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Tuesday, July 31, 2007

Is Rehab Hogwash?

Early this summer, after yet another celeb exited rehab, I posted The "Lohan" Phenomenon - Do Celebs in Rehab Diminish the Recovery Process? With last week's rehab-release fiasco, I felt the need to reiterate some important points about serious people who seriously want to kick addiction. There seems to be a general outcry/backlash occurring all over the media - from celebrity-focused TV shows, court television, newspapers, etc. Everyone has an opinion.

But what do experts in addiction treatment have to say? WebMD has two excellent pieces, the first - Rehab's Role in Treating Addiction, gives a very clear description of the addiction treatment process. Family Poll: Half of Addicts Seek Help - Survey Shows that Most Who Go for Treatment Get Better, which discusses a recent Gallup poll showing that although only half of family members seek treatment, 82% of those who seek help get better.

Although not an addiction professional, the alcoholism and drug abuse "guide" at About.com has a helpful post, Components of Effective Treatment Programs that includes a key component to successful treatment and recovery: Strong Patient Motivation, "All approaches to (alcoholism) recovery depend on the desire of the person to get and remain sober."

So, although most media stories on this topic have entertainment value, to really understand the treatment and rehab process, read what the experts in the addictions field have to say.


Sunday, July 29, 2007

Your Friends are Making You Fat (or Thin)

Researchers have discovered that your social network has a significant impact on your weight. In short if your friends gain or lose weight, you are highly likely to do the same. This is especially true if they are same sex friends, and applies to friends that live in other countries, or friends of friends that are part of your larger circle of acquaintances.

You might imagine that birds of a feather flock together, and that finding networks of obese friends is a matter of self-selection i.e. people choosing to befriend others of similar size. However the latest research shows that there is a direct causal link between changes in your weight and that of your friends.

Appearing in the July 26 issue of the New England Journal of Medicine, a study coauthored by Nicholas Christakis of Harvard Medical School and James Fowler of UC San Diego suggests that obesity is "socially contagious," spreading from person to person in a social network.

The study -- the first to examine this phenomenon -- finds that if one person becomes obese, those closely connected to them have a greater chance of becoming obese themselves. Surprisingly, the greatest effect is seen not among people sharing the same genes or the same household but among friends.

If a person you consider a friend becomes obese, the researchers found, your own chances of becoming obese go up 57 percent. Among mutual friends, the effect is even stronger, with chances increasing 171 percent.

Christakis and Fowler also looked at the influence of siblings, spouses and neighbors. Among siblings, if one becomes obese, the likelihood for the other to become obese increases 40 percent; among spouses, 37 percent. There was no effect among neighbors, unless they were also friends.


The researchers analyzed data over a period of 32 years for 12,067 adults, who underwent repeated medical assessments as part of the Framingham Heart Study. They were able to map a densely interconnected social network of the study's subjects by using the tracking sheets (which had previously been archived in a basement) that recorded not only the subjects' family members but also unrelated friends who could be expected to find them in a few years.

The network map took two years to assemble and includes information on the participants' body-mass index. Among the first things the researchers noticed was that, consistent with other studies finding an obesity epidemic in the U.S., the whole network grew heavier over time.

Also immediately apparent were distinct clusters of thin and heavy individuals. Statistical analysis revealed that this clustering could not be attributed solely to the selective formation of ties among people of comparable weights.

"It's not that obese or non-obese people simply find other similar people to hang out with," said Christakis, a physician and a professor in Harvard Medical School's department of health care policy. "Rather, there is a direct, causal relationship."

Further analysis also suggested that people's influence on each other's obesity status could not be put down just to similarities in lifestyle and environment, to, for example, people eating the same foods together or engaging in the same physical activities. Not only do siblings and spouses have less influence than friends, but also geography doesn't play a role. The striking impact of friends seems to be independent of whether or not the friends live in the same region.

"When we looked at the effect of distance, we found that your friend who's 500 miles away has just as much impact on your obesity as [one] next door," said Fowler, an associate professor of political science at UC San Diego and an expert in social networks.

In part because the study also identifies a larger effect among people of the same sex, the researchers believe that people affect not only each other's behaviors but also, more subtly, norms.

"What appears to be happening is that a person becoming obese most likely causes a change of norms about what counts as an appropriate body size. People come to think that it is okay to be bigger since those around them are bigger, and this sensibility spreads," said Christakis.

"This is about people's ideas about their bodies and their health," Fowler said. "Consciously or unconsciously, people look to others when they are deciding how much to eat, how much to exercise and how much weight is too much."

"Social effects, I think, are much stronger than people before realized. There's been an intensive effort to find genes that are responsible for obesity and physical processes that are responsible for obesity and what our paper suggests is that you really should spend time looking at the social side of life as well," said Fowler.

This has intriguing implications for weight loss support groups such as Weight Watchers, and for online support forums. What happens if you befriend people in your support group, either online or in real life, who fail to lose weight? Could this undermine your own weight loss efforts?

Check out the study for an animated graphic showing the effects of social networks on obesity and other background information and graphs.

Talia Mana

Wednesday, July 25, 2007

Making Friendships a Priority

The Importance of a Good Support System

A recent long phone conversation with a best friend reminded me of why I value my friendships so highly. What sets this friendship apart? We laugh. A lot. We cheer each other up. We "get" each other. One of the key elements of this relationship is that we can be ourselves - no posing or concern about what the other thinks of us.

It's not news that friendships and healthy support systems are important to our well-being. But when I began to do research for this post, I Googled "relationships" and got mostly sites about romantic or intimate relationships. Magazines, advice columns and other popular media are loaded with information about these. Why don't we place as much emphasis on our friendships?

As part of an initial assessment of a patient, I ask about the quality of their support system. Do they have one? Do they utilize it? I'm often surprised that most people report that this area of their lives is lacking. As a treatment goal, I list increasing that support system as a top priority. But I do acknowledge that making friends as an adult is difficult. We no longer have the school playground or classroom to meet new people or potential friends. The U.S. Department of Health and Human Service's SAMHSA (Substance Abuse and Mental Health Services Administration) division has an online publication, "Making and Keeping Friends - A Self-Help Guide" . It lists qualities we need to bring to our friendships:

    • being independent and
      self-sufficient
    • being positive, upbeat and warm
    • talking about others in a positive way
    • being honest and dependable
    • doing your share of both the talking and listening
    • being respectful of the other person's feelings
    • keeping yourself clean and well-groomed
    • accepting your individual differences
    • listening closely without interrupting
    • being nonjudgmental
    • giving the other person plenty of "space"

The article goes on to include activities for the reader to do to increase their friendships and examine their current ones.

As I mentioned above, a fundamental quality of my closest friendships is that I am free to be myself. We all need time and space to "let our hair down." The many life roles that I and others have to assume - wife, daughter, sister, therapist, artist, writer, neighbor, employee, etc. require different personas. Many of our roles necessitate constantly meeting other people's needs, which can be exhausting. Many of my women patients, who are mothers, report that they see themselves only as "Bob's wife and Tom's mommy" and that it often feels limiting and confusing. I encourage them to carve out more time with close friends who will reinforce their role as a grown-up, intelligent, interesting individual who has many more facets than simply "wife and mother." They might see themselves reflected more accurately in friends with whom they've had long-term relationships.

I can hear you saying, "But I barely have time to do the essential things I need to accomplish each day. When do I have time for my friends?!" One of the advantages of our electronically-connected world is that you can maintain contact with friends via phone, e-mails, texting, IMing, through online forums, etc. Many of my friendships are e-relationships - we've never met, but keep our relationships going through the 'Net. Of course, it does take time and effort to grow and nourish these important connections, but the returns are immeasurable.


Monday, July 23, 2007

Faith Hill Makeover Magic

faith hill redbookLast year we highlighted the Dove Campaign for Real Beauty which included a video showing how Photoshop is used to "touch up" images for fashion magazines. Now we have a real life example of Faith Fill on the cover of Redbook magazine.

The before and after images show how her age lines are removed, her waist is slimmed, as are her arms. In fact, there are at least 11 changes to the original photograph to bring us the image in the magazine.

No wonder people feel inadequate when they are constantly bombarded with unattainable images!


Talia Mana

Sunday, July 22, 2007

Psychic Hotline Addiction Costs $33,000 a year


According to a researcher at Auckland University, psychic phone line addicts, are spending up to NZ$33,000 per year (US$26,500) to seek guidance on their finances, their love life and other burning issues from psychics, tarot card readers, astrologers and other telephone hotline services. The average expenditure is in the range of NZ$6,000-7,000 (US$4,770-5,565).

Dr Robin-Marie Shepherd, from the Centre for Gambling Studies at University of Auckland is conducting global research into users of psychic hotlines. Preliminary data from approximately 30 regular phone line users has been analysed to date.

“Users of psychic hotlines seem to demonstrate a number of addictive behaviours,” says Dr Shepherd of the Faculty of Medical and Health Sciences. “Regular users talk of relapsing or needing a fix, and many exhibit signs of anxiety or depression. This study is looking at why people call psychics and whether this behaviour should be viewed as addictive and require policymakers to take notice.”
I suspect many users were exhibiting signs of anxiety or depression prior to phoning. From my discussions with users and providers of psychic hotline services, the majority of callers are lonely, sad or facing difficult decisions. Many use psychic hotlines in place of counsellors to provide guidance in life issues, or when they are in need of someone to fill them with hope about the future.

Dr Shepherd is looking for more psychic phone line users to participate in this global study. She's also interested in hearing from people who work for psychic hotlines or others involved in the industry. You can contact Dr Shepherd via email or telephone +64 (0)9 373 7599 ext 86573.

Talia Mana

Wednesday, July 18, 2007

Who are the most important leaders in the Self Improvement Industry?

According to a recent survey by Self Improvement Online the five most important leaders in the Self Improvement Industry are:

  1. Anthony Robbins
  2. Deepak Chopra
  3. Wayne Dyer
  4. Oprah
  5. Jack Canfield
I was surprised to see Oprah appearing at number four on this list. There is no doubt that she has interviewed some influential people and brought some exciting ideas to the attention of the public, but her track record in her personal life is dubious.

I sigh every time Oprah goes on yet another diet or exercise frenzy. She gets caught up in fads. It seems like every year she has a new approach to eating or exercising and a new personal trainer or nutritionist or other guru to bring to our attention. Despite Oprah's yo-yo weight and frequent U-turns in the advice she gives on dieting, which can be anything from total deprivation to sensible balanced eating, people still buy into her advice. Oprah is a self-confessed compulsive overeater, but to date none of her dietary approaches have addressed the underlying emotional and habitual thinking and behavioural patterns that lead to binge eating.

Tony Robbins is a highly successful motivator, however he does have his detractors. Many people have criticised the advertising for his seminars as Steve Salerno SHAM: How the Self-Help Movement Made America Helplessmisleading. They attend the workshops believing that they will get three whole days of Tony Robbins, only to find that Tony is attending via video feed or has instead appointed one of his trainers to run the workshops. Some attendees are so buzzed by the hyped up atmosphere that they don't care, but others feel cheated after shelling out thousands of dollars. Who can blame them?

According to Steve Salerno in his book SHAM: How the Self-Help Movement Made America Helpless, Tony Robbins is "SHAM's most convincing motivational theorist". Salerno describes Tony Robbins' seminars as "state of the art with sound systems worthy of a Sting concert, Hollywood-grade stage lighting, music, dancers and other performers."

Robbins has come under criticism for selling courses, video and audio products promoting happy relationships, and in particular describing his own "perfect" relationship with Becky, whom he separated from several years ago. Many of his 'Get the Edge' programs, sold via infomercial, still mention his happy relationship with Becky.

Take Time for Gratitude Every Day

There has been a lot written recently about the so-called "happiness/positive psychology" movement. I'm not sure why, but that has provoked a negative reaction in me; maybe because some of the literature has presented it as an innovative, ground-breaking thought - "be happy!" I think most of us would agree, achieving some level of happiness in our lives is a fundamental goal. But it concerns me that much like the latest fad diet, achieving happiness is presented as a simplistic 1-2-3-step formula in a typical pop-psychology, self-help format.

A blogging colleague, TherapyDoc, expressed a similar opinion re: positive psychology in this post: The Sunny Side of Therapy: :) :) :). I agree with one very important point - the power of positive thinking is great, but not always a viable quick fix for folks who suffer from clinical depression or other psychiatric disorders. Cognitive restructuring (learning to recognize negative and/or non-productive thinking patterns) is a basic tenet of Cognitive Behavioral Therapy (CBT). CBT certainly could be labeled "positive psychology", but unlike some of the current literature, it is a proven theory and therapy method used to treat depression and anxiety and backed by years of scientific research.

So how can tapping into positive energy be applied to treating patients in therapy and also our everyday lives? When I worked in a drug and alcohol treatment program, one very effective and important aspect of recovery for patients was the concept of "gratitude." All the alcoholics/addicts I know are very adept at listing a litany of negative aspects of their lives. So a frequent homework assignment I gave was - make a "gratitude list" of 6-10 things every night. Most lists contained being grateful for another day of sobriety - that was easy. But this assignment almost always precipitated a much deeper self-examination and began a process of reframing their thinking processes.

Now I challenge patients to make a daily gratitude list. I ask couples in therapy to share their gratitude lists with each other. It helps them focus on the positive aspects of their relationships and lives. I apply it to my own life when I am having a particularly whiny, negative day.

I recently came across a therapist colleague's writing that inspired me. Although the content relates more to our spiritual lives, I think it also applies to gratitude. For me, it was thought-provoking and also an important reminder.

My son interviewed me for a high school assignment, inquiring how parents balance personal, family and work life. He asked questions to determine how daily time was divided. I was surprised to discover that I spend an hour a day on spiritual development. I have infused Spirit into my day effortlessly over the years, which has enriched life for me and those with whom I come in contact. Here are a few tips on how one might integrate Spirit without "robbing" time from family or work:

Including Spirit In Each Day

by Cheryl Meisterman, Ph.D., LISW

Wife, Mother of three, Psychologist, Social Worker

  • Upon awakening, think of four things for which you are grateful
  • Close your eyes and breathe deeply three times, think about the gift of breath
  • Listen to inspiring audio books or music in the car or while walking with earphones
  • Pray for guidance and wisdom, throughout the day
  • Meditate for peace while doing repetitive chores: washing dishes, gardening, setting the table, mowing the lawn, etc.
  • Be in nature daily and give thanks for the wonders around you
  • Light a candle and give thanks for the light
  • Give thanks at the end of the day for the opportunities granted and for the people you love
  • Sing or play an instrument with thanks for that ability
  • Recognize beauty in simple things (the smell of food, the touch of plants, the comfort of pets, etc.)
  • Read 15 minutes of inspirational literature daily
  • Do something nice for someone else daily

My family recites nightly prayers. No need to wait until bedtime to talk to Spirit. We have the blessings to connect any second of the day.

- - -

Try making your own daily gratitude list and also time for the spiritual part of your lives.

Monday, July 16, 2007

Brain Fitness Carnival July 2007




We are excited to host the July 2007 edition of the Brain Fitness Carnival, which includes articles on Health and Well-Being and the latest education and research.

Healthy Mind

Senia presents The A.P.E. Method to Get Out of a Bad Mood posted at Positive Psychology News Daily.

Jeremy Wong presents Becoming Smarter by Meditation posted at Becoming Smarter, saying, "Meditation and it's benefits on the brain – become smarter, a higher brain activity, heightened awareness, better focus, better memory and better learning ability."

Shaheen Lakhan presents Working Out Your Brain posted at GNIF Brain Blogger.

Marc and Angel presents 10 Irrational Thoughts Rational People Often Think posted at Marc and Angel, saying, "Irrational thoughts occasionally occur in the minds of all people. Intelligence does not make someone immune to irrational
thought."

Research, Education and Professional Development

FitBuff presents Don't Get Glad, Get Mad! posted at FitBuff.com's Total Mind and Body Fitness Blog, saying, "Their findings, detailed in this month's issue of the Personality and Social Psychology Bulletin, suggest that anger helps people focus on the cues that matter most to making a rational decision and ignore cues that are irrelevant to the task of decision-making."

Joshua Hwang presents Education from a Buddhist perspective: Jinfeng's Rice Cake posted at Learning, The Gravy Way, saying, "A little post on how we can use some Buddhist teachings in everyday learning: both as a teacher and student. After reading it again the tone seems a little tough, but I'm actually a softy."

Brett Steenbarger presents Bridging the Gap Between Hot and Cold Cognitive States posted at TraderFeed.

Stephanie West Allen presents Mind advice? Bring attention to the conflict posted at Brains On Purpose™.

Alvaro Fernandez presents Brain Health for lawyers and us all posted at SharpBrains Brain Fitness Blog.

Health and Wellness

Matt presents Keep Your Mind Active posted at EverydayChange.com, saying, "Keeping your mind active and young with neurobics."

James Bishop presents Depression, Omega 3 and Clever Fries posted at Finding Optimism, saying, "New "functional" foods, with nutrients added, are hitting supermarket shelves everywhere. Manufacturers like McCain are clearly concerned about our diets."

Anne-Marie Nichols presents An Interview with Nordine Zouareg, author of Mind Over Body: The Key to Lasting Weight Loss Is All in Your Head posted at A Mama's Rant.

Michael Scanlon presents Five foods for your brain posted at Lumosity.

Jimson Lee presents Pre-Competition, Energy, Focus and Mental Alertness Drinks posted at Speedendurance.com, saying, "A good collection of OTC drinks to improve alertness, awareness, and focus during exercise."

Medicine

Christian Bachmann presents Make use of early Alzheimer's plateau posted at Med Journal Watch, saying, "When the brain is attacked by Alzheimer's disease, it fights back and gives you a last chance to make the best of the rest of your life. Take it!"

Eli Feldblum presents Alzheimer's Disease: Causes, Symptoms, Treatments posted at B12 Patch

Science

Charles H. Green presents Lie Detection and a Truthful Society posted at Trust Matters, saying, "Will infallible lie detectors ever exist? And what would it mean if they did?"

Andreas Engvig presents Apes, Speedy Learners, and new Brain Fitness Channel posted at SharpBrains Brain Fitness Blog.

Personal stories and techniques

Tracee Sioux presents Second Generation Mean Girl posted at So Sioux Me, saying, "Can we heal our childhood fashion wounds through our children? I think if we try we create new wounds where there were none. A look at what is driving the school clothes fashion show – is it a mother's memory of Mean Girls?"

almomento presents Simple Steps to Discover Your True Destiny posted at BurstCreativity.

That concludes this edition. Submit your blog article to the next edition of brain fitness using our carnival submission form.

Past posts and future hosts can be found on our blog carnival index page.

Talia Mana

Sunday, July 15, 2007

Comfort eating really does make people happier



As anyone who has dived into a chocolate cake or pizza in moments of stress will tell you, emotional eating is comforting and can cheer people up. Now researchers at the University of New South Wales in Australia have confirmed that comfort eating:

  • makes rats happier (Yeah, I know, you'd think they'd have had plenty of human volunteers for an experiment of this sort. There surely can't be any shortage of people who are prepared to munch on high fat chippies and pies in the name of science!)
  • affects brain chemicals in rats and other animals, and is therefore a biologically driven process not a psychological one
The scientists believe these findings also apply to humans. According to the researchers ‘comfort eating’ is not a socially contrived phenomenon – but rather one based in biology.

This must be a relief for people who find themselves feeling out of control when faced with temptation at times of stress. Unfortunately, it can also be a good excuse to indulge! Evidence to date is that comfort or emotional eating is a combination of biology, learned behaviour, cognitions (what you tell yourself about the situation) and coping skills.

Professor of Pharmacology, Margaret Morris, says she was surprised by findings linking a high-fat diet and pleasure in animals that had experienced stress early in life.
“What this might be telling us is that there is something going on in the brain circuits that regulate feeding if you are stressed while very young - but if you are given nice things to eat, you are more able to experience pleasure,” said Professor Morris, from the School of Medical Sciences.

“You choose that behaviour because it makes you feel good,” she said.
Professor Morris’s other findings are that:
  • Brain chemicals that regulate feeding can be changed early on in life
  • Animals over-fed while young are usually heavier as adults, with poorer cardiovascular outcomes
“While we know there are strong genetic and environmental components in obesity, there is also a strong nexus between hormones produced in your fat and what happens to your brain appetite circuits, your hunger and your drive for food,” she said.

Talia Mana

Wednesday, July 11, 2007

Depression often untreated in Parkinson's disease patients

While depression appears to be common in early Parkinson’s disease (PD), it is often not treated or diagnosed, according to newly released research. A contingent of researchers from across North America found:

  • just over 27% of Parkinson’s disease subjects screened positive for depression
  • but depression went untreated in 40% of those subjects

This study, authored by Bernard Ravina, MD at the University of Rochester and funded by the National Institutes of Health in the USA, is the first to systematically examine the impact of depressive symptoms in early, untreated PD. Previous research has found that depression, in some form, affects up to 50 per cent of patients with PD and is associated with increased disability and reduced quality of life.

“Our results show that depression in PD appears to be under diagnosed, especially at the early stages of PD. That may be because symptoms of depression, such as fatigue and insomnia, may be attributed to PD rather than as symptoms of depression,” said Dr. Richard Camicioli, assistant neurology professor at the University of Alberta and a co-author of the study. “As seen in this study, many treated patients remained depressed and may require more intensive psychiatric treatment.”

Depression was also found to be associated with impairment on daily life activities, such as eating, bathing and dressing.

“Over time it appears that depression does not actually influence the progression of motor signs, but increases the disability associated with a given level of observational motor signs of PD,” said Camicioli.

For this study, 413 early, untreated PD subjects were administered the 15-item Geriatric Depression Scale (GDS-15), a validated screening tool to assess for depressive symptoms and the use of antidepressant or referral for further psychiatric health evaluation as a marker for the treatment of depression.

In another study based on data collected at the University of Alberta and funded by the Canadian Institutes of Health Research, Dr. Richard Camicioli has also found that depressive symptoms were the largest influence on health-related quality of life in older people with Parkinson’s disease.

“While we found that depression is common in early Parkinson’s disease diagnosis, we’ve also uncovered that depressive symptoms have the most significant influence on health-related quality of life in older people with Parkinson’s disease,” said Camicioli “That is why it is crucial for health care professionals to make an effort to detect, diagnose, and properly treat depression in Parkinson patients.”

7 Common Misconceptions About Therapy

(The following reflects my own theoretical orientation and practice principles when doing therapy. All therapists have different approaches to the therapeutic process and may have different perspectives.)

1. Therapy is a long, complex process that will take many years.

While some diagnoses and life experiences may require a longer time in therapy, the majority of patients I see benefit from brief therapy - 2 to 8 months. Psychoanalysis as portrayed in early Woody Allen movies had patients seeing a therapist 3 times a week! Most people couldn't afford the time or money to do that, nor is it clinically warranted.

2. Therapy costs a lot of money.

Most working people with health insurance benefits also have a behavioral health benefit. Many times the patient's financial obligation is a small percentage of the therapist's fee or a co-pay like that charged by a doctor's office. For folks without insurance, there are community mental health centers that operate on a sliding-fee scale. This fee is usually calculated on the patient's ability to pay.

3. If my employer pays for my insurance, they will find out if I see a therapist.

There are many safeguards in place to maintain the confidentiality of your sessions with a therapist. Most employers contract with a separate insurance company that administers the insurance benefit. In addition, all licensed therapists are under strict confidentiality guidelines. There are severe penalties for violating a patient's confidentiality.

One exception might be if an employee receives a mandatory managerial referral to counseling due to problematic behavior on the job - using alcohol/drugs or being aggressive with a co-worker, for example. Most of these kinds of referrals are through an Employee Assistance Program (EAP). In my experience with these types of referrals, the only thing I'm required to report is if the employee is compliant, i.e., if they kept their appointment, etc. I have never had to reveal any specific content of my sessions.

4. I will have to do everything my therapist tells me to do.

I probably encounter this "myth" more than any other in my work with patients. Therapists really shouldn't be dictating to patients. A good therapist will make suggestions based their experience with similar situations, on observations and cues they are picking up from the patient and what they believe may be helpful. Please tell your therapist if they are suggesting something that makes you feel very uncomfortable or isn't a good "fit" for you. If they continue to insist, it may be time for a new therapist.

5. I should share everything that happens in therapy with my spouse, friends, co-workers and/or family.

This is, of course, your choice, but I wouldn't suggest it. Therapy is for you. I find when you share your experiences often those close to you feel the need to make suggestions, offer opinions and make judgments. This can be counterproductive to making healthy and productive changes in therapy.

6. The therapist will want to know about my childhood and will only focus on that.

While some patients need to heal childhood "wounds" and this is a critical part of the therapy process, in my own practice examining childhood and developmental issues is only part of of my evaluation and focus. I believe that adults are the sum of their childhood, genetics, upbringing and life experiences to date. In the brief therapy model in which I work, addressing a patient's most pressing concerns is my primary goal. If achieving their goals are significantly impeded by the childhood issues, I will address them as needed.

7. Therapy is a painful process.

Change is difficult for most people. And therapy often is about making changes in unhealthy and nonproductive behavior. But there is also the opportunity for patients to discover hidden strengths and new, exciting perspectives. I often tell patients that it is very rare for someone to wake up in the morning and say, "Wow, I think I'd like to get into therapy!" There may be aspects of the process that are uncomfortable or unfamiliar, but a good therapist will help you through it.

- - -

These are just a few of the common concerns that patients have expressed to me over the years. I feel very strongly that therapy shouldn't be portrayed as a "magical" or "mysterious" process. Patients have the right to be informed and enlightened about this service that we therapists perform.


Saturday, July 07, 2007

Through the eyes of an emotional eater

Today, I thought I would do something a little bit different.

With her permission, I'm going to share the story of a lifelong emotional eater.

Jennifer has tried just about everything. She's been to Overeaters' Anonymous, Jenny Craig, Weight Watchers and counsellors to try and help her beat her food cravings. She has even tried fasting for long periods to attempt to break the hold food has over her.

While she has experienced periods of control, she is dissatisfied at the feelings of deprivation that she experiences when she goes to Overeaters' Anonymous, which encourages abstinence from trigger foods. For Jennifer this would mean a life without the whites - white sugar, white flour and salt. For her, this is a life without pleasure.

For most of us our identity is wrapped up in the 'labels' we give ourselves. These labels can be anything from the job we do, to our relationships with others, our goals, our passions, our strengths or our weaknesses.

Dr Phil in his book Self Matters: Creating Your Life from the Inside Out, which is a pretty good book if you can get past his corny way of talking, describes labels as:

Labels are incredibly powerful influences in your life. You may not be consciously aware of even a fraction of your labels, whether they come from the outside world or from within yourself. Either way, you must acknowledge the existence of labels, challenge the "fit," and confront the impact these labels have on your concept of self.

Are you a career woman, a mom, an accountant, a politician? Are you a failure or a winner? Are you a "fat girl" or a "pretty girl?" Write down all the labels you attach to yourself, going back as far as you can remember.
With Jennifer, it soon became clear that her identity is wrapped up in her opinion of herself as a wife and mother. Any time that she perceives problems in this area, she reaches for food. For Jennifer the state of her house is a barometer of her internal health. She judges herself by the cleanliness, order and tidiness of her home. When her house is spic and span she feels confident and in control of her life. When dirty dishes accumulate on the bench and washing piles up in the bath she feels like a failure as a wife, a mother and a person.

The result? She eats. She decides that she is a bad mother and a bad wife and wallows in chippies, chocolate, pasta, pizza and greasy foods.

That’s only part of the story. Jennifer has very distorted ideas about her role as a perfect parent. Logically she knows that cleaning the kitchen can be done in a few minutes, but it is such a big psychological mountain for her to climb, that she feels as if it is taking away hours that should be spent with her children. And once again she feels the need to reward herself with food.


Jennifer's next step is to examine her distorted perceptions.

She is challenging her assumption that an overindulgent parent who did everything for her has created a lazy monster who is incapable of doing housework. Jennifer is still having trouble convincing herself that her upbringing is irrelevant. She is very attached to her family and is having trouble separating today's Jennifer from the Jennifer of her childhood. She accepts logically that she's not the same woman, and that the way she is now is a combination of nature and nurture and that she can change her habits, but emotionally she's still letting go.

She's also promised as part of her homework to not immediately dismiss positive feedback. When her husband and friends tell her she is a good wife, a good parent and a good person, she's too quick to find fault with herself. She admits that she tests people and keeps rejecting their encouragement because she doesn't believe it herself.

Finally, she's working on understanding that the state of her house is not a reflection on her as a person.

Talia Mana

Thursday, July 05, 2007

Can limiting flavours stop overeating?

The premise of The Flavour Point Diet: Use Great Flavours to Control Your Appetite and Reduce your Weight – Permanently is that you can tame your appetite and quell cravings by selecting foods according to their taste or flavour.

The authors, husband and wife team, David and Catherine Katz describe the six taste categories as sweet, sour, savoury (umami), salty, bitter and astringent and devise their diets around these. In particular, they note that sweet and salty foods are most likely to stimulate the appetite. Also, according to the authors, calorie for calorie, protein is the most filling, and is therefore the best source of food.

Their formula? A balanced diet comprising:

  • 55% complex carbohydrates
  • 20% lean protein
  • 25% healthy fats
With each day devoted to a particular flavour.

By using these flavours, you will feel satisfied sooner, and eat less. The authors speculate that fast food manufacturers add hidden flavours into their foods to stimulate overeating. Instead, they believe you need to minimise the flavours each day to reduce your appetite.

The book includes a six week eating plan and recipes, with each day focused around a flavour, such as tomato, capsicum, dill, orange and onion days. Naturally, I jumped ahead to the chocolate day, which is described as a ‘special indulgence day’. Any time after week two of the plan you are permitted one indulgence day each week. The chocolate day comprises:
  • Breakfast: 1 banana chocolate chip soft wheat muffin, 1 hot cocoa drink
  • Snack: 1 tbsp raisins, 1 tsp good quality chocolate chips (are there any other type?), 3 whole almonds
  • Lunch: chocolate and banana grilled panini, skim milk
  • Snack: strawberries dipped in dark chocolate (now we’re talking)
  • Dinner: chicken with chocolate port wine sauce
  • Dessert: 1 chocolate brownie

This diet takes a lot of planning. In theory it addresses emotional eating and cravings by ensuring that your appetite centres aren’t overstimulated by being bombarded with too many flavours. However, to implement it you need to stick precisely to this diet, which is why I wasn’t keen on it. If you want a prescriptive diet that tells you exactly what to eat and you’re not too fussy it could work well for you. But I suspect some days will be tossed out the window. For me spinach day would be the first to be ditched, followed rapidly by raisin/cranberry day.

I’m not fond of diets at the best of times, but if you’re going to make lifestyle changes, they should be changes you can live with for the rest of your life. I don’t see this as a diet that would be easy to stick with, but I noticed that the diet was reviewed very favourably at Amazon so clearly I am in the minority!

Talia Mana

Wednesday, July 04, 2007

What are your favourite topics?

We've been posting on a variety of topics over the 11 months (yes it's nearly a year!) so I thought I would ask you to let us know your favourite topics...

Please also let me know if there is anything you don't like and anything you think can be improved. Here are the topics we've been posting in the last 11 months. We'd love your feedback:

  • Anxiety
  • Bipolar
  • Book reviews
  • Codependency
  • Depression
  • Emotional eating
  • Happiness
  • Interviews with other bloggers
  • Meditation
  • Non-medication forms of treatment
  • Positive psychology
  • Psychology of success
  • Quizzes and questionnaires
  • Recent research
  • Sleep/insomnia
  • Speedlinking to other blogs
  • Stress management
  • Therapeutic options
  • Wealth creation
  • Weight loss

What are your favourite topics? What are your least favourite topics? Thanks for your help...

Talia Mana

Defining Healthy Boundaries in Parenting

My post last week, Defining Healthy Boundaries and Setting Limits, was an overview of the implications of healthy boundaries and limit-setting in adult relationships. Some comments and feedback I've received on this topic and also my post on Codependency prompted me to explore these topics further. How do these important concepts play out in young adult/adult - parent relationships?

In my therapy practice, I work with adolescents and adult patients and as I do not have specific expertise working with children under 12, I can't properly address boundary issues with that population. For a good discussion of boundaries in the child-parent relationship, I refer you to Implications of Parent-Child Boundary Dissolution for Developmental Psychopathology: Who is the Parent and Who is the Child? by Patricia K. Kerig, PhD and some of the many other books on the subject.

What's wrong with your parent being your BFF (Best Friend Forever)?
Although a close relationship with a parent can be a healthy, important aspect of growing up, I often hear adolescents and young adults describe their mothers as "friends" or "just like a sister." That always sends up a red flag for me. How can you parent someone who sees you as a sister or friend? In our popular, celebrity culture, we are bombarded with examples of this - the most extreme being the mothers or fathers of (underage!) alcohol/drug-abusing celebrities who seem to implicitly approve of their children's behavior, often to the point of going "clubbing" with them!

But what of the "normal" folk? Kristen King, who writes the Lively Women blog, forwarded me a link to this recent New York Times article by Stephanie Rosenbloom, "Mommy is Truly Dearest." The article describes young adult women, living on their own who may check in and talk to their mothers as many as 4-5 times a day. And the content of these conversations? One woman tells her mother about the quality of her sex life with her husband.

Beyond the blurred boundaries of these relationships, the article talks about a level of dependency not seen in previous generations.

Additionally, parent-child contact during the college years has dramatically
increased. Professors say that many students these days stroll around campus
talking into cellphones — and not to one another. It is not surprising, experts
say, that some of that behavior spills over into the post-college years,
including a reliance on parents to continue to pay the bills.

Some level of financial dependence on parents during the college years is to be expected. But a recent Wall Street Journal article "When Kids Don't Leave the Digital Nest" described a 29 year-old woman, who although gainfully employed, still has her cell phone bill paid by her father! Of course this can be a way to maintain communication with your adult children - no doubt one of the perks of this arrangement for the parents.

With this high level of parent-child dependence AND codependency, how do children learn to be autonomous? How do young adults learn to have appropriate relationships with authority figures like bosses? Without adequate boundaries modeled for them in their parent-child relationship, they have no point of reference for healthy, productive behavior within these relationships.

Tuesday, July 03, 2007

Emotional Eating Carnival July 2007

Welcome to the July, 2007 edition of Carnival of Emotional Eating

S. Palmer presents Overweight? Go on a mental diet. posted at Mystic Eye.

Julie Levin presents Anxiety: The Heart of Addictions and Compulsions posted at Freedom from Emotional Eating

TherapyDoc presents Obesity Wars posted at Everyone needs therapy? Lessons from a family therapist, saying, "Bah, humbug on federal policies and schools that interpret them to humiliate children. This therapydoc offers advice to policy makers and parents in fighting the obesity wars."

JoLynn Braley presents Is it Trivial to Focus on Weight Loss? posted at The Fit Shack, saying, "Emotional eating can be brought on during times of stress caused by the recent tragic news events. It is helpful to be aware that you may be susceptible to turning to food during these times so that you may focus on remaining conscious of your eating habits, and avoid emotional eating."

That concludes this edition. Submit your blog article to the next edition of carnival of emotional eating using our carnival submission form. Past posts and future hosts can be found on our blog carnival index page.

Talia Mana