Tag Archives: mental health

When you imagine something does your brain think you see it?


What is the difference between imagination and reality? Sometimes, not that much.

The February 2014 edition of the Monitor on Psychology (v. 45:2, p. 18) lists a brief note about a study published in Psychological Science that looks at eye pupil constriction when imagining light. Here’s the abstract from the link above (emphasis mine):

If a mental image is a rerepresentation of a perception, then properties such as luminance or brightness should also be conjured up in the image. We monitored pupil diameters with an infrared eye tracker while participants first saw and then generated mental images of shapes that varied in luminance or complexity, while looking at an empty gray background. Participants also imagined familiar scenarios (e.g., a “sunny sky” or a “dark room”) while looking at the same neutral screen. In all experiments, participants’ eye pupils dilated or constricted, respectively, in response to dark and bright imagined objects and scenarios. Shape complexity increased mental effort and pupillary sizes independently of shapes’ luminance. Because the participants were unable to voluntarily constrict their eyes’ pupils, the observed pupillary adjustments to imaginary light present a strong case for accounts of mental imagery as a process based on brain states similar to those that arise during perception.

So it seems that thinking about something causes your brain to respond as if it is really seeing. What might this mean about those who are trying to break free of addictions?

  • Would imagining heroin use create observable changes in they body that would make it harder to maintain abstinence
  • Would recalling sexual images create responses that make sexual addictions harder to break?

So, what is the difference between imagining an affair and actually engaging in one? From a brain perspective, maybe not that much. Certainly Jesus’ expansion of the seventh commandment suggests there isn’t a difference between the two from God’s perspective. And yet, we know that actual adultery creates more damage to more people than merely fantasizing about having an affair.

Rumination: the health killer!

I’m currently teaching students a course on psychopathology. Each week we consider a different family of problems. Thus far we have explored anxiety disorders, mood disorders (depression, mania), anger/explosive disorders and addictions. Soon we’ll look at eating disorders, trauma, and psychosis.

There is one symptom that almost every person fitting one of those above categories experiences–repetitive, negative thought patterns.

Rumination.

The content of the repetitive thoughts may change depending on the type of problem (i.e., anxious fears, depressive negative thoughts, illicit urges, fears of weight gain, fears of being hurt, irritability, etc.) but the heart of the problem is the vicious cycle that negative thought patterns produce.

While there are many very good ancillary mental health treatments (Did you know that daily exercise, getting a good 8 hours of sleep each night, and eating a diet rich in protein supports good mental health and may even prevent re-occurrence of  prior problems?) it is essential for those of us who struggle with imagining negative events to find ways to shut down the production of rumination. Mindfulness techniques, thought-stopping, alternate focus may help to interrupt imaging bad feelings, thoughts, events and thereby interrupt the body reacting as if those bad things are indeed happening.

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Filed under christian counseling, counseling, counseling science, counseling skills, Psychology, Uncategorized

Free Issue of Journal of Traumatic Stress


As a member of International Society of Traumatic Stress Studies (ISTSS), I am able to offer you a link to a free issue of their journal, Journal of Traumatic Stress.

Click this link for the February issue page with links to download individual articles.  Several essays relate to PTSD treatment for veterans, at least one essay re: child maltreatment in Uganda.

 

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Filed under counseling science, counseling skills, Post-Traumatic Stress Disorder, Psychology, ptsd, trauma

Is PTSD an internal problem causing social problems? Or the other way around?


I am finally getting around to read Ethan Watters’ polemic Crazy Like Us: The Globalization of American Psyche (Free Press, 2010). In this book he details the way America has exported not only its pharmaceuticals but have redefined mental health and disease. As the promotional material on the front cover says, the book “[uncovers] America’s role in homogenizing how the world defines wellness and healing.”

As I read the book, I find he is overly negative and pessimistic, even as he right points out some major bumbling when bringing Western mental health ideas to the world. And yet, consider this…

In chapter two he examines the way Western mental health providers flooded (bad pun but appropriate picture) Sri Lanka after the Tsunami to treat all the PTSD that would most definitely come to light. They “educated” the country about the symptoms of PTSD and trained caregivers and counselors to provide counseling interventions. When certain symptoms weren’t presenting widely, some helpers assumed victims must be living in denial.

Watters describes how one researcher began looking to see how Sri Lankans described symptoms of poor responses to trauma–instead of using a pre-determined set of symptoms. This researcher concluded that Sri Lankans experience trauma quite differently.

1. Sri Lankan PTSD symptoms were primarily physical in nature.

2. Sri Lankans did not identify anxiety, numbing, fear symptoms but rather identified isolation and loss of social connection as key to PTSD symptoms.

The root problem in PTSD? 

So, is PTSD internal or external? Intrapsychic or social? Most Westerners think of psychopathology in terms of the individual. A sick individual will likely find their social lives eroding and less supportive. It appears Sri Lankans think of pathology in terms of social connection which when broken results in some of the physical symptoms. So, does trauma cause psychological damage which in turn harms social networks…or does trauma harm social networks which in turn causes distress?

Your answer to this question likely reveals whether you see the world as a community or a group of individuals.  Or, your answer reveals whether you focus on universal human experiences or constructed human experiences.

One semi-helpful answer

My answer? Our minds, bodies, spirits and social networks are not disconnected. While distinct entities, we are far more connected than disconnected. To paraphrase the bible, if the eye is sick, the whole body is sick. Psychopathology does not reside only in one location, even if we can see it’s impact in one specific location (e.g., cells not functioning). We would not assume that seeing the destruction after a tornado would be all that is needed to find the cause of that same tornado. Whatever interventions we devise, we will not find a one-size-fits-all solution. For some, we will intervene first in the interior of their lives (medications, private counseling). For others, we will start with social reconnection.

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Filed under counseling, counseling science, counseling skills, Post-Traumatic Stress Disorder, Psychology, ptsd

What can veterans teach us?


If you read much about matters of politics and the military, you are well aware of the significant problem of PTSD in returning veterans of Iraq and Afghanistan. While only 20-30% meet criteria for PTSD, all have been forever impacted. Rightly so, the military and traumatology researchers are expending oodles of money and time trying to understand (a) ways to reduce trauma symptoms and (b) improve resilience. Thankfully, we are seeing some helpful interventions being developed. However, there is much work to be done in perfecting treatments (finding ways other than just medicating vets into a stupor), ensuring that practitioners are competent, and improving societal acceptance of PTSD as a real disorder and not just something someone can just decide not to have.

And yet, these wounded and changed warriors have something to teach us about how we see ourselves and our world. Sometimes, it takes a life-changing experience to recognize serious blind spots. Even if you haven’t served in a combat setting, you can understand a bit if you’ve gone on a mission trip and returned with a different perspective and a sense you could no longer go about life the same way.

This article is a worthy read to consider what we can learn from those who were willing to sacrifice their lives, their futures for our safety. If you are indeed thankful for a vet’s service, take a minute to read it.

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Study Global Trauma Recovery Online!


Dr. Langberg and I are forming our next cohort interested in studying global trauma recovery principles and practice. If you have thought about getting such training, now might be a good time! Check out this link to our website where you can find descriptions/objectives of courses in the series as well as application materials (see links on the right of the hyper-linked page)

 

If you aren’t sure about doing the whole series, just try our introductory month-long course. You can get graduate credit gtc-logoor 40 hours of CEs for just $500. Here’s a few more details:

 

 

  • CEs are NBCC approved
  • Class runs November 9th to December 14th (time off for Thanksgiving)
  • Workload is about 10-12 hours per week (readings, discussion boards, brief response papers)
  • 4 required live 1 hour web conference to discuss material with the professors
  • Focus of the class is to explore psychosocial trauma in international settings

 

 

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Filed under christian counseling, christian psychology, counseling skills, Missional Church, Post-Traumatic Stress Disorder, trauma

Addressing Trauma in International Settings: 3 Models in Dialogue


The 2013 AACC World Conference continues. Thursday, Drs Harriet Hill, Matthew Stanford, and Diane Langberg and myself will make the above titled presentation. Harriet will present an overview of the American Bible Society’s Trauma Healing Institute work of developing helpers who can help others re-engage Scripture around their traumas. That model is centered around the small but helpful book, “Healing Wounds of Trauma” (you can find this on bibles.com). Matthew’s work is the Mental Health Grace Alliance project of hope groups–structured support groups that have been tested in Bengazi IDP camps and other locations. Diane and I will describe the beginning work of the Global Trauma Recovery Institute which is designed to support the existing work by local caregivers.

Follow This slide show link for our slides.

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Filed under AACC, Africa, Diane Langberg, Post-Traumatic Stress Disorder

AACC 2013: Narcissistic Leaders and Systems


Today, AACC’s World Conference begins at the Opryland Hotel in Nashville. This morning, Dr. Diane Langberg and myself will be running a pre-conference workshop entitled: Narcissistic Leaders and Organizations: Assessment and Intervention. I will start us off with a meditation from 1 Kings 1 (ideas I first heard from a sermon by Phil Ryken last year). We will review current explanations of narcissism as well as an emerging model that may be helpful for those who are trying to move beyond seeing narcissists as only arrogant and exploitive.

Can a system be narcissistic?

Yes. Here are some of the features.

  1. Leader exudes god-like status and does not share power; surrounded by yea-sayers, unwilling to tolerate disagreement, accept mentoring and willing to scapegoat others when failures arise
  2. Constituents gain self-esteem/identity from the organization and love of the system is the highest priority; insider status provides immeasurable value
  3. There is an approved way of thinking, one must take sides for/against; constituents justify dictatorial behaviors of leaders
  4. No toleration for admiration of competitors
  5. Inability to assess own weaknesses

But, here is a most interesting fact: most collective narcissistic systems are NOT filled with individual narcissists! There is something  “in the water” that brings non-narcissists together to develop these 4 features (as written about by Golec de Zavala and colleagues in 104:6 of the the Journal of Personality and Social Psychology):

  1. Inflated belief and emotional investment in group superiority
  2. Required continuous external validation and vigilance against all threats of loss of status
  3. Perception that intergroup criticism is a threat and exaggerated sensitivity to any form of criticism
  4. Intergroup violence can restore positive group image (violence may be verbal as well as physical

Why teach counselors about narcissistic systems?

Counselors often interact with church and parachurch systems by consulting with the system, counseling leaders, or advocating for an individual client. It is good to be able to (a) recognize some of the unhealthy egocentric patterns (blind spots) leaders and systems develop, and (b) offer help to individuals and systems that do not get the counselor sucked into the system or unnecessarily alienate the system. I have had the opportunity to work with a significant number of churches and have learned that there are ways to help and ways that I can get in the way, especially if I begin to attack a long held belief system. For example, if parachurch organization A has had a string of CEO/Board conflicts, then I as a counselor may have to navigate some long cherished beliefs about the system when asked to consult on their next hire.

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Filed under "phil monroe", AACC, biblical counseling, christian psychology, counseling, counseling skills, personality

Want to be a Global Trauma Recovery facilitator?


Our Global Trauma Recovery Institute is gearing up to start our 2nd continuing education cohort in November for those who want training to become culturally savvy trauma recovery specialists. If you have been wanting to understand and address the issues of trauma that exist here and around the world, have graduate education in a counseling related field (or are involved in similar kind of work) and are able to complete both online and on campus training, then please check out our other site: www.globaltraumarecovery.org. This flyer will give you the nuts and bolts of our 3 course series (times, locations, and costs). This link will bring you to the course abstract downloads so you can see what you will be learning.

The first course begins November 9 and is fully on-line. We are NBCC approved provider of continuing education in mental health and counseling.

Who are the teachers? Diane Langberg, PhD and myself.

 

Check us out!

GTRI - First Graduating Class

Cohort One

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Why counseling? To be fixed or found?


Chuck DeGroat and Johnny LaLonde have written a post that some might find helpful when considering therapy or counseling (I use these words interchangeably). At some point in our lives, we all feel like life is getting out of control. We need help. We begin to wonder if there isn’t someone out there who can help us. But, even as we think these thoughts, we may also think, “what is the point? How can therapy fix this problem?”

Well, to give a partial answer, check out this first post over at Q Ideas. The authors argue that we should all be in therapy. However, they suggest that the purpose of such counseling is not so much to fix our problems but to understand ourselves, to admit our weaknesses, to be “found” or known. Now, these may sound like things that only wealthy people have the time to do. And yet, I would argue that in our isolated, individualized society, the normal communal means of being understood, supported, known, etc. are not often present in our lives.

Three paragraphs in this first post jump out for attention:

Don’t I go to therapy to get fixed? Believe it or not, I don’t advocate therapy because it fixes people. Now, while some forms of therapy help people get past difficulties that stifle them (e.g. panic attacks, major depression, bipolar symptoms), Christians should recognize there is always a deeper and more transformative purpose to counsel and care.

This was the ancient art called curam animarum—the care of souls. And the wisest therapists will foster this process. Now, the vast majority of clinicians practicing today have been trained in fix-it strategies—cognitive and behavioral solution-based processes which are aimed at quick, painless fixes. This is what sells. This is what insurance tends to pay for. But there is a profound difference here—fix-it strategies try to remove pain while deep soul care attempts to learn from it. Sometimes in the process we are afforded the mercy of pain relief. But it is not the goal. And so I counsel people to search carefully, to interview therapists, to ask many good questions.

And then this reflection:

But at the same time, I’m not convinced Christian therapists do this as well as secular therapists at times. Let me explain. Many settle for what Dietrich Bonhoeffer called “cheap grace,” a quick fix approach which stands in stark contrast to the “costly grace” of searching and knowing ourselves, through exploring our stories and examining our motives. This kind of care is, indeed, much more rare. Christian counseling which is reduced to mere Bible memorization, or repentance or a behavioral regimen misses the point.

Fixed and found?

I imagine that the authors would agree that both are possible. Therapy can lead to being fixed and found, to find relief and care for the soul. Therapies that ignore the need for immediate mercy and relief are of little value. I once talked to someone who had just completed a decade of psychoanalysis (3 sessions per week!). His therapist, a well-known analyst had just released him as having completed analysis. My new friend was looking for a therapist to deal with his longstanding panic disorder. I have also seen Christian counselors who have so emphasized discipleship that they paid little attention to easy helps for their addict clients. On the flip side, simple behavior change (now that is an oxymoron!) may provide some relief but miss insight into self and what God is up to in the world. In seeking only relief, we miss out on deepening our relationships with God and others. A superficial life lived may hurt lest, but is it worth living? 

Note at the bottom of the post there is a link to another post about how to choose a counselor. If you are looking for one, consider one who can have difficult conversations with you, one who does not over-simplify the problem, one who cares about your growing relationship with Christ, one who can provide ideas to bring immediate relief, and best of all, one who listens more than talks.

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Filed under biblical counseling, christian counseling, christian psychology, counseling, counseling skills, Psychology

When trauma isn’t “post”?


Over the last year or so I have been doing some thinking about those experiencing ongoing trauma. We talk of PTSD, Post-traumatic Stress Disorder, as a set of symptoms experienced after a traumatic event or time. But some people continue to live in ongoing trauma. I’m reading James Fergusson’s The World’s Most Dangerous Place: Inside the Outlaw State of Somalia. Early in the book, he talks of seeing “Sister Mary, a warm-hearted big-bosomed Ugandan in combat fatigues, dispensing medicines from a table in the ruins of the villa’s kitchen.” (p. 45). Sister Mary explains that there are two medical problems she sees. The one she treats most often is diarrhea. But, she says, the other problem she could not treat,

The people here are stressed, she explained. They are traumatized. They do not know where to turn.

You talk a lot in the West about PTSD-Post-Traumatic Stress Disorder…but for these people there is no “post”. The trauma never ends.

What can people do when trauma isn’t post? Do they have to wait until the traumatic experience is in the past in order to deal with it? What can we do for others who remain in precarious and life-threatening situations? A friend raised this question when working with a group of refugees in a UN temporary camp. Some of the suggestions that were given this friend

1. Helping refugees find some way to hang on to small measures of empowerment: set up classes for children, build huts for those who are just arriving, develop “positions” for adults to fill so the camp runs smoothly and has a modicum of safety.

2. Reinstate religious and cultural traditions where possible

3. Practice corporate lament along with other worship activities

4. Allow people to tell as much story as they wish, whether by voice or artistic rendering

Notice that these are finding ways to cope by (a) making the moment better and (b) bearing witness, even if they can do nothing about the crisis. When a person feels some level of ability to respond to a difficult situation, that person often experiences less trauma than those who are unable to express any agency. Further, when they feel that they matter to others (someone listened to whatever they had to say), they tend to have less long-lasting PTSD symptoms.

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