O'Grady Psychology Associates

Psychotherapy, Marriage Counseling, Neuropsychological Assessment

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Alternative & Complementary Treatment for Emotional and Physical Health

Self-care and ethics for psychologistsWith changes in health care following the Affordable Care Act, providers will soon emphasize health promotion over disease management. Integrating alternative and complementary approaches to well-being will provide patients with ways to manage their health and provide a foundation for preventing new health problems. Complementary and Alternative Medicine (CAM) has been practiced for the last 25+ years in the United States, but many of these approaches have a much longer history: well over 2,000 years, in the case of yoga. In the last decade, studies examining the effects of yoga have increased substantially—important for yoga’s acceptance as a mainstream treatment.

CAM includes health-care practices that have not generally been considered part of conventional medicine. In 1991 Congress passed legislation to provide the National Institute of Health (NIH) with $2 million in order to study unconventional medicine. Some of the most widely studied alternative approaches to health promotion and maintenance include biofeedback, meditation, dietary supplements, chiropractic treatment, massage therapy, relaxation training, movement therapy, art therapy, and acupuncture, together with spirituality, religion, and prayer. Other approaches, such as hypnosis and bodywork (including Reiki, Hanna Somatic Education, and Feldenkrais), have also been used for several decades.

Biofeedback is One of Many Treatments Shown to be Effective in Treating Medical Problems

Biofeedback can help many medical problems.
Biofeedback Before the Digital Age

I incorporated biofeedback training for the patients I saw during the eight years I worked at Kaiser Hospital in Vallejo, CA. Biofeedback informs a patient of important physical measures such as muscle tension, skin temperature, brain wave activity, and heart rate. The photo shows what was state-of-the-art equipment at the time (circa 1988.)
I treated patients referred by their PCPs, neurologists, and orthopedic physicians for chronic medical problems. These patients were considered ‘high utilizers’ of medical services such as doctor office visits, prescription drugs, and special procedures. Using a treatment model that included cognitive-behavioral therapy, biofeedback, relaxation and meditation training, patients suffering with chronic headache were able to reduce doctor’s office visits by 75%, medications by 56%, emergency room visits by 19%, and special procedures by 6% for up to five years after treatment.

We have come a long way since then. Digital developments since those early years have dramatically changed the way biofeedback services are delivered. But the principle is the same: taking responsibility for your own health.

Taking Responsibility for Your Health is Key to Lasting Change

Teaching a client to control muscle tension so they can reduce musculoskeletal pain, or showing a migraine sufferer how to increase hand temperature through relaxation and biofeedback, involves learning to be aware of stress and the body’s automatic reaction to it. Of course there are some that would rather take a pill to relax, but that doesn’t change the psychophysiological baseline. Taking a pill or a drink will give temporary relief, but will not lead to lasting changes in how the body handles stress, thereby preventing headaches or pain altogether—not treating them once they occur. Implementing positive health behaviors require discipline and consistency. When physicians have 20-minute appointments –once or twice a year—there is not sufficient time to instruct and follow-up on a patient’s exercise or yoga practice. For people who are dealing with significant life stress, medical problems or depression, making life style changes can feel insurmountable. One yoga class will not help an achy back, nor will a meditation class help control anxiety if the home practice component is ignored. Psychotherapy aimed at helping integrate and continue healthy changes can help.

Wearable sensors such as Nike+ FuelBand or the Fitbit One monitor everything from heart rate, steps taken, sleep quality, energy used, and skin temperature. As a recent New York Times article reported, there is even an app to detect signs of depression in diabetes patients through smartphones.

Taking responsibility for health by using both ancient practices and newly emerging technologies and treatments will improve lives and ultimately reduce medical costs. But the most profound outcome is engagement with a life lived fully.

References:

“The Integration of Complementary and Alternative Medicine (CAM) Into
the Practice of Psychology: A Vision for the Future,” in Professional Psychology: Research and Practice, 2012, Vol. 43, No. 6, 576–585.

Changes in medical utilization after biofeedback treatment for headache: Long-term follow-up. O’Grady, Susan J. Dissertation Abstracts International, Vol 49(1-B), Jul 1988, 241.

National Institutes of Health (NIH). (2011). NIH—The NIH almanac (NCCAM). http://www.nih.gov/about/almanac/ organization/NCCAM.htm

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How Anger Hurts Relationships

Getting angry…is easy and everyone can do it; but doing it . . . in the right amount, at the right time, and for the right end, and in the right way is no longer easy, nor can everyone do it. —Aristotle, Nicomachean Ethics (II.9, 1109a2

Managing Conflict Rather than Eliminating Conflict

Conflict is inevitable in any long-term relationship. In the Gottman approach to couples counseling, we help clients understand that conflict is normal. Rather than eliminating conflict, we help them learn to manage it. Why can’t all conflicts be resolved? Because backgrounds and personalities don’t match exactly. Couples will always have some areas of disagreement: neat/tidy, disorganized/scheduled, emotionally expressive/keeps feelings inside, to name a few. Even two tidy people may disagree on who does more work around the house or, perhaps, what cleaning routine to follow.

By the time couples come to counseling, they have often been having the same argument in different forms for many years. The issue has become gridlocked—and just as drivers stuck in traffic feel angry and frustrated, partners who can’t move beyond an issue start having negative feelings about each other and the relationship.

Learning to Listen Without Anger

Anger is often the result of feeling misunderstood. When one partner feels like they are not being heard on a particular issue, and they likewise have trouble listening to their partner’s point of view, anger simmers, sometimes for years—finally coming to a roaring boil.

Jim and Joan came to counseling because she felt he stopped participating in the family years ago. Meanwhile, Jim felt disenfranchised. His views and opinions on how they were raising the kids were ignored and he felt he was “just a paycheck.” Joan felt he had checked out and was uninterested in her, the kids, or their home. They were both angry; they both felt the other was wrong. When they tried to discuss this problem it always escalated to screaming and yelling, often within earshot of the kids.

When they started couples counseling, they had had this same fight many, many times. Jim would withdraw; Joan would become more focused on her friends and the women in the neighborhood, whom she confided in and got support from. Joan and Jim were emotionally estranged. Not surprisingly, intimacy, both emotional and physical, had come to a grinding halt.

Gridlocked Problems: Begining to Compromise

When I listened to them discussing a variation of this gridlocked problem, I saw that each became angry quickly, and the result was they stopped listening to the other. Joan would lecture and Jim would face the other way, clamming up. People have many ways of expressing anger: he was seething inside quietly, and she was ranting loudly, but both were angry.

I stopped them when this happened and had them take just a few minutes to calm themselves. To go from anger to calm by learning to self-soothe is an important skill in all relationships, but especially in marriage. It can take just a few minutes to do this. This isn’t about swallowing or denying anger; the trick is to then re-engage in the conflict discussion with a more receptive and less defensive tone.

Staying angry is much easier, but “doing it in the right amount, at the right time, and for the right end, and in the right way” (as Aristotle said) produces quite different results when dealing with a perpetual problem. It is okay to be angry. But understanding why you are angry, and learning to express your feelings in a way that is clear and void of the four horsemen will lead to a very different conversation with a different outcome. Once Joan and Jim learned to talk about their conflicts without getting flooded, they listened to each other with deeper respect for the other’s feelings. This is the first step in learning to compromise.

Practicing self-soothing is something you can do at any age, and at just about any time. Listen to this simple three-minute ”breathing space” to feel the difference in your thoughts, feelings, and physical sensations when you take just a few minutes out of a difficult situation. For it is not just the repeated, unmanaged fights that damage the relationship, but the skewed and distorted perceptions that keep you stuck in gridlock, stewing, for years—over the same issue.

Try this brief relaxation exercise:  Three Minute Mindfulness

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Being Playful Gives Freedom from the Restrictions we Put on Ourselves

Finding your playfulness again
Learning to Play

Gerald Heard visited Georgia O’Keeffe at Ghost Ranch in 1937. He had an interest in Eastern religions and metaphysics. One morning, O’Keeffe found Heard’s footprints around the tree where he had been dancing as well as a cryptic inscription he had etched into the earth at the base of the tree. “Gerald’s Tree was one of many dead cedars out in the bare, red hills of Ghost Ranch. From the footmarks around the tree, I guessed he must have been dancing around the tree before I started to paint it. So I always thought of it as Gerald’s Tree. “ Georgia O’Keeffe.

O’Keeffe painted two versions of the tree, indicating its importance to her. On a visit to Ghost Ranch, I heard this story and was captivated.

David took this photograph in 2008. The tree has not changed in the years since O’Keefe painted it. That this twisted tree, would be the subject of several paintings fascinates me. To see color in dirt takes a willing eye. It is easier to see beauty in vivid flowers or lush forests. The desert makes you work to see it’s unique beauty.

Over the years, I have made many trips to theSouthwestt. One of my favorite pieces of writing is from the novel, Song of the Lark by Willa Cather. This takes place after an intense period of her life as an opera star. She goes to the desert to rest and recuperate.

I sat down in the middle of the garden, where snakes could scarcely approach unseen, and leaned my back against a warm yellow pumpkin. There were some ground-cherry bushes growing along the furrows, full of fruit. I turned back the papery triangular sheaths that protected the berries and ate a few. All about me giant grasshoppers, twice as big as any I had ever seen, were doing acrobatic feats among the dried vines. The gophers scurried up and down the ploughed ground. There in the sheltered draw-bottom the wind did not blow very hard, but I could hear it singing its humming tune up on the level, and I could see the tall grasses wave. The earth was warm under me, and warm as I crumbled it through my fingers. Queer little red bugs came out and moved in slow squadrons around me. Their backs were polished vermilion, with black spots. I kept as still as I could. Nothing happened. I did not expect anything to happen. I was something that lay under the sun and felt it, like the pumpkins, and I did not want to be anything more. I was entirely happy. Perhaps we feel like that when we die and become a part of something entire, whether it is sun and air, or goodness and knowledge. At any rate, that is happiness; to be dissolved into something complete and great. When it comes to one, it comes as naturally as sleep. 1918

Sitting down in the dirt, or the grass, and letting the sounds and small movements of the tiniest creatures catch your attention is a way to play. Play comes naturally to children. They can play by dancing round the mulberry bush, or by laying down in the tall grass and watching the clouds move across the sky, creating castles and animals in their mind. Or watching a line of ants as they carry their burdens along their well-worn tiny paths, letting imagination carry them away.

Think of the ways you play

Wake up early, dance around the base of a tree and find a communion with nature. Being spontaneous, playful, and indeed silly gives freedom from the restrictions we put on ourselves. Think of the ways you play. Write down the most vivid times you played in the last five years. What do they have in common? What do you feel as you remember them? Then think back on some of your earliest memories of playing when you were small. Do these experiences have anything in common?

Being mindful and playing are ways to find the ever-elusive joy we often let slide by for more routine tasks of life. Give in to the urge to dance in the early morning, or in the starlight and watch as you come alive again.

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Powering off to reboot your internal drive

When your iPad or smartphone is having issues—unresponsive, randomly crashing, or just running sluggishly—it’s time to power off and reboot the system. When do you power off so that you can reboot your drive?

Irritability, Fatigue, Lack of Enthusiasm?  Time to Power Off

When you are having issues such as irritability, fatigue, or lack of enthusiasm, it’s time to power off. In a previous post, I mentioned that relaxation is one of the eight therapeutic lifestyle changes that help people cope with depression, anxiety, and sleep problems. Taking time to relax is often the last thing on a long to-do list for most people. And being last on the list, it’s often neglected. People might think they’re powering off by surfing the web, watching TV, attending to email, or having a bowl of ice cream while talking to a friend on the phone. These things will give you a break but won’t provide the restorative stillness we need to feel replenished.

When you reset your iPad by shutting it down, the apps that have been causing problems are cleared, giving a new start—a clean slate that will clear up the system so it can function the way it’s designed to. You, too, can reboot your internal drive by practicing deep relaxation. Listen to the audio at the end of this post to taste a few minutes of relaxation.

Ten Minute Lying Down Meditation