This News in Mentalists–High Plains Drifter Edition

Hey there.  I’m the Stranger, and I’m here to bring you this week’s mental health news.  I apologize in advance for the fact that I’m a Yank, and in all probability will have a Yank focus–sorry about that.  I will try my best to include other countries, don’t worry =]

Okay, firstly we have a blog post from Perri Klass from The New York Times.  This is more of a neuropsychology article than about mental disorders as such–it relates to memory formation and retention in children–but hey, since the two are intrinsically related, here it is anyway.

The crucial structure for episodic memory, the memory of autobiographical events, is the hippocampus, that little curved ridge in the middle of the brain whose shape reminded a 16th-century anatomist of a sea horse.

Dr. Bauer compared memory forming to making gelatin: “The experience is the liquid gelatin; you pour it into a mold. The mold is the hippocampus, and it has to go through a process of refrigeration known as consolidation.”

So memories can form in even very young children, it seems. But it is not clear that they can be retrieved.

“Retrieval forms later,” said Charles Nelson, a professor of pediatrics at Harvard and Boston Children’s Hospital. “You need an interconnected network of structures to retrieve things from memory. When you are working on your computer, you know enough to save things to your hard drive, but do you know enough to retrieve them?”

Recent research suggests that some of those very early memories may actually be held into childhood, but then lost as children grow into adolescence. And research has also shown a strong cultural component to the question of how far back children remember.

The article addresses the fact that this more physiological interpretation of memory evolution probably contradicts Sigmund Freud’s [rather predictable] theory that in adulthood we repress these early memories due to their sexualized nature.  Then again, the psych professions are often divided on the relevance and accuracy of Freud’s thinking on that score in the first place.  What do you think?

Writing in The Huff Post Friday, Morty Lefkoe discusses a type of cognitive behavioral therapy for clients with social anxiety disorders.

Although my experience with clients has led me to conclude that the primary source of social anxiety is our beliefs, I’ve discovered that conditioning also plays an important role.

The classic example of how conditioning works was an experiment a physiologist named Pavlov conducted with dogs. When presented with food, the dogs salivated. Then a bell was rung just prior to presenting the dogs with food. After numerous presentations of the food with the bell, the bell was rung and no food was delivered. The dogs salivated anyway, because they had associated the bell with the food. In other words, a neutral stimulus that normally would not produce a response does so because it gets associated with a stimulus that does produce a response. In other words, the neutral stimulus gets conditioned.

Here’s an example I use with my clients that will make the process of conditioning very clear. Imagine that I handed you an ice cream cone with one hand and made a fist with my other hand and drew it back as if to hit you. What would you probably feel? Some level of anxiety if you thought you might get hit. Now imagine that the next few times someone handed you an ice cream cone, the same thing happened and you felt anxious each time.

What do you think you would feel the next time you were handed an ice cream cone, even if there was no menacing fist? Probably anxious. And yet it’s clear that ice cream cones are not inherently scary. If this next time there was no fist, only ice cream, why would you feel anxious? Because ice cream cones got conditioned to produce fear. The ice cream cones just happened to be there every time you got scared by the fist.

The principle is that anything that occurs repeatedly (or even once if the incident is traumatic enough) at the same time that something else is causing an emotion will itself get conditioned to produce the same emotion.

There are four important conditionings involved in social anxiety.

  • Conditioning: Fear associated with criticism and judgment.
  • Conditioning: Fear associated with not meeting expectations.
  • Conditioning: Fear associated with people putting their attention on me.
  • Conditioning: Fear associated with rejection.

Can you see how being conditioned to experience fear in these four situations would lead to anxiety in social situations?

My personal take on this is that Lefkoe has his theory correct–i.e. that his thinking about the origins of social anxiety are scientifically valid–but I’m dubious about some of his methodology.  Then again, I have a bias in favor of analytic treatments, so am not the most impartial observer.  I am sure that there are many of you, too, who might be cynical about this approach.  On the other hand, some may find it very helpful.  What are your own views?

Another newer therapy receiving a lot of coverage at the minute is art therapy.  The same source discusses how art can benefit us psychologically [I hope this article is okay for this entry--it is actually from last Wednesday. Apologies if that is too long ago.]

Art also helps people to connect with and deal with their emotions. Art can help a person reach into largely unconscious parts of the mind and experience dimensions of self otherwise buried and voiceless. It can also help a person get a handle on emotions that are, to borrow a word from T.S. Eliot, “undisciplined,” and therefore inarticulate. Through the arts people can find voices to express dimensions of self usually left in silence. And through art, people can shape their own identity. Art is not just self-expression; it is also self-creation.

There’s another element of psychological well-being — experiences of dimensions of human life that go beyond the ordinary. Jonathan Haidt, author of The Happiness Hypothesis, refers to this as “divinity” or “sacredness,” terms I find a bit too religious.[2] I prefer the idea of “transcendent” experiences, which can be spiritual, aesthetic, or moral. These are experiences that elevate a person beyond the brutish and humdrum qualities of much of human life. What we call them — “divine,” “sacred,” “transcendent,” or something else — doesn’t matter. The experiences matter a great deal.

Art is one source of transcendent experience, not the only one but a very important one. Arthur Danto – a philosopher and art critic — refers to the transcendent capacity of art as the “transfiguration of the commonplace.”[3] By this he means that art somehow becomes imbued with meanings that go well beyond the surface of the artistic product. His example is Warhol’s Brillo Box or Campbell soup cans, which somehow convey a significance way beyond their visual surface. Some of us, of course, are not captured by Pop art; but everyone who appreciates some sort of art experiences through it something powerful, significant, and elevating.

Now, contrary to what you may think, I actually think that art can be very beneficial to an individual’s mental well-being.  I’m a believer in the idea that creativity can be “transcendent”, as the article puts it–and that does not apply just to art, but also to writing, musical composition or singing, theater and so on–and have a particular personal fondness for sculpture [not making sculptures--I'm sad to admit that I lack such talent!]  Again, art therapy can be divisive among both mental health professionals and consumers, so your views are most welcome =]

PA newspaper Times Leader reports on an issue close to my heart [I have family who are vets]–the recruitment of qualified staff to treat vets with combat-related mental health problems.

PLAINS TWP. – Local veterans and those across the country who are struggling with mental health issues will have more clinicians available to help them soon.

U.S. Secretary of Veterans Affairs Eric K. Shinseki on Tuesday announced the department would add about 1,600 mental health clinicians and nearly 300 support staff to its existing workforce nationally.

The Department of Veterans Affairs estimates that about 30 clinicians and five support personnel will be hired to support mental health operations at the Wilkes-Barre Department of Veterans Affairs Medical Center in Plains Township and six outpatient clinics in the region.

Funding has been distributed and recruitment is under way.

Mental health treatment for [ex-]soldiers in this country has been notoriously inadequate for some time–for example, many vets with such difficulties end up homeless due to a lack of support and treatment.  As the article continues, vets themselves have been concerned about the issue.

In a survey of veterans earlier this year by the Iraq and Afghanistan Veterans of America, two-thirds of those questioned said veterans are not getting the mental-health care they need, and 37 percent said they personally knew an Iraq or Afghanistan veteran who has committed suicide.

U.S. Rep. Lou Barletta, R-Hazleton, said many Northeastern Pennsylvania veterans are “in desperate need of mental-health care,” so he’s pleased that the regional medical center “will have more professionals to provide that care, close to home.”

“We promised to care for our veterans when they served years ago in places like Korea and Vietnam, more recently in Iraq and Afghanistan, and everywhere else. We owe so much to them, so it’s our duty to make sure they and their families have access to the services they need,” he said.

That’s one of the more sensible statements I’ve heard from a Republican in recent times!

Okay, let’s move away from the USA.  In the UKThe Guardian reports that eating disorders can affect people of any age–including the elderly.

Even those who are relatively fit and healthy in later years struggled with the idea that they no longer conformed to a youthful ideal, said Rumsey, who recently co-wrote TheOxford Handbook of the Psychology of Appearance. “It is a myth that older people don’t care what they look like: the ‘normal’ signs of ageing can prove very depressing and many people find it hard to see themselves in a positive light when they see a wrinkled face and a sagging body looking back in the mirror. We are now at a point where there is a social stigma around the effects of the natural ageing process, and this can lead to very low self-esteem and the classic signs of body dysmorphic disorder.”

These observations are echoed by the increasing number of body image-related cases in older people being seen by Dr Alex Yellowlees, medical director and a consultant psychiatrist at the Glasgow Priory Clinic, who is witnessing “an epidemic of self-consciousness. We are suffering from a collective body dissatisfaction, which is a contagion in our society, and we must acknowledge that it affects all walks of society, young and old.

“It was once the case that we were happy to coast into retirement and relax in our old age, but now even in these later stages of life I am seeing people who are preoccupied with shape, weight and looks in a way that was once the domain of younger people who had yet to find their path or identity in life.”

Yellowlees reports an alarming rise in older patients with eating disorders, as all sectors of society strive to achieve what he calls “an unrealistic physical ideal”.

I think most of us are theoretically aware that eating disorders can affect anyone–any age, any gender, any race, any nationality, and so on.  Still, this research flies in the face of traditional images of anorexia, bulimia and other eating difficulties.  Have you known someone of this age affected by such issues?

In Brisbane, Australia, children of kindergarten age and below are going to be “screened” for mental disorders [mainly by GPs.], as covered by The Brisbane Times.

While the aim is to prevent mental illnesses – 50 per cent of which start in childhood – the Australian Medical Association and some mental health experts fear children may be misdiagnosed or given psychiatric drugs unnecessarily.

”We have to be careful we don’t medicalise normal behaviour and that’s a real caution with children,” the AMA president, Steve Hambleton, said. ”There are genuine kids who need extra support to help them integrate into normal kindergartens and classrooms and a lot of the funding for that is driven by diagnoses so there’s a perverse incentive to diagnose conditions like autism. There are kids who need it but we don’t want to make normal kids abnormal.”

Frank Oberklaid, director of the centre for community child health at Melbourne’s Royal Children’s Hospital and chair of the expert committee appointed by the Minister for Mental Health, Mark Butler, to develop the check, said their priority was to ”first do no harm”.

”The critics are worried that we’re going to slap diagnoses on three-year-olds and treat them with drugs but this is not the point of the exercise,” Professor Oberklaid said. ”Many parents and preschool teachers face behaviours in children that are challenging and cause stress and distress. We also know that thankfully many of these are transient but we can’t predict in a particular child which ones are going to disappear and which ones are going to go on and cause mental health problems. What we’re really doing is having a more systematic way of finding out those kids who are causing difficulties and doing something about it.”

While I understand the rationale behind these examinations, I have to share the caution expressed by the “critics.”  Prof. Oberklaid’s defence is well-intentioned–of that I have little doubt–but [and I am no expert in child psychology, so take my remarks with "a pinch of salt"] is it really so easy to differentiate being a “badly-behaved” child from being a child likely to develop a mental illness?

Finally, a story–although from an English newspaper–about the European soccer championships in the Ukraine and Poland, which are on-going at the minute.  A bookmaker has appointed a psychologist to help–via Twitter!–followers cope with their favorite team’s misfortunes.

Dr Lewis said: “Every game in Euro 2012 will be played and watched on a six-inch pitch – the distance between your ears.

“Sports stars know the vital importance of staying in the zone to achieve their personal best.

“Many work with psychologists to help them do just that, but what about the fans? Euro 2012 can be a real rollercoaster of emotions with extreme highs and lows in a short space of time.”

He added: “I will provide practical advice on dealing with eventualities ranging from the dreaded penalties to a game-changing sending off.

“These easily implemented strategies could involve something as simple as a short run round the block to generate feel-good chemicals in the brain or breathing exercises to calm you down.”

I know nothing about soccer [or "football" as the Brits keep calling it =p ], so do any fans of this game think any of these “strategies” will do any good?

My wildcard is a video from Chato B. Stewart–cartoonist for the Mental Health Humor blog at PsychCentral–in which he performs a stand-up comedy routine based on his life with bipolar disorder.  I hope you enjoy it.  Now, I’d better get back to work!  =]

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About TheStrangerHPD

Aspiring research psychologist and fan of Westerns.

4 Responses to “This News in Mentalists–High Plains Drifter Edition”

  1. I really enjoyed this version of TNIM and learned a lot about what’s going on globally. Thanks for putting it together Stranger.

  2. Who is that mysterious Stranger? Some say he writes a good TNIM. :)

  3. Really interesting roundup. I have no opinion on various of the things, not knowing enough, but I’ll be interested to see what other people think!

  4. Hey all,

    Thanks so much for the positive feedback–I appreciate it! I was rather nervous about submitting this TNIM, but I’m glad that I did =]

    I’d be happy to write it again some time.

    Thanks again.

    Robert [aka The Stranger--hope that helps, Zarathurstra!]


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