Author Archives: Shervan K Shahhian, LIBERTY PSYCHOLOGICAL ASSOCIATION, The Most Comprehensive Online Library Regarding Mental Health, Psychology and Parapsychology in the World.

Doctored Degree in Clinical Psychology (PSYD) (ABD) All But Dissertation, a Masters (M.A.) in Clinical Psychology, a Bachelor's Degree (B.A.) in Psychology, a Associate Degree (AA) in Liberal Arts with an emphases in Psychology, Certification in Anger Management, Certification in MRT-Moral Reconation Therapy®, Certification in Clinical Hypnotherapy, and Certification in Advanced Hypnotherapy.

Attention Seeking Behaviors, what are they:

Attention-seeking behaviors maybe actions, conscious or unconscious, used to gain attention, validation, reassurance, or emotional connection from others.

They may or may not be inherently “bad.” In some cases, they reflect a basic human need for connection, but they can become problematic when they’re excessive, disruptive, or the person relies on them instead of healthier ways of relating.

Psychological Meaning

In psychology, attention-seeking might often point to unmet emotional needs, such as:

  • Desire for validation (“Do I matter?”)
  • Need for reassurance (“Am I safe/loved?”)
  • Fear of abandonment or being ignored
  • Low self-esteem or identity instability

Common Examples

Attention-seeking may show up in many ways, for example:

1. Overt (obvious)

  • Constantly interrupting conversations
  • Exaggerating stories or achievements
  • Dramatic emotional displays
  • Fishing for compliments

2. Covert (subtle/indirect)

  • Passive-aggressive comments
  • Playing the victim
  • Withdrawing to provoke concern (“Why didn’t anyone notice me?”)
  • Posting cryptic messages to get reactions

Psychological Roots

Different frameworks might explain it differently:

• Attachment Theory

People with insecure attachment may seek attention to feel safe or valued.

• Psychodynamic Perspective

It may relate to early childhood experiences, especially inconsistent caregiving.

• Behavioral Perspective

Attention (even negative attention) may reinforces the behavior over time.

When It Becomes a Problem

It may be clinically relevant when:

  • It disrupts relationships
  • It becomes the person’s main way of interacting
  • It causes distress or social rejection

It may appear in conditions like:

  • Histrionic Personality Disorder
  • Borderline Personality Disorder
  • Narcissistic Personality Disorder

A More Compassionate View

Instead of labeling someone as “attention-seeking” in a negative way, some clinicians may reframe it as:

 “Connection-seeking behavior”

This might shift the focus from judgment to understanding:

  • What need is not being met?
  • Why does the person feel unseen or unheard?

Healthier Alternatives

For someone struggling with this pattern:

  • Developing direct communication (“I need support right now”)
  • Building self-worth internally
  • Practicing emotion regulation
  • Engaging in therapy ( CBT, psychodynamic, or attachment-based work)

Shervan K Shahhian

The Black Sheep of the Family, what does that mean:

Calling someone “the black sheep of the family” might mean they’re the one who doesn’t fit in with the rest of the family and is often viewed as different, problematic, or embarrassing by the others.

More specifically, it usually might implies:

  • They break family norms or expectations (values, lifestyle, beliefs, career, behavior).
  • They’re criticized, blamed, or subtly excluded.
  • They may be treated as the outlier or scapegoat, even if they’re not actually doing anything wrong.

Historically, the phrase comes from sheep farming:

A black sheep’s wool couldn’t be dyed and was considered less valuable, so it stood out and was seen as undesirable.

A modern, more compassionate reframe:

  • The “black sheep” is often the truth-teller, cycle-breaker, or most psychologically differentiated person in the family.
  • In family systems psychology, this role frequently could belong to the person who expresses what others suppress.

So depending on perspective, being the black sheep might mean:

  • Family narrative: “the problem one”
  • Psychological reality: “the one who refused to conform”
  • Shervan K Shahhian

The Symptom-Bearer in Mental Health, explained:

In mental health, the “symptom-bearer” (often called the identified patient) might be the person in a family or group who shows the most visible psychological symptoms, but those symptoms may actually reflect deeper issues in the system around them.

Core idea

The symptom-bearer is:

  • The individual who expresses distress outwardly (anxiety, depression, acting out)
  • Seen as “the problem,” but…
  • Often carrying or manifesting the tension, conflict, or dysfunction of a larger system (usually the family)

Example

A teenager develops severe anxiety and panic attacks.
At first glance, they are the “patient.”

But in a broader view:

  • The parents may have unresolved conflict
  • There may be unspoken rules or emotional suppression
  • The teen’s symptoms become a signal or outlet for the family’s distress

The teen: symptom-bearer
The real issue: systemic imbalance

Origin of the concept

This idea might largely from:

  • Family systems theory
  • Structural and strategic family therapy

They emphasized that:

“The problem is not just in the person, it’s in the relationships.”

Key characteristics of a symptom-bearer

  • Often sensitive or perceptive to emotional undercurrents
  • May unconsciously absorb or express family stress
  • Symptoms might include:
    • Anxiety or depression
    • Behavioral issues
    • Psychosomatic complaints
  • Sometimes might improve when the system changes, not just individual treatment

Clinical implication

Treating only the symptom-bearer might be limiting. Effective approaches could involve:

  • Family therapy
  • Exploring relational patterns
  • Addressing communication, boundaries, and roles

Deeper perspective (important nuance)

The concept might not mean:

  • The person’s symptoms aren’t real
  • Or that they’re “just reacting”

Instead, it means:

Their suffering could be real, but it may also be meaningful within a relational context.

Shervan K Shahhian

The Identified Patient, who is it:

The identified patient (IP) maybe the person in a family, group, or system who is labeled as “the problem” and therefore might become the focus of treatment or concern?

In psychology, especially family systems therapy, the key idea is this:
The IP may be showing the symptoms, but those symptoms may often reflect stress?, conflict, or dysfunction in the larger system, not just something “wrong” with that person.

A few clarifying points:

  • The IP is the one whose behavior, emotions, or symptoms draw attention (a sibling with acting-out behavior, a teen with substance use, a spouse with depression).
  • These could be often the symptom-bearer, not necessarily the cause.
  • Focusing only on the IP can miss how family dynamics, roles, alliances, or unspoken rules might be maintaining the problem.
  • When the system changes, the IP’s symptoms could often improve without directly targeting them.

Classic example:
A sibling is brought to therapy for “behavior problems,” but therapy might reveal chronic parental conflict. The teens behavior could be an adaptive response to systemic tension.

In short:
The identified patient, could be where the distress shows up, not always where it originates.

Shervan K Shahhian

Hair Loss and Depression, the possible connection:

Hair loss and depression may or may not be connected, in both psychological and biological ways: PLEASE CONSULT WITH A DERMATOLOGIST. The relationship can form a feedback loop, where each condition may intensify the other? Here is a breakdown:

1. Psychological Pathway

Hair could be tied to identity, attractiveness, youth, and social confidence. When hair loss starts, whether subtle thinning or sudden shedding: (PLEASE CONSULT WITH A DERMATOLOGIST), it might trigger:

A. Emotional Reactions

  • Shock or disbelief
  • Embarrassment or shame
  • Fear of aging
  • Reduced self-esteem

B. Social and Behavioral Changes

  • Avoiding photos or mirrors
  • Reduced social interaction
  • Hyperfocus on appearance
  • Increased stress about “what others think”

These reactions may or may not develop into clinical depression for some, especially if hair loss is rapid: PLEASE CONSULT WITH A DERMATOLOGIST.

2. Biological Pathway (Chemical Connection)

Depression itself may or may not cause or worsen hair loss, and hair loss can worsen depression, forming a biological loop: PLEASE CONSULT WITH A DERMATOLOGIST

A. Stress Hormones

Chronic stress or depression MIGHT increase cortisol: PLEASE CONSULT WITH A DERMATOLOGIST, which can:

  • Push hair follicles into the “shedding phase”: PLEASE CONSULT WITH A DERMATOLOGIST
  • Reduce blood flow to the scalp: PLEASE CONSULT WITH A DERMATOLOGIST
  • Increase inflammation around follicles: PLEASE CONSULT WITH A DERMATOLOGIST

B. Neurochemical Changes

Depression could be linked to:

  • Changes in a persons medical health?, which might influence blood circulation, including the scalp? only a medical doctor can answer that question? (PLEASE CONSULT WITH A NEUROLOGIST/PSYCHIATRIST/DERMATOLOGIST)
  • Altered sleep, which disrupts hair growth cycles
  • Nutritional changes (low appetite, low vitamins?)

C. Medication Side-Effects

(PLEASE CONSULT WITH A PSYCHIATRIST/DERMATOLOGIST), Can some medications trigger hair shedding in sensitive people?: only a medical doctor can answer that question?

3. Which Hair Loss Types Are Most Associated with Depression?

Strongest associations might appear in:

  • Alopecia Areata (autoimmune, sudden patches, high psychological impact): (PLEASE CONSULT WITH A PSYCHIATRIST/DERMATOLOGIST)
  • Telogen Effluvium (stress-related shedding): (PLEASE CONSULT WITH A PSYCHIATRIST/DERMATOLOGIST)
  • Trichotillomania (hair-pulling disorder tied to anxiety/depression)
  • Female pattern hair thinning (social stigma often stronger for women): (PLEASE CONSULT WITH A PSYCHIATRIST/DERMATOLOGIST)
  • Postpartum hair loss (hormonal and emotional): (PLEASE CONSULT WITH A PSYCHIATRIST/DERMATOLOGIST)

4. Why Depression Intensifies the Perception of Hair Loss

When depressed, people, might:

  • Notice negative details more
  • Check appearance more often
  • Magnify small flaws
  • Engage in rumination (constant mental replaying)

This may increase subjective distress, even if the hair loss is mild.

5. How to Break the Cycle

A two-track approach works best: psychological and medical.(PLEASE CONSULT WITH A PSYCHIATRIST/DERMATOLOGIST)

Psychological Supports

  • Cognitive Behavioral Therapy (CBT)
  • Self-compassion practices
  • Body-image therapy
  • Stress-regulation training (breathing, mindfulness)

Medical Approaches

  • Checking with: (PLEASE CONSULT WITH A PSYCHIATRIST/DERMATOLOGIST)
  • Using evidence-based treatments
  • Reviewing medications with a MEDICAL DOCTOR
  • Treating depression if present

6. Key Insight

Hair loss may cause depression by itself, but the meaning we attach to hair loss can create deep psychological pain.
Depression, in turn, it might disrupts the body’s hormonal and immune systems: (PLEASE CONSULT WITH A PSYCHIATRIST/DERMATOLOGIST) could be making hair loss likely?

The two conditions may reinforce each other unless addressed together.

Shervan K Shahhian

Habit Reversal Training, an explanation:

Habit Reversal Training (HRT) could be a behavioral therapy technique used to reduce repetitive, unwanted behaviors, especially habits like nail biting, hair pulling (trichotillomania), skin picking, tics, or other body-focused repetitive behaviors.

At its core, HRT might help you become aware of the habit and replace it with a safer, incompatible action.

Possibly, The main components of HRT:

1. Awareness training
You learn to notice:

  • When the habit happens
  • What triggers it (stress, boredom, certain situations)
  • Early warning signs (hand moving toward your face)

This could be often the hardest and most important step?

2. Competing response training
You may develop a behavior that:

  • Physically prevents the habit
  • Is less harmful
  • Can be sustained for a few minutes

Examples:

  • Clenching fists instead of hair pulling
  • Sitting on hands instead of skin picking
  • Chewing gum instead of nail biting

3. Stimulus control
You might want to modify your environment to reduce triggers:

  • Wearing gloves or bandages
  • Keeping nails trimmed
  • Removing mirrors or limiting checking
  • Using fidget tools

4. Motivation & support

  • Tracking progress
  • Reminding yourself why you want to stop
  • Involving friends/family or a therapist

Simple example:

If someone has a constant nail biting habit:

  • Awareness: notices they do it while studying
  • Competing response: holds a stress ball instead
  • Stimulus control: keeps nails short and applies bitter nail polish

What HRT is good for:

  • Body-focused repetitive behaviors (BFRBs)
  • Tics (including Tourette’s)
  • Some anxiety-related habits

Important note:

HRT might work best when practiced consistently and it could be often more effective with guidance from a therapist trained in CBT or behavioral therapy.

Shervan K Shahhian

Onychophagia, what is it:

Onychophagia is the medical: (CONSULT WITH A PSYCHIATRIST) term for chronic nail biting.

It comes from Greek:

  • onycho-: nail
  • -phagia: eating

So it literally might mean: “nail eating.”

What it involves

Onychophagia could be referring to repeatedly biting one’s fingernails (and sometimes toenails). It could be common in:

  • Young people
  • People experiencing stress, anxiety, or boredom
  • Individuals with compulsive or habit-related behaviors

Is it a disorder?

Occasional nail biting is common and may not be necessarily a medical problem: (CONSULT WITH A PSYCHIATRIST/DERMATOLOGIST/ MEDICAL DOCTOR), However, when it:

  • Causes damage to the nails or surrounding skin: (CONSULT WITH A DERMATOLOGIST/ MEDICAL DOCTOR)
  • Leads to infections: (CONSULT WITH A DERMATOLOGIST/ MEDICAL DOCTOR)
  • Becomes difficult to control

It may be considered a body-focused repetitive behavior (BFRB) and sometimes linked to anxiety or obsessive-compulsive tendencies?

Possible consequences

  • Nail deformities: (CONSULT WITH A DERMATOLOGIST/ MEDICAL DOCTOR)
  • Skin infections around the nails: (CONSULT WITH A DERMATOLOGIST/ MEDICAL DOCTOR)
  • Dental problems: (CONSULT WITH A DENTIST)
  • Increased risk of illness, from germs entering the mouth: (CONSULT WITH A PSYCHIATRIST)

Treatment options

  • Behavioral therapy (especially habit-reversal training)
  • Stress management techniques
  • Bitter nail polish deterrents
  • Keeping nails trimmed short
  • Shervan K Shahhian

Premonitory Urge, what is it:

A premonitory urge could be a specific type of internal sensation might often occurs just before a repetitive movement or vocalization (a tic).

What it feels like

People could describe it as:

  • A rising tension, pressure, or discomfort in the body
  • An itch-like or “not quite right” feeling
  • A sense that something needs to be released or completed

What happens next

The person performs the tic (movement or sound), and:

  • The urge could be temporarily relieved
  • But it usually builds up again, creating a cycle

Where it’s most common

Premonitory urges could be associated with:

  • Tourette Syndrome
  • Other tic disorders (chronic motor or vocal tics)

Simple example

One might feel:

“There’s pressure in my neck… I have to jerk it.”

After the neck jerk:

  • The pressure goes away briefly
  • Then slowly returns

Clinical importance

  • These urges could be key targets in behavioral treatments, especially Habit Reversal Training (HRT)
  • Patients might learn to recognize the urge early and respond differently instead of performing the tic

Shervan K Shahhian

Tourette Syndrome, what is it:

Tourette Syndrome (TS) could be a neurodevelopmental condition: (PLEASE CONSULT WITH a PSYCHIATRIST and/or NEUROLOGIST) characterized by involuntary movements and sounds called tics. It might typically begin in childhood?

Core Features

1. Motor Tics (movement-based)

  • Eye blinking
  • Facial grimacing
  • Shoulder shrugging
  • Head jerking

2. Vocal (Phonic) Tics

  • Throat clearing
  • Grunting or sniffing
  • Repeating words or phrases

In some cases (Some), individuals may exhibit coprolalia (involuntary swearing), though this might occur in a minority.

Diagnostic Criteria (Simplified)

  • Both motor and vocal tics present at some point
  • May persist for more than 1 year
  • Possible onset before age 18
  • May not caused by substances or another condition

Causes & Mechanisms

TS could be linked to differences in brain circuits, involving:

(PLEASE CONSULT WITH a PSYCHIATRIST and/or NEUROLOGIST)

  • Basal ganglia
  • Dopamine regulation

It is considered multifactorial:

  • Genetic predisposition
  • Neurobiological factors: (PLEASE CONSULT WITH a NEUROLOGIST)
  • Environmental influences

Common Co-Occurring Conditions

Some individuals with TS also have:

  • Attention-Deficit/Hyperactivity Disorder
  • Obsessive-Compulsive Disorder
  • Anxiety disorders
  • Learning difficulties

Course & Prognosis

  • Symptoms may peak in early adolescence
  • Some people experience improvement in adulthood
  • Severity varies widely, from mild to impairing

Treatment Approaches

1. Behavioral Therapy (First-line)

  • CBIT (Comprehensive Behavioral Intervention for Tics)
    • Teaches awareness plus competing responses

2. Medications

PLEASE CONSULT WITH a PSYCHIATRIST and/or NEUROLOGIST

3. Supportive Strategies

  • Stress management (tics worsen under stress)
  • Psychoeducation for family/school

Important Clarifications

  • TS may not a psychotic disorder
  • Tics are semi-involuntary (people may suppress them briefly, but not indefinitely)
  • Intelligence is typically unaffected

Clinical vs. Experiential Perspective

Perception and anomalous experiences:
Tics in TS could be understood in psychology as neurobiological discharge patterns: (PLEASE CONSULT WITH a PSYCHIATRIST and/or NEUROLOGIST), may not be a telepathic or external signals. However, the subjective urge preceding a tic (“premonitory urge”) might feel internally compelling, sometimes described as almost like an impulse that must be released.

Shervan K Shahhian

Trichotillomania, what is it:

Trichotillomania maybe a mental health condition where someone feels a strong urge to pull out their own hair, often from the scalp, eyebrows, eyelashes, or other areas.

It maybe classified as a body-focused repetitive behavior (BFRB) and is related to conditions like OCD, but might not be exactly the same.

What it looks like

  • Repeated hair pulling, sometimes without realizing it
  • A sense of tension or urge before pulling
  • Relief, satisfaction, or even pleasure after pulling
  • Noticeable hair loss (patchy or thinning areas)
  • Sometimes playing with, biting, or eating the hair afterward

Why it happens

There may not be one single cause, but it’s often linked to:

  • Stress or anxiety
  • Boredom or habit (automatic pulling)
  • Emotional regulation (coping with difficult feelings)
  • Brain chemistry and genetics

Types of pulling

  • Focused pulling: done intentionally to relieve urges or emotions
  • Automatic pulling: happens without awareness (e.g., while watching TV or studying)

Treatment & support

It is treatable, and people can improve a lot with the right help:

  • Habit Reversal Training (HRT): a type of therapy
  • Cognitive Behavioral Therapy (CBT)
  • Identifying triggers and building competing behaviors (like squeezing a stress ball)
  • In some cases, medication, CONSULT A PSYCHIATRIST

When to get help

If it’s causing you distress, noticeable hair loss, or interfering with daily life, talking to a therapist, especially one familiar with BFRBs, can make a big difference.

Shervan K Shahhian