18
2011
18
2011
OVERCOMING BARRIERS TO BDD TREATMENT: OVERCOMING TRIVIALIZATION OF BDD
19
2010
MANAGEMENT OF BED-WETTING: BEHAVIORAL TECHNIQUES
09
2009
ANXIETY IN THE BODY: NERVOUS RASHES
There is a close relationship between the skin and the nervous system. In the early development of the fertilized human ovum into the embryo, adjacent cells are split off so that some will ultimately develop into the skin and others into the nerve cells of the central nervous system. When our skin is gently stroked our nerves are calmed, but when our skin is tickled our whole nervous system is convulsed. It is therefore not surprising that activity of brain cells is often reflected in the activity of the cells of the skin. In other words, emotional stresses in the mind are apt to produce nervous rashes in the skin. This is such common knowledge that it is reflected in our everyday speech when we talk of something “getting under our skin”; and we can observe emotional reactions in the skin when people blush with embarrassment, go pale with fear, or turn livid in anger. Thus the self-management of nervous rashes involves both a reduction in the general level of anxiety and a reduction of responsiveness to emotional stress.
A doctor’s wife came to see me because of a nervous rash which she had had for the past two years. I showed her a little about relaxation, and as she lived in the country it was arranged that she would return to the city in a month’s time for an extended visit so that I could help her further. But she wrote cancelling her appointment, saying that the rash had already cleared.
She came to see me some two years later when she had a slight recurrence. The rash quickly settled down just as on the previous occasion.
*25/57/2*
09
2009
ST JOHN’S WORT IN EVERYDAY LIFE: A PROBLEM OF SUBSYNDROMAL DEPRESSION
While depression is in itself a common condition – according to one estimate it affects about one in ten people in any given year -many others are affected by depressive symptoms to a degree that would not qualify them for this more serious diagnosis. According to Dr Lewis Judd, former Director of the US National Institute of Mental Health, and colleagues, approximately one in five people interviewed reported suffering from one or more depressive symptom in the preceding month. Huge numbers of people are suffering from very distressing problems of mood, behaviour and bodily functions of the type that are associated with depression. Nor are these symptoms benign in terms of their impact on a person’s ability to function. Judd and his colleagues found that people with ’subsyndromal depression’ reported more difficulties in their work and social relationships than were reported by a control group, and that significantly more people with these symptoms had been on disability. Given the reluctance that people have to seek medical attention even for full-blown cases of depression, and the ill-judged care they might receive once they make such a decision, it seems unlikely that a high percentage of people with subsyndromal depression will be properly treated through conventional medical channels. Such people are therefore excellent candidates for self-treatment with St John’s Wort and there is no reason to believe that it will not prove to be helpful for many of them, given its excellent track record in more severely depressed patients.
*21/75/2*
09
2009
ÑHILDREN’S SLEEP PROBLEMS/BUILDING THE BASICS: NORMAL DEVELOPMENT AFFECTS SLEEP
When children make developmental strides, it can send them into disequilibrium—and sleep is disrupted. This can affect a child in several ways. He may be so excited about learning a new skill that he has a hard time settling down—he may even be driven to practice skills in his sleep. During normal arousal, instead of going right back to sleep, the new “stander” stands in his crib. It may be easier to understand if you relate it to yourself: think about a time you were learning a new skill—when you were dreaming at tennis, going over that shot you missed, or worrying about the match next day.
Mastering one skill brings a child quickly to the next frustration. When stands in her crib, she may cry desperately because she hasn’t yet learned how to get herself down. She needs you to help until she can help herself again, needs a little extra reassurance, so separation difficulties are common.
Dealing with developmental sleep issues may be particularly frustrating because parents do not have control over a child’s development. Sometimes only “cure” is allowing the development to continue on its own with encouraging messages from you. It helps to recognize that the transition probably be short-lived. Overreacting and doing too much can only prolong problem if she becomes dependent upon your help to go to sleep.
Although each child is an individual, there are guidelines and Ü information that apply to all. Table 3 summarizes the affect of development sleep. With this foundation, you can begin to look at the specific is concerning you about your child.
*21/67/8*
09
2009
ÑHILDREN’S SLEEP PROBLEMS: SLEEPING TROUGH THE NIGHT
“Sleeping through the night” is a phrase that is probably best banned from our vocabulary. Let’s face it, no one really sleeps through the night. If you poll a group of adult friends and ask them how they slept last night, you will undoubtedly hear such things as: The wind woke me up.
At 3:00 am I looked at the clock and was relieved to see I had two more hours before the alarm would ring.
If you poll a group of parents, and get past the “She has always slept through the night,” you will hear a variety of comments:
When he is teething, he has a little trouble sleeping.
She seems so hungry at around 2:00 am—must be a growth spurt.
He has been waking with bad dreams.
If sleeping all night long, every night, is your expectation for your child,
you may be setting yourself up for frustration. Sleep needs and patterns
change with age, illness, and emotional or even environmental factors. Just as
with other parenting issues, our goals, expectations, and approaches must be
constantly re-evaluated.
It is misleading to think of sleep as a state we simply fall into at night and wake from in the morning. Sleep research has shown that there are definite patterns and fluctuations during the night. They play important roles to help refresh us and can reveal some causes behind sleep disturbances.
The descriptions of these cycles can be quite technical. Because a basic understanding is crucial, an effort has been made to give a very simple explanation of what occurs and how your child might be affected.
*1/167/8*
09
2009
CHILDREN’S SLEEP: WHY WORK ON IT?
The bags under your eyes, the weight you have been losing or gaining, the grumpiness and sheer exhaustion—these are the obvious reasons to make some changes. Your child’s physical and emotional well-being are also reasons.
Dr. Burton White, author of The First Three Years of Life, feels that sleep problems understandably occur in families where children are loved and whose needs have been met. So, in some ways, the emergence of sleep problems is not necessarily a bad sign. He notes that it is the continuance of sleep disturbances that can cause deeper problems.
Dr. Marc Weissbluth, author of Healthy Sleep Habits, Happy Child, states that the development of healthy sleep habits is not automatic. If your child has not learned them, then his functioning during wakefulness is not “optimal.”2 Put simply, a sleep-deprived child (waking several times a night or missing out on even an hour) is not at his best. His cognitive processes will be fuzzy and his social functioning will be marked by grumpy unpredictability.
A child can “adjust” to whatever sleep patterns he has fallen into. (Look at how you have “adjusted.” Do you say “I didn’t know it was possible to exist with so little sleep”?) However, there are signs—some subtle, some blatant—that he is not at his best.
It is the parents’ job to insist on healthy sleep, just as they insist on healthy nutrition, to give the child the strongest base from which to grow. Good sleep habits do not necessarily happen spontaneously. This is a skill that can be learned by children and facilitated by parents.
*6/97/8*
09
2009
POWER OVER PANIC/ QUESTIONS AND ANSWERS: WILL HYPNOSIS HELP? AND PEOPLE BECOMING HOUSEBOUND
Question
Will hypnosis help?
Answer
Hypnotism can produce a very positive response in the short term. The result will not last if we have no understanding of the disorder and don’t know how to manage the attacks and anxiety ourselves. In conjunction with panic/anxiety management skills, hypnotism can help while we work with aspects of the disorder. If we use an audio tape of the hypnosis session during periods of high anxiety and attacks, the tape must teach us how to control the anxiety and the attacks. The control does not come from a cassette tape.
Some people use subliminal tapes in an effort to ease their symptoms. We must know what the subliminal message of the tape is and, more importantly, we should consciously know and learn how to manage anxiety and the attacks ourselves.
Question
I have heard about people becoming housebound. I am the opposite. I can’t bear to be in the house. As soon as my husband goes to work I have to get out of the house. I spend my days travelling on buses or walking around shopping centres. Is this part of the disorder?
Answer
This does happen to some people. If they have difficulty in being alone, going out and being around other people is better than staying home. It can also happen to people who were housebound, but for another reason. As people progress in their recovery, some may go through a stage where the thought of being home all day brings back too many memories of their disorder. They prefer to go out as much as they can. This stage does pass.
*112/94/8*
09
2009
POWER OVER PANIC: WHO AM I?
Panic anxiety management skills allow many of us to be free of our anxiety disorder. The skills can give us a control over our lives that we have never had before; but sometimes even this isn’t enough. A little-known aspect of the working-through process can hold us back, and be the final factor in the perpetuation of the disorder. It is our lack of sense of self.
Although this aspect is not related only to anxiety disorders, it can be the single most important issue in the disorders. Despite our ongoing attacks and anxiety, it can be the one issue we are most concerned about. It is as if we intuitively know the root cause of our suffering.
The lack of identification goes beyond our cry of ‘this is not me’. When we say ‘this is not me’ we are referring to the image we had before the disorder. Despite the image we had of ourselves, we have always known that we never felt any sense of who we are. We never had a real sense of self. This essential element was always lacking in our lives, and it is from this that our feelings of inadequacy, lack of confidence and lack of self-esteem arose.
We counteracted these by our need to be perfect. Over the years we adapted and modified our behaviour to what we perceived were other people’s expectations of us. We became who we thought we should be, and in doing so suppressed much of who we could be. Our identity became dependent on other people’s perceptions of us. The more dependent we became, the more we had to suppress our real self, even if we didn’t realise we were doing it. The more we suppressed our self, the more inadequate we felt. The more inadequate we felt, the more we felt the need to be perfect.
*100/94/8*