Heygoaskalice.com

05/30/2013

"Meaningful connection starts with an act of vulnerability. Here I use the word vulnerable to mean an active state of honesty. If we consciously choose this state, we allow ourselves to access life without numbing judgement. We accept that the choices we make contribute to our internal and external connections. We opt to connect authentically. Embarking on such journeys encourages us to keep realizing our boundless possibilities. And once we feel this energy cursing through us there is no going back."
--Helen Pickkett

05/22/2013

LONELINESS
We all know that loneliness sucks. It turns out that loneliness is even more problematic than "sucking". There is a growing body of evidence suggesting than loneliness may be linked to dysregulated immune function (elevated inflammation in particular). A new study demonstrates that lonely people are more highly stress reactive than less lonely people. This study provides further evidence that close and caring relationships are essential to both our mental AND physical well-being.
("Lonelinesss Promotes Inflammation During Acute Stress", in Psychological Science, by Jaremeka et al).

05/19/2013

Hot off the press: Ketamine as a fast-acting anti-depressant-- via Ken Pope:

The Mount Sinai School of Medicine issued the following news release:

Ketamine shows significant therapeutic benefit in people with treatment-resistant depression

Drug associated with rapid antidepressant effect in largest clinical trial to date

Patients with treatment-resistant major depression saw dramatic improvement in their illness after treatment with ketamine, an anesthetic, according to the largest ketamine clinical trial to-date led by researchers from the Icahn School of Medicine at Mount Sinai.

The antidepressant benefits of ketamine were seen within 24 hours, whereas traditional antidepressants can take days or weeks to demonstrate a reduction in depression.

The research will be discussed at the American Psychiatric Association meeting on Monday, May 20, 2013 at 12:30 pm in the Press Briefing Room at the Moscone Center in San Franscico.

Led by Dan Iosifescu, MD, Associate Professor of Psychiatry at Mount Sinai; Sanjay Mathew, MD, Associate Professor of Psychiatry at Baylor College of Medicine; and James Murrough, MD Assistant Professor of Psychiatry at Mount Sinai, the research team evaluated 72 people with treatment-resistant depression--meaning their depression has failed to respond to two or more medications--who were administered a single intravenous infusion of ketamine for 40 minutes or an active placebo of midazolam, another type of anesthetic without antidepressant properties. Patients were interviewed after 24 hours and again after seven days. After 24 hours, the response rate was 63.8 percent in the ketamine group compared to 28 percent in the placebo group.

The response to ketamine was durable after seven days, with a 45.7 percent response in the ketamine group versus 18.2 percent in the placebo group. Both drugs were well tolerated.

"Using midazolam as an active placebo allowed us to independently assess the antidepressant benefit of ketamine, excluding any anesthetic effects," said Dr. Murrough, who is first author on the new report. "Ketamine continues to show significant promise as a new treatment option for patients with severe and refractory forms of depression."

Major depression is caused by a breakdown in communication between nerve cells in the brain, a process that is controlled by chemicals called neurotransmitters.

Traditional antidepressants such as selective serotonin reuptake inhibitors (SSRIs) influence the activity of the neurotransmitters serotonin and noreprenephrine to reduce depression.

In these medicines, response is often significantly delayed and up to 60 percent of people do not respond to treatment, according to the U.S Department of Health and Human Services.

Ketamine works differently than traditional antidepressants in that it influences the activity of the glutamine neurotransmitter to help restore the dysfunctional communication between nerve cells in the depressed brain, and much more quickly than traditional antidepressants.

Future studies are needed to investigate the longer term safety and efficacy of a course of ketamine in refractory depression.

Dr. Murrough recently published a preliminary report in the journal Biological Psychiatry on the safety and efficacy of ketamine given three times weekly for two weeks in patients with treatment-resistant depression.

"We found that ketamine was safe and well tolerated and that patients who demonstrated a rapid antidepressant effect after starting ketamine were able to maintain the response throughout the course of the study," Dr. Murrough said.

"Larger placebo-controlled studies will be required to more fully determine the safety and efficacy profile of ketamine in depression."

The potential of ketamine was discovered by Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai, and Executive Vice President for Academic Affairs of The Mount Sinai Medical Center, in collaboration with John H. Krystal, MD, Chair of the Department of Psychiatry at Yale University.

"Major depression is one of the most prevalent and costly illnesses in the world, and yet currently available treatments fall far short of alleviating this burden," said Dr. Charney.

"There is an urgent need for new, fast-acting therapies, and ketamine shows important potential in filling that void."

Ken Pope

05/18/2013

We all have our guards up when it comes to intimacy. Our guards have no doubt been adaptive and protective of us during our earlier years. These "guards" must be worked through before we can experience true intimacy. Until we manage to do this, our default mantra is probably something like, "Get too close and I will get hurt." However, if we stay too far, we will never experience true love.

05/16/2013

Attachment Styles in Relationships
Human connection and intimate interpersonal attachment can be both the purpose and the bane of our existence. Evolutionary-wise, attachment to a loved one is crucial. Reality-wise, human attachments are extraordinarily complex and fraught with angst. When MRI scans are taken of someone who's just broken up with a loved one, the EXACT same parts of the brain are activated as when an MRI is taken of someone who's just experienced a severe physical injury. The pain is real, folks!

I'm going to be discussing the issue of human attachment/relationships in the weeks/months ahead. Very soon, I will be welcoming (and responding to) your questions about your own relationship issue(s).

To get a head start, the following is a description of three different attachment styles, taken from Levine and Heller, ATTACHMENT—THE NEW SCIENCE OF ADULT ATTACHMENT, Penguin Books, 2010.

http://www.amazon.com/Attached-Science-Attachment-Find%C2%97-Keep%C2%97Love/dp/1585428485/ref=sr_1_1?s=books&ie=UTF8&qid=1306257623&sr=1-1

ANXIOUS. You love to be very close to your romantic partners and have the capacity fort great intimacy. You often fear, however, that your partner does not wish to be as close as you would like him/her to be. Relationships tend to consume a large part of your emotional energy. You tend to be very sensitive to small fluctuations in your partner’s moods and actions, and although your senses are often accurate, you take your partner’s behaviors too personally. You experience a lot of negative emotions within the relationship and get easily upset.As a result, you tend to act out and say things you later regret. If the other person provides a lot of security and reassurance, however, you are able to shed much of your preoccupation and feel contented.

SECURE. Being warm and loving in a relationship comes naturally to you. You enjoy being intimate without becoming overly worried about your relationships.You take things in stride when it comes to romance and don’t get easily upset over relationship matters. You effectively communicate your needs and feelings to your partner and are strong at reading your partner’s emotional cues and responding to them. You share your successes and problems with your mate, and are able to be there for him or her in times of need.

AVOIDANT. It is very important for you to maintain your independence and self-sufficiency and you often prefer autonomy to intimate relationships. Even though you do want to be close to others, you feel uncomfortable with too much closeness and tend to keep your partner at arm’s length. You don’t spend much time worrying about your romantic relationships or about being rejected. You tend not to open up to your partners and they often complain that you are emotionally distant. In relationships, you are often on high alert for any signs of control or impingement on your territory by your partner.

(Levine and Heller, ATTACHED, 2010, pps. 44-45).

05/16/2013

Terry Real Quote
Terry Real, in his wonderful book "I Don't Want to Talk About It", shares the following words of wisdom to a patient of his who is fighting his feelings for fear of breaking down:

"You're not breaking down. You're crying. Breaking down happens to people who don't cry."

05/16/2013

Vulnerability
This is one of the most succinct and insightful talks (TED.com) about relationships I've ever come across. I HIGHLY recommend you take 20 minutes to watch/listen!

http://www.ted.com/talks/brene_brown_on_vulnerability.html

Brené Brown studies human connection -- our ability to empathize, belong, love. In a poignant, funny talk, she shares a deep insight from her research, one that sent her on a personal quest to know herself as well as to understand humanity. A talk to share. (Filmed at

05/16/2013

Self-Compassion
Kristin Neff, Ph.D. has been doing research on self-compassion. Essentially, her research suggests that for emotional well-being, you should treat yourself the way you'd want others to treat you. It goes without saying that treating others the way you'd like them to treat you is a key component of a healthy, mutually respectful relationship. Neff identifies three components of self-compassion.

1) Be understanding rather than self-judgemental
2) Recognize that your experience can be framed in light of a shared human experience (we ARE all human, after all!)
3) Be mindful of your suffering in order to give it compassion. That is, you must be aware of self-criticism in order to curtail it. Crucial (and often overlooked) to this is that your mindfulness must extend to must see things as they truly are, instead of exaggerating a your misfortune and taking a "woe-is-me" attitude. This is what distinguishes healthy self- compassion from unhealthy self-pity.
(Kristin Neff, "Self-Compassion: Stop Beating Yourself Up and Leave Insecurity Behind", 2011)

05/16/2013

Stress is VERY bad for our health!
Are you one of those people who gets overly defensive at the first experience of frustration? Do you misinterpret normal situations as menacing ones? Do you perceive anger in others when it isn't there? Do you personalize slights that aren't intended? If so, you are essentially making yourself a victim to a dangerous imagined inner world. Why is this dangerous? David Brooks points out that people who live with that sort of chronic stress suffer cell loss in their hippocampus, and with it loss of memory. They have weaker immune systems. They have fewer minerals in their bones. They accumulate body fat more easily. Their levels of cortisol and epinephrine (stress hormones) skyrocket. And once our stress hormones skyrocket, it can take over one year (!) for them to subside (and this only in the best of conditions). The effects of stress, therefore, can be long and corrosive.
(David Brooks, "The Social Animal", 2011)

05/16/2013

Self-control: Willpower or Mindfulness?
Would you believe that lack of self-control has nothing to do with lack of willpower? And yet 99% of the population continues to insist that self-control is purely a matter of willpower. Instead, lack of self-control is the result of our conscious mind simply lacking the strength and awareness (mindfulness) to overcome our impulses. People with self-control and self-discipline have developed access into their unconscious needs and desires and therefore can identify them, and because of this they can make more informed choices about their subsequent behavior. Mindfulness, folks.
(David Brooks, "The Social Animal", 2011)

05/16/2013

What makes us happier: Money or Intimacy?
This won't come as a surprise. Or maybe it will. People are notoriously bad at judging what will make them happy. Research shows that we vastly overvalue work, money, and real estate when we think about what makes us happy. We vastly undervalue the importance of intimate relationships and also the importance of arduous challenges. The deeper the relationships a person has, the happier s/he will be. Joining a group that meets even just once a month produces the same happiness gain as does doubling your income! If you are in a healthy intimate relationship, it doesn't matter how much money you make-- you will still be reasonably happy. If you are not in a healthy intimate relationship, no matter how much money you make, you will not be a happy camper. Now, what on earth do arduous challenges have to do with happiness? It's actually fairly obvious. When we work really hard at something, or survive through extremely difficult circumstances, suffering setbacks and frustrations, we then appreciate the success and recognition that derives from out sweat and toil much, much more.
(David Brooks, "The Social Animal", 2011)

05/16/2013

The secret behind personality disorders
Personality disorders develop over the first several years of our life in part (there are neurological components as well, although this begs the chicken and egg issue) as a survival-based adaptation to the surroundings in which we are raised. These adaptations will, understandably, continue to be adaptive for the rest of our lives only if and when we are in surroundings similar to those in which we grew up. They will not be adaptive in healthier settings. In fact, they will then become dysfunctional and maladaptive. Bruce Wexler, in "Brain and Culture", makes the observation that we spend much of the first halves of our lives trying to build internal models that fit our world at the time, and much of the last halves trying to adjust the world so it fits these internal models. What we don't realize is that adjusting the world is, to put it mildly, an unrealistic goal. It doesn't occur to many of us that adjusting our internal model is what's necessary for our internal model to fit the new surroundings we now find ourselves in. This is why (my belief, anyway) that people with personality disorders are so often "externalizers". "Externalizers" don't take personal responsibility for the impact of their behavior on others-- they tend to blame others for being impacted instead.