LONELINESS & ANXIETY: THE UNSOLVED PUZZLE

Loneliness can lead to anxiety by triggering feelings of social inadequacy, fear of rejection, and heightened self-consciousness. When individuals feel disconnected from others, they may develop irrational beliefs about their social worth and ability to form meaningful relationships. This cognitive distortion can fuel anxiety symptoms such as excessive worrying, rumination, and avoidance of social situations. Over time, chronic loneliness can exacerbate anxiety disorders, as individuals become trapped in a cycle of negative thoughts and behaviors driven by their fear of rejection and isolation. Seeking social support and addressing underlying emotional needs are crucial in mitigating loneliness-induced anxiety.

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TRUST-
After a Breach of Trust Don’t Make It Worse.
Let's avoid the common pitfalls.

KEY POINTS-
Communication is key, especially when trust has been broken.
Defensiveness is common and damaging.
A guideline for constructive discussions about trust violations include staying focused on the issue at hand.

A trust may begin as a leap of faith, but ultimately, it is not a gift. It must be earned. Communicating is always very important, but this is especially critical when a violation occurs.

Specific conversations must occur to mend a broken trust. Through unmistakable effort, the offending partner must demonstrate that they are committed and that it is emotionally safe to be intimate with them.

Defensiveness Is Common and Damaging
Talking productively in an emotional crisis is not easy but essential. Moreover, the emotional fallout from a broken trust is not usually limited to the offended partner. The offender may also feel bad. Feeling distressed, they may react openly and validate the offended partner’s feelings, clearing the way for the breach to be repaired. This is an admirable response but, unfortunately, not common. More often, the partner who has violated trust reacts defensively, adding insult to injury.

Now, the offended partner not only feels hurt and anger, but the sense of betrayal is heightened by denial, distortion, or minimizing.

Rather than heal the wound of betrayal, the lack of openness by the offender will almost surely erode the trust base further. The couple will inevitably move toward increased and unproductive conflict, either over the areas directly involved in the source of mistrust—lying or an extramarital involvement, for example—or over a wide range of lesser issues. In either case, the relationship unravels.

Talking It Out Sensitively
The point is that there are two main ways for the offender (and the offended) to make things worse when confronted with a trust violation: One is to continue lying and underplay the breach. The other is to erupt, to emote without restraint.

When a man or woman has too many internal conversations, playing out the issues in their mind, they probably do not have enough trust with their partner. If they are screaming, hurling insults, and looking to vent without concern for the impact, not briefly, but mostly, the relationship is guaranteed to deteriorate.

Guidelines for Constructive Discussions
Stay focused. No fair dredging up mistakes made twenty years ago or complaining about how much the in-laws are hated. A fight is not an opportunity to rehash old grievances. Stick to the issue, or the discussion will surely sink from the weight of the problems.

Define issues. Be clear and specific about the problem. This will help you stay on track.

Listen and listen. Don’t just pause until it’s your turn to speak again, with your mind formulating the next sentences while your partner talks. Being defensive is a sure path to alienation.
Agreement is not essential. You don’t have to agree, but if you validate a hurt partner’s feelings sincerely, your partner will likely feel that you get it. In other words, be agreeable. To do otherwise is to risk prolonging the potential healing process. Lie? That would be stupid.

Don’t interrupt. You can be angry without being rude or bullying.
Don’t personalize. Stay with the issue rather than attack the person. Contending that your partner betrayed you in some manner is legitimate. Calling your partner names, belittling them, or verbally assaulting them is not constructive.

Recognize “his” and “her” conflict styles. Men and women have different conflict styles as well as intimacy styles. Respect the differences. A man may, for example, feel emotionally flooded and need a time-out, while a woman may view that as withdrawal. If the man reassures her that he is simply taking a few minutes to “regroup,” his partner will likely abide.

Bear in mind: A critical action on the trust-breaker’s part, to reassure their efforts to restore trust are sincere, is the willingness to delve into him or herself, confront the personal issues that lead to trust breaches, and acknowledge them openly and responsibly. And, of course, going forward with integrity is essential.

ANXIETY-
Mindfulness Should Not Be Taught in School? Really?
It must be combined with skills for feeling psychologically safe.

KEY POINTS-
Teaching mindfulness in schools has been shown to be ineffective and can increase symptoms.
Mindfulness breaks up mental rigidity, allowing emotions to be experienced.
People must also learn tools to tolerate mental discomfort.
Mindfulness-based interventions should not be discarded but used as part of a comprehensive approach.

Mental rigidity is akin to suppressing thoughts in that you allow yourself only certain sets and types of thoughts and emotions. Your emotional/mental bandwidth is limited, and it is difficult to respond appropriately to social cues and signals from others. You may behave in a manner that hurts and damages others. Mental inflexibility (rigidity) is a trait that is common to many mental health diagnoses.1

A large prospective study done in the UK tracked mindfulness-based teaching to over 8,000 students and compared it to usual practices. The mean age of students was 12 years. The study reported that there was no significant benefit and actually caused more problems among many students with prior mental health issues. The researchers recommended that non-specific mindfulness interventions not be implemented in the school system.2

Mental Rigidity
A 2023 paper extensively summarizing the literature on mental rigidity pointed out that the trait is characterized by automaticity and inflexibility and is centered around concepts of self. Patterns of thinking that may have been useful in the past remain fixed and often not relevant to the current situation. Rigidity can wreak havoc on relationships, quality of life, and ability to adapt to life’s challenges.1

Self is defined by dynamic interactions between various regions of the brain,. Lack of mental flexibility shows up on functional MRI brain scans as disruptions in connectivity between these areas.

Re-establishing flexibility seems to be important in the treatment of many health disorders, including major depression, complex psychological trauma, and substance use/addiction disorders. Mindfulness practices (MBIs) have been shown to lessen mental rigidity both clinically and on imaging studies.1

Increasing Mental Pain
The recommendation regarding mindfulness in schools overlooks an important fact— the conditions under which it is ineffective and can exacerbate mental symptoms. Part of the answer lies in looking at why rigidity exists in the first place.

One reason is that humans don't/can’t tolerate mental/emotional pain. Rigidity is one way of limiting exposure. to pain. As rigidity is broken up with mindfulness, what happens? You’ll feel even more emotional pain, which is often intolerable.3 It isn’t surprising that mindfulness increases symptoms in students with prior mental health diagnoses. People must also learn to feel safe in order to move forward. You would never cross a street unless you first felt it was safe to do so.

Used and tested alone as an approach to be implemented in the school system, mindfulness can’t work. What is also needed is teaching students how to also calm their threat physiology (flight or fight body chemistry) in order to feel safe.

Breaking up rigidity alone opens up the dam of suppressed thoughts and emotions, and it is predictable that those who are already struggling would experience a worsening of symptoms. For those without mental health issues, mindfulness alone won’t help one way or the other without further strategies to improve quality of life.

Mindfulness-based interventions (MBIs) are effective in increasing the dynamic interactions and connectivity between regions of the brain that define self. The term is the “pattern theory of self," and mental flexibility is increased.3

Define Where MBI’s Fit
Chronic disease is complex and isolated interventions are usually ineffective. However, they should not be discarded, because they can fit into a larger treatment plan. MBIs may be an excellent entry point for many people suffering from major depression, complex trauma, and addiction/substance abuse. However, opening up the flood gates without showing them a way to feel safe is problematic. MBIs favorably alter the brain activity underlying these problems. Instead of discarding MBIs, we should be asking, “what are additional effective treatments?”

Learning to tolerate mental pain is at the core of addressing mental health.

‘Centuries of history lost’: Armenians describe journey to safety after fall of Nagorno-Karabakh.
Terrified families fleeing in fear of ethnic cleansing after the collapse of Nagorno-Karabakh are running out of water and fuel during the desperate two-day journey to neighbouring Armenia.

More than 90,000 Karabakh Armenians – around three-quarters of the total population – have now left their homes in the breakaway enclave, which is internationally recognised as being part of Azerbaijan.

The United Nations fears the fall of the region could mean there will eventually be no Armenians left in Nagorno-Karabakh, prompting concerns of ethnic cleansing. It is the largest exodus of people in the South Caucasus since the collapse of the Soviet Union.

The breakaway area – also known by Armenians as Artsakh – had enjoyed de facto independence for three decades before Azerbaijan launched a lightning military operation earlier this month. It forced separatist forces to lay down their weapons and agree to formally dissolve the breakaway government.

Fearing reprisals, as Baku’s forces moved into the main cities and arrested Armenian officials, hungry and scared families packed what few belongings they could into cars and trucks and left their homes for good.

Valeri, 17, fled the village of Kichan, 70km (43 miles) north of the Armenian border with his family and neighbours. In total, they squeezed 35 people into a Ford Transit and made the four-day journey to safety, sitting on top of each other and sleeping in shifts.

Families hitched lifts on the back of trucks as they fled Nagorno-Karabakh (Handout)
Families hitched lifts on the back of trucks as they fled Nagorno-Karabakh (Handout)
“We couldn’t take anything with us because the shelling was too intense as we escaped,” he told The Independent.

They had to hide in a large waste water pipe to escape artillery fire, he said. In the chaos, families were separated and the poor mobile coverage in the mountainous regions means they are still trying to reconnect.

His family has been forced to move six times since the early 1990s and, like so many Armenians, find themselves homeless again.

“I don’t think it’s possible to go back to Kichan, even if we could go back everything will be wrecked or stolen,” he said.

Others described a 40km (25 miles) stretch of hairpin road to Armenia at a near standstill, with some vehicles breaking down for a lack of fuel. In the lead-up to Azerbaijan’s operation, Baku had imposed a 10-month blockade on the enclave leading to chronic shortages of food and petrol supplies.

“All you can see is a sea of cars stretching to the horizon, people are cooking by the side of the road,” said Gev Iskajyan, 31, executive director of the Armenian National Committee of Artsakh, as he arrived exhausted in the Armenian capital Yerevan. He fled the region’s main city Stepanakert, or Khankendi as it is known in Azerbaijan, fearing he could be arrested if he stayed.

“Resources are so scarce there, people are running out of water and fuel on the road along the way out. If anything happens to children and the elderly, no one can get to them. Ambulances can’t move,” he told The Independent.

He said most families believed they would not ever be able to return home and that this was the end of Armenian presence.

“It weighs heavy. Nagorno-Karabakh isn’t just a place, it is a culture, it has its own dialect,” he said. “You look at the people in the back of trucks, they have to fit their entire life in a single box, they can’t bring everything, they can’t go back, it breaks your heart.

“It is centuries of history lost.”

Nagorno-Karabakh isn’t just a place, it is a culture, it has its own dialect

Gev Iskajyan, an Armenian advocate who fled to Yerevan

The centuries-old conflict that has raged through the disputed enclave of Nagorno-Karabakh remains the longest-running in post-Soviet Eurasia.

The 4,400-square-kilometre territory (1,700 square-miles) is officially part of Azerbaijan but after a bloody war following the dissolution of the USSR in the 1990s, the region’s Armenian-majority population enjoyed state-like autonomy and status.

That changed in 2020 when Azerbaijan, backed by Turkey, launched a military offensive and took back swathes of territory in a six-week conflict that killed thousands of soldiers and civilians. Russia, which supports Armenia, brokered a tense cessation of hostilities.

But that was broken earlier this month when Baku launched a 24-hour blitz which proved too much for Armenian separatist forces, who are outgunned and outnumbered. They agreed to lay down their weapons and dissolve the entire enclave.

Residents still left in Nagorno-Karabakh told The Independent that Azerbaijani forces and police entered the main city.

“People are intensively fleeing after the forces entered, and took over the governmental buildings,” said one man who asked not to be named over concerns for his safety.

Baku has also detained prominent Armenians as they attempted to flee, prompting fears more arrests may follow. Among them was Ruben Vardanyan, a billionaire investment banker, who served as the head of Karabakh’s separatist government between November 2022 and February this year.

On Friday, Russian state media reported that the Azerbaijani military had also detained former separatist commander Levon Mnatsakanyan as he also tried to escape. He led the army of the self-proclaimed Republic of Artsakh from 2015 to 2018.

The UN, meanwhile, said they were readying themselves for as many as 120,000 refugees to flood into Armenia, a third of them children.

“The major concern for us is that many of them have been separated from their family,” said Regina De Dominicis, regional director of the UN’s child agency.

Kavita Belani, UNHCR representative in Armenia, said: “This is a situation where they’ve lived under nine months of blockade. When they come in, they’re full of anxiety, they’re scared, they’re frightened and they want answers.”

The Cost of Staying Silent and the Cost of Speaking Up.
Personal Perspective: We still don't talk easily about mental illness.
Reviewed by Gary Drevitch

My new boss calls me periodically to let me know about her struggles to find her optimal dose of Zoloft. I would never disclose to her that I take two antidepressants as well as a second-generation antipsychotic. Why? Because there is still a stigma against mental illness in the workplace — especially severe mental illness. It’s one thing to find out your new employee suffered from depression, yet another thing to discover she was diagnosed with borderline personality disorder.

Kaiser Permanente states that untreated depression costs $9,450 per employee per year in absenteeism and lost productivity. Why, especially within the field of mental health, is it not okay to be dealing with a mental illness? In my very first position out of college, before I became a social worker, I was working at a packaged goods company when I was diagnosed with anorexia. After two psychiatric hospitalizations a year apart I was let go. (This was prior to the Americans with Disabilities Act, which was passed in 1990.)

In my first role as a social worker after five years of being at this clinic, I was hospitalized for depression. When I returned I’d been demoted. Humiliated, I quit. That experience sent me reeling and I plummeted into a severe depressive episode that lasted 18 months.

Why don’t we talk about mental illness as easily as we talk about asthma or a broken wrist? You don’t get demoted or repurposed for being hospitalized for an asthma attack or needing surgery for a fractured wrist. According to Kaiser Permanente, 62% of missed workdays can be attributed to mental health conditions. This is the cost of silence. This is the cost of stigma.

After I recovered from that depressive episode in 2008, I found a position at an outpatient clinic in Queens, NY. I was doing well there until my father passed away in 2013. We didn’t have a good relationship and when he died I lost the chance to hear him tell me I was good enough, words I longed to hear all my life. At the beginning of 2014 I attempted suicide. When I was discharged from the medical and psychiatric hospitals, the director of the clinic forced me to step down to part-time. The clients on my caseload had been transferred to other clinicians. This was a mental health clinic penalizing one of its employees for suffering from a mental illness.

I eventually was reinstated full-time, but never was permitted to see patients again. Instead, I was tasked with administrative work. I immediately began looking for a new job and found one by the end of that year.

After those experiences, I swore to myself that as long as I could help it, I’d never take a chance and disclose my history of mental illness in the workplace again. When I started my new position, my mental health had improved significantly and I was more stable. I haven’t needed to be psychiatrically hospitalized since then, so I haven’t had any extended absences to explain.

I let my writing speak for me, fighting the stigma of mental illness with the power of the written word. I also write to let others know they’re not alone on their journey and that recovery is possible. I’m aware that all someone has to do is Google me and they will find my writing and my history. That’s fine. Silence comes in many forms. So does speaking up.

Thanks for reading.

CONFIDENCE-
Write Fast, Revise Slow.
Everyone makes mistakes but doers "do" first and fix errors later.
Reviewed by Jessica Schrader

KEY POINTS-
Everyone wants to be a critic, but sometimes the artist just needs a thumbs-up.
The maker needs to make something before they can ship anything. Focus on the doing first, and fix it later.
If rules are made to be broken, why do creatives fear breaking them? Dare to be different.
Like many creatives, I wear many hats.

Sure, I’m a wife, mother, daughter, and sister, but I’m also a chef, handyman, laundress, and housekeeper (although I’m not very good at the latter).

But what I’m thinking about here are my interests, my hobbies, and my jobs.

For 23 years, I've been a graphic designer, grant writer, website content creator, photographer, and cheerleader for The Claflin Hill Symphony Orchestra, a regional nonprofit dedicated to live music performances.

At first, my "work" was voluntary and unpaid.
As the organization grew and gained a firmer financial foundation, I became the .5 of the official 1.5 full-time employees.

One of my regular jobs is writing e-newsletters to promote upcoming concerts and prompt members to donate.

Just last night, I sent this headline—
“This is what you’ll HERE!”

Your true friends are the ones who tell you when you have spinach in your teeth or a bugger in your nose. Well, one of my good friends at the symphony sent me an email apprising me of my error. The surprising thing is that she was the one and only one to point out my mistake. There are close to 2,000 people on our email list.

But this brings me to an important point.
Even though I used the wrong word, and even though most (all?) of those who read the line also understood the line, no one else emailed me.
This surprised me because many on our list pride themselves on their English Language Usage skills.

(I wonder if I misused capitalization and/or title case in the above sentence. Frankly, I don’t care.)

What do you do when your fear of critics' comments for your infinitesimal foibles prevents you from doing what you love?
Try this:
Ignore the critics and know that no one is perfect.
When people read my book Do Your ART! 10 Simple Steps to Enhance Creativity and Elevate Mood, many comment on my misspelling of the word "ART."

I realize that the repeated misspelling offends some readers. Rules are rules, after all.

From a young age, we are taught to follow the rules.

After all, the rules of the road prevent accidents, gridlock, and road rage… well, they might actually prompt the latter.

But rules are meant to be broken, aren’t they?
Picasso represents the benefits of ignoring or bending particular established rules composition. Dickinson, too, challenged traditional poetic forms.

I explain that when I started writing my book and the phrase Do Your ART!, I accidentally mistyped and capitalized the second letter of the word.

The funny thing is that I kept making this same mistake.

You know those errors you always make but keep messing up even though you're prepared for the slip-ups?

Instead of the constant battle, I decided to embrace the mistake.
Every artist makes mistakes
The seamstress accidentally snips the fabric when trimming threads.
The gardener accidentally pulls the crop when weeding the weeds.
The baker accidentally whips the cream too long, causing the whipped cream to separate.
The musician cracks a note.
The carpenter chips aboard.
The painter overdoes the scene.
The rainbow turns from ROYGBIV into an arc of shades of brown.
The writer writes too long, too short, too detailed, and not detailed enough.

In teaching, it is crucial to help my students gain confidence. My students often come to my college writing classes with damaged self-confidence because their teachers, past and present, focus on grammar, spelling, and writing mechanics. Those things are critical, but content and organization need cultivation first.

I have an assignment that prompts my students to write an extended first essay. This past semester, the page length ranged from seven pages to 109.

In self-editing and revising, I use a very analytical approach. For example, I have done extensive reverse outlines of novels producing a colorful spreadsheet of scenes, settings, and character traits.

Write fast, revise slowly
If you want to not appear like an inscribing idiot, you could attempt careful revision tactics.

In revising Do Your ART!, I also pulled apart the text. In many ways, the process felt more like an autopsy than a revision as I laid out the text so that I could see how the words functioned on their own.

I firmly believe in writing fast and revising slowly. I tell my students that you must start with a chunk of diamond to get a beautifully faceted diamond. Let the book present itself to you. See what the story is and what it wants to be. Then, you can shape the words, and the paragraphs, into an independent, autonomous thing that must live without the author making excuses for its shortcomings, mistakes, and errors.

I am obsessed with the process of writing
Writing, rewriting, revising, and starting completely over is fun. That is why working toward a performance focuses on every step in writing and publishing. Many art forms suffer a similar "it’s never really finished" philosophy.

But performance serves as a finish line. Like final exams for my students, the end is the end, until next time.

Regardless of the hat you're wearing today, know you're doing it—you're making your "ART"
When researching and learning more about creativity, I posited, 'What is good?'
I wanted to be good.
I wanted to be great.
I wanted to know how to tell the difference between good and bad so that I could be great.
The wonderful truth about humans and their need for art is that each of us has different likes and preferences.

You like jazz. I prefer new age.
You prefer the mountains. I like the ocean.
You like realism. I prefer impressionism.
You prefer dark walnut stain. I like honey oak.
You like Mexican. I prefer Thai.
You prefer musicals. I like comedy.
You like tight-fitting pants. I prefer baggy.
Learn to love what you do.

Be your biggest fan.
Know and believe you're doing ART! because you are an artist/creative/maker.

Overlooked Reasons Why Women Don’t Get Promoted.
Promotion guidelines and non-promotable tasks are holding women back.
Reviewed by Ekua Hagan

KEY POINTS-
For every 100 men who are promoted into management, only 87 women get the same opportunity.
One way that companies reduce the likelihood of women advancing into management is by having restrictive guidelines for promotions.
Women spend a disproportionate amount of time on tasks that are important but likely won’t help them get a promotion.

Employees are increasingly looking for gender equity in the workplace, yet it remains elusive. For every 100 men who are promoted into management, only 87 women get the same opportunity, representing a broken rung in the first step of the corporate ladder.

A new financial instrument is highlighting how this broken rung can hurt a company’s bottom line: Hypatia is an exchange-traded fund that only invests in companies that are run by women. Experts are calling Hypatia a solid investment. A report by the Peterson Institute for International Economics supports this conclusion, finding that companies that have at least 30 percent of executive roles filled by women have profits that are 6 percent higher.

The broken rung also hurts employee morale and company culture. My research with my colleague Jennifer Franczak shows that companies with a larger share of female employees in management positions were viewed as better, safer, and more enjoyable places to work.

What is holding women back from advancing into management positions when it is clear that businesses benefit from having them there? While there are many factors, ranging from gender bias to hostile work environments, below are two reasons that are discussed less frequently, yet make an important impact.

Promotion Guidelines
One way that companies reduce the likelihood of women advancing into management is by having restrictive guidelines for promotions. Rebecca Shambaugh1 provides a powerful example: Many companies require that open corporate board seats are filled by someone with CEO experience. However, because of the small number of CEO positions that have historically been filled by women, this requirement may automatically rule out many qualified women.

As another example, companies often use leadership competencies to evaluate potential candidates for promotion. Because the managers who develop the lists of leadership competencies are more commonly men than women, these lists tend to reflect what makes men successful. However, it often backfires when women try to adopt the same work style as men. For example, men are typically seen as confident when they act assertively, whereas women are often considered aggressive for the same behavior and face backlash.

In general, during performance reviews, managers tend to describe2 men using task words (e.g., analytical, competent) but describe women using relational words (e.g., compassionate, energetic). When evaluating candidates for promotion, task-related characteristics hold more weight.

In our research, Jennifer Franczak and I encourage companies to begin to move past these challenges by adopting what we call “qualification diversity." We suggest that organizations reconsider their leadership competencies and promotion guidelines to ensure they are not unintentionally skewed to favor men.

Non-Promotable Tasks
Women spend a disproportionate amount of time on tasks that are important but likely won’t help them get a promotion. This invisible labor includes things such as training new hires, planning team celebrations, leading low-revenue and low-visibility projects, or taking notes in meetings. Spending time on these non-promotable tasks takes away from the time and energy women can spend on promotable tasks.

In a series of experiments, economists found that women were almost 50 percent more likely to perform non-promotable tasks than men. The economists sought to see if the higher rate of non-promotable tasks were due to the expectation workplaces place on women or due to the characteristics and preferences of women.

To do so, they collected data to see if women had unique characteristics that encouraged them to volunteer for these tasks. The data showed that they did not: Characteristics such as agreeableness, altruism, and risk aversion were not able to explain the gender gap in non-promotable tasks. Second, the economists compared all-female, all-male, and mixed-gender groups. They found that men tended to only hold back in volunteering for non-promotable tasks in the mixed-gender group but volunteered in the all-male group. The researchers concluded that gender differences in non-promotable tasks can be best explained by the expectations and norms of workplaces rather than the characteristics and preferences of female employees.

Although some may say that the solution is to encourage women to say no more often, research does not fully support this conclusion. Researchers have shown that the expectations for women around non-promotable tasks are so deeply ingrained in the workplace that women, but not men, face backlash if they do not volunteer and act as good corporate citizens.

Women too often are put in a no-win situation, which has important implications for advancement and promotion in the workplace. As explained in the book, The No Club: Putting a Stop to Women’s Dead-End Work, it is not the women that are the problem, it is the practices and norms of organizations. Workplaces still have a lot of work to do.

Egg and Sperm Donors: It's Complicated.
Some common thoughts and feelings surrounding selling one's gametes.
Reviewed by Kaja Perina

KEY POINTS-
Donating/selling one's eggs or sperm is much more than a simple business transaction.
Most donors are not properly counseled and educated beforehand and their genetic material may be sold for many years or decades into the future.
Because anonymity is not possible, donors can prepare for connections with offspring.
Egg donors have unique health risks that are often minimized by clinics.
As a counselor or as a member of a donor family, it is important to understand some of the themes that commonly arise with people who donated (sold) their gametes. Available research and decades of anecdotal reporting reveal the feelings and experiences of these sperm and egg donors.1,2

Why do people sell their gametes?
Becoming a sperm or egg donor is certainly not for everyone. So what exactly draws people to become gamete donors? Not surprisingly, the top reason for donating is for financial gain: egg donors can make $5,000 - $15,000, or more, for a single donation, while sperm donors can make $14,000 - $16,000 or more in the minimum one-year donation contract and many donors donate for many years. The other most common reasons at the top of the list are to help families who want children and to “pass along my genes”.3,4 But, selling one's gametes is far more than a financial transaction, with many far-reaching effects for future decades.

Donor Concerns
There may be frustration about a lack of pre-donation education or counseling and feel that they were not prepared for the possibility of contact with any resulting children born as a result of their donation under a false concept of anonymity.

Curiosity about offspring is very common.5,6 Many donors wonder if their offspring think of them, have concerns about the well-being of children created, and feel frustrated about not being able to know or contact them.4 One study suggested that about three-quarters of donors have feelings about wanting to contact donor children and not being able to; another quarter feels worried about their donor children's well-being.3 Another study showed that ninety-four percent of surveyed sperm donors were open to contact with offspring, with 85% being open to meeting them and 78% open to establishing a relationship with them.4 New research also tells us that a majority of egg donors would like to make contact with offspring and have the means to do so as thousands of donors have made mutual consent contact on the Donor Sibling Registry and via other methods.7

Many are concerned about anonymity. Many donors donated long before commercial DNA testing existed, and more recent donors were not provided with information about commercial DNA companies that could be used by parents and children to find them. Younger donors may be more neutral as many were given a choice of whether to be anonymous for 18 years or forever. Older ones may be more biased towards wanting to meet offspring.3 The ones who favor anonymity may want to protect the donor child's parents from feeling threatened. They may want to protect their own families or their own lying by omission about being a donor and/or having medical issues.

Once donors realize that contact is possible and probable, there can be fear:
about their parental rights and financial responsibilities (there are none for egg clinic/sperm bank donors).
about disappointing the offspring or not being successful or good enough as some donors were not 100% honest about their academic backgrounds when filling out their donor profiles and now feel ashamed.
of being found out that they were not truthful on their donor profile.
about their relatives being contacted via DNA websites.
or embarrassment associated with their family and friends finding out that they sold their gametes and/or that there are resulting children.
or worry about being exposed for their serial donating history, as it's very common for donors to sell their gametes to more than one, or many facilities.4
of rejection, as many donor-conceived people (DCP) with non-bio parents see connecting with the donor as a betrayal of sorts, and therefore do not wish to establish relationships. DCP protecting their non-bio parents can appear as though they are rejecting the donor.
When a donor attempts to report updated medical information or history that may affect their current or potential offspring, there may be frustration over the dismissive responses and lack of follow-up from their gamete vendor and the lack of guidelines for how to provide this information.6 Donors may feel guilt after finding out about medical issues amongst their donor offspring that they could be responsible for, or shame if the medical issue was something they hid in order to be accepted as a donor.

There may also be thoughts and concerns about the number of offspring that have been created using their gametes. Most egg donors feel that it is important/very important to know the number of offspring born from their donations.3 More than 40% of surveyed egg donor parents say that they were not asked by their clinic to report the birth of their child, so births are grossly underestimated.2,8 There is no entity keeping track of births and because all reporting is voluntary, accurate records are nowhere in sight. Many sperm donors now understand that they were lied to about the limits of the 10 or 20 offspring or families that they were promised and feel overwhelmed by the implications of how many offspring they have, as some have come to find out that they have more than 100 or even 200 donor children. Most sperm donors didn't realize that one single donation can be broken up into between 4-24 sellable vials, so their 2x or 3x a week donating for years can result in a slew of sellable vials. There may be concerns over how large numbers of offspring might demand too much of their time and/or attention and therefore affect their family negatively, especially if their family stability is not on solid ground. Donors may feel overwhelmed and that they (or their spouses) just don't have the emotional bandwidth to deal with dozens or hundreds of offspring.

Many donors are excited to learn about and connect with their donor progeny and reports of donors connecting with their donor-grandchildren are becoming more common.6 Many need some time and patience to figure out how to define these new relationships with their genetic children and their families. Expanding family and creating new family systems can be a bit of a challenge as the process unfolds until relationships become better defined and accepted.

Moneypantry
Earlier research suggests that about half of the egg donors feel that their relationship with their offspring is only genetic, while the other half view it as a connection beyond biological.3 More recent 2021 research asked egg donors how they viewed any children who may have resulted from their donations. The most common response (36.2%) was “special designation but not acquaintance, friend, or family” and the second most common was “my biological child” (25.7%).7 There may be fear about how the egg retrieval process might affect their future health and fertility. Several studies have raised concerns about Ovarian Hyperstimulation Syndrome (OHSS), secondary infertility, and cancer risks.1,2

All too often, donors are not properly counseled and educated about the ongoing ramifications for themselves, their families, and any children born: the ones they're raising and the donor-conceived children who will share approximately 50% of their DNA and who may be very curious about their close genetic relatives, ancestry, and medical family history. However, there is now a wealth of information and support for all members of the donor family.

The interests and well being of the children — all of them — are paramount. I believe that I do have responsibilities to the children born as a result of my donations. At the very least, those children have a right to know what my part of their genetic heritage is. I will be more than happy to get in touch, if and when they do desire. I think about them often and wonder who, where, and how they are, and what is happening in their lives. I think, that if one day some of my unknown offspring do make contact with and meet me, it might be – for them primarily and for me too — a wonderful 'jigsaw' experience! The prospect of it actually happening is a little daunting, in some ways. What if they do not like me, or I them? What if they feel unhappy with my having contributed to their creation, but then taken no responsibility for them — especially if they have had an unhappy life? How will my own family react to and view them? On and on my thinking goes. However, at the base of all of this I am quite clear in my mind, that these wonderful children do have a right to know, what they want to know about me — because in them, there is a part of me." — Former donor

Testing Your Fear of Rejection in Close Relationships.
A new study provides questions to test if you’re too sensitive to rejection.
Reviewed by Michelle Quirk

KEY POINTS-
The fear of being rejected, known as rejection sensitivity, can become a major hindrance in close relationships.
New research shows the value of a simple nine-item scale to measure this important quality and understand its meaning.
By attending to anxiety about rejection and expectations of being turned down, we can improve our mental health and relationships.

Do you ever have the feeling that you’re not accepted and supported when you’re in the emotional doldrums? Suffolk University’s Kayla Lord and colleagues define this state of mind in a recent paper (2022) as “rejection sensitivity (RS)” or “the predisposition to defensively expect, readily perceive, and react strongly to interpersonal rejection” (p. 1062). In addition to making individuals susceptible to a variety of psychiatric disorders, high rejection sensitivity is associated with a lower sense of well-being.

Even if this doesn’t apply to you, is there someone you know who fits this description? Perhaps you have a cousin whom you’re very fond of, but whom you try to steer clear of nevertheless. This cousin makes planning for family events very difficult, if not awkward. It’s generally understood in your extended family that formal invitations for such events are hardly necessary. Yet, this cousin sends out what seems to be an endless stream of texts to make sure that she really is welcome. Why, you wonder, must you constantly have to reassure her that the standing invitation is still standing?

What’s Behind Rejection Sensitivity?
As potentially trivial as your cousin’s behavior may seem to be, if it’s part of a larger pattern of chronic worry over being left out of things or uncared for, hypersensitivity to rejection may be an indicator of a more serious approach to relationships. Over time, people high in RS may behave in ways that not only perpetuate but heighten the actual rejection experiences they encounter. Thinking about that cousin, isn’t it possible that you’re tempted to drop them from the family get-together list just to avoid having to deal with all those demands for reassurance?

In the “cognitive-affective-processing” framework outlined by Lord and her fellow authors, RS takes on a self-perpetuating quality for the very reason that constant demands for reassurance can become a turnoff for those in the individual’s social network. As a “self-maintaining defensive motivational system,” RS builds on itself in response to actual rejection experiences that generate the individual’s expectation that future rejections will inevitably continue to occur. This expectation generates behaviors such as anger or withdrawal that paradoxically make those future rejections more likely.

If people are to avoid having their RS spiral out of control, this cycle of expectations leading to behavior must somehow be broken. The first step to achieving this break in the process is to come up with an accurate way to measure an individual’s level of RS.

The 9-Item Questionnaire
Developed by Gettysburg College’s Kathy Berenson and colleagues (2009), the Rejection Sensitivity Questionnaire for Adults (A-RSQ) contains nine scenario-based questions that tap into an individual’s ways of reacting to potential types of rejection. Although the questionnaire was previously published and available in the literature, Lord and her fellow researchers believed that it needed further testing to determine its validity. In particular, its so-called “factor structure” was not previously well-established, and so the meaning of a total score was not completely clear.

This lack of clear meaning of total scores is also problematic given that RS is intended to relate to such negative outcomes as poor relationship satisfaction as well as to other interpersonal sensitivities, such as insecure attachment style. Furthermore, if RS is to be regarded as distinct from such personality traits as high neuroticism and submissiveness, the status of the A-RSQ as a standalone measure needs to be further documented.

With this background, it’s time to take a look at the A-RSQ to see how you would rate yourself. Each of the nine items describes a different scenario in which you would get a positive response from someone else. Your responses would fall into the two categories of (a) being concerned or anxious about the other person’s responses and (b) expecting to be given support or help, with both on a 1-to-6 scale:

You ask your parents or another family member for a loan to help you through a difficult financial time.
You approach a close friend to talk after doing or saying something that seriously upset him/her.
You bring up the issue of sexual protection with your significant other and tell him/her how important you think it is.
You ask your supervisor for help with a problem you have been having at work.
After a bitter argument, you call or approach your significant other because you want to make up.
You ask your parents or other family members to come to an occasion important to you.
At a party, you notice someone on the other side of the room that you'd like to get to know, and you approach him or her to try to start a conversation.
Lately you've been noticing some distance between yourself and your significant other, and you ask him/her if there is something wrong.
You call a friend when there is something on your mind that you feel you really need to talk about.

In the initial scoring for the A-RSQ, each item’s score equaled the product of concern multiplied by expectation. On average, participants in the initial sample involved in the scale’s development received a score of about 9 (indicating moderate RS), and scores above 12 on an individual item would be considered above average.

The researchers examined the A-RSQ’s validity by comparing these combined scores with the results of an analysis examining concern and expectancy as separate factors. They also examined its relationship to theoretically relevant constructs including social anxiety, depression, stress, attachment style, and personality as a way of assessing the measure’s so-called “convergent” validity. If the measure is valid, it should line up with these similar (but not equal) features of people’s insecurities in general, mood, and ability to establish close and secure relationships.

The findings supported the A-RSQ’s validity in terms of these connections to other concepts. Importantly, however, the authors found that on a statistical basis, the measure held up better when scoring concern separately from expectancy. rather than using a total score. Additionally, expectancy was associated specifically with lower positive affect, including lower extraversion scores. Concern scores were related to higher levels of negative affect, including scores on distress. As the authors concluded, “rejection sensitivity is a clinically relevant transdiagnostic phenotype that influences symptom manifestation and psychosocial functioning” (p. 1069).

How to Manage High Rejection Sensitivity
This strong conclusion on the part of the Suffolk U. authors suggests that RS is an important quality indeed to be able to identify in yourself and others. Moreover, separating out the expectancy that someone will turn you down from concern about rejection seems to provide a worthwhile distinction.

From a therapeutic perspective, identifying high levels of RS could provide a useful starting point for helping individuals manage their behavior, thoughts, and feelings in close relationships. As the authors suggest, such management could include mindfulness training, where individuals learn to attend to their defensive tendencies regarding acceptance by others. Additionally, because RS can lead to antagonistic behaviors in interpersonal relationships, skill training could also have merit.

To sum up, this simple nine-item measure could provide you with significant knowledge about what keeps people, such as that cousin of yours, stuck in chronically difficult interpersonal situations. Understanding that their behavior is a reflection of a deeper cognitive-affective set of qualities can provide a path away from concerns and expectations of rejection into more healthy and fulfilling relationships.