Sexual Causes of Tension-At the present time there is a tendency to lay great emphasis on sex, and the tensions of both young and old are often ascribed to some disharmony in their sex life without due consideration of other factors. This line of approach is particularly common with the amateur psychologist. In evaluating the situation it is well for us to realize that sexual conflicts are in fact a very important cause of anxiety, but that conflicts in other areas are also important, and that anxiety often results from a summation of stresses arising from various problems.
There is another factor which makes it difficult to assess the significance of sexual troubles as a cause of anxiety. People have a tendency to give socially acceptable explanations for things. A man is working hard at his office; there are many difficult problems, and he has to work late at night. He will readily tell you this is the cause of his anxiety, and in a way it is true enough; but he does not readily discuss the tension he feels as a result of his being involved with his secretary. The patient often gives these false explanations quite knowingly for the simple reason that he is too ashamed to admit the real cause to the doctor. In other cases, the patient is too ashamed to admit the true cause even to himself. In these circumstances he believes that he is speaking the truth when he gives the socially acceptable reason as the cause of his trouble.
*27/57/2*
Anxiety may have an effect on stuttering. The right side of the body is controlled by the left side of the brain and vice versa. In the right-handed person the left side of the brain is dominant over the right, and as a result the right hand is given preference over the left. In those who are left-handed the right side of the brain is dominant over the left. It is believed that stuttering often develops when the dominance of the leading side of the brain is incomplete, or when a potentially left-handed child is trained to function as a right-hander. We see then that stuttering results when the messages from the brain to the organ of speech are indecisive. This indecision may be further increased by the presence of anxiety. This is shown very clearly by the fact that many quite normal people show a hesitancy in their speaking or even a mild stutter when confronted with the task of speaking in some formal situation which produces anxiety.
On the other hand, some people stutter without showing or feeling much tension or anxiety at all. As a general rule these people who stutter in the absence of anxiety do not gain much help in their speech difficulty by practising relaxing mental exercises. However, the majority of stutterers experience considerable tension when they are speaking, and with them the reduction of the general level of anxiety by relaxing mental exercises is a great help toward establishing a pattern of easy normal speech.
*16/57/2*
James, a 50-year-old professional, wrote to me as follows:
I have had one form or another of depression for over 10 years. My depression has greatly affected my life in many ways. Most notably, my relationship with my wife has suffered and my relationship and reactions to daily work circumstances have been greatly and negatively affected. Many of my attempts to deal with my depression failed.
James describes how he first underwent six months of psychotherapy, which was of no help, followed by a course of Lustral, which helped his depression slightly but caused him chronic diarrhoea, a liability far greater than its minimal benefit in relieving his depression. After he broke his foot, this side-effect became even more inconvenient as he had difficulty getting to the toilet in time. He decided to discontinue the medication and his depression returned with full force.
After doing some research on the herb, James decided to take St John’s Wort on his own; within six weeks of starting to take 300 mg three times a day, his feelings of depression began to subside. ‘My depression is now manageable and I would have to say almost non-existent,’ he concludes. T hope St John’s Wort remains available without a prescription and that the … medical professionals do not attempt to “prescriptionize” it… I hope my short personal history regarding my depression and travels towards St John’s Wort will help to keep it available to the general public’
*10/75/2*
Problem:
Developmental Issues:
Frequent Waking
An infant may need to be six months old before gaining the neurological maturity necessary to settle into an 8-10 hour nighttime stretch of sleep (although many do it sooner). Older children tend to wake periodically due to illness, dreams, or while learning a new developmental task. Very often the cause is undetermined.
Waking for Feeding
i
After three or four months, a healthy, full-term infant no longer needs night feedings for nutritional reasons. Early risers may wake up hungry.
Difficulty Sleeping Alone
Separation issues peak at times of developmental disequilibrium (leaps or regression). Typical times: four to six months, nine to twelve months, one and a half to two years, and subsequent half-year stages. Fears are strong for toddlers and preschoolers. Older preschoolers tend to fall asleep quickly once settled.
Unusual Cycles
An infant may have his “days and nights mixed up”—this can be adjusted. Up to and including nine months, an infant may take a third nap around dinner time, so a late bedtime is not inappropriate. Typical bedtime for a toddler/preschooler is between 7:30 and 9:00 pm.
Nightmares
Infants appear to “dream” (or to be affected by dreaming) at around 9 months. Children continue to gain the language to express dreams and fears beginning at age two. This may peak during preschool years.
Sleep Terrors
These are probably experienced by infants, occur most commonly around age four, and decrease by school age.
*10/67/8*
Children are individuals. Each one brings to the issue of sleep his ñ needs, personality, and physical functioning. This does not mean that you need to accept your child’s sleep patterns as “the way it is.” Your goal as pare is to help your child fit smoothly into your family—and into his world. You can recognize his uniqueness, while teaching him skills to make his life easier.
Commonly, after the sleep issue is resolved, parents notice real difference. The child is more easy-going, less frustrated, happier, and more predictable Parents wonder why they didn’t do something sooner. Parents, too, feel m content and self-confident.
In the long-run, the child’s sense of independence and self-esteem enhanced. When he masters sleep problems, he has mastered an important p of life. (He knows it is important by the significance you—and the rest of world—have placed on it.) Sleep and nighttime can be frightening; child need to know that Mom and Dad are in charge.
A child who continually disrupts his parents’ sleep forms an unhealthy vi of life. He learns that his needs are the only important ones. This is a far from what parents intend.
Perhaps this is the message you would like to send: / love you and I want you to grow up to be a happy person. Sleeping is part life. The way you are sleeping now doesn’t fit with the rest of our family. It becoming a problem for us all. Let’s work on it together.
*7/67/8*
It is important to remember that there have been no head-to-head trials comparing St John’s Wort with the SSRIs in the treatment of depression. All reports of comparisons between the herbal and synthetic anti-depressants are therefore anecdotal. Nevertheless, there are lessons to be learned from anecdotes and one conclusion I have reached, based on many stories that there are certain people who do better on St John’s Wort than on the SSRIs. When both types of antidepressants are used in their conventional dosages, St John’s Wort appears to be superior to the SSRIs with respect to side-effects. Particularly, it appears to cause fewer sexual side-effects, less weight gain and fewer feelings of dullness in thinking or feeling. When used in their conventional dosages it is possible that the SSRIs may be more potent and I have encountered cases where they have reversed depressive symptoms that did not respond to St John’s Wort alone. In the currently planned multi-centre research study sponsored by the US National Institute of Mental Health, St John’s Wort and the SSRI Lustral are to be compared for the first time; It will be fascinating to see how they stack up against each other. In the meanwhile each depressed person will have to choose the type of anti-depressant – herbal or synthetic -best suited to his or her needs based on the information available and his or her own personal preferences.
*96/75/2*
A cognitive behavioural therapist will normally work with various types of exposure methods pertaining to our particular anxiety disorder. When wc begin to work with our avoidance behaviour we will probably feel anxious and the ‘what ifs’ may return. In only a few seconds the ‘what ifs’ can create a mountain of fear and anxiety which seems insurmountable. We may forget any management strategies we have learnt, and become caught up in the automatic cycle of thinking.
It is most important to realise that we will feel anxious and frightened when working with a CBT program. By accepting this we can work with it, not against it.
Making allowances
As an example, part of our CBT program may include doing the shopping alone. This can be broken down into easy steps. To begin with, we can go to the shop early in the morning. We will feel more comfortable in letting the anxiety and attack happen if the shop is not too crowded. As we become more confident in letting it happen, we can begin to shop at different times of the day.
If part of our program means going to dinner or the theatre, we can ask to be seated by an aisle or an exit, or both-not so much for a quick getaway, but to help break down the feeling of being trapped. The aisle or exit is there if we do need to leave quickly. If we work with our thinking and let the anxiety and attack happen, we will find we won’t have to leave.
*93/94/8*
In earlier chapters I have provided some guidelines as to how to diagnose your own depression and when it might make sense to involve a doctor in its treatment. In this chapter I go into greater detail about this. Essentially there are five reasons for involving a doctor in the treatment of depression. First, if depression is severe, it is risky to treat it on one’s own. In addition, there is far less evidence for the efficacy of St John’s Wort in severe depression than there is for more conventional anti-depressants. Second, other conditions may masquerade as depression. A visit to a doctor may uncover the real reason for symptoms and lead to a specific and effective treatment for them. Treating such conditions with conventional anti-depressant strategies may be ineffective and will delay treatment of the underlying problem. Third, there may be other psychiatric problems that are worthy of attention in their own right and depression may even be secondary to these other problems. Treating these other conditions may be the first order of business and requires the help of a doctor. Fourth, it can be difficult to be the best judge of your own mood and progress, and a skilful observer and experienced clinician is an invaluable companion in the treatment of depression. Finally, depression is a lonely condition and a good doctor is also like a good friend to cheer you on through the dark wood into a better and brighter place.
*60/75/2*
Dr Michael Terman from Columbia University originally showed that simulating a summer dawn in the middle of winter could have a salutary effect in people with SAD, helping them to wake up and feel better during the day. He accomplished this by means of a machine that turned the bedroom lights on gradually, as though the shade on the window were becoming gradually brighter as on a sunny morning in the summertime. Since this initial observation, dawn-simulators have become more compact and affordable and have been shown to help people wake up in the morning and have anti-depressant effects in controlled studies. A commonly used version fits easily into the palm of the hand and can be connected to an ordinary bedside lamp. Although not usually sufficient in itself to reverse the symptoms of SAD, a dawn-simulator is an excellent way to get the day off to a brisk start and is a very useful part of the overall programme for managing this condition.
Another innovation to come out of Terman’s department at Columbia is the use of high-dose negative ions – charged air particles emitted from a small device that looks like an air purifier. According to one study, negative ions in high dosages may have anti-depressant effects in SAD patients. More work is warranted, though, before this treatment can be recommended with any degree of confidence. Negative ions are emitted from flowing water under natural circumstances, whereas positive ions are emitted from all sorts of indoor machinery.
*28/75/2*
