This blog post on coping with difficult thoughts and feelings is downloadable as both Word and PDF handouts.

I wrote this entry first in April of last year, but with my mother's illness and my decision to write about it, I felt it made sense to post this again.

The aim of this blog is to be helpful - for clients who come to see me, for fellow health professionals, and for other website visitors. It's pretty obvious that I may be able to offer something useful from my knowledge and experience of being a doctor and therapist for several decades. What's less obvious is whether writing about my personal life might be helpful.

Here's a gutsy, nutritional, low sunlight kind of blog post to suit our post-holiday season.  First the gutsy bit.  Irritable bowel syndrome (IBS) - with its characteristic symptoms of abdominal pain, altered bowel habit, and possibly bloating - is very common, affecting about 15% of the population.  Ford et al systematically reviewed all research on treating IBS with fibre, antispasmodics, or peppermint oil.  Fibre was some use, but only in the form of ispaghula (UK Fybogel, Isogel).  The antispasmodics otilonium and hysocine (UK Buscopan) seemed also to be of help.  But what attracted me to the study was the finding that most helpful of the three treatments seemed to be the old-fashioned remedy of taking peppermint oil. 

Sadness.  I woke feeling sad ...

PLEASE NOTE: This blog post dates back to December 2008.  All the questionnaires on this page, updated scoring details for the IES-R, the widely used Posttraumatic Cognitions Inventory, descriptions of how to do "reliving" of the trauma, written accounts, and site visits, as well as a series of other updated PTSD-relevant questionnaires and handouts are available on the relevant "Good knowledge" page of this website - "PTSD assessment, images, memories & assessment".  Also of relevance (particularly for child abuse) is the page "Life review, traumatic memories & therapeutic writing".

So here's a blast from the past ... that could be fun and useful for a New Year's resolution.  I first came across Michael Fordyce's research year's ago (Fordyce 1977; Fordyce 1983).  It was probably the first serious scientific exploration of how to help people become happier that I'd ever read.  The approach involves a training called the "Fourteen Fundamentals".  These are fourteen characteristics of happy people, extracted from research, that Fordyce argued most people could develop for themselves.  The "Fundamentals" are: 1.) Be more active and keep busy.  2.) Spend more time socializing.  3.) Be productive at meaningful work.  4.) Get better organized and plan things out.  5.) Stop worrying.  6.) Lower your expectations and aspirations.  7.) Develop positive optimistic thinking.  8.) Get present orientated.  9.) WOAHP - work on a healthy personality. 10.) Develop an outgoing, social personality.  11.) Be yourself.  12.) Eliminate negative feelings and problems.  13.) Close relationships are the #1 source of happiness. 14.) VALHAP (value happiness) - the "secret fundamental".

Here are six studies on eating and weight.  The first, by Maruyama and colleagues, demonstrates a strong association between both "eating until full" and "eating quickly" and the chances of being overweight.  The linked BMJ editorial by Denney-Wilson & Campbell discusses these findings further, including suggesting that "Clinicians should encourage parents to adopt a child led feeding strategy that acknowledges a child's desire to stop eating that begins from birth. Reassure parents that well children don't starve."  Unfortunately Llewellyn et al show that eating rate seems to be partly genetically determined - an even stronger reason to work hard to go against any tendency to gobble food.  The Denney-Wilson editorial gives other ways to encourage weight loss, and Leahy and colleagues underlines the value of one such approach - reducing the energy density (ED) of diets " ...  by decreasing fat and sugar and by increasing fruit and vegetables."  Children whose diet was changed in this way " ...

Here are the two main questionnaires currently used to assess Health Anxiety Disorder - the HAI and the HAQ.  The HAI is the one recommended by the NHS Improving Access to Psychological Therapies (IAPT) initiative.  I've also added a scale put together by Adrian Wells that assesses safety behaviours and extent of disease belief.  Finally there is a classic CBT thoughts record.  I don't use these kinds of records much any more, but I've added it for 'completeness'.

Health anxiety inventory (HAI) - the 18 item (short form) HAI is the disorder specific scale recommended by the IAPT initiative.  The third page of the download gives typical scores for a Health Anxiety group, a more general anxiety group, a control group, and so on.   

Health anxiety questionnaire (HAQ) - this 21 item health anxiety questionnaire yields four subscales, which can make it easier therapeutically to target specific behaviours like reassurance seeking.  The third page of the download gives some idea of likely scores in different disorders.

What are some implications for using forms of mind training for ourselves and for teaching others?  Reading this research study leads me to think about optimum amount of time spent practising these methods, the importance of encouraging application during daily life.  I discuss these issues in this blog posting.  It would also be fascinating and helpful to look at the challenge of maintaining the practices over time, and to consider how different forms of mind training can be directed at different targets - for example, easing symptoms, encouraging particular positive emotions (e.g. compassion, gratitude & contentment), targeting specific key wellbeing needs (e.g. self-determination theory's autonomy, competence & relatedness), and helping people live their personal values.

Here are five studies on the loose theme of how the mind affects the body, and the body affects the mind ... and that the distinction between mind and body is pretty arbitrary anyway.  Using meta-analysis, Chida & colleagues highlight considerable evidence suggesting that stress-related psychosocial factors have an adverse effect on cancer incidence and survival.  Andersen & colleagues report a randomized controlled trial to respond to this in women diagnosed with breast cancer.  Women in the stress management arm of the study received an initial one-year, 26 session intervention in groups of 8 to 12 people.  The aim was to reduce distress and improve quality of life, improve health behaviors (diet, exercise, smoking cessation), and facilitate cancer treatment compliance and medical follow-up.