Therapy

I am fairly convinced that my wife has some degree of bi-polar disorder. She goes into fits of rage over any question about her, her parents or upbringing. She constantly belittles me and talks bad about my family to the children. It has escalated in recent years with her attempting to push me, going into 20 minute tirades where she brings up everything that I had done over the last 12 years and her drinking has increased. She drinks to the point that she is carried out of neighborhood parties with the children crying out of embarrassment then blames me. Those who dont tolerate it are ‘fake people’ but the others are ‘true friends’ and she has been going out and staying out all night this past month. What is of greatest concern is that her explosions have increasingly come in front of the children resulting in them crying hysterically and her threatening to ‘kick me out’. She yells at them and then goes into a dialog of how much she does for them and how lucky they are. It is very stressful but I need confirmation that this is what I am dealing with and how do I proceed? A. It’s unclear whether your wife has bipolar disorder. Emotionally she is unstable but it might be due to her drinking. The fact that she is drinking makes it difficult to determine if a mental health disorder is present or if her drinking is the main problem. It may be a combination of both but I cannot make that determination based on this short letter. What is clear is that your wife’s drinking is excessive and is causing a great deal of distress for your marriage and for your children. Both you and the children are subjected to her tirades. It’s abusive, unacceptable and something needs to change. Encourage her to seek psychological treatment or inpatient rehabilitation if necessary. If she is unwilling to seek treatment, then you must take action. This might include seeking psychological help for yourself so that you know how best to deal with your wife or temporarily moving out of the home. Your children should not be subjected to your wife’s tirades. It most certainly frightens them and it’s abusive. You may also want to consider an intervention. By this I mean you and members of your family come together as a group and ask your wife to seek help. During the intervention, members of the group describe how her behavior is affecting them and ask her to receive help. Perhaps she would be willing to seek help if she knew how her behavior was negatively affecting friends and family. I can confirm the fact that there is a problem but I cannot determine the precise problem that is causing your wife to behave in such an unstable manner. Utilize the help of mental health professionals to assist you in dealing with your wife and children. I firmly believe that trained mental health professionals can give you the best advice about how to proceed. I wish you the best of luck. Please take care. Dr. Kristina Randle Mental Health & Criminal Justice Blog

Hi, one of my friends that I have is becoming very toxic to me and I don’t know what to do. She and I met over a decade ago when we worked in the same place. She is on the one hand, tries to be nice, loyal, helpful if I have a difficult situation, knows me well, etc. but on the other hand, she is a very bitter, critical and harsh person- and lately doing it to me as well. I can’t blame her, she is all alone except for her dh and her father (she doesn’t get along w/ her father). She has no children and no job, and has a hard life. However, every time I talk to her, she criticizes me, or the way I do thing, or she is the only one who knows how to do xyz, everyone else is stupid etc. As it is, I have low self confidence and this is very hard for me to take. For example- she’ll ask me how I make a certain dish, and when I tell her-she says in an amazed voice- ‘that’s how u make it. ugh’. (mind you, everyone says I’m a great cook.) And of course if she gives me advice or says I made a mistake, she says she tells me the truth to be helpful, because she cares- but she is so tactless, its almost nasty. I don’t want to cut her off totally- firstly bec I feel bad for her, and also bec. then I will have no friends. So how can I become more immune to her comments? A: It is time for new friends. While I don’t recommend a complete cutoff I do think that everything you’ve said indicates you need to find more people to connect with. Try taking a class, joining a group, volunteering, attending free lectures, etc. In other words, start increasing your contact and connection with other people so you have more choices. Once you have options it will be easier to deal with your friend. Wishing you patience and peace, Dr. Dan Proof Positive Blog @ PsychCentral

It may be a pure coincidence, but at the San Francisco Museum of Modern Art they're displaying a tower of brains during APA week. Meanwhile, the DSM5 is officially out: And if that weren't enough chaos for you, we have the obligatory APA protesters. (Do urologists get protesters at their conventions?) I'm looking forward to meeting with Roy and our longsuffering Clinical Psychiatry News editor for dinner tonight.----- Listen to our latest podcast at mythreeshrinks.com or subscribe to our rss feed. Email us at mythreeshrinks at gmail dot com Our book is out now.

Is 'cloning' appropriate terminology for somatic cell nuclear transfer derivation of human embryonic stem cells?... Tachibana, M., Amato, P., Sparman, M., Gutierrez, N., Tippner-Hedges, R., Ma, H., Kang, E., Fulati, A., Lee, H., Sritanaudomchai, H.... (2013) Human Embryonic Stem Cells Derived by Somatic Cell Nuclear Transfer. Cell. DOI: 10.1016/j.cell.2013.05.006 Human Embryonic Stem Cells Derived by Somatic Cell Nuclear Transfer

. In honor of 100 years of psychiatry at Johns Hopkins, Baltimore cinematographer Richard Chisolm, along with Kindall Rende, created this movie of members of the department talking about psychiatry at Hopkins. Many of the people shown in the film have been guest bloggers on Shrink Rap, and they include our mentors, colleagues, and friends. Both ClinkShrink and I are proud to be members of the department and we are both grateful for the education we've received, so we hope you'll spend a few minutes watching Richard's tribute.----- Listen to our latest podcast at mythreeshrinks.com or subscribe to our rss feed. Email us at mythreeshrinks at gmail dot com Our book is out now.

In two recent posts, I have referenced a relatively-average psychologist (again, this psychologist need not bear any resemblance to any particular person, living or dead). I found this relatively-average psychologist to be severely handicapped in their ability to think about … Continue reading →... Smallegange, R., van Gemert, G., van de Vegte-Bolmer, M., Gezan, S., Takken, W., Sauerwein, R., & Logan, J. (2013) Malaria Infected Mosquitoes Express Enhanced Attraction to Human Odor. PLoS ONE, 8(5). DOI: 10.1371/journal.pone.0063602 Malaria Infected Mosquitoes Express Enhanced Attraction to Human Odor

My fiance and I are in a long distance relationship. We were dating and engaged for 4 years before I broke up with him and relocated across county. We have now been back together a year but the demons from the past are cropping up again. We do fight, sometimes vehemently when it comes to how I choose to spend my free time. It was like this in the past. I’ve been a bit of a hermit the past year and, at his urging, he tells me to find friends and find things to do. I mention to him, a female co-worker and I were chatting about our love of cooking. She mentioned she throws a dinner party once in awhile and I said I’d love to go. She also mentioned her friend was having an art exhibit opening and that was music to my ears. I appreciate art. When I tell my fiance this he immediately says “sounds like the nightlife and acting single, have at it”. There was communication melt down after this. He is concerned that there could be another single man there so it would not be appropriate to put myself in that situation. I feel that is a good compromise since it is not a nightlife or club atmosphere. I was very angry and called him controlling and insecure. He said I was being too dominate and strong and if it made him uncomfortable I shouldn’t go. He now wants to take a break from the relationship and think things over. I feel I have a very short list of things I can do that he would approve of since it was a problem in the past for me to have dinner with friends. He thought that would lead to drinks and then more drinks and clubs and I would come home too late at night. Or I may get buzzed and do something that can damage the relationship. I’ve never violated his trust or damaged the relationship so I feel he makes up scenarios to justify the way he feels. Is there a way that I can communicate to him that me going to a dinner party, or anything of that matter is not disrespectful to him. He’s the one I love, I tell him all the time. In return I get texts or he asks why I wan’t to be with him. Please help. A: You are 35 years old, yet your fiance is treating you like a teenager who has no judgment. You’re correct. He is setting too many boundaries. It seems like all you have to do is even think about attending an art exhibit or dinner party and his mind creates a story about you getting swept up in inappropriate things. He says you are too dominant yet he thinks you are so weak you can’t make good decisions. I don’t see anything good coming out of this. You’ve never violated his trust but he acts as if you can’t be trusted at all. This isn’t a problem of communication. He is so insecure that the only way he feels comfortable in the relationship is by isolating you. Nothing you can say or do is going to change this. He needs serious therapy. I suggest you take a break from this relationship until he does some serious personal work and proves to you that he doesn’t have to limit you to feel okay. I wish you well. |Dr. Marie

Today while we were both in respective dark depressed moods, my girlfriend jumped on me and started kissing me very forcefully. I told her I really did not want to and pushed her aside. I got up and she came up to me, pulled down my pants and started groping for my penis. I pushed her away but she kept forcing and forcing herself on me. I clearly repeated ‘no’ many times. Eventually I got away, as it was difficult because I didn’t want to hurt her, and she pushed me on the bed and grabbed my penis and forcing it in her mouth. I tried to push her away but I didn’t want to hurt her, even though she was hurting me. Eventually I felt as though it was pointless to resist and just let her. I was not aroused at all but still ejaculated (is that really possible?). I since feel so invaded, hurt, angry and most of all, it made me feel even more depressed. Like I’m sinking into this black hole. I feel robbed of something but we have been dating for over 4 years and I’m a man. Should I feel like this? Do I have a right to feel like this? A: You certainly have a right to feel like this and this is an important issue you are bringing forward. Not having your girlfriend respect your refusal is extremely serious. Your boundaries were not respected, you were clear and clearly ignored. This doesn’t sound romantic, exciting, or sexy. It sound degrading and controlling: two characteristics you do not want to have in your partner. Since you are in college I would go to the counseling center and tell them what happened – not as a couple, but as someone who has survived a rape. For more information you may want to check out this article. Don’t wait. The longer you take to begin talking about this, the more uncomfortable it will become. You have taken a good first step here. Now it is time to follow it up with a counselor at your school. Wishing you patience and peace, Dr. Dan Proof Positive Blog @ PsychCentral

Eric Maisel’s new book Making Your Creative Mark promises nine keys to achieving your artistic goals. That’s a lie. The book literally chimes and jingles with keys. The last eleven pages alone has 99 of them, for example these 10: One of the best ways to help yourself create every day is to craft a starting ritual that you begin to use regularly and routinely. When your ritual becomes habitual you will find yourself moving effortlessly from not creating to creating. Reframe discipline as devotion. Creativity is your teacher. Pick a creative project whose express purpose is to teach you something about your situation or your nature. If you regularly block, what do you think are the sources of your blockage? Do you block only on certain work? Do you block at certain points in the process? Do you block at certain times of the year? Become your own expert on blockage! Learn some anxiety management techniques. Anxiety makes us undisciplined. Learn a deep-breathing technique or a relaxation technique to help you stay put. Anxiety is part of the process – learn how to manage it! Don’t shrug away the fact that you’re not completing your creative work. Get to the last sentence of the last page of the last revision. Then launch your piece into the marketplace. If you are not completing projects, do not accept that from yourself! Do you have a plan to survive the countless rejections that will come your way? Create that plan! Create everywhere. Create in the rain. Create buy the side of the road. Create wherever you find yourself! Say, “I will astonish myself.” Then you’re bound to astonish others. There may be days when the work frustrates you horribly. Maybe you’ll downright hate it. Those are the days to love your work! Remember to love your work especially on the days you hate it. And it goes on and on. The thing is that it goes on and on in that vein – the vast majority of his ideas are just really good, and not something you’ve already heard over and over again. Take what he says on anxiety. He devotes a whole chapter to stress and anxiety as it relates to the creative process. In it is a subchapter on The Stress of Marketing Art. Isn’t every creative person familiar with that? When I worked at the Alliance for Arts and Culture, advising artists on how to make money without going crazy, that was a topic we talked about a lot (kudos here to Judi Piggott, the patron saint of Vancouver artists, who invented and ran that program for twelve years). So what are the parts of that stress? Thinking about selling your art Not knowing what to say Dealing with people who hold the power and the purse strings Feeling pressured to “sell yourself” Dealing with people who dismiss you Not feeling up to asking Does any of this feel familiar? Of course. And you may not even be an artist. And over and over he says, if this creates anxiety for you, go and find a way to deal with the anxiety. Don’t give in to it. That in itself is a pretty uplifting message. Maisel doesn’t give you tons of ways to deal with the anxiety; instead he points to one of his other books, such as Mastering Creative Anxiety. Oh yes, he knows how to sell his own stuff, so he knows what he’s talking about. And he has a lot of stuff – almost 40 books, seven of them fiction. And some meditation decks. And a home study course. And he’s a coach and a therapist with a PhD. Honestly, I think every creative person should own at least one of his books. This man knows what he’s talking about.

Blue Harvest @ Wikipedia @ Family GuyI need to create a suitable atmosphere for this post, so try this music for size and think Blue Harvest...Right. The wait is over. The discussions / arguments / objections / agreements are all confined to history. Drum roll, spotlight centre-stage... enter DSM-5 and into unknown territory we all go, particularly with autism, sorry.. autism spectrum disorders (ASDs) in mind.As you can see from the link above to the new diagnostic guidelines from the American Psychiatric Association (APA) the diagnosis of autism has, as was widely anticipated, changed somewhat to encompass quite a few adaptations (see this previous post).I'm not saying too much more on this at the present time, bearing in mind 'spectrum' is a word which seems to get more of a mention in this revision of the DSM; and not just with autism in mind (see here and here*).Obviously things aren't going to just change overnight with DSM-5 as it is eventally rolled out. Clinicians will need to learn some new diagnostic brushstrokes. Remember too that DSM is only one part of the diagnostic manuals currently in use (although even ICD is subject to revision in coming years already mentioning something called Social Reciprocity Disorder?). That being said, the implications of DSM-5 on issues like the autism numbers game - same as what happened across previous versions - are probably going to be subject to some pretty intense scrutiny over the coming years.Don't also be under any disillusion that the new changes are going to herald any giant leaps forward in autism research anytime soon. Interestingly, Dr Tom Insel, head of the US National Institute of Mental Health (NIMH) was recently quoted as saying that "NIMH will be re-orienting its research away from DSM categories", reported also by other authors** (open-access). In other words, even with the fresh smell of new DSM in the air, a new 'nosology' is already planned.To close, Peter 'Han Solo' Griffin on TIE fighters... dan-dan-da-dan, da-da-dan-dan-dan...---------* Adam D. Mental health: on the spectrum. Nature. 2013; 496: 416-418.** Lai M-C. et al. Subgrouping the autism “spectrum": reflections on DSM-5. PLoS Biol. 2013; 11: e1001544.----------Lai M-C, Lombardo MV, Chakrabarti B, & Baron-Cohen S (2013). Subgrouping the Autism “Spectrum": Reflections on DSM-5 PLoS Biology... Lai M-C, Lombardo MV, Chakrabarti B, & Baron-Cohen S. (2013) Subgrouping the Autism “Spectrum": Reflections on DSM-5. PLoS Biology. info:/