Tag Archives: psychotherapy

189. Disturbing Thoughts Can be Prevented

5 Nov

I recently read some discussions of ways to eliminate disturbing thoughts. I have treated a number of patients with this problem and have some of my own ideas that could be of help with this problem.

A disturbing thought may begin with something observed in a movie, in real life, or with something heard or read. It is immediately made worse if it induces a reaction.

Here are some examples of such thoughts. I worked with a commercial pilot that was required to sit in the cockpit and do nothing but monitor instruments and watch the skies for other airplanes. His thoughts turned to all sorts of problems like his investments and affording education for his children. It is torture to have to sit and do “nothing” for long periods of time. For some, listening to music helps. Another patient was a nanny that had thoughts of killing the children that she cared for. A man tended to think about all the “silly” things he said to his girlfriends, causing them to reject him. It is pretty normal to have some such thoughts.

Understanding anxiety is the key to dealing with disturbing thoughts. . This is a set of conditions that prepare the body for dealing with attacks; generally running away or fighting. To support these vigorous actions, there is an increase in heart ate, blood pressure, some muscles tense, faster breathing, sweating, etc., all changes necessary to support increased activity. Sometimes this activation occurs when there is no threat, and it can last for days or much longer. When this “fight or flight” preparation is excessive, inappropriate, and lasts for a long time, it is called anxiety. Often there is a circular process that prolongs this reaction. Fearful thoughts stimulate the physical anxiety and the feeling of anxiety leads to fearful thoughts.

It is also helpful here to define thought It is assumed to be some type of brain activity that involves words, feelings, and/or images. Scientists know a little about certain simple thoughts, but complex thinking is not yet understood. Brain actions closely associated with sensations or movements have been studied and are fairly well understood. Some thoughts appear to have a trial-and-error function that precedes difficult decisions. For example, you want to ask your boss for a raise. Your brain will try out different words and approaches and note what “feels” best.

Here are some therapy ideas and methods:
1. Do not fight these thoughts. Allow them to pass through your mind. Accept the fact that certain thoughts may occur for a long time, but usually will gradually have less effect.
2. If bothered by a specific phrase, and other methods don’t work, try repeating the words many times, until they are meaningless. This may take many repetitions.
3. Do a “brief relaxation response” (see below) every time the disturbing thought occurs. This way, the thought will be associated calmness instead of stress.
4. Associate the thought with something pleasant or funny. For example, if you keep thinking about a mistake you made, then associate that with something good that you did.
5. Some people can accomplish these actions by themselves, but many others will need the help of a therapist.

Some people are helped by simply talking about a problem with a therapist. Others will need some physical training like “progressive muscle relaxation” or biofeedback. These physical methods will improve emotional control and will diminish anxiety. A generally healthy method, which can also help with anxiety or stress, is to stretch the major skeletal muscles. Stretching muscles tends to relax  them and will also prevent injuries.

A fully licensed Ph.D. behavior therapist is recommended for the best therapy. Psychoanalysis is generally not effective for the problems discussed above. Methods like yoga or meditation include some procedures that are helpful, but include other aspects that may not help. It is best to find a therapist that has precisely what you need, rather than using more “mystical” methods which will be less effective. For very serious cases and medication, a psychiatrist might be required. If possible, it is best to start with a Ph.D psychologist instead of psychiatric drugs.

The “brief relaxation response” mentioned above, consists of the following. The goal is to relax all major muscles of the body, and to try and make breathing as  peaceful as possible. Muscles can be relaxed by (1) tensing and loosening, (2) stretching them, and/or (3) by shaking (example: let your arms hang down very loosely and then shake them). Many patients benefit from relaxation tapes with instructions, that are available on the Internet (search “muscle relaxation tapes”). Here is a good example:

https://www.youtube.com/watch?v=1nZEdqcGVzo    

You can also find relaxing music. My version of a brief relaxation response takes about 10 to 20 seconds after training. Begin by inhaling slowly and deeply. Then, exhale slowly and as you do this, let your whole body go limp. The “limp” part requires some practice, with or without a therapist. You can add a quick neck or scalp massage, and be sure to check tension in the back and calf muscles.

Here is a possible program. Start by working a lot with a relaxation tape to develop skills. Use the “brief relaxation response” frequently during a day and before going to sleep. Try any or all of the methods to deal with your disturbing thoughts.

 

 

 

Post 8. Psychotherapy and Science

24 Apr

The topics that I will discuss here could fill books, if properly explained. My main goal is to stimulate thought and an interest in behavioral science.  I want people to understand that there is scientific psychology and it has many applications, including a role in  therapy.

My major formal education was in the area of psychology and one of my major careers (about 20 years) was clinical psychologist. I went to the University of Maryland for my Ph.D. This department was strongly oriented towards the science of behavior and clinical methods related to this science. I also have a BS in physics, which makes me even more of a science advocate.

Having this background, and being a firm believer in the power and “rightousness” of science, I have often been disappointed by clinicians and neuroscientists who neglect or ignore the tremendous efforts put forth by many psychologists to make their field scientific. Why should psychology be scientific — because it is man thinking at his very best, and it is the best way to find truth. How do I know this? Well, consider the methods of other professions: politicians, religious leaders, evangelists, philosophers, poets, novelists, reporters, etc. Of all the professions you can think of, only one has a universally accepted method, and that is scientist. All established scientists are guided by principles such as: unbiased observation, replication of findings, free criticism, precise definitions, appropriate experimental designs, use of hard evidence, etc. Also consider that scientists have produced tangible results whereas others often produce nothing but words — and the words of different persons are often contradictory.

Science has brought us computers, TV’s, contact lenses, cures for diseases, automobiles, etc.; all of the technology that we enjoy. Some would say that science also brought us the dangerous atomic bomb. But science only suggested a possibility — the bomb was financially supported and produced by the decisions of politicians.

Behavior therapy uses the results of science to help people live better lives. Science looks at what people do and say, and has little interest in speculating about what the “mind” is doing. Note that what people say about their thoughts can be included in science, but the thoughts themselves are not generally observable and cannot be included. A “thought” can only be “detected” by the thinker, and science is limited to things that can be observed by more than one person.

Biofeedback

A powerful scientific method within the framework of behavior therapy is “Biofeedback.” This method makes use of physiological measuring instruments to provide useful training information to patients. The “feedback” is electrical signals in the form of sounds or visual stimuli. Lets take an easily understood example. A common complaint of patients with stress is headaches. Many headaches are caused by tension in neck and jaw muscles. Biofeedback can provide information about the tension in specific muscles using medical instruments. The patient can observe the feedback and can learn to reduce excessive and dibilitating muscle tension. Other biofeedback methods include information about heart rate, sweat gland activity, blood pressure, respiration, etc. Most of clinical biofeedback is concerned with reducing stress, nervousness and tension, and the physical effects of these factors. Disorders include anxiety, headaches, high blood pressure, digestion disorders, heart function, insomnia, teeth-grinding, etc.  Stated in other words, feedback (lights, sounds, etc.) provides information to a patient so that he can learn to control emotions like fear, stress, and anxiety — and their related physical disorders.

Biofeedback is a powerful, but under-used learning method. Most ordinary people who seek help for psychological problems have anxiety, or anxiety is a major component of some other complaint. The most direct method of treating anxiety is biofeedback, because the feedback makes anxiety “visible” and therefore easier to control. Biofeeback methods lead to “emotional control” — a key factor in mental health. Sometimes, the reduction in anxiety is all a person needs — but often people must also talk about relationships and other concerns.

Many psychotherapists work on curing the “mind” so that a person’s behavior and “feelings” can be adjusted and improved. However, in most cases, the cause-and-effect works in the opposite direction. Developing good behaviors and a well-controlled and relaxed body first, will lead to a “cured mind.” What we have found is that if you are feeling stressed, it is better to work on relaxing your body, than trying to alter your thoughts. Working on fearful thoughts is often frustrating because a tense body keeps generating negative-thought production. There is a an evolutionary reason for this to be discussed in a later blog. Working on relaxation and biofeedback methods breaks the patterns of negative thinking and stimulates more positive and relaxed thinking. The more one studies the relationship between his body and thought process, the better he does.

Biofeedback Under-used

This effective method, which has been popular from time to time has never been widely accepted. Here are the reasons. Since biofeedback is a learning process, it should be a clinical psychology method. But people going into the profession of clinical psychology often have little technical or scientific aptitude, which would be needed to effectively use the physiological measuring equipment. Physicians may discourage the use of biofeedback because it interferes with their practice of medicene. Much of medicene depends on the prescription of medicenes. Biofeeback is a behavioral method which makes many drug procedures unnecessary.

Final Thought

The science of psychoogy has been promoted at some of the most highly-rated educational institutions, such as Harvard University. Biofeedback has been researched and used by scientists at some of the most important clinics, such as the Mayo Clinic in Minnesota. There are extreme cases of mental disorders which do require the use of drugs and other methods. But for the common stress symptoms and disorders, behavioral methods and particularly biofeedback provide the most powerful and long-term solutions, without drug dependency and addiction.