The Emotional Dance of Intimacy(For Married)

The Emotional Dance of Intimacy

You meet that special person, commit to the relationship, and maybe even move in together or get married. There will be no more lonely nights or figuring out where to meet people for you. It’s all love, joy, and romance. So, how did it come to pass that you are so miserable, have a negative dialogue about your partner running through your head, and have to continually bite your tongue lest you get into another argument? After all, you’re still a good person aren’t you? And, how could you have been so wrong about your partner? Were you really that blind to all his or her negative characteristics?

They say love is blind, and I do believe this to be true…at least early in the relationship. This is because in the early phase of a relationship, you are seeking to gain something. You are pursuing “approach goals.” When you achieve approach goals, you experience pleasure and positive emotions. You are focused on the positive and are looking at those things that you like in the other person. For many people, however, this changes once the relationship becomes committed.

Now that you “have” the other person, the goal changes to keeping their affection and avoiding losing them. This is called an “avoidance goal.” Avoidance goals are not psychologically rewarding, because when you achieve them nothing is gained. Moreover, you never can know when the goal has actually been achieved. How can you tell that you have achieved the goal of keeping your partner’s love and commitment? The answer is that you never can. All you would be doing is forever monitoring and asking for reassurance...a thankless and very disempowered position to be in; it feels really bad and it makes it even more likely that your partner will back away from you.

Point #1. Once you enter a committed relationship, set new goals that you can move toward together. Give up trying to hold on to what you had. 

So, here is where your personality comes into the picture. To make the most of the present material, it will be important to understand your attachment style and that of your partner. You may have a Secure, Preoccupied, Dismissing, or Fearful style. If you haven’t read my earlier posts, you can click on the links in the preceding sentence to see descriptions of the styles and how they impact relationships. Attachment styles are personality traits formed in childhood that persist across the lifespan. They are perceptual (what you see and how you see it), cognitive (ways of thinking), emotional, and behavioural systems designed to keep you in close proximity to your childhood secure base (i.e., the parent). As we transition into adulthood and become involved in our own close relationships, we transfer the secure-base function away from our parents and onto our romantic partners (or close friends if you are not in a romantic relationship). When someone is acting as a secure base, that person will be consistently warm, available, and responsive to you when you seek support in times of need or emotional distress. Knowing that you have a secure base will enable you to confidently go out into the world to explore and try new things, safe in the knowledge that someone is there to catch you if you fall on your proverbial face.

When difficulties surface early in a committed relationship, it is often because one person assumes that the other person is there to provide the secure base function, whereas the other person has no idea that this was part of the deal. People with dismissing styles, in particular, are not likely to understand that this is an implied expectation. Quite the opposite, they often expect their partner to fend for themselves emotionally while they go off to pursue their own achievement-oriented (work, school, sports) goals. People with preoccupied styles, in contrast, fully expect the secure base to be available and will become relatively panicked, demanding, and accusatory when their expectations for security are not being met. The preoccupied person will want to provide their partner with a secure base, but may get too absorbed in their own needs and negative feelings to truly be available for their partner.

Those with fearful styles may actually become more disregulated emotionally (at least early in the relationship, before they are done with the “testing” phase) when a partner is providing a secure base. This is because (childhood) experience has taught them that this “base” person is likely to betray their trust and harm them. They will have difficulty acting as secure bases because their own fear may lead them to prematurely terminate the relationship or engage in some other behaviour to make themselves feel better that ends up sabotaging the relationship.

Point #2. Do not assume that your romantic partner or close friend has agreed or is able to act as your secure base until you openly discuss it with them.

Point #3. Learn about your own attachment style so that you can see what interferes with your ability to act as a secure base.

I realize that such direct communication is not how society teaches us to behave in our relationships and that such a discussion may seem awkward. But, it is the best way to have a healthy relationship. People with secure styles know this naturally and automatically understand both how to use and how to provide the secure base function. Secure people also will be less shy about discussing difficult material openly.

Harkening back to my point #1, when the secure base is working properly, people are free to explore the world and pursue new goals. And, each of the attachment styles will differentially relate to what types of goals are chosen. People with secure attachment styles are likely to set new relationship goals (even new ways of being sexual or having fun) because they feel secure and confident enough to risk finding new ways of doing things. They don’t focus too much on the partner (i.e., they aren’t looking for threats or things that might go wrong). Because they expect others to be available and supportive in times of need, they allow the partner to remain relatively free of needing to give reassurances or avoiding upsetting anyone. By extension, the partner is more likely to want to be there for them.

Those with dismissing styles, in contrast, will tend to focus on achievement goals and distance themselves from setting or working on new goals in the relationship. To compound the situation, the more distress there is, and the more demands are placed on them, the more they turn away toward goals outside of the relationship. Those with preoccupied styles, on the other hand, are likely to give up pursuing new goals because they do not trust that the secure base will always be there. Thus, they will tend to focus on the aforementioned avoidance goals and try to hold onto the infatuation and more intense romantic phase of the relationship. The more they see threats and loss of this ideal relationship state, the more they will become demanding and asking of reassurance. This, in turn, acts as a self-fulfilling prophesy that actually serves to drive the other person away.

The simple patterns I have just reviewed are common among the couples I see in my practice. With some basic education on the attachment styles and how they work, most couples are able to calibrate their expectations for their partner and to not take their “negative” or “defensive” behaviors too personally. This is because they come to understand that the partner is merely regulating emotions and behaving in a way that is consistent with that person’s attachment style…it isn’t usually a matter of whether their partner loves them or not.

Sometimes I see couples who have grown to despise one another after a long history of betrayal and woundedness. In this case, the damage has reached a point where at least one partner is already exiting the relationship. Typically when we examine the relationship history, we can see that the relationship rift started in some simple patterns such as the exemplars I have presented here. I often observe two wonderful (but wounded) people who, if they had learned to work with their patterns and communicate about them openly, could have gone on to experience a healthy relationship.

Point #4. Become aware of what types of threats activate your partner’s (attachment-based) defensive systems and lead him or her to display behaviors that bother you. Then you can decide consciously if you want to activate your partner, and you will be able to anticipate the response you are likely to get.

Point #5. Learn how to read your partner’s emotional cues and how to ask openly about what they need from you to feel more secure in the relationship. Often, you will know that they have been activated before they say anything and you can adjust your behavior accordingly…if you choose to.

Point #6. Most importantly, if your emotional reactions are too intense or your partner cannot meet your need for security, you will need to either (a) find a new secure base, or (b) learn to be your own secure base and take care of at least a portion of your own emotional needs and desire for security.

Tune in next month to find out how to make these internal changes and internalize your own secure base.

Male Psychology Basics

This section is a quick summary of the things you will find on this website. If you are just looking for the quick nuggets of info, here it is.

1. It is important to note the difference between sex (being a biological male or female) and gender (having characteristics associated with being male or female). Basically this means that people can have a male body and have a variety of ways to adopt and express gender.

2. A gender role is a set of attitudes, behaviors, and self-presentation methods ascribed to members of a certain biological sex. All cultures across all times have had what I call a “culturally preferred gender role” (CPGR; what a man is supposed to be like) that males are encouraged (or forced) to adopt. Men usually grow up learning these things and other “rules of masculinity” from their fathers, media, and peer group. The three major themes of these are:

Strength: emotional toughness, courage, self-reliance, aggression, rationality
Honor: duty, loyalty, responsibility, integrity, selflessness, compassion, generativity
Action: competitiveness, ambition, dominance, risk-taking

3. When men meet the expectations of a CPGR, there are benefits that usually include acceptance from other men, success in occupations traditionally held by men, increased social status, self-esteem, access to resources, and opportunities with potential mates. Basically, if a man thinks, feels, looks, and acts “like a man should” according to his culture, there are benefits, and these benefits reinforce men to continue with this type of masculinity. This process is what I call gender role compliance advantage.

4. However, conforming to a CPGR also brings serious negative consequences that include physical, mental, and relational health problems due to how restrictive or harmful the style of masculinity is for the individual. These problems are referred to as gender role strain and gender role conflict.

5. Men that do not conform to a CPGR do not receive the previously mentioned benefits, and instead usually experience negative consequences such as social rejection, loss of status, and fewer opportunities for work and potential mates. Therefore, many men who don’t meet the expectations of a CPGR usually either a) try to change in ways that will be more in line with a CPGR, b) reject the idea of the CPGR and find the benefits through other means, or c) make efforts to create change in what the CPGR is.

6. Basically what this means is that in most cultures, men have few options related to gender expression. Thus, most men learn and make efforts to embody a CPGR to get the benefits, and then find ways to deal with the other problems that come with it. Unfortunately, a lot of the ways men cope with these problems are unhealthy (substance abuse, escapism, violence, etc) and often lead to depression, relationship destruction, and physical illness that need professional treatment. Even worse, since self-reliance is usually part of a CPGR, men often do not seek help that they need.

7. For anyone wanting to know how to understand or work with men more effectively, I think the best advice is to a) be educated about the pressures men face to follow a CPGR, b) have compassion (rather than contempt) for their struggles in dealing with it, and c) understand that changing to go against a CPGR is very difficult and can come at great personal and social cost.

8. The Integrative Model of Masculinity (Meek, 2011) incorporates all of these threads to understand an individual male’s masculinity, and the things that influence it.

Integrative Model of Masculinity

Now let’s put it all together. The following diagram illustrates the Integrative Model of Masculinity

In the center of the diagram is an individual man that has a certain style of masculinity composed of his personality, gender role, and self-concept.

On the left side of the diagram are sets of influences that impact the person’s masculinity. Each box (Cultural & Environmental, Biological & Evolutionary; Social & Familial; Psychological & Developmental) represents a different angle of research being done on men and masculinity.

The box on the bottom right represents the costs and negative impact of the individual’s style of masculinity, which feeds back to him as motivation to cope and change.

The box on the top right represents the benefits and positive impact of the individual’s style of masculinity, which feeds back to him as positive reinforcement for specific behaviors or his style of masculinity.

This offers a more complete picture of how all of these diverse elements impact an individual male’s masculinity, and I believe is useful for researchers, mental health professionals, or anyone else interested in understanding men.

Gender Role Compliance Advantage

If someone studying the psychology of men only examined things through gender role conflict and social construction lenses, he/she would be left bewildered by why anyone would want to be masculine or maintain a traditional masculine gender role since it can cause such significant problems. Yet, vast numbers of men embrace at least some (if not most) of those characteristics and behaviors despite experience of gender role strain and conflict. So why does this traditional masculinity continue in the US and comparable versions persist across the globe? Some researchers and writers say that it is a way to maintain inequality, other cite the inter-generational transmission process or larger cultural pressures.

An additional explanation that gets very little consideration in the professional literature is that men who maintain at least some level of culturally preferred masculinity benefit tremendously, often outweighing the costs associated with it. The tendency for following a culturally preferred brand of masculinity benefiting the person is what I call “gender role compliance advantage” (GRCA). Put simply, a culturally preferred gender role is functional and advantageous in many aspects of men’s lives. I believe that GRCA is the primary factor that prevents men from readily adopting (and teaching their sons) more flexible gender roles, which would reduce gender role conflict and associated problems.

Some of the benefits of GRCA are:

1. Acceptance from other men
2. Success in activities and occupations traditionally pursued by, or required of men
3. Increased social status
4. Access to income and resources
5. Increased self-esteem
6. Interest from potential mates.

Think of it this way. Each culture has their expected way of “being a man” that is collectively taught and wide accepted. When a male fulfills this expected role, he is more readily accepted by other men, will have the characteristics to be successful in professions occupied by men, and will therefore have an increased social status, income, self-esteem, and greater romantic interest from others. These are the rewards that apply pressure from the other side. It’s not just the negative things (strain, conflict) that motivate compliance with a gender role, but also the benefits that come along with successfully adopting it.

In conclusion, for individual men, a tension exists related to gender role. Maintaining a certain level of a culturally preferred style of masculinity is the source of great rewards (gender role compliance advantage) and also the source of problems (gender role strain and conflict).

Gender Role Conflict

There are specific patterns of negative consequences that emerge for men during their experience with gender role strain. These patterns are well researched and referred to as “gender role conflict” (GRC; O’Neil, 2008). For example, many men restrict their emotions. This may have positive consequences such as the ability to stay cool in a crisis situation, but a disadvantage would be the inability to emotionally connect in a relationship. The man may experience some gender role strain if he does express feelings in the relationship, and the loneliness and detachment that may following this choice is the gender role conflict.

O’Neil (2008) breaks down different types of gender role conflict in this way (quoted directly):

a) GRC within the man
Private experience of negative emotions and thoughts experienced as gender role devaluations, restrictions, and violations.
b) GRC expressed toward others
Men’s expressed gender role problems that potentially devalue, restrict, or violate someone else.
c) GRC experienced from others
Men’s interpersonal experience of gender role conflict from people interacted with that result in being personally devalued, restricted, or violated.
d) GRC experienced from role transitions
Gender role transitions are events in a man’s gender role development that alter or challenge his gender role self-assumptions and consequently produce GRC or positive life changes

O’Neil (2008) defined devaluations, restrictions, and violations this way:

“Gender role devaluations are negative critiques of self or others when conforming to, deviating from, or violating stereotypic gender role norms of masculinity ideology. Devaluations result in lessening of personal status, stature, or positive regard.”

“Gender role restrictions occur when confining others or oneself to stereotypic norms of masculinity ideology. Restrictions result in controlling people’s behavior, limiting one’s personal potential, and decreasing human freedom.

“Gender role violations result from harming oneself, harming others, or being harmed by others when deviating from or conforming to gender role norms of masculinity ideology. To be violated is to be victimized and abused, causing psychological and physical pain. (O’Neil, 2008, p.363).”

Overall, research has shown that GRC is often related to larger problems including depression, anxiety, relationship problems, low self-esteem, violence, and a variety of other undesirable things. It is possible to reduce or minimize the negative effects of GRC by (a) recognizing it, and (b) becoming more flexible in attitudes and behavior. Using the previous example of the man in the relationship, he may not be very emotionally expressive in other parts of his life but he could learn to be emotionally expressive in his relationship.

Gender Role Strain (Again for the interest of Boy Child)

Gender Role Strain

Gender role strain is the stress related to experience with a gender role. A lot of research has been conducted in the gender role strain paradigm, and it has been a great way to explain some of the physical and psychological problems that many men encounter. Pleck (1995) proposed three types of strain:

(1) Discrepancy Strain
The person unsuccessfully meets traditional gender role standards
(2) Trauma Strain
This occurs after experiencing a traumatic event or process during socialization into the traditional masculine gender role
(3) Dysfunction Strain
When fulfilment of a gender role is hazardous

A classic example is a man who has taken on some aspects of Levant’s traditional American gender role, and is experiencing moderate levels of depression. If he decides to seek help though this, he may experience discrepancy strain. If he decides not to seek help because “men need to be able to tough it out,” he is experiencing dysfunction strain. If part of the depression is related to having a tough, authoritarian father who socialized him into the more traditional gender role, then he may be experiencing trauma strain. 

Male Gender Role (This for the interest of Boy Child)

Male Gender Role

Gender role is generally defined as a set of attitudes, behaviors, and self-presentation methods ascribed to members of a certain biological sex. This includes norms for behavior, which some researchers have started to call “the rules of masculinity” or “masculine ideology.”

These include prescriptions for ways to act (be tough, stay in control, etc), attitudes to hold (work is very important, women should be be primary caregivers to children, etc), and ways to look (wear pants and suits, wear hair short, etc). It also includes proscriptions for ways not to act (don’t cry, don’t be a wimp, etc), attitudes not to hold (want to be a stay-at-home dad, it’s OK for my wife to earn more money than me, etc), and ways not to present oneself (don’t wear a dress, don’t have long hair, etc).

Similar to sex differences, there are many debates about the nature and nurture of gender roles. Some believe that these attitudes and behaviors naturally flow from biological sex and personality traits, whereas others see them as complete cultural constructions.

In reading a variety of work on these characteristics (most of which are outlined below), I believe that this work is in need of a more flexible organizing framework, and this can be used to understand the remaining concepts on this site. Therefore, I use the following three themes that make up male gender roles:

1. Strength: emotional toughness, courage, self-reliance, rationality
2. Honor: duty, loyalty, responsibility, integrity, selflessness, compassion, generativity
3. Action: competitiveness, ambition, risk-taking, agency, volition

Using this model, we can also examine different levels of them. If the above might represent a “positive” or “balanced” masculinity (male gender role presentation), below we can see levels of “hypomasculinity” and “hypermasculinity.” These clusters are generally viewed as the less healthy masculinity characteristics in the US, and many other societies.

Hypomasculinity
1. Weakness: emotional fragility, excessive fear, dependence, irrationality
2. Ambivalence: unreliability, irresponsibility, being non-committal
3. Inactivity: lethargy, submissiveness, complacency

Hypermasculinity
1. Coldness: stoicism, relational cutoff, fearlessness
2. Sociopathy: vanity, arrogance, manipulation, selfishness, lack of conscience
3. Hostility: violence, life endangering risks, hyper-aggression

Other Works
Some researchers have also tried to explore whether there is a “universal masculine” gender role, that can be seen in all cultures during all times. This proves to be quite difficult, but there are several types of social roles that have been highlighted (Gregor, 1985). Specifically, those are:

(1) Provider: Secure and provide resources
(2) Protector: Defend others and territory

Other researchers examine larger cultural trends of male gender roles. Some notable work on this includes Levant et al (1992), who summarized traditional (hegemonic) American masculinity into seven principles. It is important to note that although these are a general trajectory for many men, that there are many different configurations of expression of these depending on individual and sub-cultural differences.

(1) restrict emotions
(2) avoid being feminine
(3) focus on toughness and aggression
(4) be self-reliant
(5) make achievement the top priority
(6) be non-relational
(7) objectify sex
(8) be homophobic

Another popular structuring of this was by David & Brannon (1976), who described the four standards of the traditional American masculinity:

(1) “no sissy stuff”
Distance self from femininity, homophobia, avoid emotions
(2) “be a big wheel”
Strive for achievement and success, focus on competition
(3) “be a sturdy oak”
Avoid vulnerability, stay composed and in control, be tough
(4) “give em hell”
Act aggressively to become dominant

In contrast to what is often viewed as a negative angle on masculinity, a set of studies and papers has been focusing on positive traits associated with traditional concepts of masculinity (Hammer & Good, 2010; Kiselica et al, 2008; O’Neil, 2008; Levant, 1992). A recently presented framework for this focuses on the following 10 “strengths” of masculinity (Kiselica & Englar-Carlson, 2010):

1. Male relational styles: males form relationships through shared instrumental activities
2. Male ways of caring: protecting others and action-empathy
3. Generative fathering: engaging and responding to a child’s needs while attending to larger development
4. Male self-reliance: using resources to overcome adversity and “be your own man”
5. Worker/provider tradition: having meaningful work that provides for others
6. Group orientation: males tend to collaborate and associate in larger networks
7. Male courage: males can achieve great things through daring and risk-taking
8. Humanitarian service: fraternal organizations have a strong history of service for others
9. Men’s use of humor: this can be a means for connecting to others and coping with stress
10. Male heroism: heroic acts have a long tradition as part of manhood.

Sex Differences in Personality

Sex differences are differences associated with biological males or females. For example, males are on average taller than females, making height a statistically significant sex difference. To understand male psychology, we can look at certain clusters of personality traits often possessed at different levels by males and females. In reading the research on personality traits (see Lippa, 2005 for a great overview); it appears that three traits are more common in males than females:

(1) aggression (most types)
(2) higher-stakes risk-taking
(3) assertiveness

and these are less common in males than females:
(1) sociability
(2) harm-avoidance
(3) emotionality

Some of these traits that have been referred to as “agentic” or “instrumental,” (Bem, 1974) and are believed to have been adaptive for men and women throughout human evolution (Baumeister, 2010). There are a variety of theories of heritability of personality (Turkheimer, 2000), but it is important to note that research has also shown that socialization and culture can impact the expression of certain traits. This means that although there may be a disposition toward males and females possessing different levels of these traits, parenting, cultural influences, and the socialization process can determine their levels of expression and development of other characteristics.

Understanding Men Emotions

Understanding Emotions

As you have read in the masculine identity section, restricting emotions is a staple of traditional masculinity. This is also a central source of gender role conflict, since not having access to emotions, or processing them in healthy ways, can create a variety of negative consequences for people. The following is an overview about emotions, and some ideas on how to work with them in healthier ways.

Emotions 101
Emotions are essentially feeling states that have important and often complex information about our life experience. The English language limits the understanding of emotions since there are only a finite amount of words to identify these experiences. The actual human emotional experience does not fit nicely into boxes, and many emotional experiences are combinations of emotions that do not have names. However, there are a variety of theories that attempt to identify what would be considered “primary” or “basic” emotions that are categories of feelings that all other emotions fall into.

Emotional Intelligence
Emotional intelligence is the term used to describe how well someone understands and uses their emotions for healthy living. Overall, an emotionally intelligent person knows that emotions can be a signal to oneself, a motivator for action, a relationship monitor, and a signal to others. Asking yourself why your body experiences certain emotions can be one of the most powerful questions you can ask, since each will have a specific purpose. See the examples for the primary emotions below, again this is an incomplete description, since they can function in more nuanced ways for every person:

-ANGER: increase vigor during a competition, communicate displeasure, defend against attack
-SADNESS: recognize a loss or disruption, makes us to create meaning from life events
-FEAR: helps identify and respect a threat, avoid danger, and seek safety
-JOY: reinforces action and recognize positive outcomes

Processing Emotions
This model can be a framework for understanding the human emotional experience in five steps. Recent research on male emotional restrictiveness has encouraged use of this to understand the variety of levels that men can change their relationship to these feelings. It was originally developed by Kennedy-Moore & Watson.

1.Prereflexive Action: An event creates an automatic feeling that is due to a physiological change within the body.

2. Awareness: We become aware of the physical sensation. Problems arise when we ignore the feeling or deny its existence. Ask yourself: What am I feeling? What are the symptoms?

3. Labeling: We give a name to the feeling we are experiencing. Problems arise when we do not name them appropriately, or have an emotion vocabulary. Instead, we use words like “upset”, “bad”, or “weird”. To help, look at the above chart or emotions, name the one (or more) that you are having, and then rate how strong it is on a 1-10 scale.

4. Interpretation: We draw conclusions about what occurred to produce the feeling. Problems arise here when the cause is not acknowledged, there is a lack of attention to possible causes, or when there is a misattribution. When this is true, we say things like “I have no idea why I am feeling this way”, place the cause on something that doesn’t truly connect to the feeling, or blame another state, such as being “tired”. Ask yourself: What really caused the feeling?

5. Evaluation: We evaluate the feeling as being acceptable or unacceptable based on the situation, personal identity, personal history, and cultural expectations. Problems arise here when we view an emotion as unacceptable, or a reaction to something illegitimate. I promote the philosophy that all emotions are acceptable and valid signals of something that is happening, or are an understandable reaction to something.

6. Decision: We make a decision to take action in response to the cause of the feeling (such as expressing it, or doing something related to the perceived cause), tolerate the feeling without taking action, or seek relief from it by other methods (redirecting attention, artificially changing how we feel, using a defense mechanism, etc). Problems arise here when there are real or perceived limitations on expression, fear of “losing control”, a low tolerance for negative emotions, use of unhealthy coping strategies (substance use, avoidance, primitive defense mechanisms, etc), or lack of access to or education about healthy coping strategies or alternatives. Ask yourself: What would be a healthy way to cope with this emotion? What is the result of doing it?

Myths on Anger & Aggression
There are two common myths about anger and aggression that deserve mention. First, it is not true that men are more aggressive than women. Research shows us that the levels are the same, but the expression is different. On average, men are more likely to express their aggression through physical means (fighting, violence, etc), whereas women are more likely to act through “social aggression”, which is the work of damaging relationships.

Another myth is that “getting your aggression out” through some form of catharsis (punching something, intense weigh lifting, etc) can provide long term relief. For most people, this can provide a temporary release, but if the anger/aggression-provoking source is not tended to, then another build-up is inevitable.

In conclusion, I hope that therapists and anyone else reading this information can get started on helping yourself or someone else continue to experience and process emotions in ways that are positive and life affirming.

Screening and Early Detection of Breast Cancer

Screening and Early Detection

Regular screening tests (along with follow-up tests and treatment if diagnosed) reduce your chance of dying from breast cancer. After all, screening tests can find breast cancer early, when the chances of survival are highest. That’s why we fund local programs that provide screening tests in communities. So more people can have access to these valuable and important tools. But there are also things you can do to help improve your chances of early detection.

Know Your Normal

When other parts of your body look or feel different than they normally do, you notice. For example, if you see an unusual rash on your arm, or a worrisome change in a mole or have a toothache, you’re likely to visit your health care provider to check it out. The same should apply to any changes in your breasts. 

Understand The Warning Signs & Symptoms

Due to the use of regular mammography screening, most breast cancers in the U.S. are found at an early stage, before symptoms appear. However, not all breast cancers are found through mammography. The warning signs of breast cancer are not the same for all women. The most common symptoms are a change in the look or feel of the breast, a change in the look or feel of the nipple and nipple discharge. 

Follow Screening Recommendations

Regular breast cancer screening is important for all women, but even more so for those at higher risk. If you are at higher risk of breast cancer, you may need to be screened earlier and more often than other women. 

Physical differences in the brains of people

Researchers at Monash University have found physical differences in the brains of people who respond emotionally to others' feelings, compared to those who respond more rationally, in a study published in the journal NeuroImage.

The work, led by Robert Eres from the University's School of Psychological Sciences, pinpointed correlations between grey matter density and cognitive and affective empathy. The study looked at whether people who have more brain cells in certain areas of the brain are better at different types of empathy.

"People who are high on affective empathy are often those who get quite fearful when watching a scary movie, or start crying during a sad scene. Those who have high cognitive empathy are those who are more rational, for example a clinical psychologist counselling a client," Mr Eres said.

The researchers used voxel-based morphometry (VBM) to examine the extent to which grey matter density in 176 participants predicted their scores on tests that rated their levels for cognitive empathy compared to affective -- or emotional -- empathy.

The results showed that people with high scores for affective empathy had greater grey matter density in the insula, a region found right in the 'middle' of the brain. Those who scored higher for cognitive empathy had greater density in the midcingulate cortex -- an area above the corpus callosum, which connects the two hemispheres of the brain.

"Taken together, these results provide validation for empathy being a multi-component construct, suggesting that affective and cognitive empathy are differentially represented in brain morphometry as well as providing convergent evidence for empathy being represented by different neural and structural correlates," the study said.

The findings raise further questions about whether some kinds of empathy could be increased through training, or whether people can lose their capacity for empathy if they don't use it enough.

"Every day people use empathy with, and without, their knowledge to navigate the social world," said Mr Eres.

"We use it for communication, to build relationships, and consolidate our understanding of others."

However, the discovery also raises new questions -- like whether people could train themselves to be more empathic, and would those areas of the brain become larger if they did, or whether we can lose our ability to empathise if we don't use it enough.

"In the future we want to investigate causation by testing whether training people on empathy related tasks can lead to changes in these brain structures and investigate if damage to these brain structures, as a result of a stroke for example, can lead to empathy impairments," said Mr Eres.