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.





Fertility treatments and counselling

18 03 2015

Last Sunday, the 15th March 2015, the Sun published an article about IVF treatments and the stress – both psychological and financial – that these can place on a family. They contacted me and asked me to say a little bit about the systemic, wider-reaching impact that such a process can have on all the family members. and how therapy can often be a way for everyone to come together and process these issues.

You can see some clips of the article  as it appeared in the paper, below.

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If you, or any family members, might be interested in counselling for fertility issues or any related problems, then please do contact me to arrange an individual, couples, or family session as soon as possible. I look forward to hearing from you.





Dealing with Addiction

11 03 2015

Recently I saw a couple of encouraging articles in the news which inspired me to write a brief post about dealing with addiction. I will link to the two articles at the end of this post.

Addiction is an issue that comes up all the time in therapy. Sometimes it appears in very overt and obvious forms – such as substance misuse, gambling, or sex addiction – but often in more covert and subtle ways as well, such as compulsive exercise, workaholism, or obsessive thoughts and habits. In many ways all humans are addicts, as we are creatures of habit; we thrive on things that are familiar and comforting, and carve out repetitive patterns for ourselves. This is no bad thing, as it means that we can create healthy routines, or stick to a structured approach when making changes or adjustments; but it can also be dangerous and become an unhealthy, destructive force where a reliance on a certain way of thinking or behaving can start to interfere with the rest our lives.

So, why is it that some people can keep their habits under control and choose healthy routines for themselves, whereas others find themselves losing control to harmful urges? What decides whether we will find a healthy or an unhealthy outlet for our need for comfort? This is a complex issue, with numerous answers (see Gabor Mate’s talk on The Power Of Addiction for some great points), but I think these three are the most important:

1. Psychobiology. Some people inherit genetic traits or learned behaviours from their ancestors, where they may be predisposed to certain ways of thinking or doing things, or have a particular physiological ‘weakness’ for a certain substance.
2. Environment. We are hugely influenced by our surroundings, and by our social networks (see Nicholas Christakis’ wonderful talk on The Hidden Influence Of Social Networks for more information). The people around us shape our ideas of accepted norms and influence the behaviours that we establish; we often look to see how others are coping with their lives, and then we copy them.
3. Early attachment experiences. Our early experiences shape our identities and also, crucially, our emotion regulation strategies. If we have positive attachment experiences then we learn that we can rely on others, and turn to them during times of need; and this also teaches us that we are ‘worthy’ of other people’s care and attention. However, if we have negative attachment experiences then we learn that we cannot rely on others, and instead have to develop our own methods of self-soothing; and this also teaches that we are ‘unworthy’ of other people’s care and attention. It’s this latter group of people who often seek external sources of affirmation and validation, which can slip into addictive cycles: if it doesn’t feel emotionally safe to turn to other people for reassurance, then they will seek that comfort from the escapism and rush of sex, drugs, or gambling instead.

Amazingly, many addiction treatment programs continue to focus on only the first of those three issues. They see addiction simply as a psychobiological disease, and they dissect the cognitive, behavioural, and physiological components of this disease, and then set out to replace previous bad habits with healthy new ones. However, they often overlook the crucial factors of social networks and attachment experiences; factors which will be massively influential on a person’s chances of maintaining their recovery over time. I believe a crucial element in treating addiction is to process and repair negative attachment experiences from the past, and then to create new, healing attachment experiences in therapy; so that a client can feel a sense of attunement, and learn that it’s safe to turn to others for soothing and reassurance, rather than having to self-soothe or seek out alternative sources of validation. This process also empowers the client to develop a new sense of worthiness, overcoming internalished shame from past rejection, and recognising that they are indeed deserving of the attention, care, and love of others.

I spent several years as the Clinical Lead of a substance misuse treatment agency within the NHS in North London, and always made sure that we were taking a holistic approach to our clients’ recovery; addressing all three of the factors I list above. I continue to use this approach in therapy with my clients.

Now, here are the two articles I referred to earlier:

1. A Huffington Post article, titled “The Likely Cause Of Addiction Has Been Discovered, And It Is Not What You Think”.
2. An NPR article, titled “What Heroin Addiction Tells Us About Changing Bad Habits”.

Hopefully you will find them as informative as I did. And if you are seeking information or therapy for issues related to addiction, then please do feel free to contact me.





Wishing everyone a restful end to the year.

20 12 2014

As we’re coming to the end of the year I just want to wish everyone a restful time over the next few weeks. It’s often a time where families get to come together, but that doesn’t mean it’s any less manic or stressful than the rest of the year; in fact it can often be a time of conflict and anxiety.

I work with a lot of my clients to raise awareness of their feelings at times of conflict or anxiety, and then to manage them using techniques such as mindfulness. I see mindfulness as a means of remaining focused on the here and now, and being completely in touch with the present moment; thus removing ourselves from the constant ‘noise’ of past-oriented or future-focused thoughts buzzing around our brain. Imagine your mind as one of those Christmas snowglobes, shaken up and swirling all over the place; and mindfulness helping all the snowflakes become settled and calm, so that the globe is clear again.

Scientific evidence has shown the effectiveness of regular mindfulness, and you can read the recent experiences of the American news anchor Anderson Cooper here, as he describes how mindful practice has changed his life; enabling him to be more calm, present, and efficient.

However you spend the next few weeks, why not try out some mindfulness techniques to simply catch your breath and gather your thoughts? For example, you might want to just focus on your breathing for a couple of minutes, or try some progressive muscle relaxation, or sit through a brief guided imagery exercise. These techniques should help you feel far less stressed and anxious, and much less overwhelmed.

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I would also like to briefly thank everyone at the ACPNL, as they kindly invited me to present a workshop for them last Sunday. I have to admit I didn’t expect many people to be present – considering it was a cold and frosty Sunday morning at the end of the year – so I was delighted to have almost 50 people in attendance. I presented for 3 hours, on the topic of Social Emotion Regulation, and talked about the difference between attachment and attunement, how to create lasting and secure connections in therapy, and the basics of Emotionally Focused Therapy (as a reminder, EFT is an evidence based modality with a proven ‘total recovery’ rate of 75%, and 90% of clients showing improvements; no other modality even comes close!). The workshop was such a success that the ACPNL have requested that I go back and do another one, so I will keep you posted once dates are confirmed.

Once again, I would like to wish you all a happy and healthy end to the year, and all the best for 2015.





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!





Boys Do Cry

15 10 2014

I just wanted to post a quick link to a a couple of excellent articles.

The first was published by Vice last week, titled “A Stiff Upper Lip Is Killing British Men“. You can read it here and I think the facts speak for themselves:

“Even accounting for reproductive health, in any given year men are half as likely as women to visit their doctor in England, which doesn’t make a lot of sense. I’m pretty certain women don’t get ill twice as often as men. In the UK, the rate of premature deaths (under 50) is one and a half times higher among men than women, primarily due to cardiovascular disease, accidents, suicide, and cancer—the latter cause offering perhaps the strongest evidence of men’s reluctance to seek help. While affecting men and women equally, skin cancer kills four times as many men in the UK because we avoid addressing the issue until it’s too late… The disparity in suicide rates is another eye-opener. In spite of depression being more common in women, men are three times more likely to take their own lives in the UK. A 2012 Samaritans report concluded that the social constructs of masculinity were a major cause of this imbalance, noting that “the way men are taught, through childhood, to be ‘manly’ does not emphasize social and emotional skills,” and that, in contrast to women, “the ‘healthy’ ways men cope are using music or exercise to manage stress or worry, rather than ‘talking.’ Alcoholism is also significantly more prevalent in men, linked largely to self-medicating mental illness… Communication is the key to a successful relationship, as any happily married person will tell you. The worst part is that we know this. It’s been drilled into us by every book and TV show and film that deals with these kind of issues, but still we ignore it, forging ahead under the misconception that those rules only apply to others.”

In summary: it’s good to talk. And the stigma that men should be strong just deal with things by themselves is outdated, unnatural, and unhealthy.

The second is a lovely article by Robert Webb for The New Statesman which touches on topics such as going from boyhood to manhood, grieving a lost parent, and forgiveness. You can find it here.





Guardian Interview about sex for the over 60s

25 08 2014

A while ago I did a short interview with The Guardian, to discuss sexual health and relationships for the over 60s. It was recently published on their website, and you can read it here.

Unexpectedly, the story seems to have been picked up by a number of other international sites as well, including this American news site and some blog posts. It’s nice to see the story spreading around, and hopefully this will encourage further healthy discussion around the topic.

I think sometimes there’s a stigma that you “can’t teach your grandmother to suck eggs”; that after a certain age we just get stuck in our ways and refuse to change. So the misconception follows that therapy is reserved for younger people; from teenagers facing problems in puberty, up to married couples in their 50s facing divorce.

But the truth is that it’s always good to talk; no matter what age you are. I see many elderly couples who find it transformative to discuss their relationships and sex lives in therapy, and it’s always rewarding to see the progress they make together. It’s never too late to make a change!





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.





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.