Archives for February, 2010
Anxiety is normal and only considered a disorder when it significantly interferes with day-to-day living. A critical element of treating most anxiety disorders is exposure. Basically, exposure involves facing what you fear. Depending on your specific fear, this exposure can either be real or in the imagination. For example, someone with a deep fear of cats might start out by thinking about cats, talking about cats, and looking at pictures of cats. Then after those situations become routine, that person might go to a shelter and look at cats, then progress to touching cats. Treating some fears, like fears of getting cancer, obviously can’t be combated by real exposure. You wouldn’t suggest that someone expose themselves to cancer-causing chemicals to beat a fear of getting cancer. A common way of getting around the issue would be to imagine or talk about “the worst case scenario.” That technique involves exposure in the imagination. So, someone with overwhelming fear about getting sick might be asked to describe the most feared outcome. Exposure might involve several sessions of describing, imagining, and thinking about that worst case.
A few years ago, I read an article by Scott Lilienfeld, Ph.D. called “When Worlds Collide” in the American Psychologist. Quite fascinating actually, but that’s not the point of this blog. In a section of his article, Dr. Lilienfeld noted that most academic departments of psychology as well as many other scientific disciplines, tend to strongly discourage their members from making efforts to educate the public about their discipline. In other words, they look down their noses at those who attempt to break down science and communicate its findings to the general public. They derisively call those who engage in such activity “popularizers.” Dr. Lilienfeld even noted that the National Academy of Science went so far as to expel Dr. Carl Sagan from membership apparently because of his popularizing activity, even though he had authored many articles in well-respected journals. What does that make my wife and I, given that we write quite a few books in the For Dummies series (Wiley), which are obviously aimed at the general public? In other words, our books in this series have attempted to distill scientifically verified findings from the field while clarifying difficult concepts and making them easily digestible to the average person. We’re afraid it makes us unabashed “popularizers.” Is this really a terrible thing?
A few years ago, Chuck and I were asked to write Seasonal Affective Disorder For Dummies. SAD is thought to be a biologically caused type of depression related to the lack of sunlight in the winter. We had a great time researching and writing the material—including a trip to Alaska to interview people who live months without seeing sun and one to Merida Mexico, an area close to the equator which gets pretty steady sunlight times all year long. Here in New Mexico, we enjoy more sunny days than most locations; however, our days get shorter like most other regions. I can recall growing up in Michigan and feeling pretty weary in February. I wasn’t diagnosed (everyone I knew felt the same), but the dirty snow piled on the streets, the continued cold, and darkness of February were pretty depressing.
A recent, small study published in Behavior Research and Therapy by G. Haeffel (and passed along to us by Kenneth Pope, Ph.D.) questions the general use and even the effectiveness of self-help books as “traditionally operationalized and sold in stores.” The author states, “This also raises concerns about the benefits of self-help books (e.g., CBT for Dummies), an industry that generated an estimated $9 billion in 2004.” Parenthetically, although we’ve written books in the For Dummies series, we did not write that particular one. Since an overwhelming number of other studies support the efficacy of self-help books for the treatment of various disorders, including depression and anxiety, this one study initially came as a bit of a surprise. However, what we found more disturbing was the sweeping generalizations made about the implied ineffectiveness of self-help books in general. Mind you, most self-help books are not even especially intended to standalone as a complete intervention strategy and most authors strongly recommend that they be used as a compliment or adjunct to traditional psychotherapy. Furthermore, if attempts are made to use such books as a standalone approach, most ethical authors repeatedly warn readers to obtain additional professional assistance if symptoms don’t improve promptly.
More than a couple of decades ago, Marsha Linehan, Ph.D. developed a unique approach to the treatment of Borderline Personality Disorder (BPD) which she chose to call “Dialectical Behavior Therapy” or DBT. Research has established that DBT appears to help reduce some of the worst problems associated with BPD (such as repeated suicidal behaviors, therapy interfering behaviors, etc.). If you want more information about DBT, consider starting with Wikipedia. In addition, Marsha Linehan, Ph.D. among others have since written a number of great books for professionals and laypersons alike which you can look up on Amazon. We included many elements of DBT in our book Borderline Personality Disorder For Dummies although we mostly tried to integrate the best techniques we could find from everywhere.
I haven’t very often suffered from significant chronic pain in my life; a fact that I am quite grateful for as I’ve worked with many patients who have faced this condition. I always had considerable empathy for their plights, but never fully understood how incapacitating it can be. And the anxiety of such pain continuing for a prolonged time doesn’t help matters much either.
So, the other day, after sitting through two...