Category: Integrative Medicine

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For Those With Schizophrenia, Writing Can Help

30Creativity, Featured news, Health, Integrative Medicine, Psychopathy, Self-Help, Therapy March, 18

Source: Joe Skinner Photography at flickr, Creative Commons

A myth in popular culture: Mental illness leads to creativity. The idea is bolstered by successful movies like Total Recall, Minority Report, and Blade Runner, based on the work of author Philip K. Dick, who struggled with schizophrenia. Other notable artists, like singer-songwriter Brian Wilson from The Beach Boys, also showed schizophrenic symptoms.

These links have led scientists to question the relationship between schizophrenia and creative expression. While a connection appears to exist, the assumption that schizophrenia can cause creativity (or vice versa) doesn’t hold up, not in any simple or direct way. Often, these assumptions overlook other risk factors, such as family history, that contribute to the disorder.

And a report on brain illness and creativity by Alice Flaherty, associate professor of neurobiology at Harvard Medical School, paints a more complicated picture. While schizophrenia is not necessarily associated with creativity, one specific traitopenness to unusual ideas—relates to creativity and is prevalent among schizophrenic patients. This trait is common in many writers, as their work is a product of their imagination.

Mental health professionals have observed the therapeutic effects of writing on patients with schizophrenia—finding that the creative process assists these individuals with managing their symptoms.

Laurie Arney, who has schizophrenia, is a case in point. Arney’s therapist Christopher Austin from the Calgary Health Region in Alberta applied an approach called Narrative Therapy to help her cope with the illness. As part of the approach, Arney wrote about her thoughts, feelings, and hallucinations in an open journal to Austin, who would then write back, asking questions about her experiences and helping her process them. He found:

“Writing helped the client to express her experience of living with a mental illness, to describe her years of mental health treatment, and to find her own path toward wellness.”

As an adjunct to other therapies, the approach was helpful for Arney. She explained:

“When I am writing, I do not censor myself the same way as when I am talking. When something stressful happens to me, I can just go to my computer. As I write to Chris about the incident, I am already starting to go through the process of dealing with it. I do not have to save up all my concerns until my next [therapy] appointment.”

Writing therapy is also supported by research from Simon Mcardle at the University of Greenwich in the United Kingdom and colleagues. Certain creative or expressive writing exercises, such as poetry and story-writing, help schizophrenic patients express themselves, and control their thoughts and hallucinations.

According to Noel Shafi, a poet and neuroscience researcher, poetry can be used as a communicative tool for schizophrenic patients to share their emotions and disturbed thoughts. Shafi explains:

“The client externalized his negative beliefs in the form of a Haiku, using poetic expression for personal awareness and growth. The client had lost his sense of self-worth through his experience with psychosis and was now using poetry to validate his existence.”

But there are some risks associated with writing therapy, as these narrative exercises can elicit negative or disturbing expressions. According to Shaun Gallagher of the University of Memphis and colleagues, when using self-narratives, such as journal accounts or stories, patients can get confused between the story and real life. One patient’s narrative account reads:

“I get all mixed up so that I don’t know myself. I feel like more than one person when this happens. I’m falling apart into bits.”

Without regular monitoring, there may be difficulties, especially if patients struggle to distinguish between their thoughts and reality. Still, as a tool in the therapist’s kit, therapeutic writing does offer some help to a number of high-risk patients with serious mental-health problems.

–Afifa Mahboob, 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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Medicating Women's Sexual Desire Still Highly Controversial

00Featured news, Health, Integrative Medicine, Low Sexual Desire, Meditation, Psychopharmacology, Sex November, 17

Source: Minjung Gang at Flickr/Creative Commons

On August 18, 2015, the U.S. Food and Drug Administration (FDA) approved Flibanserin, a drug used to treat low sexual desire in women.

With the medication’s presence on the market, you’d think that low sexual desire in women would be well understood. In fact, there is still widespread debate on the issue. Marta Meana, a psychologist at the University of Nevada, writes: “Desire is the most subjective and acutely amorphous component of sexuality.”

And Lori A. Brotto, a Professor of Gynecology at the University of British Columbia, has offered a similar view: “There is no clear consensus on the causes of sexual dysfunction in women.”

While women experience obstacles to fulfillment, the causes are complex. According to Brotto, “An abundance of data indicates that low sexual desire is strongly influenced by a woman’s relationship satisfaction, mood, self-esteem, and body image.”

Medication is, at best, a partial treatment for problems with desire.

There are also differing perspectives on proper terminology. “Sexual dysfunction may not be the most accurate way to describe low sexual desire,” says Kristen Mark, Director of the Sexual Health Promotion Lab at the University of Kentucky. “Women may experience sexual problems, but sexual desire ebbs and flows, so people should expect that it will fluctuate.”

Deciding between the terms “dysfunction” or “low desire” may seem trivial. But language creates meaning and shapes how health professionals treat clients and conduct research.

Other clinicians agree. Leonore Tiefer at the New York University School of Medicine offers two metaphors for sex. The first is digestion. In this metaphor, sex is “just there.” Like digestion, it does not require learning but is a natural or innate action that the body is equipped for at birth.

The other metaphor is dance. There are many ways to dance. Some people are better at dancing, and some people like dancing more than others. Tiefer argues that sex, like dance, is a learned skill.

Tiefer has advocated extensively against pharmaceutical interventions for female sexual problems. In 2000, she convened The New View Campaign, a collective of clinicians and social scientists dedicated to reframing the conversation around sexuality.

To emphasize that sex has a social context, the New View wrote an alternative system of classification for sexual problems. The first category is “sexual problems due to socio-cultural, political, or economic factors,” and the second is “problems relating to partner and relationship.”

These categories include specific causative factors, such as “ignorance and anxiety due to inadequate sex education, lack of access to health services, or other social constraints.”

According to Tiefer: 

“Popular culture has greatly inflated public expectations about sexual function. People fed a myth that sex is “natural”—that is, a matter of automatic and unlearned biological function—at the same time as they expect high levels of performance and enduring pleasure, they are likely to look for simple solutions.”

The drug Flibanserin is one of these “simple solutions.” Its approval has been met with controversy.

According to Loes Jaspers and colleagues at Erasmus University Medical Center, the effectiveness of Flibanserin is very low. In a meta-analysis examining the effect of the medication in about 6,000 women, Jaspers found that those receiving the drug experienced, on average, only 0.5 more “sexually satisfying” events per month compared to those receiving a placebo.

At the same time, it carries a black label, which the FDA assigns to drugs that include serious side effects. For Flibanserin, these include sedation and fatigue. When combined with alcohol and other common drugs, it can cause dangerously low blood pressure and fainting.

And non-medical treatments, such as mindfulness-based sex therapy, can be effective for treating low sexual desire. According to Brotto, mindfulness shifts attention away from negative, self-defeating thoughts, and towards sensation and pleasure.

Mark, however, thinks that hope should not be abandoned for a medical solution.

“At this point, I would not recommend Flibanserin for most women coping with desire problems,” she says. “There may be a medication in the future that meets women’s needs when used in conjunction with other approaches, but this just isn’t it.”

Whether women’s sexual problems should be medically treated is still debatable. But what is clear is that social and cultural factors shaping women’s sexual experiences should not be bypassed for a quick solution.

–Rebecca Abavi, 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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Medicating women’s sexual desire still highly controversial

00Featured news, Health, Integrative Medicine, Low Sexual Desire, Meditation, Psychopharmacology, Sex November, 17

Source: Minjung Gang at flickr, Creative Commons

On August 18, 2015, the U.S. Food and Drug Administration (FDA) approved Flibanserin, a drug that treats low sexual desire in women.

With the medication’s presence on the market, you’d think that low sexual desire in women would be well understood. In fact, there is still widespread debate on the issue. Marta Meana, a psychologist at the University of Nevada, writes:

“Desire is the most subjective and acutely amorphous component of sexuality.”

And Lori A. Brotto, a Professor of Gynecology at the University of British Columbia, offers a similar view, explaining:

“There is no clear consensus on the causes of sexual dysfunction in women.”

While women experience obstacles to fulfillment, the causes are complex. According to Brotto:

“An abundance of data indicates that low sexual desire is strongly influenced by a woman’s relationship satisfaction, mood, self-esteem, and body image.”

Medication is, at best, a partial treatment for problems with desire.

There are also differing perspectives on proper terminology around the issue. In an interview with the Trauma and Mental Health Report, Kristen Mark, Director of the Sexual Health Promotion Lab at the University of Kentucky, said:

“Sexual dysfunction may not be the most accurate way to describe low sexual desire. Women may experience sexual problems, but sexual desire ebbs and flows, so people should expect that it will fluctuate.”

Deciding between the word “dysfunction” or “problem” may seem trivial. But language creates meaning, and shapes how health professionals treat clients and conduct research.

Other clinicians agree. Leonore Tiefer, Associate Professor at the New York University School of Medicine, offers two metaphors for sex. The first is digestion. In this metaphor, sex is “just there”. Like digestion, it does not require learning, but is a natural or innate action that the body is equipped for at birth.

The other metaphor is dance. There are many ways to dance. Some people are better at dancing, and some people like dancing more than others. Tiefer argues that sex, like dance, is a learned skill.

Tiefer has advocated extensively against pharmaceutical interventions for female sexual problems. In 2000, she convened The New View Campaign, a collective of clinicians and social scientists dedicated to reframing the conversation around sexuality.

In a 2006 article on disease mongering, Tiefer explains why a purely biological approach to sexual health is inadequate:

“A long history of social and political control of sexual expression created reservoirs of shame and ignorance that make it difficult for many people to understand sexual satisfaction or cope with sexual problems.”

To emphasize that sex has a social context, the New View wrote an alternative system of classification for sexual problems. The first category is “sexual problems due to socio-cultural, political, or economic factors”, and the second is, “problems relating to partner and relationship”.

These categories includes specific causative factors, such as “ignorance and anxiety due to inadequate sex education, lack of access to health services, or other social constraints.”

According to Tiefer:

“Popular culture has greatly inflated public expectations about sexual function. People are fed a myth that sex is “natural”—that is, a matter of automatic and unlearned biological function—at the same time as they expect high levels of performance and enduring pleasure, they are likely to look for simple solutions.”

The drug Flibanserin is one of these ‘simple solutions’. Its approval has been met with controversy.

According to Loes Jaspers and colleagues at Erasmus University Medical Center, the effectiveness of Flibanserin is very low. In a meta-analysis examining the effect of the medication in about 6000 women, Jaspers found that those receiving the drug experienced, on average, only 0.5 more “sexually satisfying” events per month compared to those receiving a placebo.

At the same time, it carries a black label, which the FDA assigns to drugs that include serious side effects. For Flibanserin, these include sedation and fatigue. When combined with alcohol and other common drugs, it can cause dangerously low blood pressure and fainting.

And non-medical treatments, such as mindfulness-based sex therapy, can be effective for treating low sexual desire. According to Brotto, mindfulness shifts attention away from negative, self-defeating thoughts, and towards sensation and pleasure.

Mark, however, thinks that hope should not be abandoned for a medical solution. She says:

“At this point, I would not recommend Flibanserin for most women coping with desire problems. There may be a medication in the future that meets women’s needs when used in conjunction with other approaches, but this just isn’t it.”

Whether women’s sexual problems should be medically treated is still debatable. But what is clear is that social and cultural factors shaping women’s sexual experiences should not be bypassed for a quick solution.

–Rebecca Abavi, 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