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How Art Can Re-Order A Harsh, ‘Deformed’ Childhood

Artist Evelyn Berde was born with congenital scoliosis in 1950 and spent many years in and out of Massachusetts General Hospital, confined to a bed for months at a time.

Her art, she says, is informed by her experience living with her “deformity,” as it was referred to back then, and her childhood growing up in the old West End of Boston, a low-income neighborhood near MGH and the Charles River, which was razed in the late 1950s, displacing many residents.

It wasn’t an easy childhood: Alcoholism ran in the family and Evelyn’s brother drowned in the Charles River when he was nine and she was just six. Evelyn was subjected to numerous surgeries and procedures for her scoliosis — some that now seem barbaric.

But art, she says, “has the ability to lift us out of one place and take us to another.”

Here, you can listen to Evelyn talk about five of her paintings and tell the stories that helped shape them.

Artist Evelyn Berde's "Shame" (Courtesy Berde)

Artist Evelyn Berde’s “Shame” (Courtesy Berde)

Artist Evelyn Berde's "July 12, 1956" (Courtesy Berde)

Artist Evelyn Berde’s “July 12, 1956″ (Courtesy Berde)

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Beyond Carb-Cutting: Resolutions After A Trauma — Sleep, Play, Love

(katiebordner/Flickr)

(katiebordner/Flickr)

By Rachel Zimmerman

A friend, trying to cheer me up over the holidays, suggested I find comfort in this fact: “The worst year of your life is coming to an end.”

In 2014 I became a widow, and my two young children lost their father. Needless to say our perspective and priorities have shifted radically.

Last year at this time, my New Year’s resolutions revolved around carbs, and eating fewer of them. This year, carbs are the least of my worries. My resolutions for 2015 are all about trying to let go of any notion of perfection and seek what my mother calls “crumbs of pleasure” — connection, peace and actual joy on the heels of a life-altering tragedy that could easily have pushed me into bed (with lots of comforting carbs) for a long time.

As a mom I know with stage 4 cancer put it, when your world is shaken to its core, your goals shift from things you want to “do” —  spend more time exercising, learn Italian, make your own clothes — to ways you want to “be,” knowing that your life can shift in an instant.

So, with that in mind, here are my five, research-backed, heal-the-trauma resolutions for 2015:

A Restful Sleep

Yes, at the top of my list of lofty life goals is a very pedestrian one: sleep. Lack of sleep can devastate a person’s mental health and without consistent rest, the line between emotional stability and craziness can be slim. (See postpartum depression, for one example.) In my family at least, to ward off depression and anxiety, we need good sleep and lots of it; more Arianna Huffington and less Bill Clinton.

Play, Sing, Dance

The beautiful thing about children is that despite tragedy and loss, they remain kids; they are compelled to play, climb, run and be active. Resilience, as the literature says. In their grief, they can still cartwheel on the beach, play tag or touch football in the park. Shortly after my husband died, I tried very hard to play the games my kids liked, which often felt like that scene in the “Sound of Music” where the baroness pretends to enjoy a game of catch with the children. Soon I learned to broaden my definition of play — really anything, physical, or not — that serves no other purpose other than to elicit pure joy. Continue reading

Boundary Crossing: When Doctors And Patients Get Personal For Better Health

A diabetes patient and her doctor sit down to talk as part of a novel program aimed at improving the patient-provider relationship.

A diabetes patient and her doctor sit down to talk as part of a novel program aimed at improving the patient-provider relationship.

By Dr. Annie Brewster and Jonathan Adler
Guest Contributors

As a patient you’ve no doubt had moments when you feel like your doctor just doesn’t get you, or, that you don’t get your doctor.

If you’ve never felt rushed, ignored, overlooked or vulnerable during the course of your medical care, you’ve probably never been a patient in the U.S. health care system.

And if you’re a doctor, or another type of health care provider, you’ve probably felt hassled, frustrated, and powerless to help your patient, despite your best intentions.

In today’s medical system, the patient-doctor relationship is often challenged, in large part because there’s no room for us to actually engage with each other as people, to hear each other’s stories.

In medicine, there are unspoken but clear rules about what is appropriate behavior within the context of the patient-doctor relationship: doctors should never reveal intimate details about their own lives, and patients should never ask. Patients, meanwhile, should stick to the facts of whatever is ailing them, giving their provider the data for diagnosis and treatment planning, without superfluous anecdotal detail.

Professional boundaries are certainly important. There is validity to the argument that doctors need to keep distance in order to make clear medical decisions, striving to minimize the biasing impact of emotion. And perhaps it is also true that patients benefit from some distance, in thinking of their doctor as an authority figure rather than a friend.  But this obsession with boundaries has conspired with the pressures of efficiency and economy that constrain the health care system to remove some very personal (and important) elements of the patient-provider relationship.

We are far from the small town medicine of the past, when patients and doctors knew the details  of each other’s lives because their worlds intersected outside of the exam room.

Nowadays, in the 15-20 minute appointments that we are alloted, the patient-provider relationship can feel sterile and robotic. At its worst, it can feel antagonistic. Doctors are over-loaded and time constrained, with fear of litigation and the rules of HIPAA pressing in on them, and a payment model that rewards quantity over quality.

Patients often feel hurried and neglected; overwhelmed by the task of presenting the frightening aspects of their health in the right way to get answers and treatment. Physician burnout is ubiquitous, as is patient dissatisfaction.

It is our belief that by highlighting the humanity of both individuals in the relationship, the patient-doctor bond can be strengthened, with increased satisfaction all around.

Taking it one step further, we believe that reviving the humanity in this relationship will ultimately lead to better health outcomes.

So, here at Health Story Collaborative we’ve designed a program in which a patient and a doctor come together to share and listen to one another’s personal narratives. This new patient-provider model is a variation of our already existing Healing Story Sessions program. In short, our goal is to create a space where both patient and provider can be human.

We recently launched this project in collaboration with the Cambridge Health Alliance, with a grant from the Arnold P. Gold Foundation. We met on a Tuesday evening recently with Tracey Pratt, a woman with diabetes and her health care provider of many years, Dr. David Baron. As they shared their stories, an audience, including other diabetes patients, Dr. Baron’s wife and other medical providers, listened on.

We worked with both speakers in advance to craft their narratives, encouraging personal refection as well as their thoughts about the their mutual relationship.

Tracey talked about her passion for teaching, her travel to the Great Wall of China, and about learning Merengue in Havana, Cuba. She also detailed some of the difficulties she had managing her diabetes.

David told stories about growing up in rural Ohio, picking corn in the fields as a teenager, about his time in the Peace Corps in the Dominican Republic, and his journey to becoming a doctor. Continue reading

New Year’s Resolutions: How To Keep Them Alive

(anomalily/Compfight)

(anomalily/Compfight)

By Jessica Alpert

You know the drill. Lose weight. Save more money. Keep in better touch. Or as one of my Facebook friends recently announced “make a new piece of clothing every month.”

I hate the gym in January since it’s crowded to the gills with exercise hopefuls.  By February, the regulars reign again and the wait for the treadmill is nonexistent.

A study published in the Journal of Clinical Psychology from researchers at the University of Scranton found that 45 percent of us made New Year’s Resolutions in 2014–and almost 90 percent of us failed at keeping them.

Maybe not a huge surprise but what can we do to maintain those good intentions?

Dr. Philip Levendusky, Associate Professor of Psychology at Harvard Medical School and Director of the Psychology Department at McLean Hospital, recently shared some tips.

First, is change even necessary?  Do you already work out three days a week and now you’re promising to do six? It’s a worthwhile goal but acknowledge what you already do. “We don’t always have to be striving for perfection or feel like we’re a work in progress,” Levendusky writes.

Next, remember that small changes can make a big impact.  Do you want to be a better partner? Instead of creating a list of 10 promises, start with something actionable and attainable–like being a better listener during dinner.  According to Levendusky, “building goals that can have an immediate and positive response,” may actually help keep you on track beyond the month of January.

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Embrace The Eggnog, And Other Tips To Curb Holiday Eating (And Guilt)

(Theen Moy/Flickr)

(Theen Moy/Flickr)

It’s peak season for overeating — and then beating yourself up for doing it.

Clearly, you’re not the only one treating yourself to pumpkin and pecan pie, egg nog and, yes, fruitcake. Yet it’s no comfort that everyone else and their Weight Watchers’ leader is also riddled with guilt and enduring a personal thrashing for the extra calories and potential weight gain. While this self-flagellation goes on, you’re missing out on enjoying the holidays.

If only there were a better approach to holiday eating, maybe then you’d be able to stop beating yourself up, enjoy eating what you love and savor everything else you really do love about this season.

Happily, you don’t need an emergency gastric bypass to stop the vicious cycle: putting an end to both overeating and self-criticism might be easier than you think. It might be as easy as reviewing some research-based strategies honed from a group training I lead for people with eating issues. It revolves around practicing a variety of mindful eating and self-compassion meditations.

Here are five proven tips for happier, healthier holiday eating:

1. Redefine Holiday Eating

You’ll need a better working definition of “normal holiday eating” if your definition sounds anything like my esteemed colleague and family eating expert Ellyn Satter’s:

Most people get caught up in what they should and shouldn’t eat. They’re anxious and ambivalent about eating. They might try to resist at holiday parties, but the table is laden with ‘forbidden food,’ and they throw away all control and overdo it. Many times they’re over-hungry because they’re trying to restrict themselves and lose weight. So the standard definition of holiday eating becomes eating way too much.

If you’d prefer to take fewer bites and ease the anxiety and ambivalence, now’s the time to do the exact the opposite, starting with eating regular meals and snacks. Then, come party-time, permit yourself to eat the foods you enjoy. You’re probably going to eat them anyway, so you might as well as enjoy them, without the guilt and other uncomfortable emotions that predictably fuel emotional eating.

2. Go Easier On Yourself

If, like most dieters, you’re hoping that feeding yourself a steady diet of self-criticism will inspire you to rein in your eating, think again. You’ve actually got it backward. Self-criticism — calling yourself fat, disgusting and other mean, nasty names — is really a recipe for emotional overeating and holiday weight gain. Continue reading

‘Tis The Season Of Stress: 10 Tips To Help You Cope

Happy Holidays! (Courtesy of Gene Beresin)

Happy Holidays! (Courtesy of Gene Beresin)

By Steve Schlozman, M.D. and Gene Beresin, M.D.
Guest Contributors

Imagine this fairly common holiday scene: You’re driving up and down the aisles in a very busy parking lot. There have been a few near misses, cars pulling out of briefly empty spaces, but there’s always someone waiting for that space, getting there just a second before you. Your car is a cacophony of seasonal torment: The pop music on the radio mercilessly full of holiday cheer, your little one in the car seat with a runny nose, your school-aged kid kicking the back of your seat and your teenager sitting with her legs on the dashboard while she sullenly tunes you out in favor of her iPod and its noise-cancelling earphones.

‘Tis the season…

Study after study shows us that the holidays are stressful for both parents and kids. (Like we needed a study?) People are cranky, irritable, rushed and unruly. All of us await the holidays with great anticipation and high expectations — family, fun, presents, togetherness. And these experiences are reinforced by the multitude of ads we all see on TV. Yet, for most of us, there are immeasurable stresses.

The stress can be about almost anything: the guests, the gifts, the recents divorces or deaths.

And people with psychiatric disorders often have an even harder time. Depression and substance abuse worsen, and suicide attempts appear to increase. Don’t misunderstand — the holidays are also wonderful, but we’d be fooling ourselves if we ignored the yearly misery that the holidays can potentially engender.

So, how do we navigate these frenzied days and stay on an even keel?

It turns out that there are some things we can do to manage the tough times, and though many of these things seem obvious, it’s their very obviousness that often causes us to forget. Here are 10 tips to remember:

1. Pace Yourself (if possible)

Adults and children rarely do well when they’re rushed. Kids detect the panicked demeanor of their parents, and parents then get irritable when their anxious kids act out. So, don’t do everything at once. Continue reading

The Psychological Aftermath Of The Sydney Siege

A hostage runs to armed tactical response police officers for safety after she escaped from a cafe under siege at Martin Place in Sydney, Australia, on Monday. (Rob Griffith/AP)

A hostage runs to armed tactical response police officers for safety after she escaped from a cafe under siege at Martin Place in Sydney, Australia, on Monday. (Rob Griffith/AP)

By Jessica Alpert

The images of five hostages escaping from the Lindt Chocolate Cafe in Sydney are striking. A woman runs into the arms of law enforcement, her trauma and fear palpable.

This story is still developing, but one thing is for sure: “It really doesn’t take much to instill fear,” says Max Abrahms, a professor of political science at Northeastern University and an expert on terrorism. “This one guy managed to shut down an entire city, divert many planes away from Sydney, and transfix the world in real time following this story.”

As of press time, police were reporting that the hostage taker and two people were killed. For those who survived, what lies ahead psychologically?

Dr. David Gitlin, Brigham and Women’s Hospital vice chair of clinical programs and chief of medical psychiatric services, says recent research suggests reliving or “debriefing” survivors is counterproductive and “actually may precipitate the development of PTSD.”

Instead, health professionals are encouraged to use a resilience model in the immediate aftermath of an event like this one, “helping people think about the things they need to do to feel safe and secure…to deal with things on their timetable,” says Gitlin. Of course, this may come into conflict with the needs of law enforcement, who are looking for further control of an event or preparing evidence for prosecution. As this siege has ended and it’s believed that the assailant acted alone, Gitlin hopes that those now released will not be interrogated at this time.

Gitlin, who led the Brigham’s psychiatric team after the Boston Marathon Bombings, explains that “people need to be surrounded by their loved ones, put into a safe environment, and only process this when they are ready to do so.”

Acute Stress Reaction and PTSD

There are two types of trauma, says Gitlin. Continue reading

Related:

Harvard Doc To Wikipedia: You’re Not Playing Fair On Alternative Trauma Therapy

By Dr. Eric Leskowitz, M.D.
Guest Contributor

Up until recently, I’ve thought of Wikipedia as one of the great breakthroughs of the Internet era — a gigantic encyclopedia of everything, right at our fingertips, with real-time updates in all spheres of human knowledge. I even consult it regularly for medical information as part of my work as a practicing psychiatrist.

But in the past few months, I’ve been reconsidering the venture. Why? In a nutshell, it appears that the folks at Wikipedia have a problem with a fairly new sort of therapy that I practice and find helpful for certain patients.

Here’s the backstory.

Dr. Eric Leskowitz, a Harvard psychiatrist, wonders why the founder of Wikipedia called practitioners of Energy Psychology "lunatic charlatans.'

Dr. Eric Leskowitz, a Harvard psychiatrist, wonders why the founder of Wikipedia called practitioners of Energy Psychology “lunatic charlatans.’

For several years now, I have increasingly deployed this new form of psychotherapy, called Energy Psychology (EP), in my work with chronic pain patients at Spaulding Rehabilitation Hospital’s outpatient clinic in Medford, Mass.

Energy Psychology uses a combination of exposure (intentionally re-experiencing the unpleasant emotions surrounding a stressful situation) and desensitization (affirmations of self-acceptance despite the persistence of symptoms), along with a somatic component (tapping on one’s own acupressure points) to defuse the emotional charge of those upsetting memories.

Without getting into the details of how it might work, suffice it to say that Energy Psychology has helped many of my patients make great strides, especially when Post-Traumatic Stress Disorder (PTSD) is involved. (For example, when a frightening automobile accident triggered the disorder). For some patients, full recovery is possible. I’ve seen it.

A large body of research over the last 10 years shows just how effective Energy Therapy can be for a wide range of clinical problems, as described in this review article from the American Psychological Association’s journal, Review of General Psychology.

Energy Psychology has been particularly effective in treating PTSD in combat vets. And Energy Psychology has even gotten some fairly mainstream attention, from television’s Dr. Oz to The Huffington Post.

Jimmy Wales, founder of WIkipedia (Robert Huffstutter/flickr)

Jimmy Wales, founder of WIkipedia (Robert Huffstutter/flickr)

But you’d never know about any of this from consulting Wikipedia. Their entries use a range of emotionally loaded and downright pejorative terms to describe Energy Psychology and make no mention of promising new research published in the last ten years. Their article about the related topic of Energy Medicine, for example, only includes studies conducted prior to 2004 (though more recent critical reviews are cited).

Wikipedia’s entry on the most widely used Energy Psychology protocol (Emotional Freedom Techniques, or EFT) refers to the field of Energy Psychology as “pseudoscience” and relies on judgements rendered by a non-peer-reviewed blog whose name – Quackwatch – reveals just how objective it is(n’t).

To counter what we feel are gross misrepresentations, the international Energy Psychology community and members of the national Energy Psychology organization — the Association for Comprehensive Energy Psychology (ACEP) — attempted to add new research citations to the Energy Psychology article, in accord with Wikipedia’s promise to update their entries to include scientifically validated findings.

However, new entries supporting Energy Psychology appear to be scrubbed from the site. Fortunately, many of the details of this process are stored on the “Revision History” link of any Wikipedia article, so that much of the back-and-forth process can be tracked and the inconsistencies between policy and practice become evident. (Emotional Freedom Technique’s revision history is here).

Even studies from prestigious peer-reviewed journals like the Journal of Nervous and Mental Disease whose editor-in-chief is past president of the American Psychiatric Association, have not been cited by Wikipedia, nor has it been mentioned that the American Psychological Association now allows its approved Continuing Education providers to offer Energy Psychology training for Continuing Education Units, the result of a lengthy appeals process.

Because these obstacles persisted despite several years of good-faith effort in the face of repeated “scrubbing” of Energy Psychology-favorable information from the Wikipedia website, ACEP recently initiated a petition drive through change.org, asking Wikipedia to show fairness discussing newer holistic therapies. Over 11,300 supporters have signed, and, much to our surprise (and I say “our” because I am an active member of ACEP), the founder of Wikipedia – Jimmy Wales – responded personally to the petition. Here’s what he wrote on the change.org site:

No, you have to be kidding me. Every single person who signed this petition needs to go back to check their premises and think harder about what it means to be honest, factual, truthful.

Wikipedia’s policies around this kind of thing are exactly spot-on and correct. If you can get your work published in respectable scientific journals – that is to say, if you can produce evidence through replicable scientific experiments, then Wikipedia will cover it appropriately. What we won’t do is pretend that the work of lunatic charlatans is the equivalent of “true scientific discourse”. It isn’t.

Continue reading

Instead Of Therapy, Put A Little Thanksgiving Into Regular Family Dinners

Mark's postcards from Beloit/flickr

Mark’s postcards from Beloit/flickr

Anne K. Fishel, Ph.D.
Guest Contributor

When a colleague recently told me about her Thanksgiving tradition, it got me thinking about family dinners — a topic I consider every night around 7 pm and with every patient I see in family therapy.

Indeed, as a mental health provider, I sometimes feel I’d go out of business if families had regular dinners with one another. Truly. There are dozens of research studies that show that frequent family dinners promote kids’ mental and emotional well being — by lowering rates of depression, anxiety, eating disorders and substance abuse, for starters. Family meals also strengthen children’s resilience, self-esteem and sense of connectedness to their parents. Isn’t that exactly the goal of therapy?

It’s no wonder that I often have to stifle the urge to say, ‘Stop wasting your time here. Go home and eat dinner together.’

But, I’m well aware of how hard it is for busy, harried families to find time to sit down to dinner, and I’m always looking for new ways to unlock the benefits without adding any guilt or pressure. So, that is why my colleagues remarks sparked my interest. Here’s what she said:

“My sisters and I love Thanksgiving so much that our father makes a Thanksgiving-like meal throughout the year that he dubs ‘Harvest Dinner.’ We just can’t get enough of his mashed potatoes!”

I love the idea of bringing the special quality and spirit of Thanksgiving dinner to everyday meals. Two elements could easily translate to everyday dinners: sharing the workload, and focusing on more than just food. Continue reading

Silent Wars: Helping Vets Fight Mental Health Battles At Home

By Evan Bick
Guest Contributor

The movies have it wrong. Combat, at least in my experience, was not non-stop or action-packed. Those who have experienced it know that modern warfare usually involves a lot of starting and stopping. Long stretches of quiet, even boredom, can be broken in an instant.

I was deployed to Iraq as an infantry platoon leader in 2008-2009. During that time, there may not have been constant action but there was tension — my fellow soldiers and I were on edge most of time, soldiers among civilians, going on patrols in the northwest corner of Baghdad.

Evan Bick, a veteran of the Iraq war, now works with other vets struggling with mental health problems. (Courtesy)

Evan Bick, a veteran of the Iraq war, now works with other vets struggling with mental health problems. (Courtesy)

On our first day in the city, the leaders from the unit we were replacing took us on a walk through their area of responsibility. We saw the sidelong glances from civilians as Americans walked through their streets, hidden behind rifles and sunglasses, and weighed down by cumbersome body armor. We also saw an area filled with stark contrasts — stucco houses with gated courtyards in one neighborhood, and refugee camps for Iraqis displaced by ethnic violence in the next.

Deployment is a challenging experience even when it’s boring. Whether you are patrolling ‘outside the wire’ or working behind the scenes, the sense of danger is real and omnipresent. While deployed, soldiers typically work far longer hours, and with less opportunity for relaxation than they experience at their home station. Isolation from loved ones, of course, is an important challenge both for the deployed soldier and family members back home.

Even with all those challenges, the bigger battle for many veterans begins when they return home. Without a unit that shared in your experience of war, you can feel lost — more lost than you would ever feel on patrol. It’s easy to get trapped inside your own head, and to dwell on what did not go well, and what you should have done differently. The quick reflexes and adrenaline that may have helped keep you alive overseas are probably no longer helpful.

Strategies that kept you and your fellow soldiers safe, like driving fast and straight down the middle of a road, become dangerous, and loud noises or crowds may make some part of you feel like you’re back in the desert. Continue reading