Wednesday, February 15, 2017

Is there a Pill for That?

I'll start by admitting something; medications scare me. Not all medications and not in all cases, but many. Perhaps this diminishes my credibility as a psychologist who fancies herself quite scientific, but there are reasons for my atypical stance. Allow me to state for the record that I am not a prescribing physician, and what follows is my opinion, which mostly consists of: "Buyer beware".

 In the years since I have been practicing psychology, I have seen a startling number of serious, damaging reactions to medications. In addition, I have also seen no small number of similarly bad reactions to street drugs. Years of observing and reading have thus led me to a very conservative stance regarding attempts to pharmaceutically solve health problems, both physical and psychological, as well as the ones sitting on the border thereof. Some examples follow, after which I'll provide some details about how I work with my clients in light of my observations.

Friday, January 13, 2017

Memory Again

Today is a snow day, so between bouts of shoveling in 5 degree weather, I am perusing the web. Coincidentally, today's hot topic in the places I read is memory. How accurate is memory?, how easily can memory be falsified?, is there such a thing as recovered memory?, what does memory research teach us?

For me professionally, understanding memory is important in the process of doing psychotherapy. After all, it is with people's memories that I work all day.  Early in my career, I learned that with psychotherapy the validity of a memory is less important than its impact. A client might recall an event as a painful experience, and that memory can have a present-day effect on his mood. That effect does not affirm the accuracy of the memory, just its impact. The impact is what I work with, as I can never know, minus sources of corroboration, whether my client's memory is precise.

Thursday, December 22, 2016

Is Mental Illness a Myth?

Have I piqued your interest or accidentally insulted you? I did not make this question up. Thinkers and physicians for many years have wondered the same thing. Mental illness is confusing. It is not diagnosed as is physical illness via tests for microbes, probing for damaged or diseased tissue, nor compiling a list of objectively measurable symptoms. Mental illness is diagnosed via a system of symptom clusters published in one or another manual, the contents of which are agreed upon by scholars in the field. The problems arise when the contents of those manuals change over time, because mental issues are not clear-cut diseases as are physical illnesses. Things are added and subtracted over time--but we could not imagine a time when influenza would stop being called a disease!

Science tries, year after year, to isolate specific markers for mental illness. Tests come and go, but the construct remains elusive. We can objectively test for the flu or cancer or diabetes or a broken leg, but we cannot test in a way that never changes, for depression, schizophrenia, or anxiety. This does not mean that you are not suffering with your problem. It only means in this context, that your problem is mislabeled by being lumped in with physical illness. This is important for many reasons. I hope you are still with me as I elucidate why I, and others like me, believe calling mental problems "diseases" hurts those who suffer with them.

Tuesday, November 15, 2016

When should you see a psychologist for a physical illness?

I have been writing on the topic of mind/body medicine for over 20 years, and I continue to learn and be amazed by the human mind/brain. Long years ago, a brilliant scholar named Ernest Rossi began to write about hypnosis and neuroplasticity. He was, of course, not alone in this, but he was my first formal contact with the fascinating world of brain changing body. Despite my psychological training, I began to see the mindbody connection everywhere. A client with diabetes who suffered from severe psychological distress after an amputation presented with uncontrollable vomiting and raging fevers rather than diagnosible psychological problems. People with intransigent chronic pain ran from doctor to doctor and were accused of faking or drug-seeking, but with good psychological exploration and insight, their trauma could be found and they could heal themselves. Clients with autoimmune disorders such as rheumatoid arthritis and multiple sclerosis found improvement, often dramatic, with the application of psychological techniques. A client who had attempted suicide with a .38 to the head showed NO brain damage on MRI, demonstrated no physical disabilities from the shot, but had significant amnesia for his entire life prior to the incident! The amnesia remitted with psychological treatment.

These extreme examples of the intricate mindbody connection led me to view my clients with a much more open mind. Things I had diligently learned in graduate school held less sway versus the real experiences of my clients. Medications did not appear to work miracles despite being used in ways even our textbooks said were dangerous. Diagnostic criteria and diagnosible disorders from the _DSM_ changed over time, which confused me if those listed problems were diseases. Does the definition of influenza or diabetes change with each new edition of a manual? Do they sometimes disappear from the text? And despite modern times labeling many problems as diseases in what appeared to be both an attempt to put them in the bailiwick of physicians and to remove the stigma of causality from patients and their families, suffering seemed to be getting worse, not better, and reliance on medications increasing as well. Additionally, the number of clients coming to me already taking three or more psychoactive medications appalled me. Why, after all, were they still suffering if these medications work? I began to wonder about many things I had been taught and to question common treatment practices of people seeking mental health treatment as well as physical medical treatment.

Monday, February 15, 2016

Whose Pain Is It?

Having recently arrived in Oregon, studied diligently for (and yes, passed) my ethics exam, and at long last, received my license, I had a few months in which to explore the clinical issues prevalent in my new environment. Chronic pain kept popping up in conversation, sometimes right after "oh, you do hypnosis," and sometimes before.

What I gleaned from my participation in clinical groups and meetings was that the chronic pain treatment pendulum has swung once more. In short, and without citation: Long ago, MDs prescribed heavy doses of medication for pain patients, chronic or acute. The pendulum then swung to a fear of creating addicts. This was not entirely unfounded, as overprescribing of serious pain medication was rampant, and addiction was up. (When my children left a dentist with Vicodin for the removal of wisdom teeth, I knew something was not right). So docs lived in fear of government repercussions for overprescribing, and, as with most pendulums, now it had swung too far, and even deathly ill patients were constrained from receiving comfort, by over-regulation. Back it went, and back came too many addicted patients along with, guess what? too much chronic pain.

Wednesday, December 16, 2015

New Beginnings

Center for Conscious Living has begun its second iteration. We are now located in Oregon, seeing clients in Bend and Redmond. It has taken longer than expected to get licensed in Oregon, and while it seemed excessive, I do not at all begrudge the many hours spent reviewing ethics!

It is always good to review, and reviewing the Ethical Standards for Psychologists has given me time to review how I practice and how I want to perceive my clients. These standards cover the very basics such as, never, ever enter into personal relationships with clients, maintain high standards for privacy and confidentiality, and, most important of all, FIRST DO NO HARM, a principle that is taught to every treating professional.