You're not doing it right.

The New York Times has been doing a nice job of covering one of my favorite topics: mindfulness. Their latest article highlights one of my other interests: technology and its use in psychological research. The NYT reports:

Whatever people were doing, whether it was having sex or reading or shopping, they tended to be happier if they focused on the activity instead of thinking about something else. In fact, whether and where their minds wandered was a better predictor of happiness than what they were doing."

I believe that the paper's use of the generic term "happiness" (and possibly the research article summarized therein) might be oversimplifying the experience that comes when one focuses one mindfully on an activity since other research on mindfulness finds that the emotional experience is more akin to contentment than happiness, but the point remains: if you want to feel positively, focus one-mindfully. What you're doing isn't as important as how you're doing it.

On avatars and anxiety

I've long been fascinated with the idea of using computers to deliver treatments. I've always been described as a gearhound and if you were to see my office, you'd understand why. While it may seem counter-intuitive that a psychologist would like to see computers doing more of my job, I think actual people will continue to have a place in treatment.

The New York Times reports on using computers to aid in anxiety treatment:

The anxiety rose in his throat — What if I’m not making sense? What if I’m asked questions I can’t answer? — but subsided as his therapist, observing in the background, reminded him that the audience’s reaction might have nothing to do with him. And if a question stumped him, he could just say so: no one knows everything.

There's something unique about anxiety disorders when they are found in isolation, as they are in studies such as these. Specifically, the typical response and thought patterns found are visceral and fairly predictable. These thoughts tend to be less rational and thought-out than our more mature thoughts might be, making them relatively¹ easy to refute. Similarly, the typical physiological response is pretty clear to the person suffering the anxiety, again making it an easier target to address, perhaps using mindfulness techniques to enhance your interoceptive awareness.

That said, there are a number of situations in which computer-aided psychotherapy for anxiety might not be effective. Even in the above linked article, there was a psychologist coach present for the role-playing event. The bottom-line is that we are still many years away from being able to get away from actual trained clinicians for the treatment of many of our mental disorders. And don't you think it'll still nice to be able to talk to a real person from time to time, anyway?

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1. I don't think that they are easy by any real stretch of the imagination. As far as psychotherapy goes, though, restructuring the cognitive distortions associated with a non-comorbid anxiety disorder is relatively easy. ↩

Where has all the psychotherapy gone?

In "Where has all the psychotherapy gone?", the APA Monitor asks:

"Don’t you love ‘If your antidepressant isn’t working … try Abilify!’? How about: ‘If your antidepressant isn’t working, try psychotherapy!’"

The author highlights disturbing trends in spending by drug companies and how insurance companies are encouraging the use of medication over psychotherapy. I believe this to be to the long-term detriment of patients and the insurance companies themselves. After all, we all already know how to take pills. It's the skills we need to actually make real changes in our lives. Medication is an extremely useful adjunct to therapy, but it should not be a replacement for it.

It's not just for kids, anymore.

Psychologists have long known that one's age isn't a protective factor against eating disorders, but conventional wisdom, and perhaps treatment and research, have biased us against considering how an eating disorder affects middle-aged women. The NY Times reports:

‘At a certain point,’ she said, ‘you cross that line and you can’t help what you are doing, and the eating disorder owns you. I lost my bearings on reality and maturity.’

While this is an older article, it's worth keeping in mind when thinking about how mental health needs to be monitored across the lifespan.

Prevention tips: exercise during leisure time

The BBC reports:

People who were not active in their leisure time were almost twice as likely to have symptoms of depression compared to the most active individuals, the study found.

This finding is hardly surprising, but the researchers point out two particular tidbits that may be new:

1. Exercise during leisure time is the important part, not just physical activity in general.
2. The intensity of the exercise appears to be unrelated to its protective effects.

That means it's time to get up and get moving, even if it's just a little while for a little bit.

Depression in pre-schoolers

It is probably really easy to scoff at the notion of depression in pre-schoolers and write off irritability (which can be a manifestation of sadness) as kids being difficult, but there is a qualitative difference between being crabby or sad and clinically depressed. The NY Times writes:

parents tend to feel responsible. Children of depressed parents are two to three times as likely to have major depression. Maternal depression in particular has been shown to have serious effects on development.

Keep in mind that these are just probabilities and stats and don't mean that every child of a depressed parent will be depressed. The Times continues:

But it’s easy to overstate the role of maternal depression. “Most kids of depressed parents don’t get depressed,” says Arnold Sameroff, a developmental psychologist at University of Michigan’s Center for Human Growth and Development, who has studied children of parents with mental problems.

The bottom line with this issue is that you need to trust your parental intuition. If you suspect your child isn't just being a 3 year-old, ask a professional.

Immersion and Mindfulness

I'm a big fan of games. I think a good game can be a nice distractor (a distress tolerance skill) when we need one, can be a nice reward if we're struggling with motivation (an emotion regulation skill) and help us practice mindfulness if we're, umm, mindful while playing. I came across this article a little while back which highlights some of the reasons games have the effect they do on us.

People who experience immersion tend to only consider choices that make sense in the context of the imaginary world. Someone immersed in Red Dead Redemption, for example, might be more likely to use travel methods, like stagecoaches, that make sense within the game, instead of methods that don’t (like fast traveling from a menu screen). People immersed in media also tend to enjoy it more.

It's not "research" in the sense that there's no hard data, but there is some sound theory in the reasoning and a couple of links to relevant research articles.

PSA for Paxil CR users

The New York Times reports:

Some of the antidepressant Paxil CR produced at the plant was ineffective because a layer of active ingredient split from a layer of a barrier chemical during manufacturing, the government said, and some lots contained only the barrier chemical.

This is obviously quite concerning for some of the readers of this site. The good news is that the drugs were all manufactured between 5 and 9 years ago, so you probably don't have any more of it. Please read the press release for more information.

Forbes.com: The Forgotten Patients

Forbes magazine has a lengthy article on suicidality and its treatment. The magazine reports:

Wixom spent the next year in group and individual sessions learning practical skills to manage her emotions so that they didn't spiral out of control. They included distress tolerance techniques like plunging her head into ice water, devising ways to distract herself when bad thoughts arose and learning not to leap to the conclusion that one bad day implies a life of misery. She has not been hospitalized since. "DBT is the best thing in the world. It changed my life," says Wixom, who got married halfway through therapy and is raising two daughters, ages 10 months and 2 years.

The article discusses the difficulty in finding support for the treatment of suicidality but does highlight the importance of not ignoring the issue. Related to the purpose of our practice, however, is the prominence of DBT in the treatment of chronic suicidality. There is help, you just have to know where to find it.

A Curveball’s Curve? It’s All in Your Head

Wired says:

A curveball is a unique pitch, in that the ball exhibits two distinct types of motions. The ball approaches batters, dancing across their field of view — from peripheral to center (or vice versa) — all the while rapidly spinning on its own axis.

Baseball is a game of inches, but it doesn't even take that much to fool us. The brain is so fascinating.