Cognitive Therapy of Depression

Most researches promote that a 10-12 session therapy helps as much as medications against panic attacks.
This approach utilizes coaching as anxiety management techniques and usually works better than medications especially in terms or recurrence after final treatment.

Selecting a treatment is a doctors recommendation for the therapy regimen. In severe cases, therapy and medications are combined to get the best results. For infrequent attacks, one can try self-treatment but are usually not proven to work depending on ones capacity and discipline. If after a few internal self therapy sessions, one is still not panic free, then trying another method is usually beneficial.

It is known that most stringer medications give out a faster effect compared to behavioral therapies. The known disadvantages however include side effects and the return of panic attacks after the medication is terminated. In behavioral therapy, panic attacks rarely occur after full treatment and if they do, they are often less than with medication. There is also no risk of side effects. Known disadvantages include slow response to treatment in some individuals. They may also be expensive and time-consuming. Some people also are aware of the stigma attached to therapies especially in social circles.

For some people a CBT or cognitive-behavioral therapy is actually fun as they are allowed to relate with other people suffering from the same condition and are able to recognize the different patterns of a panic attack. Psychologically, the mind does its own effort to overcome a problem when it sees one from another persons point of view. This is more applicable to persons in the beginning stages of panic attack syndromes.

Therapists try very hard to develop confidence in their patience and point out where work is needed. They are also there to aid patients which is ultimately better as psychological assistance is provided. Freely talking about a problem also relieves tension and in a way helps alleviate patterns of disruptions in panic attacks.

For fast relief of panic attacks, some people prefer medications compared to therapies which promotes a longer effect in the treatment of panic attacks. Medication may be prescribed by doctors who, through the lack of other options and knowledge of non-chemical substance treatments believe that panic attacks or anxiety are chemical conditions that a magic pill can alleviate. Sometimes in desperation, and in some cases where anxiety can still be controlled, medications may aid but soon after its effects wear off, the risks of succumbing to another attach is very much anticipated. Other panic attacks brought about by agoraphobia and dependence require more than just plain medications in its treatment.

Studying the patient before prescribing the medications is very important. Knowing the occurrence of attacks, its frequency and its strengths is vital prior to medical prescription. Other psychologists and psychiatrists would require their patients to rely on therapy and use medications for a certain period of time to allow the body and the mind to treat itself after a period of normalcy provided by the meds in the intervals between attacks.

Common medications include antidepressants to treat the panic disorder which is effective and totally eliminates panic with little or no side effects. However, antidepressants are quite slow-acting and cannot be taken in large doses all at once. Sometimes, by the time the antidepressant effects are fully generated in the body, non-invasive therapy through counseling may have already taken effect and decreased panic attacks through the brains own adjustment with little therapy.

Valium group or benzodiazepines are fast-acting within the first hour of the first dose. The side-effect is it potential to promote addiction as the body gets used to the medication. Usually, continuous usage after a period of 2-3 weeks results to drug tolerance.
Some doctors would offer benzodiazepines for a few weeks while you’re trying to find an effective therapist. As soon as they are tapered off, the doctor assumes that one should be no worse when you stop than when you started. Some individuals can take medications for a few months, then stop, and remain free from panic attacks. Ideally, medications are discontinued after a specific goal is attained.

Social phobias are more common than people may think. It can affect your life in small ways like avoiding certain roads, or in large ways, like avoiding entire social outings, all of which are done for one purpose: to prevent anxiety and panic attacks.

There are many ways to cure social phobia, but it depends on your commitment and desire to overcome social phobias. Here are a couple easy ways to ward off anxiety or panic attacks.

1. Medication: there are drugs that combat social phobia that either inhibit, block, or slows down your brain and nerves system. But these are drugs nonetheless and many doctors recommend using them as a temporary way to overcome social phobia.

2. Therapy: or more specifically, cognitive-behavioral therapy (CBT). Step by step therapy that uses positive thoughts reinforced through therapy, thus keeping your brain calm and happy in social settings.

3. Confidence: besides therapy there are ways to gain self-confidence as a social phobia cure. Doing an activity you are good or excel in while gradually surrounding yourself with more and more people is a good way to build up confidence. Focusing on the task at hand also takes away negative thoughts that might usually arise.

4. Meditation: quickness and shortness of breath is a common symptom of social phobia and panic attacks. Learning to meditate and control your breathing could eventually help you to control your breathing if you feel an anxiety or panic attack is coming.

If left untreated, social phobia can take control of your life. Depression, panic disorder, and obsessive-compulsive disorder can disrupt relationships, work, and your personal life. Find a social phobia cure for you, because it’s out there and you deserve it.  There are many self-help programs that aim to reduce anxiety and lessen the effects of phobia. To learn more about the effectiveness of these programs, visit http://www.squidoo.com/fightpanicattacks and take control of your life.

It may be a natural response to avoid what we find scary – but that doesn’t mean it’s the best response. When people with phobias dodge whatever it is that fills them with terror and anxiety they usually compound the problem – sometimes to such an extent that it eventually cripples their lives. And that is worth avoiding.

Specific phobias (excessive fear related to exposure to specific objects or situations) can affect up to one-third of the population at some point in their lives. Data released last year from a Stress and Health Study conducted nationally from January 2002 to August 2004 shows that 9,8% of Americans will suffer from agoraphobia (excessive anxiety about being in places or situations that may cause panic attacks) at some time in their lives and 2,8% will suffer from social phobia (the excessive fear of experiencing humiliation or embarrassment in a social context).

Despite this frequency, few people seek treatment. Most people only seek treatment when the phobia becomes severe and interferes significantly with their personal lives, career or interpersonal relationships.

Panic Mode

The definition of ‘phobia’ is ‘a persistent, irrational fear of a specific object, activity or situation that leads to a compelling desire to avoid it’. This ’solution’, however, soon becomes part of the problem. Avoidance and control behaviors become a handicap, forcing people to use up time, energy and attention that could be better spent on other things. People with a phobia become adept at avoiding that phobic object or situation so they never face the fear, which then becomes more intense and causes the avoidance to be more extreme.

Gradually the sufferer’s life may become increasingly restricted and governed by the phobia. For example, socially phobic people learn to avoid social situations that lead to anxiety. They may eventually avoid public-speaking engagements, eating in public or using public toilets. Over time the person avoids almost all social encounters and may even become housebound.

A phobia may also become inclusive of other things related to the phobic object or situation. A person who has a phobia of furry dogs may start to fear anything furry, and then can’t even look at a picture of furry dogs or other furry objects. As more and more situations and objects are avoided, the sufferer’s world starts to close in.

When phobic disorders go untreated they can lead to secondary conditions such as depression, other anxiety disorders, substance abuse and even suicide. Many people with social phobia become dependent on alcohol or sedatives and use them to reduce their anxiety.

Face the Fear

Two popular treatments for phobias are Cognitive Behavioral Therapy (CBT) and hypnotherapy. There is no good evidence that hypnotherapy is an effective treatment for specific phobias. CBT, however, is useful in the treatment of both specific and social phobias. With CBT, people are gradually exposed to their feared situations, beginning with the situation they fear the least. In people with social phobia, CBT can be used to correct dysfunctional thoughts about fear of failure, humiliation or embarrassment.

With CBT it’s important that exposure is graded and repeated, as forced and quick exposure is likely to reinforce the phobia. Treatment is also not dependent on knowing the cause or root of the phobia. By just recognizing and diagnosing the symptoms, treatment through CBT can be very effective.

The most typical way it’s used to diagnose clinical depression is based on the symptoms. Unlike physical ailments, mental disorders are much more difficult to accurately diagnose as many of the symptoms are based on perceptions.

At issue is what determines the baseline measurement? Take for example to very common symptoms.

1. Feelings of overwhelming sadness or fear.

2. Fatigue or a loss of mental or physical energy.

If you consider society at large as the baseline measurement for the degree of sadness and fear, we have a problem. It’s no secret that least in today’s society there is very little true satisfaction in employment in many cases family life. This is very evident by the fact that we have such high rates of divorce, job hopping and an unwillingness to make or follow through on commitments. Using society at large can be dangerous. Remember that at one time most of society thought the world was flat.

Is it possible that those of us diagnosed with depression may simply have a different or even deeper understanding of the world and life in it? While many psychologists work to understand the symptoms and provide an accurate diagnosis of depression, getting to the root cause is much more difficult.

Is it possible that people with depression may have hypersensitivity to the world around them? Do they recognize the world is in serious shape and they are unable to adjust their internal integrity and need for justice. In a world where abuse of your fellow man can bring not only riches but recognition by society as “successful” it’s no surprise that sensitive and thinking people may exhibit the symptoms of depression.

Is it possible that some of us are depressed because we see the definition of success in society is more stuff that ends up having little or no value? Do depressed people recognize the inherent inequity of the larger rules in play and have no answer or solution? Mental health professionals may recognize these types of outlooks and their answer is often times to encourage a depressed person to recognize that they can’t fix everything.

Although there are treatments, they assume the person diagnosed with depression is the one that is actually ill. If the root causes of depression are a recognition of our need for fairness, equity and justice, treatments may only change our mental perception at our own expense. This might explain why depression is a chronic condition that many fight their whole lives to control.

If at least somewhat accurate, people with depression are in mental combat with their own possibly deeper understanding of life and what they see throughout society. Wouldn’t it be interesting if between the depressed and nondepressed groups, we’ve unwisely identified the wrong ones as having a disorder.

This article offers a different perspective on identification of depression as a disorder or illness. Many of us apparently can manage the severity of the depressive symptoms because the great majority of us don’t seek help. If you’re suffering from depression and the symptoms are starting to be overwhelming, please get some help as quickly as possible. If you’re having thoughts of suicide or have simply given up, you need to get some help.

Panic and anxiety attacks affect around 5% of the population at some point in their life – usually young people up to the age of 35. Standard medical treatment includes a variety of medication to help ease the affects of the attacks and help gain control at an emotional level.
However if you are not into medication or natural remedies to treat panic attacks, then you may want to try the Three Minute Therapy: a cognitive approach to dealing with panic attacks.
This may be the most logical method of overcoming panic attacks compared to seeing a psychologist or physician. This therapy assists the mental processes that a person goes through when experiencing a panic attack. There are two stages to this: first, identifying the “must do” activities that are driving the panic attack, and secondly disputing these “must do” activities until you overcome the pressure.
Anxiety prone people are more prone to dwell and magnify things that they “must do”. For instance, a mother of small children might think that she “must know” exactly why she feels panicky. She tells herself that she “must” never lose control. She “must” not do something to look stupid. She tells herself that she “must” have a guarantee that she’s not going to make herself panic.
These “must do” activities become an unrealistic obsession, and this develops into feelings of fright, panic, becoming hysterical and ultimately depression. People with these feelings of panic might also want to avoid uncomfortable situations so as to avoid further loss of control.
Using Three Minute Therapy, the panic attack sufferer needs to identify the “must do” activities in their life. Though it is “nice” to avoid discomfort or unwanted situations, it is not entirely a “must have” situation. Being uncomfortable is a perfectly normal human feeling, every once in a while. So you will need to realise that this is part of everyday existence and get on with life.
The second step in Three Minute Therapy is to convince yourself that these “must do” activities are not really that important after all. This will be a real mental battle for some people, as it goes directly against the grain of their thinking. As a sufferer you will need to be persistent and confront these thoughts when they arrive and dispute these “must do” activities until you feel it is natural to let go with the situation.
One method of overcoming panic attacks is to practise doing things that you would otherwise be afraid of doing. This stretches your boundaries and you will be able to demonstrate that discomfort isn’t life threatening, and will tend to diminish in its ability to cause panic the more you face it.
By using Three Minute Therapy you may be able to overcome panic and anxiety attacks without the use of drugs or medication.

Introduction

Medicine, psychiatry, and dualism:

In the past, psychiatric diagnoses have been regarded as ‘mental’ in nature, in contrast to the ‘physical’ nature of medical diagnoses. This distinction reflects the absence of gross pathology in most psychiatric disorders, and the fact that these conditions usually present with disturbed mental states or behaviour rather than physical symptoms.

Underling this division of illnesses into physical and mental, is the assumption that a parallel distinction can be made in healthy people ‘body-mind dualism’. This has and continues to exert a profound influence on medical thinking.

Co-morbidity means the occurrence of two disorders. The term has been extended to describe the co-occurrence of prominent mental symptoms and bodily pathology since these patients are usually given a psychiatric and a physical diagnosis. In particular neither of these diagnoses may lead to effective treatment because a focus on either may lead to neglect of the other. An example is the widespread neglect of depression in patients with medical disease.

Somatization some patients have somatic symptoms but no evidence of bodily pathology. It is then unclear whether their illness should be categorized as medical or as psychiatric. In the past these conditions were generally given the medical diagnosis of functional illness (function is abnormal but there is no pathology). Now these conditions are usually given the psychiatric diagnosis of somatoform disorder. Such patients receive both a medical diagnosis (organic disorder) and a psychiatric diagnosis such as somatoform disorder (functional disorder) and the resulting confusion and controversy is well illustrated by literature about the condition called Chronic Fatigue Syndrome (CSF) or Myalgic Encephalomyelitis (ME).

Modern (integrated) approach:

New scientific knowledge, such as the demonstration of the neural basis to many psychiatric disorders (esp. with the functional imaging and genetics) has shown that crude dualistic thinking is untenable. Evidence for the effect of psychiatric disorder on the outcome of medical conditions such as MI (Frasure-Smith et al 1993) has pointed to the same conclusions.

Mind and brain are now increasingly regarded as two side of the same coin. This shift implies that psychiatric disorders are no more distinct from medical conditions than the higher nervous system is from the rest of the body. As Eisenberg (i986a) put it, psychiatry has to become less ‘brain-less’ and medicine less ‘mind-less’. Correspondingly medical and psychiatric care need to be more integrated.

The ‘biopsychosocial’ approach which can be further divided into predisposing, precipitating and perpetuating causes can go a long way to bridge the gap and most importantly, serve the patient.

Anxiety Disorders

Abnormal state in which the most striking features are mental and physical symptoms of anxiety, occurring in the absence of organic brain disease or another psychiatric disorder

Symptoms of anxiety:

Psychological arousal

Autonomic arousal

 Muscle tension

 Hyperventilation

 Sleep Disturbance

 Although all the symptoms can occur in any of the anxiety disorders, there is a characteristic pattern in each disorder which will be described later. The disorders share many features of their clinical picture and aetiology but there are also differences:

 The Classification of anxiety disorders (ICD-10):

 Agoraphobia (with or without panic disorder)

Social phobia

Specific phobias

 (OCD in ICD-10 is diagnosed separately, in the DSM-IV it is under anxiety disorder)

Generalized Anxiety Disorders

Clinical Picture

The symptoms in GAD are persistent and are not restricted to, or markedly increased in, any particular set of circumstances. All the previously mentioned symptoms can occur, but there are characteristic pattern comprised of the following features:

Clinical signs

The face appears strained, the brow is furrowed, and the posture is tense. The person is restless and may tremble. The skin is pale and sweating is common, especially from the hand, feet, and axillae. Readiness to tears, which may at first suggest depression, reflects the generally apprehensive state.

Note that there is no clear dividing line between GAD and normal anxiety. They differ both in the extent of the symptoms and the duration (in DSM-IV 6 month, in the ICD-10, more flexible; symptoms should have been present on most days at least several weeks at a time, and usually several month’

Comorbidity is common:

Epidemiology:

Life time rate 4-5 %

Incidence 3% per year

Aetiology:

Biopsychosocial, Interaction between stressful events, genetic causes, early experiences, personality and social circumstances.

Areas of the brain most likely involved: the amyygdala, the hippocampus.

Na, 5-HT, GABA and recently CRH (corticotrophin releasing hormone)

Prognosis

Duration is important and the longer the GAD the worse the prognosis.

Co-morbidity (physical or psychiatric) worsen the prognosis

However GAD has a very good prognosis if treated.

 Treatment

Phobic anxiety disorders:

1. Specific phobia

Same core symptoms as GAD, but occur in particular circumstances, there may be anticipatory anxiety. Grouped into:

The following specific phobias will be described briefly:

Phobia of dental treatment: 5% of adults.

Phobia of flying: CBT or behavioural treatment (desensitization is effective)

Blood injury phobia: unique in that fainting does occur, tensing works effectively with behavioural treatment.

Phobia of choking: exaggerated gag reflex (usually past experience). Desensitization works.

Phobia of illness: though recognised as irrational and not resisted.

Epidemiology:

Incidence 4.4 %per year

Prevalence 4% in M and 13 % in F.

Most start in childhood.

2. Social phobia

 Clinical picture:

Inappropriate anxiety, experienced in social situations in which the person feels observed by others and could be criticized by them. Avoidance and escape are characteristic. Can be generalised or specific (e.g. public speaking). Associated with depression and substance misuse

Two discrete social phobias require separate consideration:

 Prevalence 7%. M=F (seeking treatment). F>M (community).

Treatment with psychotherapy or medication (SSRIs and ? blockers).

 3. Agoraphobia

Patients are anxious when they are away from home, in crowds, or in situations that they cannot leave easily. They avoid these situations, feel anxious when anticipating them, and experience other symptoms. Especially panic attacks and fear of fainting and loss of control. Anticipatory anxiety is common, also depression, depersonalization and substance misuse.

 Epidemiology:

Life time prevalence 6-10% F>M

Usually begins in mid twenties (later than social or specific phobias)

 Panic disorder:

Clinical features:

Symptoms (at least 4) , more than 4 attacks in 4 weeks, or one attack followed by 4 weeks of persistent fear. Symptoms are:

 Epidemiology:

 Life-time prevalence is 5%.

Herdedibility is high, up to 30-40%.

F>M 2:1

Amongst men mortality is higher from cardiovascular disorders.

 Mixed anxiety and depressive disorder

This diagnosis is reserved when the diagnostic criteria for depression or GAD are not severe enough to meet the criteria. Mild illness

Influence of culture on anxiety disorders:

In several cultures the presenting symptoms of anxiety disorders are more often somatic than psychological. e.g. Koro ,occur amongst Chinese men , there are episodes of acute anxiety, lasting 30 min to a day or two, the person complain of palpitation, sweating, pericardia discomfort and trembling. At the same time he is convinced that the penis will retract into the abdomen and that when this process is complete he will die.

References

•1.      Stevens L, Rodin I. Psychiatry: An illustrated colour text, Churchill Livingstone 2001

•2.      Steple D. Oxford Handbook of Psychiatry, Oxford University Press, 2006

•3.      World Health Organization (WHO). ICD-10 Classification of mental and behavioural disorders. Churchill Livingstone

•4.      American Psychiatric Association (APA). DSM-IV-TR. Fourth Edition Text Revision. APA Publication

Shyness and social anxiety can develop even from infancy. Everyone can remember a time when they felt shy or embarrassed at school. Perhaps you have a bad memory of being told off in front of the class? Or perhaps a time when you had to perform on stage with your parents watching you?Even babies can feel shy and embarrassed. Often babies are much more reserved around people they are not familiar with. As children grow up, they frequently face criticism and new experiences that can be daunting. Going through puberty can be a difficult period and can greatly change the behavior as well as the physiology of a child.Teenagers start feeling things physically and mentally, that are new to them. They become self-conscious around their peers and more attention to their appearance. Everyone knows what it feels like to be shy. Situations such as talking to someone important, going on a date and attending a social event can make a person feel nervous and shy.When a person has constant anticipation of doing something embarrassing in front of others they might have social anxiety disorder. Sufferers fear social situations because of possible humiliation and embarrassment, which makes everyday life hard to cope with. They may even feel anxious walking down a street.Physical symptoms include blushing, profuse sweating, shaky voice, shaking and dizziness. Symptoms of social anxiety can worsen if the sufferer is in an emotional state or in poor health. Fatigue, worry and stress can exacerbate their condition. Each social experience might also produce different levels of anxiety. For instance, visiting a family member would not create feelings of anxiety compared to going on a first date.Social phobia can often be seen as shyness but they are not the same. Sufferers of social phobia will do anything to try and avoid being in the spotlight of others. When a person experiences negative social situations frequently, shyness can become a learned response that can further develop into social anxiety disorder.Fears and anxiety only intensify when similar bad experiences arise and only reinforce a mental association. Most sufferers develop fears from one bad experience that is followed by others. Now when a similar situation arises they immediately link it to their past bad experiences and that’s when they start to panic.Facing your fears can sometimes work in overcoming certain fears but when it comes to social phobia it needs to be gradual process. In addition deep subconscious changes to a person’s behavior are needed. Therapies such as hypnosis and CBT deal with the aspect of adjusting thought patterns and behavior.One overlooked aspect of reducing social anxiety includes improving physical health. Taking care of your body through exercise and eating well can help reduce stress and anxiety. More energy and better health will only help boost self-confidence and positvity.

Millions of people with anxiety disorders go on to live their lives without anxiety help. Many people rather not have to take medication as they can be addictive and cause unwanted side effects. Medication is also not the best solution for anxiety disorders since they only treat the symptoms and not the root cause of the problem. Often anxiety disorders are brought on by repetitive negative association with a particular experience.Some sufferers develop a dependency and can’t imagine not taking medication to help them get through their day. Prolonged use of medication can make sufferers dependent on them to the point that they can’t start their day without them. It’s not uncommon for users to continuously take medication for years. This raises concerns since sufferers not only become addicted to medication but also tolerant. What’s more anxiety symptoms often come back when sufferers eventually come off medication.Luckily there are other methods of anxiety help that do not rely on medication. Alternative methods of treatment include therapies such as hypnosis and CBT which don’t rely on medication. Some treatments combine both medication and therapy to tackle the disorder in both the short and long term. Talk to your doctor about the best option for you and also the risks involved.Some sufferers quickly give up trying after one method of treatment doesn’t work for them. Sufferers want a quick method that works instantly without trying. Unfortunately the mind takes time to recover and change, it is not a machine. Because it often takes time to develop anxiety disorders, recovering from them requires patience. Another explanation for not seeking anxiety help is because symptom are not always easy to spot. Symptoms of anxiety run into the 100s and may not even seem related to anxiety. It’s not uncommon for a sufferer to live with an anxiety disorder for years without even realizing it. What’s more there are various disorders and literally 100s of phobias, so one sufferer isn’t expected to experience the same sensations as another.Symptoms can change; one minute you have chest pains the next you might be hyperventilating. Poor emotional and physical wellbeing usually aggravates symptoms. Also they can seem non-descript or too general sounding; a headache, a stomach ache, random sharp pains and hot flashes. Most sufferers will ignore these symptoms since most people have experienced them.A person might recognize that they need help but are not sure what is wrong with them. There are those that are unfortunate and never find out what they have despite seeing their doctor repeatedly. Doctors are not always correct and sometimes misdiagnoses happen. At minimum a sufferer should expect a physical and psychiatric assessment before an accurate diagnosis is made. Moreover, anxiety help should be personalized for each patient.

You’re about to go on a date and you start experiencing anxiety symptoms. Your hands become sweaty and your chest tightens. Breathing becomes rapid and you feel on edge. Most people get a bit anxious meeting a person that they’re attracted to. But anxiety can be a bigger problem for some people and affect them daily. Anxiety symptoms can knock the confidence out of person and make them feel insecure and cause them to overreact. Because of this it can be difficult to meet people and build friendships. When an anxious person with low self-assurance meets someone they’re attracted to, they immediately have thoughts of rejection and unworthiness. It’s quite a common reaction to seem unattracted to the other person as a way to defend their pride if they do get rejected.An anxious person might unintentionally throw mixed signals constantly trying to control their emotions. Eye contact can be hard to make for them and they might seem clumsy. In an attempt to evade humiliation they might put distance between themselves and their date. Believing that a date will go badly and that your date will not like you is not a good start.Confidence is an attractive trait but you’re not expected to turn into Tony Robbins overnight. Some people look confident without even trying, they’re simple relaxed when around others. If you spend a lot of your time worrying about things that might not ever happen and feeling anxious, you might have an anxiety disorder. Social phobia and Generalized Anxiety Disorder are two very common anxiety disorders that can severely affect a person’s ability to build relationships.  Anxiety disorders can make daily life very difficult to cope with and affect both mental and physical health. Anxiety symptoms are likely to look different from one person to the next since there are hundreds of possible symptoms. While many people go on to live their lives undiagnosed, there is help and treatment for anxiety disorders. Therapy such as CBT combined with anxiety medication can help treat or reduce symptoms of anxiety.    Some of us aren’t naturally confident and may feel weak when it comes to socializing. It’s surprisingly easy to acquire confidence however with a few simple techniques. In time anyone can learn to become more confident. Do mental exercises and read self help guides to build confidence and reduce anxiety. Think of someone that is confident and strong in your eyes and try to adopt their behavior.If you find that you get anxiety symptoms next time you’re on a date, don’t do anything. Just accept the feelings, better still accept the feelings as excitement. Relax and focus on inhaling deeply and slowly. Don’t forget there’s every bit of chance your date is nervous too so need to criticize yourself too much. If things don’t go as planned just think of it as practice for next time.

The brain performs countless miracles every second of each and every day. I’d like to discuss one such miracle that brings so much hope for those suffering from mental and emotional disorders. It’s an amazing compensatory process of the brain known as neuroplasticity.

Neuroplasticity is all about the brain reorganizing its neuron-to-neuron connections in response to new circumstances and environments. Though it performs its magic primarily during infant, toddler, and pre-pubescent brain development; the adult brain can be amazingly “plastic.” Neuroplasticity also comes into play within the context of disease and injury, explaining, let’s say, how a stroke victim regains a particular function even though the area of the brain responsible for that function has been badly damaged. Neuroplasticity occurs, shall we say, automatically as a process of development. But it can also occur by choice – willfully – giving us conscious management of the dynamic. And therein lies the hope.

A very, very wise man, Dr. Jeffrey M. Schwartz, M.D., and his colleagues at UCLA, discovered that cognitive behavioral therapy (CBT) can positively impact the brain machinations involved in obsessive-compulsive disorder (OCD) in a manner similar to psychotropic medications. Briefly, CBT, a psychotherapeutic intervention, is grounded in the pivotal role of thought as it applies to our feelings and behavior. If we’re experiencing distress, the mission of CBT is to identify the faulty thinking (cognitive distortions) causing the problems and teaching us how to swap these misguided thoughts with material that’s based in reason. Then it’s a matter of taking this enlightened thinking to the world and enjoying our more desirable responses and behaviors. 

Well, the story goes that Dr. Schwartz revisited an interest in the Buddhist concept of mindfulness, a clear-minded, in-the-present-moment, self-observational technique that emphasizes viewing self without criticism or judgment. Schwartz discovered that when OCD patients practiced mindfulness meditation (as a CBT technique) upon experiencing distressful symptoms, a significant number of patients reported measurable improvement and relief. Wanting to understand why, Schwartz and his team examined PET scans administered before and after a course of CBT and found activity in the core of the brain’s OCD circuit, the orbital frontal cortex, decreased significantly. Furthermore, the observed decrease was about the same as what would be noted after meds therapy.

Schwartz needed no further evidence that choice, will, and neuroplasticity can alter the brain’s functioning, holding the potential to bring a whole lot of relief to a whole lot of people. Incidentally, I wanted to share this neat description of mindfulness before we move on. It’s from Buddhist nun and Tibetan Buddhism teacher and author, Pema Chodron. It fits perfectly here. “The root (of mindfulness practice) is experiencing the itch as well as the urge to scratch, and then not acting it out.”

Neuroplasticity is all about neurons having the ability to establish new connections throughout our brains, facilitating all sorts of new functioning. So it’s a matter of the potential for the brain to be rewired. But it’s also about how specific neural circuits got wired in the first place, resulting in current patterns of thought, emotion, and behavior.

It’s pretty clear that neurons consistently interacting together form long-lasting functional relationships, just as neurons that no longer dance together lose their connections. And these dynamics are foundational in our hope for incredibly positive and powerful change throughout the lifespan, as our brains physically change – adapt – based upon the dynamics of neuroplasticity. If we acknowledge this capability and learn how to bring it to reality, all sorts of mental and emotional healing will be right at our fingertips. 

If you want to learn more about neuroplasticity, check-out the work of Jeffrey M.Schwartz, M.D., Michael Merzenich, Ph.D., and V.S. Ramachandran, M.D., Ph.D. Amazing minds, and incredibly fascinating and useful information.