Tuesday, July 28, 2009

Do you have to be disturbed to be an artist?

Artists have often been portrayed in movies, plays and novels as being emotionally disturbed. Nicole Kidman won an Oscar a few years back for her depiction of Virginia Woolf as a writer suffering from bipolar disorder in the film, Hours. Indeed, it has become common to think of artists as being more disturbed than the average person, but is it true?

A psychologist (Ludwig 1996) did a comparative study of emotional disturbances among artists and nonartists, showing that disturbances were far more common among artists.

He found that 60 percent of actors and 41 percent of novelists were alcoholics. However, only Three percent of scientist and 10 percent of military officers were alcoholics. Likewise 17 percent of actors and 13 percent of poets suffered from bipolar disorder (formerly known as manic depression), while only one percent of scientists did so.

Goodwin and Jamison (1990), uncovered impressive evidence of a link between creativity and depression or manic depression. The list of writers who suffered from it includes not only Virginia Woolf, but also Gertrude Stein, Fydor Dostoyevsky, William Shakespeare, Pablo Picasso, Tennessee Williams, Ernest Hemingway, William Styron, F. Scott Fitzgerald, Herman Melville, Eugene O’Neill, Henry James and Honore de Balzac.

Composers who suffered from these disorders include Robert Shuman, Hector Berloiz and George Friederic Handel (who wrote The Messiah in 24 manic days); artists include Vincent van Gogh and Salvador Dali; and poets include Poe, Tennyson, Byron, Shelly and Coleridge.

These studies also suggest several theories explaining why creative people are more disposed to mental illness. The theory that makes most sense to me is the one that focuses on a combination of genetic and environmental influences. Creative peole seem to be born with more delecate senses—an ear for music, an eye for color and design, a mind that sees beneath the facades of daily life. This genetic sensitivity renders them more susceptible to becoming traumatized by environmental events.

An event such as the loss of a mother at an early age, which might cause an average person to become somewhat disturbed, might have an even greater effect on a creative person with greater sensitivity.

However, the same sensitivity that makes artists more vulnerable to stress also makes them good therapy candidates. Among all the patients I have seen over the years, creative people have usually made the most rapid advances in therapy.

Wednesday, July 22, 2009

Should parents be licensed and trained?

Vegetarian parents starve their baby to death….Mother drowns her five sons….Teenage mother throws newborn into the garbage….Toddler beaten to death by stepfather….Girl molested by father….Boy suffers brain damage from abuse.

These are some of the headlines we see in the news daily. Incidents of infant and child abuse are on the rise in America. The National Clearinghouse on Child Abuse and Neglect notes that child abuse has tripled in America over the past three decades. And these are just reported cases. It is estimated that the majority of cases are never reported, because they happen behind closed doors.

And many more cases of emotional neglect also go unreported as well, yet are equally devastating to those individuals involved.

To address this problem, Jack C. Westman and Charles D. Gill wrote a book called Licensing Parents: Can We Prevent Child Abuse and Neglect. The authors have verbalized what many in the profession have been advocating for years.

We require licenses and training for people who want to drive a car, and we require them for people to get married. The skills required to be a parent are much more complex than the skills required to drive a car. And it is certainly more important to society to have skilled parents who can raise well-adjusted children than it is to have skilled drivers who can drive safely on our highways.

How would this work? Parental licensing and training could be administered by government agencies. Newly pregnant women and their spouses (or boyfriends) would be required to register and sign up for psychological testing, parenting classes and counseling.

The testing would be a way to weed out those parents who are too emotionally disturbed to care for children. Classes and counseling would ensure that all parents would receive training and insight into themselves. One of the most important parenting skills is self-analysis: parents must be able to look at themselves objectively to understand how their own behavior is affecting their children. They need to understand how they displace violence, depression or anxiety onto their children.

Despite the rise in child abuse, a large percentage of the populace will oppose parent training and licensing. People say it would be yet another government infringement on the rights of parents—“Big Brother is watching!” Parenthood, some feel, is a sacred right that should not be interfered with by the state.

Either we interfere with parents and monitor their child rearing, or parents are going to interfere with society by producing a slew of abused and neglected children who later become maladjusted and dysfunctional adults.

Getting rid of toxic people.

Some people in your life continually cause you stress, but for some reason you hold on to them. Maybe they are people you've been friends with since the second grade. Maybe they are your parents. Maybe they are your bosses. Maybe they are your lovers or spouses.

If they are any of the above you will have a conflict about eliminating them from your life. You will tell yourself, “I can't throw my mother out of my life! I can't throw my oldest friend out of my life! I can't throw my husband out of my life!”

I have had patients who endured abusive relationships for years and were reluctant to end them. In fact, sometimes the more abusive the relationships are, the more reluctant people are to end them and the more they hold on to the hope that the abuser will change.

Mothers are the hardest to eliminate, even when they are monsters. A female patient told of being sexually abused by her alcoholic mother beginning at age three. The mother would molest her daughter with beer bottles and proclaim, “This is what men do to you.” The mother was totally deranged. The mother continued to be abusive in one way or another up to the time the woman came to see me. Yet she still went home to visit her mother, and each time she would come back to the city in a deep depression, sometimes suicidal.

She would say, “Maybe I shouldn't see her anymore.”

And I would immediately reply, “Maybe you shouldn't.”

But she would then answer, “I can't. I can't. She's my mother.”

Old friends are also hard to get rid of, especially if they've been around since the second grade. When a friendship has been around this long, a harmful relationship can take on a semblance of normality. During the course of therapy a patient began to realize how one-sided one friendship was and how it left him in a rotten mood.

This friend was narcissistic and was only interested in what my patient could to for him. He would call the patient up to vent about things, and it was the patient's job to listen. But if the patient tried to give any advice the friend would abruptly reject the advice as if it were stupid. And God forbid that my patient would ever call this friend to vent about anything. The friend would interrupt after a sentence and say, “I have to go.”

After discussing the relationship with me for a time, the patient decided to confront the friend. During one of his conversations with the friend, my patient said, “You know, I've noticed that you're always calling me to vent, but if I ever want to vent you don't have time for me.” The friend said he found that interesting and promised to think about it. The “friend” never called again.

Sometimes we hold on to relationships because we have self-esteem issues. This is often the case when somebody clings to an abusive spouse. We are convinced that somehow we deserve to be treated with disrespect and that if we lose this person we won't be able to get anybody else. These are long-standing attitudes that we have developed in childhood, due to the way we were treated by parents, siblings or other relatives. Because these attitudes are so deeply ingrained, they are difficult to overcome. Often it takes a lot of therapy to uncover the roots of the problem

But once people take that first step of eliminating a harmful person, they begin to open up. After he had eliminated his oppressive friend, my patient exclaimed, “I felt as if I could take a deep breath for the first time!”

Why would a beauty kill herself?

Ever since Ruslana Korshunova, 20, jumped from a building on Water Street in New York’s financial district several weeks ago, people have been wondering why she did it. Why would a beautiful, young, successful model kill herself?

Newspapers reported that she was unhappy, but the source of the unhappiness was unclear. In one message from her diary three months before the suicide she wrote: "I'm so lost. Will I ever find myself?" In an earlier posting, quoted in the New York Daily News, she wrote: "It hurts, as if someone took a part of me, tore it out, mercilessly stomped all over and threw it out." One cryptic entry in March reads: "My dream is to fly. Oh, my rainbow it is too high."

Other postings revealed anger. In March she wrote: "I'm a bitch. I'm a witch. I don't care what you say ... I know why my other relationships didn't work out, 'cause I'm unpredictable. "

Originally from the former Soviet republic of Kazakhstan, the almond-eyed, flowing-haired Korshunova appeared in advertisements and on runways for such designers as Marc Jacobs, Nina Ricci and DKNY. British Vogue hailed her as "a face to be excited about" in 2005. Her break came when modeling booker Debbie Jones noticed a picture of her while perusing an in-flight magazine article about Korushnova's hometown of Almaty, according to a Vogue magazine report. "She looked like something out of a fairytale!" Jones told Vogue. "We had to find her and we searched high and low until we did!"

At the time of her suicide, she was reportedly dating two American men and had broken up with a married man in Russia. She had also hired a “life coach” in Russia to help her with her relationship problems. Her mother, with whom she was supposedly very close, came to America to claim the body.

We may never solve the mystery of Korushnova’s suicide. But her case reminds me of another suicidal girl, a patient, whom I came to know a while back. Let us call her Miss M. Like Ruslana, Miss M was a beautiful young woman who was troubled by pursuers. And, like Ruslana, she was sending money back home in Europe to her mother each week.

For Miss M, the problem did not have to do with the men who dated her. It had to do with her mother. Her mother had smothered her with love when she was a child. After divorcing her alcoholic father, her mother clung to Miss M like a safety tube. When Miss M became a teenager, her mother would routinely disapprove of any man she was dating.

Miss M moved to America to get away from her mother (although she wasn’t aware of that consciously). Her mother called her every day, and Miss M would report to her the details of her love life. One after another she disapproved of her beaus and entreated Miss M to return to Russia. As Miss M went through one beau after another, she was beside herself, unable to understand the confusion within. One part wanted to give herself to a man; the other wanted to remain loyal to her mother. She suffered from confusion, depression and suicidal thoughts--a depression similar to Ruslana Korushnova’s.

Whether Ruslana had a similar childhood can only be mere speculation. But we do know that children from healthy families do not normally become suicidal.

Jealousy: the invisible hatred

In a recent interview Tish Cyrus, mother of teen star Miley Cyrus, complained that school mates were mean to her daughter. She related an incident where Miley was locked in a school bathroom for an hour by a group of girls. Apparently this was just one of many such acts of meanness.

It is not uncommon for exceptional children to arouse jealousy and meanness from those around them who are not as attractive or talented. A well-known illustration of this theme is the story of Cinderella, a beautiful girl whose stepsisters, lacking her beauty, are jealous of and nasty to her.

Jealous people not only disguise their meanness from themselves and others, but also are often unaware of it. If you ask them, “Are you jealous?” they will seldom admit it. Hence is seems to come out of nowhere—to be invisible. Jealousy is perhaps the most reviled feeling, and one that is most often disowned. This makes the acts of meanness of jealous people all the more devastating. Because these acts are disguised, they seem to come from left field. Jealous people are the typical wolves in sheep's clothing.

The jealousy-fueled acts of meanness that are directed at children are not only hurtful but perplexing. Tish Cyrus noted that Miley didn't understand why her schoolmates hated her. She had never done anything to them. She had been herself. But what she was unaware of was that her self stood out markedly. She had oodles of beauty, charm and talent that others resented. Every little girl wants to be a princess, and many are told they are princesses and come to believe it. Then when they meet a real princess, they are smitten with jealousy and with an urge to knock the real princess down.

Jealous is not limited to females by any means. Shakespeare knew this feeling well and portrayed it in plays such as Othello, where Iago's jealousy of Othello causes him to scheme the downfall of the latter. Iago is a narcissistic personality, and jealousy is found most often in narcissistic people. Narcissistic people have a need to be superior, to be admired and possess the attributes that would make them superior and admired. Often times a narcissistic parent will raise a narcissistic child. The child is not exceptional, but the mother wants so badly for her child to be exceptional that she convinces herself and the child that the latter is exceptional. Think about the stage mother syndrome.

Such an individual, told from early childhood on that she is superior, will demand to be treated that way. And such an individual, when she meets someone who truly has the attributes she wishes she had, will be filled with disappointment, jealousy and rage.

Healthy people do not feel jealous of others. They accept themselves, whether they are beautiful or plain, short or tall, smart or less than smart. People have difficulty accepting themselves when they have been told to be great but do not feel great deep inside. What they feel deep inside is emptiness.

Because they don't want to know about their emptiness, they remain unconscious of it. When they meet people who are truly superior, they resent them for feeling good about themselves. They view healthy self-esteem as conceit. So they have an urge to knock the exceptional people down, to teach them a lesson.

Hence, the schoolmates of Miley Cyrus locked her in a bathroom. They probably did not tell each other that they were jealous of her. Instead they must have rationalized that she was conceited and needed a lesson. They focused on—and laughed at—her weakness.

Thursday, July 9, 2009

Forgiveness, not revenge, is the answer

"It's not what you're eating. It's what's eating you!"

This old saying describes what happens when you suffer from prolonged stress. Chronic stress eats away inside of you. It causes your sympathetic nervous system to become continually aroused. It releases various chemicals in your body that become toxic after a while; pours sugar into your system; blocks your vessels; and weakens your immune system.

Many people attempt to deal with stress by taking some action, particularly when the cause of stress is anger at a person or situation. If somebody hurts you, you want to hurt them back. Revenge appears to be human nature. We see the motif of revenge again and again in the popular media, and often it is glorified. A man's family is horrifically murdered, and he becomes a one-man vigilante, going on a mission to eradicate all evil people from the world.

In the movies, he is made to be a hero. But such themes leave out the aftermath of revengeful behavior. Revenge has consequences. If you kill somebody in real life, even if you think it is justified, the action brings legal as well as emotional consequences. It may also bring counter-revenge. As it says in the Bible, “Violence begets violence.”

When people cannot assuage their anger through revenge, they often dwell on those who have hurt them. Day after day, night after night, they obsess about them, fantasize about ways of getting back at them, imagine ways such people might bring about their own ruin. They are also continually regretting things and putting themselves down. This constant brooding does absolutely no good but instead causes a great deal of harm.

Revenge appeals to people because it is a quick and simple solution, and it places the responsibility for one's disturbance on others. Hence, the solution is external, not internal.

But revenge is not the real answer to stress related to anger. The real answer is internal: forgiveness.
Forgiveness is not a simple thing. It is a long and complicated process. You can't just decide to forgive somebody who has hurt you. You have to look at things in a different way, and that takes time.

First of all, you have to work through the anger. That means not only talking to somebody about your anger, venting it, and letting it go, but also understanding it on the deepest level. Understanding it on this level means understanding why this incident happened and how similar incidents have happened in the past. Finally, it means understanding your contribution to the incident and forgiving yourself for that contribution.

Finally you are at a place where you may be able to forgive the person or persons who hurt you. Again, you will have to go through a process. First of all, you will ask yourself, “Why should I forgive someone who has been so mean to me?” The forgiveness is not for their sakes. It is for your sake. You do not have to love them. You do not have to see them again. But you do have to stop dwelling on them, and you can stop that by forgiving them.

A final part of the forgiveness process is to understand that you have also hurt people. We all do. If you think back on all the people you've hurt, it is easier to forgive those who hurt you.

Revenge leads to unrest; forgiveness to serenity.

Wednesday, July 8, 2009

Brain Study: Psychotherapy works

Psychotherapy really works! This is according to new brain studies that show psychotherapy induces changes to brain function in the same way that drug treatments do.Veena Kumari conducted the studies at the Institute of Psychiatry and later published her results in a 2006 issue of the journal, Acta Neuropsychiatrica.

With regard to depression, her recent brain imaging study found recovery was associated with decreased metabolism in a part of the brain known as the ventrolateral prefrontal cortex, both in patients who had improved after taking Seroxat, a medicine for depression, and in patients who had undergone cognitive behavioral psychotherapy. Successful therapy was also associated with brain changes that were not found after using Seroxat, including increased activity in the cingulate, frontal and hippocampus regions of the brain.

Similarly, in a study of obsessive compulsive disorder, a disorder in which people become obsessed with certain fears and perform compulsive rituals to prevent them, both cognitive behavioral psychotherapy and the use of Prozac were linked with brain changes Kumari referred to as “the right caudate metabolic rate.”

Cognitive behavioral therapy is known to be beneficial to schizophrenia patients who don’t respond to antipsychotic medication but no research has yet been published on its effects on the brain.

“The reviewed studies clearly demonstrate that psychological interventions, such as CBT, are able to modify activity in dysfunctional neural circuitries linked to the development of various psychopathological conditions,” Kumari concluded in her comparison review.

She added that psychotherapy may provide a clearer insight into the brain changes associated with recovery from mental illness because “it has minimal side-effects (if any) and [unlike drugs] lacks direct pharmaceutical actions to obscure brain changes directly related to behavioral change….”

The comparison of the effects of drug therapy and psychotherapy, however, only goes so far. Even if both have the same effect on the brain, psychotherapy does something that no drug can do: it allows patients to form an attachment with another human being, and through that attachment to understand themselves.

Common to all mental disturbances is a problem in relating to others. No medication can adequately address this problem, although drugs can make a person feel generally calmer about things. Psychotherapy provides a transitional attachment in which persons can learn about their relationship issues, trust or lack thereof, fear of intimacy, anger, jealousy and suspicion.

However, this study does manage to provide a scientific evidence of the effects of psychotherapy—something that has long been needed.

Now if only the whole world would go into psychotherapy.