Doris Bersing, PhD
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Chemical Imbalance and Mental Issues: An Oversimplification?

17800976_sIn Psychology and Psychiatry, there are theories of brain malfunctioning and chemical imbalance to explain the presence of symptoms or alterations we would call mental illness, too easily.  Nonetheless, beware, neurochemistry, neurophysiology, chemical imbalances, neurotransmitters have being all explanations that had tried to become the panacea that would help us understand what is inextricable and simplify the grasp of it. The most fatal blow to this “brain disease” model has been dealt by the inability of the research to validate the brain disease hypothesis. The most severe mental disorders such as schizophrenia, bipolar disorder, and major depression have been the primary targets of attempts to validate the medical model of mental suffering. Billions of dollars and thousands of research studies have gone into exactly this quest, and yet, according to a large number of highly experienced researchers, scholars and clinicians none of it is substantial. Many claim, in fact, that because the disease model continues to be unsupported in spite of the enormous amount of research that has been conducted in an attempt to validate it, the implications point strongly in the opposite direction—that these types of mental disorders are not caused by a disease of the brain.

Moreover, some doctors believe that they will help the patient feel less blameworthy by telling them,  Dr. Ronald Pies, MD wrote “You have a chemical imbalance causing your problem.” It’s easy to think you are doing the patient a favor by providing this kind of “explanation”, but often, this isn’t the case. Most of the time, the doctor knows that the “chemical balance” business is a vast oversimplification…(Read Dr. Pies’ article)

Could we say, what was first? the chemical imbalance, the symptoms, the wounds, the disease? Cd not this be a minimization of a bigger reality. What’s next? It seems that the only way to deal with this tragic dilemma is to ironically create genuine brain disease (through brain-damaging drugs, electroshock therapy, and/or other similarly harmful means) in an attempt to “deaden” you to your unbearable suffering. What came first? The egg or the chicken?


Good or Bad for Patients to Know What Therapists Think of Them?

Copyright : Steven Frame

Copyright : Steven Frame

About 700 patients at Beth Israel Deaconess Medical Center are participating in a novel experiment. Within days of a session, they can read their therapists’ notes on their computers or smartphones. It seems like open notebook study aims to improve trust, communication between patient, doctor. Some professionals oppose such an idea :…Sounds like a great idea. But when rules were changed about academic job referee reports some years ago so that the candidates could read them, all information about candidate shortcomings disappeared and only praise (sincere or not) remained. The reports became useless and appointments committees quickly learned to ignore them. The candidates who were disadvantaged were those who would have received honestly favorable reports.

One can expect an analogous effect on therapy notes that are released to the patient. Some therapists may resort to a second set of “honest” notes, the existence of which will remain secret. Or, worse for the patient, rely on their memory of the sessions. Read the article and the comments by Jan Hoffman in the New York Times


When Love Matters: Same-Sex Couples’ Children Have a Lot

                                Copyright : Maria Dubova


Copyright : Maria Dubova

The largest-ever study of same-sex parents found their children turn out healthier and happier than the general population. A study of 315 same-sex parents and 500 children in Australia found that, after correcting for socioeconomic factors, the children fared well on several measures, including asthma, dental care, behavioral issues, learning, sleep, and speech.

“…what this means is that people take on roles that are suited to their skill sets rather than falling into those gender stereotypes…At the same time, two-thirds of the parents reported a perceived stigma on at least one issue tracked by the survey. These stigmas ranged from other people gossiping about an LGBT family to same-sex parents feeling excluded at social gatherings due to their sexual orientation…” Read More

Published in Australia, the study proposes children of same-sex parents enjoy better levels of health and wellbeing than their peers from traditional family units, new Australian research suggests. Read the article So no surprises that when chosen, cherished, and desired, parenting produces more opportunities to love our children despite the gender of the parents.

 


Another Take on ADD: Trauma During Childhood

ADDAs a very good friend of mine, said when seeing this article:”…It’s about time!

People have had different takes on ADD from stating there is not a real mental illness to advocate for a cure through food and exercise. No matter what approach one takes the truth is that untreated ADD can devastate a person’s life and how helping them get on track quickly provides the biggest chance of success. Obviously there are many interventions but analyzing the cause can be a good start.

For instance, Dr. Nicole Brown’s quest to understand her misbehaving pediatric patients began with a hunch: Inattentive, hyperactive, and impulsive behavior may mirror the effects of adversity, and many doctors don’t know how—or don’t have time—to tell the difference. Brown was completing her residency at Johns Hopkins Hospital in Baltimore, when she realized that many of her low-income patients had been diagnosed with attention deficit/hyperactivity disorder (ADHD). These children lived in households and neighborhoods where violence and relentless stress prevailed. Their parents found them hard to manage and teachers described them as disruptive or inattentive. Brown knew these behaviors as classic symptoms of ADHD, a brain disorder characterized by impulsivity, hyperactivity, and an inability to focus.

When Brown looked closely, though, she saw something else: trauma. Hyper-vigilance and dissociation, for example, could be mistaken for inattention. Impulsivity might be brought on by a stress response in overdrive…” (Read More)


Because freedom can’t protect itself!

Our civil responsibility is to stay informed and support THOSE projects that represent our values. The ones that represent mine and they are not necessarily the ones to represent of all yours… but it shows one starting end to the fight and some common ground. For instance, the gossipLGBT Project works for an America free of discrimination based on sexual orientation and gender identity. This means an America where LGBT people can live openly, where our identities, relationships and families are respected, and where there is fair treatment on the job, in schools, housing, public places, health care, and government programs. Read more

We have the tendency to forget the origins/ancient institutions that fought fr our rights…only to realize that those are still the same ones that continue fighting for the same inequalities. Thus the work of the he ACLU has a long history defending the LGBT community. We brought our first LGBT rights case in 1936 and founded the LGBT Project in 1986. The ACLU’s LGBT rights strategy is based on the belief that fighting for the society we want means not just persuading judges and government officials, but ultimately changing the way society thinks about LGBT people. To end discrimination, the ACLU seeks both to change the law and to convince Americans that sexual orientation and gender identity discrimination is wrong. The ACLU carries out this work in five priority areas: Basic Rights and Liberties, Parenting, Relationships and Marriage, Youth and Schools, and Transgender Discrimination. Read More


The Closet: Psychological Issues and Psychotherapy of Coming Out for LGBT

© Lee Serenethos

© Lee Serenethos

A very commonly used terms in our society, nowadays, gay or not gay is “coming out” that refers to disclose something that has been otherwise hidden. Dr. Jack Drescher, MD in 2004 already said the experience could be extremely dissociative for the individual “in the closet”. He said: … Coming out may be the most commonly shared cultural experience that defines the modern gay identity. Historically, the term was an ironic reference to debutantes “coming out into society” (Chauncey, 1994). In contemporary usage, “coming out of the closet” means telling another person that one is gay…Years spent in the closet can make the prospect of revealing oneself an emotionally charged experience. However, the process is not just about revealing oneself to others–in coming out, gay people integrate, as best they can, dissociated aspects of the self…” Many LGBT clients had expressed their relief after coming out and finding themselves able to live a life they could not live freely while “in-the-closet”. The University of Montreal published an article in 2013 supporting the health benefits of coming out. They found:…” Lesbians, gays and bisexuals (LGBs) who are out to others have lower stress hormone levels and fewer symptoms of anxiety, depression, and burnout, according to researchers. Cortisol is a stress hormone in our body. When chronically strained, cortisol contributes to the ‘wear and tear’ exerted on multiple biological systems…Contrary to our expectations, gay and bisexual men had lower depressive symptoms and allostatic load levels than heterosexual men. Lesbians, gay men, and bisexuals who were out to family and friends had lower levels of psychiatric symptoms and lower morning cortisol levels than those who were still in the closet…”

The study found that LGBT people who needs to ‘fight-for-life” and their rights develop better coping skills and strategies to deal with social stressors. Coming out is a major milestone in our lives as LGBT and sometimes supportive guidance through the process makes it easier and really meaningful.

The Association of Gay & Lesbian Psychiatrists stresses that coming out is a very individual process and that “… the therapist needs to become familiar with issues specific to being GLB, and in particular the issue of coming out. The assumption that GLB identities are normal need not lead to “cheer leading,” nor should the therapist encourage patients who are questioning their identities to come out prematurely or to simply reassure them that “it is ok to be gay.” Therapists can be most helpful if they have no agenda as to how patients resolve complex issues of identity, affiliation, and openness, and do not push for premature resolution in these areas… The process of coming out is complex and can take years. The process is not linear. In therapy, there can be times of great movement and change interspersed with long, seemingly quiescent periods. Therapists need to be patient, respectful and open to many possible end points – including a straight identity, a gay or lesbian identity, bisexual experiences and identity, or even the patient’s rejection of a traditional identity label altogether…” (Read more)

Respecting the client’s tempo and examining his societal circumstances (family, workplace, profession), relationships, clinical stance, and psychological assets and challenges need to be part of the coming-out assessment to guide the process towards the client wants to guide it at her/his own pace. Remember one size does not fit all and what suits one client can be very risky and detrimental to other person’s reality and life experience. Supportive? Yes, Overbearing? Never.

ack Drescher,: “…Coming out may be the most commonly shared cultural experience that defines the modern gay identity. Historically, the term was an ironic reference to debutantes “coming out into society” (Chauncey, 1994). In contemporary usage, “coming out of the closet” means telling another person that one is gayYears spent in the closet can make the prospect of revealing oneself an emotionally charged experience. However, the process is not just about revealing oneself to others–in coming out, gay people integrate, as best they can, dissociated aspects of the self.

Coming out may be the most commonly shared cultural experience that defines the modern gay identity. Historically, the term was an ironic reference to debutantes “coming out into society” (Chauncey, 1994). In contemporary usage, “coming out of the closet” means telling another person that one is gay.

Years spent in the closet can make the prospect of revealing oneself an emotionally charged experience. However, the process is not just about revealing oneself to others–in coming out, gay people integrate, as best they can, dissociated aspects of the self.

– See more at: http://www.psychiatrictimes.com/articles/closet-psychological-issues-being-and-coming-out/page/0/2#sthash.4EU15UvJ.dpuf

Coming out may be the most commonly shared cultural experience that defines the modern gay identity. Historically, the term was an ironic reference to debutantes “coming out into society” (Chauncey, 1994). In contemporary usage, “coming out of the closet” means telling another person that one is gay.

Years spent in the closet can make the prospect of revealing oneself an emotionally charged experience. However, the process is not just about revealing oneself to others–in coming out, gay people integrate, as best they can, dissociated aspects of the self.

– See more at: http://www.psychiatrictimes.com/articles/closet-psychological-issues-being-and-coming-out/page/0/2#sthash.4EU15UvJ.dpuf

 


Time To Heal: What Psychotherapy to Use?

Psychotherpay: Finding Nemo!

Copyright Teerayut Yukuntapornpong

Many patients or clients often ask what is the difference between different approaches of psychotherapy and although much has been written about, there’s no simple answer. Just as people respond differently to different drugs, you might do better with one type of therapy than with another. Many people find that a blended approach — one that draws on elements of different schools of psychotherapy — suits them best. There are many forms of psychotherapy, but some of the most popular forms are psycho-dynamic therapy, cognitive behavioral therapy, humanistic, and couples therapy, which in reality can be based on any other theoretical approach but emphasizing systems oriented therapy.

Although embracing a particular approach of psychotherapy, as a clinician, has to do with your philosophical values and your concepts of health and human potential, knowledge of what can work better or not with your clients is needed. Remember it is not about what you want or like but what could be more efficient and meaningful to your clients.

Cognitive-behavioral therapy (CBT)

CBT helps you identify self-defeating thoughts and start to develop behaviors that are more constructive. And unlike, psycho-dynamic approaches you do not need to explore into issues of the past. CBT is about what happens in your mind, now and how it affects your behavior.

Psychodynamic therapy

In contrast to CBT, which focuses on conscious thoughts, psycho-dynamic therapy emphasizes feelings that are often beneath the surface yet still influence your behavior. The goal: to help you recognize how old, unresolved problems shape the way you operate today. The therapist will guide you to recognize the links between past and present so you can become more self-aware to avoid same patterns or connections. For a comparison between psycho-dynaminc and behavioral therapy click here The Huffingon Post gave it a try as well (Read more)  And my colleague Peter Strisik, Ph.D from Alaska did a more extensive job (Read his take on it). In my own practice, I called myself a humanistic-existential psychotherapist, practicing frequently the tenants of Gestalt Therapy. Of course, at this point, they seem confused and ready to run away from something so esoteric and unpractical. Yes indeed, perhaps the big difference is we do not focus on the past but on what happens in the here and now.

Humanistic therapy

This approach establishes you as the main tool in therapy, your own healer with the potential to achieve your ultimate goals. Human resilience and self-healing are at the core of this approach. The process helps unfold your self-healing potential, stimulates creativity, and promotes personal growth.

A very simplistic way to explain it is that the existential approach in psychotherapy is organized around life on earth itself and the social, cultural and spiritual ramifications of it, that is, the “human condition.” People’s existential issues are related to their mortality and impermanence, their experience of freedom of choice (or lack of it), their sense of worthiness, and their sense of separation/connection with others. We review the contributions of Kierkegaard, Nietzsche, Heidegger, Sartre, Bugental, Binswanger, Fromm, Laing, Sullivan, May, Frankl, and Yalom. We identify five themes that pervade existentialism:

  1. Meaning in life is found in the living of each moment;
  2. Passionate commitment to a way of life, to one’s purpose and one’s relationships, is the highest form of expression of one’s humanity;
  3. All human beings have freedom of choice and responsibility for our choices
  4. Openness to experience allows for the greatest possible expansion of personal expression; and
  5. In the ever-present face of death itself, we find the deepest commitment to life itself.

We also address the relationship between experiential psychotherapy, the existential approach, and Heart-Centered therapies. Needless to say that there is not a system that can really explain the complexity to f the human phenomena and of course, there is not a system that alone can give you a quick fix or a cure. The solution is in the phenomenological understanding of the situation and of the human being involved, the comprehensive analysis of the situational elements, and of the comprehensive concept of care -versus cure- that we clinicians take into account to provide the bio-psycho-social-spiritual dimensions of care.

Nonetheless, there is enough research about the patient/client being the best agent of change and the personality of the therapist being more important than the “approach” itself. Interesting, isn’t.

You can always try to do some research when trying to find the right therapist for you but let’s say that is you are ready and the therapist has enough empathy and active listening, compassion, and of course knowledge, you will be safe independently of the “approach” she/he uses.

Good Luck and do it, it is worth it… Go find Nemo!


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