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The psychology of money

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The Psychology of Money

prismAn important contribution that Jung made to understanding the personality was its tendency to dissociate, or split into parts.  He called these parts complexes, or splinter personalities.  On occasion, a person ‘falls into’ a complex and it takes over the personality for a time.  The inferiority complex is, by now, familiar in our cultural landscape and when in the grip of this, a person feels inadequate, incompetent, weak and lowly.  Even people who have objectively achieved excellence can still be prey to feeling inferior at times.

 

At the centre of a complex are some strong feelings, which are described as archetypal due to their intensity.  They are usually out of proportion to the event that has triggered them and can carry us away, into acting in ways that we might, in a different state of mind, not countenance.  Some familiar expressions capture this well: ‘I was beside myself with rage’; ‘I don’t know what came over me’; ‘it is not like me at all to…’  The ‘cure’ for complexes is for the heart of them to find expression and understanding in a safe place, which can be psychotherapy for some people.  They take quite a bit of unravelling which is why they are called complex.  If we think of small children and how intense their feelings are, it is easier for us to think of how normal it is to behave in unacceptable ways and to understand how we socialise children into our culture.  When these strong feelings are lived and accepted, they become humanised – no longer the province of the archetypal – and then they can become more integrated into the personality and put to good use.  If, however, the feelings are repressed (rather than understood and accepted)  because they are socially unacceptable, then they move into unconscious territory where they will erupt via a complex at a later stage.  Rage is not often helpful but in its attenuated state of assertiveness or healthy anger, then it is an important part of the psychic economy that can protect and stand up for us, giving us energy to do what needs to be done.

 

Anna was born into a poor family where money was tight, but just as importantly, where there was also psychic moneyimpoverishment.  Her father spent too much of the family budget on nights down the pub and was not only emotionally unavailable to his family but when he was present, he would be rough, both verbally and physically.  Anna learnt to keep out of his way and to ‘swallow’ much of her resentment, trying her best to keep the peace and to help her mother.  When she found the capacity to come to therapy in her thirties, she would fall into her ‘money complex’.  She would become profoundly anxious that she was spending the entire family budget on herself (as her father had) and terrified that she would become dependent on the therapist (as father was dependent on alcohol) and at risk of falling apart if money ran out (which was mother’s fear for herself and the family).  The parallels between the family poverty and the current deprivation were played out with money as the currency for emotional expression.  A lot of attention was given to money transactions, including the payment of fees in the therapy, as they carried a great deal of feeling.  As links were made between the past and the present and Anna’s needs were attended to, slowly there was a shift and Anna became less anxious generally and less anxious about money in particular.  Whereas some people may need to learn to rein in their spending and become more prudent, for Anna it was the opposite and she learnt to let go a little, waste a little and to enjoy herself more.  She had plenty of resources as she was intelligent, capable, and in a good and emotionally nurturing relationship.  We began to use the symbolism of money to understand that she was rich in many ways and that her financial and emotional poverty were literally a ‘small’ part of her, that is belonging to her child self.

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The sound of a defensive arrow

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My fingers are freezing. Several people around me are sitting with their sleeves drawn down as far as possible, to keep the trinkets of warmth alive. The air-condition is spitting out its icy message: ‘I’ll make sure no drop of sweat manifests itself on your forehead’. I register it and think about the irony. Outside it’s actually quite warm, much warmer than it would be in Norway, but it seems people would rather feel cold than warm. I’m at the bus from Baltimore to New York and have for three hours read a book about self-harm.

B1
Reflections are important for me

Several times I had to just stop and let my eyes rest on the view, since some emotions rose in me. It was some sense of happiness, growing in me after reading about different treatment-approachs ( to self-harm and problems with emotion regulation).

I also grew fond of the author, because of his integrity and obvious respect for his patients. He truly cares about them all, and this compassion awakened his ability to creative new thoughts that elegantly weaves into well-known models. He made them rich partly because they associated with other ideas. Together this was pure mind-candy for my psychology-hungry state of mind (who said not working was great?).
The spider-web of associations made my thoughts light up with memories of people I’ve met. So many of them have shown me love, and I feel gratitude curling itself like a cotton nest in my stomach.

The reason for putting the book aside and writing down this now, was because I read about a lovely metaphor that I just had to share with you. My heart immediately reacted with speeding up its heavy thuds, since what I read made perfect sense and resonated within me.
Maybe you will like it as much as me ?

Defensive walls in a bloody war

Imagine a wall def20130916-173515.jpgending a city. In the book this safety-precaution was compared to the defensive walls in the movie ‘the lord of the rings’. In one battle scene a city is on the brink of invasion by the orks. This means that every boy and man have go into battle regardless of their preferences or experiences. Even a little boy, shaking in his boots so that the too huge helmet clatter, must defend the city against the enemy. Everything looks hopeless until the elves suddenly appear. They help them so they survive and win, but only until they can fight for themselves.

Different constructions
The author of the book compares the war to defense. Their defense is iron-wrought pillars gathered from cuts that colored its surface. Sometimes their enemies (thoughts, emotions, memories or people they can’t trust) are lurking and they try to cement their construction with the few materials and resources they got or collected. Examples of the defensive actions can be to distract the beasts with carving their skin, believing this piece of art will awaken the hunger of the beasts. Like martyrs they settle for contributing what little they know and can do.

If the enemy has been inoculated against bloody fingerprints the fierce fighters can jump over the walls in full destruction-mode (By acting out and possibly hurting both friend and foe). As the enemies draw closer,the unexperienced heroes of war, become afraid and desperate. This in turn colors the type of defensive strategy they unmask. Often they go from mental to continually concrete and physical types of defense (from denial and avoidance to self-harm or violence). Ignoring the orks will sadly mean feeding the orks with their souls. For an eternity.

Is it really strange that they use the only defense they can think off when it looks like the20130917-093800.jpg walls will not hold ? When one feel control slipping away, ‘irrational things’ like cutting themselves might be the only mechanism they had that brought relief.

Think about the samurai’s from Japan: By killing themselves, they didn’t have to face the shame of losing against their enemies. Further; What about all the lovely people who tries to hide their ‘dark’ emotions because they think people will shunt them if not? Isn’t it understandable that instead of letting other respond to their emotion, they rather run away from it than to face it, especially when considering the addition burden of trauma many have in their pasts?

A child who misbehaves and gets punished for it might harvest their own baskets of anger. Is it strange they can be terrified of their parents ‘discovering’ they’ve been cutting their skin, when they sometimes believe they always do wrong and deserve what they get?
What can we therapists do ?

When a patients shows you the honor of telling about their shameful thoughts and actions, try to not be the ‘enemy’ who wants to breach the walls. Let them see that you come in peace, and wait until they feel safe enough to look over the wall for a bit, thereby letting us discover their battle scars from earlier war-zones. Remember that they naturally can be extremely sensitive and guarded after such experiences .

It’s sometimes easier to attack first than risking getting an arrow in your heart, and our job is to respect that and fight along with them, just like the elves.

20130917-093808.jpg

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More on self-harm

Sebrapiken
Sofia Åkerman, Humanist forlag 2011
-En selvbiografi om spiseforstyrrelser og selvskading-

other Norwegian pages:

ung.no – informasjonskanal for ungdom
Drevet av barne-, ungdoms- og familiedirektoratet

Psykisk Helse i Skolen
Opplæringsprogrammer i psykisk helse

Si det med ord
Drives av interesseorganisasjonen Mental Helse Norge.
Lavterskeltjenester for mennesker som trenger noen å snakke med eller skrive til.

Klara Klok
Spørreside for ungdom og unge voksne i aldersgruppen 10 – 30

  Behandling.

 

People, help the people

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Welcome, Mr Anxiety. Feel completely relaxed

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Have you ever been afraid of the dark?

You’re Not The Only One

Anxiety disorders refer to a high prevalence group of problems, which include excessive levels of fear and anxiety. Anxiety is a normal reaction to stress, threat, or danger and often serves us well. It enables us to deal with threatening situations by triggering the fight/flight response so that we can take evasive action. However, it is when this response is persistent, excessive and interferes with our functioning in daily life that it is referred to as an anxiety disorder; at this point a psychologist or counselling service may be required.

  • Excessive Worry/Generalised Anxiety: This is characterized by excessive anxiety and worry lasting 6 months or more. It is accompanied by central nervous problems including bodily tension, restlessness, irritability, fatigue, poor concentration and sleep disturbance. Worries usually relate to education, work, finances, safety, social issues and often minor issues such as being on time.
  • Social Phobia/Social Anxiety: Persistent fear of situations in which we are exposed to possible scrutiny of others, such as public speaking engagements, social gatherings or communication with the opposite sex. This form of anxiety elicits fear of intenseElettroshockfinalsolution_by_LucaRossato_flickr panic in such situations and avoidance of or escape from social environments
  • Panic Attacks: This form of anxiety can manifest in sudden, intense and unprovoked feelings of terror and dread often culminating in heart palpitations, dizziness, shortness of breath and an out of control or very frightening feeling. When we suffer this disorder we generally discover strong fears about when we might experience the next panic attack and often avoid places we feel we might have a panic attack or where escape may be difficult such as movie theatres, shopping malls or social gatherings.
  • Obsessions and compulsions which are characterized by persistent, uncontrollable and unwanted feeling, thoughts or images (obsessions) and/or routines or repeated behaviors(compulsions) in which individuals engage to try and prevent or rid themselves of anxiety provoked by the obsessions. Common themes through compulsions may include repeated actions such as; washing hands or cleaning the house excessively for fear of germs or checking something over repeatedly for
    PTSD
    PTSD

    errors. When we are caught in the cycle if obsession and ritual our lives are constrained and our time otherwise used for living is consumed.

  • Post Traumatic Stress: Witnessing or experiencing a traumatic event including severe physical or emotional trauma such as a natural disaster, serious accident or crime may expose us to the risk of post traumatic stress. Post Traumatic Stress can be characterized by thoughts, feelings and behaviour patterns that can become seriously affected by reminders of events, recurring nightmares and/or flashbacks, avoidance of trauma related stimuli and chronically elevated bodily arousal. These reactions mat arise weeks even years after the event.

Anxiety treatment at Sydney Emotional Fitness also covers specific phobias, a related disorder to Panic. Specific Phobias involve marked, persistent and intense fears about certain objects or situations. Specific phobias may include things such as enclosed spaces, encountering certain animals or flying in airplanes. Exposure to the feared situation or object usually elicits a panic attack leading to a tendency to avoid the feared object.

For all information about Anxiety TreatmentPsychologist CounsellingAnger CounsellingGrief CounsellingAnger ManagementRelationship CounsellingStress Management and Depression Treatment in Sydney, or any of our services that may assist you in leading a more rewarding life please call us on 1300 790 550.

EMDR: Eye movements help trauma victims

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EMDR

For those who have followed the blog for a while, you might know I mostly work as a trauma therapist, and that I use, among other methods, EMDR to integrate traumatic memories. so what does the psychologist mean?

Protected: The sound of a boomerang coming back with changes

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The anorexic brain

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The Anorexic Brain

Neuroimaging improves understanding of eating disorder

By Meghan Rosen

Web edition: July 26, 2013
Print edition: August 10, 2013; Vol.184 #3 (p. 20)

A+ A- Text Size

ENLARGE

Luke Lucas

In a spacious hotel room not far from the beach in La Jolla, Calif., Kelsey Heenan gripped her fiancé’s hand. Heenan, a 20-year-old anorexic woman, couldn’t believe what she was hearing. Walter Kaye, director of the eating disorders program at the University of California, San Diego, was telling a handful of rapt patients and their family members what the latest brain imaging research suggested about their disorder.

It’s not your fault, he told them.

Hanorexiaeenan had always assumed that she was to blame for her illness. Kaye’s data told a different story. He handed out a pile of black-and-white brain scans — some showed the brains of healthy people, others were from people with anorexia nervosa. The scans didn’t look the same. “People were shocked,” Heenan says. But above all, she remembers, the group seemed to sigh in relief, breathing out years of buried guilt about the disorder. “It’s something in the way I was wired — it’s something I didn’t choose to do,” Heenan says. “It was pretty freeing to know that there could be something else going on.”

Years of psychological and behavioral research have helped scientists better understand some signs and triggers of anorexia. But that knowledge hasn’t straightened out the disorder’s tangled roots, or pointed scientists to a therapy that works for everyone. “Anorexia has a high death rate, it’s expensive to treat and people are chronically ill,” says Kaye.

Kaye’s program uses a therapy called family-based treatment, or FBT, to teach adolescents and their families how to manage anorexia. A year after therapy, about half of the patients treated with FBT recover. In the world of eating disorders, that’s success: FBT is considered one of the very best treatments doctors have. To many scientists, that just highlights how much about anorexia remains unknown.

Kaye and others are looking to the brain for answers. Using brain imaging tools and other methods to explore what’s going on in patients’ minds, researchers have scraped together clues that suggest anorexics are wired differently than healthy people. The mental brakes people use to curb impulsive instincts, for example, might get jammed in people with anorexia. Some studies suggest that just a taste of sugar can send parts of the brain barrelling into overdrive. Other brain areas appear numb to tastes — and even sensations such as pain. For people with anorexia, a sharp pang of hunger might register instead as a dull thud.

The mishmash of different brain imaging data is just beginning to highlight the neural roots of anorexia, Kaye says. But because starvation physically changes the brain, researchers can run into trouble teasing out whether glitchy brain wiring causes anorexia, or vice versa. Still, Kaye thinks understanding what’s going on in the brain may spark new treatment ideas. It may also help the eating disorder shake off some of its noxious stereotypes.

“One of the biggest problems is that people do not take this disease seriously,” says James Lock, an eating disorders researcher at Stanford University who cowrote the book on family-based treatment. “No one gets upset at a child who has cancer,” he says. “If the treatment is hard, parents still do it because they know they need to do it to make their child well.”

Pop culture often paints anorexics as willful young women who go on diets to be beautiful, he says. But, “you can’t just choose to be anorexic,” Lock adds. “The brain data may help counteract some of the mythology.”

ENLARGE

DIFFERENT WIRING
View larger image | Studies of the brains of people with anorexia have revealed a number of complex brain circuits that show changes in activity compared with healthy people.
Medical RF, adapted by M. Atarod

Beyond dieting

A society that glamorizes thinness can encourage unhealthy eating behaviors in kids, scientists have shown. A 2011 study of Minnesota high school students reported that more than half of girls had dieted within the past year. Just under a sixth had used diet pills, vomiting, laxatives or diuretics.

But a true eating disorder goes well beyond an unhealthy diet. Anorexia involves malnutrition, excessive weight loss and often faulty thinking about one of the body’s most basic drives: hunger. The disorder is also rare. Less than 1 percent of girls develop anorexia. The disease crops up in boys too, but adolescent girls — especially in wealthy countries such as the U.S., Australia and Japan — are most likely to suffer from the illness.

As the disease progresses, people with anorexia become intensely afraid of getting fat and stick to extreme diets or exercise schedules to drop pounds. They also misjudge their own weight. Beyond these diagnostic hallmarks, patients’ symptoms can vary. Some refuse to eat, others binge and purge. Some live for years with the illness, others yo-yo between weight gain and loss. Though most anorexics gain back some weight within five years of becoming ill, anorexia is the deadliest of all mental disorders.

Though anorexia tends to run in families, scientists haven’t yet hammered out the suite of genes at play. Some individuals are particularly vulnerable to developing an eating disorder. In these people, stressful life changes, such as heading off to college, can tip the mental scales toward anorexia.

For decades, scientists have known that anorexic children behave a little differently. In school and sports, anorexic kids strive for perfection. Though Heenan, a former college basketball player, didn’t notice her symptoms creeping in until the end of high school, she remembers initiating strict practice regimens as a child. Starting in second grade, Heenan spent hours perfecting her jump shot, shooting the ball again and again until she had the technique exactly right — until her form was flawless.

“It’s very rare for me to see a person with anorexia in my office who isn’t a straight-A student,” Lock says. Even at an early age, people who later develop the eating disorder tend to exert an almost superhuman ability to practice, focus or study. “They will work and work and work,” says Lock. “The problem is they don’t know when to stop.”

In fact, many scientists think anorexics’ brains might be wired for willpower, for good and ill. Using new imaging tools that let scientists watch as a person’s mental gears grind through different tasks, researchers are starting to pin down how anorexic brains work overtime.

Control signs

ENLARGE

FOOD ALERT
Images of high-calorie foods (left) switched on a self-control center in the brains of anorexic women. Pictures of objects on plates kept the control center quiet.
Courtesy of S. Brooks

To glimpse the circuits that govern self-control, experimental neuropsychologist Samantha Brooks uses functional magnetic resonance imaging, or fMRI, a tool that measures and maps brain activity. Last year, she and colleagues scanned volunteers as they imagined eating high-calorie foods, such as chocolate cake and French fries, or using inedible objects such as clothespins piled on a plate. One result gave Brooks a jolt. A center of self-control in anorexics’ brains sprung to life when the volunteers thought about food — but only in the women who severely restricted their calories, her team reported March 2012 in PLOS ONE.

The control center, two golf ball–sized chunks of tissue called the dorsolateral prefrontal cortex, or DLPFC, helps stamp out primitive urges. “They put a brake on your impulsive behaviors,” says Brooks, now at the University of Cape Town in South Africa.

For Brooks, discovering the DLPFC data was like finding a tiny vein of gold in a heap of granite. The control center could be the nugget that reveals how anorexics clamp down on their appetites. So she and her colleagues devised an experiment to test anorexics’ DLPFC. Using a memory task known to engage the brain region, the researchers quizzed volunteers while showing them subliminal images. The quizzes tested working memory, the mental tool that lets people hold  phone numbers in their heads while hunting for a pen and paper. Compared with healthy people, anorexics tended to get more answers right, Brooks’ team wrote June 2012 in Consciousness and Cognition. “The patients were really good,” Brooks says. “They hardly made any mistakes.”

A turbocharged working memory could help anorexics hold on to rules they set for themselves about food. “It’s like saying ‘I will only eat a salad at noon, I will only eat a salad at noon,’ over and over in your mind,” says Brooks. These mantras may become so ingrained that an anorexic person can’t escape them.

But looking at subliminal images of food distracted anorexics from the memory task. “Then they did just as well as the healthy people,” Brooks says. The results suggest that anorexic people might tap into their DLPFC control circuits when faced with food.

James Lock has also seen signs of self-control circuits gone awry in people with eating disorders. In 2011, he and colleagues scanned the brains of teenagers with different eating disorders while signaling them to push a button. While volunteers lay inside the fMRI machine, researchers flashed pictures of different letters on an interior screen. For every letter but “X,” Lock’s group told the teens to push a button. During the task, anorexic teens who obsessively cut calories tended to have more active visual circuits than healthy teens or those with bulimia, a disorder that compels people to binge and purge. The result isn’t easy to explain, says Lock. “Anorexics may just be more focused in on the task.”

Bulimics’ brains told a simpler story. When teens with bulimia saw the letter “X,” broad swaths of their brains danced with activity — more so than the healthy or calorie-cutting anorexic volunteers, Lock’s team reported in theAmerican Journal of Psychiatry. For bulimics, controlling the impulse to push the button may take more brain power than for others, Lock says.

Though the data don’t reveal differences in self-control between anorexics and healthy people, Lock thinks that anorexics’ well-documented ability to swat away urges probably does have signatures in the brain. He notes that his study was small, and that the “healthy” people he used as a control group might have shared similarities with anorexics. “The people who tend to volunteer are generally pretty high performers,” he says. “The chances are good that my controls are a little bit more like anorexics than bulimics.”

Still, Lock’s results offered another flicker of proof that people with eating disorders might have glitches in their self-control circuits. A tight rein on urges could help steer anorexics toward illness, but the parts of their brain tuned into rewards, such as sugary snacks, may also be a little off track.

ENLARGE

SUGAR HIGH
When an anorexic woman unexpectedly gets a taste of sugar (yellow) or misses out on it (blue), her brain’s reward circuitry shows more activity than a healthy-weight or obese woman’s. Anorexics’ reward-processing systems may be out of order.
G. Frank et al/Neuropsychopharmacology2012

Sugar low

For many anorexics, food just doesn’t taste very good. A classic symptom of the disorder is anhedonia, or trouble experiencing pleasure. Parts of Heenan’s past reflect the symptom. When she was ill, she had trouble remembering favorite dishes from childhood, for example — a blank spot common to anorexics. “I think I enjoyed some things,” she says. Beyond frozen yogurt, she can’t really rattle off a list.

After Heenan started seriously restricting her calories in college, only one aspect of food made her feel satisfied. Skipping, rather than eating, meals felt good, she says. Some of Heenan’s symptoms may have stemmed from frays in her reward wiring, the brain circuitry connecting food to pleasure. In the past few years, researchers have found that the chemicals coursing through healthy people’s reward circuits aren’t quite the same in anorexics. And studies in rodents have linked chemical changes in reward circuitry to under- and overeating.

To find out whether under- and overweight people had altered brain chemistry, eating disorder researcher Guido Frank of the University of Colorado Denver studied anorexic, healthy-weight and obese women. He and his colleagues trained volunteers to link images, such as orange or purple shapes, with the taste of a sweet solution, slightly salty water or no liquid. Then, the researchers scanned the women’s brains while showing them the shapes and dispensing tiny squirts of flavors. But the team threw in a twist: Sometimes the flavors didn’t match up with the right images.

When anorexics got an unexpected hit of sugar, a surge of activity bloomed in their brains. Obese people had the opposite response: Their brains didn’t register the surprise. Healthy-weight women fit somewhere in the middle, Frank’s team reported August 2012, in Neuropsychopharmacology. While obese people might not be sensitive to sweets anymore, a little sugar rush goes a long way for anorexics. “It’s just too much stimulation for them,” Frank says.

One of the lively regions in anorexics’ brains was the ventral striatum, a lump of nerve cells that’s part of a person’s reward circuitry. The lump picks up signals from dopamine, a chemical that rushes in when most people see a sugary treat.

Frank says that it’s possible cutting calories could sculpt a person’s brain chemistry, but he thinks some young people are just more likely to become sugar-sensitive than others. Frank suspects anorexics’ dopamine-sensing equipment might be out of alignment to begin with. And he may be onto something. Recently, researchers in Kaye’s lab at UCSD showed that the same chemical that makes people perk up when a coworker brings in a box of doughnuts might actually trigger anxiety in anorexics.

Mixed signals

Usually a rush of dopamine triggers euphoria or a boost of energy, says Ursula Bailer, a psychiatrist and neuroimaging researcher at UCSD. Anorexics don’t seem to pick up those good feelings.

When Bailer and colleagues gave volunteers amphetamine, a drug known to trigger dopamine release, and then asked them to rate their feelings, healthy people stuck to a familiar script. The drug made them feel intensely happy, Bailer’s team described March 2012 in the International Journal of Eating Disorders. Researchers linked the volunteers’ happy feelings to a wave of dopamine flooding the brain, using an imaging technique to track the chemical’s levels.

But anorexics said something different. “People with anorexia didn’t feel euphoria — they got anxious,” Bailer says. And the more dopamine coursing through anorexics’ brains, the more anxious they felt. Anorexics’ reaction to the chemical could help explain why they steer clear of food — or at least foods that healthy people find tempting. “Anorexics don’t usually get anxious if you give them a plate of cucumbers,” Bailer says.

Beyond the anxiety finding, one other aspect of the study sticks out: Instead of examining sick patients, Bailer, Kaye and colleagues recruited women who had recovered from anorexia. By studying people whose brains are no longer starving, Kaye’s team hopes to sidestep the chicken-and-egg question of whether specific brain signatures predispose people to anorexia or whether anorexia carves those signatures in the brain.

Though Kaye says that there’s still a lot scientists don’t know about anorexia, he’s convinced it’s a disorder that starts in the brain. Compared with healthy children, anorexic children’s brains are getting different signals, he says. “Parents have to realize that it’s very hard for these kids to change.”

Kaye thinks imaging data can help families reframe their beliefs about anorexia, which might help them handle tough treatments. He thinks the data can also offer new insights into therapies tailored for anorexics’ specific traits.

Sensory underload

One trait Kaye has focused on is anorexics’ sense of awareness of their bodies. Peel back the outer lobes of the brain by the temples, and the bit that handles body awareness pops into view. These regions, little islands of tissue called the insula, are one of the first brain areas to register pain, taste and other sensations. When people hold their breath, for example, and feel the panicky claws of air hunger, “the insula lights up like crazy,” Kaye says.

Kaye and colleagues have shown that the insulas of people with anorexia seem to be somewhat dulled to sensations. In a recent study, his team strapped heat-delivering gadgets to volunteers’ arms and cranked the devices to painfully hot temperatures while measuring insula activity via fMRI.

Compared with healthy volunteers, bits of recovered anorexics’ insulas dimmed when the researchers turned up the heat. But when researchers simply warned that pain was coming, other parts of the brain region flared brightly, Kaye’s team reported in January in the International Journal of Eating Disorders. For people who have had anorexia, actually feeling pain didn’t seem as bad as anticipating it. “They don’t seem to be sensing things correctly,” says Kaye.

If anorexics can’t detect sensations like pain properly, they may also have trouble picking up other signals from the body, such as hunger. Typically when people get hungry, their insulas rev up to let them know. And in healthy hungry people, a taste of sugar really gets the insula excited. For anorexics, this hunger-sensing part of the brain seems numb. Parts of the insula barely perked up when recovered anorexic volunteers tasted sugar, Kaye’s team showed this June in the American Journal of Psychiatry. The findings “may help us understand why people can starve themselves and not get hungry,” Kaye says.

Though the brain region that tells people they’re hungry might have trouble detecting sweet signals, some reward circuits seem to overreact to the same cues. Combined with a tendency to swap happiness for anxiety, and a mental vise grip on behavior, anorexics might have just enough snags in their brain wiring to tip them toward disease.

Now, Kaye’s group hopes to tap neuroimaging data for new treatment ideas. One day, he thinks doctors might be able to help anorexics “train” their insulas using biofeedback. With real-time brain scanning, patients could watch as their insulas struggle to pick up sugar signals, and then practice strengthening the response. More effective treatment options could potentially spare anorexics the relapses many patients suffer.

Heenan says she’s one of the lucky ones. Four years have passed since she first saw the anorexic brain images at UCSD. In the months following her treatment, Heenan and her family worked together to rebuild her relationship with food. At first, her fiancé picked out all her meals, but step by step, Heenan earned autonomy over her diet. Today, Heenan, a coordinator for Minneapolis’ public schools, is married and has a new puppy. “Life can be good,” she says. “Life can be fun. I want other people to know the freedom that I do.”


Searching for treatments

The bowl of pasta sitting in front of Kelsey Heenan didn’t look especially scary.

Spaghetti, chopped asparagus and chunks of chicken glistened in an olive oil sauce. Usually, such savory fare might make a person’s mouth water. But when Heenan’s fiancé served her a portion, she started sobbing. “You can’t do this to me,” she told him. “I thought you loved me!”

Heenan was confronting her “fear foods” at the Eating Disorders Center for Treatment and Research at UCSD. Therapists in her treatment program, Intensive Multi-Family Therapy, spend five days teaching anorexic patients and families about the disorder and how to encourage healthy eating. “There’s no blame,” says Christina Wierenga, a clinical neuropsychologist at UCSD. “The focus is just on having the parent refeed the child.” Therapists lay out healthy meals and portion sizes for teens, bolster parents’ self-confidence and hammer home the dangers of not eating. Heenan compares the experience to boot camp. But by the end of her time at the center, she says, “I was starting to see glimpses of what life could be like as a healthy person.”

Treatment options for anorexia include a broad mix of behavioral and medication-based therapies. Most don’t work very well, and many lack the support of evidence-based trials. Hospitalizing patients can boost short-term weight gain, “but when people go home they lose all the weight again,” says Stanford University’s James Lock, one of the architects of family-based treatment. That treatment is currently considered the most effective therapy for adolescent anorexics.

In a 2010 clinical trial, half of teens who underwent FBT maintained a normal weight a year after therapy. In contrast, only a fifth of teens treated with adolescent-focused individual therapy, which aims to help kids cope with emotions without using starvation, hit the healthy weight goal.

Few good options exist for adult anorexics, a group notorious for dropping out of therapy. New work hints that cognitive remediation therapy, or CRT, which uses cognitive exercises to change anorexics’ behaviors, has potential. After two months of CRT, only 13 percent of patients abandoned treatment, and most regained some weight, Lock and colleagues reported in the April International Journal of Eating Disorders. Researchers still need to find out, however, if CRT helps patients keep weight on long-term. —Meghan Rosen

CITATIONS

U. F. Bailer et al. Amphetamine induced dopamine release increases anxiety in individuals recovered from anorexia nervosa. International Journal of Eating Disorders. Vol. 45, March 2012, p. 263. doi: 10.1002/eat.20937. [Go to]

S. J. Brooks et al. Subliminal food images compromise superior working memory
performance in women with restricting anorexia nervosa. Consciousness and cognition. Vol. 21, June 2012, p. 751 doi: 10.1016/j.concog.2012.02.006. [Go to]

S. J. Brooks et al. Thinking about eating food activates visual cortex with reduced bilateral Cerebellar Activation in Females with Anorexia Nervosa: An fMRI Study. PLOS ONE. Vol. 7, March 2012, p. 1. doi: 10.1371/journal.pone.0034000. [Go to]

G. K. W Frank et al. Anorexia Nervosa and Obesity are Associated with Opposite Brain Reward Response. Neuropsychopharmacology. Vol. 37, August 2012, p. 2031. doi: 10.1038/npp.2012.51. [Go to]

J. Lock et al. Aberrant brain activation during a response inhibition task in adolescent eating disorder subtypes. American Journal of Psychiatry. Vol. 168, January 2011, p. 55. doi: 10.1176/appi.ajp.2010.10010056. [Go to]

J. Lock et al. Is outpatient cognitive remediation therapy feasible to use in randomized clinical trials for anorexia nervosa? International Journal of Eating Disorders. Published online April 29, 2013. doi: 10.1002/eat.22134. [Go to]

T. A. Oberndorfer et al. Altered Insula Response to Sweet Taste Processing After Recovery From Anorexia and Bulimia Nervosa. American Journal of Psychiatry. Published online June 4, 2013. doi: 10.1176/appi.ajp.2013.11111745. [Go to]

I.A. Strigo et al. Altered Insula Activation during Pain Anticipation in Individuals Recovered from Anorexia Nervosa: Evidence of Interoceptive Dysregulation. International Journal of Eating Disorders. Vol. 46, January 2013, p. 22. doi: 10.1002/eat.22045. [Go to]

SUGGESTED READING

Eating Disorders Center for Treatment and Research at the University of California, San Diego: [Go to]

L. Sanders. Extreme eaters show abnormal brain activity. Science News. Vol. 181, May 5, 2012, p. 13. Available online: [Go to]

B. Bower. Starved for Assistance: Coercion finds a place in the treatment of two eating disorders. Science News. Vol. 171, January 20, 2007, p. 38. Available online: [Go to]

B. Bower. Wasting Away: Prozac loses promise as anorexia nervosa fighter. Science News. Vol. 169, June 17, 2006, p. 374. Available online: [Go to]

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Can psychopaths switch their empathy on?

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Psychopathic criminals have empathy switch

By Melissa Hogenboom

Science reporter, BBC News
NeuronsMirror neurons in the brain fire both when you watch someone in pain and when you experience it yourself

Psychopaths do not lack empathy, rather they can switch it on at will, according to new research.

Placed in a brain scanner, psychopathic criminals watched videos of one person hurting another and were asked to empathise with the individual in pain.

Only when asked to imagine how the pain receiver felt did the area of the brain related to pain light up.

Scientists, reporting in Brain, say their research explains how psychopaths can be both callous and charming.

The team proposes that with the right training, it could be possible to help psychopaths activate their “empathy switch”, which could bring them a step closer to rehabilitation.

Continue reading the main story

The study

a participant being slapped on the hand to localize brain regions sensitive to pain
  • Placed in an fMRI scanner, 18 criminals with psychopathy and 26 control subjects were asked to watch a series of clips without a particular instruction
  • The clips showed one hand touching the other in a loving, a painful, a socially rejecting or a neutral way
  • They were then asked to watch the same clips again but this time try and feel what the subjects in the clips felt
  • In the third part of the study they were slapped with a ruler to localise the pain region of the brain

Mirror neurons

The ability to empathise with others – to put yourself in someone else’s shoes – is crucial to social development in order to respond appropriately in everyday situations.

Criminals with psychopathy characteristically show a reduced ability to empathise with others, including their victims. Evidence suggests they are also more likely to reoffend upon release than criminals without the psychiatric condition.

Psychopathy is a personality disorder characterised by superficial charm, pathological lying and a diminished capacity for remorse.

Now scientists have found that only when asked to empathise did the criminals’ empathy reaction, also known as the mirror system, fire up the same way as it did for the controls. Without instruction, they show reduced activity in the regions of the brain associated with pain.

This mirror system refers to the mirror neurons in our brain which are known to activate when we watch someone do a task and when we do it ourselves. They are thought to play a vital role in the ability to empathise with others.

‘Bleak prospect’Christian Keysers from the University of Groningen, the Netherlands, and senior author of the study, said it could change the way psychopathic criminals were viewed.

“The predominant notion had been that they are callous individuals, unable to feel emotions themselves and therefore unable to feel emotions in others.

“Our work shows it’s not that simple. They don’t lack empathy but they have a switch to turn it on and off. By default, it seems to be off.”

The fact that they have the capacity to switch empathy on, at least under certain conditions, could have a positive side to it, Prof Keysers said.

“The notion psychopaths have no empathy at all was a bleak prospect. It would make it very hard for them to have normal moral development.

“Now that we’ve shown they have empathy – even if only in certain conditions – we can give therapists something to work with,” Prof Keysers told BBC News.

Brain activation in individuals with psychopathy was greater when asked to imagine pain (foreground) Brain activation in criminals with psychopathy was greater when asked to empathise (foreground)

But he explained that it was not yet known how this wilful capacity for empathy could be transformed into the spontaneous empathy most of us have.

Million-dollar questionEssi Viding from University College London, who was not involved with the study, said it was an extremely interesting finding, but that it remained unclear whether the psychopathic criminals’ experience of empathy felt the same as that of the controls.

“It’s dangerous to look at brain activation and say that it means they’re empathising. They are able to generate a typical neural response, but that doesn’t mean they have the same empathetic experience,” Prof Viding told BBC News.

“We know they can generate the same response but they do that in an active and effortful way. Under free-viewing conditions they don’t seem to. Just because they can emphasise, doesn’t mean they will.

“Psychopathic criminals are clearly different. The million-dollar question is whether we can devise therapeutic interventions that would shift them do this more automatically.”

Randall Salekin, from the University of Alabama, US, who works with youth offenders said: “These findings fit with much of the treatment I am doing using a mental model program, whereby youth are informed about how the brain works and then asked to make specific plans for improving their lives.

“This study is impressive because it actually shows the brain mechanisms or neural networks involved in activating the inmates’ empathy.”

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Therapy video from treatment of a woman with Multiple Personality Disorder

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Multiple Personalities

Multiple Personalities

In early times, evil spirits were thought to possess people and make them act in strange and frightening ways. By the 1800′s, the study of this hysteria led some doctors to believe one person could have separately functioning personalities.

 

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When there are several parts of you

 

In this rare research film from the 1920′s, a woman has different personalities who believes they are separate people. One is a male that is not comfortable in women’s clothes. Another is a small child. The affliction has been known by different names, but recognized for centuries. Today it is called multiple personality disorder.

Why have they become tormented and broken into different personalities? What is the childhood pain that lies buried in the unknown depths of their mind? How can they search for the deadly memories that holds the secrets of their paths and the promise of their healing?

Watch the full documentary now

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My life as a psychologist: The start of this blog

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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.

  • Narrative: Introduction

    NARRATIVE OF MY LIFE: INTRODUCTION

    Many 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.

 

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