Wednesday, November 30, 2016

Breathe. Exhale. Repeat: The Benefits of Controlled Breathing


Take a deep breath, expanding your belly. Pause. Exhale slowly to the count of five. Repeat four times.
Congratulations. You’ve just calmed your nervous system.
Controlled breathing, like what you just practiced, has been shown to reduce stress, increase alertness and boost your immune system. For centuries yogis have used breath control, or pranayama, to promote concentration and improve vitality. Buddha advocated breath-meditation as a way to reach enlightenment.
Science is just beginning to provide evidence that the benefits of this ancient practice are real. Studies have found, for example, that breathing practices can help reduce symptoms associated with anxiety, insomnia, post-traumatic stress disorder, depression and attention deficit disorder.
“Breathing is massively practical,” says Belisa Vranich, a psychologist and author of the book “Breathe,” to be published in December. “It’s meditation for people who can’t meditate.”
How controlled breathing may promote healing remains a source ofscientific study. One theory is that controlled breathing can change the response of the body’s autonomic nervous system, which controls unconscious processes such as heart rate and digestion as well as the body’s stress response, says Dr. Richard Brown, an associate clinical professor of psychiatry at Columbia University and co-author of “The Healing Power of the Breath.”
Consciously changing the way you breathe appears to send a signal to the brain to adjust the parasympathetic branch of the nervous system, which can slow heart rate and digestion and promote feelings of calm as well as the sympathetic system, which controls the release of stress hormones like cortisol.
Many maladies, such as anxiety and depression, are aggravated or triggered by stress. “I have seen patients transformed by adopting regular breathing practices,” says Dr. Brown, who has a private practice in Manhattan and teaches breathing workshops around the world.
When you take slow, steady breaths, your brain gets the message that all is well and activates the parasympathetic response, said Dr. Brown. When you take shallow rapid breaths or hold your breath, the sympathetic response is activated. “If you breathe correctly, your mind will calm down,” said Dr. Patricia Gerbarg, assistant clinical professor of psychiatry at New York Medical College and Dr. Brown’s co-author
Dr. Chris Streeter, an associate professor of psychiatry and neurology at Boston University, recently completed a small study in which she measured the effect of daily yoga and breathing on people with diagnoses of major depressive disorder.
After 12 weeks of daily yoga and coherent breathing, the subjects’ depressive symptoms significantly decreased and their levels of gamma-aminobutyric acid, a brain chemical that has calming and anti-anxiety effects, had increased. The research was presented in May at the International Congress on Integrative Medicine and Health in Las Vegas. While the study was small and lacked a control group, Dr. Streeter and her colleagues are planning a randomized controlled trial to further test the intervention.
“The findings were exciting,” she said. “They show that a behavioral intervention can have effects of similar magnitude as an antidepressant.”
Controlled breathing may also affect the immune system. Researchers at the Medical University of South Carolina divided a group of 20 healthy adults into two groups. One group was instructed to do two sets of 10-minute breathing exercises, while the other group was told to read a text of their choice for 20 minutes. The subjects’ saliva was tested at various intervals during the exercise. The researchers found that the breathing exercise group’s saliva had significantly lower levels of three cytokines that are associated with inflammation and stress. The findings were published in the journal BMC Complementary and Alternative Medicine in August.
Here are three basic breathing exercises to try on your own.
Coherent Breathing
If you have the time to learn only one technique, this is the one to try. In coherent breathing, the goal is to breathe at a rate of five breaths per minute, which generally translates into inhaling and exhaling to the count of six. If you have never practiced breathing exercises before, you may have to work up to this practice slowly, starting with inhaling and exhaling to the count of three and working your way up to six.

1. Sitting upright or lying down, place your hands on your belly.
2. Slowly breathe in, expanding your belly, to the count of five.
3. Pause.
4. Slowly breathe out to the count of six.
5. Work your way up to practicing this pattern for 10 to 20 minutes a day.
Stress Relief
When your mind is racing or you feel keyed up, try Rock and Roll breathing, which has the added benefit of strengthening your core.

1. Sit up straight on the floor or the edge of a chair.
2. Place your hands on your belly.
3. As you inhale, lean forward and expand your belly.
4. As you exhale, squeeze the breath out and curl forward while leaning backward; exhale until you’re completely empty of breath.
5. Repeat 20 times.
Energizing HA Breath
When the midafternoon slump hits, stand up and do some quick breathwork to wake up your mind and body.

1. Stand up tall, elbows bent, palms facing up.
2. As you inhale, draw your elbows back behind you, palms continuing to face up.

3. Then exhale quickly, thrusting your palms forward and turning them downward, while saying “Ha” out loud.
4. Repeat quickly 10 to 15 times.

Monday, November 28, 2016

SKIN DEEP; If You Think It, It Will Clear


Published: July 28, 2005

STRESS may be inflaming your pimples. And hypnosis may help clear them up. Or deep breathing exercises. Or maybe imagining yourself lying on a beach in Aruba.
At least that's the idea behind an emerging medical specialty that explores the interaction between the mind and the skin. Its practitioners believe that for some patients, stress may play a role in skin conditions from acne to psoriasis, rosacea, warts, eczema, blushing and hives.
These doctors, who identify themselves as psychodermatologists -- ''derm shrinks'' or ''skin shrinks'' for short -- concentrate less on medicating the skin and more on getting at the psychological components of what ails it. They do not ignore traditional medicine. But they add treatments like psychotherapy, meditation, relaxation, hypnosis, acupuncture, yoga, tai chi and even anti-anxiety drugs.
These strategies, psychodermatologists say, have the potential to help the tens of millions of Americans who suffer from chronic skin ailments. And many patients, frustrated by skin conditions that seem resistant to traditional medicine, are apparently willing to give them a try.
Mary O'Leary is one who has. A surgical nurse in Boston, Ms. O'Leary had so many plantar warts on one foot, it was painful for her to stand all day in the operating room. Her dermatologist prescribed antiviral creams, but nothing helped until she met Ted A. Grossbart, an assistant clinical professor of psychology at Harvard Medical School who specializes in skin problems.
''I spent months learning self-hypnosis,'' Ms. O'Leary said. She visualized her immune cells fighting off the virus and imagined healthy skin replacing the warts. ''It's bizarre and amazing, but it worked.''
Some doctors are skeptical of treatments based on stress relief. Larry E. Millikan, chairman of the dermatology department at Tulane University School of Medicine in New Orleans, likened some psychodermatology methods to the wart-treating strategies Tom Sawyer recommended to Huckleberry Finn: burying a dead cat at midnight or sticking one's hand in a wet, rotten tree stump while chanting ''spunk-water, spunk-water, swaller these warts!''
''The proven benefit for skin problems comes from traditional dermatology,'' Dr. Millikan said. ''That will remain true until we have hard science showing the effects of meditation and acupuncture on skin.''
But psychodermatologists say the anecdotal evidence is enough to convince them that their approach is worthwhile.
''We all have patients whose hives, pimples and eczema get worse when their personal lives or work situations get complicated,'' said Dr. Richard G. Fried, a dermatologist and psychologist in Yardley, Pa., whose staff includes an acupuncturist and a biofeedback therapist. ''But dermatologists have customarily ignored the root causes and just treated the visible symptoms.''
Joe Duke, a purchasing manager in Philadelphia, is one of Dr. Fried's patients. ''Two to three hours after a stressful situation,'' Mr. Duke said, ''I used to get a psoriasis flare-up with 20 to 30 lesions across my chest, arms and legs. You look like a leper.''
He had spent decades trying ultraviolet light treatments, prescription ointments and creams, antibiotics and even methotrexate, a drug that suppresses the immune system. Some of these worked temporarily, while others had worrisome side effects. So Dr. Fried suggested that Mr. Duke try biofeedback, which teaches patients to reduce tension by practicing deep breathing and muscle relaxation, and by imagining themselves in idyllic landscapes.
''I started biofeedback about 18 months ago, and last summer I even wore shorts for the first time in years,'' Mr. Duke said. ''For me personally, biofeedback has been like anger management for my skin.'' The result, he said, has been fewer breakouts and less reliance on prescription creams.
The number of skin specialists who combine physical and psychological treatments appears to be rising. The Association for Psychocutaneous Medicine of North America, which includes physicians and psychologists, has grown to more than 40 members from 12 in 1991. Some of these practitioners treat depressed patients with disfiguring skin conditions or psychiatric patients who harm their own skin. But most also treat common skin ailments.
David Colbert, a dermatologist in New York, employs an acupuncturist to work with some of his rosacea and psoriasis patients. And Philip D. Shenefelt, a dermatologist in Tampa, Fla., often uses hypnosis to treat itching or hives.
A few medical school dermatology programs also have begun to provide stress-relief treatments. St. Luke's-Roosevelt Hospital in New York has a Psychocutaneous Medicine Unit where dermatologists and psychologists often treat patients in tandem. And later this year the Johns Hopkins School of Medicine and the University of Rochester Medical Center plan to open psychodermatology clinics where doctors may recommend that patients try hypnosis or stress-reduction techniques.
Dr. Grossbart of Harvard, who has been treating skin complaints with psychotherapy for 25 years, said he was pleased that dermatologists were learning psychological techniques. ''If a dermatologist allots only 12 minutes to see each patient,'' he said, ''that doesn't leave time to address underlying emotional issues.''

Sunday, November 27, 2016

Access to Mental Health Care and Incarceration

1.2 million individuals living with mental illness sit in jail and prison each year.
Often their involvement with the criminal justice system begins with low-level offenses like jaywalking, disorderly conduct, or trespassing.
In 2015, The Sentencing Project ranked the states based on the number of people incarcerated in state prison per 100,000 residents.2 Comparing state-by-state rates of incarceration with the access to mental health care ranking shows a strong positive correlation between rates of adult who are in the criminal justice system and lack of access to mental health care (r =.69, p=000). 
The states with less access to mental health care have more adults who are in the criminal justice system.
Six out of 10 of the states with the least access to mental health care also have the highest rates of incarceration.
These states include:

  • Alabama
  • Arkansas
  • Mississippi
  • Texas
  • Georgia
  • Florida

  • The chart below shows the ranking of states based on the rate of adult incarceration (per 100,000 people).  The access to care ranking is the corresponding sum of scores for each state. The ten states with the least amount of access to care are highlighted in red, and the 10 states with the most access to care are highlighted in purple.

Friday, November 25, 2016

Most states with little access to mental health resources also have the highest incarceration rates

  • Brianna Provenzano, Mic
  • Oct. 20, 2016

If there's one problem in the United States more pressing than the staggering number of adults suffering from mental illness, it's the fact that nearly half of them aren't getting treatment for it. 

According to Mental Health America's recently released annual assessment, about 20% of U.S. adults — or 43.7 million people — have a mental health condition of some kind — and less than half of them are receiving the care they need.
Among children and adolescents, the news is worse: Though the incidence of depression is on the rise, 80% of the young people afflicted receive inadequate care or none at all, according to the MHA report.

"Once again, our report shows that too many Americans are suffering and far too many are not receiving the treatment they need to live healthy and productive lives," Paul Gionfriddo, president of Mental Health America, said in a statement, according to the Washington Post
"We must improve access to care and treatments, and we need to put a premium on early identification and early intervention for everyone with mental health concerns."

Judging by the resources states currently have in place to treat people with mental illnesses, those seeking to improve access to care have their work cut out for them.
The nonprofit's report ranked all 50 states and the District of Columbia on their availability of mental health treatment, and found that most states are sorely lacking available options — particularly in the Deep South.
"This is ultimately about the policy decisions we make," Gionfriddo said, according to the Washington Post. "It isn't just about what states are red and what states are blue. ... But political environments in states do seem to matter. Those that invest more in mental health clearly have to throw away less money on jails and prisons."

Judging by the resources states currently have in place to treat people with mental illnesses, those seeking to improve access to care have their work cut out for them.
The nonprofit's report ranked all 50 states and the District of Columbia on their availability of mental health treatment, and found that most states are sorely lacking available options — particularly in the Deep South.
"This is ultimately about the policy decisions we make," Gionfriddo said, according to the Washington Post. "It isn't just about what states are red and what states are blue. ... But political environments in states do seem to matter. Those that invest more in mental health clearly have to throw away less money on jails and prisons."

Tuesday, November 22, 2016

Change to Standard Time Linked to Increased Depression

Psychiatric hospitals see an increase in depression cases immediately after the transition from daylight saving time to standard time, according to a new study in Denmark.
The findings, based on an analysis of 185,419 depression diagnoses filed in the Central Psychiatric Research Register, show that Danish depression cases jump approximately eight percent the month right after the transition from daylight saving time. The study involved data from the years 1995 to 2012.

This increase in depression rates is too pronounced to be coincidental, note the researchers.
“We are relatively certain that it is the transition from daylight saving time to standard time that causes the increase in the number of depression diagnoses and not, for example, the change in the length of the day or bad weather. In fact, we take these phenomena into account in our analyses,” says Associate Professor Søren D. Østergaard at Aarhus University Hospital in Risskov, which is part of the Department of Clinical Medicine at Aarhus University.
Østergaard is one of five researchers who conducted the study, a collaboration between the departments of psychiatry and political science at the universities of Aarhus, Copenhagen and Stanford.
While the study is based on an analysis of relatively severe depression diagnosed at psychiatric hospitals, Østergaard says there is no reason to believe that the time transition only affects the tendency to develop more severe forms of depression.
“We expect that the entire spectrum of severity is affected by the transition from daylight saving time to standard time, and since depression is a highly prevalent illness, an increase of eight per cent corresponds to many cases”, says Østergaard.
Although the study does not identify the underlying mechanism behind the increase, the researchers point to some possible causes. In Denmark, the transition from daylight saving time to standard time “moves” one hour of daylight from the afternoon between 5:00 pm to 6:00 pm to the morning between 7:00 am to 8:00 am.

“We probably benefit less from the daylight in the morning between seven and eight, because many of us are either in the shower, eating breakfast, or sitting in a car or bus on the way to work or school. When we get home and have spare time in the afternoon, it is already dark,” explains Østergaard.
“Furthermore, the transition to standard time is likely to be associated with a negative psychological effect as it very clearly marks the coming of a period of long, dark and cold days.”
“Our results should give rise to increased awareness of depression in the weeks following the transition to standard time. This is especially true for people with a tendency towards depression — as well as their relatives. Furthermore the healthcare professionals who diagnose and treat depression should also take our results into consideration,” says Østergaard.

Sunday, November 20, 2016

Dyslexia caused by faulty signal processing in brain; Finding offers clues to potential treatments

August 7, 2012

Researchers have made a major step forward in understanding the cause of dyslexia. The scientists have discovered an important neural mechanism underlying dyslexia and shown that many difficulties associated with dyslexia can potentially be traced back to a malfunction of the medial geniculate body in the thalamus. The results provide an important basis for developing potential treatments.

This figure compares the situation in the brain of dyslexics and the control group. The blue area depicts the auditory cortices and the green area represents the medial geniculate bodies.
Credit: © MPI for Human Cognitive and Brain Sciences


Many children and adults have difficulties reading and writing, and the reason is not always obvious. Those who suffer from dyslexia can exhibit a variety of symptoms. Thanks to research carried out by Begoña Díaz and her colleagues at the Max Planck Institute for Human Cognitive and Brain Sciences in Leipzig, a major step forward has been made in understanding the cause of dyslexia.
The scientists have discovered an important neural mechanism underlying dyslexia and shown that many difficulties associated with dyslexia can potentially be traced back to a malfunction of the medial geniculate body in the thalamus. The results provide an important basis for developing potential treatments.
People who suffer from dyslexia have difficulties with identifying speech sounds in spoken language. For example, while most children are able to recognise whether two words rhyme even before they go to school, dyslexic children often cannot do this until late primary school age. Those affected suffer from dyslexia their whole lives. However, there are also always cases where people can compensate for their dyslexia. "This suggests that dyslexia can be treated. We are therefore trying to find the neural causes of this learning disability in order to create a basis for improved treatment options," says Díaz.
Between five and ten percent of the world's children suffer from dyslexia, yet very little is known about its causes. Even though those affected do not lack intelligence or schooling, they have difficulties in reading, understanding and explaining individual words or entire texts. The researchers showed that dyslexic adults have a malfunction in a structure that transfers auditory information from the ear to the cortex is a major cause of the impairment: the medial geniculate body in the auditory thalamus does not process speech sounds correctly. "This malfunction at a low level of language processing could percolate through the entire system. This explains why the symptoms of dyslexia are so varied," says Díaz.
Under the direction of Katharina von Kriegstein, the researchers conducted two experiments in which several volunteers had to perform various speech comprehension tasks. When affected individuals performed tasks that required the recognition of speech sounds, as compared to recognize the voices that pronounced the same speech, magnetic resonance tomography (MRT) recordings showed abnormal responses in the area around the medial geniculate body. In contrast, no differences were apparent between controls and dyslexic participants if the tasks involved only listening to the speech sounds without having to perform a specific task. "The problem, therefore, has nothing to do with sensory processing itself, but with the processing involved in speech recognition," says Díaz. No differences could be ascertained between the two test groups in other areas of the auditory signalling path.
The findings of the Leipzig scientists combine various theoretical approaches, which deal with the cause of dyslexia and, for the first time, bring together several of these theories to form an overall picture. "Recognising the cause of a problem is always the first step on the way to a successful treatment," says Díaz. The researchers' next project is now to study whether current treatment programmes can influence the medial geniculate body in order to make learning to read easier for everyone in the long term.

Story Source:
Materials provided by Max-Planck-Gesellschaft. Note: Content may be edited for style and length.


Monday, November 14, 2016

Anger, Heavy Exertion: Fast Track to Heart attack

HealthDay Reporter

MONDAY, Oct. 10, 2016 (HealthDay News) -- Intense anger or heavy physical exertion may be triggers for a first heart attack in some people, new research suggests.
In the study of more than 12,000 people, both intense activity and intense emotions each seemed to double the odds of suffering a heart attack in the next hour. That risk rose about threefold when people were upset and exerted themselves at the same time.
The study is far from the first to suggest -- and it does not prove -- that bouts of anger or physical exertion can trigger a heart attack.
But, it's larger than past studies, and more diverse -- covering first-time heart attack patients in 52 countries, said Barry Jacobs, a spokesman for the American Heart Association who was not involved in the research.
"This confirms that blowing your top is not good -- for other people, or for you," Jacobs said.
Do the findings mean that everyone who gets angry will see a similar spike in their heart attack risk?
"Common sense says no," said Jacobs, director of behavioral sciences at the Crozer-Keystone Family Medicine Residency Program in Springfield, Pa.
He pointed to the underlying biology of it all: Intense emotions or activity can drive up blood pressure and heart rate, and cause blood vessels to constrict. That, in turn, may cause any artery-clogging "plaques" to rupture and cut off blood flow to the heart -- prompting a heart attack.
But a person would have to harbor those plaques in the first place, Jacobs said.
In the study, researchers asked the heart attack patients whether they had been angry or emotionally upset in the hour before their heart attack, or during the same hour the day before. They also asked about heavy physical exertion.
The study did not dig for details -- such as the type of physical activity, or whether a person had an angry outburst or silently simmered.
"What we felt was important was to ask the same person about two different time periods," said lead researcher Dr. Andrew Smyth, of the Population Health Research Center at McMaster University, in Canada.

On average, his team found, people were over two times more likely to suffer a heart attack in the hour after a bout of intense emotions or activity, versus the same hour a day before.
In all, almost 14 percent of study participants said they'd exerted themselves in the hour before their heart attack symptoms arose. A similar number said they'd been angry or upset.
Smyth said his team did look at other factors that affect heart attack risk -- but none of them changed the risks linked to exertion and intense emotions. Physical exertion, for example, raised people's heart attack risk whether they were normally sedentary or regularly exercised.
Still, the researchers said, people face "external triggers" like anger and exertion every day, without succumbing to a heart attack. So, it's likely that those triggers come into play only when a person has artery-clogging plaques that are particularly vulnerable to rupturing.
The findings on heavy exertion do not negate the importance of regular exercise, Smyth said. It's well known, he noted, that exercise has many long-term health benefits -- including a reduced risk of heart disease.

But Smyth did advise avoiding "extremes" -- physical and emotional.
"I do appreciate the difficulty in doing this," he said. "There are times when exposure to extremes of either is unavoidable."
However, people with risk factors for heart attack can limit heavy exertion when possible, and "employ strategies" to avoid extreme emotions, according to Smyth.
Jacobs agreed. He said he does not advocate "burying your emotions." But, he added, "people can learn more appropriate ways of dealing with their emotions."
Jacobs pointed to meditation, breathing and relaxation exercises, and anger and stress management programs as sources of help. He suggested people talk to their doctor about resources in their community, or go online to learn simple techniques, such as breathing practices.
The findings were published Oct. 11 in the journal Circulation.

Saturday, November 12, 2016

7 Simple Steps to Effective Decision-Making Promote Personal Responsibility

Dr. Paula suggests a framework to help kids make effective decisions and to accept personal responsibility for their consequences.

Shared By Paula A. Calabrese (Open Post) - Updated Date Don't show on local voices May 8, 2011

Our kids are at an age when they want to make some of their own decisions.  My husband and I feel that we’ve given them some ground rules for making good decisions, but I’m wondering if we’ve left out anything really important. Are there are some guidelines that we could use when we talk with the kids about decision-making?  -Elizabeth W.
For me, responsible decisions are all about values, values, values— just like real estate is all about location, location, location. You choose what you value. You value what you choose.
Effective decision-making is a skill that will serve your kids for the rest of their lives. Teaching them how to decide and how to think through the consequences of their decisions is a gift that will keep on giving. It’s never too early or too late to give kids the tools necessary to guide their decision-making process.

Making decisions is basically a step-by-step process built on a strong foundation of personal values that are influenced by the family, mentoring adults, friends and peers, life experiences and societal mores. Although values are essentially an individual’s own choice, they are heavily influenced by others.  But it always comes down to the individual’s decision. Here are some steps to share with your youngsters when you talk with them about the importance of informed decision-making. Consider using this 7-step framework as the basis of your conversation with your youngster.
 1. Identify core personal values
Having a clear understanding of your own values really helps when it comes to making decisions. Values are like budgeted money. What you budget for is a clear indication of what’s important in your life. If you have 50 percent of your budget targeted for clothing and only 10 percent for
education, then it’s clear that outward appearance is more valuable to you than learning. Where you spend your money demonstrates what’s important to you.  The decisions you make are an outward expression of the values you hold dear.

This is key to decision-making. You base your decisions on the values that are most important to you.
 This is a pretty abstract concept, so you may have to start with a few concrete examples. Explain your family’s values in general and how they are played out in your daily lives: places you go, things you do, money you spend, work that you do.

 Then have the kids make a list of their own values. Start by asking your kids to tell you about 10 things that are important to them. Then, help them define the listed items. For example, is looking good to others more important than being respected by others? Is being liked by others more important than being independent? Is having lots of money more important than sharing with others? Once you get the kids talking about what they value, you might have them list their values in their order of importance to them. This list then becomes the standard against which decisions are made and measured.

2. Recognize and identify the situation that demands a decision
Reflect on the situation. Discuss it with others who might be knowledgeable about it so that they can help to clarify the issues that need to be considered. For example, a youngster might be faced with the dilemma of whether to cover for a friend who skipped school when the friend’s parents inquire. Talking it out with the friend might help both to see one another’s points of view.

3. Brainstorm lots of ideas
Now that the situation is clear, state it in a question: If my friend’s parents ask his about skipping school should I tell the truth or cover up for him?  Then, write down all the possibilities, crazy or not, that you can think of.  In this case, you could avoid talking with the parents; not answer the question directly, but skirt the issue; deflect to another friend and tell the parents to ask that person; tell your friend to tell his own parents the truth himself; lie to the parents etc. Then, weigh the options against your own values list. What do you value?  How do you act, based on your values? Which value would you preserve or deny if you complied with your friend’s request?

Friday, November 11, 2016

The Effective Decision

FROM Harvard Business School  

Effective executives do not make a great many decisions. They concentrate on what is important. They try to make the few important decisions on the highest level of conceptual understanding. They try to find the constants in a situation, to think through what is strategic and generic rather than to “solve problems.” They are, therefore, not overly impressed by speed in decision making; rather, they consider virtuosity in manipulating a great many variables a symptom of sloppy thinking. They want to know what the decision is all about and what the underlying realities are which it has to satisfy. They want impact rather than technique. And they want to be sound rather than clever.

Effective executives know when a decision has to be based on principle and when it should be made pragmatically, on the merits of the case. They know the trickiest decision is that between the right and the wrong compromise, and they have learned to tell one from the other. They know that the most time-consuming step in the process is not making the decision but putting it into effect. Unless a decision has degenerated into work, it is not a decision; it is at best a good intention. This means that, while the effective decision itself is based on the highest level of conceptual understanding, the action commitment should be as close as possible to the capacities of the people who have to carry it out. Above all, effective executives know that decision making has its own systematic process and its own clearly defined elements.

Sequential Steps
The elements do not by themselves “make” the decisions. Indeed, every decision is a risk-taking judgment. But unless these elements are the stepping stones of the decision process, the executive will not arrive at a right, and certainly not at an effective, decision. Therefore, in this article I shall describe the sequence of steps involved in the decision-making process.
1. Classifying the problem. Is it generic? Is it exceptional and unique? Or is it the first manifestation of a new genus for which a rule has yet to be developed?
2. Defining the problem. What are we dealing with?
3. Specifying the answer to the problem. What are the “boundary conditions”?
4. Deciding what is “right,” rather than what is acceptable, in order to meet the boundary conditions.. What will fully satisfy the specifications before attention is given to the compromises, adaptations, and concessions needed to make the decision acceptable?
5. Building into the decision the action to carry it out. What does the action commitment have to be? Who has to know about it? more

6. Testing the validity and effectiveness of the decision against the actual course of events. How is the decision being carried out? Are the assumptions on which it is based appropriate or obsolete?
Let us take a look at each of these individual elements.
The Classification
The effective decision maker asks: Is this a symptom of a fundamental disorder or a stray event? The generic always has to be answered through a rule, a principle. But the truly exceptional event can only be handled as such and as it comes.
Strictly speaking, the executive might distinguish among four, rather than between two, different types of occurrences.
First, there is the truly generic event, of which the individual occurrence is only a symptom. Most of the “problems” that come up in the course of the executive’s work are of this nature. Inventory
decisions in a business, for instance, are not “decisions.” They are adaptations. The problem is generic. This is even more likely to be true of occurrences within manufacturing organizations. For example:

A product control and engineering group will typically handle many hundreds of problems in the course of a month. Yet, whenever these are analyzed, the great majority prove to be just symptoms—and manifestations—of underlying basic situations. The individual process control engineer or production engineer who works in one part of the plant usually cannot see this. He might have a few problems each month with the couplings in the pipes that carry steam or hot liquids, and that’s all.
Only when the total workload of the group over several months is analyzed does the generic problem appear. Then it is seen that temperatures or pressures have become too great for the existing equipment and that the couplings holding the various lines together need to be redesigned for greater loads. Until this analysis is done, process control will spend a tremendous amount of time fixing leaks without ever getting control of the situation.
The second type of occurrence is the problem which, while a unique event for the individual institution, is actually generic. Consider:
The company that receives an offer to merge from another, larger one, will never receive such an offer again if it accepts. This is a nonrecurrent situation as far as the individual company, its board of directors, and its management are concerned. But it is, of course, a generic situation which occurs all the time. Thinking through whether to accept or to reject the offer requires some general
rules. For these, however, the executive has to look to the experience of others.

for more:

Thursday, November 10, 2016

7 Steps to Clearer, More Confident Decision Making

By: Susanna Halonen  |  Coaching
SimpleReach Slide Plugin Version: 0.7.6
I felt my heart rate increase and my blood pressure rise. My breath got shallower and shallower, and I felt the temperature in my body rise. I started to feel hot, sweaty and claustrophobic. Anxiety kicked in. I felt trapped, lost and incompetent. My decision making skills flew out the window.
Even the thought of deciding what underwear to wear today made me panic. I was so overwhelmed I could barely remember to breathe. And then I remembered: it’s ok. 

It’s ok to feel overwhelmed sometimes and it’s ok to feel anxious. It’s a completely natural part of being human, especially in today’s lifestyle where busyness seems to define our day to day life.

As an ambitious perfectionist and over-achiever, I suffer from anxiety when I feel like I’ve lost control of my to-dos or when I’m trying to decide between two equally attractive options. This tends to happen when I’ve lost sight of where I want to go, or when someone dangles a new tempting option (that wasn’t in my plan originally) on front of me.
Sometimes the anxiety gets so bad it leads to indecision paralysis. Anything you ever knew about decision making disappears from your life and you have no idea what to do. This can feel like the end of the world. And again, that’s ok. It’s not whether this happens to you or not that matters; it’s what you do to get out of it that does.
That brings me to decision making 101. You (and I) want to be clear and confident when deciding what to prioritise and how to choose between two (or more) attractive looking options. You want to commit to a choice with vigour and determination, not with fear and self-doubt. And there are things you can do to make that happen.
These are the seven steps I take to get that clarity and confidence back in my decision making process:

1. Breathe.
It sounds silly and unhelpful – yet it’s the first thing you have to do when you feel the anxiety kicking in. The faster, shallower breaths you take, the more stressed you’ll feel and the less clear your head will be. Take at least five deep breaths to calm yourself down (inhale for at least four seconds and exhale for eight) and get back in control of your brain.
2. Remind yourself what your long-term vision or goal is.
Clarity on this is crucial if you want to make sound decisions. Then, when you’re deciding between Option A and Option B, you can ask yourself, Is this going to get me closer to where I want to be?  You can apply this same question to everything on your to-do list and prioritise based on that. If it’s the long-term vision you’re struggling to get clear on, visualise your dream life. Write about your best possible self. Imagine if you had the life you dreamed of in one year’s time, what would a typical day and week look like in your life? It doesn’t me you have to build the dream life in one year, but it does mean you have to get clear on what kind of days and weeks you want to have.
3. Stop asking people what you should do.
You can not ask the people around you to tell you how to live your life. Sure, chat about your dilemma with your partner and your friends, but do that to get clearer on what’s in your head rather than to obsess about the advice they’re offering. Otherwise you run the danger of being inundated with conflicting opinions and tips. Your voice will get lost with the voices of the other people and you won’t remember which voice is yours anymore.
4. Listen to your intuition.
Sounds cliche but it is so important. Your full being probably knows the answer already and it’s time you listened to it. I know this is even harder when you’re feeling anxious or stressed, but it’s even more important then. Take the time to breathe and reconnect with your soul with whatever way that works for you. It could be exercise, yoga, reading a good book, going for a walk in the park, taking a long bath or a million other things. For me, it’s riding my horse Mickey, cuddling and playing with dogs, and writing. Then, re-visit your choices and think about how each of them make you feel. If one of them makes you feel open, inspired and nervously excited, this is a good one to go with. On the other hand, if a choice is making you feel sick, lethargic and beaten down, this is probably not the path for you.
Another fun trick that can help with this is assigning each side of a coin one of your two options. Say to yourself that whatever side the coin lands on is exactly what you will do. Flip the coin up in the air and then pay attention to which side you actually want the coin to land on. Or alternatively, observe your initial reaction once the coin has landed and chosen the option for you. If you feel like you want to flip again, you probably want to go with the other option.

5. Do the classic pros and cons list.
Another cliche that helps! Think about the pros and cons for every option, and how much each item on your list actually weighs. When I was thinking about moving back to London from rural Surrey, I knew I’d have to commit time and energy to commuting to my horse and I’d also have to be prepared to pay higher living costs. I also knew I wanted to be closer to my partner, my friends and my clients who were all mainly in London. In the end it was a no brainer as the pros of making the move clearly outweighed the cons in my eyes.
6. Let go of your attachment to the outcome you desire.
Focus on the journey instead. If you choose Option A, it could lead to X, Y or Z – but regardless of what it leads to, will you enjoy the journey of working towards it? If you obsess purely about the outcome you desire, you will be too afraid to make a confident choice because you will forever keep thinking What if? to the other option. You can come up with a million What if’s but they won’t help you to commit to a decision with confidence.
For example, I’ve recently been brainstorming what kind of online courses I want to start offering. My biggest barrier to getting on with them has been the evil inner critic voice saying, What if no one buys them? You’ll waste all this time and effort into designing them and then they just sit there all alone. I’ve had to fight this voice back with: Regardless of what happens, I’ve been wanting to try them for a year now and people have asked for them. Even if they don’t sell as well as I’d like them to, they’ll still be there for some people to benefit from and potentially create some passive income. They could even be turned into books in the future.

Wednesday, November 9, 2016

Decision Making: 7 Steps Involved in Decision Making | Business Management

even most essential steps involved in decision making process are: 1. Define the problem, 2. Analysing the problem, 3. Developing alternative solutions, 4. Selecting the best type of alternative, 5. Implementation of the decision, 6. Follow up, 7. Monitoring and feedback!
Decision-making is concerned with the selection of one alternative course of action from two or more alternative courses of action.

Precisely it can be stated as a choice-making activity.

These steps can be explained as under: 
1. Define the problem:
The first and the foremost step in the decision-making process are to define the real problem. A problem can be explained as a question for and appropriate solution. The manager should consider critical or strategic factors in defining the problem. These factors are, in fact, obstacles in the way of finding proper solution. These are also known as limiting factors.
For example, if a machine stops working due to non-availability of screw, screw is the limiting factor in this case. Similarly fuse is a limiting or critical factor in house lighting. While selecting alternative or probable solution to the problem, the more the decision-making takes into account those factors that are limiting or critical to the alternative solutions, the easier it becomes to take the best decision.
Other examples of critical or limiting factor may be materials, money, managerial skill, technical know-how, employee morale and customer demand, political situation and government regulations, etc.

2. Analysing the problem:

After defining the problem, the next important step is a systematic analysis of the available data. Sound decisions are based on proper collection, classification and analysis of facts and figures.

here are three principles relating to the analysis and classification as explained below:
(i) The futurity of the decision. This means to what length of time, the decision will be applicable to a course of action.
(ii) The impact of decision on other functions and areas of the business

3. Developing alternative solutions:
After defining and analysing the problem, the next step is to develop alternative solutions. The main aim of developing alternative solutions is to have the best possible decision out of the available alternative courses of action. In developing alternative solutions the manager comes across creative or original solutions to the problems.
In modern times, the techniques of operations research and computer applications are immensely helpful in the development of alternative courses of action.

4. Selecting the best type of alternative:
After developing various alternatives, the manager has to select the best alternative. It is not an easy task.
The following are the four important points to be kept in mind in selecting the best from various alternatives:
(a) Risk element involved in each course of action against the expected gain.
(b) Economy of effort involved in each alternative, i.e. securing desired results with the least efforts.
(c) Proper timing of the decision and action.
(d) Final selection of decision is also affected by the limited resources available at our disposal. Human resources are always limited. We must have right type of people to carry out our decisions. Their calibre , understanding, intelligence and skill will finally determine what they can and cannot do.

5. Implementation of the decision:
Under this step, a manager has to put the selected decision into action.
For proper and effective execution of the decision, three things are very important i.e.,
(a) Proper and effective communication of decisions to the subordinates. Decisions should be communicated in clear, concise and understandable manner.
(b) Acceptance of decision by the subordinates is important. Group participation and involvement of the employees will facilitate the smooth execution of decisions.
(c) Correct timing in the execution of decision minimizes the resistance to change. Almost every decision introduces a change and people are hesitant to accept a change. Implementation of the decision at the proper time plays an important role in the execution of the decision.

6. Follow up:
A follow up system ensures the achievement of the objectives. It is exercised through control. Simply stated it is concerned with the process of checking the proper implementation of decision. Follow up is indispensable so as to modify and improve upon the decisions at the earliest opportunity.
7. Monitoring and feedback:
Feedback provides the means of determining the effectiveness of the implemented decision. If possible, a mechanism should be built which would give periodic reports on the success of the implementation. In addition, the mechanisms should also serve as an instrument of “preventive maintenance”, so that the problems can be prevented before they occur.
According to Peter Drucker, the monitoring system should be such that the manager can go and look for himself for first hand information which is always better than the written reports or other second-hand sources. In many situations, however, computers are very successfully used in monitoring since the information retrieval process is very quick and accurate and in some instances the self-correcting is instantaneous.

Tuesday, November 8, 2016

7 steps to make sounds decision

by :
Guy Winch Ph.D.

We typically make dozens of decisions a day--what to eat, what to wear, with whom to socialize, short term planning, long-term planning, small and large life decisions and the list goes on. But some decisions are harder to make than others, whether because of our mood, our motivation, the situation, or the specifics of the decision itself and its implications—we just become stuck. We feel paralyzed and keep putting off the decision, which makes us feel worse and more pressured, which makes us feel even more paralyzed.
Here are the steps to take when you are struggling to make a decision:

1. Define the decision and the steps required to make it. Example: You don’t know if you should go on a vacation because finances have been tight and you’re not sure you can find something in your budget that will be worthwhile. What you are debating is not Should I go on vacation? or Where should I go on vacation? But Will the best vacation that fits my budget be worth the expense? In other words, sitting down to define the decision will make you realize it has two distinct steps: First you have to find the best option that fits your budget and only then will you be able to decide if it will be worth the expense.

2. List the options. Remember to include non-actions as options. For example, you have to decide whether to invite someone you’re not super close with to your birthday party. There are three options: You can decide to invite them, you can decide not to invite them, and you can avoid making the decision. For those of you quick to point out that not making a decision is basically the same as not inviting the person (as they don’t get invited either way) that is true factually but not psychologically. Unmade decisions can be sources of distraction and stress and the more of them hover over us, they more we are burdening ourselves unnecessarily.

3. List the pros and cons for each of the options. Make sure to consider as many perspectives as possible. For example, when listing the pros and cons of going home for the holidays or staying put and celebrating with friends, consider your experiences of holidays past, both ones in which you went home and ones in which you did not. Consider whether you will then be obliged to visit at another time instead and whether that visit will be better or worse, consider the feelings of other family members, the feelings of your friends who will not enjoy your company, the logistics of travel or cooking, etc…

4. Come up with a decision deadline. Some decisions have time urgency. For example, deciding whether to accept a new job offer or stay in your current job, or deciding whether to join friends on an unplanned weekend trip when you had planned to catch up on schoolwork. Other decisions have more open timelines, such as deciding whether to go on a diet, clean out the attic, or join a social media platform. When dealing with non-urgent decisions, either impose an artificial deadline for making the decision or if you feel unready to do so, decide to defer the decision to a later (specific) date when you will revisit the issue (so it doesn’t hover over you as an outstanding task).

5. Visualize the different options. We often make decisions based on our gut but let’s make sure to give our gut enough information to work with. Find a quiet spot, close your eyes, and in your mind, play out each of the options before you in graphic detail (i.e., take the time to truly paint the scene—the more detail, the more real it will seem, the truer your gut read will be). For example, if you’re deciding whether to buy an expensive item of clothing you really want but cannot really afford, envision what it would be like to get the item and wear it in a specific circumstance but also envision looking at your empty bank account, having to forgo something else you might have wanted, or the stress of big credit card bills until you pay it off.

6. Put it all together. Now that your gut has a better read on what you should do, choose the option you are leaning toward most. If you suspect your decision was more emotional than rational (i.e., one made by your gut) proceed to the next step. If not—you have made your decision.

7. Sleep on it. If you think your decision was motivated by emotion (e. g., “I kind of shouldn’t but I really want to!”) get a good night’s sleep and go over the pros and cons again the next day to make sure you’re not succumbing to impulse.

Monday, November 7, 2016

Assessment 101: Types of Evaluations

by Aida Khan, Ph.D.

Assessment 101 is a series of three articles about developmental assessments by Dr. Aida Khan, clinical psychologist and neuropsychologist and Lecturer in the Department of Brain and Cognitive Sciences at the Massachusetts Institute of Technology.
Types of Evaluations
Assessments Provide a Roadmap
Assessment professionals try to understand how your child thinks, reasons, and processes information. A formal evaluation should give you a clearer understanding of your child.  An evaluation should also offer strategies for addressing your child’s needs. A good evaluation creates a road map about what to anticipate as your son or daughter gets older and expectations increase at school and elsewhere.
Assessment or testing are other terms for evaluations. In an assessment, the evaluator works with a student using paper and pencil tasks and other activities to figure out your child’s skill levels in different areas. The evaluator’s observations of a child’s behavior and problem solving style also provide information about individual difficulties and strengths.
The larger goal of the assessment process is to provide a big picture view of your child’s vulnerabilities—and resources. This information helps guide your decisions about education, behavior, and other areas.

Neuropsychological Assessments
Neuropsychological evaluation is the most time-consuming and comprehensive of the assessment options. A neuropsychological assessment will provide a snapshot of your child’s functioning and developmental profile today.
This evaluation describes your child’s strengths and weaknesses as a thinker and learner. It tells you how your child’s skill levels compare to his peers.
Neuropsychologists are specialized psychologists with a doctoral degree in psychology or a related field. You may see Ph.D., Ed.D., or Psy.D. listed after their names. They usually have done a postdoctoral fellowship in clinical neuropsychology after getting their doctoral degree.
What do neuropsychologists do? They try to understand how a child’s underlying temperament interacts with life and school experience. These experiences shape a young person’s learning style, personality, and overall functioning.
Temperament refers to the intellectual ability, learning style, and personality traits your child came into the world with—the foundation. Experiences in life and at school will further shape a child’s natural temperament. These experiences will influence who your child becomes as she moves through her development.
A neuropsychologist does a battery of tests to assess many areas of your child’s functioning, including:
  • Intellectual level
  • Language skills
  • Nonverbal or visual skills
  • Memory
  • Attention
  • Organization, judgment, planning, efficiency at producing work
  • Academic skills
  • Emotional status
The assessment takes four to six hours of your child’s time. The evaluator may spend another two or more hours to talk with you to learn your child’s history and share impressions of your child. Neuropsychologists review a range of records and may observe your child at school. Usually, a neuropsychological evaluation takes place over two to four meetings.
The report the neuropsychologist writes after the assessment should include:
  • Explicit answers to the questions that brought you to the evaluation
  • Information about your child’s weaknesses and strengths as a learner
  • An opinion about whether your child has a learning disorder or other developmental disorder
  • Practical recommendations for interventions at school and home
Neuropsychologists cannot look in-depth at every area. The goal is to identify the big picture of your child’s strengths and weaknesses and to integrate this picture into an understanding of the whole child.
The neuropsychologist may refer your child for additional evaluations if there are areas of weakness that need to be better understood. Additional evaluations are often recommended to provide more information about: a) language skills, b) academic skills, c) fine or gross motor abilities, or d) emotional functioning.

Speech/language Evaluations
If a child’s language skills are not developing as expected, he should receive a referral for a speech/language evaluation. This is usually about a three to four-hour commitment for a family.
Speech/language pathologists have master’s degrees. They assess:
  • The ability to mechanically form language (to say words and sentences in terms of using the tongue and lips correctly)
  • The ability to process language (to understand spoken and printed language and to express oneself verbally and in writing)
Speech/language pathologists look at five main areas:
1. They want to see how well your child understands the language spoken by others (directions, stories read to her, teacher lecture, classroom discussion).
2. They want to see how well he expresses herself in language (expresses needs, thoughts, and ideas verbally).
3. They want to see if your child grasps the underlying structure of language. The structure of language means how well she understands aspects of language such as grammar, vocabulary, word usage, and how words go together to form sentences.
4.  They assess how well a child uses language to meet his own needs and navigate the social world.
5. They evaluate whether your child has acquired the foundation of skills needed in order to learn to read and write in early elementary school.
Psycho-educational Evaluations
Psycho-educational evaluations focus on your child’s intellectual ability and academic skill levels. These evaluations take about four hours.
One goal of psycho-educational evaluations is to figure out whether your child is performing in reading, spelling, writing, and math at grade level and at his intelligence level.
Professionals with master’s degrees or doctoral degrees in education or psychology do these evaluations.
Psycho-educational evaluations can provide useful information but they are not as comprehensive as a neuropsychological evaluation.
If this is your child’s first evaluation, a neuropsychological evaluation is likely to provide more useful information. In my opinion, you should get an initial neuropsychological evaluation, then if needed a psycho-educational evaluation as a follow-up a year or more later to track your child’s rate of progress over time.
Think of it this way. The neuropsychological evaluation provides an initial detailed map of the terrain. The psycho-educational evaluation tracks progress, developments, and changes in that terrain over time.
Educational Evaluations
If your child is falling behind her peers in academic skills, an academic or educational evaluation will reveal whether your child's skills are at grade level in academic subjects. This usually takes about three hours of your time.
It is important to know if your child is behind equally in all areas or if she shows clusters of difficulties that suggest a pattern of weaknesses in learning. Does she have trouble in language arts, but is strong in math? Is the pattern the opposite?
Educational evaluators usually have master's or doctoral degrees in education or psychology. Sometimes special education teachers do these evaluations.
Occupational Therapy Evaluations
Young children are expected to learn many complex fine motor activities. They draw, copy, write, and pick up and manipulate small objects.
Verdana, Arial, Helvetica, sans-serifIf your child has trouble with these skills, she is likely to need a referral for an occupational therapy evaluation. This evaluation takes about two to four hours. The evaluator is a professional with a master's degree.
Occupational therapists evaluate hand skills and sensory motor abilities. This refers to the ability to manipulate things with the hands, the ability to write smoothly and control a pencil or scissors, and the ability to plan and carry out drawing and other visual motor tasks.
Occupational therapists also assess the child’s ability to track things visually. They may assess your child’s strength, range of motion, and balance. Knowing how your child’s skills affect her ability to carry out tasks of daily life, like brushing her teeth, can also be part of an occupational therapy evaluation.
Personality or Projective Evaluations
Doctoral-level psychologists do personality assessments, which are also known as projective evaluations. This assessment can take between two and four hours. The goal is to understand your child’s inner emotional life and psychological preoccupations.
Is his thinking disturbed or not connected to reality? Are her social perceptions accurate or faulty? How does your child think about relationships with family and friends?
Figuring out how resilient your child is emotionally is an important part of this evaluation. How does she handle emotions and upset feelings? How does she cope with unpleasant feelings? How does he manage the stress and strain of life in the real world?
These evaluations should identify areas of distress as well as the emotional tools and coping strategies the child already has for managing life’s difficulties.
The word projective means the evaluator gives your child ambiguous test materials and asks her to respond to them. Without saying it explicitly, the evaluator is asking your child to project her own thoughts and feelings onto the materials. Examples of ambiguous materials include pictures of interpersonal situations or the well-known inkblots of the Rorschach test.
In sharing what she sees in these ambiguous materials, we presume your child is projecting her own beliefs and psychological preoccupations onto the materials. The evaluator interprets the meaning of your child’s projections and offers insight into her psychological state and internal emotional life.
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