BBC News story on smartphone addiction

13 02 2019

I made a brief appearance on the BBC London News last week, for a story on smartphone addiction. You should still be able to view the video clip here on iPlayer, for the next few days at least.

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The story was about a secondary school in Wembley, North London, which is selling old-style ‘brick’ mobile phones to its teenage students for just £10, to encourage them to stop using smartphones. Having trialled a smartphone amnesty, students who had switched to the older phones reported better sleep, better concentration, improved relationships, and increasing levels of happiness.

Smartphone and computer addictions are increasingly common, particularly among teens who may already struggle to regulate their rapidly developing brains and bodies. The lure of the smartphone means that we are often not fully present with those around us, which decreases levels of attunement and secure attachment, as seen in the Still Face Experiment. I often hear disconnected couples in therapy talk about how they feel that their partner’s laptop or phone has become the priority at home; pushing them into second place. This may also escalate into behaviours such as videogame or online porn addiction.

It is important to recognise that addiction is a habitual experience of disconnection. Disconnection from disowned parts of our selves, from uncomfortable feelings – such as boredom, loneliness, or sadness – and from others. Recovery, therefore, is the process of learning to slowly reconnect to these disowned parts of ourselves, these uncomfortable feelings, and others. The opposite of addiction is connection. This is why attunement and attachment, which shape our capacity to connect, are crucial elements in the recovery framework, and to work on in therapy.

If you would like to explore working on these, or any other, issues in therapy, please do not hesitate to contact me.

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6 things a sex therapist wishes you knew

22 05 2018

Here’s an article I did for Prima magazine a couple of years ago, but omitted to post on here at the time:

6 Things A Sex Therapist Wishes You Knew

My 6 tips were as follows:

1. It’s good to talk about sex!
Lots of clients still feel like opening up about their sex lives is a real taboo, and that sexual thoughts should be kept private and hidden away. But the truth is that sex is a huge part of who we are – it plays a vital role in determining our identities, and in shaping the relationships we choose throughout our lives – so it’s good to talk about it, and there’s nothing shameful or degrading about doing so.

You might not think that your sexual thoughts are relevant to certain other issues in your life, but sometimes sharing these inner desires can really shine a light on something else that’s seemingly unconnected.

2. …but don’t JUST talk about sex
Sex is often the symptom, not the cause. Lots of people come to therapy looking to resolve a sexual issue, and often there’s a temptation to focus on that issue and not talk about anything else. But as you explore around the problem, you tend to find that what’s being played out in the bedroom is often related to other thoughts and feelings.

Even something as innocuous as moving house or changing job can have an unexpected impact on libido, as attention and energy levels are focused elsewhere. So it’s really important to get the full picture of what’s going on.

3. There’s nothing you could say that would surprise your therapist
People go to therapy for all kinds of sexual issues. This might be a question of their own orientation, making sense of a certain fetish, or exploring some kind of dysfunction, which they feel is preventing them from having the sex life they truly desire.

No matter how embarrassed you might feel about a certain sex-related issue, your therapist won’t judge you for it, and will remain calm and impartial as you explore the problem. Sexual issues are very common reasons for people to seek therapy, so your therapist has most likely heard it all before; and however filthy or unusual you might think your kink is, someone else has probably already shared it.

4. The biggest sexual organ is the brain
People spend so much time focusing on genitals, but often forget about the brain. Sex is a deeply psychological process, and one person’s turn ons can be another’s turn offs. This is because we all get aroused by different sensory stimuli, and have a different set of positive and negative associations for all kinds of situations and events; often relating back to previous experiences.

You can have a lot of fun with your body, but truly great sex needs to involve the brain as well. After all, it’s the brain that gets flooded with a magical cocktail of chemicals – dopamine, serotonin, oxytocin and endorphins – at the point of orgasm, to produce an almost trance-like experience.

5. Sex means different things to different people, at different times
There’s no single definition of a good sex life. Sexuality is fluid, and needs and desires can change drastically from person to person, and even day to day. For example, at the start of a relationship sex is usually about pleasure and passion, but over time it can become more about intimacy and connection, and then if a couple decide to have children it can suddenly become quite outcome-focused.

Sometimes people struggle to cope with these transitions, or may find that their own needs don’t match with their partners’, and this is why talking about sex is so important in relationships.

6. Don’t put it off
If you do have a sex-related worry or concern, it’s best to talk about it as soon as possible. If you don’t feel comfortable discussing it with a family member or a friend or partner, then seek out a good therapist to explore the issue with you. The longer you wait, the more it becomes likely that you build the issue up in your head, or start to complicate it even further.

It’s always best to tackle issues, rather than to let them fester or be ignored. More than ever, people are talking openly about their sexual orientations and desires, so there’s no need to deal with your worries alone. Everyone deserves to feel sexually fulfilled, and that includes you.

I specialise in sex and relationship issues, so if you would like to discuss any of these in a safe and secure environment, either individually or as part of a couple of family, then please contact me and I will schedule a session for you.





Association of Counsellors and Psychotherapists in North London (ACPNL)

23 10 2014

I’m really honoured to have been invited to be a guest speaker by the Association Of Counsellors and Psychotherapists in North London (ACPNL). I will be presenting there on Sunday December 14th, from 10am to 1pm, and you can find full details on their events calendar.

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The title of my presentation will be “Social Emotion Regulation: Bringing The ‘Other’ Into Therapy”, and a brief description is as follows:

“Often in therapy we focus on the internal struggles our clients face, exploring intrapsychic variables such as troubling narratives, conflicting beliefs, or self- defeating messages. We discuss our clients’ emotion regulation strategies, and give them the tools to develop new ones, such as meditation, mindfulness, exercise, awareness of automatic thought patterns, and so on. However, these are all relatively isolated activities, and the social circumstances of our clients’ lives are often left unexplored. In this workshop, Stefan Walters explores the importance of social emotional regulation, and how a sense of being part of a supportive and enriching social network is absolutely vital to good mental health. Stefan looks at the links between self-worth and other-worth, and discusses how we can bring the ‘other’ into therapy, to assist our clients with their issues.”

Tickets are £30 for non-members of the ACPNL, or £20 for members, and can be purchased on the website. I hope to see you there!





Private Practice Made Simple

4 02 2012

My review of “Private Practice Made Simple” by Randy J. Paterson, PhD:

Private Practice Made Simple front cover

There are plenty of books and websites out there offering advice to mental health professionals who want to know how to establish their own private practice. With this new release Randy J. Paterson, PhD offers his own comprehensive take on this popular topic, promising to provide “everything you need to know to set up and manage a successful mental health practice,” from “getting client referrals and creating a positive and comfortable office atmosphere to building a strong and thriving therapy practice that can serve both you and your clients.”

As the 2008 recipient of the Canadian Psychological Association’s Distinguished Practitioner Award, and the owner of a private multiple-provider outpatient practice in Vancouver, Paterson certainly seems to write with a wealth of personal experience in this area. Indeed, what differentiates this book from so many of the others available on the market is that personal touch, as Paterson shares his own journey into private practice, and the lessons learned along the way, explaining that:

No one really teaches you how to manage a mental health or counseling practice. As clinicians we stumble through our careers, gradually picking up shortcuts and strategies that make our lives (or those of our clients) a lot easier. Many of these useful ideas aren’t rocket science and could have been taught to us in an afternoon if anyone had thought about it. That’s what this book is for: it’s nothing more than a collection of useful basic tips … The emphasis of the book is on quick and easy strategies that can save a lot of headaches.

This light, conversational style typifies Paterson’s everyman approach to the topic, ensuring that the book is easy to read and full of accessible ideas for anyone contemplating the possibility of working in private practice.

While some other books might launch straight into the practical side of running a private practice, Paterson predicates this by starting his book with a chapter focusing on the importance of weighing up the pros and cons of running this kind of business in the first place. Paterson lists his ten most frequently-heard arguments both for and against private practice, and I can guarantee that any mental health professional will be able to relate to at least some of this debate.

The arguments in favor are listed as:

1. No Big-Organization Hassles
2. Getting Away from the Medical Model of Distress
3. Increased Accessibility for Clients
4. You Get to See Whom You Want
5. More Money
6. Supplement Your Salaried Income
7. Flexible Hours and Holidays
8. Work Fewer Hours
9. No Commute!
10. A Service Based on Your Own Vision

Whilst the arguments against are:

1. You’ll Never Get Clients
2. You’re No Good at Networking or Marketing
3. Uncertainty About Income from Month to Month
4. You Hate All the Clerical and Business Demands
5. You Don’t Know Enough to Practice Independently
6. Dealing with Fees will be a Huge Hassle
7. You’ll be Helpless in the Face of Insurers or Funders
8. No Retirement Plan or Benefits
9. You’ll Burn Out and Won’t Have a Safety Net
10. You Won’t have a Sense of Meaning in Your Work

Paterson follows this up with a considered appraisal of what is truly involved in the day-to-day running of a successful private practice, and then allows you to make up your own mind as to whether you’re really suited to this type of business. Assuming that you are, this book then serves as a comprehensive guide to everything involved in setting up and maintaining your practice, from such subtle nuances as the ‘olfactory environment’ and placement of clocks, to website design and finance tips.

As Paterson says, many of the ideas in this book aren’t rocket science, and might initially just seem like common sense, but don’t let this be a deterrent. As you make your way through the book you’ll realize there are also countless suggestions here which will leave you wondering “Why didn’t I ever think of that before?” and feeling enlightened. One such example is the section on ‘The Client’s View,’where Paterson explains the importance of the contents of the therapist’s bookcase:

Look at your own bookshelf from the client’s position. Notice where your eye naturally falls. These are the most salient shelves. Banish books that imply you are having significant problems yourself (Avoiding Burnout, The Wounded Healer), your introductory psychology textbooks, the trashy novels you secretly read at lunch, the books on handling problem clients, the self-help books you wouldn’t recommend to your worst enemy, and all the books on managing the finances of your private practice (including this book). Shift those books upward or downward, and replace them with scholarly books on your specialty areas of practice, books on diversity, a book or two on sexuality (this subtly gives clients to put such issues on the table), the self-help books you most frequently recommend, high-level books on practice and therapy, and other books that communicate your expertise, interests, and breadth of knowledge.

Once you’ve thought about it this seems so obvious, but I have seen plenty of counseling rooms where this advice had clearly been sorely missed, and where business may have suffered as a result.

It is these kinds of subtle tips which can make a huge amount of difference to the way a private practice is run, and which might distinguish an outstanding business from a mediocre one. Having all of these ideas listed in one simple book is truly invaluable, and will surely offer numerous benefits to anyone in the mental health profession. I couldn’t think of anything which Paterson had missed from this book, and he even includes a link to free downloads of practice worksheets and sample forms to help you on your way. If you’ve ever considered setting up a private practice, or you’re running one already, then this book’s for you.

3 out of 5 stars.





How To Change Your Drinking: A Harm Reduction Guide to Alcohol

16 12 2011

My review of “How To Change Your Drinking: A Harm Reduction Guide to Alcohol” by Kenneth Anderson:

How to change your drinking front cover

Substance misuse is one of the most common and widely discussed topics within the mental health community, as both clients and professionals debate the most effective ways to deal with addictions and their causes.

In the past, treatment might typically have involved a focus on abstinence as the ultimate goal, through zero-tolerance groups such as Alcoholics Anonymous, or a 12-step program, where clients would be rewarded only for complete sobriety and nothing less.

This has slowly changed over the past decade, though, through the realization that complete abstinence simply wasn’t a realistic or achievable goal for some, and that such a harsh insistence on withdrawal simply wasn’t working. In fact, it is estimated that 60 to 95 percent of clients who enter 12-step programs either drop out or otherwise fail to maintain abstinence from alcohol, and the NIAAA’s statistics suggest that only 7 percent of people who suffer from an alcohol use disorder will typically seek treatment within any given year.

As a result the treatment focus has shifted from simple cold turkey toward an overall emphasis on healthier and safer habits, and lowering risks. This has seen an emerging popularity for modalities such as motivational interviewing, where both the pros and cons of sustaining the negative behaviors are acknowledged. The client is then free to decide how, and at what pace, to proceed.

The HAMS group takes a similar “baby steps” approach. HAMS — the acronym stands for Harm reduction, Alcohol abstinence, and Moderation Support — describes itself as “a free of charge, lay-led support and informational group for people who want to change their drinking for the better.” Founder and CEO Kenneth Anderson is himself a former problem drinker.

In this book, How To Change Your Drinking: A Harm Reduction Guide To Alcohol, Anderson presents a comprehensive summary of the harm reduction approach to drug and alcohol problems, suggesting it could “either be used as a self-help manual for people working on their own or by people who are participating in a harm reduction support group.”

The book begins by introducing the underlying theories of harm reduction, and is written in a nonjudgmental tone that will be reassuring to most readers:

Some folks today want to say that everything fun is an addiction and that everyone had better spend their lives in 12 step meetings talking about their ‘Higher Power’ and holding hands and saying the Lord’s Prayer instead of ever doing anything fun. We beg to differ with these people. Prohibition does not work because there is nothing essentially evil, sinful, or diseased about having fun. There is nothing evil, sinful or diseased about drinking alcohol moderately, and for that matter there is nothing sinful, evil or diseased about engaging in recreational intoxication either.

There is not some specific magical quantity which we can say is too much alcohol – free individuals have the right to make up their own minds about how much they believe is too much for them personally. Occasional intoxication is not a symptom of a disease; it is a choice.

It is this focus on individual choice and empowerment which personifies this book and differentiates it from much of the rest of the substance misuse canon. Instead of focusing on problematic labels or clinical diagnosis as a means of demanding perfect abstinence, the author leads the reader on a step-by-step journey toward deciding what their own goals should be, and offers advice and support on the healthiest ways to achieve and maintain them. There is even a short section titled “Ken’s Story,” where Anderson talks about his own previous drinking problems and near-death experiences in AA. Those led to his resolution to “find a better way” and start the HAMS network.

The opening chapters might seem familiar to many mental health professionals, as Anderson suggests that each reader completes a Cost Benefit Analysis exercise, similar to those used in motivational interviewing techniques:

Miller and Rollnick (2002) say, ‘Often individuals considering changing a problem behavior will concentrate on all the negative aspects of the behavior. ‘I know how bad my drinking is for me,’ they say. In fact, they can often produce a litany of reasons why what they are doing is bad for them. Clinician and client are often baffled by the fact that even with all these negatives, change does not occur. The reality is that if the behavior were not in some way beneficial to the client, he or she would not be doing it. Until the client acknowledges the ‘good things’ about the behavior, they cannot prepare to combat temptation once they make an attempt to change. The decisional balance helps facilitate this process.

It is clear that Anderson has done his research in this field, and even though much of the book features personal stories and experiences, these are all presented within a scientifically supported framework, using clinically proven techniques and offering further resources where appropriate. Later in the book, Anderson explains Prochaska’s “stages of change” model, leading the reader through each stage and explaining the range of thoughts and behaviors that might accompany this process. He offers readers a large quantity of materials to help them along this journey, too, ranging from goal-setting and risk-ranking worksheets, to consumption charts and graphs, to the chemical breakdown of different alcoholic beverages and how they are processed within the body.

The book also addresses the addict’s friends and family. Anderson features chapters on specific topics such as spousal goals, alcoholism’s effects on children, and a study of drinking patterns as affected by ethnic identity and religious affiliation.

There is a wealth of knowledge in this book, but the clear, concise and easy-to-read style ensures that it never becomes overwhelming or difficult to follow. Anderson describes things in layman’s terms and it is doubtless this open, reassuring style which attracts so many of the HAMSters to the harm reduction approach.

As a comprehensive manual to changing drinking behaviors, readers will be hard-pressed to find a better book than this. If you’re looking for support, advice, scientific facts, or recovery tools, you’ll find them all here, clearly laid out for both mental health professionals and clients alike.

4 out of 5 stars.

It is worth noting that alcohol misuse has been a major issue in the British media since I wrote this review; with suggestions of major changes in government policy and the introduction of ‘drunk tanks’ and ‘booze buses’. I have a lot more to say on this topic, and it is one that is close to my heart as I do a lot of work for a substance misuse agency within the NHS in North London; but that’ll have to wait for another time.





Assessing Adult Attachment: A Dynamic-Maturational Approach to Discourse Analysis

10 09 2011

My review of “Assessing Adult Attachment: A Dynamic-Maturational Approach to Discourse Analysis”.

Assessing Adult Attachment front cover

Attachment theory has come a long way since John Bowlby’s paper “Forty-four Juvenile Thieves” was published in 1944. In the paper Bowlby wrote about his work with disturbed youth in London. He theorized for the first time that the nature and security of an individual’s relationships to their primary caregivers during infancy and early childhood equips them with the methods they will use to express their feelings and needs in later life. Those relationships also predict how people will form relationships with significant others during adulthood.

Through further research into Bowlby’s initial ideas – and the invention of the Strange Situation experiment – Mary Ainsworth was able to develop a clear system of classification for this theory, which could be used to identify three unique patterns of attachment: Type A (Avoidant), Type B (Secure), and Type C (Ambivalent).

This rudimentary ABC system has been at the heart of attachment theory since its inception, and has paved the way for a host of psychological texts and theories. Titles such as “Attached” by Dr. Amir Levine and the “Attachment-Focused Family Workbook” by Daniel A. Hughes join countless other attachment-specific books currently on sale, and Dr. Sue Johnson’s research into relationships and subsequent development of her Emotionally Focused Therapy (EFT) program have brought about a revolution in the field of couples therapy. Indeed, a recent issue of the American Association of Marriage and Family Therapy’s ‘Family Therapy Magazine’ was entirely devoted to The Science Of Love, reporting the recent findings of groundbreaking research focused on the understanding of romantic love and adult attachment.

It is clear, therefore, that the ABC classification system of attachment theory has a lot to offer those in the therapeutic field, but it is not without its problems, either. First, it often seems overly simplistic: the classifications can be vague and unreliable, everyone is forced to classify themselves with one of just three basic attachment styles, and there is no option of further classification within each division. Second, it is too limiting: people frequently feel typecast and stuck within one specific attachment style, with no option for change or progress. Third, it is outdated and culturally biased: the system was derived from work in the cognitive sciences in the late 1970s, and based largely on findings from observations of middle-income, low-risk American families. And fourth, it offers very little in terms of a solution: once someone has identified their attachment style, then what?

The main cause of these problems has been the source of the classification data itself: the Adult Attachment Interview (AAI), an interview and coding method developed by Mary Main and Ruth Goldwyn in the 1980s which has been the primary method of collecting and interpreting attachment information ever since. Now, at last, with this book, Crittenden and Landini have provided us with a more up-to-date, efficient and multicultural alternative, which continues to be compatible with the AAI data collection method, but works equally well with other forms of interview, too: their own Dynamic-Maturational Model (DMM) of attachment.

Various theoretical perspectives on attachment can be applied to the interpretation of the AAI. Main and her colleagues developed the AAI based on a version of attachment theory that assumed that (1) by adulthood most adults had a single representation of attachment relationships, (2) this relationship reflected one of the Ainsworth patterns of infant attachment, (3) these patterns were transmitted from mother to child across generations, and (4) frightening circumstances disrupted the organizational process, leading to a state of disorganization in infancy or lack of resolution of the frightening circumstances in adulthood.

In the Dynamic-Maturational Model of attachment and adaptation, none of these four assumptions are made. To the contrary, the DMM approach to attachment theory presumes that adults have multiple dispositional representations, each unique to the information processes underlying it. Second, the array of strategies is developmentally expanded from its roots in infancy, with endangered individuals most often using the later developing and more complex strategies. Third, it is understood that each individual constructs his or her own dispositional representation from his or her own experience. Sometimes this will reflect similarities to the parent’s dispositional representation, but, especially in cases of parental disturbance or inadequacy, children will often organize the opposite strategy from the parent… Finally, exposure to danger is assumed to be the essential condition that elicits attachment behavior, and, across repeated experiences, leads to organized self-protective strategies.

Clearly, the introduction of this model represents a major leap forward in our understanding of attachment and attachment theory, offering a far more detailed and multicultural system of classification than the old ABC model. Over the course of this book, Crittenden and Landini fastidiously lay out a new classification system, with many numeric subdivisions within each individual attachment strategy. In fact, the research is so exhaustive and delivered in such great detail that it seems almost impossible that any clinicians reading this would not recognize each of their clients at least somewhere within the text. The downside to this is that this is not an easy book to read; it is certainly not something you will want to flick through to help you relax at the end of the day. But those who do make their way through the sometimes dense and challenging text will come out feeling incredibly rewarded for their perseverance, armed with a new treatment model for working with their clients and a new understanding of the complexities of adult attachment.

Essentially, what the field of attachment theory has been sorely lacking is its own Diagnostic and Statistical Manual — a modern, flexible, and multicultural tool which will provide practitioners with the common language and standard criteria for the classification of specific attachment styles, and their best-practice solutions. Now, with Crittenden and Landini’s long-awaited book, it finally has it.

Critically, though, this book aims to do much more than serve as just a DSM for attachment theory. As well as a basis for gathering empirical data, the authors provide us with a compassionate new guide for treatment formulation, and there is a chapter – titled ‘But What Shall I Do?’ – dedicated specifically to this cause:

Researchers are happy with a reliable classification, but not so psychotherapists and others who must guide troubled individuals and their families. They need an action plan. In this chapter we describe how one uses an AAI classification, combined with information about the history and current functioning of the speaker and his or her family, to derive a functional formulation. The functional formulation is the professional’s dispositional representation (DR) of the relation between the service structure and the individual and his or her relationships. Like all DRs, a functional formulation is dynamic; it is always changing as new information is integrated into the existing set of information… We describe how to derive functional formulations that can guide treatment both at its onset and, with feedback and updating, across the course of treatment.

Crittenden and Landini then go on to demonstrate exactly how their model can be used as a therapeutic tool, using the initial classification as starting point to guide both the therapist and client toward the resolution of past issues and the reorganization of the thoughts and language that shape both our ideas of self and attachment strategy. Furthermore, this model aims to shift the focus on attachment styles from one of disorder to one of function; from the old deficit-based model to one that is dynamic and optimistic. Rather than an emphasis on diagnosis simply for the sake of identification or labels, the authors stress their hopes that this model might open the doors to new ways of thinking in not just the mental health field, but others as well, concluding that:

When functioning is understood as attempts to protect rather than to damage or harm, alliances between mental health professionals and people in need of care become more likely.

Many say that DMM theory and methods are complex, too complex for working clinicians. After a century of trying to understand and ameliorate mental illness, it seems unlikely that simple theory, simple assessment, and quick manualized treatment will be more successful than our past efforts. It is more likely that theory needs to be sufficiently complex to represent the crucial aspects of the life experiences of people with mental illness. The assessments need to be sensitively attuned to the encrypted communications of very distressed adults, and to be coded by skilled professionals trained to a high level of reliability.

Possibly, the greatest potential of the DMM-AAI is its capacity to focus observation precisely while retaining the openness to expand and change understanding of observations. We hope this book will be used to promote accuracy of observation, clarity of interpretation, and – most important – discovery of new ideas about human adaptation. Psychological tools that yield useful data without restricting thinking are very valuable. The DMM-AAI does more: It opens the door to groundbreaking basic and applied research of as much relevance for the social sciences as for the healing professions.

This is a groundbreaking piece of work, containing a life-span view of adaptation that is both intuitively succinct and simple in structure, yet also completely nuanced in execution. Researchers and clinicians alike will undoubtedly benefit from the wealth of information shared here, and it is a must-have for anyone with an interest in attachment theory, representing a major evolutionary step forward in the field.

5 out of 5 stars.





Stop Suffering Needlessly: How to Quickly Recover from Depression

18 07 2011

Another book review: “Stop Suffering Needlessly: How to Quickly Recover from Depression”, by Kathy Reagan.

Stop Suffering Needlessly cover

Almost everyone reading this review – particularly those in the mental health field – will have had first-hand experience of dealing with depression at one time or another, whether the sufferer was a client, a relative, a friend, or themselves. The World Health Organization predicts that by 2020, depression will be the second largest cause of suffering in the world, second only to heart disease. Depression affects over 15 million Americans alone, and is one of the most prevalent and debilitating mental illnesses in the world today, often going undiagnosed and untreated. So there is no doubt that this is a topic which deserves to be written about, and which requires serious attention.

With her new book ‘Stop Suffering Needlessly’, Kathy Reagan joins the host of other self-help authors who all proclaim to be able to offer their readers the secret cure to depression. The back cover of Reagan’s book suggests that “If you’re one of the majority of people who aren’t receiving any treatment for your depression, this book will teach you everything that you need to know to recover quickly.” The cover also promises that “Stop Suffering Needlessly will benefit you, whatever your age, gender, ethnicity, geography, socioeconomic status, sexual orientation, or religious beliefs.” Bold statements indeed.

Unfortunately, on just the second page of the book, these promises begin to come undone, when Reagan says:

Whether we suffer as a result of things we can or cannot control, I believe that there is value in suffering. I believe that God gives all of us at least one opportunity, if not many opportunities (especially for those of us who don’t get it the first time), to fall to our knees, acknowledge our weaknesses, and ask for help. Maybe that’s the lesson to be learned when we suffer. Maybe learning to finally ‘let go and let God,’ and rely on a Power greater than ourselves, is the true value of suffering.

Reagan goes on to explain that:

I believe that there is a Divine plan, which calls each of us to heal from whatever suffering we may experience, to learn and choose to be happy, to pay it forward, and to grow toward our Maker. This is why I wrote Stop Suffering Needlessly.

It quickly becomes clear that this is not a book which would appeal to the general populace. In fact, Reagan seems to be writing exclusively for a very specific audience here: those who share only her own religious beliefs. One of Reagan’s concluding remarks tells us to “Learn to give up control, rely on God or your Higher Power,” and to say the Serenity Prayer daily. The book will also be of most relevance to American readers, as Reagan quotes only from American television shows throughout, and all of her statistics are taken from the American Psychological Association (APA).

This is a disappointing approach to the topic, as it will immediately alienate a huge part of Reagan’s potential audience from her book and limit it to a niche market; rendering many of her suggestions invalid and not applicable to other people. It is also a surprising one, as one would not expect to find such a polarizing opinion in the field of mental health advice or self-help, especially coming from someone who has worked as a professional therapist for almost 20 years. Far from the unbiased, open-minded and nonjudgmental approach we might expect, Reagan makes no hesitation in stating her own beliefs, and repeats them again and again throughout her book, seemingly imposing them on her readers:

I believe that guilt and shame are gifts to help us become better human beings. Following the Ten Commandments for example, is a wonderful guide for our conscience and behavior, and feeling and experiencing some guilt for breaking a commandment can help us do better.

At best this makes Reagan’s book come across as one which should only be read by a select readership, but at worst it comes across as patronizing, insulting, or downright irresponsible. I can only hope that Reagan has adopted this tone for her writing alone, and does not voice her personal beliefs so openly in session, with her clients.

Sadly, the problems with this book do not end at Reagan’s insistence on expressing her beliefs, but continue to emerge as she gives her advice on the topic of depression and its cures. Reagan’s suggestions are purely anecdotal; drawn from her own memories and personal experiences, rather than from any kind of professional research or actual facts. She scatters the phrases “in my experience” and “in my opinion” frequently throughout her book, but fails to back up her theories with any proof or further evidence, instead supplying the reader with occasional quotes from TV shows:

Rejection is God’s protection is a line from a recent episode of ‘Law and Order.’ If you’ve experienced rejection (who hasn’t at one time or another?), consider the possibility that this statement is true. If you’re suffering from the loss of a relationship, is it possible that God is protecting you from some future danger or sorrow that you can’t see? Or that God has something better planned for you in the future?

As if this wasn’t bad enough, Reagan consistently makes sweeping statements, offering vague generalizations and clichés:

It’s common for people who experience depression, and women in particular, to lose a sense of themselves, especially if they have been trained to be care-givers for their partners, children, or others. Do you know who you are and what you need? Do you even have a clue what you need? Many women do not.

As seen here, Reagan has a tendency to pepper her prose with incessant questions, one after the other, presumably aimed at her imaginary readers. Unfortunately these have the effect of making it seem like the author herself is not sure of the answers, and at times make the book completely unreadable, as the text dissolves into entire paragraphs of theoretical questioning and rhetoric.

I do not wish to be overly critical here, as there are a few snippets of worthwhile information hidden among the text. Some of Reagan’s stories do contain interesting suggestions and techniques, and she supplies a useful collection of links and resources in her Appendix. Her nine steps toward taking control of depression may also be of use to some readers:

1. Recognize and acknowledge your depression.
2. Ask for help. Expect to recover.
3. Take medication if you need it.
4. Take care of your body.
5. Seek therapy.
6. Practice Cognitive Behavioral Therapy (CBT).
7. Learn other important skills.
8. Increase your social support.
9. Develop a relapse prevention plan: Take responsibility for your depression and your recovery.

However, whenever Reagan seems to latch on to something of interest, or to present a promising theme, she just as quickly goes on to contradict herself, or undo her sentiments entirely. In an early chapter Reagan writes:

Have you ever heard the phrase’ Just pull yourself up by your bootstraps?’ Or ‘Just think positively!’ These old simplistic and cavalier responses to people with depression now sound ridiculous, knowing that depression is a medical illness. As if depressed people could do just that and recover easily… Effective treatment for the medical illness of depression involves more than trite solutions.

Then, just a few pages later she says:

Even if you currently don’t have health insurance, that doesn’t mean that you cannot receive recommended treatment if you want it. You are likely still eligible for some kind of assistance or program, so if you want help, ask for it.

And again, in another chapter, Reagan repeats this sentiment:

Do what you need to do to obtain care. Some health care providers also provide pro bono (free) care. Some retail and drug stores offer free walk-in services too. If you need treatment, you can find it.

These simplistic and cavalier suggestions do indeed come across as ridiculous, particularly as Reagan herself dismissed them earlier, and they seem to lack the sensitivity or understanding one would expect from an author in this field. One can only wonder how a seriously depressed reader might feel, if they turned to this book during a time of utter desperation and exhaustion, only to find such unsympathetic, matter-of-fact advice. Even the book’s title, Stop Suffering Needlessly, seems accusatory and blunt when taken in this context.

Even though I operate from a strengths-based perspective and believe in carrying this approach across to all aspects of my life — including book reviews — it is hard to find many positives in this self-published text. It may conceivably be helpful to the few readers who happen to share Reagan’s exact outlook on life and her religious beliefs, but otherwise it would be best avoided. There are numerous other books on offer which cover this same topic, and do so far better, without any sense of discrimination or prejudice against their readers, and with a grounding in reputable clinical experience and scientific fact, all of which are lacking here.

Reagan is right about one thing: the effective treatment of depression definitely does involve more than trite solutions. Unfortunately, those are all you’ll find in this book.

1 out of 5 stars.