Triple Point Series: Dealing With Cancer
Triple Point Series – Dealing with Cancer from Medical Psychology Center on Vimeo.
Triple Point Series – Dealing with Cancer from Medical Psychology Center on Vimeo.
By Guy R. Croteau, MSW, LICSW
Psychologists, psychiatrists and other mental health professionals agree that homosexuality is not an illness, mental disorder or an emotional problem. Adolescent children need to know that their parents, mental health and primary care providers understand them, accept them and help them through potentially difficult times. It has been over 25 years that both the American Psychiatric Association and the American Psychological Association urged mental health professionals to help dispel the stigma of mental illness that some people still associate with homosexual orientation. However, statistics show that our gay and lesbian youth are at higher risk for hate crimes, homelessness, substance abuse and suicide. Education about sexual orientation and homosexuality is likely to diminish anti-gay prejudice, reduce physical harm and improve overall physical and mental health. Moreover, fears that access to such information as an origin for homosexuality have no validity. Accurate information about homosexuality is especially important to young people who are first discovering and seeking to understand their sexuality—whether homosexual, bisexual, or heterosexual. To fully understand sexuality, it is important to clarify the distinctions between biological gender or sex, gender identity, social gender roles and sexual orientation. Our biological gender/sex refers to that of being male or female and having the physical and genetic components that make up males and females and in rare cases, both (hermaphrodites). Gender identity is the psychological sense of being male or female. Social gender roles are those cultural norms and societal rules for masculine and feminine behaviors. Sexual Orientation involves the emotional, romantic, or sexual feelings to another person that appear on a continuum from exclusive heterosexuality (opposite sex) to various forms of bisexuality (both sexes) to exclusive homosexuality (same sex). Orientation differs from behavior because it refers to feelings of concept. Persons may or may not express their sexual orientation in their behaviors. Research suggests various components make up a persons sexual orientation including a complex interaction of environmental, cognitive and biological (including genetic and hormonal) factors, which differ from person to person. For example, studies indicate neurochemical and neurophysiological differences between individuals of different sexual orientations. One neuroanatomist at the Salk Institute examined the hypothalamus of deceased men and found a difference in size between heterosexuals and homosexuals, suggesting a biological mechanism involved in sexual orientation.
Studies conducted at Northwestern University and Boston University found that if one sibling is homosexual, the chance of another sibling being homosexual is as follows: 52% for an identical twin, 22% for a fraternal (non-identical) twin and 10% for adopted or non-twin genetic siblings. The results suggest a strong genetic component for sexual orientation.Is it a choice? According to the APA and most of the scientific community the answer is ‘no.’ Sexual orientation emerges for most people in early adolescents without any prior sexual experience and cannot be voluntarily changed. “Gay male adolescents report becoming aware of a distinct feeling of ‘being different’ between ages 5-7; they also report that they did not yet connect this feeling to the issue of sexuality” (Journal of School Health, September 1992). The median age at which lesbian and gay youth become aware that their feelings of ‘difference’ are linked to a same-sex orientation is 13 and 9% of high school students identify as ‘gay, lesbian, bisexual or questioning’.But being gay is not simply a desire for sex with the same sex. That is homosexuality. Being ‘gay’ is also an identity, a culture, a community, a place. And while some are born homosexual, there is a choice to be gay. This requires strength and courage to create a space in which gay men and lesbians can define their lives as fundamentally part of rather than marginalized from the rest of society. Why Should We Care?Here are just a few statistics that primary care providers, mental health professionals and other allied health professions should be concerned with:According to a 1992 study in Philadelphia, 19% of gay men and 25% of lesbians report suffering physical violence at the hands of family members as a result of their sexual orientation.The Journal of Pediatrics reports that 26% of adolescent gay males report having to leave home as a result of conflicts with their family over their sexual orientation.According to the US Department of Justice, homosexuals are probably the most frequent victims of hate crimes in the U.S. and that 20% of LGB Youth report skipping school at least once a month because of feeling unsafe while there.The “Streetwork Project Study” (1991) report that 42% of homeless youth self-identify as gay or lesbian. They also report that 42% of adolescent lesbians and 34% of gay males who have suffered physical attack also attempt suicide.In 1992 it was reported that 68% of adolescent gay males used alcohol and 44% used other drugs. 83% of adolescent lesbians used alcohol and 56% used other drugs.The CDC reported in 1995 that 31% of LGB students have used cocaine as opposed to 7% of non-LGB students.What Can Be Done to Overcome the Prejudice and Discrimination that Gay Men, Lesbians, and Bisexuals Experience? Research has found that the people who have the most positive attitudes toward gay men, lesbians and bisexuals are those who say they know one or more gay, lesbian or bisexual person well—often as a friend or co-worker. For this reason, psychologists believe negative attitudes toward gay people as a group are prejudices that are not grounded in actual experiences but are based on stereotypes and prejudice. Furthermore, protection against violence and discrimination is very important, just as it is for other minority groups. Some states include violence against an individual on the basis of his or her sexual orientation as a “hate crime” and 10 U.S. states have laws against discrimination on the basis of sexual orientation.In 1973 the American Psychiatric Association confirmed the importance of the new, better-designed research and removed homosexuality from the official manual that lists mental and emotional disorders. Two years later, the American Psychological Association passed a resolution supporting this removal. For more than 25 years, both associations have urged all mental health professionals to help dispel the stigma of mental illness that some people still associate with homosexual orientation. Yet we still face important challenges to help our gay youth continue to accept themselves and avoid both internal and external conflicts as they develop. In 1992, a young lesbian student reported in a public hearing conducted by the Massachusetts Governor’s Commission on Gay and Lesbian Youth “Due to societal fear and ignorance, my teachers and counselors labeled my confusion as rebellion, and placed me in the category of a trouble discipline problem. But still I had nothing to identify with and no role models to guide me, to help me sort out this confusion, and I began to believe that I was simply alone. A few weeks into my sophomore year, I woke up in a psych hospital after taking my father’s camping knife violently to my wrists and hoping for success.” What to look forThe signs of distress in gay, lesbian and bisexual youth are no different than that of the general population. It is crucial for caregivers and parents to be aware of danger signs indicating the need for psychological treatment include: expressions of hopelessness, helplessness, and anger to oneself or the world; withdrawal and isolation; marks on the body, scratching and other evidence of self-destructive acts; acute personality changes or moodiness or new involvement in high-risk activities; sudden dramatic decline or improvement in academic performance; sleeplessness, excessive sleeping, chronic headaches, disturbances in appetite or eating; use or increase use of substances. Clinicians who are sensitive to the needs of the GLBT population work towards creating a safe refuge for youth and their families so they can evaluate the negative messages they receive from culture and society. We work with families to forge important dialogues about varying beliefs as well as help the gay man, lesbian or bisexual form healthy identities and lead productive lives. If you are interested in discussing these issues or would like to refer a patient, please feel free to contact the Medical Psychology Center at (978) 921-4000, ext. #16.
The complaint of daily or nearly daily headaches could be the result of overuse of pain medication by headache sufferers. Clinical reports and articles over the past fifteen years have noted that along with certain prescription medications such as ergotamine, the frequent use of analgesics including aspirin, acetaminophen, and ibuprofen, alone or in compounds, may contribute to the occurrence of analgesic rebound headaches. Daily use of analgesics could result in chronic head pain in adults and children (Vasconcellos, et al,1998).
What constitutes “overuse” appears to be quite variable: some studies note that daily use, even for only a few days, may set up this vicious cycle where pain increases as the effect of the medication wears off and the pain is then treated again with the analgesic, often with decreasing effectiveness. While the phenomenon is not fully understood it appears that the daily use of the analgesics seems to interfere with the body’s pain-blocking system. Interestingly, analgesics appear to only induce headache in headache sufferers, not in patients being treated with analgesics for other painful conditions such as arthritis.
A recent physician survey (Rapoport, et al, 1996) found that 73% of patients seen with this condition were women and it occurred most frequently in patients in their thirties. No one analgesic was consistently shown to be problematic. Physicians responding to the survey noted a high incidence of depression as well as gastrointestinal symptoms in their populations.
Prevention & Treatment A 1995 article in The British Medical Journal (Olesen, J.) recommends that patients not take analgesics every day (setting a maximum of 15 days a month) and that narcotic and compound analgesics should be avoided as far as possible. The author also suggests that the frequency of use of ergotamine and sumatriptan be limited.
Discontinuing daily analgesic usage should occur under a physician’s care. Weaning from the analgesic with the use of other medications (amitriptyline is frequently cited) along with psychological support can contribute to a highly favorable prognosis according to most reports. Improvement may take several months and hospitalization may be necessary in some cases.
Psychophysiological interventions such as biofeedback, relaxation training and cognitive therapy have been found to be as effective as pharmacological treatment in many headache patients (Arena, J. & Blanchard, E. 1996; Hatch, 1993). These non-drug interventions can be very helpful in the management of headache patients and could help prevent the overuse of pain relievers that may lead to chronic daily headaches.The Medical Psychology Center offers behavioral and psychological treatment services for headache. If you have any questions or would like to make a referral, please call the Center at (978) 921-4000.
Cognitive Therapy
By Timothy Hynick, PsyD
Persons usually pursue psychotherapy for a variety of reasons including; a wish to explore areas of concern in their life, receive support to help them conquer a developmental hurdle, or to obtain relief from unpleasant thoughts or feelings. When persons struggle with symptoms of anxiety or depression, they may experience a less productive thought process. There are a variety of psychotherapeutic approaches available to persons who are seeking support. Cognitive therapy is one such treatment intervention.
Cognitive therapy (CT) is a treatment approach that examines the role of thoughts/beliefs as they impact upon a person’s behavior and emotion. CT is used to help one gain a better understanding of the manner in which their perceptions and beliefs impact upon their daily life. It especially focuses on exploring thoughts and ideas that may be faulty and restrict one’s behaviors. CT is utilized for a variety of disorders including anxieties, phobias, depression, and relationship issues.
CT is an active mode of treatment intervention that often includes the development of assignments for the client to complete outside of the treatment sessions. A major objective of the assignments is to help the person explore the reality of their perceptions. CT also helps a person become more aware of their automatic thoughts. These are ideas that one may immediately entertain or believe but which may not be accurate. CT also explores errors in thinking described as cognitive distortions. Some typical cognitive distortions may include;
1) Catastrophizing (thinking the worst in a situation)
2) Magnifying (blowing things out of proportion)
3) Minimizing (glossing over positive factors in a situation)
4) All or none thinking (not being able to entertain the “grey areas” in a situation.
5) Jumping to conclusions about an issue (without exploring the range of possibilities)
CT is generally regarded as a short-term treatment intervention that can be effective to address a focused area of concern and to help a person gain relief of symptoms of anxiety or depression. However, it must be noted that there are different schools of CT that include more long-term therapeutic interventions. Some of these variants may include approaches that examine one’s “life story” and the development of their belief system. Another version described as cognitive-interpersonal is utilized to help a person examine their internal working models of self and others. In these longer term therapies, therapist and client may examine core beliefs, the developmental history of those beliefs, and their deeper meaning.
Although CT may be a goal-directed and shorter term treatment intervention, it is important to remember that it is not a technical or mechanical approach to treatment that does not include respect for the role of emotion. Rather, cognitive therapy examines the interplay of feelings, thoughts, and behaviors. Finally, any approach to psychotherapy will not be successful if there is not a positive and trusting therapeutic alliance as well as an understanding of a person’s development and history. These are important assessment interventions utilized in any school of cognitive therapy.
If you would like to schedule an appointment, please contact Timothy Hynick, PsyD at 978-921-4000 ext 32.
HOMEWORK BATTLES
Dr. Robert Gallant
Recognize that your role in homework is as a helper, not a doer. Once you get the role straight, your battle is half over. The responsibility rests in your kid’s hands, not yours.
Homework enhances not only children’s learning but also essential skills they will need to succeed in school and in life, such as organization, problem solving, attention span, memory, goal setting, discipline, and persistence. But sometimes in our quest to help kids succeed, we get carried away and provide too much help. Here are some strategies to be used as a guide to help your child become a more successful and independent learner:
Strategies to Ease Homework Pains
You may feel these suggestions put more pressure and responsibility on you. At first it is extra work. But we need to teach study skills to our kids allowing them to compensate for inner disorganization & to create good habits in the future. The older the child is, the harder it will be to break the old routines and establish new ones. As they get used to the routine, and begin to see themselves succeeding, it will get easier and take less time each night.
ART THERAPY
By Suzanne Speede, MA, ATR-BC, LMHC
Art therapy is the therapeutic use of art making, within a professional relationship, by people who experience illness, trauma or challenges in living, and by people who seek personal development. Through creating art and reflecting on the art products and processes, people can increase awareness of self and others cope with symptoms, stress, and traumatic experiences; enhance cognitive abilities; and enjoy life-affirming pleasures of making art.
Art Therapists are professionals trained in both art and therapy. They are knowledgeable about human development, psychological theories, clinical practice, spiritual, multicultural and artistic traditions, and the healing potential of art.
Art Therapy has many benefits. It is a particularly useful tool to help children express themselves verbally and non-verbally. The opportunity to grow emotionally, socially and cognitively is possible through the art process. Children that might have difficulty expressing themselves with words are offered creative ways to communicate their thoughts and feelings. When children are able to communicate in a natural way, such as through drawing, painting, collage, and sculpting, to name a few, they learn to effectively express themselves and to get their needs met appropriately. Art therapy provide a safe, non threatening, non judgmental environment where children can have fun and enjoy sharing their stories. The art created in a therapy session provides a tangible object that reflects the child’s feelings, needs and issues which the child may otherwise not be able to talk about directly.
Therapeutic benefits of Art Therapy:
To make an appointment at Medical Psychology Center,
please contact our intake coordinator at (978) 921-4000×18
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