Tuesday, June 1, 2021

Why EMDR and other nonsense hangs around

 


When Prince Harry talked about EMDR, my heart sank. People talking about mental health is usually good, but when they promote quackery, they do a lot of harm.

But EMDR is reckoned okay by organisations like the NHS and more, you might say. Yes, and the lobotomy was considered brilliant and the doctor who pioneered it was awarded a Nobel prize.

So, am I trashing the profession? No, I’m using this to explain some of the issues you should be aware of so that you can make more informed decisions.

The thing is, we are constantly learning more about our world and ourselves. As a result, ideas and theories are accepted one year and discarded the next.

The lobotomy is an extreme example that I used to get your attention but it’s not strictly speaking in the field, so let’s take something more appropriate and accessible.

About 100 years ago, Alfred Adler proposed that personality is linked to birth order. Being the eldest, youngest and middle child shapes who you are, he said.

For some years, his theory was accepted. A load of people wrote papers and books supporting the idea.

However, evidence disproving the theory also emerged. Lots and lots of evidence. Loads of it. As it piled up, Adler’s theory became less popular and less accepted.

Today you’ll not find many psychologists who believe that birth order influences personality. But that doesn’t mean it’s vanished. There are people who hang on to the idea.

The question is why. I think there are several answers.

1. Understanding scientific method takes training. Critically evaluating a quantitative psychology experiment, for example, includes knowing how sample selection, methods of statistical analysis and other elements affect the work. On top of that, you need to relate the findings into context of other work.

It really is a challenge. Although all practitioners are trained, it is generally the academics who are more practiced at this. And even many of the academics struggle to evaluate and keep up with new work.

Also, as psychology is a massive field, professionals tend to work in niche areas. Me, I read papers devoted to depression, anxiety and abuse but I’m hopelessly lost reading papers on other subjects. Reading out of your field is like a marathon runner having a go at sailing.

2. Practically speaking, a new theory is always controversial. Informed evaluation takes a lot of time.

It typically takes years for a new idea to be thoroughly examined.

During this time, people become attached to the work. This is quite normal. When you've spent months or years on a subject, it's very hard to say, "Well that sucks. On with the next idea."

So ideas hang around a lot longer than they should within the profession.

3. The public also become invested. Theories need to be tested, and it’s rare for a new approach not to help someone, somewhere. So when professionals announce that their last idea hasn’t panned out, there is public disappointment.

As explaining why a theory or approach is problematic or even bogus can be difficult, and "because I said so" doesn't go over well, a lot of us don't speak up.

Maybe we should, but there’s another problem...

4. Crooks, cons and folk intent on making money and gaining influence work very hard to market nonsense. They typically offer absolute certainty (i.e., a sure fix) with a touch of scientific sounding hocus pocus. Very often, they set up schools and associations with themselves as chief guru. Scammers are really hot at monetising!

When consumers are faced with a choice between, "There are few certainties and we're learning constantly but I'll do my best for you" and "Here's a sure-fire fix, cross my palm with silver for total satisfaction guaranteed, you can trust me, honest" it's terribly tempting to settle for the nonsense. Because we desire certainty in an uncertain world.

5. When professionals see consumers falling for scams, outdated theories and so on, they want to speak out. However, the quacks who have invested in the scheme scream blue murder. Very often, the quiet words of sense are drowned out by those who yell loudest.

Whistle-blowers tend to be punished and mental health professionals are human. We get tired of being attacked by mobs demanding we respect quack theories. Because of public pressure, now even hospitals have "alternative therapy" and "complimentary therapy."

Below is a list of therapies that professionals believe are harmful or bogus (from a journal paper published in 2008) It’s an eye opener. You'll see that EMDR has been on the nonsense list since 1996.

6. Finally, as nonsense is easier to sell and takes less effort, some mental health professionals give in and join the dark side. Doctors too. I know of several psychologists and two local doctors who have left proper practice in order to sell quackery.

Frankly, sometimes I think I should increase my fees tenfold and sell neurolinguistic programming (NLP), EMDR and dream interpretation. But I just couldn't face myself in the mirror. It's a real shame because my crazy cat lady image would fit in really well.

In short, it takes an awful lot of work to tell what's what. And as 'truth' is temporary and evolving, there is a lot of controversy.

As for EMDR, read the articles below that dig into it. They explain simply what’s wrong with it

Having said all this, if you want to go for it, feel free. You're an adult and you make your own decisions. Thankfully, EMDR won't hurt you. Except that it tends to cost a lot more than plain old exposure that does the job and without the hocus pocus.

So, there's my take on the subject. If you want to fight, that's cool. I'm available Tuesday afternoon.

If you have questions or comments, say so below or PM me. I’ll try to answer and if I don’t know, I will ask others to contribute. Do note that they may be shy because of point 5.

Here's a list of topics I’ve seen this week that I put firmly in the nonsense and avoid section. I'll add some web sites and papers at the end of this post.

Attachment therapy
Conversion therapy
Eye movement desensitization and reprocessing (EMDR)
Law of attraction
Myers-Briggs Type Indicator
Neuro-linguistic programming (NLP)

Some good resources

An easy-to-read paper, Psychological Treatments to Avoid, by Dr. Timothy C. Thomason, Northern Arizona University
https://files.eric.ed.gov/fulltext/EJ911995.pdf

Index of Questionable Treatments from Quackwatch
https://quackwatch.org/related/treatmentindex
 
A nice easy paper on some of the common research study problems Why Most Published Research Findings Are False
https://journals.plos.org/plosmedicine/article?id=10.1371%2Fjournal.pmed.0020124&fbclid=IwAR03xI9mK7AstLrdgpg16y5vPb27Uu_0TW2-NVwy299BG08osBJcZhHt79A

It's free, easy to read, and there's a chapter on avoiding scammers
https://www.draft2digital.com/book/635773
 
Why EMDR is bogus
http://skepdic.com/emdr.html

Image courtesy of Gerd Altmann from Pixabay

Monday, May 24, 2021

Want new insight? Use this perspective exercise

We tend to be awesome at advising friends, but when it comes to giving ourselves good advice, it can be a different story. This is because we tend not to see our own situation clearly.

We find it hard to advise ourselves for many reasons, including:
"    Our self-image, "I should be XYZ" gets in the way
"    Our inner fears sabotage us
"    We can't analyse other people's behaviour clearly because we our feelings about them get in the way

A perspective exercise helps you step away and gain a fresh perspective. This is how it works.

Suppose Rachel has a problem that goes like this. "I am in a relationship with John, and we've been dating for three months. We're exclusive and we're getting along really well. He's hot and sweet and sexy and I think he is The Real Thing. So, he disappears from time to time. I thought he was at the library, studying, but then I walked past Starbucks and there he was WITH HIS EX!!! My heart just died. I had no idea he was still seeing her."

Step 1: Tell your story, but tell it as if it's happening to other people.

Pro tip #1: it helps to switch genders around so you get rid of gender stereotyping issues
Pro tip #2: make up names of people you don't know, so you see them as strangers

"Fred is in a relationship with Julie. They have been dating for three months. They're exclusive. One day Fred thinks Julie is at the library but when he walks past Starbucks, he sees Julie having coffee with her ex. This surprises him as he didn't realise Julie was still in touch with him."

Step 2: examine the story and identify the underlying issue. "Fred is surprised because Julie is talking to her ex. It may be because he feels his partner hid information. And he may also be jealous or insecure."

Step 3: give good advice to the people in the story.
Pro tip #3: It helps to do this in bullet points
"    You fear she is hiding information from you but you are jumping to conclusions: she may have just bumped into him
"    Why do you feel unsettled by her seeing her ex for a coffee? What exactly are you worried about?
"    Also, how do you feel about exes in general? Note: people have the right to friendships, and that includes friendships with exes.
"    Fred should talk openly to Julie about the issue.  Then they need to work out how to communicate better

Step 4: now examine your issue again and see if the advice you gave applies to yourself.

Of course, this looks much easier than it is. It can be quite hard to tell your story as if it's happening to other people - and you have to be super good about not framing the story so that you give yourself the advice you secretly want to follow ??

But on the whole, I find this a super useful exercise and it gets easier as you practice. So have a go and let me know what you think

Sunday, April 25, 2021

How to listen to abuse victims. Communicating as an ally in multicultural situations.


When your friend or colleague tells you they were abused, are you stuck for words? Here are some ideas for how to communicate as an ally.

Before you start, understand that violence and abuse are common.

Statistics from the World Health Organisation:
7% of men were sexually abused before age 18
20% of women were sexually abused before age 18
25% of adults have a history of being physically abused as kids
50% of kids today have suffered from violence in the last year

Consequences of violence:
It's not just physical harm. Victims suffer from low self-esteem, anxiety, depression and other mental health issues as well as physical damage.

Why violence continues:
Violence is passed down through families. A kid that is abused is more likely to learn this behaviour and then abuse their own kids.

There is no easy quick fix. To stop violence, we must all work together.

#1 Thing to do: shut up and listen
Those statistics show that this is a common problem but there is a massive conspiracy of silence. It takes huge courage for victims to speak out. So when they do, listen with love.

#2 Don't make helpful suggestions
Why is there a conspiracy of silence? Because victims who speak up are told, "They didn't mean it" and "Those were different times" and "You should forgive."

Anyone who says "You should forgive" and makes excuses is really saying, "I'm totally okay with people abusing you." <- don't do this.

#3 Don't ask for details
Making people relive trauma is cruel. <- don't do this.

Also, it can come across as judgmental, as if you get to decide what is abuse and what isn't. Unless you happen to be the sitting judge in a court case, you don't get to decide.

#4 Do say, "I'm sorry this happened to you."
Victims are used to being blamed, dismissed and hurt, so let them hear your support.

#5 Don't ask why they didn't leave or fight back
Because it sounds like, "You were asking for it." <- don't do this

#6 Ask, "What can I do to support you?"
And accept that sometimes the answer is, "Just listen."

#7 Inch forward and accept there are no solid rules.
There's a lot of narrative that says "Call rape, rape" and "Call out the perpetrators." With respect, that's great stuff for privileged people.

For some people, that direct vocabulary can be triggering. And the mere idea of calling out a violent person can have victims panicking. This is especially true in societies where victims of abuse are murdered or jailed.

Just be gentle, listen and let them talk.

#8 Say, "You didn't do anything wrong" and "You are the victim in this."
Because guilt comes from punishment. We tend to think that guilt follows wrongdoing but that is very much not true. Guilt comes from pain, from hurt, from danger. So victims need to hear that they are not to blame. That they're good people, and victims.

#9 If the victim is up for it, and it is safe to do so in your society, offer to help source them help.
Telling the story is exhausting. So if your friend or colleague is tired, you can offer to sort through available support groups (NGOs, government departments etc) and get help.

Note: not all support systems are good. Some exist to blame victims. So as the friend, be certain to weed out the black hats. Check around, ask questions, search social media to see what these groups post and how people talk about them.  

I hope this helps 💙 

Photo credit: Alexas 

Tuesday, March 9, 2021

The Introvert’s Guide To Socialising

Are you secretly relieved that the Covid lockdowns have given you a really good excuse to avoid social obligations? If so, you’re not alone.

Usually, we talk about introverts being drained and/or overwhelmed by social interaction and extraverts being fueled by social interaction. And typically, we think that people are one or the other.

However, it’s not quite that black and white.  

Stress, Emotion and Sociability
During holidays, do you sometimes overbook your schedule and find yourself groaning at the thought of another dinner or party – even if it’s with people you love?

I see introversion-extraversion as a continuum, and I think our position changes according to various elements including our general stress levels and our emotions about the type of event.

For example, I might rate myself as a 7 when it comes to going out for lunch, dinner and hanging out with colleagues and friends. However, a horrible month at work might push me to a 4 or even a 3 for a few weeks.

Or, I may be a 5 about socialising with strangers, but rate myself at a 9 when it comes to meeting friends.

Of course, there are people who say that no matter what, they are more towards one end of the scale than the other.

Tip: Schedule for Stress
If you're a typically on the introvert side of the scale, then you may face some challenges as work and study often include networking and other social components.

From sessions with introverts, the most practical bit of information is that it can be helpful to see whether you are best off scheduling all your social interactions on one day or whether you are better pacing yourself throughout the week or month.

This is very personal, and likely linked to your overall energy levels, so do what suits you best and know that what you like now may change from time to time.  

Tip: Reward Yourself
This is controversial, however, studies into anxiety and Post Traumatic Stress Disorder suggest that reward can help rewire your emotions somewhat. (Source, and another source, and another source)

This is a blog post and we’d need a book to discuss it but I think it can be useful to say to yourself: I have to attend a conference and make nice with strangers for work. So my goal is to attend three presentations where I can sit silently and smile a lot, and then to talk for two minutes to three people and six minutes to two more people. After that, I consider it job done and I get a reward.  

For this, the important thing is to: pinpoint the issue, pinpoint your goal in clear terms, and then after you’ve completed it to pat yourself on the back and reward yourself.

Note: the patting yourself on the back is part of a mindful strategy. Again, mindfulness is controversial because studies are usually small and tend to overreach with their claims. However, practically speaking, clients tell me that they feel a bit daft sometimes at the mindful self back-patting but they also note that it helps.

Types of Introverts
Even more interesting, Jonathan Cheek, a psychology professor at Wellesley College, suggests there are different kinds of introverts.

Social Introverts 
Prefer small groups to large ones. Or prefer solitude over any kind of socialising. 

Reserved/Restrained Introverts
Take a while to warm up and are then okay 

Anxious Introverts
Worry they may 'do the wrong thing' while socialising and ruminate afterwards, often falsely convinced they've somehow messed up

Thinking Introverts
Usually creative, live in their own mind world and have trouble connecting outside of it

Socialising For Introverts - Organised by Type
Figuring out how much you want or can socialise is personal. But if you're looking to get out and about a bit more, here are some suggestions for activities.

Note: these come from me, not from Creek's work. This list is the result of working with introverts in sessions. So they're tested but there's nothing 'scientifically proven' about them. They're a suggestion.

Activities for Social Introverts 
As your top preference is for personal time, do things by yourself.  

If you have to socialise, try to keep groups very small and opt for engagements that are time limited. For example, avoid dinner parties that include hours of lingering over coffee and go for weekday lunches where people need to get back to work. 

Activities for Reserved/Restrained Introverts
Try sticking to socialising with a small group of people whom you already know and like. Think dinner or lunch parties with individuals or with small groups of good friends or perhaps mall walking or a private hike with a good friend.

The main point is to avoid activities where strangers will be invited or present. For example, you may enjoy playing squash, badminton or some other sport where you play in pairs with friends. But you might find it too stressful to join leagues where you are paired up at random.

Activities for Anxious Introverts
Go for a one-on-one with gentle and empowering people and think about structured activities so that you have a game plan to follow. (also, read up on how stress provokes your anxiety to push up your hidden fears.)

For example: two of you going on a bicycle ride, two of you baking cookies, two of you going to the cinema or theatre (lots of quiet sitting about!). Or taking a flower arranging class (very structured, so you have very structured conversations)

Activities for Thinking Introverts
For you, consider taking the same approach as the social introverts but include the caveat that when you do socialise, pick small groups of like-minded people who share your passions and only attend events that are based on your passions. 

For example, one on one chats with a close friend over a lunch are great, and you may want to attend a class, tour or lecture based on your topic of interest. However, think twice about going out with good friends to do something new as it will likely stress you. 

Tip from Sessions About Comfort Zones
If you feel you need to expand your comfort zone, plan to dip in a toe and have a plan to exit quickly if you become too stressed. Also, take it slowly. As you are sensitive to stress and possibly quite resistant to change, consider trying it a few times before you truly know if it's for you or not. 

Finally, my introvert clients tell me that they find good exercise and sports include yoga classes and swimming because people don't talk during those. One person sports like running, plogging, and cycling are good too. But don't go for diving or dancing, because people tend to chat a lot during those activities. 

Hope you found this interesting.  If you ever want to talk to a mental health professional about this or some other matter, email me. 

Sunday, January 24, 2021

How Secret Are Sessions, and what else should I know? About Therapy Agreements

When you go and see a mental health professional, you may do no paperwork at all. Or, you may be asked to sign screeds of incomprehensible bumpf.  With me, it's a bit in the middle.

I'm hot on informed consent, meaning that I want my clients to understand exactly what terms govern our sessions. 

However, ethics can be complex, and clients are not up for a three week discussion on the subject.

Also, many of my clients speak English as a second, third or fourth language, so it's important to keep terms simple.  

So what I do is offer clients a short chat about the basics before we start, and then I send them a very simple agreement afterwards. My main aim is to make sure we agree and that we have the emergency contact details in place. 

If you're curious about terms, Alvin and I talk about the basics, plus basic ethical issues, in Reaching Out: Your Easy Guide to Finding Affordable Quality Online Therapy A Practitioner's Perspective available FREE on Amazon, Google Play, Kobo and other shops.

And this is my agreement;

Therapy Agreement

Benefits and Risks of Therapy

Therapy is about helping you make changes in your life.

Therapy can help you feel better about yourself, understand and improve relationships, cope with stress and many other issues.

Sometimes though talking about problems or remembering bad times can be uncomfortable.

Age and Consent

I work with adults only, so you must be over 18 years of age. 

Confidentiality

We need to keep you safe and our sessions as secret as possible.

Everything we discuss is secret. EXCEPT: 

·         If I believe you are actively suicidal, or

·         If I believe you are going to hurt yourself badly, or

·         If I believe you are going to try and hurt someone else,

If this happens, we ask your emergency contact to help.  I won’t do this without telling you first, and we can tell them together.

·         If you ask me to talk to your doctor, HR or other person.

I will write a letter and give it to you. Then you decide who gets to see it and when.

Finally,

·         If the police or a court judge tells me I have to answer questions I have to obey because it’s the law.

Notes

When we talk, we exchange a lot of information.  You will see me take notes. This is because I check our progress after we speak.

The notes are secret – but not from you. I will send you the notes the day after our session.

How We Talk

We talk over online video Skype, WhatsApp, Messenger or Google Meet. 

Our sessions are intensive, and there should be no interruptions. While we talk, our phones are off. 

Also, do not talk to me from bed. This is a professional session. Be up and dressed.

Scheduling Sessions

We will schedule sessions in advance. Be on time!

If you have to cancel, do so 24 hours before our session. If you do not cancel in time, I will charge for the session.

You can email me at ellen.whyte@gmail.com and you can send me an SMS or WhatsApp to XXXXX.  I will answer as soon as I can. However, my phone is off at night, and when I am in meetings.

In the event of a lightning strike or other issue that kills our computer connection, we communicate over WhatsApp.

Mid Therapy Termination

If you decide this isn’t working for you, or you’ve changed your mind, please just tell me.  There are no termination fees.  You also keep all the notes so you can work with someone else.

Although it’s a very rare event, I sometimes call a halt to a therapy relationship. I do this if:

·         I think you need to see a different professional.

·         I think you're not interested in the sessions.

·         You turn up late too often or are on your phone with others.

Fees

First 20 minute session: free

Notes service: free

Session: RM100 if you pay directly into my bank. US$35 over PayPal

I invoice the day after the session. Please pay promptly.

I love what I do but I don't want to be involved in endless hassles over payment. So it's 'pay as you go'. If you decide not to pay after a session, our relationship ends.

I am a private practitioner and do not work with insurance companies.

Security

I use firewalls and systems to keep your notes safe. Please make sure you do the same thing.

Don't use company phones and email; use your own private phone and email.

I have had the opportunity to discuss any questions I have about this information and I agree to the terms.

If you've questions, feel free to ask.