Evelyn Goodman, Psy.D.   Newsletter #1, August 2006

Welcome to the first monthly newsletter!

Relapse
Questions about relapse or setbacks come up frequently. Relapses happen quite frequently when the
treatment has been medication only, and with less frequency when psychotherapy or the combination
of psychotherapy with medication was used. According to the National Institute of Mental Health relapses
for anxiety, depression, and chemical dependency is about 70%; they did not break down the type of
treatment received.

Some level of relapse is understandable. There is no "cure" for anxiety as this alarm system is built into
our nervous system to help keep us safe. Fleeing, fighting, or freezing is nature's way of helping us cope
with threatening situations. It gets confusing when the threat is internal, psychological, or unconscious,
rather than "out there".

Ask yourself these questions:

     What about therapy was helpful?
     What did I learn about myself and the development of anxiety that may be happening now?
     What problems have arisen recently and how am I handling them?
     What have I done to maintain my progress after therapy?
     What may be getting in the way of maintaining my progress?

Very frequently, people go back to maladaptive ways of thinking, coping, handling emotions, that
contributed to their anxiety/depression in the first place. If you find you are relapsing despite all efforts
made, it may be a good idea to schedule some booster sessions.

Herbal Interactions

Many people use herbs and other supplements to aid in reducing anxiety/depression symptoms.
For anxiety, kava, valerian, chamomile, passion flower and ashwaganda are commonly used. For
depression St. John's Wort, rhodiola, or Sam E can be helpful. It's important to be aware of potential
interactions of these herbs with any other medications you may use. The following link provides
such important information: www.altmedicine.about.com/od/herbsupplementguide/a/herb_mistakes.htm?nl=1

Clinical Hypnosis

Clinical hypnosis, or hypnotherapy, can be a helpful tool in overcoming problems related to phobias,
habit control difficulties (e.g. smoking, overeating, nail biting), chronic pain, anxiety around medical
procedures, and many other areas related to mental health.

It is not unusual to be in a trance state without trying to, such as when you are driving, lost in thought,
and then realize you are not sure where you are for a few seconds. This is said to be a separation of the
conscious and unconscious parts of the mind ("dissociated"). Hypnosis is an intentionally created trance
state where one is more open to suggestions that are compatible with your belief system and intentions.
In short, it is a state of calm focused attention. This state can also be achieved by meditation, guided
imagery, visualization, and breathing techniques.

While it is not a panacea, as an adjunct technique, it can be helpful for overcoming anxiety, panic, and
phobic disorders.  For more detailed information, The New England Society for Clincial Hypnosis is a
good resource (www.nesch.org). You can also find hypnosis scripts for many conditions at
www.hypnosisdownloads.com.

Book Recommendation

This months book recommendation is The Glass Castle, a memoir by Jeannette Walls.
It is her true story of growing up in a very unique and dysfunctional family. Besides being written
in a manner that captures attention, it raises many questions regarding dysfunctional families,
mental illness,  and emotional resilience, just to name a few.  I hope you will enjoy it as much as
I did.

Parting Words

From Carl Jung: "Who looks outside dreams; who looks inside awakes."

Counseling and Psychotherapy
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