Emotional Strength Doesn’t Come from Ignoring Your Feelings

Going about our lives emotionlessly is robotic at best and, at worst, sociopathic.

It’s pathetic that the trope of the strong, independent woman who lacks any emotion except intense ferocity is still a thing we subscribe to at all. When strong fictional female characters on screen show compassion, lust or grief, it’s considered a “moment of weakness.”

5 Steps To Opening Up Emotionally In Your Relationship

In our daily lives, women are constantly told not to “get emotional” if we want to be taken seriously. This may be an oversimplification of the matter, but the point stands that, in our society, to show any emotion besides “determined, ambitious passion” somehow translates to weakness. And it’s bullsh*t.

A strong person can encounter an intense emotion, feel it deeply, control it, and use it as fuel to make the world a better place. The sad truth is that most people are terrified of uncomfortable feelings, both in themselves and especially in others.

Humanity is quick to dismiss an individual who exudes mental despair — only the strongest people have the compassion to run toward this type of distress and provide authentic comfort. This is rare.

Ignoring your feelings won’t make you stronger; in fact, just the opposite. Going about our lives emotionlessly is robotic at best, and, at worst, sociopathic. Ultimately, it’s a cowardly way to live and, as science has shown repeatedly, detrimental to our health.

Your feelings are there for a reason: to act like a rudder to navigate your life. Taking time to honor them not only spares you from unexpected, messy meltdowns, but it’s also the secret to creating your truest, happiest life.

This is not to say that emotions aren’t terrifying or really, really painful to deal with at times; they absolutely are. That’s what makes so many of us run away from them in the first place. But looking at them head-on, figuring out where they originate, and using them to propel you forward takes courage.

It also takes incredible discipline to feel sometimes devastating emotions and not lose yourself in them completely — a skill most people never have the strength to develop.

This enormous scope of emotion is among the greatest gifts we have as humans. It’s way past time to stop feeling too ashamed to fully experience this very natural tool for self-discovery just because those around us are afraid.

25 Things Ambitious, Get-What-They-Want Women Do WAY Differently

Dig deep. Feel what you need to feel (soberly and without hurting anyone). Use it to learn about yourself and live the life you’ll be happiest with. And don’t waste too much time on anyone who’s still afraid of tears or anger. Just don’t let them convince you that you’re the weak one.

This guest article originally appeared on YourTango.com: Being Emotionally Strong Doesn’t Mean Ignoring Your Feelings.

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Marriage Therapy AND Applied Behavior Analysis

An interesting connection has been developing that combines the two separate fields of marriage therapy and applied behavior analysis. This could be a very useful collaboration that could help many couples address their problems and enhance the behaviors and well-being in their relationships.

One example of this intersection of the two fields is the following dissertation.

Applied Behavior Analysis To Modify Couple’s Behavioral Patterns: A Program Design

by Smith, Yramnna, Psy.D., THE CHICAGO SCHOOL OF PROFESSIONAL PSYCHOLOGY, 2016, 67 pages; 10117129

Abstract:

Marriage family therapy and applied behavior analysis are two separate fields that have the potential to be joined together to introduce a cutting edge way of exploring and treating couples who are experience marital distresses. This dissertation explores both fields while highlighting the various ways they are used to provide treatment across settings, individuals, and presenting problems. Based on previous research there was a clear gap in the field of applied behavior analysis that displays the potential utilization to manage couples martial presenting problems. In attempts to explore the promise of applied behavior analysis to treat couples presenting problem of arguing; this project consisted of the development of a couples manual based on the principles of applied behavior analysis, the development of two measurement tools to determine the effectiveness of the manual, and the evaluation of the manual by expert marriage family therapists and board certified behavior analysts. Based on the data analysis of feedback from both licensed marriage family therapists and board certified behavior analysts, the purposed manual shows promise that the couple manual could be an effective tool for couples treatment and suggests further research be completed to test the manual using human subjects in the future.

Here is another example of connecting the fields of behavior analysis and marriage therapy:

Behavior Analysis of Forgiveness in Couples Therapy

James Cordova, Ph.D., Joseph Cautilli, Ph.D., Corrina Simon and Robin Axelrod Sabag

Abstract

Behavioral couples’ therapy has a long history of success with couples and is an
empirically validated treatment for marital discord (Task Force on Promotion and Dissemination
of Psychological Procedures, 1995). However, only about 50% of all couples in treatment
experience long-term change (2 years). One of the founders of behavioral couples’ therapy called
for the therapy to return to its original roots in functional analysis (Jacobson, 1997). This
produced integrative behavioral couples’ therapy. As behavioral couples’ therapy attempts to
reach the maximum number of couples possible, we believe further attention to behavior analytic
principles will continue to contribute to advances in the field. We propose that an operational
analysis of forgiveness will help to strengthen behavioral couples’ therapy by creating a direct
module to handle some of the most entrenched situations, those commonly referred to as betrayal.

Another journal article can be found at the following link:

Behavior Analysis and the Scientific Study of Couples

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What Behavior Technicians Should Know When Provide ABA (Applied Behavior Analysis)

As a BCBA, specifically in the field of working with children with autism spectrum disorder, you are likely to supervise and be responsible for training behavior technicians who will be implementing the treatment plans that you develop. Here is a list of some (not all) of the things that your supervisees will need to know.

• Understand data collection procedures
• Competent in collecting data accurately
• Basic knowledge of behavior analytic principles
• Be able to provide discrete trial teaching
• Be able to provide natural teaching strategies
• Understand behavior reduction plans written by the BCBA
• Competent in implementing behavior reduction plans
• Understand and skilled in responding appropriately to health and safety concerns of clients
• Write objective treatment notes
• Understand and behave with respect to maintaining confidentiality
• Respond appropriately to feedback given from supervisors
• Act in a respectful and professional manner toward clients and caregivers of minor clients

Reference: RBT Task List, BACB.

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Tracking how HIV disrupts immune system informs vaccine development

One of the main mysteries confounding development of an HIV vaccine is why some people infected with the virus make the desired antibodies after several years, but a vaccine can’t seem to induce the same response. Studying 100 HIV-infected people — half whose immune systems eventually made antibodies capable of broadly neutralizing the virus and […]

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Avoid This Dietary Fat Because It Destroys Cognitive Function

Avoid This Dietary Fat Because It Destroys Cognitive Function

 

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Book Review: Mindfulness on the Run

For most people, it’s not that mindfulness isn’t valuable, but rather it’s something they simply don’t have time for. Yet in her new book, Mindfulness on the Run: Quick, Effective Mindfulness Techniques for Busy People,Dr. Chantal Hofstee shows us just how easily — and effectively — mindfulness can be incorporated into even the busiest lives.

Dr. Hofstee, a practicing clinical psychologist, draws upon her clinical experience, as well as some convincing research, to offer numerous tips, tools, and exercises to use mindfulness to improve our brain function, emotional control, relationship to ourselves and others, reaction to stress, and even how we handle conflict.

Dr. Hofstee begins by explaining that while many of us view stress as a normal part of life (and something that cannot be mitigated), it is actually when we are most busy and cannot spare time for a mindfulness retreat that we most need to practice mindfulness. However, no matter how much mindfulness practice we do, we can’t ever eradicate stressful and challenging situations from our lives.

What mindfulness can do is teach us to respond differently. Dr. Hofstee points to an eight year study conducted at the University of Wisconsin Madison that demonstrated that while a high level of stress does increase risk of premature death, this effect was only true for those participants who believed that stress was harmful to their health.

Just what we believe, and how we respond to those beliefs has a powerful effect on our brains. Here, Dr. Hofstee introduces the concept of red-brains and green-brains. A red-brain, she tells us, is in a state of stress, often activating our fight or flight response. And while the red-brain is often triggered by actual threat, it is also frequently triggered simply by our thoughts about the events in our lives. The green-brain, on the other hand is “calm and present”, ready to learn, open to relationships, and essential for our physical health.

And while many of us find ourselves stuck in the productivity myth — believing that success will lead to happiness — the best way to control our brain states is to learn to control our thoughts. Dr. Hofstee gives the example of running late to work and feeling overwhelmed and stressed, or making a conscious effort to find things to be grateful for. And because mindfulness is a state largely comprised of two components, attention and attitude, when we choose what we pay attention to and our attitude about it, we can learn to cultivate a kind and non-judgmental response and move from reaction to response.

Mindfulness doesn’t just help us respond better to the events in our lives and the people around us, Dr. Hofstee tells us, it also changes the way we relate to ourselves. “You grow in self-compassion and kindness towards yourself,” she writes. Not only do we learn to accept our own uncomfortable emotions but we also learn to accept those of others and stop trying to fix them, which improves our connection to them. By making someone feel heard, acknowledged, and validated, Dr. Hofstee tells us, we activate their green-brain, which improves their mood, as well as our own.

And yet practicing mindfulness, Dr. Hofstee acknowledges, it not a foolproof strategy. In many cases it may not work. Yet in each instance, Dr. Hofstee offers useful exercises to help us train our brains to operate more mindfully. One of these is called, “Turn it Around”, where we are encouraged to take a negative thought and first ask if it can be true, if we can absolutely know if it is true, how we react and who we would be when we believe that it is true, and lastly, turn the thought around to the self, to the other, or to the opposite. In the example Dr. Hofstee gives, “I don’t have enough time,” can be turned around to, “Time doesn’t have enough of me.”

By learning to recognize especially our recurring stressful thoughts, we can also learn to recognize our core beliefs, which Dr. Hofstee compares to glasses through which we view the world and color our perceptions. “This insight,” Dr. Hofstee writes, “allows your mind to open up to the possibility that things may not be true even when they feel true.”

One of those possibilities is that our positive thoughts materialize in concrete ways. This self-fulfilling nature of thoughts reminds us of the importance of being aware our thoughts and particularly thinking only that which we wish to be true. But we may also simply feel better. When we are able to control our stressful thoughts, Dr. Hofstee explains, we are able to de-escalate the stress response and release hormones that will actually reduce stress, muscle tension, heart rate and blood pressure.

Learning to control not the events that cause stress, but rather, the way we respond to them might be the most important lesson Dr. Hofstee offers. And as she effectively demonstrates, not just do we need mindfulness most when we are busy, but when we have the right tools, it is possible to practice it on even the tightest schedule.

Mindfulness on the Run: Quick, Effective Mindfulness Techniques for Busy People
Exisle Publishing, July 2016
Paperback, 256 Pages
$18.95

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The Kind of Stress That Makes You Appear Older

One particular type of stress takes the greatest toll on your appearance.

 

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Mental Health: The Biggest Company Perk

“Working yourself to death?” your friend teases.

In America, this is more than a hackneyed expression. We stifle yawns on our morning commute; we slump into cramped seats on our way home. In between, our mental health hemorrhages. Yes, we are accessories to our mental health crisis.

The average American is overworked, clocking in at 47 per hours per week. In the legal and medical professions, young lawyers and doctors surpass 100 hours per week. Half of salaried employers average 50 or more hours per week.

Striving for the next promotion, raise, and title, stress and mental health issues are ancillary. We mythologize stress; it is a necessary ingredient to scale the corporate ladder. Hard-charging professionals boast about sacrificing sleep for spreadsheets. Amazon, in an infamous New York Times op-ed, brags about its workaholic culture. Its company ethos: work hard, play less. And if you question its turbo-charged culture, you can find serenity in your next position.

Sensing sagging morale among bleary-eyed staffers, well-meaning employers place foosball tables and complimentary snacks in posh break rooms. Other employers offer unlimited vacation time. But amidst the workplace soirees and complimentary baseball tickets, there is a tacit understanding: discuss mental health issues at your own peril.

The on-campus dry cleaning and complimentary tai chi classes are well-received perks. But they obscure the overarching issue: mental health stressors are compromising the American workforce. The statistics are sobering. According to an Impact of Depression at Work Audit study, a quarter of American workers have a diagnosable mental health issue. Nearly 40 percent of employees take 10 days off per year as a result of a mental health condition.

Mental health, despite its prevalence, remains a taboo subject within the American workforce. In today’s competitive workforce, employees are loathe to divulge mental health tribulations. They — rightfully so — fear employer reprisals and stigmatization.

Employers, meanwhile, offer limited, if any, accommodations to employees. Corporate wellness programs target diet, not depression. In the pressurized job market, productivity remains the benchmark. Mental health connotes weakness and unreliability; it is a convenient excuse for disinterested malcontents. “If you can’t do the job, we will find someone who can,” a callous employer disparages a chastened employee battling mental health issues. The unspoken consensus on mental health: you are on your own.

Employers and employees perpetuate this vicious cycle. Employers, disparaging mental health, cycle through “unproductive” employees. These employees, mischaracterized as malingerers, are unceremoniously dismissed. The economic fallout: an estimated $23 billion.

Meanwhile, employees, fearful of retribution, conceal their mental health diagnosis. Masking depression, anxiety, or bipolar disorder, inconsistency marks their performance. Some days the employer earns glowing reviews for his dedication; other days he arrives two hours late for the shareholder meeting. Employers, without any knowledge of an employee’s mental health trials, react punitively to the perceived insubordination. The result: talented workers jettisoned from position to position.

Here’s the sad irony: Companies spend millions in employee welfare, from gleaming campuses to the latest software upgrades. But when it comes to actual employee welfare, there is a fundamental disconnect between mental health and company performance. Company performance encompasses both the latest NASDAQ report and employers’ emotional well-being. Over 23 million Americans are nodding in agreement.

References

Saad, L. (2014, August 29). The 40-Hour Workweek Is Actually Longer — by Seven Hours. Retrieved from http://ift.tt/1pQKeFG.

Kantor, J. and Streitfeld, D. (2015, August 15). Inside Amazon: Wrestling Big Ideas In a Bruising Workforce. Retrieved from http://ift.tt/1IT6AfJ.

Investopedia (2013, 10 July). The Causes and Costs of Absenteeism in the Workplace. Retrieved from http://ift.tt/2aCvl9W.

Witters, D., Liu, D. & Agrawal, S. (2013, July 24). Depression Costs U.S. Workforce $23 Billion in Absenteeism. Retrieved from http://ift.tt/16jWTHa.

Kasia Bialasiewicz/Bigstock

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The End of Ego-Depletion Theory?

It's not been a good month for the theory of ego-depletion - the idea that self-control is a limited resource that can be depleted by overuse. Two weeks ago, researchers reported evidence of bias in the published literature examinig the question of whether glucose can reverse ego-depletion. Now, the very existence of the ego-depletion phenomenon has been questioned by an international collaboration of psychologists who conducted a preregistered replication attempt (RRR). The results have just...

Hagger, M., & Chatzisarantis, N. (2016) A Multilab Preregistered Replication of the Ego-Depletion Effect. Perspectives on Psychological Science, 11(4), 546-573. DOI: 10.1177/1745691616652873  

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The Long-Term Effects of Adult Sibling Bullying

You know that sinking feeling all too well. You’re expected to make an appearance at an upcoming family gathering, and you just know your sibling will be there — putting you down, as usual.

While some parents see bullying among their children as a normal form of sibling rivalry, few people realize that, in many families, it can continue well into adulthood.

So, what is it and why does it occur?

Sibling bullying can take many forms, but it is always done with the intention of shaming, belittling or excluding their victim. It can include name calling, threats, constant teasing and enlisting other siblings to join them in the bullying.

Bullying among siblings can occur because parents don’t take it seriously, assuming it is just a phase or that it is natural for siblings to fight and squabble among themselves. More often than not, though, bullying takes root within families where abuse and bullying tactics are practiced by the parents.

Children are wired to imitate the behavior they see around them, so it is no surprise that a child who is being bullied by an abusive parent goes on to bully others. As is so often the case with bullies, it will be those even less powerful than they are, such as younger siblings or classmates, who end up being the target. The child may also resort to various forms of bullying as a way of venting the frustration they feel at their parent’s ill treatment of them, but which they are powerless to stop.

Relationship dynamics between the bully and the victim often remain unchanged from childhood into adulthood. The bully continues to victimize their sibling because having someone to pick on boosts their own fragile sense of self-worth. The victim, worn down by years of ill treatment at the hands of their sibling, may feel resentful, but may also be at a loss as to how to change the situation, thus allowing the abuse to continue.

The bully may have become so used to having a sibling who can’t or won’t defend themselves that they don’t want the dynamic between them to change and become more healthy. Having someone to blame for their problems or take their frustration out on suits the bully and so they deliberately resist any attempts at sincere reconciliation.

After many attempts at trying to have a healthy relationship with the bullying sibling, most victims simply give up and accept the situation, however miserable it makes them. Some take the drastic, but necessary measure of avoiding contact with their sibling.

Estrangement between adult siblings is not as uncommon as most people think, with a recent study at Cornell University finding that one in ten adults have one or more family members from whom they are estranged. For many people in this situation, it is a last resort and one they may grapple with for years before finally taking the plunge. However, most report feeling a strong sense of relief that they no longer have to endure their bullying sibling’s behavior.

Luis Santos/Bigstock

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Practice Guidelines for ABA with Individuals with Autism Spectrum Disorder

The BACB (Behavior Analyst Certification Board) provides an amazing tool for those BCBA’s who work with individuals with autism spectrum disorder. In addition to following the BACB Code of Ethics, being aware and practicing in compliance with the document provided by the BACB specifically for the autism population can help you in your practice.

The document, “Applied Behavior Analysis Treatment of Autism Spectrum Disorders: Practice Guidelines for Healthcare Funders and Managers (2nd ed.),” is highly recommended as a resource you should become familiar with if you work with children with autism.

Here is a sample from the document. The document’s executive summary states the following:

The purpose of this document is to inform decision-making regarding the use of Applied Behavior
Analysis (ABA) to treat medically necessary conditions so as to develop, maintain, or restore, to the
maximum extent practicable, the functioning of individuals with Autism Spectrum Disorder (ASD) in
ways that are both efficacious and cost effective.1

The document is based on the best available scientific evidence and expert clinical opinion regarding
the use of ABA as a behavioral health treatment for individuals diagnosed with ASD. The guidelines
are intended to be a brief and user-friendly introduction to the delivery of ABA services for ASD.
These guidelines are written for healthcare funders and managers, such as insurance companies,
government health programs, employers, among others. The guidelines may also be useful for
consumers, service providers, and regulatory bodies.

This document provides clinical guidelines and other information about ABA as a treatment for
ASD. As a behavioral health treatment, ABA includes a number of unique clinical and delivery
components. Thus, it is important that those charged with building a provider network understand
these unique features of ABA.

A few important points that are discussed in the practice guidelines document include:

• Continuous assessment to evaluate functioning and progress
• Addressing socially significant targets of behavior change
• Considering the function of the behavior
• Training for caregivers
• Prioritize behaviors that are harmful to the client’s self or toward others
• Secondly, prioritze behaviors that are fundamental to health, social inclusion, and independence (ex: feeding, toileting, dressing, etc.)
• Treatment should be provided in multiple settings; Consider the settings that will promote generalization of skills as well as socially significant behavior targets
• AND MUCH MORE! (Review the document for more recommendations.)

Here is the link to download the complete document.

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Resources for Parents on Applied Behavior Analysis (ABA) and Autism

Applied behavior analysis can be a confusing field to fully comprehend especially if you have not heard of this practice before. When your child has autism, he or she may receive ABA. Applied behavior analysis is becoming much more highly recommended as the treatment of choice as it is an evidence-based practice for children with autism spectrum disorder. This means that scientific literature has repeatedly shown that ABA has been an effective treatment for helping children with autism make progress and learn new skills.

I will list some resources for you (parents) to help you better understand the treatment (ABA) that your child may receive. I hope you find these resources useful.

A Parent’s Guide to Applied Behavior Analysis

A Checklist for Parents: Recognizing Quality Providers

Autism Teaching Methods

Autism Speaks: Applied Behavior Analysis (ABA)

What is ABA? (A Video)

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Problem Solving, Instruction: Chicken, Egg

When research has more fairly compared PS-I with I-PS, it has concluded that, in general, the sequence doesn't matter all that much, though there are some positive trends on conceptual and transfer assessments for PS-I....

Loibl, K., Roll, I., & Rummel, N. (2016) Towards a Theory of When and How Problem Solving Followed by Instruction Supports Learning. Educational Psychology Review. DOI: 10.1007/s10648-016-9379-x  

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The College Triangle: Finding Balance Without Abusing Your Body

I remember the day I turned 18 like it was yesterday. It came with a feeling of power and determination and the opportunity to finally put to use all of those things I knew to be true. I was young, dumb and, well, you can finish that phrase in your head.

We spend our teen years so sure of things. Those of us lucky enough to have nurturing, caring parents grew up in a cocoon of love and support. Our conceptions of the world are based on rose-tinted glasses telling us how the world should work.

I always got the usual eye rolls when I claimed something as fact that clearly wasn’t true. But now I was free to prove everyone wrong. I knew how the world worked and I was going to make it work for me. So, I didn’t need anyone’s help, right?

I was off to school. I had the freedom to stay out late and decide how I’d spend my free time. I could even choose not to go to class and make all of my time free time. I understood the value of an education, as I had seen my parents struggle growing up, so there was no way I was going to lose out on a world-class education.

But, I had the same theory every other freshman had. I believed I could stay out all night partying and still wake up for class in the morning without letting my grades slip. For all of you soon-to-be freshmen out there, I would like to draw your attention to what I like to call the “College Triangle Dilemma.”

I found myself choosing to have a vibrant social life while still getting good grades. That meant very little sleep. So, I turned to energy drinks. Lots and lots of energy drinks in the morning and afternoon would keep me fully awake in class. I swear, there were times where I could literally see sounds.

But chugging energy drinks meant that when I desperately needed sleep I couldn’t simply doze off. I turned to heavily drinking alcohol before bed. A couple screwdrivers would usually do the trick. I found that I could crash virtually on demand. Blacking out from alcohol is a very predictable way to fall asleep.

I was developing unhealthy habits. The more I relied on stimulants and sedatives to control my sleep/wake cycle, the more I was losing control and requiring heavier doses. My tolerance was my worst enemy. I kept drinking, consuming and sometimes even shooting more and more.

Amazingly, I earned a 4.0 GPA that year, but winter break was a disaster. Coming home for a few weeks meant my parents could monitor me.

Summer break was even worse. Months of trying to smuggle a case of Red Bull and vodka into the house wasn’t easy. Plus, my parents knew I was a bit “off.” My personality had warped into a more dependent version of me. If my levels weren’t just right, I was moody and incredibly mean. I knew I couldn’t keep poisoning my body. I knew I needed help.

The last thing I wanted to do was admit that I had failed to my parents. My grades were amazing and I had lots of friends, but mentally I was losing it. How could I admit that I needed help when I so desperately needed to show them I really was smarter than them and knew how the world worked?

I started Googling for answers. I thought that I could just go cold turkey and break the cycle. Some people can, some people can’t. Withdrawal can take weeks, months, or years.

Going back to school in a few months meant I needed answers quickly. So, I gave in. I asked for help and I had a long, painful conversation with my family. To my surprise they were supportive.

Recovery cost me a year of my education. I stayed at home and worked part-time at a grocery store to make ends meet. Then, when I was ready, I returned to school with a newfound respect for the “College Triangle.” I focused on finding balance, even when it was hard to say no to hanging out with friends. Creating a schedule for studying and sleeping allowed me to better budget my free time. Calibration is tough, but developing the willpower to balance yourself in the real world is a lifelong skill.

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Fish oil vs. lard -- why some fat can help or hinder your diet

A diet high in saturated fat can make your brain struggle to control what you eat. If people are looking to lose weight, stay clear of saturated fat. Consuming these types of fatty food affects a part of the brain called the hypothalamus, which helps regulate hunger. ...

Viggiano, E., Mollica, M., Lionetti, L., Cavaliere, G., Trinchese, G., De Filippo, C., Chieffi, S., Gaita, M., Barletta, A., De Luca, B.... (2016) Effects of an High-Fat Diet Enriched in Lard or in Fish Oil on the Hypothalamic Amp-Activated Protein Kinase and Inflammatory Mediators. Frontiers in Cellular Neuroscience. DOI: 10.3389/fncel.2016.00150  

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Fish oil vs. lard — why some fat can help or hinder your diet

A diet high in saturated fat can make your brain struggle to control what you eat. If people are looking to lose weight, stay clear of saturated fat. Consuming these types of fatty food affects a part of the brain called the hypothalamus, which helps regulate hunger. The fat causes inflammation that impedes the brain to […]

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Ethical Question about Marriage Counselor Diagnosing My Father with Aspergers

My father and step-mother were seeing a counselor for marital issues (imago therapy–I’m not sure what that means). After a couple of sessions–a little more than a year ago–the therapist told my father in front of my step-mother that she believes he has Aspergers. I’ve since witnessed my step-mother routinely manipulate and abuse my father with this informal diagnosis. She’s broadcast to friends, acquaintances, even strangers, that her husband has Aspergers. She talks openly about her daily struggles while touting her own strength of character and tolerance for putting up with my father. She tells him he’s incapable of empathizing with people, then scoffs at him for crying–“that’s not empathy. You’re just being sentimental.” (I cry every time I I think about it,) My father’s friends and family have pulled away from him, because my step-mother makes them uncomfortable. At times it feels surreal, like I’m living in a case study from that book by R. Hare (the  psychopathy checklist). My father has an eccentric personality and mild social anxiety (he doesn’t like large gatherings, but he manages). Those are the only Aspergers traits he exhibits. My father’s friends and family are very concerned about him, and I can’t help feeling like his therapist gave my step-mother the weapon she’s using to pummel my father. I don’t know what to do. Are there guidelines about offering diagnoses in a family therapy setting? I feel like I’m watching a train wreck. My father agrees with me that something is wrong, but he won’t walk away, even when my step-mother leaves him for weeks at a time, and tells him she loves someone else. What can I do. Am I making a scapegoat of their therapist? It just feels like she behaved recklessly and at the expense of my father. (age 38, from US)

A: This is a great question and one that I’m sure could get lots of different responses based on the therapist answering. However, my short answer is that it is not the therapist who is in the wrong here as much as your stepmother. In this case it may have been ultimately unhelpful  that the therapist offered a suggested diagnosis in the marital session, but not unethical. If she is a licensed mental health therapist it is within her scope to diagnose and if your father and stepmother are having trouble connecting and communicating, this diagnosis could help explain that. However, it would be best if he underwent a formal assessment in order to clarify the diagnosis and based on what you have shared, may be unnecessary.

However, the real problem is that your stepmother has used this information against your father. It may be that she is trying to justify her own behavior so that others would understand if the marriage doesn’t work. I’m sure it is difficult for you to watch all this transpire, but your father is the one in the marriage and has to be the one to make decisions about it. The best you can hope to do is share your concerns and observations and support whatever decisions he makes. Unconditional love can be difficult to express when we feel a loved one is being mistreated, but it is his marriage, not yours.

Imago Relationship Therapy, by the way, was created by Dr. Harville Hendrix and is based on his book, “Getting the Love You Want.”  It is an emotionally focused form of therapy and often assumes a connection between the frustrations experienced in adult relationships and early childhood experiences.

I wish you and your father all the best,

Dr. Holly Counts

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8 Hidden Psychological Effects Of Being Right- Or Left-Handed

The right-hand bias, the leftie advantage, handedness and mental illness and more...

 

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Book Review: My Mother’s House

Approximately 61.5 million Americans are living with a mental illness. Given that and given that the average American family in 2015 consisted of 2.54 people, then it is safe to estimate that at least 156.21 million people in America are affected by mental illness. David Armand’s memoir, My Mother’s House, illustrates the impact that mental illness can have, even on the individual’s who are not suffering from the illness.

My Mother’s House follows Armand’s life story in southern Louisiana. His memoir is carries a weighty underlying message of why mental healthcare is so important. He opens his memoir recounting his earliest memory of his mother: she and her own mother are screaming at one another while Armand’s uncle and grandfather watch on, injecting themselves at random points. The tale peaks with his mother driving off in the car, his uncle running and beating on the hood, and little David is cowering and crying at his grandmother’s knees.

Subsequently, David was adopted by his uncle and aunt. The theme of mental illness continued in their home, though, with David’s uncle, Bryan, slipping into alcoholism. With the ever-present alcohol, David’s uncle was the ultimate bully; he exhibited a desire to want to beat the “macho” into his sons. For instance, Armand describes a “game” the children would often play with their dad. While Bryan sat in the middle of the trampoline, the children would attempt to find a way onto it. However, Bryan had a tennis ball as his protection and would throw it at the children to keep them from climbing on. David described how while he did not enjoy the game, the punishment that would come from not playing was far more terrifying. Bryan used any sign of weakness as a reason to attack the children.

The alcoholism continued to plague the family. There was the cringe-worthy description of Bryan sawing a chunk of David’s cast off of his arm (and cutting the young boy in the process). Later, when Bryan was fired from yet another job, he proceeded to hunt down his wife and daughter with a shotgun. Thankfully, no one was physically hurt in that incident.

The saga continues after Bryan’s death, when David is reintroduced to his birth mother, Susie, whom he has not seen for most of his life. He learned quickly, and the hard way, that his mother was seriously ill. His first interaction with her concludes with her collapsing into a near comatose state in an effort to keep him from leaving for the night. Her illness was not helped by the fact that she married an abusive and controlling man. Later, David would come to find that his step-father had been keeping his own mother locked up. When discovered, the woman was malnourished and severely dehydrated. David’s mother had played a role in the abuse that the old woman underwent although it is unclear whether she fully comprehended what was happening.

When Susie’s husband passed away, David allowed her to move in with his family. It is then that he got a hard look at her illness. She paced the floors at all hours of the night talking to herself. She stole items from his daugthers’ rooms and added them to the hoard in her own room. Then there is the case of her little dog, Toby. She would stay locked up in her room with Toby all day and kept him wrapped up in a way that is described as close to suffocation. At that point, David got an in-depth look at the mental healthcare system. For years, David worked to get his mother the help she clearly needed. There were various mental institutions, group homes, doctors, etc. Yet, ultimately, he was worn down to merely a shred of his own sanity and has to cut off his relationship with his mother. He leaves her to her trailer hoard, where she is most comfortable.

While most memoirs contain narratives that are focused on the author, David Armand focuses more on the impact that other people have on him. Centrally focused on his biological mother and his adopted father, it is clear to any reader how much of an impact these two individuals had on his development. Armand’s self-awareness is prevalent throughout the book and is particularly impressive in the memories of his childhood. He describes early on how he remembers recognizing that fear can physically feel differently depending on the situation. His commentary provides powerful insight on issues of emotional abuse, and how this particular kind of bruise does not heal. The author also states that he was vigilant about looking for signs of mental illness in himself during his twenties and thirties. It is interesting to note how little he mentions his wife and children. This is likely because he wanted to focus primarily on the role mental illness played in his life; keeping the focus on mental illness pushes his advocacy for mental healthcare reform to the foreground.

Armand’s voice is resilient throughout his narrative. It is not surprising to learn that he has published a few novels. He is able to construct a memoir that has the fine-tuned descriptions found in successful novels without losing the warming and mesmerizing perspective that is characteristic of story-tellers.

Armand’s memoir closes with his thoughts on mental illness and the mental healthcare system in the United States. Anyone who has had to manage mental illness, their own or a loved one’s, can attest to the struggle that is prevalent throughout the system. I believe it is safe to say that Armand’s memoir provides a clear call to arms for everyone to stand up for mental health awareness, education, and reform.

My Mother’s House
Texas Review Press, March 2016
Paperback, 192 pages
$18.95

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Video: Building a Resilience Toolbox

Resilience is one of the most useful skills there is. Having bad things happen to me and being able to bounce back without getting caught up in negative thoughts? Where do I sign up for that?

But even though we talk about “resilience” like it’s one thing, it might be more accurate to say that resilience is a collection of different coping skills. The more of these coping skills we accumulate, the more resilient we become.

It’s hard to just become more resilient but adding new coping skills to your resilience toolbox one at a time is a less daunting task.

For example, one skill to have in your resilience toolbox might be going out of your way to treat other people with kindness and generosity when you’re feeling down. Doing so builds resilience because even on days when negative things are happening in your life, you can still bring positivity to other people’s lives, which will make you feel good and in turn bring some positivity back to your life.

Similarly, you could work on building resilience by finding activities that create meaning in your life. You might discover that the more you have stable things in your life that give you a sense of ongoing purpose, the less you’ll be able to get blown off course by other bad things that happen to you.

Which coping skills turn out to be the most powerful tools in your resilience toolbox will be unique to you, so a little trial and error is called for. If you try as many different resilience-building coping tools as possible, you can keep the ones that work for your toolbox and throw out the rest.

So where do I find these resilience-building tools anyway? Not to worry. Ask the Therapists Marie Hartwell-Walker and Daniel J. Tomasulo have your back.

In this video, they describe several coping skills for developing resilience. Watch the video below, and visit Psych Central’s YouTube channel for more Ask the Therapist videos.

Alexsnail/Bigstock

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So You Think You Want a Practice Partner

Whether just starting out in private practice or considering expansion by taking on a partner, finding the person who is the right “fit” may not be as easy as you think. Oh, sometimes the stars do align and the perfect partner is found with little or no effort. But most of the time, finding someone with whom to share the business of doing business requires careful mutual investigation of values and skills.

Choosing a business partner is in many ways as big a decision as choosing who to marry. You will be spending many hours together each week. You will be entangled financially. You will be looking to each other for mutual support and counting on each other for back-up when either of you has to be away from the practice because of illness, vacations or conferences. Probably most importantly: You will each be known and judged by the reputation of the other. As one of Aesop’s Fables states: “You are known by the company you keep.”

 What to Look For in a Business Partner

1. Look for a partner who shares your vision for the business: If one of you has ambitions to be the top practice in town while the other is content to dabble, you will soon be disenchanted with each other, regardless of how much you like each other personally. Make sure you have similar goals, a similar work ethic and the same standards for excellence. Talk about how much energy you each have for the entrepreneurial side of working for yourselves. That probably means doing pro bono work and networking at least half the time during your first few years together.

 

2. Find a partner whose professional ethics are above reproach. Make double sure you share a commitment to professional ethics. Be specific about the many ways that values level issues will play out in terms of personal behavior both on and off the job. Your community will judge the each of you for your character as much as for your skills.

 

3. Look for someone with complementary skills: One of the primary reasons to go into business with someone else is to fill in your own professional gaps. Of course, you both have to be competent and caring therapists. But that’s only half the story in a successful business. Look for someone with complementary business skills.  One of you, for example, may be terrific at the details of billing, navigating the various insurance companies and keeping accounts. The other may be a whiz at networking and marketing. As long as you both agree the other’s skills are essential and are of equal value, it doesn’t matter how you divide tasks.  But you do have to have the same level of skill in the skills you bring.

 

4. Make sure you can count on each other to do the business side of the business: Therapists who go into private work are often trying to free themselves from onerous paperwork and agency policies with which they disagree. In fact, being in business means being even more attentive to practice policies and paperwork. With no big agency lawyers to defend you if a case goes badly, you need to count on each other to maintain pristine documentation to support the validity of your work. Success in private practice requires acceptance that there is no one else to do it and it still has to be done – and done perfectly, if not cheerfully.

 

5. Look for a partner who is emotionally stable: You’d think this is self-evident but I’ve consulted to a number of practices where one partner overlooked or discounted the instability of the other when they agreed to work together. It was done with good intentions. People who like each other don’t always look squarely at red flags. But overlooking personal problems is a set-up for problems in the business. The stability of your practice depends on the stability of both of you.

 

6. Find someone who is financially stable: It is likely that you won’t be able to draw much of a salary in the beginning. You’ll need to capitalize the business to get it up and running. Make sure that you are both able to contribute equally to your venture and that you have shared ideas about money management. A person with considerable personal debt may not be the best choice for your business. He or she may not be skilled in budgeting or may be too financially needy to make good financial decisions for the sake of growing the business.

 

7. Don’t forget to consider how much you like each other: Mutual respect is essential but it’s not enough. You are more likely to survive as a business if you genuinely like each other. The ability to help each other see the lighter side of things, whether a computer crash or even the stress of managing difficult clients, can make all the difference in whether your business survives and thrives.

 

Those who are drawn to the helping professions often have difficulty with the demands of being an entrepreneur. They see their work more as a calling than a money-making venture. In fact, it is both. Yes, we therapists are healers. But to make a private practice successful enough to support a couple of families requires that we also define ourselves as small business owners with all that it entails. Choosing the right partner can ease the burdens and provide support for that dual role.

Kurhan/Bigstock

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Scared When I Am Alone

Typically when I am alone, I always feel like I’m being watched, seeing things that aren’t real, about to be attacked, or about to be killed. These feelings all seem like they could either happen from a real person or from some sort of nonliving being, which the nonliving being is the more common of the two. It makes me feel discomforted, scared, and/or sick in my own home, car, or outside (for example: taking my dog for a walk). I feel this way all day and night, but usually more at night because of my like of vision. Because of this, I typically lose a lot of sleep and don’t know what would even happen if something like a nonliving being were to appear in my house, but I am in constant fear of any of these things being able to occur to me.

A. It would have been helpful to have had more information about what precipitated your symptoms. Did you experience any life changes such as marriage, divorce, giving birth, moving, a car accident, or a death in the family? What about drug use? Life stressors or drug use can sometimes trigger symptoms like the ones you have described.

Your lack of sleep is likely making your symptoms worse. If this remains a problem, then seek help from a mental health professional. Medication and counseling could be very helpful for your symptoms. The sooner you seek help, the sooner this problem can be resolved.

You can start the process of acquiring professional help by asking your primary care physician for a referral. There likely are mental health professionals in your community. You want to choose the one with whom you feel the strongest connection. Report your symptoms and ask for their help. Your symptoms are highly treatable. Please take care.

Dr. Kristina Randle

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Psychology Around the Net: July 30, 2016

Happy Saturday, sweet readers!

It’s the last weekend of July so I hope you’re all going to go out and make the most of it!

Right after you check out our latest mental health news updates, of course, wink wink. Keep reading for new information on the psychology of superstition and luck, research regarding transgender and mental illness, ways to find happiness in today’s tumultuous times, and more.

The Psychology of Luck: How Superstition Can Help You Win: According to Stuart Vyse, psychologist and author of Believing in Magic: The Psychology of Superstition, lucky objects or rituals we perform for luck give us a feeling of security and “an illusion of control.” Vyse adds, however, that a “generally positive attitude towards life” seems to make more happy events happen for a person.

Psychiatry in the Streets: Unique Services for People Experiencing Homelessness: “As a practice, Street Medicine is the ‘provision of medical care directly to those living and sleeping on the streets through mobile services such as walking teams, medical vans, and outdoor clinics.’ This outreach tradition stretches back to the dawn of contemporary endemic homelessness, beginning in the early 1980s. Teams of professionals and workers who themselves are formerly homeless connect with people sleeping on the streets, methodically engage them, and help them obtain services, shelter, and housing.”

Being Transgender Is Not a Mental Disorder: Study: A new study has found that, rather than being the sole result of being transgender, it looks like the main source of transgender people’s mental distress comes from the violence and social rejection many of them suffer.

Anticipatory Stress of After-Hours Email Exhausting Employees: Many of us have been there. It’s around seven or eight o’clock in the evening and you know — you just know — that your boss is going to email you about something that really could — and should — wait until the next day’s work hours begin. According to “Exhausted But Unable to Disconnect,” a new study that will be presented during the August annual meeting of the Academy of Management, after-hours emailing negatively effects employees’ emotional states, causing them to experience “burnout” and a lack of work-family balance.

Teen Brain Scans Offer Clues to Timing of Mental Illness: According to Ed Bullmore, Head of Psychiatry at the University of Cambridge, generally the first signs of mental disorders such as depression and schizophrenia start showing during adolescence, and recent research suggests this is due to the rapid development of certain brain regions during this time: “This study gives us a clue why this is the case: It’s during these teenage years that those brain regions that have the strongest link to the schizophrenia risk genes are developing most rapidly.”

Happiness And Inner Peace During Turbulent Times: Unless you’ve been — no, you know what? — even if you have been living under a rock, you’re well aware of the extremely turbulent times our world has been experiencing recently. Marilyn Tam, a board-certified coach in executive, corporate, and leadership issues and the author of The Happiness Choice, has compiled a list of five tips you can try to help find your balance and happiness again.

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More scientific flesh on the bones of non-coeliac gluten/wheat sensitivity

I was really, really pleased to read the paper by Melanie Uhde and colleagues [1] (open-access) I don't mind telling you. Covering a topic close to my blogging and research heart - sensitivity to wheat or gluten but not coeliac disease - the authors provide some much needed scientific clarification when it comes to how gluten or wheat might impact on some of those "who reported symptoms in response to wheat intake and in whom coeliac disease and wheat allergy were ruled out." Some media interest in the paper can also be seen here.With an authorship list including some of the great and good on this issue (see here for example) researchers included 80 participants presenting with non-coeliac wheat sensitivity (NCWS) according to "criteria recently proposed by an expert group" [2]. These NCWS participants reported "experiencing intestinal and/or extraintestinal symptoms after ingestion of gluten-containing foods, including wheat, rye or barley. The reported symptoms in all subjects improved or disappeared when those foods were withdrawn for a period of 6 months, and recurred when they were re-introduced for a period of up to 1 month." All 80 provided serum samples for analysis that were compared with similar samples from 40 participants with "biopsy-proven active coeliac disease" and 40 samples from asymptomatic controls on a non-restrictive diet.The sort of information sought from those serum samples included quite a bit. Not only were "established markers" of coeliac disease (CD) assayed for - including IgA antibody to TG2 - but various immunological markers towards gluten were also included for study. Based also on the idea that "intestinal cell damage and systemic immune response to microbial components" might be an important feature of NCWS, researchers also markers associated with "compromised intestinal epithelial barrier integrity."Results: well, as per the media interest in this paper: "The findings suggest that these individuals [with NCWS] have a weakened intestinal barrier, which leads to a body-wide inflammatory immune response."A few further details are worthwhile discussing. First, the genetics of coeliac disease (those DQ2 and/or DQ8 heterodimers) were present in about a quarter of those with NCWS "a rate not substantially different than in the general population." Second, most of those with NCWS did not show the characteristic mucosal signs of CD as per the Marsh gradings (0 or 1) throughout the cohort. This was in direct contrast to the CD participants who all "expressed HLA DQ2 and/or DQ8 and presented with Marsh 3 grade intestinal histological findings." The conclusion: CD and NCWS participants are not one and the same (just in case you needed telling).Next: "Serum levels of both LBP [lipopolysaccharide (LPS)-binding protein (LBP)] and sCD14 were significantly elevated in individuals with NCWS in comparison with patients with coeliac disease and healthy individuals." This implies that there is 'systemic immune activation' on-going in those participants with NCWS not seen to the same extent in the other groups. These findings were also complemented by results indicative of that compromised intestinal epithelial barrier integrity previously discussed. The final picture emerging being one where NCWS participants seem to be in a state of 'immune activation' "linked to increased translocation of microbial and dietary components from the gut into circulation, in part due to intestinal cell damage and weakening of the intestinal barrier." I might add that some smaller scale analysis of serum samples from those NCWS participants "both before and after 6 months of a self-monitored diet free of wheat, rye and barley" suggested "a significant decline in the markers of immune activation and gut epithelial cell damage, in conjunction with the improvement of symptoms."And rest.For those as interested in this area of research as I am, I'm sure that you can understand my happiness in seeing the Uhde results and what it might mean for many, many people who've been perhaps been 'fobbed off' down the years with regards to their gluten ills. I can't help but see a possible connection between these findings and others reported with autism in mind for example (see here and see here). The added suggestion that 'intestinal cell damage' might be a feature of NCWS also possibly ties in with all that talk about 'leaky gut' and some autism (see here) but I don't doubt it may go well beyond just [some] autism [3]. Not looking so tree-hugging now eh?Of course there is more to do in this area: "Further research is needed to investigate the mechanism responsible for the intestinal damage and breach of the epithelial barrier, assess the potential use of the identified immune markers for the diagnosis of affected individuals and/or monitoring the response to specific treatment strategies, and examine potential therapies to counter epithelial cell damage and systemic immune activation in affected individuals." I might also add in a role for those trillions of wee beasties that call our gut home (the gut microbiota) as potentially also being a target for further scientific research too (see here for example).I await further studies...----------[1] Uhde M. et al. Intestinal cell damage and systemic immune activation in individuals reporting sensitivity to wheat in the absence of coeliac disease. Gut. 2016. July 25.[2] Catassi C. et al. Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts’ Criteria. Nutrients. 2015;7(6):4966-4977.[3] Whiteley P. Nutritional management of (some) autism: a case for gluten- and casein-free diets? Proc Nutr Soc. 2015 Aug;74(3):202-7.----------Uhde, M., Ajamian, M., Caio, G., De Giorgio, R., Indart, A., Green, P., Verna, E., Volta, U., & Alaedini, A. (2016). Intestinal cell damage and systemic immune activation in individuals reporting sensitivity to wheat in the absence of coeliac disease Gut DOI: 10.1136/gutjnl-2016-311964...

Uhde, M., Ajamian, M., Caio, G., De Giorgio, R., Indart, A., Green, P., Verna, E., Volta, U., & Alaedini, A. (2016) Intestinal cell damage and systemic immune activation in individuals reporting sensitivity to wheat in the absence of coeliac disease. Gut. DOI: 10.1136/gutjnl-2016-311964  

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Clinical Trial for Alzheimer's Disease - Is LMTX Ineffective or Unprecedented?

AustrianTribune.com

New Scientist

So which is it? Ineffective or unprecedented?

TauRx Alzheimer's Drug LMTX Fails in Large Study Although Some Benefit Seen

Wednesday, 27 Jul 2016 | 11:23 AM ET

TauRx Pharmaceuticals' experimental Alzheimer's drug LMTX failed to improve cognitive and functional skills in patients with mild to moderate Alzheimer's disease, a large, late-stage study showed.

But in a perplexing twist, the drug did show a significant benefit in about 15 percent of patients in the trial who were not taking other standard Alzheimer's drugs, according to the findings released on Wednesday at the Alzheimer's Association International Conference in Toronto.

 Reuters

LMTX was ineffective in a clinical trial of 891 patients with Alzheimer's disease (AD), although a post hoc analysis in a small subgroup of patients showed a benefit for those taking no other medications for AD (when compared to an inappropriate control group).

lol this RCT actually had a negative result. Fascinating to compare UK vs US media coverage. https://t.co/z4hfC3DSB8 https://t.co/Jgk8wsleci

— ben goldacre (@bengoldacre) July 27, 2016

Ben Goldacre, Chris Chambers, and others on Twitter took the UK media to task for their misleading articles on the outcome of the trial conducted by TauRx Pharmaceuticals.

As the name implies, TauRx is developing Alzheimer's treatments based on disrupting tau protein, which accumulates in pathological tangles in the brain. Tau aggregation inhibitors are presumed to disrupt these tangles, thereby slowing neurodegeneration and memory loss. The degradation of tau aggregates in vitro was first demonstrated 20 years ago (Wischik et al., 1996), using the stain methylene blue. LMTX is a variant of methylene blue, which turns urine blue. For that reason, the placebo group in the TauRx trial received a tiny amount of the drug for blinding purposes.

The clinical trial protocol is NCT01689246, Safety and Efficacy Study Evaluating TRx0237 in Subjects With Mild to Moderate Alzheimer's Disease. The original enrollment across 121 sites was estimated at 833, and the original duration was 12 months. The duration was changed to 15 months about a year later, and five other outcome measures were added. And a secondary outcome measure (ADCS-ADL23) and a primary outcome measure (ADCS-CGIC) were swapped.

The company press release used a vague headline (TauRx Reports First Phase 3 Results for LMTX®) to announce the results, but led off with the subgroup analysis (no surprise):

TauRx Therapeutics Ltd today announced Phase 3 clinical trial results that show treatment with LMTX®, the company's novel tau aggregation inhibitor, had a marked beneficial effect on key measures of Alzheimer's disease in patients with mild or moderate forms of the disease.

While the TRx-237-015 study in 891 subjects failed to meet its co-primary endpoints, clinically meaningful and statistically significant reductions in the rate of disease progression were observed across three key measures in patients who were treated with LMTX® as their only Alzheimer's disease medication. These three key measures comprised a cognitive assessment (ADAS-Cog), a functional assessment (ADCS-ADL) and an assessment of the level of brain atrophy (lateral ventricular volume, LVV, as measured by MRI). An abstract of the results will be presented during an open session at the 2016 Alzheimer's Association International Conference (AAIC) in Toronto, Canada this afternoon by Dr. Serge Gauthier, CM, MD.

The ADCS-ADL was originally a secondary outcome measure, and hippocampal volume (not reported) was included as an “Other” outcome measure along with the lateral ventricle volume measurements. Keep in mind these results are preliminary (not peer-reviewed). However, given the possibility of a true positive treatment effect, I can understand why publication would be of secondary importance. There should be no delay in starting AD patients on an effective new and proven treatment (which this is not).

It took a while to find the conference abstract by Gaultier et al. (2016), but an excerpt is below. The actual results were not included — the abstract aimed to “highlight the potential therapeutic value” of LMTX (also called LMTM and TRx-0237) — but the text did mention the “85% were taking approved AD treatments” aspect of the study.

Gaultier et al., AAIC 2016

LMTM (TRx-0237) is a novel stabilized reduced form of the methylthioninium moiety with potential for efficacy in treatment of Alzheimer's disease. ... It acts as a selective tau aggregation inhibitor in vitro and in transgenic mouse models  The present 15-month double-blind, placebo-controlled trial (NCT01689246) was performed in patients with probable AD, MMSE score in the range 14-26, Clinical Dementia Rating 1-2 and age < 90 years. Patients were randomized 3:3:4 to receive oral LMTM at doses of 150 or 250 mg/day or placebo (containing 8 mg/day, to maintain blinding) respectively. Primary efficacy outcomes were change from baseline on cognitive (ADAS-Cog) and functional (ADCS-ADL) scores. Three-monthly assessment included magnetic resonance imaging (MRI) as a disease modifying outcome. Other secondary outcomes included ADCS-CGIC and MMSE. Results: A total of 891 patients were randomized, of whom 62% were female. Approved AD treatments were being taken in 85%. The mean age was 70.6 (SD 9.0) years and baseline MMSE score was 18.7 (SD 3.4). ... The study efficacy and safety outcomes will be reported. The outcomes of this phase 3 trial will highlight the potential therapeutic value of tau aggregation inhibitor therapy in AD. A second phase 3 trial of LMTM for AD will be completed and reported later in 2016.

[The entire abstract with authors and affiliations is at the end of this post.]

The 15% who benefited from LMTX® were the patients who were not taking any other medications for dementia (e.g., acetylcholinesterase inhibitors). This monotherapy subgroup was compared to the entire placebo group, not to the subgroup of placebo patients not on any other dementia meds (as pointed out by @bengoldacre). It was nice to read critical coverage of the TauRx spin (and media reporting) at Forbes, BuzzFeed, and Quartz.


Meanwhile, New Scientist updated their headline (and url) to more accurately reflect reality.

Is it worthwhile for TauRx to pursue a proper clinical trial of LMTX as a monotherapy? Maybe. The big mystery is why LMTX didn't work in patients taking the usual medications for dementia. There's no convincing mechanism to explain that odd result (Wischik: “other Alzheimer’s treatments help to clear toxic material out of the brain, and may also clear away LMTX too”). Or it could be a p-hacked false positive, or a function of milder severity or diagnostic issues or study site in the 15%. If TauRx is truly confident that LMTX taken alone can slow the progression of AD by 80%, then run another randomized controlled study where LMTX + no AD meds is compared to placebo + no AD meds.

Meanwhile, exaggerated reporting on “the first drug to halt Alzheimer’s” is highly unethical.


AAIC Conference Abstract

Phase 3 Trial of the Tau Aggregation Inhibitor Leuco-Methylthioninium-Bis(hydromethanesulfonate) (LMTM) in Mild to Moderate Alzheimer's Disease

Serge Gauthier, MD¹; Howard H Feldman, MD²; Lon S Schneider, MD, MS³; Gordon Wilcock, MD⁴; Giovanni B Frisoni, MD⁵; Jiri Hardlund, MD⁶; Karin Kook, PhD⁷; Damon J Wischik, PhD⁶; Bjoern O Schelter, PhD⁸; John M Storey, PhD^6,8; Charles R Harrington, PhD^6,8 and Claude M Wischik, MD, PhD^6,8, (1)McGill University Research Centre for Studies in Aging, Verdun, QC, Canada, (2)University of British Columbia, Vancouver, BC, Canada, (3)Keck School of Medicine of USC, Los Angeles, CA, USA, (4)Oxford University, Oxford, United Kingdom, (5)Universite de Geneve, Geneve, Switzerland, (6)TauRx Therapeutics Ltd, Aberdeen, United Kingdom, (7)Salamandra LLC, Bethesda, MD, USA, (8)University of Aberdeen, Aberdeen, United Kingdom

Background: Leuco-methylthioninium-bis(hydromethanesulfonate) (LMTM; TRx-0237) is a novel stabilized reduced form of the methylthioninium (MT) moiety (Harrington et al. J Biol Chem 2015;290:10862) with potential for efficacy in treatment of Alzheimer's disease (AD). A previous trial using the oxidized form of MT identified dose dependent absorption limitations (Wischik et al. J Alzheimers Dis 2015;44:705). LMTM is better absorbed and tolerated (Baddeley et al. J Pharmacol Exptl Therapeutics 2015;352:110) permitting higher doses to be tested. It acts as a selective tau aggregation inhibitor in vitro (Harrington et al. J Biol Chem 2015;290:10862) and in transgenic mouse models (Melis et al. Behav Pharmacol 2015;26:353). Methods: The present 15-month double-blind, placebo-controlled trial (NCT01689246) was performed in patients with probable AD, Mini-Mental State Examination (MMSE) score in the range 14-26, Clinical Dementia Rating (CDR) 1-2 and age < 90 years. Patients were randomized 3:3:4 to receive oral LMTM at doses of 150 or 250 mg/day or placebo (containing 8 mg/day, to maintain blinding) respectively. Primary efficacy outcomes were change from baseline on cognitive (Alzheimer's Disease Assessment Scale cognitive subscale; ADAS-Cog) and functional (Alzheimer's Disease Cooperative Study Activities of Daily Living; ADCS-ADL) scores. Three-monthly assessment included magnetic resonance imaging (MRI) as a disease modifying outcome. Other secondary outcomes included ADCS-CGIC and MMSE. Results: A total of 891 patients were randomized, of whom 62% were female. Approved AD treatments were being taken in 85%. The mean age was 70.6 (SD 9.0) years and baseline MMSE score was 18.7 (SD 3.4). Dementia was of moderate severity (MMSE score 14-19) in 61%. The study efficacy and safety outcomes will be reported. Conclusions: The outcomes of this phase 3 trial will highlight the potential therapeutic value of tau aggregation inhibitor therapy in AD. A second phase 3 trial of LMTM for AD will be completed and reported later in 2016.

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New Study Explains Why We Find Narcissists So Attractive

Why do we fall for them when we know we shouldn’t?

Narcissists LOVE themselves. And, unfortunately, according to science, we love them too, which doesn’t seem fair.

Shouldn’t there be something fundamentally unattractive about a person who finds themselves so damned attractive? Apparently not.

You’re Not The Kind Of Girl Who Settles — Keep Not Settling

Emanuel Jauk of Austria’s University of Graz published a study in the recent edition of the European Journal of Personality that confirmed our worst fears (and narcissists’ fondest desires):

People find narcissists more attractive than non-narcissists — at least, when it comes to dating.

Jauk set up a study involving 90 people who participated in a series of speed-dating meet-ups. (Speed-dating, though lame, acts as a good showcase to gather people’s immediate reactions to potential dating partners.)

Every participant was evaluated to determine their level of personal narcissism. They were also shown pictures of the other speed-dating participants and asked to rank their physical attractiveness. Jauk’s subjects then went through several rounds of speed dating (resulting in almost 700 “dates”) and then were asked to rate the people they interacted with.

They were asked to say whether they wanted to interact with each person in a short-term relationship — wonderfully described by the researchers as “arranging meetings purely for sex on an ad hoc basis” — OR a long-term relationship (a.k.a. let’s go to IKEA together and buy some bookshelves).

The results were very interesting. They clearly showed that, in dating situations, people LOVE narcissists. There were definite correlations between the people that men and women selected for short- and long-term relationships and their levels of narcissism. To quote a Guardian summary of the study, “those with the highest scores on the narcissism scale also tended to be perceived as most desirable by members of the opposite sex.”

While these results might be frustrating for all you non-narcissists out there looking for short- or long-term hook-ups, when you think about it, they shouldn’t be all that surprising.

There are DEFINITELY some factors about narcissists that will logically make them thrive in a dating environment. For starters, narcissists CARE what they look like. Like a lot. Like way too much. And, while that might be annoying as hell in the long-term (particularly if you have to share a bathroom with them), when it comes to dating, physical appearance DOES play a huge role in how we select a partner.

We live in a culture of very, very quick first impressions, where your decision to have sex with someone can be determined by whether or not you found their Tinder picture to be “swipeable.” So, if narcissists (due to their personal craziness) spend all day trying to make themselves look amazing, yes, that probably will favorably work in their favor when they’re out on the town, looking to hook up. It plays to their strengths.

Narcissists are also, by definition, kind of desperate for self-love. They need you to love them as much as they love themselves. And all that self-love means that they have a TON of experience SELLING themselves.

Every damn day, they look into a mirror and tell themselves that they are AWESOME. With all that practice, they’re going to get pretty good at it, which gives them a big sales advantage when it comes to pitching themselves to you. They know all their best angles. They thrive when it comes to presentation. They know how to make people LOVE them.

Does confidence also play a factor? Sure. People who are confident — and people who are smoking hot — have a big advantage when it comes to dating. But Jauk’s study is interesting because it shows that, in dating situations, confidence and physical attractiveness are only smaller factors in the larger narcissist game.

Strong Women Don’t Settle For Mediocre Men — They’d Rather Be Alone

The BIG reason it seems like narcissists thrive at dating is because all of the relative “symptoms” of narcissism — attention to physical appearance, flattery, extroversion — make it look like they’re making an effort to their potential partners. Narcissists get dates because it looks like they’re TRYING.

Which is something to keep in mind the next time you’re struggling to find someone special. Maybe you don’t have to transform yourself into a self-obsessed a**hole just to go home with the hot guy or girl at the bar. Maybe the key is just putting some effort into your appearance, your attitude, and your overall game. Because, c’mon, people — we can’t let those smug a**holes get all the good dates. Let’s take the best parts of self-love, try our hardest, and make things more difficult for the narcissists at Last Call, OK?

This guest article originally appeared on YourTango.com: New Study Explains Why Narcissists Are SO Damn Attractive.

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Breastfeeding associated with better brain development and neurocognitive outcomes

A new study, which followed 180 preterm infants from birth to age seven, found that babies who were fed more breast milk within the first 28 days of life had had larger volumes of certain regions of the brain at term equivalent and had better IQs, academic achievement, working memory, and motor function. “Our data […]

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I’m Not in My Body

When I was 15, after a suicide attempt, I was diagnosed with Borderline Personality Disorder. I’m 20 now and after another suicide attempt, they diagnosed me with bipolar. I’m confused. I rarely have any symptoms of bipolar. All of my symptoms and signs point to BPD. For instance, my husband and I lost our jobs and anytime I come into contact with money, I blow it. I can’t stop flirting with other people either. And sometimes I check out of my body. I don’t remember what I do. That’s really been scaring me lately. I checked so far out I wasn’t recognizing anything. I feel like a passenger rather than the driver. My temper has been getting shorter. I feel very trapped and I’m panicking. I don’t know what to do.

A: I can appreciate that different diagnoses can be confusing and unsettling. The only reason a diagnosis is ever helpful is if it leads to a way of understanding symptoms, which then leads to a way of understanding and treating the symptoms. I wouldn’t get too hung up on the label. I’d focus more on what opportunities for healing may come from looking at your pain through that lens. The diagnosis is only important if it helps. I would ask what the medical and psychological treatments are and see if they make sense to try.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

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I’m Not in My Body

When I was 15, after a suicide attempt, I was diagnosed with Borderline Personality Disorder. I’m 20 now and after another suicide attempt, they diagnosed me with bipolar. I’m confused. I rarely have any symptoms of bipolar. All of my symptoms and signs point to BPD. For instance, my husband and I lost our jobs and anytime I come into contact with money, I blow it. I can’t stop flirting with other people either. And sometimes I check out of my body. I don’t remember what I do. That’s really been scaring me lately. I checked so far out I wasn’t recognizing anything. I feel like a passenger rather than the driver. My temper has been getting shorter. I feel very trapped and I’m panicking. I don’t know what to do.

A: I can appreciate that different diagnoses can be confusing and unsettling. The only reason a diagnosis is ever helpful is if it leads to a way of understanding symptoms, which then leads to a way of understanding and treating the symptoms. I wouldn’t get too hung up on the label. I’d focus more on what opportunities for healing may come from looking at your pain through that lens. The diagnosis is only important if it helps. I would ask what the medical and psychological treatments are and see if they make sense to try.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

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The Question That Boosts Motivation And Performance

Self-affirmations are not the best type of self-talk to help motivate you.

 

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Book Review: Show Me Your Scars

What comes to mind when you think of the term mental illness?

Do you think of individuals who are thriving, successful, independent, and happy? Or do you picture individuals who are locked away from society because of dangerous hallucinations and delusions? Either perception is skewed not only by preconceived notions of mental illness, but also by a lack of knowledge, education, and sensitivity. Mental health challenges can occur in any culture, age group, and socioeconomic class. Struggling with mental illness does not mean an individual will never “measure up.” We’re all susceptible in some way. Sadly, a lack of sensitivity and knowledge about topics involving mental health can lead to months, years, and even decades of isolation, pain, discrimination, and suffering. It is a painful reality.

That’s why Lee Gutkind compiled a great book of examples of the lives of those suffering from mental health challenges. His compiled work, Show Me All Your Scars: True Stories of Living with Mental Illness, awakens readers to the depths of the abyss for so many sufferers who are not only afraid to reach out for help, but who also struggle with the reality that their lives may never be free of pain and suffering. Each story outlines the barriers, fears, confusion, tribulation, and even danger of mental health challenges.

As a licensed child and adolescent therapist who has experience working with adults, my fear has always been that my clients are so convinced they are losing the “fight” that they not only decide to live a life of pure, unadulterated hell by giving into self-defeating thoughts and risky behaviors, but also that they give in to their suicidal or even homicidal thoughts. I have seen my fair share of adults, teens, and even children who have “given up” and have either decided to follow, or could not remain psychologically separate from, a path of destruction. Many of my child and adolescent clients have made statements such as “I want to kill myself, but I’m afraid I may hurt my family.” Sadly, I have even had cases where my clients have attempted homicide. In other cases, the suicidal urge is so strong that many of my inpatient child clients tried anything and everything to end the pain.

The cycle of hopelessness, pain, and sorrow is real in the lives of those suffering from debilitating mental health challenges. But how do we get society to understand the rawness and the realness of those living with and trying to cope with mental illness? For starters, we must educate through words. That’s what so many of the writers Show Me All Your Scars decided to do. Many of the talented writers in the book are able to put emotions, thoughts, and psychological turmoil into words.

As a writer myself, I was impressed by how each writer concisely described the experience of mental illness while also maintaining the integrity that is often missing from mainstream society when discussing this subject. There were some sentences or chapters that I felt were not needed to make the point, but overall, each writer portrayed their experience, their pain, their suffering, and their sorrow in ways that are relatable not only to those experiencing mental illness, but also to those working and living with sufferers. The book is simplistic, but not so simplistic that it blends in with similar books on the market.

Each writer provides the reader with a different story, a different illness, a different perspective, and a different battle of the mind. I must admit that although I have worked with clients of all ages and in many capacities for over 7 years within the field, I was glued to the pages. I felt that the book contributed to my understanding some of the challenges that many of my clients experience. Although society may have a general understanding of mental health challenges, a book like this provides the “color” that is needed in order to relate and extend compassion.

Although the book does not specifically provide resources for the reader to utilize or tips on how to cope, it is a good starting point for opening up a discussion about mental health. It is a good starting point for those who have been newly diagnosed, for those who are struggling with accepting a diagnosis, for those who are trying to support a loved one or friend, and for those who are seeking emotional solace through awareness of other’s challenges.

We all have scars of some kind. We should not be afraid to share our scars because of an inaccurate perception of what life and human beings should be. No fantasy and no positive thinking can erase the scars we all have. It is certainly healthy to reframe negative experiences and to search for hope within a painful world. But it is not healthy to ignore or “hide” the reality that life includes pain and that it also can deal us a bad set of cards sometimes. That’s why books like Show Me All Your Scars are educational in more ways than one.

Show Me All Your Scars: True Stories of Living with Mental Illness.
In Fact Books, June 2016
Paperback, 320 pages
$15.95

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