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Posts Tagged ‘CBT’

Problem-Solving Therapy (PST)

Posted by Sun on July 27, 2012

Problem-Solving Therapy (PST) is a well-established form of cognitive-behavioural therapy (CBT) with a substantial body of research evidence supporting its theory and practice.  It was developed in the early 1970s by behaviour therapists seeking to design a general-purpose set of strategies for helping clients to enhance their creative problem-solving abilities.  We now know that Problem-Solving Therapy (PST) is particularly effective in helping people who suffer from depression, and it tends to be combined with assertiveness training and other therapeutic approaches.

The goal of Problem-Solving Therapy isn’t merely to help you solve your own problems but to make you a more skilled ans self-confident problem-solver in general.  Problem-solving is traditionally divided into five main component skills, which can be taught and practised in therapy sessions,

  1. Problem Orientation.  Your mind-set or attitude toward problems, i.e., seeing problems as a normal part of life, as challenges to be overcome rather than overwhelming threats, and a willingness to approach them in a systematic and timely manner.
  2. Problem Definition.  The ability to define problems and corresponding goals accurately and objectively, without unhelpful assumptions or emotive language, i.e., to stick to the key facts and pinpoint what it is that makes the situation a problem.
  3. Generating Alternatives.  The ability to look at things from different perspectives and creatively brainstorm an exhaustive list of potential solutions, i.e., to identify all of the available options.
  4. Decision-Making.  The ability to prioritise the best solutions and evaluate them from all the relevant perspectives, i.e., in terms of both short and long-term consequences and the effect upon yourself and other people.  The ability to identify the best solution or combination and to develop a realistic plan of action.
  5. Solution Implementation.  The ability to test your action plan out in the real world, putting it into practice and evaluating the outcome, in an “experimental” manner.  The ability to adapt plans or employ “backup plans” where appropriate and to repeat the problem-solving process where problems remain unresolved.



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CBT Psychotherapy Best For Anxiety Disorders

Posted by Sun on July 23, 2012

A University of Houston researcher has found that patients suffering fromanxiety disorders showed the most improvement when treated with cognitive-behavioral therapy (CBT) — in conjunction with a “transdiagnostic” approach, which allows therapists to use one kind of treatment no matter what the anxiety.

The problem up to now, according to Peter Norton, Ph.D., an associate professor in clinical psychology and director of the Anxiety Disorder Clinic at the University of Houston, has been that each anxiety disorder — such aspanic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder, and phobias — has had a targeted treatment.

The transdiagnostic approach recognizes that many overlapping dimensions exist among these anxiety disorders. It suggests that thinking about anxiety disorders as a whole from a behavioral dimension and/or psychological dimension perspective may yield important insights into these disorders.

Norton, who says the specific treatments aren’t all that different from each other, has shown that a combination of CBT with the transdiagnostic approach has proven more effective than CBT combined with other types of anxiety disorder treatments, such as relaxation training.

“The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been an important breakthrough in understanding mental health, but people are dissatisfied with its fine level of differentiation,” he said. The DSM uses a categorical approach to classifying mental disorders, including anxiety concerns.

“Panic disorders are considered something different from social phobia, which is considered something different from PTSD. The hope was that by getting refined in the diagnosis we could target interventions for each of these diagnoses, but in reality that just hasn’t played out.”

Norton’s research began 10 years ago when he was a graduate student in Nebraska and found he couldn’t get enough people together on the same night to run a group session for social phobia.

“What I realized is that I could open a group to people with anxiety disorders in general and develop a treatment program regardless of the artificial distinctions between social phobia and panic disorder, or obsessive-compulsive disorder, and focus on the core underlying things that are going wrong,” said Norton.

He says cognitive-behavioral therapy, which has a specific time frame and goals, is the most effective treatment as it helps patients understand the thoughts and feelings that influence their behaviors. The twist for him was using CBT in conjunction with the transdiagnostic approach.

The patients receiving the transdiagnostic treatment showed considerable improvement, especially with treating comorbid diagnoses, a disease or condition that co-exists with a primary disease and can stand on its own as a specific disease, like depression. Anxiety disorders often occur with a secondary illness, such as depression or substance and alcohol abuse, he noted.

“What I have learned from my past research is that if you treat your principal diagnosis, such as social phobia, you are going to show improvement on some of your secondary diagnosis,” he said. “Your mood is going to get a little better, your fear of heights might dissipate. So there is some effect there, but when we approach things with a transdiagnostic approach, we see a much bigger impact on comorbid diagnoses.”

“In my research study, over two-thirds of [co-existing] diagnoses went away, versus what we typically find when I’m treating a specific diagnosis such as a panic disorder, where only about 40 percent of people will show that sort of remission in their secondary diagnosis,” he continued.

“The transdiagnostic treatment approach [appears to be] more efficient in treating the whole person rather than just treating the diagnosis… then treating the next diagnoses.”

Norton notes the larger contributions of the studies are to guide further development and interventions for how clinical psychologists, therapists and social workers treat people with anxiety disorders. The data collected will be useful for people out on the front lines to effectively treat people to reduce anxiety disorders, he said.

Source: University of Houston

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CBT, pharmacologic interventions decrease depressive symptoms in cancer patients

Posted by Sun on July 23, 2012

Despite guidelines recommending screening for depression in cancer patients, it’s been unclear whether interventions designed to treat this depression are effective. A study by the University of Colorado Cancer Center and other institutions, published in theJournal of the National Cancer Institute, changes that. This meta-analysis of 10 studies encompassing 1362 patients shows that especially cognitive behavioral therapy and pharmacologic interventions decrease depressive symptoms in cancer patients.

“In the past, we had looked at interventions as a whole – most of which were designed to help cancer patients cope generally with stress but not specifically with depression – and found moderate effects. This study shows not only that interventions specific to depression in cancer patients can improve symptoms, but shows which interventions are likely to offer the most benefit,” says Kristin Kilbourn, PhD, CU Cancer Center investigator and assistant professor of psychology at the University of Colorado Denver.

The recent study is the culmination of a five-year effort during which Kilbourn and collaborators combed the literature for studies that met stringent criteria specifying that studies were randomized control trials in which cancer patients reported a significant number of depressive symptoms prior to starting the intervention.

“Still, many questions exist,” Kilbourn says. “For example, which interventions are best in early cancers versus metastatic disease? Do we find similar effectiveness if patients were diagnosed with depression before their cancer? And which interventions are most effective with different cultural and ethnic subpopulations?” Likewise, Kilbourn hopes further study will explore the durability of gains patients experience with these interventions.

Finally, “This study supports the notion that screening for depression in cancer patients is important because if we could identify people early in the process and intervene, we now know definitively that we can affect the trajectory of this depression,” Kilbourn says.

Source: University of Colorado Denver

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The Principles of Reality Therapy

Posted by Sun on July 13, 2012

There are several basic principles of reality therapy that must be applied to make this technique most successful.

  • Focus on the present and avoid discussing the past because all human problems are caused by unsatisfying present relationships.
  • Avoid discussing symptoms and complaints as much as possible since these are often the ineffective ways that clients choose to deal with (and hold on to) unsatisfying relationships.
  • Understand the concept of total behavior, which means focus on what clients can do, directly act, and think. *Spend less time on what they cannot do directly such as changing their feelings and physiology. Feelings and physiology can be changed indirectly, but only if there is a change in the acting and thinking.
  • Avoid criticizing, blaming and/or complaining and help clients do the same. By doing this, they learn to avoid these extremely harmful external control behaviors that destroy relationships.
  • Remain non-judgmental and non-coercive, but encourage people to judge all they are doing by the Choice Theory axiom: Is what I am doing getting me closer to the people I need? If the choice of behaviors is not getting people closer, then the therapist works to help the client find new behaviors that lead to a better connection.
  • Teach clients that legitimate or not, excuses stand directly in the way of their ability to make needed connections.
  • Focus on specifics. Find out as soon as possible who clients are disconnected from and work to help them choose reconnecting behaviors. If they are completely disconnected, focus on helping them find a new connection.
  • Help them make specific, workable plans to reconnect with the people they need, and then follow through on what was planned by helping them evaluate their progress. Based on their experience, therapists may suggest plans, but should not give the message that there is only one plan. A plan is always open to revision or rejection by the client.
  • Be patient and supportive but keep focusing on the source of the problem: disconnectedness. Clients who have been disconnected for a long time will find it difficult to reconnect. They are often so involved in the harmful behavior that they have lost sight of the fact that they need to reconnect. Help them to understand Choice Theory and explain that whatever their complaint, reconnecting is the best possible solution to their problem.

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Wisdom Comes With Age, At Least When It Comes To Emotions

Posted by Sun on July 6, 2012

ScienceDaily (June 12, 2008) — A University of Alberta researcher in collaboration with researchers from Duke University has proven that wisdom really does come with age, at least when it comes to your emotions.

A study conducted by Dr. Florin Dolcos, assistant professor of psychiatry and neuroscience in the Faculty of Medicine & Dentistry, identified brain patterns that help healthy older people regulate and control emotion better than their younger counterparts. The study identified two regions in the brain that showed increased activity when participants over the age of 60 were shown standardized pictures of emotionally challenging situations.

“Previous studies have provided evidence that healthy older individuals have a positivity bias — they can actually manage how much attention they give to negative situations so they’re less upset by them,” said Dr. Dolcos, a member of the Alberta Cognitive Neuroscience Group, which brings together researchers from the University of Alberta to explore how the brain works in human thought, including issues like perception, attention, learning, memory, language, decision-making, emotion and development. “We didn’t understand how the brain worked to give seniors this sense of perspective until now.”

During the study, younger and older participants were asked to rate the emotional content of standardized images as positive, neutral or negative, while their brain activity was monitored with a functional magnetic resonance imaging (fMRI) machine, a high-tech device that uses a large magnet to take pictures inside the brain. The older participants rated the images as less negative than the younger participants. The fMRI scans helped researchers observe this reaction in the senior participants. The scans showed increased interactions between the amygdala, a brain region involved in emotion detection, and the anterior cingulate cortex, a brain region involved in emotion control.

According to Dr. Dolcos, “These findings indicate that emotional control improves with aging, and that it’s the increased interaction between these two brain regions that allows healthy seniors to control their emotional response so that they are less affected by upsetting situations.”

The study, published in the journal Neurobiology of Aging, was performed under the co-ordination of Dr. Roberto Cabeza and in collaboration with Ms. Peggy St. Jacques, both of Duke University where Dr. Dolcos received his training in brain imaging research.

This research may have clinical implications. “If we can better understand how the brain works to create a positivity bias in older people, then we can apply this knowledge to better understand and treat mental health issues with a negativity bias, such as depression and anxiety disorders, in which patients have difficulty coping with emotionally challenging situations,” Dolcos said.

Dr. Florin Dolcos’s current research projects are funded by grants from the U.S.-based National Alliance for Research on Schizophrenia and Depression (NARSAD), the Canadian Psychiatric Research Foundation (CPRF), the University Hospital Foundation (UHF) in Edmonton and the University of Alberta.

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Secret to Successful Aging: How ‘Positivity Effect’ Works in Brain

Posted by Sun on July 6, 2012

ScienceDaily (July 14, 2011) — Whether we choose to accept or fight it, the fact is that we will all age, but will we do so successfully? Aging successfully has been linked with the “positivity effect,” a biased tendency towards and preference for positive, emotionally gratifying experiences. New research published in Biological Psychiatry now explains how and when this effect works in the brain.

German neuroscientists studied this effect by using neuroimaging to evaluate brain engagement in young and old adults while they performed a specialized cognitive task that included supposedly irrelevant pictures of either neutral, happy, sad or fearful faces. During parts of the task when they didn’t have to pay as much attention, the elderly subjects were significantly more distracted by the happy faces. When this occurred, they had increased engagement in the part of the brain that helps control emotions and this stronger signal in the brain was correlated with those who showed the greatest emotional stability.

“Integrating our findings with the assumptions of life span theories we suggest that motivational goal-shifting in healthy aging leads to a self-regulated engagement in positive emotions even when this is not required by the setting,” explained author Dr. Stefanie Brassen. “In addition, our finding of a relationship between rostral anterior cingulate cortex activity and emotional stability further strengthens the hypothesis that this increased emotional control in aging enhances emotional well being.”

“The lessons of healthy aging seem to be similar to those of resilience, throughout life. As recently summarized in other work by Drs. Dennis Charney and Steven Southwick, when coping with extremely stressful life challenges, it is critical to realistically appraise the situation but also to approach it with a positive attitude,” noted Dr. John H. Krystal, the Editor ofBiological Psychiatry.

Lifespan theories explain that positivity bias in later life reflects a greater emphasis on short-term rather than long-term priorities. The study by Dr. Brassen and colleagues now provides another clue to how the brain contributes to this age-related shift in priorities.

This makes aging successfully sound so simple — use your brain to focus on the positive.

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Acceptance and Commitment Therapy (ACT)

Posted by Sun on June 21, 2012

Acceptance and Commitment Therapy (ACT) is a cognitive–behavioral model of psychotherapy that helps you accept difficult thoughts, emotions, or sensations and get commitment to change is based on chosen values.

Research shows ACT is effective in treatment of variety of problems including addictions, smoking cessation, depression, anxiety, workplace stress, weight management, eating disorders, burn out, and several other areas.

ACT focuses on 3 areas:

Accept your reactions and be present
Choose a valued direction
Take action.

Core principles

ACT uses six core principles to help clients develop psychological flexibility.

1.    Contact with the present moment: The present moment is the only time anyone can really act and experience happiness. Awareness of the here and now, experienced with openness, interest, and receptiveness can increase our ability to change.
2.    Cognitive defusion: Learning methods detach from unhelpful thoughts and worries and memories

3.    Acceptance: To deny or control painful thoughts and feelings leads to get all caught up in feelings, or overwhelmed by them. Allow to painful feelings come and go without struggling with them.

4.    Observing the self: We are not our thoughts, emotions, behaviors and etc. we can view our identities as separate from the content of our experience

5.    Values provide an internal reference for what is good, beneficial, important, useful, beautiful, desirable, constructive, etc. We can change our values. It’s important we choose the values are in harmony with our true self.
6.    Committed action:  take action guided by your values and do whatever you have to do, even if it’s difficult or uncomfortable.

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What the World Needs Now? More Wisdom

Posted by Sun on June 15, 2012

ScienceDaily (Apr. 6, 2011) — Revolution in Libya. Revolution in Egypt. Revolution in Tunisia. The Middle East and North Africa face unprecedented change as dictatorships crumble and people clamor for democracy.

Yet it remains unclear whether these nations will experience more equity under new regimes. The reshaping of societies raises fundamental questions that require monumental thought. “What the world needs now, especially in these times, is more wisdom,” observes Dolores Pushkar, a professor in Concordia’s Department of Psychology and member of the Centre for Research in Human Development.

While all nations need wise leaders, the Middle East and North Africa require sensible leaders with fresh outlooks who are in antithesis to self-serving dictators of the past. “Since wisdom is defined as something that benefits society as a whole as well as the self,” continues Pushkar.

Human wellbeing and life satisfaction

Current events are on Pushkar’s mind, since the bulk of her research has focused on human wellbeing and life satisfaction. And she’s found wisdom plays a central role in both. “Wisdom and intelligence aren’t the same thing,” she points out, estimating that only 5 percent of the population can be described as truly wise and that advanced insight begins after adolescence as the brain matures.

Pushkar recently coauthored an overview on the topic, What Philosophers Say Compared with What Psychologists Find in Discerning Values: How Wise People Interpret Life. Her coauthors include Andrew Burr, Sarah Etezadi and Tracy Lyster of the Concordia Department of Psychology and Sheila Mason of the Department of Philosophy.

The research team compiled data from several Concordia studies, as well as international findings, to assess how wisdom shapes life. The result? “Wisdom has an impact on how people cope in situations and whether they are more or less satisfied with life,” explains Etezadi, a PhD student under Pushkar’s direction.

No single definition of wisdom exists, but hallmarks include knowledge, deep understanding of human nature, life contentment, empathy and the flexibility to see issues from others’ perspectives. “Wise people can see the positive side of a negative situation,” says Etezadi, adding the wise are open to new avenues. “A practical aspect of wisdom is how it translates to street smarts.”

Injustice can prevent people from garnering wisdom

Yet studies have shown that overwhelming and prolonged stress, in cases such as genocide or soul-crushing child abuse, are injustices that can prevent people from garnering wisdom. “The more overwhelming the stress, the greater its magnitude, the less likely people are to develop wisdom from the experience,” says Pushkar, citing research from peers undertaken after major calamities and wars. “Chronic adversity can destroy wisdom.”

Pushkar stresses that wise people often espouse common sense — but what makes them smarter than most is how they actually follow their own advice. And contrary to popular notions, gender does not influence wisdom. “For centuries, males had access to education and that’s how the stereotype of the wise old man came to be,” says Etezadi.

Age is another irrelevant factor in life smarts. “Some people garner wisdom sooner than others,” Pushkar suggests. “That’s why we call them old souls, since they are quicker to learn what leads to a better life.”

Etezadi and Pushkar, who notably studied life contentment among seniors, also discovered that lifelong optimists are wiser than their pessimistic peers. “We found that people who are wiser maintain a sense of happiness,” says Etezadi. “They are high on wisdom, which has a buffering effect.”

“Bitterness,” Pushkar counters, “disqualifies a person from being considered as wise. It means they haven’t learned any beneficial lessons from their experience.”

This study was supported by the Canadian Institutes of Health Research, the Social Sciences and Humanities Research Council of Canada and Quebec’s Fonds de recherche sur la société et la culture.

Reference: Pushkar,D., Mason, S., Burr, A., Etezadi, S. & Lyster, T. (2010). What philosophers say compared with what psychologists find in discerning values: How wise people interpret life. In A. Columbus (Ed.) Advances in Psychology Research, Volume 65. Nova Science Publishers: New York. Also published separately in the Psychology Research Progress Series, (2010). Novinka, Nova Science Publishers: New York.

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Juveniles Build Up Physical — But Not Mental — Tolerance for Alcohol

Posted by Sun on June 15, 2012

ScienceDaily (June 13, 2012) — Research into alcohol’s effect on juvenile rats shows they have an ability to build up a physical, but not cognitive, tolerance over the short term — a finding that could have implications for adolescent humans, according to Baylor University psychologists.

The research findings are significant because they indicate that blood alcohol concentration levels alone may not fully account for impaired orientation and navigation ability, said Jim Diaz-Granados, Ph.D., professor and chair of psychology and neuroscience at Baylor. He co-authored the study, published in the journal Brain Research.  “There’s been a lot of supposition about the reaction to blood alcohol levels,” Diaz-Granados said. “We use the blood alcohol level to decide if someone is going to get arrested, because we think that a high level means impairment. But here we see a model where we can separate that out. You may have a tolerance in metabolism, but just because your blood alcohol concentration is less than the legal limit doesn’t mean your behavior isn’t impaired.”

“More research is needed to fully understand how adolescents react to alcohol, but this contributes a piece to the puzzle,” said study co-author Douglas Matthews, Ph.D., a research scientist at Baylor and an associate professor in Psychology at Nanyang Technological University in Singapore.

The study was conducted in the Baylor Addiction Research Center of Baylor’s Department of Psychology and Neuroscience in Baylor’s College of Arts & Sciences.

More than half of under-age alcohol use is due to binge drinking, according to the Substance Abuse and Mental Health Services Administration, and “when initial alcohol use occurs during adolescence, it increases the chance of developing alcoholism later in life,” said lead study author Candice E. Van Skike, a doctoral candidate in psychology at Baylor. Researchers have long been interested in whether adolescents react differently to alcohol than adults and how alcohol use affects their brains when they reach adulthood, but Baylor researchers also wanted to test the short-term effect of alcohol on adolescents’ brains in terms of memory about space and dimension.

In the study, 96 rats were trained to navigate a water maze to an escape platform. Half were exposed to alcohol vapor in chambers for 16 hours a day over four days (a method to approximate binge-like alcohol intake), while others were exposed only to air. After a 28-hour break, some were injected with alcohol, then both groups tested again in the maze. A comparison found that those who had undergone the chronic intermittent ethanol exposure built up a metabolic tolerance. They were better able to eliminate alcohol from their systems than ones who had been exposed only to air, based on a comparison of the blood ethanol concentrations of the two groups after they had been injected with alcohol later. While the alcohol-injected rats swam as hard and as fast as the others, their ability to find the escape platform was impaired.

Previous research at Baylor led by Matthews showed that adolescents are less sensitive than adults to motor impairment during alcohol intake because a particular neuron fires more slowly in adults who are drinking. The lack of sensitivity may be part of the reason adolescents do not realize they have had too much to drink.

“It’s difficult to compare metabolic and cognitive tolerance in adults with those of juveniles, because many studies that have looked at the cognitive aspect of chronic ethanol exposure didn’t measure blood alcohol concentration levels,” Van Skike said. “It would be an interesting comparison to make, and it is an avenue for future research.”

Other research has shown that high levels of alcohol consumption during human adolescence are mirrored in animals. Adolescent rats consume two to three times more ethanol than adults relative to body weight, suggesting that adolescents are who drink are pre-disposed to do so in binges.

Another collaborator in the Baylor study was Adelle Novier, a doctoral candidate in psychology at Baylor.

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Thoughts That Win

Posted by Sun on June 13, 2012

ScienceDaily (May 25, 2011) — Back in high school, on the soccer field, poised to take a crucial penalty kick, “I always had a lot of thoughts going on in my head; I think most people do” says sports psychologist Antonis Hatzigeorgiadis. “I was setting the ball and planning my shot; I was the captain and never missed those types of shots; then I had that thought striking me that it was not going to be good. I knew I was going to miss,” he recalls, “and I did miss.” Even then, he could see that his mind had a big effect on his body.

From these unhappy experiences evolved Hatzigeorgiadis’ interest in the psychology of sport — the link between one’s thoughts and performance, and specifically in “self-talk” — the mental strategy that aims to improve performance through the use of self-addressed cues (words or small phrases), which trigger appropriate responses and action, mostly by focusing attention and psyching-up.

“We know this strategy works, and it works in sports,” says Hatzigeorgiadis. But what makes it work better, and in what situations? To find out, Hatzigeorgiadis and his colleagues at the Department of Physical Education and Sport Sciences at the University of Thessaly, Nikos Zourbanos, Evangelos Galanis, and Yiannis Theodorakis conducted a meta-analysis of 32 sport psychological studies on the subject with a total of 62 measured effects. Their findings will be published in an upcoming issue ofPerspectives on Psychological Science, a journal of the Association for Psychological Science.

As expected, the analysis revealed that self-talk improves sport performance.

But the researchers teased out more — different self-talk cues work differently in different situations. For tasks requiring fine skills or for improving technique “instructional self-talk,” such as a technical instruction (“elbow-up” which Hatzigeorgiadis coaches beginner freestyle swimmers to say) is more effective than ‘motivational self-talk’ (e.g., “give it all”), which seems to be more effective in tasks requiring strength or endurance, boosting confidence and psyching-up for competition. Thus, we should carefully design the self-talk athletes use according to needs.

Some other findings are that self-talk has a greater effect on tasks involving fine skills (such as sinking a golf ball) rather than gross skills (e.g., cycling); probably because self-talk is a technique which mostly improves concentration. Self-talk is more effective for novel tasks rather than well-learned tasks; because it is easier to improve at the early steps of learning. Nevertheless, both beginners and experienced athletes can benefit, especially when they practice the self-talk technique.

Most important, says Hatzigeorgiadis, is that athletes train to self-talk — they prepare their scripts and use them consistently in training under varying conditions to better prepare themselves for competition.

The main goals behind self-talk — like other techniques such as visualization to “rehearse” a performance or meditation to improve focus and relaxation — are twofold, says Hatzigeorgiadis: “to enhance your potential; and to perform during competition in terms of your ability and not less.”

The meta-analysis can help sports psychologists and athletes refine their training. But the strategy has implications beyond the playing field. “The mind guides action. If we succeed in regulating our thoughts, then this will help our behavior,” says Hatzigeorgiadis.

“The goal of being prepared is to do the best you can do.”

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Is There A Seat Of Wisdom In The Brain?

Posted by Sun on June 13, 2012

ScienceDaily (Apr. 6, 2009) — Researchers at the University of California, San Diego School of Medicine have compiled the first-ever review of the neurobiology of wisdom – once the sole province of religion and philosophy.

The study by Dilip V. Jeste, MD, and Thomas W. Meeks, MD, of UC San Diego’s Department of Psychiatry and the Stein Institute for Research on Aging, is published in theArchives of General Psychiatry.

“Defining wisdom is rather subjective, though there are many similarities in definition across time and cultures,” said Jeste, who is the Estelle and Edgar Levi Chair in Aging, professor of psychiatry and neuroscience and chief of geriatric psychiatry at UC San Diego. “However, our research suggests that there may be a basis in neurobiology for wisdom’s most universal traits.”

Wisdom has been defined over centuries and civilizations to encompass numerous psychological traits. Components of wisdom are commonly agreed to include such attributes as empathy, compassion or altruism, emotional stability, self-understanding, and pro-social attitudes, including a tolerance for others’ values.

“But questions remain: is wisdom universal, or culturally based?” said Jeste. “Is it uniquely human, related to age? Is it dependent on experience or can wisdom be taught?”

Empirical research on wisdom is a relatively new phenomenon. Meeks and Jeste noted that in the 1970s, there were only 20 peer-reviewed articles on wisdom, but since 2000, there have been more than 250 such publications. However, the researchers found no previous studies using the keyword “wisdom” in combination with the terms neurobiology, neuroimaging or neurotransmitters.

In order to determine if specific brain circuits and pathways might be responsible for wisdom, the researchers examined existing articles, publications and other documents for six attributes most commonly included in the definition of wisdom, and for the brain circuitry associated with those attributes.

Meeks and Jeste focused primarily on functional neuroimaging studies, studies which measure changes in blood flow or metabolic alterations in the brain, as well as on neurotransmitter functions and genetics. They found, for example, that pondering a situation calling for altruism activates the medial pre-frontal cortex, while moral decision-making is a combination of rational (the dorsolateral prefrontal cortex, which plays a role in sustaining attention and working memory), emotional/social (medial pre-frontal cortex), and conflict detection (the anterior cingulate cortex, sometimes also associated with a so-called “sixth sense”) functions.

Interestingly, several common brain regions appear to be involved in different components of wisdom. The UC San Diego researchers suggest that the neurobiology of wisdom may involve an optimal balance between more primitive brain regions (the limbic system) and the newest ones (pre-frontal cortex.) Knowledge of the underlying mechanisms in the brain could potentially lead to developing interventions for enhancing wisdom.

“Understanding the neurobiology of wisdom may have considerable clinical significance, for example, in studying how certain disorders or traumatic brain injuries can affect traits related to wisdom,” said Jeste, stressing that this study is only a first step in a long process.

The study was supported in part by grants from the National Institute on Mental Health, the National Institute on Aging, the U.S. Health Resources and Services Administration, the Sam and Rose Stein Institute for Research on Aging at UC San Diego and the Department of Veterans Affairs.

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Molecular Imaging Finds Link Between Low Dopamine Levels and Aggression

Posted by Sun on June 12, 2012

ScienceDaily (June 11, 2012) — Out of control competitive aggression could be a result of a lagging neurotransmitter called dopamine, say researchers presenting a study at the Society of Nuclear Medicine’s 2012 Annual Meeting. During a computer game against a putative cheating adversary, participants who had a lower capacity to synthesize this neurotransmitter in the brain were more distracted from their basic motivation to earn money and were more likely to act out with aggression.

For many people, anger is an almost automatic response to life’s challenges. In clinical psychiatry, scientists look at not only the impact of aggressive behavior on the individual, their loved ones and the community but also the triggers in the brain that lead to aggressive response. The neurobiology of aggression is not well understood, but scientists are aware of a relationship between the neurotransmitter serotonin and certain aggressive behaviors. The objective of this study was to explore whether higher levels of another brain chemical called dopamine, involved in pleasure and reward, increased aggressive response in its subjects. To scientists’ surprise, it was not as they first theorized.

“The results of this study were astonishingly opposite of what was previously hypothesized,” says Ingo Vernaleken, M.D., lead author of the study and research scientist for the department of psychiatry at RWTH Aachen University in Aachen, Germany. “Subjects with more functional dopaminergic reward-systems were not more aggressive in competitive situations and could concentrate even more on the game. Subjects with lower dopaminergic capacity were more likely to be distracted by the cheating behavior.”

In this study, 18 healthy adults in their twenties were tested for aggression using the psychological behavioral task known as the point subtraction aggression paradigm (PSAP). Participants were asked to play a computer game that required them to press a bar multiple times with the incentive of winning money, but they were also told that an adversary in the next room who is able to cheat may steal some of their winnings. What the paranoid participants did not know was that there was no adversary. The computer program is designed to perform randomized deductions of the subjects’ monetary reward to simulate the cheating competitor.The participant had three choices to react: punish the cheater, shield against the adversary by repeatedly pressing a defense button, or continue playing the game in order to maximize their ability to win cash, which indicated resilience.

“The PSAP focuses on aggressive reaction within a competitive situation,” says Vernaleken. “Aggression and its neurobiological mechanisms in humans have been only moderately investigated in the past. Furthermore, most of the previous studies mainly covered the more reactive part of aggression, which merely reflects impulsive behavior and appears to be associated merely with the serotonin system. This investigation focuses on the association with the dopaminergic reward-system, which reflects goal-directed aggression.”

Subjects’ brains were imaged using positron emission tomography, which provides a range of information about physiological functions inside the body, depending on the imaging probe used. In this investigation, F-18 FDOPA, a biomarker that lights up enzymes’ ability to synthesize this transmitter, was used and the uptake of this drug in the brain was analyzed to gauge the correlation between the participants’ dopamine synthesis capacity and aggressive behavior.

Results of the study showed a significant impact on aggressive response in areas in the brain where dopamine synthesis was present, especially in the basal ganglia, which among other functions include the motivation center. Minimized aggression was associated with higher dopamine levels in both the midbrain and the striatum, which plays a role in planning and executive function. People with greater capacity for dopamine synthesis were more invested in the monetary reward aspect of the PSAP, instead of acting in defense or with aggression against their perceived adversary, whereas subjects with lower capacities had a higher vulnerability to act either aggressive, defensive or both.

“Thus, we think that a well-functioning reward system causes more resilience against provocation,” says Vernaleken. “However, we cannot exclude that in a situation where the subject would directly profit from aggressive behavior, in absence of alternatives, the correlation might be the other way around.”

Further research is required to explore the link between dopamine and a range of aggressive behavior. More insight into these relationships could potentially lead to new psychological therapies and drug treatments to moderate or prevent aggressive response.

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Training the Brain to Think Ahead in Addiction

Posted by Sun on June 8, 2012

ScienceDaily (Jan. 27, 2011) — The growing numbers of new cases of substance abuse disorders are perplexing. After all, the course of drug addiction so often ends badly. The negative consequences of drug abuse appear regularly on TV, from stories of celebrities behaving in socially inappropriate and self-destructive ways while intoxicated to dramatization of the rigors of drug withdrawal on “Intervention” and other reality shows.

Schools now educate students about the risks of addiction. While having a keen awareness of the negative long-term repercussions of substance use protects some people from developing addictions, others remain vulnerable.

One reason that education alone cannot prevent substance abuse is that people who are vulnerable to developing substance abuse disorders tend to exhibit a trait called “delay discounting,” which is the tendency to devalue rewards and punishments that occur in the future. Delay discounting may be paralleled by “reward myopia,” a tendency to opt for immediately rewarding stimuli, like drugs.

Thus, people vulnerable to addiction who know that drugs are harmful in the long run tend to devalue this information and to instead be drawn to the immediately rewarding effects of drugs.

Delay discounting is a cognitive function that involves circuits including the frontal cortex. It builds upon working memory, the brain’s “scratchpad,” i.e., a system for temporarily storing and managing information reasoning to guide behavior.

In a new article in Biological Psychiatry that studied this process, Warren Bickel and colleagues used an approach borrowed from the rehabilitation of individuals who have suffered a stroke or a traumatic brain injury. They had stimulant abusers repeatedly perform a working memory task, “exercising” their brains in a way that promoted the functional enhancement of the underlying cognitive circuits.

They found that this type of training improved working memory and also reduced their discounting of delayed rewards.

“The legal punishments and medical damages associated with the consumption of drugs of abuse may be meaningless to the addict in the moment when they have to choose whether or not to take their drug. Their mind is filled with the imagination of the pleasure to follow,” commented Dr. John Krystal, Editor ofBiological Psychiatry. “We now see evidence that this myopic view of immediate pleasures and delayed punishments is not a fixed feature of addiction. Perhaps cognitive training is one tool that clinicians may employ to end the hijacking of imagination by drugs of abuse.”

Dr. Bickel agrees, adding that “although this research will need to be replicated and extended, we hope that it will provide a new target for treatment and a new method to intervene on the problem of addiction.”

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Positive Reframing, Acceptance and Humor Are the Most Effective Coping Strategies

Posted by Sun on June 4, 2012

ScienceDaily (July 4, 2011) — New research from the University of Kent has revealed that positive reframing, acceptance and humour are the most effective coping strategies for people dealing with failures.

In a paper published by the international journal Anxiety, Stress & Coping, Dr Joachim Stoeber and Dr Dirk Janssen from the University’s School of Psychology describe a diary study that found these three strategies to be most effective in dealing with small failures and setbacks, and helping people to keep up their spirits and feel satisfied at the end of the day.

For the study, a sample of 149 students completed daily diary reports for 3 — 14 days, reporting the most bothersome failure they experienced during the day, what strategies they used to cope with the failure, and how satisfied they felt at the end of the day. Their coping strategies included: using emotional or instrumental support; self-distraction; denial; religion; venting; substance use; self-blame; and behavioural disengagement.

Of these, using social support (both emotional and instrumental), denial, venting, behavioural disengagement, and self-blame coping had negative effects on satisfaction at the end of the day: the more students used these coping strategies in dealing with the day’s most bothersome failure, the less satisfied they felt at the end of the day.

In contrast, positive reframing (i.e. trying to see things in a more positive light, looking for something good in what happened), acceptance and humour coping had positive effects on satisfaction: the more students used these coping strategies in dealing with failures, the more satisfied they felt at the end of the day.

Dr Stoeber, a leading authority on perfectionism, motivation and performance, believes that the findings of this study will be of significant interest to clinicians, counsellors and anyone working on stress research. He said: ‘The finding that positive reframing was helpful for students high in perfectionistic concerns is particularly important because it suggests that even people high in perfectionistic concerns, who have a tendency to be dissatisfied no matter what they achieve, are able to experience high levels of satisfaction if they use positive reframing coping when dealing with perceived failures.’

He added that a helpful recommendation for anyone trying to cope would be to try to find positive aspects in the outcomes they regard as ‘failures’; and reframe these outcomes in a more positive way; for example, by focusing on what has been achieved, rather than on what has not been achieved. ‘It’s no use ruminating about small failures and setbacks and drag yourself further down,’ he said. ‘Instead it is more helpful to try to accept what happened, look for positive aspects and — if it is a small thing — have a laugh about it.’

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Cognitive Behavioral Therapy for Major Depression

Posted by Sun on June 3, 2012

Modern cognitive behavioral therapy (CBT) was developed independently by two separate individuals: Aaron Beck, a psychiatrist, and Albert Ellis, a clinical psychologist. Both Beck and Ellis began working on their versions of the therapy in and around the late 1950s and early 60s. Both versions of the therapy are founded on the single basic idea that cognition, in the form of thoughts and preconceived judgments, precedes and determines people’s emotional responses.

In other words, what people think about an event that has occurred determines how they will feel about that event. Depression happens because people develop a disposition to view situations and circumstances in habitually negative and biased ways, leading them to habitually experience negative feelings and emotions as a result.

More specifically, Cognitive-Behavioral (CBT) therapists suggest that depression is caused by a combination of an unhelpful dysfunctional thought process and by maladaptive behaviors motivated by that thought process. Because these dysfunctional thoughts and behaviors are learned, people with depression can also learn new, more adaptive skills that raise their mood and increase their ability to cope with daily hassles and stressors. Another basic idea behind CBT is that if a person changes their thoughts and behavior, a positive change in mood will follow.

The cognitive aspect of CBT involves learning to identify distorted patterns of thinking and forming judgments. These maladaptive thought patterns are also known as negative or maladaptive schemas, or core beliefs. Core beliefs are fundamental assumptions people have made that influence how they view the world and themselves.

People get so used to thinking in these core ways that they stop noticing them or questioning them. Simply put, core beliefs are the unquestioned background themes that govern depressed people’s perceptions. For example, a depressed person might think “I am unlovable” or “I am inadequate and inferior” and because these beliefs are unquestioned, they are acted upon as though they are real and true.

Core beliefs serve as a filter through which people see the world. Core beliefs influence the development of “intermediate beliefs”, which are related attitudes, rules and assumptions that follow from core beliefs. When depressed people’s core beliefs are negative and unrealistic, they lead people to experience predominately negative and unrealistic thoughts.

Following along with the example started above, our depressed person might develop the attitude that, “It’s terrible to be unloved”. Similarly, the intermediate belief might include the following rule, “I must please everyone” and an assumption to the effect that, “If I please everyone then people will love me.”

Intermediate beliefs can influence people’s view of a particular situation by generating “automatic thoughts,” the actual thoughts or images that people experience flitting through their minds. Automatic thoughts are evaluative cognitions which occur in response to a particular situation. They are spontaneous (hence the term automatic), rather than the result of deliberate extended thinking or the logical reasoning that occurs when someone concentrates.

Automatic thoughts occur effortlessly, more or less all the time. Most of the time we are unaware that they are occurring, not because they are unconscious sorts of things but rather because we’re so used to them that we don’t notice them anymore. Automatic thoughts influence emotions and behaviors and can provoke physiological responses.

To continue the above example, if a friend of our depressed person does not return a phone call, our depressed person might think, “He’s not calling me back because he hates me”. It may never occur to her to generate alternative and less irrational explanations for the lack of a callback such as,”He must be really busy today.” Because the automatic thought “he hates me” is allowed to stand unchallenged, our depressed person starts feeling hated, and thus depressed.

Though every patient’s automatic thoughts are unique, there are also clear patterns of depressive automatic thoughts that form that are common across many depressed people’s minds. Some common patterns of negative and irrational automatic thoughts include:

  • Catastrophizing – always anticipating the worst possible outcome to occur (e.g., expecting to be criticized or fired when the boss calls).
  • Filtering – exaggerating the negative and minimizing the positive aspects of an experience (e.g., focusing on all the extra work that went into a promotion rather than on how nice it is to have the promotion).
  • Personalizing – automatically accepting blame when something bad occurs even when you had nothing to do with the cause of the negative event (e.g., He didn’t return my phone call because I am a terrible friend or a boring person; I caused him to not call.).
  • (Over)Generalizing – viewing isolated troubling events as evidence that all following events will become troubled (e.g., having one bad day means that the entire week is ruined).
  • Polarizing – viewing situations in black or white (all bad or all good) terms rather than looking for the shades of gray (e.g., “I missed two questions on my exam, therefore I am stupid”, instead of “I need to study harder next time, but hey – I did pretty good anyway!”).
  • Emotionalizing – allowing feelings about an event to override logical evaluation of the events that occurred during the event. (e.g., I feel so stupid that it’s obvious that I’m a stupid person).

Dysfunctional beliefs are thinking habits that people learn which happen to be irrational and not based on reality (e.g., on objective, unbiased observation). Because such beliefs are not linked to reality very well, they tend to appear rather distorted when compared with reality.

Distorted though they may be, dysfunctional beliefs are all people typically have to help them make sense out of the events that happen to them. Snap judgments are made (called Cognitive Appraisals) based on the assumptions present within dysfunctional beliefs, and those judgments end up being, not surprisingly, biased and irrational.

People look to their appraisals of stressful situations to know how to react, and when they do, they see that situations look simply awful (worse than it really would appear if some reality testing were to occur). They react to that false or exaggerated sense of awfulness, and correspondingly experience depressive symptoms.


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Cognitive-Behavioral Theory of Personality Disorders

Posted by Sun on June 3, 2012

Thus far, the theories we have described have focused on explaining the mental organizations and representations thought to create dysfunctional behavior. These theories are based on the inherent assumption that it is necessary to know why something works the way it does, in order to change, repair, or correct it.

But theorists from a different school of thought, cognitive-behavioral theorists, have taken a more pragmatic approach by concluding it is not necessary to know why something works the way it does, in order to change or correct it (e.g., a damaged personality). To illustrate this somewhat counter-intuitive concept: Suppose you need to cross the street but it has somehow become inexplicably flooded, thereby blocking your passage to the other side.

Now you could stand there and ponder how on earth the street got flooded like that, and wonder where all that water came from in the first place. Or you could simply skip that step and immediately begin to work out a solution to get you over to the other side. Cognitive-behavioral theorists prefer to immediately focus on a solution that works, to get to the other side so-to-speak, rather than focusing on the origins of the behavior which needs to be changed, repaired, or corrected.

This is not to say that modern cognitive-behavioral theory (CBT) is silent about the origins of dysfunctional behavioral-emotional patterns. Originally based on the works of Aaron Beck, M.D.. and Albert Ellis, Ph.D., CBT emerged from the observation that people react emotionally and behaviorally to events according to their interpretation of those events. In other words, our thoughts (cognitions) lead to our emotions and subsequent behavior.

By way of illustration, suppose someone stepped on your foot. You might interpret this action by concluding that this person was intentionally trying to hurt you. In response to this “assault,” you might become angry and maybe even retaliate against the foot-stepper. Alternatively, you could interpret the same event as an indication of the other person’s clumsiness, in which case you might laugh, and feel compassionate and forgiving.

Notice, the identical environmental event (someone stepping on your foot) resulted in two entirely different sets of emotions and behaviors, simply by the way your mind interpreted the event.

The way in which we interpret an event is critically linked to another type of cognition: our core beliefs. A complex blend of factors derived from both “nature” and “nurture” are thought to drive the formation of people’s core beliefs. Cognitive theory assumes there are certain inherited dispositions such as temperament (nature), which interact with children’s environments (nurture), to influence the ultimate shape of their personality, and their characteristic interpersonal strategies.

Moreover, cognitive theory emphasizes the importance of social learning with respect to personality development. Childhood experiences, including childhood trauma and abuse, are seen as important factors that establish these core beliefs about the world. These core beliefs will later color, and potentially distort, people’s perceptions and interpretations of subsequent experiences. For more information about this nature-nurture influence on personality development please refer to that section.

Thus, our appraisal of events is influenced not only by our immediate experience of the situation or event before us, but also by preconceived ideas and beliefs formed in the past (i.e., our core beliefs) which we draw upon in order to make sense of things. When our core beliefs are faulty, biased, or distorted we may end up drawing incorrect, irrational conclusions about the meaning of events, and may subsequently behave in ways which cause us unnecessary distress.

Dr. Beck’s cognitive explanation of personality disorders essentially asserts that people with personality disorders act in the dysfunctional ways that they do because their beliefs and assumptions about themselves, other people, and the world around them, are biased or distorted in characteristic patterns that cause them to consistently misinterpret the situations they find themselves in.

In a rather ironic twist of fate, these dysfunctional interpretations lead people to behave in such a manner that they unwittingly provoke reactions from other people that are consistent with their misinterpretations. The unfortunate and ironic consequence is that the person ends up “proving” the correctness of their initial, albeit faulty, interpretation, thereby strengthening the erroneous core belief.

We can illustrate how this works by recalling our earlier example of the clumsy foot stepper. A person with a Paranoid Personality Disorder would be likely to interpret that event as an intentional provocation and attack, based on the core belief that “the world is a dangerous place.” Applied consistently, this core belief leads the person with Paranoid Personality Disorder to become vigilant for potential danger, slights, and insults which leads them to easily misinterpret another person’s innocent, but clumsy behavior.

A natural consequence of this faulty interpretation (acted upon as though it was true even when it is not) is to experience anger or frustration and these feelings then motivate the paranoid person to attack the foot-stepper in retaliation. A harsh and hostile reaction like that, directed toward the innocent but clumsy foot-stepper, will naturally provoke a defensive and angry reaction from the foot-stepper (because now she has been attacked without cause!).

Ironically, this angry and defensive reaction by our clumsy foot-stepper only serves to confirm the initial faulty interpretation (i.e., the foot stepper was intent on harming me!) and validates the core belief “The world is a dangerous place” thereby creating a pervasive, self-perpetuating, interpersonal cycle.

Classic cognitive-behavioral therapies for personality disorder derived from this analysis, (described in the treatment section) were designed to help therapy clients to develop a conscious awareness of their dysfunctional core beliefs and to evaluate their validity. Once they learn to recognize when their core beliefs become activated, and they can then work to modify or “restructure” their core beliefs to become more rational in nature, and more evidence-based.


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Cognitive-Behavioral Therapy for Personality Disorders (CBT)

Posted by Sun on June 1, 2012

Cognitive Behavioral Therapy (CBT) derives from cognitive-behavioral theory. CBT is a highly effective, evidence-based therapy that has been used to successfully treat a variety of mental disorders particularly depressive disorders and anxiety disorders such as Obsessive Compulsive Disorder, and Posttraumatic Stress Disorder (Paris, 2008). However, we will limit our discussion to the application of CBT in the treatment of personality disorders.

CBT techniques emerge from a fundamental premise of cognitive-behavioral theory: our thoughts (cognitions) lead to our emotions and subsequent behavior. Of particular importance for people with personality disorders is the way in which external events in the environment (such as interpersonal interactions with others) are uniquely interpreted and assigned a meaning based upon core beliefs.

Childhood experiences, coupled with an innate, biologically-determined disposition, establish our initial beliefs about the world, and evolve into fairly stable, core beliefs which shape people’s perceptions and interpretations of subsequent experiences.

When these preconceived beliefs are faulty, distorted, or biased, we may end up drawing incorrect, irrational conclusions about the meaning of external events (particularly interpersonal interactions) and we may subsequently behave in ways that cause us unnecessary distress and suffering. For more detailed information about these concepts please return to the section on cognitive-behavioral theory.

You may recall, people with personality disorders have characteristic patterns of thinking that get them into trouble, because their ways of thinking tend to be somewhat extreme, inflexible, and distorted. CBT is particularly helpful for people with personality disorders because of its emphasis on identifying and changing dysfunctional thinking patterns while exposing and challenging the core beliefs that underlie those thoughts.

Thus, cognitive-behavioral therapy functions to identify and challenge automatic and faulty interpretations of the environment that are driven by core beliefs. Once the person discontinues these faulty interpretations of the environment, and replaces them with more accurate, rational interpretations, the environment responds in kind because there is a circular causality between people and their environment: The environment has an effect upon me, and I have an effect upon my environment.

These new, positive experiences allow for the person to update their core beliefs about the world, enabling them to have more positive and affirming experiences and so on. As core beliefs become more rational and less biased, the client’s appraisals of the meaning of events becomes more accurate, and their emotional and behavioral reactions become less exaggerated and problematic.

There are several steps to this corrective process. First, the therapist and participant work together to identify the problematic patterns of interpretation. This is accomplished by asking the therapy participant to keep track of problematic events and to record their thoughts in response to these events.

In other words, the person would be asked to keep track of what they say to themselves during these problematic events. Next, the participant would learn to consider whether there are alternative interpretations of the same event. The ultimate goal of this process is to identify the common patterns of distorted thinking and how they play out in this person’s life, and then to interrupt the automatic but distorted thoughts as they occur, while learning to entertain the possibility that there may be alternative interpretations of these same events.

With practice and gradual success, the recovering person begins to feel better and behave differently, and the environment responds more favorably to the new and different behavior.

Let’s return to the example of the clumsy foot stepper and the man with a Paranoid Personality Disorder. His core belief, the-world-is-a-dangerous-place, causes him to misinterpret other people’s behaviors as hostile and exploitive, with the intent of causing him harm.

CBT would begin by asking him to record situations in which he felt threatened and to record his immediate thoughts and feelings when these situations occur. So one day when the clumsy foot stepper accidently stepped on our hypothetical man with Paranoid Personality Disorder, he might find himself thinking: “There we go again. That person just stepped on my foot intentionally. They want to hurt me.

I better stand up for myself and get back at them. I’ll show them! Just who do they think they are anyway?” The therapist would ask this client to consider alternatives to the conclusion the foot-stepper was intentionally trying to harm him, such as to consider that perhaps the foot-stepper was simply clumsy.

The therapist would also ask the client to rationally examine the evidence that led to the conclusion the foot-stepper was intentionally trying to harm him. For instance, how likely is it that someone would go out of their way to intentionally step on a stranger’s foot, just for the sheer fun of it? If this event is highly unlikely, what caused the client to think of this unlikely explanation?

In so doing, the client comes into contact with the core belief, the-world-is-a-dangerous-place, and learns to challenge that belief. Over time, the core belief is repeatedly challenged and is subsequently replaced with a core belief that is more realistic, flexible, and adaptive. As the dysfunctional core belief evolves into a more adaptive one, the client will begin to behave in ways that are less hostile and aggressive.

In so doing, other people respond in kind. This new, positive experience of being treated well by other people further solidifies the new, more moderate and accurate belief, that most people are safe.


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Music Changes Perception, Research Shows

Posted by Sun on June 1, 2012

ScienceDaily (Apr. 27, 2011) — Music is not only able to affect your mood — listening to particularly happy or sad music can even change the way we perceive the world, according to researchers from the University of Groningen.

Music and mood are closely interrelated — listening to a sad or happy song on the radio can make you feel more sad or happy. However, such mood changes not only affect how you feel, they also change your perception. For example, people will recognize happy faces if they are feeling happy themselves.

A new study by researcher Jacob Jolij and student Maaike Meurs of the Psychology Department of the University of Groningen shows that music has an even more dramatic effect on perception: even if there is nothing to see, people sometimes still see happy faces when they are listening to happy music and sad faces when they are listening to sad music.


Jolij and Meurs had their test subjects perform a task in which they had to identify happy and sad smileys while listening to happy or sad music. Music turned out to have a great influence on what the subjects saw: smileys that matched the music were identified much more accurately. And even when no smiley at all was shown, the subjects often thought they recognized a happy smiley when listening to happy music and a sad one when listening to sad music.


The latter finding is particularly interesting according to the researchers. Jolij: ‘Seeing things that are not there is the result of top-down processes in the brain. Conscious perception is largely based on these top-down processes: your brain continuously compares the information that comes in through your eyes with what it expects on the basis of what you know about the world. The final result of this comparison process is what we eventually experience as reality. Our research results suggest that the brain builds up expectations not just on the basis of experience but on your mood as well.’

The research was published in the open access journal PLoS ONE on 21 April.

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The Treatment of Panic Disorder

Posted by Sun on May 30, 2012

The Treatment of Anxiety Disorders

Now that we have reviewed the various theories and associated therapies that are used to treat anxiety disorders, we will turn our attention to specific anxiety disorders to describe the usual treatment approach for each disorder. However, it is important to bear in mind, that therapists tailor their treatment approach for each person.

Treatment for Panic Disorder

Panic Disorder is characterized by uncued panic attacks triggered by a false alarm. Cognitive-behavioral therapy for Panic Disorder usually begins with psychoeducation about the disorder. Psychoeducation assists therapy participants (and their family members) to better understand their disorder. This increased understanding serves an important therapeutic purpose. You may recall that two specific cognitive distortions result in an inaccurate appraisal of risk, leading to a subsequent increase in anxiety symptoms: 1) the overestimation of threat and 2) the underestimation of coping abilities.Psychoeducation enables therapy participants to make a more accurate appraisal of risk, and to improve their coping skills in the following ways:

Psychoeducation teaches therapy participants that the physical sensations of the fight-or-flight response are harmless. Therefore, persons-in-recovery learn to more accurately interpret the physical sensations they experience during a panic attack. This increased knowledge helps to reduce the anxiety resulting from an over-estimation of the risk posed by a panic attack. People with Panic Disorder are comforted to know that even though they may feel as though they are losing control, or having a heart attack, these symptoms are perfectly safe, and even adaptive in true situations of danger.

Similarly, people with Panic Disorder benefit from skills training to improve their coping skills through relaxation exercises and breath retraining. Breath retraining involves learning to consciously regulate breath during a panic attack, while relaxation training involves learning to consciously release muscle tension. The purpose of relaxation exercises and breath retraining is to “turn-off” the sympathetic nervous system, which becomes activated during fight-or-flight, and instead “turn-on” the parasympathetic nervous system. In addition, these new skills help to strengthen patients’ appraisal of their coping skills; thereby further reducing their anxiety. These skills can be taught during individual therapy sessions or in a skills-training group.


In addition to psycho-education and skills training, cognitive therapy also helps persons-in-recovery to identify, and target, disorder-specific dysfunctional thoughts, such as the tendency to misinterpret any physical sensation as dangerous or harmful, and the tendency to believe that certain situations “cause” panic attacks (leading to avoidance of those situations). Furthermore, the relationship between underlying life stressors and the initial, uncued panic attacks may be explored. Therapy participants are encouraged to develop strategies to reduce or eliminate these stressors. 

After receiving psychoeducation, skills training, and cognitive therapy, the therapy participant is now ready to participate in the behavioral component of treatment called exposure and response prevention therapy. There are two separate components to the behavioral therapy for Panic Disorder. The first is called interoceptive cue exposure. This type of exposure is meant to desensitize the participant to their specific physical sensations of a panic attack while refraining from his/her typical avoidance or safety behaviors. For example, if a person tends to experience rapid heart rate and perspiration during an attack, the therapist would instruct this person to run up and down stairs in the heat to mimic those same uncomfortable sensations. With repeated practice, the person will no longer become anxious when experiencing these sensations.

Once the therapy participant has learned to become more relaxed in the presence of their physical sensations, the second type of exposure involves confronting the specific situations that typically precipitate their panic attacks, such as an elevator, driving over a bridge, and/or going to a crowded, public place.

Due to the process of paired association, these neutral situations have become linked to the panic attacks and now spontaneously precipitate a panic attack. Therapy participants may practice their relaxation and breath techniques during exposure to prevent a panic attack from occurring.

With practice, the fearful response becomes extinguished: i.e., the exposure to these feared situations, without a panic attack, allows the fear to fade away. In one important study, the combination of interoceptive cue exposure, along with cognitive therapy, led to 85% of the participants being panic-free (Barlow, Craske, Cerny, & Klosko, 1989).

Despite psychoeducation, skills training, and cognitive therapy, some people are unable or unwilling to tolerate exposure therapy. For these people a variety of approaches are still available. Some people with Panic Disorder may benefit from the addition of medication. In addition, the therapist may decide to take a different approach by assisting therapy participants learn to tolerate and accept their symptoms. Both Dialectical Behavior Therapy and Acceptance and Commitment Therapy are useful tools in this regard.


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Some Reasons Why I Use REBT in My Private Practice and Personal Life

Posted by Sun on May 30, 2012

Clear and Practical

There are many reasons why I use REBT. Perhaps the most important one is because it seems very logical and has a clear and focused practical application, in practice and everyday life. Since I first listened to some of Ellis’ tapes of therapy sessions with clients, and read a number of his article reprints1962, I was hooked. It appealed to my ‘logical’ understanding and ‘knowledge’ of psychology. I loved the straight forward, hard hitting, and forceful use of reason to ‘attack’ the ‘illogic’ and seemingly self-defeating thinking of the clients he was interviewing. I liked the fact that his articles, like his therapy dialogue, were clear and specific. His writings are well referenced. They seem particularly well informed (scholarly) and lacking in the fuzzy terminology many psychologists and other professionals seem predisposed to use. Ellis’ approach appears to weave the ideas and empirical findings of a broad range of individuals into a comprehensive, ‘common sense’ kind of approach.

Recently2006, I noted that Ellis and Abrams had commented that some problem-solving people, not trained in REBT, but faced with a terminal condition, find rational ways of coping that, like REBT, are “common sense” solutions to life’s problems(1). This supports my own notion of REBT’s ‘common sense’ appeal and practicality, its non mystical, non magical, workable, approach to life’s often difficult challenges.

Life Is Hassle with a Capital H

Part of a background of childhood illness (allergies and asthma) probably led me to push or pursue practical solutions to problems harder than average. To the best of my ability, I developed, and continue to develop, critical thinking abilities. I ‘understand’ Al’s comment that “Life is a hassle with a capital H.” I have been particularly interested in learning about medical illness(es), including ‘mental’ illnesses, out of personal concern, and a genuine desire to help myself and others. Being naturally curious, I find health issues quite interesting. At the same time, I gain pleasure out of helping others. I assign an important meaning to the term ‘fallible human being.’ No exalted reason here, just plain, simple enlightened self-interest (another Ellis term). No thought about ‘getting into heaven’ by helping others –just a sincere desire to help because I enjoy practical problem solving. I also hold some belief in Ralph Waldo Emerson’s statement that “It is one of the most beautiful compensations of life, that no man can sincerely try to help another without helping himself.” Certainly, there are tons of evidence (metaphorically speaking), for human ‘fallibility’ and need for psycho-logical (Korzybski’s term) care and treatment. Unfortunately, the self-stigma associated with seeking psychological help prevents many from using this medium (2). Becoming aware of the limitations and negative aspects of psychiatric labeling might help us improve attempts to provide help.

Ellis Incorporates General Semantics Concepts

Ellis’s continued references to Korzybski’s important work (3), beginning with his earliest writings (4,5) and referenced in many later ones (e.g., 6,7,8) reflect a strong commitment to semantic accuracy. Having had classes with O.R.Bontrager1958, a student and associate of Korzybski, and believing Korzybski’s work as having profound significance for human well being, I was delighted to find that Ellis considered this work important. Language, how we use it, and its effect on our nervous system, both lower and higher brain centers, seems of primary importance in scientific advancement. So noting Al’s attention to general semantics was, in effect, a confirmation of my belief in its value. I felt confident that his awareness and attention to these ideas allowed a more accurate and concise approach.

An Attitude of Science

I am confident that Al’s emphasis on science, like Korzybski’s, as a process to pursue structures that most accurately reflect ‘reality,’ proves to be the most efficient method for progress in human affairs. The ‘attitude of science’ involves making hypotheses in clinical situations that ‘test’ a hypothesis and observe whether it seems confirmed or disconfirmed by the outcome(s). It seems a method of approximation, one which can be continually revised as indicated, as new data becomes available.

Al has stated that he “…has a gene for efficiency” and an ‘unbiased’ observer, with specific criteria of observation, would presumably be able to confirm that. His prodigious accomplishments, in spite of a history of illness(es) beginning in childhood, great professional and societal resistances to his ideas1950’s…2006… etc., would seem to bear out this ‘efficiency.’

Dealing with Illness Adversity

Having a chronic illness since age two, I have been quite interested and curious about how Ellis dealt with his difficulty of childhood illness and later development of insulin dependent diabetes, for over 50 years. I am sure his strong motivation to develop a dependable theory and philosophy of life, based on the soundest ideas imaginable, was/is influenced by illness adversity. Presently, he is dealing with the greatest challenge(s) of his lifeSept, 2006, and doing it stubbornly and courageously. This sets an example for anyone ultimately faced with issues of illness and ageing, who wants to handle adversities as rationally as possible.

Flexible Standards Regarding Individual and Collective Actions

An important part of REBT’s value lies in its offering a flexible, workable standard of evaluation to ‘understand’ “rational” or “helpful” emotions and behaviors, perhaps most importantly, to the problems of inherent aggressive tendencies of humans (9). Our present world situation2006 appears to be acutely increasing in violent rhetoric and action. Korzybski1933 noted that, while the United States proclaimed “…the doctrine that man is ‘free and independent’…we are, in fact, not free, but are inherently interdependent (p. 270). We hear much rhetoric today about “freedom” etc., often by individuals who appear quite unaware of the assumptions and false-to-fact ‘reality’ underlying their thinking. Ellis, like Korzybski, believes we’d better take into account the effect of our individual, and collective, actions. In recognizing that human thinking often has both ‘rational’ and ‘irrational’ aspects at the same time, and avoiding either/or, black/white, good/bad dichotomies of thinking, REBT ‘recognizes’ that terrorists, like Americans and others who oppose them, insanely believe similar notions. When terrorists believe that Americans must be punished to prove that they (the terrorists) are worthwhile, that America must not oppose them, and that all Americans are bad and must be killed, etc. they act insanely. Conversely, when Americans and others who oppose the terrorists believe similar ideas, it leads to an endless upward cycle of violence leading, possibly, to a world war and perhaps the end of our planet. By strongly working for, and adopting a less blaming or non blaming attitude toward oneself and others, we increase our chances of getting along with others, at the same time, becoming less prone to anger and other emotional upset (10).

While there are many other reasons why I use REBT in my practice and daily life, these seem to be ones with overriding importance, on September 1st, 2006.


(1)Ellis, Albert and Abrams, Michael. How to Cope With a Fatal Illness: The Rational Management of Death and Dying. Barricade Books, Inc. New York, 1994.

(2)Vogel, D.L, Wade, N.G. and Haake, S. “Measuring the Self-Stigma Associated With Seeking Psychological Help”. InJournal of Counseling Psychology, Vol. 53, No.3, July, 2006, pp. 325-337.

(3)Korzybski, Alfred. Science and Sanity: An Introduction to Non-Aristotelian Systems And General Semantics. Fourth Edition. The International Non-Aristotelian Library Publishing Company. Distributed by the Institute of General Semantics, Lakeville, Connecticut.

(4)Ellis, Albert. How to Live With a “Neurotic” At Home and At Work. Crown Publishers, Inc. New York, 1957.

(5)Ellis, Albert and Harper, Robert. A Guide to Rational Living in an Irrational World. Prentice- Hall, Inc. Englewood Cliffs, N.J. 1961.

(6)Ellis, Albert: New Directions in Rational Emotive Behavior Therapy: Overcoming Destructive Beliefs, Feelings, and Behaviors. Prometheus Books, Amherst, New York. 2001.

(7)Ellis, Albert. Overcoming Resistance: A Rational Emotive Behavior Therapy Integrated Approach. 2nd Edition. Springer Publishing Company. 2002.

(8)Ellis, Albert. How to Stubbornly Refuse to Make Yourself Miserable about Anything, Yes, Anything. Rev. and Updated. Kensington Publishing Corporation, New York, N.Y.2006.

(9)Ellis, Albert. Anger: How to Live With and Without It. Revised and Updated. Kensington Publishing Corporation Corp. New York, N.Y. 2003.

(10)Ellis, Albert and Harper, Robert.. A Guide To Rational Living. 3rd Edition. Thoroughly Revisd And Updated For The Twenty-First Century.Wilshire Book Company, Hollywood, Ca. 1997.

About the Author

John Minor, Ph.D. — Clinical Psychologist. Associate Fellow, REBT. Training faculty, REBT. Affiliated with Albert Ellis and REBT since 1962. Fellow, International College of Prescription Psychology. Taught at the University of California, Los Angeles, UC Irvine, and California University, Long Beach.


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