Life Therapy Counseling Services

06/27/2024

This is one of the best papers I've ever read.

"Highlights

Depression is neither disease nor disorder rather an adaptation that evolved to serve a purpose.

Depression is so much more prevalent than currently recognized that it is “species typical”.

Antidepressants may suppress symptoms in a manner that increases risk for subsequent relapse.

Cognitive therapy works by making rumination more efficient and “unsticking” self-blame.

Adding antidepressants may interfere with any enduring effect that cognitive therapy may have."

https://www.sciencedirect.com/science/article/pii/S0005796724001268?fbclid=IwZXh0bgNhZW0CMTEAAR0NmP4OWMFgs0mJQphs9rZ2VxfI4o5i-R445L_t05sc2bo5x7t_FEaNTUs_aem_87KzxkTigsJ4fyUI-H0j_w

04/11/2024

""Dr Hilary Cass, a former President of the Royal College of Paediatrics and Child Health, was employed by the NHS to conduct a review of the published evidence on the use of puberty blockers and cross-s*x hormones in children and young people with gender dysphoria. In March 2021, she concluded that they had not been able to find evidence “strong enough to form the basis of a policy position”. It was clear then, at least to those paying attention, that the evidence needed to justify the existing clinical practice in Gids did not exist. And yet, it wasn’t until last month that the NHS announced it would no longer be offering puberty blockers to young people in England and Wales.
Today, as Cass finally publishes the results of her wide-ranging review, the reason seems obvious: her 388-page report concludes that, for most young people, up to the age of 25, “a medical pathway will not be the best way to manage their gender-related distress”. Commenting further on the lack of evidence, she states that not only is there no way for a clinician to accurately determine who will continue to identify as trans for life and who won’t, but that the fundamental rationale for using puberty blockers in the first place “remains unclear”. She speaks of the need to balance medical innovation with the potential “creep of unproven approaches into clinical practice” and calls for the use of “standard evidence-based” interventions instead.
Cass also makes it clear that the factors influencing gender-related distress might be as much social as psychological or biological, with a particular focus on the new cohort of adolescent girls who now make up the majority of gender clinic patients. Instead, she suggests, we need to draw on bio-psycho-social thinking to ensure that future child patients receive the safe and effective care they deserve."

https://unherd.com/2024/04/can-the-cass-report-really-be-enforced/?=frlh&fbclid=IwAR21PZjdZivH6I4VK_qlrBTozATkEQf8XIY-iMMgD82Xdo8OVuGz5HroQ-A_aem_AZqjt9kC7POdXhp8-r4Op53JxSlQeQWNKy92350iH35OjT7tepZYmOXA2VqgXT9wvTkY5-g2zymkXWLrAEsdf8Yf

Can the Cass Report really be enforced? Vulnerable young children deserve justice A protestor outside Downing Street (Vuk Valcic/SOPA Images/LightRocket via Getty Images) A protestor outside Downing Street (Vuk Valcic/SOPA Images/LightRocket via Getty Images) Cass ReportGenderHealthNHSSocietyTransge...

08/17/2023

I'm delighted that Quillette has published this essay of mine.

Should mental-health care strive to be ethically neutral?

07/29/2023

""So there we have the conundrum: the understandable human need to feel unconditionally valued and respected versus the understandable human need to give yourself and your child the best shot at life possible (which may include acknowledging areas of difficulty and trying to remedy them). This complex and sensitive dilemma is being navigated against the backdrop of a needlessly toxic and angry Twittersphere, where we emote rather than think critically. Can’t we do both?
Nuance is imperative if we are to move through this impasse. We need to think clearly and speak candidly about these difficult topics. Rather than react in a polarised manner, we need to step back and consider the complex feelings of those with autism, their families, and their caregivers, as well as their needs and the functional limitations imposed by their disability. We need to be prepared to look at each person as an individual with different needs, abilities, and circumstances. All of those with disabilities deserve to feel valued and respected. And all human beings deserve the best possible opportunity to thrive, which often includes an acknowledgement of their areas of difficulty and interventions to reduce those difficulties."

https://quillette.com/2023/07/29/neuraffirmation-a-therapists-concerns/?fbclid=IwAR0kabqRwDPHMkbfiHNKu-0kUFRYUZuRs0Ih1BWRSsN-n4B9hG6NcqlcKnQ

I worry about the unintended consequences of the neurodiversity movement, particularly when their demands are promulgated religiously and without nuance.

07/11/2023

"Trauma-informed care, which pathologizes normal everyday stressors, is radically changing how people define mental health and practice mental health care. This model depicts people seeking mental health and addiction services as oppressed victims and counsellors, social workers and psychologists as their saviors. This is the language of benefactors and charity cases, of gallant knights and damsels in distress.
TIC receives significant amounts of government funding and the support of many major policy bodies. SAMHSA’s 2014 Treatment Protocols state that trauma-informed care “must permeate [their own] organization from top to bottom,” since “An organizational culture of care, safety, and respect demands activities that foster the development of trauma-informed counselors.”
Perhaps the worst aspect of this supposedly compassionate approach to mental health is a phenomenon I call therapeutic absolution. It allows therapists to effortlessly absolve their patients of responsibility for their own behavior. This is extremely unhelpful. Addicts, for example, have almost always caused considerable turmoil in both their own and other people’s lives. They need help to turn their lives around. They shouldn’t be told that “it is society that must change, not you.”
In a recent article published by Edinburgh University Press, entitled “Trauma: An ideology in search of evidence,” Mark Smith, Claire Cameron and Sebastian Monteux argue that “The prominence given to trauma perspectives has potentially iatrogenic consequences for those identified or self-identifying as traumatized.” In other words, frivolous trauma diagnoses and misguided policies can leave vulnerable people worse off than they were before they encountered mental health services. "

https://quillette.com/2023/07/10/the-ever-expanding-definition-of-trauma/?fbclid=IwAR1wkyy2pV7uriWpkfFBTcqwG4b8F00F6fzpB_k-SHh02zThVcLlM0mHsLA

In diluting the word's meaning mental health professionals are creating a generation of victims.

05/05/2023

""And then there are the logical flaws in the doctors’ arguments. The claims from both van der Kolk and Maté that ancient trauma can surface in the body years later cannot be disproved, which makes their claims unscientific.

Think about it: most of us have had at least one bad, even awful, early experience. And most of us also suffer with some kind of ongoing physical or mental ailment. Anyone who wants to connect the dots can easily do so and call it a causal chain of events. Like the palm reader who sees heartbreak in your past—my God, she’s right!—adverse events will always be there, ready to be mined for a future diagnosis of “trauma.”

But who can really know what from our past truly explains our current circumstances?

Maté’s trauma theory also contains some worrisome falsehoods.
“The idea that most of us are carrying past traumas, it’s not true,” clinical psychologist George Bonanno, director of the Loss, Trauma, and Emotion Lab at Teachers College at Columbia, told me.
In his 2021 book, The End of Trauma: How the New Science of Resilience Is Changing How We Think About PTSD, Bonanno summarizes years of epidemiological research showing that most people who’ve experienced potentially traumatic events are not crippled by the experience later in life.

Indeed, a large body of research confirms that resilience is the human default response to trauma. Bonanno says most patients have a “flexibility” mindset, giving them optimism and confidence in their ability to cope. According to his findings, patients usually take a “challenge orientation” in their approach to past trauma—believing they can overcome the challenge rather than be defeated by it.

And yet, the trauma therapists continue to see suffering everywhere."

https://www.thefp.com/p/trauma-therapy-has-captured-americaand?utm_source=substack&utm_medium=email&fbclid=IwAR0xc6asafqPV0eLBu7jFmTSqzizwW_DVe3xIhLHeNNHqzuSEaIh-QQ6vWQ

The alluring, but spurious, notion that all our problems stem from childhood has infiltrated our society.

01/31/2023

The Cruel Paradox of “Low Self-esteem”
By Bob Fancher

"[P]eople with low self-esteem sometimes sabotage their relationships by underestimating their partner’s love for them and perceiving disregard when none exists.
"People with low self-regard find it hard to believe that they
are well and truly loved by their partners and, as a result, they tend not to be optimistic that their loves will last. . . .
"This leads them to overreact to their partner’s occasional bad moods; they feel more rejected, experience more hurt, and get more angry than do those with higher self-esteem. And those painful feelings make it harder for them to behave constructively in response to their imagined peril.
"Whereas people with high self-regard draw closer to their partners and seek to repair the relationship when frustrations arise, people with low self-esteem defensively distance themselves, stay surly, and behave badly. They also feel even worse about themselves. . . .
"[P]eople with low self-esteem put their fragile egos before their relationships."
(Rowland S. Miller, Intimate Relationships, pp 303)

If you suffer low self-esteem, you’re actively and consistently undermining your own welfare. To get over it, you have the face the fact that you’re doing this, identify the many ways you do it, and change how you think and act.

There’s the rub: To stop thinking ill of yourself you have to face some unfortunate facts about yourself. If you’re not careful, facing such facts may seem to confirm your bad opinion of yourself.

Here’s a truism, though: you can’t solve a problem you can’t face. You have to identify it, break it down, see what causes it and keeps it going, and do something to interrupt the sustaining processes.

Of course, there’s no shortage of advice on how to boost self-esteem. If you google “increase self-esteem,” you will get over forty-two million hits. If you go to Amazon and look for books on self-esteem, you will find well over a thousand.

While the advice on boosting self-esteem is all very humane and lovely—so I certainly don’t wish to say harsh things about it—most of doesn’t make much scientific or logical sense.

People who study self-esteem scientifically—as opposed to clinicians who generalize from their surmises—generally distinguish between “state self-esteem” (how one feels about one’s self at a given moment) and “trait self-esteem” (one’s more general sense of one’s worth). People with lots of moments of achievement—high state self-esteem—may still suffer low self-esteem generally.

That’s just how cognition works. As cognitive scientists have known for well over fifty years—since the work of Jerome Bruner brought about what’s called “the New Look” in psychology—our basic cognitive repertoire consists of broad generalizations that orient us within our experience, providing rules for how to interpret particular experiences and behave in particular situations. We are more likely to give weight to data that confirm our general orientation and to find ways to discount or explain away anomalies. We don’t give up our general orientation to living very easily.

That’s what makes any false belief pernicious: for any deeply-held belief, we look for confirming evidence and minimize or dismiss conflicting evidence—and keep thinking and acting badly.

Changing trait self-esteem requires dismantling some very deep beliefs about one’s self—and one’s value in the world.

Unfortunately, the advice self-esteem boosters most often give is just wrong. Here, for instance, one of the gurus of the topic, Carol Hillman:
“Self-esteem can come only from the inside, from inner acceptance and approval. If this self-approval is not there, then the effects of outside commendation and rewards last only as long as the kudos keep rolling in. When they cease, the achievement ju**ie suffers a dramatic drop in self-esteem, and often becomes depressed. To be truly anchored in feelings of self-worth, we need to approve of ourselves for who we are.”

This just doesn’t fit the facts—the science. Self-esteem is by its very nature an assessment of how we are valued by others—whether we are likely to be accepted or rejected. Self-approval won’t get the job done.

As M.R. Leary, a leading scientist of social relationships, says,
“. . . events that are known (or potentially known) by other people have much greater effects on self-esteem than events that are known only by the individual him- or herself. If self-esteem involved only private self-judgments, as many psychologists have assumed, public events should have no greater impact on self-esteem than private ones.
“ . . . Most often, self-esteem is lowered by failure, criticism, rejection, and other events that have negative implications for relational evaluation . . . . Even the mere possibility of rejection can lower self-esteem, a finding that makes sense if the function of the self-esteem system is to warn the person of possible relational devaluation in time to take corrective action.
“The attributes on which people’s self esteem is based are precisely the characteristics that determine the degree to which people are valued and accepted by others. Specifically, high trait self-esteem is associated with believing that one possesses socially desirable attributes such as competence, personal likability, and physical attractiveness. Furthermore, self-esteem is related most strongly to one’s standing on attributes that one believes are valued by significant others . . .
“Subjective feelings of self-esteem provide ongoing feedback regarding one’s relational value vis-à-vis other people. . . ”

Ms. Hillman, like most clinicians, has observed the corrosive effects of negative self-esteem correctly. She has also noted but misunderstood the fact that high state self-esteem doesn’t necessarily change trait self-esteem. However, she fails to analyze the cause or the cure correctly.

Generally, low self-esteem fits what we know about cognition quite well: a significant body of experiences of social rejection—sad to say, often from early childhood, often within the family— lead one to formulate, logically enough, a belief that one is not socially valuable. One then interprets further data, and bases one’s actions, on that assumption. Contrary data are not trusted. Hence, the underlying view of one’s self is preserved and serves as the basis for further perception and action—and continues to undermine one’s quality of life.

As it turns out, research has shown that changing how one “feels about one’s self” doesn’t actually help much. Changing specific ways one understands one’s value, and acts, within one’s social relationships does—but only if you are willing to recognize the falsity of the negative beliefs you’ve been using to understand yourself, the world, and the feedback you’ve gotten.

That’s not easy. It can be done—but usually it requires help from someone you trust (a) who is willing and able to show you where you interpret yourself and others wrongly and thus act to create self-fulfilling prophesies of rejection and failure, and (b) who can support you through this less-than-happy process and (c) help you locate your real potential actually to do better.

Generally, it helps to identify where and how you originated your negative sense of yourself. Often it requires revising downward one’s sense of one’s family life, or otherwise revisiting painful experiences. That can be sad, but recognizing that one’s negative view makes sense, relative to formative experiences and perfectly normal cognitive processes, lessens the blow to one’s current sense of self. That’s part of how we resolve the cruel paradox of low self-esteem—we realize that we’ve come by it honestly, drawing plausible conclusions from early experience and living accordingly, but that it really doesn’t need to continue.

11/15/2022

"As a result of the pandemic, more selfish and antisocial behavior have risen, thus threatening to multiply psychiatric diagnoses in the next few years," Scheggia added. "Unraveling the nature of brain mechanisms underlying social decision-making could represent a crucial step to suggest novel treatments for social dysfunctions and antisocial behavior that occur in several psychiatric conditions and neurodegenerative disorders. Building on the findings of our recent study, we are now exploring the role of previous experience and emotional memories on prosocial and selfish choices."

Medical Research > NeuroscienceStudy identifies neural connections that regulate prosocial and selfish behavior in miceUpdated November 12, 2022 | Originally published on MedicalXpress Breaking News-and-Events Our Team's TakeawaysKey points summarized by the MDLinx Team.Humans and animals can ex...

10/09/2022

"Coleman: We're becoming increasingly atomized; our definitions of what constitutes a good relationship makes us very fragile. The notion of boundaries, however useful they are, means we're constantly evaluating whether a relationship is good or bad for us. That puts enormous pressure and stress on the self. It also creates a lot of anxiety. So everybody's sort of looking for their tribe, but tribes can be very fragile, and they aren't necessarily able to provide the kind of corrective feedback that we all need, and that we're more used to getting from family and closest friends. Now, this isn't to idealize the family, because I think, to your point, families can be very hurtful and disruptive and traumas are a real thing and can occur in families. It's just that what is considered to be traumatic, harmful, abusive or neglectful behavior today, has radically changed. There was an important article by the Australian psychologist Nick Haslam, who talked about how in the past three decades, there's been an increasing “concept creep” in terms of what we define as being harmful, abusive, neglectful behavior. On the one hand, that's great. It provides us a much more detailed way to talk about feeling injured or hurt or misunderstood by others. On the other hand, it pathologizes the fairly normal slings and arrows of family life, and it presents an idealization of the possibilities of parenthood that isn't very realistic.

Every day there's some new article like “10 Signs That You're with a Narcissist,” “How to Deal with a Narcissist,” or “Why You Should Go No-Contact with Your Parent.” These things give a kind of a legitimacy or authority to cutting off people for reasons that, in other generations, would have been considered obnoxious, maybe irritating or burdensome. But the idea that you should just be constantly wiggling out of problematic relationships because they're upsetting to you is very problematic. And we're constantly confusing conflict with abuse. So many things today get called abusive which are just conflictual. And the difference between them is that if you conceptualize something that's conflictual, then there is a remedy for it. We can sort of assume that there's a pathway. But if you consider it as just abuse, narcissism, borderline personality disorder or any of those things, you've essentially dehumanized the other person, and you've also closed off the possibility that the relationship can be healed. "

Listen now (44 min) | Yascha Mounk and Joshua Coleman discuss how the nature of family life has shifted in recent decades.

09/14/2022

"When I challenge those who value authenticity with questions like these, they generally respond that wanting to be a murderous dictator or a bitter bar fighter are artificial and alien desires. And since racism must be learned, that too is artificial and alien. After a string of such responses, they usually end up defining the true self as that self of which they morally approve. Of course, this makes the praiseworthiness of authenticity tautological, since the true self is, by this definition, capable only of generating morally laudable beliefs and behaviors.

For the value of authenticity to have force, it must mean something more than “One should live in a way that I consider to be admirable.” The most natural meaning of the claim is that a person should live in accordance with his or her natural tendencies and beliefs. But, as already noted, this proposition runs into problems once we accept that (1) some natural tendencies and beliefs are either offensive or destructive; and (2) some people are full of antisocial tendencies and abhorrent beliefs.

I would go even further, though. To get something worth praising from humanity requires effort, discipline, and constant constraint. The celebration of authenticity is premised, often only half-knowingly, on a quasi-Rousseauist belief that humans are naturally good and only corrupted by society. But this belief is patently wrong. Humans are not naturally good or evil. Rather, they are flawed, limited, and contradictory creatures, capable of envisioning a peaceful, cooperative society of abundance, but unable to achieve it because their efforts are undermined by selfishness and rivalry. Although they cannot fully achieve their moral goals, they can, with the guidance of wise norms and institutions, create a lively and flourishing civilization. And the function of these wise norms and institutions is to suppress, discipline, and reshape our natural inclinations. It is, in other words, to produce a cultured and civilized—that is, an artificial—human.

But to be human is to be artificial. And to contend that it is inauthentic to conform to one’s culture and to strive to suppress and overcome one’s natural tendencies is like contending that it is inauthentic for a mockingbird to imitate the song of another species. Paradoxically, the most authentic thing we can do is strive to transcend ourselves and become what we are not."

To be human is to be artificial.

09/04/2022

Good synopsis by the guy who literally wrote the book, "Male, Female."

"The extent of s*x differences in the brain, cognition (for example, spatial abilities), and behavior (for example, personality) continue to be vigorously debated. But minimalists tend to focus on individual behavioral and psychological traits when making their case. Hyde, for instance, argues that most of these differences (such as self-esteem) are small or close to zero. But while single psychological traits are interesting and useful to study, they do not stand alone in the real world. Like physical traits, they are components of more complicated and integrated systems, and s*x differences in these suites of traits are much larger than those found for the individual components.

Brains are a mosaic of integrated regions that in most areas are more similar than different across boys and girls and men and women. At the same time, we would expect s*x differences in the brain to be distributed across regions that are integrated into functional systems (areas that work in concert), such as those that support physical fighting or simultaneously processing and responding to different forms of social information (language, gesture, and so on). The result would be small to moderate differences in some areas, but potentially large differences in whole-brain patterns.

These patterns are the key to fully understanding s*x differences. For individual personality traits, such as emotional stability (about seven out of 10 men are more stable than the average woman) or social agreeableness (about three out of five women are more agreeable than the average man), there are small to moderate differences. These are interesting and important, but if we look at the entire structure of personality, including things like risk-taking, openness to new ideas and experiences, conscientiousness, and so forth, the differences are now two to five times larger than they are for these individual traits.

One study examined the patterns of grey and white matter in the brains of nearly 10,000 boys and girls and asked whether the s*x of the child could be determined by these patterns. They can. The s*x of 93 percent of the children was correctly identified.""

Boys and girls are not infinitely malleable, socially constructed products of the patriarchy.

08/31/2022

Lobotomy led to the only Nobel Prize given for psychiatry. I suspect gender transitioning will eventually be as disgraced.

"Until recently, such mental health issues would have made therapists hesitant to facilitate transition for a young patient. The original Dutch protocol for treating adolescents with gender dysphoria, for instance, was based on research on patients with no serious comorbid psychiatric disorders. Although Dutch clinicians recommended the use of puberty blockers for certain patients, the children were not socially transitioned, which can increase the persistence of gender dysphoria.

But in recent years, concurrent with an exponential increase in gender dysphoria cases among teenage girls, the Dutch protocol has been overtaken by the gender-affirmative model. In this approach, “providers recognise, validate, and support the identity stated or expressed by the individuals served”, per the American Psychiatry Association. This means that clinicians are encouraged to facilitate social transition based on their patients’ self-diagnoses. In stark contrast to the kids from the original Dutch studies, however, the adolescents now presenting with “gender dysphoria” tend to have complicated mental health profiles.

In effect, the mental health profession has performed a U-turn. Whereas it was once understood that complex comorbidities such as depression, anxiety, or eating disorders might be the source of adolescent gender dysphoria, today, American doctors increasingly see it……. as the cause of all other comorbidities. Treat the dysphoria, the thinking goes, and the other conditions melt away. "

Affirmation is not necessarily the right approach