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!