Sorry for never being around D:

  • Working at the clinic from 8:00 am - 4:00 pm daily.
  • Two lab meetings per week.
  • 2.5 hour class to teach on Wednesdays.
  • GRE studying.
  • Still trying to plan a few studies once this professor gets back to me.
  • Applying to schools.

Life is hard, y’all.

Eventually I’ll carve out time to make some posts, at least some small stuff. Maybe this weekend or the next. Hang tight, friends.

"Life" is a strong word…let’s not get carried away and start labeling what I do "having a life"!

"Life" is a strong word…let’s not get carried away and start labeling what I do "having a life"!

Sorry for inactivity

I’ve been visiting home/family while trying to balance work at the same time. Needless to say, Tumblr is not immediate priority, so that’s the first thing that gets benched! Keeping an eye on inbox and tagged posts, though, so I’ll get around to them in due time and as they come in.

I’ll be back at it more regularly within a week or so!

Anonymous asked:

Do you know of any research into treating people with extremely violent obsessions/impulses BEFORE they offend?

approachingsignificance:

Hello!

Honestly, I have only seen research in treatment  of violent obsessions or thoughts in persons with OCD before they offend. That is actually an area that needs massive research contributions. Having violent obsessions does not constitute a mental illness by itself, it is usually a symptoms of a larger diagnosis. Also, without knowing the person or the behaviors, it would be difficult to say that that are indeed obsessions (in the clinical sense) and not symptoms of poor emotional regulation. I have read pieces written by persons that are sexually attracted to children (that do not offend) having a hard time finding treatment options. 

Once they offend, there is mixed research on the treatment of violent offenders. Researchers often combine all types of treatment into a category leading many to believe the “nothing works” doctrine. Recent research has become more methodologically advanced and most point to cognitive behavioral therapies as the most successful treatment program. A recent thread of research focuses primarily on “treatment ready” signaling. 

So there is research in treatment of violent obsessions, most of it seems to revolve around OCD. There are violence avoidance techniques for these persons, but I am not sure how many of them have been rigorously tested. 

Anyone else familiar with this literature? psydoctor8 tedbunny cognitivedefusion scienceofeds psychhealth

Hopefully I address this as you asked it, but let me know if I am missing something.

Typically with OCD, the individual is remarkably distressed by the feared event, and so the last thing they want to do is something that would lead to that outcome. There are some individuals with hallucinations or delusions that are violent in nature, and there is some sense of relief that comes from “giving in” to them. That’s usually not how OCD is conceptualized, though.

An example that makes people nervous: there are parents with OCD who are terrified that they will harm their children. For instance, many parents will not let their babies sit in the kitchen with them while cooking for fear that they (the parent) will cause harm upon the baby with a knife. There’s zero intention, and of course the thought causes a remarkable amount of fear, it’s just that thought-action fusion taking place where “what if” turns into “oh my god that will happen.”

Exposure for such individuals is, to the dismay of many, have the baby in the kitchen while the individual is chopping food or cooking. It’s a violent obsession, yes, but individuals with OCD are terrified of those obsessions, and so their safety behavior is to avoid it at all costs. The notion that someone with pure OCD will “give in” to their obsessions by engaging in an act that will lead to the feared outcome, even when it is a violent obsession, just doesn’t seem to fit OCD pathology.

Same thing for people who think they will harm themselves. Exposure would be giving them a knife and holding it to their skin. Or giving them a bottle of pills to hold. (Of course this is only done when there is no history of suicidality.)

Basically if someone has a violent obsession and actually engages in some act that makes that obsession come to fruition, my hunch is that it’s either not OCD, or there’s something comorbid with the OCD that is driving the violence.

As you pointed out, I think there needs to be more research to tease those components out, but pure OCD is typically a persistent attempt to reduce the anxiety stemming from a feared situation as to avoid the situation itself; doing something exactly the opposite by actually fulfilling the violent thought would be very different from that.

Does any of that make sense?

socialworkeroneday:

connect-the-dots-backward:


Hayes, S. C., Levin, M. E., Plumb-Vilardaga, J., Villatte, J. L., & Pistorello, J. (2013). Acceptance and commitment therapy and contextual behavioral science: Examining the progress of a distinctive model of behavioral and cognitive therapy. Behavior Therapy, 44(2), 180-198.

This. This. This.

so maybe I just need to read it a few more times to fully understand it. Or I’m just dumb. But
connect-the-dots-backward
what is this EXACTLY saying lol? I sorta get it. But I’m not content with my assumed understanding

"Feeling better" has not been found to lead to or cause getting better in functional ways (e.g., establishing relationships, pursuing a meaningful career, practicing health habits, etc.) It seems to be more the case that establishing those relationships and pursuing a meaningful career and practicing healthy habits leads to “feeling better.”
So engaging in those positive behaviors even when you don’t “feel” great or your symptoms are distressful is more important than simply getting to a place where you “feel better.”
Practicing healthy things when distressed > waiting until no longer distressed (if possible) and then practicing healthy things.

socialworkeroneday:

connect-the-dots-backward:

Hayes, S. C., Levin, M. E., Plumb-Vilardaga, J., Villatte, J. L., & Pistorello, J. (2013). Acceptance and commitment therapy and contextual behavioral science: Examining the progress of a distinctive model of behavioral and cognitive therapy. Behavior Therapy, 44(2), 180-198.

This. This. This.

so maybe I just need to read it a few more times to fully understand it. Or I’m just dumb. But
connect-the-dots-backward
what is this EXACTLY saying lol? I sorta get it. But I’m not content with my assumed understanding

"Feeling better" has not been found to lead to or cause getting better in functional ways (e.g., establishing relationships, pursuing a meaningful career, practicing health habits, etc.) It seems to be more the case that establishing those relationships and pursuing a meaningful career and practicing healthy habits leads to “feeling better.”

So engaging in those positive behaviors even when you don’t “feel” great or your symptoms are distressful is more important than simply getting to a place where you “feel better.”

Practicing healthy things when distressed > waiting until no longer distressed (if possible) and then practicing healthy things.

Anonymous asked:

I feel like flooding, while sometimes very useful, can also be very traumatic. Speaking from personal experience, and also from education.

I don’t know if I’ve heard of any instance where there has ever been a re-traumatizing effect, even in case studies. Understand though that a distressful experience, even an intense one, would not necessarily count as “traumatic” in the clinical sense. It might be stressful and terrifying, but that’s not enough to be clinically traumatizing, if that makes sense?

Remember that, even in cases of flooding, there’s still psychoeducation and preparation for what is going to happen. And, of course, clients have the right to terminate the process at any point. So it’s not like they walk in and have spiders thrown on them without knowing what’s about to happen. It’s at least 1 session providing education and explaining the process, and letting the client decide what they want. And once therapy starts, the client decides how far it goes.

How was your flooding experience done?

Anonymous asked:

What would exposure with a child look like?

Mechanically, it’d be the same as with an adult. Eventually meaning that the therapist would expose the child to very distressing fears. If it’s a snake phobia, then the child would hold a snake or let it slither on their back. If it’s trauma, then the child would recall the traumatic experience itself. If it’s OCD, then the child would be exposed to the feared situations and would refrain from engaging in compulsions.

The delivery might be a bit different, however. For instance, an integral part of therapy is providing psychoeducation on the condition itself along with the treatment, and specifically how that treatment addresses the underlying condition. Such a description would have to be tweaked a bit so it would be more accessible to children so they can understand why they need to be exposed to fearful situations in order to overcome them (something I’ve had to do with high schoolers, even).

Further, you might go a bit slower with the exposure tasks themselves. Eventually you’d want to create as much anxiety as you can in order for optimal new learning to occur (i.e., facilitating the most effective learning possible for the child to see that their fears are “unfounded”), but you might start with very easy tasks to help the child become more accustomed and acclimated to the process itself.

Hope that helps a bit! Let me know if you have anything else.

Anonymous asked:

What would therapy be like for a kid that is in the 0-5 range? Why do kids that young usually go into therapy?

Elimination disorders, anxiety, general temperament, hyperactivity, etc. Typically the bar is set a bit higher, where serious one-on-one treatment is not pursued unless there’s very clear impairment. So a child who is hyperactive but within an average level usually isn’t given intense psychotherapy, for example. Often there’s more parental empowerment in such cases, and families are equipped to monitor potential symptoms so more serious help can be pursued in the event that symptoms worsen or do not subside over time.

Anonymous asked:

I 'd just like to say that emdr isn't solely eye movement based therapy.I have been doing it for quite some time and for the past5yrs nothing else has worked at chipping away at the trauma flashbacks,nightmares,or anything relating to it. It's been 8 yrs this week since the rape. I developed an eating disorder & was on a tube.&I'm not allowed to let some fool preach that emdr isn't what's it's cracked up to be when it's scary how much shit you remember. Don't take away real hope from others.

I am sorry to hear about your struggles but am glad you have found some relief. Let me clarify some misunderstandings here.

First off, my take on EMDR is purely based on research and objective findings. For example, I am not claiming that no one who has experienced EMDR has found relief from it. Quite the contrary, actually, as research suggests EMDR helps those with PTSD. No part of what I say is an attempt to negate the personal experiences of clients who have been treated with EMDR.

I am concerned with questions such as why does EMDR work? or how does EMDR work? That is all I am concerned with. I can elaborate on that now.

You are correct in that EMDR in its original form can be broken down into two components: exposure and eye movement exercises. The utilization of exposure for PTSD is well-documented in its effectiveness, and so as stated before, it is not surprising that many people find relief through EMDR given that one component has been shown to be very efficacious.

But now the question is: what about the eye movement exercises? And the answer thus far is very simple: they don’t provide any additional relief beyond the exposure component.

Think of it this way: if A = 5, and A + B = 5, then it must be the case that B = 0.

Now understand that, based on research, A = exposure and B = eye movement exercises. The eye movement exercises do nothing.

So this begs the question, “if it works, then who cares?” A few reasons come to mind:

  1. Ideally what we want to do is take the active part of treatment (i.e., the exposure) and increase its dosage and/or its effectiveness.
  2. One risk is that, for those who learn EMDR in the future, greater emphasis is placed on the eye movement exercises rather than the exposure despite the fact that the eye exercises do nothing. This would have obviously problematic implications by watering down the effectiveness of the treatment itself.
  3. It poses the risk of wasting time and money for clients.

My intention is never to take hope away from others, but rather to urge them to pursue therapies which have been shown time and time again to yield the greatest odds of improvement.

Haha, possibly to an extent, but not in any formal sense. No more “ACT” than challenging thoughts is “CBT,” you know? Diet ACT, maybe?

Haha, possibly to an extent, but not in any formal sense. No more “ACT” than challenging thoughts is “CBT,” you know? Diet ACT, maybe?

anxiety-tips asked:

The person asked for temporary ailments, stating that she already knows about prevention tips and other forms of treatment. I don't understand the problem :)

The thing about anxiety is that “temporary strategies” run directly counter to long-term relief. Does the individual understand that? Do we know? The very process of downregulating or reducing one’s anxiety has received wide empirical support to be a major variable in both developing and maintaining one’s anxiety.

The issue here meaning: helping an individual to reduce anxiety short-term means you are directly aiding them in maintaining/strengthening their anxiety long-term. Relaxing during a panic attack increases the probability that the panic disorder itself is maintained. That’s the issue.

And so I don’t think it’s for us to suggest options for such individuals when those options could pose harm. Such an option should be given by professionals who can actually discuss this information in-depth with the client, and can also monitor progress/problems over time.

smallfryami asked:

So I've gotten lots of tips for preventing anxiety and panic attacks but that doesn't help me when I'm in the middle of one. What are some tips to help stop or lessen an anxiety attack? I've been having them daily and I would love some guidance on how to help stop them when I'm in the middle of one or i can feel it coming. Thanks for the follow btw (:

anxiety-tips:

How to Deal with Panic Attacks?

Dear smallfryami, you’re welcome! :)

As for panic attacks - when you’re having one, accept that you’re having one. Don’t pretend it’s not there and ignore it. After that, stay calm and observe how the panic attack affects you. Now, if you’re doing something which needs concentration (driving, precise work, something like that), then try the mentioned steps, but also try to persevere in your current task. If you’re not then just stay calm, observe how the attack affects you and try to stay calm.

Read More

This is why it’s not wise to give treatment advice on the internet. Those suggestions are not helpful to addressing panic pathology, and will only strengthen the probability of maintaining it long-term. It’s trading in long-term benefit for a short-term bandage, at best.