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Psychotherapy: The Active Treatment

My friend Anne and I were talking the other day when the conversation turned to a recent airplane flight she was on. She recounted how it was on one of those smaller, turboprop planes with just 3 seats per row:

"We hit some turbulence and then it was like we were free-falling. It was only a few seconds, but it was the scariest moment in my life. I felt so helpless and out of control. I know it was irrational to think anything bad would happen, but still ..."

When a person isn't in control of his or her own destiny, most people feel powerless. Powerlessness can lead to feelings of helplessness as well. Most people prefer to be able to exert some influence on their destiny, on their future. We'd like to think that we actually have something to do with the way our life turns out, don't we?

So why are so many people seemingly so willing to give up their power when it comes to treating their own mental health condition?

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Brain and Behavior

Bending Science in Service of Book Promotion

If you don't have a Ph.D. (or its educational equivalent), you shouldn't consider yourself a serious researcher. The Ph.D. degree prepares (and qualifies) you to do solid empirical research that can stand up to peer-review.

You can certainly do science with any degree (heck, you don't even need a degree to do science!), so naturally medical doctors (M.D.s) can do science. But it's also why you see the really serious medical researchers go on and get a Ph.D. as well. The Ph.D. provides the deep didactic training in research methods and statistics you need to actually do serious research, not just interpret it.

That's why I'm not a serious researcher -- I know my limitations. I can interpret research until the cows come home, but I do very little of it myself.

That's also why it was enjoyable reading Vaughan Bell's post over at
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Introducing Light, Laughter and Life

I’m pleased to introduce you to our blog, Light, Laughter and Life with Leslie Hull. Leslie hopes that with a blend of humor, compassion and healing, Light, Laughter and Life will present the perspective of a woman who has realized that bipolar is such an integral part of her foundation, that the castles we build each day could never be achieved without this component that makes us who we are.

Here's an excerpt from her first entry, A Case for Staying In:

A couple...
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Women and Men’s Defensiveness Impacts Health

You probably already know that men and women deal and react to stress differently. What you may not have realized is just how different we are when it comes to dealing with stress. And one of the keys appears to be how defensive we are:
Defensiveness is a trait characterized by avoidance, denial or repression of information perceived as threatening.

In women, a strong defensive reaction to judgment from others or a threat to self-esteem will result in high blood pressure and heart rate.

But in older men, the researchers found those with low defensive reactions have higher cardiovascular rates.
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Surrender to the Brain: When the Reframing Gets Old

I sometimes wish I didn't have fodder for this blog, that I could graduate to writing a Happiness Project like Gretchen Rubin, and give you tips that could increase your happiness level. Alas, after weekends like last, I know that I will have the content to write a blog on depression for many more days.

In Beyond Blue the book, I describe my analogy of recovery from depression and bipolar, from anxiety and addiction, as a four-story apartment: the first level is staying alive, the second staying out of the psych ward, the third status quo, and the fourth gusting toward better health. Although I wish I could say the majority is spent in the penthouse on the deck, the truth is that I stay mostly on the third, going up for a quick visit to the fourth some afternoons, and taking the escalator down to the second at times.

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Best of the Web

A Psychopath’s Brain on fMRI

Our newest blogger, Dr. Kelly McAleer, has an interesting two-part post about the use of fMRI imaging technologies to try and detect psychopathology in criminals:

In my last post, I discussed how Dr. Kent Kiehl, a neuroscientist, is using fMRI technology to detect brain abnormalities in people with psychopathy. His participants are prison inmates who score high on the PCL-R, a psychodiagnostic measure used to assess psychopathy. Once he determines that the participant is, in fact, a psychopath based on their PCL-R score, he takes scans of their brains using an fMRI to determine if there are brain differences between psychopathic participants and normal controls. He has found defects in the paralimbic system that he believes relate to psychopathy.

Interestingly, Dr. Kiehl’s research is being used by perpetrators to avoid prison or to reduce sentencing. One such case has plagued the Chicago area for over two decades. Brian Dugan, a 52-year-old man with a 13-year crime spree, including murders, rapes, arson, and burglaries, spanning the 1970s and 80s finally went to trial for his crimes in late 2009. For those interested in death penalty laws, this case has a lot of history, and contributed to the moratorium on the death penalty in Illinois due to the wrongful conviction of three men for one of the murders (Jeanine Nicarico) that Dugan committed.

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Why Psychologists Shouldn’t Prescribe

Beware psychiatrists bearing gifts.

If psychology wants to remain a science based upon the understanding of human behavior -- both normal and abnormal -- and helping those with the "abnormal" components, it would do well to avoid going down the road of prescription privileges. But perhaps it's already too late.

We first noted this disturbing trend in 2006, how they were shot down 9 out of 9 times trying to gain prescription privileges in 2007, and why prescription privileges for psychologists will eventually drive psychiatrists out of a job. We also noted that one of the programs setup to help psychologists get prescription training wasn't a "college" at all.

The fundamental problem with psychologists gaining prescription privileges is the inevitable decline over time in the use of psychotherapy by those same psychologists. This is precisely what happened to psychiatry -- they went from the psychotherapy providers of choice, to the medication prescribers of choice. Now it's hard to find a psychiatrist that even offers psychotherapy.
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Depression Smack Talk on the Playing Field

This comes as no surprise to anyone, but in the heat of a rugby match the other day in Australia, Storm fullback Billy Slater's allegedly taunted the Knights forward Cory Paterson with the words, "go to your room and have a cry." This referred to Paterson's battle with depression over the past two years, keeping him off the playing field all of last season.

In sports, one would expect a certain level of smack talk on the playing field. Most of it is meant to incite the other team's players, so that they react and play more emotionally. A player who plays from anger rather from their rational mind is likely to make more mistakes, so goes the common wisdom.

Where do we draw the line on the playing field?
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Brain and Behavior

Spirituality and Prayer Relieve Stress

The last thing I think of when I'm stressed out with work deadlines and complicated homework projects with the kids is to get on my knees or attend Mass. But a growing body of research suggests prayer and religion rank high among the best stress busters.

In her new book, The SuperStress Solution, Dr. Roberta Lee devotes a section to the topic of spirituality and prayer.

"Research shows that people who are more religious or spiritual use their spirituality to cope with life," notes Dr. Lee.

"They're better able to cope with stress, they heal faster from illness, and they experience increased benefits to their health and well-being. On an intellectual level, spirituality connects you to the world, which in turn enables you to stop trying to control things all by yourself. When you feel part of a greater whole, it's easy to understand that you aren't responsible for everything that happens in life."

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Brain and Behavior

The Truth About Quitting Smoking

Usually, I like to point out all of the positives of the self-help methods available to help an individual with a specific problem in life. Whether it be reading a self-help book about your relationship, or trying out a self-help program online to combat depression, I find such methods a good first step toward seeking help. Or getting better.

But sometimes such methods obscure the truth. For many -- but not all -- mental health concerns, the truth is that time alone will often heal a person -- it just takes longer as you grapple with the concern. This doesn't work for things like bipolar disorder or schizophrenia, but for an adjustment disorder or even a simple phobia, treatment is often unnecessary (adjustment disorders usually resolve on their own over time and simple phobias can usually be avoided).

So let's turn our attention to a habit that many people have trouble kicking -- smoking. We've been told over and over again that it's difficult to quit because the nicotine in cigarettes is addicting. You know, like cocaine. Or caffeine. But what you're rarely told is that it is the behaviors associated with smoking that are often the strongest reinforcers of smoking. Taking a smoke after eating? That has nothing to do with your addiction to nicotine, but has everything to do with the association you've built up between food and smoking.
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On Being a Student Therapist: Making a Diagnosis

We're back from spring break, and the push to the end of the semester is on. Depending on who you ask, we either have seven weeks left (the university calendar), or approximately 35 more drives to campus (my personal calculation). Now that I've gotten over the hump of juggling six clients who needed to be seen four times each in five weeks’ time, seeing eight clients who need to be seen at least four times each in seven weeks’ time sounds like a piece of cake!

During my supervision session prior to break, I expressed frustration to my supervisor about a client who had asked to continue counseling beyond her class requirement. I questioned this client’s commitment to counseling and whether her problems were significant enough to warrant additional sessions, especially since I had been assigned six new clients, and therefore, continuing counseling with this client would mean extra work for me. My supervisor reminded me that I had been very excited to work with this client initially, and gently encouraged me to keep working with her for a few more sessions.

Then my supervisor did her job: she suggested that my client might have a serious disorder, one I hadn’t even considered, or honestly, would have even occurred to me on my own.
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Introducing Forensic Focus

I'm pleased to introduce and welcome Kelly McAleer, to our blogging team! She will be blogging on the topic of forensic psychology over at the new Forensic Focus blog.

The Forensic Focus blog will discuss issues in forensic psychology such as current legal cases and recent research. Topics will cover forensic psychology in the media, book reviews, and general discussions about crime and human behavior.

I'm excited by the potential of this blog to dig into some of the legal and psychological...
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