Monday, October 12, 2009

Risk of Non-Professional "Mental Health" Help: Rebekah Lawrence Sad, and Bizarre, Story

Risk of Non-Professional “Mental Health” Help: Rebekah Lawrence Sad, and Bizarre, Story

“Self-help course may have led to her suicideSome say the seminar Rebekah Lawrence attended led to her death”

This problem might be related to the problems that were developed oy overzealous therapists who believed that everyone had undiagnosed multiple personality disorder. The False Memory Syndrome Foundation is a great source of background, and the book by Mark Pendergrast is also a great source. If you "google" "SRA" you will find a lot of this terrible type of brainwashing in the name of “therapy.”

There are a few notable, well-documented cases where it is clear that the bizarre reported events never happened.The other clinical area where similar things have been noted has been the case reports of intensive meditation leading to psychosis. These may happen in meditation where the focus is on nothing, rather than on something. There basically are two types of meditation: focus on something (breathing, imagined candle, imagined rainbow or some other color phenomenon, etc.) and a focus on nothing: being conscious, awake, aware, but with nothing in your awareness -- FYI - I myself strongly recommend against this because in my limited knowledge, I have heard about bad things coming from this, and I just don’t see it being worth the risk. Certainly, others will strongly disagree.

A couple citations for support:

Kuijpers HJ, van der Heijden FM, Tuinier S, Verhoeven WM.
Meditation-induced psychosis.
Psychopathology. 2007;40(6):461-4. Epub 2007 Sep 11.

Sethi S, Bhargava SC.
Relationship of meditation and psychosis: case studies.
Aust N Z J Psychiatry. 2003 Jun;37(3):382.

French AP, Schmid AC, Ingalls E.
Transcendental meditation, altered reality testing, and behavioral change: a case
J Nerv Ment Dis. 1975 Jul;161(1):55-8.

"Mindfulness meditation," the type that has largely been in the media, and a health psychology component, as at Jon Kabat-Zinn's Massachusetts Stress center, has a focus on something. They have worked with many people, in medical settings, with ongoing health care – they would know if their program led to psychosis in some portion of people – it just does not.

In the 1970s, we also had the phenomenon of the "isolation tank." This spawned its own popular media, and I guess a bunch of people trying it out. BTW: in my opinion, this should also be avoided. Sensory Deprivation can lead to bad outcomes. I can find only one citation in pubmed, but I am sure there is some info on the web.

A common ingredient in these various esoteric self-improvement efforts is a guided and prolonged focus on self-examination/self-confession. By prolonged, I mean hours in a row. Talk psychotherapy rarely does this. And generally, most "schools" of talk therapy do not have this type of activity as part of their mix.

An exception is "Gestalt therapy." Back in the heyday, people participated in day-long encounter groups, getting "real," and trying to shake their "hang-ups." Some people walked away OK, but some really got messed up.

“Arch Gen Psychiatry. 1977 Apr;34(4):399-415. The impact of a weekend group experience on individual therapy. Yalom ID, Bond G, Bloch S, Zimmerman E, Friedman L. Thirty-three patients in long-term individual therapy were referred to one of three weekend groups: two experimental (affect-arousing, gestalt therapy) groups and one control (meditation-Tai Chi) group. The impact of the weekend group experience (WGE) on individual therapy was examined six and 12 weeks later. At six weeks the patients in the experimental groups showed, on some measures, a significantly greater improvement in their individual therapy than did controls. By 12 weeks, there were no demonstrable differences. The WGE was not without risk: even though the group leaders were highly trained, responsible clinicians, two patients suffered considerable psychological damage. The control (meditation-Tai Chi) group offered a relatively innocuous experience; there was no risk, but few members found the specific procedures useful in their lives.Intense affect arousal in the WGE was not related to positive change insubsequent individual therapy. Those expressing the greatest affect in either experimental group were no more likely to have had a measurable positive impact on their subsequent individual therapy than patients expressing little or no measurable affect.”

Of course, anyone can always claim that a person probably was psychologically fragile to begin with. Maybe.But I note this seemingly bizarre news story to note that the experiences encouraged by these non-therapists may fit the pattern of these other problem areas.

Since these are rare events, we need to learn from them. We need to learn what types of self-improvement activities are actually harmful to some - and it is probably highly unlikely that we could ever figure out who can participate safely and who migth get bothered -- either traumatized, or have some kind of other psychological adverse event, such as psychoticism.

Hopefully, if there is some common problem in these diverse topics, I am not the only person noting the relation.

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