New book explains how ‘fatal pauses’ cause us to become stuck

Dr. Stuart Yudofsky
Dr. Stuart Yudofsky

Have you ever felt trapped in an unhealthy relationship or a dysfunctional situation?

Dr. Stuart Yudofsky, a Distinguished Service Professor and chair of the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine, says the feeling of “being stuck” can be attributed to not putting an end to behavior that is bad for us—such as drinking, smoking, destructive relationships, wasting time playing video games—or not choosing or engaging in behavior that is beneficial–such as exercise, or treatment for alcohol and substance abuse.

According to Yudofsky, author of the new book “Fatal Pauses: Getting Unstuck Through the Power of No and the Power of Go,” we “get stuck” due to evolutionary disequilibrium,” which has two components.

fatal-pausesFirst, the neocortex (the new part of our brain) invents or develops things that the paleocortex (the old part of our brain) has difficulty resisting such as cigarettes; foods high in salt, fats, sugars; alcohol and drugs; internet pornography.

Secondly, rewards are immediate and punishments, such as lung cancer; Type II diabetes; alcohol-caused dementia and pancreatitis, are long-delayed.

“Delayed reinforcement is a terrible model for learning and behavioral change; and it is inconsistent with how we evolved over millennia,” he noted.

Yudofsky’s Three-D Method for helping us “get unstuck” enables our new brain to regain control over our old brain.

During a recent presentation for the Partnership at Baylor College of Medicine, Yudofsky provided a case study of a female executive who dealt with low self-esteem by being a perfectionist and self-sacrificing. She believed that she was valued only because she performed at such a high level, and drank alcohol when she became frustrated and resentful.

The Three-Ds encouraged her to:

1.    Discover the subtle causes and sources the conflicts that led to destroying her life with alcohol in the first place.

2.    Decide what she wanted most—to escape her feelings with alcohol or stop drinking and deal directly with her problems.

3.    Exert Discipline to stop drinking entirely and take those actions that are necessary to sustain abstinence. In her case, she needed to engage in ongoing psychotherapy, attend Alcoholics Anonymous on a regular basis, and make behavioral changes that left her so resentful.

Yudofsky noted that his motivation to write Fatal Pauses, which is a hybrid book for both mental heath professionals and the general public, was to help people who could not stop behaviors that led to their being unhappy and jeopardized their health and safety.

-By Dipali Pathak

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