Yoga and the Brain
Depression and anxiety are increasingly common throughout the world, and although each may be a consequence of psychological and environmental stresses, there is also a genetic predisposition and an increasing number of reproducible disturbances in the brain.
In recent years, there has been increasing interest in the role of brain gamma-aminobutyric acid (GABA) levels, which is the brain’s primary inhibitory neurotransmitter, in both depression and anxiety, following the finding that each may be associated with low levels of GABA in different regions of the brain.
There have also been reports that yoga may help stress and anxiety as well as depression.
Now colleagues from Boston University School of Medicine (BUSM) and McLean Hospital have found that practicing hatha yoga may elevate brain GABA levels.
This new research is published in last month’s issue of Journal of Alternative and Complementary Medicine.
The researchers used magnetic resonance spectroscopic imaging to compare the GABA levels of eight subjects before and after one hour of yoga. The control group consisted of 11 people who read a book or magazine instead of doing yoga. They found a twenty-seven percent increase in GABA levels in the yoga practitioner group after their session, but no change in the comparison subject group after an hour spent reading.
It is too early to start recommending yoga for the treatment of depression or anxiety, but it is fascinating that it will produce changes in brain chemistry that are very similar to those that we hope to achieve with other forms of therapy.
Biofeedback for Tension Headaches
Tension headaches are common and can cause a great deal of pain and distress. They can also be hellish hard to treat.
Medicines do not always help, so I have since the 1970s been interested in anything else that could help. In 1982 my boss gave me the money to set up a biofeedback laboratory at Charing Cross Hospital in London, and it turned out that this form of treatment helped around a third of people with tension headaches. Most experts have assumed that biofeedback helps by reducing muscle tension, though I have never been so sure: not everyone with tension headache has increased muscle tone, and many simply reported that they felt less stressed and more in control of their lives.
So it was very interesting to see some new research (NR10) presented yesterday at the 2007 Annual Meeting of the American Psychiatric Association in San Diego, California.
Researchers from Ingok Ja-Ae Hospital in Chungbuk Eumseong, South Korea looked at the efficacy of biofeedback assisted autogenic training for chronic tension headaches.
They examined 35 people aged 20-40 with chronic tension headaches. 17 had treatment as usual, and 18 received 8 sessions of biofeedback. The researchers used some standard measures of headache. Both groups improved, but the people who had biofeedback showed a greater improvement using a simple visual analog scale.
But this is what was interesting: people who had biofeedback had a significant improvement in their levels of anxiety and depression. The reductions of anxiety correlated with the improvements in headache, while biofeedback had no impact on the electrical activity of the muscles in the head and neck. This is an important finding, since it suggests that biofeedback may be helpful with other problems in which anxiety is an issue. There are few problems that are only physical or only psychological: there will almost always be a psychological component in anyone who suffers from chronic pain.
I recently discussed the use of a particular form of biofeedback that seems to help many people with attention-deficit/hyperactivity disorder (ADHD). The treatment seems to help attention itself, but it would also be very helpful if it reduces anxiety, since excessive worrying is a common issue in ADHD.
I shall keep you updated on the use of biofeedback as more research is published.
The most important conclusion from all this work is that it confirms that the mind has extraordinary powers over the body.
And that is incredibly encouraging for all of us.
Psychological Problems, Stigma and Success
I do a lot of work to try and de-stigmatize mental illness, and to emphasize that all of my experience and all the scientific evidence makes it very clear that most psychological and psychiatric problems lie on a spectrum. We define something as an “illness” only if it is causing suffering or distress.
Because of my work I know about the physical and psychological problems of a great many people in the public eye, but I will obviously not talk about people unless they decide to say something themselves.
When I am speaking to politicians or the media I often show them a list of some of the people with psychological problems who have gone public.
I just found this long list of Deborah Serani’s blog. There were a number of names of people whom I did not know had revealed that they had suffered from problems. I am pleased that Deborah offered some references. I have also added a few names from my own research.
If there are any mistakes, please let me know and I shall correct them.
I would like to make three points:
- Psychological problems and psychiatric illnesses are common and usually treatable
- Having been diagnosed with one of these problems does not preclude you from outstanding success
- This list does not include people with substance abuse problems, though these problems are usually as physical as any other
I do hope that you will find it helpful to see just how many terrific people have had their downs as well as their ups!
John Quincy Adams (US President)
Alvin Ailey (Choreographer)
Lionel Aldridge (Football Star)
Buzz Aldrin (Astronaut)
Adam Ant A.K.A. Stuart Goddard (Singer)
Ann-Margaret (Actor)
Louie Anderson (Comedian Actor)
Gillian Anderson (Actress)
Fiona Apple (Musician)
Diane Arbus (Photographer)
Isaac Asimov (Author)
Drew Barrymore (Actor/Producer)
Daniel Boorstin (Former Us Presidential Adviser)
Zach Braff (Actor)
Art Buchwald (Columnist)
Oksana Baiul (Skating Star)
Kim Basinger (Actress)
Ned Beatty (Actor)
Syd Barrett (Musician)
Ludwig Van Beethoven (Composer)
Maurice Bernard (Actor)
Irving Berlin (Composer)
Danny Bonaduce (Actor/Radio DJ)
Halle Berry (Actor)
Kjell Magne Bondevik (Prime Minister of Norway)
Steve Blass (Baseball Star)
Charles “Buddy” Bolden (Musician)
Robert Borrstin (Political Advisor)
David Bowie (Singer)
Marlon Brando (Actor)
Jeremy Brett (Actor)
Charlotte Bronte (Author)
Robert Burns (Poet)
Willie Burton (Athlete)
Barbara Bush (Former First Lady – U.S.)
Delta Burke (Actor)
Carol Burnett (Actress/Comedian)
Lord Byron (Poet)
Cher (Singer/Actress)
Dick Clark (Producer/Music Magnate)
John Candy (Comedian)
Ray Charles (Musician)
Deanna Carter (Singer)
Helen Caldicott (Activist/Writer)
Dean Cain (Actor)
Drew Carey (Actor/ Comedian)
Earl Campbell (Football Star)
Eric Clapton (Musician)
Jim Carrey (Actor/Comedian)
Melanie Chisholm (Singer)
Naomi Campbell (Model)
Rosemary Clooney(Singer)
Jose Canseco (Baseball Star)
Shawn Colvin (Musician)
Mary Jo Codey (First Lady Of New Jersey)
Judy Collins (Musician)
Dick Cavett (TV Host/Writer)
Courtney Cox (Actor)
Margaret Cho (Actor/Comedian)
Natalie Cole (Singer)
Michael Crichton (Writer)
Francis Ford Coppola (Director)
Sheryl Crow (Musician)
Winston Churchill (English Prime Minister)
Nicolas Cage (Actor)
Sandra Cisneros (Writer)
Patricia Cornwell (Writer)
John Cleese (Comedian/Actor)
Leonard Cohen (Musician)
Paula Cole (Actor)
Shayne Corson (Hockey Star)
Judy Collins (Musician)
Shawn Colvin (Musician)
Jeff Conaway (Actor)
Ty Cobb (Baseball Star)
Pat Conroy (Writer)
Billy Corgan (Musician)
Calvin Coolidge (US President)
Bill Dana (Comedian)
John Daly (Golf Star)
Rodney Dangerfield (Comedian/ Actor)
Charles Darwin (Scientist)
Jefferson Davis (President Of The Confederate States Of America)
Jonathan Davis (Musician)
Sandra Dee (Actor)
Gaetano Donizetti (Opera Singer)
Mike Douglas (TV Host)
Walt Disney (Entrepreneur)
John Denver (Musician)
Dame Edna Everage a.k.a. Barry Humphries (Comedian)
Ellen Degeneres (Comedian/Actor)
Richard Dreyfuss (Actor)
Johnny Depp (Actor)
Paolo Dicanio (Soccer Star)
Eric Douglas (Actor)
Charles Dickens (Author)
Patty Duke (Actress)
Scott Donie (Olympic Star)
Kitty Dukakis (Former First Lady Of Massachusetts)
Michael English (Singer)
Jim Eisenreich (Baseball Star)
Thomas Edison (Inventor)
Ralph Waldo Emerson (Writer)
Robert Evans (Film Producer)
Jules Feiffer (Cartoonist)
James Farmer (Civil Rights Leader)
Edie Falco (Actress)
Betty Ford (Former US First Lady)
Carrie Fisher (Actress)
James Forrestal (Undersecretary Of US)
Eddie Fisher (Singer)
Aretha Franklin (Singer)
Harrison Ford (Actor)
Albert French (Writer)
Sally Field (Actress)
Connie Francis (Singer)
Sarah Ferguson (Duchess Of York)
Sigmund Freud (Psychoanalyst)
Stephen Fry (Actor)
Shecky Greene (Comedian)
Barbara Gordon (Filmmaker)
Phil Graham (Washington Post)
James Gandolfini (Actor)
James Garner (Actor)
Peter Gabriel (Musician)
Kendall Gill (Basketball Star)
Ruth Graham (Writer)
John Gibson (Pianist)
Danny Glover (Actor)
Dwight Gooden (Baseball Star)
Tipper Gore (Former US First Lady)
Galileo (Scientist)
Carey Grant (Actor)
Mariette Hartley (Actor/Activist)
Tim Howard (Soccer Star)
Juliana Hatfield (Musician)
Ernest Hemingway (Writer/ Nobel Laureate)
Margaux Hemingway (Actor)
Audrey Hepburn (Actor/Activist)
Olivia Hussey (Actress)
Pete Harnisch (Baseball Star)
Linda Hamilton (Actor)
Stephen Hawking (Physicist)
Sir Anthony Hopkins (Actor)
Marty Ingels (Comedian)
Janet Jackson (Musician)
Kay Redfield Jamison (Psychologist/Author)
Richard Jeni (Comedian)
Jim Jenson (Newscaster)
Billy Joel (Musician)
Beverly Johnson (Supermodel)
Elton John (Musician)
Angelina Jolie (Actor/Activist)
Daniel Johns (Musician)
Ashley Judd (Actor)
Naomi Judd (Singer)
Al Kasha (Songwriter)
Danny Kaye (Actor)
Leila Kenzle (Actress)
John Keats (Poet)
Franz Kafka (Writer)
Gelsey Kirkland (Dancer)
Margot Kidder (Actress)
Nicole Kidman (Actress)
Joey Kramer (Musician)
Julie Krone (Star Athlete)
Pat Lafontaine (Hockey Star)
Jessica Lange (Actor)
Robert E. Lee (US General)
Jacob Lawrence (Artist)
Vivien Leigh (Actress)
Peter Nolan Lawrence (Writer)
Primo Levi (Writer)
John Lennon (Musician)
Meriwether Lewis (Explorer)
Courtney Love (Singer)
Allie Light (Director)
Abraham Lincoln (American President)
Rick London (Cartoonist)
Mary Todd Lincoln (Former US First Lady)
Salvador Luria (Scientist/Nobel Laureate)
John Madden (Football Star)
Meat Loaf (Musician/Actor)
Camryn Manheim (Actor)
Martha Manning (Psychologist)
Gustav Mahler (Composer)
Alanis Morisette (Singer)
Howie Mandel (Comic)
Bette Midler (Singer/Actress)
Dave Matthews (Musician)
Gary Mcdonald (Actor)
A.J. Mclean (Musician)
Burgess Meredith (Actor)
Sir Paul Mccartney (Musician)
Robert Mcfarlane (Security Advisor)
Sarah Mclachlan (Musician)
Rod Mckuen (Writer)
Gary Mcdonald (Actor)
Les Murray (Poet)
John Stuart Mill (Philosopher)
J.P. Morgan (Industrialist)
Edvard Munch (Artist)
John Mellencamp (Musician)
Paul Merton (Comedian)
Kate Millet (Writer/Feminist)
Carmen Miranda (Dancer)
Claude Monet (Artist)
Many Moore (Singer)
Michelangelo (Artist)
V.S. Naipaul (Writer/Nobel Laureate)
John Nash (Mathematician /Nobel Prize)
Ralph Nader (Consumer Rights Advocate)
Stevie Nicks (Musician)
Vaclav Nijinsky (Dancer)
Sir Isaac Newton (Scientist)
Deborah Norville (Journalist)
Marie Osmond (Entertainer)
Sir Laurence Olivier (Actor)
Rosie O’Donnell (Comedian/Actress)
Georgia O’Keefe (Artist)
Donny Osmond (Entertainer)
Lani O’Grady (Actress)
Eugene O’Neill (Playwright)
Dolly Parton (Musician)
Meera Popkin (Broadway Star)
Charley Pell (Football Coach)
George Patton (US General)
Jane Pauley (Journalist)
Teddy Pendergrass (Musician)
Edgar Allan Poe (Writer)
Elvis Presley (Entertainer)
Ezra Pound (Poet)
Jason Pollock (Artist)
Cole Porter (Composer)
Jimmy Piersall (Baseball Star)
Alma Powell (Wife Of General Colin Powell)
Susan Powter (Motivational Speaker)
Freddie Prinze Jr. (Actor)
Roseanne (Comedian/Actress)
Bonnie Raitt (Musician)
Burt Reynolds (Actor)
Lou Reed (Musician)
Norman Rockwell (Artist)
Theodore Roosevelt ( President Of The United States)
Joan Rivers (Comedian Actress)
Mac Rebennack A.K.A. Dr. John (Musician)
Alex Rodriguez (Baseball Star)
Alys Robi (Vocalist)
Axel Rose (Singer)
Winona Ryder (Actress)
Yves Saint Laurent (Fashion Designer)
Sam Shepard (Playwright)
Tom Snyder (TV Host)
Monica Seles (Tennis Star)
Linda Sexton (Writer)
Neil Simon (Playwright)
William T. Sherman (US General)
Marc Summers (TV Host)
Diana Spencer (Princess Of Wales)
John Steinbeck (Author)
Paul Simon (Musician)
Lauren Slater (Writer)
Willard Scott (Star Weatherman)
William Shakespeare (Writer)
Carly Simon (Singer)
Jose Solano (Actor)
Rick Springfield (Musician/Actor)
Brooke Shields (Model/Actress)
Rod Steiger (Actor)
George Stephanopoulos (Political Advisor)
Barbra Streisand (Singer/Actress)
William Styron (Writer)
Charles Schulz (Cartoonist)
Teresa Stratas (Opera Singer)
Sissy Spacek (Actress),
Dave Stewart (Singer)
Darryl Strawberry (Baseball Star)
Lori Schiller (Writer)
Francis Sherwood (Writer)
Scott Simmie (Journalist)
Earl Simmons A.K.A. DMX (Musician/Actor)
Alonzo Spellman (Football Star)
Nikola Tesla (Inventor)
Spencer Tracy (Actor)
Hunter Tylo (Actor)
Leo Tolstoy (Author)
Ted Turner (Entrepreneur)
Henri De Toulouse-Lautrec (Artist)
Mark Twain (Author)
Peter Illyich Tchaikovsky (Composer)
Anne Tyler (Author)
Tracy Ullman (Actor)
Dimitrius Underwood (Football Star)
Vivian Vance (Actor)
Kurt Vonnegut (Writer)
Tom Waits (Musician)
Mike Wallace (Journalist)
Michael Warren (Editor Canada Post)
George Washington (US President)
Evelyn Waugh (Novelist)
Damon Wayans (Comedian/Actor)
Tennessee Williams (Writer)
Dar Williams (Musician)
Robin Williams (Comedian/Actor)
Ann Wilson (Singer)
Bill Wilson (Founder Of Alcoholics Anonymous)
Brian Wilson (Musician)
Oprah Winfrey (TV Host)
Jonathan Winters (Comedian)
Ed Wood (Director)
Tom Wolfe (Writer)
Lewis Wolpert (Scientist)
Hugo Wolf (Composer)
Virginia Woolf (Novelist)
Luther Wright (Basketball Star)
W.B. Yeats (Poet)
Robert Young (Actor)
Bert Yancey (Golf Star)
William Zeckendorf (Industrialist)
Renee Zellweger (Actor)
References
Buchwald, A. (1999). Famous, important people who have suffered depression. Psychology Today.
Fonda, J. (2005). My life, so far. New York: Random House.
Jamison, K.R. (1993). Touched with fire. Manic depressive illness and artistic temperment. New York: Free Press.
Shepard, S. (1999). Mrs. gore breaks the ice on mental illness. Wahsington Bureau: The Palm Beach Post.
Shields, B. (2005). Down came the rain: My journey through post partum depression.
New York: Hyperion Books.
______(2005). Health: Celebrities who have admitted suffering from depression. England: Burmingham Post.
People with Mental Illness Enrich Our Lives
http://www.nami.org/helpline/peoplew.htm
Celebrity with Anxiety Disorders
http://www.anxietysecrets.com/celebrities.htm
Famous People Who Have Battled Depression
http://www.funkstop.com/ed/depression
Mindfulness and Eating Disorders
There is a very interesting report about a study that is going on at Griffith University in Brisbane, Australia.
They are using a psychological technique called "mindfulness" that is firmly rooted in Buddhist philosophy, in which a person becomes intentionally aware of his or her thoughts and actions in the present moment, non-judgmentally. Mindfulness is applied to both bodily actions and the mind’s own thoughts and feelings.
The idea is to help them understand and deal with the emotions that trigger their binges. Unlike many other therapies used in the treatment of eating disorders, there is less focus on food and controlling eating and more on providing freedom from negative thoughts and emotions.
Psychologists Michelle Hanisch and Angela Morgan said that women who binged were often high-achievers and perfectionists and when they perceived that they didn’t measure up to self-imposed standards or were not in control of situations, they indulged in secretive eating binges.
It is well known that many women with eating disorders develop elaborate methods of hiding the evidence of their binges. Some feel so guilty afterwards they also induce vomiting, overuse laxatives or exercise excessively to counteract the effects of the binge.
The researchers say, "Binge eating is largely a distraction – a temporary escape from events and emotions that nevertheless can cause long-term physical problems including electrolyte imbalances. Instead, women need to learn how to react in a different way… Women who have been through the program report less dissatisfaction with their bodies, increased self-esteem and improved personal relationships," and "They learn that thoughts and emotions don’t have any power over us as they are just passing phenomena and aren’t permanent."
Mindfulness involves techniques and exercises that are very similar to meditation. They could help people live more in the moment, and develop a healthy acceptance of self and become aware of potentially destructive habitual responses.
There is quite a large literature on the use of mindfulness in a variety of clinical situations including substance abuse, oncology, chronic stress, reducing symptoms after organ transplantation, chronic headache and perhaps anxiety.
It will be interesting to see the final results of this study: I shall keep you informed about this and other studies on mindfulness, meditation and acceptance and committment therapy (ACT).
“Peace can be reached through meditation on the knowledge which dreams can give. Peace can also be reached through concentration upon that which is dearest to the heart.”
–Patanjali (Indian Philosopher said to be the Compiler of the Yoga Sutras, Dates Unknown)
"Meditation is not to escape from society, but to come
back to ourselves and see what is going on. Once there is
seeing, there must be acting. With mindfulness, we know
what to do and what not to do to help.”
Thich Nhat Hanh (Vietnamese Buddhist Monk, 1926-)
“Generosity is another quality which, like patience, letting go, non-judging, and trust, provides a solid foundation for mindfulness practice. You might experiment with using the cultivation of generosity as a vehicle for deep self-observation and inquiry as well as an exercise in giving. A good place to start is with yourself. See if you can give yourself gifts that may be true blessings, such as self-acceptance, or some time each day with no purpose. Practice feeling deserving enough to accept these gifts without obligation — to simply receive from yourself, and from the universe.”
–Jon Kabat Zinn (American Mindfulness Meditation Teacher and Associate Professor of Medicine at the University of Massachusetts Medical School, 1944-)
Procrastination and Perfectionism
Regular readers will know that I am convinced that we are now in a fourth phase of the personal development movement, in which it is now incumbent on writers and speakers to support their propositions and suggestions with empirical data. And if there is no data, then they need to collect some.
There is an idea that has launched a thousand self-help books, websites and seminars: that perfectionism is the primary cause of procrastination. There was a time when I was the Prince of Procastinators. After my “recovery” I became an expert on helping others overcome the problem. So I’ve done a lot of research on procrastination. As I was preparing this posting I looked at over a dozen books and two dozen websites, and almost every one of them had “perfectionism” as a or the cause of procrastination.
But is it true?
The answer is “No.”
Professor Piers Steel from the University of Calgary Haskayne School of Business has published an important paper in the current issue of the American Psychological Association’s Psychological Bulletin.
The paper confirms some things that we have always suspected, for instance that most people’s New Year’s resolutions are doomed to failure, but demolishes the idea perfectionism is the root of procrastination.
The evidence from this work – which is the fruit of ten years of research – is that procrastinators have less confidence in themselves and a lower expectancy that they can actually complete a task. By contrast, perfectionists procrastinate less, but they worry about it more.
These are the main predictors of procrastination:
- Low levels of self-confidence
- Low expectancy of being able to complete a task
- Being task averse
- Impulsivity
- Distractibility
- Motivation to complete the task
The paper also makes the point that not all delays are procrastination: the key factor is that a person must believe that it would be better to start working on given tasks immediately, but still not start work on it.
It is said that 95% of people procrastinate at some time in their lives and 15-20% are chronic procrastinators.
Amazingly, there is a mathematical formula that predicts procrastination. Steel calls this Temporal Motivational Theory, which takes into account the key factors such as the expectancy a person has of succeeding with a given task (E), the value of completing the task (V), the desirability of the task (Utility), its immediacy or availability (Ã) and the person’s sensitivity to delay (D).
This is the magic formula: Utility = E x V/ (Ã) D
I am impressed by this work, but it is also supremely practical, because it helps point us at appropriate targets to treat our own tendency to procrastinate.
There is also something else that is very important. Many of us believe from our own experience that perfectionism is indeed the root of our own procrastination. For a long time I thought so myself. But research like his helps us to re-analyze our understanding of ourselves. We all begin by using folk psychology to explain our behavior and the behaviors of other people. The trouble is that those explanations are often wrong. Research like this can be enormously helpful as we grow and develop as individuals.
It remains unclear why some people may be more prone to procrastination, but some evidence suggests it may be genetic. It may also be more common in people with anxiety disorders or attention deficit disorder.
You may also be interested to evaluate your own tendency to procrastinate. There is a terrific resource here.
“If we wait for the moment when everything, absolutely everything is ready, we shall never begin.”
–Ivan Sergeyevich Turgenev (Russian Writer, 1818-1883)
“The wise does at once what the fool does at last.”
–Baltasar Gracián (Spanish Jesuit Philosopher and Writer, 1601-1658)
“Procrastination is opportunity’s assassin.”
–Victor Kiam (American Businessman and Former CEO of Remington, 1926-2001)
“I have spent my days stringing and unstringing my instrument, while the song I came to sing remains unsung.”
— Rabindranath Tagore
(Indian Poet, Playwright, Essayist, Painter and, in 1913, Winner of the Nobel Prize for Literature, 1861-1941)
Decaffeinated Coffee
Your humble reporter has always been skeptical about all those people who ask for decaf coffee because it is supposed to be somehow safer and not cause insomnia.
Not only have I had the philosophical question, “How can chemically altering a natural substance be safer?!” but I’ve seen plenty of people with all the clinical signs of caffeinism after only drinking decaffeinated coffee. You probably know – or perhaps have experienced – the key features:
- Restlessness
- Nervousness
- Excitement
- Insomnia
- Flushed face
- Diuresis (passing excessive amounts of urine)
- Gastrointestinal disturbance
- Muscle twitching
- Rambling flow of thought and speech
- Tachycardia or cardiac arrhythmia (Fast heart rate or irregularity of the heart)
- Periods of inexhaustibility
- Psychomotor agitation
People vary greatly in their sensitivity to caffeine. It is also important to know that caffeine can interact with some medications like lithium and anxiolytics.
Now researchers from the University of Florida College of Medicine in Gainesville, Florida and ConeChem Research in Maryland have published an interesting paper in the Journal of Analytical Toxicology.
The researchers tested ten cup of decaf coffee collected from nine independent and national coffee establishments. They found that drinking five or more mugs of coffee could have the same kick as drinking one or two cups of regular coffee.
The conclusion: you need to know that decaffeinated coffee can contain significant amounts of caffeine that may cause you all kinds of symptoms, as well as possible interfering with the actions of some herbal and homeopathic remedies.
“Moderately drunk, coffee removes vapours from the brain, occasioned by fumes of wine, or other strong liquors; eases pains in the head, prevents sour belchings, and provokes appetite.”
–England’s Happiness Improved (1699)
Alexithymia
There is an important psychological symptom that can cause a great deal of distress, particularly in relationships. It is called alexithymia.
The Harvard psychiatrist Peter Sifneos originally coined the term in 1972 to describe people who had extreme difficulty in emotional cognition. The word “alexithymia” literally means “no words for mood.” People with this problem lacked the ability to understanding, processing or describing their feelings verbally. As a result, most people who have the problem are largely unaware of their own feelings or what they signify. As a result they only rarely talk about their emotions or their emotional preferences, and they are largely unable to use their feelings or imagination to focus and fuel their drives and motivations.
People with alexithymia seem unable to fantasize and many report multiple somatic symptoms. However, alexithymia is also associated with a number of other complaints, such as hypertension, irritable bowel syndrome, substance use disorders, and some anxiety disorders. Their speech is often concrete, mundane and closely tied to external events. So they will describe physical symptoms rather than emotions, and don’t understand that their bodily sensations are signals of emotional distress.
Alexithymia lies on spectrum: regular readers will remember some of our discussions about categorical and dimensional diagnoses. For some people it is little more than an inability to get in touch with their emotions. But at the other end of the spectrum are a number of illnesses in which alexithymia may occur, including schizoid personality disorder, posttraumatic stress disorder, anorexia nervosa or Asperger’s syndrome. It is also much more common in victims of trauma.
Much has been written about alexithymia: a literature search earlier today generated over 8,500 publications.
It is still not clear what causes alexithymia. But this much is clear: in some people, there is a strong inborn predisposition to developing it, while in others it can develop in response to life events such as being raised in a low socioeconomic group with little social stimulation, trauma or chronic stress. For this reason we often talk about primary and secondary alexithymia.
Some neuropsychological studies have indicated that alexithymia may be due to a disturbance to the right hemisphere of the brain, which usually plays a predominant role in processing emotions. Other studies show evidence that there may be a deficit in the transmission of information between the hemispheres of the brain, with emotional information from the right hemisphere not being properly transferred to the language regions in the left hemisphere. Other studies have suggested that alexithymia may be related to a dysfunction of the anterior cingulate cortex a region of the brain involved in the control of attention, empathy, emotion and the anticipation of rewards.
Alexithymia can have some serious consequences. Apart from making relationships very difficult, it is more common in people who have near-fatal asthma attacks or have poor diabetic control. People with a history of alcohol abuse who have alexithymia are more likely to relapse. Alexithymia may predispose people to developing the insulin resistance syndrome.
As you can see, alexithymia can be dangerous: we have to have words for our feelings, or the feelings will express themselves though our bodies. It can predispose us to just about every stress-related illness, and even some illnesses that we don’t normally think of as stress-related. Since alexithymia is all about an ability to express emotions, it can be thought of as a social or informational disease. If we cannot inform others about our wants and needs, and if our minds cannot send us signals to say that something is going wrong, there could be a catastrophe lying in wait for us.
People with extreme forms of alexithymia can be very difficult to help using conventional medicine.
However, many people have minor degrees of alexithymia, and these can be helped by therapies designed to help them express emotions:
- First is to become aware of the problem: I’ve had good success with asking people to keep an emotions “log book:” if they are having odd symptoms, how good are they about having appropriate emotions? I ask them to keep a note of their emotions in response to normal interactions with other people, or while watching television or a movie. If the person feels nothing while watching something really emotional, that can help him or her see that there is a problem. Simply learning to be more expressive can help mild cases: there are an array of forms of psychotherapy that can help.
- In mild cases, we have had some good results with flower essences. There’s not a shred of scientific proof that they help, but clinically they often do. The same goes for two other helpful approaches:
- Homeopathy: there are over a dozen remedies that may help
- Tapping therapies
Music Therapy
Music therapy has been in use for millennia: in the Bible David played his harp to try to ease the suffering of King Saul and there are whole systems of musical healing in the traditional healing systems of China and India. I have commented before on the extraordinary power of music.
Apart from our experience, there is an astonishingly large and diverse body of scientific literature on music therapy, not just to help individuals, but also on possibly improving the performance of health care providers. Many surgeons attest that they do a better technical job if they are listening to music.
This month’s issue of the British Journal of Psychiatry carries an interesting article about the value of music therapy in people with schizophrenic illnesses. Though small, it indicates that music therapy can be helpful, and speaks to the integrity of many components of the nervous systems of people with this large and diverse group of problems.
There is good evidence that music therapy may help with:
- Treatment-related distress in people having treatment for several cancers
- Autistic spectrum disorders
- Calming people who are having cardiac catheterization procedures
- Pain relief
- Distress after total knee replacement
- Pain after leg fractures
- Apathy in people with dementia
- Sleep and heart rate patterns in pre-term babies
This is by no means an exhaustive list: I have found several hundred studies, many of which are quite well designed. There are also several professional organizations such as the American Music Therapy Association.
It is clearly important to choose the right kind of music: I would guess that Metallica is less likely to soothe the fevered brow than Steve Halpern.
Background music can be wonderful for improving the ambience of your home or workplace. But you can also be more focused in your use of music to help or support other types of health and wellness programs.
Select the music that you like: there are now many wonderful programs geared toward using music for healing: I can give you a list of some that I have tested. The good ones will entrain your heart rate, some of your brain rhythms and the subtle systems of your body.
If you can find 20 minutes, the right music listened to while sitting or lying with your eyes closed can be as effective as a short meditation. For this to work well, it is best to use good quality headphones and to allow the music to wash over and soak you like a warm bath, while gradually slowing and deepening your breath.
I’ve also made extensive use of specifically chosen music during massage, acupuncture, yoga, and while practicing t’ai chi ch’uan and qigong. Some purists don’t like using music while doing these activities, but I’ve usually found that music can enhance each type of practice.
Try it and see what you think.
A Very Useful Demonstration of Thought Field Therapy
I have written several times about the tapping therapies: primarily thought field therapy (TFT) and its child: emotional freedom technique (EFT). They also play a central role in the combination of techniques that I discuss in Healing, Meaning and Purpose, and my forthcoming book, Sacred Cycles.
Andy Hunt in the UK has a very nice blog, and I found a reference to another website for the Center for Integrative Psychotherapy. This one contains a very nicely done short video demonstrating TFT.
I’ve had a lot of experience with these therapies, and despite a paucity of research, they really do seem to work with a great many people. This video is a wonderful service: it shows you what to expect from treatment.
Thank you Andy for alerting me to the site, and thank you to Mary Sise for making the video and for making it available for free.
Fibromyalgia and Childhood Abuse
There is a small and growing literature about a link between fibromyalgia and a history of abuse, primarily in childhood or early adolescence.
A new study has shown that people with fibromyalgia who had experienced physical abuse in childhood did not have the normal daily fluctuations in the stress hormone cortisol. They also had sudden surges in the hormone as soon as they were woken up, which can be a good stressor. People who had been sexually abused also had this odd cortisol response on being awakened. These findings suggest that severe traumatic experiences in childhood may be a factor in causing hormonal disturbances in people suffering from fibromyalgia. This adds to the growing body of evidence that in women having pain early in the day, there is a high likelihood that the entire stress hormone system does not function normally.
Colleagues from the Department of Psychiatry, UMDNJ-New Jersey Medical School in Newark, New Jersey have reported that women who have been raped are ten times more likely to experience chronic pelvic pain as well as generalized pain.
Another study has found close correlations between childhood abuse and the subsequent development of chronic pain. The link between rape and the subsequent development of fibromyalgia seems to be mediated by chronic stress, in the form of posttraumatic stress disorder.
What this means is that professionals need to consider this:
- It is important careful to inquire about any history of past or present abuse or other severe trauma
- That empathy and constructive validation of disease and suffering can be very helpful
- That dysfunctional pain behaviors and personality traits may be a consequence of abuse together with a lack of resilience
- That multidisciplinary treatments including psychotherapy may be the best approach to helping people. Using the methods of Integrated Medicine is often far better than reliance on potentially habit-forming medications.
If we remember that there is more and more evidence of inflammation and other physical problems in fibromyalgia, and that stress and maltreatment in early life can alter the structure and function of specific regions of the brain, what this all shows us is that abuse in childhood can have a long term impact on the way in which both the body and the brain functions.
