Medicines and the Mind

One of the most common questions about mental health problems: is it just a chemical imbalance in the brain? To give a reliable answer we need to go beyond measuring the uptake of neurotransmitters in particular brain regions. We need to combine accounts from people (sufferers and voluntary subjects) with an understanding of drugs and how they behave in our bodies, and also how our brains react (or not) to drugs, especially by observing changes during live brain scans.

My father, who died over 20 years ago, suffered in his last year from a degree of dementia; this was never properly diagnosed but it seemed more like Parkinson’s disease than any other condition. He may have had a series of mini-strokes in one of the regions of his brain controlling movement. In particular we were astonished when he told us he had seen a dog in the house, when we were certain there had been no dog. My father didn’t doubt he had seen a dog – it wasn’t like a dream. We later learned that such hallucinations are not uncommon in Parkinson’s patients.

I read very recently about Mitul Mehta’s work in London investigating the ways in which drugs actually affect the mind and brain. His team used psilocybin, a hallucinogenic drug, to simulate hallucinations. They knew that there can be an increase in the 5-HT2A receptors in the visual pathways in Parkinson’s patients suffering visual hallucinations. They also knew of a drug developed for cancer treatment that reduces the effects of 5-HT2A stimulation. Could the cancer drug help the Parkinson’s patients? Volunteers were given the cancer drug, put into a scanner then given psylocibin. It reduced the hallucinations. Later actual Parkinson’s patients were given the drug for 2 weeks; their reactions were monitored and they were also scanned to try and find changes in their visual processing pathways.

Most drugs used to treat mental health conditions were developed before scanners were available. Mehta believes that it is now time to open new windows on how our brains respond to such drugs using scanners as part of controlled experiments, and hopefully point the way to better medications. Eventually we may have better answers to those tough questions, by altering medications, seeing directly how they change the brain, and asking patients what their experiences were.

Written by:
Dr Tim Bunn

Consultant Educational Psychologist
SACAC Counselling

When to turn, turn, turn? Let them tell you

I’m not prone to quoting biblical phrases too often, so I shall take these from a song instead:

To everything

(Turn, turn, turn)

There is a season

(Turn, turn, turn)

And a time to every purpose

Under Heaven

A time to build up, a time to break down

A time to dance, a time to mourn

A time to cast away stones, a time to gather stones together

Seeger, P (1959)

There is something very settling and yet unsettling about these words. They suggest perhaps a sense of order and of sequence, something which can ground us and orient us. This is surely a comfort when we try to navigate the seeming unpredictability and randomness of life. Yet, it is not always clear when the time is, especially when you live in a place with less defined seasons; is it a time to build up or to break down? Is casting away such a good idea? In many ways, perhaps, these are not things for us to know – as the song suggests. But there is, it seems, a stronger pull to provide answers in our currently abnormal world. It is something we may do well to caution against.

You don’t have to go far at the moment to find someone with an answer to life’s questions. Despite a growing tendency to denigrate established thinking, everyone seems to be an expert (even me for some reason). Consultants abound, and people seek to ‘influence’ others on all aspects of life. News can sound more like opinion than fact and in an age where you can study Klingon at university, the act of building knowledge may seem increasingly trivial. 

However, for your child, it is a developmental process which should be allowed to take its course – and not just at school. Curiosity is at its core, and never more clearly expressed than in play. I spend much of my time – somewhat to the bemusement of many parents – following children’s play. They seem to take it all quite seriously, which draws me in. To paraphrase Winnicott, a paediatrician and psycho-analyst of deceptive simplicity; it is only in playing that a child is able to be creative, and ‘…it is only in being creative that the individual discovers the self.’ (Winnicott, 1971, P.54) This experience is an exploration and one which is not known from the outset, even by the most organised of children. Momentum develops and takes it somewhere. This unpredictability has value and is the space for development. It is something to allow, to go along with, to follow and discover – if you try and construct or control it, it loses that value. It’s a bit like a conversation. You have to listen to do it properly.

So when your child asks you to play, get stuck in. And the next time they ask whether it’s a time to lose or a time to keep, perhaps consider seeing what they think before saying more. They may well surprise you. 

Winnicott, D. (1971) Playing and Reality. London, Routledge.

McGuinn, R. The Byrds. (1965) Seeger, P (1959) ‘Turn! Turn! Turn!’ Los Angeles, Columbia Records.  

(Adapted from; King James Version. (1611) The Holy Bible; Ecclesiastes (3:1-8))

Written by:
Robert Leveson, 
Psychotherapist & Counsellor, 
Children and Families (Reg; TSP, BPC)

Making a Habit of Connection

What can I say about forming habits? The idea that what we do over and over again will create a change in our life, for better or worse. While we know this to be true with respect to organizing our calendars, exercising or learning a new skill, can we apply that same mindset to deepening our relationships?

As we know, good and bad habits are both formed by repeating the same behavior over time with practice. Many times when I am working with couples or families, I am their final stop before divorce court or complete disengagement in the family.  I begin work with them after years of repetitive negative interactions and behaviors towards one another, habits if you will. And interestingly, they will often come in with a litany of things that have been tried and failed.  One question I have recently been following-up with has been, “for how long did you try…surprising your spouse, making time to talk about what you appreciate about one another, asking them about their day…(fill in the blank).”

When disenchantment with relationships set in, instead of being in a relationship where we allow ourselves to be influenced by our unintentional habits, what if we consciously create habits that allow us to connect and feel closer to our spouse, our child, even our boss or co-workers? Could it change how we view our relationships, how connected and happy we feel in our relationships? 

According to Shawn Achor, Author of the Happiness advantage, the answer is yes.  In his Tedx Talk: The Happy secret to better work,  he explains, “it is not necessarily reality that shapes us but the lens through which your brain views the world that shapes your reality.  If we change the lens, we change the outcome…Ninety percent of your happiness is predicted by how your brain views the world.” He goes on to talk about how if you make one positive 2-minute change for 21 consecutive days, your brain actually works more positively.

While a 2-minute change in how you relate or changing a habit doesn’t sound like much, it can be a simple step to enhancing your positive feelings in your relationships. This idea is shared by  Author James, in his book, Atomic Habits: tiny changes, remarkable results, he explains, “the difference a tiny improvement over time is astounding…success is the product of daily habits-not once in a lifetime transformations.” A 1% improvement isn’t much initially but with consistency and time, you will see big changes and feel more connected. A 1% investment in positive connection habits compound over time (just like money in the bank); you will be able to see marked improvements with just a little effort.  So when deciding between the extravagant getaway and the daily note to say what you like about your relationship, perhaps the daily note will be a better way to impact your relationships than the grand gesture. 

When we begin to make changes, it is important to stick with the habit.  So many times we are seeing no change, we give up or revert back to old patterns of thinking and relating.  Progress, while it is slow and steady, is often unseen. Mr. Clear describes this phenomenon as “the plateau of latent potential.” He explains this by using the example of the formation of bamboo; “Bamboo can barely be seen for the first five years as it builds extensive root systems underground before exploding ninety feet into the air within six weeks.” It is important to keep at something to see change, we can’t expect that deepening connection is going to be an overnight process when it has usually taken years to lose it. 

Remember, connection is a habit. It doesn’t always come easily and life can get in our way, negativity can develop into resentments.  But when this happens, we have to stop and think about how we might be able to positively influence our relationships. How might we build the types of relationships that feel supportive, connected and strong? We have to work at it. We have to dedicate ourselves to the process of being better, by being committed to small change, by being consistent with that change and being patient enough to reap the long-term gains. If we do this, perhaps we can spend more time enjoying one another and less time trying to triage our relationships after the negativity is all that we can see.  

Ted Talks: The Happy Secret to Better work
Clear, J (2018) Atomic Habits: Tiny changes remarkable results. London: Penguin Random House UK publishers

Written by:
Kimberly Fisel
Marriage and Family Therapist

Releasing The Anger Towards Our Parents- Seeing Reality As What It Is

This article deals with a highly difficult, sensitive, but important topic.
It is about the pain of having a childhood where our needs are not met, the
unresolved anger we hold towards our parents, and what we can do about it.
It will feel particularly relevant if you have been through childhood trauma, caused either by neglect, abuse, or other toxic family dynamics. The goal is not for us to harbour self-pity or to blame anyone, but simply to validate some of the painful experiences, and to look at what we can do now to release some of these emotional poisons that we have carried for far too long. Even when we are living as successful individuals in independent adult bodies, we can feel caged by these strong emotional turmoil.

The pain of unresolved relational trauma from childhood often presents as self-critical thoughts, feeling intolerant of our mistakes, or engaging in self-harming behaviors. Self-compassion allows us to transform our pain.
It is not difficult to feel compassion in response to another person’s suffering. It evokes a desire to understand their pain and be of service by offering help or kindness. This same intention of warmth and caring can be offered to ourselves in the form of self-compassion when we set an intention to respond to our own suffering with warmth and gentleness.

“Self-compassion involves two key actions. First, we must set limits with ourselves to reduce habitual negative thoughts and behaviors that perpetuate harm. Second, we must repeatedly practice new kind and loving thoughts and behaviors.”
Self-compassion Dr. Arielle Schwartz

In order to heal from childhood trauma, it is important to acknowledge the pain that you felt there. There is a clinical reason to reflect on your memories of your parents and, doing so does not make you wrong or bad, it’s important to understand that your experience with your parents may not only have been either/or, it possibly has been both/and. The ability to hold both positive and negative aspects of another person, such as your parents, is a healthy, positive thing. When we recognize that, it opens up the possibility for us to feel more fully, to make more sense of our experiences, to seek out the right supports, and to decide more clearly what, if anything, we may need or want to do in that relationship and/or just for ourselves.

As the old therapy saying goes: “We cannot heal what we cannot feel.”
Healing happens by acknowledging your full spectrum of feelings about your parents. When we can hold both views about the painful and the positive aspects of our parents, we grow more accustomed to holding integrated views of others and of ourselves.

Therapy and therapists often get negative criticism for making our clients exhume the past simply for the sake of complaining and “making mom and dad” wrong. While therapy absolutely does invite you to turn backward, to look at what was, there is intentionality and clinical reasoning to that.
When we’re able to recall our memories, to make sense of them, and to feel all of our attendant feelings about those memories in the presence of a kind, compassionate witness, we’re able to support our nervous systems and psyches in healing.

Written by:
Laura Spalvieri
M. Soc. Sc. Prof. Counselling, Prof. Dip. Psychotherapy, GDAPP, GDPC
Counsellor/ Psychotherapist/ TA Practitioner
SACAC Counselling