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.

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.

Your Privacy and the Psychiatric State

I wrote some weeks ago about Thomas Szasz, M.D., and his many books about the fallacies of modern psychiatry. Dr. Szasz is known for his stance on individual rights and the separation of state from medicine, particularly psychiatry.

We are entering a new era in the potential for government to control you via your physician. The HIPPA Act is ostensibly about Privacy and Portability. The problem is that those are mutually exclusive. Either you have privacy, OR your medical information is portable. Perhaps you are one of those unlucky few whose test results have gone to the wrong physician or whose bill has arrived at the wrong address due to mix-ups in computer-managed records. Perhaps your physician's records have been hacked, and your medical record leaked into the wrong hands. This is but the tip of the iceberg. You might also be someone who has been refused health or life insurance because long years ago you visited a doctor for some symptom. The symptom turned out to be benign and is long gone, but the permanent record that followed you around is not.

These days, a new threat to life, liberty, and medical care has arrived in the form of gun control. I know, this is a weird topic for a psychologist to take on, and I am not presenting a stance for or against in this blog. However, I feel strongly about your privacy, and the new reality is that if you have ever been on a psychotropic medication, this is now on your permanent, electronic medical record. And the government has sent a recommendation to physicians that they query the presence of guns in your home. The inevitable conclusion? Your medical record thus becomes the vehicle by which your rights can be taken away. One must ask, what other way might be found for your personal medical information to be used to your detriment? What other rights are at risk when your physician records the answers to non-medical questions and when everything you tell her and everything she discovers or speculates about you is placed in a permanent, electronic file?

Exciting news: New Article Published

I had the pleasure of working with Irving Kirsch, PhD on an article for the American Journal of Clinical Hypnosis on a pet topic of mine-- why psychotherapy is superior to medication in the treatment of depression. Dr. Kirsch has been the author of many meta-analyses (taking the results of various research studies and combining them to increase the effect size and draw general conclusions)( The Emperor's New Drugs , Irving Kirsch: Deja Vu all Over Again , Listening to Prozac and Hearing Placebo).

The conclusion of these many studies continues to be that antidepressant medications involve a high risk of side effects with little potential for gain, while psychotherapy, including psychotherapy using clinical hypnosis, is safer and more effective. I enjoying being part of the following article and offer it for your edification:

Suggestion in the Treatment of Depression
Irving Kirsch, Carol B. Low
American Journal of Clinical Hypnosis
Vol. 55, Iss. 3, 2013 221-229.

Abstract

Meta-analyses consistently reveal that most of the response to antidepressant treatment can be obtained by placebo, and the difference between response to the drug and the response to any treatment is not clinically significant for most individuals diagnosed with major depressive disorder. Furthermore, the best predictor of antidepressant efficacy is the response to placebo during the so-called placebo run-in period. It can also be shown that a significant portion of the placebo effect is expectancy. These data thus indicate that suggestion is a central factor in treating depression. Therefore, the use of hypnosis, which is based on suggestion, as a treatment adjunct can be expected to enhance treatment outcome.

Happy New Year--we can help you enhance your mood: call 630-249-9183 or write Dr. Low today.

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!

Depression and Food

Sooooooo, we have all seen on TV that depression is biological, right? And all of that stuff about how therefore you need pills to fix it. What if it IS biological--a natural response of the system to things not being right, whether inside or out......BUT there is no magic pill that cures it?
One of the first things I want to know from all clients is how they eat. Now this might seem rather odd for a psychologist to ask, but I have a purpose. If depression is biological. because after all, you are a biological entity, then it has biological causes and effects. In fact, I liken depression to hibernation. A hibernating bear eats a lot before going into that log for the winter. He eats a lot now and then when the sun comes out. He puts on a lot of fat and wakes up rather thinner one sunny morning. He is not discriminating about what he eats when nature instructs him to fatten up or when he is skinny and starved (ask those folks who think they can outsmart bears and hang out in Alaska prior to hibernation season!) .
When you are depressed, your eating patterns change--some of us eat too much, others too little, but few of us eat well when our mood is slumping. We may eat lazily as well, choosing faster, less nourishing items over slower, healthier foods.
What this has led me to conclude over years of observing clients is that if I can help them to eat better, at least some portion of that depression will lift without me ever applying all those brilliant psychotherapeutic techniques I learned in school. Simple, elegant, and cheap. (Well, except for the cost of real food over chips.)
I have also discovered that most of my clients are like I was when I first got out of college: they know a lot of stuff from TV and government ads and high school health class about food, but not really very much about actual nutrition. Hence, I have taken numerous classes in nutrition and obtained a certification in fitness nutrition so that I can better serve clients who are confused about food. Learn to make better choices in eating as well as better choices in living as YOU overcome depression now.
There is joy after depression. And there is an after........

What is hypnosis?

Pretty much everyone has seen a stage hypnotist--he gets people to do odd and embarrassing things in front of an audience. When you think of hypnosis, you probably conjure up such an image and wonder if that was all an act or if you will somehow be at a disadvantage if you go to a professional for clinical hypnosis.
So what is hypnosis? In simplest terms, it is a narrowing of the focus of attention. So that person on stage is attending only to the hypnotist. By choice--or else why did she raise her hand, right? A stage hypnotist carefully selects volunteers from those with raised hands by observing their degree of attentiveness as he speaks.
In the clinic this translates into a way to tap into powers of your mind that you do not use to their fullest potential. The power to change bad habits, to project a happier future, to reframe an unpleasant past event, to calm your immune or nervous system. Hypnosis is not magic and it is NOT me controlling you. It is you being guided to learn to use that deeper potential of you mind to help yourself.
In my office, hypnosis is most often taught in conjunction with rational-emotive or cognitive therapy for overcoming phobias, depression, anxiety, or bad eating habits.
Learn self-hypnosis as a way to carry the new learning with you always.
Can clinical hypnosis help you?
Call the Center at 630-249-1983 for a free consultation.
http://www.centerforconsciousliving.com/hypnosis

Holistic Psychology?

The practice of clinical psychology can involve many types of therapy as well as advice-giving and counseling. When I talk about holistic psychology, I do not mean a type of therapy, but a philosophical approach that informs my approach to therapy.

Many approaches to mental health rely upon what we call reductionism--the idea that the mind and the body are separate and can be treated separately. The whole idea that mental distress is cured by a pill falls into this category. In contrast, the holistic approach says that each individual is an indivisible whole and must be treated as such. Thus, a mental health issue such as depression is not a "mental illness", but an adaptation of some sort to the individual's current reality, and a whole picture needs to be formed of the individual in order to adequately treat the problem.

In the same way, physical ills are influenced by a variety of factors we call stressors. stressors can be internal or external, mental or physical. temporary or permanent. Even a cold is influenced by the weather and the state of your immune system, not just the exposure to a virus. Some illnesses are more multi-determined that others. Irritable bowel is more a disease of response to stressors than the flu, for example.

The holistic approach requires individual treatment planning and a collaborative relationship between professional and client, rather than a traditional doctor-patient relationship. In this regard, I often refer to myself as a teacher or even a tour guide. The client cures him- or herself--I lead the way. With this approach, you have a sense of control over your fate and gain mastery over the problem that was vexing you.