Dissertation Complete By August, 2010

I recently completed my first draft dissertation proposal, and expect to have it defended by mid-April of this year. My research will be the beginning of a process to empirically validate a set of clinical hypnosis training modules. To the best of my knowledge, this will be the first ever attempt to develop materials for clinical education that are proven to impart the information and clinical skills that they are intended to impart. My committee consists of: Stephen P. Kahn, Ph.D. (Chair), Edward J. Frischholz, Ph.D., ABPH, and Robert T. Baker III, Psy.D.

Advancing Clinical Hypnosis On The Web

You may be aware that I am the Webmaster and Listserv Coordinator for APA Division 30. I recently spoke at length with Stephen Lankton, the current editor of the American Journal of Clinical Hypnosis, about the possibilities for using the internet to better disseminate the information published in the Journal and to increase the scientific presence of clinical hypnosis. Toward that end, I may soon be joining the editorial board of the AJCH in order to help compile a topic-organized bibliography from the journal to enable dissemination of the research through prominent web sites like Wikipedia.

Advancing Clinical Hypnosis At The Adler School

This semester I have been working as a Research Assistant and Teaching Assistant for Dr. Steve Kahn, head of the Clinical Hypnosis program at the Adler School of Professional Psychology. Dr. Kahn, Scott Hoye, and I have formed an official student hypnosis organization, the Adler Clinical Hypnosis Association (ACHA). Through this organization we will be leading in-school presentations to increase enrollment in the hypnosis program as well as out-of-school discussions to enhance members’ knowledge and skill in the use of clinical hypnosis. I am presently serving a term as Vice President of ACHA.

We have also been in the process of developing new training sites for hypnosis students at Adler. Problems with the economy over the past decade have caused a shortage of training sites for all types of clinical students, and I am aware of only one practicum site in Chicago that currently offers students the explicit ability to build up their skill in utilizing hypnosis with their patients–and that site is having trouble maintaining funding. At the request of Dr. David Paul Smith, I have written up a brief editorial piece for the upcoming issue of SCEH’s FOCUS newsletter explaining why I believe that expanding the available training opportunities is the single most important thing the professional hypnosis societies can do to improve the future of clinical hypnosis.

Articles Posted Around The Web

I have recently posted a number of original articles on this web site and elsewhere around the web. Here are some that come to mind:

• A Review of Interventions for Reducing Mental Health Stigma – Mental health stigma has been identified as a major barrier to the delivery of appropriate mental health services, but few coherent attempts to reduce this barrier have been made. This analysis examines the interventions that have been tried, their results, and considers possibilities for more robust community interventions.
• Robert Cialdini’s 6 Principles of Influence: Video + Cheatsheet – Shows a recent video of Dr. Cialdini explaining some of the principles of influence. The most useful part of this post is the cheatsheet I put together based on his book Influence: Science And Practice. The post describes each of the “weapons” of social influence in brief for quick reference.
• An Egodynamic Model of Hypnosis – Presents a model for understanding hypnotic phenomena from an ego psychological perspective.
• Cannabis, Metabolic Syndrome, and Emotional Distress – Reviews evidence that cannabinoids play a critical role in the regulation of metabolism, and argues that chronic cannabis use may represent a form of self-medication for metabolic syndrome and the emotional distress that is associated with this condition.
• Hypnotizability May Be Unrelated To Dissociation & Cognitive Inhibition – A person’s apparently innate capacity to experience a particular level of hypnotic phenomena – referred to as “hypnotizability” – is an important concept in modern hypnosis research. This post reports on an article by Diennes et al published in the peer-reviewed journal Conciousness and Cognition.
• Early Recollections And The Lifestyle – Explains an Adlerian technique for assessing the private logic and internal motivations of therapy clients.
• Aging Brains Only Shrink When They’re Sick – Reports on a study published in the APA journal Neuropsychology that found that age-related loss of brain mass (And associated cognitive decline) may be a function of illness, rather than a natural part of the aging process as has been generally assumed.
• Adlerian Career Assessment & Counseling – Critically evaluates Adlerian frameworks for assessing individuals’ career paths, and for helping them to develop their careers and career identities.
• Transformational Leadership In Mental Health Administration – Examines the benefits of transformational leadership styles on organizational outcomes in mental health care.
• Re-Branding Psychology: Why Therapists Have Got It All Wrong & What We Can Do About It – Argues that psychotherapists and psychology groups such as the APA should be more aggressively marketing the proven positive benefits of psychotherapy.
• A 2009 Mental Health Parity Policy Analysis – In this policy analysis I review the history of mental health parity advocacy and the philosophy underlying this movement. I also critically examine the practical consequences of both the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 and its predecessor, the Mental Health Parity Act of 1996.

Dabney Ewin presents on the treatment of warts, hives, herpes, and asthma

As a faculty member I was in the esteemed company of Dolores Bjorkman, Dabney Ewin, Ed Frischholz, Hedy Howard, Steve Kahn, Rick Kluft, Dave Patterson, Steve Pauker, and Eric Willmarth. My role as a faculty member was to provide supervision during each of the five supervised small group practice sessions, and to assist in the scheduled demonstrations of hypnotic induction and hypnotic phenomena.

As the least experienced member of the faculty, I did not present any didactic material. However, I received 22 CEU credit for my attendance at these workshop sessions and am now competent in the provision of introductory clinical hypnosis training. There are plans for the Chicago Society of Clinical Hypnosis to offer a basic workshop this winter, and I will be on faculty for this event as well.

Ed Frischholz, Steve Kahn, Tom Nagy, & Rick Kluft

Outside of workshop hours, I also had an opportunity to attend a few presentations and one scientific paper session. I was excited to see Dave Wark present on alert, eyes-open hypnosis. I am very interested in the potential use of alert hypnosis, particularly in performance-enhancement and coaching scenarios.

I also has the pleasure of seeing Ron Pekala present his ideas on the conceptualization and measurement of the phenomenology of consciousness. I was trained in provision of the Phenomenology of Consciousness Inventory Hypnotic Assessment Procedure (PCI-HAP) during my own introductory hypnosis training under Dr. Ian Wickramesekera II.

I spent the year externing on the Valeo Intensive Outpatient Unit at Chicago Lakeshore Hospital. Lakeshore is a freestanding psychiatric hospital, and the IOP unit is located a couple blocks away in a separate building. Many of the patients I saw there were transitioning from inpatient care, some were going back and forth between inpatient and outpatient, and some were admitted solely for intensive outpatient treatment.

Valeo is a specialty program that serves gay, lesbian, bisexual, and transgender (GLBT) individuals, and patients come from a wide range of socio-economic, cultural, and personal backgrounds. Nearly all patients were dually diagnosed mentally ill substance abusers (MISA), with a few patients being treated solely for mental illness and others presenting with primary addictions.

The bulk of my experience there was in providing group psychotherapy and group substance abuse counseling, and one of the major challenges of the practicum was in balancing groups between the needs of highly diverse patients presenting with a wide variety of complaints and levels of functioning. I was also able to work with a number of patients individually in addition to my time with them in group. This allowed for the rapid expression of some fairly powerful dynamics, and offered unique treatment opportunities.

Over the course of the year I was able to do a great deal of individual and group psychotherapy work with patients suffering from severe anxiety and personality disorders. I used this opportunity to develop my skill in the use of techniques such as relaxation, mindfulness training, and visualization. In my final review, my supervisor reported that my work in this area had made a substantial contribution to the program.

I also gained experience in administrative aspects of the intensive outpatient program, particularly in planning and executive treatment groups. As a final project, I designed and administered a series of therapy groups focusing on attachment styles. I provided psychoeducation on the early formation and adult manifestation of various attachment styles, and relating these ideas to recovery concepts such as codependency. Next I provided cognitive-behavioral group psychotherapy aimed at helping patients to recognize the ways that their own styles of attachment impacted their relationships and to begin to approach those relationships in ways that promote increased feelings of security. Finally, I engaged the group in a visualization exercise designed to access and amplify existing experiences of security and adequacy.

I will be receiving my Master’s degree in Counseling after the summer term, and plan on sitting for the Licensed Professional Counselor license. I have only a few classes left to take, so over the next year I will be finishing those up, writing my doctoral dissertation, and hopefully working as a counselor. If you know of any job opportunities in Chicago, please let me know!

These three sites collaborate to provide their externs with weekly didactic sessions on issues specific to individuals within the GLBT community. So, over the past year I gained a very broad base of knowledge about the clinical issues and approaches recognized within this field, while simultaneously working with gay, lesbian, bisexual, and transgendered clients. This provided an integrative experience that definitely improved my understanding of the interactions between social and psychological factors for minority groups.

Didactic sessions I attended included:

• Boundaries & Self Disclosure
• Internalized Devaluation & the Coming Out Process
• Substance Abuse Assessment Issues
• Assessment Issues with Transgender Clients
• Domestic Violence Assessment Issues
• GLBT Youth
• Midlife Issues for GLBT Clients
• Issues in Older Adult GLBT Populations
• GLBT Sexual Assault: Barriers to Care, Recovery, & Survivorship
• Work with the BDSM/Kink/Leather Communities
• GLBT Issues in Higher Levels of Care
• Spirituality Issues in the GLBT Community
• Termination Issues
• HIV Grief & Loss Issues
• Legal Issues in HIV/AIDS Clinical Work
• Ethnic Minority GLBT Clients: African American
• Ethnic Minority GLBT Clients: Hispanic/Latino
• The Gay/Straight Divide in Therapy
• Children of Same-Sex Parenting
• Working with Female Couples
• Working with Male Couples

While many very specific issues were covered during the course of these training sessions, I found that ultimately it is the similarities between people that are the most useful as a psychotherapist. I do think that it can be valuable to learn about a specific minority population in-depth in order to be able to be more conversant in their culture. However, for me the main takeaway message has been that ultimately the diversity one finds within any group tends to be equal to the diversity between groups.

If a therapist enters the therapy ready to try to understand the individual clients’ specific worldview, I think they will tend to be more successful than even a better-informed therapist who has it in mind that a client should fit into a particular type of category. Having worked with clients from a tremendous variety of backgrounds over this past year, I have found that openness and candor are two of the most important prerequisites of successful therapy, regardless of the client’s race, ethnicity, gender, sexual orientation, socio-economic status, or any other demographic factor.

This is a tricky thing to do, for a number of reasons:

• It’s tricky to figure out what’s going on with anybody, psychologically. People are pretty complicated; when things go wrong, they rarely go wrong for just one reason. Typically any psychological problem will have some genetic components, some environmental components, some relational components, and some intrapsychic components. You don’t really get the luxury of pointing to one thing in someone’s past and saying you’ve found the answer.
• These people tend to be especially complicated. There’s some research to suggest that chronic pain patients are more likely to meet criteria for personality disorders than other types of patients. In my experiences, I’ve found that even those who don’t meet criteria for those diagnoses usually have pretty deep-seated ways of interacting with the world that unintentionally serve to maintain their pain status.
• Headache patients, in particular, are usually pretty resistant to psychological asssessment. This is mostly because they have gotten used to being told that the very real pain that they experience on a daily basis is “all in their head.” Usually they hear this from physicians who are simply frustrated that none of their tests come back positive and nothing they do seems to change anything. The same goes for any other type of chronic pain patient, and probably many people with IBS as well.

So what I do currently is I go into each patient’s hospital room and spend about 30-60 minutes finding out how they feel, what their life is like, what it was like growing up, what kinds of relationships they have, and what kinds of stress they experience. From this, I try to draw connections between all of the different factors, in order to figure out what kinds of psychological treatments might be effective in reducing their headache pain. If a case is particularly complicated, and if we have the time, I will administer the patient an intensive 8-hour battery of psychological tests which help me to pin-point exactly what kinds of cognitive and personality issues they face.

It’s actually quite beautiful: my entire job is to find out how people are put together and what makes them tick. What I’m especially looking for, when I conduct a psychological interview, are the parts that the patients themselves cannot possibly allow themselves to know. And when I say this, I want you to know that I am not only talking about chronic pain patients. We all have parts of ourselves and our lives that we cannot know, that we must defend against at all costs.

For now, I’d like to announce a new clinical practicum! After I finish up at Diamond Headache in June, I’ll begin a new one-year psychotherapy externship at Chicago Lakeshore Hospital’s Valeo Program, which is Chicago’s only inpatient and intensive outpatient therapy for GLBT individuals. About 50% of my patients there will be HIV positive, and about 50% of them will suffer from substance abuse disorders in addition to their other psychological troubles, which will run the gamut from anxiety and depression, to eating disorders, to identity disturbances, to personality disorders. I’ll be taking on anywhere from 4 to 8 individual patients per week, and doing 2 or 3 therapy groups each week as well.

The Valeo program is a very competitive training site, and I was selected from more than 60 applicants!