Cognitive Therapy For Writers Part II Revenge of the Smart Brain



Raaaawr! All right. So, we've established that everyone has a Sneaky Brain, the part of you that whispers all sorts of nasty things that make you feel bad.
You know, like:

• If I don't get an agent or get published, I freaking suck as a writer.
• Because that agent/editor rejected me, I am a failure.
• I got a few rejections this week/today/in the last hour, so that means no one will ever want to represent/publish me.
• I wrote one book/chapter/page/sentence, and now I can't think of what to write next. I've run out of words FOREVAH!!!!! AAAAAAH!!!!!!!

Let's pause right here and acknowledge that not everyone who writes is going to end up a published author. Not everyone who writes is even good enough to be published. Period. That's the way it is. Language is powerful, but it can be difficult to wield. The art of storytelling adds another level of difficulty. And then there's marketability ... whoa.

SO, taking into account that I, or you, might be among those who reach as far as we can but still can't close our hands around that elusive prize, how do we keep feeling OK? How do we keep our Sneaky Brains from sapping us of whatever talent and energy and creativity we have? How do we stay on track and keep writing, keep telling the stories we want to tell?

We all have Smart Brains, too. We should use them.

Don't be afraid to fight dirty.

 1. Recognize those sneaky thoughts. Listen hard, my loves. You have to HEAR and recognize what Sneaky's saying, because those thoughts can become pretty automatic over time, meaning you stop hearing them and just skip straight to the drinking-Wild-Turkey part of the equation. Don't. Listen. What do you hear?

If you hear any of the following words, perk up and slap on those boxing gloves:

ALWAYS
NEVER
SHOULD
ONLY
FOREVER

If you find yourself thinking "sure, I had some success a year/month/day/hour ago, but THAT DOESN'T COUNT ... ", do some pushups, man, because you've got some work to do.

Or if you hear "since she rejected me, that means EVERYONE will", strap on some brass knuckles. You've got a fight on your hands.

After you've recognized what the Sneaky Brain is saying ...

2. Recognize Sneaky as a bully. Sure, it's inside your brain, but that don't mean it speaks the truth, baby. When I work with kids, we "externalize the problem". Picture me (see stick figure above) talking in funny voices with puppets strapped on my 18-inch fingers.


Just like this dude.
But probably not as ripped.

 OK, don't. Instead, picture Sneaky sitting in front of you--and see what a liar it is. Those things it's whispering are a one-way ticket to depression. Despair. Giving up. What right does it have to do that to you? What right does ANYONE HAVE TO DO THAT TO YOU?!? I don't care if the bully resides between your ears. It's still a bully.






Once you recognize that:

3. Confront the bully and talk back to it. Because, seriously, logic is not its friend.

If someone's done something to upset you, like they rejected you or gave you a bit of harsh feedback, and your Sneaky Brain is saying "it's because they hate your writing and think you're a tool", use your Smart Brain to say, "Really? 'Cuz

1. they only read a tiny sample of my writing--or only a query, or
2. they had some nice things to say, too, or
3. I got a request/compliment, etc. from this same person/similarly skilled person(s) before, or
4. they probably spent a total of 60 seconds looking at it because they had 300 other queries waiting, or
5. the idea probably just didn't float their boat, but it could float other boats ...

You get the point. Use your Smart Brain to be ... smart? Use logic. Be a skeptic. If the Sneaky Brain says you're a failure because you got one rejection, I mean, WTF? Really? How many agents and editors are out there?

If it says "you should have an agent by now" or "you always mess this up" or "you will never ..." Oh, geez. What does it know? This process is frustrating enough without Sneaky going to illogical extremes. "Always"? Yeah? Use your Smart Brain to question how that could possibly be true. If you can't, that just means your Smart Brain's out of shape, NOT that Sneaky speaks the truth.

And if it whispers "the only way to be successful and happy is to get published," your Smart Brain should be screaming, "I am more than a writer. And there are many kinds of writers. And I write for many reasons. And sometimes, the end result isn't what it's about. Sometimes, it's the JOURNEY." Then, maybe toss out some obscene hand gestures for good measure. Stupid Sneaky Brain. Gut it with a spoon, my friends. That's what it deserves.

You don't have to be the only one who talks back to Sneaky. I'll bet you have friends or family or beta-readers or intriguing-strangers-you-meet-in-a-coffee-shop who can help you. Listen to their encouragement and don't discount it. But know this: no voice will ever pack a punch as powerful as your own Smart Brain.

So ... confession time. I'll be going on submission in the new year. And you know what? I'm going to be using every single one of these strategies every single day to stay calm and sane and happy. I know it won't always be easy. I know my Smart Brain won't win every round. BUT, I also know my Smart Brain is pretty damn smart. No matter what happens, I'm going to be OK. I'm going to be successful. And I'm going to define what that means for myself--I won't let anyone, including my own Sneaky Brain, define it for me.

That shapeless lump is my vanquished Sneaky Brain.

What about you? What challenge are you facing now? What's that Sneaky Brain telling you? And just how do you plan to kick its a$$??

Drug Companies Lobbying the Government in the United States

From: http://www.opensecrets.org/lobby/indusclient.php?id=H04&year=a

It’s no surprise that American corporations spend billions of dollars each year on lobbying government, trying to gain favorable treatment from legislators. And succeeding wildly. What some may find a bit surprising is which industry spends the most in these efforts.

Wendell Potter of the Center for Public Integrity, says that it is the pharmaceutical industry! According to OpenSecrets.org, it spent a total of over $2.6 billion on lobbying activities from 1998 through 2012. In comparison, energy companies spent a mere $1.4 billion.

So what are their lobbyists seeking in return? Well, one obvious thing is that pharmaceutical companies engage in outrageous pricing practices, particularly in the United States. Drugs cost far more in the States than they do in most other countries.  

The companies also keep exclusive rights to manufacture new drugs for 20 years or more. 

This despite the fact that drug price inflation is one of the main drivers of health care costs for individuals and families and threatens the fiscal health of our public health care programs.  

The industry's policy goals include: resisting government-run health care, ensuring a quicker approval process for drugs and products entering the market, and strengthening intellectual property protections. Top 2008 contributor Pfizer supports efforts to protect pharmaceutical manufacturers by restricting the use of generic copies of their drugs.

The gap between what Americans and citizens of other countries pay for drugs is actually increasing. So, in response, many people started to buy their medications from sellers in other countries. Canada was particularly attractive for this purpose. What were the drug companies to do? With a push from their lobbyists, the practice of individuals importing their medications from Canada was made illegal.

This is kind of funny, since it is also true that a lot of the drugs available in Canada are manufactured in the United States to begin with, and the exact same drug companies are selling them in both countries!

According to a paper published by the National Institute of Health, an amazingly stupid argument that was made to justify this consisted of scare tactics designed to frighten an ill-informed public. Here it is:

Many concerns restrict drug reimportation from being a legal practice in the US. These include safety, efficacy, and therapeutic equivalency of reimported drugs. While these drugs are manufactured in the US, the storage and packaging conditions in countries where drugs were exported cannot be monitored by the US Food and Drug Administration (FDA). In addition, inappropriate storage conditions while reimporting medications back to the US may degrade the quality of drugs. 

The most important issue is distinguishing between drugs that are manufactured in the US from those which were manufactured elsewhere. Although technically ‘reimportation’ involves importing back drugs manufactured in the US, there are no means to check the originality of drugs. Similarly, it is difficult to determine whether the drugs purchased from other countries have the same dosage form, potency, and amount of active ingredient as the prescribed medication... The pharmaceutical industry criticizes the reimportation practice due to the potential harm to the recovery of the research and development (R&D) costs required for new drugs. While these opponents prevent the legalization of drug reimportation, various consumer advocacy groups support the practice.

The bit about dosage form, potency, and the amount of active ingredients is especially insane because pharmaceutical companies in the US import many of their ingredients for their products from countries such as China or India, where safety and quality oversight by the government is considerably worse than it is in Canada.

Readers may also be familiar with another law that came courtesy of Pharma lobbying: While private insurers, hospitals and even the US Department of Veterans Affairs can bargain with drug makers to get better deals on prices, the Medicare Part D drug program cannot. The Congressional Budget Office estimates that the government could save $112 billion over the coming decade if Congress reconsidered this 2006 gift to drug makers and instead gave Medicare the ability to negotiate prices. 

Do you really believe that the only way to keep the program from going broke is to cut benefits and raise the eligibility age for Medicare from 65 to 67?

Not surprisingly, when the Medicare Part D program was first passed by the US Congress, one of the only major classes of drugs explicitly excluded from all support was benzodiazepines. This restriction was finally eliminated, but only this year.

Readers of this blog already know that I think that Big Pharma has purposely demonized this class of drugs by doing such things as grossly exaggerating its dangers of addiction. Benzo’s are just too cheap, safe, and effective for their tastes. They want you to buy their expensive and far more potentially toxic antipsychotics and other classes of medication if you need a sedative. 

Since the Health Industry practically wrote the Medicare Part D legislation, I think it’s reasonable to assume that this is why benzo’s were excluded, although I can’t prove it.

Efforts to restrict the use of benzo’s have also been made at the state level.  Just last year, my state of Tennessee made it illegal for pharmacies to dispense more than 30 days of a benzo at one time. Most insurance plans these days make it cheaper for their customers to get a 90 day supply of meds than three 30 day supplies - not to mention the fact that patients have to make extra trips to the pharmacy. So this new law makes benzo prescriptions a headache for many consumers.

The ostensible reason for the law? To prevent deaths by overdose. Now it is true that opiate addicts and those on methadone maintenance programs have combined those drugs with benzodiazepines in fatal overdoses, as the combination can depress breathing. But so can the opiates all by themselves.  

That drug combination is actually just about the only way that benzo’s can cause deaths, short of someone falling asleep in the bathtub like Whitney Houston or choking on the actual pills. Not to mention that most of the addicts who overdose get all their pills illegally anyway, so the law accomplishes absolutely nothing other than creating a problem for those who have a legitimate need for the medication, such as patients who have panic disorder.

When it comes to the profits of drug companies, however, this concern for drug addicts evaporates. The pharmaceutical industry wants pseudephedrine, its over-the-counter cold and allergy medicine, to remain easily and readily available for consumers who use the product.  

Unfortunately, that drug is also used by drug dealers to manufacture methamphetamine, and this has caused legislatures across the country to try to limit the ease by which the average consumer can buy it. (Of course Adderall, a drug which is almost a identical to meth, is not a big legislative concern).

In response, the drug companies have suddenly jumped to the defense of the consumer. Not only do the companies lobby governments to reduce these regulations, but they are now appealing directly to the public to lobby their legislatures against them. I actually agree with them on this particular point. There are other better, effective ways to limit the use of pseudephedrine in meth production. But the double standard for pseudephendrine and benzodiazepines is palpable.

A drug company trade group deceptively named the Consumer Health Care Product Association has a website designed to motivate consumers to act in their behalf and write their state legislators: http://stopmethnotmeds.com/.  You know how I heard about it? The group has radio ads promoting it across Tennessee, because Tennessee is one state considering further limiting access to pseudephendrine.

Psychiatrist Dr Catherine Syengo Mutisya Beyond the call Eve Woman Magazine

By Silvia Wakhisi

Updated Friday, August 1st 2014 at 12:05 GMT +3

 

 inShare

When Psychiatrist Dr Catherine Syengo Mutisya decided to leave mainstream medicine for psychiatry, some of the people around her asked her why she wanted to work with "mad people".SILVIA WAKHISI followed her into her world to find out what inspired her to work with the mentally ill.

For any family, having to take care of a loved one who is suffering from a mental illness can be a devastating affair. Many will easily give up on them because of the difficulties they have to put up with trying to ensure they live a normal life and accord them the best care.

But having come face to face with this harsh reality, Dr Catherine Syengo Mutisya purposed from a young age that she will devote her life to taking care of people with mental illness, help them get back on their feet and lead a normal life.

"I grew up as the youngest of five children. My upbringing was a very regular, middle class one. My father was a teacher and my mother was into business," she says. "One of my brothers had intellectual disability. He was more of the 'baby' and needed all the care and attention. I am told he got sick and contracted pneumonia. My parents had to struggle to bring him up. He is now 42," says Catherine.

In addition, one of Catherine's uncles was diagnosed with schizophrenia, a mental disorder often characterised by abnormal social behavior and failure to recognise what is real.

"I grew up seeing my uncle become psychotic. Since his wife was not able to handle him, my dad would bring him to stay with us as he sought proper medical care for him. He would often wake up early in the morning to travel from Kitui and take him to Machakos General Hospital, which is now Machakos Level 5, since it was the nearest facility that offered psychiatric services," she says.

Though she was a little girl then, these experiences sparked in her the zeal to one day offer assistance to others who suffered the same fate.

It's no wonder then that when Catherine talks about her brother, which is often, she speaks with warm affection.

Born and raised in Kitui, Catherine, now 39, has risen to become a formidable lady whose greatest passion has become mental health. She currently serves as the Deputy Medical Superintendent at Mathari Hospital and is one of the renowned psychiatrists in the country.

But when I meet her for the interview, Catherine doesn't strike me as typical white-coated government health official. Her smile is captivating and infectious and her warm personality easily welcomes me into her world. She is down to earth and easy to talk to.

"For someone to discover their purpose in life, they have to go through rocky patches. My journey of self-discovery wasn't plain sailing itself. It hurt me to see my brother in that condition though there was little I could do to help then. However, that experience shaped me into the woman I am today," she says.

She offers: "As I grew up, the closest I got to interacting with someone from the medical field was with my aunt, who was a nurse. When I went to high school, I discovered there was something better than just a nurse. And that's when I decided that I would take up medicine as a career."

GO TO PAGE 1 2 3 Next »

Horror Stories in the Public Domain Often More to the Story

The Nocebo Effect

Since I started this blog, I have corresponded or interacted with several respectful, thoughtful, and caring (as well as some hateful, ignorant, and not so well-meaning) individuals who run websites that are critical of psychiatrists or psychiatric medication, or who run support groups for the parents of individuals with various psychiatric diagnoses. These folks collect and publish horror stories. Some of their readers report having had bad reactions to psychiatric drugs and/or awful interactions with mental health professionals, while others discuss interactions with relatives with specific psychiatric or psychological disorders.  

As to the psychiatry critics' drug websites: Of course, anyone who reads this blog knows that I believe that there are a lot of really bad psychiatrists out there who end up doing real harm to their patients. Mostly, they drug patients unnecessarily or over-medicate them, and do not recommend  - and therefore deprive patients of - psychotherapy or family therapy that might do their patients some real good. Others do not monitor patients for adverse reactions, with sometimes catastrophic results. These websites can often contain information that can be very helpful to such individuals.

It is also quite true that a small proportion of those taking any drug on the market, psychiatric or otherwise, can have bad reactions or bad withdrawal symptoms, and that certain drugs are of such high risk for potential toxicity that they should not be prescribed for anything but the most serious of reasons. Toxicity from drugs that for many people are truely helpful and indicated can be monitored for, of course, but often doctors do not do this, as mentioned above.

While a majority of the horror stories about drugs are therefore probably true, although unrepresentative for reasons about to be discussed, this does not necessarily mean that any story website readers submit about a bad reaction that they seem to have had to a drug is, in fact, due to the drug. That should go without saying.

First, there is what is called a nocebo reaction, which is sort of like a placebo reaction in reverse. People will develop symptoms that are not actually due to the drug itself because of their expectations about the drug - just like people can have a bad or good reaction to a sugar pill that is basically inactive, pharmacologically speaking. The popularity of the obviously bogus science of homeopathy, in which individuals are given what is basically water, attests to the power of placebos and nocebos.

It is ironic how some of the more strident anti-psychiatry folks go on and on about high placebo response rates in drug studies, yet systematically deny that anyone ever has a nocebo response. This lack of consistency is always an excellent clue that anything such a person says may be highly prejudiced, and that their reading of evidence is highly selective.

Of course, people who have good responses to drugs are not going to write into the sites designed for people who have a complaint. In a similar vein, parents who were severely abusive to their offspring are not going to write to parent support groups for the families of patients with alleged psychiatric “diseases.”  Therefore, both the leaders of parent support groups and drug site webmasters are hearing from a highly select sample of individuals who are probably not at all representative of the majority of people who are involved.  

Parents who contact the two support groups for the parents of patients with borderline personality disorder (BPD),  NEA-BPD and TARA, are an excellent example of an unrepresentative sample. Yet the leaders of these groups often deny or minimize the role child abuse and general family dysfunction play in the genesis of BPD because of their tendency to overgeneralize from their readers, despite the FACT that every study ever done shows that these factors are highly prevalent in families that produce children who grow up to have BPD.

As to the people who do seek help from support groups for relatives of people with various disorders: At least some if not most of these individuals have a strong need to blame their interpersonal problems solely on a mental illness that their relatives supposedly have. If that were the case, they would not have to feel guilty about their role in the family member’s problems. I discussed this phenomenon a long time ago in a post about a website supporting the parents of children who supposedly had bipolar disorder but were in actuality just plain ol' acting out. The post showed how Pharma, with the cooperation of corrupt psychiatrists, took advantage of these parents to sell inappropriate drugs for their kids.

Similarly, complainers about drugs may actually be miserable because of family problems, but would rather blame their misery on the drug rather than face the facts of their family dysfunction. This is the defense mechanism called displacement. 

Again, of course there are real psychiatric diseases like schizophrenia and real manic depressive illness, but as readers of my blog know, I believe that what are just behavior and interpersonal problems are frequently mislabeled as "diseases" by both mental health providers and the general public alike, such as ADHD, bipolar (my ass) disorder, and even borderline personality disorder. 

The webmasters for the sites under discussion here, and the leaders of these support groups, tend to just accept the pronouncements of their “customers” as true and complete and do not question them. Blindly taking the word of people who may have several skeletons in their family closets is probably not wise. These are people the webmasters usually do not know at all, although in some cases they may have corresponded more extensively, and there is rarely any way to verify what they say. Therefore, it seems to me that one can easily be misled about both the prevalence and/or the basic nature of these problems from reading these websites.

The same question of whether one is getting the whole story might also be said about letters to newspaper advice columnists. Admittedly, I have been guilty of using such letters to illustrate various points I make on this blog. Some letters to Dear Abby and her colleagues may be completely fraudulent, and they can easily be fooled into publishing a fake one.  

An even bigger problem is that, even when a letter writer is completely sincere, many times he or she is only telling part of a much bigger story. Patients, letter writers, and website visitors can be completely truthful in what they say, but leave out highly relevant facts that would change the opinion of anyone listening to them.

As a therapist, and as I have mentioned in previous posts, sometimes the truth about what is really transpiring with a patient, particularly during their interactions with family members, are not revealed until literally months or even years into ongoing psychotherapy. Family skeletons tend to remain family skeletons for a reason.

A great example of someone leaving out a lot of relevant details, if true, was seen in a couple of letters to the advice column Annie’s Mailbox. A daughter-in-law was accused by a letter writer of what sounded like some pretty rude and unpleasant behavior, and the Annies were sympathetic in their answer to the writer. Then the daughter-in-law herself wrote in with her side of the story. Although I cannot be certain that the letter writers were not making this stuff up, I reproduce the letters because I have seen real examples of patients “spinning” facts to make themselves look better than they are, or in many cases, to make themselves look worse than they are.

These letters do illustrate some of the ways that facts can indeed be “spun” in such a way that a reader or listener is completely misled.

Letter #1: Aug 5, 2013. Dear Annie: My husband and I drove a long distance from our home to help our son and his wife with their move from another state. They have two infant daughters, and we wanted to help in whatever way we could. The first morning, Dad went with our son to the bank, leaving me at the house with the movers. My daughter-in-law stayed in her bedroom with the babies. The movers' questions were directed to me, and my daughter-in-law didn't come out of the bedroom until my son came home. It was hard to believe she wouldn't want to be involved in the decision-making process about where her furniture should go. 

On the fourth day, our son went back to work, and we were left to fend for ourselves in the morning while his wife slept in. There wasn't even a TV to keep us occupied while we waited for her to get up. At 11 a.m., we decided it was time to leave, and we cut our stay short. We called our son on the way back home and explained the situation. In seven months of our son saying everything was "fine," they never initiated any contact. There were no acknowledgements of Christmas and birthday gifts, much less a thank you. There were no phone calls. Now his wife is demanding an apology from us, saying we were rude to leave so abruptly. We believe this was inappropriate behavior on her part. What is your opinion? -- Disappointed Parents

Dear Parents: We think you will have ongoing problems with your daughter-in-law. She was rude and ungracious. But she is your son's wife, and he is disinclined to stand up to her. You will have to work through her if you wish to maintain a relationship with your son and grandchildren. Apologize, even if it sticks in your throat. If she avoids you by staying in the bedroom, don't make it a problem. Learn to keep your negative opinions to yourself. Remain upbeat and positive. Always be nice to her. Remember, you can catch more flies with honey than vinegar.

Letter #2:10/18/13.  Dear Annie: I am the daughter-in-law mentioned in the letter from "Disappointed Parents," who said I retreated to the bedroom while my mother-in-law handled the movers. From their letter, I can understand why you think I might be a problem. Yes, they did travel a long distance to help us with our move, and it was greatly appreciated. I kept thanking them and continuously asked whether they were OK and whether they needed anything. I was told over and over that they were just fine. The day the movers arrived, my husband and I agreed that he would deal with them and I would keep our small children out of the way in our bedroom. He didn't tell me that he and his father left to go to the bank, leaving his stepmother to handle the movers. 

My husband and I both slept until noon that day, but they only castigated me for being "lazy." They didn't mention that I was up until 4 a.m. unpacking. They were bothered that I didn't have breakfast ready for them, even though the kitchen wasn't unpacked. They expected to be entertained. When they decided to leave in a huff, I was bathing our kids. They didn't even lock the front door behind them. After they left, I received nasty emails saying how rude I was and that I need to apologize. Each one included a laundry list of the ways I am a terrible daughter-in-law and don't know my place. I didn't send birthday and Christmas greetings because my husband said he wasn't interested in doing so. His father has a history of anger issues and has alienated every other family member. My last email stated that I was cutting off contact. I am too busy raising my children to raise my in-laws. They smile to your face while making lists of slights behind your back. I don't want my kids around such behavior. Thank you for reading my side of the events. — Shell-Shocked Daughter-in-Law

Dear Shell-Shocked: Thanks for providing it. Many readers came to your defense, saying that a new mother who had just moved had her hands full and deserved more consideration. We agree.

Often the possibility that details are being left out of a description of an interpersonal problem can be suspected from a very careful reading or listening to what is said. For example, I see a lot of letters to advice columnists by elderly parents complaining that their adult children are ignoring them or are angry at them, seemingly for no apparent reason. In point of fact, there is always a reason. For example:

Dear Annie: I could have written the letter from "Hurt in Florida," whose children and grandchildren don't include her in their get-togethers. My daughter told me they are "just too busy" for me. But they somehow have time for her dad and stepmother, as well as her in-laws and several friends. I haven't seen them in more than a year. We don't talk because I don't call. I don't understand any of it. I just wanted to let "Florida" know that she's not alone. I'm hurting with her. — Midwest Grandma

The key question raised by what is said in this letter is why said daughter seems to love to get together with every family member exceptthe letter writer. Could it be that the writer has distanced her child in some way? You can almost bet on it.

My Take on the Wall Street Journal Article About YA

Yesterday I watched Twitter explode in response to a Wall Street Journal article by Mrs. Meghan Cox Gurdon, entitled "Darkness Too Visible." In the article, the author makes the argument that YA is rife with all flavors of depravity and peddled by editors eager to "bulldoze coarseness and misery into children's lives."

My initial reaction to the article was incredulous amusement--when my agent sent me the link, I assumed I was going to be reading something well-informed and balanced. However, it was immediately apparent by the contemptuous and smugly dismissive tone that this was a completely one-sided opinion piece.

OK. The lady is entitled to her opinion.

The problem I have is if her opinion is mistaken for thorough, well-informed analysis.

Here there be dragons. Or, er,
OCD and depression. BEWARE.

Her argument: YA is full of "hideously distorted portrayals of the way life really is." And then she targets several books (most of which I have read, some of which I have discussed here on this blog) that include main characters grappling with mental illness, trauma, or substance abuse. She implies that describing these struggles in "stomach-clenching detail" is harmful to teens, and further implies  books that either omit or gloss over these conditions are preferable.

To which I say: huh?


Guess what? One in five teens has a diagnosable mental illness. Anxiety? Thirteen percent. Mood disorders? Seven percent. Disruptive behavior disorders (this includes ADHD and conduct disorder)? Ten percent. And that's just a few categories. In EVERY high school classroom, there are at least a few adolescents struggling with one of these conditions, not to mention abuse, bullying, dating violence, or other trauma.

To pretend these individuals don't exist is offensive. To imply books written for teens should not include them--as if their experiences are not real, as if knowing what they really go through is harmful to others, as if reading books full of sunshine and light will fix them--is highly distressing. And, I'll say it: harmful.

I mean, is that the message we want to send to teens? Let's brush kids with problems under the rug? Let's only tell the stories of well-adjusted kids from two-parent homes? If you read about someone doing drugs, having sex, self-mutilating, feeling depressed, going through a trauma,  or living the brutal reality of poverty and violence, you'll be messed up or catch a mental illness like a bad cold?

There's NO empirical evidence to suggest that is true.

Mrs. Gurdon asserts that reading about a behavior, such as self-mutilation, gives teens ideas they do not otherwise have and encourages them to try it. Although she probably didn't know it, she was referring to the concept of social learning, a well-tested theory which postulates that human beings learn through watching others engage in a behavior and get rewarded for it. An example: teenage girls might watch ultra-skinny models vaunted for their beauty and portrayed as living glamorous lives, and get the idea that starving themselves is a good idea. There is evidence to suggest that is, to some extent, true (though the mechanisms behind eating disorders are MORE COMPLICATED than that by far, or every girl in the US would have an eating disorder).

However, is that really the case with YA? For those of you who read this blog regularly, you know the kind of books I read. Nearly all of them are about mental illness or trauma. I've read dozens of them. Not once have I read a YA book that glorified unhealthy behavior. YA authors are brilliant at showing the complex consequences of their protagonists' choices. No, the writers are not preaching. But OH YES are they showing realistic outcomes. Do they cultivate sympathy for their characters? Absolutely. Do they show their characters getting out of situations unscathed? No way.

If someone publishes a peer-reviewed prospective study of how reading specific content in YA leads directly to the portrayed behavior (while controlling for other predictive factors, of course), I will humbly eat these words. Until then ...

Mrs. Gurdon also laments that YA books that realistically portray mental illness or disturbance might normalize this stuff.

To which I say: ARGH.

Again, recall how many teens experience mental illness. Think about what they face. In one study, ninety percent of kids diagnosed with a mental illness (and taking medication) reported experiencing some type of stigma. They were socially isolated and felt ashamed of their conditions. Do increased feelings of shame and isolation help a person to heal? One guess as to the answer.

Research shows that the more middle schoolers and older teens know about mental illness and its treatment, the more healthy their attitudes become. Research also shows that fostering empathy is an important tool to prevent bullying. Based on my observations, YA does two things relevant to those research findings: it shows kids they're not the only ones going through this stuff. And it shows all kids the perspectives and experiences of others with whom they share the world.

But here's the thing: each kid is an individual with strengths and vulnerabilities. So is every parent. What will be good, even redemptive and life-changing, to one teen will be triggering or disturbing to another. Just like everything else, literature isn't one-size-fits-all. When parents come into my office and ask if roughhousing or video games are okay, for example, I do NOT say, "no." I answer based on my knowledge of the child (and the parent). And the answer is not AN ANSWER. It's a discussion. A collaborative consideration of the individual kid, parent, and environment.

With teenagers, it's a more complex conversation. At that point, it becomes a matter of negotiation and problem-solving rather than one of parent-decides-kid-obeys (actually, ideally, parents begin having problem-solving discussions with their children long before adolescence--the earlier you're in the game, the more likely your kid is to keep letting you play). Parent-child communication--and appropriate parental limit-setting-- protects kids from all sorts of risks. Parental autocracy? Doesn't.

What I've seen many, many YA authors suggest is that parents should read alongside their kids. These authors are NOT saying every kid should read every book. Rather, they are saying parents should talk to their kids. Decide together (and the older the teen, the more freedom he/she has to make independent decisions). Have frank discussions about the material. Be open and receptive and don't freak out. This is the approach mental health professionals happen to advocate as well.
All right, I'm done.

Have you read the WSJ article? What did you think? Are you concerned about teens being desensitized? That mental illness or substance abuse will be "normalized"? Do you find there is a dearth of light-hearted or "innocent" books out there? Are you a parent? Are you having to negotiate the world of books with your kid, and how are you accomplishing that?

Sufferers in the Media

Andrea McLean pulls out of Loose Women due to panic attack

http://www.mirror.co.uk/celebs/tv/2012/01/28/andrea-mclean-suffers-panic-attack-and-pulls-out-of-loose-women-at-the-last-moment-115875-23723544/ 

Peter Breggin Goes Off the Deep End

Peter Breggin

Peter Breggan is a psychiatrist who is often highly critical of the use of any and all psychiatric medication, which makes him the favorite psychiatrist of the rabid anti-psychiatry movement along with Tom Ssazz. 

For some of these zealots, it is very understandable why they hate psychiatrists so much.  As anyone who reads my blog knows, incompetent psychiatrists or those docs who have been brainwashed by big Pharma often do a lot of damage to patients through misdiagnosing them, using inappropriate medications, and/or not monitoring their patients for side effects.

I cannot blame such victims for having a highly emotionally charged negative attitude towards my entire profession. 

Still, that does not make everything they think correct.  In fact, it often kind of impairs their ability to be objective about psychoactive substances.

Personally, I always felt that Breggin has used half truths to justify some of his opinions.  But now I think he has gone completely off the deep end. 

After reading what follows, I have this to say to anyone who still thinks he has a shred of credibility: You should look into joining the Flat Earth Society. You’d fit right in.

A news article by Phil Willon of the Los Angeles Times appeared on June 12, 2012, with a follow up story the very next day and again on June 21.  I quote parts of the three stories:

“A San Bernardino County prosecutor Tuesday urged a jury not to be swayed by testimony that the antidepressant Zoloft put a former Westminster police detective in a fog that made him not responsible for kidnapping and raping a waitress in 2010. Deputy Dist. Atty. Debbie Ploghaus called the so-called Zoloft defense, backed by a psychiatrist's testimony, "a bunch of baloney" and a desperate attempt by Anthony Nicholas Orban to sidestep overwhelming evidence against him.

Orban was identified by the victim, was implicated by his best friend, was captured on security video footage at the scene of the attack and left his police service weapon, with his name on it, in the victim's car. Ploghaus told the jury that while bar-hopping in Ontario before the kidnapping, Orban groped a woman's chest, grabbed a man's crotch and repeatedly texted a former girlfriend hoping for an afternoon tryst. "He was a highly trained officer who wanted to have sex. He had sex on the mind. Don't forget that," Ploghaus told jurors in her closing argument.

The Westminster detective is accused of abducting the waitress, then 25, as she walked to her car after a Saturday shift at the Ontario Mills mall. His police service weapon drawn, Orban forced the victim to drive to a self-storage lot in Fontana, according to authorities. The victim told the jury that Orban sexually brutalized her in the parked car, hidden behind tinted windows, as people walked a few feet away.

At one point, Orban snapped pictures with his cellphone, telling her to "smile for the camera." He chambered a round in his semiautomatic pistol, shoving the barrel deep into her mouth as tears rolled down her cheeks, she said. "He said if I cried, he would kill me," the victim told jurors. "Then he pulled the gun out and said, 'I think we'll continue this in the desert.'"

Orban had shared eight margaritas and two pitchers of beer with a friend, and was seeking sexual encounters before he kidnapped the victim at gunpoint and made her drive to a Fontana storage facility, where he raped her, Ploghaus told jurors.

Orban's attorney, James Blatt of Los Angeles, said the assault ran counter to a life spent protecting community and country as a police detective and a Marine veteran of the Iraq war. The only plausible explanation for the defendant's behavior, Blatt argued, was the potent effects of Zoloft, which sent Orban spiraling into an "unconscious" delirium.

"At the time he was not aware, not aware of the torturous things he had done,'' Blatt told the jury…The victim sat in the front row of the Rancho Cucamonga courtroom, clutching a friend's hand, as the prosecutor recounted her testimony that Orban rubbed his weapon against her face during the attack.

Now here’s the relevant part:

The defense relied on Dr. Peter Breggin, a New York psychiatrist and critic of psychotropic drugs who has testified in other cases across North America. Breggin said he believed Orban suffered a psychotic break from reality shortly before the kidnapping and was in an unconscious state of delirium, void of control or memory, during the attack. "I don't even think he knows he's tormenting her," Breggin testified. "He would not under any circumstances behave like this if he was not driven over the edge by the drugs." Orban had temporarily quit taking Zoloft, prescribed by his psychiatrist, then resumed it at full dosage five days before the attack, which Breggin said sent him into a state of manic psychosis.

Breggin testified that Orban had stopped taking the prescribed antidepressant, then resumed it at full dose, provoking a psychotic break during which he was "delirious" and not fully aware of his actions.

The prosecutor criticized Breggin as "intentionally misleading" and told jurors that the scientific community rejects his medical theories. Ploghaus' medical expert, Dr. Douglas Jacobs, an associate clinical professor at Harvard, testified that Zoloft has been prescribed to millions of people and proved to be safe. There has been no evidence that Zoloft causes delirium or unconsciousness, he said.

While antidepressants can definitely cause someone who actually has bipolar disorder to become manic (more on that near the end of the post), and even though Breggin used the word "manic" in his testimony, symptoms of mania were not what Breggin and the defendant testified to.  


They said he was in an unconscious state of delirium.  That is not and has never been alleged to be a symptom of mania at all.  And the degree of the planning and execution of the series of events involved in the rapes is entirely inconsistent with delirium, which is defined as a disturbance of consciousness - reduced clarity of awareness of the environment with reduced ability to focus, sustain or shift attention - and is usually caused by metabolic abnormalities due to a medical condition or to an overdose of certain drugs, Zoloft not being one of those drugs.  


The actions of the defendant seemed  pretty focused to me! In fact, it sounded as if he were mentally quite sharp even though he had mixed the Zoloft with a lot of alcohol. (Being drunk is not at all the same as being delirious).


And then there was this from the defendant:

Within days, he said, he was overwhelmed, hearing voices at night, contemplating suicide and fantasizing about killing his wife and dog.

Sounds more like depression to me, not mania.  Perhaps a “mixed state,” but those are fairly rare.

And the kicker: the prosecutor questioned the defendant about parallels between his testimony and similar accounts in a magazine and book by a well-known critic of psychotropic drugs.  Orban acknowledged reading both works, but denied they had influenced his testimony.  Oh, and the critic who authored the book?  Breggin!


And now to the issue of antidepressant-induced mania. Apparently no one else testified that the detective had any history of having the disorder.  If he were bipolar and Zoloft was going to make him switch into mania, it would have most likely already happened when he was first taking the drug – not when he resumed it after a short break.  Resuming a “full dose” may lead to other side effects, but not that one.  As far as I know, the ability of antidepressants to kick someone into a manic state is not dose-related.

Besides, very few patients in a manic state become violent rapists. 

And patients in a manic state still can still tell right from wrong unless they are out-of-their-mind psychotic.  There was apparently no evidence he was delusional.  (If there is, then I might have to take back some of what I am saying about this case, and, if it turns out that the detective had a grandiose delusion that raping the woman would somehow save the world from an alien invasion, owe Dr. Breggin an apology).


As to the rape being "counter to a life spent protecting community and country?"  As we all know, soldiers in Iraq and police are never guilty of violent behavior.  Before he died, you could have asked Rodney King.  And I suppose we know for a fact that this was not just the first time he got caught.

What this is, barring further revelations about the defendant’s history of mental illness, is a variation of “The devil made me do it.”  Or perhaps a version of assassin Dan White’s defense in the case of his murder of two San Francisco politicians, “He did it because he was depressed, as evidenced by the fact that he was pigging out on a lot of Twinkies.”

Dan White assassinated  San Francisco Mayor George Moscone and  Supervisor (and gay hero) Harvey Milk on November 27, 1978, and was sentenced to only seven years

Apparently, the jurors also thought it was a stupid defense:

A jury of eight women and four men deliberated less than a day before dismissing that defense and finding Orban guilty of kidnapping, two counts of rape, two counts of forced oral copulation, two counts of sexual penetration with a foreign object and one count of making a criminal threat.

Orban is now facing a sanity hearing to determine whether he knew the difference between right and wrong at the time of the attack. He almost certainly faces a life prison sentence if the jury determines he was sane. If declared insane, he would be sent to a state mental institution for treatment, and later could be released. The same jurors have been impaneled for the sanity proceeding.

"What it comes down to is whether, at the time of this incident, he understood the difference between right and wrong," Orban's attorney, James Blatt of Los Angeles, said outside the courtroom. "I believe [the jury] will keep an open mind in reference to the sanity phase."


Addendum (6/27/12): The jury rejected the insanity defense, although some prosecutors apparently did blame the alcohol (rather than the Zolfot) for his "mental fog."  That's nonsense, too, considering the intricacies of his actions during the attack.  Looks like he had a lot of tolerance to the booze.

Have you heard the one about the agoraphobic who collected restaurant menus

Sounds like the set-up line for a joke, right? It's not. According to this Atlantic blog post, the Smithsonian Institution's National Museum of American History recently added to its archives a collection of 4,500 menus from restaurants around the world, collected over four decades by one Virginia Mericle of Washington, DC.:

Mericle was a life-long collector. As a star-struck 16 year old, she would write to movie studios and request photographs of actors. Bing Crosby, John Wayne, and Dean Martin were a few of her favorite stars. She received many replies; some of the pictures were even signed by the stars themselves.

After marrying and having children, Mericle developed agoraphobia and gradually stopped venturing outside her home. Yet she remained very connected to the outside world -- through the mail.

...Interestingly, Mericle seems to have taken little interest in the actual menus, and merely sorted them into American and international piles. Furthermore, the influx of menus had no impact on the family's culinary habits. It is quite possible that Mericle simply wanted to feel connected to the outside world, and accomplished this goal through mail correspondence. Perhaps her experience with the movie studios taught her to select institutions that would readily respond to impersonal mail solicitations.

The Willows, in Honolulu. Timmy Chan's in Houston. The Luau Hut of Silver Spring, MD. Apparently, if you bring a little yearning purpose and vision to it, your hoard can end up being thought of as a collection. Go forth, agoraphobics, and bring into being exquisite collections of yellowing documents! Just remember menus have already been done.

Nairobi Parenting Clinic Stress depression and the holidays Coping Tips

Nairobi Parenting Clinic: Stress, depression and the holidays: Coping Tips: Stress and depression can ruin your holidays and hurt your health. Being realistic, planning ahead and seeking support can help ward of...

Guest Post Breaking Free of Being the Perfect Child

Today's guest post is by Paul Taylor. This is the fourth post in which a writer recounts his or her own experience in a family with a problematic history, as well as its aftermath. Itillustrates a couple of themes of my blog very well: a family role that must be played by a member – or else - and the existential horror and despondency people feel when they try to break away from it. His criticism of cognitive psychotherapy for this sort of problem is also right on.

It is hard being the perfect child. According to my family, I was born perfect. I was quiet and obedient and always willing to help out. From the time I was very small my family relied on me to be the good, responsible child. Although I was not too much older than my siblings and cousins I was relied on to make sure they were safe, happy, and cooperative too.

As I got older and some of the extended family moved away my responsibilities changed. I was now supposed to go to school and do all my work without complaint or question, answering any inquires about what I was learning with an in depth explanation. Then I was supposed to help my younger brother complete his school work while also teaching him what he missed in class due to his ADD. After that came helping with chores like ironing, laundry, dishes, yard work, vacuuming etc. That I was also supposed to do without complaint for as long as it took. 

Every member of the family had set chores and I was expected to not only do mine, as quickly and quietly as possible, but also “help out” with everyone else’s. That meant doing the dirtiest, hardest or most complex jobs while they watched and shook their heads –feeling helplessly confused all the while.

If I finished everything I was then expected to have “family time” which consisted of sitting around the television, watching something my brother and I were not interested in. I was supposed to keep him quietly entertained so we could “be a family.” If, by chance, there was time left over before bed I snuck in reading a chapter or two of my books, which were my only escape from reality.

When I got into my teen years and nothing changed, I began to become uncomfortable with the arrangement. 

I had not made many friends outside of school before then, of course, due to my packed schedule. When I attempted to make plans with friends and let my family know ahead of time, some emergency inevitably came up: a last minute project, a chore that had to be done RIGHT NOW, or just a guilt trip of “not being with your family.”After a few attempts I decided it was not worth the effort and went back to my routine.

Finally when I reached my twenties I realized that my life style was not normal. I started to try to pull away. I knew that I wanted to become my own person and not just the person they told me I was. I wanted to make choices based on my own needs and desires instead of doing what would make them happy or what would not get me in trouble with my family. It was very hard for me to break out of the thinking patterns that had formed from my many years as the perfect child. 

I constantly had to remind myself that I was not responsible for anyone else’s happiness or emotional welfare. I could not change anyone no matter how much I did for them or how much I loved them. In fact I was only allowing them to continue to suffer because they never had to grow as long as I picked up their slack.

At first I planned to move out. I started to squirrel away money for an apartment and shopped around near my work during lunch to see what I could afford. Then a few weeks before I decided I would make my move, a family member had to have emergency surgery.

Well, of course I couldn’t leave then. There was an actual sick person to take care of; the house had one less person to help with clean up, and the person that did not work and stayed home needed a break in the evenings. It was only reasonable.

Six months went by and I decided that I would take a smaller step towards being independent. I planned on going on a trip by myself for two weeks. I would use the money I had saved to pay for the gas, and I had a tent so I could just go on a road trip and camp along the way. I got permission from my work and was all ready to go. I decided to give my family two weeks’ notice so that they could adjust to the idea.

Bad idea.

As I started to pull away, my family teamed up against me. From telling me I was wrong in my thinking to guilt trips to outright anger and abuse, they piled on the difficulties and tried to make me conform to their way of thinking; the way that was easiest for them. I fought back for a while but eventually got worn out, and found myself being sucked back in.

I postponed my trip indefinitely.

However, this time I was aware of what was going on around me. I felt like I was living in another world. I watched in horror as I went through the same day-to-day routine of being the perfect child and cleaning up the messes they left behind. I felt disconnected from reality and just went through my days with a kind of hopeless, formless, pointless movement. Somehow I thought that as long as my body was moving I was still all right and functioning.

What I did not realize is that I had become seriously depressed. I had been depressed in the past but had repressed the dark times in my life to the point where I did not even remember them happening. I tried to function on auto-pilot without my own conscious approval. However, this time around the auto pilot would not engage. I had become too self-aware to let my brain slip into a waking coma.

It got to the point where I would be driving and would consider just letting go of the wheel and seeing what happened. After all, it did not matter one way or the other. What was the point of living like this?

After having several similar thoughts, I sought professional help. Although it did help to have my irrational thinking pointed out to me, it did not help in the sense of giving me something concrete to do.

“Move out,” they said, “Get away.”

Well, that is all well and good for someone to say, but the practicality of it was beyond me. I had been beaten down by the combined forces of my family. From bills to pay to broken down cars to guilt trips and attacks of hysteria I had so much to deal with that even planning a way out was beyond me.

I checked out. I really did. I went to work every day and somehow managed to crank out my job with no brain power. I got home and took care of the chores and bills and things that needed to be done. I chatted pleasantly about the weather, feigned listening attentively to problems, and worked steadily until it was time to fall into bed and start the whole day over again.

Weekends and weekdays were indistinguishable except for the physical activity required. It was much more restful at work, sitting at a desk, then at home running errands, cleaning up messes, and trying to pretend everything was fine.

Hopeless does not even begin to describe it.

I tried to express to my family why I was so angry, or stressed, or just listless. Their solution:

“Just stop thinking so much. Everything will work out.”

Eventually I got fed up with the whole thing. Working with friends I came up with a way to get out of the house. One day I just moved, taking only a couple of bags of clothes and tossing them in the trunk of my car I left.

After the meltdown, things changed. I was still the ‘perfect child’ in some ways but I learned the benefits of boundaries and getting away from people. The physical distance helped me to create a personal space where I could feel safe and grow. It was still very hard for a long time but it has gradually gotten better. My family still attempts guilt trips and manipulation but now that I have time to see things as they really are I can resist them and deal with them in a healthier way.

Author Bio:

Paul Taylor started www.babysittingjobs.com which offers an aggregated look at those sites to help families find sitters and to help sitters find families easier than ever. He loves writing, with the help of his wife. He has contributed quality articles for different blogs & websites.