I am slowly figuring out how we might move the existing health care system toward better care of stress illness patients. I learned a lot more yesterday when, for seven hours, I shared ideas with two dozen mental health clinicians who came from a wide range of training backgrounds and professional positions.
Archive for the ‘Stress Relief’ Category
Stress Illness and The Health Care System (2)
Saturday, April 24th, 2010Stress Illness and The Health Care System (1)
Thursday, April 22nd, 2010Physical illness caused by psychosocial stress is a clinical dilemma that was known to Hippocrates nearly 2500 years ago. We still don’t have a good solution. Medical clinicians aren’t trained to ask about people’s lives and connect what they find with symptoms. Mental health clinicians don’t see too many patients whose main concern is pain or other body symptoms. But I’m optimistic that in the 21st century will see growing use of good solutions.
Closing the Blind Spot
Thursday, April 8th, 2010Kauai is a wonderful place to talk about stress, primarily because it is difficult to have any while you are there. Last week I went to the Garden Isle to present my lecture on stress illness to clinicians of a variety of specialties from the Pierce County (Washington State including Tacoma & Mt Rainer) Medical Society. They asked a number of thoughtful questions. They were clearly interested in diagnosing stress illness but felt the need for greater support from mental health clinicians (MHCs) than was available in their community. This referred to the limited number of MHCs and also to MHCs experience evaluating patients with unexplained physical symptoms.
Stress and Massage
Monday, April 5th, 2010Recently I hiked to the bottom of Waimea canyon on the Hawaiian island of Kauai with a massage therapist who works as a guide on her days off. Along the way we discovered there was more overlap in our professions than you might guess. Her training, which was a bit unusual, included the idea that some people, while undergoing massage, will experience recall of past or present stress. My guide was taught to ask clients about what they were feeling in their bodies in the area that was being massaged. This gentle prompting led many people to recall significant challenging life issues. Other massage therapists have told me similar stories even though their practice did not include asking leading questions.
Changing Your Life
Tuesday, March 23rd, 2010A woman approached me before a lecture and said “I heard your talk a few years ago, went home afterward and told my husband I wanted a divorce.” I was so surprised I couldn’t think of an intelligent response before she went on to say “…and as soon as it was final all the pain in my jaw went away and hasn’t come back so I wanted to thank you.”
American Psychosomatic Society (4)
Thursday, March 18th, 2010One important exception to the physiology-focused research presented at the APS meeting was a study led by my friend and colleague Dr Howard Schubiner. His well-developed treatment program was used by a group of patients with fibromyalgia with good relief of their symptoms. The process emphasizes techniques for uncovering the emotional issues that underly the symptoms in most cases. Some patients did not benefit but most did which is a tremendous achievement in an illness as difficult as fibromyalgia. It is likely that most forms of stress-related illness would benefit from this process. Dr Schubiner’s book is due out by the end of this month and can be ordered via his web site (click on his name above).
Self-Care Skills
Tuesday, March 2nd, 2010Are you the kind of person who cares for everyone but yourself? In #4 of my series of posts about the DSM-5, I proposed a new definition for Complex Somatic Symptom Disorder. Part B of the definition included the concept that symptoms improve in response to treatment of ongoing social or psychological stresses including insufficient self-care skills. In this post I want to elaborate on the latter.
Anorexia Anecdote (8)
Thursday, February 18th, 2010To help Antoaneta understand emotions about sexual abuse in her childhood, I began by asking her to imagine how she would feel watching a child she cares about growing up exactly as she did. Most of my childhood stress survivors spent years learning to suppress feelings connected to their abuse. As a result, they find it difficult to consciously connect with those emotions. But if they imagine the same experience being inflicted on an innocent child, usually they begin to experience those long-buried emotions. Once they have this connection, the next step, when they feel ready, is to write about what they are feeling. Writing has an almost magical ability to pull out emotions of which people are only slightly aware.
Anorexia Anecdote (7)
Wednesday, February 17th, 2010The second part of Antoaneta’s treatment for anorexia focused on unexpressed outrage about her sexual abuse in childhood. To survive the abuse, many children find a place to lock emotions away. By the time they become adults, their ability to experience those feelings is limited. As their self-esteem recovers during the adult years, recognition of how wrongly they were treated grows and pressure to express the associated emotions becomes compelling. Lacking facility in verbalizing those feelings, many of my patients (including Antoaneta a few years earlier) express them somatically (which means via the body) which results in physical symptoms. In others, such as Antoaneta during the time of her anorexia, the emotional pressure causes a sense of chaos for which tight control over eating and weight provides some relief. The common source of both the physical symptoms and the anorexia lies in the unexpressed outrage at maltreatment in childhood. This is why treatment methods developed to relieve physical symptoms also succeeded in relieving Antoaneta’s anorexia. The key is to help the patient learn to express the emotions verbally. More in the next post.
Anorexia Anecdote (6)
Tuesday, February 16th, 2010The first part of treating Antoaneta’s anorexia focused on her low self-esteem. I deliberately avoided discussion of eating habits, body image or weight.
