Barbells, Protein Powder, and Psychology

Does anyone out there have a New Year’s resolution to lose weight? Many of us do. It is hard not to think about your weight after you've gotten through two months of holiday celebrations and winter weather.  An article on Yahoo News today, “Psychology Hits the Gym” highlighted the importance of paying attention to the psychology of weight loss in addition to the usual stuff we should think about like diet and exercise. Many studies have found that combining both a physical and psychological approach to weight loss is most effective. Many weight loss programs across the nation and programs that offer bariatric surgery partner with psychologists to offer the most effective treatment.  So what are some ways that psychology can help with weight loss? Here are a few:

• Help people identify triggers to eating and reasons for eating
• Help people develop coping skills to replace emotional eating
• Teach people about the difference between “physical hunger” and “psychological hunger” or “emotional hunger”
• Teach people about effective goal setting
• Teach skills like mindful eating
• Help people to identify their emotions
• Address body image and self-esteem issues
• Address emotional trauma related to many body issues like abuse, bullying, and medical concerns
• Address the psychological implications of things like diabetes and physical disabilities
• Help people have healthier relationships that support healthy lifestyle changes

These are just a few of the ways that a psychologist can help with weight loss or other health goals. While you are in line to sign up for the gym this January you may want to think about scheduling an appointment with a psychologist to talk about ways that you can make your New Year’s resolution more successful than ever!

Social media and psychology: A marriage made in heaven?

In a study published this month in “The Lancet”, a medical journal, researchers found that combining psychological principals and social media lead to more than double the amount of participants getting tested for HIV. Seven of the study participants tested positive and were linked with medical care. People in the control group were linked to social media without the psychological intervention and were about 50% less likely to get tested. This study suggests that combining psychology and social media may be an effective way to increase healthy behaviors and get health interventions to many people in need.

This has not been the first study that has found that social media could be a new forum for health promotion. A meta analysis published last month in the journal of Sexually Transmitted Infections looked at multiple studies that examined the effect of social media on condom use and STD testing. The results showed that the interventions lead to significant increases in both of these health behaviors. Social media is also being used to contact difficult to reach populations like veterans about things like mental health treatment.

An important thing to take away from the research is that the psychology is an important part of why this works. Just putting information out on blogs, Twitter, Facebook, or other social media outlets is not effective by itself. Using psychological principals to inform the ways in which you engage people about health information is important. As with any marriage, each partner contributes something important. Social media and psychology work best together to engage people in thinking about their health.

Social media combined with psychology can empower it’s users to be healthier and be more active in their own healthcare. As with any medium there are things to be aware of when looking to social media for information and guidance about health. Here are some tips to help you be a savy social media user:

• Evaluate the source and the quality of the information that you are reading. Just because it appears online doesn't make it reliable or true.
• Understand that there are implications for privacy when you use online mediums. If you are concerned about privacy be sure to read the user and privacy agreements for the services you use.
• Monitor your social media use and ensure that it is having a positive impact on your daily life. It should be a tool to help you stay connected to others and information. If it becomes something that causes you stress, anxiety, or impacts your ability to pursue offline interests you may need to evaluate your use.
• Try to remember to take technology breaks. It is important to be present in your life and unplugging can be a really good way to do that.

A Christmas Story

So you made it through Thanksgiving. Congratulations! Whether you survived a second helping of Aunt Stella’s green bean casserole or made it through a day filled with a cacophony of clanking dishes, screaming children, and interrogations from distant relatives – you made it through. For many though, that is just the first hurdle in a daunting holiday season. While the holidays are wonderful for some people, (I admit I am one of those star eyed holiday junkies who loves everything from fudge to trees) they aren’t for everyone. The holidays are often part of a larger seasonal depression or a reminder of things lost. The holidays also fall on a time of year when many families are doing struggling with loss of seasonal work, high heating bills, and healthcare expenses.

A recent article in the Providence Journal by psychologist Ben Johnson, PhD “Mental Edge: 10 Ways to Keep the Blues atBay this Holiday Season” might give you some insight into ways you can beat the blues if they are a problem for you this season. All of these are good suggestions but one of them caught my eye, “Let go of limiting life stories.”  The way we tell our stories can have a profound impact on our lives. 

There have been many research studies that have investigated and found that how we tell our stories is directly related to things like mood, longevity, and self-concept. David Snowdon and colleagues (2001) examined handwritten autobiographies from 180 Catholic nuns, composed when participants were in their 20’s.  They found that those narratives that had more positive emotional content were associated with longevity over six decades later.  In another study, Libby and colleagues (2005) found that the way people described an embarrassing incident from high school impacted their views on their change and development since that time. It also affected the way that they were able to sustain self-improvement.   

As a psychologist working in a clinical setting I see examples of this nearly every day. Those clients who describe difficulties as challenges and not as things that are inherently wrong with themselves are much more easily able to overcome their difficulties.  In the last Psyowa blog post, one of the tips for practicing gratitude was to look at situations in a different way. This is very similar, but now you are looking at your life story in a different way.

Many people have had horrible things happen in their lives, but how you tell that story can make a huge difference. Let’s look at a story and see how viewing it differently might impact someone.  

When John was a small child he was the victim of physical and emotional abuse in his home. His parents were both alcoholics and were poor parents to John. He often would come home to an empty house and his parents would return late in the night waking him to violent outbursts. The family had little money and John often wore ragged clothes to school. Many of the other children picked on him and he had few friends.

Looking back at that story John could tell himself that all of those things happened because he was a looser and didn’t deserve better. He could tell himself that he had no choice in life and his life will always be terrible because it is his destiny. Alternatively, he could tell himself that the things that happened to him in childhood had little to do with him. They were unfortunate things that happened and now that he is an adult he can choose differently. He can applaud himself for surviving such difficult times and see himself as a strong man for doing so. There are stark differences in how each of those stories might affect John, even though they are based on the same set of life events.

One of the most popular holiday movies, “It’s a Wonderful Life”, operates on the same concept. The main character tells himself that he isn't very valuable and that his life didn't impact others. As a result, he doesn't feel his life is worth living. After he is shown a different story, based on the same events, he realizes how valuable his life is.

This holiday season when you start to feel blue about your situation think about the story you are telling yourself about your own life. If you find that it’s a story of sorrow, difficulty, and hopelessness it may be time to rewrite your story. Instead of focusing on the things that are wrong in your life, focus on what is right. Think about the ways in which your story weaves in with others’ stories. Just like in the movie the main character finds that his time on earth deeply impacted others and changed their stories. Whether its smiling at a man on the bus on your way to work or saving your brother from drowning in a freezing pond, your story matters. It is the season for a new kind of Christmas story.

Danner, D.D., Snowdon,D.A., and Friesen, W.V. (2001) Positive emotions in early life and longevity: Findings from the nun study. Journal of Personality and Social Psychology, Vol 80(5), May 2001, 804-813.

Johnson, B. (2014, November 30). Mental Edge: 10 ways to keep blues at bay and enjoy the holiday season. Retrieved December 2, 2014.

Libby , L. K. , Eibach , R. P. , & Gilovich , T . ( 2005 ). Here’s looking at me: the eff ect of memory perspective on assessments of personal change. Journal of Personality and Social Psychology ,88 , 50 – 62.

Being Thankful Might Be as Important as Eating Your Veggies This Thanksgiving

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On the eve of everyone getting ready to fill their plates with turkey and all the trimmings it is good to have a reminder of what Thanksgiving stands for. Of course many of us have already been reminded by the “28 days of thankfulness” circulating on social networks or the school projects children bring home. One thing you might not know about gratitude is that it can have health benefits. That’s right, something that is totally free, doesn't require you to cut down on your pumpkin pie intake, or get on a treadmill this holiday season has health benefits.

Research has shown that gratitude, or being thankful can have mental and physical health benefits.  (Emmons & McCullough, 2003) Those who practice being thankful have been shown to:

• Practice better self-care
• Have better quality of sleep
• Exercise and eat healthy more
• Be more alert
• Practice more proactive health behaviors
• Cope with stress
• Have stronger immunity
• Be more optimistic 

Most of us know how to say “thank you”, but how do we adopt it as a practice? There are several ways including:

• Focus on what you do have instead of what you don’t. We all could make long lists of the things we wish we did have; a better job, a bigger house, or those new tennis shoes. Focusing on the things we do have like our health, a place to live, loved ones, etc. helps us to be grateful.
• Make a list of the things you are thankful for. Our elementary school teachers were doing even more than they thought with this assignment.  Keeping notes, sending thank you notes,  journaling about what you are thankful for, or just making a list of the things you are thankful for can be a good reminder of what we are thankful for.
• Try to notice negativity and re-frame it in a positive way. Any situation can be seen from many viewpoints. For example, let’s say Jane is driving to work today and gets in a fender bender. She could be very negative and focus on feeling awful that she got into an accident or she could focus on the fact that no one was hurt. Trying to catch your automatic tendency to evaluate things negatively and replacing it with something positive can help you to notice things that you are grateful for.
• Try to be thankful for even the things that are difficult in your life. This one is a tricky one, but often there are lessons to be learned in even the difficult and painful things. If we pull a muscle running too much our body might be telling us to slow down. If a relationship ends it may have been unhealthy. A friend of mine often asks, "what information did that give you?" Sometimes it takes time and a step back to see the reasons to be thankful but often they are hidden in the most unlikely of places. What would it be like if we were thankful for everything?  

The important thing is to sustain your gratitude and make it a way of life rather than a once a year occasion. Recently, in celebration of the month of November a colleague shared a list of quotes about thankfulness with me and one quote by Sarah Ban Breathnach stuck with me “Real life isn’t always going to be perfect or go your way, but the recurring acknowledgement of what is working in our lives can help us not only to survive but to surmount our difficulties.”

Emmons, R. A., & McCullough, M. E. (2003). Counting blessings versus burdens: Experimental studies of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology, 84, 377–389.

A special thank you to Vanessa Shileny, MSW for sharing her thankfulness resources. 

The Brain: The Last Frontier

The brain is a pretty amazing thing. It is one of the true "last frontiers." We know many things about the brain but not everything. It is kind of like America in pre-colonial days. We know the brain exists but we haven't fully explored it or been able to fully utilize it's resources. 

New and exciting things are being discovered all the time.  Recently, doctors discovered a woman in China who was born without a cerebellum. The cerebellum is a part of your brain that sits just above the top of your brain stem. Cerebellum is Latin for "little brain" and this part of the brain contains nearly half of the brains total neurons. This part of the brain is responsible for controlling fine movements and balance. It helps us do things like writing, riding a bike, and jumping. It also may be involved in some of the mechanics of speaking and communicating to others. The woman in China is a miracle because there are very few cases in history of humans surviving without this part of their brain. The picture below is an image of what her brain looks like without the cerebellum. The black area is filled with cerebral spinal fluid, a liquid that provides cushioning for our brains. 

You may be wondering about how she survived without an important part of her brain. Believe it or not, there are people all over the world that survive and live reasonably well without parts of their brain. Some people have an operation at a young age called a hemispherectomy in which half of their brain tissue is removed.  This is often done to control seizures. When this operation is done early enough in a person's life the brain can begin to "rewire" itself. The brain, especially when we are younger has plasticity and can change to recover from injury or to learn new things. Scientists are finding out that this plasticity lasts well into adulthood and in some parts of our brain throughout life. The Youtube video below details the journey of a little boy who had a hemispherectomy named Josiah:

In the case of the woman in China and those who have had this operation, other parts of the brain have had to assume some of the roles of the missing areas. The woman in China did have some delays in walking and talking and never has been able to jump, Considering she is missing a crucial part of her brain she functions well and has a child of her own. I have had the opportunity to work with some patients who have had this or a similar procedure and it is amazing to watch them learn and grow. From one month to the next they learn new things and regain functioning. 

An important lesson in all this is that we need to take care of our brains and make sure to provide them with stimulation and activity so they continue to grow and get stronger throughout our lives. Some ways you can take of your brain are: 

• Get enough exercise; Research has shown that regular exercise can increase our brains ability to process information, problem solve, and maintain attention. 
• Meditation- Research in this field is in it's early stages but early findings suggest that meditation and things like mindfulness can improve brain function at any age. 
• Manage your stress: Stress and anxiety can increase harmful things in our body and impact our ability to think and remain calm. 
• Learn and learn some more: Learning new things stimulates the brain. Become a life long learner; read books, take a dance class, or find a new hobby. 
• Eat a healthy diet that includes a wide variety of vegetables, fruits, and proteins. All of these things are important for your mind. 
• Control your weight- Fat, bad cholesterol, blood pressure, and  blood sugar levels can all have a negative impact on your brain. It is much easier to control these things when you are at a healthy weight. 
• Drink alcohol in moderation- Excess alcohol and other drugs can be very harmful to your brain. 
• Tease your brain-Brain teasers and brain games can be fun and useful ways to maintain or improve your brains skills in attention, focus, and problem solving.

If you need further information or have concerns about how your brain is working contact a psychologist in your area. They can provide information about ways to help your brain function its best, help you cope with changes, and provide testing to find out if their might be a problem. 

Stigma Can Be Deadly

Many people were touched by the death of Robin Williams in many ways. I myself was moved to tears when I heard about it in a text from a family member. The movie "Patch Adams" is my favorite movie of all time and a source for inspiration about the type of doctor I want to be. His comedy and talent has touched my own life in many ways. Many of the clients walking through my door recently have been deeply affected by the loss or affected by the coverage of his death.There was a flurry of articles on other blogs, in the news, and social media exploded. The details of the death were detailed, gruesome, and some might argue insensitive to the family's privacy. I considered when the right time might be for posting about this on the PSYowa blog and what the post might say. The issue of suicide is a sensitive topic, however many issues in psychology and concerning mental health are sensitive. This doesn't mean that we shouldn't talk about them or give voice to their importance.

As a friend reminded me when I was struggling with what to say in this blog, Robin Williams death should be kept private. As we would want the death of any of our own loved ones to be. There have been many discussions throughout all of this about the selfishness of suicide and the character of those who choose to complete suicide. I am not going to address that. The situations involved in each individual's choice to take their own lives are different and there is not enough time or space to give light to their stories in a respectful or meaningful way. The important thing that we should take from this tragedy is the very public fact that mental illness can affect anyone. Rather than shaming and stigmatizing mental illness we can make a choice to embrace that it is a part of humanity and address how to get help to so many who need it.

For some people who commit suicide we may never know why. For others it may be an apparent journey with the struggles of depression. By lessening the stigma and having conversations about mental illness we can create a safe environment where people do not feel afraid or ashamed to ask for help.

One way to decrease stigma is to be vigilant for people in your own lives who may be struggling and to reach out to them in a compassionate way. For those of you who are not familiar with the signs of depression they can include:

• A sad mood 
• Irritability 
• A change in sleeping patterns (either too much or too little)
• Significant changes in weight or appetite 
• Loss of interest in things they usually enjoy
• Increased anxiety
• Withdrawal from family or friends
• Loss of energy
• Difficulty concentrating 
• Feelings of guilt or worthlessness
• Thoughts or comments about death
• Hopelessness 
• Inability to see positive aspects of situations 

Depression can look very different in different people. While there are a set of symptoms that are common, the ways in which people show them can depend on their personality, environment, and culture. If you are unsure don't be afraid to ask a friend or family member how they are feeling. When you ask, listen without judging. This can be very hard when it is someone you love but remember this is about them, not you. Be ready to hear things that you might not like or that you may not want to hear. Just listening and creating a safe environment for them to talk can make a lot of difference. It is important that you allow them to feel what they are feeling without telling them they are wrong. You may want to say affirming things like "you're right, that's difficult." Arguing with them that they are wrong may only make it more difficult for them to talk. Being affirming is important when you are talking to someone that is going through depression. Point out whatever you can to help them to see that they aren't broken or defective and that there is hope. They may need your help to see that depression is just a part of human life and whatever the situation may be it isn't permanent.

Another important thing is to not fear asking questions about their safety. Asking about suicide will not cause someone to kill themselves. Let them know you are asking about suicide because you care about them. It can be hard but the best way is just to ask someone about their safety is to be direct.  It is important to ask things like "Have you been thinking about killing yourself?" Being tentative or saying things like "You haven't thought of doing something stupid like killing yourself have you?" can make a person feel unsafe telling you or can make it easier for them to say "no."

Having this conversation with a friend, co-worker, or loved one may be hard. It also may save their life. It may be one step towards making the world a safe place to share our difficulties and get the support we need.

If you are immediately concerned about someone in your life you can call the police and ask for a health and welfare check or call 911. If you are considering suicide or need to talk to someone you can call the National Suicide Hotline at 1-800-273-TALK. You can also utilize the American Psychological Association's Psychologist Locator here: http://locator.apa.org/ to find a psychologist near you.

Thank you to Lori Schoh, TMHC from Capstone Behavioral Healthcare for volunteering to serve as guest reviewer/editor on this post.

Why is moving so stressful?

One of the reasons there may have been fewer posts lately is that I have been moving. This weekend as I loaded all of my worldly possessions into cardboard boxes and put them on a truck I reminded myself that moving can be stressful for everyone even if it is a positive move.

The truth is that any kind of change even positive ones like moving to a bigger house, getting married, or starting a new job can be stressful. Your routine and your environment are often changed and it takes time to adjust. As I have mentioned before in previous posts stress can be harmful. In this blog by Belle Beth Cooper http://blog.bufferapp.com/the-science-of-stress-how-its-breaking-down-your-body she shares studies that have shown parts of the brain actually shrank in animals exposed to stress.

As Cooper points out one of the most important factors to successful stressing is how you handle it. It is a normal part of moving to be emotional, to be functioning less efficiently mentally, and to feel stressed out when you relocate. Reminding yourself of this and allowing yourself some time to adjust can be a simple fix. Other tips that might help are:

Stay organized- keep lists, label boxes, keep out a calendar, change your address, and anything else you can do to keep yourself as organized as possible will help to ease chaos during the move.

Get enough sleep - long nights of packing and unpacking can infringe on our shut eye. Be sure to get plenty of shut eye during this time to fight the stress.

Eat healthy- when the dishes and pans are all packed we are tempted to go to fast food restaurants during a move. Good, whole nutrition will help to fuel your body as you deal with all the physical and mental demands of a move.

Take breaks-the world wont end if you don't unpack that box of books tonight. Go take a walk in your new neighborhood, check out the library, or go see a movie. Taking breaks will help you feel more energized when you do work.

Stay positive- your perspective can completely change how you feel. Try to remember all of the positive reasons you moved and focus on those. Whether it was a new job, a bigger house, a cool destination, or to be closer to friends and family keeping your eye on the prize can mentally help you deal with the broken dishes or the cost of new trash cans.

If the stress is unbearable consider taking a break to look up a psychologist in your new area to help you find new ways to deal with the changes and cope with stress. Your brain, your loved ones, and your unbroken dishes will thank you for it!

HIGH TECH TOOLS HELP IOWA PSYCHOLOGIST COUNSEL PATIENTS WITH WEIGHT ISSUES

As you read the PSYowa blog you may be surprised to learn about all the things that psychologists do and the many ways in which they touch and change the world around you. Psychologists are involved in many health related areas including weight management, chronic pain, addiction, and oncology. One Iowa psychologist is doing some important work in weight management.

A Grinnell psychologist and bariatric counselor has published a study that may change the way we all look at weight management, and help those who struggle with weight issues develop realistic goals.

Dr. Brandon Davis recently published a pilot study in the Archives of Medical and Biomedical Research that focuses on a new way to look at metabolism, which the study calls the “Metabolic Factor.”

Metabolic Factor is found by determining how many calories a person burns per day at rest, or their resting metabolic rate, and dividing that number by their weight. The resting metabolic rate is measured with an FDA-approved machine that measures how much oxygen a person uses and how much carbon dioxide they exhale.

“We all know people who can eat nearly anything and seemingly not gain weight, while some people have controlled intake for years and struggle with weight issues,” Davis said. “This study is helping confirm that some people do indeed have fast or slow metabolisms.”

Davis said because Metabolic Factor does not change, when one loses weight, their caloric intake needs to continue to drop to lose or even maintain weight, because there are fewer pounds burning calories. For a psychologist who counsels patients who struggle with weight issues, the information is very important.

“I believe in taking the shame out of obesity issues,” Davis said. “And I also believe in helping people be happy with a healthy weight that they can realistically maintain. If I can show somebody with a Metabolic Factor of 8 that they could only eat 880 calories in order to maintain a 110 pound weight, it goes a long way toward more realistic goals and acceptance of their own body”

In addition to Metabolic Factor, Dr. Davis provides patients with information such as the suggested number of daily calories for weight loss and other data useful in creating and maintaining a healthy lifestyle.

“Common sense, a sustainable plan and an approach that recognizes there is no guilt or shame is how I approach weight management,” he said. “People can be healthier and happy at the same time.”

For more information, visit www.davispsychservices.org or watch this video by the American Association of Bariatric Counselors at https://www.youtube.com/watch?v=m-yteY5HkxE

Dr. Brandon Davis earned his Ph.D. in Counseling Psychology from Texas A&M University in 2004. He has performed bariatric surgery pre-operative evaluations and served on a Bariatric Review Committee since 2006. After opening Davis Psychological Services, PC in Grinnell in 2011, Dr. Davis expanded his services to provide therapy to people struggling with obesity. In 2013, he earned a certification in bariatric counseling from the American Association of Bariatric Counselors. He has been invited to speak about obesity and his first study in the field of bariatrics was published in June.

Contagious stress?

If any of you were watching the news recently you may have heard the story about stress being contagious. As if we didn't have enough ways to get stressed!

An ABC News blog reported that researchers at the University of St. Louis recently found that a stress response could be elicited watching someone else, even if you'd never met them, under stress. This isn't the first time researchers have found that those being stressed around us can cause our own stress levels to be higher. Researchers have found evidence of transmission of stress between spouses and parents and children (Engert, et. al., 2014 & Waters, West, & Mendes, 2014). Too much stress can have some very negative effects on us. These can include:

From the Mayo Clinic

How do we relieve stress? I recently had the opportunity to attend a YMCA Healthy Kids Day event in Oskaloosa, Iowa and at our table we asked families to share the ways they relieve stress. Children and adults of all ages participated and came up with some pretty good ideas. Some of them included:

• Deep breathing 
• Running and other types of exercise/sports 
• Praying 
• Massage 
• Meditation 
• Fishing 
• Drawing 
• Quilting 
• Woodworking 
• Spending time with friends 
• Playing games or with toys 
• Being Outside 
• Yoga 
• Taking a nap 
• Getting enough sleep 
• Watch a movie 
• Laugh 

These are all great stress relievers. Can you think of any other good ideas?

Engert, V., Plessow, F., Miller, R., Kirschbaum, C., & Singer, T. (2014). Cortisol Increase in Empathic Stress is modulated by Social Closeness and Observation Modality. Psychoneuroendocrinology.

Waters, S. F., West, T. V., & Mendes, W. B. (2014). Stress Contagion Physiological Covariation Between Mothers and Infants. Psychological Science.

Fighting Cancer with Passion

Check out a recent article in the Marshalltown Times Republican about a recent presentation at the Marshalltown YMCA-YWCA for their Livestrong program. Check out the article here: Fighting cancer with a passion  It is a great group that provides mental and physical supports to cancer survivors. It was my third time speaking for different Livestrong classes there. They are a wonderful group and the Y is also awesome!

I was speaking about using non-pharmaceutical interventions for pain management. I focused mainly on mindfulness as a tool for pain management. Maybe there will be an upcoming blog post about mindfulness???

At the end of the presentation we did an exercise called the three minute breathing space to give participants a little slice of mindfulness. I received the exercise from Chris Klug, MA a mindfulness instructor from the University of Iowa @ one of his retreats at the Prairie Woods Retreat Center near Cedar Rapids. Try it for yourself:

The 3-Minute Breathing Space – Basic Instructions

1.    Awareness

 Bring yourself into the present moment by deliberately adopting an erect and dignified posture.  If possible, close your eyes.  Then ask:

“What is my experience right now…in thoughts…in feelings…and in bodily sensations?

Acknowledge and register your experience, even if it is unwanted.

2.     Gathering

Then, gently redirect full attention to breathing, to each in-breath and to each out-breath as they follow, one after the other.

Your breath can function as an anchor to bring you into the present and help you tune into a state of awareness and stillness.

3.     Expanding

Expand the field of your awareness around your breathing, so that it includes a sense of the body as a whole, your posture, and facial expression.

  

The breathing space provides a way to step out of automatic pilot mode and reconnect with the present moment. 

The key skill in using Mindfulness is to maintain awareness in the moment.  Nothing else.

From Segal, Williams and Teasdale (2002).  Mindfulness-Based Cognitive Therapy for Depression.  Guilford Press

Psychologists’ roles in chronic pain management

For those with chronic, intractable pain, life is a strain. Those who cannot find relief from pain often develop psychological symptoms, such as depression, withdrawal from activities, helplessness, and anxiety. Counseling by psychologists can sometimes help chronic pain patients find a quality of life, despite their pain. A multidisciplinary pain program can teach various coping skills for pain. Psychologists have a role in pain management, addressing the emotional and cognitive factors that affect the experience of pain. When pain cannot be avoided, people can learn to work around it; to keep on living their lives despite the pain. In addition, many pain patients seek relief through treatments with chiropractic, physical therapy, exercise, massage, injections, a TENS unit, and even back surgery.

If these means do not help, people sometimes seek relief through implantation of a Spinal Cord Stimulator (SCS). An SCS is a mechanical device that stimulates some of the nerves sending pain signals to the brain. It is believed that stimulating certain nerves closes a “pain gate”, meaning that the individual experiences a reduction in perceived pain. The SCS is surgically implanted in the back. A psychologist’s role in the SCS procedure is to complete a psychological evaluation of a person before a surgeon does the implant. The reason for this evaluation is to be sure the candidate is able to understand and to cope with the perceived surgery. In addition, as a practical matter, third party payers often require a psychological evaluation before consenting to pay for the SCS.

In helping prepare a candidate for the SCS surgery, psychologists use an interview and one or more psychological tests. Tests, such as the MMPI-2-RF and MBMD, have norms for pain patients. They take 1 – 2 hours to complete and the interview usually lasts about an hour. The psychologist is looking for strengths, as well as emotional struggles the person is experiencing.

One area to be assessed is the history of the person’s pain, how it affects him/her currently, and treatments s/he have received for it. Family life, especially how the family has responded to the chronic pain condition, is another area to be assessed. The candidate’s emotional status, including any treatment for psychiatric disorders, is part of the assessment. General ability to understand the procedure being proposed is important to assess, because the surgery is permanent and the candidate will have to manipulate a remote control device.

Some “red flags” which may mean the person is not a good candidate for surgery, but should be treated by another provider, are the following:

• candidates who do not understand reality correctly, who have a psychotic disorder and who may distort their pain experience
• candidates who have any other severe mental disorder, such as depression, anxiety, or active substance use disorders 
• candidates who have chronic difficulty getting along with others, including their physicians
• candidates who have active suicidal or homicidal behavior, or have difficulty controlling anger or have a past history of violent behavior

The above post was written by guest contributor Dr. Don Damsteegt. From his practice website: 

Dr. Damsteegt is the owner of Family Psychology Associates, P.C. and is a Licensed Psychologist and a Health Service Provider in Psychology.

Dr. Damsteegt is a licensed psychologist and a Health Service Provider in Psychology. He has been in practice since 1983, including a year of post-doctoral residency in the Department of Psychiatry at the University of Iowa Hospitals and Clinics. His specialties include assessment and treatment of individuals and couples. He has been trained Cognitive Therapy, which is an empirically validated treatment for many disorders, including depression and anxiety. He also is a certified Imago Relationship Therapist. He does assessment of personality, intelligence, ADHD and substance abuse, including being a DOT-SAP. He holds a PhD in Counseling Psychology from the University of Nebraska in 1981.

How Do I Turn Won't Power into Willpower?

Earlier this year we discussed New Year's resolutions. How are you doing at keeping them? If you have, that's great. If you haven't you are like many people who have difficulty with finding the willpower to stick to their goals. One thing that we psychologists are good at is turning to the research to find solutions to the problems we face. Luckily, I recently had the privilege of attending a presentation on willpower at the 2014 APA State Leadership Conference by Dr. Mark Muraven, a researcher at SUNY Albany. He shared some really interesting ideas about willpower.

One helpful bit of information from his presentation is that using an “implementation intention” can help you to be more successful. Usually these intentions take the form of “if-then” statements that help people plan for obstacles to achieving their goal. For example, someone who is trying to avoid sweets might say, "If anyone brings sweets to work today, then I will eat some almonds instead." Research has shown that implementation intentions improve self-control even when people's willpower had been depleted. Another way to set an intention is to do things that help support your intention. This may mean throwing out the sweets in the house to prevent snacking on them or setting out your running clothes by the bed so they are there when you wake up for your run in the morning. Planning, acting, and thinking like you will be successful helps to support you to get there.

Research also suggests that willpower is a somewhat limited resource. Even though it also suggests that we have a reserve of willpower that can be called upon given the right motivation under normal circumstances we only have so much. This means that making a list of ten New Year's resolutions was probably not the best idea. Simultaneously trying to quit smoking, lose weight, and get out of debt may be too difficult. Choosing one important goal at a time to work on can help to conserve the willpower you do have to be successful.

As with almost anything it also helps to strengthen the muscles you're going ot use in any task. According to research, willpower is very much like a muscle. Researchers found that when people were asked to practice willpower prior to working on something like quitting smoking they were more successful at their goal. So practicing willpower regularly could help you to be more successful in the long run.

There are lots of great researchers like Dr. Muraven that have learned a lot of very helpful things about willpower. Their insights and the information they've learned through their research can be a very helpful resource to those of us who have goals to accomplish. The video below is from Kelly McGonigal about her book The willpower Instinct, another great resource on willpower. Even if you have had a setback or two in accomplishing your resolution now is a perfect time to refocus your attention on an important goal and set an intention that will help you to succeed!

Webb, T., & Muraven, M. (2010). Practicing self-control lowers the risk of smoking lapse. Psychology of Addictive Behaviors, 24(3), 446–452.

 Muraven, M., & Slessareva, E. (2003). Mechanisms of self-control failure: Motivation and limited resources. Personality and Social Psychology Bulletin, 29(7), 894–906.

Muraven, M., et al. (1999). Longitudinal improvement of self-regulation through practice: Building self-control strength through repeated exercise. Journal of Social Psychology, 139(4), 446–457

Sheeran, P. (2003). Can implementation intentions help to overcome ego depletion? Journal of Experimental Social Psychology, 39(3), 279–286.

Is Cabin Fever a Diagnosis?

 

The winter has been particularly intense and long this year. While cabin fever is not an official diagnosis, the weather can affect our moods. Some people suffer from depression or anxiety that has a seasonal pattern. These people often have new or worse symptoms during the winter months which can include changes in mood, anxiety, sleep problems, fatigue, changes in appetite, sleep issues, and irritability. Even for those who don't have a mental health diagnosis with a seasonal pattern winter can be difficult. The snow, ice, cold, and cloudiness seem to make everyone more tired, more irritable, and more likely to want to hibernate. If you are feeling this way you aren't alone. Many other people, especially those in northern latitudes suffer from "the winter blues" (Rosen, et. al, 1990)

Unfortunately, we have little control over whether the ground hog will see his shadow and if spring will be on it's way soon. There are however some things that you can do to help you through until your episode of "cabin fever" passes:

• Eat  a healthy diet. When our bodies are healthy and have all the vitamins, minerals, and nutrients they need to function we feel better. It might be even more important in winter when we have less access to fresh fruits and veggies and the benefits of the sun to count on.
• Exercise. Exercising can improve your mood and increase your energy level. Aim to get some regular exercise and it will help to beat the blues.
• Don't isolate. Make plans with friends and family or give a friend a call. Due to the weather and low mood people tend to spend less time with others in the winter months. Spending time with others provides social support and can improve our mood.
• Make plans. It can often help our mood if we have something to look forward to. This could be anything from a road trip to planning a nice dinner party with friends.
• Steer clear of alcohol. Alcohol is a depressant and can make your mood worse. It is okay in moderation but drinking large amounts of alcohol can make mood problems worse and make you more irritable.
• Enjoy winter. It can be hard to do but there are lots of things to do to enjoy winter like sledding, snowboarding, skiing, snow shoeing, making a snow man, or going to an outdoor ice skating rink. When you enjoy the moment instead of wishing for the next one it can make a big difference.

These are just a few tips to help you through the winter months. Feel free to comment with any other tips that you may have. As always, if you feel that your mood has worsened significantly contact a mental health professional for consultation.

Rosen, L. N., Targum, S. D., Terman, M., Bryant, M. J., Hoffman, H., Kasper, S. F., ... & Rosenthal, N. E. (1990). Prevalence of seasonal affective disorder at four latitudes. Psychiatry research, 31(2), 131-144.

Comic from: http://thephoenix.com/boston/life/98815-cabin-fever-2010/ by David Kish.

What kind of tests does a psychologist do?

When you see a list of things that a psychologist does on a website or brochure, psychological testing and assessment are usually on the list. You may be wondering what that means. There are many types of psychological testing and assessment but the main purpose of psychological testing and assessment is to clarify what psychological issues may be affecting a person. Testing and assessment could be done for a number of reasons including:

• Intelligence
• Learning disabilities
• Autism Spectrum Disorder(s)
• Personality Testing
• ADHD
• Appropriateness for certain medical procedures
• Suitability for certain professions like law enforcement

Most of the time there are multiple things involved in psychological testing and assessment because it is important for psychologists to investigate many facets of a person's thoughts, feelings, behavior, and environment to help them understand the whole picture of what is going on. Tests and assessments may include things like questionnaires, puzzles, computer activities, a psychologist's observations, or a clinical interview. All of the pieces of an assessment that a psychologist chooses to do are important and are carefully integrated to provide the best picture possible of the person they are evaluating. Check out the video below about psychological testing for more information:

What exactly is a psychologist again?

If you walk into a mental health clinic, hospital, or private practice there is a chance that you will meet many different types of professionals. Some common types that you will see in a mental health setting are (the official title of these professions may vary from state to state):  

• Psychologists
• Social Workers
• Mental Health Counselors
• Psychiatrists
• Nurse Practitioners
• Physician’s Assistants
• Nurses
• Medical Assistants
• Trainees , residents, interns, or post-docs

It can be confusing sometimes to distinguish between the people you meet and what they can do for you. I often meet people for the first time who ask some version of “what is a psychologist exactly?” In short, a psychologist in a clinical setting is a doctorally trained mental health professional who evaluates, performs testing, and treats psychological concerns. In all truth though, they can do many more things including:

 

• Individual, group, couples, and family therapy
• Helping students to overcome learning challenges in all levels of school
• Psychological testing to evaluate ADHD, intelligence, head injury, memory, dementia, personality disorders, and a variety of mental health concerns
• Psychological testing to determine if you are a good candidate for things like bariatric surgery and pain treatments
• Consulting with businesses to increase communication skills, reduce conflict, and improve work environments
• Working with athletes to aid in performance and to deal with injury
• Helping people to set goals and work with barriers to change
• Teach social skills
• Do outreach and educate the community on a variety of topics
• Evaluate treatments to determine if improvements are being made
• Evaluate programs and consult with other professionals to improve them
• Develop and utilize innovative and research based treatments and assessments

Those are just a few of the great things that psychologists can do. They go to school for a very long time and receive a lot of hands on training so that they can be exceptional mental health providers. To be a licensed psychologist, an individual needs to obtain a doctoral degree (PhD, PsyD, EdD) and at least two years of supervised experience working with patients. They receive more training in psychology and mental health than any other mental health professional. This can sometimes mean 6 to 7 years beyond an undergraduate (BA or BS) degree!

Hopefully, that gives you more of any idea of what a psychologist is. Each psychologist may differ in the things that they specialize in or typically do in their setting. In future blogs we may have some guest contributors who will share what they do as a psychologist or what they are learning as a psychology student.

Why is there a psychologist at my YMCA?

If you happen to be at your local YMCA you may bump into a psychologist. You may think to yourself, "what is a psychologist doing at a YMCA?" Since 2008 the American Psychological Association and YMCA of the USA have been partnering to provide resources for individuals and families in communities across the country. Some psychologists volunteer their time in local YMCAs offering workshops, staffing health fairs, or being involved in various programs offered by the YMCA.

Recently the public education committee of the Iowa Psychological Association, an affiliate of the American Psychological Association has been making an effort to strengthen the partnership between the YMCA of Iowa and psychologists in Iowa. In the fall of 2013 they began working to make contact with Y directors across the state and facilitate partnerships between the YMCA and local psychologists.

This is an important initiative because it gets psychologists out of their offices and into communities. It can help to reduce the stigma surrounding mental health and mental health professionals. People out in the community also can learn more about what psychologists can offer and can take advantage of psychologists' expertise in a variety of areas. Psychologists can offer expertise on many topics important to the YMCA and their communities including:

Weight loss

Living healthy with illness

Goal setting

Making healthy choices for your family

Aging Issues

Children's Mental Health

Sport's psychology

Stress management

Work/Life balance

Since the new effort to partner with YMCA in Iowa the Iowa Psychological Association has provided multiple psychologists to speak at workshops and has become involved in one community's wellness initiative. The collaboration is continuing with future events being planned and hopefully more psychologists and communities getting involved. So next time you are at an event at your local Y don't be surprised if you bump into a psychologist!

Setting a Resolution to Keep Your Resolution

How many of you set New Year’s resolutions? How many of you have stuck with your New Year’s resolution? If so, great job! You made it through a week! The statistics are pretty high that many people will make it through the first week but beyond that the number of successful people start to dwindle. Don't fret though, there are some things you can do to increase the likelihood that you will be successful. One way is to see if your resolutions is a SMART resolution. Doran (1981) came up with the SMART acronym for setting good goals that applies really well to resolutions:

• S-specific
• M-measurable
• A- achievable/attainable 
• R- realistic
• T- time bound

Ask yourself if the resolution that you set meets these criteria. If not, it may need adjusted. For example, if your resolution was to be healthier it may need to be more specific and measurable. A possible alternative to "be healthier" might be "get 30 minutes of exercise before going to work each day."  In addition to making your resolutions SMART there are a few other things to keep in mind:

• It may be best to narrow down to one resolution rather than an entire list.
• It can be helpful to enlist support from friends, family, and other important people in your life.
• Reward yourself along the way.
• Make setting goals for yourself a year long practice instead of waiting until January to get started. 
• Check with your doctor if your resolutions involve any significant health or physical changes to make sure you are in good health and to get helpful tips.
• Give yourself positive affirmations to encourage you along the way. These can be written on sticky notes, put on your screen saver, or you can even use websites like http://textitlater.com/ to schedule a text to be sent to yourself later.
• You can always enlist the help of a psychologist to help you set good goals, change behaviors, and find ways to stick to them.

Doran, G. T. (1981). There's a S.M.A.R.T. way to write management's goals and objectives. Management Review, Volume 70, Issue 11, pp. 35-36.