Monthly Archives: October 2013

Therapy relieves chronic stomach pain in kids

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I’ve always known there was a connection between my physical state and my mental state. This was most obvious whenever I had a big test or presentation in school: my digestive system would tell me. I don’t want to go into too much detail, but in my family, we always knew that if someone had a nerve-wracking performance coming up, they could most likely be found in the bathroom some time before the big event. Sometimes I’ve appreciated this because I haven’t actually felt the nervousness or stress as an emotion. I’ve wondered if it somehow that nervous energy gets channeled into my stomach or how my body is processing its food. It’s hard to know exactly how that connection works, but a recent study shows some evidence behind this mind body connection ― and how talk therapy (a behavioral and cognitive activity) can help reduce what’s going on in the stomach.

The study was done by researchers at Emma Children’s Hospital Academic Medical Center in Amsterdam, Holland. They randomly assigned children, ages 7 to 18, to talk therapy sessions or to meet weekly with a pediatrician. The children who went to therapy were treated with cognitive behavior therapy (CBT) that was tailored to the needs of each child. Techniques included relaxation exercises and strategies to distract kids from stomach pain or change the way they thought about their pain. The children who met with a pediatrician were given information about diet and nutrition and prescribed medication if necessary.

After one year of treatment, both groups noted significant improvement, but it is interesting to note that more children improved via the CBT method than with medication and dietary changes. This is notable because somewhere between 8 and 25 percent of kids suffer from chronic abdominal pain ― pain that does not seem to have any direct medical cause, such as celiac disease or inflammatory bowel disease. 

Source: Randomized controlled trial published in Pediatrics Oct. 14, 2013: http://pediatrics.aappublications.org/content/early/2013/10/09/peds.2013-0242

The easy argument against ‘other’

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The recent news stories regarding the police shooting and killing a 34-year-old woman after she had driven frantically through the Capitol were concerning on several fronts. As is often the case with an event appearing to be a threat to our national security, the reports following it discussed the mental health status of the woman. Family members explained that she was experiencing postpartum depression with psychosis.

As the news media seeks to provide an explanation for what occurred, I fear that the general public will focus on several key facts printed in the media:

– the mental health diagnosis
– the psychiatric medications the person was prescribed
– the person’s medical history of psychiatric hospitalizations
– and at times, the personal history of trauma in childhood or prior to the event.

It seems easy for people to classify these things as “other,” alien or foreign, and attribute them as reasons why a person would be so “unreasonable” as to drive frantically away from police officers, or take a trip from her home in Connecticut to Washington, DC to potentially confront the president regarding ideas she had about him putting surveillance on her home.

What’s disturbing is the fear, and the reaction our community has if a person acts unreasonably … it’s violent. It’s with law enforcement. It’s starting to appear that there’s no room for error or “unstable,” confused thinking. I’m not saying that we excuse delusional thinking, but we need to be ready to work with people a little bit. The person who is on psychiatric medications or who has a history of hospitalizations is not so different than the rest of us – that could be me, or that could be you. A person with a family, a person with a career, a person who is possibly very scared and uncertain about what they are experiencing, and unsure who to go to for fear that they will be chastised or pushed away. This idea that they are something unique or “other” smacks of Freudian defense mechanisms like projection or reaction formation. People who may speak out against the mentally ill may actually be aware, on some unconscious level, that they relate to that person, that they are not so far from some kind of mental health issue themselves (because, really, we aren’t). But it’s much easier to push that away and on a conscious level, state that the person was “crazy.”

While we used to have state psychiatric hospitals where people were housed, now, too often, I believe, we are pushing so hard against the mentally ill that we are prosecuting them legally, and housing them in prisons. It’s distressing to see a health problem, treated as a legal problem. We had hoped to deinstitutionalize this country years ago, but if we look at the statistics of how our jails and prisons have grown, we see that another type of institutionalization is occurring. One were many nonviolent offenders are put behind bars for convictions related to drugs or other crimes, some related to mental health issues.

As Dr. Gabor Mate states in a wonderful documentary on the criminalization of addiction (The House I Live In), we cannot view the results — the erratic behavior or, in this case, the high speed car chase that might pose a threat to our security as “the problem. It’s not the problem. It’s simply the manifestation of a problem. It’s a symptom.”