Psychologist Bert Karon to Present at 2nd Empathic Therapy Conference
           

Psychologist Joanne Cacciatore Advocates for Those Affected by Traumatic Loss

Want to know what a real warrior looks like? Find a person who is truly in mourning and who is able to sit with the ineffable truth of suffering. Cowards dare not enter that house of pain. Only the courageous walk barefoot, blindfolded, through the darkness.
- Dr. Joanne Cacciatore

As the founder of the MISS Foundation, Joanne is an advocate of “green” mental health care and she is a Diplomate in the American Psychotherapy Association, as well as a member of the Association for Contemplative Mind in Higher Education, the International Society for Traumatic Stress Studies, and the National Center for Crisis Management. She is regarded as an expert in traumatic loss and child death in families, and has been counseling and aiding  individuals and families since 1996.  She spearheaded and now directs the Certificate of Trauma and Bereavement graduate program and is a faculty affiliate in the Family Communication Consortium at ASU.

Dr. Cacciatore has been an outspoken advocate on the part of the bereaved; opposing the classification of grief as a mental illness and opposing its inclusion in the psychiatric Diagnostic and Statistical Manual.  She is a vibrant and inspiring speaker.


Award Winning Filmmaker
Kevin P. Miller Presents
"Beyond Generation Rx--
What's Next?"

Filmmaker Kevin P. Miller released "Generation Rx" in 2008. This beautifully filmed and impecibly documented work is still the best introduction to the tragedy of children placed in the hands of psychiatry.  Kevin will be talking about "Generation Rx" and how he continues to increase awareness of the dangers of psychiatry diagnosing and treating children.  Additionally, Kevin will discuss and offer some clips from his next project! 


Psychotropic Medications in Maltreated Children
by Bruce D. Perry, M.D., Ph.D.
The ChildTrauma Academy

In this last month several academic (see report of study in Pediatrics), government (GAO report of Psychotropic Drug Use in Foster Care), and media (e.g., ABC's 20/20 report on overuse of psychotropics in children in foster care; the Houston Press article "Down the Hatch") reports have highlighted the use and overuse of psychotropic medications in children in foster care.  Please take the time to click on the links above to learn more about this issue.  It is one of the most challenging problems facing clinicians working with maltreated and traumatized children; at the heart of the issue is the "evidence" that may (or may not) support the use of some of these medications in traumatized children. 

The simple fact is that there is very minimal outcome data to support the effectiveness of any medication in this population; this is in part because this population has not been adequately studied in controlled studies.  Linked to this challenge is the inter-related problem of diagnosis.  Any clinician working with traumatized children - especially those with complex histories of chaos, neglect and multiple traumatic experiences - can tell you about the inadequate "diagnostic" labels available to characterize these children.

Both of these issues - overuse of psychotropic medication  and inadequate diagnostic formulations - in traumatized children illustrate the need for a different approach to understanding and treating the complex neuropsychiatric problems seen in this population.  As our field matures, a developmentally-aware and trauma-informed perspective will help move us beyond the current over-simplistic and inadequate approach to clinical work with these complicated children and their equally complex families and communities. 

The good news is that many excellent clinicians and working groups are beginning to make this shift - in future newsletters we will share the progress of some of the groups working towards developmentally sensitive and trauma-informed practices (e.g., Sandy Bloom's Sanctuary Model; Kristi Brandt's Mobius Care Model).

This article is republished from the ChildTrauma Academy Newsletter, December 2011. For more information about Dr. Bruce Perry's important work see his website: http://www.childtrauma.org/
 

Xanax Facts and Whitney Houston
by Peter R. Breggin, MD
first published on The Huffington Post

Often when I think about how much I love my wife, Ginger, I wish I could sing to her. But I cannot sing. Instead, I imagine Whitney Houston singing to Ginger in her incredible soaring voice. Whitney became the voice expressing how much I love my wife. That is how much Whitney came to mean to so many of us who knew her only through her music. She became the music about love we carry in our hearts.

Whitney's passing has raised the specter that she was taking the benzodiazepine Xanax (alprazolam) at the time she died.

If it turns out that Whitney was under the influence of Xanax (alprazolam), then there's a good chance she would be alive today if that drug had never been put on the market.

Although Xanax is the most commonly prescribed benzodiazepine, and in my experience the most dangerous, the same harmful effects can be caused by all benzodiazepines, including Valium, Ativan, Klonopin, Serax, Halcion, Dalmane, and Halcion. When I address Xanax, I'm also talking about all of these drugs.

Reports that Xanax and other benzos are not usually lethal when taken alone are vastly misleading. Xanax is rarely taken alone. Why? Because as much or more than any other prescribed drug, Xanax causes medication spellbinding. It corrupts judgment, memory and self-control, so that individuals have no idea how badly they are being impaired. Eventually it erodes all mental faculties, often without the person fully grasping this loss of function. The impairment of judgment and self-control causes people to overdose on drugs or alcohol without intending to, leading to coma, cardiovascular collapse and death. The Xanax-induced memory impairment causes them to forget how many pills or how much alcohol they have already taken, again increasing the lethal risk.

Read the rest of the article here.

A Clinical Illustration of the Difference Between Empathy and Sympathy
By Joseph Burgo, PhD
An Exclusive for the Empathic Therapy Newsletter       

Most people, even many psychotherapists, tend to use EMPATHY and SYMPATHY interchangeably, as if those words mean the same thing.  In fact, the difference between them has important ramifications for our work:  clients often want us to SYMPATHIZE with what they have told us when they may actually need us to EMPATHIZE with feelings they are not consciously expressing.

Here are two dictionary definitions from Merriam-Webster:

Sympathy:
"the act or capacity of entering into or sharing the feelings or interests of another"

Empathy:
"the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts and experience of another of either the past or present without having the feelings, thoughts and experience fully communicated in an objectively explicit manner"

While those definitions sound quite similar, the second introduces the possibility that the experience which we are sharing may not have been verbally and intentionally communicated to us.  As therapists emotionally attuned to our clients, we may on occasion empathize with a feeling of which a client is not actually conscious.  I believe this exact experience informs our work more fully than we sometimes recognize; for the psychodynamic psychotherapist, it lends conviction to interventions we make when we try to bring an unconscious feeling into awareness. 
 
I find this to be especially true where hostility and aggression are in the field.  Such feelings are by and large socially unacceptable, to begin with; most people don't want to appear hostile or even to know about their own angry feelings, however understandable the hostility and anger may be.  And yet, for certain clients who seek our help -- some profoundly  depressed men and women, or people who present features associated with the personality disorders -- coming into contact with and learning to bear hostility is exactly what they may need to do.

Let me give a clinical illustration.  One of my clients (I'll refer to her as "Stephanie") sought professional help due to severe depression and insomnia, and because she occasionally cut herself with razor blades.  She was in her late teens when she started treatment.  During one session, she was relating an experience from elementary school which she had recalled.  With tears in her eyes and her voice choking up, Stephanie told of several very "mean" children who were torturing a wounded bird they had found on the playground.  She appeared to be upset by the memory; from her looks and verbal cues, it was clear to me that she very much wanted me to share and sympathize with her expressed feelings of horror at the cruel behavior of those other children.  She could not understand them, she told me, because she had always tried hard to be a good person and would never intentionally hurt a fly.

I did not sympathize with Stephanie, however; I found her tears to be emotionally unpersuasive -- what we sometimes refer to as "crocodile tears," except that she was not CONSCIOUSLY trying to manipulate me.  Instead, though I didn't fully understand it at that point, I felt an inkling of her unconscious rage.   Sensations in my face and body gave me the clue; all feelings register somewhere within our body, and paying close attention to our own physical experience often helps us to name and understand the feelings with which we are empathizing.  At that time, early in our work together, I couldn't articulate it even to myself, but I had a strong sense that Stephanie unconsciously felt something quite different from the feelings she wanted me to share. 

In the ensuing months, as I heard more such material (about the cruel and hostile behavior of OTHER PEOPLE, always other people), coupled with similar emotional and physical experiences in response -- I eventually replied in terms that ran something like this:  "I think you're afraid that you might not be as nice as you'd like to believe, and that underneath, you have a whole bunch of very angry and destructive feelings that scare you."  Over time, especially when she began to tell me about incidents of her explosive hostility, the evidence to support that my statement became clear to her.  She developed a conviction of its truthfulness and came to feel understood, even if she disliked what I had understood about her.

So in the beginning, Stephanie wanted me to SYMPATHIZE with her somewhat sentimental view of herself as a "good person", thereby supporting defensive attempts to ward off that scary violence inside; in the course of our work, however, I instead came to EMPATHIZE with her unconscious violence and help her to make acquaintance with a split-off part of herself that lay at the root of her troubles.  Had I sympathized instead, I would have colluded with her defenses and our work together would have gone nowhere.

Joseph Burgo, Ph.D. has practiced psychotherapy for 30 years, holding licenses as a marriage and family therapist and clinical psychologist. He earned his undergraduate degree at UCLA and his masters and doctorate at California Graduate Institute in Los Angeles. As an instructor, he has taught graduate students in psychology and supervised their training in community counseling centers. He is also a graduate psychoanalyst and has served as a board member, officer and instructor at a component society of the International Psychoanalytic Association. As a writer, he has published two novels, both works of genre fiction released some time ago and now out of print. In addition to his After Psychotherapy website, he co-writes a blog with Marla Estes called "Movies and Mental Health," hosted on PsychCentral.com.  His forthcoming book on psychological defense mechanisms will be released by New Harbinger Publications in Spring 2013.

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