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Sensory Integration Therapy for Defiant Children

When Faulty Sensory Processing Affects Behavior

Karen Smith

In our culture, we don't take kindly to children who refuse to do what they are told. We label them with euphemisms, such as difficult, willful or spirited. When these kids show up in my office as early as age 3 or 4, their parents---often tearful, angry, guilt ridden---want quick advice about how to win the battles they are losing. Because we assume that these children are neurologically and physiologically capable of doing what we ask them to do, we may describe them as inattentive, hyperactive or clumsy and complain that they are stubborn, angry or oppositional. In fact, they are all of those things---but for a reason. That reason is faulty sensory processing.

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Revisiting Our Relationship with Insomnia

Why Our Trouble Sleeping Is More Normal Than We Think

Mary Sykes Wylie

Insomnia. Almost everybody has it at one time or another. Some poor souls live (or barely live) with it. It's hard to know exactly how widespread it is—prevalence rates are all over the map. But some researchers are drawing the conclusion that midnight or early-morning insomnia is possibly more "natural" than the pattern of eight hours straight sleep that we've come to expect, but often fail to achieve. Perhaps, the implication is, we ought to accept the reality of those hours awake and cultivate a better attitude toward the inevitable---we should accept and make friends with those wakeful hours in the middle of the night.

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The Rebirth of Borderline Personality Disorder Treatment

How Marsha Linehan Revolutionized Therapy with DBT

Katy Butler, Katy Butler

For decades, most clinicians who had a choice avoided borderline clients, while agency staff (who couldn't) went through the motions with a sense of futility. Therapy consisted of guarding against "manipulation" and mining the borderline's reactions to the therapist for clues to her fragmented inner world. It was hard on clients---and on therapists as well. Then, in 1991, a behavioral psychologist and Zen student at the University of Washington named Marsha Linehan introduced an alternative. Her treatment was called Dialectical Behavior Therapy, or DBT.

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Mindfulness Therapy: The New Trauma Treatment?

Eliminating the Intrusive Thoughts of Ordinary Trauma

Robert Scaer

When we catch ourselves in a state of nonpresence, we’re likely to chalk it up to “mind chatter.” When a client reports these repetitive intrusions, we may wonder about a tendency toward obsessiveness or the possibility of depression and/or anxiety. While all of these interpretations may have some validity, I believe that much more is at stake. I propose that in many of these moments of body-mind intrusion, our brain is trying to protect us from mortal danger arising from memories of old, unresolved threats. In short, we’re in survival mode.

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Sleepless in America

Making it Through the Night in a Wired World

Mary Sykes Wylie

Insomnia. Almost everybody has it at one time or another. Some poor souls live (or barely live) with it. It's hard to know exactly how widespread it is—prevalence rates are all over the map. As many as 30 percent of the population, or as few as 9 percent (depending on the source of the statistic, or how insomnia is defined, or what impact it has), suffer from some form of it at least some of the time. What's undisputed, however, is that sleep is as necessary to physical and mental health as air and water, and that, without it, we suffer—often severely. So, those annoying world-beaters, who brag about needing only four hours of sleep a night (the better to forge multimillion-dollar start-ups and do their Nobel Prize–winning research) are perhaps not being entirely candid.

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Revolution on the Horizon

DBT Challenges the Borderline Diagnosis

Katy Butler, Katy Butler

DBT was no walk in the park: it required team treatment, including weekly individual therapy, a year-long "skills training" class, telephone coaching and supportive supervision for the therapist. But it offered clients and therapists alike a way out of chaos--a systematic clinical package that integrated the technical and analytical strengths of behaviorism, the subtleties of Zen training, the warmth and acceptance of relationship-centered therapies and the often undervalued power of psychoeducation.

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The Precarious Present

Why is it So Hard to Stay in the Moment?

Robert Scaer

When a client reports repetitive intrusions, we may wonder about a tendency toward obsessiveness or the possibility of depression and/or anxiety. While all of these interpretations may have some validity, I believe that much more is at stake. I propose that in many of these moments of body-mind intrusion, our brain is trying to protect us from mortal danger arising from memories of old, unresolved threats. In short, we're in survival mode.

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Understanding the Dangers of Diagnostic Epidemics

The Most Powerful Psychiatrist in America on Why DSM-5 Is a Step Backward

Rich Simon

Allen Frances learned first-hand how, even when motivated by the best of intentions, changes in the “bible of psychiatry” can have large-scale negative consequences no one can foresee.

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The Best DSM Ever Written?

Jack Klott, an Advocate for DSM-5, Speaks Out

Rich Simon

In the intense debate its publication has sparked, DSM-5 has both its critics and its champions. One of the latter is Jack Klott, who says that the new edition is “the best DSM ever written.”

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