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DIFFICULTY FALLING OR STAYING ASLEEP: PSYCHIATRIC DIMS – STUDY OF EEG TRACINGS

admin — Sun, 23 Jan 2011 14:53:55 +0000

What’s more, study of EEG tracings can help us monitor the way a patient is responding to treatment. Many antidepressant medications serve to suppress REM sleep—in fact, REM suppression may be one of the mechanisms by which such drugs work. (Interestingly, depressed patients also show improvement when they are deprived of REM sleep merely by being awakened at those points in the sleep cycle.) A patient who experiences REM sleep immediately after dropping off is thought to be responding poorly to antidepressants and may need to try a combination of drugs. Similarly, some patients who may respond better to electroshock therapy tend to show much shorter onset of REM sleep than others. Perhaps in the not-too-distant future physicians will be able to diagnose and categorize a patient’s illness and prescribe appropriate therapy primarily on the basis of EEG sleep records.
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DIFFICULTY FALLING OR STAYING ASLEEP: USING DISORDER AS A MECHANISM TO AVOID CERTAIN ISSUES OR OBLIGATIONS IN PERSONAL LIVES

admin — Thu, 13 Jan 2011 14:53:14 +0000

I’ve also found that some insomniacs use their disorder as a mechanism to avoid certain issues or obligations in their personal lives. One of my patients, a thirty-six-year-old man I’ll call Jim, had experienced difficulty falling asleep for nearly ten out of the twelve years he had been married. While his wife usually went to bed by 11:30, Jim would stay up for hours, finding a number of tasks, such as balancing the checkbook, that had to be done before he could turn in. He was convinced that he suffered from some kind of “chemical imbalance” that simply prevented him from enjoying normal sleep patterns; he believed that a prescription for sleeping pills was all he needed.
During one discussion, however, Jim made a casual remark to the effect that the birth control method he used was celibacy. To my surprise, I discovered that he had intercourse with his wife no more than half a dozen times a year. On further probing I learned that Jim suffered from deep-seated fears about his sexual performance, which apparently stemmed from some thoughtlessly facetious remarks his wife had made shortly after they were married. Eventually, it seems, his fears were transformed into a behavior pattern that kept him from going to bed at the same time as his wife, in order to avoid confronting the issue of sex and exposing himself to the risk of what he perceived as “further ridicule.” After some encouragement and therapy Jim discussed these feelings with his wife, who, I am happy to say, cooperated by reassuring him about his sexual desirability and performance. At last report Jim’s sleep pattern—as well as his sex life—has returned to nearly normal.
As you can see from this example, Jim subconsciously used his insomnia as a means of avoiding sexual confrontation. Similarly, other patients blame sleeplessness for poor performance at work or use it to minimize expectations people might have of them or to avoid risk of failure. Still others find they can avoid family or social obligations by using their chronic fatigue as a constant excuse.
In some cases, of course, DIMS stems not from psychological causes but from a true organic abnormality, such as a disruption in the nervous system responsible for controlling breathing. Complicating matters is the fact that such organic insomnia often mimics the symptoms of psychological insomnia, especially when the problem is one of interrupted sleep. Organic sleep disturbance seldom results in premature morning waking—an example of why a detailed understanding of an individual’s sleep pattern is so important in diagnosis. To reiterate, however, a psychological element will be found in most cases of insomnia.
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SEX AND DREAMS: SEXUAL DREAMS

admin — Fri, 08 May 2009 09:32:01 +0000

According to Sigmund Freud, the father of psychoanalysis, most dreams which appear to be asexual are in fact symbolic of some sexual nature. In the days of Freud there were no sleep laboratories and no one knew anything about REM sleep and dream erections. However, it is common knowledge among men that they have erections in the morning. Now we know, of course, that this is because they wake up in the morning in the midst of one of these recurring dream erections. Freud could have also observed that whenever he was dreaming he had an erection. This could have influenced his theory put forth in The Interpretation of Dreams. He maintained that sexual drive was the primary motivation of most dreams, and he even had a list of sex symbols to go along with his theory. Freud, if alive today, would say that dream erections are caused by the sexual nature of dreams, even if the dreams appear to be asexual to the dreamer. Freud placed a great emphasis on sex in all his dream interpretations. Could this be because of his observations of his own erections associated with every dream? But are there other explanations?

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THE SELF-MANAGEMENT OF ANXIETY: DO NOT BE IMPATIENT WITH YOURSELF WHEN AT FIRST YOU CANNOT RELAX

admin — Wed, 29 Apr 2009 10:22:22 +0000

This is important. The relaxing is not difficult, but if you could do it in two minutes there would be no need for me to write these detailed instructions. It takes a little time to learn it. And in the initial phase while you are mastering it, you must be patient with yourself—and with me too.

There is one thing that you must not do. Do not under any circumstances say to yourself, “I can’t relax; it might suit other people; it is not for me.” In my experience almost everybody who is tense or who has anxiety symptoms can in fact learn to do it, and will receive help as a result.

There is another phase also when people often get cross with themselves. We first get our body relaxed, and then we bring the feeling of our bodily relaxation into our mind. Some people find that they can achieve bodily relaxation very easily; but the relaxation of the mind does not seem to follow it. They tend to get cross with themselves, and are likely to give up. The point to remember is this: Almost everyone—and I say “almost” only because as a scientist I must allow such a possibility—almost everyone who can achieve good physical relaxation of the body can go on and achieve similar relaxation of the mind. It only requires a little patience and persistence.

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