Demystifying Neuroplasticity

The science of Neuroplasticity is finally entering the public consciousness through the media such as in the documentary “Changing Your Mind” on the Nature of Things.

We used to believe that once a person reached adulthood, their brain was set and unchangeable with the exception of damage through a stroke, brain injury, or other intracranial insult.  Medical science viewed the brain as a mechanical construct, not an organ that can heal or alter its function or structure.  But with the advent of Magnetic Resonance Imaging, science can now see the brain functioning as various areas become active.

One of the first things we learned was that Post Traumatic Stress actually changed not only the function of a person’s brain, but also its structure - in many PTS cases, the hippocampi [the brain organs responsible for memory storage and retrieval] shrink.  But as MRI technology was used to monitor treatment, we also discovered that this brain damage can be reversed.  A 2011 study conducted in Canada with people suffering from PTS showed that using targeted mindfulness therapies that enhance Neuroplasticity saw the patients’ hippocampi grow on average of 25%.  A result that startled the professionals conducting the study.

The analogy I often use to explain how mindfulness and other therapies enhance Neuroplasticity is to imagine a path through the forest; The more we use a specific path, the deeper and smoother that path becomes and being so, following it is easier that traveling through the forest any other way.  Our minds are the same - we develop neural pathways in our brain by repeated use and if those pathways lead us to depression, anxiety, or disordered thinking we feel stuck on those paths.

With targeted therapies such as mindfulness, Cognitive Behaviour Therapy and others, we can create new pathways.  And like paths through a forest, as we follow the new healthier paths and they become easier to walk down and the old troublesome ones will grow over and no longer be paths we choose to follow.

I integrated Neuroplasticity enhancement in my practice as a Multimodal therapist over a year ago, and my clients have experienced great success in overcoming mental health issues that have plagued them for years.  Because I employ a multimodal approach, I can utilize a vast array of therapeutic techniques that fit the strengths, needs, abilities, and preferences of each individual client.

Typically though, I begin with breathing and relaxation techniques to address their immediate symptoms, then move to mindfulness practice and Cognitive or Dialectic Behaviour Therapy as clients develop mastery over each progressive step.  Throughout the process, I provide psychoeducation for my clients so they are aware of the science behind each technique because I believe in taking a collaborative approach with my clients - to place their healing in their own hands.

With the growing knowledge of Neuroplasticity and techniques to enhance it, there is no better time for someone to embark on the road to mental health, no matter how long they have suffered from an anxiety, mood, or traumatic disorder.

Aaron D. McClelland, RPC - www.interiorcounselling.com/aaron

Why I Recommend Yoga to Clients

As a Multimodal Therapist, I not only look at the seven modalities that make us whole persons, but I employ therapeutic interventions that fall outside of standard “talk therapy” strategies.

One of the interventions I use is to encourage some clients to take up the practice of Yoga – specifically; Yoga styles that are gentle and incorporate measured diaphragmatic breathing as their core foundation.  The reason for this is that diaphragmatic or “belly” breathing enhances neuroplasticity, which is – after all – the key to effective psychological therapy.

 Yoga is also another form of mindfulness, which is emerging as one of the most effective therapies to help people overcome anxiety and mood disorders.  When combined with other traditional therapies, such as Cognitive Behaviour Therapy, mindfulness is extremely effective in reducing symptoms of anxiety and depression.  I’ve added Yoga to that list.

Yoga is a winning adjunct to therapy for a number of reasons;

• It helps us reconnect to our body
• It teaches us distress tolerance much in the same way mindful meditation does
• It helps us supply oxygen to, [and removes carbon dioxide from] our muscles – and being that excess carbon dioxide alone can trigger panic attacks, measured breathing can reduce symptoms of anxiety
• It lowers the stress hormone Cortisol in our body
• It lowers Dopamine levels – too much dopamine in the limbic system has been linked to paranoia and withdrawal from social situations
• It lowers Norepinephrine levels which can trigger a flight or fight response, raise the heart rate, raise the blood pressure, and trigger the release of excess sugar into the bloodstream
• It raises GABA [gamma-Aminobutyric acid] levels - a neurotransmitter that inhibits the fear and anxiety caused by overactive neurons
• It raises Serotonin levels - a neurotransmitter used both in our brain and our digestive system that keeps everything working properly 

All of these, and other physiological actions, reduce depression and anxiety, increases cognition and the ability to focus, and helps us sleep better.

A recent paper titled; “Yoga on our minds: a systematic review of yoga for neuropsychiatricdisorders”, by Meera Balasubramaniam, Shirley Telles, and P. Murali Doraiswamy explored 124 trials on the effectiveness of Yoga in treating symptoms of various mental and emotional disorders.  The study concluded that there is emerging evidence that Yoga has proven success in treating depression, sleep disorders, and anxiety when used as an augmentation therapy.

The styles of Yoga that have the highest efficacy for my clients are;

• Hatha Yoga – postures, regulated breathing, and meditation
• Viniyoga – gentle yoga with an emphasis on synchronizing postures and breathing
• Tibetan Yoga – fine, flowing movements, and controlled breathing

There is little doubt that Yoga is a physically healthy practice, but with emerging studies indicating its ability to bring about healthy changes in brain chemistry, any therapist should explore it as an augmentation to traditional mental health therapy.

Aaron D. McClelland, RPC – www.interiorcounselling.com/aaron

SIAD - March 1st, 2013

Friday, March 1st, 2013 is Self-Injury Awareness Day [SIAD].  To support those who struggle with non-suicidal self-injury, wear something orange.

Self-injury is a disorder shrouded by mythology, misunderstanding, and malice.  Many sufferers already feel shame and guilt because of their need to use self-injury to manage overwhelming emotional distress, and when facing the judgement and ignorance of others feel further isolated and hopeless.

If you've ever had a bad itch and scratched it until it "hurt-so-good", you've had a small taste of the relief those who use self-injury to cope with out of control emotions feel.

Many people who self-injure become addicted to it; During injury, the body releases endorphins into the bloodstream to mitigate pain.  Endorphins are the body's natural heroin.

The other thing to keep in mind is ... We just celebrated Pink Shirt Day as a means to bring a halt to bullying.  85% of those who self-injure disclose experiencing some form of trauma, including being bullied.  Many have also experienced physical abuse, child sexual abuse, and rape.

If you wish to learn more about self-injury, please read the series of articles I published on the subject last year.  They can be found here Self-Injury, Putting the Pieces Together.  There is a link at the bottom of each section that will take you to the next in the series.

Most of all, please wear something orange each March 1st.  Because most keep it secret, those who self-injure will not thank you for it, but seeing it may help some know we care.

Aaron D. McClelland, RPC - www.interiorcounselling.com/aaron

Real Fiscal Responsibility

Once more we are seeing cuts to services for mental health problems in our province.  This time the cuts have been kept under wraps by the Ministry of Child & Family Development [MCFD].  A directive went out late last year for local managers to cut “full-time equivalency” by 8%.  What this means is that as positions come vacant within MCFD, managers are not to hire new staff until staffing levels across BC are reduced by 8%.

What this also means is that Social Workers - who already have case loads ridiculously high - will now be expected to take on more cases and services to families in crisis will suffer.

The evidence of how this is shaking down can be found in my own hometown of Summerland.  As of January 1^st, 2013, the local MCFD office no longer performs intake for children and families in need, nor will they respond to crisis or child or spousal abuse reports.  Children and families who are in crisis must apply for services in the nearby town of Penticton.

Penticton is only a 15 minute drive away, but if a family in crisis doesn’t have a vehicle or can’t convince someone to drive them, they are out of luck – there is no rapid transit between the towns and Greyhound - the only commercial transportation available - just drastically cut their services in the region.

Centralizing investigations and intake at MCFD was attempted back in the 90s and failed miserably.  And it’s starting to fail this time already; A local community leader was approached by a child who had tried to get help from MCFD in Penticton and has been passed between five different Social Workers in the past two weeks.  And nothing has been done for this child.

Please don’t get me wrong; This isn’t an indictment of our Social Workers.  They are on our side - They are just as frustrated and heartsick with the ongoing cuts as we are.  As one Social Worker told be recently when I asked how things were going at MCFD; “Chaos.  Utter chaos.”

Both our Federal and Provincial governments have been playing the “fiscal responsibility” card when explaining the cuts to needed services over the past eight years.  To put it bluntly; They are full of crap.

Here are some startling facts about the financial impact of mental health issues, released last year by the Mental Health Commission of Canada;

• 1 in 5 Canadians have a diagnosable mental health problem
• Every day, 500,000 people miss work because of mental health problems
• Mental health problems cost the Canadian economy a staggering $50 billion each year – No, that isn’t a typo: $50 BILLION per year

How does cutting services that can reduce those numbers be called fiscally responsible?

A study by Simon Fraser University’s Centre for Applied Research in Mental Health and Addiction (CARMA) estimated that in British Columbia, the current financial cost to taxpayers for services to homeless people with severe addictions and/or mental illness is $55,000 a year per person. In contrast, providing these people with adequate housing and supports costs $37,000 a year per person. This would save taxpayers $211 million dollars a year in direct costs.

Here’s another angle that I can provide;

In my private practice I specialize in anxiety & mood disorders including Obsessive Compulsive Disorder [OCD] among others.  I am surprised at how many of my clients arrive at my office in crisis with OCD and I’m pleased to report that by using a client-specific tailored treatment plan my clients have found relief from their symptoms [without medication] by the second session and are able to manage their disorder within 10 – 12 sessions.

I also offer a greatly reduced rate [$30 per session] to anyone referred through three local non-profit outreach agencies who see low income individuals and families on a daily basis.  I do this because I believe in the Civic Humanist ethical tenet that if one makes a living within a society, one must give back to that society.

I also am willing to do home sessions in some cases.

With that in mind, I’d be willing to offer the same to children, youth, and families in crisis referred by MCFD.

So let’s do THAT math; If an individual was referred to me by MCFD who was struggling with debilitating OCD [as an example] and I worked with them for 12 sessions to relieve their symptoms and they were then able to manage their disorder and return to normal functioning within the workforce, it would cost MCFD a whopping $360.00.

And I'm pretty sure I could convince many of my colleagues with the Canadian Professional Counsellors Association to do the same.

So if MCFD and other government agencies across Canada chose to stop making excuses for the cuts to their budgets and take advantage of effective mental health professionals offering some real solutions, we could make some solid headway in reducing that $50 billion annual loss.

And that, my friends, would be true fiscal responsibility.

Aaron D. McClelland, RPC – www.interiorcounselling.com/aaron

When The Boss Is A Psychopath

A colleague who works in an administrative position within a mental health agency, recently told me about a crushing defeat she’d suffered while pursuing a dream some years ago.

She’d always wanted to work in the creative side of advertising and had been told by a number of industry peers that she had true talent for the job and was urged to apply for a position with a large advertising firm.  My colleague was thrilled when she got the job, and was put into the print media department under a manager who was praised for the results his team produced.  She truly thought she’d landed her dream job and would be mentoring under a seasoned veteran who would teach her the skills she needed to advance in the field.  Little did she know that her dream would soon become a nightmare of bullying, abuse, and intimidation.

“I would go to him [her manager] to ask advice and was told to go figure it out myself or find another job.” she said, “I ended up working 10 - 12 hours a day, not only doing my job, but his as well.”

And when she produced excellent work; “... he would take it from my desk and present it to upper management, claiming it was his.” and when she confronted him on it, he responded with threats to fire her and the intimidation and bullying increased.

“It was a huge blow to my self-esteem.” she confessed, stating she felt at the time that she wasn’t good enough to live up to her manager’s demanding standards, and feeling lost in a corporate world she didn’t understand; No matter how hard she worked, she never got credit for a job well done, while her manager basked in the praise from upper management for producing excellent work.

“You couldn’t win.” I told her, and went on to list some characteristics her manager may have had;

• Grandiose - believing he was smarter and more talented than anyone else
• Lack of skills relating to the job while taking credit for the work of others
• Lack of positive leadership skills
• “Managing” his staff through threats, bullying, and intimidation
• Blaming others for his own failings
• The ability to feign emotions while in the presence of superiors, but being callous otherwise

“EXACTLY!” she exclaimed.

The reason my colleague couldn’t win with that manager was that she was dealing with psychopathy.  In popular vernacular, her manager was a psychopath.

Though there is no sanctioning psychiatric or psychological body for a diagnosis of psychopathy, our criminal justice system uses screening tools to assess for psychopathy.  Dr Robert Hare, the world’s leading authority on psychopathy, created a checklist of signs to identify someone as a psychopath;

Factor 1: Personality "Aggressive narcissism"

• Glibness/superficial charm
• Grandiose sense of self-worth
• Pathological lying
• Conning/manipulative
• Lack of remorse or guilt
• Shallow affect (genuine emotion is short-lived and egocentric)
• Callousness; lack of empathy
• Failure to accept responsibility for own actions

Factor 2: Case history "Socially deviant lifestyle".

• Need for stimulation/proneness to boredom
• Parasitic lifestyle
• Poor behavioral control
• Lack of realistic long-term goals
• Impulsivity
• Irresponsibility
• Juvenile delinquency
• Early behavior problems
• Revocation of conditional release
• Traits not correlated with either factor
• Promiscuous sexual behavior
• Many short-term (marital) relationships
• Criminal versatility
• Acquired behavioural sociopathy/sociological conditioning (Item 21: a newly identified trait i.e., a person relying on sociological strategies and tricks to deceive)

When we think of a “psychopath”, we typically think of a violent criminal or serial killer.  Now it can be argued that all serial killers are psychopaths, but not all psychopaths are serial killers.  In fact, through his lifetime of research, Dr. Hare discovered that there is a higher percentage of psychopaths in the corporate world than there are in the criminal justice system, and even co-authored a book about it; Snakes in Suits - When Psychopaths go to Work. 

Psychopaths play by a different set of rules and they are very good at it.  They spend their time observing human emotions and behaviours and devising ways to use those to their advantage.  They are constantly “sizing up the prey” and many believe that everyone thinks like they do, so they maintain a “get them before they get me” belief system.

I’m sure many of us have experienced what my colleague did; working for a boss who was a psychopath.  Though my colleague was relieved to hear that it was her boss' psychopathy and no fault of her own, her lost dream remains lost.

If you find yourself working for someone who meets the criteria for psychopathy, find another job as fast as you can.  The lesson here is - You can’t win.

Aaron D. McClelland, RPC - www.interiorcounselling.com/aaron

Thank you Lady Gaga!

Reposting, because this is awesome:

Lady Gaga Offers Free Mental Health Counseling to Fans Before Concerts

by Rebecca Macatee

Lady Gaga sure loves her Little Monsters.

The pop star announced Friday that she would offer free counseling to fans before her Born This Way Ball shows.

In a Facebook post, Gaga, 26, described the concert's BornBrave pre-show as "a fun tailgating experience for monsters to unite," but it will also be a place where they can seek help.

"At the BornBrave Bus you have access to professional private or group chats about mental health, depression, bullying, school & friends," she wrote. "There will also be food and games, DJ White Shadow and Lady Starlight will DJ with host BREEDLOVE to keep the experience fun."

She clarified that the BornBrave Bus will be "a place where mental health + depression are taken seriously w/ no judgement, FREE real help available to all.:

"I feel like most kids don't look for help because they feel embarrassed so mom + I wanted to break the stigmas around 'help' and make it fun," she wrote.

Good for you, Gaga!

Find the original article here

Imposed Morality

Prior to the holiday season, a dear friend was alarmed at something she witnessed while visiting Disneyland.  She had watched the Santa Claus Parade on Disneyland’s Main Street and it was the song “Santa Claus is Coming to Town” that she found – as she put it – “creepy”.

The part of the lyric that bothered her most was;

“He sees you when you’re sleeping,

He knows when you’re awake.”

You see, my friend is Jewish and has had very minimal exposure to Christmas traditions and songs, so imagining a bearded stranger peeking in the bedroom windows of children was disturbing to her.

Beside being charmed by her fresh perspective, her observations got me thinking about imposed morality; moral behaviour elicited through a promise of reward or threat of punishment, and continual monitoring by a supernatural being …

“He’s making a list and checking it twice,

Going to find out who’s naughty and nice.”

Most religions are enforced through a system of reward and punishment in a post-death judgment ritual, and many offer heaven or hell as the two alternative final destinations.  We must answer for our “sins”.  So, the message is; If you are “good” then you will go to heaven, and if you are “bad” you will go to hell.  Catholic-based religions add the third locale of “Purgatory” where your sins will be stripped away through a painful purification process.

In the Islamic faith system, when men die – especially while killing the enemies of Allah - they will be rewarded with 72 virgin sexual slaves and an eternal erection.  Not sure what the women get, although some Islamic Clerics claim that upwards of 95% of the occupants of hell are women.

But can morality that is derived through threat of punishment and reward truly be moral?  If one believes that he must live by rules of conduct imposed by a powerful and judgmental supernatural being, can he claim true morality?   Or is he just following orders out of fear?

There have been hundreds of studies that clearly demonstrate that punishment does not achieve the purpose it is intended for.  Punishing children for “bad” behaviour can result in two probable outcomes; In the first, the child learns to lie about and conceal their actions in order to avoid punishment; In the second, the child becomes so fearful of punishment that they are paralyzed from taking healthy risks that can aid in their development.

On a societal level, the best indicator that punishment doesn’t work is that if it did, we wouldn’t have prisons – all citizens would have learned “right” and “wrong” in childhood through being punished at home and at school.

There is also the question of how we can define “good” and “bad” behaviour in a universal way.  Most religions have a set of rules that dictate these concepts, yet in real life they are often not so clear-cut.

For example; Lying is a sin.  Yet during the Nazi occupation during WWII, if the Gestapo arrived at your front door to ask; “Are there any Jews living here?”  Would you lie?  Or would you tell them about the Jewish family living in your attic whom you had given protection to?

Even more striking are challenges to the 10 commandments such as; “Honour thy mother and thy father”.  What if that mother or father was abusive to their child?  What if a parent sexually abused their child causing long-term psychological harm?  Is that child still required to “honour” that parent?

Dr. Alice Miller had a lot to say about that in her book; “The Body Never Lies – The Lingering Effects of Cruel Parenting”.

There also is the question of interpreting scripture.  One of the prominent arguments by the Christian right is that gay marriage should not be allowed, this according to book of Leviticus.  Yet most Christians don’t follow the rest of Leviticus’ rules; That men aren’t allowed to shave their beards; That they should never work on the Sabbath; That it is okay to own slaves so long as they come from a foreign country; That having bacon on your cheeseburger is a sin.

Historic scholars understand that the laws laid down by Leviticus were an attempt to strengthen the tribes of Israel by protecting individuals from disease, promoting propagation, and ensuring that members maintained their identities as Jews.

But when we are faced with ancient laws that are no longer applicable in our modern world, who among us gets to choose which are imposed and which are left behind in the annals of history where they belong?  Most religions have appointed clerics or religious leaders - [some self-appointed] - who claim authority to make these decisions; Pastors, Reverends, Priests, Rabbis, Mullahs, and so forth.  Yet even with a mortal religious scholar making moral decisions, it is still expected that the individual should comply with that imposed morality.

As a Humanist, not only is morality an active exploration and learning experience for me, I also ascribe to Eric Ericson’s concept of syntonic and dystonic to describe actions or events and their relationship to people.  If something is syntonic, then it is beneficial to a person [such as lying to the Gestapo].  If it is dystonic, it negatively impacts a person.  To live as a Humanist requires thoughtful consideration of all points of view – it is an active philosophic process that does not rely on following an imposed set of rigid moral rules but rather by following one’s reasoning, knowledge and empathy for self and others.

When I engage in this internal debate, I am often reminded of a statement made in “The Grapes of Wrath” by John Steinbeck; A preacher, who had become disillusioned by the suffering he saw during the Great Depression, came to the realization that he no longer had answers.  He said that all he really knew was; “Anything living is holy.  Anything that hurts it is a sin.”

Personally, I think that’s a pretty good place to start.

Aaron D. McClelland, RPC – www.interiorcounselling.com/aaron