We Must Not Think Too Much

How To Smile | Psychology Today

2011-05-10T09:20:00.000-07:00

How To Smile | Psychology Today

According to the story, each morning the 500 employees of the Keihin Electric Express Railway Company smile into a camera hooked up to a computer. Analyzed are facial features such as lip curvature and facial wrinkles. Spit back at each employee is an overall rating of his or her smile quality, from 0 to 100. If the smile quality is insufficient, the computer provides feedback - e.g., "lift up your mouth corners." The computer also prints out an ideal smile to which employees can refer throughout the day.

Obesity, mental illness are interlinked - Times Of India

2011-05-10T08:01:00.000-07:00

Obesity, mental illness are interlinked - Times Of India

University of Tasmania researchers studied data collected from 1,135 girls in 1985, and again 20 years later, and found "persistent obesity" was linked to the mood disorder, reports English.news.cn.

"Overweight or obese girls who were able to attain a healthy weight when they were an adult, they didn't have an increased risk of depression," lead researcher Kristy Sanderson said.

"It was only overweight girls who became obese women ... they had twice the risk of depression, so it was quite a strong effect, " he said.

Depression May Be Foretold in How We Remember - NYTimes.com

2011-05-10T07:59:00.000-07:00

Depression May Be Foretold in How We Remember - NYTimes.com

But in studies under way at Oxford and elsewhere, scientists are looking to such failures to gain new insights into the diagnosis and treatment of depression. They are focusing not on what people remember, but how.

The phenomenon is called overgeneral memory, a tendency to recall past events in a broad, vague manner. “It’s an unsung vulnerability factor for unhelpful reactions when things go wrong in life,” said Mark Williams, the clinical psychologist who has been leading the Oxford studies.

Some forgetting is essential for healthy functioning — “If you’re trying to remember where you parked the car at the supermarket, it would be disastrous if all other times you parked the car at the supermarket came to mind,” said Martin Conway, a cognitive psychologist at the University of Leeds in England. But, a chronic tendency to obliterate details has been linked to longer and more intense episodes of depression.

The Beaver Movie Review: A Dark, Realistic Look at Mental Illness - Reel Movie News

2011-05-10T07:57:00.000-07:00

The Beaver Movie Review: A Dark, Realistic Look at Mental Illness - Reel Movie News

It doesn't depict depression or bi-polar disorder (of which Mel's character Walter seems to have) as an irrational, "crazy-person" disease like other Hollywood portrayals. The film focuses on a man who used to function, but now his debilitating depression has taken any semblance of life.

New Study on Mindfulness: Turning the Volume Down in Your Brain | Mindfulness and Psychotherapy

2011-05-10T07:53:00.000-07:00

New Study on Mindfulness: Turning the Volume Down in Your Brain | Mindfulness and Psychotherapy

"When it comes to our lives, sometimes we have to turn down the volume on the thoughts in our minds. I wouldn’t be surprised if this worked in a similar fashion to outside noises. It’s also my experience that more practice helps me get better at regulating my thoughts, emotions and physical sensations."

Compassion for those who ruin our plans (a little story) — Susan Piver

2011-05-10T07:52:00.000-07:00

Compassion for those who ruin our plans (a little story) — Susan Piver

Los Angeles Times: Economy got you down? Try new federal website!

2009-04-01T03:29:00.001-07:00

Economy got you down? Try new federal website!
8:59 AM, March 31, 2009

Anxious and depressed about the economy, your finances and, well, your state of anxiety and depression over the economy and your finances? While the $800-billion stimulus package is designed to boost the economy, the Department of Health and Human Services' Substance Abuse and Mental Health Services Administration, or SAMHSA, today unveils a new website to boost your mood and help you cope with the psychological effects of unemployment, foreclosure, bankruptcy and financial losses and generalized financial worry (which is not yet characterized as a psychiatric disorder).

It's a first-of-its-kind website designed to be one-stop shopping (except that it's free to use) for information and resources on how to protect, sustain and improve your mental health in the midst of economic hardship.

As you've no doubt read in the L.A. Times Health section, economic troubles can increase your risk for a wide range of psychological ills, including substance abuse, compulsive behaviors such as over-eating, excessive gambling, buying too much and, of course, depression, anxiety and thoughts of suicide. The SAMHSA website lays out warning signs for those and other psychological adjustment problems, and offers advice -- based on the latest research -- on how to cope with them and where to go to seek help.

SAMHSA's acting director, Eric Broderick, explains in a news release that "by helping people remain resilient, we can help promote the overall recovery of our nation." The idea that the government wants to help its citizens with their mental health needs drew jeers of derision from conservative quarters, which promptly dubbed the website a stalking horse for the "nanny state."

What do you think? Should a government agency worry about your state of worry over the economy?

-- Melissa Healy

uuworld.org: A religion for hard times

2009-03-30T07:43:00.001-07:00

Faith is what’s left when you stop responding to radical uncertainty with panic and denial.
By Doug Muder
3.30.09

Is Unitarian Universalism a religion for hard times?

We’re in the process of finding out. Hard times, to paraphrase Thomas Paine, try our souls. They also try our congregations, our theologies, and our faith. Is Unitarian Universalism up to the challenge?

In easy times, almost any religion will do. Easy times tempt us to believe we have life under control. When we need to make choices, the conventional wisdom seems more than adequate. If we supplement it with our own research or cleverness or insight, it’s because we’re trying to get ahead, not save our necks. Even life’s unpredictable possibilities seem manageable: We can list them, assign probabilities to them, and perhaps even take out insurance—without the slightest worry that the insurance company might fail.

An easy-time religion can even be generous and helpful in an easy-going way. We can stand up for the poor without worrying that we might join them. We can comfort the dying without facing our own deaths.

Hard times force us to remember what uncertainty really is. Life is not like roulette—its possibilities spaced evenly around a wheel, our chips stacked neatly in front of us, our bets depending only on our choices and calculations. Sometimes life is more like being lost in the woods at night, wondering not just whether this is the right trail, but whether it is actually a trail at all.

All around us now, people are facing situations they never imagined. They’re losing jobs they expected to retire from, losing homes they thought their grandchildren would visit someday. Nest eggs that once seemed to guarantee a comfortable old age—invested in apparently safe and steady companies like AIG or Citicorp or General Motors—have shattered like Humpty Dumpty. Promises made with love and confidence—“you just get the grades and let me worry about paying for college”—can’t be kept.

Helping such people deal with their new situations is an enormous practical problem for our congregations, many of which are facing their own pressures from lowered contributions and shrinking endowments. But while we must never turn away from nitty-gritty concerns, I think it’s important that we not get lost in them and miss the bigger picture. Facing the uncertainty of life is fundamentally a religious problem, not just a practical problem. Hard times don’t just call for help, they call for faith.

The wake-up call I received from the financial crisis—my personal reminder that I don’t have life tied up in a neat bow—was comparatively mild. Shortly after the Lehman Brothers bankruptcy last fall, my money market fund notified its shareholders that it would be returning our money—most of it—on its schedule, not ours. Six months later, the fund’s liquidation is still incomplete.

In a theoretical sense I had known this possibility, but it was the last thing I expected. I had thought of that account like a stack of twenties under my mattress. It was my security blanket, my what-if money. But I wasn’t prepared for this what-if: What if one of the oldest and most respected money-market funds in the business goes under?

That splash of cold water made all the other bad news real to me: triple-A companies bankrupt, trillions of dollars lost, millions of jobs gone. Each day seemed to bring a headline more awful and unimaginable than the last. I have no idea what can and can’t happen, I realized. I thought I did, but I don’t.

I pride myself on being a reasonable person, but that kind of uncertainty is not a job for reason alone. Reason helps you manage your knowledge and figure out how to apply it. But once you’ve had the thought that totally unexpected things can happen on a totally unexpected scale, you need more than Mr. Spock and his logic. You need faith. 

Faith is a difficult word for many Unitarian Universalists. Like God or soul or love, it repels definition. In The Devil’s Dictionary, Ambrose Bierce defined faith as “belief without evidence in what is told by one who speaks without knowledge, of things without parallel.” Sam Harris also adopted the “belief without evidence” definition in The End of Faith. No wonder he wanted to declare an end to it.

But the kind of faith I’m talking about is not an attachment to some supernatural order of facts. It is a way of living in the present, closer to a mindset or an attitude than a belief. Like any experience—like sweet or red or comfortable—faith can’t be grasped through a definition. All you can do is describe situations where the experience might be had, and hope that those who have had it will recognize it. I can’t even do that directly. The best I can manage is to start with a situation—radical uncertainty—and peel away the more common reactions—panic and denial. Faith is what’s left.

Panic is the most obvious reaction to that feeling of being lost in the woods. That’s actually where the word comes from: the Greek panikon, meaning “pertaining to Pan.” Pan was the god of wild places, the unmapped, uncharted regions where strange creatures might lurk and none of the familiar rules or patterns necessarily applied. It may seem odd to think of Pan roaming the floors of stock exchanges or the virtual worlds of credit default swap markets, but in a sense he does. We used to describe all financial crises as panics, until our leaders decided that depression sounded less alarming.

The simplest way to avoid panic is denial: Tell yourself nothing is wrong. You aren’t off the map, or you’ll be back on it any second now. Stuff like this happens to you all the time. Not a problem. All part of the plan.

Just about every religion tells you not to panic, but religion and denial have an ambiguous relationship. What some people call faith—the kind of faith rightfully rejected by Bierce and Harris—is a way to prop up denial, not transcend it. We put aside uncertainty by claiming God’s certainty as our own. God’s plan is not a mystery to which we must adjust ourselves, it is our plan copied over in God’s handwriting. And so the Almighty becomes an agent carrying out our will rather than the other way around. Of course God will cure our loved ones’ diseases, save our factories, restore the value of our 401(k)s, or stave off disaster in some other miraculous way. How could S/He not?

Many of the people most hostile to religion today are the disappointed veterans of such denial-enhancing theologies. “I hate it when people say prayer works,” says one of the anonymous postcards of the Post Secret Project (which I described in an earlier column), “because it didn’t when I was begging God to save my baby’s life.”

Humanism and secularism can prop up denial too, when their beliefs become too sweeping, too certain, or too optimistic. Excessive confidence in progress, evolution, or the human spirit can close our eyes to real uncertainty. The arc of the universe may indeed bend towards justice, but that doesn’t guarantee that any particular justice-seeking effort will succeed, no matter how ardently and sincerely we pursue it. And letting ourselves imagine that science’s map is complete—that questions with no answers need never be asked at all—is yet another way of denying Pan his due.

Faith is something else, a third experience of moving through Pan’s domain. A way seems to open up and you take it. You have no guarantees of where it will lead you, only the confidence that you are doing what you can do, and that you will be able to accept the consequences, whatever they turn out to be.

No religion holds the patent on faith. Christianity describes it as “trusting God.” In Buddhism it’s “action without attachment to outcome.” Twelve-steppers are pointing to that emerging path through Pan’s woods when they say: “One day at a time.” The lives of many Humanists, some of whom never use the word faith, are inspiring testimonies to their faith in truth and conscience.

Our actions may succeed, they may fail, or they may be completely irrelevant when the hurricane comes. If you know that and act anyway, confidently and yet with total awareness that anything at all can happen—that’s what I’m calling faith. That—not denial—is what people need from a religion in hard times.

Does Unitarian Universalism provide, support, or engender that kind of faith?

It can, but it doesn’t always. We’re good at popping bubbles of denial. But if that’s all we do, we’ll just send people back to panic.

Our congregations are full of faithful people, people who have survived not just financial setbacks, but also illness, betrayal, the death of loved ones, the failure of plans long crafted, and every other kind of hardship life can muster. Many have come through with their eyes open and their heads high.

Now is the time for such people to testify—time for all of us to testify about our experiences of faith, however large or small they might be. Not to spread false confidence, not to reassure each other that everything will work out the way we want, but to tell our stories of what has kept us going and what keeps us going today—even though we can’t be sure where this path through the woods will lead.

Psychology Today: Q and A: Irreverence Material

2009-03-25T08:07:00.001-07:00

Five questions for comedian John Hodgman.

By: Matthew Hutson

John Hodgman has an answer for everything. What it may lack in veracity, or even sense, it makes up for in staid charm and eccentric pseudointellectualism. You know him as a PC in Apple's hit ad campaign; here the author of The Areas of My Expertise and More Information Than You Require discusses satire, truthiness, and Hobbits.

What is the value of fake facts?

In both of my books, I have struggled against plain absurdity. Pure non sequiturs have a certain flighty charm to them, but I like some factness with my fakery. Ideally, fake facts help to jostle our imaginations. They remind us how much of actual history is so strange, and novelistic, and practically unbelievable.

How similar are you to your persona?

I bear an uncanny resemblance to myself. Obviously, I am named John Hodgman, and the details revealed about my life in my books always have one foot in the truth. Or at least a peg leg.

Where does your children's expertise trump yours?

They know a lot more about my neighbors than I do, for the common playdate allows the child access to other people's apartments and private lives that no adult will ever enjoy. In fact, it seems to me that children would make very good private investigators.

In which domains do you know more information than you require?

For a brief time in the early 2000s, being able to quickly name the three races of Hobbits was a handy skill that made you popular at parties. That is all over now, so I could probably free up some brain space there. But the truth is, I can never get enough information about invented, whole worlds. Including the whole world.

Your delivery is famously dry. Do you ever crack yourself up?

I find it to be comedically unethical to laugh at your own jokes on stage. But I probably feel so strongly because it happens pretty frequently lately, and I am ashamed. My deadpan needs re-deadening (see my new book, on the various historical styles of deadpan). But the reverse is true when writing. If my brain can fool myself into a surprised chuckle, my guess is that it can also fool you.

McSweeney's Internet Tendency: Emotional State 3A.

2009-03-25T07:59:00.001-07:00

EMOTIONAL STATE 3A.
BY STEPHEN DAU

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It has recently been brought to our attention that some of you are stuck in emotional state 3A, Consumed by Fear. Though we have made a number of announcements recently about the need for an emotional-state change, and had hoped that this would be a relatively smooth and uniform process, we understand that 3A is a particularly robust state and that many of you may need further guidance on how to proceed.

You might remember that 3A was invoked, as a purely temporary response, after the Event of Great Magnitude. At the time, it was thought that 3A would be in effect for no longer than a short period, and that it would be at most a medium-term measure. We never intended for 3A to be a long-term solution. That said, it has become obvious that some of you have been unable to extricate yourselves from state 3A, despite our continued suggestions that you do so, and, thus, are attempting to function in an emotional state that does not efficiently deal with our current reality.

It has been found that an incremental approach may prove fruitful. Perhaps it would be helpful at this time for us to make some specific suggestions of alternative states you may want to explore, as a way of gradually distancing yourself from 3A. Our studies indicate that good first steps might be 5E, Generally Fearful; 10B, Apprehensive; or 11C, Jittery. (Check your manuals for appropriate definitions.) Again, these would only be stopgap measures, methods for moving slowly away from 3A and toward one of the currently recommended emotional states, such as 75D, Cautiously Guarded; 78A, Vaguely Alert; or even 105M, Mildly Optimistic.

Some of you may be tempted to try to go cold turkey, as it were, and plunge directly from emotional state 3A into one of the recommended states in the 70s or 80s. Though such efforts are not unheard of, we would emphasize that nearly all the known successful attempts have been conducted in laboratory settings, and that the procedure is rarely successful in real-world situations. That said, if you remain determined, we have made available a number of pamphlets outlining the generally accepted research in this area.

Please be aware that we are by no means recommending that you try to go anywhere near emotional state 800A, Calmly Focused; 805B, Gently Aware; or any of their associated states. As you probably know, these are advanced states that require a great deal of practice, and, depending on your region, there may be licensing requirements. These states should only be attempted by trained professionals operating in controlled conditions.

This brings us to the subject of unauthorized emotional states. As you may know, we have received multiple reports of unauthorized emotional states, many of them emanating from Sector 2 (not that we are pointing any fingers!), and we find ourselves Troubled (53B). Therefore, this may be a good opportunity to review some of the basic tenets of the Emotional State Paradigm, as agreed to at the 11th General Council, many of which relate directly to the aforementioned occurrences.

Emotional state 485G, Wild Abandon, is officially reserved for weddings and public holidays, with significant leeway given for personal triumphs. The same goes for 430A, Effusive Joy; 430B, Elation; and 437C, Overwhelming Glee. (Again, see your manuals for definitions.) Although the decision to officially sanction these emotional states was regarded by some at the time as controversial, it was seen as a necessary precaution in the wake of the High-Level Hoax (remember how that turned out?) and, though carefully regulated, these states are now standard.

Given the large number of reports of recent instances of officially controlled emotional states, we would like to recommend some viable options for those of you wishing to express a more vibrant point of view. For those of you tempted to exhibit 485G, Wild Abandon, may we suggest 375B, Moderate Giddiness? This would provide the necessary irreverence of 485G but without the inherent danger. Another viable alternative might be 493E, General Excitability, which provides a similar adrenal rush but in more controllable doses. We have also seen success with 487C, Wholehearted Enthusiasm. Whatever method of substitution you choose to pursue, the main thing to keep in mind is that moderation is the key.

We are living in tumultuous times, which have obviously proved challenging, both for those of you striving to return from previously used emotional states that are no longer desirable and for those tempted into unauthorized states as a result of the recent, broadly perceived changes. Our goal is to be encouraging, not prescriptive, and punitive only in the face of the most egregious violations. We draw your attention to the large number of publicly available resources existent to help you through this period, and, as always, we remain humbly at your service.

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McSweeney's Internet Tendency:Selected Personals From the American Psychiatric Association's Dating Website.

2009-03-11T12:33:00.001-07:00

BY FRANK FERRI

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"Home, sweet home"

Agoraphobe seeks agoraphobe for long-distance relationship.

"Touchy, but in a good way"

Obsessive-compulsive with need to tap exactly four times any lampshade he passes seeks woman with similar interests for frequent checks of stoves and doors. If you're the one, let's get together for a romantic walk without stepping on any cracks.

"Waiting, with heart wide open"

Claustrophobic female seeks male (age not an issue) with empty 50,000-square-foot warehouse with high ceilings.

"Needed: perfect foil for my fiery personality"

Pyromaniac seeks pyrophobe for possible sitcom.

"What, me worry? You betcha!"

Woman with generalized anxiety disorder looking for someone to share evenings catastrophizing about possible reasons why my mother hasn't returned my voicemail, which I left almost an hour ago. If your mind goes straight to car accident, fell down a well, or mistook her car for a time machine, traveled to the late 1600s, and became a victim of the Salem witch trials, then you and I need to talk. Talk ourselves into a panic, that is!

"Fuck you"

Good-looking guy with Tourette's looking for—fucking asshole bitch motherfucker—soul mate with passion for fine wine—douchebag shit fuck—and antiquing.

"Don't sweat the small stuff—keep it!"

Recently divorced compulsive hoarder seeks male with a lot of love—and even more stuff. Must be willing to move in with me immediately. Interests include shopping for unnecessary items, refusing to throw away outdated newspapers, and keeping receipts from the 1950s.

"Don't mock me"

Love to laugh? Then you're not my type. Female katagelophobe seeks female geliophobe for serious, no-nonsense relationship.

"The more the merrier"

Male frotteur in search of tightly packed crowd of women.

"Come on, Daddy needs a new friend!"

Easygoing compulsive gambler in search of male or female for friendship. Must be financially independent and have an excellent line of credit. Desire to travel a must—specifically, to places like Macau, Las Vegas, A.C., and Vicksburg, Mississippi. Roll the dice and find a true friend. Age doesn't matter, but if you're 21, that could be good luck.

"What is this for again?"

Female with adult attention-deficit disorder seeks male for—look at that bird! What is that? An egret? I love their long necks.

"I'm not worthy"

Guy with self-defeating personality disorder thinks he's funny but isn't. Seeking alcohol-free/drug-free female. Must be willing to treat me poorly, undermine any happiness I may experience, and stop me if I'm about to accomplish something I could potentially be proud of.

"Drink me in"

Alcoholic male has thirst for female enabler for long-term co-dependent relationship.

"Nothing to hide"

Disinhibited 48-year-old, 142-pound woman with hemorrhoids, herpes, a penchant for one-night stands with random men, and a history of cheating on her taxes seeks equally overly self-disclosing male to co-host dinner parties with. Together we can make our guests excruciatingly uncomfortable with our unfiltered conversation. Last two hubbies died. Mysteriously.

"Night and day, day and night"

Nyctophobe seeks photophobe for fun battles over the light switch.

"R-E-S-P-E-C-T"

Dominant woman seeking Stockholm-syndrome-prone male. Contact me and I'll capture your heart.

"We're connected"

Person with dissociative identity disorder seeks you, you, and you. Or is it me, me, and me? Doesn't matter. We're meant for each other. Call me. I just did. Great, let's set up a date. Sounds good. Must be Jewish. I am. Great, this is going well.

"Oh, you're going to wear that?
No, no, that looks nice. Really, it does"

Passive-aggressive woman seeks marriage-ready male. I enjoy purposely taking too long to get ready and making us late for reservations. I'm great at "forgetting" to do important tasks, such as mailing in mortgage payments, thus damaging our credit scores just because I won't come out and tell you that I don't like the long hours you work.

"You're not the one for me"

Lonely lady with avoidant personality disorder seeks no one to interact with, share love with, or grow old with.

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EMax Health: Identification, Characterization Of Sensitive Periods For Neurodevelopment Of Mental Illness

2009-03-11T11:42:00.001-07:00

Submitted by ruzik_tuzik on Mar 10th, 2009

Identification and characterization of sensitive periods for neurodevelopment of mental illnesses is a new initiative, that will stimulate neurodevelopmental research in humans and animals that will increase our understanding of the neurobiology underlying developmentally sensitive periods for risk, resilience, and intervention.

Rationale and Description

The goal of this initiative is to accelerate and stimulate research on sensitive periods (i.e., periods during which the developing brain is maximally sensitive to environmental influences that confer risk or resilience) for the neurodevelopment of mental illness. While brain development may start from a genetic blueprint, it is the overlay of experience that shapes development and leads to either normal function or pyschopathology.

We have limited knowledge of either the timing and specificity of sensitive periods in humans or the neurobiological trajectories in mental disorders. By increasing research focused on sensitive periods in behaviors related to mental health, the field will make exponential progress in the treatment of mental illness. Furthermore, with more fundamental information on sensitive periods in humans, we can develop more specific and focused hypotheses about mechanisms to be tested in preclinical animal models. Therefore, the potential advances gained from this initiative are essential for the ultimate understanding, prevention, and cure of mental disorders.

Read more here ...

Time: Redefining Crazy: Researchers Revise the DSM

2009-03-11T11:37:00.001-07:00

Wednesday, Mar. 11, 2009
By John Cloud

If you wanted to make a list of important books you should read, what would you choose? Anna Karenina, maybe? The Bible? How about the Diagnostic and Statistical Manual of Mental Disorders?

It may not be at the top of your list, but the DSM, as it's usually called, is one of the most important books in the world. It attempts to categorize, describe and give a code number to literally every problem that can occur in your mind, from schizophrenia to borderline personality disorder to something called mathematics disorder, which is essentially being so bad at math that it amounts to a mental problem.

The DSM is important not only because it is wildly ambitious but also because mental-health professionals around the world have adopted its classification system. In the U.S., it is virtually impossible to get reimbursed by an insurance company for treatment unless a mental-health professional identifies your condition by a DSM diagnosis number. (The DSM code number for mathematics disorder, if you were wondering, is 315.1. The code for Tourette syndrome is 307.23; the code for sexual sadism is 302.84. As I said, the DSM tries to cover everything.) (See the top 10 medical breakthroughs of 2008.)

The American Psychiatric Association (APA), which owns the DSM, is in the process of rewriting the book, which was first published in 1952. The DSM-V, as the fifth edition will be called, is set to be published in 2012. But the process of researching it began way back in 1999 — five years after the publication of the last major revision, the DSM-IV — meaning the new book's production will take 13 years overall. (Read "How We Get Labeled By the DSM.")

Why so long? Last week, a research organization called the American Psychopathological Association (which goes by the acronym APPA, to distinguish it from the APA) brought many of the key players in the development of the DSM-V to a New York City conference to discuss some of the reasons the writing of the book is so complicated.

One obvious reason is that so many people have a stake in what the world defines as crazy and what it calls normal. Famously, homosexuality was listed as a DSM condition until a 1974 vote among APA members to remove it. Other groups of mental-health professionals and patients want certain disorders to be added (and covered by insurance): sexual compulsivity, for instance, is not in the DSM, even though "sexual aversion disorder" (302.79) — the persistent and distressing avoidance of genital contact not explained by another disorder such as depression — is included. (Read an interview with an author who has bipolar disorder.)

Debates about what should and shouldn't be in the DSM are fascinating and often bitter, and as I have pointed out before, the book makes at least one fundamental error in the way it conceives of mental problems: it ignores causes almost entirely. If you feel sad and tired for a couple of months, have trouble sleeping and making decisions, and gain weight, you can be given a DSM diagnosis of depression (296.31 or 296.32, mild or moderate, recurrent) and prescribed drugs for it — even if the reason for your funk is that you just lost your job. Such physiological responses as insomnia are evolutionarily natural (and sometimes helpful, in a jump-starting sort of way) when you go through a trauma like losing your job. But according to the DSM, only perfect is considered normal. Another basic problem with the DSM: it tries to reduce the vastly complex experiences of your mind to a single number.

At last week's conference, there were tantalizing hints that the DSM-V might fix some of these problems. Dr. Steven Hyman, provost of Harvard, a former psychiatry professor at its medical school and former director of the National Institute of Mental Health, agitated at the meeting for a new DSM framework that would stop trying to divide mental problems into discrete all-or-nothing categories. That method works for some medical problems — you either have leukemia or you don't — but depression, for instance, doesn't work like that. (Read "Why Do the Mentally Ill Die Younger?")

Rather, Hyman argued that many mental illnesses are problems that lie along a continuum from normal and functioning to disordered and tragic. To the annoyance of some old-fashioned DSM defenders, he made the case that the DSM should regard mental illness as "continuous with normal": less like leukemia and more like hypertension. You don't get diagnosed with hypertension until you meet a cut-off point for high blood pressure that takes into account other extenuating factors: your age, for instance, or the conditions under which the blood-pressure reading is taken. Depression should be the same: if you are sad because you just got divorced, the DSM shouldn't necessarily consider you to have an illness.

Such a diagnostic model wouldn't be simple, though, which is one reason the DSM is taking 13 years to rewrite. And in the meantime, the book still has to be useful to everyday clinicians seeing patients who need a code number for insurance companies. "It's like wondering how you repair the airport while the planes are still flying," Hyman said at the conference.

Hyman noted that medical problems, whether in the mind or in the body or both, are usually caused by some combination of genes, environment, behavior and chance. Despite the comforting modern notion that severe psychological illnesses are simply due to an unfortunate genetic inheritance, it is the exceedingly rare mental condition caused only by genes (Rett syndrome is one example.) Rather, if you take something like generalized anxiety disorder (300.02), there may be a variety of causes that set it off: genes that cause excessive activity in the fear-producing part of the brain called the amygdala; a stressful job that stimulates that activity; engaging in a dumb behavior like having an affair that exacerbates your anxiety; then randomly getting into an anxiety-heightening situation like a car accident. The DSM has to try to account for all of that complexity — causes, effects, unintended consequences — and still be definitive.

Hyman said in an interview that one way the DSM currently handles this complexity is to have what he called a "wastebasket" diagnosis called "not otherwise specified" (NOS), which captures just about anything that doesn't easily fit the categorical model. One major problem with the NOS diagnosis: pretty much anyone can qualify for a diagnosis that, by definition, is not specified. A 2005 American Journal of Psychiatry paper found that nearly half of a group of 859 people who sought psychological help in Rhode Island could be considered to have a DSM personality disorder if diagnosticians were allowed to include the "not otherwise specified" option. Another problem: how do you adequately treat patients whose illness is unspecified?

A continuum model like the one Hyman proposes could help solve this problem by recognizing that people aren't always one thing or another. They're sometimes just a little depressed, or a little anxious. To avoid medicalizing normal stress, the DSM-V would set a cut-off point within the spectrum. Of course, determining the right cut-off point for the DSM's 350 illnesses would take an enormous research effort, one that has begun for some disorders like depression but likely hasn't even been thought about for rare problems like sexual sadism.

Other attendees at the APPA conference indicated that the new DSM will almost certainly adopt a continuum model for mental illnesses. But don't be surprised if the book doesn't come out as scheduled in 2012. If the three-day conference came to any solid conclusion, it was that totting up all the ways our minds can fail is a lot harder than, say, explaining why your appendix might burst.

Speaking of Faith: The Soul In Depression: Poetry for Reflection, Help and Healing

2009-03-01T16:45:00.001-08:00

Speaking of Faith: The Soul In Depression

Poems by Rainer Maria Rilke

Ich liebe meines Wesens Dunkelstunden

I love the dark hours of my being.
My mind deepens into them.
There I can find, as in old letters,
the days of my life, already lived,
and held like a legend, and understood.

Then the knowing comes: I can open
to another life that's wide and timeless.

So I am sometimes like a tree
rustling over a gravesite
and making real the dream
of the one its living roots
embrace:

a dream once lost
among sorrows and songs.

Dich wundert nicht des Sturmes Wucht

You are not surprised at the force of the storm—
you have seen it growing.
The trees flee. Their flight
sets the boulevards streaming. And you know:
he whom they flee is the one
you move toward. All your senses
sing him, as you stand at the window.

The weeks stood still in summer.
The trees' blood rose. Now you feel
it wants to sink back
into the source of everything. You thought
you could trust that power
when you plucked the fruit;
now it becomes a riddle again,
and you again a stranger.

Summer was like your house: you knew
where each thing stood.
Now you must go out into your heart
as onto a vast plain. Now
the immense loneliness begins.

The days go numb, the wind
sucks the world from your senses like withered
leaves.

Through the empty branches the sky remains.
It is what you have.
Be earth now, and evensong.
Be the ground lying under that sky.
Be modest now, like a thing
ripened until it is real,
so that he who began it all
can feel you when he reaches for you.

Poems by Anita Barrows

Questo muro

Quando mi vide star pur fermo e duro
turbato un poco disse: "Or vedi figlio:
tra Beatrice e te è questo muro."

(When he [Virgil] saw me standing there unmoving,
he was a bit disturbed and said, "Now look, son,
between Beatrice and you there is this wall.")
-Dante, Purgatorio XXVII

You will come at a turning of the trail
to a wall of flame

After the hard climb & the exhausted dreaming

you will come to a place where he
with whom you have walked this far
will stop, will stand

beside you on the treacherous steep path
& stare as you shiver at the moving wall, the flame

that blocks your vision of what
comes after. And that one
who you thought would accompany you always,

who held your face
tenderly a little while in his hands—
who pressed the palms of his hands into drenched grass
& washed from your cheeks the soot, the tear-tracks—

he is telling you now
that all that stands between you
& everything you have known since the beginning

is this: this wall. Between yourself
& the beloved, between yourself & your joy,
the riverbank swaying with wildflowers, the shaft

of sunlight on the rock, the song.
Will you pass through it now, will you let it consume

whatever solidness this is
you call your life, & send
you out, a tremor of heat,

a radiance, a changed
flickering thing?

Heart Work

Monday. Bronze sunlight
on the worn gray rug
in the dining room where Viva sits
playing her recorder. Pain-ripened sunlight

I nearly wrote, like the huge
vine-ripened tomato
my friend brought yesterday
from her garden, to add to our salad:
meaning what comes

in its time to its own
end, then breaks
off easily, needing no more
from summer.

The notes
of some medieval dance
spill gracefully from the stream
of Viva's breath. Something
that had been stopped

is beginning to move: a leaf
driven against rock
by a current
frees itself, finds its way again
through moving water. The angle of light

is low, but still it fills
this space we're in. What interrupts me

is sometimes an abundance. My sorrow too,
which grew large through summer
feels to me this morning

as though if I touched it
where the thick dark stem

is joined to the root, it would release itself
whole, it would be something I could use.

"Back" by Jane Kenyon

We try a new drug, a new combination
of drugs, and suddenly
I fall into my life again

like a vole picked up by a storm
then dropped three valleys
and two mountains away from home.

I can find my way back. I know
I will recognize the store
where I used to buy milk and gas.

I remember the house and barn,
the rake, the blue cups and plates,
the Russian novels I loved so much,

and the black silk nightgown
that he once thrust
into the toe of my Christmas stocking.

Speaking of Faith: The Soul In Depression

2009-03-01T15:47:00.001-08:00

The Soul in Depression
February 26, 2009

SOF OnDemand:
» Download (mp3, 53:09)
» Listen Now (RealAudio, 53:09)
» Podcast

One in ten Americans, and even more dramatically, about one in four women, will experience clinical depression at some point in their lives. We take an intimate look at the spiritual dimensions of this illness and its aftermath.

Program Details

* » Particulars an annotated guide to the radio program with readings, images, and links
* » Resources
* » Books + Music
* » Krista's Journal
* » Transcript
* » Credits

» Depression and Me
The vulnerability of revisiting this conversation reminds Krista to embrace "dark times as expressions of human vitality."

» Confessions of a Yoga Convert
For our yoga show, Krista reflects on the impact of her own practice in dealing with depression — and how it liberated her to see value in the graceful transitioning and not just the outcome.

» The First Breath After a Coma
If you've had a long day and are looking for a moment of reflection, watch Carolina LaBranche's lovely two-minute homage to her mother.

We had to cut these three interviews down quite a bit to fold them into one program. Hear each conversation in full and uncut, and let us know what you think of our edits.
» Unedited Interview with Palmer (mp3, 56:54)
» Unedited Interview with Solomon (mp3, 45:57)
» Unedited Interview with Barrows (mp3, 59:49)

Poetry for Reflection, Help, and Healing

» Rainer Maria Rilke
Translations of the two poems recited by Anita Barrows.

» Anita Barrows
Texts of "Questo muro" and "Heartwork."

» Jane Kenyon
Read "Back" cited by Solomon

» Psalms of the Old Testament
Helpful examples for meditation during and after depression.

» William Shakespeare
Passage from The Winter's Tale.

Solomon is author of The Noonday Demon: An Atlas of Depression, which won the National Book Award in 2001.

Palmer is an educator, activist, and author of Let Your Life Speak: Listening for the Voice of Vocation.

Barrows is a poet and psychologist, and translator of Rilke's Book of Hours: Love Poems to God.

Storied Mind: Why Depressed Men Leave - 2

2009-02-25T19:00:00.001-08:00

Written by john on February 21st, 2009

Some Rights Reserved by nyki_m at Flickr

Some of the comments on the last post in this series hit hard on two issues. First is the question of personal choice: is a man supposed to escape responsibility for destructive behavior by attributing everything to depression? The answer is no! Depression is never an excuse for inflicting pain and loss, breaking up families, violent rages or destructive behavior of any kind. The other compelling question that is asked over and over again, often in desperation, is: What can I do?

I’ll try here to deal with both of these issues here rather than put them off to the end of the series, as I had originally planned.

1. Responsibility

Whatever might roil me internally in the midst of this condition doesn’t change or lessen my responsibility for the harm my behavior is causing. My wife hasn’t kept silent but has confronted me whenever she needed to about what I was doing to our relationship and everything I was putting at risk. Hearing that from her was not enough by itself to shatter the power of denial, but it was essential to be confronted with the facts of her feelings. That truth needs to get through the layers of depressive self-absorption and isolation in order for recovery to begin, but it is knowledge that has to be put to use by me. I had to decide to take responsibility for my own recovery.

Read more ...

Storied Mind: Why Depressed Men Leave - 1

2009-02-25T18:58:00.001-08:00

Written by john on February 9th, 2009

Why Depressed Men Leave - 1

Written by john on February 9th, 2009

Some Rights Reserved by lepiaf.geo at Flickr

About a year ago, I wrote a series of posts about my experience with the fantasies of a better life that often prompt depressed men to leave their families. You can find the first of those stories here, here and here. Those brief pieces tell only a small part of a long and troubling story. To stay in recovery I have to know more, and so I’m starting a new series of posts specifically about why men want to leave, how we change, where we want to go.
Read more ...

Hara Estroff Marano: Buddhism and the Blues

2009-02-25T18:42:00.001-08:00

Buddhist psychology's core techniques of meditation and awareness may have much to offer ordinary Westerners.

By: Hara Estroff Marano

To most people Buddhism is an ancient Eastern religion, although a very special one. It has no god, it has no central creed or dogma and its primary goal is the expansion of consciousness, or awareness.

But to the Dalai Lama, it's a highly refined tradition, perfected over the course of 2,500 years, of analyzing and investigating the inner world of the mind in order to transform mental states and promote happiness. "Whether you are a believer or not in the faith," the Dalai Lama told a conference of Buddhists and scientists at the Massachusetts Institute of Technology, you can use its time-honored techniques to voluntarily control your emotional state.

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Anger in the Age of Entitlement: Uncertainty Is Your Friend, Part III: Emotions Are All of the Above

2009-02-25T17:43:00.001-08:00

By Steven Stosny in Anger in the Age of Entitlement

All available evidence suggests that the brain has enormous flexibility to do a lot of different things at one time. Mental focus is hard because it forces the brain to concentrate its resources, something it is naturally inclined to do only with the prospect of reward or in the face of threat.

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Anger in the Age of Entitlement: Uncertainty is Your Friend, Part II: Testing the Illusion of Certainty about Emotions

2009-02-25T12:26:00.001-08:00

By Steven Stosny in Anger in the Age of Entitlement

There's a famous story about the philosopher Ludwig Wittgenstein watching a sunset with a student and marveling about how anyone could have believed that the sun revolved around the earth.

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Anger in the Age of Entitlement: Uncertainty is Your Friend, Part I

2009-02-25T12:24:00.001-08:00

By Steven Stosny in Anger in the Age of Entitlement

A number of years ago the dean of a leading medical school opened the commencement ceremonies with a message to the newly graduated physicians, "Fifty percent of what we taught you is wrong.

Read More

In Practice: Fuhgeddaboudit

2009-02-25T12:22:00.001-08:00

By Peter D. Kramer in In Practice

If we had a drug that could erase bad memories, should we use it? That was the question the press extracted from an arguably limited set of observations reported in an on-line article in Nature Neuroscience.

You've probably heard about the experiment. A trio of Dutch researchers showed normal subjects photos of spiders, accompanying one image with an electric shock. The next day, the scientiest re-presented the images, with or without pre-administering the subjects an anti-adrenalin drug, propranolol. Down the road, those who had taken propranolol were less likely to startle when exposed to a loud noise in the presence of an offending picture. The conclusion was that the drug interfered with the consolidation of the emotional memory, stripping it of its fear element.

This finding is a slim reed on which to rest a philosophical inquiry, but in truth the medical ethics field has been debating the broader question for the better part of a decade, based on earlier, similar suggestive research involving propranolol. In 2003, the President's Council on Bioethics weighed in, arguing that the modification of emotional memory was a worrisome alteration of personhood, one that risked trivializing signal forms of pain that compose a complex self. In 2007, the American Journal of Bioethics devoted most of an issue to discussions of an essay that argued in favor of choice in the matter of muting disabling fear.

Yesterday, for better or for worse, I represented the bioethics community when AirTalk with Larry Mantle, a public radio show, took up this issue, under the heading "The Spotless Mind." The broadcast does a fair job of presenting the issues — those who are interested should give a listen.

I want here only to clarify a single point - one that was at the heart of Listening to Prozac. When we wrestle with an ethics question in neuroscience, often it is important to ask what worries us: Is it that we disapprove of the goal of an intervention, or that we dislike the intervention itself.

Do we really, for the most part, worry about the attenuation of fearful memories? Let's say that a patient comes to a doctor and says, "I had a terrible experience yesterday, and I'm worried that it will haunt me. Can you help prevent the fear from lingering?" That's the set up.

Now imagine that the doctor prescribes "tincture of time," that is, she reassures the patient: "Don't worry. I know you. That memory will fade." No one, I would guess, has moral worries about that scenario. Yes, there will be a change in the self, but so what? The content in our library of memories shifts all the time. If the self is continuous, that's not because our emotions are always identical.

What if the doctor says, "You're adept at meditation. Tomorrow, when you recall the event, enter into a relaxed state. Later, the memory will upset you less." Do we object to that prescription? If not, then in truth we do not fret about the result, a muted emotional response to a real stimulus.

How about a more mechanical behavioral prescription? Let's say we believe in the efficacy of "Eye Movement Desensitization and Reprocessing," or EMDR, in its simplest form. The doctor trains the patient to recall the trauma while moving his eyes this back and forth. The memory loses its force. Are we alarmed? Well, perhaps this approach does seem a bit eerie.

Now think of an ingested substance, chocolate or green tea. The doctor has the patient call up the memory while enjoying a soothing snack. Do we object to that sort of interference with reconsolidation?

My point is a simple one. We only initiate an ethics debate when the intervention is a medication - here, one with a complex name, propanolol. (In truth, the consolidation of anxiety may be a fairly easy target; it looks as if steroids, opiates, benzodiazepines, and anesthetics might do the job, along with beta-blockers.) That category, medication, seems to bring into play technology, doctors, patient status, and drug companies, and therefore hierarchy, social coercion, and communal norms. Now we worry, if we do, about altering the self in ways that the culture favors.

There's much more to say on this topic, but for the moment, I think I'll stop with this question: Why is it that we debate the ethics of muting anxious memories now, in the years since it's seemed propranolol can do the trick, when we never argued over that capacity before? Like everyone else, I understand the dystopian science fiction scenario of "eternal sunshine," but to undertake a serious philosophical discussion we need to do better of specifying what's at issue. Why precisely do we worry over a drug's doing a job we are happy to see accomplished by any number of other means?

Urban Mindfulness: Mindfulness and the Financial Crisis

2009-02-25T12:13:00.001-08:00

By Jonathan Kaplan, Ph.D. in Urban Mindfulness

Here in the city (and all over the country), anxiety about the financial crisis is palpable and omnipresent. Thousands of people, especially within the financial services industry, have been losing their jobs. Real estate construction and development have slowed or ceased, while home sales plummet. Retail businesses and restaurants have been doing poorly too as many of us cope with a decrease in income by reducing our spending.

How can mindfulness help?

Mindfulness can help by reducing our suffering in a very painful situation. The financial crisis has a negative effect on our home finances, savings, and fulfillment of some life dreams (at least temporarily). This is our current reality--and it hurts. Unfortunately, we often make this bad situation worse as we become mired in regret, fantasy, and worry. "If only I sold my stocks 1 year ago..." or "I'm never gonna get another job" are common reactions to the crisis. However, emotionally such thoughts make us feel worse. So here are a few mindfulness pointers:

* Notice where your mind goes. Are you stuck in regret or blaming others? Are you catastrophizing about the future? Bring your attention back to rest on your breathing.

* Find ways to reconnect with positive aspects in your life, like your health, family, or faith. Often, we dismiss expressing such appreciations by adding "Yes, but..." The "but" takes away any joy or satisfaction from things that are going well. Real life is good and bad, not good but bad.

* Re-evaluate and do constructive planning and problem-solving. Mindfulness can help us see what is really happening and deal with it appropriately. Not being able to pay the bills might be a reality for you. So, minus the worry, anxiety, and recrimination, what are your options? How can you increase the money coming in and reduce the money going out? Perhaps you need to find another job, borrow money from friends or family, or sell some of your stuff. None of these actions are easy, but they might be necessary. Getting caught-up in worry, guilt, shame, and other destructive emotions can only delay taking productive action and make you feel even more miserable.

* Finally, notice your mindset now vs. 1 year ago. Chances are, you saw your life as being deficient at that time, too. You wanted more money, an iPhone, or whatever. You told yourself, "If only I had [X], I would be happy." Now, we are confronted with reality of having less than we did previously; our mindset matches actually matches our circumstances. In fact, we might even find ourselves longing for how good we had it before, at least financially. At the time though, we weren't satisfied with it. This irony suggests that we need to recognize the problem in dwelling on thoughts that we're deficient or need something that we do not have. Not until we recognize and accept our current circumstances can we be free to change it.

The Human Experience: Emotional Hunger Vs. Love

2009-02-25T12:10:00.001-08:00

By Robert Firestone, Ph.D. in The Human Experience

Emotional hunger is not love. It is a strong emotional need caused by deprivation in childhood. It is a primitive condition of pain and longing which people often act out in a desperate attempt to fill a void or emptiness. This emptiness is related to the pain of aloneness and separateness and can never realistically be fully satisfied in an adult relationship. Yet people refuse to bear their pain and to face the futility of gratifying these primitive needs and dependency. They deny the fact of their own ultimate death and do everything in their power to create an illusion that they are connected to other persons. This fantasy of belonging to another person allays the anxiety about death and gives people a sense of immortality. Hunger is a powerful emotion, which is both exploitive and destructive to others when it is acted out. People identify this feeling with love and mistakenly associate these longings with genuine affection. Nothing could be further from the truth.

Feelings of emotional hunger are deep and are like a dull but powerful aching in your insides. You may often find yourself reaching out and touching others or expressing affection and loving movements in order to attempt to kill off this aching sensation. People often give physical affection and attention when they feel the most need for it themselves. This type of physical affection is draining of the emotional resources of loved ones, particularly one's children, rather than enhancing their development psychologically. It is wise to be suspicious of your own use of the word "love" or "I love you." If you search yourself truthfully you may discover that you say these words most often, not when you feel the most for others, but rather when you experience strong dependency needs and feel the need for reassurance.

To read more, click here ...

Telegraph.co.uk: Florence Nightingale 'might never have succeeded with modern stigma against mental illness'

2009-02-13T09:47:00.000-08:00

She became world-famous as the saviour of countless lives and the inventor of modern nursing, but a new report suggests that Florence Nightingale might never have been able to transform hospitals if she had to combat today's stigma against mental illness.

By Kate Devlin, Medical Correspondent
Last Updated: 3:48PM GMT 10 Feb 2009

The document, co-written by Alastair Campbell, the former Government spin doctor, also questions whether a modern politician could reach the top of their profession suffering from Winston Churchill's "black dog" of depression.

And it queries whether the ideas of other leading figures, including Charles Darwin, Marie Curie and Abraham Lincoln, would be ignored in today's society, which the report found was heavily prejudiced against people with mental health problems.

More than one in four people, 29 per cent, do not think that someone with a mental illness can hold down a responsible job, the study found, while 60 per cent of employers said that they would feel unable to employ someone suffering from mental health problems.

The report warns that achievements including the theory of evolution, the creation of modern nursing, developments in cancer treatment and the abolition of slavery may never have happened under modern ideas about mental health.

As well as Churchill, Curie and Lincoln both suffered from depression, while Darwin had extreme bouts of anxiety and agoraphobia and experts believe that Florence Nightingale suffered from bipolar disorder, also known as manic depression.

The report speculates that without Churchill, Britain could have made a compromise peace agreement in 1940, allowing a Nazi-dominated Europe and the loss of freedom and democracy.

It also warns that the "next Churchill" could be missed because of the modern demands on politicians.

Mr Campbell said: "I am not convinced that a modern politician who admitted to mental health problems would be able to get to the top.

"Churchill was by common consent Britain's greatest ever leader, and voted the greatest ever Briton, but I wonder whether his depression would have stopped him becoming Prime Minister in modern Britain.

"As I watch politicians and other public figures deal with the pressures of modern leadership, not least dealing with harsh 24 hour scrutiny, I sometimes wonder how these great historic figures would have fared had they been alive today.

"Churchill with his depressions, drinking and long lie-ins; Darwin with his severe anxiety that showed up in stomach disorders, crippling headaches, agoraphobia, trembling, palpitations of the heart, and mental torment which often left him in floods of tears.

"Would the media and public have been understanding about their conditions? – these statistics suggest otherwise."

The report, released today and co-written by historian Nigel Jones, is part of a campaign called Time to Change, organised by the mental health charities Mental Health Media, Mind and Rethink.

According to the report almost nine out of ten people with mental health problems have experienced stigma and discrimination, often by employers.

One in four Britons suffer from it at some point in their life, and Mr Campbell said that his own experience had shown how important the role of work could be to aid a patient's recovery.

He said: "When Tony Blair asked me to work for him in 1994, I told him about my breakdown and my drink problem. He said he wasn't worried. If a Prime Minister can have that attitude, then I think it is about time the six out of ten who say they wouldn't consider taking on someone with a history of mental illness join the four out of ten who say they would."

Sustainablog: Is Climate Change Making Us Mental?

2009-02-13T09:39:00.001-08:00

Written by Robin Shreeves

Published on February 11th, 2009

If you were to click on my bio here for Sustainablog, you’d see that I started down this green path because my son who was six at the time had read about global warming and gave us the “what for” over the SUV we owned. We joke now with him that he was the one that got this whole thing started for our family, yet at times he seems, at almost ten years old, the least interested in the environment. In a way, that may be a good thing.

The Boston Globe reported that climate change takes a mental toll, and that children and adults alike are starting to have “psychosis or anxiety disorders focused on climate change.” Children especially “are having nightmares about global-warming-related natural disasters.”

Read the rest of the article here:

San Jose Mercury News: Lawmakers debate mental health cuts

2009-02-13T09:35:00.001-08:00

By CATHY BUSSEWITZ Associated Press Writer
Posted: 02/12/2009 04:27:26 PM PST

CARSON CITY, Nev.—Lawmakers challenged major cuts in the state's mental health services on Thursday, saying they won't agree to reductions that would jeopardize the health and safety of Nevada communities.

Gov. Jim Gibbons has proposed closing 11 of the state's 21 rural mental health clinics, and increasing the number of patients per staff member at mental health facilities in Reno and Las Vegas.

While overall human services spending, about a third of the state's general funds, for the coming two fiscal years is up, funding for mental health services would decrease 5 percent, to $473 million.

"Several of us took vows that we would never support reductions again," said Sen. Bob Coffin, D-Las Vegas, referring to budget cuts to mental health in 1991. "Now we face the greatest reduction I've ever seen."

"The mentally ill cannot complain. Their families are shy about complaining," Coffin said during a joint Senate-Assembly budget subcommittee hearing. "Who is going to fight for the mentally ill? I am not going to support these cuts. I am going to follow through with my vow of 1991."

Of the 21 rural mental health clinics, two already are closed, another nine would be closed by June 30, and services would be moved to regional hubs.

Read the full article here:

The Buffalo News: Hard times are pushing many into mental illness

2009-02-13T09:32:00.001-08:00

By Deidre Williams
NEWS STAFF REPORTER

It’s all weighing pretty heavily on Barbara Smith, a widowed grandmother who lives in the Black Rock section of Buffalo.

She fears layoffs are coming soon at her job a local nonprofit agency. That’s on top of the hours that were cut recently at her part-time job at a local florist.

And don’t forget the weather: the very cold, very snowy past weeks, followed by a couple of days of warming, then 60 -mph winds and wet snow that knocked out power to more than 50,000 homes and businesses.

“I guess the news is bad for everybody,” Smith said, “and it just seems to get worse.”

All this contributes to what experts call the new face of mental illness.

Doom and gloom seem to have dominated the news lately.

Consider the headlines:

• A global economic crisis.

• A recession here at home.

• The near-daily tally of job cuts at large companies worldwide.

• Record snow and frigid temperatures locally, then flooding and a wind storm.

• Gasoline prices creeping up again after receding from record highs.

“There’s a lot of bad news,” said Brian D. Barnas, a University at Buffalo student. “That’s the times we’re in right now. That’s what’s going on in the world.”

As a result, many Americans are facing fear, anxiety, uncertainty and stress.

The despair and desperation that come with such feelings is the “modern face of mental illness,” said Thomas P. McNulty, president and chief executive officer of the Mental Health Association of Erie County.

Many people have heard of schizophrenia, bipolarity, and eating and personality disorders, McNulty said.

“But today the modern face of mental illness includes mortgage crises, job loss, people stressed to the limit financially. It’s an entirely different emotional situation,” McNulty said. “The modern-day things we can face can turn into a severe emotional disturbance.”

Read the full article here:

Monkey See: Valentine's Day Un-Romances

2009-02-13T09:27:00.001-08:00

by Linda Holmes

I have a long history with romantic movies of all kinds. Goopy musicals, kicky-girl rom-coms, masterpieces of banter -- you name it, and I've probably fallen for it at one time or another. Unfortunately, the older one gets, the more some of these fall apart, and the more others don't work at all. I give you five (of many) Un-Romances. Be warned: all descriptions contain spoilers.

1. Jerry Maguire

This really pains me, because I thought this was a terribly touching story the first time I saw it. As much as "you complete me" and "you had me at hello" are now as dessicated as "Show me the money!" there was a time when they seemed like sort of nifty things for people to say to each other. Of course...I was 25.

Why it's an Un-Romance: What's frustrating is that for the first three-quarters or so, this movie demonstrates all kinds of incredibly valid points. Don't perform dramatic stunts (like quitting your job) to impress guys with good teeth. Don't have drunks over to your house. Don't introduce your kid to guys he'll fall in love with unless you're pretty sure about them. Don't date your boss. Don't try to save disasters. Don't ignore your sister when she warns you about guys who are "hanging onto the bottom rung." Don't get married as an alternative to the nightmare of driving a U-Haul.

And then in the closing moments: BOOM! It turns out that the guy who clearly was not in love with you can suddenly discover he's in love with you, and that all your bad decisions are now irrelevant. If only real life worked...anything like that.

More, after the jump...

2. Sex And The City

This may not even need saying at this point, but given that we're being threatened with a sequel, perhaps that's not the case.

Why it's an Un-Romance: Oh, where to begin. With the ditching of the faithful Smith, one of the only nice men in the history of the entire show? With the refusal to dump the endlessly dumpworthy Big? With the shoes/clothes/closets obsessions that seemingly eclipse every other interest? You can't have a romance between characters unless you have characters, and "loves shoes" is not a character.

2. The Mirror Has Two Faces

This mostly obscure 1996 Barbra Streisand film is simply the first one that came to mind to represent all movies of its kind: the It Was Only After Your Makeover That I Realized You Never Needed A Makeover love story.

Why it's an Un-Romance: Certainly, it's dangerous for anyone to fall into the post hoc ergo propter hoc fallacy, and it could be that it's a coincidence that the "falling in love" part comes after the "application of artificial nails" part. But it doesn't seem that way. It kind of seems like, in the above clip, Glam Barbra wins the happiness that Dumpy Barbra was not entitled to.

3. Sweet Home Alabama

One of the romantic comedies that made Reese Witherspoon the It-Girl of the genre for a time, it seems like a sort of funny, harmless, torn-between-two-lovers piece of business. As if its effect on Witherspoon were not enough, it also did good things for a fellow named Patrick Dempsey.

Why It's An Un-Romance: Agreeing to marry someone when you are in love with someone else and then dumping the person you've agreed to marry at the altar is not romantic, full stop. You are not a romantic hero; you are...kind of a jerk. Having never been left at the altar (whew!), I can't say I speak from experience, but in the many (many) movies in which this happens, the perpetrator always loses my sympathy instantly. See also: Affairs are not romantic, and I am talking to you, The Bridges Of Madison County.

5. Reality Bites

The ultimate early-'90s slacker romance, here is another one that does
a lot of things right in the first three-quarters. No, wait -- the
first nine-tenths.

Why it's an Un-Romance: Ethan Hawke's work in
the front part of this movie is grossly underrated: he may be
detestable, but the guy is pitch-perfectly infuriating, disguising
meanness as a complex personality and push-pulling on Winona Ryder
until she finally does actually sleep with him, at which point he
flakes out and she -- in the movie's truest scene -- stomps her foot
and screams, "I knew this was going to happen!" And she did, and it
did, and that's what makes it a sad (and plausible) story. What isn't
plausible is that he then, out of nowhere, appears at the end to
announce that he's sorry and he's in love with her and now they will go
off happily into the future with only his acoustic guitar and her
father's gas card to sustain them.

NYTimes: Coffee Linked to Lower Dementia Risk

2009-01-26T08:54:00.001-08:00

By NICHOLAS BAKALAR

Drinking coffee may do more than just keep you awake. A new study suggests an intriguing potential link to mental health later in life, as well.

A team of Swedish and Danish researchers tracked coffee consumption in a group of 1,409 middle-age men and women for an average of 21 years. During that time, 61 participants developed dementia, 48 with Alzheimer’s disease.

After controlling for numerous socioeconomic and health factors, including high cholesterol and high blood pressure, the scientists found that the subjects who had reported drinking three to five cups of coffee daily were 65 percent less likely to have developed dementia, compared with those who drank two cups or less. People who drank more than five cups a day also were at reduced risk of dementia, the researchers said, but there were not enough people in this group to draw statistically significant conclusions.

Dr. Miia Kivipelto, an associate professor of neurology at the Karolinska Institute in Stockholm and lead author of the study, does not as yet advocate drinking coffee as a preventive health measure. “This is an observational study,” she said. “We have no evidence that for people who are not drinking coffee, taking up drinking will have a protective effect.”

Dr. Kivipelto and her colleagues suggest several possibilities for why coffee might reduce the risk of dementia later in life. First, earlier studies have linked coffee consumption with a decreased risk of type 2 diabetes, which in turn has been associated with a greater risk of dementia. In animal studies, caffeine has been shown to reduce the formation of amyloid plaques in the brain, one of the hallmarks of Alzheimer’s disease. Finally, coffee may have an antioxidant effect in the bloodstream, reducing vascular risk factors for dementia.

Dr. Kivipelto noted that previous studies have shown that coffee drinking may also be linked to a reduced risk of Parkinson’s disease.

The new study, published this month in The Journal of Alzheimer’s Disease, is unusual in that more than 70 percent of the original group of 2,000 people randomly selected for tracking were available for re-examination 21 years later. The dietary information had been collected at the beginning of the study, which reduced the possibility of errors introduced by people inaccurately recalling their consumption. Still, the authors acknowledge that any self-reported data is subject to inaccuracies.

Canine Corner: Dogs as Therapists

2009-01-26T08:49:00.001-08:00

By Stanley Coren, Ph.D. in Canine Corner

On January 11, 2009 Mickey Rourke won the Golden Globe Award for best actor for his performance in Darren Aronofsky's "The Wrestler." When actors give acceptance speeches for such awards it is quite common for them to thank God and their family for the win, but Mickey Rourke thanked his dogs. If it had not been for the therapeutic effects of his relationship with his dogs, Mickey Rourke might not have been alive to accept this award.

In the film, "The Wrestler," Rourke plays the part of Randy "The Ram" Robinson, a professional wrestler who is now well past his prime, holding on to the remains of a once-famous career, and presented with the opportunity for a comeback. These are circumstances that run more than little parallel to the actor's own life story.

Rourke seemed destined to be a superstar in the 1980's. Most critics agreed that his performances in "Diner" (1982), "Rumble Fish" (1983) "9 ½ Weeks" (1986), and "Angel Heart" (1987) seemed to contain signs that the world was witnessing the appearance of another James Dean or even Robert De Niro.

Unfortunately Rourke's acting career eventually became overshadowed by his personal life and some seemingly eccentric career decisions. Directors such as Alan Parker found it difficult to work with him. Parker stated that "working with Mickey is a nightmare. He is very dangerous on the set because you never know what he is going to do". In addition Rourke began to show the effects of substance abuse. He associated with motorcycle gang members and was involved in several aggressive instances including a charge of spousal abuse (later dropped). Ultimately he virtually disappeared from the cinematic world.

Rourke's career was revived when director Robert Rodriguez cast him in the role of a sinister hit man in "Once Upon a Time in Mexico" (2003). Two years later Rodriguez again called upon him, this time to play Marv, one of the antiheroes from writer-artist Frank Miller's crime noir comic book series "Sin City" (2005). In that film Rourke delivered a unforgettable performance, alternately chilling and amusing, that reminded any doubters that he was still a force to be reckoned with. However to get to this stage in his life Rourke required the intervention of a dog.

The possibility that dogs can produce major psychological and health benefits for their human companions has been a subject of much recent serious psychological research. Scientific evidence about the health benefits of a relationship with a dog was first published about 30 years ago by a psychologist, Alan Beck of Purdue University and a psychiatrist, Aaron Katcher of the University of Pennsylvania. These researchers measured what happens physically when a person pets a friendly and familiar dog. They found that the person's blood pressure lowered, his heart rate slowed, breathing became more regular and muscle tension relaxed-all of which are signs of reduced stress.

A recent study published in the Journal of Psychosomatic Medicine not only confirmed these effects, but showed changes in blood chemistry demonstrating a lower amount of stress-related hormones such as cortisol. These effects seem to be automatic, they do not require any conscious efforts or training on the part of the stressed individual. Perhaps most amazingly, these positive psychological effects are achieved faster-after only five to 24 minutes of interacting with a dog-than the result from taking most stress-relieving drugs. Compare this to some of the Prozac or Xanax-type drugs used to deal with stress and depression. Such drugs alter the levels of the neurotransmitter serotonin in the body and can take weeks to show any positive effects. Furthermore, the benefits that build up over this long course of medication can be lost with only few missed doses of the drug. Petting a dog has a virtually immediate effect and can be done at any time. Recently, researchers extended this research by looking at a group of people aged 60 and older, living alone, except for a pet. Non-pet owners were four times more likely to be diagnosed as clinically depressed than pet owners of the same age. The evidence also showed that pet owners required fewer medical services and were more satisfied with their lives.Mickey Rourke and Loki

Depression was, indeed, Mickey Rourke's problem in the 1990's. In his case when all friends left him he was left with only his dog, for solace. Rourke admits that things had gotten bad enough so that went into a closet with his beloved dog Beau Jack, locking the door and planning to commit suicide with a drug overdose. In the end he just couldn't go through with it because of his relationship to his little Chihuahua-cross dog. Rourke describes the scene saying, "(I was) doing some crazy s**t, but I saw a look in Beau Jack's eyes, and I put the s**t down. That dog saved my life."

Rourke's life took a major turn after these events. He became active in animal welfare issues, including an involvement with PETA and its spay and neutering campaign. He increased the number of dogs in his house, first by adding Beau Jack's daughter, Loki. The depth of his bond to his dogs became obvious when Beau Jack died in 2002. He recalls, "I gave him mouth-to-mouth for 45 minutes before they peeled me off. Depressed? He died at my home, and I didn't go back for two weeks."

Rourke's canine family has continued to grow. He says "I have five now - Loki, Jaws, Ruby Baby, La Negra and Bella Loca--but Loki is my number one." In describing his relationship to Loki he added, "My dog [Loki] is very old, she is 16 and she is not going to be around for long so I want to spend every moment with her. When I was filming "Stormbreaker" in England, I had to have her flown over because I missed her so much. I had to get her from New York to Paris and Paris to England, and also pay for someone to come with her. The whole thing cost about $5,400."

Rourke seems to understand the therapeutic value of dogs. He says of Loki, "She's like a giant Xanax, you know? I'm not going to get religious on your ass, but I truly believe God created dogs for a cause. They are the greatest companions a man could ever have."

So it was that following his remarkable comeback to a successful acting career, and following his rise from the depth of depression, that Mickey Rourke was able to stand in front of colleagues to accept his Golden Globe award. However his speech was different from the others. It not only included references to the contributions and the support of colleagues and professional associates, but also contained the lines, "I'd like to thank all my dogs, the ones that are here, the ones that aren't here anymore, because sometimes when a man's alone that's all you got is your dog, and they meant the world to me."

FOXNews.com - Clinically Depressed Poodle Mauls Former French President Chirac

2009-01-25T19:28:00.001-08:00

Thursday , January 22, 2009

Former French President Jacques Chirac was rushed to a hospital after being mauled by his pet dog who is being treated for depression, in a dramatic incident that rattled the ex-president's wife.

The couple's white Maltese poodle, called Sumo, has a history of frenzied fits and became increasingly prone to making "vicious, unprovoked attacks" despite receiving treatment with anti-depressants, Chirac's wife Bernadette said.

"If you only knew! I had a dramatic day yesterday," she told VSD magazine. "Sumo bit my husband!"

Mrs. Chirac, 74, did not reveal where the former president was bitten, but said, "the dog went for him for no apparent reason."

"We were aware the animal was unpredictable and is being treated with pills for depression. My husband was bitten quite badly but he is certain to make a full recovery in weeks."

Chirac was taken to a hospital in Paris where he was treated as an outpatient and later sent home.

The 76-year-old was president of France for 12 years until 2007.

Beyond Blue: I, Too, Have a Dream

2009-01-21T08:11:00.001-08:00

Monday January 19, 2009

I have a dream that one day I won't hold my breath every time I tell a person that I suffer from bipolar disorder, that I won't feel shameful in confessing my mental illness.

I have a dream that people won't feel the need to applaud me for my courage on writing and speaking publicly about my disease, because the diagnosis of depression and bipolar disorder would be understood no differently than that of diabetes, arthritis, or dementia.

I have a dream that the research into genetics of mood disorders will continue to pinpoint specific genes that may predispose individuals and families to depression and bipolar disorder (like the gene G72/G30, located on chromosome 13q), just as specific genes associated with schizophrenia and obsessive-compulsive disorder have been located and identified.

I have a dream that brain-imaging technology will continue to advance in discovering what, exactly, is going on inside the brain, that a neurological perspective coupled with a biochemical approach to mental illness will develop targeted treatments: new medication and better response to particular medications--that we can cut out that painful trial-and-error process.

I have a dream depressives won't have to risk their jobs in divulging their condition, that employers will respond more empathetically to the country's 7.8 million working depressives, that the general public will be more educated on mental illness so that it doesn't cost this country more than $44 billion each year (like it does now).

I have a dream that families, friends, and co-workers will show kindness to depressives, not reproach them for not being stronger, for not having enough will power and discipline and incentive to get well, for not snapping out of it, for not being grateful enough, for not seeing the cup half full, for not controlling their emotions.

I have a dream that tabloids like "In Touch Weekly" won't lump allegations of Britney Spears' taking antidepressants into the same category as her 24-hour marriage, all-night clubbing, and pantyless photos--that our world might be more sophisticated and informed than that.

I have a dream that people will no longer use the following terms to describe persons with mental illness: fruity, loony, wacky, nutty, cuckoo, loopy, crazy, wacko, gonzo, nutso, batty, bonkers, ditzy, bananas, and crazy.

I have a dream that spiritual leaders might preach compassion to persons with mental illness, not indict them for not praying hard enough, or in the right way, or often enough, and that judgmental new-age thinkers who blame all illness on blocked energy (in chakras one through seven) might be enlightened to understand that fish oil, mindfulness meditation, and acupuncture can't cure everything.

I have a dream that health insurance companies will stop serving Satan, and read a medical report every now and then, where they would learn that depression is a legitimate, organic brain disease, and that those who suffer from it aren't a bunch of weak, pathetic people who can't cope with life's hard knocks.

I dream that one day depression won't destroy so many marriages and families, that better and faster treatment will work in favor of every form of intimacy.

I have a dream that suicide won't take more lives than traffic accidents, lung disease, or AIDS, that together we can do better to reduce the 30,000 suicides that happen annually in the United States, and that communities will lovingly embrace those friends and families of persons who ran out of hope, instead of simply ignoring the tragedy or attaching fault where none should be.

I have a dream that one day depression, bipolar disorder, and all kinds of mental illness will lose their stigma, that I won't have to whisper the word "Zoloft" to the pharmacist at Rite Aid, that people will be able to have loud conversations in coffee shops about how they treat their depression (in addition to the excellent dialogue we have here on "Beyond Blue").

Mostly, I dream about a day when I can wake up and think about coffee first thing in the morning, rather than my mood--is it a serene one, a panicked one, or somewhere in between?--and fretting about whether or not I'm heading toward the black hole of despair. I dream that I'll never ever have to go back to that harrowing and lonely place of a year ago. That no one else should have to either. But if they do (or if I do), that they not give up hope. Because eventually their tomorrow will be better than their today. And they will be able to dream again too.

Uradiance: Survival Techniques for 2009

2009-01-04T16:26:00.000-08:00

SURVIVAL TECHNIQUES FOR 2009

Rochester Post Bulletin: New law equalizes mental health insurance coverage

2008-12-23T09:44:00.001-08:00

By Jeff Hansel
Post-Bulletin, Rochester MN

Insurance that covers 80 percent of the cost for an appendectomy might pay only 50 percent for mental-health care.

After a decades-long battle, that disparity is about to change.

The Paul Wellstone Mental Health and Addiction Equity Act used the $700 billion economic rescue package to gain enough votes. Along with financial rescue came federally mandated insurance equality for people with mental illness.

"Finally it's being recognized," said Pat Schwartzhoff of Rochester, who has experienced depression and talks at school assemblies about mental illness. The bill passed in October and was signed into law by Pres. George W. Bush.

The mental-health equality portion of the bill is just as significant for many people as the Americans with Disabilities Act, which in 1990 banned discrimination against people with disabilities.

Mental illness insurance coverage must now equal coverage for physical illness.

Minnesota's Sen. Paul Wellstone, who died in a 2002 plane crash, fought to pass such legislation, but the needed votes eluded him before his death.

"I am absolutely proud that it's named after my father," said the late senator's son, Dave Wellstone.

The younger Wellstone started working to get the bill passed right after the plane crash that killed his parents, sister and five others.

"We all know somebody with a mental illness or who suffers from addiction," Wellstone said. "This is going to be groundbreaking."

The bill doesn't require that mental health be covered. Instead, it simply requires that, if physical health is covered, that mental health is covered at the same level.

"If it's offered now, then it will have to be brought up to par with the physical illnesses," Wellstone said.

The bill lagged for many reasons, he said. For one, there's a lot of stigma related to mental illness.

"To be able to help leave that legacy that's now in law, it's kind of a way to make sense of things," Wellstone said.

Working for the bill helped him heal.

"When you lose your family, you try sometimes to make sense out of it, and try to have good things happen," Wellstone said.

Pat Schwartzhoff's husband Earl, 64, said he worked as a health-insurance company manager for more than 25 years, supervising, at one point, three states.

"If you have an appendectomy, with most insurance companies, the claim will be handled easily," he said. Not so with mental illness. Two sets of rules exist, one for mental and one for physical health.

"They will quiz you, for lack of a better word. It's like they question the diagnosis of your doctor and you have to jump through so many hoops," Schwartzhoff said.

The new national law takes effect in 2010.

Laura redefines insanity ... and sheds some light on our modern world

2008-12-23T09:17:00.000-08:00

My buddy Laura (or my close personal friend Laura, as I refer to her when I'm trying to bask in reflected glory) writes a fascinating blog about birds called "Laura's Birding Blog" and edits an equally fascinating but whimsical blog called "Twin Beaks" (actually, i think she writes that one, too, but I have learned NEVER to antagonize our local chickadees) when she's not writing books -- or instant messages to me.

This week I happened to share that when you tell IT urchins (the Information Technology students who work at the University where I do) that you have renamed "My Computer" to "Pete," it bewilders them.

Which prompted this thoughtful reply from Laura:

IT urchins are always bewildered. They expect the world to work exactly opposite of the definition of insanity--there is supposed to be a way of analyzing a problem and finding a solution. But computers don't work that way. My computer at work, when it turns on, either has a working cursor or doesn't--you can't predict which times it won't, and all you can do is turn it off and reboot it. And part of the time that works, and part of the time it doesn't. So to make it work one must do exactly the same thing over and over, hoping for a different result.

No wonder IT people are fragile and bewildered.

The Orange County Register: Giant poodles save the day

2008-12-18T16:04:00.001-08:00

The canine versions of Jimmy Stewart and Rita Hayworth help a Santa Ana psychologist work with children.
LORI BASHEDA
The Orange County Register

There I sat on psychologist Amy Stark’s couch with her sidekick Jim sitting practically on top of me. I had only known Jim for a couple of minutes and already his face was so close to mine.

I could smell his breath as he stared hard into my eyes.

Longingly? Wistfully? Sadly? I couldn’t tell.

I wondered what he was thinking. That I was clearly in need of some counseling? Or was he just wondering if I had a can of Purina in my purse?

Jim is a giant poodle.

Standard poodle is the correct name. But Jim is 4-feet tall from his enormous toe pads to his curly head. That’s only a foot shorter than I am. So to me, he’s a giant poodle.

Rita is not as tall as Jim, and more high strung, but she is friendly.

Rita is also a giant poodle.

•••

It was Rita who greeted me when I walked into Stark’s waiting room the other day in Santa Ana.

On the wall hung framed head shots of Jim and Rita with the title: “Employees of the Month.”

And behind the counter, standing on her hind legs, peering out from behind that little window that doctors offices have, was a rather serious Rita, her front paws resting on the counter like she was about to collect a co-pay.

She was taller than me and her head was the size of a human’s. I laughed nervously, but she just stared at me, all business.

Jim and Rita followed me into Stark’s office, which is really too cold a word for what I found. It was more like someone’s cozy living room with sofas and lots of stuffed animals.

“I want this to be a calm place, because we have to talk about some hard stuff here,” Stark says.

A PhD clinical psychologist, Stark gives court-ordered therapy in family reunification and child custody cases. Most of her patients are kids; kids who have been through the wringer and have an easier time trusting giant poodles than humans.

In Stark’s office, the kids let Rita lick their ears and invite Jim to rest his head in their lap.

“Some of these kids come and lay on Jim if they’ve had a hard day,” she says.

Jim tends to go to whoever in the room is upset. If a different person becomes upset, he moves to that person. Basically, Stark says, “if Jim sleeps through a session, we know we’re doing better.”

When Stark’s young patients use puppets to role play, giving her a window into what might be going on in their lives, Rita and Jim are an attentive audience.

“My dogs love to watch puppet shows,” Stark says. “They cock their heads and get really involved. Sometimes they march behind the chair to see the kid and then go back and sit down and watch.”

By the end of a day, they’re exhausted.

•••

At Stark’s home, Jim and Rita unwind on leather recliners in the den. Stark had to teach them to stop reclining because she was afraid they might hurt themselves.

Jim likes to watch TV. “Oh, he loves the Westminster dog show,” she says. “Every year, he watches the whole thing.”

He also likes dramas. But sometimes they upset him. Once, Jim got so worked up over some actors fighting on TV that his baby sitter (Stark was having a garden tour that day) had to turn the station to the gardening channel.

“I gotta say, sometimes I think Jim is not even a dog. It’s like Jim’s a person and Rita is his dog. Like Goofy and Pluto.”

The dogs spend a few weekends a year with a trainer to brush up on their manners so they’re in control at the office. They also get groomed twice a month; the Park Avenue cut. And Stark brushes their teeth twice a week. To keep them healthy, she feeds them Himalayan berry juice, cranberry extract and vitamin supplements with their Purina.

Stark’s first dog was a Boston terrier she got as a child. His name was Princie. “He was a snarly little thing,” she says. And that might explain why she now gravitates to the large dog.

The first dog she bought as an adult was a black standard Poodle she named Greta Garbo. Stark had Greta trained as a therapy dog and together they would visit hospitals and senior homes.

When Greta died seven years ago, Stark drove to Northern California to look over two new litters of giant poodle pups and returned to her home in Floral Park, an English Tudor with English fairy gardens, with Jim and Rita.

•••

Stark initially gave Jim a different name: Spencer, after Spencer Tracy. But he wouldn’t answer to Spencer. So she switched it to Jimmy Stewart. “Plus he’s tall and lanky and very likable like Jimmy Stewart,” she says.

Rita is named after Rita Hayworth. Once while walking Rita in Laguna Beach, a woman overheard Stark call Rita’s name: “Rita Hayworth, come back here!” she shouted. The woman told Stark she had actually been an old friend of Rita Hayworth’s and that her old friend would have been pleased.

As soon as Stark finishes her book about ballroom dancing (she competes at the bronze level), she plans to write a book about Jim and Rita.

“When you think about it, they hear a lot of stuff,” she says.

The book will be stories about them, the kids they’ve helped and the letters and notes they’ve received, some of which are taped to the back of Stark’s office door. “Jim Rocks,” reads one tribute, in crayon.

It won’t be Stark’s first book. She had a book published in 1992 called “Because I said so.” It was about people taking their childhood dynamics into their work lives and the problems that causes. After the book came out, Oprah had Stark on her couch for a show called “Bosses wives who drive secretaries insane.”

Maybe Oprah can have Stark on again.

The show can be called “Giant poodles save the day.”

Contact the writer: dramystark.com714-932-1705 or lbasheda@ocregister.com

SFGate: Brain workout may help anxiety, study suggests

2008-12-18T15:54:00.001-08:00

Charles Burress, Chronicle Staff Writer

Wednesday, December 17, 2008

Could Sudoku be a balm for anxious people?

A new study suggests that intellectually demanding challenges like crossword puzzles or chess may be more successful at keeping worry-prone people from worrying than supposedly relaxing pastimes like watching TV or shopping.

Contrary to theories that "as things get harder, anxious people fall apart, this suggests it's the opposite way around," said UC Berkeley psychologist Sonia Bishop, lead researcher on the study published online this week by Nature Neuroscience.

The study showed that anxious people performed just as well as others when facing tasks that demanded concentration, but they took more time than others to complete tasks that were easier, Bishop said.

Their slower response time to challenges not requiring full attention was accompanied by reduced blood flow to the prefrontal cortex, which serves as the brain's CEO in thinking, planning and active memory.

The study indicated that anxious individuals have a weakened ability to block out distractions and that they might benefit from mindfulness training, which often uses meditation and stress-reduction exercises to help increase one's awareness and focus.

"With some very popular therapies like mindfulness training, people aren't sure why they work," Bishop said. "This perhaps gives us a rationale for why they do."

The results also challenge another explanation for why anxious people face day-to-day problems in concentration and work-related cognitive function, Bishop said. It has been argued that the "fight or flight" response center of the brain, the amygdala, overreacts to threat-related stimuli in anxious people, thus playing a central role in undermining concentration. But the new study suggests that attention-focusing ability in such individuals is impaired even when the amygdala is not extra-active, and thus their difficulties with concentration may be determined by a different mechanism, she said.

The study consisted of simple letter-recognition tests given to 17 volunteers, ages 19 to 48, while blood flow to a section in the front of the brain called the dorsolateral prefrontal cortex was measured by magnetic resonance imaging. The volunteers, seven female and 10 male, were from Cambridge, England, where Bishop did research at the University of Cambridge before becoming an assistant professor at Berkeley in July.

The results were scored according to the difficulty of the tests, including the distraction level of extraneous elements, and correlated to the volunteers' degree of anxiety. Surveys indicate that nearly a fifth of U.S. adults suffer from one or more anxiety disorders in a given year, Bishop noted in the study, titled "Trait anxiety and impoverished prefrontal control of attention."

Stuck: Cut, Then Run

2008-12-14T14:14:00.001-08:00

By Anneli Rufus on December 14, 2008 in Stuck

One poignant thing about the holiday season is all those Ghosts of Christmas, Chanukah and Kwanzaa past: folks who were once essential features around your table or tree but now ... aren't.

Why are they no longer with you? Some are literally gone; they're deceased, and you miss them and mourn them and know you'll never get them back. Others have drifted away. From some friends and relatives, you've grown apart. Yet others ... well, you snipped those bonds for what seemed like good reasons at the time but now you wonder, as the years go by and the gaps around that table or tree increase: Was losing that once-loved one really worth it? What fight was it, what quirk, what offhand remark in the wrong place, at the wrong time?

Sometimes the answer is clear, the moral crime in neon lights, the wound irreparable. She stole my husband. He stole my job. They ridiculed me in front of my children. But other times (most times), when we choose to end a relationship - intimate or platonic or biological - it's because that person insulted us in some way that felt unforgivable. These scenarios are as subtle and diverse as we are. And the trail of burned bridges extending behind us represents one of the trickiest paradoxes in human life: Where do we draw the line between forgivable insults and unforgivable ones, between wounds that will and will not heal? We are told from infancy onward that forgiveness is divine. Yet we are also schooled to sustain sky-high self-esteem, to not abide those who deflate it. Sometimes it's hard to have both. Where do we draw the line between forgiveness and self-abasement, forgiveness and selling out our own souls? At what point can you reliably say that someone has gone too far?

Granted, most people end relationships in stages. They announce that they're upset, they explain why, and the alleged upsetter gets a chance to explain and potentially redeem him- or herself. This either works or not. But at least he or she had a chance. I, on the other hand, am a cut-and-runner. Gone without a trace. Vanishing act. Now you see me, now you don't. I never was the kind to stay and fight. Not that I'm proud ot this: When interpersonal matters reach a certain degree of unpleasantness, rather than talk it out I flee. I always vow to change: Next time, I tell myself. Next time.

But no. I've always been this way. I had a college friend who liked to mock me in public. No sooner would I vouchsafe Gwen a secret than she would announce it at a party in front of everyone.

Guess what, you guys? Gwen would declare, pointing at me. She went to the emergency room in the middle of the night because she thought she had leprosy!

One night at one of those parties I shouldered my backpack, turned and left. This is how it is with cut-and-runners. We reach a saturation point and silently, without warning, flee. Gwen was neither the first nor the last. Cut-and-running is a desperate act and only vaguely punitive. Escape elates one at first, a giggly euphoria as one spends a few days relishing the tingly relief of the survivor. Afterwards - sometimes years afterwards, and often at holidays - regret seeps in. We should have talked. We should have had it out. If for no other reason, then at least to have said: You've hurt me and here's how. A kind of horoscope - if for no other reason, then at least to maybe save others from being hurt somewhere down the road.

This is a core theme in Elizabeth Drummond's intelligently tender new novel An Accidental Light. Two of its main characters are adults long estranged from their parents; after a personal tragedy, each ponders the option of rebuilding those burnt bridges.

How late is too late?

Thea Gilmore: Songs were Thea's way out of depression

2008-12-11T10:45:00.001-08:00

THEA GILMORE

Before the release of Harpo’s Ghost, Thea had been diagnosed with depression. During this time Thea had split with her previous record label and (temporarily) with her long term partner. Prior to Liejacker, Thea was faced with further hard-times when she parted company with her manager of ten years standing, split with her “new” and biggest record label yet after one album - and, almost as if for good measure, gave birth to her first child.

Liejacker is the testament to that journey. It began with Thea still battling off the shadows from her illness, writing her darkest, starkest songs ever. Liejacker also sees Thea at her most direct, “where in the past I’ve probably been guilty of hiding a little bit, falling back on an image or a metaphor - this time I was trying to get to the bone, to just tell it like it is. The genesis of this record was very different from my previous albums. It’s the first album that I’ve really felt a deep burn to make.”

Even whilst making Harpo’s Ghost - perhaps as a reaction to that record’s harder, glossier sheen - Thea spent hours buying up reams of quirky acoustic instruments - old banjoes, harmoniums from India, dobro guitars: and these became the instruments on which the new songs found their home.

The next step was to practically barricade herself in her newly acquired home studio, “Well I say studio... it’s basically a tiny 9 foot square room in my house. I practically had to mount the mike stand on the desk to sing and when I recorded the guitars I’d have to be halfway out the door. But for all the recording oddities, I was making music that was gritty and genuine. The songs kept coming and coming and I was able to record them as they arrived. As a result, I think they have a much less self-conscious feel to them. They are entities in themselves, quite apart from me.”

Thea went beyond merely the writing stage to create musical parts and arrangements herself. Before playing them to producer Nigel Stonier and her team, “The new material was so personal, it told a new story and I wasn’t even sure at first whether I wanted the world to hear that story in quite such direct terms... but the words kept appearing.”

Some of them were positively harrowing; “And You Shall Know No Other God But Me” is a chilling account of the dependencies we all fall prey to at some time in our lives. “The Wrong Side” has a jaunty lope that masks a descent into self loathing and a sympathetic suggestion to her lover that he should jump ship for his own sake and, right at the core of them, “Black Letter”, which has to be the most pithy song about depression since Nick Drake wrote “Black Eyed Dog”.

Just around the corner were the redemptive “Breathe” with its triumphant air of self-acceptance, and “Dance In New York” an exultant ode to the power of longing and the deep need for solid ground. New York takes the role of the eternal lover, arms always open. And then there’s the ethereal “Old Soul”, the album’s first single. Thea wrote the song while 8 months pregnant, and says “I was determined not to turn to mother-mush after having my son. So many people just wait for the fluff to appear in your music as soon as you so much as whisper “pregnancy” and I never really could figure out why. But the concept of “Home” and what it really means to me is a recurring theme in my music, has been for a long time. When I had a child, I really understood what home meant to me. That very deep, primal instinctive warmth for another and the roots that bind you in this life and down every generation to come. That’s my home, and it is eternal.” The metaphysical search is there in the lyric for all to interpret.

And ultimately, there’s the bonding force that both pulls the album’s themes together and also closes the record. “The Lower Road” is an almost unbearably moving peaen to hard won victories, to endurance and forgiveness. It begins with a racist lynching, references the grim shadow of the war in Iraq and everyday domestic abuse, in amidst insisiting that “We will be rolling on”. Not exactly “You’re Beautiful” then. The song closes with perhaps Thea’s finest words yet:

“There’s no telling which way, boys,
This thing is gonna take hold
From the fruit on a poplar tree
To the bruise round a band of gold
From the blood in a far country
To the war of just growing old
We travel a lower road
It’s lonely and it is cold
But we will keep rolling on...”

Emerging from the home studio with her new store of songs, Thea chose to leave the performances untouched - and that’s how many of them appear on the final record. Hence many of the original vocals remain, hence the groove on ‘The Wrong Side “ comes from a cutlery drawer, grill pan and a chimney hood rather than orthodox drums and.hence any guitar solos on the record are by Thea herself.

But having brought the material into her favourite studio, the Loft in Liverpool, and for good measure adding a couple of new tunes to the pot, Thea then called upon some of her favourite kindred spirits. Erin McKeown added vocals to ‘Dance In New York”, and Waterboy Steve Wickham was invited to play fiddle on “The Lower Road.” Zuton-in-chief Dave McCabe duetted on “Old Soul” and unearthed magical, hitherto unheard soft tones to his bluesy voice. Thea was then left with the task of finishing “The Lower Road”, whose narrative is told in several different voices: she delivered “Liejacker”s last trump card by inviting the legendary Joan Baez - a long term fan with whom she has toured the US - to duet on the song. “Joan Baez practically invented my job some forty odd years ago - I can’t think of anyone else on the planet with the voice, the presence and the standing to carry this off.” Not only was Joan pleased to be asked, but she fell in love with the song and has recorded it now for her own forthcoming album.

So Liejacker, born of the darkest beginnings, ends with positives abounding. The mood remains stark and acoustic, with celloes, dulcimers and ukeleles adding colour here, texture there. “Old Soul”, chosen as the first single sets the record in motion with its quest for the truest of truths - and “The Lower Road” closes it. The album is thus framed by guest appearances with an arena filling indie rocker and an iconic folk singer/activist: but while the compliment paid implicitly by their involvement is indicative of the esteem in which Thea Gilmore is held, the songs and the story of Liejacker are solely the work of one pen and one voice, Thea Gilmore. According to Mojo she remains “the most coherent and literate of singer/songwriters”. Liejacker is a beautiful piece of work that will only enhance the evolving legend.

Ventura County Reporter : Uncomfortably numb

2008-12-11T07:33:00.001-08:00

Mental health, illness and wellness in Ventura County

By James Scolari 12/11/2008

Last week my aunt found herself crying in a restaurant for no reason that she could discern, and found that she couldn’t stop. She was with her husband of nearly four decades, a man whom she loves, and their life is good — they raised four daughters, all of whom have more kids than I can count, every one of them well and whole and hale. The bills are paid; by nearly any measure she is blessed, and yet there she sat, in the Olive Garden, unable to stop crying. As I loaned a sympathetic ear to her malaise, I couldn’t help but hear the strains of Pink Floyd, of Roger Waters singing from the landmark album Dark Side Of the Moon:

The lunatic is on the grass
The lunatic is on the grass
Remembering games and daisy chains and laughs
Got to keep the loonies on the path.

It’s not that I minimized or failed to understand her distress; in point of fact, I understood her too well — even if impromptu, irrational tears strike me as, well, a little nuts, though it feels as if it’s more about the age than about her life.

If there was an age that could broker nameless malaise without tangible source, it would be this one.

People often refer to others of good sense or emotional stability as being “well-adjusted,” which connotes a subtext that looks, upon examination, rather dire. Adjusted to what, I wonder — to the generalized, de rigeur madness of a world that evolved more in service of commerce, power and busy-ness than humanity? Fearing that might construe an intuitive leap into a logical abyss, I consulted an expert.

“The term ‘well-adjusted’ suggests a stable personality that can dynamically adjust to life’s vagaries,” offers Matthew Bennett, Psy.D., of the Ventana Center for Psychotherapy. “It’s not an easy thing to build a self — it’s a vastly more difficult endeavor than most realize. The structure of a personality must be flexible and consistent and sustainable, in the face of what are the often-extreme demands of an unpredictable world and its inhabitants. While most of us seem to manage it,” he concludes, “we do so with more difficulty than is apparent to the casual eye.”

Read the full article ....

Minnesota Spokesman-Recorder: Penetrating the isolation of mental illness

2008-12-11T07:29:00.001-08:00

by Susan Budig

Minnesota Spokesman-Recorder

Reaching those who need help requires dispelling old prejudices

Like a lot of kids, Ramon gave his folks trouble. And like any earnest parent, Lanice Palmer-Cole tried various methods to rein him in. She thought she knew her son well, although he was “different.” Palmer-Cole says, “He was a deep, deep thinker.” She felt hopeful that her son would grow up to be a productive member of society.

But then a significant thing happened to this Detroit family and “Ramon lost his mind,” Palmer-Cole tells us in a confessional voice, speaking for the first time in public as she narrates the story of her mentally ill son.

Last Thursday evening, December 4, while most people were hunkered down in their homes, a couple dozen concerned citizens braved the bitter cold to gather at United Church of God and Christ in St. Paul. They came to hear the stories of those grappling with mental illness and to network with one another as webs were woven in an effort to catch those individuals, especially those within communities of color, who too often fall through the cracks.

Read the full article ....

Financial Post: Margaret Trudeau to write about struggle with mental illness

2008-12-11T07:25:00.001-08:00

Paul Gessell, The Ottawa Citizen Published: Wednesday, December 10, 2008

Mike Carroccetto, The Ottawa Citizen

OTTAWA - Margaret Trudeau is writing a memoir, to be published in the fall of 2010, detailing her many years struggling with bipolar depression.

News of the forthcoming book was announced Wednesday by Ms. Trudeau's Toronto-based publisher, HarperCollins Canada.

"The memoir, intended to guide and inspire others suffering from mental illness, will also describe in some detail how the Canadian medical system helped her and where it fell short," according to a statement from HarperCollins.

Iris Tupholme, vice president, publisher and editor-in-chief of HarperCollins, says the former wife of the late Pierre Trudeau will be offering "a very honest, very candid account" of her battle with a mental illness that affected her and those close to her.

"This is a brave and compassionate book - one that will remain an important part of the Canadian consciousness for years to come," Ms. Tupholme says. Ms. Trudeau, while the prime minister's wife in the 1970s, publicly acknowledged that she had sought psychiatric treatment for "severe emotional stress," but not until 2006 did she publicly describe herself as suffering from bipolar disorder. She has since lent her name and profile to educating the public about mental illness. Her efforts have been recognized. She won the 2008 Lectureship Award from the College of Family Physicians of Canada. She sits on the University of British Columbia's Mental Health Institute Executive Advisory Board and will receive the 2009 Humanitarian Award from the Society of Biological Psychiatry in May 2009.

Ms. Trudeau, 60, has written two other autobiographical books, both of a kiss-and-tell nature. Beyond Reason and Consequences dealt with her rocky marriage to Mr. Trudeau, the initial years after their 1977 separation and various romantic adventures after leaving 24 Sussex. The Trudeaus had three sons, Justin (currently a Montreal MP), Alexandre (a Montreal film-maker) and Michel (who was killed in an avalanche in British Columbia in 1998).

After divorcing Pierre in 1984, Margaret married Ottawa businessman Fried Kemper. They had two children, Kyle and Alicia. That marriage also faltered. Ms. Trudeau now lives in Montreal.

While still in Ottawa, Ms. Trudeau volunteered with various charitable organizations and frequently appeared in gossip columns.

In an interview in 2007, she said she wanted to help others who "feel so helpless they consider suicide because they don't think there's any way they're going to get off the (bipolar) roller-coaster."

There are, in fact, ways to get off that roller-coaster, she said.

"You can get off if there is good treatment and medical science has come a long way in the last 10 or 15 years to create drugs and therapies that really help you to achieve balance."

FOXNews: Japan Princess' Mental Depression Improving, After 5-Year Absence From Public Eye

2008-12-11T07:21:00.001-08:00

TOKYO —
Japan's reclusive and troubled Crown Princess Masako said Tuesday that her health is improving and she is feeling more able to take part in social activities.

Her father-in-law, Emperor Akihito, is also suffering from stress and inflammation of the stomach, the Imperial Household Agency said Tuesday. Akihito, who turns 75 later this month, had surgery for prostate cancer in 2003.

Masako, who married Crown Prince Naruhito in 1993, has skipped much of her duties in the last five years, mostly because of stress-related symptoms and mental depression.

"My performance still is not at its best, but I'm beginning to feel I'm now able to do more things, little by little," she said in a statement for her 45th birthday on Tuesday.

Royal doctors said Masako has made "steady progress" over the last two years, and is starting to resume public appearances, including welcoming Spanish King Juan Carlos and his wife, Queen Sofia, last month — her first participation in an official event in five years.

But they warned she remains unstable and needs rest.

"The biggest reason for her condition is that she has unpredictable ups and downs in her physical and mental condition," the doctors said in a statement Tuesday.

Though she was reportedly feeling better mentally, the Imperial Household Agency said Masako canceled meetings Tuesday with the Emperor and the Empress, as well as palace officials, because of a fever and sore throat associated with a cold.

Speculation about Masako's health has become a staple of the Japanese media. Some tabloid magazines and newspapers have criticized her for lavish dinners and shopping outings while missing her official duties.

Although Masako has been seen on nationally televised news shows attending family events at her 7-year-old daughter Aiko's school, she has skipped formal events that are standard fare for Japanese royalty, such as greeting guests, attending charities and making overseas trips.

Public expectations for Masako, a former diplomat and Harvard graduate, were high from the moment she became engaged to Naruhito, with many hoping she would be a role model for the modern Japanese woman.

The couple's failure to have a son has put a great deal of pressure on the princess as only sons can inherit the country's Chrysanthemum Throne. Masako had a miscarriage before giving birth to Aiko.

Rigid and insular palace life is also believed to have contributed to her mental illness.

Science Daily: Depression Treatment: Mindfulness-based Cognitive Therapy As Effective As Anti-depressant Medication, Study Suggests

2008-12-07T16:42:00.000-08:00

ScienceDaily (2008-12-02) -- Research shows for the first time that a group-based psychological treatment, Mindfulness Based Cognitive Therapy, could be a viable alternative to prescription drugs for people suffering from long-term depression. In this study, MBCT proved as effective as maintenance anti-depressants in preventing a relapse and more effective in enhancing peoples' quality of life. The study also showed MBCT to be as cost-effective as prescription drugs in helping people with a history of depression stay well in the longer-term.

Read the full article ...

Santa Barbara Independent: Tender Hearts, Tender Times

2008-12-07T16:38:00.001-08:00

Goleta Church Helps the Grieving Through the Holidays
By Elena Gray-Blanc

Sunday, December 7, 2008

For most, the holiday season is one of cheer. For others, most notably those who have suffered a loss — be it the death of a loved one, a divorce, or other trauma — Christmas, Hanukkah, the New Year, and all the attending merriment can be insult added to injury, a constant and contrasting reminder of grief.

Reverend Erika Hewitt, minister at Live Oak Unitarian Universalist Congregation in Goleta, has set out to provide a comforting, open, and pressure-free environment for anyone in the community who might be grieving, and is holding a “Tender Hearts, Tender Times” service on Sunday, December 14.

“Sometimes,” Hewitt said in a recent phone conversation, “the merriness gets forced down our throats… That first Christmas [after a loss], people lose their bearings. They don’t know how it’s ‘supposed’ to be. [Live Oak] is creating space to acknowledge that.” And what makes Rev. Hewitt’s service so special is that it is just and only that — an acknowledgement of trouble and grief, without any pressure to share a story or emote. “I don’t ask questions,” she said. “And we’re not going to go around the circle and talk about it.”

Read the complete article ...

Science Daily: Depression Treatment: Mindfulness-based Cognitive Therapy As Effective As Anti-depressant Medication, Study Suggests

2008-12-01T05:11:00.000-08:00

Depression Treatment: Mindfulness-based Cognitive Therapy As Effective As Anti-depressant Medication, Study Suggests

ScienceDaily (2008-11-30) -- Research shows for the first time that a group-based psychological treatment, Mindfulness Based Cognitive Therapy, could be a viable alternative to prescription drugs for people suffering from long-term depression. In this study, MBCT proved as effective as maintenance anti-depressants in preventing a relapse and more effective in enhancing peoples' quality of life. The study also showed MBCT to be as cost-effective as prescription drugs in helping people with a history of depression stay well in the longer-term. ... read full article

Reuters UK: Sick leave for mental illness linked to early death

2008-12-01T04:19:00.000-08:00

By Amy Norton

NEW YORK (Reuters Health) - People who need to take time off from work for a mental health problem may live shorter lives than those in better psychiatric health, a new study suggests.

Researchers found that among nearly 20,000 French workers they followed, those who'd taken at least 1 week's sick leave for a mental health disorder had a higher death rate over 14 years.

At the outset, 41 percent of the workers -- all public utility employees -- had taken at least 1 week's sick leave over the past 3 years. Those who'd taken time off specifically for depression or other mental health disorders were one quarter to one third more likely to die over the study period than workers with no mental-health absences.

"Basically the message is that workers with medically certified absences for mental diagnoses should be considered a population at a higher risk of fatal disease," lead researcher Dr. Jane E. Ferrie, of the University College London in the UK, told Reuters Health.

She stressed, however, that the findings point to a relatively higher death rate in this group as a whole -- and that does not mean that any one person with a mental health disorder has an unusually high risk of early death.

When studies observe large populations over time to look for patterns, the results cannot be used to "infer risk at the level of the individual," Ferrie explained.

The findings, published in the Journal of Epidemiology and Community Health, are based on 19,235 public utility employees (5271 female) who were part of long-range health study. The researchers used employment records to verify any medically certified work absences the employees had between 1990 and 1992. (French law requires workers to get a medical certificate from their doctors for each day of sick leave.)

Between 1993 and 2007, there were 902 deaths among the study participants. Those who'd taken 7 days or more off from work for a mental health disorder had a higher risk of death, even when their age and type of job were taken into account.

With the exception of extreme cases, mental health problems do not, in themselves, kill people, Ferrie pointed out. Instead, she explained, poor mental health is often connected to poor physical health.

On one hand, physical conditions may lead to depression or other mental health problems, Ferrie noted. On the other, psychiatric conditions may directly impair physical health, possibly by affecting the nervous and hormonal systems.

SOURCE: Journal of Epidemiology and Community Health, November 25, 2008.

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globeandmail.com: Psychiatry: A specialty relegated to the basement

2008-11-29T04:12:00.000-08:00

CAROLYN ABRAHAM
November 24, 2008 at 8:52 PM EST

Jai Shah could have been any sort of doctor he wished. Even before he graduated with honours from the University of Toronto's medical school, the 30-year-old Edmonton native had earned a master's degree in international health policy from the London School of Economics, published papers and worked for the Canadian Institutes of Health Research.

Praise follows him wherever he goes. Except for last fall – when he decided to specialize in psychiatry.

“A psychiatrist?” some of his supervisors said, “But you're smart! … You're taking the easy way out … Your patients will make your life hell … Your patients will make you depressed … What a waste of talent!”

Dr. Shah knew mentally ill people battle both their disorders and the social stigma their conditions carry. But it surprised him that psychiatrists confront a certain stigma, too.

“I'm sure the feedback has discouraged some young doctors from choosing this as their career,” said Dr. Shah, now at the Harvard Longwood Psychiatry Residency Training Program in Boston.

In fact, Susan Abbey, who heads the U of T first-year residency program in psychiatry, said the disparaging comments are “ubiquitous.”

“I don't think there's one of our incoming residents who hasn't been exposed to negative comments from family or friends or academic supervisors,” Dr. Abbey said.

Just as lawyers can face a barrage of bottom-feeder jokes, psychiatrists, both in film and real life, have long been seen as doctors of a lesser science. Even their own physician colleagues can view their patients as difficult and time-consuming. The negativity, experts say, is contributing to a national shortage of psychiatrists and shoddy care for mentally ill people.

Across the country, Canadians are unable to see a psychiatrist when they need one. A survey from the B.C.-based Fraser Institute released last month suggests the national median waiting time for psychiatric care this year is 18.6 weeks, longer than for any physical treatment.

A Canadian Psychiatric Association survey has found that even in emergency cases – where the CPA recommends a patient be admitted for acute care within 24 hours due to a “high degree of risk to self or others” – delays in some regions range from 57 hours to nearly five days.

“It's the patients who doubly suffer from the stigma,” Dr. Shah said. “First, from the social perception of their illness and then, on top of it all, from the shortage of treaters, and the gaps in care reflect the stigma within the medical profession and that contributes [to the social perception]… so it's a vicious circle.”

Studies suggest these attitudes take a toll on medicine's front lines: Mentally ill people have a tougher time finding a family doctor, are more likely to need urgent medical care and less likely to receive life-saving treatments. They're also more likely to die of conditions such as heart attacks, strokes and cancer.

At the same time, funding for mental-health research and psychiatric services has paled compared with monies doled out for physical ailments. Mental illness, meanwhile, is the No. 1 cause of disabilities in Canada and accounts for 20 per cent of all hospital admissions.

The inequities are so apparent that the Mental Health Commission of Canada has made it a top priority to fight stigma among health-care professionals, and this year the Canadian Medical Association, which represents the country's doctors, has launched a campaign to combat the stigma within its ranks.

“Doctors will be inclined to see mental illness differently than other medical illnesses … it's not like a broken bone, you don't see it clearly,” said CMA president Dr. Robert Ouellet. “We feel mental illness has not received its fair share of attention.”

Read more ...

The Independent: Nervous breakdown: Happy survivors

2008-11-27T04:25:00.000-08:00

Anyone can have a nervous breakdown – high-flyers included. But it doesn't have to mean the end of a contented life, says Sophie Morris

Out the other side: Emma Mansfield's bipolar condition makes her prone to frenetic activity and slumps

At 25, Emma Mansfield was a poster girl for successful young women. She lived in Bristol and loved her job as a producer of natural history programmes, which allowed her to travel all over the world. She had also met and fallen for a wonderful new boyfriend. She was in the pink, you might say, so the last thing she was expecting was to be dragged down into the deep blue storm of a nervous breakdown. "It was like somebody had pulled a rug out from under me," she remembers, eight years, another nervous breakdown and spells of clinical depression, psychosis and time in hospital later. "I didn't know what the hell was happening to me. I'd feel like I was being sucked down in this vortex, like in Harry Potter where the death-eaters suck out your soul."

The term "nervous breakdown" is neither medical nor scientific, but a shorthand for someone who can no longer cope in their normal life, explains Phillip Hodson, of the British Association for Counselling and Psychotherapy (BACP). "It describes someone who has gone through the tipping point. They have gone from stress and distress, to an over-stressed situation. It's the difference between, 'I'm very uncomfortable but I'm managing' to 'I'm so unhappy and fraught that I'm not functioning.'" Not functioning might manifest itself in strange behaviour such as stepping out in front of buses, flaring up at other people, having suicidal thoughts or going into states such as a trance, catatonia or gibbering."

Mansfield's breakdown unravelled over a few days. "I looked around me," she says, now 33, "and thought, I'm living in a city I don't know. I don't know many people. I don't go walking or riding any more. I don't have mates I can go for a cup of tea with or down to the pub with. This isn't very balanced. I had a dream I was being asphyxiated and made a decision that I had to deal with it."

A diagnosis of clinical depression followed and she suffered suicidal thoughts for a week. After undergoing a lot of therapy and a year on antidepressants, Mansfield realised her tale fitted the notorious pattern of too much, too soon, too quickly. "I was an extremely high flyer at a young age," she admits. "I think it all caught up with me. I came out of education and thought, well, life should be easy now. Actually, it's not. Life becomes even more challenging and complex."

Although Mansfield sought help early on, many sufferers of nervous breakdowns feel too ashamed to admit they are experiencing difficulties. Mental illness has a stigma, and admitting to one can be tantamount to scoring one's reputation with an indelible black mark. When well known personalities admit to struggling, the subject is demystified. More useful than clarifying a confusing topic, though, is the message that it is OK to have a breakdown, and that you can recover. It is not a life sentence.

Stephen Fry has spoken openly about his breakdown, a painfully public collapse when he walked out of a play in 1995 and disappeared for weeks. In Stephen Fry: The Secret Life of the Manic Depressive, he interviewed other sufferers including Carrie Fisher, Richard Dreyfuss, Robbie Williams and Jo Brand.

More recently, Alastair Campbell revisited his own breakdown of 1986, in the BBC programme Cracking Up. One interviewee was Ruby Wax, another of the few brave enough to speak out about depression and anxiety.

Why did Fry tip over when he was in a successful play? Mansfield was similarly flying high when crisis struck. She now believes the comfort of a loving relationship provided her with the space to confront issues she hadn't worked through, which presented themselves as depression. She comes from a supportive family and had suffered none of the physical, emotional or sexual abuse that often leads to mental illness, though she had sought counselling at university. "I always knew there were things I needed to work out," she explains, "such as taking everything very much to heart. I was open, but also quite vulnerable."

"Experiencing a nervous breakdown was terrifying – especially because I didn't know what had caused it. My breakdown was physical, emotional and psychological, it was as though my mind went into an enormous spin while my body, particularly my nervous system, was coping to process the incredible sensory and physical assault which accompanied the experience. I felt extremely anxious and fearful. I couldn't eat. I couldn't think. I was confused, disoriented and hyperventilating. I lost a lot of weight."

Mansfield confronted her deteriorating situation head on, switching her job and busy lifestyle for the countryside and a new job. First, though, she went to recuperate at her family home in Essex.

Eight long months there made her even more determined to move on with her life. "I knew I had to get to grips with my mental state and focus on what I wanted next."

She chose Cornwall as the place she could best "get to grips" with her state of mind. It was familiar from childhood family holidays. "The sea and the fresh air were what I needed more than anything."

Cornwall suited her. She had found Bristol isolating and overwhelming and she missed the sense of community and belonging of living in a small town or village. She found a job as an arts administrator at the Eden Project, and threw herself into the role. She discovered she was far more creative than a television career had allowed her to realise, but her dedication proved too much, leading to a second breakdown in the spring of 2006, much more serious than the first.

"It was a complete and utter nervous collapse," she recalls. "I couldn't eat or sleep for four or five days." She was admitted to hospital for five days and sedated, giving her space to calm down. "It is terrifying when you lose your mind. You think you know who you are and what you're doing, and all of a sudden your mind goes into spin drive. I experienced paranoia and psychosis."

"Psychosis," explains Phillip Hodson, "is where you may not be responsible for your actions. The obvious psychoses are things such as schizophrenia, mania and bipolar disorder."

In May, 32-year-old barrister Mark Saunders was shot dead by police after firing his shotgun from his Chelsea home. Last June, a Spanish insurance executive, Alberto Izaga, plunged into such a psychotic meltdown that he battered his two-year-old daughter to death. It is possible that both men were experiencing episodes of psychosis as part of a nervous breakdown.

Campbell entered a psychosis after a period of heavy drinking, where he thought he was being tested on his actions, and saw everything as part of this test. He was arrested and admitted to hospital, where he was heavily medicated. The episode left him depressed, but he rebuilt his life. He is proof that a nervous breakdown is a heavy burden, but not a life sentence.

Despite her experience of mental illness and knowledge of counselling and therapy, both as a patient and student, Mansfield had not seen her own burn-out coming. "I think I'd had enough," she says, as if she did nothing more but collapse on the sofa. It is her bipolar condition that makes her prone to frenetic activity – mania – followed by depressive slumps. "I'm very driven and self-disciplined," she observes, "so sometimes I don't realise how much energy I put into things until I need to go and lie down for two weeks."

One such exhausting undertaking is Mansfield's new book, The Little Book of the Mind, a touching and informative encyclopaedia of mental illness, which attacks the stigma around diseases of the mind. It follows The Little Book of Cornwall, about her adopted county.

Mansfield advises anyone who thinks they might be experiencing some sort of mental illness to visit their GP and get the six free therapy sessions on offer, though she admits that most problems take much, much longer to resolve.

Mansfield thinks herself lucky, because she found the resilience to fight her illnesses. She has left the Eden Project and works with young people, coaching them to write for the local newspaper, runs several choirs and arranges music. She can walk her dog in the fresh air whenever the mood takes her. "It all depends," she says, "on whether you think you can change your life."

'The Little Book of the Mind' is published by Lovely Little Books, £6.99. Available in Waterstone's

Ambigamy: Thanksgrieving: Cheer up 'cause it's downhill from here (a musical op-ed)

2008-11-26T03:01:00.001-08:00

By Jeremy Sherman, Ph.D. on November 25, 2008 in Ambigamy

When we're down, people sometimes try to cheer us up with reminders that other people are much worse off than we are. Comparing misfortune to good effect also applies to our future selves. We should all cheer up because compared to who we'll be in our declining years we're doing great. Along with AARP cards, one perk senior citizens get is the occasional amusement of consoling some youngster who is distressed to be growing so old. I wrote this song after just such an experience, me at 51 consoling a 36 year old who was distressed about aging.

Enjoying the happiness we get depends upon our ability to manage our interpretation of wellbeing as either a complement to, or substitute for future happiness. If my happiness today is a complement to happiness tomorrow--if it sets up an expectation that I'll be happy then because I'm happy now-then unhappiness tomorrow will be disappointing. If my happiness today is a substitute for happiness tomorrow--if it sets up an expectation that I might not be happy tomorrow then I won't be as disappointed. Happy today I like to remind myself that when I'm old I'll be able to look back and say, "I had my turn."

Buddha is often interpreted as saying that you should work to have no expectations, which, to me makes no sense. Expectations are absolutely essential to life. It's all about expectation management. So here's my Thanksgrieving gift (see last years at loving ingratitude) an uplifting ditty for us, the temporarily-abled.

Here I sing it and play a seven-string fretless bass solo along with my four piece virtual jazz combo: http://www.mindreadersdictionary.com/downhillfromhere.mp3

Downhill from here

Sure your things are sagging
You can see you're in decline
A glimpse into the mirror shows
The ravages of time

Just remember that compared to now
the future's looking sour
And looking back in decades
this will have been the finer hour.

At the rate that things are going
yes our future looks austere
Cheer up ‘cause it's downhill from here.

If you notice your ability
To jump and skip is slipping
And much of your agility
Is going, don't be trippin'

Compared to 20 years from now
You're agile and you're well
Viewed from future wheelchairs
Today you're a gazelle.

At the rate that things are going
Yes, our future looks austere
Cheer up ‘cause it's downhill from here.

I'm a forward thinking pessimist
It makes my days much brighter
Tomorrow will be heavier
today is therefore lighter

Life's decline is certain
Of what's left this time's the best
Enjoy it now it's bound to be
much better than the rest

If the crowd is suffocating you
in the rat race to success
and your edge is always slipping
and you cannot take the stress

Just remember that the pile of product's
only getting deeper
And your grandkid's competition
will certainly be steeper.

At the rate that things are going
our futures looks austere
Cheer up ‘cause it's downhill from here.

ABC News: Florida Teen Live-Streams His Own Suicide

2008-11-25T15:47:00.001-08:00

Abraham Biggs, 19, Was Egged On by Fellow Bloggers, Cops Say
By EMILY FRIEDMAN

Nov. 21, 2008 —

A Florida teenager who used a webcam to live-stream his suicide Wednesday was reportedly encouraged by other people on the Web site, authorities told ABCNews.com.

"People were egging him on and saying things like 'go ahead and do it, faggot,' said Wendy Crane, an investigator at the Broward County Medical Examiner's office.

Abraham Biggs, 19, of Pembroke Pines, Fla., had been blogging on an online body-building message board and had linked to his page on Justin.tv, a live video streaming Web site, where the camera rolled as he overdosed on prescription pills, according to Crane.

Biggs, who had reportedly been discussing his suicide on the forums, also posted a suicide note on a body-building forum, which has since been taken down, in which he wrote, "I hate myself and I hate living."

"I have let everyone down and I feel as though I will never change or never improve," Biggs wrote in the posting. "I am in love with a girl and I know that I am not good enough for her. I have come to believe that my life has all been meaningless. I keep trying and I keep failing. I have thought about and attempted suicide many times in the past."

The video and blog postings have since been removed from the sites, but Crane, who has seen both, said that at first viewers thought the suicide was a hoax.

"The bloggers said that Biggs had threatened to kill himself before and had faked it, so at first they didn't believe him," said Crane. "Gradually, as you read the blog further into the day the bloggers start commenting on how Biggs isn't moving."

Crane said comments on the thread included an exchange about whether the image of Biggs' motionless body was a still photograph or a video, and eventually resulted in one of the site's visitors calling the police, who tracked down the teen through his computer IP address.

According to Wired magazine, online viewers watching the video ranged from "OMG" -- Internet slang for oh my god -- and LOL -- an abbreviation for laughing out loud.

Blog Posts

On a blog where Biggs wrote about his suicidal thoughts, which has since been removed, commenters wrote, "hahaha hahahahha hahahahahah ahhaha." Wired reported that someone else wrote: "Instant Darwinism ..." to which a fellow commenter wrote: "f**king a nicely put." Others called the teen a "coward," "faggot" and a "dick."

In the Web stream, Crane said viewers saw a piece of a door frame -- which had splintered from the police kicking in the teen's bedroom door -- hit Biggs, who is curled up on his bed and facing away from the camera.

"Then you see a police officer go in and check on him, and then the EMS pronounced him dead," said Crane.

Biggs was pronounced dead at 3:30 p.m. Nov. 19 -- about 12 hours after he had begun blogging about his suicide.

The official cause of death was suicide combined with drug toxicity. Crane said that benzodiazepines and opiates were found near the body, but a blood toxicology to quantify just how much Biggs consumed is still under way.

Crane said that at least one of the prescription drugs was in Biggs' name.

Michael Seibel, the CEO of Justin.tv, posted a blog entry on the site titled "A Moment of Silence."

"Justin.tv staff would like to take a moment to recognize and reflect upon the tragedy that occurred within our community today," wrote Seibel. "We respect the privacy of the broadcaster and his family during this challenging time."

Reached by telephone, Biggs' father, Abraham Biggs Sr., told ABCNews.com that he was shocked to learn of his son's death.

"He was a good kid. Everyone knows him," said Biggs. "We live together and everything was fine -- I'm so surprised."

Biggs' father was not home at the time of his son's suicide, and the father told ABCNews.com that he was not aware that his son used Justin.tv.

Biggs had struggled with depression, according to his father, and had been prescribed medication for bipolar disorder. Benzodiazepine is commonly prescribed as a sleep aid or an anti-anxiety medication.

Even so, Biggs had been "doing better," according to his father and had been attending daily classes at Broward College, where he was pursing a career as a paramedic.

Internet Provides Outlet to Suffer in Public

"I am upset that Justin.tv streamed this live," said Biggs. "I have not seen it, and I do not intend to look at it.

"There seems to be a lack of control as to what people put out on the Internet," he said. "There's a lot of garbage out there that should not be, and unfortunately, this was allowed to happen."

David Griner, a social media strategist for Luckie & Company, said that while public deaths are not new, online chatrooms provide an especially accessible forum for those debating suicide.

"The social Web tends to create a sideshow atmosphere, like public executions in the 1700s," said Griner. "The anonymity and lack of personal connection bring out the worst in people."

Griner points out that there have been several other online suicides, and some have been faked as well.

In February 2008 a girl who identified herself only as "90 Day Jane" wrote an anonymous blog chronicling the days leading up to her death. The blog turned out to be a hoax, and "Jane" later described it as an "art project."

The United Kingdom had an online suicide in March 2007, when 42-year-old Kevin Whitrick hanged himself while others watched. According to the BBC, some onlookers tried to stop him while others urged him on.

"The explosion of high-speed Internet access in the past few years has made it so that almost anyone can broadcast a live video in front of a global audience," said Griner. "It's impossible for sites like Justin.tv to monitor everything that's going on, so that puts the burden on the community to help stop bad things from happening."

Griner believes that those who encourage suicidal people are simply a sad reality of an unrestricted World Wide Web. Even so, some potential suicides are prevented on the Internet as well.

"You'll always have the morbid jerks who yell 'Jump!' when someone's on a rooftop, and you'll always have people threatening suicide in a public venue," said Griner. "And while it's easy to focus on the abundance of bloodthirsty trolls online, the bright side is that the Internet also gives more decent people the opportunity to intervene and try to save a life."

"Most times, they just need someone to talk to, and the Internet is the only forum they have."

ABC 7 News : Family outraged, distraught over teen's cyber suicide

2008-11-25T15:43:00.001-08:00

The family of a college student who killed himself live on the Internet say they're horrified his life ended before a virtual audience, and infuriated that viewers of the live webcam or operators of the Web site that hosted it didn't act sooner to save him. Only after police arrived to find Abraham Biggs dead in his father's bed did the Web feed stop Wednesday - 12 hours after the 19-year-old Broward College student first declared on a Web site that he hated himself and planned to die.

"It didn't have to be," said the victim's sister, Rosalind Bigg. "They got hits, they got viewers, nothing happened for hours."

Biggs announced his plans to kill himself over a Web site for bodybuilders, authorities said. He posted a link from there to Justin.tv, a site that allows users to broadcast live videos from their webcams.

A computer user who claimed to have watched said that after swallowing some pills, Biggs went to sleep and appeared to be breathing for a few hours while others cracked jokes.

Some members of his virtual audience encouraged him to do it, others tried to talk him out of it, and some discussed whether he was taking a dose big enough to kill himself, said Wendy Crane, an investigator with the Broward County medical examiner's office.

Some users told investigators they did not take him seriously because he had threatened suicide on the site before.

Eventually, someone notified the moderator of the bodybuilding site, who traced Biggs' location and called police, Crane said. The drama unfolded live on Justin.tv, which allows viewers to post comments alongside the video images.

As police entered the room, the audience's reaction was filled with Internet shorthand: "OMFG," one wrote, meaning "Oh, my God." Others, either not knowing what they were seeing, or not caring, wrote "lol," which means "laughing out loud," and "hahahah."

His father, Abraham Biggs Sr., told The Miami Herald he didn't want to watch the video.

"We were very good friends," he said. "It's wrong that it was allowed to happen."

An autopsy concluded Biggs died from a combination of opiates and benzodiazepine, which his family said was prescribed for his bipolar disorder.

"Abe, i still wish this was all a joke," a friend wrote on the teenager's MySpace page, which he described himself as a goodhearted guy who would always be available for his pals, no matter what time of day.

In a statement, Justin.tv CEO Michael Seibel said: "We regret that this has occurred and want to respect the privacy of the broadcaster and his family during this time."

It is unclear how many people watched it happen. The Web site would not say how many people were watching the broadcast. The site as a whole had 672,000 unique visitors in October, according to Nielsen.

Biggs was not the first person to commit suicide with a webcam rolling. But the drawn-out drama - and the reaction of those watching - was seen as an extreme example of young people's penchant for sharing intimate details about themselves over the Internet.

Montana Miller, an assistant professor of popular culture at Bowling Green State University in Ohio, said Biggs' very public suicide was not shocking, given the way teenagers chronicle every facet of their lives on sites like Facebook and MySpace.

"If it's not recorded or documented then it doesn't even seem worthwhile," she said. "For today's generation it might seem, 'What's the point of doing it if everyone isn't going to see it?'"

She likened Biggs' death to other public ways of committing suicide, like jumping off a bridge.

Crane said she knows of a case in which a Florida man shot himself in the head in front of an online audience, though she didn't know how much viewers saw. In Britain last year, a man hanged himself while chatting online.

Miami lawyer William Hill said there is probably nothing that could be done legally to those who watched and did not act. As for whether the Web site could be held liable, Hill said there doesn't seem to be much of a case for negligence.

"There could conceivably be some liability if they knew this was happening and they had some ability to intervene and didn't take action," said Hill, who does business litigation and has represented a number of Internet-based clients. But "I think it would be a stretch."

Condolences poured into Biggs' MySpace page, where the mostly unsmiling teen is seen posing in a series of pictures with various young women. On the bodybuilding Web site, Biggs used the screen name CandyJunkie. His Justin.tv alias was "feels_like_ecstacy."

Bigg described her brother as an outgoing person who struck up conversations with Starbucks baristas and enjoyed taking his young nieces to Chuck E. Cheese. He was health-conscious and exercised but was not a bodybuilder, she said.

"This is very, very sudden and unexpected for us," the sister said. "It boggles the mind. We don't understand."

Anger in the Age of Entitlement: Emotional Abuse (Overcoming Victim Identity)

2008-11-18T14:24:00.000-08:00

By Steven Stosny in Anger in the Age of Entitlement

In terms of your health, happiness, and deepest values, one of the worst things that can happen is to live with a resentful, angry, or emotionally abusive partner. The worst thing you can develop, in terms of your health, happiness, and deepest values, is an identity as a victim.

Victim identity destroys personal power and undermines the sense of self. It makes you falsely identify with "damage" done to you or with bad things that have happened to you. The cry I hear over and over again from those who live with resentful, angry, or emotionally abusive partners is, "I don't like the person I've become."

Once emotional abuse occurs in a relationship, it becomes necessary not only to stop the abuse but to overcome victim identity through a strong identification with your inherent strengths, talents, skills, power, and appreciation of the self as a unique, ever-growing, competent, and compassionate person. This is accomplished through an emphasis on healing, growth, and empowerment, not by reviewing checklists of behaviors that qualify you as a victim or by reading lengthy descriptions of the resentful, angry, or abusive behavior and attitudes of your partner.

Detailed descriptions of your possible symptoms or of your partner's angry, abusive behavior are not only unnecessary for your recovery, they can cause harm by encouraging victim identity. If you live with an abusive person, you know better than any self-help author or advocate that your relationship has put thorns in your heart. You don't need a description of the thorns to know how much they hurt. You need to learn how to take them out and heal the wounds in ways that prevent scarring.

Perhaps the most insidious thorn in the heart that comes from living with a resentful, angry, or emotionally abusive partner is the feeling that you cannot be well until your partner changes. This understandable but tragic assumption is the first thorn you must remove from your heart. You deserve to heal and grow, whether or not your partner does.

Although a sense of fairness and justice tells you that your abusive partner ought to be the one to make changes, your pain tells you that you need to become the fully alive person you are meant to be. (Pain is not a punishment; it motivates behavior that heals, improves, and protects.) This means that you have to remove the focus from your partner and put it squarely on you. Renewed compassion for yourself will lead directly to a deeper compassion for your resentful, angry, or abusive partner. With that compassion you will demand meaningful, lasting change, for you will appreciate the enormous harm he does to himself when he hurts you. One of two things is likely to result from your reclamation of self and your compassionate demands on your abusive partner. You may be able to stop walking on eggshells and step into a deeper relationship with a more compassionate, loving partner. But if he chooses not to do the hard work of breaking abusive habits, for his sake, for the sake of your children, and for your own sake, you will no longer tolerate his resentful, angry, or abusive behavior. From your core value, you will stop walking on eggshells, one way or the other.

As you experience the enormous depth of your core value, the last thing you will want to do is identify with being a victim, or a survivor, for that matter. You want to outgrow walking on eggshells, not simply survive it, and you do that only by realizing your fullest value as a person.

In Practice: Chicken and Egg

2008-11-18T14:20:00.001-08:00

By Peter D. Kramer in In Practice

Does depression cause brain differences, or do brain differences cause depression? A scientist whose past research pointed to the latter conclusion has just published findings that reverse the direction.

The prevailing contemporary model for depression suggests that in vulnerable people, repeated stress gives rise to adverse changes in the brain; depression is itself a stressor. The primary evidence for this hypothesis comes from rodent studies, where early deprivation and later mild stress cause what look like mood changes - and shrinkage in areas of the brain that correspond to our hippocampus and prefrontal cortex. Human studies have tended to be correlational: patients who have suffered more days of mood disorder have more differences in brain volume. These findings are ambiguous. Perhaps a person with a small hippocampus is more prone to depression.

Evidence for the second theory, in which small hippocampal size creates vulnerability, came from the laboratory of the German psychiatrist , Thomas Frodl. He found that over the course of a year, chronic depression did not predict hippocampal change, but small hippocampal size predicted chronicity of depression. That's what makes a new study particularly intriguing. Looking now at a three-year interval, Frodl has found that depression does lead to loss of volume in critical regions of the brain.

The study contrasted 38 patients hospitalized for depression with 30 matched controls and used MRI scans coded by new software technology that distinguishes changes throughout the brain, not just in areas pre-selected by researchers. Over the next three years, the patients, and not the controls, showed a "decline in gray matter density" in the hippocampus, prefrontal cortex, and elsewhere. There was no part of the brain where the depressed patients showed increased volume or density. Patients whose mood disorder had remitted showed less volume decline. Overall, Frodl concluded, this prospective study in humans supports the findings from animal models in which stress and depression-like disorders cause brain change.

In the just-published study, antidepressants did not have a separate effect - it was getting better that conferred some protection. But the month before, in September, Frodl contributed an analysis showing that in some patients who took antidepressants for the whole of three years "hippocampal volumes increased significantly." A critical interactive factor may have been hippocampal size at the start of treatment. (It should be said that this study had a high attrition rate; its conclusions are necessarily speculative.) In the September paper, Frodl concluded that "a relatively small hippocampal volume may be a vulnerability factor for a bad treatment response in major depression."

Both may be true: depression attacks the hippocampus, and a small hippocampus impairs resilience. In Against Depression, I wrote that the evidence favored this combined hypothesis - so the theory is not new. But Frodl's current research does point to movement in the field toward the conclusion that depression or stress in the presence of depression injures the brain. That model suggests a need for vigorous early intervention and extended treatment. Recovery seems to offer some protection. Although the evidence is hardly clear-cut, long-term antidepressant use may as well.

Quirky Little Things: Imposter!

2008-11-18T14:14:00.001-08:00

By Jesse Bering, Ph.D. in Quirky Little Things

I don't know what it says about me that as a thirteen-year-old boy my favourite television show was The Golden Girls, but like many fans I was saddened earlier this year to learn of the death of Estelle Getty, who played the sassy Sicilian octogenarian Sophia Petrillo in this long-lived series. Given her obvious talent and inimitable delivery on screen, you might be surprised that Estelle Getty felt like a fraud as an actress. Here's what she said in a 1988 interview with Entertainment Tonight:

"I'm awed every day of my life. I think, this is Bea Arthur, this is Betty White. This is a big hit #1 show in the country. I'm afraid. I live with fear as a constant companion. Can I do this week after week? Am I good enough? Will I be able to pull it off this week? Will I be able to fool them again? And every day I'm a little scared. And every Friday I'm scared out of my wits. I keep thinking, I can't believe I'm in this. Wait till they find out I can't do it."

Now, I've never been on an '80s television series, nor has my name been stitched into the fabric of popular culture as a beloved character actress, but I have a pretty good sense of what Estelle Getty is talking about here. Years ago I interviewed for a position on the faculty of psychology at Harvard University. My selection committee comprised Steven Pinker, Susan Carey, and Elizabeth Spelke and in terms of stature in the field of psychological science, Pinker is something like the equivalent of Bea Arthur and Carey is a good analogy for Betty White. (Comparing Spelke to Rue McClanahan requires a bit more shoehorning, but you get the idea.) One of the reasons I botched the interview was because I couldn't get over the fact that I'd actually pulled this much off. I mean, come on, these are all-star celebrity researchers, bona fide superheroes of psychology who'd achieved posterity. And I'm a third-rate academic from Ohio who'd cavalierly graduated at the bottom of his high school class, earned a PhD from a university most people have never heard of, and who'd been toiling away in obscurity at the University of Arkansas as an assistant professor. Like Estelle Getty at her initial casting call, I felt like a charlatan, a ruse, a fake at Harvard. An impostor. Actually, I suspect I was, since in the end they didn't offer me the post.

But what Estelle and I describe is a psychological experience known as the impostor phenomenon (IP), defined by Georgia State University psychologists Joe Langford and Pauline Clance as, "believing that one's accomplishments came about not through genuine ability, but as a result of having been lucky, having worked harder than others, or having manipulated other people's impressions." Here are some more basic facts about IP:

• Impostors attribute their successes to attributes unrelated to the actual talent required for their success, such as personal charm or attractiveness. Some people who experience IP are especially prone to 'chameleon-type' behaviours, modifying their attitudes and actions in ways that foster approval from onlookers. (I inherited from my salesman father a rather chronic but often disingenuous smile, which seems to have a mind of its own.)

• Although early research suggested women are more likely than men to feel like impostors given the lower expectations of success for the former, subsequent studies revealed no difference between the sexes. However, IP appears to express itself differently in men and women. Women tend to be less "playful" (doing things just for fun) and less sociable. Female impostors are also usually extra cautious and averse to risks, whereas men who experience IP tend to score high in impulsivity, express a strong need for change and a low need for order. (Suffice it to say that I've bought and sold 7 houses over the past 4 years and I haven't balanced my check book since 1994.)

• People who experience IP don't simply have low self-esteem in general, but only negative feelings about the self in relation to their particular area of success. And introverts - who are often shy, anxious and lacking in confidence - are more likely than extroverts to feel like phonies, presumably because they're less expressive and more prone to keeping their 'private self' hidden from others. (You may think you know me....)

• When impostors do fail, their reaction displays a stereotypical pattern: they withdraw from the task, blame themselves for the failure, and experience anxiety and shame. Impostors often need to come across as smart or intelligent in front of an audience; women impostors view intelligence as a fixed entity (either one's clever or not, no room for argument) rather than a malleable quality.

• An impostor's sense of worth and importance is unusually dependent on others' feedback. (This one reminds me of 17th century Baroque painter Caravaggio, a bad-tempered genius who allegedly once tore up one of his masterpieces at a slight word of criticism.) Langford and Clance say that impostors "have a strong need to protect themselves from narcissistic injury."

• Impostors often resort to self-deprecation and avoid the attention of others. (Have I told you yet how much I dislike myself? In any event, I hope you're not reading this.)

Estelle Getty wasn't an impostor, of course. She was a brilliant, Emmy-Award winning actress. I suspect deep down I'm not entirely a phony either, though if were to begin talking about my successes I'd just turn my own stomach with nauseating lines of braggadocio, and if there's anything I can't stand more than an impostor, it's a braggart. Ugh, it's a no-win situation for us impostors, isn't it.

Beliefnet.com: 10 Ways to Transform Toxic Thoughts

2008-11-18T09:29:00.000-08:00

If you've ever felt the way anger or fear can electrify the atmosphere in a room, you'll know what Sandra Ingerman means by 'toxic thoughts.' The author, a family therapist and shaman practitioner, believes our thoughts and emotions transmit an invisible but palpable energy that can affect our mental and physical well-being. 'Psychic punches,' she writes, are as real as physical violence.

Click here for ten simple ways to protect yourself from negative thoughts and learn to radiate positive energy.

Text by Sandra Ingerman, adapted from her book, 'How to Heal Toxic Thoughts: Simple Tools for Personal Transformation'"

Time: Defending Nebraska's Child Abandonment Law

2008-11-18T08:19:00.001-08:00

By Karen Ball / Lincoln

Nebraska never wanted the attention that came with the heart-wrenching reports of sobbing children at hospitals and desperate parents leaving kids, little ones and unruly teenagers alike, under the state's new "safe haven" law. "We were being ridiculed every day," says state Sen. Dianna Schimek of Lincoln, "but I have no apologies because something good will come of this. We uncovered something that we need to address. And it's not just Nebraska — it's widespread."

The Nebraska Legislature's Judiciary Committee met in a special session Monday to begin rewriting a law that has resulted in an epidemic of abandoned children — some parents driving from Florida, Arizona and Georgia to leave off their problem kids. Most states allow a parent to leave an infant at a fire station or hospital without fear of prosecution, but because Nebraska's law did not define "child," 34 kids have been dropped off at Omaha hospitals since September. None were infants. The rest of America was stunned. But, as the special session proceeded, some legislators defended the intent of the law.

While Gov. Dave Heineman is pushing to limit a rewritten law to newborns of 72 hours, some lawmakers argue the abandonments have exposed an urgent need to fix gaping holes in state mental health services, which they claim fail to assist families with little resources to help problem children. Sen. Annette Dubas introduced an alternate bill that would retain "safe haven" for parents with kids age one to 15 through June 2009, so that the Legislature could address the broader issues come January. "Do not forget those struggling families," she urged her colleagues.

Some lawmakers were angered at what they see as a callous response from Heineman's administration — that state welfare agents appear to be accusing parents of too easily abdicating responsibility. "It's been very disturbing, how judgmental you've been," Sen. Amanda McGill scolded the state's Health and Human Services chief, Todd Landry. "You've had plenty of time to make these judgmental statements to the press" but not to return phone calls from desperate parents, she said. Landry argued that the state offers many lifelines, that services are available. "So all a parent has to do is call a hotline?" Sen. Steve Lathrop asked skeptically. "What is the harm," he asked repeatedly, of allowing distraught parents to bring older kids in?

But the voices that appear to have won the day were those of the abandoned. "I'll be good — I'll be good, I promise," one child begged as the mother walked away, Ann Schaumacher of Immanuel Hospital in Omaha told the Judiciary Committee. "It is not the right place for relinquishment to occur," Schaumacher said of the emergency room abandonments. Some hardened adolescents show no emotion at all, she recalled. An older teen was left by a mother who simply said, "I can't do it anymore." "These children will never be the same, and that's the tragedy of this law," said Schaumacher, who, like most hospital representatives, argues that the law should be limited to newborns and infants.

Near the end of a four-hour-plus hearing, Lyman "Scott" Wostrel gave a grown man's choked testimony of the experience of abandonment. His mother gave him up at 14, he said, in urging lawmakers to limit the law to newborns. "It doesn't matter what a person says. The action speaks — I don't love you. Any kid can figure that out," he said.

At the end of the work day, the Judiciary Committee voted to send a measure to the floor of the full unicameral legislature on Tuesday and Wednesday that amended the governor's bill to extend the law to children as old as 30 days. (Some legislators wanted the limit to be as much as a year or more.) Chairman Brad Ashford said he expected vigorous debate and further amendments. A 24-hour cooling off period will then go in effect before a final vote comes Friday.

Even though Governor Heineman is likely to have the law pared back to apply only to infancy, the broader issue of childhood mental illness did have its hearing. A majority of the kids abandoned had a history of mental illness — 90% of the parents or guardians had sought state services for them before. Many had at least one parent in jail. One big hole in the safety net, said Dr. Jane Theobald, an Omaha psychiatrist and representative for the Nebraska Psychiatric Association, is that there are simply not enough facilities for troubled youngsters. A teenager who attempts suicide might stay at a general medical hospital for days, waiting for an opening in a mental health facility that may or may not come. "I've sent kids out of state or four hours away for a bed. That's typical, not the exception."

Lawmakers sympathetic to the parents and guardians of older, troubled children note that Omaha is, after all, home to the original Boys Town of Father Flanagan fame. In the city, there's a statue of one young boy carrying another on his back, with the words chiseled underneath, "He ain't heavy, Father, he's m' brother." During the Great Depression, parents would scrape together bus fare and hang a sign, "Take Me to Boys Town,' around their child's neck. Tysheema Brown, the Atlanta woman who drove 1,000 miles to Omaha to drop off her 12-year-old son, had been taken to Boys Town herself as a teenager. She had tried to get a spot for him in a similar Georgia institution for six months and failed. On that long drive she reportedly told her son what was happening; she reasoned later he would not hate her because she believes she is sparing him from a jail cell.

Father Steven Boes, president of Boys Town, didn't bother to attend Monday's hearing because he thinks little can be done on the big issues of mental health. He says he'll be back in Lincoln in January "to strike while the iron is hot" when legislators are scheduled to debate privatizing behavioral services for troubled adolescents. Meanwhile, Boes had good news for Tysheema Brown. The priest said he's working with Georgia alumni to get her housing and find her son a spot, hopefully in Omaha.

Don Marquis: "The Lesson of the Moth"

2008-11-16T11:19:00.001-08:00

By Don Marquis, in "archy and mehitabel," 1927

i was talking to a moth
the other evening
he was trying to break into
an electric light bulb
and fry himself on the wires

why do you fellows
pull this stunt i asked him
because it is the conventional
thing for moths or why
if that had been an uncovered
candle instead of an electric
light bulb you would
now be a small unsightly cinder
have you no sense

plenty of it he answered
but at times we get tired
of using it
we get bored with the routine
and crave beauty
and excitement
fire is beautiful
and we know that if we get
too close it will kill us
but what does that matter
it is better to be happy
for a moment
and be burned up with beauty
than to live a long time
and be bored all the while
so we wad all our life up
into one little roll
and then we shoot the roll
that is what life is for
it is better to be a part of beauty
for one instant and then cease to
exist than to exist forever
and never be a part of beauty
our attitude toward life
is come easy go easy
we are like human beings
used to be before they became
too civilized to enjoy themselves

and before i could argue him
out of his philosophy
he went and immolated himself
on a patent cigar lighter
i do not agree with him
myself i would rather have
half the happiness and twice
the longevity

but at the same time i wish
there was something i wanted
as badly as he wanted to fry himself

archy

MSNBC.com: Pacemaker for brain may ease mental illness

2008-11-13T03:00:00.001-08:00

MSNBC.com
Obsessive-compulsive symptoms improved, but some had major side effects
The Associated Press

NEW YORK - The same kind of deep brain stimulation used to treat some patients for Parkinson’s disease also helped a few people suffering from obsessive-compulsive disorder, French scientists reported.

Their study involved only 16 patients, but in four of them, symptoms nearly disappeared. However, many patients had serious side effects, including one case of bleeding in the brain.

The treatment involved an experimental brain pacemaker, and it reduced repetitive thoughts and behaviors in some of the patients — just as it blocks tremors for some Parkinson’s sufferers.

Read more...

The Last Psychiatrist: Those Five Days Matter More Than Anything, Except The Other Days

2008-11-12T16:42:00.001-08:00

Guys, remember that time when you were 24 and you were on the subway, and you saw that girl with the glasses reading a book wearing a black leather coat, and you were obsessing over whether to go up to her or not but then your stop came, and you were like, screw it, she'll probably mace me, so you got off and went to the library to study for your chem exam?

You chose wrong.

In the Atlantic appears First Person Plural, an article about the growing evidence that identity is more complex than a simple collection of traits and beliefs.

The view I'm interested in... accepts that brains give rise to selves that last over time, plan for the future, and so on. But it is radical in that it gives up the idea that there is just one self per head. The idea is that instead, within each brain, different selves are continually popping in and out of existence. They have different desires, and they fight for control--bargaining with, deceiving, and plotting against one another.

Examples from the article include the hidden zero effect, in which choices are made differently depending on how far in the future are the payoffs. We can't imagine well who we will be in that future, so we choose what is better for the person in the now.

Personality also changes according to situation; even the most thuggish teenager is not the same around his buddies as he is when having tea with Grandma.... In the 1920s, Yale psychologists tested more than 10,000 children, giving them a battery of aptitude tests and putting them in morally dicey situations, such as having an opportunity to cheat on a test. They found a striking lack of consistency. A child's propensity to cheat at sports, for instance, had little to do with whether he or she would lie to a teacher.

With rare exception (of personality structure), who we are has a lot to do with what's going on at that moment. Hence the Nausea-- the feeling when you understand that there is no "you"-- at any moment you can decide to do or be anything. You didn't murder that guy because you're not a murderer. You didn't murder him because, well, it didn't come up.

II.

Yet there are an abundance of studies showing character traits are inherited; that behaviors are often predictable; and our own daily experience that there is at least a common thread to our identity. What of that?

Bad faith. It appears there's a commonality because, simply, we are not tested. But, more accurately, one is never tested; only parts of his identity are tested at a time. That's why the loving family man who then becomes a Nazi is still a loving family man-- that part was never strained. He is a good person and a bad person. Multiple selves.

The question is not whether traits are heritable-- they are-- the question is what self you are going to let dominate.

III.

Here's an example, from Barron's:

But such gloomy sentiments aren't a reason to get out of the stock market... Consider that $1 invested in stocks from February 1966 through May 2007 would have grown to $16.58 in that period. That's a 7% annual return.

Awesome, and by awesome I mean what a complete waste of one's life.

Somehow people demote investment income over any other kind of income. It's important to go to work every day, or clip a coupon, but it is nigh impossible to people to open a Roth. The money, I guess, doesn't seem real.

That's money; but if I grabbed the average teenager and told him his life and happiness would grow at 7% a year, he'd probably kill himself. 7% to the young is basically telling them not to even bother. To be young means you still have hope, that your energy and talents will eventually payoff, in a big way. The difference between a mature adolescent and an immature adolescent is not their expectation of massive success-- they both think they're going to rule the world-- but how they see it happening. Mature kids see a steady climb to awesomeness; immature kids see it happening one day, all at once, at some arbitrary point in the future. I know this because I see them in Starbucks, laptops open, staring out the window. I was one of those kids, too.

7% a year financial growth isn't good, it's a pacifier, a hoax (it serves, therefore, the same social function as psychiatry.) Furthermore, it can be wiped out in one week. If you bought and held over the past ten years, you made nothing. It was all a waste. Don't believe me? Go ask a retiree.

And you shouldn't accept 7% growth in your life, either. Every day must be a struggle for self-improvement in the service of improvement of the world.

IV.

Well, it turns out it is much worse than all that. Barron's again:

By contrast, investors who were out of the market in the five best days each year during that span were left with only 11 cents.

The implications for money management are obvious, but for life they're nauseating: if you take out the five most significant days of each year, then you are basically a completely different person. By money analogy, taking out those five best days made you massively worse off. You would have been better off not even going through the year. Studying for the chem exam always seems like a good idea, but there's an opportunity cost. And you have to measure that opportunity in real time, because in retrospect it will be too late.

The old generally think themselves exempt from this, but they are not; a day can alter their entire existence and legacy. November 4 will change how we remember John McCain forever. Nothing beside remains.

Who you are is a product of your experience, and also a product of the experiences you did not have. You didn't talk to that girl, now that's part of you-- you are the guy who was too scared/angry/self-absorbed/whatever to talk to her, and that is an entirely different guy then the guy who does talk to her and it works; and an entirely different guy from the one who gets maced. That was one of the most important days of your life, and you didn't even know it. Which brings me to the real point: every day is the most important day of your life, and you don't even know it.

there are worse things than
being Alone
but it often takes decades
to realize this
and most often
when you do
it's too late
and there's nothing worse
than
too late.

-- Charles Bukowski

Stress Remedy: Nothing to Fear, but Fear Itself?

2008-11-12T16:30:00.001-08:00

By Jay Winner, M.D. in Stress Remedy

Now
is a perfect time to reflect on FDR's first inauguration speech - when
the economic situation was far worse than it is now (excerpts as
follows):
"This great Nation will endure as it has endured, will
revive and will prosper. So, first of all, let me assert my firm belief
that the only thing we have to fear is fear itself-nameless,
unreasoning, unjustified terror which paralyzes needed efforts to
convert retreat into advance..." "In such a spirit on my part and on
yours we face our common difficulties. They concern, thank God, only
material things... Only a foolish optimist can deny the dark realities
of the moment. Yet our distress comes from no failure of substance. We
are stricken by no plague of locusts. Compared with the perils which
our forefathers conquered because they believed and were not afraid, we
have still much to be thankful for... We now realize as we have never
realized before our interdependence on each other; that we can not
merely take but we must give as well..." (When you get the chance, I
recommend you read the whole speech here.)

Timely messages from this great speech include:
1. This great nation will endure as it has through all sorts of extreme challenges.
2. Fear itself is a key factor in making the economic problem worse.
3. Despite the hard economic times, we have much to be thankful for. (See my previous post Investing in Stress Reduction for more info on this.)
4. We must stand together to solve the problems.

Many people are living in fear that is made worse by constant
consumption of news media. I am not a financial expert, so I would not
presume to know the future course of our economy. (The financial
experts, on the other hand, can correctly predict market direction
almost 50% of the time.) We do, however, need to look at the
motivations of the media who advise us. Keep in mind that one of the
main goals of media is to keep you consuming it. If you quickly change
the channel to another station, they don't make money. Watching people
talk about financial "concerns" will likely not keep your eyes glued to
the tube as much as talk of a financial "crisis."

Since
this is a psychology blog, let's look at one more aspect of "the only
thing to fear is fear itself." What is the fear of fear? In the extreme
it can cause variety of psychological problems. For instance, people
with agoraphobia may be so afraid of having a panic attack that they
limit their activities. At its worst, a person with this disorder, may
be too fearful to leave his house.

This fear of fear speaks to an issue pertinent to us all. It is an
example of a what in Dialectical Behavior Therapy is called a secondary
emotion. When an event happens, we may have a primary emotion. For
example, if you break up with a significant other, you may have the
primary emotion of being sad. If you think that you shouldn't be so
sad, you may get sad about being sad. Being sad about being sad, angry
about being angry, or fearful of being fearful are all examples of
secondary emotions. These secondary emotions may prolong feelings of
sadness, anxiety and anger. To avoid being stuck in any of these
emotions, let go of thoughts of how your primary emotion should be
different. Welcome how you feel, and the primary emotion relatively
quickly comes and goes.

As we accept our feeling of fear, the fear does not last as long.
Fear is an embodiment of our ancient fight-or-flight response. The
adrenaline is released from our adrenal glands and heightens ones
ability to physically react. This adrenaline response can be
experienced in a number of ways including fear and worry. This fear and
worry can be thought of as "distress" or bad stress. The adrenaline
response can also be experienced as excitement or enthusiasm which can
be thought of as "eustress" or good stress.

Interestingly, if you say the word "eustress' out loud, it sounds a
lot like "use stress." Indeed, by using the adrenaline, you can convert
the distress to eustress. When you feel stressed, you can try relaxing
to classical music. Alternatively, let go of thoughts of how you should
feel different, and then use the energy to rock out to the Black Eyed
Peas! Even if you don't use the additional adrenaline to dance or run,
you can enjoy the feeling of it flowing it through your veins!

Heeding to FDR's great words, will help you weather these difficult financial times.
Learning to experience your primary emotions without resistance, will help you weather all sorts of emotional storms.

Jay Winner, M.D. is the founder of the Stress Reduction Program at Sansum Clinic

and the author of Take the Stress Out of Your Life: A Medical Doctor's Proven Program to Minimize Stress and Maximize Health.

The Mystery of Happiness: Self-love precedes the love of others

2008-11-12T16:25:00.001-08:00

By T. Byram Karasu, M.D. in The Mystery of Happiness

T. Byram Karasu, M.D. is Silverman Professor of Psychiatry at Albert Einstein College of Medicine.

Self-love is benign self-compassion, not malignant self-centeredness, which unfortunately we call narcissism. Narcissism refers to a metaphor that describes a particular state of mind in which the world appears as a mirror of the self. It is used as an expression of unprincipled self-preoccupation. Even at that level of reading, as Thomas Moore says, "Narcissus falls in love with his image [and] discovers by his own experience that he is lovable." We tolerate better, and in fact find warmness in, such self-love when we see it in children.

This positive view of the myth of Narcissus tells a story of transformation through self-love. The word narcissism derives from the classical Greek myth, in which the main character, a youth called Narcissus, falls in love with himself. The child, in fact, is so beautiful that not only he but everyone else is in love with him. In his self-absorption, he is unable to relate to anyone, never mind being able to love another. The closest he gets to anyone is to a nymph (ironically called Echo), who can only repeat what she hears. She becomes a mere voice reflecting him. Isolated and unengaged, he gazes at his own image in the water and yearns only for himself. As he reaches down to touch his reflection, he disappears into the abyss of the waters of the river Styx. Ultimately what remains in his place is a flower, a yellow-centered daffodil with white petals--The narcissus. Although Western psychology generally interprets the myth as Narcissus drowning in his own pathology, in fact the story has less to do with being destroyed by one's self-preoccupation than with the ultimate salvation inherent even within the most desperate of us. It is the story of transformation from one form of nature to another-a boy who becomes a flower. In such a transformation, the boy becomes a part of a larger whole.

In self-love, there is a potential for being part of the whole. In this sense, self-love engenders a feeling of union with the rest of nature. It is a mutual self-love, a form of communion among the creatures. This is a merciful self-love, healthy narcissism and, far from being pathological, it is very much needed as a basic ingredient for attachment to and love of others.

From The Art of Serenity

Mind over natter ... sorta ...

2008-11-11T18:05:00.000-08:00

Going through a breakup.

It hurts.

Racing thoughts ... obsession sessions ... ruminating ... the whole deal.

Aha, think I -- I should be practicing mindfulness.

So I picture myself lying on soft, green grass of a quiet field.

I picture my thoughts and feelings as soft, puffy clouds ... just moving across the blue, blue sky. Try letting them appear ... and move across the sky ... and disappear, unjudged ... untouched by me....

Suddenly, the clouds begin to change shape. They become ... airplanes ... airplanes with the rotund contours of World War II planes in Warner Brothers cartoons. More and more clouds become airplanes ... and then they start dropping bombs on me -- hundreds of tiny bombs falling from the sky and exploding all around me as I lie on the grass.

Hmmm, I think. That's pretty funny. Not particularly mindful, granted, but still, actually pretty funny.

Then I remember what my therapist said the last time we talked. What should I do, I asked, when I am trying to sit with thoughts and feelings without following them ... but without running away from them, either?

Ask yourself, he said, What do I need to do to take care of myself right now?

Answer: laugh.
Answer: invent funny methaphor to impress therapist.
Answer: Remember to ask the question.

Done and done.

Medical News Today: Serious Mental Illness Linked To Increased Risk Of Stillbirth And Newborn Deaths

2008-11-10T17:55:00.001-08:00

Mothers with any form of serious mental illness are more likely to have children who are stillborn or who die within the first month, finds research published ahead of print in the Archives of Disease in Childhood (Fetal and Neonatal Edition).

But the links between the causes of stillbirth and newborn death depend on the type of mental illness the mother has, the research shows.

The researchers looked at 1.45 million live births and 7021 stillbirths over a 25 year period from 1973 to 1998 in Denmark, to investigate links with serious mental illness.

But the chances of stillbirth and newborn death from any cause were considerably greater for babies whose mothers had been admitted to hospital for mental illness at any point before the birth of their child, than mothers who had never been admitted.

Read more .....

The Sydney Morning Herald: Depression's silent victims

2008-11-10T17:51:00.001-08:00

November 8, 2008

One Saturday, a few months before the mental collapse that would end John Brogden's political career, the then NSW opposition leader and his wife decided they were overdue for some family time, so they scheduled a day's outing.

"We got picked up by the car and driver," Lucy Brogden recalls. "John and the driver sat in front. There was me in the back with the baby seat, and a staffer on the other side."

Then began a bizarre South Coast road trip that started with an official morning tea at Sylvania. It progressed to lunch with Liberal Party people at Cronulla - for Mr Brogden. Mrs Brogden fed her toddler son and ate in the car with the driver. Next it was on to Kiama for afternoon tea with dignitaries, before a dinner in Nowra, with party people again.

When Mrs Brogden looks back on the mounting intensities of the time, she always returns to that day in early 2005 - its ugly caricature of leisure a telling portrait of her complicity in their unsustainable life. She was, she says, like the classic boiling frog: as the water gradually heated up around her, she found her stress threshold climbed higher than she could have imagined.

Her husband was bingeing on work, overeating then consuming nothing but Diet Coke for up to week at a time, and alternating extreme sleepiness with phases of insomnia. It could not have been clearer that he had big problems. There were times of relative normality but over the years the situation escalated. "I could see he was spiralling out of control," Mrs Brogden says. "But that's part of the issue people have. They're losing their own self-awareness.

"The more I pushed him, the deeper he went into denial … a young outwardly successful man … to put up his hand and say, 'I think I'm depressed, I think I'm suffering from a mental illness' - it's a pretty big call."

The partners of people suffering from psychological disorders are a new frontier in the work of depression groups, amid growing recognition of the immense effect of the condition on their lives, and the role they can play in helping their loved one recover.

Graeme Cowan, a survivor of depression, earlier this year conducted a survey of 351 people caring for a mentally ill partner or relative, recruited through the websites of Sydney's Black Dog Institute, beyondblue and the Queensland Alliance of Mental Illness and Psychiatric Disability.

Top of their list of concerns were feeling rejected by their depressed love one, the negative effect on their sex life, exasperation and a desire for the person to snap out of it, and feeling that the loved one was no longer the person they thought they knew.

They also complained that their role was poorly acknowledged. Few formal resources were aimed at carers and there was a reluctance by some doctors to discuss the situation with anyone other than the patient.

Read more ...

BBC NEWS: Depression treatment trial launch

2008-11-10T17:41:00.001-08:00

Ruby Wax on Mindfulness

Hundreds of volunteers are being urged to take part in trials for a treatment for depression known as Mindfulness.

Comedian Ruby Wax says she benefited from the techniques, which is explained as a way to teach people to approach their problem in a different way.

She has visited Bangor to speak about it, and universities in the Gwynedd town and Oxford are joining forces to seek 150 volunteers from each area.

It is claimed the treatment could also help people with chronic pain.

"The way in which we react to stressful or emotional situations we face can cause further stress," said Rebecca Crane, director of training at Bangor University for Mindfulness Research and Practice.

"Mindfulness is effective in reducing this extra layer of difficulty and struggle," she added.

"The acceptance of pain reduces the struggle we experience around the pain and so reduces the stress.

"This can often have the effect of reducing the actual experience of pain," she added.

Professor Mark Williams from the University of Oxford (and formerly Bangor University) said people suffering from depression could learn skills to stay well.

Early signs

"Sir Winston Churchill famously described it as his 'black dog'", he said.

"People who have had one major attack of depression are more likely to experience further episodes.

"Our research, however has shown that they can learn skills to stay well," he added.

Key to this was recognising the warning signs early enough, and then be able to stand back and not be sucked in by negative feelings, he said.

"It takes some effort to learn how best to do this, but it can be done," he added.

Ruby Wax said of her experience: "Under stress the only way I can reduce my anxiety, both physically and mentally, is by practising Mindfulness.

"My heart rate lowers, I can breathe again and my mind becomes clear so I can deal more effectively with the situation," she added.

Anyone interested in taking part in the trial is invited to contact either Bangor University or the University of Oxford.

washingtonpost.com: It Isn't About the Trash Can

2008-11-10T17:36:00.001-08:00

By Christine B. Whelan
Special to The Washington Post

Picture this: You're staring at the kitchen trash and feel a surge of frustration. You just saw your partner stuff one more thing into the already overflowing bin without making a move to empty it. Ready to pick a fight, you're about to lash out with an angry indictment of your partner's overall worth as a human being. Then you stop.

You've been taking classes in something called mindfulness, so you take a deep breath and step back. You identify and feel your emotions, and then let them pass. You find the real source of your frustration: It's not the trash; it's that you don't feel appreciated around the house. Instead of an opening volley of obscenities, you consider how to resolve the broader issue.

Sound too New Age-y to work in your household? It might be worth a try: Researchers at major universities are exploring the benefits of Buddhist mindfulness techniques to help families increase feelings of closeness and decrease relationship stress -- and the results are promising. Just as the latest Hollywood incarnation of the Incredible Hulk keeps his green-hot anger under control with daily meditations, so are some people learning to manage emotions in their relationships.

In mental health terms, mindfulness is the awareness that emerges from focusing on the present and the ability to perceive -- but not judge -- your own emotions with detachment; it enables you to choose helpful responses to difficult situations rather than reacting out of habit. While Western thought separates religion and science, Buddhists see mindfulness as both a spiritual and psychological force.

Mindfulness isn't simply about calming down, and it's certainly not about giving in. It's about recognizing that you're tired as you go home on a crowded Metro train, so that when somebody bumps into you, you decide to say, "Excuse me!" instead of pushing back. It's about picking an effective way to discipline your teenager for staying out until 3 a.m. rather than responding like an angry child yourself.

Read more ...

Comfort Queen: Comfort During Fearful Times

2008-11-09T18:43:00.001-08:00

I finis hed reading Acedia and Me by Kathleen Norris last night and I want to shout (I guess blogging is my shouting), “This book could change your life!”

Acedia - what the hell is that? I’d never heard of it before. Kathleen defines it as:

…as the spiritual aspect of sloth. The word literally means not-caring, or being unable to care, and ultimately, being unable to care that you can’t care. Acedia is spiritual morphine, but it does more than mask pain. It causes us to lose faith in ourselves and in our relationships with others.”

We are awakening from a time of collective spiritual morphine stupor. We sank into a profound state of weary not caring — not everybody, not all the time but a lot of us. Now we feel the breath of hopeful possibility, the brush of optimist trust upon our hearts and to help that goodness grow into sustainable action, we need to name the demon that has beset us (excuse the demon talk but it feels right, especially after reading the book).

There is such power in naming. Reading Kathleen’s struggles with acedia woven with early Christian theology and reflections on contemporary life, I kept having that electrifying feeling of being known. Of “Oh me too, me, too.” I kept having to stop and read sections aloud to Bob.

One reason I wrote this book was to explore my suspicion that much of the restless boredom, frantic escapism, commitment phobia, and enervating despair that plague us today are the ancient demon of acedia in modern dress. When we look at acedia’s root meaning, as not caring, we can see it as a social problem, and perceive that the sloth it engenders is anything but an insignificant physical laziness. It may even manifest as hyper-activity, but it is more like the activity of a hamster on a treadmill than action that will enhance the common good.

I was very glad to find the late playwright Wendy Wasserstein’s observation that “When you achieve true slothdom, you have no desire for the world to change. True sloths are not revolutionaries,” she adds, but “the lazy guardians at the gate of the status quo.” The question she raises is one I think we have to ask ourselves: “Are these hyperscheduled, overactive individuals really creating anything new? Are they guilty of passion in any way? Do they have a new vision for their government? For their community? Or for themselves?” She suspects that “Their purpose is to keep themselves so busy, so entrenched in their active lives, that their spirit reaches a permanent state of lethargiosis.” Lethargy, acedia: in some ways I think they define American culture today. The plethora of 24-hour news sources are perfect carriers of the disease, bombarding us with so much “information” that we can no longer distinguish between what is important and what is not, and discern what we truly need to care about.”

We live in a time where traditional ways of making meaning have mostly vanished. Heck, it used to be surviving was our meaning, then we had close (murderous) tribal ties and work that had a final product that could be touched, eaten, bartered. We had religion.

But in the post-modern world, we’re not even sure we believe in meaning. We often don’t have a community with whom to share our questions of “What the hell am I doing with my life?” We fall prey to a questioning of our life’s purpose that eats away at our souls and our ability to get out of bed. And when we do try to find our purpose, it can easily turn into a narcissistic quest that ends up feeding the acedia.

The concept of acedia has always been closed linked with that of vocation. Acedia was, and remains, the monk’s most dangerous temptation, as it makes the life he has vowed to undertake seem foolish, if not completely futile… Artists can feel a similar disconnect… Acedia is a danger to anyone whose work requires great concentration and discipline yet is considered by many to be of little practical value. The world does not care if I write another word, and if I am to care, I have to summon all my interior motivation and strength.”

I’m in this boat, summoning all my strength to create a life, and work, that feels worthwhile. Have you ever felt that way? What do you think the link between acedia and fear is — I think it’s the petri dish fear grows in.

Sydney Morning Herald: Anxiety can drain your spirit during troubled times

2008-11-06T08:27:00.001-08:00

Greg Barns
November 6, 2008

Over the past decade the lid has been lifted on depression. Organisations such as Beyond Blue and the Black Dog Institute, among others, have shone a light on those feelings of darkness and despair that invade so many lives and which impair them. But depression is not simply about feeling blue. It can be linked to anxiety. People who seem upbeat each day might be physically and mentally drained inside by the relentless drumbeat of gloom and fear about themselves and their sense of security.

If you ask the average person to describe the symptoms of depression, unless they have acute medical knowledge themselves, they will generally use phrases such as "feeling sad" or "feeling low". Perhaps it is because the word "depression" conjures these feelings and perceptions.

A British Medical Journal survey in 1996 confirmed that the perception in the community is that depression is mainly about feelings of sadness or a lack of energy. Among survey participants, the reported noted, "when the discussion moved on to depression itself, most mentioned the symptoms of weepiness, irritability, feeling low, inability to cope, and loss of appetite".

The anxiety sufferer can often be labelled as "stressed out" or a "constant worrier" by colleagues and friends whereas the person who is gloomy, teary and lacks energy can be more readily understood as a person suffering from depression.

The Australian Bureau of Statistics reported last month that one in five Australians in 2007 suffered mental illness and of those 14 per cent suffered some form of anxiety disorder or frequent panic attacks. Yet according to research released in 2006 by drug company Pfizer and the Anxiety Disorders Alliance, 61 per cent of Australians have little or no knowledge about anxiety disorders.

Perhaps this is because some anxiety, and even panic, can be useful to all of us. If we are threatened by an intruder in our homes, then the anxiety we feel can enable us to react quickly to protect ourselves. And anxiety about exams or a presentation we have to undertake in front of our peers in the workplace can also be useful in enhancing our performance.

But if we spend some time each day for a period of weeks, months or even years regularly worrying about things, or have a general sense of unease, then the anxiety has become a disorder.

And while anxiety disorders can include everything from panic and phobias to post-traumatic stress disorder, the common garden variety manifestation of this illness is generalised anxiety disorder or GAD. The inherent difficulty with GAD is that it is hard to diagnose and for individuals to recognise they have it, and for others to understand what it entails.

As one English GAD sufferer, Jane Phillimore, put it in 2001, "what's remarkable about GAD is that, unlike post-traumatic stress disorder or phobias where the symptoms and focus of anxiety are easily recognised, it is hard to define. Sufferers worry about anything and possibly everything. This makes it sound like nothing more than an extension of the everyday worry all human beings experience. And GAD may start there.

"But it can escalate into a disabling disorder in which outwardly ordinary, normally successful people are crippled by inner lives of intense distress," Phillimore wrote in The Observer on October 14, 2001.

So how do we recognise the GAD sufferer? Let me answer that as someone who has regular bouts of anxiety, as well as feeling blue. The person who regularly, if not on a daily basis, fears that things are out their control, has a sense of unease about their life, fears a catastrophic event is about to befall them, and who worries endlessly about things said to them or about them by others when there is no rational basis for their doing so - this is probably an individual who is suffering from GAD.

An acute attack of GAD is emotionally and physically destabilising and exhausting. When someone worries about doom and gloom being just around the corner day-in and day-out over a lengthy period, this leads to feeling constantly tired and rundown physically, and it can mean being inattentive and distracted when with you are with other people, even individuals to whom you are emotionally close.

Perhaps those in government and in health groups such as Beyond Blue need to focus their awareness campaigns on highlighting that GAD is a serious mental illness that affects millions.

For individuals pre-disposed towards anxiety, it is in troubled and uncertain times like these that this can turn into a full-blown illness. We need help as a community to recognise the symptoms.

NPR: Happiness: Is A Priority On Well Being

2008-11-06T02:58:00.001-08:00

by Philip Reeves

Morning Edition, November 6, 2008 · The tiny Himalayan nation of Bhutan has crowned its 5th king in an elaborate Buddhist ceremony. It was the new king's father who pioneered the concept of "gross national Hapiness." Meaning there's more to a country than economic growth — spiritual and mental well-being matter just as much to people.

The Writer's Almanac: "Lessons" by Pat Schneider

2008-11-05T08:27:00.000-08:00

I have learned
that life goes on,
or doesn't.
That days are measured out
in tiny increments
as a woman in a kitchen
measures teaspoons
of cinnamon, vanilla,
or half a cup of sugar
into a bowl.

I have learned
that moments are as precious as nutmeg,
and it has occurred to me
that busy interruptions
are like tiny grain moths,
or mice.
They nibble, pee, and poop,
or make their little worms and webs
until you have to throw out the good stuff
with the bad.

It took two deaths
and coming close myself
for me to learn
that there is not an infinite supply
of good things in the pantry.

"Lessons" by Pat Schneider from Another River: New and Selected Poems. © Amherst Writers and Artists Press, 2005.

The Last Psychiatrist: The Sex-Starved Wife

2008-11-05T08:25:00.001-08:00

On the one hand, you have articles in th Economist saying people are spending less time at work and more at home, on the other hand Time writes about the sex-starved wife. If they're both home more and at work less, why aren't they naked?

The answer isn't porn.

Sex is a good proxy for a lot of things. The Time article offers a number of explanations for why a man might have a lower libido than his wife, but not the correct one: narcissism. In women, narcissism manifests itself as a greater libido, and in men, a lesser one.

You might think this is backwards, but it isn't. The wife is more involved with every part of the relationship-- the money, the jobs-- his and hers-- the troubles, everything-- that the man has no way to construct an artificial identity she'd believe. He can't pretend he's anything-- suave, a major force at work, a successful investor, whatever-- because she knows his reality in text message speed. She talks to her husband not once, but four or five times a day. What's he going to say she doesn't already know? Even legitimate successes are subdued because they are not at all surprises.

Here's the mistake: women say, "but I get turned on by him anyway, he doesn't have to impress me, he has me." And my unscientific poll of... some... women suggests they are more sexually open and experimental than ever. So what's wrong? And so maybe the wife thinks she's not hot enough? And catchers his glances at the waitress, the porn on the computer.

Well, the problem with his libido isn't how hot she is. He's a narcissist: the problem is his libido is that it depends on how hot he is.

It's what women used to go through. He looks in the mirror, sees a gut-- he doesn't feel sexy, he can't imagine she would find him sexy, so the libido falls. In the past he could at least draw confidence from the fact that he has a good job; but now he doesn't have a "good " job, it's an okay job, one that pays the bills, but not something that you can build an identity with. And anyway she has one just as good. What's his appeal?

Read more ...

Anger in the Age of Entitlement: Post Election Stress Disorder

2008-11-05T08:15:00.001-08:00

By Steven Stosny in Anger in the Age of Entitlement

National elections are tough times for those of a bi-partisan nature, not to mention a blogger who comments on the negative effects of emotional pollution. I'd like to think that we are the silent majority, those of us who long for civility and respect in the discourse of decent people presenting their vision and plans for the nation. After all, poles say that the public is fed up with negative campaigning with its misleading and often downright false advertising. We're appalled at the costs of this election cycle, which exceeds that of the Revolutionary War and the duration that nearly doubles our participation in World War I.

This election has been so disappointing because it held out promise to be better. Both candidates really seemed above personal and negative attacks. The use of the military word, "campaign," to describe political contests is apt; the first casualty in war and politics is truth.

The maelstrom of the election has been personal for me, as my dearest friends and closest relatives are at the extreme - though not radical or reactionary - ends of the political spectrum. My inbox is bombarded by negative points about the policies and characters of both candidates and their running mates. Passionate arguments that would not, to be kind, pass peer review on their merits are put forth by good and bright people. I understand that certainty is an emotional, not an intellectual state that requires limiting the amount of information considered and that political campaigns are designed to exploit bias rather than reveal it. Still, I wonder how they can be so certain about such enormously complex problems. But then I am probably confusing personal tastes and biases with an objective and informed analysis of problems. Political passions are closer to, "I don't know anything about art, but I know what I don't like." And I am no better for trusting those who are the most certain the least.

Part of my post election stress disorder may be due to the fact that I'm vastly overworked. I specialize in couples living in resentment, anger, or emotional abuse. Two conditions greatly increase demand for my services: economic crises and national elections. When they occur together, it's like a perfect storm of family contention. I have written previously in this blog about how so many people download and recycle the negativity in their environment and ultimately take it out on the closest people to them. A web of emotions connects us all, for better or worse. I long for a politician to realize that to make the country stronger, we must love the people closest to us, respect and tolerate the differences of everyone, and let compassion spread through the web of emotion that connects us all, for the better.

Comfort Queen: Comfort During Fearful Times

2008-11-05T08:13:00.001-08:00

November 5, 2008

I said I would share a story today about the power of moving the body… what was I thinking?

Today is how-can-anyone-not-be-voting day?

Today is how can anybody-get-any-work-done-day?

Today is I-get-why-democracy-is-worth-dying-for-day.

Today is history-making.
Today is hope-making.

Today may be the day in which we collectively begin to turn away from fear-mongering and begin to have a relationship with our real fears. Which will, hopefully, allow us to create real solutions.

No matter which candidate you are voting for, no matter what voting shenanigans take place, no matter how long the lines, no matter that the archaic electoral college still exists, millions of people have enough faith that their opinion matters that they are casting a ballot.

Not one voter, however, will be killed for voting. No one will not be shot at. No one will lose their job. No one will have their children or family tortured.
No one.

As often in my life as I have felt shame at being an American because of choices our government has made or the lies our leaders have told or my own complicity in not marching in the streets when those things happen, more often I have felt gratitude.

Gratitude that I can complain about those choices and lies, that I can write a blog, newsletter or article that is not censored, that I can send a slip of paper through the mail (we have mail-only voting in my county) without retribution.

I have even more gratitude that my child can walk safely to school, that I can walk the streets day or night without fear, that I can buy food, that I can sleep at night without wondering if someone will burst through my door and kill everyone I love.

We may be profoundly poorer in the coming months and years, in dollars and international good will, and it is entirely possible we will become vastly richer in self-determination, integrity and the deep remembrance that each of can truly make a difference when we remember we have a choice.

When we remember our fears do not define us.

Today, I cry with gratitude and hope for the ideals of our country. Flawed and dented as they may be, they are ideals each person who casts a vote today is living.

They are ideals worth overcoming our fears for, whatever those fears may be.

To the power of voting, the glory of freedom and the remembrance that remaining awake to our choices is our first and most challenging duty.

Tomorrow, the great story! Promise.

Wow! I'm not depressed anymore! But wait, this blog is about depression so ...

2008-11-04T14:42:00.000-08:00

Ok, so I have to think about the ramifications of this email on my depression (or lack thereof) but in the meantime, it's too good not to pass along!

Therese Borchard is the author of Beyond Blue on Beliefnet ... and I thought she was the coolest even BEFORE this email arrived!

-------- Original Message --------

Subject:	Blog.com's Top 10 Mental Health Blogs
Date:	Tue, 4 Nov 2008 09:24:41 -0500
From:	Therese Borchard

Hi folks,

I've been asked by the blog directory/website, blogs.com, to select the 10 best mental health blogs. I picked yours! I'll send you the link when it's up. Best, Therese

1. Finding Optimism

http://www.findingoptimism.com/

2. Bipolar Beat

http://blogs.psychcentral.com/bipolar/

3. We Must Not Think Too Much

http://wemustnotthinktoomuch.blogspot.com/

4. Furious Seasons

http://www.furiousseasons.com/

5. The Trouble with Spikol

http://trouble.philadelphiaweekly.com/

6. Postpartum Progress

http://www.postpartumprogress.typepad.com/

7. Coping with Life

http://www.coping-with-life.com/

8. Storied Mind

http://www.storiedmind.com/

9. If You’re Going Through Hell Keep Going

http://www.mcmanweb.com/

10. McMan’s Depression and Bipolar Web

http://www.mcmanweb.com/

Reality Sandwich: Meditation for Life: The Spirit of Grieving

2008-10-30T08:39:00.001-07:00

Adam Elenbaas

In a recent scientific study conducted at the University of California Los Angeles, researchers examined the neurological processes surrounding short and long term grieving. The results, although partially speculative, provide an excellent backdrop for a conversation regarding meditation and its age old role in coping with sadness, depression and personal loss.

The study at UCLA examined 23 women who had lost a loved one within five years, eleven of whom still suffered from what psychologists call "CG" or "complicated grief": prolonged grieving resulting in depression, stress, fatigue, and lowered immune efficiency. While monitoring brain activity, researchers showed each woman pictures of her deceased loved one or words and phrases strongly associated with her deceased loved one. The results, as expected, showed that each woman in the study had social pain and grieving effects related to the images and words. But the interesting result was the commonality that all of the "complicated grievers" showed during the brain monitoring.

Each of the complicated grievers demonstrated high reward, pleasure, and addiction activity responses in the brain, in addition to the social grieving response. This finding suggests that brain interference could be responsible for "complicated grieving," and its fallout symptoms: fatigue, depression, stress, lowered immune efficiency and an inability to let go of the past. Some puzzling results, right?

Well, science is a funny thing. After all, it was the human mind that created the scientific method and rationalism, not the scientific method that created the rational mind. In other words, it's important to remember that human experience, in its full palette, inspired this kind of study in the first place. Therefore, interpreting the results of scientific data in a healthy conversation is the fertile ground where we might determine which seeds of cultural evolution are worth planting next. So what might this study imply about depression and how might it relate to meditation?

Let's make a few assumptions. Let's assume that being healthy and strong and "selfcentered" means that you are independently happy. In other words, you have established a healthy balance between the outside world (food, shelter, nature, clothing, jobs, people) and your inside world (emotions, thoughts, words, and actions). Now let's assume that people are thrown out of balance when they place too much emphasis on their internal world or the external world to create that sense of harmony and well being. In the case of the UCLA study, how would these assumptions about health filter out?

Let's say that your internal world feels terrible. You don't like who you are. You don't like your emotions, or they are too much to handle. Your mind moves too fast. You don't enjoy life. And you're always questioning what you say or why you said it. The immediate answer is often to look for another human or something outside to fix what is going on inside. It's not a terrible impulse. Sometimes it works. Sometimes when I'm feeling sad inside I will call a friend for a reminder that I am strong and special. Then something inside of me clicks over and I say, "Oh yeah, that's right. I am doing just fine." And in most of my friendships there is an equal balance of giving and taking from one another. We call each other for help about the same amount, or else we would start resenting each other.

But sometimes we get into relationships that are based around a constant and habitual need for something that we simply do not know how to do inside yet. It's as if we each have a muscle inside of us that must learn, as we grow up, to lift ourselves up when we need help and happiness. When this muscle has atrophied (because our parents didn't do a good job or because we got into a bad habit, or you believe in Karma, or sin, etc,) we often look for all of our strength in someone else, a relationship of some kind. It's human to need love, right?

On the surface this kind of relationship might seem perfectly normal. It might seem like love. When I'm weak my partner makes me strong and when my partner is weak I make them strong. However this isn't how it works. Instead it usually works like this: When I am weak my partner is strong, and when I am strong my partner is weak.

This unhealthy relationship looks like a seesaw. One person is always out of balance because of the other. This is not intimacy. Instead it is a constant and competitive swing between high and low that is most commonly associated with extreme behavioral disorders and addiction. Whereas the image of intimacy is more like a yoke of oxen. Life can be difficult and challenging. So it's important that if we're carrying a load, the ox on the left and the ox on the right have an equal amount of weight distributed between them. This means that each person has the same amount of internal muscle strength.

We often wonder why the divorce rate in our country is so high. Maybe it's because many relationships are unhealthy "seesaw" addictions instead of compatible teammates walking with equal weight distribution? And maybe when we see folks grieving for excessively long periods of time after losing a loved one it is because their relationship to that person was more like the see-saw addiction than a balanced relationship? In the wake of losing such a relationship a person might have to go through a prolonged period of sadness, just like a drug withdrawal.

How miserable would it be to withdraw from a person instead of appropriately mourning their passing? How confusing and painful. But it happens all of the time. So here's where meditation comes in. Because the obvious question to ask is, "How can we avoid these imbalanced relationships or how can we heal ourselves if we're coming out of an imbalanced relationship?"

I'm a meditation teacher, and I practice daily so perhaps I'm partial. But meditation is a way to develop the internal muscle that is needed to lift yourself off the mat when you feel like life is beating you up. Meditation has been proven to be of great help to people fighting or coping with behavioral disorders: people in AA or drug rehab, schizophrenics, terminally ill medical patients, and many others. By mediating and getting quiet inside we learn how to find happiness within ourselves, and we learn how to develop that internal muscle of self-love. As a healing technology, meditation is great for rehabilitating our wounds and could be a natural way for a person coping with prolonged grief to start reprogramming their mind and body to something new.

On the flip side, meditation is like preventative health care because strengthening that muscle makes it difficult to get into a co-dependent relationship in the first place (although the club might not be a fun place to meet people any longer, and you might become pickier about who you're thinking of spending your time with).

In closing it is interesting to think that since the dawn of time the indigenous peoples of our planet had ways of mending unhealthy relationships after death. In both the Hindu and Christian traditions, for example, early tribes and families had ritual times of mourning and releasing sadness. Beyond this it was thought of as inappropriate to mourn because it would tamper with the deceased soul's ability to travel forward beyond the earth. In fact, some cultures believed that excessive grieving trapped spirits on the earth and made them angry, causing a tribe to be haunted or cursed. In these situations special medicine men or religious authorities would sing songs and create additional healing rituals in order to detach a soul from the griever. Sometimes people would be sent into wilderness vision quest ceremonies to meditate for weeks and weeks in order to heal their minds and say a proper goodbye before they were allowed back into the community.

Is it so different today?

Newsday.com: Mental health, perspective in economic crises

2008-10-30T07:49:00.001-07:00

BY TONI RAITEN-D'ANTONIO | Toni Raiten-D'Antonio is a private practice psychotherapist and professor of social services at the Hauppauge branch of SUNY Empire State College
October 30, 2008

Switch on the TV news and you hear about a Massachusetts woman facing foreclosure who committed suicide, and a man from Nebraska who abandoned his children because he was overwhelmed by his responsibilities.

Want more proof that people are coming unhinged over the economy? Check out the recent American Psychological Association study reporting a stark rise in headaches, stomachaches and muscle tension - all caused by money worries. Given the headlines, you might expect that psychotherapists are seeing sky-high anxiety in their patients. In my private practice the opposite is true.

While others fret and grieve, nearly all of the men and women I see for therapy are moving quickly through the shock of recent economic events to important realizations about themselves, their social environment and the truly important things in their lives. For them, the sudden decline of a retirement account or the impending loss of a home has been the equivalent of being diagnosed with a life-threatening illness. The initial shock is followed by intense self-reflection and a decision to create a new perspective on life that is, in every way, better.

In the analysis stage, I hear patients acknowledge that they have long been in a kind of trance, eagerly buying stuff - cars, houses, clothes, etc. - under the assumption that objects could make them feel good. Deep inside they had harbored doubts about this status-oriented way of life, but everyone they knew had fallen under the same spell, which was reinforced by an overheated consumer culture and a false sense of wealth based on credit.

Some even felt that all the getting and consuming was patriotic. Didn't the president ask us to go out shopping in response to 9/11?

Others recognized the shallow roots of happiness bought with home equity loans, but chose denial over defying the culture. Competition over who had the best stuff was rampant and "normal."

Now that the real estate and financial markets have collapsed, the spell is broken and thoughtful people are searching for a way to transcend the sense of crisis. They aren't looking for a solution in the mass media, which once encouraged us to find happiness in things and now demands we feel frightened and desperate. While they accept that certain things, like the Dow, are beyond their control, they find that true happiness lies with their relationships, creative pursuits, and caring for themselves and others.

In other words, they are pursuing mental health instead of material wealth.

One older woman put it to me this way: "Hug your kids. Feed your friends. Pet the dog."

A recently married younger woman said, "I'm finding out that coping with this is actually romantic. We're in it together, creating solutions. It actually feels good, in a weird way."

As my patients deal with the crisis, they give me hope that just like them, our society will set new priorities and grow wiser. This is what happened during the Great Depression, when people were forced to abandon materialism. The playful popular music and films of the time reflected this process, and it's there that one film buff who sees me for therapy finds inspiration.

Last week, she recalled how the good witch Glinda in "The Wizard of Oz" reminded Dorothy that she had always held the power to go home to Kansas - to find peace - within herself. Fortunately for us, we don't have to travel at all to realize the same truth.

The Guardian: Pet Theories

2008-10-21T10:14:00.000-07:00

American researchers have discovered that owning a pet can significantly reduce your risk of a common cancer. And that's not all, says Emine Saner

The Guardian,
Emine Saner

The body of evidence supporting the notion that pet ownership is good for your health grew even fatter this month. A new study, published in Cancer Epidemiology Biomarkers and Prevention, found that keeping animals can cut the risk of developing the relatively common cancer of the immune system, non-Hodgkins lymphoma, by almost one third.
"The idea that pets and good health are associated goes back 20 years or more," says Dr June McNicholas, a psychologist who has researched the relationship between people and their pets. The catalogue of health plusses can't all be attributed to regular dogwalking however. When a study suggested that people who own pets have better cardiac health, says McNicholas, "one of the significant factors in people recovering well from a heart attack was owning a pet, but it wasn't just dogs. It applied equally to cats." Here are some of the many ways in which pets have been found to strengthen our constitutions.

Pets are good for cardiac health

The Baker Medical Research Institute in Australia studied 6,000 people and found that those who kept animals had lower blood pressure and lower cholesterol - and therefore, a lower risk of heart attack. Another study, conducted at the University of Minnesota and published earlier this year, concluded that cat owners were 40% less likely to suffer a fatal heart attack than people who didn't have a cat. Adnan Qureshi, the neurology professor who led the study of nearly 4,500 people, said he believed that people who stroked their cat experienced less stress and anxiety and therefore were at a lower risk of developing cardiovascular diseases.

Pets boost the immune system

This month, a study by researchers from Stanford University and the University of California found that regular exposure to a cat or a dog could reduce one's chance of developing non-Hodgkins lymphoma. It is thought that exposure to allergens - from cats and dogs - could boost the immune system.
The immune-boosting power of pets is something that McNicholas has also investigated. In 2002, she studied 256 primary school children and found that children aged from five to seven from pet-owning households attended school for three weeks more than those who didn't. "We found that children brought up with pets had more stable immune systems. There have been other studies which suggest that children born into a household that already has a dog or a cat are less likely to develop asthma. Moderate exposure [to allergens] will prime the immune system." Meanwhile, a study in Japan found that pet owners over the age of 65 made almost a third fewer visits to their GP than people the same age who didn't have pets.

Dogs can act as a health warnings

After 20 years working for the charity Hearing Dogs for the Deaf, Claire Guest was struck by the story of a colleague whose dog had repeatedly sniffed at a mole on her leg before it was diagnosed as a malignant melanoma. Guest went on to work with researchers at Amersham hospital in Buckinghamshire, to discover whether dogs could be trained to detect bladder cancer in urine samples, and found that they could.
Similarly, in 2006, a cancer research centre in California published a study which found that ordinary household dogs could be trained to detect early breast and lung cancer between 88% and 97% of the time, by sniffing people's breath - it is thought that these particular cancer cells give off miniscule traces of volatile odours that dogs can smell. The idea is that, once they have worked out which odours dogs are detecting and which cancers emit them, a diagnostic machine could be developed.
Guest also trains dogs to warn owners with Type 1 diabetes of an impending hypoglycaemic, or low blood sugar, episode - they usually alert their owners by jumping up. "We don't know exactly how the dogs do it, but again they pick up on scent because they sniff the person before deciding whether to warn them or not. Because they also have a relationship with their owner, they may be able to pick up on other signs."

Pets can improve self-esteem and decrease the likelihood of depression

"There have been studies that have suggested pet owners are more likely to have higher self-worth and are less likely to suffer loneliness and depression," says Dr Deborah Wells, senior lecturer in psychology at the University of Belfast, who has conducted several studies on the benefits of pet ownership. "Dogs seem to bring people the biggest benefits - you have to get out and walk them every day, and they can act as a social catalyst."
Wells says pets are particularly useful for children. "Pets can become like a therapist, for want of a better word. If children are bullied at school, or their parents are getting divorced, children will often tell their pets their problems whereas they wouldn't always talk to a person."
The charity Pets As Therapy has been running for 25 years and has 4,000 dogs and 106 cats, which visit 120,000 people in hospitals, hospices, care homes, day care centres and schools for children with special needs every week. "We started taking dogs into nursing homes, because elderly people had had to give up their pets when they went in and it was making them depressed and in many cases ill," says Maureen Fennis, the chief executive. "At one nursing home, there was a lady who used to say the visits were her reason for staying alive."
The routine and "normality" of having a pet can help people suffering a traumatic event, such as bereavement or a diagnosis of terminal illness. In one study, McNicholas found that people with animals to care for adjusted far better after the death of someone close than those without pets. "We live in a society where we do not like to cry in front of people," she adds, "but there are a large number of people who can cry in front of their pets" ·

Seattle Times: Mindfulness: Take charge of your mind and body

2008-10-21T08:20:00.001-07:00

By Richard Seven, Seattle Times staff reporter

Boeing engineer Miryam Chavarria has, like the rest of us, reasons to stress. She is concerned about upcoming labor negotiations, the future of her job, and a chronic health condition she must manage. She even disregarded her husband's warning and peeked at their plummeting 401(k) bottom-line.
In times like these, she turns to her practice of mindfulness. It's a meditative approach that focuses attention on the present — not on what might happen or what she should have done.
"I thought it was a bunch of hocus-pocus at first," Chavarria says. "I had a rough first session, but I chose to stay with the meditation and it has caused a great transformation in me. I find I'm more myself, rather than what the world expects of me."
She doesn't meditate every day but takes time to take self-inventory, to become absorbed in rote chores like washing dishes and be relaxed yet purposeful during so-called down time, like waiting in a line.
To be in here-and-now has never been harder. Is your job to safe? How low can the retirement nest-egg shrink? Will this political sniping ever end? Will the sun ever again shine in Seattle? Will our teams ever win? The world gets more complex. Layoffs, the constant drip of bad news, 24-hour doomsday hype, and the diving stock hammers that home.
There can be a fine line between dealing with what's happening and dwelling on it. That's where practices like mindfulness might help. You don't need to head to a retreat to gain a little perspective.
Read the rest of the article here:

Living Mindfulness: take charge of your mind and body Seattle Times Newspaper

We interrupt our regularly scheduled blog for this message ...

2008-10-15T14:05:00.000-07:00

Blogger News Network: Governor Palin’s Mental Health Problems Surface

2008-10-13T16:15:00.001-07:00

Posted on October 12th, 2008
by psburton in 2008 Election Coverage, Alaska News, All News, Arizona News, Blogosphere News, Breaking News, Op-ed, US Politics
Read 496 times.

In the wake of Governor Sarah Palin’s cheerful insistence the legislative report into the trooper gate probe cleared her of any wrongdoing. I join those who share concern the pressures of the campaign may be taking a negative toll on her mental health. Its an issue that obligates me to set aside partisan perspective and reach out with compassion to someone who is in obvious distress. After all when you come upon a person who is drowning, who amongst us stops to ask party affiliation before diving in to help.

Like every other blog pundit, I was waiting with baited breath to pounce when Sarah attempted to spin the damming legislative findings in the best possible light, but to my utter astonishment the poor woman stated she was delighted to learn the report cleared her. We would anticipate an individual in otherwise good mental health to express anger and perhaps outrage at being unfairly smeared by what she perceived as the findings of partisan political witch hunt.

But as any mental health expert would probably tell you, if a person in high public office is confronted with bi-partisan finding she abused the power of her office and violated public trust, and responds by happily reporting her thankfulness at being cleared. Its a strong indication of possible dissociative denial and time to set politics aside for a moment and see if we cant get Sarah some help. That she gave birth within the last year might suggest it’s related to postpartum depression, despite the ludicrous claims of scientologists. Modern mental heath professionals do wonders in helping those afflicted with a mental disorder to lead positive and fulfilling lives.

Of course we cant know till after an appropriate examination is conducted, whether it’s simply short term problems related to the chemical imbalances of postpartum depression or a more permanent condition like bi-polar disorder. But the good news folks is irregardless of what ever seems to be pushing our Sarah off the mental health reservation, help is available.

Of course the first step in finding out how we can help Governor Palin is discovering what’s wrong, a clinical evaluation would take only a few days and depending on the diagnosis, treatment could begin at once. And thankfully we no longer need to treat the majority of those afflicted with short or long term mental illness in a hospital setting.

Unless Sarah is suffering from a behavior disorder that can express itself in violent outbursts, I am confident mental health experts would agree she would be fit to resume her duties as Governor in a relatively short period and if she were to be elected vice president she would have access to the best mental health experts in the country 24/7.

As we explore the subject of Governor Palin's mental health problems, in retrospect perhaps we can see that some of her other statements on the stump reflect a person whose mental clarity seems clouded. Though generations ago mental illness like a Physical disability was something which could be an impediment to holding public office. Times have changed for the better. While F.D.R went to great lengths to hide his disability from the public and Senator Tom Eagleton was forced to with draw as George McGovern’s vice presidential running mate when it was revealed he had undergone treatment for depression.

Happily we have moved past that type of thinking, If a candidate for President or vice President is ill, be it in mind or body, our instinct is to put aside political rhetoric and offer help and support. I simply couldn’t imagine any thing but an out pouring of understanding and prayer when Governor Palin acknowledges she is suffering and a swelling of public sentiment that becomes an encouragement to seek out appropriate treatment.

That’s my view, yours may be different

The Writer's Almanac: May Day

2008-10-10T16:28:00.001-07:00

May Day

I've decided to waste my life again,
Like I used to: get drunk on
The light in the leaves, find a wall
Against which something can happen,

Whatever may have happened
Long ago—let a bullet hole echoing
The will of an executioner, a crevice
In which a love note was hidden,

Be a cell where a struggling tendril
Utters a few spare syllables at dawn.
I've decided to waste my life
In a new way, to forget whoever

Touched a hair on my head, because
It doesn't matter what came to pass,
Only that it passed, because we repeat
Ourselves, we repeat ourselves.

I've decided to walk a long way
Out of the way, to allow something
Dreaded to waken for no good reason,
Let it go without saying,

Let it go as it will to the place
It will go without saying: a wall
Against which a body was pressed
For no good reason, other than this.

"May Day" by Phillis Levin from May Day. © Penguin Books, 2008.

Psychminded.co.uk: Cognitive behavioural therapy is a quick fix

2008-10-09T07:44:00.001-07:00

October 9, 2008
Dorothy Rowe: Cognitive behavioural therapy is a quick fix

The government has started recruiting thousands of more CBT-trained therapists in a bid to "cure" 450,000 people with depression and anxiety in England and Wales. But cognitive behavioural therapy is based on a desperate simplification of what lies at the heart of distress, argues Dorothy Rowe

.....

In mental distress the real problem always arises from some kind of threat or insult to the sense of being a person. This can be hard to uncover, and difficult to ameliorate. It is never amenable to a quick fix.

New Labour has always favoured the quick fix. Children can’t read and write? Set a national curriculum and test them. Methicillin-resistant Staphylococcus aureus (MRSA) a problem in hospitals? Deep-clean them. The fact that weighing piglets doesn’t fatten them, and that it’s people, not walls and floors, that pass on infections is irrelevant.

The next problem was that people who are depressed are unlikely to be good workers. Anti-depressants are expensive and inefficient, so let’s use the simplest of all the therapies, train people quickly and cheaply as therapists, and get these depressed people back to work.

If only life were that simple! Many experienced CBT therapists have found that it isn’t. About ten years ago, they discovered that they needed to take into account how the client saw the therapist, something that Freud had called it ‘counter-transference’. Next, some CBT therapists concluded that doing prescribed homework wasn’t enough to change those pesky dysfunctional cognitions. What was needed was mindfulness, something that the Buddha mentioned. Now what’s important is compassion, something that features in all religions. Although it’s possible now to do a Master’s degree in mindfulness, and to write academic papers on compassion, it’s not easy to put mindfulness and compassion into a CBT formulation.

Mindfulness is concerned with how we experience our individual existence. I try to write about this, but I always find that there’s a dearth of words in English to describe these powerful experiences. Compassion concerns those other powerful experiences when, in some extraordinary way, we’re able to make a connection with another person, even though each of us is trapped in our own world of meaning. Again, our language lacks the words with which to talk about these experiences.

All my work has been concerned with how we experience our sense of existence and our connections to other people, and how we make sense of our world. My first article on this was published in 1971, and I’m still writing about it because I can never come to the end of understanding what it is to be a human being. I continually see something new, or something that I’ve seen before, but now from a different angle. No one can ever be a trained therapist. You can acquire a certain amount of experience with which you might be let loose to engage in a conversation with a trouble person, but you never come to the end of discovering what you need to know.

CBT is a dishonest therapy in that it fails to acknowledge the basis on which it has been built. The use of the categories as set out in the DSM in the curriculum of the IAPT (Improving Access to Psychological Therapies) implies that the dysfunctional cognitions in depression are caused by that disorder. Many CBT therapists don’t acknowledge, or perhaps don’t know, that CBT is actually based on the proposition that what determines our behaviour isn’t what happens to us, but how we interpret what happens to us. This proposition has a secure base in what neuroscientists have discovered about how our brain operates. Neuropsychologist Chris Frith wrote, "Even if all our senses are intact and our brain is functioning normally, we do not have direct access to the real world. It may feel as if we have direct access, but this is an illusion created by our brain." He also wrote, "Another of the many illusions which my brain creates is my sense of self. I experience myself as an island of stability in an ever-changing world." [i]

What we experience isn’t the real world but the guesses which our brain has constructed about the world, using the interpretations of our past experience which our brain has stored. Since no two people ever have exactly the same experience, no two people ever see anything in exactly the same way. Our constant stream of interpretations in the form of thoughts, feelings or images develops a kind of whirlpool which we call our self or our sense of being a person. Whirlpools aren’t stable. Our self, the most important part of our existence, is made up of guesses that can be proved wrong by events. When this happens, we feel that our sense of being a person will vanish like a wisp of smoke in the wind, and we are terrified. We create all kinds of defences to prevent our self being annihilated. Some of these defences are what CBT therapists call dysfunctional cognitions.

When I was training as an educational psychologist in 1961, one of my teachers, Bess Kemp, told me the one thing that is always found in therapy. She said, "the presenting problem is never the real problem." In mental distress the real problem always arises from some kind of threat or insult to the sense of being a person. This can be hard to uncover, and difficult to ameliorate. It is never amenable to a quick fix.

Ref: [i] Making Up the Mind Blackwell Publishing, Oxford, 2007, p.40, p.169.

* Dorothy Rowe is a clinical psychologist and author of 15 books, including Depression: The Way Out of Your Prison and Beyond Fear. Her latest book, What Should I Believe? considers beliefs about death. Dr Rowe is Emeritus Associate of the Royal College of Psychiatrists

NYT: In ‘Sweetie’ and ‘Dear,’ a Hurt for the Elderly

2008-10-08T07:39:00.001-07:00

October 7, 2008
By JOHN LELAND

Professionals call it elderspeak, the sweetly belittling form of address that has always rankled older people: the doctor who talks to their child rather than to them about their health; the store clerk who assumes that an older person does not know how to work a computer, or needs to be addressed slowly or in a loud voice. Then there are those who address any elderly person as “dear.”

“People think they’re being nice,” said Elvira Nagle, 83, of Dublin, Calif., “but when I hear it, it raises my hackles.”

Now studies are finding that the insults can have health consequences, especially if people mutely accept the attitudes behind them, said Becca Levy, an associate professor of epidemiology and psychology at Yale University, who studies the health effects of such messages on elderly people.

“Those little insults can lead to more negative images of aging,” Dr. Levy said. “And those who have more negative images of aging have worse functional health over time, including lower rates of survival.”

In a long-term survey of 660 people over age 50 in a small Ohio town, published in 2002, Dr. Levy and her fellow researchers found that those who had positive perceptions of aging lived an average of 7.5 years longer, a bigger increase than that associated with exercising or not smoking. The findings held up even when the researchers controlled for differences in the participants’ health conditions.

In her forthcoming study, Dr. Levy found that older people exposed to negative images of aging, including words like “forgetful,” “feeble” and “shaky,” performed significantly worse on memory and balance tests; in previous experiments, they also showed higher levels of stress.

Despite such research, the worst offenders are often health care workers, said Kristine Williams, a nurse gerontologist and associate professor at the University of Kansas School of Nursing.

To study the effects of elderspeak on people with mild to moderate dementia, Dr. Williams and a team of researchers videotaped interactions in a nursing home between 20 residents and staff members. They found that when nurses used phrases like “good girl” or “How are we feeling?” patients were more aggressive and less cooperative or receptive to care. If addressed as infants, some showed their irritation by grimacing, screaming or refusing to do what staff members asked of them.

The researchers, who will publish their findings in The American Journal of Alzheimer’s Disease and Other Dementias, concluded that elderspeak sent a message that the patient was incompetent and “begins a negative downward spiral for older persons, who react with decreased self-esteem, depression, withdrawal and the assumption of dependent behaviors.”

Dr. Williams said health care workers often thought that using words like “dear” or “sweetie” conveyed that they cared and made them easier to understand. “But they don’t realize the implications,” she said, “that it’s also giving messages to older adults that they’re incompetent.”

“The main task for a person with Alzheimer’s is to maintain a sense of self or personhood,” Dr. Williams said. “If you know you’re losing your cognitive abilities and trying to maintain your personhood, and someone talks to you like a baby, it’s upsetting to you.”

She added that patients who reacted aggressively against elderspeak might receive less care.

For people without cognitive problems, elderspeak can sometimes make them livid. When Sarah Plummer’s pharmacy changed her monthly prescription for cancer drugs from a vial to a contraption she could not open, she said, the pharmacist explained that the packaging was intended to help her remember her daily dose.

“I exploded,” Ms. Plummer wrote to a New York Times blog, The New Old Age, which asked readers about how they were treated in their daily life.

“Who says I don’t take my medicine as prescribed?” wrote Ms. Plummer, 61, who lives in Champaign, Ill. “I am alive right now because I take these pills! What am I supposed to do? Hold it with vice grips and cut it with a hack saw?’”

She added, “I believed my dignity and integrity were being assaulted.”

Health care workers are often not trained to avoid elderspeak, said Vicki Rosebrook, the executive director of the Macklin Intergenerational Institute in Findlay, Ohio, a combined facility for elderly people and children that is part of a retirement community.

Dr. Rosebrook said that even in her facility, “we have 300 elders who are ‘sweetie’d’ here. Our kids talk to elders with more respect than some of our professional care providers.”

She said she considered elderspeak a form of bullying. “It’s talking down to them,” she said. “We do it to children so well. And it’s natural for the sandwich generation, since they address children that way.”

Not all older people object to being called sweetie or dear, and some, like Jan Rowell, 61, of West Linn, Ore., say they appreciate the underlying warmth. “We’re all reaching across the chasm,” Ms. Rowell said. “If someone calls us sweetie or honey, it’s not diminishing us; it’s just their way to connect, in a positive way.”

She added, “What would reinforce negative stereotypes is the idea that old people are filled with pet peeves, taking offense at innocent attempts to be friendly.”

But Ellen Kirschman, 68, a police psychologist in Northern California, said she objected to people calling her “young lady,” which she called “mocking and disingenuous.” She added: “As I get older, I don’t want to be recognized for my age. I want to be recognized for my accomplishments, for my wisdom.”

To avoid stereotyping, Ms. Kirschman said, she often sprinkles her conversation with profanities when she is among people who do not know her. “That makes them think, This is someone to be reckoned with,” she said. “A little sharpness seems to help.”

Bea Howard, 77, a retired teacher in Berkeley, Calif., said she objected less to the ways people addressed her than to their ignoring her altogether. At recent meals with a younger friend, Ms. Howard said, the restaurant’s staff spoke only to the friend.

“They ask my friend, ‘How are you; how are you feeling?’ just turning on the charm to my partner,” Ms. Howard said. “Then they ask for my order. I say: ‘I feel you’re ignoring me; I’m at this table, too.’ And they immediately deny it. They say, no, not at all. And they may not even know they’re doing it.”

Dr. Levy of Yale said that even among professionals, there appeared to be little movement to reduce elderspeak. Words like “dear,” she said, have a life of their own. “It’s harder to change,” Dr. Levy said, “because people spend so much of their lives observing it without having a stake in it, not realizing it’s belittling to call someone that.”

In the meantime, people who are offended might do well to follow the advice of Warren Cassell of Portland, Ore., who said it irritated him when “teenage store clerks and about 95 percent of the rest of society” called him by his first name. “It’s the faux familiarity,” said Mr. Cassell, 78.

But he mostly shrugs it off, he said. “I’m irked by it, but I can’t think about it that much,” he said. “There are too many more important things to think about.”

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NYT: Bailout Provides More Mental Health Coverage

2008-10-06T15:11:00.001-07:00

October 6, 2008
By ROBERT PEAR

WASHINGTON — More than one-third of all Americans will soon receive better insurance coverage for mental health treatments because of a new law that, for the first time, requires equal coverage of mental and physical illnesses.

The requirement, included in the economic bailout bill that President Bush signed on Friday, is the result of 12 years of passionate advocacy by friends and relatives of people with mental illness and addiction disorders. They described the new law as a milestone in the quest for civil rights, an effort to end insurance discrimination and to reduce the stigma of mental illness.

Most employers and group health plans provide less coverage for mental health care than for the treatment of physical conditions like cancer, heart disease or broken bones. They will need to adjust their benefits to comply with the new law, which requires equivalence, or parity, in the coverage.

For decades, insurers have set higher co-payments and deductibles and stricter limits on treatment for addiction and mental illnesses.

By wiping away such restrictions, doctors said, the new law will make it easier for people to obtain treatment for a wide range of conditions, including depression, autism, schizophrenia, eating disorders and alcohol and drug abuse.

Frank B. McArdle, a health policy expert at Hewitt Associates, a benefits consulting firm, said the law would force sweeping changes in the workplace.

“A large majority of health plans currently have limits on hospital inpatient days and outpatient visits for mental health treatments, but not for other treatments,” Mr. McArdle said. “They will have to change their plan design.”

Federal officials said the law would improve coverage for 113 million people, including 82 million in employer-sponsored plans that are not subject to state regulation. The effective date, for most health plans, will be Jan. 1, 2010.

The Congressional Budget Office estimates that the new requirement will increase premiums by an average of about two-tenths of 1 percent. Businesses with 50 or fewer employees are exempt.

The goal of mental health parity once seemed politically unrealistic but gained widespread support for several reasons:

¶Researchers have found biological causes and effective treatments for numerous mental illnesses.

¶A number of companies now specialize in managing mental health benefits, making the costs to insurers and employers more affordable. The law allows these companies to continue managing benefits.

¶Employers have found that productivity tends to increase after workers are treated for mental illnesses and drug or alcohol dependence. Such treatments can reduce the number of lost work days.

¶The stigma of mental illness may have faded as people see members of the armed forces returning from Iraq and Afghanistan with serious mental problems.

¶Parity has proved workable when tried at the state level and in the health insurance program for federal employees, including members of Congress.

Dr. Steven E. Hyman, a former director of the National Institute of Mental Health, said it was impossible to justify insurance discrimination when an overwhelming body of scientific evidence showed that “mental illnesses represent real diseases of the brain.”

“Genetic mutations and unlucky combinations of normal genes contribute to the risk of autism and schizophrenia,” Dr. Hyman said. “There is also strong evidence that people with schizophrenia have thinning of the gray matter in parts of the brain that permit us to control our thoughts and behavior.”

The drive for mental health parity was led by Senator Pete V. Domenici, Republican of New Mexico, who has a daughter with schizophrenia, and Senator Paul Wellstone, the Minnesota Democrat who was killed in a plane crash in 2002. Mr. Wellstone had a brother with severe mental illness.

Prominent members of both parties, including Betty Ford, Rosalynn Carter and Tipper Gore, pleaded with Congress to pass the legislation.

Representatives Patrick J. Kennedy, Democrat of Rhode Island, and Jim Ramstad, Republican of Minnesota, led the fight in the House. Mr. Kennedy has been treated for depression and, by his own account, became “the public face of alcoholism and addiction” after a car crash on Capitol Hill in 2006. Mr. Ramstad traces his zeal to the day in 1981 when he woke up in a jail cell in South Dakota after an alcoholic blackout.

The Senate passed a mental health parity bill in September 2007. The House passed a different version in March of this year.

A breakthrough occurred when sponsors of the House bill agreed to drop a provision that required insurers to cover treatment for any condition listed in the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association.

Employers objected to such a requirement, saying it would have severely limited their discretion over what benefits to provide. Among the conditions in the manual, critics noted, are caffeine intoxication and sleep disorders resulting from jet lag.

Doctors often complain that insurers, especially managed care companies, interfere in their treatment decisions. But doctors and mental health advocates cited the work of such companies in arguing that mental health parity would be affordable, because the benefits could be managed.

Pamela B. Greenberg, president of the Association for Behavioral Health and Wellness, a trade group, said providers of mental health care typically drafted a treatment plan for each person. In complex cases, she said, a case manager or care coordinator monitors the patient’s progress.

A managed care company can refuse to pay for care, on the grounds that it is not medically necessary or “clinically appropriate.” But under the new law, insurers must disclose their criteria for determining medical necessity, as well as the reason for denying any particular claim for mental health services.

Andrew Sperling, a lobbyist at the National Alliance on Mental Illness, an advocacy group, said, “Under the new law, we will probably see more aggressive management of mental health benefits because insurers can no longer impose arbitrary limits.”

The law will also encourage insurers to integrate coverage for mental health care with medical and surgical benefits. Under the law, insurers cannot have separate cost-sharing requirements or treatment limits that apply only to mental illness and addiction disorders.

The law comes just three months after Congress eliminated discriminatory co-payments in Medicare, the program for people who are 65 and older or disabled.

Medicare beneficiaries pay 20 percent of the government-approved amount for most doctors’ services but 50 percent for outpatient mental health services. The co-payment for mental health care will be gradually reduced to 20 percent over six years.

The mental health parity law was forged in a highly unusual consensus-building process. For years, mental health advocates had been lobbying on the issue.

Insurers and employers, which had resisted earlier versions of the legislation, came to the table in 2004 at the request of Mr. Domenici and Senators Edward M. Kennedy, Democrat of Massachusetts, and Michael B. Enzi, Republican of Wyoming.

Each side had, in effect, a veto over the language of any bill. Insurers and employers, seeing broad bipartisan support for the goal in both houses of Congress, decided to work with mental health advocates. Each side gained the other’s trust.

“It was an incredible process,” said E. Neil Trautwein, a vice president of the National Retail Federation, a trade group. “We built the bill piece by piece from the ground up. It’s a good harbinger for future efforts on health care reform.”

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The Hour: Calming your thoughts through mindfulness

2008-10-06T15:04:00.001-07:00

BY HOWARD COHEN
McClatchy Newspapers

MIAMI -- Our worries.

They're crescendoing like the finale of Beethoven's "Ninth": Bailouts, buyouts. Recession, depression.

Enter the meditative practice of mindfulness. Born of Buddhist roots, it's increasingly recognized as a measure to calm the mind's chatter and elevate the brain's thinking and organizational processes.

Mindfulness seminars. Mindfulness books. Even the medical mainstream is taking note -- the Sept. 17 issue of the Journal of the American Medical Association had a piece titled "Mindfulness in Medicine."

"The uncertainty of tomorrow creates a lot of the angst or discomfort," says Scott Rogers, director of the Institute for Mindfulness Studies in Miami Beach. "People are looking more and more to bring a little bit of 'ahhh ...' Not just stress reduction, but allowance and acceptance."

Mindfulness is built around the premise of disengaging from overly emotional responses and extraneous thoughts that clutter the mind's ability to think clearly. By using techniques such as breathing, visual imagery and meditation to slow down and focus on the present, the theory goes, a person can tap into a higher level of awareness. The more acute awareness is the byproduct of more active brain waves brought on by meditation, studies have shown.

Simply put, it's going from worrier to warrior, says Rogers, 45, a lawyer who conducts seminars for other lawyers and school groups.

"We want to move into a place where the outside world will do whatever it's going to do without us going through the roller coaster of emotions," Rogers says. "We want to maintain this more alive, vigilant, present way of being that is somewhat independent of how things are going."

Dr. Patricia Isis runs a mindfulness seminar at South Miami Hospital and says her weekly classes fill immediately. "People are stressed to the max," she says.

"Mindfulness is an opportunity to be awake and aware as much as possible from moment to moment in this one wild and precious life of ours," she says.

The mindfulness practice has ties to sports psychology, says Dr. Janet Konefal, the assistant dean for complementary integrative medicine at the University of Miami.

"Most of the research about this self talk comes from coaches and psychologists involved in sports," she said. "They're interested in how athletes talk to themselves and how that can make the difference and be cutting edge."

Olympics swimmer Michael Phelps, for one, is renowned for envisioning every race before he dives into the water. He focuses on the time he wants to achieve -- down to the hundredth of a second -- and the exact stroke count per lap he needs to achieve his goal. He credits this focus with winning a gold medal in the 200-meter butterfly at the Beijing Olympics last month despite a goggles failure that impaired his vision.

There is a growing body of evidence that this type of mental discipline and meditative practice can carve new pathways in the brain. It's a concept called neuroplasticity and it's just the opposite of what scientists had believed for years -- that the brain's nerve cells were set in childhood and didn't change.

Research has shown otherwise. A 2005 study published in the Proceedings of the National Academy of Sciences measured the brain waves in a group of Tibetan monks schooled in Buddhist meditative practices from centuries ago. The researchers at the University of Wisconsin found that when the monks meditated -- especially the ones most skilled in meditative practices -- their brain waves, as measured by brain-scanning machines, recorded much greater and more powerful activity than previous standards of healthy people. The Dalai Lama sent the monks to the Wisconsin lab.

Rogers recounts an experiment conducted by Harvard Medical School two years ago. A group of pianists were instructed to play a five-finger scale repeatedly to a metronome's steady beat. For five days the volunteers played the same pattern for two hours. The volunteers were hooked to a machine that sent a brief magnetic pulse into the motor cortex of their brains. This allowed scientists to gauge brain activity.

After a week of practice, scientists found that the motor cortex devoted to these finger movements took over surrounding areas in the brain, thus creating new pathways.

The experiment was repeated, but this time the volunteers were instructed to imagine themselves playing the piano. Hands never touched keys. The results were the same: The brain still cut new pathways.

"Twenty years ago, they would have said this is absolutely impossible," Rogers says. "In stroke victims this is hugely significant because we now know parts of the brain that we thought were localized -- this part for vision, hearing, the moving of the hand -- won't repair itself.

"Now we know this other portion of the brain can take on the necessary function to work with the arm. This has totally changed how we work with stroke victims. That part is not growing back but another part of the brain says, 'I can do that."'

Even earlier, in 1982, researcher Jon Kabat-Zinn studied patients with medical pain of six months to 48 years' duration who agreed to receive training in mindfulness-based stress reduction. The 51 participants who completed the program -- 88 percent of the 58 total enrolled -- said their perceived pain decreased significantly. In fact, half reported a reduction of 50 percent or greater, the Sept. 17 Journal of the American Medical Association reports.

Actor Alan Alda, at a recent appearance in Coral Gables for Books & Books, told an anecdote about how he used the "being present" technique of mindfulness to alleviate the pain of having a fingernail torn off in a fluke accident in an airplane bathroom. He says he went into a state of becoming fully aware of everything -- the sights, the sounds, even the throbbing in his finger, "and the pain went away," Alda insisted.

Andee Weiner, a grandparent and mother of three grown children in Miami, turned to mindfulness after a heart attack in 2006. She enrolled in an eight-week Mindfulness-Based Stress Reduction course at South Miami Hospital, a program based on the teachings of Kabat-Zinn, author of "Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness" (Delta; $20).

"I had no expectations because I had never done this before," said Weiner, 59. "It's one of the best things I've done for myself. A year and nine months later, I can't believe how it's enhanced my life. I have found myself to be more proactive in my medical care and trusting my instincts with a better understanding."

Weiner cites several examples of how mindfulness works for her: "I can be in traffic and instead of having nasty thoughts I can bring myself into a state where I focus on my breathing and those thoughts leave me. Or, I'm sitting in a doctor's office and instead of getting agitated while I'm waiting, I'm not agitated, my blood pressure is not sky high and I let go of a lot of baggage."

Techniques

There are several mindfulness techniques anyone can practice, anywhere. Here are some:

Scott Rogers, director of the Institute for Mindfulness Studies in Miami Beach, offers these techniques to help reduce stress and stay centered:

4-7-8 hand-breathing exercise

--Inhale and open your hands to the count of four.

--Hold breath and stretch fingers to the count of seven.

--Exhale and close your hands to the count of eight.

Every step my heart beats

Slow down and feel the foot as it presses the ground, getting in touch with your heartbeat on each stride. Next, incorporate the thought of a loved one's heartbeat beating in time with your pace. It can be a child, pet, partner. "This brings us a connectedness to the moment," Rogers says.

Accept your thoughts as natural

"There is a myth about meditation that you are quieting your mind. The mind's job is to be all over the place. It's about accepting wherever your mind is and bringing it back to the moment," says Dr. Patricia Isis, mental health counselor with South Miami Hospital. "The reality is our minds are fairly active most of the time and that's why people think they can't meditate."

Adds Rogers, "It's said we have about 50,000 to 60,000 thoughts a day and most of those are thoughts that we had yesterday and the day before.

"Just a small number are really relevant to what's taking place. If we can tone down the chatter, we get rid of the static," Rogers says.

"Mindfulness is catching the mind as it wanders. That's perfectly OK. We have a mind that wanders and is likened to a puppy dog. 'Stay here.' It walks off. 'There you are, you wandered."' Just bring it back to the moment.

Ambigamy: Five steps to Optimal Illusion: The path to sophisticated self-deception

2008-10-06T08:26:00.001-07:00

By Jeremy Sherman, Ph.D. on October 03, 2008 in Ambigamy

Self-deception - the sweetest and sourest taboo: There's no more reliable way to stimulate a rich discussion than to get catty about other people's self-deceptions. And there's no better way to curdle a conversation than to accuse someone of self-deception to his or her face: Self-deception is the other guy's folly. We're above it. Or, at least, we think so for a while.

Here's a back-of-the-napkin sketch of how we come to terms with our own potential for self-deception:

Stage 1- naïve: We come into the world with no notion of deception, let alone self-deception. Gradually, however, it dawns on us that people lie, and sometimes even lie to themselves. This makes us wary. We learn to spot other people's self-deception.

Stage 2-Exempt by contempt: We get pretty good at spotting other people's self-deception. We assume that because we can spot their deceptions and they can't, we must be experts on spotting deceptions. As experts, when we inspect our own thoughts presumably with the same scrutiny we apply to others we don't notice any self-deception. So we must be exempt. The more contempt we feel for other people's self-deceptions, the more expert and exempt we feel.

Stage 3-I once was lost, but now I'm blind: Sooner or later. we catch a glimpse of our own potential for self-deception. Maybe we overhear someone at stage 2 giving us a taste of our own medicine. Maybe we catch ourselves. Now we have to come to terms with it - and come to terms we do. We surrender. We admit that we had a potential for self-deception. We give ourselves credit for seeing it. We're no longer exempt by contempt. But we were brave enough to face our self-deceptions, which gives us a different, more sophisticated exemption. OK, so we used to be lost. We didn't know ourselves. But we learned. Now we know ourselves. Pat. In this stage, we talk about other people's self-deceptions. But we tell self-effacing stories about our own past follies, too.

Stage 4-Eternally nonexempt: We discover that even with the exceptional self-knowledge we acquired in stage 3, we still lie to ourselves. It turns out that self-deception isn't a onetime thing: No matter how skeptical we get with ourselves, we just can't keep up. No matter how much we pursue the truth, it will never catch us. Now we're wary of ourselves. In stage 4, talking about self-deception is a bummer. It's a rare person who gets past stage 3, because stage 4 is so little fun.

Stage 5-Optimal illusion: If there's no escaping self-deception, then maybe it's not all bad. What is it, anyway? Is it self-deceptive to hope and pray and believe that of the many ways a situation could turn out, it will turn out well? Of course not. But if it turns out poorly, you'll wonder why you kidded yourself. And the folks stuck at stage 2 will snigger about you behind your back. But maybe they're wrong. Maybe the trick isn't eliminating self-deception, but learning how to use it well. Here, we embrace optimal illusion:

The trick isn't being an orthodox realist or an orthodox dreamer, but, rather, getting the right mix of the two, absorbing and ignoring reality checks in the right combination in order to keep ourselves motivated, focused, and flexible, our feet on the solid ground to keep from falling, our heads in the air to improve our chances of achieving lift-off. It's not an easy balance to achieve. In fact, it's unachievable - optimal illusion is a lifelong pursuit.

Not everybody gets to all five stages. And we don't graduate from one to the next; rather, we expand our repertoire, adding the stages as we go and changing the frequency with which we visit each. Even the best optimal illusionists get catty sometimes, as though they are still at stage 2. Sometimes, laughing at other people's folly is the optimal illusion, the best way to resist surrendering to their alternative viewpoint.

Without cattiness, it may be impossible to climb to the higher stages. Cattiness sharpens our claws. As they grow, they curl back in on us, causing the sharp self-inflicted pain from which we learn.

OPTIMAL ILLUSION

Jeremy Sherman

Can musicians feel the music
though they know the notes by name?

Can athletes play a death match
though they know it's just a game?

Could Vargas feel the heat and lust
from a pinup he had painted?

When materialists know it's glandular
do their love affairs get tainted?

When you know it's lights on silver screen
do the movies seem more pallid?

If you see through God to his creator
does your creed become less valid?

No, apparently we're able to both see through and
believe

What an awesome gift from God is this, our power to
self-deceive.