Psych Central Original articles in mental health, psychology, relationships and more, published weekly. 2016-08-29T14:57:09Z http://psychcentral.com/lib/feed/atom/ K.M. McCann, PhD <![CDATA[Book Review: Wired to Connect]]> http://psychcentral.com/lib/?p=44910 2016-08-24T12:58:20Z 2016-08-29T14:57:09Z A friend of mine recently ended an intimate relationship because she felt her beau not only misunderstood her, but that he also prevented her from being her true self. There […]]]>

A friend of mine recently ended an intimate relationship because she felt her beau not only misunderstood her, but that he also prevented her from being her true self. There were telltale signs of the end, as there always are, things like needing more time apart, feeling trapped during time spent together, and more. “I don’t know who I am anymore,” she confided. “I’m losing more of myself the longer I stay in this relationship.” So, should she have stayed and tried harder? Or, was she right to end an otherwise dead-end relationship? If only relationships were that easy. Few of us have weathered intimacy without enduring at least a few broken-hearted moments.

It is true that a certain amount of compromise is required in a healthy relationship, but as with anything, there are limits to how much of ourselves we should suppress. Too much compromise may result in a loss of self and personal identity and an imbalance in the relationship. According to Amy Banks and Leigh Ann Hirschman’s new book, Wired to Connect: The Surprising Link Between Brain Science and Strong, Healthy Relationships, relationships with people who do not understand you may weaken neural circuits that enable you to connect in healthier ways. “Healthy relationships nurture our neural capacity for resonance,” write Banks and Hirschman. Damaging relationships, on the other hand, cause those same circuits to “wither from disuse.” Relationships come in many shades, from parent-child to sibling-sibling to friend-lover, and more. Any relationship can be damaging or hold the opportunity for forging deeper human connection. But how do we know which relationships are promising and which ones are doomed from the start?

As it turns out, the truth resides in the physical body as well as in the emotional life. The sympathetic and parasympathetic nervous systems, better known as the places where our “fight, flight, or freeze responses” come from, are warning signals for the stress we feel. The problem is that “fight, flight, or freeze” aren’t the only options on the nervous system menu, write Banks and Hirschman. According to evolutionary theory, mammals have evolved a much more sophisticated way to identify and respond to stressors. That evolutionary nugget is the smart vagus, and it lets us know, through facial expression, body language, and other means, whether we are in the company of trustworthy people such as friends and family.

The safety feeling set off by the smart vagus, say Banks and Hirschman, permits us to be more animated, more open, and to respond in other socially appropriate ways that signal our comfort level around those with whom we feel secure. The smart vagus, however smart, can be wrong. Misreading friend for foe and vice versa comes, suggest Banks and Hirschman, from early childhood shaping and from subsequent patterns of dysfunction. This is not to say that we should blame our parents for our broken nervous systems; instead, we should see the issue for what it is and work to correct the error. In effect, we need to retrain ourselves to correctly identify signals and respond in socially appropriate ways.

“Neural pathways compete for brain space” and if you want the good ones to stay, then “you must starve” the negative ones that are competing for space. Whenever you identify a negative message “relabel it as a cultural message that sabotages your goal of reclaiming your connected brain…With practice, the world can transform in front of your eyes.”

Banks and Hirschman do an excellent job detailing the primary parts of the brain that are responsible for connection and sustaining healthy relationships. Perhaps most intriguing about the book is the discussion on how to reprogram the brain and, in effect, how to free oneself from patterns of dysfunction. Neuroanatomy and brain function are not easy subjects, but the authors present them in a way that makes them accessible to nearly any reader. Through masterfully selected clinical examples and easy-to-understand self-assessment tools, Banks and Hirschman avoid some of the primary problems often present in books of this kind. They brings a complex and invaluable topic to their readers in a way that makes it palatable and also extremely practical. This is no easy task where brain science is concerned and the authors handle it with aplomb.

I strongly recommend this book, not only for those who wish to better understand the mechanics of intimacy, but also for all of those who wish to shed outdated patterns and reprogram the brain for a healthier, more joyful life.

Wired to Connect: The Surprising Link Between Brain Science and Strong, Healthy Relationships
TarcherPerigee, February 2016
Paperback, 310 pages
$16.00

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Megan Riddle <![CDATA[Book Review: The Conscious Parent’s Guide to ADHD]]> http://psychcentral.com/lib/?p=44904 2016-08-25T21:05:28Z 2016-08-28T17:45:28Z “Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing it is stupid.” ~ Albert Einstein […]]]>

“Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing it is stupid.”
~ Albert Einstein

For some, the symptoms are more subtle — it is the child who sits gazing out the window, her mind far from the classroom where her classmates are hard at work. For others, the symptoms are more blatant — a child who cannot sit still, bouncing up from his chair, calling out in class, poking his neighbor. At home, chores are left undone and often not started, homework is a battle, and the latest videogame is like a black-hole sucking in all of the child’s attention. Attention Deficit Hyperactivity Disorder can take different forms and affects all aspects of a child’s life, which can frustrate parents, teachers, and children alike. In her new book, The Conscious Parent’s Guide to ADHD: A Mindful Approach for Helping Your Child Gain Focus and Self-Control, Rebecca Branstetter, PhD, offers advice on parenting children with ADHD, who can sometimes stretch the skills and patience of the most committed parent.

Dr. Branstetter is a psychologist who works both in private practice and as a school psychologist, giving her a wealth of experience that she shares in The Conscious Parent’s Guide to ADHD. The book starts with the basics, offering an overview of ADHD and detailing the different ways children with ADHD may interact with the world. She incorporates basic neuroscience in an understandable way that will resonate with those who share their lives with children who have ADHD. For instance, Branstetter notes that “researchers have found that a sluggish reward circuit in the brains of children with ADHD makes otherwise interesting tasks seem mundane or boring. Children with ADHD need a higher level of reward or interest to sustain attention. Video games and other high-reward and stimulating activities seem to fit the bill.”

Suddenly, that child’s ability to spend hours staring at an interactive screen, but only three minutes on homework seems less a case of poor willpower (or poor parenting) and more the result of biology. However, having a sense that there may be an issue is only the first step. She follows this with a chapter on how to navigate getting a diagnosis, including descriptions of the experts who may or may not be able to offer help.

The next section of the book focuses on how to support a child with ADHD from preschool through the teenage years. Each chapter highlights the challenges children with ADHD may face at different stages of life, but rather than dwell on the negative, Branstetter also highlights these children’s strengths. For example, on the section about attention to detail, she reframes the issue to highlight that, “many children with ADHD also have a holistic thinking style that focuses on the big picture at the expense of details that they find boring or mind-numbing.” Regarding hyperfocus, she points out that many of these children are able to spend hours poring over topics that they find interesting, often to the detriment of their spelling or math homework.

However, “the ability to concentrate intensely can be an asset — especially when a child with ADHD goes to college, where creativity and thinking outside the box are more highly valued.” Each chapter also includes specific ways to help the child succeed at every stage, whether that’s which classroom structures work best or how to facilitate homework completion. In addition, each chapter contains ways to encourage the child to practice mindfulness using age-appropriate methods. For preschoolers, that includes things like engaging their senses and blowing bubbles, while for teens she offers ways to help them find their own mindfulness rituals. The latter half of the book delves further into many of these themes, discussing mindfulness, how to help the child face scholastic and social challenges, and offering guidance on sorting through various treatment options.

Throughout the book, Dr. Branstetter provides a mix of hope and reality, offering practical guidance for what can be a frustrating disorder. Each chapter is thorough without being weighed down with details. This is a worthwhile read for those who love a child with ADHD.

The Conscious Parent’s Guide to ADHD: A Mindful Approach for Helping Your Child Gain Focus and Self-Control
Adams Media, December 2015
Paperback, 240 pages
$26.75

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Tina Arnoldi <![CDATA[Book Review: The Mindfulness & Acceptance Workbook for Anxiety]]> http://psychcentral.com/lib/?p=44914 2016-08-25T21:05:18Z 2016-08-27T17:49:05Z When you experience anxiety, worry, or fear, have you ever thought about embracing it rather than running away from it? In The Mindfulness & Acceptance Workbook for Anxiety, John P. […]]]>

When you experience anxiety, worry, or fear, have you ever thought about embracing it rather than running away from it? In The Mindfulness & Acceptance Workbook for Anxiety, John P. Forsyth and Georg H. Eifert present a whole new way of thinking about anxiety that is quite different from traditional treatment methods. What’s interesting is that they do not aim to teach the reader ways to control anxiety. Instead they try to go to the root of the problem and get beyond simply treating the symptoms. They do make a very good point when they say that, ”thinking and feeling well does not automatically translate into living well, nor is it a path to genuine happiness,” and that’s why their approach is more holistic than traditional treatment methods.

Part One of the book invites the reader to consider this new way of thinking about anxiety and using a new treatment approach. Forsyth and Eifert say,“We know that to get a different outcome we need to change what we’re doing now.” It’s such an easy concept, yet it’s one we tend to forget as we fall back into our old habits and routines. This section of the book gives a lot of introductory material that is beneficial to those who are not familiar with the concept of mindfulness. It starts with the practice of helping people learn how to be in the present. From the very start, Forsyth and Eifert teach readers practical exercises that can be done at home. They also provide recommendations at the end of each chapter on how to practice what was learned. A number of quizzes are provided to help readers understand the difference between anxiety and fear, and understanding the difference between the two helps people learn how to respond to those feelings.

Although their intention is not to label, Forsyth and Eifert do distinguish between panic disorders, phobias, social anxiety disorder, OCD, GAD, and PTSD. This is helpful for readers who can sense that something is wrong but do not have the background or education to distinguish between the different types of anxiety disorders. The authors steer away from complicated clinical language and provide easy-to-understand descriptions of a concept. For example, they compare anxiety to poison ivy, saying that when people scratch at poison ivy, it only gets worse. Likewise, if you scratch anxiety by struggling against it, anxiety only gets worse. I also appreciate that they discuss common misconceptions about anxiety and fear, which will give hope to those readers who might not have had good experiences with anxiety treatment in the past.

Part Two provides steps to start this new journey of self-care. The authors help readers determine how invested they are in their own treatment by asking them to examine the current cost of managing their anxiety. Whether this impacts them with career, health, energy, or emotions, there is a cost in trying to continually manage anxiety. Readers are also asked to evaluate what they’ve given up to manage anxiety using only traditional treatment methods. The authors challenge readers to think about how they want to be remembered, what legacy they want to leave behind, and how that is negatively impacted by spending so much time managing anxiety. The solution they propose is to stop struggling with anxiety and surrender to it.

Surrender does not imply that one is surrendering the hope of getting well, but rather accepting that thoughts and feelings will be with the reader wherever they go and that continuing to fight may not the best answer. One thing everyone has control over is his or her own actions. And yes, it can be hard to admit that at times because it is much easier to blame someone else and adopt a victim mentality. On the other hand, it can be reassuring to know that many things people don’t like in their lives are things they do have control over.  Acceptance in this context is about accepting the experience of the anxiety, not liking the experience. But awareness is the first step to help people recognize what might need to change. As Forsyth and Eifert say, “we can only choose what we pay attention to, how we pay attention, and what we do.”

Part Three is very detailed, with suggestions on how people with anxiety can reclaim their lives. This process starts by examining their values, asking, “Am I making choices based on what I deeply value and care about for my life? And am I doing things that really matter to me and make my life worthwhile? Or have my choices and actions been driven more by avoiding or minimizing my pain?” Defining one’s values is a way to get started and to stay focused on healing. It involves stopping to examine the actions one takes and determining if those actions get him or her closer or further away from living the type of life desired. This section is filled with exercises that build on the concepts presented in Parts One and Two. Exercises are both cognitive and behaviorally based, encouraging the reader to take action.

As a therapist, my one caution about The Mindfulness & Acceptance Workbook for Anxiety is that some clients might do best working through this book with a counselor. Although the book was written as a stand-alone workbook, patients with severe anxiety would benefit from the support and guidance of a trained clinician as they get at the root of these concerns. Also, readers have to be very self-motivated to address these concerns on their own. It is a lot of work and can seem overwhelming initially, which is why I would recommend having a guide or even accountability partner to help walk someone through this workbook.

What I appreciate about Forsyth and Eifert’s approach, though, is the focus on quality of life instead of avoiding anxiety. And it makes sense. Do we really want to spend so much of our effort and focus on things we do not want? Instead, shouldn’t we invest our efforts on the things we do want in our lives? And although this is a different approach, it is similar to CBT with the emphasis on how we think and take action through our behaviors. The takeaway from this workbook is that as people begin to examine what they need to live a valuable life, the anxiety, worry, and fear will naturally decline.

The Mindfulness and Acceptance Workbook for Anxiety: A Guide to Breaking Free from Anxiety, Phobias, and Worry Using Acceptance and Commitment Therapy
New Harbinger Publications, April 2016
Paperback, 342 pages
$24.95

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Claire Nana <![CDATA[Book Review: The Un-Prescription for Autism]]> http://psychcentral.com/lib/?p=44918 2016-08-25T21:04:42Z 2016-08-26T22:35:16Z For any parent coping with raising an autistic child, managing the chaos that earmarks the disorder — not to mention the dizzying array of medications, treatments, and therapies — can […]]]>

For any parent coping with raising an autistic child, managing the chaos that earmarks the disorder — not to mention the dizzying array of medications, treatments, and therapies — can often feel exhausting, overwhelming, and quite frequently, disheartening. autism is simply a very difficult and very complex disorder to treat. Yet, according to Janet Lintala and Martha Murphy, authors of The Un-Prescription for Autism: A Natural Approach to a Calmer, Happier, and More Focused Child, the problem might just be that we are targeting the symptoms and not the root cause of autism.

Janet Lintala, a mother of an autistic son herself, lends her many years’ experience coping with her son Evan’s violent outbursts, irritability, poor impulse control, and difficulty focusing before uncovering that it was only through using a natural approach heavily anchored in restoring gastrointestinal health that her son found any palpable relief. Now the founder of Autism Health, Lintala writes, “We discovered that children on the [autism] spectrum aren’t mentally ill or inherently violent, that they have underlying gastrointestinal, immunological, and other metabolic dysfunctions that cause many of the problems Evan was experiencing, and that they are in a lot of pain.”

According to Lintala, the typical constellation of autism symptoms — difficulties with mood, behavior, language, cognition, and mental clarity — only masks a much deeper and more pervasive problem autistic children face: poor gut health. And while medications may attenuate some autistic symptoms, they don’t improve gut health and often make it worse. Gut health, Lintala tells us, begins during birth, and children who are born through C-section are not exposed to the necessary bacteria that create a healthy gut microflora. Without this, children often suffer from constipation, rashes, allergies, infections, chronic inflammation, and irritability.

Treating the gut microflora then becomes the first step toward improving autistic symptoms. To do this, Lintala offers a helpful questionnaire, including everything from bathroom routines to in-school behavior to demonstrate just how interconnected gut health and autism are. “It is estimated that 60 percent of ASD children may struggle with mitochondrial dysfunction which may be due in part to oxidative stress caused by chronic inflammation,” she writes.

To go about restoring gut health, Lintala’s approach is comprehensive and ongoing. To begin, parents must first correct their autistic child’s constipation, as it leads not just to reflux, poor sleep, and difficult behavior, but also disables the body’s natural ability to detoxify and absorb nutrients. Through progressive use of enzymes — Lintala offers advice about just which types to buy — gastrointestinal regularity can often be restored.

Lintala then emphasizes the importance of probiotics: “As a matter of fact, in 2005, probiotics were suggested as a beneficial addition to therapy for depression.” In addition to improving mood, probiotics serve a wide range of helpful functions including, activating neural pathways, improving brain signaling systems, and enhancing brain development, all of which are critical for autistic children. Here again, Lintala offers a wealth of helpful information on just which probiotics to buy, when to give them, and any potential drawbacks. For example, she advises never starting a probiotic at the beginning of the week as use can lead to some initial discomfort.

On the topic of antifungal rotation, Lintala shares the story of Bindee, a young girl who was initially treated for Helicobacter pylori (a bacterium that may cause peptic ulcers) upon which her behavioral symptoms resolved. Six months later, however, Bindee’s screaming fits, crying, and irritability returned, along with a bloated belly. What Lintala discovered through a stool test was a parasite called Ascaris lumbricoides, also known as giant human roundworms. Lintala writes, “Bindee’s story is a call to action to parents and pediatricians everywhere to realize that irritability is a symptom, not a core deficit of autism.”

However, autistic children can also suffer from chronic immune deficiency and particularly inflammation. Lintala writes, “Inflammation, which is a tool of the immune system, may be left in the “on” position leaving a child in a state of systemic inflammation, including brain inflammation.” Restoring proper immune function, like with gut health, is an ongoing practice, but Lintala offers many helpful and some surprising tips: use Zinc, moderate levels of Selenium, exercise daily, and avoid hand sanitizers as they are thought to be endocrine disruptors.

And if parents are left wondering just how to put the wealth of information Lintala provides together, she includes a year-long sample of her basic gastrointestinal health diet, along with a list of typical setbacks and how to prevent them. One setback is not giving her methods time to work. Treating autism, and ultimately transforming a child’s behavior, she reminds us, is not impossible, but it does take time, dedication, and perseverance through the tough times.

The Un-Prescription for Autism: A Natural Approach for a Calmer, Happier, and More Focused Child
AMACOM, April 2016
Paperback, 234 Pages
$18.95

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Edie Weinstein, MSW, LSW <![CDATA[Does Failure Groom Us for Success?]]> http://psychcentral.com/lib/?p=46042 2016-08-25T21:03:51Z 2016-08-26T14:11:07Z ]]> does failure breed success?
“Do not be embarrassed by your failures, learn from them and start again.” ~ Richard Branson

“Many of life’s failures are people who did not realize how close they were to success when they gave up.” ~ Thomas A. Edison

“Winning is great, sure, but if you are really going to do something in life, the secret is learning how to lose. Nobody goes undefeated all the time. If you can pick up after a crushing defeat, and go on to win again, you are going to be a champion someday.” ~ Wilma Rudolph

An entrepreneur, an inventor and an athlete, emerging from varying life experiences with a shared perspective. They have learned that before the ultimate success may initially come several failures.

They are not alone, as some of the world’s most iconic figures had a long runway to traverse before they each skyrocketed to fame. They include: Steve Jobs, Milton Hershey, Walt Disney and Arianna Huffington.

Relationships end, businesses fall apart, folks change careers, students drop out of school, those in recovery relapse. These may be considered failures or they can be viewed as an opportunity for do-overs.

Consider a child who is learning to walk. Generally, at around a year old, he or she takes a first step. Most likely it will result in a tumble to the ground, with diaper padding cushioning the landing. If there are supportive adults around, clapping and cheering will occur. That little one is likely going to pull up again and take the next step. Nowhere in that child’s mind is the thought, “I’m so clumsy that I will never learn to walk and will scoot around on my butt for the rest of my life.”

This anecdote was shared by a friend and it stands as a testament to the power of paradox in the area of success and failure.

“Failure grooms us for success: I heard this incredible story the other day. That at a dinner table, a dad asked all his kids each night: “What did you fail at today?” And they would each recount their failures for the day. And he would celebrate them. He would always say: “Good for you! You tried something. You put yourself out there. That is the real success anyway. Keep trying new things. Don’t worry about how it turns out. Just keep trying, learning and growing.”

This counterintuitive approach to parenting encourages curiosity and expansion, rather than fear. This is a rare occurrence, as most view failure as an indication of character flaw, of inadequacy or incompetence.

Maria was taught that nothing could be considered failure if she put her heart and soul into her endeavors. She grew up in a family in which education was valued. There were books in nearly every room of her childhood home. Even the bathroom was not exempt as her father referred to it as “the library.” She was read to by her parents each night before bed and many happy hours were spent at the library up the street.

Her questions were met with the best responses her parents could offer and when they didn’t know the answers, they told her, “Look it up.” As a result, she learned to research until the resolution was found. They encouraged her to stretch her comfort zones in academics and athletics. She became an A student and a blue ribbon-winning swimmer. In the midst of all of this, she still had self-doubt, which even the most confident-seeming person can harbor. Her fear was not specifically of failure, but rather, of disappointing her parents and others who believed in her. This was not directly communicated to her, but she interpreted their confidence in her as contingent on her performance.

Megan McArdle, MBA, the author of The Upside of Down: Why Failing Well is the Key To Success, reinforces the belief, “You’re not a failure. You’re someone who has failed. . . just like everyone else who ever lived on the planet, from Alexander the Great to Abraham Lincoln. Failure is what makes success possible. It’s how we learn what doesn’t work — and therefore how we learn what does.”

Does Failure Build Character?

According to New York Times journalist and commentator David Brooks, who penned The Road to Character: “We live in a culture that teaches us to promote and advertise ourselves and to master the skills required for success, but that gives little encouragement to humility, sympathy, and honest self-confrontation, which are necessary for building character.”

Success and Failure Seesaw

There are times when we feel as if we are on a seesaw that has us up in the air with delight that our goals have been achieved and then bumping our bottoms on the ground as we feel let down that we haven’t crossed the finish line ahead of the pack. Here are some markers that shape our relationship with these two polarities:

  • Lack of belief in your own abilities or faith in them
  • You have figuratively fallen and skinned your knees (or perhaps literally) and are fearful of getting hurt again
  • Perfectionistic tendencies
  • Unworthiness to have what you want
  • Failure can be a self-fulfilling prophecy
  • Your internalized definition of what success means
  • What you were told success means by the adults in your life
  • There may be a family history of failure that seems as if it is encoded in DNA that is passed down from generation to generation
  • Your role models for success and failure
  • An entrenched belief that before you can be happy, you have to be successful, rather than the other way around

How to see failure as friend, not foe:

  • See it as a learning experience rather than one that is demoralizing
  • Refrain from perceiving it as a measure of your worth as a person
  • Be willing to take calculated risks
  • Know that most endeavors are not a matter of life and death
  • Ask yourself if a particular outcome will matter five years down the road
  • Be curious and ask yourself, “Hmmmm…I wonder if I can do it this way…. I wonder how this can work…”
  • Have ‘now what?’ thinking. You can complain, “Oh no, now what?” or motivate yourself by inquiring, “Okay, now what?”
  • Know what you can and can’t control
  • Envision successful scenarios and keep your eye on the prize
  • Know that progress and not perfection is the ideal
  • Stretch comfort zones to the point that a manageable bit of nervousness (not full blown anxiety or panic) is present as fuel for your endeavors
  • View obstacles as exercise equipment that makes you stronger and more flexible
  • Take responsibility for your choices, successes and failures
  • Be open to constructive feedback from those who have been where you are
  • Have a vision for your life and move in that direction, knowing that there will be detours
  • Use positive self-talk to reinforce what you do want, rather than what you don’t want
  • Recognize your resilience, remembering that you have survived everything that has ever happened to you

Gino Santa Maria/Bigstock

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Bella DePaulo <![CDATA[Book Review: The Secret Life of Sleep]]> http://psychcentral.com/lib/?p=44861 2016-08-24T12:46:06Z 2016-08-26T01:45:03Z Kat Duff’s carefully researched, engagingly written, and wide-ranging The Secret Life of Sleep is an ode to sleep. The author documents the contemporary preoccupation with productivity, alertness, and cheating sleep. […]]]>

Kat Duff’s carefully researched, engagingly written, and wide-ranging The Secret Life of Sleep is an ode to sleep. The author documents the contemporary preoccupation with productivity, alertness, and cheating sleep. She points to the many ways we are urged along on that path, from breezy sloganeering (e.g., “you snooze, you lose”) to the popularity and easy availability of stimulants. But she’s not cheering for that mindset.

Instead, she enlightens us about the ways in which contemporary Western ways of sleeping and thinking about sleep are out-of-step with the ways people have been sleeping for centuries, and the ways they have been, and still are, thinking about sleeping and dreaming beyond the Western world.

Drawing from the latest research, Duff addresses all the questions you would expect in a book on sleep. They include, for example, how much sleep we need and how much we get, how it matters when we don’t get enough sleep, and what’s important about the different kinds of sleep we get and the different kinds of dreams we remember.

But then, instead of adding to our alarm about our sleep deficits and the effects of our sleep deprivation on our functioning, health, and well-being, she soothes us with reasons to relax. For example, she reassures us that we shouldn’t worry so much about not sleeping through the night. Throughout most of history, people rarely did and rarely expected to.

Yes, she concedes, it is true that people who are woken from a sound sleep — as happens often in sleep studies — don’t think as quickly, remember as well, or do math as successfully as those who got to sleep through the night. But why, she asks, do we measure and value such a narrow set of qualities? Instead, she asks, “Why not test for mental flexibility, emotional receptivity or creativity, qualities that emerge at the soft edges and lapses of waking focus?”

And why are we so obsessed with alertness and focus, to the exclusion of pensiveness and dreaminess? Duff goes on to say, “While there are some professions that truly demand long hours of sharp focus, such as surgery, most of us do not risk anyone’s life when our attention drifts. We can allow ourselves to cycle between phases of rest and activity, diffuse and pointed awareness, as our biology requires.”

More fundamentally, why do we cherish our waking hours so much more than our time spent sleeping? Why do we try to draw such a sharp distinction between the two, when in fact, the states are not so separate, and “our waking and sleeping lives require and inform each other?”

Duff doesn’t deny the serious implications of getting insufficient sleep or of sleep experiences that are disturbing rather than replenishing. But she thinks our contemporary perspectives on sleeping put too much of the onus for change on the individual rather than broader social forces: “Even though the causes of insomnia are usually located in larger socioeconomic contexts, be it the hectic pace of modern living, the prevalence of shift work, or new-fangled technology, the solutions offered are inevitably individual. Experts address the sleepers, rather than their employers or the city light department, with their lists of things to do and not do.”

There is a famous dictum in journalism and politics: Follow the money. That’s how you figure out who is ultimately benefiting. Duff follows the money of the sleep industry. She finds, for example, that in 2005, “more than twenty-six million prescriptions for Ambien were written in the United States alone, totaling more than $2 billion.” Yet on the average, sleep medications “increase the total sleep time by only 11.4 minutes. Moreover, functioning does not improve the next day.”

The big picture is even more telling: “Prescription and over-the-counter medications, sleep studies, white noise machines, earplugs, eye masks, apnea devices, sleep monitors, specialty mattresses, high-thread-count sheets, aromatherapy pillows, high-end beds, and alarm clocks fuel a sleep economy worth more than $20 billion a year.”

Over the course of The Secret Life of Sleep, Duff nudges us to be more open-minded in how we think about sleep and dreaming. In a section on dream visitations and travels, for example, she notes, “The notion that each of us has an immaterial soul, a shadow or secret self, which separates from the body in sleep, is ubiquitous among non-Westernized people.” I confess to being far too entrenched in my Western ways to take spirit travel seriously, but The Secret Life of Sleep was still a mind-expanding experience for me.

The Secret Life of Sleep
Atria Books/Beyond Words, March 2014
Hardcover, 256 pages
$24.00

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Janet Singer <![CDATA[Anxiety and Exposure and Response Prevention (ERP) Therapy]]> http://psychcentral.com/lib/?p=46025 2016-08-22T21:27:42Z 2016-08-25T17:45:37Z ]]> anxiety and exposure and response prevention therapyWhen my son Dan was first diagnosed with obsessive-compulsive disorder, he did not receive proper treatment. This is actually not uncommon for those with OCD. Wrong therapy, wrong drugs. His OCD spiraled out of control and less than a year later it was so severe he could not even eat.

So when he entered a top OCD residential treatment program, my husband and I finally breathed a sigh of relief. Dan was on his way! The therapy used in this program was exposure and response prevention (ERP), the recommended psychological treatment for OCD.

By all accounts from his social worker, Dan settled in quickly at the program and was already working hard: facing his fears (exposures) and refraining from engaging in his compulsions (response prevention). And from what we were told, he was making good progress.

We were so pleased and excited! We couldn’t wait to see Dan and almost ran into the clinic for our first weekly meeting. How wonderful it would be to see him not so tormented by this horrible disorder!

Well, what we found was not what we imagined. Dan had lost more weight off his already tall, much-too-thin frame and had black circles under his eyes. He was noticeably nervous, anxious, and jittery, and appeared to be in even worse condition than when he first entered the program.

What went wrong?

Actually, nothing.

What my husband and I didn’t realize at the time is that ERP therapy, by its very nature, raises anxiety. Our son was being asked not only to face his greatest fears, but to refrain from engaging in the thoughts or actions that he believed (at least on some level) kept him, or those he cared about, safe.

Let’s take an example. A common obsession in OCD is worrying about the possibility of hitting someone while driving. Maybe a person with this obsession might avoid driving, but if he has to drive, he makes sure to go back and check every time he thinks he might possibly have hit someone. This compulsion temporarily reduces our friend’s anxiety, but actually strengthens his OCD.

Enter ERP. Now he not only has to face his fear of driving, he has to force himself not to turn the car around to make sure he hasn’t hit anyone. This causes a spike in anxiety, which is actually an integral part of ERP therapy. While the anxiety will be intense, it always resolves at some point. It might take a long time at first, but each time this person drives without checking, the anxiety will typically take a little less time to dissipate until finally, the person with OCD is no longer tormented by this obsession. He has learned to live with the uncertainty of the situation.

Back to Dan. So while we didn’t know it at the time, my husband and I should have been happy to see him so anxious. As he himself told us, “I feel horrible, but that’s good.” That meant he was truly immersing himself in his ERP therapy, and it was working. It’s a tough battle, but as I’ve said many times before, I’ve never met anyone who has regretted doing ERP therapy. The only regret is not having done it sooner.

FancyTapis/Bigstock

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Megan Riddle <![CDATA[Book Review: When a Family Member Has OCD]]> http://psychcentral.com/lib/?p=44898 2016-08-24T12:44:48Z 2016-08-25T14:43:35Z “Every family is a system of constantly moving parts. When one part of the system changes, it creates change in all the other parts. What this means is that when […]]]>

“Every family is a system of constantly moving parts. When one part of the system changes, it creates change in all the other parts. What this means is that when one family member experiences a mental health challenge, all family members are affected.”

– Jon Hershfield, MFT, in When a Family Member has OCD

Obsessive compulsive disorder can be incredibly disabling for the affected individual and completely baffling for the family. So much more than frequent hand washing, OCD can take over the life of those struggling with this disorder and that of their family. In his new book, When a Family Member has OCD: Mindfulness & Cognitive Behavioral Skills to Help Families Affected by Obsessive-Compulsive Disorder, Jon Hershfield provides a guide for navigating the many twists and turns of supporting a family member with OCD, from understanding the illness and its treatment to coping with the complex family dynamics.

Hershfield’s book provides a unique perspective as he has been on both sides of the therapeutic coin. In the introduction, he shares, “I grew up in an OCD family. By the time I asked for help for my OCD (around age fourteen), I was already used to hearing about ‘his OCD,’ ‘her OCD,’ ‘their OCD,’ and everybody else’s OCD throughout the family tree.” The son of a psychiatrist, he had the good fortune of a supportive and understanding family that helped him deal with his own mental illness, noting, “Mom sent me care packages in college with the usual — you know, mail from home, a new pair of socks, a Prozac refill.” When he decided to complete a Master’s degree, he focused on CBT for OCD. His professional focus still remains on OCD, but, as he points out, “I live and breathe OCD, but in a much different way now. The irony is not lost on me.” He brings this experience — as provider, family member and patient — to bear in his book.

In the first section of the book “Understanding OCD,” Hershfield gives an overview of the illness. While written in a way that is understandable for the uninitiated, he covers the important aspects including biological, genetic, and psychological contributions to the disorder. But he goes beyond the textbook understanding to incorporate true-to-life examples and apparent paradoxes, anticipating the frustrations of those living with OCD. He writes, “If your family member has Contamination OCD, you may wonder how he can be so particular about some things and so complacent about others. How can he wash his hands 100 times a day yet leave garbage on his bedroom floor?” His explanations of these conundrums resonate with the feeling of someone who has been there. “Don’t judge yourself too harshly if you think [the behavior of the person with OCD] is somewhat ridiculous. It boggles your mind and it doesn’t make sense because you can’t help but look at it from a more logical standpoint.” His understanding for the family members of those with OCD offers reassurance in what can be a frustrating process.

The second section, “Supporting your Family with OCD,” builds upon the first. Living in a family, Hershfield notes, requires accommodation. However, when living with someone with OCD, “there’s a hole in the system and a nearly unlimited supply of accommodation to fill the hole…” Rather than helping, accommodation can provide fertile ground in which OCD can flourish. Thus, this section offers specific, detailed strategies to help divert this unending need for accommodation and provide support for dealing with their obsessions and compulsions. He goes into further detail in separate chapters focusing on various common issues with OCD families may encounter, such as repetitive checking, an incessant need for reassurance, and constant washing and cleaning.

The final section examines the perspectives of various family members dealing with a loved one with OCD. Whether you are the parent, partner, or sibling, Hershfield offers a series of dos, don’ts and observations about how to support both the individual affected with OCD and yourself. He also provides an overview of the treatment providers and treatment options to help the family negotiate the process with the affected person.

This article courtesy of:
Pediatrics for Parents

Overall, When a Family Member has OCD is packed with important information on living with and loving someone who struggles with obsessive compulsive disorder. OCD affects the entire family, but also the whole family can be involved in addressing it. As Hershfield eloquently writes, “When your family system comes together to battle OCD, the system will evolve: your family will grow closer, more cherished, and more reliable than ever.”

When a Family Member has OCD: Mindfulness & Cognitive Behavioral Skills to Help Families Affected by Obsessive-Compulsive Disorder
New Harbinger Publications, December 2015
Paperback, 200 pages
$16.95

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Claire Nana <![CDATA[Book Review: How I Overcame Social Anxiety (& How You Can Too)]]> http://psychcentral.com/lib/?p=44895 2016-08-24T12:43:24Z 2016-08-25T01:42:11Z For those who suffer from social anxiety, self-help books can often feel like clinical prescriptions. Yet, Tobias J. Atkins new book, How I Overcame Social Anxiety (And You Can Too): […]]]>

For those who suffer from social anxiety, self-help books can often feel like clinical prescriptions. Yet, Tobias J. Atkins new book, How I Overcame Social Anxiety (And You Can Too): An Introverts Guide To Recovering From Social Anxiety, Self-Doubt, and Low Self-Esteem is as useful as it is readable.

Atkins is not a clinical psychologist, counselor, or therapist; he is a professionally diagnosed social anxiety sufferer whose turning point came several years into his own treatment. He writes, “After spending well upwards of $35,000 on treatments …. The catalyst for change came after meeting a man who had recovered from social anxiety himself.”

This fortuitous meeting, and the recovery that ensued, motivated Atkins to write his book, in which he shares the very day-to day practices that not just helped him find more confidence, but also more happiness. The book is divided into four sections: Thoughts & Beliefs, Actions & Exposure, Healthy Diet, and Lifestyle Choices.

Atkins begins by telling us that his book is not a cure-all, and that to overcome social anxiety, we will have make a daily practice and continue working on it. However, the first hurdle we have to overcome is the belief that social anxiety and shyness are a life sentence. On the contrary, Atkins writes, “Genetics play a large role in social anxiety but it has been scientifically proven that genetic expression can be changed by thoughts, environment, emotions, and beliefs.”

Overcoming social anxiety starts with changing how we think about anxiety. Accepting where we are is important for Atkins, but he also underscores the idea that our self-consciousness in any situation will eventually subside. But Atkins emphasizes that we should be careful about “shoulding ourselves” as this only exacerbate feeling of shame, self-rejection, and self-hate, which often linger longer than the anxiety itself.

What we can do is focus less on the problem of anxiety and more on the solution. Some key steps Atkins offers are to let go of disempowering stories about ourselves, especially those that keep us in the “victim mentality”, and no longer give others the power to make us feel worthless, inferior, nervous, or embarrassed. Some examples Atkins points to of ways we can give our power over are through people pleasing, accepting other people’s opinions as facts, and approval seeking behaviors. A helpful exercise Atkins shares to mitigate this problem is stopping and asking ourselves if we are honest. For most of us, the answer will be yes, but if we review the times we may have said yes when we really meant no or agreed to something we didn’t really want to do, we will often recognize a contradiction.

But we may also harbor negative beliefs rooted in perfectionism, lack of self-love, or looking for self-worth outside of ourselves. When we do these things, Atkins tells us, we collect a host of damaging thoughts, such as believing that we are inferior to almost everyone, believing that others have to like us, and believing that in order to be liked we must be perfect and do everything others ask of us. Again, Atkins shares a helpful exercise: first list all of your negative thoughts, ask yourself if they are proven facts, and then create more realistic, helpful thoughts.

On improving self-image, Atkins suggests consistent visualization, along with remembering our good points, avoiding social comparisons, choosing our company more wisely, and giving thanks. He writes, “When we visualize, we’re giving our brains a blueprint of the person we want to become.”

Developing the right mindset, Atkins tells us, is the prerequisite to taking the action necessary to truly overcome social anxiety. To begin the process of taking action, however, we must first have a strong reason why we want to gain confidence and feel freed from our anxiety. From this point, confidence develops with regular practice outside of our comfort zone. But operating out of our comfort zone also means recognizing there will be pain, which goes against instinct for most people. Atkins writes, “Our whole lives we try to run from pain. It’s one of our fundamental survival principles.” To combat this tendency, Atkins shares several techniques, such as acknowledging our rationalizations, holding ourselves accountable, and stopping our excuses. To cement our motivation, Atkins suggests asking ourselves what our life would be like in twenty years if we didn’t change.

On the topic of lifestyle choices, Atkins offers both the staple advice — eating healthy, cutting out stress, exercising regularly, meditating — as well as the insightful — stop reading comments on blog posts (they often harbor negative threads, complainers, and trolls), working fewer hours, and getting thirty minutes of sunlight every day.

With practical steps and sound advice, How I Overcame Social Anxiety doesn’t promise any glamorous results. What is does offer is recognizable relief for anyone willing to work hard enough to overcome social anxiety.

How I Overcame Social Anxiety (And You Can Too): An Introverts Guide To Recovering From Social Anxiety, Self-Doubt, and Low Self-Esteem
Lifestyle Entrepreneurs Press, April 2016
Paperback, 162 Pages
$14.97

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Marie Hartwell-Walker, Ed.D. <![CDATA[10 New School Year Resolutions]]> http://psychcentral.com/lib/?p=46033 2016-08-22T21:28:13Z 2016-08-24T17:45:59Z ]]> new school year resolutionsHappy New School Year! I’ve been either in school, teaching school, sending kids to school or consulting with schools for over 65 years. The result? I see September 1 as far more meaningful as the beginning of a “new year” than January 1. Our family’s life makes a major shift every year about this time. With that shift comes new (or revisited) resolutions. And, just as with those well-intended January resolutions, there are some we keep better than others.

Having been connected to schools for so many years as a consultant and psychologist as well as a parent, here is a list of school year resolutions I think all of us parents should work hard to keep.

  1. Talk positively about school.
    For many parents, their own school experience was less than wonderful. Even if it was wonderful, there were probably teachers you didn’t like or assignments that were really, really hard or days you hated school.

    It isn’t helpful to revisit those negative experiences by telling tales to your kids. No, you don’t need to be dishonest. But you do need to emphasize the positive. Kids who are struggling need our empathy, but they don’t need to be encouraged to see school as unnecessary or too difficult or too confining. Help them feel good about confronting challenges and finding ways to get along with difficult teachers. Those lessons are as important as whatever math assignment they are struggling with.

  2. Set up a routine.
    Kids of all ages respond well to friendly structure. This is doubly true if a kid has ADHD or is challenged by anxiety or autistic features. Set up an after-school or after-dinner routine that includes some downtime as well as homework time.

    In many families, after-school time goes something like this: snack, play outdoors for an hour, come in and do homework while dinner is being made. In other families, the kids are free for the afternoon but after dinner they go immediately to the homework table. TV or video games happen only when homework is completely done. Having an established routine eliminates negotiating, arguing, complaining, and daily decision-making. It actually frees a kid up to do good work.

  3. Set up a workspace for homework.
    When adults go to a job, they usually go to an environment or office to do it. Being there means they are “at work.” It is a visual support for doing work tasks. Kids, too, respond well to having a work space. It doesn’t matter if it is the kitchen table once the dinner dishes are cleared away or if it is a special desk. Parents who set aside time and space for homework give the kids a clear message that their “work” is important.
  4. Have supplies handy.
    It’s difficult to do any job without the tools needed to do it. Make sure the kids have basic supplies like paper and pencils and art supplies. Keeping supplies on a designated shelf or in a special box eliminates aimless wandering around to find a pencil and keeps the kids on task. It also means that homework gets done in less time.
  5. Make a master calendar of due dates.
    Every week, make sure that important due dates are entered on a master calendar. Help your children break long-term projects down into smaller parts with their own due dates. By setting intermediate goals and regularly reviewing due dates, you help kids avoid that sudden and terrible realization that their monthly science report is due tomorrow. It’s also a valuable lesson in time management.
  6. Attend parent-teacher conferences and check in with teachers now and then.
    You are an important part of your kids’ educational teams. Introduce yourself to teachers. Go to parent-teacher conferences. Attend the open house. When teachers and parents know and like each other, they are more willing and able to stay in friendly conversation. Being actively involved with your kids’ schools keeps you in the know about larger concerns and successes that are affecting your kids.
  7. Talk about current events and school assignments.
    Supporting education means supporting the value of knowledge. Kids whose parents talk to them about current events, politics and issues of local and national concern expand their thinking from the classroom to the world. Share news articles. When the kids express any curiosity, take the time to look up information on the Internet. Make sponging up information a family value.
  8. Make reading a priority.
    It’s a fact. Kids whose parents read to them when they are young and who encourage reading as they get older are kids who are more successful in school and in life. Make a family ritual of reading time. When you are beyond reading bedtime stories, just establish a reading hour. You read your book. They read theirs.
  9. Make sure kids get enough sleep, eat well, and get some exercise.
    It’s another fact. American kids in general don’t get enough sleep, eat more junk food than they should and don’t get an hour a day of physical activity. Sleep, good food and daily physical activity are the basics for being healthy and alert. Without them, it’s difficult for any kid to do well in school or, indeed, in life. It’s up to us parents to inculcate good habits.
  10. Limit screen time.
    Not so finally: Take charge of time on the TV, computers and phones. Kids and teens, being kids and teens, don’t have good judgment about when and how to use devices. They are still learning about self-discipline and time management. It is up to us parents to be good role models and to provide the external rules the kids need until they internalize them.

    Turn off the TVs during mealtimes and homework time. Confiscate the phones until homework is done. Resist the pleas for one more show or one more video game until other responsibilities (homework, bathing, organizing for tomorrow) are accomplished. Get devices and TVs out of their bedrooms. Make sure they get off screens and into bed on time.

We parents may not keep all of these resolutions perfectly all the time. There are always reasons why a particular day or situation requires compromises. But we can do our very best. When we do, and when we do it consistently over their years in school, our children learn the habits and self-discipline that will help them be successful throughout their lives. Happy New School Year, everyone.

yobro/Bigstock

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Bethany Duarte <![CDATA[Book Review: The Power of Names]]> http://psychcentral.com/lib/?p=44928 2016-08-24T12:42:03Z 2016-08-24T14:40:48Z Since I was a child, the origin and meaning of my name has always been a personal Holy Grail. Though the origin was somewhat straightforward — literally, the name of […]]]>

Since I was a child, the origin and meaning of my name has always been a personal Holy Grail. Though the origin was somewhat straightforward — literally, the name of an ancient city — I have never been content to stop there, instead wanting to find deeper layers of meaning and significance to the word that has come to embody me so well. It was from this deep, vested interest in names and their significance that I opened The Power of Names: Uncovering the Mystery of What We Are Called, by Mavis Himes.

As a psychoanalyst, Himes has composed a work that is somehow cerebral and coffee shop conversation all at once. Equal parts essay, etymological discourse, and transparent autobiography, The Power of Names balances the line between deep, personal, self-effacing, and widely accessible with masterful ease. Himes goes further than simply providing a history of etymology and how names gained their significance; she delves into the foundational components of the self and the role a given name plays in identity, all through the telling of her own journey of discovery.

Most studies of names I’ve encountered skirted the surface, pointing to the ancestral roots and the obvious meanings found by defining the word in its language of origin. These books have been a disappointment, especially to a linguistics and language junkie who searches for meaning anywhere it can be found. The Power of Names is unique in its approach. While rich in history and the ancestral origins one would expect in a academic thesis or article, it is sprinkled with humanity in the form of Himes’ journey through her own Jewish ancestry and the role her name has played in her own life.

As Himes states, “to be named is to occupy the spirit of one’s identity, no matter who one’s parents and grandparents may be and no matter how one’s life will unfolds&hellips;to inhabit one’s name is to enter the shared universe of discourse and activity with other speaking beings.” In the early sections of her book, Himes introduces naming as that first initiation to life, often preceding the birthing process by days, months or even years in some cases. As the section is titled, to be named is to be “Called Into Existence,” offering the very essence of life and identity in a single word or phrase. This particular point was one that I had never thought about, though I can now see that the earliest acknowledgement of my identity was when my pregnant mother would speak to me in the womb, calling me by the very name I now sign to every thing. As mentioned, this section is mixed with personal history as Himes traces her ancestral lineage, showing how her names exist in separate worlds — Jewish and English. The extent of history and etymological research shown in this section is comprehensive and appreciated as it provides a primer on naming back to Biblical times.

The latter portion of the work focuses on the weight — the “Burden or Blessing” — of an individual name. Himes explains the burden of family history, pedigree, racial and ethnic tensions and even personal dislike when it comes to naming, as well as the great honor and blessing that can be transmitted at the same moment. As she states, “Names are rarely neutral. There is pride or there is shame; there is a bond or there is a rupture; there is a positive association or there is a negative disassociation: There is curiosity, there is gratitude, or there is regret.” She also discusses the challenge of living up to a heavily weighted name, the effort many take to run from the history of a tragic name, or the personal turmoil one might experience if that name has no history or meaning at all.

According to the preface, The Power of Names was the result of the author’s exploration into her own name within the context of a larger etymological study. Peppered with autobiographical components and tidbits from Himes’ own client base mesh together to turn what could have been a dry discourse on the history of naming practices into a personal, rich, and at times, emotional journey. As such, it stands out as both an autobiography and etymological study and was a very pleasant and engaging read.

Suitable as both a casual read and a course text for those studying the history of naming, The Power of Names is a pleasantly personal look at what it means to name and be named, all through the lens of the author. The personal discovery is communicated in a deep, thoughtful, yet accessible manner that simultaneously educates, empowers, and entertains.

The Power of Names: Uncovering the Mystery of What We Are Called
Rowman & Littlefield, May 2016
Paperback, 238 pages
$35.00

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Janet Singer <![CDATA[OCD and Early Treatment Experiences]]> http://psychcentral.com/lib/?p=46019 2016-08-20T18:50:11Z 2016-08-23T17:45:52Z ]]> OCD and early treatment experiencesAs an advocate for OCD awareness, I have connected with many people who have obsessive-compulsive disorder. It seems to me that most people, in particular those who are older, have some kind of story to tell about their early experiences reaching out for help. And they’re typically not positive accounts. They include details of misdiagnosis, mistreatment, or both. They are tales of being told by family they are fine, or they must be exaggerating. They are advised to just “suck it up” or at the very least relax. If they are lucky enough to receive a proper diagnosis early on, they are often either just given medication with no offer of additional therapy, or treated with the wrong kind of therapy.

As many people with obsessive-compulsive disorder will attest, asking for help, especially that very first time, is a difficult and scary thing to do. People with OCD typically realize their obsessions and compulsions make no sense, so they understandably don’t want to put themselves out there, risk embarrassing themselves, and admit to irrational thoughts and actions. In some cases, those with OCD do finally muster the courage to tell a loved one or a professional about their obsessions and compulsions. In other situations, it has just become too obvious to hide anymore. Either way, it can be a terrifying experience to have your OCD out into the open, especially when you are so frightened, confused and anxious. To finally admit you need help, and then be dealt with so poorly, can be devastating. These early negative experiences might make those with OCD not only leery of future treatment, but left feeling hopeless. What’s the point?

In my son Dan’s case, he correctly diagnosed himself with obsessive-compulsive disorder at the age of seventeen, but then met with a therapist who, unbeknownst to us, didn’t know how to properly treat the disorder. Appropriate treatment was therefore delayed for over a year and a half, and of course his OCD worsened. He also became depressed and disheartened. Why wasn’t the therapy working? Was his OCD not treatable? Thankfully, he eventually did receive the right treatment in the form of exposure and response prevention (ERP) therapy, but finding the right help was far from easy. So much wasted time. So much unnecessary suffering for not only Dan, but for our entire family.

How much smoother the journey back to good health would be for all those with OCD if each and every health-care provider was able to properly diagnose obsessive-compulsive disorder and point those who are suffering toward the right treatment. We need to keep advocating for OCD awareness and education, so that these negative early treatment stories are replaced with positive ones. Getting the right help early on (even young children can learn the skills necessary to fight OCD) can substantially weaken the power of OCD. I can’t think of a better way to fight OCD than by attacking it way before it has had a chance to completely devastate your life.

Meg Wallace Photography/Bigstock

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Luciano Devoto https://truecounsellor.com.au/ <![CDATA[What’s the Difference between Acceptance and Commitment Therapy & Mindfulness-Based Cognitive Therapy?]]> http://psychcentral.com/lib/?p=45963 2016-08-20T18:48:14Z 2016-08-22T17:45:36Z ]]> acceptance and commitment therapy vs. mindfulness-based cognitive therapyAcceptance and Commitment Therapy and Mindfulness-Based Cognitive Therapy are both popular approaches used by a variety of mental health professionals to help individuals become more aware of their current circumstances and also how they react to these circumstances.

Both can be useful in the treatment of anxiety, depression, OCD, addictions and also everyday situations such as improving relationships or athletic performances.

What is acceptance and commitment therapy (ACT)?

Acceptance and Commitment Therapy is a form of behavioral therapy, developed in the late 1980’s, that combines the practice of acceptance with mindfulness strategies. It assumes that by acknowledging and accepting negative thoughts and feelings, we can learn to observe them passively and develop new ways to relate to them. ACT also helps individuals to become more flexible psychologically, gain a better understanding of their personal values and become more connected in the present moment.

Negative thought patterns impact many aspects of daily life, including relationships and careers. ACT uses a range of techniques to reduce the power of these thoughts and feelings, without denying their existence.

ACT involves the use of 6 core skills or thought processes that allow participants to develop greater psychological flexibility. These are not taught in any specific order. They are:

Acceptance – Acknowledging and embracing painful or negative thoughts without trying to change them is an essential skill to master in Acceptance and Commitment Therapy.

Cognitive diffusion – This means changing the way in which negative thoughts and feelings function as well as changing how we relate to them. For example, seeing the troublesome issue as a particular shape or colour can help to reduce its significance or perceived value.

Contacting the present moment – Being more aware of the immediate environment and focusing on what is happening right now helps to ensurethatour current actions align with our personal values.

The observing self – In ACT therapy, the mind is seen to have two parts or functions. The ‘thinking self’ deals with thoughts, feelings, goals, beliefs and so on. The ‘observing self’ deals with awareness and attention. Actively developing these mindfulness skills can lead to greater levels of acceptance and cognitive diffusion.

Values – Defining the qualities and principals we chose to live by is also a key component of ACT. Understandingour personal values allows us to better understand our current actions, thoughts and feelings.

Committed action – Once we understand our values, we can use them to help shape our goals. In Acceptance and Commitment Therapy, individuals are asked to actively select these goals and commit to specific actions that will lead to achieving them. This helps to generate a greater sense of confidence and control over current circumstances.

What is mindfulness-based cognitive therapy (MBCT)?

MBCT is a combination of Cognitive Behavioral Therapy and Mindfulness Therapy.

CBT is based on the concept that the way we think affects the way we behave. It allows participants to analyze and reflect on their underlying beliefs and thought patterns (often developed during childhood) and then see how these may have influenced current behaviors.

Mindfulness is a technique used by many ancient cultures that teaches people to calmly observe themselves and their surroundings in the present moment and to use this impartial information to develop a greater sense of self-awareness and understanding. Observations include noticing negative reactions to everyday situations, particularly stressful ones, with the aim of reducing or stopping those reactions over time.

During the 1970’s, mindfulness was used by psychologists as a tool to help manage stress, anxiety and chronic pain. It was later also used to help manage depression and other mental health issues. For nearly 50 years it has been intensely researched and its effectiveness has been acknowledged by leading institutions and specialists.

The technique is practiced in a number of ways (including meditation and physical activities like Tai Chi and Yoga) and helps to increase physical awareness and calm the mind. Mindfulness meditation comes easier to some people than others but, as with many things in life, it simply takes regular practice and a willingness to learn.

Mindfulness-Based Cognitive Therapy uses the best aspects of both these therapies. Also, like Acceptance and Commitment Therapy, it takes the view that the mind has 2 functional modes, the ‘doing’ mode and the ‘being’ mode. In the ‘doing’ mode, the mind focuses on goals — seeing the difference between how things are now and how it would like them to be in the future. On the other hand, the ‘being’ mode simply accepts things as they are. So, unlike CBT, MBCT looks at both cognitive modes and how they combine to influence behavior.

What is the difference between ACT and MBCT?

Both ACT and MBCT use specific mindfulness exercises to help individuals become more aware of their situation and automatic reactions. Both also encourage acceptance of things as they are, including negative experiences — seeing thoughts as merely verbal events and not actual events. The main difference lies in when and how mindfulness techniques are used.

In MBCT, formal meditation practices are a major focus and are linked to everyday activities. ACT, however, also focuses on the development of other cognitive skills like diffusion and defining values. For those that find MBCT challenging, ACT offers many of the same benefits without having to meditate.

If you are unsure of which approach is best for you, find a therapist that practices both and allow them to let you try both methods. You may even decide to do a combination of both.In the end it is purely a personal choice.

Kasia Bialasiewicz/Bigstock

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Janet Singer <![CDATA[OCD and Evidence-Based Therapy]]> http://psychcentral.com/lib/?p=45919 2016-08-14T22:29:26Z 2016-08-21T17:45:19Z ]]> OCD and evidence-based therapyThere is an eye-opening article in the New York Times called “Looking for Evidence That Therapy Works.” It states that while the evidence-based treatment known as cognitive behavioral therapy (CBT) has been shown to be effective in treating many disorders, including obsessive-compulsive disorder, the majority of therapists only use CBT occasionally, or in conjunction with other therapies. It’s not that they don’t know about the documented benefits of CBT, it’s that they view their craft as an art, where they individualize treatment depending on their own personalities and their relationships with their patients.

I find this highly disturbing. While establishing a good rapport with a patient is important, a good relationship in conjunction with the wrong therapy won’t help someone who suffers with OCD, and may very well be harmful. In my opinion, it’s similar to having cancer that is highly treatable, only to have your oncologist forge ahead on a new, unproven treatment path.

It’s interesting that, according to the article, “every clinician overestimates how well they [themselves] are doing.” In many cases, patients are not honest with their therapist. For example, instead of letting their therapist know they are doing poorly, they will simply say they’re fine and are done with treatment. They will then leave and look for another therapist.

My son Dan’s first therapist did not use exposure and response prevention (ERP) therapy (the CBT used to treat OCD), yet I’m sure this therapist thought he was still helping Dan. We all did. It wasn’t until his OCD became severe, and I became more knowledgeable, that we realized the therapist had gotten it wrong. By then he had retired, so I never had the chance to talk with him about it. So yes, he is one of the many clinicians who overestimated his success.

I certainly don’t want to paint a negative picture of all therapists, as there are so many dedicated, caring, professionals out there who go above and beyond what is expected of them to try to help their patients. These therapists recognize their obligation to be aware of, and implement, evidence-based therapy whenever possible. If they are not well-trained in the appropriate therapy, they realize it is their responsibility to refer their patient to someone who is. They care.
I am aware that many people with OCD also struggle with depression, additional anxiety disorders, or other mental health issues. Certainly these comorbid conditions have the potential to complicate the path to recovery. That is just one of the many reasons why those with OCD should seek out therapists who specialize in treating their disorder.

How do we find these therapists, these specialists who use or at least work toward using evidence-based therapy? At the end of the article, the author proposes some great questions to ask potential therapists. I highly recommend reading it in its entirety, or at the very least, checking out the list of questions. With the right therapist and the right therapy, recovery from OCD is absolutely possible.

fordzolo/Bigstock

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Jamie Hale, M.S. <![CDATA[What’s Your Learning Style?]]> http://psychcentral.com/lib/?p=45875 2016-08-11T17:37:39Z 2016-08-20T17:45:20Z ]]> what's your learning style?Do a Google search for the words “learning styles” and you will find a large number of websites claiming they can identify your preferred learning style in a matter of minutes. Are you a verbal learner? Are you a auditory learner? Are you a kinesthetic learner? Supposedly, those with expertise in the VAK (visual, auditory, kinesthetic) classification system can answer those questions; they can provide a diagnosis regarding your best learning style.

The VAK system is one of many that claims to be able to identify learning style. In one review researchers identified over 70 different learning style (LS) classification systems (1). The definition of learning styles vary, but most in the education field seem to agree that at the very least it involves identifying an individual’s preferred style of learning and matching instruction with that style.

The concept of Learning Styles is attractive to students, parents and educators. Obviously, people are unique, they learn at different rates and prefer different type of experiences. As an extension, Learning Styles makes good sense. Learning Styles allow students to self-test and determine how they best learn. No-one likes to think they have learning difficulties. It is much more comfortable to believe the material was hard to learn because the teaching style didn’t match one’s learning preference, rather than to think it was difficult because the appropriate learning strategies were not used.

Parents like the idea that their child is receiving an education specific to their personal learning style. Parents of children that don’t learn well may find it at least slightly consoling that their child’s learning problems may be due to improper instruction, rather than a problem specific to the child.

A survey administered by Dekker and colleagues showed that 93% of UK schoolteachers believed that individuals learn better when they are instructed according to their preferred learning style (2). A study conducted using a sample of higher education faculty (in the USA) found that 64% of the study participants answered yes to the statement “does teaching to a student’s learning style enhance learning” (3). A 2008 search of the Educational Resources Information Center (ERIC) found almost 2000 journal articles, approximately 900 conference presentations, and 700 books or book chapters on LS (4). With such a wide spread belief in the LS concept there must be strong evidence to support it? Less than 25% of the entries from the 2008 ERIC database search were peer-reviewed articles.

Coffield and colleagues assembled a large database of LS relevant information (1). The database consisted of books, journal articles, theses, magazine articles, websites, conference papers, and unpublished literature. A small portion of the information was from peer-reviewed journals, and an even smaller amount was well controlled studies.

Massa and Mayer conducted a set of experiments to test the attribute-treatment interaction (ATI) hypothesis (5). The ATI hypothesis predicts that visualizers will perform best on tests when they receive visual rather than verbal methods of instruction, and verbalizers will perform best on tests when they receive verbal rather than visual methods of instruction. The results of the study did not support the hypothesis. “Overall, our results do not provide a convincing rationale for customizing different on-line instruction programs for visualizers and verbalizers.”

Kratzig and Arbuthnott tested whether learning style preference correlated with memory in each of the 3 sensory modalities (visual, auditory, kinesthetic)(6). The results indicate test performance did not correlate with learning style preference. The researchers concluded that their results challenge the claim that individuals learn best when instructed according to their preferred sensory modality.

There is no strong evidence to support LS. However, this shouldn’t discourage educators from striving to improve teaching methods. Teaching beginners in a specific area might require different strategies than teaching those with high levels of knowledge. Different teaching strategies might be required for teaching different things; that is, strategies may depend on context.

There is a large body of research on strategies to maximize learning. Educators and students are advised to review and use information from that line of research, rather than spending excessive time trying to identify their illusive learning style.

References

  1. Coffield, F., Moseley, D., Hall, E., & Ecclestone, K. (2004). Learning Styles and Pedagogy in Post 16 Learning: A Systematic and Critical Review. London: Learning and Skills Research Centre.
  2. Dekker, S., Lee, N.C., Howard-Jones, P., & Jolles, J. (2012). Neuromyths in education: prevalence and predictors of misconceptions among teachers. Frontiers in Psychology, 3, 429.
  3. Dandy, K., & Bendersky, K. (2014). Student and faculty beliefs about learning in higher education: implications for teaching. International Journal of Teaching and Learning in Higher Education, 26, 358-380.
  4. Lilienfeld, S.O., Lynn, S.J., Ruscio, J., & Beyerstein, B.L. (2010). 50 Great Myths Of Popular Psychology: Shattering Widespread Misconceptions about Human Behavior. Malden, MA: Wiley-Blackwell.
  5. Massa, L.J., & Mayer, R.E. (2006). Testing the ATI hypothesis: Should multimedia instruction accommodate verbalizer-visualizer cognitive style. Learning and Individual Differences, 16, 321-335.
  6. Kratzig, G.P., & Arbuthnott, K.D. (2006). Perceptual learning style and learning proficiency: A test of the hypothesis. Journal of Educational Psychology, 98(1), 238-246.

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