Blog Posts – Page 3 – Dr. David Godot

SCEH 2009 in Reno, Nevada

I recently had the great pleasure of attending the 2009 Society for Clinical and Experimental Hypnosis conference in Reno, Nevada. My primary purpose in attending was to serve on the faculty for the Introductory Workshop in Clinical Hypnosis. I had spent the previous weeks helping workshop co-chair Dr. Edward Frischholz in preparing an updated curriculum for the workshop. Dr. Frischholz’ vision for the new training model is to enhance the workshop’s focus on empirically validated methods of assessment, treatment, and training.

As a faculty member I was in the esteemed company of Dolores Bjorkman, Dabney Ewin, Ed Frischholz, Hedy Howard, Steve Kahn, Rick Kluft, Dave Patterson, Steve Pauker, and Eric Willmarth. My role as a faculty member was to provide supervision during each of the five supervised small group practice sessions, and to assist in the scheduled demonstrations of hypnotic induction and hypnotic phenomena.

As the least experienced member of the faculty, I did not present any didactic material. However, I received 22 CEU credit for my attendance at these workshop sessions and am now competent in the provision of introductory clinical hypnosis training. There are plans for the Chicago Society of Clinical Hypnosis to offer a basic workshop this winter, and I will be on faculty for this event as well.

Outside of workshop hours, I also had an opportunity to attend a few presentations and one scientific paper session. I was excited to see Dave Wark present on alert, eyes-open hypnosis. I am very interested in the potential use of alert hypnosis, particularly in performance-enhancement and coaching scenarios.

I also has the pleasure of seeing Ron Pekala present his ideas on the conceptualization and measurement of the phenomenology of consciousness. I was trained in provision of the Phenomenology of Consciousness Inventory Hypnotic Assessment Procedure (PCI-HAP) during my own introductory hypnosis training under Dr. Ian Wickramesekera II.

Homemade Low Carb Chicken Soup Recipe

I’m not feeling very well this week. Last week I came down with something I’m pretty sure was swine flu, while Sara Kay was busy coming down with a wicked head cold. As usual, we each let our diseases run their course and then traded off to extend the fun. So now I’ve traded in H1N1 for a good old-fashioned rhinovirus.

I spent the morning in my least favorite class of the semester, and then went over to my friend and mentor’s office to work on planning our schedule for the upcoming Society of Clinical and Experimental Hypnosis conference workshop. By the time I was done there my head just about felt like it was going to fall off, and my nose was running, and of course it was a cold and rainy day in Chicago, so I decided I absolutely needed a big pot of homemade chicken soup. Continue reading Homemade Low Carb Chicken Soup Recipe

What To Think About Before You Start Therapy

When you’re considering psychotherapy, you should remember that the most important aspect of the treatment, in terms of predicting whether it will be effective for you, is the relationship itself. A deeply trusting and cooperative relationship with your therapist must be developed in order for all the other things that need to happen to happen. So, first of all, find a therapist you like and feel understood by. That means calling up a few different therapists and speaking with them over the phone, maybe even going in for consultations, until you find someone who you feel like you can relate to.

The next thing to understand is that different therapists will approach the treatment from different angles. I’ve spoken with an awful lot of people who had “tried psychotherapy” and been disappointed by a therapist whose treatment style just didn’t mesh with their own way of thinking. In some respects, the ability to adapt to the needs of the patient is the mark of a really good psychotherapist. But there is also an element of the basic theoretical underpinnings of different types of therapy simply not being a good fit for a certain individual’s personal style. So you may want to look for a psychotherapist whose theoretical orientation is basically appealing to you.

There are three major theoretical schools in modern psychotherapy: Cognitive Behaviorism; Humanistic, also called Client-Centered; and Psychodynamic. Each of them approaches the patient and the treatment from a different place, and they will each feel very different to you in practice. There’s been a good deal of research to try and determine which of these is the most effective, and it’s pretty much all come back that they are equally effective, so I think you should simply go with whichever one seems most appealing to you (or whichever one your favorite and most respected therapist happens to practice.)

Cogntive Behavioral Therapy approaches the treatment from the understanding that we are all engaged in a dialogue with ourselves all the time. It happens automatically, and it’s one of the main ways that we generate feelings and behaviors. That applies to positive feelings as well as negative ones, so a Cognitive-Behavioral therapist will attempt to help you identify the automatic negative thoughts that are making you feel and act in suboptimal ways. Once you’re able to recognize the cognitive mistakes that have been lodged in your thought process, this type of therapist will help you to modify these ways of thinking, so that your automatic thoughts are more conducive to the types of emotions and activities that you want.

Humanistic or Client-Centered Psychotherapy approaches the treatment from the understanding that every person has an inherent tendency to grow and to improve—to self-actualize. And that all we need to activate our tendency to begin growing into better versions of ourselves is just a basic level of nurturance and empathy. So, a Client-Centered psychotherapist will gradually help you to experience the therapeutic relationship as a place where you will never be rejected, no matter what happens. They will allow you to explore your own emotions and come to your own realizations at your own speed, by providing you with the basic ingredient of simple, unconditional positive regard.

Psychodynamic Psychotherapy approaches the treatment from the understanding that we are all thrown into this world cold and naked, surrounded by omnipotent giants whom we are absolutely dependent upon for survival. From there, we simply do whatever we have to do to adapt to that situation—and we generally do a very good job of adapting. The difficulty comes when the situation changes. Despite finding new situations and new people, we generally tend to feel and behave as though we were still in the same situation with the same people. So, a Psychodynamic psychotherapist will spend some time helping you to understand the ways you adapted to your early life, and how those early experiences are affecting your current circumstances. Then they will help you to reconfigure your approach to the world so that it is more flexible, and more congruent with your current situation.

Those are the three major types of psychotherapists that you’ll encounter in the wild. Of course, there are a wide variety of offshoot sects and in-betweener “eclectics” with whom your mileage may vary. The important thing is that you can personally like and respect the therapist, and feel liked and respected by them. It is also important that you enter into the therapeutic relationship with a good understanding of how your therapist will approach the treatment and why. In many cases they will offer you an explanation of how they work as a part of the early stage of therapy, but if they don’t you should definitely ask.

This is because psychotherapy is a collaboration. There is no magic pill for the therapist to feed you to make you perfectly happy and well-adjusted, and there is nothing the the therapist can really do “to you” to make it happen either. It’s going to take some work on your part. A good therapist will be able to help you to feel motivated to do that work to some extent, and to help you figure out exactly what types of things you need to do, but do not expect to enter into psychotherapy as a passive recipient of treatment. That’s why it is so important for you to know what is going on in the therapy, to understand your therapist’s theory of change: so that you have some idea of what you’re expected to do if you’re going to change yourself and your life for the better.

Aging Brains Only Shrink When They’re Sick

It is well known that the average brain size of elderly people is smaller than that of younger ones. Most doctors and scientists have decided that this is a normal part of aging. However, it turns out that this may not be the case.

A new study in the APA journal Neuropsychology used a highly controlled sample from Maastricht University’s long-term Aging Study in Holland. These individuals were screened every three years for a wide range of neurological problems, and divided into groups based on level of functioning. Neuropsychological test batteries were used to determine how well participants maintained neural functioning, and MRI scans were used to measure the physical size of seven brain areas important for aging, including hippocampal and parahippocampal areas as well as the frontal and cingulate cortices.

Study participants showed a loss of brain mass in direct relationship to cognitive decline. The researchers conclude that age-related decreases in brain size likely reflect pathological changes in the brain, rather than natural processes of aging.

This is a great example of the need for more cautious and methodical interpretation of clinical research. In attempting to determine what is normal, it is too easy for clinical researchers to miss the mark on what is optimal.

Citation: Burgmans, S., van Boxtel, M.P.J., Vuurman, E.F.M.P., Smeets, F., Gronenschild, E.H.B.M., Uylings, H.B.M., & Jolles, J. (2009). The prevalence of cortical gray matter atrophy may be overestimated in the healthy aging brain. Neuropsychology, 23 (5), 541-550. [PDF]

Mental Health Parity: A Policy Analysis

Although psychological and addictive disorders have come to be recognized as common and treatable conditions within the medical profession and even among the general population, the United States health care system is still lagging behind. Insurance companies do not provide equal coverage for mental health services, and most Americans lack access to even basic mental health care. The goal of interest groups campaigning for better mental health coverage has been to achieve “mental health parity,” meaning that that mental health services would be covered at the same level as general medical services and surgical procedures.

The first major victory is this campaign came in 1996, when Congress passed a law mandating equal annual and lifetime dollar limits for mental health benefits. A more recent piece of legislation has extended this parity in benefits to co-payments, deductibles, out-of-pocket limits, and caps on the number of inpatient or outpatient visits. The passage of this law is being hailed as a tremendous success by advocacy groups. However, the law has problematic limitations that may actually serve to increase systemic barriers to mental health treatment, particularly among the working poor and the lower middle class.

In this analysis we will examine the consequences of the present mental health parity law, and the structural barriers that continue to limit access to mental health services. We will examine the consequences of these limitations, both for the affected individuals and for the society as a whole. Finally, we will propose changes to the current policies which could remedy the problems we outline.

Why Mental Health Parity Is Needed

The Substance Abuse and Mental Health Services Administration (SAMHSA) conducted a comprehensive National Survey on Drug Use and Health in 2002, and found that more than five million individuals meeting criteria for serious mental illness “perceived themselves as having an unmet need for treatment in the year prior to the survey” (Bender, 2003). Of these, nearly 2.5 million severely mentally ill individuals cited insufficient financial resources as the primary reason that they were unable to receive appropriate treatments.

This means that, as of 2002, nearly 1% of the entire population of the United States is comprised of severely mentally ill individuals who want treatment but are unable to afford it (U.S. Census Bureau, 2003). This figure does not include individuals whose mental illnesses are distressing but not debilitating, who likely number in the tens of millions, nor does it include individuals suffering from substance abuse disorders, of whom there may be more still. The magnitude of the problems we face in ensuring treatment of psychological and addictive disorders constitutes a public health crisis.

This crisis reaches beyond the mental health system by putting an undue strain on the nation’s medical infrastructure. According to O’Donohue & Cucciare (2005), “research consistently shows that patients with psychological problems use more [medical] services than those without diagnosable psychological problems.” For example, one recent study tracked a sample of individuals admitted for inpatient treatment of various medical conditions. At four years, patients who demonstrated psychological factors such as depressive or aggressive tendencies had been readmitted for further medical treatment at a rate twice that of their counterparts with no psychological comorbidity. The total number of days of inpatient care utilized for the treatment of physiological conditions also doubled for these patients (Saravay, Pollack, Steinberg, Weinschel, & Habert, 1996).

The good news is that psychotherapeutic treatment reliably reduces medical service utilization. Mumford, Schlesinger, Glass, Patrick, & Cuerdon (1998) describe a history of research demonstrating that the delivery of mental health services is strongly predictive of decreased utilization of medical services across the board. They conclude that the evidence for a general cost-offset effect following outpatient psychotherapy is “widespread and persistent” (p. 85), with the most substantial savings coming from a decrease in inpatient service utilization.

Steps Toward Mental Health Parity Implementation

As we have mentioned, the first step toward mental health parity in the United States came with the passage of the Mental Health Parity Act of 1996 (MHPA). The act required that insurance policies which included mental health coverage do so at the same annual and lifetime dollar value as their coverage for general medical and surgical services (NASW, 2002). However, disparities between co-payments, deductibles, and out-of-pocket expenses were not affected by the bill, nor were any of the millions of insurance policies which provided no mental health coverage at all.

The U.S. Congress expanded on this effort to improve mental health coverage for Americans in 2008, by passing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The MHPAEA addressed a number our concerns regarding the MHPA. It required that employers whose insurance plans include mental health and/or substance abuse coverage eliminate any remaining disparity with medical coverage, including co-payment amounts, total out-of-pocket expense limits, deductibles, and annual limits on inpatient and outpatient visits (Bernstein, 2008).

However, the MHPAEA still placed no requirements on payees to provide mental health coverage to their beneficiaries. This means that, as before, only patients whose medical coverage includes optional mental health benefits will be able to benefit from the new law. Individuals’ whose insurance coverage does not include optional mental health coverage will remain without access, as will the millions of uninsured Americans (Jenkins, 2008).

Problematic Impacts of Mental Health Parity Legislation

Like the 1996 Act, The MHPAEA places a substantial financial burden on employers and other insurance payers without placing any additional regulation on insurance providers and managed care organizations. Opponents of comprehensive parity legislation have argued that any new regulations on the insurance industry would precipitate the loss of other, unprotected health care benefits in order to offset the cost (Carroll, 2004). However, placing the burden on employers will likely result in severe consequences for lower and middle class workers.

We can predict this because it is essentially what took place after the passage of the MHPA, which represented much less of an imposition on employers. According to the National Association of Social Workers, the “U.S. General Accounting Office reported in May 2001 that 86 percent of employers surveyed reported that they had complied with the requirements of the 1996 Act. Nevertheless, the vast majority of those employers substituted new restrictions on mental health benefits, thereby evading the spirit of the law” (NASW, 2002, Background and legislative history section, ¶ 10). With the new requirements being much more demanding, it is likely that many employers will simply see no benefit in continuing to provide mental health coverage, particularly for employees who are not considered valuable enough to warrant competitive benefits packages.

This means that by placing the burden of providing additional coverage on employers, the MHPAEA has essentially given employers an incentive to drop existing mental health coverage for low-wage employees. Workers who previously had inadequate access to mental health services are likely to see even their inadequate mental health benefits disappear. Such a change will disproportionately affect the working poor, a group whose high levels of external stress create a greater need for the very services they will be losing access to.

Meanwhile, advocacy groups such as the American Psychological Association are lauding this new law as a huge victory in the fight to end discrimination against sufferers of psychological illness (APA, 2008). What has actually taken place is the passage of federal legislation which effectively institutionalizes the medical discrimination which was already taking place within the insurance industry. Furthermore, the Act has freed the insurance industry from any responsibility for ending that discrimination, instead placing the burden on a group which has far less interest in the provision of those benefits to the individuals who need them most.

Solving The Problem Of Mental Health Parity

The laws that have been passed so far are out of line with the basic ideology underlying mental health parity, which is that mental illness is a medical condition. Based on this premise, it is reasonable that sufferers of mental illness be able to expect treatment comparable to that which they would receive for any other illness. Any medical service plan that excludes coverage for psychological conditions is therefore unfairly discriminating against sufferers of a particular set of conditions in a way that has been outlawed when it has occurred in the past.

There are two main counter-arguments that can be made against this premise. The first is that mental illnesses are not medical conditions (Kershaw, 2008). However, as executive director of the Suicide Prevention Action Network USA in Washington Jerry Reed (2007) points out, a growing body of research has solidly established distinct physiological correlates of individual mental illnesses. Furthermore, mental illness results in a far greater number of fatalities each year than HIV/AIDS. There are nearly 30,000 mental illness-related suicides in the United States each year (Reed, 2007).

The second major counter-argument against our premise of mental health parity is that insurers should have the right to exclude certain classes of conditions as they see fit. As we have already discussed, legislative precedent contradicts this idea. Congress has already specifically outlawed this type of exclusion both for the elderly and for patients diagnosed with HIV/AIDS (Wellstone, 2002). This precedent takes on added weight when we consider that the level of fatality resulting from mental illness is much higher than that of the very disease for which Congress previously intervened.

Given, then, that the premise of mental health parity is sound, it becomes the duty of insurance providers to include mental health coverage as a part of basic medical benefit packages. Placing the burden of improving mental health coverage onto the individuals and organizations purchasing the coverage is not in keeping with the philosophy that mental illness and its treatments are equivalent and of equal importance to all other medical conditions and services. The way to implement that philosophy would be to require that insurance providers simply include mental health services under the existing terms of their coverage for general medical services.

Aside from being philosophically sound, this method of implementing mental health parity is also highly pragmatic. Insurers stand to benefit financially from offering better coverage for mental health services. Full mental health parity would represent a total cost increase of about 1.5% for most managed care organizations (Carroll, 2002). That increase would be more than offset within just a few years by the resulting reduction in general medical service utilization (Mumford et al, 1998). Employers, on the other hand, may stand to realize some increases in worker productivity as a result of better access to mental health services (see, for example, Wang, et al, 2007; Hartmann & Zepf, 2004; Hafner, Haug, & Kachele, 2004; Jordan, Grissom, Alonzo, Dietzen, & Sangsland, 2008), but ultimately have far less demonstrable interest in the provision of these services.

We therefore conclude that the most logical, feasible, and enforceable method of implementing mental health parity is to require insurance providers to include mental health treatments in their definitions of general medical treatments. By prohibiting the segregation of mental illness from physiological illness, equitable coverage is ensured without the substantial loopholes seen in the 1996 Parity Act and again in the 2008 Act. Furthermore, this method of enactment provides an ultimate financial benefit to the very organizations it holds responsible for implementation.

The problem in implementing this strategy is, of course, a political one. The insurance lobby is both exceptionally powerful and highly resistant to legislation which would increase its obligations. They have, unsurprisingly, supported legislation which offloads responsibility for mental health coverage onto businesses. For this reason, the business lobby seems like a natural ally in our attempts to redefine medical coverage to include mental health services. However, it is arguable that they have enough to gain to make substantial involvement worth their while.

The primary stakeholders in this redesignation seem to be healthcare providers and patient groups. Providers stand to gain from the opportunity to expand their mental health services, while patient groups have an interest in ensuring that comprehensive services are available. It may be possible to enhance the support of both groups by forming grass-roots organizations for individuals and families whose medical status has been affected by inadequate mental health care. These groups could act as emissaries between other stakeholder groups.

References

American Psychological Association (APA). (2008, October 3). Landmark victory: Mental health parity is now law [Press release]. Retrieved November 17, 2009 from http://www.apa.org/releases/parity-law1008.html
Bender, E. (2003). Cost, confidentiality keep many from MH treatment. Psychiatric News, 38(19), 13.
Bernstein, E. (2008, October 16). How New Law Boosts Coverage Of Mental Health Care. Wall Street Journal. Retrieved November 17, 2009 from http://online.wsj.com/article/SB122411631825638659.html
Hafner, S., Haug, S., & Kachele, H. (2004). Need for mental health services in employees. Psychotherapeut 49(1), 7-14.
Hartmann, S., & Zepf, S. (2004). Improvement of general psychological functioning achieved by psychotherapy: A comparison of three psychotherapeutic methods. Psychotherapeut, 49(1), 27-36.
Kershaw, S. (2008, March 20). The murky politics of mind-body. The New York Times, WK1-WK4.
Mumford, E., Schlesinger, H.J, Glass, G.V., Patrick, C., & Cuerdon, T. (1998). A New Look at Evidence About Reduced Cost of Medical Utilization Following Mental Health Treatment. Journal of Psychotherapy Practice and Research, 7, 65-86.
National Association of Social Workers (NASW). (2002). Mental Health Parity. Retrieved November 17, 2009, from http://www.socialworkers.org/advocacy/updates/2003/021103_mental.asp
United States Census Bureau. (2003). Statistical abstract of the United States: Population 1900 to 2002 (HS-1). Retrieved November 17, 2009 from http://www.census.gov/statab/hist/HS-01.pdf
Wellstone, P. (2002, June 19). It’s time to act on mental health parity issue. The Hill, p.42.
Wang, P.S., Simon, G.E., Avorn, J., Azoca, F., Ludman, E.J., McCulloch, J., Petukhova, M.Z., & Kessler, R.C. (2007). Telephone screening, outreach, and care management for depressed workers and impact on clinical and work productivity outcomes. JAMA: Journal of the American Medical Association, 289(12), 1401-1411.

Hypnotizability May Be Unrelated To Dissociation & Cognitive Inhibition

The prevailing theories of hypnotic susceptibility hold that the ability to experience hypnotic phenomena is a function of either dissociative capacity or of attentional control. However, an upcoming study in the journal Consciousness And Cognition claims to challenge both of these ideas.

The researchers administered the Waterloo-Stanford Group Scale of Hypnotic Susceptibility (Form C), the Dissociative Experiences Scale (normed for non-clinical populations), and a series of cognitive inhibition tasks to 180 study participants. They conclude, decisively, that “the data ruled out even moderate correlations between hypnotic suggestibility and all the measures of dissociation and cognitive inhibition.”

The implications of these findings are uncertain. After all, the idea that hypnotizability exists as a biological or personality trait at all is controversial. From the perspective of those therapists who suspect that everyone is susceptible to some form of hypnotic experience, it is unsurprising that investigations into hypnotic ability should lead to unpredictable and ultimately meaningless results.

But even if we assume the validity of hypnotic susceptibility as an individual trait, then these findings are of questionable value. With regard to dissociation, this study’s findings are not new. Many conflicting studies have found varying levels of relationship between hypnosis and dissociation, which are now generally considered to be related but separate phenomena.

The study’s findings on cognitive inhibition are interesting, but without the use of a reliable measure of inhibitory cognitive control little can be said other than more research in this area may be warranted.

Citation: Dienes, Z., Brown, E., Hutton, S., Kirsch, I., Mazzoni, G., & Wright, D.B. (2009) Hypnotic suggestibility, cognitive inhibition, and dissociation. Consciousness And Cognition.

Early Recollections And The Lifestyle

A few years ago, when I was only just beginning to learn about Adlerian theory and therapy, I attended a workshop given by Al Milliren for the Chicago Adlerian Society. The topic was the evolving nature of the lifestyle.

At this time I had barely begun taking doctoral classes at the Adler School of Professional Psychology in Chicago, and had not yet had any formal education in Adlerian psychology. Some of the powerful ideas that I learned at this workshop greatly influenced the way that I would later learn and incorporate the use of early recollections and lifestyle assessment in my own clinical practice.

When an individual recalls any event from the past, Adlerians hold that the recollection will be shaped and rewritten according to the private logic of the individual’s present condition. Milliren argued that it is seldom necessary to perform a full lifestyle assessment, because the information presented through recollections is packed densely enough to provide all the necessary information that a therapist needs to understand the presenting problem and discover appropriate solutions.

For example, if you were to ask a client how they learned to ride a bicycle, they will normally be able to recount this process with little trouble. They would explain the extent to which they were attended to and encouraged by an adult, recount their early successes or failures and the social consequences of these experiences, and likely offer a pretty good idea of the feeling they were left with through this process. Since we know that the information being provided is not necessarily representative of past events, then what can we assume we know?

Here the patient has described his or her entire process of learning. As a therapist, you now know to what extent the patient will need or want handholding as they learn to overcome their difficulties. You know how much of the learning process must take place in solitude, and what kinds of fears and anxieties will surface during that process. The patient has provided you with a full map of what you can do to help them learn.

Of course, this is only one example. The idea of taking early recollections has always been to ascertain the client’s current orientation toward themselves, the world, and others. It is only a subtle extension of this idea to arrive at a fully holographic model of recollection, in which each recollection contains, more or less, the entire lifestyle.

Re-Branding Psychology: Why Therapists Have Got It All Wrong & What We Can Do About It

The field of psychology is suffering a crisis of identity which is devaluing its services and damaging its practitioners. The problem, in my opinion, is the paradigm of mental health versus mental illness. “Mental illness” is a terribly stigmatizing descriptor, and “mental health” is not a sufficiently attractive construct to warrant the average person subjecting themselves to the stigma of association with the mentally ill.

Who Are The Mentally Ill?

My discussions with contemporary psychologists lead me to believe that most therapists use terms like mental health and mental illness in an attempt to normalize their patients’ experiences. They conceive of mental illness as a spectrum parallel to that of medical illness, and assume that their patients feel the same way. And, for patients who are cultivating a dependency upon the mental healthcare system, this is the case.

However, I believe the average person has a very different idea of what mental illness is. The average person conceives of “the mentally ill” as the sort of folks who one sees babbling incoherently on the street, frightening children on public buses, and overturning chairs in psychiatric hospitals. There are some fairly good historical bases for this association, owing largely to the language used by mental health professionals over the past century and the inadequate treatments that have been available for severe mental illness.

People are afraid of the mentally ill, and you’re not doing anybody any favors by trying to tell them not to be. It is simply not an efficient approach to reducing stigma. A better way is to adjust your terminology so as to not activate preexisting stigmas.

The Message Of Psychotherapy

In other words, psychologists have entirely missed the point of their own services, and in so doing have degraded the entire profession. The message of psychotherapy is that any individual, at any stage of maturity and any station in life, can gain better control over his or her own mind. That’s it.

There is a wide body of literature which demonstrates that psychotherapy can improve the quality of life of normal people with no diagnosable psychological disorder. That it can improve relationships, coping, and enjoyment. That it can improve physiological health, both in healthy people and in people suffering from medical conditions. That it can prevent medical and psychological conditions for which one is at risk. There is scientific proof that psychotherapy can make people better.

And yet we focus exclusively on the curative aspects of our profession. We use terms like ‘mental health’ which draw on 20th-century associations to ‘mental patients.’ We offer ourselves up for relational handholding, condescending analysis of cognitive errors, and pseudo-medical advice-giving.

Psychotherapists have a unique, and extremely lucrative, opportunity to place themselves at the very cusp of the oncoming transformation of medicine from a remedial art to a preventative and cosmetic one. And, for the most part, we are wasting that opportunity.

What Can Psychotherapists Do?

It is our responsibility as therapists to reduce the stigma associated with our profession and with our patients. In the cultural climate that we have helped to create, this sounds like a very difficult thing to do.

Indeed, there is a fair amount of literature in which prestigious and otherwise intelligent flop around the issue of what can possibly be done to intervene in mental health stigma. They tend to focus on small presentations from individuals who have suffered from mental illness, and tend to show small to moderate effectiveness in modifying the attitudes of group participants.

Nope, That’s Not It

The narrowness of this approach is striking. Remember, it was not that long ago that psychotherapy (or at least psychoanalysis) was considered a luxury service. It was a sign of affluence to attend thrice-weekly sessions at substantial expense. There was an air of mystery and exploration around the process, and it was highly sought-after. And we actually have a lot more to offer now than we did back then!

But if there is one thing that contemporary psychotherapists seem to adore, it is demystification. And for the life of me I cannot understand why that would be. It does not add any benefit to the treatment, does not help keep patients in therapy, and does not help attract new patients to therapy. And yet we seem to want to give the impression that everything is all figured out and that we’re not really doing that much at all.

The human mind is incredibly deep and mysterious. In developing our intuitive sense of its inner logic, its cryptic compensations and metaphoric leaps, we are making ourselves nothing less than the shamans of the modern age. The process of psychotherapy should absolutely be based on scientific understandings, but we must not delude ourselves that we have really fully figured out what is going on in there. We have not.

And when we market our services based on the pseudomedicalization of functional disruption, that is exactly what we are implying. We are not only misrepresenting ourselves, we are actually doing so to our own detriment and to the detriment of our patients.

So Here’s What We Need To Do

If we are going to rectify the situation, we must begin using our knowledge of psychology to market our services for what they are and for what people want them to be. We must reintroduce the mystery of being human and suggest that we can help to explore, deepen, and enrich that mystery.

We must advertise the incredible improvements that skillful psychotherapy can introduce into a person’s life. We need to stop going on about this misguided notion of “mental illness” and instead start focusing on what people stand to gain from coming to see us. This is not rocket science; it’s not even slick advertising. It’s just plain good business.

Completed My Doctoral Psychotherapy Practicum

As of Wednesday evening my psychotherapy practicum is complete!

I spent the year externing on the Valeo Intensive Outpatient Unit at Chicago Lakeshore Hospital. Lakeshore is a freestanding psychiatric hospital, and the IOP unit is located a couple blocks away in a separate building. Many of the patients I saw there were transitioning from inpatient care, some were going back and forth between inpatient and outpatient, and some were admitted solely for intensive outpatient treatment.

Valeo is a specialty program that serves gay, lesbian, bisexual, and transgender (GLBT) individuals, and patients come from a wide range of socio-economic, cultural, and personal backgrounds. Nearly all patients were dually diagnosed mentally ill substance abusers (MISA), with a few patients being treated solely for mental illness and others presenting with primary addictions.

The bulk of my experience there was in providing group psychotherapy and group substance abuse counseling, and one of the major challenges of the practicum was in balancing groups between the needs of highly diverse patients presenting with a wide variety of complaints and levels of functioning. I was also able to work with a number of patients individually in addition to my time with them in group. This allowed for the rapid expression of some fairly powerful dynamics, and offered unique treatment opportunities.

Over the course of the year I was able to do a great deal of individual and group psychotherapy work with patients suffering from severe anxiety and personality disorders. I used this opportunity to develop my skill in the use of techniques such as relaxation, mindfulness training, and visualization. In my final review, my supervisor reported that my work in this area had made a substantial contribution to the program.

I also gained experience in administrative aspects of the intensive outpatient program, particularly in planning and executive treatment groups. As a final project, I designed and administered a series of therapy groups focusing on attachment styles. I provided psychoeducation on the early formation and adult manifestation of various attachment styles, and relating these ideas to recovery concepts such as codependency. Next I provided cognitive-behavioral group psychotherapy aimed at helping patients to recognize the ways that their own styles of attachment impacted their relationships and to begin to approach those relationships in ways that promote increased feelings of security. Finally, I engaged the group in a visualization exercise designed to access and amplify existing experiences of security and adequacy.

I will be receiving my Master’s degree in Counseling after the summer term, and plan on sitting for the Licensed Professional Counselor license. I have only a few classes left to take, so over the next year I will be finishing those up, writing my doctoral dissertation, and hopefully working as a counselor. If you know of any job opportunities in Chicago, please let me know!

Chicago GLBT Behavioral Health Training Consortium

My doctoral psychotherapy practicum on the Valeo Intensive Outpatient Unit at Chicago Lakeshore Hospital focused on the treatment of mentally ill substance abusers within the gay, lesbian, bisexual, and transgender (GLBT) community. Valeo is one of three GLBT-focused treatment programs in the Chicago area, along with Howard Brown and The Center on Halsted.

These three sites collaborate to provide their externs with weekly didactic sessions on issues specific to individuals within the GLBT community. So, over the past year I gained a very broad base of knowledge about the clinical issues and approaches recognized within this field, while simultaneously working with gay, lesbian, bisexual, and transgendered clients. This provided an integrative experience that definitely improved my understanding of the interactions between social and psychological factors for minority groups.

Didactic sessions I attended included:

Boundaries & Self Disclosure
Internalized Devaluation & the Coming Out Process
Substance Abuse Assessment Issues
Assessment Issues with Transgender Clients
Domestic Violence Assessment Issues
GLBT Youth
Midlife Issues for GLBT Clients
Issues in Older Adult GLBT Populations
GLBT Sexual Assault: Barriers to Care, Recovery, & Survivorship
Work with the BDSM/Kink/Leather Communities
GLBT Issues in Higher Levels of Care
Spirituality Issues in the GLBT Community
Termination Issues
HIV Grief & Loss Issues
Legal Issues in HIV/AIDS Clinical Work
Ethnic Minority GLBT Clients: African American
Ethnic Minority GLBT Clients: Hispanic/Latino
The Gay/Straight Divide in Therapy
Children of Same-Sex Parenting
Working with Female Couples
Working with Male Couples

While many very specific issues were covered during the course of these training sessions, I found that ultimately it is the similarities between people that are the most useful as a psychotherapist. I do think that it can be valuable to learn about a specific minority population in-depth in order to be able to be more conversant in their culture. However, for me the main takeaway message has been that ultimately the diversity one finds within any group tends to be equal to the diversity between groups.

If a therapist enters the therapy ready to try to understand the individual clients’ specific worldview, I think they will tend to be more successful than even a better-informed therapist who has it in mind that a client should fit into a particular type of category. Having worked with clients from a tremendous variety of backgrounds over this past year, I have found that openness and candor are two of the most important prerequisites of successful therapy, regardless of the client’s race, ethnicity, gender, sexual orientation, socio-economic status, or any other demographic factor.

Hermann Rorschach & The Amazing Technicolor Inkblot

On a psychodiagnostic residency, where your job is just to understand people, one of the tools you use is the famous Rorschach Inkblot Test. In this test, the patient is shown a standard series of pictures created by squirting ink onto a page and then folding the page over. They are then asked to describe what they see in the blots. The answers contain all the keys to the patient’s perception. You may not see, at first, how an explanation of this technique can be of any practical value to you unless you are training to be a psychologist, but if you’ll read on I can promise you there is a payoff for us wayward seekers of personal growth.

First, though, I need to give you a little background. Most people who are being trained to administer the Rorschach tend to be a little amazed at first when it actually works. And, of course, potential recipients of this test tend to be a little skeptical that it will actually be able to provide any worthwhile information about them. After all, what’s in an inkblot?

The story goes back to the early days of psychoanalysis, when the idea of an unconscious mind was fairly fresh and everyone was trying to figure ways to bring it out of hiding. Around this time, Carl Jung was discovering that a person’s reaction times to word associations could be used to detect complexes, which are hidden pockets of emotional energy that essentially take on a life of their own. For Rorschach, showing people random pictures–inkblots–was a way to see the content of those complexes in the backwards, metaphorical, dreamlike state that they exist.

Enter Exner. John Exner decided to administer the Rorschach test to a large number of people and then statistically analyze not only the content of their answers, but the process. From this he would ascertain what types of people approach the problem in specific ways. After all, it is a highly generalizable situation: the patient is presented with a series of ambiguous stimuli and tasked with making some kind of sense out of them. How like life.

So you hold the card, you twist and turn it, and forms emerge. It is just like when you stare up into the clouds. Sometimes the images you see are simple and sometimes they are highly detailed; sometimes you can show other people exactly where they are and how they look, while other times your ideas about the cloud are a little bit far out and no one else can see it the way that you see it. Sometimes the way the edges of the cloud disperse light make it look rounded and three-dimensional, and sometimes the cloud’s texture or coloration contributes to the image. It’s a big fluffy dog, or a scaly dragon, or a ferocious mother-in-law.

Any way you slice it, you can be certain that the image you see is as much a part of you as it is a quality of the cloud, and the same is true for a Rorschach inkblot. When you look at this ambiguous picture, you interpret it in a way that only you are uniquely prone to interpret things. There are, of course popular answers which many people see in a certain card.

The interesting thing is that even if someone gives nothing but popular answers, the interpreter can still tell a great deal about them as a person and about their mental state at the time the test was performed. This is because the most obvious forms that you might see in an inkblot are determined by the cultural frame of reference. If every answer you give on a Rorschach test is entirely conventional, I can consider that you are probably very highly adapted to the specific frame of reference that our western culture would suggest. After all, most people are not nearly so conventional in their perceptions. So, no matter how popular or unpopular your answers, the Rorschach inkblots help me to formulate my inquiry into you as an individual: How did you come to interpret the world in the way that you currently interpret it?

Now I promised a payoff when this article began, and hope to not disappoint. I’ve told you about a tool that I and other mental health professionals use to understand people, and I’ve told you how it basically works: present someone with an ambiguous stimulus, notice how they interpret it, and formulate questions that might help to explain their interpretive method. The only reason it is necessary to go through the procedure of administering a Rorschach inkblot test with someone is because I am unable to see through their eyes.

I am able, however, to see through my own eyes. And you are able to see through yours. And the world is a series of highly ambiguous stimuli. Therefore, the takeaway message is that your own perceptions represent a rich source of information about the parts of your own inner life that you have not yet gained access to. As always, the majority of our inner experience is completely unconscious, and we are only able to recognize the signatures of our unconscious workings in retrospect by examining what we have done.

So how would you go about interpreting these results? Of course I feel that everyone with the means to do so should find a psychotherapist to work with in order to get objective help with their continual growth. But you can also learn to recognize some of what’s going on under your own hood just by becoming more mindful of the active role that your brain takes in interpreting the world around you.

I already mentioned conventionality as a factor worth looking into, so that will be a good place to draw an example from. What types of situations do you respond to in ways that are very much like your idea of what is normal, and what types of situations do you find yourself responding to in a more personalized or idiosyncratic way? Next, think about where your idea of normalcy came from.

Some people feel strongly that their own lives and situations have been very ordinary, while others think of “normal” as the type of thing that happens to the folks next door. And is this mundane vision something you aspire to, or something you strive to break away from? Now look back at whatever it was you thought of when I asked about the situations you respond to in a way that feels normal to you. In some ways, you’re likely to find that it matches your conscious ideals. But in other ways, you’ll often find that you act contrary to the way you have idealized. And bingo.

That’s the beginning of the exploration of an unconscious decision-making process. Just continue to connect the dots and rationally inquire into the ways that you perceive things. If you find yourself alone in a dark room you might perceive that situation as comfortable and soothing because it lacks any social demands and gives you a needed rest from your strong inclination to figure out what’s going on around you. On the other hand, you might feel threatened by the lack of activity and contact in the room because you are highly invested in maintaining a positive level of interaction with the outside world. There are any number of ways you might respond, the key is simply to ask why you should respond that way.

Psychotherapy vs. Medication Management

Rose writes:

Can I get treated for depression? I’ve just been prescribed new antidepressants and sedatives and I’m really frightened but feel I have no alternative as I can’t function normally.

Thanks for writing in, Rose. Your question touches on an issue that has stirred up a great deal of controversy over the last hundred years: the “talking cure,” as Freud called psychotherapy, versus pharmacological intervention. Personally, I think that both can be very useful if applied appropriately.

It sounds like you’re struggling with feelings of both depression and anxiety, and have a lot of ambivalence about whether you should seek help with those feelings. So the first thing I’d like to put out there is that everyone is entitled to feel okay. There is no reason why anyone should have to go through their life feeling sad or fearful. Life is for enjoying. Few people would think twice about seeing a doctor for physical pain, but emotional pain has a stigma attached to it in our culture. People tend to feel guilty or inadequate when they find themselves suffering from depression and anxiety.

The problem is that we’re assuming that we somehow have control over the way we feel emotionally. So then when we feel bad we act as though it were our fault, or as though we deserve it. The fact is, the average person has no greater level of control over their cognitive or emotional functioning than they have over their autonomic or endocrine functioning. Neurologically, your thoughts, feelings, and even your actions originate outside of your awareness.

The good news is that human consciousness is extremely flexible, and you can use that to your advantage. You can learn to gain awareness of things that were previously very deeply unconscious, and you can also learn to change the way that those unconscious processes work. Psychologists can use techniques like biofeedback to teach you to control involuntary physiological functions like heart rate, blood pressure, and circulation. Techniques like neurofeedback can teach you to exert direct control over otherwise involuntary neurological functions. And psychotherapy can teach you how to understand and control your emotional life. None of these are things you will probably ever be able to do without special training. Psychologists are people whose job it is to scientifically investigate and implement ways of training people to accomplish feats that are essentially comparable to yoga.

The problem I have with using medications to manage things like depression and anxiety are that the medications teach you nothing. They chemically alter the way that your brain processes your experience, but the experience itself remains largely the same. Please don’t get me wrong on this, a lot of people genuinely benefit from taking psychiatric medication, and if they have been prescribed to you then you should probably either take them as prescribed or seek a second opinion. Especially if you feel you’re not able to function normally.

However, some very good research has shown that people who receive psychotherapy in addition to medication tend to achieve much better long-term results than people who just take the meds. To me, this is completely unsurprising. I believe that people feel things for good reasons, that all of our thoughts and actions serve a purpose for us. You can suppress or modify the biological mechanics of what’s going on with drugs, but it won’t do anything about the underlying psychological reasons for what you’re experiencing. So, what happens a lot of the time is that people will either feel fine until they go off their meds, or do well on new antidepressants until they start developing other types of psychological symptoms.

In my opinion, anyone who is suffering with uncontrollable thoughts or feelings should absolutely find a psychotherapist and commit to treatment. The value of psychiatric medications is that they can alleviate your symptoms in the short term, so that you’re able to regain a higher level of functionality while you address the real, underlying issues in therapy. And, to answer your question, psychotherapy is a very effective treatment for both depression and anxiety. Just be sure that you follow the guidelines in the article I linked to above about selecting a therapist who you can trust in and identify with enough to develop a good working alliance.

How To Enjoy The Simple Pleasures

A nice, relaxed meal; a slow walk on a sunny spring day; time alone with loved ones. It’s an accepted wisdom that the little things in life are often the most enjoyable. The more you allow yourself to stay in the moment and focus in on the simple pleasures, the better your overall quality of life will be. We all know this already.

The problem lies in trying to remember this simple truth in the midst of all of life’s craziness. Most of us have so much going on in our lives that it seems like all we can do to keep our focus on the deadlines we have to meet, the objectives we have to reach, and the expectations we have to live up to. On top of that, most of us find ourselves surrounded by people who are at least as preoccupied with these things as we are, which reinforces our focus squarely on those things which have the least chance of making us happy right now, in this moment.

The strategy outlined below will help you to structure your life around those little things that really matter, while still allowing you to accomplish all of the things you want to accomplish. In fact, following this strategy will actually increase your ability to get things done. You’ll be able to feel happier and more focused knowing that you will be properly rewarded for your efforts not just in some distant future, but right away! When we feel fulfilled, the work we do toward future goals feels more satisfying; it loses the desperate quality of work that comes from an unfulfilled and desperate place.

Plan ahead to really enjoy this next experience

We’re often simpler creatures than we give ourselves credit for. One of the main components in having any type of experience that you want to have is simply planning to have that experience. You have to lay it out in no uncertain terms so that your conscious and unconscious processes can all get on the same page.

If you keep a to-do list or a day-planner, add in time specifically set aside for enjoying the simple pleasures in your life. Do this even if you already know you’re going to be doing them. If you know you’ll have only 15 minutes for lunch, pencil yourself in. 12:00-12:15 Enjoy a breather with a nice quick lunch. By planning it out this way, you give yourself permission to take that 15 minutes and enjoy it, rather than rushing through it on your way to something else.

If you’re like me, you don’t have any kind of cohesive calendaring system, and that’s fine too. When you’re about to take that cigarette break, or that 20 minutes to futz around with your MySpace page, or that half hour before bed to just unwind, don’t be afraid to talk to yourself. Say, “Okay, great. Now I’ll have this many minutes to just enjoy this nice cool spring breeze with this beautiful glass of wine.” Be descriptive, sell yourself on it. It’s not just a meal break, it’s free time to enjoy a luscious meal.

Use the reward system to overcome procrastination

When all you’re feeling is the stress of having to get something done, it becomes much more difficult to focus on doing what you need to do. You can reduce this effect and allow yourself some moments of pure and simple pleasure by planning your reward. It shouldn’t be anything fancy—new research actually shows that the promise of big rewards tends to reduce productivity. It’s the little things that we really crave, and so that’s exactly what you should promise yourself as soon as you finish your task. And follow through on your promise!

Plan what you’ll do afterward to know you deserve this time for yourself

Really busy people often complain that they can’t enjoy their free time because they feel guilty over all the things they’re not getting done. Believe me, I can identify. A nice way to overcome this feeling is by not only marking out your time that is specifically for enjoyment, but also planning what productive thing you’re going to do when you’re done.

One of the key experiences of this relaxation guilt is the flight of ideas about all the things you could or should be doing. A lot of the time this is because you’re so used to having a plan of action that you’re not quite sure how to step outside of that. So don’t fight it! Let yourself be whatever you will be, and make your plan for action and get it all settled before you begin relaxing, so that you can be absolutely sure you’ll be fresh and ready to go when the time comes.

Post a comment about the simple pleasures that you enjoy the most, and the ways you find to cram them into your busy life.

We Live in Memories and Dreams

In my recent article on hypnosis, I mentioned that we don’t live in the present moment. We live in memories and dreams. This is an idea that will not be unfamiliar to those with a mystic bent, but the rest of you may suspect that there is some craziness going on here. In fact, there is! But it is a craziness that is supported by a tremendous amount of neurological and psychological research.

Psychologists have been talking about a phenomenon called transference for over a hundred years now. Transference is what happens when you react to someone in a way that isn’t justified by the situation itself, but rather points back to an earlier experience that you had with someone else. You have transferred the feelings from the person in your past onto the person in your present.

The reason this has been such a big topic in psychology is because it becomes a major factor in psychotherapy: in order to understand what’s happening with your patient, you have to unravel the mysteries of their transferences both outside and inside of the consulting room. Where this gets difficult is that the therapist is in no way immune from this effect. The therapist experiences what is called countertransference. Essentially, the whole time that the therapist is trying to figure out what kinds of misplaced emotions and perceptions the patient has brought into the room, they must also figure out which of those feelings belong to their own past, rather than to the patient’s.

The last thirty years of neuroscience have been gradually building up to an understanding of the way that we represent people and situations within our actual brains. This has involved a lot of deep thinking about the nature of experience, and also a large number of cut-up rat brains. Researchers have traced the paths of neurological signals as they activate emotional responses, as they stimulate the formation of new memories, and as they trigger the retrieval of old memories.

In fact, we never experience the actual reality that we believe we are interacting with. We experience a kind of touched up version of the world around us, running on a slight time-delay, and filtered through the patterns of all of our prior experiences. In other words, we experience the present only in relation to previous versions of the same moment that have been neurologically coded into response pathways. To put it in more psychological terms, we experience a version of reality that largely conforms to our existing worldview. We take the endless quantity of information around us, and fit it into a pattern that makes sense.

Of course, all of this is done completely automatically. The part of you that you identify with and think of as your self—the consciousness—constitutes only a very small portion of the total neurological (and psychological) functioning. What’s more, the consciousness is consistently late to the party: it only receives the finished perceptions from the rest of the brain after they have been fully processed. And that includes not only perceptions of what is going on outside of you, but inside as well. Even actions. When you feel like you are making a conscious decision to perform a certain movement of your body, for example, neurologically the decision was made before you had the conscious idea for it. The parts of your brain that govern the movement itself go to work before the parts that make the conscious decision to move.

The you that’s doing all of this is larger than “you” could possibly imagine, and you can only find out what it’s up to by examining your actions after-the-fact. We do not live in the world, we live in a series of memories and dreams about the world. These experiences are produced for us by a vast unconscious mind that is unconcerned with our claims to conscious decision-making.

8 Myths About Hypnosis

Hypnosis is a sort of spooky and misunderstood phenomenon. Most of what people generally know about hypnosis comes from movies and stage performers, not real clinical hypnotists.

You may not even realize that clinical hypnosis is a very well-established and scientifically validated medical practice. It’s used by psychotherapists, physicians, nurses, dentists, and anesthesiologists to produce a profound sense of serenity in patients who might otherwise be really freaking out.

As it turns out, hypnosis is an incredibly versatile and powerful psychological technique, so it would be in your best interests to know a little bit about it and to be open to the idea. With that in mind, I’ll dispel some of the major myths about hypnosis and tell you some far-out realities about it as well:

1. Hypnosis has no relationship to gullibility

A lot of people believe that only gullible people can be hypnotized. This is actually a pretty natural assumption, since the hypnotic experience does involve a heightened state of suggestibility. There have even been studies done to measure “gullibility” and “suggestibility” as a personality factor, and to try and correlate those factors with hypnotic susceptibility.

In fact, none of those studies has ever established such a correlation. There seems to be simply no relationship at all between how gullible you are and how susceptible you are to hypnosis. You might be a really hard-nosed critical thinker and be highly hypnotizable, or you could be a real sucker and actually have very low hypnotic ability. There’s simply no relationship at all.

2. There is some correlation to intelligence and creativity

Hypnotic ability is actually somewhat related to IQ. Highly hypnotizable people tend to be just a little more intelligent and a little more creative than the rest of the world. Sound familiar?

3. It’s partly genetic

That’s right, to some extent you actually inherit the ability to be hypnotized. Pretty much anyone can be hypnotized to some extent, however, so the major difference is basically just how good at it you are.

There are also a variety of ways that you can actually improve your hypnotic ability, too. Anything that generally improves your mind-body relationship will also tend to improve your hypnotic ability. So things like mindfulness meditation, biofeedback, and artistic, musical, or theatrical training all tend to enhance your ability to experience hypnotic phenomena.

4. You can’t get stuck in a hypnotic trance

We all want to have an Office Space experience and breeze through a few weeks of our lives on autopilot. Some people are probably a little apprehensive, though, about losing control and getting stuck in some catatonic state.

Rest assured, this is not possible. If someone left you in a hypnotic trance, the worst that could happen would probably be feeling a little confused. More likely, you would probably just fall asleep, and eventually wake up feeling happy and refreshed.

5. You probably do it every day

The hypnotic experience is not at all unusual! Have you ever rocked a baby? It’s such a simple thing to do—but just by introducing a nice gentle rhythm into the baby’s experience, you change its whole frame of mind. You hypnotize babies.

Even my cat hypnotizes me! It lays on my chest and matches its purring to my heartbeat, gradually leading me down into slower and slower rhythms so I won’t get up and spoil its nap. Any time a group of people are in a room together, the tendency is for all of them to fall into a similar breathing pattern.

Basically everything we do involves varying levels of trance phenomena. If you’ve ever been driving in your car and suddenly realized you had arrived without really being able to remember the trip, it’s pretty safe to say that you were experiencing a trance state very much like hypnosis. Another great example is when the credits start to roll and you suddenly realize you’re in a movie theatre! You’ve been enjoying a very nice hypnotic trance.

6. People have surgery with no anesthesia, and have a good time!

Probably not everyone is hypnotically gifted enough to maintain a state of complete comfort through a surgery without any drugs, but it’s not nearly as uncommon as you’d think!

7. Hypnosis can turn off inflammation like a switch

Burns, bites, allergies? Your mind has the ability to completely change your body’s response to any of these.

Under hypnosis, burned skin can be told not to swell up or to detach from the underlying flesh. This means that if you know how, you can actually talk your body out of blistering. You can even talk your body into blistering. I’m not sure why you’d want to, but I’ve seen it done! Allergic reactions can literally be convinced not to happen.

8. Hypnosis might be able to alter your genes

There’s a very famous old case from 1952 that was studied by the British Royal Society of Medicine, where a boy had a congenital skin disorder that gave him crusty, fish-like scales all over his body. The disease is called congenital ichtyosiform erythrodermia of brocq, and it means that your skin’s oil glands don’t develop, so your skin cells won’t flake off as they die.

The boy was unwittingly treated with hypnosis by a doctor who thought he simply had a bad case of warts, since hypnosis is very effective for warts. Actually, it turned out that you can do that!

Nobody knows for sure exactly what changed in the boy’s physiology. In order for this condition to be cured, you’d have to modify the way the boy’s genes are expressed. Modern gene therapy isn’t even close yet, but in the early 50s this guy healed a kid’s genetic skin condition using nothing but the power of the boy’s own mind. Crazier still, there’s actually a lot of more modern scientific evidence that hypnosis can affect the way that genes are expressed. What a ride.