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This is a long overdue summary of recent psychology news items that I have found to be of interest.
Estrogen Relieves Psychotic Symptoms in Women With Schizophrenia – In a single double-blind study of the use of estrogen in women with severe schizophrenia, it was found that symptoms were significantly reduced compared to placebo. This study was related to the observation that many women with schizophrenia experience a relapse of psychotic symptoms or increased psychosis during low-estrogen phases of the menstrual cycle. This is interesting in that I have seen at least one patient who experienced psychosis ONLY during this phase.
Experimental Agent Safe, May “Dissolve” Amyloid Plaques in Mild to Moderate AD – If you have a parent, grandparent, or another relative with presumed Alzheimer’s disease, you probably know something about how devastating it can be. One theory of Alzheimer’s disease involves the notion of a build up of beta amyloid plaques in the brain. Apparently, this studied demonstrated the ability of an antibody to attack these plaques. While interesting, the researchers have yet to demonstrate that this actually improves cognition and memory. They hope this has to do with the short duration of the study, which was basically to test the safety of the drug.
Early Study Finds Increased Non-Hodgkin’s Lymphoma in Long-Term Users of Tricyclic Antidepressants – A recently published study showed an association between lymphoma and use of tricyclic antidepressant medication. The authors were careful to point out, that this was just an association, and there was no proof that the medications caused lymphoma. Tricyclic medications are an older generation of medication than the current SSRI medications. They are sometimes used when there is no response to SSRIs, and sometimes can be used as a sleep aid (trazadone specifically). The risk was higher with long-term use.
Sage Oil Supplements May Help Short-Term Memory – Short-term memory is commonly used to what’s referred to as recent memory. A study found that Sage oil supplements helped people have better recall on a word-learning task.
I find that the idea of “Locus of Control” often comes up in treatment. (1)
A person with an Internal locus of control is said to believe that they have control over their own decisions and things that happen in their lives. A person with an external locus of control, believes that their personal decisions and things that happens in life, are determined by external factors (the situation that they find themselves in).
So, very often, in treatment, it is important to establish what things a person has control over, and what things a person does not have control over. I’d say in probably 70 to 80% of the people I see, there are distortions in their notions of control. Sometimes, they feel like they should be able to control everything. Even those situations which we have no control over. Other times, they don’t feel like they have control over anything, including any aspect of themselves.
An exaggerated notion of external locus of control is often associated with depression. An exaggerated notion of internal locus of control is often associated with anxiety and anger. The point is, that there are some things you can control in your life and within yourself, and there are other things that you cannot. As with many things in life, the point is finding the most realistic balance between the two. This is not something that is easily done, and will be a continual balancing act for almost everyone.
I quoted this old proverb previously in On Feeling Defective:
“For want of a nail the shoe was lost.
For want of a shoe the horse was lost.
For want of a horse the rider was lost.
For want of a rider the battle was lost.
For want of a battle the kingdom was lost.
And all for the want of a horseshoe nail.”
This quote has often been used by my mentor. I used this to describe my approach to treatment. But, as I’ve been thinking about this more, it also applies to all of our lives. Sometimes, we get caught up in intellectual arguments. Sometimes, we get caught up in our desires. Sometimes, we get caught up in the everyday details of everyday life.
But, I think what you want to do in a lot of situations, is to find that nail. It may be extremely difficult. And there are times when there is no nail. But, most often the nail is there if you are open, and dig enough. Most often for believers, you might find that nail to be God. Not, that all your problems will be solved. I don’t mean to say that like many televangelists do, but I do think that nail that God provides can often help to win that war in your life. Regardless, I think it is important to focus on “What is the most important thing?” Whether this be your outlook on life, or a difficult situation that you face.
I’ve noted before that the role of psychiatrists is largely focused only the medication that a patient takes. To be fair, there are a few psychiatrists out there who do actual psychotherapy. Recent research shows this to be declining very steadily. (1)
I think the recent research on the decline of psychotherapy in psychiatry underestimates the ‘true’ shift in the field of psychiatry. The research is based on billing codes, and I know a little about that. I do computer consulting with a mental health center on their electronic medical record system. If the session goes over 15 minutes, it is billed as medication review + MD psychotherapy. So, in other words, if the session lasts more than 15 minutes, it is considered psychotherapy. This is whether it is true psychotherapy, or just an extended discussion of medication. There are no psychiatrists within a 50 mile radius of my practice that I would consider that provide true “psychotherapy.” So, the research results from 2004-2005 showing that 29% of psychiatrists provide ‘psychotherapy,’ is quite distorted. It frankly just means that sometimes they run over 15 minutes in the discussion of medication. I’m not saying that there are not any psychiatrists who provide psychotherapy, I’m just saying that it is very rare. That’s why you ought to be very skeptical about psychologists who have prescription privileges, because it is likely that they will go the way of psychiatrists.
(1). http://www.medscape.com/viewarticle/578684?src=mpnews&spon=12&uac=107497SN
“Pain in life is not optional, suffering is.” –Author Unknown
Without a single doubt. You will experience pain in life, both physical and emotional. All people will recognize this as true. Now, suffering is a state of emotion and thought. Suffering is a state that amplifies physical and emotional pain. To suffer, is to allow the pain (physical or emotional), to have an overriding and defining influence on your life.
Let’s see a little bit about how suffering works in thought.
I’m miserable and I always will be.
Pain rules my world. The only thing I do is hurt.
I can’t deal with anything. My life is hopeless.
Let’s see what kind of difference a minor shift in perspective might make.
I’m anxious a lot, but sometimes I’m not. I really enjoy myself when I’m not.
I have a lot of pain, but I get a lot of enjoyment out of writing and sewing.
Some things are hard for me to cope with, but other things I cope with quite well!
These thoughts may seem like a minor shift in perspective, but they are really a major shift in the manner of living life. Whatever situation you find yourself in, you want to do everything you can to add positives to your life–to give your life that extra meaning. That shift in perspective can help you, if nothing else, to divert your attention from your pain (whether it be physical or emotional). Now, I never advocate lying to yourself. For example, I wouldn’t tell you to tell yourself, “Hey!! My life is great!!!” if it is not. BUT, I will tell you to not focus on only the negatives and to make your life more than the negatives. By adding positives, you will shrink the negatives. Often, you have the knowledge of what will help you to feel better….what helped you to feel better in the past? Start doing those things that you can do again, and put less emphasis on what you can’t do.
Now, these approaches do not eliminate pain, but may help prevent suffering. And the goal really can’t be to eliminate pain, but we can shrink its significance.
Viktor Frankl, author of Man’s Search for Meaning, observed that a person who has a strong enough “why” can cope with any “how.” What he meant by this was that if your reason for enduring something is powerful enough (the why), you can endure whatever you need to for achieving your goal (the how). His observations were based on his experiences in a Nazi concentration camp. He observed that when others in the camp gave up their reasons for being, they died within a few days. So, your meaning in life can actually have a link to and affect your physical health. For some, their driving sense of meaning was their faith, and for others–seeing their families again. The most important thing was that they had this sense of meaning.
Now towards the end of the book, he describes a survey that he conducted. He found that one of the most meaningful experiences a person can have is overcoming great difficulty and then helping others to do the same. I understand this on a very personal level as a Shrink, and it is very true. I recommend the book if you haven’t read it. It can give you a different perspective on life and suffering.
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