Archive for August 4th, 2012

Does Your Therapist Bully You?


If you said to your primary care physician, “My elbow is hurting” and he replied, “Yes, fine, that’s interesting, but let’s examine your ear,” you’d probably wonder what was going on and you might even ask him, “Why?” If he replied, “In my experience your ear tells me everything I need to know about your body,” what would you think?

Historically, psychotherapists have had their agendas and have demanded that clients focus their attention in a direction determined by the therapist. Two classic examples of demands of this sort are the demands in traditional psychoanalysis that the client free associate and that the client report dreams

If, for example, you are a client in therapy with a certain sort of analyst and have the audacity to want to chat about something that did not happen to appear to you in a dream, that analyst is likely simply not allow it. This may strike you as far-fetched and yet it occurs all the time. Here is a report from one client, as reported by the analyst Louis Breger in his excellent Psychotherapy: Lives Intersecting, a book in which he traces his own journey from classical analyst to human analyst. The client reported:

“In my first session, this psychologist prompted, ‘Did you have a dream?’ I did. She listened attentively and then offered some interpretation. When I told her that the interpretation didn’t really resonate, she explained that this was due to my resistance. This irritated me. She indicated that my irritation was an indication that her interpretation had touched a nerve, and that we were, therefore, on the right track. I continued seeing her for several months. The sessions were always the same—I would begin by talking about events in my life—she would listen impatiently and eventually interrupt me with, ‘Did you have a dream?’”

It is as difficult to answer the question “Where do authoritarian therapists come from?” as it is to answer the more general question of where authoritarian leaders and their sometimes cowed, sometimes enraged followers come from. While we may not know where they come from, we should at least be alert to their existence. If you walk into therapy and find yourself sitting across from a bully, you will want to get out of there before real damage gets done to you.

Not all therapist toughness is bullying. It is completely sensible and appropriate for a therapist to be direct, clear, and even tough sometimes. If your drinking is out of control, you don’t want your therapist to ignore that fact, collude with you in your alcoholism, and in effect smile her way through therapy with you. That isn’t kindness. Her toughness on that score is warranted and in your ultimate service. You may not like it but she is right to demand that you look at your drinking.

That is very different from your therapist refusing to collaborate with you as one human being to another. If her chair seems several inches higher than your chair that is a kind of bullying. If she charges you with “resistance” any time you disagree with her that is a kind of bullying. If she uses diagnostic labels and professional jargon as gospel that is a kind of bullying. The forms of bullying in a therapist’s office are not the same as those on a schoolyard but they feel the same: that is, bad.

Yes, you have the job of distinguishing between whether you are feeling bad because you have been caught in one of your tricks or because you are being bullied. The very same action may amount to bullying in one case and compassionate intervening in another. Say, for example, that you are inclined to tell the same story about a past grievance over and over again. A bullying therapist might interrupt you so as to proceed with his agenda. A compassionate therapist might interrupt you but for a very different reason, because she wants to be of help rather than allow the session to be spent on you rehashing this same old story. Differences of this sort are on your shoulders to discern.

Good therapy is good relating. The therapist does her part to be as human and as wise as she can be; the client does his part by wryly admitting his own trickiness, by accepting that change is difficult, by actively affirming his life and by actually caring about his life, and so on. Even then mistakes will happen, impasses will be reached, and not every session will produce spectacular results. But that is still very different from sitting across from someone whose primary expertise is in bullying.

You don’t want to be bullied by your therapist any more than you want to be bullied by your primary care physician or your car mechanic. It is very easy for a person in a position of authority and power to abuse his position, especially when he is a putative expert in a very suspect system like the current pseudo-medical “mental disorder” model of psychotherapy. Indeed, if a bullying therapist were able to take off his metaphoric white coat, put his cards on table, and explain that he dealt in problems of living and not medicine, he just might instantly shed some of his need to bully.

If you are interested in how therapy ought to work, I recommend Psychotherapy: Lives Intersecting to you. Breger writes: “It is clear that the relationship between the patients and myself was at the heart of these successful outcomes. Experiencing my attention and affection, admitting and repairing mistakes, catharsis, insight gained from collaboratively constructed interpretations, self-disclosure, humor, flexible fees, and openness to concomitant forms of treatment, all played their roles.” This is what a human and humane enterprise sounds like.

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Eric Maisel, Ph.D., is a psychotherapist, bestselling author of 40 books, founder of natural psychology, and widely regarded as America’s foremost creativity coach. Learn more about natural psychology and access the groundbreaking Natural Psychology: The New Psychology of Meaning at www.naturalpsychology.net. Learn more about Dr. Maisel at www.ericmaisel.com or contact him at ericmaisel@hotmail.com.

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Alzheimer’s More Aggressive in Younger Elderly


Alzheimers More Aggressive in Younger Elderly New research shows that Alzheimer’s disease hits people in their 60s and 70s harder than people who are 80 years and older.

Researchers at the University of California, San Diego School of Medicine note that the greatest risk factor for Alzheimer’s is age. In fact, by the age of 85, the likelihood of developing the dreaded neurological disorder is roughly 50 percent, they say.

But in their study, they found that the “younger elderly” — those in their 60s and 70s — showed higher rates of cognitive decline and faster rates of tissue loss in brain regions that are vulnerable during the early stages of Alzheimer’s, according to Dominic Holland, Ph.D., a researcher in the Department of Neurosciences at UC San Diego and the study’s first author.

“Additionally cerebrospinal fluid biomarker levels indicate a greater disease burden in younger than in older individuals,” he said.

Holland and his colleagues, using imaging and biomarker data from participants in the Alzheimer’s Disease Neuroimaging Initiative, examined 723 people, ages 65 to 90 years, who were categorized as either cognitively normal, with mild cognitive impairment (an intermediate stage between normal, age-related cognitive decline and dementia) or suffering from full-blown Alzheimer’s disease (AD).

The findings have implications for diagnosing the disease — which currently afflicts an estimated 5.6 million Americans, a number expected to triple by 2050 — and efforts to find new treatments, the researchers said.

At present, there is no cure for Alzheimer’s and existing therapies do not slow or stop the disease’s progression.

A key feature in the diagnosis of Alzheimer’s is its “relentless progressive course,” Holland said.

“Patients typically show marked deterioration year after year. If older patients are not showing the same deterioration from one year to the next, doctors may be hesitant to diagnose AD, and thus these patients may not receive appropriate care, which can be very important for their quality of life.”

Holland said it’s not clear why the disease is more aggressive among the younger elderly.

“It may be that patients who show onset of dementia at an older age, and are declining slowly, have been declining at that rate for a long time,” added co-author Linda McEvoy, Ph.D., associate professor of radiology. “But because of cognitive reserve or other still-unknown factors that provide ‘resistance’ against brain damage, clinical symptoms do not manifest till later age.”

Another possibility is that older patients may be suffering from mixed dementia — a combination of Alzheimer’s and other neurological conditions, Holland said. These patients might withstand the effects of Alzheimer’s until other adverse factors, such as brain lesions caused by cerebrovascular disease, take hold. At that time, Alzheimer’s can only be definitively diagnosed by an autopsy, he said.

Clinical trials to find new treatments for the disease may be affected by the differing rates of progression, researchers said.

“Our results show that if clinical trials of candidate therapies predominately enroll older elderly, who show slower rates of change over time, the ability of a therapy to successfully slow disease progression may not be recognized, leading to failure of the clinical trial,” said Holland. “It’s critical to take into account age as a factor when enrolling subjects for AD clinical trials.”

While the obvious downside of the findings is that younger patients with Alzheimer’s lose more of their productive years, “the good news in all of this is that our results indicate those who survive into the later years before showing symptoms of AD will experience a less aggressive form of the disease,” Holland concluded.

The research appears online in the journal PLOS One.

Source: University of California, San Diego

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Early Relationships Key to Happiness


Positive social relationships in childhood and adolescence are the key to adult happiness, according to new research.

Researchers at Deakin University and the Murdoch Children’s Research Institute in Australia also found that academic achievement had little effect on adult well-being.

A team of researchers led by Craig Olsson, Ph.D., analyzed data for 804 people, who were followed for 32 years in the Dunedin Multidisciplinary Health and Development Study (DMHDS) in New Zealand.

They particularly focused on the relationship between social connectedness in childhood, language development in childhood, social connectedness in adolescence, academic achievement in adolescence, and well-being in adulthood.

Social connectedness in childhood was defined by parent and teacher ratings of the child being liked, not being alone, and the child’s level of confidence. Social connectedness in adolescence was demonstrated by social attachments with parents and peers, as well as participation in youth groups and sporting clubs.

The researchers found a strong connection between child and adolescent social connectedness and adult well-being, noting this illustrates the “enduring significance of positive social relationships over the lifespan to adulthood.”

The researchers also found that the connection from early language development, through adolescent academic achievement, to adult well-being was weak, which is in line with existing research showing a lack of association between socioeconomic prosperity and happiness.

The analysis also suggests that the social and academic paths are not related to one another, and may actually be parallel paths, the researchers said.

“If these pathways are separate, then positive social development across childhood and adolescence requires investments beyond development of the academic curriculum,” the researchers conclude.

The study is published online in Journal of Happiness Studies.

Source: Springer

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