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Planning ahead
I have a really bad headache but hope that the paracetamol will kick in soon. I have so many things to organize! My list is getting shorter every day. Next Tuesday I’m organizing a day in the park for families with free barbeque-food and refreshments. I have to buy a lot of stuff and need to find people willing to volunteer. I have already recruited some people and hope more will be willing to help. In addition to barbequing, there will be face painting and competing. I really hope that the weather will be good! The weather forecast predicts cloudy weather with a bit of sun, but it can suddenly change. If it starts to rain, we can end the event earlier and postpone it. I want to try to organize something like this later this summer, too, and hope that we can get some sponsors. Luckily there are many energetic people here, that want to make life better for others. I hope that organizing activities like these for everyone, will bring people together. Mental health depends on living a meaningful life together with others, and if you manage to inspire anxious and lonely people, they get a chance to heal.
Like I have written before, I want medication to just be a supplement to more extensive therapy. In my view, we also need to change attitudes and prejudices influencing us at an unconscious level. The best way to do this, is by engaging people and empowering them. Marthin Luther King and Gandhi, both inspired others and changed attitudes step by step. So can we.

LocalReligious devotees worry about the yoga-ization of meditation in the U.S.
June 6 at 9:04 PM
Inside the newly opened Meditation Museum in Silver Spring, exhibits refer to the pursuit of “God,” the “Supreme Soul” and often “The One.” A constant visual theme is orangeish-reddish light emanating from a vague, otherworldly source. The message is clear: Meditation is about connecting with the divine.
“If the mind can be in a state of experiencing the energy of God’s light or presence,” said Sister Jenna Mahraj, a nightclub owner turned spiritual teacher whose organization opened the museum this year, “it’s like everything we tend to find so disheveled — it starts to find its own purpose.”
Yet in gyms, businesses and public schools in every direction from the museum — which sits on busy Georgia Avenue — meditation is often presented as something akin to mental weight-lifting: a secular practice that keeps your brain and emotions in shape. Gyms list it alongside Zumba classes, and public schools say it can help students chill out before tests by calming the mind and training it to look upon disruptive thoughts from a non-judgmental perspective.
This rough juxtaposition between the religious and secular versions of meditation epitomizes a key debate about the ancient practice as it explodes in the United States: What is the purpose of meditation? And who decides?
To Mahraj and her community, called the Brahma Kumaris, promoting the religious component is part of the purpose of the Silver Spring center, which is more about spiritual advocacy than a museum in the classic sense.
“This country needs to stop thinking meditation is about emptying your mind,” she said during a recent tour. “I respect all meditation practices, but I don’t necessarily believe in a practice that tries to ‘empty’ your thoughts. . . . I don’t think that’s normal.”
Mahraj is not alone in her concern that meditation might be getting too secular, which can be shorthand for saying that today it is often taught value-free — unattached to a philosophy or worldview. Hindu and Buddhist leaders in particular have raised concerns that meditation may be going the route yoga has in the West, where it has largely morphed from being a tool for enlightenment to one for a firmer tush.
“What are we teaching? That’s a very serious question for anyone who is taking these techniques out of a religious context and into the secular world,” said Clark Strand, a former Zen Buddhist monk who now writes and lectures on spirituality and the way Eastern philosophies are transformed in the West.
“Once you remove them from the spiritual context, then goals default to those of the culture, and that could be to win a war, or make money, or to self-medicate so you can do a job you hate or for which you aren’t paid enough,” Strand said. “Who does [meditation] serve today? Who does it belong to? Is its purpose spiritual or just a commodity?”
Ironically, when meditation began its expansion a decade or so ago from Buddhist retreats and alternative communes to the American mainstream, institutional religion was wary that the practice was too religious — but not in a sufficiently monotheistic Judeo-Christian way.
“The biblical worldview is completely at odds with the pantheistic concepts driving Eastern meditation. We are not one with an impersonal absolute being that is called ‘God.’ Rather, we are estranged from the true personal God” because of our inherent sin, evangelical philosopher Douglas Groothuis wrote in Christianity Today in 2004 — a piece typical of what was found in religious media as meditation began its ascent. “The answer to our plight is not found in some ‘higher level of consciousness’ (really a deceptive state of mind), but in placing our faith in the unmatched achievements of Jesus Christ on our behalf.”
But meditation has spread too far and too successfully into areas such as the treatment of depression, addiction and post-traumatic stress disorder for the debate to remain simply: Is it too secular or too religious? This is because meditation’s boom comes at a time of remarkable openness to questions about religion itself, with people — particularly young ones — probing much more about what, exactly, constitutes a “religious” practice, belief or prayer.
For example, while some say meditating for stress relief is “secular,” doesn’t that address a very modern-day type of suffering? Or is something else theologically meant by the word “suffering”? If you practice a type of focus meditation that involves, for example, chanting a basic word such as “love,” is that secular or religious?
And what is really meant by meditation leaders who tell students to practice “emptying their mind”? People such as Mahraj would see such a phrase as devoid of any philosophy, but others would say secular-sounding phrases aren’t necessarily “empty.”
“That’s a straw man,” prominent brain-science writer Daniel Goleman said of the idea that secular practice teaches nothing in particular. “It pays to stop your stressed-out mind state, let your psychology calm down and your mind clear, that’s just human engineering. In the Buddhist context that’s a preliminary state to a spiritual journey.”
Goleman is the author of “A Force for Good,” a book due out this month about pragmatic — one might say secular — applications of the Dalai Lama’s teachings.
The blurry lines between religious and secular are at play in Mahraj’s work, too. The Brahma Kumaris, an 80-year-old spiritual movement with roots in India, teaches that meditation and prayer are about coming closer to God and “that each one of us is an eternal spirit or soul.” In an effort to spread its teachings in the Washington region, the group opened its museum in downtown Silver Spring six years ago. It relocated to the new space in April.
But in addition to espousing the beliefs of those behind the center, the museum offers a broad range of more secular self-help activities such as courses on vegetarian cooking and budgeting. Mahraj, whose parents were Hindu and Catholic, speaks in area schools, to challenged youth in particular. She hosts a Web-based talk show called “America Meditating.”
But Mahraj says that the purpose of the meditation her group teaches is religious. The regular practice of the Brahma Kumaris is to meditate at home for 45 minutes at 4 a.m., then attend a class together at 6 a.m. that is part silent meditation and part teaching, she said.
“We’re not teaching people to empty their minds,” she said. “We’re teaching them to fill their minds with the right kind of things.”
The soaring interest in meditation has prompted many religious groups to revive their own ancient meditative practices. Jesuit meditation retreats and church-run classes on “centering prayers” — a contemplative Christian practice — are popping up everywhere, as are programs on Jewish meditation. Muslims are discussing more if the classic practice of reciting many names of Allah is a type of meditation.
But the secular-religious debate is appearing among faith groups, too. Some find centering prayers — which call for the practitioner to focus on a general word such as “mercy” rather than liturgy — too secular, said the Rev. Jim Martin, a popular Catholic writer on spirituality who leads retreats in Catholic contemplative practices.
“Some Catholics are suspicious about centering. They’ll say: ‘That’s so Buddhist, is that a mantra?’ ” he said.
Martin and others see meditation as perhaps a secular society’s way of tiptoeing back to God.
“Some say the Christian of the future will be a mystic or not a Christian at all,” he said. “You have to have a spiritual life.”
Anout the author:
Michelle Boorstein is the Post’s religion reporter, where she reports on the busy marketplace of American religion.
Control and false memory
There has been much debate around therapy and false memory. How can therapists be sure that they not suggest anything that hasn`t happened? Like the recent revelation about the false memories of Thomas Quick, who remembered he murdered 8 people he did not actually kill. A recent documentary about the pscyhiatric ward that installed these memories in him, shows how destructive it can be if therapists lead their clients towards their own understanding of the world (lack of real empathy and mentalization). To not say things that provoke mental events that didn`t occur, can be harder than one thinks. So, what is important to think about to prevent this from happening?
To not “create” a child part that isn`t real: If you ask if a part has a certain age, you can ask: Are you the same age as the ANP? Are you older? Are you younger?
When one asks about the perpetrator: Was it someone you knew? Was it a stranger? Was he/her young, old, related, a neigbor?
When you ask about memories, you must be careful not to hint there HAS been something there. When doing EMDR, you just say: Whatever comes up, is okay. If nothing comes up, that is okay too.
When exploring, have an open mind, don`t think that you know what has happened, as we don`t. The most important thing we can do, is to just be there. It is actually very difficult to just Accept what is, without interpreting everything, but it`s something all therapist must try if they want to do a good job.
My life as a psychologist: The start of this blog
It Is strange that it’s been 9 months since I started this blog. Since then when I was sure no one would be interested in reading my posts, I have found so many interesting people in the blog-sphere and some of them have really inspired me with their stories. I am so thankful for the comments and people actually finding inspiration here: Seeing how much horror there can be in the world, it means so much to feel able to do some small things to make it better.
For new readers who haven’t followed me from the beginning, I present what I wrote for the first time on this blog. I knew nothing about blogging, and was so anxious. But I continued, and now I can’t imagine that I’ll ever quit. Thank you, faithful followers, and welcome
To those who have just found this
Blog. I am absolutely thrilled when I get feedback, both good and ‘bad’, so don’t feel afraid of contacting me. I believe in friendships across borders.
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Narrative: Introduction
NARRATIVE OF MY LIFE: INTRODUCTION
Posted on September 21, 2012 by mirrorgirlMany people wonder: Where do I begin when they get the chance to tell their story. Since I work with people every day, I have heard many variants, and I will personally choose the `overview` variant to give you an idea of who I am and how I became that way. I am already, in the age of 26 (27 tomorrow) eager to share my story, and hope this might give me many fascinating stories in return.
I have always been interested in other people. I guess that explains hours spent on movies, reading and reality shows. Today I work with what I love, talking to people from 8-16 as a therapist. People often ask : Don’t you get tired of it? My answer still is: No! Even if I read hundred books, I never get tired of that either. Some books are better than others of course, but I love it when I find something that manage to surprise me, and humans never stop to amaze me. Every person has their own personality, that you usually grasp automatically based on intuition, that unexplained x-factor that make you love and hate, sometimes because of unknown reasons. To hear how someone became like they are, is like opening a gift box. You may have an inkling of what might come, but it never ceases to surprise me. It can be a touching description of somebody’s day, for example how they worried that their mother would be hit by a car, or a summary of their childhood. It can be how they talk, dress and behave, and even better, when you get to share a moment of transformation in the therapy room.
I feel in many ways that I have an essence, but outwardly and inwardly I have also changed a lot. When I look at video-camera footage of myself, I almost get a bit ashamed. Was that me? How could I be so obnoxious? The same thing happens when I look at my writing from back then. I could not understand what I did wrong, now it blinks and announces itself with great vigor, and I have to smile at how pleased I was then.I hope my life story will be an inspiration and a journey inside my mind. It’s full of sad, happy and normal memories, but I know nobody out there has exactly the same story as me, in that case I would like to meet you very much! If you have questions along the way, please feel free to ask.
Proudly presents
Some mornings I wake up with a volcano inside me, full of ideas that long for their release. My brain is burning. I woke up slowly, and far to late, but felt so good. Just did things like play with things on the floor, looking out at the room without trying to find anything specific, and felt everything about this nothingness that is my life. I love all of it, the little spider I found in my drawer, the one sock lying relaxed on my floor and the cool feel of the blanket over my foot. I love it all, because it means I`m alive. I went to the bathroom and then my brain took over. It was a volcano eruption of ideas, and I wrote them all hastingly fast down on a piece of paper. The one that pushed all my inner lava forwards, was “project validation”. It started with the thoughts I had in connection with talking to my American friend, who watched the video “validation”, showed it to her sister, who was inspired and actually did something nice for a man the next day. I was thinking, stories like these need more focus, not just everything that is WRONG in the world.
I truly believe stories like that have the ability to inspire people to do good things themselves, and I will personally equip myself with small bombs, machetes, guns and a safety west for battling down the fear that tries to stop me, from doing what I feel is right. I continued the thought on spreading hope, and thought maybe we should ask if every reader does something nice for someone else, and then write WHAT they did on this blog. This would be positive news, and an example of how small efforts can have big effects. For every thing we do, we have to ask that person to do something for one other person. A little like the movie “pay it forward”. Then I thought: Why not make this a BLOG project, spreading it everywhere. It is like earth hour in that everyone just does one small thing, but it might have a huge effect. I even thought about telling it to my work (we have places where people stay for days and weeks, what if we had “good morning” rounds where everyone shared with the group something they liked with the others? ).
I actually did that when we were on the work-related trip: We sat drinking and joking and started to say something I liked with every one of them. They followed up, and I found it really touching.
For that reason I have now started a new blog, called forfreepsychology.wordpress.com
I made a twitter profile, and a facebook page and am now working with getting guest writers and finding interesting news that encourage people to help themselves and others. If you want to, check it out, and if someone have an important and inspirering story to tell, contact me here or send an email at forfreepsychology@gmail.com
Antipsychotics and brain shrinkage
Antipsychotics and Brain Shrinkage:
An Update
Joanna Moncrieff
June 19, 2013
Evidence that antipsychotics cause brain shrinkage has been accumulating over the last few years, but the psychiatric research establishment is finding its own results difficult to swallow. A new paper by a group of American researchers once again tries to ‘blame the disease,’ a time-honoured tactic for diverting attention from the nasty and dangerous effects of some psychiatric treatments.
In 2011, these researchers, led by the former editor of the American Journal of Psychiatry, Nancy Andreasen, reported follow-up data for their study of 211 patients diagnosed for the first time with an episode of ‘schizophrenia’. They found a strong correlation between the level of antipsychotic treatment someone had taken over the course of the follow-up period, and the amount of shrinkage of brain matter as measured by repeated MRI scans. The group concluded that “antipsychotics have a subtle but measurable influence on brain tissue loss” (1).
This study confirmed other evidence that antipsychotics shrink the brain. When MRI scans became available in the 1990s, they were able to detect subtle levels of brain volume reduction in people diagnosed with schizophrenia or psychosis. This lead to the idea that psychosis is a toxic brain state, and was used to justify the claim that early treatment with antipsychotics was necessary to prevent brain damage. People even started to refer to these drugs as having “neuroprotective” properties, and schizophrenia was increasingly described in neo-Kraeplinian terms as a neurodegenerative condition(2).
The trouble with this interpretation was that all the people in these studies were taking antipsychotic drugs. Peter Breggin suggested that the smaller brains and larger brain cavities observed in people diagnosed with schizophrenia in these and older studies using the less sensitive CT scans, were a consequence of antipsychotic drugs(3), but no one took him seriously. It was assumed that these findings revealed the brain abnormalities that were thought to constitute schizophrenia, and for a long time no one paid much attention to the effects of treatment. Where the effects of antipsychotics were explored, however, there were some indications that the drugs might have a negative impact on brain volume(4).
In 2005, another American group, led by Jeffrey Lieberman who headed up the CATIE study, published the largest scanning study up to that point of people with a first episode of psychosis or schizophrenia(5). The study was funded by Eli Lilly, and consisted of a randomised comparison of Lilly’s drug olanzapine (Zyprexa) and the older drug haloperidol. Patients were scanned at the start of the study, 12 weeks and one year later and patients’ scans were compared with those of a control group of ‘healthy’ volunteers.
At 12 weeks haloperidol-treated subjects showed a statistically significant reduction of the brain’s grey matter (the nerve cell bodies) compared with controls, and at one year both olanzapine- and haloperidol-treated subjects had lost more grey matter than controls. The comparative degree of shrinkage in the olanzapine group was smaller than that in the haloperidol group, and the authors declared the olanzapine-related change not to be statistically significant because, although the result reached the conventional level of statistical significance (p=0.03) they said they had done so many tests that the result might have occurred by chance. In both haloperidol and olanzapine treated patients,however, there was a consistent effect that was diffuse and visible in most parts of the brain hemispheres.
The idea that schizophrenia or psychosis represent degenerative brain diseases was so influential at this point, that the authors first explanation for these results was that olanzapine, but not haloperidol, can halt the underlying process of brain shrinkage caused by the mental condition. They did concede, however, that an alternative explanation might be that haloperidol causes brain shrinkage. They never admitted that olanzapine might do this.
It seems as if Eli Lilly and its collaborators were so confident about their preferred explanation, that they set up a study to investigate the effects of olanzapine and haloperidol in macaque monkeys. This study proved beyond reasonable doubt that both antipsychotics cause brain shrinkage. After 18 months of treatment monkeys treated with olanzapine or haloperidol, at doses equivalent to those used in humans, had approximately 10% lighter brains than those treated with a placebo preparation.(6)
Still psychiatrists went on behaving as if antipsychotics were essentially benign and arguing that they were necessary to prevent an underlying toxic brain disease (Jarskoget al 07 Annual review). Andreasen’s 2011 paper was widely publicised however, and it started to be increasingly acknowledged that antipsychotics can cause brain shrinkage. Almost as soon as the cat was out of the bag, however, attention was diverted back to the idea that the real problem is the mental condition.
Later in 2011 Andreasen’s group published a paper that reasserted the idea that schizophrenia is responsible for brain shrinkage, in which there is barely a mention of the effects of antipsychotics that were revealed in the group’s earlier paper(7). In this second paper, what the authors did was to assume that any brain shrinkage that could not be accounted for by the method of analysis used to explore the effects of antipsychotic treatment must be attributable to the underlying disease.
The way they had analysed drug treatment in the first paper only looked for a linear association between antipsychotic exposure and changes in brain volume, however. A linear analysis only detects an association that is smooth and consistent- in other words an association in which brain volume shrinks by a consistent amount with each increment in antipsychotic exposure. The total effect of drug treatment may not follow this pattern however. It seems from other evidence that there is a threshold effect whereby being on any amount of an antipsychotic has the greatest relative effect, with a levelling out of the impact as duration of exposure reaches a certain level.(8) In any case, without a comparison group which has not been medicated, a virtual impossibility in this day and age, it is simply not possible to conclude that the whole effect is not drug-induced.
The latest paper by this research group replicates the findings on antipsychotic-induced brain shrinkage, but also claims that brain volume reduction is related to relapse of the psychotic disorder(9). Relapse was defined retrospectively by the research team for the purposes of this particular analysis, however, and not at the time the study data were collected. Moreover, the definition used does not refer to any significant change in functioning, but only to a deterioration in the severity of symptoms. But the group’s previous analysis of severity of symptoms, using data collected at the time, found that severity had only a weak association with brain volume changes, and moreover that symptom severity was correlated with antipsychotic exposure.(1)
The most recent analysis ignores the probable association between antipsychotic treatment intensity and relapse, but it seems likely that people undergoing periods of ‘relapse,’ or more accurately deterioration of symptoms, would be treated with higher doses of antipsychotics. If this is so, and the two variables ‘relapse’ and ‘treatment intensity’ are correlated with each other, then the analysis is questionable since the statistical methods used assume that the variables are independent of each other.
So Andreasen’s group have found strong evidence of an antipsychotic-induced effect, which they have replicated in two analyses now. The predictive value of the severity of symptoms, on the other hand (which is essentially what relapse appears to define) is weak in the initial analysis, and in neither analysis was it clearly differentiated from drug-induced effects.
These researchers seem determined to prove that ‘schizophrenia’ causes brain shrinkage, although their data simply cannot establish this, as none of their subjects seem to have gone without drug treatment for any significant length of time. So even though their recent analysis once again confirms the damaging effects of antipsychotics, they conclude that the results demonstrate the need to make sure patients take, and do not stop, their antipsychotic medication. The only concession made to the antipsychotic-induced changes revealed is the suggestion that low doses of antipsychotics should be used where possible.
Yet other prominent psychiatric researchers have now abandoned the idea that schizophrenia is a progressive, neurodegenerative condition, and do not consider that Andreasen’s study provides evidence of this.(10) Bizarrely, Nancy Andreasen is a co-author of a recently published meta-analysis which combines results of 30 studies of brain volume over time, which clearly confirms the association between antipsychotic treatment and brain shrinkage (specifically the grey matter) and finds no relationship with severity of symptoms or duration of the underlying condition.(11)
What should antipsychotic users and their families and carers make of this research? Obviously it sounds frightening and worrying, but the first thing to stress is that the reductions in brain volume that are detected in these MRI studies are small, and it is not certain that changes of this sort have any functional implications. We do not yet know whether these changes are reversible or not. Of course the value of antipsychotics has been much debated on this site and elsewhere, and their utility almost certainly depends on the particular circumstances of each individual user, so it is impossible to issue any blanket advice. If people are worried, they need to discuss the pros and cons of continuing to take antipsychotic treatment with their prescriber, bearing in mind the difficulties that are associated with coming off these drugs.(12) People should not stop drug treatment suddenly, especially if they have been taking it for a long time.
People need to know about this research because it indicates that antipsychotics are not the innocuous substances that they have frequently been portrayed as. We still have no conclusive evidence that the disorders labeled as schizophrenia or psychosis are associated with any underlying abnormalities of the brain, but we do have strong evidence that the drugs we use to treat these conditions cause brain changes. This does not mean that taking antipsychotics is not sometimes useful and worthwhile, despite these effects, but it does mean we have to be very cautious indeed about using them.
Reference List
(1) Ho BC, Andreasen NC, Ziebell S, Pierson R, Magnotta V. Long-term Antipsychotic Treatment and Brain Volumes: A Longitudinal Study of First-Episode Schizophrenia. Arch Gen Psychiatry 2011 Feb;68(2):128-37.
(2) Lieberman JA. Is schizophrenia a neurodegenerative disorder? A clinical and neurobiological perspective. Biol Psychiatry 1999 Sep 15;46(6):729-39.
(3) Breggin PR. Toxic Psychiatry. London: Fontana; 1993.
(4) Moncrieff J, Leo J. A systematic review of the effects of antipsychotic drugs on brain volume. Psychol Med 2010 Jan 20;1-14.
(5) Lieberman JA, Tollefson GD, Charles C, Zipursky R, Sharma T, Kahn RS, et al. Antipsychotic drug effects on brain morphology in first-episode psychosis. Arch Gen Psychiatry 2005 Apr;62(4):361-70.
(6) Dorph-Petersen KA, Pierri JN, Perel JM, Sun Z, Sampson AR, Lewis DA. The influence of chronic exposure to antipsychotic medications on brain size before and after tissue fixation: a comparison of haloperidol and olanzapine in macaque monkeys. Neuropsychopharmacology 2005 Sep;30(9):1649-61.
(7) Andreasen NC, Nopoulos P, Magnotta V, Pierson R, Ziebell S, Ho BC. Progressive brain change in schizophrenia: a prospective longitudinal study of first-episode schizophrenia. Biol Psychiatry 2011 Oct 1;70(7):672-9.
(8) Molina V, Sanz J, Benito C, Palomo T. Direct association between orbitofrontal atrophy and the response of psychotic symptoms to olanzapine in schizophrenia. Int Clin Psychopharmacol 2004 Jul;19(4):221-8.
(9) Andreasen NC, Liu D, Ziebell S, Vora A, Ho BC. Relapse duration, treatment intensity, and brain tissue loss in schizophrenia: a prospective longitudinal MRI study. Am J Psychiatry 2013 Jun 1;170(6):609-15.
(10) Zipursky RB, Reilly TJ, Murray RM. The Myth of Schizophrenia as a Progressive Brain Disease. Schizophr Bull 2012 Dec 7.
(11) Fusar-Poli P, Smieskova R, Kempton MJ, Ho BC, Andreasen NC, Borgwardt S. Progressive brain changes in schizophrenia related to antipsychotic treatment? A meta-analysis of longitudinal mri studies. Neurosci Biobehav Rev 2013 Jun 13.
(12) Moncrieff J. Why is it so difficult to stop psychiatric drug treatment? It may be nothing to do with the original problem. Med Hypotheses 2006;67(3):517-23.
This entry was posted in Antipsychotics, Blogs, Featured Blogs, Foreign Correspondents, Psychiatric Drugs by Joanna Moncrieff. Bookmark the permalink.
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The Helpers
The events in USA lately has gotten to many of us. We start to think about evil and unjustice. If you think to much about that, it`s easy to feel helpless and scared. Completely natural and reasonable, but just remember how many good people there are. I have personally talked with one of them this week, and she actually lives in Boston. If you read this, thank you so much for everything, and I wish you the very best tomorrow!
I know you also know a lot of good people out there. Put you`r imagination on fire, and let them mentally hug you. For people who still need more inspiration, read about more good people (relevant for the latest events) in the reblogged post!
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