Friday, January 29, 2010

Friday News Roundup

Using Hypnosis to Treat Dyspepsia

Dyspepsia is a common disorder of the gastrointestinal tract. The major symptom of this disorder is upper abdominal pain. There appears to be no known type of disease that underlies the disorder. Hypnosis has already been shown by several research studies to be effective in the treatment of irritable bowel syndrome, which often overlaps with dyspepsia. A recent study of 126 participants looked at the effects of hypnosis on patients with this disorder. In the study, participants received either hypnotherapy or supportive therapy and either placebo or medical treatment. The symptoms of dyspepsia were  analyzed before the treatment began, after the 16-week treatment, and during the 56-week follow-up. The results indicated that the hypnotherapy group saw more short term improvement (16 weeks) compared to the therapy and medication groups. IN the long term, hypnotherapy group showed significant improved symptoms (73% reporting improvement compared to 43% in the medicine group and 34% of the therapy group).

Curious about hypnotherapy? Check out my web page for a brief discussion of clinical hypnosis, post a comment here for discussion, or send me an e-mail.

The Americanization of Mental Illness

A recent New York Times magazine article discussed the Americanization of Mental Illness. In a statement that I found particular stunning, the article wrote that for many years we have "been busily engaged in a grande project of Americanizing the world's understanding of mental health and illness. We may indeed be far along in homogenizing the way the world goes mad." It's common sense, I think, to notice that concepts of mental illness are not understood the same across the entire world. An example from the article is polio. Polio is polio, no matter where it occurs. Is depression, however, the same in the United States as it is in Uganda, or New Guinea, or elsewhere?

I liked the idea of cultures possessing a symptom repertoire, which was discussed in the article. Different cultures across the world--and different cultures across time--have a different repertoire of symptoms that express a range of psychological conflicts. This notion is in significant contrast with modern psychiatry and psychology which "aggressively spread our modern knowledge of mental illness around the world." The end result is that our modern Western symptom repertoire is being exported around the word with the "speed of contagious diseases."

I'm not so sure this is a good thing. What gets missed, the article points out, is a "deep understanding of how the expectations and beliefs of the sufferer shape their suffering." What's stunning to me is that a deep understanding of how someone changes, heals, or grows is also lost. I'm going to be thinking a lot about this over the next few months. I hope you do, too.

Wednesday, January 27, 2010

What's The Conversation?

Over the last week, I've been thinking a lot about how people have conversations. This line of thought has mostly been stimulated by the post-election discussions in Massachusetts. The senatorial campaign, and the conversation about how it happened, so easily gets reduced down into small bits of digested sound bites. Based on the tv ads and most of the interviews I saw, I really don't know what either candidate stands for. I know they think this issue is good, or this other issue is bad. I don't know why they think so. I really don't know what plans either might have to make things better. In fact, I'm not even sure if I know what exactly either of them wanted to make better.

Conversations I've had with friends or have observed other people have haven't been  much better. See, they aren't really conversations. They are well phrased and nuanced sound bites that don't really reveal anything. Rather than talking about political parties with different ideas we've moved to a world of knee-jerk politics and reactionary sound bites. What ever happened to ideas? Where is the discourse about how to improve the world?

Take for example of few snippets of conversation on Facebook about the Massachusetts elections:

  • "You over tax the people, you over spend, you grow government to big, and you push bills that the American people overwhelming [sic] don't want. Health care, cap and trade, bail outs, etc. That's how they lost his seat. There will be many  more to follow in November."
  • "Good. Maybe in 3 years the president will be next."
  • "Were you living outside the United States between January 2001 to January 2009? The country between those dates was in utter shambles and I don't understand why you would feel the need to repeat that."

It's hard to find good conversation about politics. This morning at the gym I was listening to a pod-cast from Talk of the Nation. It struck me on several different levels. First, and perhaps foremost, it was a smart conversation. Secondly, I stopped and thought for awhile. I first found this caller funny, though I don't think he intended to be so. After I finished my chuckle, I really noticed just how ill-equipped we all are for having conversations. We don't talk about things (my mini-tirade about the election is about that). This caller made me see that we've lost so many conversational skills that we don't even know what one is. This is a portion of the callers question:

"I have a question regarding the conversation whites and blacks folks are supposed to be having... I've never seen anybody having an actual conversation. I've seen people talking.. we need to have a conversation. What is the conversation supposed to be about? Hey, what do you hate about white people? Hey, what do you hate about black people? Are we supposed to have that? What is the conversation supposed to take place? I'm thinking like a CSPAN or some sort of news thing... I want to see the conversation actually happen."

If I had a chance to respond to the caller it would be something like this: the conversation is one we could have right now. It's not about what one group of people hates about another group of people. It's a conversation about what your own experience is like to be you. What does being white mean to you? What does being black? Why does it mean that to you? How has it come to mean that? What might you not know about your own experience or that of someone else? How might you get to know it?

I've often said that part of effective psychotherapy is the ability to have (or the ability to learn to have) a really good conversation. For the rest of the morning I thought a lot about different interactions I've had in my office this week. Among other things, I've talked about race, sex, politics, feelings, and martial problems. Each time I met this situation with a conversation--I ask good questions that I hope make my clients stop, think, and look at a situation in a new way. It mostly doesn't matter to me what a client is thinking about a particular situation: it matters to me how they are thinking about a particular situation.

What are you thinking today? How are you thinking about it? Can you think of it in a different way?

Saturday, January 23, 2010

The Nuts and Bolts: Using Your Insurance for Mental Health Services

It seems that every time January comes around I spend an increased time on the phone with insurance companies. This year is proving to be no different. People's policies change, employers don't always provide clear information, and confusion ensues.

This might be a good time to take a bit of time out to do a little self-education about your own insurance plan. I've put together a list of questions to ask your insurance company. You can find that on my website, here. Additionally, I have made a glossary of insurance terms. It's helpful when you are trying to decode what it is you are reading when you receive an EOB (explanation of benefits) or are on the phone with your insurance company. Check out that glossary here.

Lastly, I've come across a helpful posting about health insurance that I thought I would share. This link will take you to it: The Nuts and Bolts: Using Your Insurance for Mental Health Services

Wednesday, January 20, 2010

Repairing or Maintaining a Relationship

The longer that I am a practicing a psychologist, the more I start to take for granted the things I've learned along the way. I'm thankful each and every time something happens that reminds me not to take this knowledge for granted.

It's second nature for me to engage in "active listening." I know how to pay attention, make eye contact, and let the person who is talking to me to know that I'm alive, paying attention, and taking what they say seriously. I had a telephone conversation the other day with a customer service person and found myself incredibly frustrated. They weren't engaged in active listening. I was first just plain annoyed that I had to work so hard to get my point across. It dawned on me that the person on the other end of the line had no idea how to listen to me. I was still annoyed, but softened up a little bit realizing that there was a lack of training and knowledge: the person wasn't really trying to annoy me.

I slipped into therapist mode for a minute, stopped yelling to get my point across, and used another skill that is second nature to me as a therapist: GIVE.

GIVE is a skill that is part of a trio of interpersonal effectiveness skills that are taught in dialectical behavioral therapy. While some of the acronyms that are used are a little corny, they are a good way to be reminded how to be effective in life.

be Gentle
act Interested
use and Easy manner.

What does being gentle mean? Generally if you are finding yourself yelling, telling someone that they are dumb, stupid, or out of their minds, you are not being gentle. Take a breath. Play nice. Make a gentle joke if you are that sort or perhaps just make reference to the conversation being difficult.

Act interested? When someone is upset with you, don't say "blah blah blah", mock them, roll your eyes, twiddle your thumbs, or watch TV. Look at them, pay attention, let them know you are taking them seriously.

Take it a step further and validate what they are saying. Let them know you are alive, you hear them, and what they are saying is making some sort of impact.

Finally, use an easy manner. Make yourself approachable.

Try it out. You'll feel better about yourself and your relationships will be stronger.

Friday, January 15, 2010

Friday News Roundup

Sleep: Are We Depriving Our Teenagers of Mental Health?

A study analyzed data taking from 15,569 U.S. students in grades 7 through 12 during a two year time period. The average teenager reported getting seven hours and 53 minutes of sleep a night. As a reference point, the American Academy of Sleep Medicine suggests teens get nine or more hours of sleep.

Here is the take home message: adolescents who slept five or fewer hours a night were 1.71 times more likely to suffer from depression and 1.48 times more likely to to think about committing suicide than those who got eight hours of sleep a night.

Of course, one symptom of depression can be difficulty sleeping. The survey data might simply be recording that depressed teens sleep less than non-depressed teens (which would be obvious). Without closer research it would be hard to draw the conclusion that lack of sleep can cause depression.

Regardless, it's a good idea to encourage our teens (and ourselves) to get a good night sleep. It helps reduce emotional vulnerability and just might even help insulate someone from depression.  Want to know more about what is considered a health night sleep? Check out this link that discusses sleep hygiene.

Exercise Preserves Memory 

This is less news (at least to me) and more of a reminder.  According to two reports that appeared in the January issue of Archives of Neurology, moderate levels of physical activity during middle age or later appears to have a protective effect: it can reduce the risk of mild cognitive impairment which is a common condition preceding dementia. Further, six months of high-intensity aerobic exercise can improve cognitive function in individuals who already have the condition.

This makes me glad I went running this morning!

Sunday, January 10, 2010

My 5 For Education: Part Four

My 5 For Education: Part Three

My 5 For Education: Part Two

Earlier today I posted a video of Queen Rania. She has made a request for people to tell her in five words or five seconds why they think education is important. Having both adequate sleep and coffee this morning, I knew right away both what I wanted to say and how I wanted to say it.

Be More Than Your Dreams

It wasn't hard because this is very close to what I often will tell people about psychotherapy: it offers us the potential to be bigger than we thought possible. Is good education really all that different than good psychotherapy?

There is a fence around a reservoir where I frequently walk Maggie. In my mind's eye I saw the words printed out and fluttering along the fence atop the hill. It is a setting that speaks directly to the challenge, hope, and difficulties of education.

Easy image to dream, somewhat more difficult to execute. It's all of eleven degrees outside and windy. Try getting paper to flutter in the right direction so you can capture a five second video, managing a puppy who wants to sled with the neighborhood children, and avoiding frost bite.

I'm editing the video and photos. I'll post them here when I am done. In the meantime, what are your five words/five seconds for education? Are they similar to what you'd describe as the potential of psychotherapy? If you you are feeling so motivated post your five on Queen Rania's website. If you are so inclined, and feel it speaks to therapy as well, send it to me and I'll post it here on my blog.

My 5 For Education

Now here is an interesting campaign for education. I follow Queen Rania on twitter and this caught my eye right away. It seems like a great way to quickly capture people's attention and have them think about an important topic. I personally am enjoying the opportunity to think about my own five for education (five words/five seconds). Watch this space for my response!