Psychotherapy Perspectives

Monday, May 26, 2008

Talk Therapy changes the Brain and helps with Depression and Bipolar

by Garth Mintun, LCSW, ACSW

This week I watched the PBS special “Depression: Out of the Shadows.” Dr. Dennis Charney, the Medical Director and Dean of the medical school at Mount Sinai, presented on a panel of experts with Jean Pauley. He stated that depression “on average is 35% genetic and 65% environmental.” (This is for the average person; people with histories of depression or who are bipolar will have higher percentages of the genetic factors). He stated that medication and talk therapy access different parts the brain, thus the change these treatments produce take place in different areas of the brain. Research indicates that people who undergo both psychotherapy or talk therapy and anti-depressant or bipolar medications show more progress in lessoning their depression or bipolar symptoms than they would if they simply engaged in one method of treatment. For more information, please go to the PBS web site to see the video clip or read the transcript of the discussion with Dr. Charney, the panel of experts, and Jean Pauley at: http://www.pbs.org/search/search_results.html?q=dr+dennis+charney&btnG.x=8&btnG.y=10

This report is very good news. It is excellent in its ability to help people understand bipolar and depression and it also attempts to deal with the stigma of mental illness. I suggest that psychotherapists recommend this PBS series to their clients suffering from depression. Often in my practice in Indianapolis, I find that clients on medication for depression or bipolar show improvement when participating in talk therapy/counseling. These clients tend to experience a decrease in their levels of anxiety and lessoned feelings of the inertia when they come in to psychotherapy on medication. Consequently, people are able to deal with difficult core interpersonal issues with less anxiety and vulnerability than they would if they were not on anti-depressant and or bipolar medication.

The other piece of good news is that “talk therapy “actually changes the brain as well, producing biological effects. This program shows how people who have been suffering from long-term depression can perhaps see how their “talk therapy” actually changes the way they think in profound ways and compliments the medication therapy approach.

Often people go to their family practice physicians just for medication, rather than also attending talk therapy. After reviewing the research, people suffering from depression and bipolar may want to receive more comprehensive help by adding psychotherapy to their treatment. Again, the PBS show “Out of the Shadows” is an excellent vehicle for consumers to understand depression and bipolar and learn about ways that they might go about receiving help.

Friday, May 02, 2008

Electronic spying: Impact on couples in the Modern Information Age

By Garth Mintun, LCSW, ACSW

In this modern information age with the Internet, mobile phones and GPS systems, we can share or obtain information at a breathtaking speed. The playing field between the small entrepreneur and the corporation is more equal then ever before, as information is much more widely available and accessible at all levels.

For relationships, this comes as a mixed blessing. While this technology certainly has its advantages, it also provides ample opportunity for crossed boundaries and a lack of privacy. For example, one’s wife, husband, partner or significant other can rather easily spy if they think their partner is not being truthful. Your partner might do this by checking your emails, text messages and phone numbers on your mobile phone, your history on the internet, and transportation monitoring via the GPS locator system.

In the years of being a practicing professional working with relationships and families, it is becoming much more common for me to hear about “evidence collected” via information technology. My sense is that, in adult relationships in the modern age, there is a growing dynamic involving the lack of direct communication about emotional needs and desires. Often, couples state that they quite simply “don’t have time” for this level of communication, given the combination of most people working over 40 hours per week, responsibilities of children, and the pressures of the economic recession.

This “busyness” impacts couples by increasing the possibility that their needs will not get met. The hectic schedule and lack of quality time together tends to reduce communication to purely the essential, and prevents the repair of past emotional wounds. Often the result of this involves one partner blaming the other excessively and the other partner passively resisting the blame by either “stonewalling” or “shutting down”. Couples play the roles of “chase and run.” This can play out when one person is the pursuer in the relationship and the other “runs” by shutting down and not responding (the silent treatment). Couples may reverse roles week by week or day by day. However the pattern created prevents the relationship from growing and old emotional wounds are not healed as the problems intensify.

When emotional wounds are not healed in the relationship, trust breaks down and partners can become fearful that the other is meeting their needs elsewhere. That is when the cell phone monitoring begins to take place and the history of the internet sites comes into play, as one of the partners “collects evidence”. In this modern information age, the information is easy to collect and privacy is invaded. Often then the partner confronts the other with the allegations of betrayal and both partners feel like the victim. The partner that “collects the evidence” feels betrayed because of the traces they had found of their partner’s intimate communication with another individual and the other person feels violated because of the “spying”.

When confronted with marital crisis, couples will sometimes turn for help to a psychotherapist at the point when the “evidence is collected”. The couple begins to work to overcome trust issues, anger, and sadness. The couple also begins to address the breakdown from a chronic period of time when the couple did not significantly repair their emotional disconnect. The relationship can be repaired at this stage if the couple chooses to prioritize time and attention with one another. This step involves setting time aside for weekly therapy and arranging “dates” or time together during the week to “wipe the slate clean.” This provides the couple with a basis to engage in the process of rediscovering why the couple originally came together in the first place.

In summary: if you find yourself “collecting evidence” on your partner, or if you find you are beginning to shut down, then it is time to receive professional help for your relationship. A psychotherapist can be very helpful by assisting you with making time for your relationship. Secondly, once the couple feels the relationship is a priority again, they can work on the emotional barriers that have been keeping them from intimate connection. Thirdly, as the trust builds, the need for electronic tracking will become obsolete. Psychotherapy can help both partners remember the initial “sparks” in their relationship and he provide guidance as both individuals to work together to rekindle those sparks.