Category: Therapy

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Barriers Prevent Soldiers From Seeking Psychological Help

00Featured news, Health, Post-Traumatic Stress Disorder, Psychopathy, Therapy, Trauma August, 17

After two tours of duty in Iraq, Sergeant Eric James of the United States Army returned home to Colorado where he began experiencing symptoms of Post-Traumatic Stress Disorder (PTSD).

James sought out a military psychiatrist for his declining mental health. In over 20 hours of recorded audio, therapists and officers at Fort Carson in Colorado can be heard berating James for suggesting he may be suffering from serious mental illness and ignoring his repeated requests for help. James was told that he was not emotionally crippled because he was “not in a corner rocking back and forth and drooling.”

James’ experience in seeking mental-health treatment may be indicative of a wider, systemic issue within the military. As pleas for help go unanswered, soldiers have begun to actively avoid mental health treatment, fearing consequences like forced retirement or reduced pay.

An article in the The Globe and Mail addressed one of these issues directly:

“Because Canadian Forces members do not earn a pension until they have served 10 years, this encourages some to wait until they’ve reached that milestone before asking the military for mental health counseling and other aid.”

Mental-health programs become inaccessible as soldiers are caught between a desire to seek out support and a fear of losing financial security, potentially losing their livelihood or living with declining mental health.

Worse, a 2012 Harvard Gazette report on the US Military stated that:

“Estimates of PTSD are higher when surveys are anonymous than when they are not anonymous.”

There may be consequences for soldiers who speak up about their mental health issues, and these consequences act as a barrier to seeking help.

It’s also possible that James’ case may be an example of the old “patch ’em up and send ’em back” approach to treating members of the military, whereby doctors and therapists devise a quick fix for physical and mental problems in an effort to get soldiers back into active duty.

Donald (name changed for anonymity), a current member of the Canadian Armed Forces, told the Trauma and Mental Health Report in an interview that painkillers and antidepressants are often prescribed in place of a more comprehensive approach to health concerns. These treatments address symptoms, but not the underlying causes.

Using medications to help sufferers of PTSD manage symptoms is an important aspect of treatment. But if supportive psychotherapy is provided either on its own or alongside drug therapy, the need for medications can be significantly decreased.

A study published with the American Psychiatric Association noted that:

“While treating PTSD with drug therapy has accumulated some empirical support, the Institute of Medicine rates trauma-focused cognitive behavioral therapy as the only first-level treatment for PTSD.”

And while proper treatment for PTSD is necessary, it can be expensive. An article from the LA Times reported a military estimate of treating PTSD to be $1.5 million over a soldier’s lifetime.

For James, after an internal investigation, he was ultimately sent for treatment and received a medical retirement with benefits. Many of our military personnel receive no treatment at all, leaving them to struggle with PTSD on their own.

–Andrei Nistor, Contributing Writer, The Trauma and Mental Health Report.
–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report.

Copyright Robert T. Muller

This article was originally published on Psychology Today

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A Hands-On Approach to Psychotherapy?

00Empathy, Featured news, Health, Therapy, Trauma July, 17

Source: stux at Pixabay, Creative Commons

A friend of mine, Sigourney (name changed), once told me she would never see a therapist who wouldn’t hug her. Adamant that non-sexual touch in therapy helped her feel connected, she characterized a therapist who wouldn’t touch her as rejecting, cold, and untrustworthy.

The subject of non-sexual touch in therapy is controversial, and seems to vary depending on the professional training of the clinician. A study of clinical psychologists by Cheryl Stenzel and Patricia Rupert of Loyola University shows that many practitioners worry touch can be misinterpreted as erotic, or can damage a vulnerable client. There is also the risk of ethical complaints, so most psychologists refrain from touching clients under any circumstances.

In contrast, a summary of research by James Phelan of the American Psychoanalytic Association shows that, in surveys of psychotherapists and social workers, more than 80% touch their clients in non-erotic ways. This touch might include a pat on the arm or back, a side hug, or a full-on embrace.

So, when is touch appropriate in a therapy session?

Little training or discussion exists on therapeutic touch. Students of psychotherapy are often left confused, unsure of how to proceed, and afraid to broach the topic with their supervisors. The ethics code of the American Psychological Association does not prohibit non-sexual touch, while sexual contact, of course, is forbidden. In an interview with the Trauma and Mental Health Report, social worker Cara Grosset, a 20-year practitioner of trauma counselling, says that touching a client depends on the context and the person.

“I work with children and adolescents who have experienced or witnessed severe traumas. They may have discovered a parent who died from suicide or seen their parent killed. If they are sobbing uncontrollably in a session when describing this experience, it seems almost inhuman to not reach out with a comforting and appropriate touch.”

Grosset sees many of her clients in group situations, such as summer camps for grieving youth. In this type of setting, a soothing side hug or pat on the back during a difficult discussion happens publicly, leaving little room for misinterpretation. She has found that these gestures help the healing process.

Another example of successful non-sexual touch happens when Grosset facilitates therapy with children and their parents. Some of her young clients run to her at the beginning of a session to hug her as their parents stand by. An affirming response from Grosset is important for the child to feel nurtured and valued.

But Grosset understands why some therapists are reluctant. Many clients don’t want to be touched, and it’s important to know each person’s boundaries. Touch must be for the client’s sake, not the therapist’s. And when touch helps build connection with the client, it can be a beneficial adjunct to talk therapy.

At the same time, touch can be difficult to navigate in private sessions due to ambiguous professional guidelines and taboos surrounding touch in this type of setting. Grosset’s viewpoints are substantiated by other therapists in qualitative research by Carmel Harrison and colleagues at Bangor University in Wales:

“The values of touch included the ideas that touch could offer clients support, acknowledgement and containment. Despite this, all therapists emphasised the rarity and cautious use of touch in their practice. They discussed touch as being outside the remit of clinicians, and considered how limited discussion and training perpetuated this belief.”

It’s easy to find opposing points of view. Some clients feel that a touch from their therapist increases their self-esteem and enables them to move past feelings of worthlessness. For example, a response to a blog on the website ‘Jung at Heart’ read:

“Twenty years ago, my therapy sessions were, after the first six months to a year, almost always punctuated at the end by a hug. Those hugs saved my young life.”

On the same website, others state that they would feel awkward and violated by a therapist’s touch:

“As a therapy client, I really don’t want my therapist touching me. Not a hug, or a pat of the shoulder, or even a handshake.”

In a 2015 New York Times blog, psychotherapist Hilary Jacobs Hendel explains how she spontaneously hugged a client, but still feels uncomfortable about integrating touch into her practice. Instead, she uses imaginary touch, asking her clients to visualize hugs: “Even when I think a physical hug would be therapeutic, I continue to rely on fantasy.” This unique workaround ties back to concerns of actually touching clients.

The benefit of non-sexual touch in therapy is still open to interpretation. Even thoughresearch shows that human touch is important to wellbeing, individual clients and therapists differ greatly in their beliefs on the subject, and risk-management leans toward using it sparingly if at all.

–Lysianne Buie, Contributing Writer, The Trauma and Mental Health Report.
–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report.

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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Losing a Pregnancy Only to Lose One Again

00Fear, Featured news, Grief, Pregnancy, Resilience, Therapy, Trauma July, 17

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Anna R. was having an ultrasound, prepared to see her baby for the first time. When she asked the technician what the sex of the baby was, the tech quickly left the room. The physician then entered to tell Anna there was no heartbeat. This became the first of seven pregnancy losses that she would endure.

Recurrent pregnancy loss (RPL) is typically defined as three consecutive losses prior to 20 weeks from the last menstrual period.

Affecting 1-2% of women, the causes of RPL differ. Advancing maternal age is associated with elevated risks of miscarriages, particularly in women 45 or older. Paternal age can also be a variable, with environmental and genetic factors playing a role as well. The risk of miscarriages further increases with the number of previous miscarriages, reaching approximately 40% after three consecutive losses.

While these causes have been established within the medical community, doctors still struggle to predict what ultimately leads to a couple’s pregnancy loss. Even after numerous tests, Anna’s physicians never found anything wrong, making the loss that much harder to cope with.

After her eighth miscarriage, Tracey Beadle of County Durham, UK told The Northern Echo:

“I think I wanted for them to find something wrong, because that would mean something could either be fixed or give us a reason to stop trying for a baby. We did not know when to stop.”

Janet Jaffe, a clinical psychologist and co-author of the book “Reproductive Trauma: Psychotherapy with Infertility and Pregnancy Loss Clients”, told the American Psychological Association:

“A miscarriage is a traumatic loss, not only of the pregnancy, but of a woman’s sense of self and her hopes and dreams of the future. She has lost her ‘reproductive story’, and it needs to be grieved.”

This grief is unique, in that expectant mothers and fathers mourn a child that never came to be. As Kate Evans, a woman who had six miscarriages said in an article in the Independent:

“If there’s no body, how can I grieve? I feel as though I must be kidding myself, wallowing in a morass of grief over a person who never even lived. Every time my mind trips back to this death, this loss, it strikes on empty, because there’s nothing there to miss.”

While there is no physical body to grieve, the hopes and dreams for a future with the child are ultimately the elements missed the most.

This grief is further complicated by feelings of isolation. When a loved one dies, there is often comfort in collective mourning with other grief-stricken individuals. But grieving the loss of a pregnancy can be an isolating experience for parents, as others haven’t formed the same connection with the unborn child and may struggle to understand why the experience is so painful.

Outsiders may also lack empathy for the mother’s experiences and fault her for the outcome of the pregnancy. Anna explained that people unintentionally implied that she was to blame for her miscarriage through comments like, “Do the doctors know what’s wrong with you?” or “Maybe you weren’t taking good care of yourself.”

RPL has been shown to severely disrupt the parents’ mental health. According to astudy by psychiatrist Michael Craig and colleagues at the Institute of Psychiatry, King’s College London, of 81 women with recurrent miscarriages, 33% were classified as depressed, with 7.4% suffering from severe depression. And 21% of the women also had clinically significant anxiety, while some experienced heightened anger and guilt.

Research documenting fathers’ grieving processes showed that, unlike women, many men do not react with increased depressive symptoms, crying, or feeling the need to talk. But similar to women, a major source of grieving arises from relinquishing their hopes and expectations for their unborn child.

While physical treatments for RPL include surgeries, medications, genetic screening, and lifestyle changes, the emotional and psychological toll must also be addressed.

A report by the Practice Committee of the American Society for Reproductive Medicine indicates that psychological support in early pregnancy results in significant improvement of pregnancy outcomes. Psychotherapy can also help work out anxieties and fears from previous miscarriages.

According to Anna, therapy was what helped her through seven painful miscarriages:

“My therapist became my saving grace. I could comfortably tell her anything and everything—especially things I didn’t want to discuss with my husband, like thoughts of suicide. She was the voice of reason in my confused and isolated world.”

Individuals can find additional help through in-person support groups at local organizations, or through online sites, such as the Baby Center, which offer web-based clubs and blogs. Connecting with these groups allows individuals to interact with others experiencing the same grief, which may reduce feelings of isolation.

In the midst of hopelessness, people may feel safer bracing themselves for more heartache. But it is important to remember that, even after four consecutive losses, a patient has a greater than 60% to 65% chance of carrying the next pregnancy to term. In the meantime, seeking psychological support to work through the anxiety and grief may be beneficial.

–Eleenor Abraham, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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Conversation Cards Help Therapists Dig Deeper

00Child Development, Education, Featured news, Parenting, Therapy, Trauma June, 17

Source: Michael on flickr, Creative Commons

As a counselor, social worker, or therapist, how do you begin conversations with your clients? What are the best ways to break the ice and generate meaningful discussions? These are questions that Jane Evans, trauma, parenting and behaviour expert, found to be common among her colleagues in the field.

Evans is a therapist and member of NEYTCO, the National Early Years Trainers and Consultants Organization, located in the UK. She has spent over 20 years working with parents and children who experience difficulty in relationships.

In an interview with the Trauma and Mental Health Report, Evans explains:

“I find that many practitioners don’t entirely understand childhood trauma and they struggle to talk to parents about it.”

To facilitate more open dialogue, Evans created Fink Cards—a conversation tool that provides structure to therapy sessions and helps therapists and clients engage in meaningful discussions. The Cards list questions to help parents who have trouble communicating and forming a good relationship with their children. And the Cards help parents and families who have encountered trauma in the past.

Since Evans sees trauma as a major factor in difficult parent-child relationships, she directly addresses this issue with the Fink Cards. They ask questions like “what does the word trauma make you think about?” to open the door to therapy work. The Cards support the counselor in facilitating discussion, and assist clients.

Evans found, while working with families, that parents are not always aware of how their own actions, as well as their interactions with the child, may in fact perpetuate problem behaviours. She says:

“Most parents see the child as the problem; they’re always aiming to fix the child. However, these cards invite them on a different journey. Parents consider what has happened early in their own lives or in their child’s early years and how that impacts their child’s behaviour now.”

Questions like “who was in charge of discipline when you were a child?” and “who notices when you are worried or anxious?” help parents reflect on how their early experiences and current support systems shape their parenting practices, as well as any negative impact these may be having on the child. As parents consider how these events impact their parenting choices, the therapist is able to work with them to implement more effective methods of communication and alternative coping strategies.

Research has shown that conversation cards can help patients become more open about their feelings. In a study conducted by researchers at Stratheden Hospital in the UK, 6D cards were used to facilitate holistic, patient-led communication. 6D cards are a type of conversation card developed to help physicians and nurses ensure a meaningful consultation with female patients in a gynecology clinic. They contain six categories, or dimensions, of health, including healthcare, emotions, lifestyle, interpersonal relationships, symptoms, and life events. The purpose of these cards is to allow the patients to lead the conversation.

Another study, conducted by the Design Council of the UK and the Bolton Primary Care Trust, focused on creating stronger methods of communication and management for diabetic patients with the use of Agent Cards, which are similar to both the 6D and Fink Cards. Agent Card statements encourage patient-led conversations with practitioners. Results of the study showed that using the cards helped facilitate more open discussion.

With Evans’ Fink Cards, clients have the freedom to choose questions from four categories during sessions: the parent’s early childhood and upbringing; the parent’s relationship with his or her child; the parent and child’s worries and anxieties; and how early trauma may have affected the child.

“These cards are a way of having difficult conversations, but it’s not just me putting the questions to the patient and saying ‘you have a problem,’” Evans explains.

While the effectiveness of Fink Cards does require more research, they have already made their way into the marketplace, and look to be a promising resource in clinical settings. Sometimes building rapport or discussing sensitive topics with a client can be difficult, but Fink Cards may go a long way in helping therapists and clients ease into healthy conversations in an educational and comfortable way.

–Afifa Mahboob, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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Male Rape Victims Face Difficulty Finding Support

00Depression, Featured news, Post-Traumatic Stress Disorder, Suicide, Therapy, Trauma April, 17

Source: Fabrizio Lonzini on flickr, Creative Commons

In October 2015, Sweden opened the world’s first male rape center. It is the only known center that provides emergency medical care for men and boys who are victims of rape or sexual abuse. Although most rape centers don’t turn male victims away, there are no others that cater specifically to the physical and emotional needs of men who undergo such trauma.

The issue of male-on-male, and especially female-on-male rape and sexual abuse is largely unacknowledged in part because these forms of trauma are much less common than those involving a female victim. Statistics Canada reports that approximately 8% of sexual assaults involve a male victim.

In the 1980s, the word “rape” was removed from the Criminal Code of Canada and replaced by three different levels of sexual assault, specified by whether or not force or threats were involved and to what degree they were present. The problem with this approach is that “sexual assault” sounds like a lesser issue; it doesn’t carry the same weight as “rape”.

In October 2013, Kirk Makin wrote in an article for The Globe and Mail:

“Instead of the loaded word rape—with all its moral and social baggage—three levels of sexual assault were written into law, each level escalating in gravity. But getting rid of the legal term ‘rape’ didn’t stop it. In fact, many argue that it profoundly defanged the justice system and has resulted in lighter—not tougher—sentencing.”

Terminology may partly account for a lack of male rape centers, but so might the negative cultural view of a man being raped, particularly by a woman.

Popular culture and the media typically portray rape as involving penetration, which assumes only a male can perpetrate it. So, the common view is that men cannot be raped by women. For example, if a victim tells a friend he’s experienced unwanted sexual activity, the friend’s reaction is likely to be as congratulatory as horrified. And the victim is less likely to report the crime. An article on rape from Stanford University’s Encyclopedia of Philosophy even states in its premise the assumption that perpetrators are male and that victims are female, disregarding the issue of male rape altogether.

There is a common sentiment that men are always open to sexual advances and, therefore, automatically consent. This misconception can lead to situations where, if a man is intoxicated or otherwise unable to provide consent, he may subsequently be sexually assaulted. Contrary to stereotypes, the common view of “no means no” applies to both genders, and a lack of consent is just as significant as an expression of non-consent.

Another problem focuses on the male-on-male rape that occurs in prisons. Jokes about not “dropping the soap” are rampant in the media, giving the impression that, since these individuals are criminals, they should expect—indeed deserve—sexual assault.

And rape committed in prisons is not even included in national statistics, an omission that has the effect of failing to prevent abuse, as well as diminishing the issue. As a result, there is an insufficient allocation of resources for victims within the prison system. Victims require both emergency medical services, as well as counselling, to address the physical and emotional damage of sexual violence.

The opening of a male rape center in Sweden is a positive step, suggesting some progress toward support for male rape victims. But on a broader scale, the problem goes unacknowledged. Attitudes cannot change without a more systemic shift in how male rape is viewed and addressed.

–Andrei Nistor, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Remote Northwest Territories Lacking Mental Health Care

00Environment, Featured news, Health, Self-Harm, Suicide, Therapy, Trauma November, 16

Source: Gloria Williams on Flickr, Creative Commons

On April 26, 2015, 19-year-old Timothy Henderson, a resident of the North West Territories in Canada, was taken off life support after sustaining self-harm injuries, the culmination of a long battle with depression and other mental health issues.

Beginning in adolescence, Timothy struggled with symptoms of ADHD and Asperger’s syndrome (Autism spectrum). When he felt overwhelmed by his condition, he reached out for support, but felt dismissed, and began to lose hope that the help he needed would be available.

Shortly before his death, Timothy admitted himself to Stanton Territorial Hospital for the fifth time in a year, where he again disclosed details about a tendency to self-harm. He was released two days later, without adequate follow-up or a long-term care plan. Later that month, he sustained self-inflicted injuries that led to his death.

Timothy’s case is not uncommon in the Northwest Territories, a remote region of northern Canada. The NWT Mental Health Act states that a medical practitioner can only detain an individual for psychiatric assessment for a maximum of 48 hours. This time limitation often results in rushed and insufficient care—a result of a system that is understaffed and overworked.

The territory’s current Mental Health Act, introduced in June 1988, has been cited as a main cause of inadequate services for individuals suffering from mental illness. The act is out-of-date and has not been modernized with strategies to address the current mental health climate of the NWT.

In a report by the Alternative North Health Coalition, the mental wellbeing of residents in the NWT is shown to be much lower than that of the average Canadian, with a national rate of suicide three times greater than those living in the more populous south. Lack of access to staff, resources, and community-based treatments are all relevant aspects of the act that impede adequate treatment and prevention strategies.

Timothy’s mother, Connie Boraski, believes Timothy’s mental health began to worsen when he turned 17, and no longer qualified for the pediatric healthcare program. This transition resulted in lengthier waits for treatment and drastic changes in privacy laws that prevented Timothy’s parents from having access to information about their son’s treatment. Mental health legislation regarding the legal rights of family members and other caregivers is an aspect of the Mental Health Act that restricts parents, like Timothy’s, from intervening to support their children.

After being repeatedly dismissed, Timothy eventually stopped asking for help. Boraski explains:

“Timothy never wanted to be a burden to anyone. That was a real challenge for him, to ask for help.”

Deficiencies in the quality and quantity of staff and resources reflect the isolation and socioeconomic climate of the NWT. Due to the small and relatively isolated nature of the region, accessing facilities within the community can be difficult. Timothy had to travel between hospitals in the NWT and Alberta to obtain psychiatric help, which resulted in seeing a different doctor on each occasion. This kind of disjointed doctor-patient relationship makes it difficult to stay connected.

The public outrage following Timothy’s death eventually drove NWT Health Minister, Glen Abernethy, to open a review into Timothy’s case and bring changes to mental health legislation. In addition to other important components, the new act will include information on services such as Assertive Community Treatment (ACT), which will allow patients to have access to specialized treatment and supervision within remote communities of the NWT.

The revised act, if passed, is expected to come into effect sometime in 2016. Though implementation of a new mental health act is too late for Timothy Henderson, the hope is that a new mandate will provide the Northwest Territories with better preventative measures and resources for residents suffering with mental illness.

– Nonna Khakpour, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Illustrating Mental Health with Cartoons

00Charisma, Creativity, Depression, Featured news, Health, Humor, Therapy November, 16

Source: Allie Brosh

From the darkness of despair, Gemma Correll and Allie Brosh have created deeply personal cartoons to illustrate their experiences with mental illness. Maintaining popular online blogs, they have recently published cartoon books revealing their innermost struggles and fears.

Through simple drawings, Correll and Brosh make it easy for audiences to grasp the intricate aspects of psychological disorders. The unique illustrations are designed to be informative, yet dark and humorous.

In her 2015 book, The Worrier’s Guide to Life, Correll portrays her experience with anxiety, including unwanted intrusions from unexpected guests and unwelcome phone calls that one would prefer to avoid. She labels them “Real Life Horror Movies.”

Another example of Correll’s sharp humour comes in the form of a red poster, shouting: “I can’t keep calm and carry on because I have an anxiety disorder.”

Though the images are vital to the message, the corresponding narratives are equally important. Correll explains her images only make sense in combination with the words. One poignant cartoon called “Visit Depression Land! It’s the crappiest place on earth,”depicts a “non” amusement park with commentary on all of the “non” amusing things you can do while visiting.

The comics are both painful and funny. One of Correll’s fans sums up the experience on Twitter: “I’m laughing but I’m also crying. But I’m also laughing.”

A common thread in the struggle with mental illness is the accompanying isolation; in these comics, readers see themselves and their situations, and perhaps realize that they are not alone in the experience. In an interview with NPR, Correll explains, “I think people are really glad to find somebody who’s had the same kind of experience. Anxiety and depression can make you feel quite isolated.”

This sentiment was echoed by Brosh in an online Reddit question and answer session:

“Depression is such an isolating experience, but there’s always a tiny amount of comfort from knowing that someone else has been out there too. I mean, I never thought that writing about my depression would circle back around and make me feel less isolated, but in a strange way, it has.”

Although depression can be difficult to explain, Brosh chronicles it with startling clarity in her blog Hyperbole and a Half:

“I spent months shut in my house. I couldn’t feel anything through the self-hatred. Trying to use willpower to overcome the apathetic sort of sadness that accompanies depression is like a person with no arms trying to punch themselves until their hands grow back.”

In another blog entry with an accompanying cartoon, Brosh captures how depression feels:

“You’re stuck in the boring, lonely, meaningless void without anything to distract you from how boring, lonely, and meaningless it is.”

Brosh painstakingly works to get the facial expressions and body stances of her characters just right, to depict the emotions she wants to convey. Visual cues give meaning where words fail.

Depression is often misunderstood by those who don’t suffer from it. Many think that giving advice and imposing optimism are the answers. Brosh illustrates this disconnect.

Psychologists and professors are taking note—sharing the blogs widely and using them as teaching tools.

Psychologist Jonathan Rottenberg of the University of South Florida devoted a post on Psychology Today to Brosh:

“I know of no better depiction of the guts of what it’s like to be severely depressed. If you’ve been severely depressed, or if you know someone who is and you want to know more about what they are experiencing, please read ‘Hyperbole and a Half.’ “

Psychotherapist, psychology student, and Reddit user ‘busterbrother’ also explains on Reddit how the cartoons made a difference in her practice and at school. One of her suicidal clients struggling with depression felt that no one understood. Using Brosh’s blog, the therapist could offer an account of someone facing similar difficulties. ‘Busterbrother’ also used the blog in a presentation to illustrate depression to others in her cohort, after which her professor began incorporating it into his own classes:

“The professor said that this blog is the best way that he has ever seen someone talk about depression to someone who has never experienced it.”

This idea is supported by research. In the International Journal of Humor Research, Yan Piaw Chua, a professor at the University of Malaya in Malaysia, demonstrated how this type of humour can enhance student comprehension and motivation to learn. And studies show that humour can improve wellbeing and reduce depression.

Researchers Shelley Crawford and Nerina Caltabiano at James Cook University in Australia developed a humour skills program that included a booklet with jokes and funny stories. They found that participants achieved heightened wellbeing, as well as decreased depression and anxiety, in comparison to groups that received treatment without humour or no treatment at all. Other studies have shown similar results.

As one reader put it: “…these comic strips make my day whenever I am feeling a little glum and need an instant pick-me-up.”

Being able to communicate feelings of depression and anxiety without being judged, and doing so creatively… what better way to combat demons?

–Lysianne Buie, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Biased Publication Standards Hinder Schizophrenia Research

00Addiction, Bias, Deception, Education, Ethics and Morality, Featured news, Psychopharmacology, Therapy September, 16

Source: Erin on Flickr

The effects of schizophrenia are profound. Characterized by delusions, hallucinations, and social withdrawal, the disorder has no known cure. The introduction of antipsychotic medications in the 1950s has helped many sufferers cope. Following diagnosis, patients usually take antipsychotics for the rest of their lives.

But recently, a 20-year study by professor emeritus Martin Harrow and colleagues at the University of Illinois found evidence to support alternative treatment methods. In fact, non-medicated patients in the study reported better community functioning and fewer hospitalizations than patients who stayed on antipsychotics.

So why do medications continue to be the most commonly prescribed treatment for schizophrenia?

Antipsychotic drugs are the largest grossing category of prescription medication in the United States, with a revenue of over $16 billion in 2010. And much of the research that exists on treatment of schizophrenia is directly funded by pharmaceutical companies, making it challenging for independent researchers like Harrow and his team to get studies published. A bias exists towards silencing unfavourable research.

An analysis looking into possible publications biases surrounding antipsychotic drug trials in the U.S. found that, of the trials that did not get published, 75% were negative, meaning that the drug was no better than placebo. On the other hand, 75% of the trials that did get published found positive results for the antipsychotics being tested.

The Washington Post wrote an article in 2012 claiming that four different studies conducted on a new antipsychotic drug called Iloperidone were never published. Each of the studies pointed to the ineffectiveness of the drug, finding that it was no more effective than a sugar pill for the treatment of schizophrenia. A publication bias like this is worrisome.

Research has also shown that staying on antipsychotic drugs for long periods of time negatively impacts brain functioning and could potentially lead to a worsening of some of the initial symptoms of the illness, including social withdrawal and flat affect.

A growing body of research is focusing on cognitive therapy and community based treatments for schizophrenia, as either a replacement for or in combination with traditional pharmacological treatments. So far, outcomes have been promising.

A study by Anthony Morrison, a professor at the University of Manchester found that patients undergoing cognitive therapy showed the same reduction in psychotic symptoms as patients receiving drug treatment. Likewise, research by psychiatristLoren Mosher, an advocate for non-drug treatments for schizophrenia, showed that antipsychotic medication is often far less effective without added psychotherapy. Onestudy by Mosher showed that patients receiving alternative community based treatment had far fewer symptoms of schizophrenia than patients who received traditional treatment in a hospital setting.

When antipsychotic medication was introduced, many hoped it would represent themagic pill for an illness previously thought to be incurable. But little was known about the long-term effects, and even today, many claims of medication efficacy or lack of side effects remain questionable.

Research in schizophrenia is burgeoning and whether a safer, more effective treatment can be developed remains to be seen. Yet for such developments to be possible, it is important for the scientific and medical communities to open themselves up to the possibility of alternative treatments instead of limiting research that challenges the status quo. While antipsychotic medications offer great benefits in terms of reducing acute positive symptoms like hallucinations or delusions, they are by no means a cure.

–Essi Numminen, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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“Ex-Gay” Conversion Therapy Movement Puts Lives at Risk

00Conformity, Featured news, Health, Sexual Orientation, Social Life, Stress, Therapy September, 16

Source: Photographee.eu/Shutterstock

There is a billboard in Richmond, Virginia hanging above the interstate with a picture of identical male twins and a caption that reads: “Identical Twins: One Gay, One Not. We believe twin research studies show nobody is born gay.”

Parents and Friends of Ex-Gays & Gays (PFOX), the organization that created the ad, promotes the view that being gay is a choice, not a genetic predisposition, despite extensive research showing the contrary.

The claims in the ad are not only false, but the men featured are not actually twins at all, or even brothers. According to the Huffington Post, the face of South African model, Kyle Roux, was superimposed onto two different bodies to give the illusion of twins. Roux was shocked to see his face on the ad, as he didn’t give permission for the image to be used. And…he is openly gay.

PFOX is part of the controversial Ex-Gay Movement, encouraging gay persons to refrain from same-sex relationships, eliminate homosexual tendencies, and develop heterosexual desires. Their view: Gay must be cured.

They consider sexual orientation a choice, and those who identify as gay are willingly choosing a deviant lifestyle. But this ideology results in family rejection and self-hatred among LGBTQ individuals, as well as intolerance and discrimination in the community.

Organizations promoting this view are often affiliated with religious institutions. PFOX believes gay people can renounce homosexuality through religious revelations or conversion therapy, also known as reparative therapy.

Sexual orientation conversion therapy became popular in the 1960s. According to the American Psychological Association report, Appropriate Therapeutic Responses to Sexual Orientation, different disciplines of psychology influenced practices of conversion therapy.

In response to such treatments, numerous mental health and psychological organizations publically announced that homosexuality is not a mental disorder and is not something that can or should be cured. In fact, the American Psychiatric Association’s Board of Trustees removed homosexuality from the Diagnostic and Statistical Manual of Mental Disorders, Second Edition (DSM II) in 1973. And in 2000, they further stated:

“The potential risks of reparative therapy are great, including depression, anxiety and self-destructive behavior, since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by the patient.”

The risks are even greater among gay youth. A 2009 study by Caitlin Ryan of San Francisco State University found that young adults who experience family rejection based on their sexual orientation are eight times more likely to attempt suicide and six times more likely to experience depression.

Despite these findings and professional opposition to conversion therapy by both the American Psychiatric and American Psychological Associations, many of these treatments continue to be used and promoted.

Michele Bachmann, a Republican former member of the U.S. House of Representatives, considers homosexuality a choice. Bachmann and her husband were found to be practicing conversion therapy at their Christian counseling clinic in Minnesota.

Conversion therapy is still legal in most U.S. states, though anti-conversion bills have been signed into law in California, New Jersey, and Washington DC. Campaigns such as the #BornPerfect movement are working toward expanding state bans into other areas.

While public attitudes and legislation are shifting toward respect for LGBTQ individuals, conversion therapy is still a common practice, compromising mental health, threatening lives, and undermining efforts of movements that stress tolerance and equality.

–Eleenor Abraham, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Exercising Your Way to PTSD Recovery

00Featured news, Health, Post-Traumatic Stress Disorder, Stress, Therapy, Trauma August, 16

Source: Wounded Warrior Regiment on Flickr

Recent headlines about suicide, domestic violence, and shootings have brought public awareness to the mental health strain that is placed on the men and women in our military.

Post-traumatic stress disorder (PTSD) can drastically alter the lives of sufferers and is particularly common in veterans. The condition has been documented in 8% of Canadian soldiers who served between 2001 and 2008 in Afghanistan.

Effects include flashbacks, high anxiety, personality changes, startle responses, mood swings, and disturbed sleep, with typical treatment involving antidepressants and psychotherapy.

In an effort to develop treatment options, many are looking to physical remedies such as intense exercise to help those suffering from PTSD. We know that those who exercise regularly are less likely to suffer from anxiety and depression. But research by Mathew Fetzner and Gordon Asmundson at the University of Regina found that two weeks of stationary biking can be helpful in reducing PTSD symptoms and improving mood.

Further, researchers at Loughborough University have reviewed multiple studies that looked at the impact of sport and physical activity on combat veterans diagnosed with PTSD. Their findings: physical activity enhances well-being in veterans by reducing symptoms and improving coping strategies.

Symptom reduction in these studies seems to occur through a renewed sense of determination and hope, increased quality of life, and the cultivation of positive self-identity. The researchers explain that participating in sports and physical activities helps combat veterans gain or regain a sense of achievement.

Exercise also increases respiratory sinus arrhythmia. This naturally occurring variation in heart rate is linked to higher levels of emotion-focused coping—an ability disrupted in those with PTSD.

Treatment adherence is often a problem for PTSD sufferers, given that formal therapy is not always appealing to them, Fetzner claims. Low dropout rates of therapies involving physical exercise make the intervention feasible.

But the positive effects of intensive exercise on PTSD may be suitable only for some combat veterans: those with the physical ability to participate.

According to Veterans Affairs in Canada, psychiatric conditions are the second-most common cause of disability among returning soldiers. Debilitating physical injuries, such as amputations, and traumatic brain and spinal chord injuries are more common. And in addition to PTSD, the two most common mental health problems among returning soldiers are substance abuse and depression. More than 80 percent of the time, combat veterans have more than one diagnosis.

While aerobic exercise significantly reduces depression symptoms and helps prevent the abuse of drugs, the high rates of physical impairment in returning soldiers complicates the optimistic picture of exercise’s benefits on PTSD.

Less physically demanding exercise may be an option. Recent research shows that yoga, for example, may help individuals with PTSD focus on the present, reduce rumination, and combat negative thinking patterns.

While strenuous physical exercise may only be helpful for some returning veterans, milder forms of exercise and physiotherapy may be a useful adjunct to traditional treatment for many others. In either case, it is important for researchers and clinicians alike to take note of alternative ways of treating PTSD in an effort to provide options to those affected with the debilitating disorder.

–Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today