Philosophy and Addiction

……This allegory is richly wonderful for understanding addiction, relapse and recovery. Most people who become addicted become enchained to their drug of choice. The word “addiction” comes from the Latin verb “addicere,” which means to give over, dedicate or surrender. In the case of many alcoholics, for instance, including my own, this is just what happens. What had perhaps started as fun and harmless use begins to grow troubling, painful and difficult to stop. The alcoholic becomes chained to alcohol in a way different from others who “drink normally.”

In various scenarios of addiction, the addicted person’s fixation on a shadow reality — one that does not conform to the world outside his or her use — is apparent to others. When the personal cost of drinking or drug use becomes noticeable, it can still be written off or excused as merely atypical. Addicts tend to orient their activities around their addictive behavior; they may forego friends and activities where drinking or drug use is not featured. Some may isolate themselves; others may change their circle of friends in order to be with people who drink or use in the same way they do. They engage in faulty yet persuasive alcoholic reasoning, willing to take anything as evidence that they do not have a problem; no amount of reasoning will persuade them otherwise. Each time the addict makes a promise to cut down or stop but does not, the chains get more constricting.

Yet for many reasons, some people begin to wriggle against the chains of addiction. Whether it is because they have experiences that scare them to death (not uncommon) or lose something that really matters (also not uncommon), some people begin to work themselves out of the chains. People whose descent into addiction came later in life have more memories of what life can be like sober. Some will be able to turn and see the fire and the half wall and recognize the puppets causing the shadows. Those whose use started so young that it is all they really know will often experience the fear and confusion that Plato described. But as sometimes happens in recovery, they can start to come out of the cave, too.

The brightness of the light can be painful, as many alcoholic or drug dependent people realize once their use stops. Those who drank or used drugs to numb feelings or avoid painful memories may feel defenseless. This is why they will retreat back to the familiar darkness of the cave. Back with their drinking friends, they will find comfort. This is one way to understand relapse.

By PEG O’CONNOR from the New York Times Opinionator

Autism Language Difficulties

By age 3, most children have passed several predictable milestones on the path to learning language. One of the earliest is babbling. By the first birthday, a typical toddler says words, turns when he hears his name, points when he wants a toy, and when offered something distasteful, makes it very clear that his answer is no. By age 2, most children begin to put together sentences like “See doggie,” or “More cookie,” and can follow simple directions.

Research shows that about half of the children diagnosed with autism remain mute throughout their lives. Some infants who later show signs of autism do coo and babble during the first 6 months of life. But they soon stop. Although they may learn to communicate using sign language or special electronic equipment, they may never speak. Others may be delayed, developing language as late as age 5 to 8.

Those who do speak often use language in unusual ways. Some seem unable to combine words into meaningful sentences. Some speak only single words. Others repeat the same phrase no matter what the situation.

Some children with autism are only able to parrot what they hear, a condition called echolalia. Without persistent training, echoing other people’s phrases may be the only language that people with autism ever acquire. What they repeat might be a question they were just asked, or an advertisement on television. Or out of the blue, a child may shout, “Stay on your own side of the road!” — something he heard his father say weeks before. Although children without autism go through a stage where they repeat what they hear, it normally passes by the time they are 3.

People with autism also tend to confuse pronouns. They fail to grasp that words like “my,” “I,” and “you,” change meaning depending on who is speaking. When Alan’s teacher asks, “What is my name?” he answers, “My name is Alan.”


Celebrities with Mental Health Disorders

By Marianne English,

With 26 percent of Americans 18 years or older living with a diagnosable mental disorder, it’s no wonder mental health is an increasing priority for the average person. But what about the celebrities or famous people we’ve come to follow so closely? They aren’t exempt from mental health issues, either. Some are more private about their mental health, while others strive to raise awareness in hopes of debunking misconceptions about disorders. This slide show includes some of Hollywood and history’s most well-known names.

Catherine Zeta Jones: bipolar II disorder

Mel Gibson: bipolar disorder

Brooke Shields: postpartum depression

John Nash: paranoid schizophrenia

Carrie Fisher: substance abuse and bipolar

Emma Thompson: depression

Herschel Walker: dissociative identity disorder

Michael Phelps: ADHD

Howard Hughes: obsessive compulsive disorder

Paula Deen: panic attacks and agoraphobia

Elton John: substance abuse and bulimia

Craig Ferguson: alcoholism

Margot Kidder: bipolar with paranoia

Sinead O’Connor: bipolar

Kurt Cobain: ADD and bipolar


Anger: How to Recognize and Deal with a Common Emotion

American Psychological Association

Seven questions for anger expert Howard Kassinove, PhD

Everyone knows what it feels like to be angry. Yet the causes, effects and ways to control anger are sometimes not well understood. Psychologists can help people recognize and avoid anger triggers. They also can provide ways to deal with anger when it does occur.   

Howard Kassinove, PhD, ABPPHoward Kassinove, PhD, ABPP, is professor of psychology at Hofstra University and director of the university’s Institute for the Study and Treatment of Anger and Aggression. A former director of Hofstra’s PhD program and chair of the Psychology Department, he has more than 40 years’ experience as a scientist and professional psychologist.

Kassinove is a fellow of the American Psychological Association and the Association for Psychological Science. He is board certified in clinical psychology and is the current president of the American Board of Cognitive and Behavioral Psychology. He has co-authored two books about anger: Anger Management: The Complete Treatment Guidebook for Practitioners (2002, Impact Publishers) and Anger Management for Everyone: Seven Proven Ways to Control Anger and Live a Happier Life (2009, Impact Publishers).

APA recently asked Dr. Kassinove the following questions about anger.

APA: What is anger and how does it differ from aggression?

Dr. Kassinove: Anger is a negative feeling state that is typically associated with hostile thoughts, physiological arousal and maladaptive behaviors. It usually develops in response to the unwanted actions of another person who is perceived to be disrespectful, demeaning, threatening or neglectful. Anger involves certain styles of thinking such as, “My boss criticized me in front of my colleagues. Now, I’m fuming. He shouldn’t be so disrespectful!” or “That woman in front of me is driving so slowly. This is exasperating. She shouldn’t be allowed to drive on the freeway!” Anger energizes us to retaliate. Our data indicate that about 25 percent of anger incidents involve thoughts of revenge such as, “I’m going to spread rumors about my boss to get even,” or “I’d like to just bump her car to put her in her place.” Interestingly, anger usually emerges from interactions with people we like or love, such as children, spouses and close friends.

Angry thoughts may be accompanied by muscle tension, headaches or an increased heart rate. In addition, the verbal and physical expressions of anger may serve as a warning to others about our displeasure. The verbal expressions include yelling, arguing, cursing and sarcasm. However, anger can also be expressed physically by raising a clenched fist, throwing a book on the floor, breaking a pencil or hitting a wall. Sometimes, anger is not expressed externally but remains as internal rumination.

Aggression, in contrast, refers to intentional behavior that aims to harm another person. Often, it reflects a desire for dominance and control. In the cases I see in my clinical and research work, weapons are often involved. Aggression can be shown by punching, shoving, hitting or even maiming another person, and it can occur in marital violence, child or elder abuse, bullying or gang and criminal activities.

Since anger is typically expressed only through loud verbalizations, it is the cases of aggression that wind up in the criminal justice system. Our research shows that about 90 percent of aggressive incidents are preceded by anger. However, only 10 percent of anger experiences are actually followed by aggression. People often want to act aggressively when angry but, fortunately, most do not actually take aggressive actions. Also, there is sometimes an impulse to engage in problem solving behaviors when angry.

Yet, anger is an important problem in its own right with negative consequences in many aspects of life such as marriages, the workplace, parent-child interactions and driving behavior. Anger is associated with interpersonal conflicts, negative evaluations by others, erratic driving, property destruction, occupational maladjustment, inappropriate risk taking, accidents, substance abuse and so-called crimes of passion.

APA: What are some of the positive aspects of anger?

Dr. Kassinove: Many of the longer-term outcomes of anger are negative. Yet, anger is part of our biological history. It is part of the fight-or-flight reaction. It had survival value in the past and it has some positives in the present. Many of these, however, are short-term benefits as few of us like to spend time with angry people.

Anger can be an appropriate response to injustice. No doubt, anger played a useful part in social movements for equality for blacks, the elderly and women, among others. Anger may also lead to better outcomes in business negotiations as well as an increased motivation to right the wrongs we see in the world.

The positives include its alerting function. Anger tells others it is important to listen to us – that we feel agitated and it is wise to be alert to our words and actions. It may also lead to compliance by others. Strongly asserting that we were first in line at a store counter may lead to better service. Also, in the short term, children and others may be more likely to comply with our requests when we are angry. “Don’t go in the street without holding mommy’s hand!” when said angrily to a small child, can be lifesaving.

Anger sometimes just feels good and righteous. We may feel angry when watching a movie or a play where a character suffers inappropriately. Then, when good triumphs over evil, anger is replaced with a feeling of satisfaction.  Playwrights have known about this for eons. In a similar vein, anger provides a certain zest for life. Can you imagine a world with no anger? The healthier, milder levels of irritation and annoyance add spice to daily existence and we all seem to enjoy that.

APA: What are some of the potential health consequences of anger?

Dr. Kassinove: Many people consider excessive anger to be just a psychological problem. That is a gross simplification. When we become angry, the autonomic nervous system is aroused. For example, anger precipitated by the discovery of a spouse’s secret affair will likely lead to arousal of the sympathetic nervous system and associated hormonal and neurochemical changes. These physiological reactions can lead to increases in cardiovascular responding, in respiration and perspiration, in blood flow to active muscles and in strength. As the anger persists, it will affect many of the body’s systems, such as the cardiovascular, immune, digestive and central nervous systems. This will lead to increased risks of hypertension and stroke, heart disease, gastric ulcers, and bowel diseases, as well as slower wound healing and a possible increased risk of some types of cancers.

Research has found that anger is an independent risk factor for heart disease. Having a tendency to experience anger frequently, in many types of situations, is known as high trait anger. One study followed 12,986 adults for approximately three years and found a two to three times increased risk of coronary events in people with normal blood pressure but with high trait anger. Another study followed 4,083 adults for 10 to 15 years. Those who were lowest on anger control had the highest risk of fatal and non-fatal cardiovascular events. After reviewing the literature, experts have concluded that high trait anger, chronic hostility, anger expression and acute anger episodes can lead to new and recurrent cardiovascular disease. When anger is experienced moderately and expressed assertively it may be less disruptive than when it is frequent, intense and enduring.

APA: What has psychological research revealed about why some people are more prone to anger than others?

Dr. Kassinove: Proneness to anger has to be examined with regard to thoughts, physiological reactions and physical activity. With regard to the physiological reactions, some people are easily aroused and quickly respond to aversive stimuli. They rapidly become angered by bad smells, heat and annoying noises. Others are slow to react and seem not bothered by such stimuli. Genetic variability plays a big part here.

Physical expressions of anger, such as sulking, banging the desk or hitting the wall are learned by the forces of reinforcement and copying others.

Finally, some evidence suggests that violent video games and, perhaps, listening to angry music with violent lyrics may fuel anger and aggression in some people. In violent videogames, players hear quick-paced, excitatory angry music. They learn to be hyper alert, to respond impulsively and to kill opponents. This leads to reinforcement in the form of points, acquisition of new weapons, access to upper levels of the games and accolades by others in the gaming environment.

APA: What are some of the steps that people can take when dealing with anger among family members or friends?  How would they differ from dealing with a stranger – such as a store clerk, taxi driver or other service person?

Dr. Kassinove: Anger felt when dealing with strangers emerges from transient interactions. You may never see the clerk or driver or waiter again. If you ask yourself how important the annoying situation really is, you usually come up with, “not very important at all.” At most, you have suffered from paying a bit too much for the taxi ride or being delayed a few minutes by the clerk. Recognize that these are unpleasant events, not catastrophes, and work around them. Go to a different restaurant or go to the store at off hours to return a purchase.

Also, recognize the difference between events that you can change and those that are beyond you. When you take a cab ride, tell the driver about your preferred route. When you order that steak in the restaurant, ask for extra ketchup before the waiter leaves the table never to be seen again. You have less control over other events. Airplanes, for various reasons, are frequently late. There is little you can do. Accept the delay as an opportunity to read or relax, not disastrous or worthy of anger.

Anger felt when dealing with family members or friends is different because of the ongoing interactions. To address this kind of anger, the self-help strategies that are quickest and easiest to use are avoidance and escape, relaxation, cognitive restructuring and assertive expression.

Directly facing all problems may not be the best solution. Sometimes, avoiding an interaction that is likely to lead to anger is best. For example, allow a spouse to deal with an unfair store clerk or a disruptive child. Learn that you can occasionally lean on others to work out problems. Relaxation is a great tool to deal with anger, since angry folks tense their muscles and develop headaches and stomach aches. Find a comfortable chair that will support the arms and legs, and a quiet time. Take deep breaths and focus on allowing the muscles to voluntarily relax. Become aware that muscular relaxation is learned through practice. Soft music often helps. Cognitive restructuring refers to learning how to appropriately analyze aversive situations. Anger experiences are often associated with cognitive distortions, such as misappraisals about the importance of the event or about the capacity to cope. Anger is a moral emotion and typically associated with justice-oriented demands in the form of “should.” In addition, angry adults make overgeneralizations about the meaning of behaviors shown by others and they limit their options with “either/or” thinking, such as “Either he’s my friend or he’s not. It’s just that simple!” Learn to see negative situations as bad, but also as opportunities to develop coping skills and learn new behaviors. Recognize that others do good and bad things. Get rid of those broad generalizations about people.

To be assertive means expressing anger directly, in an appropriate tone and without demeaning the other person. If you have been offended or disrespected, it is OK to say, “When you said my work was subpar in front of the others, I felt angry. I’d like to talk to you about the situation so that we can improve our relationship.” It is quite another thing to say, “You acted like a real jerk today. How dare you talk like that in front of the others! You have plenty wrong with you also!”

APA: At what point should a person seek professional help for anger?

Dr. Kassinove: Some degree of anger will be with us for all of our lives. So, this is the question to ask: “Is my anger working for me?” When anger is mild, infrequent, dissipates quickly and is expressed assertively (directly to the problem person, in a non-accusatory manner) and without aggression, then professional help is not needed.  In such circumstances, anger may serve the role of simply highlighting your annoyance and it can lead to problem resolution.

However, if your anger is moderate to intense, experienced frequently, endures to the point where you are holding a grudge and are planning to get even, and is expressed in aggressive verbal and physical actions, then there is cause for alarm. You are likely at risk for the negative relationship, health and sometimes legal repercussions related to inappropriate anger expression.

APA: What are the most effective treatments for people who have a serious anger problem and wish to gain control over the emotion?

Dr. Kassinove: Anger management works. There have been six large-scale analyses of adult anger management programs. The latest one reviewed 96 different studies and concluded that psychological treatments are moderately effective for treating anger in various groups. This includes work to reduce anger in college and university settings, community treatment facilities, correctional facilities and hospitals. In some cases, significant effects were found in as little as eight treatment sessions and the results were maintained in follow-ups of a month to a year. The strongest effects are found with multicomponent treatment programs. Interventions based on cognitive or cognitive-behavioral therapy, psychodynamic therapy and skill training work best. Relaxation programs, stress inoculation programs and exposure-based interventions are also helpful.

It is wise for individuals seeking anger management services to begin at their local universities or hospitals and to ask how long they have offered anger management services. Personnel with up-to-date research knowledge and specific training and more experience working in the area of anger management are likely to provide the best service.

Dr. Kassinove can be contacted by email or at (516) 463-5625


Averill, J. R. (1983). “Studies on anger and aggression: Implications for theories of emotion.” American Psychologist, 38 (11), 1145-1160.

Gouin, J., Kiecolt-Glaser, J.,Malarkey, W. & Glaser, R. (2008). The influence of anger expression on wound healing.” Brain, Behavior, and Immunity, 22(5), 699-708.

Harburg, E., Julius, M., Kaciroti, N., Gleiberman, L., Schork, & Anthony. (2003) “Expressive/suppressive anger-coping responses, gender and types of mortality:A 17-year follow-up (Tecumseh, Michigan, 1971-1988). Psychosomatic Medicine, 65(4), 588-597.

Johnson, Ernest H. (1990).“The deadly emotions: The role of anger, hostility and aggression in health and emotional well-being.” New York, NY, Praeger Publishers.

Kune, G., Kune, S., Watson, L., Bahnson, & Claus, B. (1991). “Personality as a risk factor in large bowel cancer: Data from the Melbourne Colorectal Cancer Study.” Psychological Medicine: A Journal of Research in Psychiatry and the Allied Sciences, 21(1), 29-41.

Sharma, S., Ghosh, S. & Spielberger, C. (1995). Anxiety, anger expression and chronic gastric ulcer. Psychological Studies, 40(3), 187-191.

Suinn, Richard M. (2001).“The Terrible Twos – Anger and Anxiety: Hazardous to your health.” American Psychologist, 56 (1), 26-37.

Tafrate, R.C., Kassinove, H., & Dundin, R. (2002). “Anger episodes of angry community residents.” Journal of Clinical Psychology, 58, 1573-1590.

Yi, Joyce., Yi, J., Vitaliano, P., & Weinger, K. (2008).“How does your anger coping style affect glycemic control in diabetes patients?” International Journal of Behavioral Medicine, 15(3), 167-172.

The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States and is the world’s largest association of psychologists. APA’s membership includes more than 137,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting health, education and human welfare.

Mentors Help Individuals With Disabilities Get Through Psychology Graduate Programs

Individuals with disabilities are sorely underrepresented in graduate psychology programs and careers. Few enter the field, and those who do often experience frustration that may sometimes give way to higher than average drop out rates for these students. One strategy shown to increase the success of underrepresented groups in graduate school and entering professions is a mentoring program. In light of the evidence that mentoring has proven helpful to other underrepresented groups, the Disability Issues in Psychology Office is pleased to announce its Mentoring Program that will support psychology students with disabilities, disabled psychologist entering the field, and psychologists in the field who develop a disability.

Please note that matching with a mentor in the Disability Mentoring Program is contingent on the number and availability of mentors enrolled in our program.

–American Psychological Association

Mental Health Services and Choosing a College

Must Do’s Before Applying

Know Your Rights Before Selecting a College


Research Psychological and Psychiatric Services on Campus


  • Most campus websites offer an overview of services
  • Be proactive and call or visit to make sure they offer adequate treatment tailored to your situation
  • Ask whether the services are free to students or if they are available for a fee
  • Find out how many psychologists are on staff and make sure the school employs at least one licensed psychiatrist. In the case of larger universities, multiple psychiatrists should be on staff.
  • Make sure the school keeps your records confidential from other entities, both within the college and outside of it

Research Hospitals and Private Practices in the Community

  • Nearly all school health or counseling centers only offer short term care, then the student must find a practice in the community
  • Find practices compatible with your insurance
  • If you don’t have a car, look up information on public transportation in order to get to the clinic or practice
  • Ask if they offer discounted rates or a sliding scale for students

Research Disability Resources

  • Discover the breadth of disability resources the college offers for psychiatric disabilities, as they vary greatly from campus to campus
  • Inquire as to what specific services are provided, i.e.: test rescheduling, priority registration, reduced course load, class substitution etc.
  • Find out the confidentiality policies, especially ask whether professors and instructors are informed of the student’s disability or just the accommodations to be made for him or her

Helpful Hints

Campus Counseling Centers

  • Counseling centers on campus typically offer excellent services when dealing with typical ‘college’ problems, such as: relationship conflicts, adjusting to college and academic problems. They also deal with anxious and depressed moods, substance abuse, and trauma recovery. Dealing with these problems is very important, as they produce added stress which may trigger the onset of an episode, or compound on a current one.
  • However, there are certain drawbacks to most counseling centers:
    • Again, they usually only offer short term care; the student must then find another place for therapy, usually a private practice. The counseling services typically assist in this
  • Most counseling centers on campus are not equipped to effectively handle more serious mental illnesses such as schizophrenia, bipolar disorder, major depression, anxiety disorders etc.

Psychiatric Care on Campus

  • There is typically a long wait to see a psychiatrist on campus
    • Try and make an appointment as soon as you can, possibly even in the summer, prior to arriving at school. This will allow you to see a doctor earlier and establish a set schedule
  • Nearly all psychiatrists on campuses take students upon referral only
  • As with the counseling services, some psychiatrists also have a limit on the number of times a patient can be seen
  • If you see a private doctor and your school’s medical center has a pharmacy, check to see if they will fill prescriptions from outside practices. Many times certain medications are filled for free as a result of the student fees paid each semester.
  • Know what to do in case of an emergency
    • Ask about emergency procedures are during business hours at the psychological services center as well as with a psychiatrist.
    • A few schools offer a 24 hour hotline to call; however, most don’t, so be sure to have the number of a local hospital in case of a emergency during evening or weekend hours

Campus Size

  • Smaller campuses can feel less overwhelming than a large university. However, there tends to be less psychological services on smaller campuses
  • Large campuses generally offer a wider array of services. Nonetheless, even though more services are available, the wait is still usually long due to the size of the campus.
  • If attending a large campus, try to join an organization, find a social group, and make friends, especially in the dorms. This will make the campus seem smaller and less overwhelming
  • Compare the number of counselors and especially psychiatrists that are employed at the school to the number of students on campus. This is a good indicator of how long the wait will be, and shows the importance and dedication the school places on mental health

Making a decision

  • The most important factor is narrowing your search to a few schools where you can see yourself living at for four years, where you will feel comfortable at and feel that you will succeed while you are there
  • When looking at mental health services, keep in mind that you will need to find a balance
    • You will most likely not find a program that meets your needs in every aspect of your care
    • Keep in mind your specific condition and needs, and use that as a guide when making a decision


Benzodiazepine Use in Patients With Schizophrenia Associated With Increase in Mortality

Polypharmacy with antipsychotics, antidepressants, or benzodiazepines and mortality in schizophrenia.

Arch Gen Psychiatry. 2012; 69(5):476-83 (ISSN: 1538-3636)

According to a study by Tiihonen J; Suokas JT; Suvisaari JM; Haukka J; Korhonen P,   Benzodiazepine use was associated with a marked increase in mortality among patients with schizophrenia, whereas the use of an antidepressant or several concomitant antipsychotics was not. Antidepressant use was associated with decreased suicide deaths. The literature indicates that long-term use of benzodiazepines among patients with schizophrenia is more prevalent in other countries (eg, the United States) compared with Finland, which suggests that benzodiazepine use may contribute to mortality among this patient population worldwide.

Rethinking Addiction’s Roots, and Its Treatment

There is an age-old debate over alcoholism: is the problem in the sufferer’s head — something that can be overcome through willpower, spirituality or talk therapy, perhaps — or is it a physical disease, one that needs continuing medical treatment in much the same way as, say, diabetes or epilepsy?

Dr. Christine Pace helps Derek Anderson manage his heroin addiction at Boston University Medical Center. With the help of medication, Mr. Anderson has been clean for six years.Increasingly, the medical establishment is putting its weight behind the physical diagnosis. In the latest evidence, 10 medical institutions have just introduced the first accredited residency programs in addiction medicine, where doctors who have completed medical school and a primary residency will be able to spend a year studying the relationship between addiction and brain chemistry.

“This is a first step toward bringing recognition, respectability and rigor to addiction medicine,” said David Withers, who oversees the new residency program at the Marworth Alcohol and Chemical Dependency Treatment Center in Waverly, Pa.

The goal of the residency programs, which started July 1 with 20 students at the various institutions, is to establish addiction medicine as a standard specialty along the lines of pediatrics, oncology or dermatology. The residents will treat patients with a range of addictions — to alcohol, drugs, prescription medicines, nicotine and more — and study the brain chemistry involved, as well as the role of heredity.

“In the past, the specialty was very much targeted toward psychiatrists,” said Nora D. Volkow, the neuroscientist in charge of the National Institute on Drug Abuse. “It’s a gap in our training program.” She called the lack of substance-abuse education among general practitioners “a very serious problem.”

By DOUGLAS QUENQUA at the New York Times

The Most Ignored Strategy For Staying Motivated

Are you trying to make positive changes in your life?  When we want to do something differently, say, to stop smoking, curb our temper or exercise more frequently, we often start with enthusiasm.  But habits are hard to change. After an initial burst of energy, it’s easy to fall back into old patterns of behavior.

What we too frequently ignore when we try to make changes is what is happening around us that either enhances motivation or encourages us to slip back into the status quo.

When you are trying to make changes, what happens as soon as you act in a particular way has an impact on whether you will stick it out.  Say, for example, you’d like to exercise more often.  We all know the long-term benefits of exercise, but what happens as soon as you make the decision to exercise?

Do you have to pull yourself away from the TV or out of bed?  Do you think about what you’re missing by exercising (lunch with friends or quiet time to yourself in the evening)? Does someone in your life encourage you to skip it, just this once?

By CHRISTY MATTA, MA at PsychCentral

Experiences With the Paranormal: Differentiating Between Spirituality and Psychopathology

A matter of perspective

The issue of spirituality versus psychopathology seems to be a matter of perspective. Overvalued ideas about one’s spiritual belief system can be interpreted by others as symptoms of a personality disorder or psychosis. How do we differentiate between healthy spirituality and psychopathology? The Diagnostic and Statistical Manual of Mental Disorders (DSM) offers some guidance, defining delusional beliefs as beliefs “not ordinarily accepted by other members of the person’s culture or subculture.” However, with ever-increasing spiritual sects, it can be difficult for the clinician to know what beliefs might be shared. Additionally, theDSM references the level of impairment, context of behavior or belief and symptoms that may be substance-induced. Thus, isolated experiences that are not part of a broad pattern of disturbance should not be diagnosed.

At times a patient’s spiritual beliefs can interfere (from the clinician’s perspective) with their ability to function in a social, occupational or academic setting. These cases can be challenging to filter through the diagnostic decision tree, especially when it seems as though no one can know for sure the extent of truth to any unusual experience.

For example, I met with a patient who had a strong sense that he was “different” from others; he believed he had lived many past lives and had a special connection with the world that most people he encountered could never understand. He described countless “messages from the universe” directing him in his everyday activities.

From a diagnostic perspective his descriptions bordered on quirky if not impairing. He became quite concerned with physical symptoms, such as feeling like his body was being taken over by an unexplained force, which doctors could not explain. He continually found hidden meanings in TV commercials or friends’ comments that most would consider ordinary experiences. Although he was able to function for the most part independently, he maintained an outlook on the world that made it difficult for him to relate to others and ultimately caused rifts in his relationships.

by HEATHER KRANZ, MED, CRC at Say No To Stigma blog from the Menninger Clinic