The value of art in expanding our minds

Sculpture by Mary Hecht

You may have noticed there's a lot of emphasis on science thesedays, but a recent study by neurophysicians at the Memory Clinic at St Michael's Hospital in Toronto demonstrates the value, endurance and mysterious role of art in enriching human lives.

The lead author, Dr Luis Fornazzari, reports the case of Mary Hecht, an internationally renowned sculptor who died in April 2013 with vascular dementia, whom he cites as "a remarkable example of how artistic abilities are preserved in spite of degeneration of the brain and a loss in the more mundane, day-to-day memory functions."

Because of her neurological condition, Hecht had lost the ability to conduct a normal conversation, remember words she was asked to recall and even illustrate the time on a clock. But to the astonishment of Dr Fornazzari and his team, she was able to quickly sketch an accurate portrait of of a research student from the Clinic, as well as other people and objects from memory. While drawing, she was able to speak eloquently and without hesitation, in contrast to her prevailing level of functionality.

This shows, at the very least, the unique terrain occupied by art in our brains and Dr Fornazzari concludes that "art should be taught to everyone. It's better than many medications and is as important as mathematics and history."

For those of us who have friends or loved ones with vascular dementia, this work offers hope, in that so often, activities which once gave pleasure, like cooking or gardening or basic activities of daily living, can no longer be undertaken. Could it be that providing them with paper and pencils and painting sets may open the window to freedom and joy, even if for a limited time? It is possible Hecht's extraordinary talent may have been part of the key, but it's certainly worth a try.

No matter how alluring the promises of a life filled with logic and scientific discovery, we dismiss the value of art at our peril. In all its forms, it points to a place where there are no easy answers, touching upon states which we can only feel and barely describe. Our brain is a brain of two halves - let's not succumb to the seductive temptations of a life lived on one side.

Written by Jacqui Hogan

Face-to-face beats Facebook, hands down

You kind of know it in your heart, don't you. Spending too much time communing with your computer can't be good for you. But who would have guessed that, even when the communing involves engaging with a large number of like-minded people (and I've heard it said that the population of Facebook makes it the third largest 'country' in the world), it still isn't good for you. What about all those friends?

A new study supports the notion that Facebook can have a negative impact on the way you feel - researchers from the University of Michigan published in the journal Plos One that "rather than enhancing well-being... Facebook may undermine it."

Using the technique of 'experience sampling', the authors text-messaged 82 young adult participants five times per day for two weeks to examine how Facebook use influenced two components of subjective wellbeing  - how they felt from moment-to-moment and how satisfied they were with their lives.

What they discovered was that the more participants used Facebook on any given day, the worse they felt next time they were text-messaged, and the more they used Facebook over the course of the whole fourteen days, the more their experience of life satisfaction declined.

One explanation put forward by the authors was that loneliness and/or worry might be causing participants to increase Facebook use, which would suggest that Facebook was not the problem at all, and that negative feelings were driving its use. However, even when they accounted for the loneliness and worry variables within the study design, Facebook use continued to predict declines in subjective wellbeing.

These findings deserve consideration in light of the suggestion that Facebook can be considered an addiction, in much the same way that any substance or behaviour can - the Bergen Facebook Addiction Scale (BFAS), developed by Norwegian researchers, testifies to this. As with alcohol, for example, developing a Facebook habit would appear to run counter to improving your psychological wellbeing.

So what are we to make of these findings? As usual, mother knew best, and it's moderation in everything. We'd do well to keep an eye on how much time we're devoting to the use of social media at the expense of participating face-to-face in our real life communities. Probably a good place to end a blog post, don't you think?

Written by Jacqui Hogan

Focus on Ritalin

This week, the annual Care Quality Commission (CQC) Report on Controlled Drugs revealed that the number of prescriptions for Ritalin, the drug commonly used for treating children with Attention Deficit Hyperactivity Disorder (ADHD) has risen by 56% in the last five years. That is to say, in 2007 GPs in England wrote 420,000 prescriptions for Ritalin and in 2012 they wrote 657,000.

You might be forgiven for thinking that Ritalin (chemical name methylphenidate) must be a relatively new kid on the block (pardon the pun) given its recent rise to prominence. But in fact, it was first prescribed as far back as 1957 for the treatment of chronic fatigue, depression, psychosis associated with depression and narcolepsy. By the 1960s, research interest focused on its use in the treatment of hyperkinetic syndrome, which would eventually be labelled ADHD.

Although technically not an amphetamine, Ritalin is a brain stimulant that seems to behave in a similar manner; its mechanism of action is still not understood. Most experts agree that it affects the part of the brain involved with impulse control (the midbrain) and researchers have reported a link between Ritalin and serotonin, a naturally occurring brain neurotransmitter (also the target of antidepressants known as Selective Serotonin Reuptake Inhibitors, SSRIs, of which Prozac is a prime example).

A recent new Canadian study among thousands of children http://www.nber.org/papers/w19105 should give us pause for thought when it comes to the subject of Ritalin prescriptions. It showed that Ritalin and other such stimulants have no long-term benefits and, if anything, children on these drugs experienced worse outcomes than children not taking them. To quote the authors:

"We find evidence of increases in emotional problems among girls and reductions in educational attainment among boys. Our results are silent on the effects on optimal use of medication for ADHD, but suggest that expanding medication can have negative consequences given the average way these drugs are used in the community."

Why this, one wonders? One thought is that while Ritalin may work to quiet children down, it may also give the appearance that their behavioural problems have been solved. The difficulty is, that if the underlying cause of an ADHD diagnosis remains unaddressed, it won't necessarily go away and when the drug is discontinued, symptoms will inevitably re-emerge. Children who have been 'damped down' in this way are also (arguably) less likely to get any additional academic help they may need, which may have been an unconscious reason for the original disruptive behaviour.

It is recommended that Ritalin should always be prescribed alongside non-medical psychological treatments such as counselling, though in practice this doesn't always happen. This removes a significant check from the treatment equation. Psychoactive medication combined with failure to treat underlying causes rarely ever prospers the patient.

None of this is to say that Ritalin is not an effective treatment for a small, but significant, number of children with ADHD, whose lives without the drug would probably be all the poorer. But clinicians are rightly becoming disturbed by the rapidly rising number of children who are now receiving treatment as a matter of course - an incredible 11% of all school children in the USA (nearly 20% of high school-aged boys). From these latest CQC figures, it appears that a similar trend is emerging in the UK.

Given the large demographic, particularly in the USA, are children being medicated for the 'disorder' of being a child, one has to ask. What are your thoughts? We'd love to hear them.

Written by Jacqui Hogan

I thirst for you - cognitive performance, that is!

A recent study by Caroline Edmonds and her colleagues from the University of East London and the University of Westminster has shown that when people are thirsty, they tend to respond more slowly in performing tasks. Interestingly, extended response times were not associated with actual physical dehydration, but more with the experience of being thirsty.

In the experiment, participants abstained from fluid overnight on two separate occasions. The following day, on the first occasion, they were given 500ml of fluid to drink before performing a specified task and on the second they were given no fluid to drink before performing the same task. Their reaction times were measured and only those who were subjectively thirsty demonstrated compromised reaction times - the level of physical hydration itself was not the issue!

What can we take from this novel finding? Well, we at number 96 plan to make sure, from this moment on, that our water cooler is always topped up - specially during the warmer weather. We figure, at least for ourselves, we need all the support we can get when it comes to maintaining optimal cognitive performance!

So if you're wandering down Harley Street and feel in need of a cooling draught, please do press the buzzer - we'll welcome you to our waiting room (water cooler to the right of the fireplace, pictured above) with open arms.

Written by Jacqui Hogan

Merry Christmas from all at 96 Harley Psychotherapy

Christmas is upon us and, amidst all the welcome chaos of Christmas decorating and last-minute appointments, we're trying to make the time - sometimes successfully, sometimes not - to take inventory of the year that has been, in order to process the old and make preparation for welcoming in the new.

We've seen lots of new and exciting developments here at number 96 during 2012, with new therapists Sheron Green, Claire White, Roisin Golding and Renee Thurston expanding and enriching our therapeutic offering with their skills in trauma, hypnotherapy, acupuncture, NLP and child psychotherapy. Along with our many long-standing therapists, it's fair to say there isn't a psychological ailment we can't address on these premises, with sensitivity, experience and a vast amount of specialist knowledge.

As many of our clients will know, 96 Harley Street, as well as being a world class psychotherapeutic hub, is home to a a broad range of other medical specialities, among them dermatology, gastroenterology, gynaecology, physiotherapy and psychiatry. During 2012, we have also welcomed Rheumatologist Professor Hasan Tahir and Men's Health Physicians Malcolm Carruthers and Kam Mann, all distinguished experts in their fields.

This growth is consistent with our vision to create a multidisciplinary centre of healthcare excellence, in which healthcare professionals of every discipline will benefit from the cross-fertilisation of ideas that can only come from working under the one (magnificent!) roof. Many of our clients have reported they appreciate the convenience of having all their specialists gathered together, and we hope to build on the number and range of practitioners operating from the house in 2013.

Another development this year has been our decision to apply for registration with the Care Quality Commission (CQC), to provide reassurance for our clients  that our services are accredited to the highest possible standard. This is expected to benefit our therapists as well, who, having met our exacting recruitment criteria, will enjoy full accreditation with the CQC under our auspices.

We're delighted to report the continued flourishing of our website, which, with the help of our SEO and  marketing experts continues to hold its own in the search engine rankings. We have noted an increase in the number of enquiries fielded through the site, just as we had planned. The website provides a powerful canvas for all of our therapists to use in promoting their services to the public at large, and we strongly encourage everyone to take advantage of this. One of our aspirations for 2013 is to persuade more of our therapists to make use of the website for promoting their workshops and other activities.

All that remains, then, is to wish you all a merry Christmas and a happy and prosperous new year. We look forward to seeing you, all shiny and renewed, in 2013.

Written by Jacqui Hogan

Focus on burnout

As 2012 draws to a close, it’s natural to start turning our minds to the events of the past year – what we’ve achieved, how things have changed, significant occurrences, how we feel about the passing of time and the imminent approach of 2013.

It’s often at moments like these we reflect on the broad categories of our lives – relationship, job, health, family – and identify what’s working well and what’s not. In the spirit of such enquiry, this post we’re focusing on burnout, a condition gaining momentum in the public mind, and one which our therapists are increasingly encountering at 96 Harley Psychotherapy.

Which begs the question – what is burnout? Well, you’ll find various definitions, but basically it’s a state of depletion and exhaustion, caused by excessive and sustained stress in a particular role. It’s important here to distinguish what stress is too, since stress comes in many forms and is highly dependent upon individual factors. So while one individual might experience stress by being in work that is inconsistent with his or her values, another might experience it as a consequence of not being appreciated in an assigned role. Burnout is often associated with continued frustration and the perception (either real or imagined) that nothing will ever change, and that the situation is somehow hopeless.

Some of the symptoms of burnout include loss of motivation, a feeling of little or no control over work (or the area in question), a sense of helplessness, disengagement, isolation and a feeling that there is no worthwhile future. If that sounds like depression, you’re right – burnout is a kind of depression, and one for which, thankfully, a cause can be traced. Unlike stress, which we think of as a reaction to real-time pressure, burnout is a gradual process that occurs in response to pressure – physical, emotional and spiritual – over an extended period of time. With each small internal experience of ‘this isn’t working for me’ (combined with failure to address it) the momentum builds. Once it reaches the critical stage, there is no turning back.

Early warning signs of burnout include:

·          Physical tiredness – feeling tired a lot of the time, but especially when undertaking the role in question

·         Loss of motivation – where once the role may have inspired, now there is a heaviness associated with it and resistance to doing it

·        A decreased sense of satisfaction – and a diminished feeling of accomplishment when undertaking the role

·        Increased negative thinking – in particular, self-criticism and creeping despair about the future

·        Loss of concentration – where once the job was relatively easy, it is no longer taken in one’s stride, but associated with procrastination and inefficiency

By intervening on these symptoms, it is possible to ‘turn the ship round’, which many people do. But sometimes, the reality is, it's too late. This ‘too lateness’ can sometimes be absolutely necessary to break the pattern of passivity, the continued unwillingness to listen to the internal voice, now grown hoarse from repetition. Sometimes we are forced to stop, because of physical, mental or emotional breakdown. We literally have to step aside.

When this happens, there are many positive actions you can take. The first is to commit to taking time out, telling yourself that you have now reached breaking point and you are going to give yourself time to recover. It will be necessary to limit the number of activities you undertake and to rest a great deal. 

The second is to get support, perhaps from a counsellor and/or, if possible, from others who have experienced burnout. The tendency with burnout, because of depleted energy reserves is to isolate. While it is necessary to cut back on the activities you have been doing which led to the burnout, some activities will be supportive, such as reaching out to others. Talking to the right people about whatever it was that made you believe you had to keep going at all costs will be vital too.

When you are in this surrendered state and beginning to process some of the feelings associated with breaking down, a time will come when you will need to address what it is that isn’t working in your life and consider taking actions that are more consistent with your aspirations and aptitudes. At this point many discover the great gift of burnout – and begin to see it as a necessary development for getting on track with our true life purpose.

Sometimes burnout will be a signal that you need to change jobs or change career altogether. Sometimes it will be the catalyst for changing the way you do what you do and having you realise that, actually, you are on track. No matter what, the forced life appraisal that comes about as a result of burnout can be a major turning point and the beginning of a remarkable new phase of growth and productivity.

If you think you may be affected by burnout and would like to speak in confidence to one of our therapists, please browse our therapists section (details here) or, if you would prefer, contact the practice manager (details here) who may be able to point you in the right direction.

Written by Jacqui Hogan

Counselling in (neoclassical) style

Patients of Dr Robin Lawrence are in for a treat. For those who are unfamiliar with the Grade II listed house at number 96 Harley Street, it is arguably a national treasure, showcasing the superb work of Robert Adam (1728- 1792), the Scottish neoclassical Architect who was foremost of his day. Adam reserved some of his finest work for the consulting room into which Robin now moves (first floor rear) and you'll see evidence of his sublime craftsmanship in the ceiling frieze, parquet flooring and dramatic window design (the photograph above is of the ceiling of the adjacent room at the front of the house).

But enough about Robert Adams. Robin Lawrence is also engaged in his own form of craftsmanship - the craft of freeing mind and hearts with the aid of his own particular skill, psychiatry and counselling/psychotherapy. Robin currently divides his time between seeing private patients at 96 Harley Psychotherapy, and giving free consultations to patients at Holy Trinity Brompton in Kensington and the homeless at St Augustine's, also in Kensington. He is currently undertaking an MA in Theology.

To read more about Dr Lawrence's work interests and specialities, please visit our website 96harleypsychotherapy.co.uk. Or, if you'd simply like to visit his office to ogle one of the most beautiful, historic interiors in London, contact the Practice Manager and we'll see what can be arranged!

Written by Jacqui Hogan