate. It happens a lot.”

I said, “If anyone hears about funeral arrangements, please let me know. I’d like to attend.

“I was talking to Shakes yesterday. He was at his daughter Hattie’s, for her birthday party on Sunday. She had been beaten by her boyfriend.”

Joy said, “That Kit, what a scumbag, beating a woman six months pregnant with his twins, their son looking on. Someone is going to take care of this. I see him every day crossing in front of our apartment.”

Shakes came over. I asked, “What kind of injuries does Hattie have?”

“Her face and ribs are badly bruised; beyond that, I don’t know.”

I asked, “Has her boyfriend been charged?”

Joy said, “We don’t do that. We wait until someone is nearly beaten to death, and left in a pool of blood to die, as I was; or like Fran, with her back permanently fucked. That’s the reason that Big Jake and Gene are in jail.”

Outcast waved at a woman passing by on the sidewalk. “Did you see that woman I waved to? She’s my boss. Two days a week I volunteer at the Salvation Army. She’s the Executive Director. She posted bail for me one time. I’ll always be thankful to her for the help she gave me. She’s not surprised to see me here. She knows that I’m an alcoholic and a drug addict… and always will be. I was sentenced to ten years, of course, I didn’t have to serve the full term.”

I sat down on the grass with Little Jake. “How have you been this past week?”

“I’m not allowed to pan, because I’m on probation. That sucks!”

“Have you had your court appearance yet?”

“That’s on August 30th. I’ll know what’s going to happen then. I fell off my bike a few days ago.”

“Where were you injured?”

“My knees and my elbows were scraped. I have bruises on my right leg. I was wasted. I don’t know what happened. They found my bike in the hedge. It was in pieces, so I threw it away.”

“You probably hit the curb. I’ve done that before, and have the scars to prove it.”

“Yeah, that’s probably what happened.”

“Riding drunk probably seemed like a good idea at the time.”

Joy said, “Everything seems like a good idea at the time.”

Shawn said, “There is such a thing as common sense, and everybody has it to some degree. Even people with down syndrome, or any of the syndromes, have it. I’ve had some experience with that, mind you, I have a mental disability and I’m getting a pension for it, but my mind has two settings; either I’m polite, or I’m all out crazy. There’s no in between.” He took off his shoe and said, “See how the middle three toes come up and down as one? I got three pins in them attached to another piece in my instep. They’re from jumping out of a three-story window. It seemed like a good idea at the time, but I wish I had just put my hands up and gone with the cops.

“What happened was, me and another guy were in a hotel room making a drug deal. He left to get some more, and the cops followed him back. We were both standing there, at the table, the scales at one end, the drugs at the other, when the cops broke the door down. I backed towards the balcony, said, ‘I’m out of here!’ and over I went. I landed in the alley, which was concrete. It would have been nice if I had landed in soft earth or even some bushes. I was lucky to have gotten off so easy, but I still went to prison. I could have saved myself a lot of pain.

“Now when I go through a metal detector, at the airport, all the alarms go off. They ask me to take my shoes off. ‘No problem,’ I say. It happens all the time.”

I said, “I have the same problem with metal detectors. I have an artificial hip and a rod in my right femur from a motorcycle accident. Do you think it would help, for you and I, to bring an x-ray to the airport?”

“No, they want to see for themselves.

“On another occasion, I was at home listening to music. It was 10:30, I had the volume up. Then I heard this pounding and kicking at my door. When I heard that I figured somebody had come for a fight. I opened the door and this guy was screaming at me to turn the music down. I said, ‘No!’ I saw his fist coming up. I just reached over it and connected with his jaw. He took off, like a scared rabbit, down the street. I thought he lived next door. If he lived down the street why would he be complaining about the music. It wasn’t that loud. I yelled after him, ‘You can stop running now. I’m not going to hit you again.’ I did turn the music down. Some people — go figure!”

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The anorexic brain

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The Anorexic Brain

Neuroimaging improves understanding of eating disorder

By Meghan Rosen

Web edition: July 26, 2013
Print edition: August 10, 2013; Vol.184 #3 (p. 20)

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Luke Lucas

In a spacious hotel room not far from the beach in La Jolla, Calif., Kelsey Heenan gripped her fiancé’s hand. Heenan, a 20-year-old anorexic woman, couldn’t believe what she was hearing. Walter Kaye, director of the eating disorders program at the University of California, San Diego, was telling a handful of rapt patients and their family members what the latest brain imaging research suggested about their disorder.

It’s not your fault, he told them.

Heenan had always assumed that she was to blame for her illness. Kaye’s data told a different story. He handed out a pile of black-and-white brain scans — some showed the brains of healthy people, others were from people with anorexia nervosa. The scans didn’t look the same. “People were shocked,” Heenan says. But above all, she remembers, the group seemed to sigh in relief, breathing out years of buried guilt about the disorder. “It’s something in the way I was wired — it’s something I didn’t choose to do,” Heenan says. “It was pretty freeing to know that there could be something else going on.”

Years of psychological and behavioral research have helped scientists better understand some signs and triggers of anorexia. But that knowledge hasn’t straightened out the disorder’s tangled roots, or pointed scientists to a therapy that works for everyone. “Anorexia has a high death rate, it’s expensive to treat and people are chronically ill,” says Kaye.

Kaye’s program uses a therapy called family-based treatment, or FBT, to teach adolescents and their families how to manage anorexia. A year after therapy, about half of the patients treated with FBT recover. In the world of eating disorders, that’s success: FBT is considered one of the very best treatments doctors have. To many scientists, that just highlights how much about anorexia remains unknown.

Kaye and others are looking to the brain for answers. Using brain imaging tools and other methods to explore what’s going on in patients’ minds, researchers have scraped together clues that suggest anorexics are wired differently than healthy people. The mental brakes people use to curb impulsive instincts, for example, might get jammed in people with anorexia. Some studies suggest that just a taste of sugar can send parts of the brain barrelling into overdrive. Other brain areas appear numb to tastes — and even sensations such as pain. For people with anorexia, a sharp pang of hunger might register instead as a dull thud.

The mishmash of different brain imaging data is just beginning to highlight the neural roots of anorexia, Kaye says. But because starvation physically changes the brain, researchers can run into trouble teasing out whether glitchy brain wiring causes anorexia, or vice versa. Still, Kaye thinks understanding what’s going on in the brain may spark new treatment ideas. It may also help the eating disorder shake off some of its noxious stereotypes.

“One of the biggest problems is that people do not take this disease seriously,” says James Lock, an eating disorders researcher at Stanford University who cowrote the book on family-based treatment. “No one gets upset at a child who has cancer,” he says. “If the treatment is hard, parents still do it because they know they need to do it to make their child well.”

Pop culture often paints anorexics as willful young women who go on diets to be beautiful, he says. But, “you can’t just choose to be anorexic,” Lock adds. “The brain data may help counteract some of the mythology.”

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DIFFERENT WIRING
View larger image | Studies of the brains of people with anorexia have revealed a number of complex brain circuits that show changes in activity compared with healthy people.
Medical RF, adapted by M. Atarod

Beyond dieting

A society that glamorizes thinness can encourage unhealthy eating behaviors in kids, scientists have shown. A 2011 study of Minnesota high school students reported that more than half of girls had dieted within the past year. Just under a sixth had used diet pills, vomiting, laxatives or diuretics.

But a true eating disorder goes well beyond an unhealthy diet. Anorexia involves malnutrition, excessive weight loss and often faulty thinking about one of the body’s most basic drives: hunger. The disorder is also rare. Less than 1 percent of girls develop anorexia. The disease crops up in boys too, but adolescent girls — especially in wealthy countries such as the U.S., Australia and Japan — are most likely to suffer from the illness.

As the disease progresses, people with anorexia become intensely afraid of getting fat and stick to extreme diets or exercise schedules to drop pounds. They also misjudge their own weight. Beyond these diagnostic hallmarks, patients’ symptoms can vary. Some refuse to eat, others binge and purge. Some live for years with the illness, others yo-yo between weight gain and loss. Though most anorexics gain back some weight within five years of becoming ill, anorexia is the deadliest of all mental disorders.

Though anorexia tends to run in families, scientists haven’t yet hammered out the suite of genes at play. Some individuals are particularly vulnerable to developing an eating disorder. In these people, stressful life changes, such as heading off to college, can tip the mental scales toward anorexia.

For decades, scientists have known that anorexic children behave a little differently. In school and sports, anorexic kids strive for perfection. Though Heenan, a former college basketball player, didn’t notice her symptoms creeping in until the end of high school, she remembers initiating strict practice regimens as a child. Starting in second grade, Heenan spent hours perfecting her jump shot, shooting the ball again and again until she had the technique exactly right — until her form was flawless.

“It’s very rare for me to see a person with anorexia in my office who isn’t a straight-A student,” Lock says. Even at an early age, people who later develop the eating disorder tend to exert an almost superhuman ability to practice, focus or study. “They will work and work and work,” says Lock. “The problem is they don’t know when to stop.”

In fact, many scientists think anorexics’ brains might be wired for willpower, for good and ill. Using new imaging tools that let scientists watch as a person’s mental gears grind through different tasks, researchers are starting to pin down how anorexic brains work overtime.

Control signs

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FOOD ALERT
Images of high-calorie foods (left) switched on a self-control center in the brains of anorexic women. Pictures of objects on plates kept the control center quiet.
Courtesy of S. Brooks

To glimpse the circuits that govern self-control, experimental neuropsychologist Samantha Brooks uses functional magnetic resonance imaging, or fMRI, a tool that measures and maps brain activity. Last year, she and colleagues scanned volunteers as they imagined eating high-calorie foods, such as chocolate cake and French fries, or using inedible objects such as clothespins piled on a plate. One result gave Brooks a jolt. A center of self-control in anorexics’ brains sprung to life when the volunteers thought about food — but only in the women who severely restricted their calories, her team reported March 2012 in PLOS ONE.

The control center, two golf ball–sized chunks of tissue called the dorsolateral prefrontal cortex, or DLPFC, helps stamp out primitive urges. “They put a brake on your impulsive behaviors,” says Brooks, now at the University of Cape Town in South Africa.

For Brooks, discovering the DLPFC data was like finding a tiny vein of gold in a heap of granite. The control center could be the nugget that reveals how anorexics clamp down on their appetites. So she and her colleagues devised an experiment to test anorexics’ DLPFC. Using a memory task known to engage the brain region, the researchers quizzed volunteers while showing them subliminal images. The quizzes tested working memory, the mental tool that lets people hold  phone numbers in their heads while hunting for a pen and paper. Compared with healthy people, anorexics tended to get more answers right, Brooks’ team wrote June 2012 in Consciousness and Cognition. “The patients were really good,” Brooks says. “They hardly made any mistakes.”

A turbocharged working memory could help anorexics hold on to rules they set for themselves about food. “It’s like saying ‘I will only eat a salad at noon, I will only eat a salad at noon,’ over and over in your mind,” says Brooks. These mantras may become so ingrained that an anorexic person can’t escape them.

But looking at subliminal images of food distracted anorexics from the memory task. “Then they did just as well as the healthy people,” Brooks says. The results suggest that anorexic people might tap into their DLPFC control circuits when faced with food.

James Lock has also seen signs of self-control circuits gone awry in people with eating disorders. In 2011, he and colleagues scanned the brains of teenagers with different eating disorders while signaling them to push a button. While volunteers lay inside the fMRI machine, researchers flashed pictures of different letters on an interior screen. For every letter but “X,” Lock’s group told the teens to push a button. During the task, anorexic teens who obsessively cut calories tended to have more active visual circuits than healthy teens or those with bulimia, a disorder that compels people to binge and purge. The result isn’t easy to explain, says Lock. “Anorexics may just be more focused in on the task.”

Bulimics’ brains told a simpler story. When teens with bulimia saw the letter “X,” broad swaths of their brains danced with activity — more so than the healthy or calorie-cutting anorexic volunteers, Lock’s team reported in theAmerican Journal of Psychiatry. For bulimics, controlling the impulse to push the button may take more brain power than for others, Lock says.

Though the data don’t reveal differences in self-control between anorexics and healthy people, Lock thinks that anorexics’ well-documented ability to swat away urges probably does have signatures in the brain. He notes that his study was small, and that the “healthy” people he used as a control group might have shared similarities with anorexics. “The people who tend to volunteer are generally pretty high performers,” he says. “The chances are good that my controls are a little bit more like anorexics than bulimics.”

Still, Lock’s results offered another flicker of proof that people with eating disorders might have glitches in their self-control circuits. A tight rein on urges could help steer anorexics toward illness, but the parts of their brain tuned into rewards, such as sugary snacks, may also be a little off track.

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SUGAR HIGH
When an anorexic woman unexpectedly gets a taste of sugar (yellow) or misses out on it (blue), her brain’s reward circuitry shows more activity than a healthy-weight or obese woman’s. Anorexics’ reward-processing systems may be out of order.
G. Frank et al/Neuropsychopharmacology2012

Sugar low

For many anorexics, food just doesn’t taste very good. A classic symptom of the disorder is anhedonia, or trouble experiencing pleasure. Parts of Heenan’s past reflect the symptom. When she was ill, she had trouble remembering favorite dishes from childhood, for example — a blank spot common to anorexics. “I think I enjoyed some things,” she says. Beyond frozen yogurt, she can’t really rattle off a list.

After Heenan started seriously restricting her calories in college, only one aspect of food made her feel satisfied. Skipping, rather than eating, meals felt good, she says. Some of Heenan’s symptoms may have stemmed from frays in her reward wiring, the brain circuitry connecting food to pleasure. In the past few years, researchers have found that the chemicals coursing through healthy people’s reward circuits aren’t quite the same in anorexics. And studies in rodents have linked chemical changes in reward circuitry to under- and overeating.

anorexiaTo find out whether under- and overweight people had altered brain chemistry, eating disorder researcher Guido Frank of the University of Colorado Denver studied anorexic, healthy-weight and obese women. He and his colleagues trained volunteers to link images, such as orange or purple shapes, with the taste of a sweet solution, slightly salty water or no liquid. Then, the researchers scanned the women’s brains while showing them the shapes and dispensing tiny squirts of flavors. But the team threw in a twist: Sometimes the flavors didn’t match up with the right images.

When anorexics got an unexpected hit of sugar, a surge of activity bloomed in their brains. Obese people had the opposite response: Their brains didn’t register the surprise. Healthy-weight women fit somewhere in the middle, Frank’s team reported August 2012, in Neuropsychopharmacology. While obese people might not be sensitive to sweets anymore, a little sugar rush goes a long way for anorexics. “It’s just too much stimulation for them,” Frank says.

One of the lively regions in anorexics’ brains was the ventral striatum, a lump of nerve cells that’s part of a person’s reward circuitry. The lump picks up signals from dopamine, a chemical that rushes in when most people see a sugary treat.

Frank says that it’s possible cutting calories could sculpt a person’s brain chemistry, but he thinks some young people are just more likely to become sugar-sensitive than others. Frank suspects anorexics’ dopamine-sensing equipment might be out of alignment to begin with. And he may be onto something. Recently, researchers in Kaye’s lab at UCSD showed that the same chemical that makes people perk up when a coworker brings in a box of doughnuts might actually trigger anxiety in anorexics.

Mixed signals

Usually a rush of dopamine triggers euphoria or a boost of energy, says Ursula Bailer, a psychiatrist and neuroimaging researcher at UCSD. Anorexics don’t seem to pick up those good feelings.

When Bailer and colleagues gave volunteers amphetamine, a drug known to trigger dopamine release, and then asked them to rate their feelings, healthy people stuck to a familiar script. The drug made them feel intensely happy, Bailer’s team described March 2012 in the International Journal of Eating Disorders. Researchers linked the volunteers’ happy feelings to a wave of dopamine flooding the brain, using an imaging technique to track the chemical’s levels.

But anorexics said something different. “People with anorexia didn’t feel euphoria — they got anxious,” Bailer says. And the more dopamine coursing through anorexics’ brains, the more anxious they felt. Anorexics’ reaction to the chemical could help explain why they steer clear of food — or at least foods that healthy people find tempting. “Anorexics don’t usually get anxious if you give them a plate of cucumbers,” Bailer says.

Beyond the anxiety finding, one other aspect of the study sticks out: Instead of examining sick patients, Bailer, Kaye and colleagues recruited women who had recovered from anorexia. By studying people whose brains are no longer starving, Kaye’s team hopes to sidestep the chicken-and-egg question of whether specific brain signatures predispose people to anorexia or whether anorexia carves those signatures in the brain.

Though Kaye says that there’s still a lot scientists don’t know about anorexia, he’s convinced it’s a disorder that starts in the brain. Compared with healthy children, anorexic children’s brains are getting different signals, he says. “Parents have to realize that it’s very hard for these kids to change.”

Kaye thinks imaging data can help families reframe their beliefs about anorexia, which might help them handle tough treatments. He thinks the data can also offer new insights into therapies tailored for anorexics’ specific traits.

Sensory underload

One trait Kaye has focused on is anorexics’ sense of awareness of their bodies. Peel back the outer lobes of the brain by the temples, and the bit that handles body awareness pops into view. These regions, little islands of tissue called the insula, are one of the first brain areas to register pain, taste and other sensations. When people hold their breath, for example, and feel the panicky claws of air hunger, “the insula lights up like crazy,” Kaye says.

Kaye and colleagues have shown that the insulas of people with anorexia seem to be somewhat dulled to sensations. In a recent study, his team strapped heat-delivering gadgets to volunteers’ arms and cranked the devices to painfully hot temperatures while measuring insula activity via fMRI.

Compared with healthy volunteers, bits of recovered anorexics’ insulas dimmed when the researchers turned up the heat. But when researchers simply warned that pain was coming, other parts of the brain region flared brightly, Kaye’s team reported in January in the International Journal of Eating Disorders. For people who have had anorexia, actually feeling pain didn’t seem as bad as anticipating it. “They don’t seem to be sensing things correctly,” says Kaye.

If anorexics can’t detect sensations like pain properly, they may also have trouble picking up other signals from the body, such as hunger. Typically when people get hungry, their insulas rev up to let them know. And in healthy hungry people, a taste of sugar really gets the insula excited. For anorexics, this hunger-sensing part of the brain seems numb. Parts of the insula barely perked up when recovered anorexic volunteers tasted sugar, Kaye’s team showed this June in the American Journal of Psychiatry. The findings “may help us understand why people can starve themselves and not get hungry,” Kaye says.

Though the brain region that tells people they’re hungry might have trouble detecting sweet signals, some reward circuits seem to overreact to the same cues. Combined with a tendency to swap happiness for anxiety, and a mental vise grip on behavior, anorexics might have just enough snags in their brain wiring to tip them toward disease.

Now, Kaye’s group hopes to tap neuroimaging data for new treatment ideas. One day, he thinks doctors might be able to help anorexics “train” their insulas using biofeedback. With real-time brain scanning, patients could watch as their insulas struggle to pick up sugar signals, and then practice strengthening the response. More effective treatment options could potentially spare anorexics the relapses many patients suffer.

Heenan says she’s one of the lucky ones. Four years have passed since she first saw the anorexic brain images at UCSD. In the months following her treatment, Heenan and her family worked together to rebuild her relationship with food. At first, her fiancé picked out all her meals, but step by step, Heenan earned autonomy over her diet. Today, Heenan, a coordinator for Minneapolis’ public schools, is married and has a new puppy. “Life can be good,” she says. “Life can be fun. I want other people to know the freedom that I do.”


Searching for treatments

The bowl of pasta sitting in front of Kelsey Heenan didn’t look especially scary.

Spaghetti, chopped asparagus and chunks of chicken glistened in an olive oil sauce. Usually, such savory fare might make a person’s mouth water. But when Heenan’s fiancé served her a portion, she started sobbing. “You can’t do this to me,” she told him. “I thought you loved me!”

Heenan was confronting her “fear foods” at the Eating Disorders Center for Treatment and Research at UCSD. Therapists in her treatment program, Intensive Multi-Family Therapy, spend five days teaching anorexic patients and families about the disorder and how to encourage healthy eating. “There’s no blame,” says Christina Wierenga, a clinical neuropsychologist at UCSD. “The focus is just on having the parent refeed the child.” Therapists lay out healthy meals and portion sizes for teens, bolster parents’ self-confidence and hammer home the dangers of not eating. Heenan compares the experience to boot camp. But by the end of her time at the center, she says, “I was starting to see glimpses of what life could be like as a healthy person.”

Treatment options for anorexia include a broad mix of behavioral and medication-based therapies. Most don’t work very well, and many lack the support of evidence-based trials. Hospitalizing patients can boost short-term weight gain, “but when people go home they lose all the weight again,” says Stanford University’s James Lock, one of the architects of family-based treatment. That treatment is currently considered the most effective therapy for adolescent anorexics.

In a 2010 clinical trial, half of teens who underwent FBT maintained a normal weight a year after therapy. In contrast, only a fifth of teens treated with adolescent-focused individual therapy, which aims to help kids cope with emotions without using starvation, hit the healthy weight goal.

Few good options exist for adult anorexics, a group notorious for dropping out of therapy. New work hints that cognitive remediation therapy, or CRT, which uses cognitive exercises to change anorexics’ behaviors, has potential. After two months of CRT, only 13 percent of patients abandoned treatment, and most regained some weight, Lock and colleagues reported in the April International Journal of Eating Disorders. Researchers still need to find out, however, if CRT helps patients keep weight on long-term. —Meghan Rosen

CITATIONS

U. F. Bailer et al. Amphetamine induced dopamine release increases anxiety in individuals recovered from anorexia nervosa. International Journal of Eating Disorders. Vol. 45, March 2012, p. 263. doi: 10.1002/eat.20937. [Go to]

S. J. Brooks et al. Subliminal food images compromise superior working memory
performance in women with restricting anorexia nervosa. Consciousness and cognition. Vol. 21, June 2012, p. 751 doi: 10.1016/j.concog.2012.02.006. [Go to]

S. J. Brooks et al. Thinking about eating food activates visual cortex with reduced bilateral Cerebellar Activation in Females with Anorexia Nervosa: An fMRI Study. PLOS ONE. Vol. 7, March 2012, p. 1. doi: 10.1371/journal.pone.0034000. [Go to]

G. K. W Frank et al. Anorexia Nervosa and Obesity are Associated with Opposite Brain Reward Response. Neuropsychopharmacology. Vol. 37, August 2012, p. 2031. doi: 10.1038/npp.2012.51. [Go to]

J. Lock et al. Aberrant brain activation during a response inhibition task in adolescent eating disorder subtypes. American Journal of Psychiatry. Vol. 168, January 2011, p. 55. doi: 10.1176/appi.ajp.2010.10010056. [Go to]

J. Lock et al. Is outpatient cognitive remediation therapy feasible to use in randomized clinical trials for anorexia nervosa? International Journal of Eating Disorders. Published online April 29, 2013. doi: 10.1002/eat.22134. [Go to]

T. A. Oberndorfer et al. Altered Insula Response to Sweet Taste Processing After Recovery From Anorexia and Bulimia Nervosa. American Journal of Psychiatry. Published online June 4, 2013. doi: 10.1176/appi.ajp.2013.11111745. [Go to]

I.A. Strigo et al. Altered Insula Activation during Pain Anticipation in Individuals Recovered from Anorexia Nervosa: Evidence of Interoceptive Dysregulation. International Journal of Eating Disorders. Vol. 46, January 2013, p. 22. doi: 10.1002/eat.22045. [Go to]

SUGGESTED READING

Eating Disorders Center for Treatment and Research at the University of California, San Diego: [Go to]

L. Sanders. Extreme eaters show abnormal brain activity. Science News. Vol. 181, May 5, 2012, p. 13. Available online: [Go to]

B. Bower. Starved for Assistance: Coercion finds a place in the treatment of two eating disorders. Science News. Vol. 171, January 20, 2007, p. 38. Available online: [Go to]

B. Bower. Wasting Away: Prozac loses promise as anorexia nervosa fighter. Science News. Vol. 169, June 17, 2006, p. 374. Available online: [Go to]

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