The Crisis of Youth Mental Health

Author Article

(Illustration by Mike McQuade)

One in five children in the United States has a diagnosable mental health condition. Unfortunately, access to care for these children is poor: At least 85 percent of those in need of treatment do not get it.1 More than half of mental illness emerges before age 14, so getting children the help they need, in addition to ameliorating their immediate suffering, can also prevent future pain. The result of not getting help can be dire, as suicide is now the second leading cause of death for those between ages 10 and 34.2

Mental illness exacts a staggering cost on society. It leads most measures of economic burden for noncommunicable diseases. The World Economic Forum issued a report that mental illness has a greater impact on economic output than cancer, heart disease, or diabetes.3 The report’s authors estimate the worldwide cost of mental illness to be $16 trillion between 2011 and 2030. Other recent research has indicated that untreated anxiety and depression costs society $1.15 trillion annually.4

While the economic burden of mental illness is staggering, the total spending devoted to addressing it is shockingly low.5 In low-income countries, outlays are minuscule: less than 1 percent of total health budgets. But even in high-income countries such as the United States, the expenditure on mental health as a percent of total health budgets is grossly inadequate, given the prevalence of mental illness. Overall, it is widespread in children, its cost to society in terms of pain and suffering and financial burden is enormous, and its overall funding is insufficient.

Those who work in mental health call the shortfall between the percentage of people with a mental health condition and those who receive help the “treatment gap.” Its persistence indicates a problem that government and business have failed to address. It is especially important to prevent children and adolescents from falling into the gap, because of the compounded costs of untreated mental illness that continues into adulthood. Private philanthropy is in a unique position to lead the effort, in collaboration with government, business, and the nonprofit sectors, to ensure that all children needing mental health treatment receive it. The availability of proven or promising interventions, growing public awareness of the importance of mental health, and the projections of significant private philanthropic funds becoming available in the next decade make this an opportune time for private philanthropy to lead the effort to close the gap.

Mind the Gap

Why do children in need of mental health treatment not get it? The World Health Organization (WHO) outlines three primary components of access to health care: physical accessibility, financial affordability, and acceptability.6 Physical accessibility involves health care’s geographical proximity and availability at convenient times for the people who need it. Affordability means that those who want health care can get it without financial hardship. Acceptability means that people believe health care is effective and respectful of their social and cultural background.

During the past 30 years, health care has focused on “evidence-based medicine,” which incorporates available scientific research into clinical decision making to ensure optimal patient care. This focus has spawned hundreds of scientifically tested, evidence-based mental health treatments, most of which use individual psychotherapy to address specific clinical problems, such as depression or anxiety. For the past two decades, mental health treatment researchers have been optimistic that implementation science might help improve physical access to evidence-based care. Implementation science is the study of systematically developing and testing strategies for spreading, scaling, and sustaining evidence-based treatments. But implementation science has had, at best, marginal effects on access to evidence-based mental health care. For example, a recent study showed that for children using publicly funded services in the United States, only 2 percent received an evidence-based treatment based on scientific research.7

Click to enlarge. SOURCE: Adapted from David E. Bloom, et al., “The Global Economic Burden of Non-communicable Diseases,” Geneva: World Economic Forum, 2011.

Some states, such as Connecticut, have invested considerable public funds into increasing access to evidence-based treatments and have achieved better results.8 For example, at the children’s behavioral health agency that I lead, the Child Guidance Center of Southern Connecticut, 8 percent of the 1,386 children we served in 2017 received an evidence-based treatment that adhered to strict standards that the developers of these treatments established. Although this figure is four times the US average, most of the children we served are not getting these treatments. Instead, they are receiving individual psychotherapy that, while helpful, may not always be as effective as
evidence-based practice. Unfortunately, even in a state like Connecticut, where evidence-based treatments are more geographically accessible, there are often wait lists for these treatments that render them inaccessible for the vast majority of children.

The numbers we serve at the Child Guidance Center with an evidence-based model are relatively small because it requires such extensive staff training and consultation. None of the state grants we receive to implement and sustain evidence-based practices comes close to covering the costs of these practices. Researchers who recently examined the costs of sustaining one evidence-based treatment in Connecticut calculated an incremental per-patient annual expense of $1,896.9 For the Child Guidance Center of Southern Connecticut to treat all children in need of outpatient or home-based services with an evidence-based practice like the one these researchers highlighted, it would cost an additional $2,627,856 (1,386 patients at $1,896 each). This expense would increase our $5.2 million annual budget by more than 50 percent and would require twice the amount of funding we currently receive from the state of Connecticut to deliver these services. We serve a small percentage of the roughly 56,200 Connecticut children who receive behavioral health care through Medicaid. To cover all of these publicly funded children with evidence-based treatment would cost an additional $106,555,200 annually. No state is flush enough in these austere times to absorb that kind of incremental cost. Thus, evidence-based treatments as they are currently delivered are not affordable.

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While there is considerable scientific support for evidence-based psychosocial interventions for children’s mental health problems, this research is based primarily on studies of non-Hispanic white children. There is much less evidence supporting these interventions for ethnic minority youth.10 Cultural factors, such as perceived stigmas and different conceptions of mental illness or treatment, likely influence the effectiveness of existing evidence-based interventions, as does a dramatic shortage of ethnic-minority mental health clinicians. Approximately 90 percent of mental health clinicians in the United States are non-Hispanic white, but 30 percent of people in the United States belong to a racial or ethnic minority.11 In states that have growing immigrant populations, such as Connecticut, competition is fierce among nonprofit mental health agencies seeking to hire qualified bilingual clinicians, because there simply aren’t enough of them to serve the expanding population. Consequently, the acceptability of evidence-based mental health interventions among racial or ethnic minority populations is inconsistent.

The shortage of racial and ethnic minority mental health clinicians is part of a much larger problem. Given the prevalence of mental health needs, there are not enough clinicians of any race or culture. Recent estimates of the number of mental health clinicians range between 550,000 and 700,000, which is clearly not enough when 25 percent of people in the United States—approximately 80 million people—have a mental health disorder.12 In addition, most providers do not treat children, which is why only 15 percent of children who need treatment get it. Alan Kazdin, an internationally renowned psychologist and longtime developer and advocate of evidence-based treatments, has concluded that using the dominant model of psychosocial treatment—individual psychotherapy with a mental health professional in an office-based setting—to address the treatment gap is not possible. He writes:

Expanding the workforce to deliver treatment with the usual, in person, one-to-one model of care with a trained mental health professional is not likely to have a major impact on reaching the vast number of people in need of services. The increased person power is not likely to provide treatments where they are needed, for the problems that are needed, and attract the cultural and ethnic mix of clientele that are essential. 13

Kazdin is not suggesting that we stop providing individual, evidence-based treatments. Rather, he argues that we also need to develop new models of delivery to reach the vast majority of those who need help but are unlikely to receive individual therapy. The mental-health-care sector needs to develop innovative treatment delivery models and to test and implement existing new models. But to do so, it needs far more funding than it is currently receiving.

The State of Funding

Getting a handle on mental health research funding is not easy. Analysts have used several methods to determine its status, one of which is to study bibliographic funder acknowledgments from published mental health research articles. In 2016, the RAND Corporation conducted a bibliographic study of the acknowledgments in 220,000 mental health research publications between 2009 and 2014.14 The report found 1,900 funders that had more than 10 acknowledgments. Charities, foundations, and nonprofits represented 39 percent of these funders, government 33 percent, and academia 28 percent. The high percentage for papers funded by charities, foundations, and nonprofits suggests that foundations and charities may affect the field of mental health research more than public support does.

Researchers have also examined government and private funding of mental health research in the United States and the United Kingdom. The results reveal a startling lack of funding relative to the burden of mental illness. The largest funder of research in children’s mental health in the United States, the National Institute of Mental Health (NIMH), decreased funding for child and adolescent services and intervention research by 42 percent from 2005 to 2015 ($52 million to $30 million annually).15 Over the same period, the overall NIMH budget was flat and funding for neuroscience and basic behavioral research increased by 28 percent. Perhaps even more important, the $30 million dedicated to child and adolescent mental health represented only a 2.1 percent share of the total NIMH budget authority of $1.4 billion for 2015. This amount is disproportionately small, given that mental illness leads all measures of the economic cost of noncommunicable diseases.

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The data from private philanthropic support for mental health research in the United States are not much better. While funding increased in absolute dollars from 2006 to 2015, it decreased as a percentage of foundation funding of health care, from 6.2 percent to 5.6 percent.16 These downward funding trends are consistent with earlier researchers who reported that from 1998 to 2006, philanthropic support for mental health funding decreased as a percentage of foundation funding of health care, from 10.5 percent to 6.3 percent.17 More important, as a percentage of overall foundation funding of mental health, support for children’s mental health decreased from 37.1 percent to 34.2 percent and support for children’s mental health research decreased from 3.8 percent to 1.6 percent.

We find the same tale in the United Kingdom. The private British mental health charity MQ found that UK government funding for mental health research for children and adults was 5.5 percent of the total budget. By comparison, cancer research was nearly four times higher, at 19.6 percent.18 MQ also reported that mental health research accounts for just 3.1 percent of charity-funded research, compared with more than 30 percent for cancer, 13.5 percent for infection, and 7.6 percent for cardiovascular research. For every £1 the UK government spends on cancer research, the general public invests £2.75; for heart and circulatory problems, it’s £1.35. By contrast, for mental health research, the figure is £0.003, or a third of a penny.

New Delivery Models

Such a paucity of research funding should concern everyone in the health-care industry, given the widespread incidence of children’s mental illness and the high percentage of children who are not getting help. We can address this treatment gap by developing service-delivery models other than individual therapy and medication, but the effort will require more investment to drive the spread of these models.

Private philanthropy is especially suited to addressing the mental health treatment gap for children. As philanthropist Laura Arrillaga-Andreessen said in an interview with Forbes magazine,

Philanthropy is often seen as society’s risk capital. That means the onus is on philanthropists, nonprofit leaders, and social entrepreneurs to innovate. But philanthropic innovation is not just about creating something new. It also means applying new thinking to old problems, processes, and systems. 19

The mental health treatment gap in children is a prototypical example of a complex problem that requires new thinking, because the current service-delivery model—individual psychotherapy and medication—is ineffective in reaching the vast majority of kids. Unlike the business sector, which is accountable to shareholders; government, which is accountable to voters and special interest groups; and public charities, which are accountable to donors, private foundations need only meet their legal requirement within IRS regulations to disperse at least 5 percent of their endowments annually to tax-exempt causes. Private philanthropy is therefore in a position to take big risks. In addition, because of philanthropies’ capacity to fund, they can convene a variety of important parties, such as government funders and regulators, private industry, policy-
makers, and advocacy groups.20 The ability to convene and the freedom to take risks places private philanthropy in an ideal position to catalyze solutions to complex, multisystem problems like this one.

In his 2018 book, Innovations in Psychosocial Interventions and Their Delivery, Alan Kazdin proposes eight characteristics to guide the development and implementation of mental health service-delivery models to address the treatment gap.21 I have highlighted the three features that I believe are most important for funders: scalability, affordability, and acceptability. These characteristics offer a way for funders to weigh the impact that different service-delivery models might have in closing the treatment gap, and to compare and contrast the relative strengths and weaknesses of different models, because closing the treatment gap will require integrating many different service-delivery models. (No one model will address all problems or all populations.) Not coincidentally, affordability and acceptability are also two of the three components of the WHO’s definition of access to treatment described earlier. Ultimately, closing the treatment gap is about making mental health interventions accessible to all who need them. 
Several systemic changes in health care have already begun to foster new models of delivery that may improve the accessibility of care for children struggling with mental health problems. For example, health insurers and payers, including Medicare and Medicaid, have begun moving from volume to value—from reimbursement based on fees for service (e.g., a session of individual therapy) to reimbursement based on population health outcomes. Population health emphasizes scalability at the outset of designing ways to improve children’s mental health. Focusing on the mental health of entire populations fosters prevention and early intervention in children, because these practices are likely to be less expensive than waiting until mental health problems arise or become more severe.

We now have the opportunity to build on these changes by furthering the adoption of new models. Specifically, funders should consider four innovative models of delivery to reach children struggling with mental health needs. Private foundations have begun incubating all of these innovative models, yet the time is ripe for philanthropy to play a much larger role in funding these models to close the treatment gap once and for all. Let’s consider them in turn.

Task Shifting

Task shifting is the process of delegating tasks, when appropriate, to less specialized health workers. Other countries have used task shifting for decades to improve access to care. In the United States, the change to value-based purchasing is driving health-care delivery systems to employ task shifting to both improve access and lower costs. Most people have become familiar with task shifting through visits to their doctor’s office, where they are seen first by a medical assistant, then by a nurse or physician’s assistant, and then, finally, for a few minutes by a physician.22

A particularly innovative example of task shifting is Project Echo, which trains primary-care clinicians to provide specialty services by linking these clinicians via videoconference to multidisciplinary teams of specialists in academic medical centers. Project Echo’s first test of its model, with hepatitis C in rural New Mexico, was so successful that the prototype has been expanded to cover more than 100 diseases, including adult psychiatric and substance-use disorders. The Robert Wood Johnson Foundation has funded Project Echo to treat behavioral health problems in pediatric care.23 Project Echo aims to reduce disparities in access to care, expand the workforce of behavioral health clinicians, and diffuse best practices. However, as some researchers have cautioned, more research is needed to evaluate the clinical outcomes and cost effectiveness of Project Echo for diseases besides hepatitis C.

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Task shifting can also train laypersons to treat mental health needs, such as depression and anxiety, in low- and middle-income countries where few specialized providers exist.24In the United States, the professionalization of lay counselors into “peer specialists” is another example of task shifting. In March 2017, Mental Health America, in collaboration with the Florida Certification Board and Kaiser Permanente, developed the National Certified Peer Specialist Certification, which requires background checks, work experience, training, a certification test, and continuing education. In Connecticut, Beacon Health Options, the state’s administrative care organization for Medicaid, has employed peer specialists to reduce psychiatric inpatient days by 57 percent for children transitioning to a different level of care.25

Wider implementation of these interventions in the United States has been hampered by state licensing departments that are designed to protect the public from fraudulent practice and by mental health professional associations that exist to promote the reputation and financial viability of their professional members. As a result, many children who could be served will continue to go without treatment. Private foundations could play a role in advocating for change within professional associations, since foundations cannot lobby for changes in legislation. Because the treatment gap is so large, professional associations can endorse the use of lay therapists without adversely affecting the livelihoods of their professional constituents.

Task shifting shows promise along Kazdin’s three dimensions for new models. It makes care more affordable, by offering service considerably less expensive than the dominant model of individual psychotherapy conducted by a mental health professional. In addition, the fact that lay counselors and peer specialists have been well received by consumers suggests that their acceptability is high.26 The scalability of these models is yet to be fully evaluated, but the rapid expansion of task shifting and the growth of innovative models such as Project Echo imply that the scalability of task shifting is promising.

Digital Self-Help Technology

Digital technology—computers, the Internet, mobile devices, and apps—offers considerable promise as a delivery model that sidesteps stigmas and could expand access to evidence-based mental health care.27 Digital versions of a range of evidence-based psychotherapies are available, including Internet-based cognitive behavioral interventions for anxiety, depression, and post-traumatic stress disorder that focus on modifying unhealthy ways of thinking and improving behavioral coping skills.28 In addition, online self-help interventions exist to prevent anxiety and depression, such as MoodGym, which was designed for people ages 15 to 25 and has helped more than one million users. MoodGym has five interactive modules with information, exercises, and quizzes that focus on feelings, thoughts, and relationships. The modules are based on cognitive behavioral therapy and interpersonal therapy, which emphasizes changing social and familial difficulties. Clinician-supported digital interventions have been found as effective as face-to-face treatment.29 In addition, virtual reality treatment has proven effective for a number of child mental health conditions, including anxiety, depression, attention deficit hyperactivity disorder, eating disorders, and autism.30

Estimates of new philanthropic funding becoming available are sizable. But funding for children’s mental health is trending downward.

In 2014, the Colorado Health Foundation made its first program-related investment in MyStrength, an evidence-based online mental health treatment platform designed to expand access to mental health and wellness interventions for a range of clinical problems. The foundation structured its investment in this for-profit company as a $1.5 million senior loan agreement. Private foundations can use a range of program-related investments, including equity investments, investing in intermediary funders, loans, and recoverable grants, to fund early-stage for-profit companies that are expanding access to mental health care for children. The Bill & Melinda Gates Foundation has used many of these vehicles to foster the development and spread of health-care innovation and to prevent the spread of disease.

The digital self-help model is affordable and scalable, because more than 50 percent of the world’s population has Internet access, but the acceptability of these treatments needs further evaluation. Translation of digital interventions into different languages and cultures is an area for further study and funding.

Integration of Behavioral Health and Primary Care

Another market force influencing the development of new delivery models is the Affordable Care Act (ACA), which then-president Barack Obama signed into law in 2010. The ACA provided incentives for practices to adopt a patient-centered medical home, an integrated-care delivery model with the physician at the center of a team that included behavioral health specialists. ACA funding has also encouraged the further integration of medical and behavioral health care.

Federally Qualified Health Centers (FQHCs) are perhaps the most widespread example of integrated care. Many FQHCs provide fully integrated medical, dental, and behavioral health care for children and adults, facilitating “one-stop shopping” where entire families can get treatment for multiple needs at the same site at the same time. Research has found that primary care providers, rather than specialists, treat roughly three-quarters of children’s mental health needs, so integrating care makes sense.31 In addition, it can decrease stigmas surrounding mental health needs, because a “warm handoff” from a pediatrician to a mental health provider can reinforce the principle that “mental health is health.” 32

In smaller primary-care practices where it is not feasible to have on-site child psychiatrists or psychiatric advanced-practice registered nurses, more than 30 states have adopted the Massachusetts Child Psychiatry Access Program model, wherein pediatricians and other primary-care providers can talk to a team of child psychiatrists, licensed mental health clinicians, and resource coordinators for medication consultation, referral, and treatment recommendations, regardless of the client’s insurance. The National Network of Child Psychiatry Access Programs is a nonprofit member organization that provides methods and consultation to support the implementation of this model throughout the United States. Further foundation funding to design and implement innovative models like this could enhance the integration of mental health and pediatric care to reach more children with mental health needs.

Accountable Communities for Health

Value-based purchasing has spurred public and private health-care payers’ interest in the social determinants of health (SDOH). They increasingly recognize that improving the health of entire populations requires addressing the social determinants, within the communities where people live, work, and raise their children, believed to account for as much as 60 percent of the factors responsible for premature death.33 Addressing the SDOH calls for collaboration among multiple service systems, including health care, housing, public health, social services, and job training.

Accountable Communities for Health (ACHs) are community-based partnerships that bring together these systems to address the SDOH. In 2016, the US Department of Health and Human Services funded a five-year, $157 million program to develop the ACH model in 31 communities throughout the United States. A number of private funders, including the Robert Wood Johnson Foundation, the Kresge Foundation, the W. K. Kellogg Foundation, and the California Endowment, have also embraced this model for improving health. The California Endowment is one of several private foundations invested in the California Accountable Communities for Health Initiative, a public-private partnership to develop ACHs in 15 California communities. At the national level, these foundations have joined with public funders, including the Center for Medicare and Medicaid Innovation, the Centers for Disease Control and Prevention, and the Health Resources and Services Administration in the Funders Forum on Accountable Health, a vehicle sponsored by George Washington University’s Milken Institute School of Public Health, to share ideas and develop ways to assess the impact of ACHs.

The National Academy of Medicine recently proposed the concept of an ACH focused on children and families.34 ACHs offer considerable promise in using prevention and early intervention to improve children’s mental health and reduce the economic and psychological burden of mental illness. In a recent blog post for Health Affairs, Benjamin F. Miller, chief strategy officer of Well Being Trust, and Anne De Biasi, director of policy development at Trust for America’s Health, highlighted the need for foundations to fund policy initiatives that close the “prevention gap” in mental health, which emerges prior to the first symptom of a mental health condition.35 All three of the new delivery models we have discussed—task shifting, digital self-help technology, and the integration of behavioral health and primary care—could be integrated within an ACH to prevent and treat the emergence of mental health conditions. Although it is too early in the development of ACHs to evaluate their long-term effectiveness, their potential to improve the SDOH makes them a promising model in the quest to close the mental health treatment gap.

An Opportune Time

Estimates of new philanthropic funding becoming available in the next decade are sizable. According to a recent analysis by LOCUS Impact Investing and the Center for Rural Entrepreneurship, “If only 5 percent of the $9 trillion in assets projected to pass from Americans’ estates over the next decade were captured by philanthropy, it would create the equivalent of 10 Gates Foundations” and would generate an additional $22.5 billion in grantmaking annually.36 In spite of this anticipated increase, funding for children’s mental health is trending downward. This is unacceptable.

There has never been a better time for private foundations to invest in solutions to close the mental health treatment gap for children and adolescents. They have the capital, and there are many ideas worth funding. New delivery models that are scalable, affordable, and acceptable to the children and families they serve and that address the social determinants of health will require collaboration among many parties, including government funders and regulators, private industry, policymakers, and advocacy groups. Private philanthropy is in an ideal position to convene them to help drive the further development and spread of these delivery models.

Lucid Dreamers May Help Unravel the Mystery of Consciousness

Author Article

We spend around six years of our lives dreaming – that’s 2,190 days or 52,560 hours. Although we can be aware of the perceptions and emotions we experience in our dreams, we are not conscious in the same way as when we’re awake. This explains why we can’t recognize that we’re in a dream and often mistake these bizarre narratives for reality.

But some people – lucid dreamers – have the ability to experience awareness during their dreams by “re-awakening” some aspects of their waking consciousness. They can even take control and act with intention in the dream world (think Leonardo DiCaprio in the film Inception).

Lucid dreaming is still an understudied subject, but recent advances suggest it’s a hybrid state of waking consciousness and sleep.

Sleep paralysis. My Dream, My Bad Dream, 1915. (Credit: Fritz Schwimbeck/Wikimedia)

Lucid dreaming is one of many “anomalous” experiences that can occur during sleep. Sleep paralysis, where you wake up terrified and paralyzed while remaining in a state of sleep, is another. There are also false awakenings, where you believe you have woken up only to discover that you are in fact dreaming. Along with lucid dreams, all these experiences reflect an increase in subjective awareness while remaining in a state of sleep. To find out more about the transitions between these states – and hopefully consciousness itself – we have launched a large-scale online survey on sleep experiences to look at the relationships between these different states of hybrid consciousness.

Lucid Dreaming and the Brain

About half of us will experience at least one lucid dream in our lives. And it could be something to look forward to because it allows people to simulate desired scenarios from meeting the love of their life to winning a medieval battle. There is some evidence that lucid dreaming can be induced, and a number of large online communities now exist where users share tips and tricks for achieving greater lucidity during their dreams (such as having dream totems, a familiar object from the waking world that can help determine if you are in a dream, or spinning around in dreams to stop lucidity from slipping away).

recent study that asked participants to report in detail on their most recent dream found that lucid (compared to non-lucid) dreams were indeed characterized by far greater insight into the fact that the sleeper was in a dream. Participants who experienced lucid dreams also said they had greater control over thoughts and actions within the dream, had the ability to think logically, and were even better at accessing real memories of their waking life.

Another study looking at people’s ability to make conscious decisions in waking life as well as during lucid and non-lucid dreams found a large degree of overlap between volitional abilities when we are awake and when we are having lucid dreams. However, the ability to plan was considerably worse in lucid dreams compared to wakefulness.

Lucid and non-lucid dreams certainly feel subjectively different and this might suggest that they are associated with different patterns of brain activity. But confirming this is not as easy as it might seem. Participants have to be in a brain scanner overnight and researchers have to decipher when a lucid dream is happening so that they can compare brain activity during the lucid dream with that of non-lucid dreaming.

Ingenious studies examining this have devised a communication code between lucid dreamer participants and researchers during Rapid Eye Movement (REM) sleep, when dreaming typically takes place. Before going to sleep, the participant and the researcher agree on a specific eye movement (for example two movements left then two movements right) that participants make to signal that they are lucid.

The prefrontal cortex. (Credit: Natalie M. Zahr, Ph.D., and Edith V. Sullivan, Ph.D. – Natalie M. Zahr, Ph.D., and Edith V. Sullivan, Ph.D.)

By using this approach, studies have found that the shift from non-lucid to lucid REM sleep is associated with an increased activity of the frontal areas of the brain. Significantly, these areas are associated with “higher order” cognitive functioning such as logical reasoning and voluntary behaviour which are typically only observed during waking states. The type of brain activity observed, gamma wave activity, is also known to allow different aspects of our experience; perceptions, emotions, thoughts, and memories to “bind” together into an integrated consciousness. A follow-up study found that electrically stimulating these areas caused an increase in the degree of lucidity experienced during a dream.

Another study more accurately specified the brain regionsinvolved in lucid dreams, and found increased activity in regions such as the pre-frontal cortex and the precuneus. These brain areas are associated with higher cognitive abilities such as self-referential processing and a sense of agency – again supporting the view that lucid dreaming is a hybrid state of consciousness.

Tackling the Consciousness Problem

How consciousness arises in the brain is one of the most perplexing questions in neuroscience. But it has been suggestedthat studying lucid dreams could pave the way for new insights into the neuroscience of consciousness.

This is because lucid and non-lucid REM sleep are two states where our conscious experience is markedly different, yet the overall brain state remains the same (we are in REM sleep all the time, often dreaming). By comparing specific differences in brain activity from a lucid dream with a non-lucid one, then, we can look at features that may be facilitating the enhanced awareness experienced in the lucid dream.

Furthermore, by using eye signaling as a marker of when a sleeper is in a lucid dream, it is possible to study the neurobiological activity at this point to further understand not only what characterizes and maintains this heightened consciousness, but how it emerges in the first place.

This article was originally published on The Conversation. Read the original article.

How to Use Humor to Become Happier and More Successful

Author Article

There are many times in life when a person with a sense of humor lightens the mood of a meeting, family gathering, or party. You may actually look forward to going to work if you know you can count on having a good laughor two at some point during the day. The endless meetings or tedious job tasks that are part of your workload are made more tolerable if these witty folks infuse their observations into the situation. If the person is the boss, even better. You can’t help but admire leaders who don’t take everything all that seriously, including themselves. Similarly, outside of work you may highly value your friends and family members who can either tell a good joke or make light of what might otherwise be a serious occasion, at least from time to time.

In a new study, University of Arizona’s Jonathan B. Evans and colleagues (2019), noted that although humor has the potential to create an environment conducive to positive outcomes, at work and elsewhere, this potential may fail to be realized. If a joke falls flat, the person telling it can look inept or even cruel.  Telling jokes can also influence the way you’re perceived by the people who you’re trying to entertain. Based on a model known as “parallel-constraint-satisfaction” theory, which proposes that stereotypes affect the way people interpret the behavior of others, Evans and his colleagues hypothesized that men would benefit and women would be penalized when using humor specifically in the workplace. Men will gain status when they make jokes, and women will lose.

This proposal may ring true if you think about comments over the years suggesting that women can’t be funny. Rather than add to this debate, however, the Arizona researchers looked not at what’s funny or not, but how telling jokes affects they way the joke-teller is perceived which, in turn, influence the joke’s impact. Think about times when you’ve been in a meeting or group setting in which a man constantly makes wisecracks while everyone else is trying to stay task-focused. Try as you might, you find yourself unable to suppress a giggle now and then. You don’t think any less of the jokester and, in fact, find your estimation of him rising as he shows his humorous side. Now imagine that it’s a woman in the role of jester. Do you still think of her as gaining in status, or does she just seem silly?

Parallel-constraint-satisfaction-theory (PCST) proposes that people evaluate a target along multiple dimensions simultaneously, influencing the way they evaluate others. With humor, the joke-teller can be seen as either serving a positive purpose by alleviating tension or as disruptive by distracting people from the task at hand. Gender interacts with this dimension, with male stereotype of a man being high in agency (individual drive) and rationality with women seen as low in personal agency and rationality. Men therefore have the humor-as-functional perception working in their favor but women, seen as irrational and flighty, are perceived as disruptive and even non-funny.

In the first of two studies, Evans et al. asked 96 online participants to rate the disruptiveness and functionality of humor as shown by either a male or female manager performing in an online video. The manager was described in the research materials as a highly successful and talented individual. As the research team predicted, participants rated as more disruptive and less functional the same jokes expressed by women as by men. In the second study, 216 online participants watched videos of either a man or a woman either telling jokes or not telling jokes. Following the presentation of the video, participants then rated the managers on their status, performance and leadership capability.

As the authors predicted, participants rated female joke-tellers as lower in status, which in turn led participants to view them as lower in performance and leadership capability than men. They note that, like an elbow nudge, humor’s meaning can be ambiguous. We impose onto that behavior, they maintain, our stereotypes about the joke-teller. There is no reason that the same jokes, whether told by a male or female, should have the same impact on those hearing the jokes. By supporting the PCST approach, the Arizona researchers showed that humor’s perception is bent by the gender of the joke-teller.

Thus, being sarcastic and teasing violates the female gender stereotype but fits perfectly with that of the male’s. Evans and his fellow researchers maintain that they have added to the literature regarding the lower proportion of female than male CEO’s. If men can get to the top by being funny, but women lower their status potential by engaging in the very same behavior, this would provide yet another cause of the glass ceiling for female executives.

To sum up, humor’s ability to provide fulfillment should be gender-neutral, but since the Evans et al. study suggests it’s not, perhaps there can come a time when, in the words of the authors, “increased awareness can help reduce its occurrence.” Give the female joke-teller some slack, and you’ll be part of that long-overdue impetus for change.

15 Signs That You’re An Introvert With High-Functioning Anxiety

Author Article

Anxiety is the voice in the back of your head that says, “something bad is going to happen.” It’s what keeps you awake at 2 a.m. thinking about something embarrassing you did — five years ago.

Not all introverts have anxiety, and extroverts and ambiverts can struggle with it, too. To be clear, introversion and anxiety aren’t the same thing. Introversion is defined as a preference for calm, minimally stimulating environments, whereas anxiety is a general term for disorders that cause excessive fear, worrying, and nervousness.

However, for many introverts, anxiety is a regular part of their lives. And indeed, anxiety is more common among introverts than extroverts, according to Dr. Laurie Helgoe.

What Is High-Functioning Anxiety?
Sometimes anxiety is obvious (think: panic attacks and sweaty palms), but that’s not always the case. Many people live with a secret form of anxiety called “high-functioning anxiety.” Outwardly, they appear to have it all together. They may even lead very successful lives. No one can tell from the outside that they’re driven by fear. Sometimes they don’t even realize it themselves.

Do you have high-functioning anxiety? Although not an official diagnosis, high-functioning anxiety is something countless people identify with. It’s closely related to Generalized Anxiety disorder, which affects 6.8 million adults in the U.S., women being twice as likely to experience it as men.

Symptoms of High-Functioning Anxiety
Here are fifteen common symptoms of high-functioning anxiety.

1. You’re always prepared.
Your mind frequently jumps to the worst-case scenario in any given situation. As a result, you may find yourself over-preparing. For example, you might pack underwear and makeup in both your checked luggage and your carry-on, just in case the airline loses your suitcase. People see you as being the reliable one — and often your preparations do come in handy — but few people (if any!) know that your “ready for anything” mentality stems from anxiety.

2. You may be freaking out on the inside, but you’re stoic on the outside.
Interestingly, many people with high-functioning anxiety don’t reveal just how nervous they are, which is another reason why it’s often a secret anxiety. You may have learned to compartmentalize your emotions.

3. You see the world in a fundamentally different way.
Your anxiety isn’t “just in your head.” Researchers from the Weizmann Institute of Science in Israel found that people who are anxious see the world differently than people who aren’t anxious. In the study, anxious people were less able to distinguish between a safe stimulus and one that was earlier associated with a threat. In other words, anxious people overgeneralize emotional experiences — even if they aren’t threatening.

4. You constantly feel the need to be doing something.
Which can be a real problem if you’re an introvert who needs plenty of downtime to recharge. This doesn’t necessarily mean you’re attending lots of social events; instead, you may feel a compulsion to always be getting things done or staying on top of things. Staying busy distracts you from your anxiety and gives you a sense of control.

5. You’re outwardly successful.
Achievement-oriented, organized, detail-oriented, and proactive in planning ahead for all possibilities, you may be the picture of success. Problem is, it’s never enough. You always feel like you should be doing more.

6. You’re afraid of disappointing others.
You might be a people-pleaser. You’re so afraid of letting others down that you work hard to make everyone around you happy — even if it means sacrificing your own needs.

7. You chatter nervously.
Even though you’re an introvert who prefers calm and quiet, you chatter on and on — out of nervousness. For this reason, sometimes you’re mistaken for an extrovert.

8. You’ve built your life around avoidance.
You’ve shrunk your world to prevent overwhelm. You stick to routines and familiar experiences that give you a sense of comfort and control; you avoid intense emotional experiences like travel, social events, conflict, or anything else that might trigger your anxiety.

9. You’re prone to rumination and overthinking.
You do a lot of negative self-talk. You often replay past mistakes in your mind, dwell on scary “what if” scenarios, and struggle to enjoy the moment because you’re expecting the worst. Sometimes your mind races and you can’t stop it.

10. You’re a perfectionist.
You try to calm your worries by getting your work or your appearance just right. This can bring positive results, but it comes at a cost. You may have an “all-or-nothing” mentality (“If I’m not the best student, then I’m the worst”). You may have unrealistic expectations of yourself, and a catastrophic fear of falling short of them.

11. You have aches, repetitive habits, or tics.
According to psychotherapist Annie Wright, your anxiety might manifest physically in your body as frequent muscle tension or aches. Similarly, you might unconsciously pick at the skin around your nails, tap your foot, scratch your scalp, or do other repetitive things that get your nervous energy out — even if you appear composed in other ways.

12. You’re tired all the time.
Your mind is always going, so you have trouble falling asleep or staying asleep. Even when you sleep well, you feel tired during the day, because dealing with a constant underlying level of anxiety is exhausting.

13. You startle easily.
That’s because your nervous system is in over-drive. A slammed door, an ambulance siren, or other unexpected sounds really rattle you.

14. You get irritated and stressed easily.
You’re living with constant low-level stress, so even minor problems or annoyances have the power to frazzle you.

15. You can’t “just stop it.”
Anxiety isn’t something you can tell yourself to just stop doing. In fact, the above-mentioned researchers from the Weizmann Institute of Science found that people who are anxious have somewhat different brains than people who aren’t anxious. They noted that people can’t control their anxious reactions, due to a fundamental brain difference. (However, you can learn to cope with your anxiety and greatly lessen it — see the resources below).

Why Being A Night Owl Might Be Damaging Your Mental Health

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woman sleeping in bed

GETTY IMAGESCAIAIMAGE/PAUL BRADBURY

Not only is being a ‘night owl’ annoying when you have to get up for work the next day, it apparently affects more than just your body clock – it has a big impact on mental health, too.

According to a new study published in the journal Nature Communications, people who are naturally early risers are less likely to develop mental health problems than those who go to bed late and sleep in.

The large-scale genetics study, conducted at the University of Exeter, used data from 250,000 research participants signed up to the private genetics company 23andMe, and 450,000 people in the UK Biobank study. Participants were asked whether they were a “morning person” or an “evening person”, and their genomes were analysed, revealing certain genes people shared that appeared to influence sleep patterns.

Lead study author Samuel Jones, a research fellow studying the genetics of sleeping patterns at the University of Exeter, said:

“Part of the reason why some people are up with the lark while others are night owls is because of differences in both the way our brains react to external light signals and the normal functioning of our internal clocks.

“The large number of people in our study means we have provided the strongest evidence to date that ‘night owls’ are at higher risk of mental health problems, such as schizophrenia and lower mental wellbeing, although further studies are needed to fully understand this link.”

The results found uncovered an apparent causal link between being a night owl and being more prone to depression, anxiety and schizophrenia – with evening types 10% more likely to develop the latter condition.

However, they found no increased risk of obesity and diabetes among night owls, despite what some earlier studies have said.

Samuel Jones said the conclusion is that night owls are more likely to have to work against their natural body clock in school and the world of work, which may have negative consequences on their mindset.

So, how can you go about adjusting your sleep schedule? Hope Bastine, sleep psychologist for high-tech mattress maker Simba, says we need to identify our individual sleep needs first.

“Experiment with your productivity and your performance rate and adjusting your time schedule to that,” she told Cosmopolitan UK. “Find a rhythm, a schedule, a lifestyle that really suits you, and that makes you feel in harmony with yourself. Make sure your sleep schedule is as non-negotiable as possible.”

Putting sleep first? Done.

Follow Abbi on Instagram.

A 5-Minute Meditation Practice You Can Do Anywhere to Let Go of Jealous

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How To Overcome Jealousy Meditation

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If you’ve ever wondered how to stop being jealous after a scroll through your Facebook feed leaves you feeling like a crazy person, you’re not alone. I’ve been there, too. As ashamed as we might be to admit it, jealousy is a tough demon to beat.

Before Facebook posts were a thing, I could go about my daily life not knowing what my ex was doing with his new girlfriend or what amazing new job a high school classmate had just got. But now we’re in the modern world, and we have the privilege — and burden — of knowing everything about everyone. Well, maybe not everything. Social media, after all, is just a highlight reel.

Nevertheless, it’s difficult to remember that we shouldn’t really be comparing ourselves to others. Why? Because our feelings of envy can linger and have unpleasant effects on our mood and our perspective of our own lives. So, If you’re feeling or have ever felt like the grass was greener on the other side, you might want consider giving meditation a try.

How can meditation help jealousy?

Most people think of meditation for stress relief, but not everyone considers jealousy a stressor. The truth is, feeling jealous can indicate that a person’s sense of safety is threatened, so these emotions really should be addressed. Luckily, meditation can actually work to rewire the brain for more positive thinking and relief from envious feelings.

According to Psychology Today, meditation affects the prefrontal cortex, more specifically the “Me Center” of the brain — the same part associated with jealous feelings. It also affects the amygdala, or the “fear center,” that governs our fight or flight response. Balancing these systems with meditation can help you to gain control over negative thoughts and emotions, and can even improve your ability to connect with others. Scroll down for a simple practice to get started with today.

1. Notice your feelings.

The first step to overcoming any problem is becoming aware of it. Meditation doesn’t always look like someone sitting down in a tranquil environment with flute music in the background. It can be as simple as taking a moment — in any environment or situation — to pause and to notice.

When a jealous feeling arises, acknowledge it. Before you run off on a thought tangent, take a moment and a deep breath into your belly and recognize that the feeling is there. You might say (aloud or to yourself), “I am feeling jealous.” Observing your thoughts gives you the power to take control of their direction. Simple enough, right?

2. Breathe and reflect.

The magic of meditation is really in the breath. Once you’ve noticed that you’re feeling jealous, simply paying attention to your breathing and taking slow, conscious breaths can ease the tension by bringing you back to the present moment. It can even stop you from following that one negative thought down a rabbit hole of more pessimism.

This practice may seem really simple, but it’s tough at first since our brains are conditioned in old habits of thinking. Try to practice your breathing for at least one minute, with deep inhales into your belly and deep exhales out, making the exhales longer than the inhales. With repetition, this exercise can be the one that saves you from what may be the most common happiness killer — overthinking.

3. Practice letting go — and use a mantra.

If it were as simple as “just let it go,” then you probably wouldn’t have read this far. The idea of letting a negative thought or thought pattern go is great, but our brains don’t necessarily work that way. If we’re going to give up a habit that’s essential to the way we view ourselves and others in the world, we need to replace it with something. That’s where a mantra comes in.

Your mantra doesn’t have to be complicated; all it has to do is propose a positive to replace a negative thought. Because jealousy often arises as a result of feeling inadequate, mantras combat jealousy by focusing on abundance. Think about it this way, if you believe there’s enough for everyone, there’s nothing to compete for.

Your mantra could be something like, “I have enough. I am abundant,” if you’re struggling with feeling like others have more than you have, or “I am enough,” if you find that you’re struggling with feeling inadequate. To use your mantra, simply repeat it slowly over and over, with a big long breath in between each repetition. Do this for a few minutes, even if it feels like lying at first — which it might if your mind is fighting to tell you the old same story. Saying a mantra gives your mind something else to focus on and introduces a new way of thinking. Eventually, and with repetition, you’ll start to actually believe it.

A simple meditation practice like this one can do wonders in training the mind to think more positively about ourselves and the world around us. Taking some time in our day to pause, breathe, and reflect is an act of self care that allows us to connect with ourselves in a way that benefits everyone. We hope that you’ll give this practice a try and remember, the grass is always greener where it’s watered.

How Domestic Violence Affects Women’s Mental Health

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Every week in Australia, a woman is murdered by someone she knows. And it’s usually an intimate male partner or ex-partner.

One in three women has suffered physical violence since the age of 15. In most cases (92% of the time) it’s by a man she knows.

Added to this, one-quarter of Australian women have suffered emotional abuse from a current or former partner. This occurs when a partner seeks to gain psychological and emotional control of the woman by demeaning her, controlling her actions, being verbally abusive and intimidating her.

Physical and emotional abuse is not only distressing, it’s psychologically damaging and increases women’s risk of developing a mental illness.


Read more: Revealed: the hidden problem of economic abuse in Australia


How violence increases the risk

Women who have experienced domestic violence or abuse are at a significantly higher risk of experiencing a range of mental health conditions including post-traumatic stress disorder (PTSD), depression, anxiety, substance abuse, and thoughts of suicide.

In situations of domestic violence, an abuser’s outburst is commonly followed by remorse and apology. But this “honeymoon” period usually ends in violence and abuse. This cycle means women are constantly anticipating the next outburst. Women in these situations feel they have little control, particularly when the abuse is happening in their own home.


It’s no wonder living under such physical and emotional pressure impacts on mental and physical well-being.

One review of studies found the odds of experiencing PTSD was about seven times higher for women who had been victims of domestic violence than those who had not.

The likelihood of developing depression was 2.7 times greater, anxiety four times greater, and drug and alcohol misuse six times greater.

The likelihood of having suicidal thoughts was 3.5 times greater for women who had experienced domestic violence than those who hadn’t.

Survivors of domestic abuse are often reluctant to talk about their experiences. From shutterstock.com

An Australian study of 1,257 female patients visiting GPs found women who were depressed were 5.8 times more likely to have experienced physical, emotional or sexual abuse than women who were not depressed.

Not only is domestic violence and abuse a risk factor for psychological disorders, but women who have pre-existing mental health issues are more likely to be targets for domestic abusers.

Women who are receiving mental health services for depression, anxiety and PTSD, for instance, are at higher risk of experiencing domestic violence compared to women who do not have these disorders.


How do mental health services respond?

Although survivors of domestic violence are more likely to suffer mental illness, they are not routinely asked about domestic violence or abuse when getting mental health treatment. So they’re not provided with appropriate referrals or support.

One study found only 15% of mental health practitioners routinely enquired about domestic violence. Some 60% reported a lack of knowledge about domestic violence, while 27% believed they did not have adequate referral resources.

One-quarter (27%) of mental health practitioners provided women experiencing domestic violence with information about support services and 23% made a referral to counselling.

In the absence of direct questioning, survivors of domestic violence are reluctant to disclose abuse to health service providers. If mental health providers are managing the symptoms of the mental illness but ignoring the cause of the trauma, treatment is less likely to be successful.

Practitioners need to routinely ask women about present or past incidents of domestic violence if they are diagnosed as depressed or anxious, or if they show any other signs of mental distress.

Practitioners should be able to provide referrals to specialist services and need to be adequately trained to respond to those who disclose domestic violence. This means not focusing solely on medical treatment, but also on referrals and support.

How To Become Calm, Confident And Happy In Just 10 Minutes A Day

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Anything can quickly lead us to a crisis point – the car breaking down, being late for work, your credit card bill. A busy life juggling work and home can lead to butterflies in your stomach and a feeling that you can no longer cope.
 
This means that your fight or flight response has been engaged – an unconscious and involuntary reaction to perceived threat or danger.
 
In our daily life, our stress response can be triggered so frequently that we spend a lot of time unable to think clearly and remain calm.
 
Here are some tips on staying happy, confident and calm – all backed with the latest neuroscience research:
 
1. Practice compassion
 
It’s worth focusing on compassion as it is really good for your well-being. It feels great to show compassion to others – but it’s even more important to show compassion to yourself.
 
When you show compassion, your body releases chemicals like dopamine and oxytocin, which increases feelings of calmness, safety and trust. They reduce the feelings of anxiety we place on ourselves. So stop beating yourself up – compassion is good for both you, and those around you.
 
2. Be adaptive
 
As humans, we tend not to like change. We find comfort in order, stability and sameness.
 
Learning to be adaptive can be scary, as we are taken out of our comfort zone, so you can start by taking a few measured risks – like walking a different route home, learning a new language, trying a new exercises class. You will soon start to see change as a positive with less threat.
 
With less threat comes less stress, so you will begin to feel calmer consistently. Practicing adaptive behaviour has also been linked to a lesser risk of dementia later in life.
 
3. Buzz or Burden? The Stress Response
 
We all need some stress in our lives – think of the buzz you experience with positive pressure (healthy stress), or the feeling you get just before a big presentation. However, it’s important to recognise when feelings of stress are unhealthy.
 
Use mindfulness to bring yourself back to a healthy buzz, when you feel like you are beginning to tip into feelings of burden.
 
Stress occurs when perceived pressure exceeds your perceived ability to cope – Professor Stephen Palmer.
 
4. I’m a Perfectionist! That’s good, right?
 
Perfection is worn as a badge of honour by society – but beware! It can never be reached. Our advice to you is to replace your pursuit of perfection with a quest for the achievement of excellence.
 
Lives can be ruined through delaying tasks out of fear they won’t be perfect. Try instead to opt for excellence. Be as good as you can be – be your best self. That way, you’ll get more done in much less time. And you’ll feel calmer in the process. There! Perfect. Sorry!
 
5. Try Mindfulness
 
Mindfulness is an ancient Buddhist meditation practice. It’s now been proven by neuroscientists to be highly effective for calming the mind – in other words, it works! It allows us to be present in the moment and experience life clearly and fully. It trains the mind to keep intrusive, unhelpful thoughts at bay so that we can rationally problem solve. Mindfulness allows us to fully appreciate the present. It’s great to spend time there – it’s all we have!

How An INFJ Travels

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an INFJ makes travel plans
Lately, I’ve been obsessed with Myers-Briggs personality types (as many of my close friends and coworkers can tell you!). The MBTI, a personality inventory based on the work of C. G. Jung, is not a perfect system, and of course, a test will never be able to completely define who you are. Nevertheless, it’s been an immensely helpful tool in understanding myself better.I’m an INFJ, the rarest of the 16 personality types. This sensitive and emotional introverted personality makes up only 1-2 percent of the population and is described by 16 Personalities as “quiet and mystical, yet very inspiring and tireless idealists.” Those who know me well would dispute the “quiet” part, but for the most part, reading descriptions of the INFJ was scarily accurate. It felt like someone was reaching into my brain and explaining my thoughts, mindset, and struggles more eloquently than I have ever been able to do.

(What’s your personality type? We recommend this free personality assessment.)

INFJs are known as both dreamers and doers, the ones who think big and also follow through on their dreams and goals. For me, that big goal is traveling to 100 countries before age 100 and helping other young professionals travel better and cheaper through my blog MeWantTravel. Based on my personal experience and my research about INFJs, here’s a glimpse into how this personality type travels.

How an INFJ Travels

1. Despite being “extroverted” introverts, we will still need alone time.

For the introvert, alone time is absolutely necessary. If you’re traveling with extroverts, they may not understand why you need to disappear into your room and recharge after a busy day of sightseeing, but I’m here to tell you that it’s perfectly okay to ask for that time. After you recharge, you’ll essentially be a better you. So tell your extroverted friends that they will like you more for it!

2. Deep, meaningful conversations are key.

INFJs crave meaning in all that they do, and relationships are no exception. Conversations of substance — not just small talk — are very important to us, and we may find that speaking to locals is both eye-opening and crucial to truly experiencing a new place. For me, the more I travel, the more I realize that people everywhere are the same at their core. Though we may look different and speak different languages, we all have fears, dreams, and people we deeply cherish. We can choose to find common ground and stand together, or we can choose to be divided and separated by our differences. As INFJs, we will always be in favor of — and push for — the first option.

3. We may want to write about our travels.

INFJs are highly creative, especially when it comes to working with words. And when we travel, we often want to somehow creatively capture what we’re experiencing, whether it’s through the written word, art, or something else. This helps us reflect on our experiences, and as INFJs, we love optimizing, learning, and personal growth. In terms of journals, I personally love ones that are small and easy to carry around in your backpack or purse, so I can jot down notes or ideas as they strike me. And who knows, when you write down those personal recollections or draw that stunning view, it may just be the beginning of your memoir.

4. Whenever possible, we aim for the “local” experience.

This may mean dining at local hidden gems and skipping some of the “must see” tourist traps. It may also mean staying in Airbnbs or hostels as opposed to hotels because it gives us an opportunity to learn about the culture by staying with a local, and it gives us a guaranteed chance to meet other folks. A paradox of the INFJ is that we’re genuinely interested in (and fascinated by) other people — so much that we’re mistaken for extroverts. But we truly are introverts who need that precious downtime. Having a private room in a hostel or Airbnb home is the perfect way to get the best of both worlds.

5. Being “judgers,” planning is a must.

As a “judging” personality, we INFJs like to know what we’re doing in advance and where we’re sleeping, and we may or may not have a pre-researched list of all the places we want to go, eat, and explore (okay, we probably will have that list!). There’s little that stresses out an INFJ more than having to make rapid-fire decisions on the fly. Meanwhile, “perceiving” personalities, like the INFP or ISTP, feel more comfortable going with the flow and being spontaneous. For them, it might even be fun to roll into a new city with no solid plans and discover what they’ll do and where they’ll stay as it strikes them.


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6. Use your “chameleon” abilities to your advantage.

INFJs are chameleons who can adapt to pretty much any social situation, because we’re tuned into social norms and expectations, and we read others well. This can be draining, however, because it means you’re constantly assessing and reassessing the room. This radar is part of who we INFJs are, and it’s not something we can easily turn off. But one thing I’ve learned the hard way is not to sacrifice social harmony at the expense of myself!

INFJ, take care of yourself; know that even though people may misunderstand you, this doesn’t make your feelings or thoughts invalid. Continue to be the INFJ boss that you are and take pride in your uniqueness — and then go out there and experience all those exotic places you’ve been dreaming about!