Month: March 2016

A woman therapist with wavy hair sitting on a couch speaking with a middle-aged brunette woman in a blue striped shirt.

Treating the Root Causes of Anorexia with Therapy

There are many misconceptions surrounding the prevalence of anorexia nervosa. According to statistics provided by the Renfrew Center Foundation for Eating Disorders, approximately 24 million Americans and 70 million individuals worldwide struggle with an eating disorder of some kind. The Mental Health Services Administration in the United States Department of Health and Human Services reveals that around 90% of people who struggle with an eating disorder are women aged 12-25. However, it’s wrong to assume that this condition only affects women. The misrepresentation of anorexia and other eating disorders as “women’s diseases” has led to the severe underreporting of such disorders in males.

It is believed that around 10-15% individuals with anorexia or bulimia are males. Many more men might struggle with an eating disorder but are afraid to come forward because they believe admitting to having an eating disorder is emasculating. Conversely, it is believed that 1 in every 5 women will struggle with an eating disorder at some point during their lifetimes.

Public Misconceptions about Eating Disorders

Public perceptions and understandings of eating disorders like anorexia nervosa are shrouded in myth. Dr. Paul Rhodes, an associate professor at the University of Sydney, explains it thusly: “At best they think maybe its because of media influence, skinny girls in magazines, or that it is a persons’ attempt to get control in difficult circumstances. This kind of simplistic view protects them from thinking about the pain and suffering involved, the deep distress caused by an illness that has its roots in genetics, personality, society, you name it.”

In other words, the reality behind anorexia for many people is complex and difficult for many of us who are not familiar with the disorder to both understand and accept. This can make seeking treatment challenging, particularly for adolescents who are afraid of facing judgment from their peers and family. However, according to Dr. Rhodes, “We know that up to 60 percent can recover through family-based treatment.” The effort put in by parents over a 12-month period can sometimes make all the difference in their child’s recovery. When caught early, usually within the first three years, the chances of remission become very good.

A New Approach to How We Treat Eating Disorders

But in recent years, leaders within the psychological community have been developing a new way of addressing patients with anorexia nervosa. Their focus has shifted from simply “curing” patients to enhancing their overall quality of life. In essence, what this means is expanding the focus of treatment from solely promoting weight gain to full medical stability. In doing this, they seek to establish communities of care and support. This new approach helps offer the patients not only rehabilitation but the hope that it is possible to survive and thrive through a more holistic model of treatment.

This new approach consists of several key components:

  1. Putting focus on improving nutrition and maintaining the safety of the patient – not just on gaining weight.
  2. Develop the patient’s quality of life – this includes engaging them in meaningful activities.
  3. Work on developing independence and interpersonal skills.
  4. Establish a multidisciplinary team and work collaboratively during medical crises if they occur.
  5. Support the patient’s family members and help them receive care for their own distress.
  6. Don’t just focus on the problems – also focus on the patient’s strengths and abilities.

An Effective Method of Treatment

This new approach to treating anorexia nervosa and other eating disorders just might be more effective than previous treatments. Dr. Rhodes cites the results from one study in particular, published by the US National Library of Medicine. This study compared the effectiveness of this treatment with the more traditional approach of cognitive behavioral therapy, or CBT. In doing so, they compared it to supportive clinical management. According to Dr. Rhodes: “At 12 months CBT had improved social interactions, lowered some of the psychological symptoms of anorexia, and increased the readiness of the patient to consider recovery. Drop out from treatment was only 13 percent, remarkably low for people struggling with anorexia nervosa.”

So what does this mean? Well, for one thing, it shows that there may be an alternative and more successful open for rehabilitating individuals struggling with eating disorders. This approach encourages the patients to acknowledge their own potential and focuses as much on their happiness and well-being as it does on simply remedying weight loss. This new program is also inclusive of the individual’s family and loved ones and takes into account the stress they endure as supporters of someone who is struggling with an eating disorder. As such, it acknowledges the road to recovery as a collaborative effort, inclusive of family, the patient themselves, and the professionals who seek to help the patient overcome their disorder and return to healthy living.

It’s also worth noting that this approach might even benefit those with severe and enduring anorexia. While individuals in this particular circumstance may feel helpless, interventions such as these can help small groups of patients at a time can, as Dr. Rhodes states, “do the impossible.” There may be no set “cure” for anorexia or other eating disorders, no solid answer, but there is treatment and, with that treatment, the hope for a better way of life.

red haired woman sitting on a smile couch, wearing headphones doing music therapy

Therapy with a Different Kind of Notes

Years ago, therapy was only thought of to be a space where a person and a therapist would meet and talk things through. While talk therapy still exists and can be extremely effective, our perspectives on what exactly therapy is and can be has greatly broadened over the years.

These days there are a number of new therapeutic treatment options being developed to address a wide variety of mental health concerns. With the growing popularity of alternative treatment options, more creative approaches to therapy are increasing in popularity. This is likely because many of these alternative therapies use subliminal elements to address the client’s inner needs and feelings without confronting them directly and, consequently, meeting a barrier of instinctive resistance. In other words, therapies like art therapy and play therapy allow the therapist to communicate with their clients in such a way that they can get to the root of their problems by reframing them. In this way, these concerns might become easier or perhaps more comfortable to address for the client.

Music Therapy: What is It?

Another form of therapy, however, has recently been gaining popularity amongst mental health professionals. Although lesser known than more conventional methods like traditional talk therapy, music therapy is being shown to be an effective form of therapeutic treatment for many individuals. But first, what is music therapy? Not many people know what exactly goes on during a typical session, which might make them hesitant to try it out in the first place. According to board-certified music therapist Dr. Dean Olsher, what music therapy actually is is a “ a rich and varied set of traditions co-existing under one big tent.”

But what does this mean? When congresswoman Gabrielle Giffords suffered a near-fatal gunshot wound to the head, it rendered her nearly incapable of speaking. She was only able to regain this ability when neurological music therapists used singing to help her learn to speak again. The application of music into therapy is many and varied, taking on different forms to suit the individual client’s needs. Music therapy has also been shown to be able to reach ndividuals with dementia. In these instances, the patients might be able to make music of their own, or simply listen and respond.

In psychotherapy, which once developed as an alternative to Sigmund Freud’s the “talking cure,” practitioners tend to align themselves with any number of orientations. These include psychoanalysis, humanistic psychology, and cognitive behavioral therapy (CBT). Like psychotherapy, music therapy can take on many different forms. Olsher describes: “Therapy happens in any number of ways, including improvisation, writing new lyrics to existing songs, you name it.” The versatility of music therapy is, in part, what makes it so effective. It can be customized to fit the client’s specific needs through music. Music, in and of itself, is an emotional and thoughtful medium. We might feel affected by certain songs or sounds, while others might resonate with us in ways that we might not have really been able to express otherwise. This ability to transcend linguistic barriers is, in part, what makes music such an effective medium for therapeutic treatment. Music can help give a voice to the voiceless in a similar way that art or images can, in many cases, speak more than words alone can.

How Music Therapy Works

Music therapy is specially designed to meet the needs of the individual. In some sessions of music therapy, the client might simply listen to music prescribed by the therapy. Conversely, in others, the client might be encouraged to sing, write a song, or play an instrument. In this way,  music therapy can be somewhat similar to occupational therapy – a form of therapy in which the client seeks recovery from a physical or mental health illness through the performance of activities that will be useful in their daily lives.

However, it might be incorrect to characterize either of these forms of treatment as either active, or passive, says Olsher, since it’s not quite that simple. He explains that “even ‘passive’ music therapy is actually active, because the music therapist is inviting the client to listen actively and to respond in some way or to reflect on how and which aspects of a particular piece of music/song is/are relevant or meaningful to that individual’s experience. An example of this is Guided Imagery and Music (GIM for short) in which the client images to specifically programmed music, with the music therapist serving as a guide of sorts. Afterward they process the material that emerges as a part of the listening, sometimes using active music-making to do so.”

It is also worth noting that music therapy differs from other activity-based therapies, including the aforementioned occupational therapy, because it is more specialized. Music therapists use their knowledge about how music affects the brain and employs musical elements in various different ways to meet the client’s needs. For example, an occupational therapist may incorporate music into their sessions, but their focus and expertise is not specifically in the area of musical intervention. Music therapists are more likely to invite clients to engage in and reflect on the interpersonal process of music. Moreover, they’re interested in supporting the emotional and relational growth of a person or group. These are not the focus of occupational therapy.

Music Therapy is an Option Worth Trying

Music therapy is one of many options available to individuals who need help coping with mental and emotional distress. It has been shown in many instances to help overcome linguistic barriers and help heal individuals after traumatic incidents. While lesser known than more conventional methods of therapy such as psychotherapy and talk therapy, it can nevertheless be highly effective in individuals who respond more strongly to music than words alone. As such, music therapy may be worth considering if you feel as though you might benefit from this form of interactive treatment.

A couple sits with a therapy to talk about good relationship skills

How to Tell Good Therapy from Bad Therapy

Many approaches have been taken to therapy over the years. Modern therapy as we know it began with Sigmund Freud who experimented early on with what he believed to be the talking cure. Today’s psychotherapy, however, comes in a number of forms, but the common thread lies in the communication between therapist and patient.

Dr. Noam Shpancer, professor of psychology at Otterbein University in Westerville Ohio, describes the differences in today’s therapeutic methods thusly: “The psychoanalyst will probe your unconscious; the behaviorist will rearrange your reinforcement contingencies; the cognitive therapist will challenge your irrational thoughts; the humanist will provide a safe space within which you may activate your self actualization tendency; the existentialist will encourage your find meaning in the desert of existence; the reality therapist will guide you toward choosing behaviors that facilitate your connection to others; the feminist therapist may show you how your personal problems are manifestations of political patriarchal oppression, and so forth, on and on.” However, it’s worth noting that no single form of treatment negates any other. In other words, there is no “right” or “wrong” form of treatment, objectively speaking; it depends entirely on what works best for the individual patient.

That being said, there is such a distinction as that between good and bad therapy. Just as there are many forms of therapies available there is a chance that some experiences may be successful and others less than successful. Despite this diverse array of options available, many patients will experience the most success if their treatment adheres to the basic principles which pervades all effective therapies. According to Dr. Shpancer, these principles are as follows:

5 Principles of Beneficial Therapy

1. Good Therapy is not Friendship

While it is important to build a foundation of trust between patient and therapist, therapy is not the same as establishing a friendship. The relationship between patient and professional differs from that between friends in a number of ways. Firstly, the relationships between friends can be many and varied, transcending contexts. For example, you may work with friends, see them socially, or even borrow money from them. Conversely, you will not see your therapist outside of the designated setting of your therapy. While the therapist may have a friendly demeanor, they are not friends. If they are friends, then they are not therapists.

Friendships do not normally have goals of any kind, whereas therapy relies on setting goals and meeting them. When we spend time with friends, we can do so because we simply enjoy it, not because we have anything specific that we are trying to accomplish. Therapy, however, has a purpose. It is not an end within itself.

Friendship is forged on equal grounds. Friends typically have equal standing in each encounter. You might consider your friend’s needs just as important as your own. This also goes for interests. In contrast, the relationship between the therapist and their client is one sided. Therapy is about your needs, not the therapist’s. If the therapist uses the patient’s time to discuss their own needs, then it is not good therapy.

2. Good Therapy Affirms One’s Sense of Dignity and Self-Worth

The goal of therapy should ultimately be to affirm the client’s sense of dignity and self-worth. As Dr. Shpancer describes: “Mental health, however, is not a destination, not an end in itself, not a place you arrive at, pearly-gates style, to be ushered into bliss. Rather, mental health is a process you adopt and use in the pursuit of your chosen goals.” Another way to look at this is to think of mental health as driving skill, not the destination to be arrived at. In this perspective, the therapist is the driving instructor.

While therapy can include judgments, it is not about judging the patient. The majority of people who seek therapy have been judged, often harshly, for their thoughts and feelings. Good therapists, however, provide judgment that is constructive, coupled with helpful advice, to help the healing process and offer a corrective experience. After all, patients need more than anything empathy, understanding, attention, acceptance, and encouragement. Good therapy does not patronize,condescend, lie, abuse, or cheat.

3. Good Therapy Encourages Independence and Confidence

Therapy should help the patient improve their resilience, independence, life-confidence, and decision-making. If this is not being accomplished, then good therapy is not taking place. Dr. Shpancer notes that “A good sign of therapy at the brink of failure, or of therapy that’s not legitimate, is when your dependence on the therapist increases over time.” The therapist’s job is not to solve the patient’s problems, it is to equip them with the skills they need to solve their own problems. Otherwise, the therapy isn’t effective.

4. Good Therapy Offers Support and Encourages Action

One of the primary roles of the therapist is to engage the client on multiple levels. This means involving the client’s emotion, cognition, and behavior. Therapists will often focus on understanding their patients empathetically. In doing this, a sort of alliance is established. Through this alliance we can begin to realize the inner workings of our own minds, as well as gain new perspective on our lives. This is how therapy can facilitate learning, providing us with new insights and new ways of thinking about ourselves and our relationships with others. Therapy can also show us new ways of communicating and managing our emotions. Good therapy should also focus on the client’s actions in the world: showing them how to practice new skills, and adopt new habits to improve how they function in the world around them.

5. Good Therapy Lets the Client Do Their Work

A sign that a particular therapy experience might not be working out can be seen if a therapist appears to be taking credit for the client’s work. Therapists are guiding figures, but changes and improvements in their patients are caused the by individual’s own motivation, resources, social support, and determination. Dr. Shpancer also acknowledges that “The client’s experience of the therapy also matters more than the objective measurement of therapy ingredients.” Dr. Shpancer believes that all therapy is fundamentally directed towards the self. He states: “If therapy is to work for the client, the client has to work for the therapy.” Initiation of change is not caused by the therapist, but by the client’s own willingness to change. Good therapy acknowledges this and allows the client to do their own work in addition to providing guidance and encouragement from the therapist.

Knowing the Difference Between Good and Bad Therapy

Knowing the difference between good and bad therapy can mean the difference between having an experience which is effective or ineffective. By recognizing what constitutes good therapy, clients can become more aware of when certain methods of treatment are or aren’t working for them. By acknowledging these feelings and experiences, individuals can make informed decisions and discover what treatments will best help them to become happy, functional, and at peace with their minds and lives.

hands up to sky, holding the sun

How Light Therapy Can Combat Seasonal Depression

It’s not uncommon to feel “down” or “blue” from time to time. After all, life comes with it’s fair share of ups and downs and, as humans, we’re all along for the ride. Some seasons, however, might make us more prone to feeling blue than others. Known as seasonal depression, seasonal affective disorder (SAD), or “winter blues,” something about the cooler months seems to make many of us more likely to feel depressed than during any other part of the year. While scientists have yet to come up with a definitive reason as to why this might be the case, the most popular theory is that it has to do with the amount of daylight we receive (or lack thereof) during this part of the year when compared to all other seasons.

Understanding Seasonal Depression

Marlynn Wei is a board-certified Harvard and Yale-trained psychiatrist and therapist. Dr. Wei is also a certified yoga instructor and author who frequently writes about the healing powers of yoga, meditation, exercise, and healthy nutrition. According to Dr. Wei, seasonal depression is about more than just being sluggish due to colder weather. She explains that: “Shorter days from early fall through winter can cause even your serotonin to hibernate in your neurons.” In other words, this shorter amount of sunlight exposure can actually affect us on a biochemical level, causing us to feel more tired and less motivated. This decrease in physical activity and increase in desire to sleep can contribute to the depressive symptoms commonly associated with Seasonal Affective Disorder.

Dr. Wei’s research has shown that “You’re more at risk for the winter blues if you’re a woman, younger, live further from the equator, or have family members who have depression or a mood disorder.” Furthermore, she adds that “People with seasonal depression have been found to 5% higher levels of a transporter protein(link is external) that whisks serotonin away from the space in between neurons and moves serotonin back into the presynaptic neuron, which can lead to depression.”

Typically, sunlight during the summer months prevents this from happening, but during winter there is less sunlight which can lead to more serotonin hibernating in the neurons. This, many believe, is what truly causes seasonal depression. However, people with Seasonal Affective Disorder may be more prone to over-producing melatonin during the winter. This hormone is released in response to darkness and is what causes us to feel sleepy.

Benefits of Light Therapy

Phototherapy is a common and fairly effective treatment for individuals struggling with SAD or seasonal depression. Alternatively known as Bright Light Therapy, this form of therapy is usually employed in conjunction with antidepressants, Vitamin D, and traditional psychotherapy for maximum success in afflicted patients. That being said, light therapy is more than just simply standing in front of a box of light or sitting in an illuminated room. In order for the treatment to work, individuals and their practitioners must take care to avoid common mistakes which may cause the treatment to be less effective. Below are a few of them:

1. The Light Box must be 10,000 lux.

According to Dr. Wei, it’s important that the lightboxes employed during this form of therapy closely mimic the full spectrum of sunlight. As such, regular, ordinary lamps are fairly ineffective for this purpose. There are light boxes specially made for Bright Light Therapy or phototherapy that are designed to emit at least 10,000 lux. This is 20 times the strength of your typical indoor lighting. Lamps with fewer lux units would need to be used for longer periods of time to achieve the same benefit.

2. The Light Box Must Provide the Full Spectrum of Bright White Light (Minus the UV Rays)

One of the benefits of using a light box is that you can actually avoid exposure to harmful UV-rays, which is a risk that can come with overexposure to the sun. The light box one uses during phototherapy should filter out 99% of ultraviolet rays which could otherwise cause bodily harm.

3. The Box Should Be at Eye Level or Higher and 2 Feet from the Eyes, at an Angle.

Because the purpose of the light box is to mimic the sunlight it’s important that it’s kept at least eye level or higher. According to Dr. Wei, the ideal distance is also approximately 2 feet away from the eyes. Although, if the light box is weaker than the recommended 10,000 lux then one should seat themselves closer depending on strength to achieve the same effectiveness. Another important tip is to keep the box angled 45 degrees either to the left or right. Dr. Wei advises against putting the box directly in front of the eyes.

4. Use the Light Box Every Morning for 20-60 Minutes Between Fall and Winter.

When using phototherapy, consistency is key in order to see results. Dr. Wei recommends starting out at 20-30 minutes every morning to see if it causes a boost in mood and energy. If this period of time doesn’t seem to make a difference, then she recommends going up to maximum of 60 minutes. Light therapy time can also be used to multitask and go about one’s usual routine. Perhaps have a cup of coffee or check email, if it suits you and doesn’t seem to distract from the desired effects. Using light therapy every morning from early fall to winter can help maximize effectiveness whereas only using it a few times a week for a shorter period of time can make the treatment less effective overall.

Don’t Use if You’re Taking Medications Which Make You Photosensitive

This one might seem obvious but it can be surprisingly easy to overlook. Certain medications can make one photosensitive, meaning that the skin will become more sensitive to light. This can lead to sunburns or rashes with overexposure. Such medications typically include lithium, melatonin, certain antibiotics, and certain acne medications like isotretinoin, more commonly known as Accutane.

6. Monitor Your Mood and Combine With Other Treatments if Necessary

Improved mood and energy should be noticeable within 1 to 2 weeks with regular treatment, however, many people notice a more immediate response. That being said, it’s very important to talk with one’s doctor first to find out if phototherapy is right for you. Otherwise, there is the potential for a negative reaction such as developing excess energy (hypomania) and lacking in sleep as a result. There are worksheets available to track one’s mood during treatment so that it can be easier to keep track of changes. However, if light therapy isn’t enough, this treatment can be combined with other forms of therapy, like cognitive behavioral therapy (CBT), mindfulness, meditation, and exercise.

A male and female interlocking hands in what appears to be a strong, happy relationship.

Building Communication with Relationship Therapy

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Man sitting on couch holding hands over his face as his partner walks away angrily.

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Vintage photo of a peaceful, beautiful nature scene with river and trees.

Smell The Roses: The Benefits of Nature Therapy

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