Aug 27
In an article for The American Scholar, T. M. Luhrmann presents a new understanding for how to deal with disturbing voices:
“Voices arise when the person is confronted with overwhelming emotional trauma he cannot handle,” Marius Romme explained as he strode across the stage at the Maastricht conference. “We know this.” It is generally agreed that the concept of dissociation was coined by Pierre Janet, as the 19th century turned into the 20th, to describe a disruption in the normally integrated processes of identity, memory, and consciousness.
If it is true that distressing auditory hallucinations are the dissociative consequences of trauma, the implications are enormous. Dissociative disorder has a positive prognosis, one of the most positive in the realm of psychiatric disease, whereas schizophrenia is often thought to have the worst. Dissociative disorder is understood to be a reaction to events in the world; schizophrenia is usually imagined as a largely inherited vulnerability. Dissociation is best treated with therapy and interaction; schizophrenia is assumed to require medication, often heavy. The new way of thinking opens the possibility that people do not hear voices because they are crazy, but that their apparent craziness may be the result of the brain-numbing chaos that can result from hearing voices. It suggests that we can help by teaching people to cope with their voices, rather than viewing the voices as evidence of organic damnation.

In an article for The American Scholar, T. M. Luhrmann presents a new understanding for how to deal with disturbing voices:

“Voices arise when the person is confronted with overwhelming emotional trauma he cannot handle,” Marius Romme explained as he strode across the stage at the Maastricht conference. “We know this.” It is generally agreed that the concept of dissociation was coined by Pierre Janet, as the 19th century turned into the 20th, to describe a disruption in the normally integrated processes of identity, memory, and consciousness.
If it is true that distressing auditory hallucinations are the dissociative consequences of trauma, the implications are enormous. Dissociative disorder has a positive prognosis, one of the most positive in the realm of psychiatric disease, whereas schizophrenia is often thought to have the worst. Dissociative disorder is understood to be a reaction to events in the world; schizophrenia is usually imagined as a largely inherited vulnerability. Dissociation is best treated with therapy and interaction; schizophrenia is assumed to require medication, often heavy. The new way of thinking opens the possibility that people do not hear voices because they are crazy, but that their apparent craziness may be the result of the brain-numbing chaos that can result from hearing voices. It suggests that we can help by teaching people to cope with their voices, rather than viewing the voices as evidence of organic damnation.
Jul 05
Dr. Marty Klein, a licensed marriage and family therapist and certified sex therapist in Palo Alto, California, contributed this insightful article, You’re Addicted to What?, to the July/August 2012 issue of The Humanist:
I don’t diagnose people I haven’t met. More importantly, I don’t use the diagnosis of sex addiction. In thirty-one years as a sex therapist, marriage counselor, and psychotherapist, I’ve never seen sex addiction. I’ve heard about virtually every sexual variation, obsession, fantasy, trauma, and involvement with sex workers, but I’ve never seen sex addiction.

New patients tell me all the time how they can’t keep from doing self-destructive sexual things; still, I see no sex addiction. Instead, I see people regretting the sexual choices they make, often denying that these are decisions. I see people wanting to change, but not wanting to give up what makes them feel alive or young or loved or adequate; wanting the advantages of changing, but not wanting to give up what makes them feel they’re better or sexier or naughtier than other people. Most importantly, I see people wanting to stop doing what makes them feel powerful, attractive, or loved, but since they don’t want to stop feeling powerful, attractive or loved, they can’t seem to stop the repetitive sex clumsily designed to create those feelings.
The article is quite long, but thoroughly worth the read.

Dr. Marty Klein, a licensed marriage and family therapist and certified sex therapist in Palo Alto, California, contributed this insightful article, You’re Addicted to What?, to the July/August 2012 issue of The Humanist:

I don’t diagnose people I haven’t met. More importantly, I don’t use the diagnosis of sex addiction. In thirty-one years as a sex therapist, marriage counselor, and psychotherapist, I’ve never seen sex addiction. I’ve heard about virtually every sexual variation, obsession, fantasy, trauma, and involvement with sex workers, but I’ve never seen sex addiction.

New patients tell me all the time how they can’t keep from doing self-destructive sexual things; still, I see no sex addiction. Instead, I see people regretting the sexual choices they make, often denying that these are decisions. I see people wanting to change, but not wanting to give up what makes them feel alive or young or loved or adequate; wanting the advantages of changing, but not wanting to give up what makes them feel they’re better or sexier or naughtier than other people. Most importantly, I see people wanting to stop doing what makes them feel powerful, attractive, or loved, but since they don’t want to stop feeling powerful, attractive or loved, they can’t seem to stop the repetitive sex clumsily designed to create those feelings.
The article is quite long, but thoroughly worth the read.
Jun 25

"In this new, highly anticipated update of her pioneering Killing Us Softly series, the first in more than a decade, Jean Kilbourne takes a fresh look at how advertising traffics in distorted and destructive ideals of femininity. The film marshals a range of new print and television advertisements to lay bare a stunning pattern of damaging gender stereotypes — images and messages that too often reinforce unrealistic, and unhealthy, perceptions of beauty, perfection, and sexuality. By bringing Kilbourne’s groundbreaking analysis up to date, Killing Us Softly 4 stands to challenge a new generation of students to take advertising seriously, and to think critically about popular culture and its relationship to sexism, eating disorders, and gender violence."

Jun 20
Uncomfortable in Our Skin, Eva Wiseman’s intelligent report on the pressures distorting the way we think and feel:
Liberal Democrat MP Jo Swinson (who has succeeded in pulling a number of L’Oréal ad campaigns for being unrealistic) is one of a growing group of people whose campaigning indicates that [body image is] something worth worrying about. Last year I attended every session of her government inquiry into body image, the results of which were published in a report this month. She cited research showing how current “airbrushing” culture leads to huge self-esteem problems – half of all 16- to 21-year-old women would consider cosmetic surgery and in the past 15 years eating disorders have doubled. Young people, she said, don’t perform actively in class when they’re not feeling confident about their appearance.

It is research backed up by a new documentary by Jennifer Siebel Newsom, Miss Representation, about the under-representation of women in positions of power – women who are high “self objectifiers” have low political power. They’re less likely to run in politics, and less likely to vote: if value lies in their imperfect bodies, they feel disempowered. The long-term effects, the piling on of pressures one by one, like a dangerous Jenga tower, means women’s – and increasingly men’s, 69% of whom “often” wish they looked like someone else – lives are being damaged, not by the way they look but by the way they feel about the way they look. It’s complicated.

Uncomfortable in Our Skin, Eva Wiseman’s intelligent report on the pressures distorting the way we think and feel:

Liberal Democrat MP Jo Swinson (who has succeeded in pulling a number of L’Oréal ad campaigns for being unrealistic) is one of a growing group of people whose campaigning indicates that [body image is] something worth worrying about. Last year I attended every session of her government inquiry into body image, the results of which were published in a report this month. She cited research showing how current “airbrushing” culture leads to huge self-esteem problems – half of all 16- to 21-year-old women would consider cosmetic surgery and in the past 15 years eating disorders have doubled. Young people, she said, don’t perform actively in class when they’re not feeling confident about their appearance.

It is research backed up by a new documentary by Jennifer Siebel Newsom, Miss Representation, about the under-representation of women in positions of power – women who are high “self objectifiers” have low political power. They’re less likely to run in politics, and less likely to vote: if value lies in their imperfect bodies, they feel disempowered. The long-term effects, the piling on of pressures one by one, like a dangerous Jenga tower, means women’s – and increasingly men’s, 69% of whom “often” wish they looked like someone else – lives are being damaged, not by the way they look but by the way they feel about the way they look. It’s complicated.
Oct 23

Last night I went to see Take Shelter, an intensive psychological thriller starring Michael Shannon and Jessica Chastain. This is a film that compassionately explores the emotional and relational burden of suffering from mental distress. I think Andrew O’Hehir says it best:

What makes this gripping and compact tale of marriage, faith, madness and possible apocalypse so unusual is the fact that it works so well on all levels. Nichols and cinematographer Adam Stone capture the undramatic Ohio landscape and wide Midwestern sky in almost lyrical compositions, and the rituals of Curtis and Samantha’s days and nights are captured with no hint of anthropological condescension. Yet as Curtis’ visions become more pronounced and more troubling — they almost always begin with eerie and unexpected storms, involve unseen but dangerous intruders, and often end with someone he loves or trusts turning against him violently — the sense that something shocking lies just below the film’s everyday realism becomes almost unbearable. And with no more than a few deft allusions, Nichols makes the point that the pressure on Curtis and Samantha is coming from all directions, and is not purely psychological: Extreme weather and climate change, bad economic news, vanishing healthcare and the prospect of unemployment and bankruptcy are all very real threats for this family and millions of others. (Even the painfully inadequate mental-health services available to someone in Curtis’ position play an agonizing role in the story.)
My favorite scenes in this film are the ones that give voice to an empathic and validating response to mental illness, a response recognizing the tortured person instead of an uncomfortable eccentricity.
Oct 03

Last week I saw Drive and I haven’t been able to get this song by Desire out of my head. My favorite movie reviewer, Stephanie Zacharek, gives a bit of a hint as to why:

If you’re thinking Driver is the quintessential laid-back selfless hero, cool as cool can be in the Steve McQueen mode, the kind of guy you’ve seen hundreds of times in good movies and in bad ones — you’re right. In fact, if you’ve watched any movies made in the past 40 years, you’ll see and hear lots of familiar elements in Drive: The slightly grainy, low-lit look of ’70s cheapies; the new-wave neon-pink script used in the credit sequences; the at-first jarring but later sublimely perfect ’80s-style synth score. I’ve already talked to some critics who have dismissed the film, saying they’ve seen it all before. But that’s precisely the point. [Director] Refn doesn’t pretend to have invented any of this stuff; his movie is 90 percent unapologetic homage, and he knows how to recombine familiar elements in a way that feels fresh and exciting.
Jun 23
Neuroscientist David Eagleman takes us on an enlightening tour of all that our brains are up to behind our backs in his new book Incognito: The Secret Lives of the Brain. In an interview with Wired Magazine, Eagleman explains how even time can teach us about our brains:

One of the experiments we did a few years ago showed that if we inject a small delay between your motor act and some sensory feedback, then when we remove that delay, you’ll have the impression that the feedback happened before you did the act. So, if you press a button and that causes a flash of light to go off, you quickly learn that you are causing the flash of light. Now if we insert a small delay so that when you press the button, there’s a tenth of a second before the flash, you don’t notice that delay, but your brain starts to adjust for it. Then, if we suddenly remove that delay, you’ll hit the button, the flash of light will happen immediately, but you will swear the flash of light happened before you pressed the button.

This is an illusory reversal of action and effect. What people say in this situation is, “It wasn’t me. The flash happened before I pressed the button.” And that struck me as very interesting because this is something that we see in schizophrenia. Schizophrenics will do what’s called credit misattribution where they will make an act, and they will claim that they are not the ones responsible for it.

So that immediately got me thinking that maybe what’s happening in schizophrenia is fundamentally a disorder of time perception. Because if you’re putting out actions into the world and you’re getting feedback, but you’re not getting the timing correct, then you will have cognitive fragmentation, which is what schizophrenics have.

We always talk to ourselves internally and listen to ourselves — we have an internal monologue going on. Now imagine that the talking and the hearing that’s going on internally, imagine that the order got reversed. Well, you would have to attribute that voice to somebody else. That’s an auditory hallucination, and that’s another thing that characterizes schizophrenia.

Neuroscientist David Eagleman takes us on an enlightening tour of all that our brains are up to behind our backs in his new book Incognito: The Secret Lives of the Brain. In an interview with Wired Magazine, Eagleman explains how even time can teach us about our brains:

One of the experiments we did a few years ago showed that if we inject a small delay between your motor act and some sensory feedback, then when we remove that delay, you’ll have the impression that the feedback happened before you did the act. So, if you press a button and that causes a flash of light to go off, you quickly learn that you are causing the flash of light. Now if we insert a small delay so that when you press the button, there’s a tenth of a second before the flash, you don’t notice that delay, but your brain starts to adjust for it. Then, if we suddenly remove that delay, you’ll hit the button, the flash of light will happen immediately, but you will swear the flash of light happened before you pressed the button.

This is an illusory reversal of action and effect. What people say in this situation is, “It wasn’t me. The flash happened before I pressed the button.” And that struck me as very interesting because this is something that we see in schizophrenia. Schizophrenics will do what’s called credit misattribution where they will make an act, and they will claim that they are not the ones responsible for it.

So that immediately got me thinking that maybe what’s happening in schizophrenia is fundamentally a disorder of time perception. Because if you’re putting out actions into the world and you’re getting feedback, but you’re not getting the timing correct, then you will have cognitive fragmentation, which is what schizophrenics have.

We always talk to ourselves internally and listen to ourselves — we have an internal monologue going on. Now imagine that the talking and the hearing that’s going on internally, imagine that the order got reversed. Well, you would have to attribute that voice to somebody else. That’s an auditory hallucination, and that’s another thing that characterizes schizophrenia.
Jun 20
In the current issue of the New York Review of Books, Marcia Angell discusses the widespread use of psychoactive drugs in children, and the baleful influence of the pharmaceutical industry on the practice of psychiatry:
The drug industry, of course, supports other specialists and professional societies, too, but Daniel Carlat [author of the book Unhinged] asks, “Why do psychiatrists consistently lead the pack of specialties when it comes to taking money from drug companies?” His answer: “Our diagnoses are subjective and expandable, and we have few rational reasons for choosing one treatment over another.” Unlike the conditions treated in most other branches of medicine, there are no objective signs or tests for mental illness — no lab data or MRI findings — and the boundaries between normal and abnormal are often unclear. That makes it possible to expand diagnostic boundaries or even create new diagnoses, in ways that would be impossible, say, in a field like cardiology. And drug companies have every interest in inducing psychiatrists to do just that.
As low-income families experience growing economic hardship, many are finding that applying for Supplemental Security Income (SSI) payments on the basis of mental disability is the only way to survive. It is more generous than welfare, and it virtually ensures that the family will also qualify for Medicaid. According to MIT economics professor David Autor, “This has become the new welfare.” Hospitals and state welfare agencies also have incentives to encourage uninsured families to apply for SSI payments, since hospitals will get paid and states will save money by shifting welfare costs to the federal government.

In the current issue of the New York Review of Books, Marcia Angell discusses the widespread use of psychoactive drugs in children, and the baleful influence of the pharmaceutical industry on the practice of psychiatry:

The drug industry, of course, supports other specialists and professional societies, too, but Daniel Carlat [author of the book Unhinged] asks, “Why do psychiatrists consistently lead the pack of specialties when it comes to taking money from drug companies?” His answer: “Our diagnoses are subjective and expandable, and we have few rational reasons for choosing one treatment over another.” Unlike the conditions treated in most other branches of medicine, there are no objective signs or tests for mental illness — no lab data or MRI findings — and the boundaries between normal and abnormal are often unclear. That makes it possible to expand diagnostic boundaries or even create new diagnoses, in ways that would be impossible, say, in a field like cardiology. And drug companies have every interest in inducing psychiatrists to do just that.
As low-income families experience growing economic hardship, many are finding that applying for Supplemental Security Income (SSI) payments on the basis of mental disability is the only way to survive. It is more generous than welfare, and it virtually ensures that the family will also qualify for Medicaid. According to MIT economics professor David Autor, “This has become the new welfare.” Hospitals and state welfare agencies also have incentives to encourage uninsured families to apply for SSI payments, since hospitals will get paid and states will save money by shifting welfare costs to the federal government.
Jun 18
It is sometimes an appropriate response to reality to go insane.
Philip K. Dick
Mar 17
In doing some research about mental disorders, Patrick Smith decided to create these brilliant, minimalist posters.

In doing some research about mental disorders, Patrick Smith decided to create these brilliant, minimalist posters.

Feb 25

Let There Be Light is a 1946 American documentary film directed by John Huston.

The film, commissioned by the United States Army Signal Corps, was the final entry in a John Huston trilogy of films produced at the request of the U.S. Government. This documentary film follows 75 U.S. soldiers who have sustained debilitating emotional trauma and depression. A series of scenes chronicle their entry into a psychiatric hospital, their treatment and eventual recovery.

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