Of Illnesses and Panics

The situation into which we have been thrust both by this new coronavirus AND the responses of our government and our fellow citizens is unique. 

Each of us must choose whom to believe, how much to read, and how to respond. We must weigh logic and emotion, time and trust. Everything is in motion.

I saw a joke calling it "Schrodinger's virus"--you have to act both as if you have it (isolate and wear a mask) and as if you don't (go shopping for yourself and others, stay home because you are not immune) . If you might have it, you also might not be able to get treatment nor a test, but you are supposed to go home rather than to the doctor or emergency room. What's not to love? You can easily feel confused, anxious, and threatened. 

Reading Temple Grandin Offers a New Perspective on REBT!

I have long agreed with Albert Ellis that his Rational Emotive Therapy (modernized to Rational Emotive Behavior Therapy), is a simple, elegant method for helping clients to learn how to improve their mood and live more comfortably. It is also a derivative of the ancient philosophy of Stoicism. I have worked with individuals and groups for many years, and most people to whom I have introduced REBT easily learn and use this technique for calming their unruly emotions and feeling better. It is not instant. It is not magic. But it really works. As with anything, using REBT well requires practice. 

One of my long-standing puzzles as a therapist has been how CBT (Cognitive Behavioral Therapy) has gained more popularity than REBT as the go-to therapy. There are indeed many books by many authors on each technique. Does CBT work better? Does it have better press? Are there more practitioners? is it easier to teach to therapists in training? Is it easier to teach to clients? 

My take on the above questions is  quite the opposite. I find REBT to be easier to learn, easier to teach, and more effective than CBT. I am trained in both, and, while I learned CBT in school and learned it first, when I studied REBT (Albert Ellis was one of my instructors), I was immediately stuck by how easy it was to learn, to teach, and to put into effect in my own life not to mention those of my clients. So is it the press? Perhaps.

Is a Psychiatric Diagnosis Just Another Name for What You're Feeling? A Rose by Any Other Name.....

The concept of mental illness is at its core about control. When someone is labeled mentally ill, a system including physicians, social workers, and government authorities begins to gain access to her life. People have problems. People have mental or psychological problems. The practice of calling these problems by names reflecting illness and thus putting them into the purview of physicians has been doing harm for decades. It is also demeaning, taking ultimate control from the individual and placing it within their genes or their parents.

I have said it many times and shall say it for as long as I can: there is not a pill for that. Make no mistake, your brain is a biological entity--YOU are a biological entity--thus distress of the mind and emotions are also biological entities, but this does not imply that the only or even the best or even a viable way to solve problems of the mind and emotions is with a pill. The overused "chemical imbalance" theory is dead. On the contrary, psychoactive pills cause chemical imbalances--they change your brain in ways science does not understand, sometimes they alleviate symptoms, but they do not CURE distress.

Thus one danger of calling mental distress a "disease" is that it is then treated as such--you become a patient and you look to a doctor to fix something. This works with appendicitis and broken legs and cancer. It is a fact, however, that not all things clearly within the realm of medical disorders are treatable by medical doctors. In general, there is no treatment for the flu or even the common cold, and physicians are stymied by irritable bowel and migraine. Medical science certainly does not work with depression, anxiety, phobia, PTSD, and the many variations of psychological distress delineated in the various manuals of disease such as the DSM and the ICD, because these are not diseases in the once-commonly understood meaning of the term. These problems do not show demonstrable tissue damage such as a cancer or a stroke, nor do they have symptoms that represent the body fighting a foreign invader, such as cough, fever, runny nose. Rather they have emotions and behaviors as their hallmarks.

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.

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.

Does School Cause Anxiety?

Most of the young people I see suffer in one way or another from school anxiety.

Whether they actually perceive themselves to be anxious, or have headache, stomach ache, or hives, many school-aged children are nervous about school.

In the language of Rational Emotive Therapy, it is not an external thing or event that causes anxiety, as anxiety arises from how we THINK about that external thing or event. However, in the case of the modern classroom, a case can be made that the way in which classes are managed is so stressful for the average young person, that it is rather difficult to avoid school-driven anxiety. Whether your student is scared of tests, a given teacher, big projects, group projects, or speaking in front of the class, there are things about modern education that essentially create situations too stressful for the average young person to manage easily. And, even more unfortunately, parents are often made into unwilling assistants in the creation of school anxiety.

Let's begin with a question: What is the root cause of school anxiety? In short, the basic assumption of intellectual education that all children ought to learn on the same schedule. Granted, we now have gifted classrooms and special education classrooms to accommodate variations from the average, but the basic premise remains that the mind can be educated on a fixed schedule, a schedule that is determined by bureaucrats.

Really, this ought to give us all pause. We send our children for swimming lessons and karate lessons and ice skating lessons, all of which operate based upon skills testing. A child works on a set of skills as long as she needs to, and when she passes them, she may proceed to another set of skills. Why does the mind of your child get less consideration than the body?

The Myth of Mental Illness and the Late, Great Thomas Szasz

For those who know me, you know that I dislike diagnoses. My clients have to specially request a diagnostic code to put in the little box their insurance demands in order to reimburse them. I treat people, not diseases. I treat people, not disorders. I treat people, not symptoms. I work at treating them with respect--respect for the ultimate fact they while I guide a healing process, it is the client who cures herself. Or to use words Dr. Szasz might use, it is the client who solves her own "problem in living".

People come to me with vexing life problems. They have chronic pain that has mystified a handful of competent physicians. They have had anxiety since grade school, and it has now blossomed into panic attacks. They feel depressed and unmotivated. They have failed to lose weight despite having tried a score of conventional means. My job is to look at the individual in front of me, and learn what ails her and how it may have come to be so. I apply a kind of scientific method where I form hypotheses with the help of the individual in my office, and we challenge the hypothesis with a treatment plan--if it works, it was likely true, or at least close enough to true to solve the problem.

Dr. Szasz and I have had our differences on some delicate points--can some of this material I help to discover and interrelate be hidden in the unconscious, and my client not know about it? Can historical events cause strange symptoms today that the client has not chosen as a solution, but rather that seem to have chosen her? Can my client essentially develop symptoms that solve a problem in an unfortunate way that she is consciously, directly, unable to alter? Is there a scientific way to apply psychotherapy? Dr. Szasz was quite clear that the answer to all of these questions was no. I, on the other hand, am clear that the answer is yes.

Those minor differences aside, the legacy of Dr. Thomas Szasz is immeasurable. He championed the human mind. He fought the psychiatric state--the ability of the government to control individuals by means of their mental state. He fought the medicalization of psychology, thus attempting to empower the individual to change himself rather then being at the mercy of a physician. Dr. Szasz did not believe in "helpful coercion" --a phrase that chills the blood. For me, reestablishing or maintaining the power of my client to change is the essence of good therapy.

Center for Conscious Living.......a name with a meaning. I see my task as helping you, the client, my employer, to improve the quality of your life by guiding you to discover and use your personal power to change. Yes, I guide and you do the rest of the work. Sorry, but there is no magic pill. What there is is power--the power you discover to help yourself! The joy of my work comes from seeing clients find and utilize their power and--um--get me off the payroll (not that I would mind if they gratefully paid me forever.....). Stop therapy because you are better, not because you are bored! Contact Dr. Low at the Center via e-mail: drlow@pobox.com, or phone. 630-249-1983. I look forward to hearing from you!

Just Because I Am Afraid of Heights Does Not Mean I Am Crazy!

So you have a phobia? And you FEEL crazy because you know it is not rational to be afraid to fly or afraid of dogs or afraid to go up in an elevator...... What if it turns put a phobia is part of an ancient survival mechanism you have inadvertently activated? This then means that you are not crazy, you are simply mistaken. And mistakes can be rectified.

In general, a phobia is created when something bad happens or you THINK something bad has happened and you logically avoid similar experiences in the future. You get stuck in an elevator and for a few weeks you stay away from them--your primitive brain then decides that those new-fangled things are DANGEROUS and warns you strongly away from them. Even if you did not panic the first time you got stuck, you are likely to panic the next time you get into an elevator, weeks later, having now taught your primitive brain that the only way to stay safe is to avoid elevators. You get bitten by a vicious dog and avoid all dogs for a while until you feel like testing the situation. Only now you find that you are terrified at the sight of dogs and cannot make yourself approach one! Perhaps you have a full-out panic attack with racing heart and sweating palms as soon as you get on the same side of the street at the neighbor's pup. So you continue your avoidance tactic, because at least this prevents panic.

Of course, there are downsides to such choices. Now you are stuck avoiding everyday things that you encounter all too often. AND you are afraid not only of dogs or elevators, but also of feeling panicky. And being afraid of feeling panicky seems logical whereas being afraid of elevators does not, so you now can justify your irrational behavior on the grounds that if you panic, you will get hurt or hurt someone else (What if I run into the street to get away from a dog? What if I drive into a tree in my state of panic? What if I faint?) Of course, it has not ever occurred to you that you have been injured or injured another in a state of panic,but again, the primitive protective mechanisms work hard to convince you to stay safe.

So now you have a panic problem---essentially a panic-phobia, though others would label it "panic disorder") along with your phobia, and you find yourself more and more restricted in things that feel safe to do. The fun begins to drain out of your life. You go to the doctor and are told you have a panic disorder. Perhaps you are given an anxiety drug, but more likely, you are given and anti-depressant, because anxiety drugs are quite addictive and MDs do not like to prescribe them. The result of this is that you feel defective because you have this disorder. The drug might work to a small extent and decrease your overall anxiety, but it is NOT a cure for panic AND it has many unsavory side-effects. Besides which, you have not learned anything to help yourself, so you also feel helpless, a feeling that can lead to more and more anxiety and even depressed feelings.

So, you ask, what on earth can help you if drugs and your favorite MD cannot? The answer is to take control. You and that first dog/elevator/germ/airplane created this problem and you can uncreate it. First you must stop all avoidance behaviors--that's right--hair of the dog, so to speak--go into the situations you fear, and you begin to retrain that primitive brain mechanism that dogs were NOT the terrible danger they seemed. But this is too hard, you exclaim--after all, a panic attack is nothing to sneeze at--people go to emergency rooms every day thinking they are actually going to die from the miserable feelings involved in a panic attack. Correct you are--this is no small feat, but it is an achievable one.

Thus comes the inevitable offer--if you need help to conquer your phobia or panic WITHOUT being accused of being crazy or diseased or defective, without being drugged, please phone the Center fro Conscious Living and Dr. Low can teach you the steps to regaining control of your brain! Call 630-249-1983 today.