surgery

Pre-Surgical Evaluations for Chronic Pain

The goal of a pre-surgical evaluation is to determine which patients will have the best chance of responding to surgery. Some patients will be poor responders to surgical intervention regardless of how successful the procedure may be. Here's what you should know. Others may have a better chance of responding to surgery if they have first received other appropriate treatments which make them more receptive to a surgical intervention. Some patients may first need to become more aware of factors in their lives which will interfere with a successful response to surgery. These same patients may need help in identifying...
Stethoscope

How NOT to Talk to Your Doctor

In order to understand how to best talk with your doctor (or psychiatrist, psychiatric mental health nurse practitioner, or other medical provider), you need to know one very important concept: Your doctor wants to help you! However, as healthcare costs continue to rise, there is a push for doctors to see as many patients as they can. This can frustrate even the best doctors, and happens more often than not. Also, doctors are human beings and despite our expectations, they tend to dislike displays of unpleasant emotions, disorganized patients or those that make them feel as if they must "fix"...
ice cream cone melting

Correlation vs. Causation

We've all heard the phrase, correlation does not imply causation. Unfortunately, we rarely understand this phenomenon and are often mistaken by what we often label as evidence after examining the data. Sometimes both are referred to as cause and effect, which is potentially misleading. What exactly do we mean by correlation and causation? Let's examine one interesting fact: In the United States, the number of ice cream cones sold is directly related to the amount of home burglaries. In other words, there is a correlation between the number of ice cream cones sold and the number of thefts from home residences. If...
great white shark

How to Swim with the “Difficult Sharks” in our Lives

No one WANTS to swim with sharks. However, difficult people are, by their very nature, sharks: Aggressive, territorial, and tribal. When we unexpectedly find ourselves dealing with a difficult person, we assume that they will "play fair". In our desire to "get along with others", we often make the situation worse. In reality, we have no choice but to learn how to identify and respond assertively without being "eaten alive". Swimming with sharks is like any other skill: It cannot be learned from books alone; the novice must practice in order to develop the skills. The RULES, if followed, will...
panic attack blur

What’s Wrong With Me? The Logic of Panic Attacks

Panic attacks can be overwhelming and exhausting, leaving us feeling out of control. You can feel your own heart beating in your chest, you start feeling numbness or tingling in your arms or legs, and you suddenly find yourself afraid of going crazy, dying or possibly losing control.  This cycle can grow and become a vicious circle from which it seems as if there's no escape. Understanding what is happening and the fears behind panic can help us to better control ourselves. So, what causes panic attacks? As hard is it is to hear, you cause it! Nothing outside of you causes...
Fibromyalgia impact

Fibromyalgia Treatment in the Primary Care Setting

This article discusses some of the different approaches in the treatment of Fibromyalgia Syndrome (FMS) in the primary care setting. However, this approach can be adapted towards multiple clinical treatment settings, such as behavioral/mental health. Let's examine a hypothetical case history with a 42-year-old female with continuous pain following an automobile collision 18 months ago. She presents with the following: Seen multiple doctors Has tried acupuncture and chiropractic She is disabled and irritable You review her hand carried records showing an extensive work up including X-rays and MRI of C and LS spine Multiple failed drug trials; only Vicodin helps a little Her presenting...
stadium alone

Why Do I Keep Choosing the Wrong Person?

We sometimes wonder why we get ourselves into difficult relationships that “turn out bad” when they seemed so “promising” at the beginning. Sometimes we notice ourselves continuing to “pick the wrong ones” over and over again and cannot figure out what is happening. Many times we attribute it to the other person and think that there are so many “wrong people out there” that we just better “stay away” or “put up with it.” Understanding a few issues will be of a great deal of help and assistance. Modeling of our Family Much as we might had to admit it, much...
Pain, Change and Growth like a flower in the wilderness

How Do I Deal with Painful Feelings?

In our efforts to escape pain, loss, and suffering, we often miss the very happiness that we are searching for in life. When painful feelings get pushed to the side, we find ourselves falling apart, our relationships suffer, and often we just simply "shut down" in an attempt to avoid feeling, experiencing, and changing. Paradoxically, our attempts to "not feel" robs us of our own growth, which requires us to be vulnerable in the present moment. Irritability, anger, tension, outbursts of temper are common during times of stress and problems. Sometimes we end up dealing with things by getting divorced, falling...
Careers in mental health

Careers in Mental Health

I have been frequently asked about what it takes to become a psychologist, psychiatrist, therapist or a clinical social worker. Many people are interested in becoming a therapist, or mental health professional. Ironically, there are not many places to find the answers. My goal is to shed some light on this and answer some of your questions. In general, you must go to four years of college to get a B.A. or B.S. (Bachelor's) degree. This is the general preparation for entry into professional graduate education which starts AFTER you have completed college. Many students will major in psychology or...
fire explosion

Bottling Up Emotions: Time Bombs for the Future

We all tend to bottle up our emotions. We hope that with a little time and effort, we can figure out things on our own. The problem is that the more we hold things in, the more we feel like we are “just going to explode.” Even the slightest thing can set us off. When we finally explode, we over-react. We might feel guilty and sorry that we ever said anything, so again we try to bottle up our feelings. This only continues the vicious cycle of holding things in and exploding when it becomes too much to handle. Some of this...