Wednesday, August 7, 2013
One quotation that I have found especially helpful in re-framing problems that we all struggle with is: "Pain is inevitable, suffering is optional." What I like about this quote is that it highlights the role the sufferer has in the creation of his or her misery. Pain cannot be avoided. It is an essential though unpleasant aspect of being alive. We can, however, choose to accept this reality instead of engaging in the grandiose fantasy that pain can be avoided or negated. We often find that the pain, once regarded as intolerable, is actually manageable once we let go of the delusion that it can be avoided.
So much of what my patients come to treatment for relief from is the by-product of frantically trying to avoid discomfort. Alcohol, drugs, sex or compulsive shopping all promise relief from, or at least avoidance of pain but in the end they only create suffering.
Using mindfulness techniques can help us "sit with" and tolerate all of our feelings, painful or otherwise, and to function with resilience. Our culture of immediate gratification and pursuit of the latest and greatest makes this hard but we can choose to exercise mindfulness just like any other muscle. When we do, we live more intentional and satisfying lives.
Wednesday, July 31, 2013
Each state has the authority to regulate the activities of professionals who offer services to citizens of the state. Each board is established by the legislature of the state and interprets the laws pertaining to professional practice in that state. As a Pennsylvania licensed psychologist, I am required to adhere to the standards and regulations put forth by my state's licensing board. If I do not, I risk sanction or the loss of my license to practice. Anyone who wishes to practice psychology in Pennsylvania must apply to the board for permission to do so.
That's where the rub comes in the Kentucky case. It seems that Rosemond, who has written 14 books on parenting, offered advice on parenting to which one retired psychologist in Kentucky took exception and wrote to the Kentucky board to complain.
The job of any professional board is to protect the public from harm and in this instance the Kentucky board reasoned that Rosemond's advice constituted the provision of psychological services for which he was not licensed in Kentucky.
Potentially, this opens a whole can of worms if one accepts that advice given in a syndicated column constitutes provision of psychological services. Writers from a libertarian perspective cry foul because this would seem to limit first amendment rights to free speech.
It's hard to know exactly what argument was made in the Kentucky case but licensing boards are generally quite careful to deliberate fully before making a move. They try to talk through the potential ramifications of various steps and to interpret the law as clearly as possible.
Another problematic situation that many state psychology boards are trying to work out is how to regulate the provision of counseling via electronic means. For example, let's say you decide to start working with Dr. X who practices in California because he is an expert in the treatment of a disorder that you have. Because he is in California and you are in, let's say Pennsylvania, you decide to conduct your sessions through Skype.
So what state regulates this professional service, California or Pennsylvania? Who has jurisdiction to prosecute Dr. X if you feel that he has acted unethically or committed malpractice? One suggestion is to have a national "passport" or universal certification but this may run afoul of state laws that prevent states from relinquishing regulatory authority.
Whatever the answer, this issue is likely to come up more frequently as consumers increasingly look to electronic sources for healthcare. Some studies are even finding that internet based psychotherapy is as effective as face-to-face therapy. There will be more to say about that later.
Monday, July 22, 2013
Both stories are admittedly intriguing and the scientists interviewed are not crackpots. So how do we really evaluate the science we hear and apply it sensibly in our lives?
One thing to keep foremost in our minds is that a relationship between two events does not tell us anything about the causality that may or may not link them. Because schizophrenia increased when we started keeping cats as pets does not establish a causal relationship between cats and schizophrenia. In fairness, the relationship between certain mental illnesses and toxoplasma has been reported elsewhere, I'm exaggerating somewhat to make a point.
The relationships between these issues is complex. There is more interdependence, or what statisticians call covariance, than direct causal relationships among the variables. It is more interesting to talk about the possibility of grand relationships and science fiction than to tackle the nuances of the relationships. Who wants to read a dry science article when we can talk about protozoa taking over our minds.
So the point is to take science reporting at face value. Dig deeper if a topic interests you and treat grandiose claims as what they are, bad science.
Sunday, July 21, 2013
But in doing so we flee the here and now for imagined comfort of somewhere else. We trade our lived experience, the only true reality, for some imagined talisman that will end our suffering.
Saturday, July 20, 2013
Tuesday, July 16, 2013
"The test uses an electroencephalogram, or EEG, with sensors attached to a child’s head and hooked by wires to a computer to measure brain waves. It traces different types of electrical impulses given off by nerve cells in the brain and records how many times those impulses are given off each second.The test takes 15 to 20 minutes, and measures two kinds of brain waves — theta and beta. Certain combinations of those waves tend to be more prevalent in children with A.D.H.D., the Food and Drug Administration said in a news release."So will this eliminate our uncertainty when making a diagnosis of ADHD? Probably not. Our diagnostic system or nosology rests on a false belief in the reality of diagnostic categories. In reality there is no such thing as "depression"or "ADHD." I do not mean to imply that people do not suffer or that their lives are not impacted by these disorders, only that as an objective reality, these diagnoses are just constructs, ways of organizing phenomena into categories.
Without getting too philosophical (professors can get that way), suffice it to say that EEG's and medical tests exaggerate the certainty with which we draw conclusions. We still do not know that a patient has ADHD even if they test positively on this new procedure. What is more important is understanding the context and function of the symptoms so that we can help the patient. As Freud pointed out, we need to make sense of the symptom and not just categorize them.
Sunday, July 14, 2013
Wednesday, July 10, 2013
Tuesday, July 9, 2013
Monday, July 8, 2013
Sunday, July 7, 2013
Saturday, July 6, 2013
Original post here:
This weekend, take some time to genuinely relax and unwind. Take kind care of yourself. In fact, give yourself a break. A real one.
Here’s a list of ideas to get you started, whether you have 50 minutes or five.
- Learn to meditate.
- Practice this body scan.
- Visit the library or bookstore, and pick out a new book (or an old favorite). Curl up on a comfy chair, or thumb through your book while sipping a yummy drink. Or bring it home, or bring it to the beach.
- Have a picnic at the park, beach or your backyard. Feast on your summer favorites, like berries, burgers, frozen yogurt, pasta salad, popsicles, watermelon and corn on the cob.
- Try a yoga class — in person or online. Anna, founder of Curvy Yoga, offers a great collection of videos, podcasts and written practices (all free!).
- Put on your softest, most comfortable clothes.
- Sit by a sunny spot, and let the sunshine envelope you. Savor the silence, or focus on the sounds swirling around you.
- Give your hands (and your neck) a massage.
- Put on classical music, sit back, and close your eyes.
- Take a long shower or a bubble bath. Focus on how the water feels against your skin. Breathe in the aroma of your body wash or shampoo. Listen to the water cascading down. In other words, focus intently on your shower or bath. Be in the moment.
- Get up early to watch the sunrise.
- Or sleep in, and take a bit longer to get up, enjoying the warmth of the covers.
- Jot down a few pages in your journal, in the morning or at bedtime. Or take a journaling break during the day.
- Veg out for a few hours, watching your favorite shows. (Brian and I just started watching “The Big Bang Theory,” thanks to my mom, who loves the show. It’s hilarious! We laugh every few seconds. Seriously.)
- Try this guided meditation or this one.
- Whatever you’re doing, wherever you are, take several long, deep breaths.
- Make sand castles.
- Drink a cup of green tea, savoring each sip.
- Visit the botanical gardens.
- Eat at an outdoor cafe.
- Spend a full day outside. Breathe in the fresh air.
- Read poetry in bed.
- Find peace within yourself.
- Cook a simple meal. It’s amazing, for instance, how washing and chopping vegetables can put you in a kind of lull, in a kind of rhythm that soothes you.
- Speaking of rhythm, try doing laps. The repetition of your arms and the cadence of your breath is super calming. I’m a terrible swimmer, but doing laps in the pool — I like to think of my lap style as “the fish” — feels both exhilarating and relaxing.
- Think of five things that make you happily sigh with relaxation. Then add them to this weekend and the rest of your week.
- Tend to yourself. I love this tip from Rachel, which I included in another piece on 20 ways to unwind.
“When I need to rest and restore, I tend,” said Rachel W. Cole, a life coach and retreat leader. She defines tending as “care with intention.” And it can take many forms.
Cole tends to her home by cleaning the sheets, washing windows and “getting rid of unused and unloved items.”
She also whips up delicious and nourishing meals in her kitchen. And on some days, she tends to her finances and “need for a walk in the sunshine. Tending brings calm, order, and a deep reminder that I’m cared for and safe.”