Dr. Lisa Law, ClinPsyD

Critical research

Dr. Lisa Law — Sun, 14 Feb 2010 07:20:59 +0000

Research, no matter from which discipline, provides us with rich data to help us develop our understandings about the world we live in, the way we live, our own selves and so on. Humans are often described as natural scientists, that is, from the moment we are born we are curious and we yearn for knowledge and understanding.

There are many theories about knowledge, as the philosophy of epistemology explores. Epistemology wonders: ‘how do we know what we know’ or perhaps even: ‘how do we know what we think we know?’ Some theories of knowledge, such as those from the natural sciences, assume that there is always a truth ‘out there’ to be discovered and as long as we have access to the appropriate tools we can discover it. Other theories, such as the theory of social constructionism, view the world as a collection of negotiated understandings created via culture and language; that there is no one real truth to be discoverd; we simply reach agreements about things we decide to name truths.

In western society we are educated to particularly value scientific knowledge and to pursue objective facts through quantitative research. We are most often convinced by statistics and scientific fact. However, whilst enjoying the fruits of research and valuing academic endeavour, it is vital that, in the spirit of academic rigour, we always retain a critical stance towards our pursuit for knowledge.

For example, in an analysis of American Psychological Association (APA) research journals between 2003 and 2007, it was found that 68% of psychological research participants were from the US and 96% were from Western industrialised countries, mainly North America, Europe, Australia, and Israel (Arnett, 2008). This means that 96% of psychological samples came from countries with only 12% of the world’s population. Arnett raises concern that “the result is an understanding of psychology that is incomplete and does not adequately represent humanity… the majority of the world’s population lives in conditions vastly different from the conditions of Americans [who are the vast majority of psychological research participants].”

A philosophy of science that emphasises fundamental processes and does not give significant weight to cultural context would not find this state of affairs troublesome. However, I believe it does raise the question: how culturally valid is our research in Psychology? That is, are we taking enough care to ensure that we are realistic about the generalisability and validity of our research findings?

Is therapy worth it?

Dr. Lisa Law — Thu, 11 Feb 2010 17:21:26 +0000

One of the most frequently asked questions about therapy is whether it is worth the expense? Certainly beginning a course of therapy is a financial commitment and of course we want to know if it is likely to ‘pay off’.

A study by Chris Boyce at the University of Warwick, England reported by the Bet Israel Deconess Medical Center, has found some interesting results. By examining data from thousands of people who had provided information about their mental well-being, it was found that the increase in happiness from a $1,329 course of therapy was so significant that it would take a pay raise of more than $41,542 to achieve an equal boost in well-being. This means that therapy could be perhaps as much as 32 times more cost-effective at improving well-being than receiving money.

Boyce explains that “often the importance of money for improving our well-being and bringing greater happiness is vastly over-valued in our societies. The benefits of having good mental health, on the other hand, are often not fully appreciated and people do not realize the powerful effect that psychological therapy, such as non-directive counseling, can have on improving our well-being.”

‘An Autobiography’

Dr. Lisa Law — Tue, 12 Jan 2010 15:20:21 +0000

A beautifully wise poem by Portia Nelson:

Chapter 1

I walked down the street. There’s a deep hole in the sidewalk
I fall in. I am lost. I am helpless
It isn’t my fault
It takes forever to get out

Chapter 2

I walked down the same street. There’s a deep hole in the sidewalk
I pretend I don’t see it
I fall in again. I can’t believe I am in the same place
But it isn’t my fault
It still takes a long time to get out

Chapter 3

I walked down the same street. There’s a deep hole in the sidewalk
I see it there
I still fall in. It’s a habit.
My eyes are open. I know where I am.
It is my fault
I get out immediately

Chapter 4

I walked down the same street. There’s a deep hole in the sidewalk
I walk around it

Chapter 5

I walk down another street.

Looking at cake can make me healthier?!

Dr. Lisa Law — Tue, 15 Dec 2009 07:37:12 +0000

Apparently so. Contrary to popular belief, the New Scientist reports that images of unhealthy foods instead of resulting in temptation, actually promote healthy eating. Dr Floor Kroese, a Psychologist at Uterecht University in the Netherlands, found that the weight-conscious women in her study who were shown pictures of chocolate cake were more likely to choose to eat healthy snacks than participants who had been shown a neutral image of a flower.

”In moderation” says Psychologist Dr Ayelet Fishbach, originally of Tel Aviv University and now at the University of Chicago, “this positive impact of food temptations will overcome the negative impact – the urge to indulge”.

So perhaps a picture on the fridge door of tempting foods may aid good dieting habits. Kroese warns, however, that whilst highly tempting images can remind people of their eating intentions, weakly attractive images do not have the same impact and may in fact cause the reverse!

Maya Angelou: Sharing Wisdom

Dr. Lisa Law — Mon, 30 Nov 2009 18:25:24 +0000

”I long, as does every human being, to be at home wherever I find myself.”

”There is no greater agony than bearing an untold story inside of you.”

How can I promote emotional well-being?

Dr. Lisa Law — Wed, 18 Nov 2009 08:10:06 +0000

There are lots of ways in which we can encourage our sense of wellness.

The following is a list, based on an article by The Mental Health Foundation. which summarises some excellent ideas for boosting our emotional well-being and getting the most out of life.

1) “It’s good to talk”

It is important to be able to talk about how you feel with other people so that feelings don’t get ‘bottled up’ inside. By talking to family, friends or a professional we release tension, feel heard and get support.

2) Get active

Lots of research shows that physical activity makes us feel better. The chemicals released through exercise lift our mood, help us concentrate and improve our sleep quality. Generally healthy people should aim to be physically active for at least 30 minutes five times per week. Of course the activity chosen should be something you enjoy!

3) Eat well

A healthy balanced diet has a positive effect on well-being. Try to eat 3 meals a day which include:

lots of different types of fruit and vegetables
wholegrain cereals or bread
nuts and seeds
dairy products
oily fish
plenty of water.

Try to limit alcohol, high-caffeine and sugary drinks.

4) Be social

Being in touch with family and friends, whether it is in person, by phone or online, is important for making us feel grounded and supported. If life circumstances make it difficult to be in touch with others, then try to become involved with a group or a hobby.

5) Take care

Actually taking care of others helps us take care of ourselves. Helping a friend, looking after a pet or doing volunteer work can help boost self-esteem and a sense of well-being.

6) Time out

We all need a break now and again. Whether it’s a 5 minute pause during the day, a long lunch or a holiday, it is vital to relax and replenish. Yoga and meditation are also excellent ways of helping the body and mind relax and of course it is essential to get a good night’s sleep.

7) Do what you like

Spend time investing in something that you enjoy. Hobbies and activities make us feel good about ourselves, de-stress and express ourselves – particularly physical or creative activities.

8 ) I am who I am

Everyone is different. It’s much healthier to accept that you are unique than to wish you were more like someone else. Be proud of who you are. If there are things that you would like to change check out if your expectations are realistic and if they are, work towards change in small steps.

9) Ask for help

Sometimes it’s simply all a bit much. At these times it is essential to seek help from family, friends or professional services.

Aliyah and Identity: ‘The heartache of two homelands’

Dr. Lisa Law — Mon, 12 Oct 2009 11:42:00 +0000

Perhaps only migrating birds know–
Suspended between earth and sky–
The heartache of two homelands.
—Leah Goldberg, 1970

Leah Goldberg’s poem ‘Pine’ poignantly captures the ambivalent position of many Olim caught between two countries and two identities. For many, negotiation of a more complex, integrated identity that sits between two cultures is realisable. For others, finding a comfortable way to be is more difficult.

Research shows that when we are able to create a multi-faceted identity, which integrates the original and new identities, we are more likely to feel well both mentally and physically (e.g. Berry & Kim[1]). Living in a new culture is always a challenge. It brings with it the exhilarating and the exasperating. Garza-Guerrero[2], says that one of the main difficulties is that the continuity, confirmation, and consistency of our sense of self become threatened. In other words, without the feedback we were used to in our old cultures, we can become less sure of who we are and feel less good about ourselves.

So how can we try to create a healthy, multi-faceted identity? Walsh and Shulman’s research[3]with young Russian immigrants in Israel gives us some interesting ideas. After interviewing each participant twice, with a year interval in between, about their Aliyah experience, they found that immigrants who tried to form a complex identity early on were less comfortable, functioning and satisfied one year later.

What does this mean? Perhaps we can hypothesise that although trying to integrate ambivalence between two cultures is helpful in the long-term, in the short-term it seems to be important to hold on to ambivalence. It seems important to experience the conflict of leaving home and settling into a new culture. As Pianta and colleagues note[4], we need to give ourselves the space to mourn the losses and learn a new reality in order to allow an integrated and coherent story to emerge. Despite the rich and often wonderful culture, heritage and opportunities that Israel offers, each Oleh will have lost: people, language, music, food, cultural norms and so on.

We can probably all think of the days when we have had enough of ‘using our elbows’ or dealing with the humidity; the days when we miss our loved ones, a favourite TV show, or a bar of Dairy Milk. There are also the days when we are relieved we don’t have to bear our own culture’s annoying habits; or we are moved to tears by a national ‘tekes’ or by our bravery for simply doing this. At the start these, often quite dramatic, splits and even shifts between the old or new culture being ‘all good’ or ‘all bad’ are normal, even healthy, according to the research. Then, as time goes on, we can more easily accept that neither our old home nor our new one is perfect. We then somehow find a way to join the culture more fully and re-create ourselves as an Anglo Israeli – or is it an Israeli Anglo?

[1]Berry, J. W., & Kim, U. (1988). Acculturation and mental health. In P. R. Dasen, J. W. Berry, & N. Sartorius (Eds.). Health and cross-cultural psychology: Toward applications (pp. 207–236).Thousand Oaks, CA: Sage.
[2] Garza-Guerrero, A. C. (1974). Culture shock: It’s mourning and the vicissitudes of identity. Journal of the American Psychoanalytic Association, 22, 408–429.
[3] Walsh, S. D. & Shulman, S. (2007) Splits in the Self following Immigration: An Adaptive Defense or a Pathological Reaction? Psychoanalytic Psychology, 24, 2, 355–372
[4]Pianta, R., Marvin, R., Britner, P., & Borowitz, K. (1996). Mothers’ resolution of their children’s diagnosis: Organized patterns of caregiving representations. Infant Mental Health Journal, 17, 239–256.

Reflections on Surviving Swine Flu

Dr. Lisa Law — Wed, 30 Sep 2009 07:17:15 +0000

A few weeks ago I found out that it was 80% likely I had caught swine flu. Interestingly, despite all I had heard, it wasn’t all that bad: a headache, sore joints and muscles and of course the well-publicised high temperature. In fact, it was so much less dramatic than I had anticipated, I had apparently contracted it at least eight days prior to diagnosis.

When the headache didn’t shift and I started to feel pretty lousy, I went to the local clinic and it was here that I truly began to feel miserable. When the secretary understood there was suspicion of swine flu, she physically jumped two steps back, curled her mouth into a look of extreme disgust, told me not to move and left the room. A few moments later she returned dangling a surgeon’s mask like toxic waste, barking: “Put this on! Don’t sit near anybody!”

Feeling pretty humiliated, angry and sorry for myself I looked around the waiting room, to be looked back at by sets of staring, anxious eyes. The patients were spread out more or less evenly. There was no free area for me to sit in, so, feeling pretty weak from the fever, I put on my mask and sat on the floor. Eventually a corner became free and I parked myself there, trying to ignore the stares, the whispering about my suspected condition and the pregnant lady voicing her, of course valid, concerns about me waiting with everyone else.

The frustrating and humiliating story goes on - the wait from nurse to doctor (who both incidentally were very kind and helpful) was all in all an hour and 40 minutes. For me, however, although we all enjoy a good moan now and again, this is not the most interesting part of the story…

A couple of things struck my attention over my period of unwellness. Firstly, how automatically our reactions of fear and disgust can be revealed by our faces (and how hurtful this can be to others). Different cultures are expressive to different extents (see this). For this secretary (of note the second secretary behind the desk facially expressed warmth and concern), despite working in a clinic which had diagnosed many cases of swine flu, could not ‘reign in’ her automatic reaction for the sake of professionalism.

Secondly, how influenced we are by thoughts, words and knowledge. Up until my trip to the clinic I wasn’t too bothered by my symptoms. As soon as I found out there was an 80% chance I had swine flu, I felt significantly worse. Each time I measured my, continually fluctuating, temperature, my sense of illness/wellness altered according to the number on the thermometer. This is some of the theory behind Cognitive Behavioural Therapy - that the thoughts we have, or the reactions we have to physiological experiences, effect our mood and well-being.

Certainly the most powerful reflection on contracting an infectious illness which can evoke fear or disgust in some, is the nominal insight to the lives of those who live daily with diseases such as HIV, disabilities or disfigurements.

Incidently, as an epilogue to this story, it wasn’t swine flu after all.

Tips for a stress-free chag

Dr. Lisa Law — Mon, 14 Sep 2009 07:05:20 +0000

The chagim can be a wonderful break from routine; an opportunity to spend time with family, eat good food, take a look back at the year gone past and look forward to the year to come.

Of course, it is not always and for everyone the celebratory experience we would hope for. Dr Darnel, a Psychiatrist at the Asaf Harofeh hospital, comments on the many families in Israel who find the chagim particularly difficult. In addition to the stress and balagan of preparation and entertaining and the sometimes overwhelming combination of personalities at the dinner table, for families who have experienced difficulties, the chagim can be extremely challenging. How do you react to your recently divorced cousin? Do you sit in the empty chair of your lost family member? Do you ask your long-term looking-for-work brother-in-law if he has any leads? How do you cope with the difficulties you experience with your family in this concentrated environment?

Dr Darnel writes that it is important in these situations we remember that such intense family get-togethers are rare and temporary. He encourages the reader to come to the chag with empathy, respect and patience and, very importantly, to think before speaking.

But what about those without family in Israel? Chagim can be an especially difficult time for olim and other foreigners living here. Even if family occasions weren’t always perfect back home, suddenly being far away from them and with new traditions and new ways of doing things, they can seem very nostalgic or ’right’. A chag can become a very lonely time, particularly when you look around and everyone else seems so busy and happy.

If the chagim are tough for you there are a few things that may help. Firstly, try not to be alone as much as possible. Take advantage of the famous Israeli hospitality and if you have been offered a dinner invitation, try to accept. If this is not an option, you could try to arrange to be with other people who are alone for chag, perhaps seeing friends who are olim chadashim, or going to something organised for the community through one of the olim organisations or religious groups.

It is important to make sure you have plans, even if they are simply to finish that book you keep meaning to, and to be in touch with those that you miss. If you find yourself extremely upset over the chagim and you become concerned about yourself, then give Eran (the hotline for emotional support) a call.

However you spend your chag I hope it is a chag sameach and a shana tova!

Happiness – can we map the genes?

Dr. Lisa Law — Thu, 10 Sep 2009 07:57:43 +0000

New research from Tel Aviv University by Yoram Barak claims that we may one day be able to find the genetic component of happiness, which may be up to 50% responsible for an optimistic outlook. The researchers are excited that we may potentially be able to manipulate systems and increase levels of happiness.

Clearly, such a scenario sounds very appealing, but Katie Gilbert asks some thought-provoking questions… Is the genetic theory of happiness sophisticated or reductive? What kind of happiness are we looking for and who decides what happiness is? “Potent and staccato or diluted and sustained? Reality-enhancing or distorting? Self-aggrandizing or humbling?” Furthermore, “how do we account for the way happiness matures and transforms and takes on new definitions over a lifetime?”

Gilbert raises the question: what if we do discover a genetic ’switch’ (or a thousand of them) that over a life time is undoubtedly switched on and switched off an uncountable number of times, would we really want it any other way?

Certainly Barak’s research is exciting and fascinating, but at the same time, as with any genetic research, voices such as Gilbert’s are essential to open up our discussions and consider the implications of manipulating our genes.