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Thursday, July 29, 2010

T3 - Abusers in Society

A while back, I did a series of posts on abusers, which Miss Sharp indicated sparked this question: "I'd like to know more about how a therapist approaches an abuser and how abusers do or do not cloak their real selves in society."

The truth of the matter is that an abuser doesn't think of themselves as bad. They are very ego-centric (for more on this, see my post "Inside the Head of an Abuser"), so if you are writing a story in which your villain is an abuser, you essentially are writing a villain who doesn't see himself as villainous.

In general, an abuser isn't going to want to talk to a counselor. That shift of power or control is very disconcerting and uncomfortable for them, so they would avoid authority figures who have the ability to strip them of their power.

It's important to note here that the current standard for treating couples who have domestic violence is not to treat them together if there is active abuse going on. The reason is that the victim can be put in even greater danger and end up reluctant to say anything at all to the counselor. For example, after a session in which the victim opens up to say something about what the abuser did, the abuser goes home and punishes the victim for saying it in the first place.

But if faced with a situation in which they have to interact with someone in a position of authority over them, they can turn on the charm to such an extent that a therapist or other authority figure can actually doubt the victim's assertions of abuse. They do not come off in anyway as a creep or power miser. They appear average and usually nondescript. There is no physical formula to identify an abuser. They are not always huge monsters who pump iron, but are sometimes physically slight.

Abusers have figured out how to throw people off-balance. They are masters at it because they do it to their victims every day. An abuser can make the victim feel like the abuse is their fault or that they are going crazy. This type of playing of mind games with the victim as sometimes been termed gaslighting, named after the 1938 play, Gas Light in which the husband convinces his wife that she's essentially going crazy. There is nothing to prevent an abuser from trying to make the therapist think the victim is crazy, as well.

Hopefully this helps answer your question, Miss Sharp. If not, feel free to ask further questions in the comment section.

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Tuesday, July 27, 2010

Treatment Tuesday - Mercenary Catholic?

This week's assessment comes from Robrecht via facebook, which was new for me! He's writing about Josh*, a devout Roman Catholic shadowrunner (futuristic mercenary for hire) with a very strict moral code not to kill unless he's defending himself or his family. He attended medical school at NYU, and as a result, he got into "shadow work" to pay his mounting tuition. He tended wounded shadowrunners before being offered a gig in Miami, Florida. He made a lot of enemies, often from his own team, as he refused to kill wounded bad guys since they weren't an immediate threat to his safety. Many times, it would have been wiser to kill them so that they wouldn't be a future threat.

Robrecht wants to know: Is it possible to remain a "good Catholic" (or at least for the character to believe he is one without being seriously deluded) while being a mercenary?

I thought this was a great question, because the juxtaposition of faith against actions has always been a prime topic in theological and philosophical debates for years...so why shouldn't it cause our characters angst and confusion?

The Apostle Paul wrote, "I do not understand what I do. For what I want to do I do not do, but what I hate I do" (Romans 7:15). He was talking about struggling with our sinful nature. No one would probably accuse Paul of being less than a "good Christian," yet he knew the war raging within himself.

Personally, I think making Josh a Roman Catholic mercenary is such a great internal tension-builder. We want our characters to wrestle with huge life questions, and because the value Roman Catholics place on life is so great, you've given him a doozy of a life question!

I got this from the Vatican's website, which is a quote from Saint Ambrose: "Every murder is a violation of the 'spiritual' kinship uniting mankind in one great family, in which all share the same fundamental good: equal personal dignity."

Josh's little "quirk" of not killing someone who is wounded and not about to try to kill him or his family is his concession to the sanctity of life. I mean, killing people as a mercenary isn't "good Catholicism," but when the killing can almost be justifiable as self-defense, it's a gray area. Reckless killing isn't what Josh is doing. He's very controlled and pointed about pulling the trigger, which actually errs on the side of good Catholicism. (Not sure I'm making sense here, but it sounds right to me!)


One must think about the type of people mercenaries kill, and they usually aren't the Mother Teresas of the world. I mention this because they likely are murderers themselves. I think an interesting little verse from Genesis, referring back to Cain and Abel, might serve as a internal mantra or sorts of Josh.

God put a mark on Cain, "lest any who came upon him should kill him." To review, God has punished Cain by sending him to live in the wilderness and desert where the ground will not bring forth fruit for him. But this mark he puts on him isn't to condemn him, but, according to the Catholic Church, it's to protect and defend him from those wishing to kill him. The mark is God's mercy even as he punishes, because not even a murderer loses personal dignity...and maybe that's another reason Josh refuses to kill those wounded to finish them off.

Another way to give Josh tension both internally and externally is if you give him a desire to sink roots deep down into one place, but yet his mercenary job keeps him "on the run" or "wandering." This is similar to what happened to Cain after he murdered his brother Abel. He became a "fugitive and wanderer on earth" (Gen 4:14). So maybe Josh's goal is to stay in one place and settle down, yet his punishment for the career he's chosen as a shadowrunner makes this impossible....the "curse" he must live with, similar to Cain.

Hopefully this assessment has given you something to chew on, although I'm afraid I drew more from the Catholic Church's website than from psychology. Please ask any additional questions in the comment section if you don't think I covered it well enough!

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Thursday, July 22, 2010

T3 - Ambivalent Attachment

Since I'm still answering questions from the response section of this post, this week I'm tackling
TrophyofGrace's question about ambivalent attachment:

"I'd really like to understand more about ambivalent attachment in adults and the effects of relationships it can have and the symptoms, etc. How would you go about lessening ambivalent attachment?"
For those who don't know what attachment is, much less ambivalent attachment, I did a series of posts here on the different types of attachment. In short, attachment is a lasting psychological connection between human beings. We learn how to relate to others by how our parents related to us. There is a direct link between childhood attachment patterns, adult attachment styles, and functioning in intimate and romantic relationships.

Those who are ambivalently attached have relationships often characterized by anxiety and uncertainty. Because they have such a low opinion of themselves (that they are unworthy of love and unable to get they love they need without being angry and clingy), they can be excessively vigilant and jealous. The might always demand reassurance of faithfulness and end up scaring others away. It's a catch 22--they have a profound need for closeness but can't trust that their partner will be emotionally available.

So, as you can imagine, the effects on a relationship can be disastrous. When a partner doesn't feel trusted, it picks at the very foundation of a good relationship. Initially, the partner might just think, "Oh, she needs a bit more of my attention." But since he's into you, he'll go with it for a while....until it becomes over-the-top and, quite honestly, annoying. No one wants to keep reassuring their mate that they love them or find them attractive. I'm sure it would get old. Eventually the mate would likely become bitter about it, and arguments spring forth. The end is a short time away. And the ambivalently attached person seeks to do this all over again.

Lessening ambivalent attachment problems--or ANY attachment problem--will be easier with therapy. Trained professionals know how to dig in and treat the root cause of the attachment disorder. Here are two options besides seeking individual therapy:

1) Join a grief group.

Moving through the process of grieving childhood losses is important to feeling comfortable in our adult roles. Resolving old grief around how we were brought up will help us not to bring these unresolved feelings into our intimate relationships.

2) Undergo communication skills training.

You don't have to go to therapy for this one. This kind of training happens on the job, by picking up a self-help book, etc. But learning the basics of listening and talking can take a strained relationship and make it more successful. Learning the art of creating safe environments to discuss in, being attuned to the other's needs, learning empathy, understanding the difference between passive/aggressive/assertive communication styles, utilizing body language...all of these skills can help you talk better to your spouse or intimate partner.

I hope this helps with your writing, TrophyofGrace!

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Tuesday, July 20, 2010

Treatment Tuesday - THE BIG 3

Erica wrote in with this question (among many others):
I need some suggestions for what exactly my character's parents
fight about?
I thought this would be a great opportunity to expound on what I like to call the Big 3 of Marital Discord (not to be confused with the Triple Threat, which is the top 3 reasons couples get divorced).

Married couples most likely fight over (not necessarily in this order):

1) Money

Money is what makes the world go round, right? Everything you do depends on money, and you work all day to make it. So when it's spent wrong or ill-gained, it causes major problems. Couples typically start out marital bliss up to their necks in debt nowadays, and debt is a major strain.

Maybe one partner has a gambling problem or drug addiction, and uses family resources to pay for it. Or one has trouble keeping a lid on internet shopping, and the bills are piling up, debt collection agencies are calling, letters from the bank come...any of the above could be cause for marital fighting.

2) Sex

Ooo. Always a big ticket item amongst couples. and probably one of the hardest to seek help about, since sex is supposed to be private. So what's to fight about? Frequency. Quantity. Positions. Quality. Suspicions of infidelity. Porn.

As an aside, I really believe in therapy helping in this area. Once couples get past the awkwardness of just talking about sex in front of another person, it's actually very freeing to have a safe place to discuss things.

3) Children

Parents argue about how to raise their children almost from day 1. Very rarely will a husband and wife come to a marriage from similar backgrounds. Part of parenting is learning how to merge two different lifestyles into one.

How to discipline, what the kids should eat, what school or church they should go to, who is going to change the poppy diaper, give them a bath...the list just goes on and on at any age. Also, in couples who don't have children, whether or not to have them can also crop up commonly, usually when one partner wants to and the other doesn't.


Hopefully this will give you something to start on Erica. I'll address the rest of your questions in a future Treatment Tuesday.


And for those of you who are just dying to know....the Triple Threat almost reads just like the Big 3. The top 3 reasons for divorce are: Money, Sex, and Inability to Communicate (not necessarily in that order).

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Thursday, July 15, 2010

T3 - YA Character Development

A little different twist for the Therapeutic Thought today. audrey4j asked about the way YA characters are developed--compared to adult-read books.

She wrote, "I've heard that teen boys want stories that don't go deep into characterization or added details that slow the story (romance, too many characters, etc), but I didn't pay a lot of attention because I didn't intend to write YA. But here I am, writing YA! Any comments/instruction?"


So while I might not be able to write about whats selling or what editors/agents want, I can shed some light on a person's development during this time period.

According to Erik Erickson, the Adolescent stage of development (ages 12-19, depending on who you quote) marks the beginning of when what we do makes more of a difference than what is done to us. The YA reader is neither child nor adult, so they are grappling with who or what, exactly, they are.

They are trying to define themselves with their actions, which can be translated into behaviors that alter their appearance, such as tattoos, piercings, and dying their hair, or where they choose to spend their time (church v. mall v. the downtown "strip" where they ride in each others' cars---you know you did this). All of it is an attempt to figure out the main question children this age want answered: "Who am I and where am I going?"

This can be summed up by saying a YA will have an identity crisis (indeed, Erickson was the one who is credited with coining this term). Life gets bigger and bigger the longer they are in it, and they realize they no longer are the center of the universe eventually. They grapple with social and moral issues. Teens are building up their ideals, because at this time, it's easier to think in terms of ideals than reality, because a teenager has little experience. So give them something to idealize, care about, ponder.

The most significant relationships teens have are with their peers. They most likely aren't going to want to read about a teen hero's problems with his parents. Romance is burgeoning during this stage, so not including a romantic theme would be a mistake (according to developmental theories, anyway).

The main thing is for the reader to identify with the character, so your YA character should be struggling to find their place in the world, what they want to do with their life, who they want to be. It's cliche, but coming of age stories work for this age group.

So I guess I'd have to respectfully disagree with whoever told you deeper characterization wasn't for this age group, as characterization is all of what I wrote about above and more. Don't sell teens short and just give them fluff. This is the time where they are experimenting and need to be reminded of what all is out there, both good and bad.

Whatever else you might want to say about Twilight, it had great development of the characters of Bella, Edward, and Jacob. They had their own limitations, motivations, and goals. They had their own quirks (Edward's insistence of no sex before marriage, Bella's clumsiness, Jacob's intensity) and flaws (Edward's, um, desire for blood, Bella's dragging along both boys, Jacob's temper and obsession). Even if it hadn't been a world-wide phenomenon, these are the kind of characters YAs want to read about.

For a little advice on where you can go to read about adolescent boy development in particular, I have to direct you to one of my favorite cartoons, Zits. It's about Jeremy Duncan, a teenage boy plagued with parents who know nothing, boredom and angst. Hilarious, and SO TRUE. Google it to find out more.

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Tuesday, July 13, 2010

No Treatment Tuesday - Spring Cleaning


Will be back Thursday for my Therapeutic Thought!

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Monday, July 12, 2010

Candace Calvert's Critical Care

This book is still being offered for FREE on Amazon Kindle, so if you haven't downloaded it yet, skip this review and go immediately to Amazon to do so! Then come back and read why you should give yourself a pat on the back. :)

From the author's wesite:

After her brother dies in a trauma room, nurse Claire Avery can no longer face the ER. She's determined to make a fresh start--new hospital, new career in nursing education--move forward, no turning back. But her plans fall apart when she's called to offer stress counseling for medical staff after a heart-breaking day care center explosion. Worse, she's forced back to the ER, where she clashes with Logan Caldwell, a doctor who believes touchy-feely counseling is a waste of time. He demands his staff be as tough as he is. Yet he finds himself drawn to this nurse educator ... who just might teach him the true meaning of healing.

Within the first chapter, you've got high tension in an ER that is reminiscent of, well, ER. And with the onset of the day-care explosion, Claire has to re-enter the world of emergency room life as a Critical Incident Stress debriefer.

Since I recently was a mental health professional on-call during a fire that broke out in one of the facilities I oversee mental health services in, I had to do one step up from what Claire was doing, as Claire was a "peer counselor," not a licensed clinician. It's still tough, people. Having the people participating in the trauma tell you what they were doing, what their role was, how they are feeling...it can be hard.

Kudos to Calvert, who obviously did her research, and knew appropriate protocol and terminology. That's always nice to read as a therapist, but then again, Calvert knows her stuff. She was a former ER nurse herself, so all those scenes are very realistic, many of which pull at your heart strings.

Claire essentially has PTSD from her brother's death. Calvert does a fine job showing how Claire reacts to even stepping foot inside another ER again. What I also liked was the gradual way Calvert reintroduced Claire to ER work (very much against her will). This is what would actually happen in therapy...sort of asking the client to develop a hierarchy of worst-case scenarios and then taking them through them.

I loved that Logan had a "thing" about counseling. I've run across a couple Logans in my time, and they can be pains in the you-kn0w-what. But Logan is just hot enough that I didn't mind him coping a little attitude about it. He's got his own emotional baggage to work through, as does Claire, and the end is more than satisfying.

In short, I'm trying to track Calvert down on the web to try to win her second book in the Mercy Hospital series, Disaster Status, which just released in April 2010. I've got to see how Erin's story goes!

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Thursday, July 8, 2010

T3 - Post-Cult Trauma

This week's Therapeutic Thought is from Julia M. Reffner, who commented on my post Pick My Brain without Having to Write In ... "I would love to see something about cults and the lasting emotional effects on those who leave them."

One of the things to be aware of that might help when talking about cult involvement is how similar cultic abuse is to domestic abuse. Since I just finished up a series on domestic violence, that will already give you a head start into figuring out the lasting effects of abuse in general.

Just as an aside, a person doesn't set out to be in a repressive cult, just like no one decides, "Hey, I think I'll marry an abuser." It's not on someone's to-do list. But there are people who might be more susceptible to cults. According to psychologist Dr. Paul Martin, there are three types:

1) Seekers of God looking for a worthy cause or way to serve

2) Lonely or depressed who find a caring community in the group

3) Idolizers of the charisma of the leader or excitement of the movement

Post-Cult Trauma is characterized by a variety of symptoms, depending on the person and type cult they were involved with. Dr. Margaret Singer, a professor of psychology at the University of California, Berkeley, did extensive research with thousands of former cult members, and she observed intense depression, anxiety, low self-esteem, loneliness, inability to concentrate, confusion, sleep disorders, guilt, loss of identity, suicidal ideation, somatic complaints and over-dependence in a significant number of them. Some even had acute psychosis, meaning they were in need of serious psychiatric care.

As with anything ending that you have invested a part of yourself in, a person leaving (or being forced to exit) a cult will feel conflicting emotions. There are two sides to every coin. People can develop friendships and a sense of belonging in a cult, just as they can have a sense of purpose inherit in the group's mission or ideals. I'm not trying to glamorize a cult, but a person leaving a cult will experience grief over these losses...and that's normal and shouldn't be denied them.

Cults often entrench their members, many times resulting to brainwashing. Upon breaking away the cult, the person will find themselves isolated from others who understood the cult's brand of brainwash (for lack of better terms). They might still adhere to their cultish beliefs and be scared that they might lose their salvation, be cursed/condemned, incur God's wrath, or be susceptible to evil spirits now that they are no longer "protected" by the cult.

An interesting note is that cult members sometimes assume a pseudo-identity in a cult, perhaps taking on a different name or even personality. Occasionally, after exiting the cult, they might slip back into that pseudo-identity, a term called floating. I just ran across this in my research, so I'd google this if you want more information, but it's similar to dissociating.

On the other hand, some people who used to be in cults look at their breaking away as a freedom from oppression. They might have different symptoms, like guilt at what all they did in the cult when they were brainwashed, either to themselves or to someone else.

Other symptoms of post-cult trauma are: flashbacks to cult life--even including actual chanting, being triggered by cultic language used innocently by someone else, etc., simplistic black-white thinking, sexual conflicts, confusion about right v. wrong, spontaneous crying, difficulty holding down a job/managing time, panic disproportionate to one's circumstances, fear of going insane, dread of running into cult members by mistake, hostile reactions toward either the cult of criticizers of the cult, Stockholm Syndrome, and excessive rigidity about even minor rules.

These symptoms can last a couple of months for most people, and usually subside after being reintroduced to mainstream routines and everyday life outside the cult. In a small number of cases, symptoms continue...but I don't have a percentage for you. If you find one, drop me a comment.

Thanks for the question, Julia. It's not too late for you to get your question in if you've got one percolating!

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Tuesday, July 6, 2010

Treatment Tuesday - Character Stereotypes: Cynicism

What exactly is a cynic?
Main Entry: cyn•ic
Pronunciation: \ˈsi-nik\
Function:noun
1 : a faultfinding captious critic; especially: one who believes that human conduct is motivated wholly by self-interest
I hate it when Webster’s definition has me looking up another word to get the full meaning, but captious means “marked by an often ill-natured inclination to stress faults and raise objections.” Basically, a cynic is an unpleasant person to be around.
People do not consider cynicism a good trait. These are not the people we seek out to eat lunch with or to babysit our children. They don’t inspire us to scale mountains or overcome obstacles. They are obstacles themselves.
Authors have, by and large, given cynicism to a character more as a vice, a personal thing for him or her to work through on an inward journey. I’m hoping to give some insight into how cynics get that way.
Most people are not born with this disposition, they become this way due to life circumstances. For this exposé on cynics, I want to examine a few key characteristics of cynics that need to be present in your manuscript to make their cynicism ring true...

Click here to read the rest of the article at Christian Fiction Online Magazine.

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Monday, July 5, 2010

Anxiety Reduction for the ACFW Conference

The American Christian Fiction Writer's conference is coming up in Indianapolis this year, from September 17-20. With the advent of such an amazing conference, there can be a lot of anxiety--especially as you wait your turn to pitch to an agent or editor! So read on for anxiety-reduction techniques to use while either attending the conference or not.

I selected a few techniques that can be done at any time or place.


Square Breathing

You can do this technique standing or sitting, although I prefer clients to sit. If you were in my office, I'd say close your eyes, but if people are milling about, just leave them open. The instructions are simple:

a) Slowly count to 3 as you take a deep breath in through your nose
b) Hold your breath for 3 counts
c) Let the breath out through your mouth for 3 counts
d) Hold for 3 counts
e) Repeat a few times/as needed

You can increase the count to 4 if this suits your lung capacity better.


Mindfulness

Mindfulness is bringing yourself into the present moment. It's making yourself relax and become aware of your breath, thoughts, feelings, surroundings and sensations. You give your self-critical, controlling mind a rest and accept the moment with peace and non-resistance. (Yes, sounds a little new-agey, but it works and you won't need to go to church afterward to repent.)

Since anxiety lives in the body as chronic tension, just breathing can help undo that tension, which restores balance to the body and mind. It's hard to remember your breath, so setting aside time to do so amidst the hustle and bustle of conference will help you relax. (Breath is key!)

a) Sit as relaxed and still as possible
b) Don't try to control your thoughts - just observe your breath and other sensations/sounds. Don't engage your thoughts, just let them come and go
c) Focus on breathing or heart beat or the rise/fall of your belly/chest


Progressive Muscle Relaxation (PMR)

PMR is when you tense and relax various muscle groups in your body in a progression. You hold the tension for about 10 seconds and then relax, noticing the difference between relaxed and tense. You usually work bottom to top, right to left.

a) Right foot, calf, thigh, entire leg
b) Left foot, calf, thigh, entire leg
c) Right hand, forearm, bicep, entire arm
d) Left hand, forearm, bicep, entire arm
e) Buttocks
f) Abdomen
g) Chest (fill and hold lungs)
h) Shoulders
i) Neck
j) Face (stretch out forehead and cheeks by exaggeratedly mouthing the vowel sounds - you might want some privacy for this part, or leave it out)

While you're waiting for the Book of the Year (Carol Award) or Genesis Awards to be revealed, or waiting in line to see the agent or editor of your dreams, use one or all of these techniques to bring you back to a more relaxed state of mind. Remember, God is master of your anxiety.

Hope to see many of you at the conference this year!! Additional details below.





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Thursday, July 1, 2010

T3 - Coping Mechanisms

Shannon asked me to cover this topic when she commented on my post, Pick My Brain Without Writing In. (It's not too late to ask your own questions!)

Coping mechanisms. We all have 'em. We all use 'em. But what the heck are they?

Coping mechanism is a broader term to define everything a person does to handle the difficulties in their life. There are many types of coping mechanisms, some of which are never known by others and therefore not seen as "problematic," and others which are very public. Here's a brief run-down:

  • Adaptive mechanisms: This is more of a positive approach to handling our problems. if only we did more of these.
  • Attack mechanisms: Probably one of the more detrimental ways to cope, and that is to lash out at others, be passive-aggressive, or trivialize things in a hurtful way.
  • Avoidance mechanisms: These coping mechanisms simply delay the inevitable time when you will have to deal with the problem. While maybe not overtly negative or positive, the delay in and of itself can cause harm.
  • Behavioral mechanisms: A lot of what has already been mentioned above fit into this category. However, additional coping mechanisms that change how we act might be regressing to a childlike state to avoid a problem, or compensating in one direction to make up for a perceived flaw in another.
  • Cognitive mechanisms: Changing the way we think about our problem is a way to cope, for example, psychosomatic symptoms develop mentally, or we fantasize to escape reality.
  • Conversion mechanisms: These coping mechanisms transform one problem into another, for example, if you get angry, you so chop firewood. The payoff is that you're fitter and have firewood and nobody got harmed (this is sublimation).
  • Defense mechanisms: Freud's original set of defense mechanisms is the gold standard people generally think about when coping mechanisms is mentioned. Denial, projection, regression. Good stuff.
  • Self-harm mechanisms: These mechanisms end up hurting our selves. This could be self-harming or subconsciously converting stress into physical symptoms.
If you're not wide-eyed with too much information, I picked a few interesting coping mechanisms (to me) to delve into.

1) Dissociation

Some of you might think that only really whacked-out people dissociate (this means to disconnect from their mental state into a separate one). In really extreme forms, this can lead to separate personalities, but on the other end of the spectrum, you've got people who dissociate driving down boring I-5. Suddenly you'll "come to" and wonder what the heck you were doing during the last 5 miles.

Dissociation can be a way to cope with being bored, but not to be confused with fantasizing. (A good example of the latter would be the character Rebecca Bloomwood in Sophie Kinsella's Confessions of a Shopaholic. She always imagined things were happening to her that weren't.)

2) Superstitions

Some people develop superstitions to ward off a potential evil or bring about good luck. Most notably, athletes do this a lot. Read this article here on various superstitions some athletes had. One of my favorite depictions of this was from the show Frasier, when Niles was used as a good luck charm by a Seattle SuperSonics team member who wanted to rub his head before every game.

Of course, superstitions don't have to be odd or weird. Maybe a character's way of coping with living in a bad neighborhood is to check all doors and windows a few times before going to bed. Some would argue this might be obsessive-compulsive, but others would argue it's just to stay safe.

3) Humor

Since this is one of my own mechanisms to cope with everyday life, I wanted to include it. It can be positive, a way to diffuse tension in a room or break the ice in a group, but it can also be negative, in that the humor, while funny, is biting (as in sarcasm) or offensive (as in bad jokes). People spout off when nervous or fearful, or they hide behind their humor (such as the case of cynics, which you can read about in my Christian Fiction Online Magazine article this month--hopefully the link works, as I'm doing this post in advance).

So there are a few coping mechanisms, as well as links to pages that discuss the many varieties of coping mechanisms above. Hope this helps, Shannon! Thanks for the question...it was a great idea for a post. :)

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