Category Archives: Research

The Therapeutic Alliance: The Essential Ingredient for Psychotherapy



 I am currently writing on the ‘therapeutic alliance’ – its relation to mindfulness, psychotherapy, understanding, and ‘being listened to…’   What follows is an interesting article that I came across that may interest some of you…


Have you ever tried to change the way you do something? It could be anything — the way you hold your tennis racket, blow into a flute, meditate — you name it. If so, think about that experience. No matter how motivated you were to change, and no matter how much you knew that it would help your serve, musicality, or sense of inner peace, it can be difficult and scary to change even the smallest thing. In order to change, you have to give up your old way of doing something first and then try the new way. That means that for a while you’re in a free fall — you no longer have your old habit to rely on and you don’t yet have the new one.

The anxiety of trying to change something as complex and entrenched as how you relate to people close to you or manage stress takes the feeling to a whole new level. Yet, that’s just what you do when you enter psychotherapy. Just as you had to put yourself into the hand of your teachers and coaches, in therapy you need to gradually do just that with your therapist to help you through what can be a harrowing adventure. The foundation for therapy is called the therapeutic alliance (1, 2). When it’s there, you know that your therapist is there to help you, no matter how hard the going gets.

The therapeutic alliance might be the most important part of beginning a psychotherapy. In fact, many studies indicate that the therapeutic alliance is the best predictor of treatment outcome (3-5).

See entire article:


A mad world A diagnosis of mental illness is more common than ever – did psychiatrists create the problem, or just recognise it?


Unfortunate Events

When a psychiatrist meets people at a party and reveals what he or she does for a living, two responses are typical. People either say, ‘I’d better be careful what I say around you,’ and then clam up, or they say, ‘I could talk to you for hours,’ and then launch into a litany of complaints and diagnostic questions, usually about one or another family member, in-law, co-worker, or other acquaintance. It seems that people are quick to acknowledge the ubiquity of those who might benefit from a psychiatrist’s attention, while expressing a deep reluctance ever to seek it out themselves…

…While a continuous view of mental illness probably reflects underlying reality, it inevitably results in grey areas where ‘caseness’ (whether someone does or does not have a mental disorder) must be decided based on judgment calls made by experienced clinicians. In psychiatry, those calls usually depend on whether a patient’s complaints are associated with significant distress or impaired functioning. Unlike medical disorders where morbidity is often determined by physical limitations or the threat of impending death, the distress and disruption of social functioning associated with mental illness can be fairly subjective. Even those on the softer, less severe end of the mental illness spectrum can experience considerable suffering and impairment. For example, someone with mild depression might not be on the verge of suicide, but could really be struggling with work due to anxiety and poor concentration. Many people might experience sub-clinical conditions that fall short of the threshold for a mental disorder, but still might benefit from intervention.

See link for interesting article on psychiatry…and bits about the importance of psychotherapeutic intervention…

12 Years a Slave

12 Years a Slave

You don’t have to be a huge movie-going fan to know that the Academy Award for Best Motion Picture was “12 Years a Slave,” a riveting historical drama film adapted from the1853 memoir of Solomon Northup, an African American male born in the free state of New York. Solomon was kidnapped and sold into slavery for twelve years before he regained his freedom.

We have at our disposal a new, excellently crafted piece of work that takes us on our own emotional journey as we enter Solomon’s life on the big screen. We are witness to the horrific truth of how people treated each other based on the color of their skin; the miserable practice of slavery in this country. Perhaps one of the reasons for the popularity of the movie is that we can walk away with a sense of relief and happiness in the fact that we have progressed as a people and grown in our compassion and understanding and most of all, our humanity. We can pride ourselves in developing further along the way emotionally and learning to love and care for each other more. Right?

Sadly and unfortunately, not! In a recently published study that appeared in The British Journal of Developmental Psychology, children as young as 7 years of age reported that they believed black children feel less pain than white children do. The study was performed at the University of Virginia and indicates continued racial biases.

Children Playing

Children Playing

Another bias that shows up repeatedly involves the preference for children (both black and white) to play with friends of their own race. What we, as a humanitarian society need to look at, is what type of interventions do parents and teachers need to employ regularly in order to prevent the biases from happening.

The new batch of studies shows that if we are to have any positive method of preventing these biases, the interventions have to occur well before a child reaches the age of ten. The younger the child is, the better; because we are seeing strong biases already existing in 7-year-olds.

I can’t think of any better way to express it than Lieutenant Cable. Some of you may remember the name from the magical team of Rogers and Hammerstein and their sensational presentation, South Pacific, all the way back in 1949.

South Pacific

South Pacific

“You’ve Got To Be Carefully Taught”

You’ve got to be taught to hate and fear,
You’ve got to be taught from year to year,
It’s got to be drummed in your dear little ear,
You’ve got to be carefully taught.

You’ve got to be taught to be afraid
Of people whose eyes are oddly made,
And people whose skin is a diff’rent shade,
You’ve got to be carefully taught.

You’ve got to be taught before it’s too late,
Before you are six or seven or eight,
To hate all the people your relatives hate,
You’ve got to be carefully taught!

From the looks of things, maybe we haven’t really progressed as much as we think we have when it comes to certain things.

Judy is a licensed clinical social worker and has worked extensively as a counselor with children, adolescents, couples and families. Judy’s professional experience in the mental health field along with her love of writing, provide insight into real-life experiences and relationships. Her fresh voice and down-to-earth approach to living a happier, more meaningful life are easy to understand and just as easy to start implementing right away for positive results!

Happy Heart – Healthy Heart

Panel Discussion

Panel Discussion

Earlier this week, Circulation, an online journal published the newest findings of a 12-person panel of experts who went on record determining that depression should be listed as a risk for heart disease along with already known risk factors such as obesity, smoking, high blood pressure and diabetes.

The recommendation was made to the American Heart Association (AHA), after Robert M. Carney, PhD, and Kenneth E. Freedland, PhD, both professors of psychiatry at Washington University School of Medicine in St. Louis and ten other experts in the field performed an extensive review of hundreds of studies in the scientific literature that looked specifically at correlating depression and heart attacks and eventual death from heart disease.



Doctors Caney and Freeland have been studying the effects of depression on heart disease for more than 25 years when they reported the increased risk of more severe cardiac problems in patients with pre-existing heart disease, who also were diagnosed with depression. A very high percentage of all the studies they conducted since beginning in 1988, support their findings that depression is a risk factor for death in people with heart disease.

Unlike definitive findings that are found when obese people lose a significant amount of weight in a healthy way, or people who successfully quit smoking or manage to lower their blood pressure; there are very few studies that support lowered risk of heart disease in people who undergo treatment for depression.

Heart Disease

Heart Disease

A large cause for this might be that for most people who suffer from depression don’t ‘quit’ depression the way they quit smoking. Even with proper treatment, depression isn’t known to ‘lower’ the way blood pressure lowers when treated properly. And as with many psychological issues, neither cause nor effect is as clear cut and easy to draw conclusions from.

Carney and Freeland are undaunted, however. They are ready to begin new studies with different approaches to treatment for depression so they can determine if these new approaches conclusively show a decrease in lowering heart problems. For now, it is clear that treating depression might effectively impact both the health and quality of life of a person and so, the commitment to continued research lives on.

Citations Circulation, Feb. 24, 2014

Judy is a licensed clinical social worker and has worked extensively as a counselor with children, adolescents, couples and families. Judy’s professional experience in the mental health field along with her love of writing, provide insight into real-life experiences and relationships. Her fresh voice and down-to-earth approach to living a happier, more meaningful life are easy to understand and just as easy to start implementing right away for positive results!

What Color Is Your Flower?

Unable to Focus

Unable to Focus

The other day, I read something that spoke about neuro scientific research reporting that the average person spends 13 per cent of their time in a frame of mind that is best described as “zoned out.”

At first I felt upset with this information, considering all the wasted time that this indicated my mind wandered. But as I read on, the tone of the article remained upbeat and optimistic. Why? Because these periods where we zone out and don’t have the cognitive awareness we feel we should possess are actually good for us. Yep, it seems they are vital to our being able to stay imaginative and creative. This is the place where our brains free float through what seems like insignificant streams of consciousness.

The reality is that these places of spontaneous thinking are the birth places of creativity and imagination. They are places where our judgmental selves don’t have a chance of surviving so we are free to just let ourselves go. These zone out times permit us to unleash restrictive, rational thought and just allow whatever comes to come.

I have nothing against rational and logical thinking. Far from it. Thinking logically is totally necessary and a good thing. But giving our brains the ability to zone out and just free-flow is equally necessary and provides us with a healthy compliment to routine, structured and rational thoughts.

Harry Chapin

Harry Chapin

One of my favorite songsters of all time is Harry Chapin. I hope most of you have heard of him and remember him, not only for the songs that were the most popular like “Taxi” or “Cats in the Cradle” although they were good songs with a message or story to tell too. But the song that comes to mind is called “Flowers are Red,” a song with a wonderful message about society’s traditional response to thinking differently and seeing things through a lens that is different than the one most of us see through.

There is a degree of comfort in knowing we are all alike and zeroing in on all the similarities we share with our fellow human beings, but there is also something extremely worthwhile when we celebrate our differences and our being unique. There is so much we can learn from these differences. We can complement each other because of these differences if we learn how to embrace them and value them.

This is still something I am learning how to do better. Sometimes my knee-jerk reaction is to expect other people to think the way I think or feel the way I feel and I get upset if they don’t. I want to feel more connected to them and I mistakenly think if they are more like me then we are more connected.

Embrace Diversity

Embrace Diversity

Relationships take a lot of work because of the differences. We need to learn how to accept and respect people despite them. Even if we are similar to another person in our beliefs, the times when we have our zone out moments may not be the same. We may be experiencing something quite crucial to us when our most trusted and closest confidant is going through a zone out moment and is unable to be there to understand.

We may be zoned out when our co-worker asks us for our utmost attention or when our son or daughter is facing potential danger.

Nobody said relationships were easy, and with some of the newer finding about human behavior, we are able to better understand ourselves and each other; and hopefully help us deal with each other with more understanding and kindness.

And what better time to start than right now as this holiday season begins?

Schizophrenia and Poverty, Crime and Violence



Schizophrenia and Poverty, Crime and Violence
For people who have schizophrenia, and don’t get treatment, the result is far too often that they end up homeless or in jail (most often due to minor offenses).
  • Approximately 200,000 individuals with schizophrenia or manic-depressive (bipolar disorder) illness are homeless, constituting one-third of the approximately 600,000 homeless population (total homeless population statistic based on data from Department of Health and Human Services). These 200,000 individuals comprise more than the entire population of many U.S. cities, such as Hartford, Connecticut; Charleston, South Carolina; Reno, Nevada; Boise, Idaho; Scottsdale, Arizona; Orlando, Florida; Winston Salem, North Carolina; Ann Arbor, Michigan; Abilene, Texas or Topeka, Kansas.
  • At any given time, there are more people with untreated severe psychiatric illnesses living on America’s streets than are receiving care in hospitals. Approximately 90,000 individuals with schizophrenia or manic-depressive illness are in hospitals receiving treatment for their disease.
    Source: Treatment…

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When Ignorance Begets Confidence



“There are few people whom I really love, and still fewer of whom I think well. The more I see of the world, the more am I dissatisfied with it; and every day confirms my belief of the inconsistency of all human characters, and of the little dependence that can be placed on the appearance of either merit or sense.”  Pride and Prejudice by Jane Austen

I begin with this quote to convey the feelings evoked in a recent exchange with a neighbor, one in which surprise (and some horror) was felt during the course of the conversation.  Logic and ‘reasonableness’ had little place in the interchange. I had just been reading a short article that looked at particular German words that gave expression to complex emotional states. An excerpt is as follows: 

“Fremdschämen describes embarrassment which is experienced in response to someone else’s actions, but it is markedly different from simply being embarrassed for someone else….Fremdscham (the noun) describes the almost-horror you feel when you notice that somebody is oblivious to how embarrassing they truly are.” Further…”Fremdscham-inducing events…usually cause one to ask this question: “how on earth can these people be unaware of how stupid they are being right now?”.

I invite you to read this short article on the cognitive bias created in the Dunning Kruger effect – an effect that causes one to be unaware of their performance – and their incompetence.

CG Jung and the ‘Leap of Faith’ Into Individuation


The Red Book has been described as Jung’s creative response to the threat of madness, yet it has also been seen as a deliberate exercise in self-analysis. I believe it’s likely both. When creating The Red Book, Jung knew he was on the verge of madness, and he also knew his analytical skills and expertise as a psychiatrist were his best chance at alleviating suffering, if not creating the conditions for transformation.

In many regards, The Red Book reads like a healing journey — a phrase often used to describe the reclaiming of self after a history of abuse — which is a transformative period that happens for many people committed to overcoming early life trauma. On the way to an authentic self there is first the need to step away from the person one became to survive abuse. Those confronted with this journey often experience a period of ‘going crazy’ on their way to establishing an authentic sense of self.

As The Red Book shows, individuation is a blessed curse. It opens the way to becoming one’s authentic self, and yet also the risk of alienation from the ‘tribe’. Childhood trauma survivors often know this conundrum intimately. Transformation requires a significant reorienting away from the beliefs, feelings, fantasies, and body states that made possible living in traumatizing conditions. Invariably, there is a part of the self that has gone unacknowledged or rejected, and aches to be reclaimed.

In The Red Book Jung found a process for continually rediscovering authenticity. As he often remarked, individuation is an ongoing journey and not an endpoint reached. Jung also intimated the need for what I called in an earlier post leaps of faith: turning away from the larger world’s expectations and towards one’s inner world of wisdom with acceptance and curiosity.

This quote from The Red Book inspires the impulse to creatively go forth into all that you are:

“Woe betide those who live by way of examples! Life is not with them. If you live according to an example, you thus live the life of that example, but who should live your own life if not yourself? So live yourselves.

“The signposts have fallen, unblazed trails lie before us. Do not be greedy to gobble up the fruits of foreign fields. Do you not know that you yourselves are the fertile acre which bears everything that avails you?”

Jung knew such a ‘leap of faith’ is not easy. He also wrote:

“To live oneself means: to be one’s own task. Never say that it is a pleasure to live oneself. It will be no joy but a long suffering since you must become your own creator.”

But he gives helpful advice for the journey, particularly how to live if the world feels contrary to whom you are becoming. Then you must learn to be your own guide:

“To certain things of the world I must say: you should not be thus, but you should be different. Yet first I look carefully at their nature, otherwise I cannot change it. I proceed in the same way with certain thoughts. You change those things of the world that, not being useful in themselves, endanger your welfare. Proceed likewise with your thoughts. Nothing is complete, and much is in dispute. The way of life is transformation, not exclusion. Well-being is a better judge than the law.”

Reprinted in full with permission by the original author Laura K. Kerr, Ph.D, who moderates the blog, Trauma’s Labyrinth: Finding Ways Out Of Trauma. Laura K. Kerr is a mental health scholar, blogger and trauma-focused psychotherapist. [Her] focus is on healing, with special attention to trauma, modernity, and mental health systems of care.

Stress and Memory From a Neuroscience Perspective

Stress and Memory From a Neuroscience Perspective







“From a neuroscience perspective, amnesia in the absence of brain damage can be partially explained in biochemical terms. Stress causes a chemical reaction that affects regions of the brain responsible for memory. With repeated overwhelming stress, neurotransmitters and stress hormones are released in the brain in such excess quantity that they can adversely affect portions of the brain responsible for emotional memories as well as other kinds of memory.” p. 33, The Wandering Mind: Understanding Dissociation from Daydreaming to Disorders by John A Biever, M.D. and Maryann Karinch.

i'm not out to convince you or draw upon your mind*Image Credits (all work used with permission through CC license)–
“i’m not out to convince you or draw upon your mind” by Andrea Joseph
“Standing at the Gates of Hell” by Shane Gorski

The Language Of Schizophrenia


Professor Robert Sapolsky finishes his lecture on language and then dives into his discussion about schizophrenia. He discusses environmental factors as well as genetic characteristics that could apply to people who are affected. He describes schizophrenia as a disease of thought disorder and inappropriate emotional attributes. [quoted from the description box beneath the video]