Archives for Cognitive Behavioral Therapy
Several new diagnoses will appear in the soon to-be-released Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-V). In fact, quite a bit of controversy surrounds the inclusion of several of these new “disorders” in what is considered to be the mental health world’s diagnostic “bible,” as many question their validity and appropriateness for inclusion. Among the new DSM-V disorders is Excoriation (Skin Picking) Disorder, classified within the Obsessive Compulsive and Related Disorders. It is understandable that the initial public reaction to this release of information has been skeptical (at best). News outlets have begun to question the validity of the diagnosis. Readers have begun to leave comments such as, “Great, now we’re all mentally ill.” Yes, everyone picks at his or her skin at some point; however, Excoriation Disorder far exceeds “normal” grooming behavior. Think of grooming behavior as occurring on a continuum, with normal, washing and exfoliating on one end of the continuum, extending to picking, scraping, or gouging that results in scarring or disfigurement on the other end.
Everyone experiences anxiety. Anxiety is our body’s reaction to what we perceive as threatening. Anxiety can be a healthy and adaptive response to stress. But, anxiety occurs on a continuum, ranging from normal, healthy concern, on one end, to worry, anxiety, and panic toward the other end. Normal caution and concern can help to motivate you, to estimate risks, and to get things done. Worry, anxiety, and panic are more akin to apprehension or fear. They can dominate your thoughts and make things harder for you. They don’t help you solve problems. They create more problems. Where do you fall on the anxiety scale? Test your level of anxiety and discover ways to manage your daily stress.
We know that when we get anxious, the fight-or-flight response is triggered and our bodies experience many physiological changes and symptoms that we find stressful and unpleasant. But, do you know what causes us to get anxious? It may not be what you think. No, it’s not that upcoming presentation at work or that plane flight next week. It's not something external. I’m a psychologist, so I’m going to try to help you discover the answer. Here’s an example. You and a friend are out on a morning walk and a neighborhood dog barks loudly. You love dogs and this makes you smile as you comment, “He’s up bright and early.” Your friend, on the other hand, is startled. Her heart begins to race and she finds herself a bit breathless, as she comments, “Oh my! Where is it? I don’t like dogs.” Same situation. Very different reactions. Okay, now do you have an idea of what causes anxiety?
Improving the Diagnosis of Bipolar Disorder in Children Approximately 1.5% of the population, worldwide, bipolar disorder is not uncommon. However, bipolar disorder in children presents differently than it does in adults, an important difference which is not addressed in our current diagnostic manual (DSM-IV-TR). As a result, it is frequently misdiagnosed. Let's look at the facts:
Approximately 6 million individuals experience panic disorder each year. Panic disorder is characterized by recurrent, intense periods of anxiety/panic, which are often unprovoked, or, “out-of-the blue,” and are accompanied by anticipatory anxiety regarding the possibility of future attacks. Panic disorder can be quite debilitating, sometimes accompanied by agoraphobia, or avoidance of pubic places due to fear of being in a setting or situation from which escape or finding help may be difficult. Before we get to what DOES NOT work, let’s discuss what DOES work. Evidence for effective treatment of panic disorder is very well documented. The data show with great robust that cognitive behavioral therapy (CBT) is effective and is superior to a number of other treatment strategies. Cognitive behavioral therapy for panic disorder often includes:
I am very excited to welcome Dr. Donna Marino to Therapy That Works as a guest blogger. I find her area of expertise, Positive Psychology, to be an exciting, evidence-based approach to wellness, as I'm sure you will as well. Dr. Marino: While Positive Psychology is not exactly new (it’s been around for almost 15 years now, started by Martin Seligman, in 1998, during his APA presidency), it is still considered new to the field of psychology. It is a new perspective on mental health that research is demonstrating, can lead to “a new you.” Now, will you wake up singing like Beyoncé or swimming like Michael Phelps? Well, no, but research shows that it will make you happier. In fact, Positive Psychology has been referred to as the “Science of Happiness.” The key difference between Positive Psychology and Self-help or Pop Psychology is its grounding in research. It is considered an evidence-based treatment. So, what is Positive Psychology?
Below, is a nice summary regarding this exciting avenue of treatment by principal investigator and Trichotillomania Learning Center (TLC) Scientific Advisory Board member, Dr. Jon Grant: N-Acetyl Cysteine (NAC), a dietary supplement and amino acid that affects glutamate levels in the brain, has been studied in the treatment of a number of conditions across medicine and psychiatry. In recent years, NAC has been thought to have the potential to improve symptoms of Trichotillomania (hair pulling). As no medication or other substance to date has shown effectiveness in the treatment of TTM, this finding is one of promise and one that warrants consideration and further investigation.
The compulsion to hoard belongings has been likened to addiction; yet there are some important differences between the two. In a previous post, some of those differences were discussed. Most importantly, however, are the differences in treatment approach. I am frequently asked by loved ones, "Can't I just go in and clean the house?" It can be difficult to understand why this is not in the best interest of the individual struggling with hoarding difficulties. Herein lies the reason:
The topic of compulsive hoarding has garnered much attention in recent years in the mainstream media. Compulsive hoarding has been likened to addiction in some discussions of the problem, yet they are very different constructs. Let’s take a look at the what we know about the similarities and differences in order to answer the burning question of why can’t someone clean a hoarder’s home for him/her. For brevity’s sake, let’s look at the two behaviors in simplistic terms (although they are both quite complex):
WHAT IS COMPULSIVE HOARDING? Compulsive hoarding is a disorder that involves the accumulation of belongings to such an extent that the resulting clutter renders parts of the living space unusable. WHAT ARE THE SIGNS/SYMPTOMS OF COMPULSIVE HOARDING? The acquisition and failure to discard a large number of items/possession that are considered by most to be of little or no value These possessions clutter the living space, rendering the space unable to be used in the manner in which it was intended The hoarding behavior causes marked distress or interferes with one’s daily functioning NOT JUST MESSY Clutter is a symptom, not the problem. People who hoard form powerful attachments to objects.