Article: PTSD and Rap Music

I just came across this article on Yahoo!News. Check it out...really interesting how an Iraqi Vet is using music to help him with his PTSD. 

Click the link

Iraq Veteran Uses Rap to Treat His PTSD

Two for Tuesday!

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Eating Disorders: Interview with an Art Therapist

As promised, here at ClinicallySpeaking we not only like to write and talk about the published articles and different treatments, we like to speak to those professionals who are in the field and "in the trenches". 

ClinicallySpeaking had a chance to catch up with Jennifer Lipstein, LCAT-ATR, BC (Aka Licensed Certified Art Therapist). She works with people suffering from Eating Disorders at the Renfrew Center, they are a well known agency for treating people with eating disorders.

CS: Thank you Jennifer for giving ClinicallySpeaking some of your time to talk about eating disorders and your experience.  

JL: Absolutely no problem!

CS: In your experience, have you encountered that there are more people suffering from bulimia or anorexia?

JL: In my experience, I have encountered more people suffering from Anorexia then Bulimia, although that is not to say that one is more prevalent then the other.

CS: Is there a more prevalent in certain cultures/ethnicity or do you see it even across the board?

JL: It is definitely uneven, it is more prevalent in middle white class, and over achiever type of personalities. Families that have certain expectations on the actual individual.

CS: Other than having diagnosis, what are the other challenges that come up while treating them?

JL: Many individuals who suffer with eating disorders also struggle with anxiety and depression. Many individuals have encountered some sort of trauma (trauma being a very broad term). ED has very little to do with the actual food (if at all). The food is used as a tool to dissociate and detach from feelings, as well as provides an individual with a sense of comfort and control; in a lot of ways that ED is empowering. While re-teaching ones body to recognize hunger cues and accept food- it is important that one is also learning the meaning behind the food-what does it mean to feed your self/ to allow your self to feel, to take care of you self/ to listen to your emotions, to provide your self with nourishment/nurture? In order to heal the ED it is important to understand its roots, and devise healthy eating habits and coping mechanisms to deal with the underlying problem.

CS: As an art therapist, what techniques do you rely on that are most effective with this population?

JL: Art allows for one to express thoughts and feelings that are indescribable. It turns abstract feelings in to something tangible and approachable, as well as provides one with an opportunity to approach the situation from a different perspective, and in a non-threatening manner. Through creative expression one gains insight into ones self and the situation. I typically provide my patients with some sort of open directive and a choice of materials. It is important to create a structured/safe environment, while also giving the individual the space and freedom to independently explore. Using a variety of different art mediums i.e. paint, collage,plaster... one is encouraged to identify and explore feelings in ones body, explore relationships such as; ones relationship with family, friends, and food. Furthermore, art is used to explore body image, trust, boundaries... the possibilities are endless. I personally encourage my patients to escape their mind and allow their emotions to guide their hand. After finishing, it is then important to reflect back on their work- recognize patterns and themes, identify emotions while creating the art work as well as while reflecting, and create coping mechanism to help appropriately respond to challenging situations.

You can contact Jennifer at Jylipstein@gmail.com for questions, comments, and treatment.

If you or someone you know appears to be suffering from an Eating Disorder. Here is a link to take short quiz to identify if you need to obtain professional services. Eating Disorders Questionnaire

Top of the week to ya lads and lassies!

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Eating Disorders: Treatment and Prevention

Continuing with the theme of eating disorders this week, we will be talking about different treatment and some preventions that are being made globally to help those with eating disorders.

Much like other mental illness, behavioral problems, and addiction treatment people suffering from this disease can utilize any modality of treatment (i.e. individual and group therapy). However, there are two leading types of therapy that are used most in treating eating disorders. The first, FBT, or Family Based Treatment. There was a study that was published in October 2010, that showed that "more than 50 percent of patients receiving family based treatment (FBT) were in full remission after a year-long treatment period, compared to 23 percent of those receiving adolescent-focused individual therapy (AFT). After a year of follow-up, only 10 percent of patients who achieved remission during family based treatment relapsed, compared to 40 percent of AFT subjects", as reported by University of Chicago. That is though working with the adolescent and young adult population, what about the adult population? It appears from my research on the topic while adults who do suffer from it, the majority of the population who is Dx with an eating disorder are adolescents and young adults, 95% of those who have eating disorders are between the ages of 12 and 25.8. Quite alarming...

Another well known and adopted from of treatment is the use of Art therapy either in individual counseling or group therapy. Art therapist helps the patient to become creative and express themselves through a painting, or sculpting. Not only is the activity that they are involved with potentially soothing, it will allow the therapist to get a glimpse of how they are reacting and feeling through the pictures and the non-verbal communication. During these sessions, art therapist promote finding new ways of nurturing themselves rather than hurting their bodies.

Last week was a big week in the world of eating disorders and prevention. The fashion world has always been under a microscope regarding models and their health. Last Thursday as reported by Latina.foxnews.com that "19 editors of Vogue magazines around the world made a pact to have healthy models on their pages, according to a Conde Nast International...Vogue believes that good health is beautiful. Vogue Editors around the world want the magazines to reflect their commitment to the health of the models who appear on the pages and the well-being of their readers," said Conde Nast International Chairman Jonathan Newhouse in a statement...Models' health - and especially their weight - has been a lightning rod the past few years, especially after the death of two models from apparent complications from eating disorders in 2006-07."  

At the end of march, Israeli lawmakers have passed legislation "that requires that male and female models in Israel must have a body mass index (or BMI, a measure of weight proportionate to height) of no less than 18.5—a standard used by the World Health Organization—or a note from a doctor saying they are not underweight before they can be hired for a modeling job. A six-foot-tall model, for example, must weigh no less than 136.5 pounds. The legislation also bans use of models who "look underweight," and creators of ads must disclose whether they used Photoshop or graphic programs to manipulate images to make the models look skinnier...Lawmakers are hoping the measure encourages a healthier body image among teens and fights the spread of eating disorders like bulimia and anorexia. According to a study cited by the Associated Press, 2 percent of girls aged 14 to 18 in Israel have eating disorders", as reported by Yahoo! news.

A scary but interesting stat that eating disorders have the highest mortality rate of any mental illness...

Happy Thursday!

YES 

Eating Disorders: Take your seats class time to learn!

Today we are going to explore the different Eating Disorders according to the DSM-IV-TR. Here we go...

Anorexia Nervosa

-Refusal to maintain body weight at or above a minimally normal weight for age and height: Weight loss leading to maintenance of body weight <85% of that expected or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected.

-Fear of gaining weight or becoming fat, even though under weight.

-Disturbance in the way one's body weight or shape are experienced, undue influence of body weight or shape on self evaluation, or denial of the seriousness of the current low body weight.

-Amenorrhea (at least three consecutive cycles) in postmenarchal girls and women. Amenorrhea is defined as periods occurring only following hormone (e.g., estrogen) administration.

Subtype- Restricting type-During the current episode of anorexia nervosa, the person has not regularly engaged in binge-eating or purging behavior (self-induced vomiting or misuse of laxatives, diuretics, or enemas).

               Binge-eating–purging type- During the current episode of anorexia nervosa, the person has regularly engaged in binge-eating or purging behavior (self-induced vomiting or the misuse of laxatives, diuretics, or enemas).

Bulimia Nervosa

-Recurrent episodes of binge eating characterized by both:

                 * Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances

                 *A sense of lack of control over eating during the episode, defined by a feeling that one cannot stop eating or control what or how much one is eating.

-Recurrent inappropriate compensatory behavior to prevent weight gain: Self-induced vomiting, misuse of laxatives, diuretics, enemas, or other medications, fasting, excessive exercise.

-The binge eating and inappropriate compensatory behavior both occur, on average, at least twice a week for 3 months.

-Self evaluation is unduly influenced by body shape and weight.

-The disturbance does not occur exclusively during episodes of anorexia nervosa.

Subtype-Purging type- During the current episode of bulimia nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas.

               Nonpurging type- During the current episode of bulimia nervosa, the person has used inappropriate compensatory behavior but has not regularly engaged in self-induced vomiting or misused laxatives, diuretics, or enemas.

Eating Disorder Not Otherwise Specified (NOS)

Eating disorder not otherwise specified includes disorders of eating that do not meet the criteria for any specific eating disorder. For instance, maintaing normal weight despite meeting criteria for Anorexia, or repeatedly chewing and spitting out, but not swallowing, large amounts of food.

Finally, both anorexia nervosa and bulimia nervosa are more commonly seen in girls and women. Estimates of female-to-male ratio range from 6 : 1 to 10 : 1.

This concludes today's lesson...

Have good one y'all

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Eating Disorders Week

The next few posts will be all about eating disorders. We will learn about what the different disorders are, who it effects, recent studies and treatment for this disorder. We will also be interviewing an art therapist who has primarily worked with those who suffer from eating disorders. Today's post will be coming soon and it will review the different eating disorders....stay tuned!!!

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Interesting links and articles

Hi guys,

Don't have too much time today, but I thought I'd post some interesting articles for your weekend(when your sitting out and tanning...supposed to be in the 70's here in the Northeast)

Just click the link and you're on your way!

1) The Science of Swearing

2) Blood Pressure Drug Linked with lower PTSD Symptoms

3) The Psychology of Video Games

May the Fourth be with you on this TGIF!!!

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Sports and Mental Health

In the wake of three incidents that have captured the sports nation; the alleged suicide of former NFL player and two NBA stars who have been unable to control their anger, thought it might be apropos to talk about it. Over the past 24 hours, I wondered if athletes in general don't obtain services and if that is true...why? One answer could be the same reason why anyone doesn't obtain services: Stigma. But are there other reasons?

In New Zealand, psychologist Karen Nimmo said "A survey by the New Zealand Rugby Players’ Association found 35 percent of recently-retired players suffer feelings of despair or depression...Sport (associations) need to be realistic about the number of … serious problems that athletes face. There are a number of good sports psychs, but I don’t think sports have yet realized that they need to place attention on clinical issues in sport", as reported by New Zealand Herald newspaper.*

Dr. Chris Stankovich, a sports and culture psychologist made a point after he wrote an article in 2010 in the response to an NFL receiver, Kenny McKinley, who committed suicide, that "hopefully some of the smarter GM’s will see that by adding a line in the budget devoted to mental health will yield a return on investment and more than pay for itself – on and off the field". Furthermore, he wrote yesterday in regards to the alleged suicide by another former NFL player Junior Seau, that he believes that pro-athletes are not being educated once they are "retired" on how to adjust to a normal life(eerily similar to veteran coming home from war...interesting).**

Countless athletes in past and current suffer from anxiety and depression. Within the last couple of years Major League Baseball and the National Football League have started realizing that mental health is a problem when in the past it has been relegated to "shake it off, and get back in the game". Athletes are now seeking treatment. For instance, New York Mets' pitcher Mike Pelfrey, and Milwaukee Brewers' pitcher Zach Grienke both treated for an anxiety disorder. Running Back Rickey Williams reported that he was battling depression while playing, and Wide Receiver Brandon Marshall reported that he was diagnosed with Borderline Personality Disorder.

With the suspension of Metta World Peace aka Ron Artest, who elbowed a player, is most notably been in psychotherapy for some time now for anger management. Though, he has donated time and money for mental health awareness it gives you an idea that although people who have mental health problems who seek treatment, it takes time and real effort to reduce those problems. 

Conversely, Do you think Amare Stoudemire needs anger management counseling? Maybe, it is possible  that he overreacted, that doesn't mean he needs counseling. If it becomes a trend then there might be a case, but mental health professionals still need to assess what is going on to prevent it from happening again.

Each league, front office, and retirement services need to address mental health issues while they are playing as well as when they are retired. Mental health isn't like a broken bone, cast and in 6 weeks you're good to go, its a life long battle that people who suffer from it need to work on. They need to employ professionals and help deal with the issues on and off the field/court. 

*Fears for top athletes' mental health

**Junior Seau's Suicide is another example of the difficulties of sports retirement

Happy Thursday! (& Lets go Devils and Knicks!)

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