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Viewing: Blog Posts Tagged with: therapy, Most Recent at Top [Help]
Results 1 - 20 of 20
1. Mentalization and borderline personality disorder (part two)

Sigmund Karterud is a pioneer of group therapy for borderline personality disorders. He focuses on mentalization: our ability to understand ourselves and other people in terms of mental phenomena – beliefs, feelings, wishes, and hopes.

The post Mentalization and borderline personality disorder (part two) appeared first on OUPblog.

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2. Mentalization and borderline personality disorder (part one)

Sigmund Karterud is a pioneer of group therapy for borderline personality disorders. He focuses on mentalization: our ability to understand ourselves and other people in terms of mental phenomena – beliefs, feelings, wishes, and hopes. Marketing assistant Joe Hitchcock sat down with the Norwegian psychiatrist from Ulleval University Hospital to explore the concepts, history, and effectiveness of the treatment.

The post Mentalization and borderline personality disorder (part one) appeared first on OUPblog.

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3. How to cope when the words don’t come

Imagine someone close to you disappears. She no longer shows up on the day on which she always visited. She does not call or write. No one says where she has gone or if she is coming back. To make matters worse, you cannot ask about her. You experience feelings of sadness, anger, disappointment, and grief, to name a few. The only way you have to express yourself is through your behavior. You may retreat into yourself or lash out at others, but those who provide your care do not understand the source of your behaviors.

The post How to cope when the words don’t come appeared first on OUPblog.

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4. Never Ending, by Martyn Bedford | Book Review

Fifteen-year-old Shiv doesn’t think she’ll ever be able to forgive herself for what she’s done. And she’s not sure she wants to, either. Her young brother and best friend, Declan, is dead, and she’s to blame.

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5. If you’re stressed, or in distress or crisis, see this fantastic article by Toronto psychotherapist Jo-Anne Beggs

for some concrete techniques to help you get through–without doing anything to make it worse. These are techniques that actually help!

And if you’re looking for a therapist in Toronto or Mississauga, I highly recommend her! She’s one of the most compassionate, warm-hearted, good people I know, and she’s got a ton of skill and experience.

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6. The rise of music therapy

By Scott Huntington

Music therapy involves the use of clinical, evidence-supported musical interventions to meet a patient’s specific goals for healing (a useful fact sheet). The musical therapist should have the proper credentials and be licensed in the field of music therapy.

Music therapy is performed in rehabilitation centers such as 12 Keys Rehab, psychiatric and even general hospitals, private practices, nursing homes, schools, etc. to treat a wide variety of issues, including social, cognitive, emotional, and physical needs. After an initial assessment, the musical therapist prescribes a treatment plan in which the patient sings, moves and dances, creates, or simply listens to music. This experience facilitates a healthy outlet for patients to communicate and express their feelings, in addition to rehabilitating the patient physically.

Rand De Mattei, a music instructor with Blues in the Schools, gets in tune with Petty Officer 2nd Class Tyreen S. McRae, a participant in neurologic music therapy, at Naval Medical Center San Diego Feb. 28. Neurologic music therapy helps Wounded Warriors recover.

Rand De Mattei, a music instructor with Blues in the Schools, gets in tune with Petty Officer 2nd Class Tyreen S. McRae, a participant in neurologic music therapy, at Naval Medical Center San Diego Feb. 28. Neurologic music therapy helps Wounded Warriors recover. Public domain via Wikimedia Commons

Music therapy and special populations

As it has become more prevalent, music therapy has proven to be useful for a wide variety of populations. One such population is victims of crisis and trauma. After the 9/11 terror attacks in New York City, the American Music Therapy Association founded The New York City Music Therapy Relief Project. The goal of the project was to serve the children and adults living in the metropolitan vicinity by providing them with music therapy services. Some of these musical therapy programs were customized with the specific needs of caregivers in mind, targeting teachers, counselors, social workers, doctors, and nurses. More than 3,000 teachers and students were served through eleven different music therapy programs that reached out to eight local schools.

Music therapy has also been used in the treatment of mental illness. In addition to the basic care they should be receiving, music therapy helped patients with schizophrenia to achieve an enhanced mental state along with improving their overall condition. What’s more, music therapy has been shown to drastically reduce the unwanted symptoms these patients sometimes experience, making them more capable of having conversations with other people, thereby alleviating feelings of isolation and giving them more of an interest in what is going on around them.

Along with helping those suffering from schizophrenia, music therapy has also been used as an effective way to treat clinical depression. Studies have shown that when adolescents who were depressed listened to music, they had a notable drop in the levels of cortisol (a stress hormone), and the left frontal lobe of their brain was activated, which was reported to be a positive outcome.

Those who struggle with anger have also benefited from music therapy treatments. When assessed with the Achenbach’s Teacher’s Report Form, music therapy patients made significant improvements on the scale of aggression and hostility. Studies suggest that group sessions of music therapy allow patients to express themselves in a positive way, transforming their aggression and rage into healthier forms of communication

While music therapy can go a long way in improving the mental health of a patient, it can also help in more physical ways. For one thing, music therapy lowers a patient’s perception of their pain so that what might normally be extremely painful becomes a much more tolerable experience. For patients suffering with cancer and undergoing chemotherapy, music therapy has been known to lower incidences of nausea and anxiety, sometimes significantly lowering the fatigue, anxiety, and pain of those in hospice care.

Talking to a music therapist

I caught up with Alyssa Regan, who is in her second year in the master’s equivalency program for music therapy at Immaculata University. She’s also near the end of her full-time internship at Children’s Hospital of Philadelphia.

How have you personally seen music therapy work on someone?

I was planning on having a session with one of my patients that I had been seeing regularly since the beginning of my internship. This patient was only 16 months old and suffered from many medical complications. When I arrived at his room, I noticed an entire medical team standing around his bed; his monitor was beeping, his heart rate and respiratory rate were so erratic that numbers weren’t even showing. My patient’s face was red and he seemed to be writhing in discomfort. With approval from the medical team, I came in and began to quietly play guitar. Around the same time, the patient was given some medication. As I began to sing, my patient’s face calmed. I aimed to match the tempo of my music with his breathing and then gradually slow it down. His HR and RR appeared on the monitors and slowly decreased. After 20 minutes or so, his vitals were stable and he was asleep. After the session, one of the nurses said, “Well, either you’re a miracle worker or those drugs kicked in extremely fast!” I’m sure the medicine had a little to do with it, but it was also the music.

Since you started studying music therapy, have you seen it grow?

Yes. I think that more of the general population is beginning to recognize it as a credible field, especially as it seems to be gaining more publicity recently (e.g. the Gabby Giffords documentary and the recent segment on the news about music therapy with premature infants). I hope it continues to grow!

Is music therapy becoming more recognized in hospitals, nursing homes, etc.? 

I think it is becoming more recognized in general, which hopefully means that there will be more jobs available. The most growth seems to be happening in hospice care.

How do you see music therapy expanding over the next ten years?

Ideally, I’d like music therapy to be seen as important as physical therapy, speech therapy, or occupational therapy. Will that happen over the next ten years? Probably not. However, I would not be too surprised if every hospice care organization, children’s hospital, and major medical and psychiatric institution in the United States had at least one music therapist on staff in ten years.

Scott Huntington is a percussionist specializing in marimba. He’s also a writer, reporter and blogger. He lives in Pennsylvania with his wife and son and does Internet marketing for WebpageFX in Harrisburg. Scott strives to play music whenever and wherever possible. Follow him on Twitter at @SMHuntington.

Oxford Music Online is the gateway offering users the ability to access and cross-search multiple music reference resources in one location. With Grove Music Online as its cornerstone, Oxford Music Online also contains The Oxford Companion to Music, The Oxford Dictionary of Music, and The Encyclopedia of Popular Music.

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7. Utilizing the Body to Address Emotions: Integrative Body-Mind-Spirit Social Work


Integrative Body-Mind-Spirit Social Work: An Empirically Based Approach to Assessment and Treatment, is the first book to strongly connect Western therapy with Eastern philosophy and practices, while also providing a comprehensive practice agenda for social work and mental health professionals.  The authors argue that integrative body-mind-spirit social work is indeed a practical therapeutic approach in bringing about tangible changes in clients.  In the excerpt below we look at just one technique and one patient, Rebecca.The authors are highly regarded researchers from both Asia and America.  Mo Yee Lee is a Professor in the College of Social Work at The Ohio State University.  Siu-man Ng is an Assistant 9780195301021Professor in the Department of Social Work and Social Administration and the Associate Director of the Centre on Behavioral Health at the University of Hong Kong.  Pamela Pui Yu Leung is an Assistant Professor in the Department of Social Work and Social Administration at the University of Hong Kong.  Cecilia Lai Wan Chan is a Professor in the Department of Social Work and Social Administration, the Director of the Centre on Behavioral Health, the Associate Director of the HKJC Centre for Suicide Research and Prevention at the University of Hong Kong.

Rebecca was a lady in her thirties.  When she first came to the therapist’s office, she talked with a soft and weak voice and seemed afraid of looking directly at the therapist.  She did not clearly express what she wanted.  She gave the therapist the impression that she was a timid, little girl instead of a woman in her late thirties.  After building rapport, she shared with the therapist that she was thinking about changing careers but was not certain about what she could do.  She hoped the therapist could help her develop self-confidence so that she could take charge of her life.

In the first few sessions, the therapist helped Rebecca to explore and clarify what she wanted.  She wanted to make some changes in her life, but she was afraid of the uncertainty that would go with the change.  She realized that she was stuck because she was used to staying with the familiar and not taking risks.  Rebecca also discovered that she had made herself psychologically dependent on others, her father in particular.  This dependence had developed into a pattern so that she always relied on others to make decisions for her.  Though there was an inner voice calling her to meet a new challenge and attempt a new job, she dared not, as her father did not support the idea.

During the fifth session, the therapist revisited the treatment goal with Rebecca and tried to help her to make a choice for herself regarding her pattern of being dependent on others.  The therapist said, “You told me that your goal is to take charge of your life.  Now you realize that you have developed a pattern of being dependent on others.  What are you going to do with this pattern? Do you want to keep it, or change it?”  Rebeca promptly responded that she did not want to keep the old pattern, but having been used to relying on others for so many years, she felt uncertain of what sh

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8. Edna Foa On Being A Time Magazine Honoree

Edna Foa is a Professor of Clinical Psychology in Psychiatry at the University of Pennsylvania and Director of the Center for the Treatment and Study of Anxiety.  Her most recent book, Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences, was written with Elizabeth Hembree and Barbara Olaslov Rothbaum. The guide gives clinicians the information they need to treat clients who exhibit the symptoms of PTSD.  Recently Foa was name by Time Magazine as one of the most influential people in 2010.  Below she reacts to the honor.

My first reaction was that of disbelief when I learned that I had been selected for Time Magazine’s list of the 100 most influential people in 2010. I thought someone was pulling my leg. I called my husband and shared the news with him, he thought I was pulling his leg. My youngest daughter said: “get out of here, you must be joking”. But of course, we all know that the email was genuine. First, I was stunned. After all, I am not a rock star, not a head of state, not even a famous athlete. And then I was delighted. Isn’t it wonderful that someone at Time recognized the importance of the work we, clinical psychology researchers, do to help PTSD sufferers. I felt quite honored to represent our field.

As clinical scientists we know that we have a lot of powerful treatments. But we also are painfully aware of how difficult it is to make these treatments widely available. The treatments that we have for anxiety disorders are particularly efficacious and yet most clinicians do not deliver them. For many reasons it is hard to get mental health clinicians to adopt new treatments. As a result, countless individuals with anxiety and other disorders experience needless suffering that could be decreased or terminated via the application of the effective treatments we developed.

The cost of bad treatment reaches beyond individuals. Institutions and society as a whole suffer from what is a public health issue. For example, the VA, the military and insurance companies all have a stake in individuals receiving the most effective treatments for psychological disorders. And yet, there have been very few effective initiatives requiring practitioners to learn and deliver the best psychological treatments.

And so I hope that Time Magazine’s recognition of my work is in essence recognition of the tremendous importance of not only developing effective, evidence-based treatment, but more importantly, disseminating them among mental health professionals. The wars in Iraq and Afghanistan have brought home the awareness of how important it is to deliver effective treatments to the many soldiers who return from these wars with posttraumatic stress disorder (PTSD). I strongly believe that PTSD is not only a mental health disorder; it is also a societal problem. It is the responsibility of our society to help PTSD sufferers as a result of being injured at work, raped in our schools, physically assaulted in our streets, or experiencing the horror of war. We know that effective treatments for PTSD such as Prolonged Exposure (PE) can help patients regain their lives in as few as 10 sessions over the course of 5 weeks. It is no long

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9. The Blessing Next to the Wound


by tatiana de la tierra

Inside the psyche of a young man being tortured in that cell at the top of a hill there is a book that will one day tell his story: The Blessing Next to the Wound. A political memoir rife with intimate and harrowing details of fractured life, this book takes deeply personal wounds on a journey to global healing. This is the story of Hector Aristizábal, a Colombian theater artist, activist and psychologist. It is about some difficult issues—abortion, homophobia, drug addiction, racism, exile, prison, immigration, murder, torture, and the U.S. juvenile justice system. It is about the intersection of creativity, ruptured reality, ritual, and therapy. And it is about Colombia, where the story begins and returns to at critical junctures.

Co-written with Diane Lefer, The Blessing takes place in Medellín, Colombia and Los Angeles, California, with many stops throughout the world. Aristizábal hails from the low-income barrios on the outskirts of Medellín. Rounded up at four in the morning in 1982 by the army in search of guerrilleros, the twenty-two year old university student was taken to a compound where he underwent questioning along with beatings, waterboarding, electric shocks, mock executions, and psychological terror. Ten days later, thanks to pressure from human rights activists, he was released (and went into hiding). His brother Juan Fernando, who had also been arrested, was imprisoned for several months for carrying a machete. In 1999, when his brother was murdered by paramilitaries for his past ties to the Ejército de Liberación Nacional guerrilla group, the enraged Aristizábal demanded an autopsy of his brother’s corpse and photographed the event.

Out of this experience came “Nightwind,” a solo play that re-enacts Aristizábal’s torture and his brother’s autopsy. Co-created with author Diane Lefer and musician Enzo Fina, Aristizábal performs “Nightwind” in the U.S. and around the world.

“The play opened doors for me,” he says. Diane Lefer, Hector and I meet for coffee and conversation one morning in Pasadena. He’s recently returned from an ayahuasca retreat in the Amazon jungle, where he experienced the plant’s healing, illuminating, and maddening psychedelic “pintas” for the first time. Later tonight, he’s heading to Nepal to perform “Nightwind” and “Kiss of the Spider Woman” at the Kathmandu International Theatre Festival. “‘Nightwind’ opened the chamber of torture for people to see inside, opening the chamber for me to come out of it and not continue to live in it.”

The play also led to further collaboration between Lefer and Aristizábal, including writing and publishing magazine articles. The two joined political and artistic forces after people responded with suggestions that they write a book. Armed with Hector’s journal and his Masters thesis, Diane immersed herself in his voice and interviewed him, his family and others for further details. “W

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10. So what do we think? Waking Rose: a fairy tale retold


 Doman, Regina. (2007) Waking Rose: a fairy tale retold. Front Royal, VA: Chesterton Press. ISBN #978-0-981-93184-5. Author recommended age: 16 +. Litland.com also recommends 16+.  See author explanation for parents at http://www.fairytalenovels.com/page.cfm/cat/116//

Publisher’s description: Ever since he rescued her from Certain Death, Rose Brier has had a crush on Ben Denniston, otherwise known as Fish. But Fish, struggling with problems of his own, thinks that Rose should go looking elsewhere for a knight in shining armor. Trying to forget him, Rose goes to college, takes up with a sword-wielding band of brothers, and starts an investigation into her family’s past that proves increasingly mysterious. Then a tragic accident occurs, and Fish, assisted by Rose’s new friends, finds himself drawn into a search through a tangle of revenge and corruption that might be threatening Rose’s very life. The climax is a crucible of fear, fight, and fire that Fish must pass through to reach Rose and conquer his dragons.

Our thoughts:

It is difficult to capture the essence of this story coherently because it touches upon so many aspects of life. There is the mystery, of course, and continuing depth of family loyalty amongst the Briers. The craziness of those first years experienced when young adults leave their nest and venture into the outer world of college life, whether as newbie freshmen or advanced graduate students. Unlikely friendships as the strong nurture the weak with Kateri mentoring Donna in her mental illness, and Rose guiding Fish through abuse recovery. Fish’s loyalty to Rose, taken to the extreme, becomes unforgiving. But then self-denigration turns into enlightenment and hope.

And after all of that is said, we are left with the relationship of Fish and Rose finally reaching a neat and tidy conclusion :>)

The girls have progressed in the series to young adults. Blanche just married Bear and Rose is off to college. Fish continues in his college program too. Doman shows us the challenges young adults face when they first enter the world on their own, particularly in making friends and exploring crushes. We can imagine ourselves engaged in the chit chat and horseplay typical in budding relationships. Important also is the picture implanted in our mind of courtship.

Throughout the story, we can see the existence of three pillars: faith, family and friends. Whenever one of these pillars is weakened, internal conflict and unsafe situations arise. Maintaining the balance, we see Rose’s keen ability for discernment that has been honed as a result of consistency in faith life, family home “culture, and choice of friends. Her discernment is key to good decisions, keeping safe, etc.

Going beyond stereotypes, the dialogue paints a clear picture of the perceptions held by non-Christians against Christians, countered with a realistic portrayal of the passionate young Christian student. Previous books portrayed ac

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11. Joan Didion on psychiatric trends and diagnoses

In her forthcoming memoir, Blue Nights, Joan Didion remembers the way her daughter’s (above, left) psychiatric diagnosis kept changing. Manic depression became OCD; OCD became something else, something she can’t remember now, but something that ultimately gave way to many other conditions before “the least programmatic of her doctors settled on one that actually seemed to apply”: borderline personality disorder.

Diagnosis never seems to lead to a cure, Didion observes, only an enforced debility. But as with a psychiatric evaluation of herself conducted in 1968 and excerpted in The White Album (and quoted in part below), Didion sees and reflects on the truths of the assessment even as she ponders it at arm’s length.

I’ll have much more to say about her new book when it’s out in November, but this paradoxical blend of skepticism, acceptance, and astringent detachment in matters pertaining to psychology and its insights and connection to the culture, has always characterized Didion’s writing. It’s one of the reasons I’m so drawn to her work.

In the title essay of The White Album, the one that begins with the famous line “We tell ourselves stories in order the live,” she recalls “a time when I began to doubt the premises of all the stories I had ever told myself, a common condition, but one I found troubling.” She continues:

I was supposed to have a script, and had mislaid it. I was supposed to hear cues, and no longer did. I was meant to know the plot but all I knew was what I saw: flash pictures in variable sequence, images with no “meaning” beyond their temporary arrangement, not a movie but a cutting-room experience. In what would probably be the mid-point of my life I wanted still to believe in narrative and in the narrative’s intelligibility, but to know that one could change the sense with every cut was to begin to perceive the experience as rather more electrical than ethical…

Another flash cut:

In June of this year patient experienced an attack of vertigo, nausea, and a feeling that she was going to pass out… The Rorschach record is interpreted as describing a personality in process of deterioration with abundant signs of failing defenses and increasing inability of the ego to mediate the world of reality and to cope with normal stress… Emotionally, patient has alienated herself almost entirely from the world of other human beings. Her fantasy life appears to have been virtually completely preempted by primitive, regressive libidinal preoccupations many of which are distorted and bizarre… In a technical sense basic affective controls appear to be intact but it is equally clear that they are insecurely and tenuously maintained for the present by a variety of defense mechanisms including intellectualization, obsessive-compulsive devices, projection, reaction-formation, and somatization, all of which now seem inadequate to their task of controlling or containing an underlying psyhotic process and are therefore in process of failure. The content of patient’s responses is highly unconventional and frequently bizarre, filled with sexual and anatomical preoccupations, and basic reality contact is obviously and seriously impaired at times. In quality and level of sophistical patients responses are characteristic of those of individuals of high average or superior intelligence but she is now functioning intellectually in impaired fashion at barely average level. Patient’s th

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12. Didion’s Blue Nights: stitched from grief

joan didion

I reviewed Joan Didion’s Blue Nights, which is both gorgeous and terrible (terrible in the King James sense of awesome, dreadful, and fearsome, like when God appears to Moses).

In 2003′s Where I Was From, Joan Didion tells of a long wagon journey on which her great-great-grandmother buried a child, gave birth to another, contracted mountain fever twice, and sewed a quilt, “a blinding and pointless compaction of stitches,” that she must have finished en route, “somewhere in the wilderness of her own grief and illness, and just kept on stitching.” Throughout the book, Didion ruminates on her female forbears, women “pragmatic and in their deepest instincts clinically radical, given to breaking clean with everyone and everything they knew,” even their own dead babies.

It was Didion’s adopted daughter Quintana, at age five or six, who first made all this heredity start to seem remote. And if the author harbored any lingering doubt about whether she shared her ancestors’ breaking-clean tendencies, the shattering effect of Quintana’s death in 2005, at age 39, must have swept it away. In her new memoir, Blue Nights, about life before and after the loss of her daughter, Didion writes, “When we talk about mortality, we are talking about our children.”

You can read the full review at B&N Review, watch Didion reading from the book in a Daily Beast video, and listen to her talk about it at NPR.

Previously: Didion on psychiatric trends and diagnoses; the specter of the unanswered letter; “I didn’t want to be a writer. I wanted to be an actress”; and a short but revealing 1970 TV interview with Tom Brokaw.

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13. OCD treatment through storytelling

Obsessive Compulsive Disorder (OCD) is an often misunderstood anxiety disorder. It’s treatment of choice, a form of Cognitive Behavioral Therapy known as Exposure and Response Prevention (ERP), is likewise difficult to grasp and properly use in therapy for both consumers and their therapists. This is in part because of the counter-intuitive nature of ERP, as well as the subtle twists and turns that OCD can take during the course of treatment.

Dr. Allen Weg, a licensed psychologist, has perfected the art of storytelling and metaphor use as a way of explaining and employing ERP to his clients in therapy. He utilizes this same technique to train other therapists in the use of ERP for OCD. In this brief, entertaining video, Dr. Weg walks you through 3 of those stories, and introduces you to his book entitled, OCD Treatment Through Storytelling: A strategy for successful therapy, a collection of more than 50 such stories that he has developed over the last 25 years in his work with OCD.

Click here to view the embedded video.

View more about this book on the

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14. The Book Review Club - Waiting to Forget

Waiting to Forget
Sheila Kelly Welch
middle grade

Because of the age of the protagonist, I've tagged this as middle grade, as did the publisher, namelos; however, it seems wise and fair to point out that this is the story of a current day child-survivor of abuse and neglect. This isn't a light read. It's tough. It's a great book for talking through and exploring emotions, but I wouldn't send a child off to read this alone.

Basic plot: T.J.'s little sister, Angela, fell from the second story balcony into the entryway of their new adopted parent's home. While T.J. waits at the hospital to find out if his sister will be all right, he tells their story in flashback. It's a heartrending account of a mother who neglects her children, has a string of boyfriends, some nice and some less than nice, that ultimately lead her to abandoning her kids to follow her man, who has abused the children. The children then cycle through various foster homes until they're adopted. The transition to a new home is difficult, wrought with feelings of guilt and distrust and the fear of loving anyone again.

The story alternates between present tense for the here and now and past for the story leading up to the hospital. For a young reader, changing tense can be confusing. Yet another aspect of the story that makes it well-suited for group reading and discussion.

As I was reading this book, I asked myself many times "what's the point" of a story of this nature. I'll readily admit, I'm sometimes a bit slow in getting it when it comes to gritty fiction about scarring abuse for a young audience. I faced a similar paradox with the aspect of double dead parents in my own middle grade, Dragon Wishes. For me, the theme felt too heavy as a stand alone. Thus I added a second story to the first, a fantasy, that broke up the heaviness of the main, present day story, while intertwining with it to push plot forward. That was my personal choice because the topic, death of both parents, just felt too heavy all by itself for a young audience. In Waiting to Forget, there is no break from reality. The distant past is painful, the recent past is jumbled and painful, and the present is scary painful. Angela may die.

Is this a story worth telling? Absolutely. However, it's probably one that's best read and shared together for the story to have its true effect, i.e. helping children either to cope with abuse in their lives or to understand abuse and its effects on their peers.

For other great reads, hop on over to Barrie Summy's site. They're in full bloom!

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15. So what do we think? Heaven in her Arms

Hickem, Catherine. (2012). Heaven in Her Arms: Why God Chose Mary to Raise His Son and What It Means for You. Nashville, TN: Thomas Nelson. ISBN 978-1-4002-0036-8.

What do we know of Mary?

 What we know of Mary’s family is that she is of the house of David; it is from her lineage Jesus fulfilled the prophecy. Given the archeological ruins of the various places thought to have been living quarters for their family, it is likely the home was a room out from which sleeping quarters (cells) branched. As Mary and her mother Anne would be busy maintaining the household, with young Mary working at her mother’s command, it is likely Anne would be nearby or in the same room during the Annunciation. Thus Mary would not have had a scandalous secret to later share with her parents but, rather, a miraculous supernatural experience, the salvific meaning of which her Holy parents would understand and possibly even witnessed.

 Mary and Joseph were betrothed, not engaged. They were already married, likely in the form of a marriage contract, but the marriage had not yet been “consummated”. This is why he was going to divorce her when he learned of the pregnancy. If it were a mere engagement, he would have broken it off without too much scandal.

 Married but not yet joined with her husband, her mother would prepare her by teaching her all that she needed to know. This is further reason to assume that Mary would be working diligently under her mother’s eye when the Annunciation took place.

 We know that her cousin Elizabeth’s pregnancy was kept in secret for five months, and not made known until the sixth month when the Angel Gabriel proclaimed it to Mary. We know Mary then rushed to be at her elderly cousin’s side for three months (the remaining duration of Elizabeth’s pregnancy), and that this rushing appeared to be in response to Elizabeth’s pregnancy (to congratulate her), not an attempt to hide Mary’s pregnancy. Note how all of this is connected to Elizabeth’s pregnancy rather than Mary’s circumstances. As Mary was married to Joseph, he likely would have been informed of the trip. Had the intent been to hide Mary, she would have remained with Elizabeth until Jesus was born, not returned to her family after the first trimester, which is just about the time that her pregnancy was visible and obvious.

 So we these misconceptions clarified, we can put Mary’s example within an even deeper context and more fully relate to her experience. We can imagine living in a faith-filled family who raises their child in strict accordance of God’s word. The extended family members may not understand, and certainly their community will not, so Mary, Anne and Joachim, and Joseph face extreme scandal as well as possible action from Jewish authorities. But they faced this together steep in conversation with God, providing a model for today’s family.

 Although sometimes scriptural interpretations are flavored with modern-day eye, overall this book will be more than just a quick read for a young mother (or new bride, or teen aspiring to overcome the challenges of American culture, or single parent losing her mind). It is a heartwarming reflection with many examples that open up conversation with God. As an experienced psychotherapist, the author’s examples are spot on and easy to relate to. We do not need to have had the same experiences to empathize, reflect, and pursue meaning; we see it around us in everyday life. As such, a reflective look upon these examples can help one overcome an impasse in their own relationship with God and also open the reader up to self-knowledge as Hi

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16. Musical ways of interacting with children

By Professor Jane Edwards

What does the baby have to learn in these first 12-18 months (before they can speak)? The list  includes what you do with your eyes when with another, how long to hold a mutual gaze, what turn-off head movements work, and with whom, how close you should let the other come to you… how to read body positions… how to enter into turn taking when vocalizing with another… how to joke around, negotiate escalate, back off… make friends, and so on.
Daniel Stern, Forms of Vitality (OUP, 2010) p. 110-111

As a music therapy scholar, teacher, and practitioner for more than 20 years, I have been able to learn from many sources about the crucial role our early years play in our lives. The ability to reflect on challenges experienced in our adult lives by linking back to childhood experiences is an essential aspect of the way that many music therapists practice. Rather than using descriptions of family histories to apportion blame, the therapist tries to understand the current experience of the patient and their worldview through the lens of past experience, to see if there is some way to make sense of self-destructive behaviours, or difficulties experienced in creating meaningful and satisfying relationships with others.

I began my early music therapy practice in mental health services and in nursing homes, working with people diagnosed with Alzheimer’s Disease or other types of dementia. Many people, whether in group or individual music therapy programmes, offered reflections on their early life, and described aspects of their parents’ availability or unavailability; referring to the quality of these first relationships in ways that helped me to understand something of what might have been unresolved or unsatisfying for them. Eventually I found myself very keen to work with people much earlier in life to see whether music therapy could ameliorate some of the issues my older patients were facing.

Although I worked in paediatric music therapy for seven years at a children’s hospital, it was only when I was writing the first proposal to found the (now) international parent-infant support programme Sing & Grow that I had the chance to bring all of my past experience to bear: to make a case for the importance of promoting loving, playful, and nurturing interactions between parents and infants where vulnerability was in evidence. Through my work in this field, I have become increasingly aware of an unrecognised field of practice in music therapy: parent-infant work. This involves the referral of vulnerable parents to a music therapy service. Parents usually attend with their infants and the music therapist provides a safe and accepting space in which the parent and infant pair or group can be encouraged to play and interact in supportive and mutually satisfying ways. This is not always ‘music’ as it might be generally understood; rather it is a musical way of interacting that the therapist encourages.

When adults speak to infants we use particular ways of interaction that seem to be the same across the world. But we should ask why do we use such an exaggerated, playful, and musical way of speaking to infants? The obvious answer is because the infants like it — they raise their eyebrows, fix their gaze on the speaker’s face, and sometimes smile quite quickly on hearing us say ‘ooohhh whooo is my little baaaby?’ This is especially true if the speaker is a family member but it also can occur in new encounters when the conversational partner knows and can offer this communication in a playful and experimental way.  However, there are many more powerful scientific and theoretical findings that indicate how this type of interaction builds the bonds of trust and love between parents and infants.

Work by psychobiologist Colwyn Trevarthen, the ethologist Ellen Dissanayake, and researcher Sandra Trehub and her team at the University of Toronto, has paved the way in showing how the functions of this interaction have less to do with entertaining and engaging the baby and are more aligned with the infant’s ability to evoke and interpret these signals from adults and their siblings within weeks of birth. For me, and for the researchers mentioned above, these interactions are easily identified as musical. Observations of the nature of these interactions between parents and infants led Stephen Malloch to coin the term ‘Communicative Musicality’, to capture the unique pitch and rhythmic structures that communicative partners use.

This type of interaction is, as the quote from Stern at the opening attests, playful, rich, and highly involved. It teaches the many skills we need in being able to be with people successfully in intimate relationships, in relationships involving teachers and students, and in work groups. When we do not have adequately rich and supported experiences of attachment in infancy there can be lifelong consequences. Therefore, offering support to parents and infants in difficulty can provide long term benefits. Music therapy is uniquely poised to make a useful contribution to this work as infants are receptive to musical and music-like interactions from sensitive and responsive adults.

Professor Jane Edwards is an Associate Professor at the University of Limerick where she directs the Music & Health Research Group and is co-ordinator of the MA in Music Therapy in the Irish World Academy of Music & Dance. She was formerly a guest professor at the University of the Arts in Berlin (2004-2011). She is President of the International Association for Music & Medicine. She has published extensively in the field of music therapy including Music Therapy and Parent-Infant Bonding (OUP, 2011), and is sole editor for the first Oxford Handbook of Music Therapy (forthcoming).

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Image credit: ‘Mother Kissing Baby’ By Vera Kratochvil (public domain via Wikimedia Commons).

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17. Music: a proxy language for autistic children

By Adam Ockelford

I spend around 12 hours a week – every week – sharing thoughts, feelings, new ideas, reminiscences and even jokes with some very special children who have extraordinary musical talents, and many of whom are severely autistic. I’m Professor of Music at the University of Roehampton, and the children come to see me in a large practice room in Southlands College where there are two pianos, so we don’t have to scrap over personal space. My pupils usually indicate what piece they would like us to play together, and they tell me when they’ve had enough. Sometimes, they tease me by seeming to suggest one thing when they mean another. We share many jokes and the occasional sad moment too.

But the children rarely say a word. They communicate everything through their playing. For them, music is a proxy language.

On Sunday mornings, at 10.00 a.m., I steel myself for Romy’s arrival. I know that the next two hours will be an exacting test of my musical mettle. Yet Romy, aged 11, has severe learning difficulties, and she doesn’t speak at all. She is musical to the core, though: she lives and breathes music – it is the very essence of her being. With her passion comes a high degree of particularity: Romy knows precisely which piece she wants me to play, at what tempo and in which key. And woe betide me if I get it wrong.

When we started working together, four years ago, mistakes and misunderstandings occurred all too frequently, since (as it turned out), there were very few pieces that Romy would tolerate: the theme from Für Elise (never the middle section), for example, the Habanera from Carmen, and some snippets from ‘Buckaroo Holiday’ (the first movement of Aaron Copland’s Rodeo). Romy’s acute neophobia meant that even one note of a different piece would evoke shrieks of fear-cum-anger, and the session could easily grow into an emotional conflagration.

So gradually, gradually, over weeks, then months, and then years, I introduced new pieces – sometimes, quite literally, at the rate of one note per session. On occasion, if things were difficult, I would even take a step back before trying to move on again the next time. And, imperceptibly at first, Romy’s fears started to melt away. The theme from Brahms’s Haydn Variations became something of an obsession, followed by the slow movement of Beethoven’s Pathetique sonata. Then it was Joplin’s The Entertainer, and Rocking All Over the World by Status Quo.

Over the four years, Romy’s jigsaw box of musical pieces – fragments ranging from just a few seconds to a minute or so in length – has filled up at an ever-increasing rate. Now it’s overflowing, and it’s difficult to keep up with Romy’s mercurial musical mind: mixing and matching ideas in our improvised sessions, and even changing melodies and harmonies so they mesh together, or to ensure that my contributions don’t!

As we play, new pictures in sound emerge and then retreat as a kaleidoscope of ideas whirls between us. Sometimes a single melody persists for 15 minutes, even half an hour. For Romy, no matter how often it is repeated, a fragment of music seems to stay fresh and vibrant. At other times, it sounds as though she is trying to play several pieces at the same time – she just can’t get them out quickly enough, and a veritable nest of earworms wriggle their way onto the piano keyboard. Vainly I attempt to herd them into a common direction of musical travel.

So here I am, sitting at the piano in Roehampton, on a Sunday morning in mid-November, waiting for Romy to join me (not to be there when she arrives is asking for trouble). I’m limbering up with a rather sedate rendition of the opening of Chopin’s Etude in C major, Op. 10, No. 1, when I hear her coming down the corridor, vocalising with increasing fervour. I feel the tension rising, and as her father pushes open the door, she breaks away from him, rushes over to the piano and, with a shriek and an extraordinarily agile sweep of her arm, elbows my right hand out of the way at the precise moment that I was going to hit the D an octave above middle C. She usurps this note to her own ends, ushering in her favourite Brahms-Haydn theme. Instantly, Romy smiles, relaxes and gives me the choice of moving out of the way or having my lap appropriated as an unwilling cushion on the piano stool. I choose the former, sliding to my left onto a chair that I’d placed earlier in readiness for the move that I knew I would have to make.

I join in the Brahms, and encourage her to use her left hand to add a bass line. She tolerates this up to the end of the first section of the theme, but in her mind she’s already moved on, and without a break in the sound, Romy steps onto the set of A Little Night Music, gently noodling around the introduction to Send in the Clowns. But it’s in the wrong key – G instead of E flat – which I know from experience means that she doesn’t really want us to go into the Sondheim classic, but instead wants me to play the first four bars (and only the first four bars) of Schumann’s Kleine Studie Op. 68, No. 14. Trying to perform the fifth bar would in any case be futile since Romy’s already started to play … now, is it I am Sailing or O Freedom. The opening ascent from D through E to G could signal either of those possibilities. Almost tentatively, Romy presses those three notes down and then looks at me and smiles, waiting, and knowing that whichever option I choose will be the wrong one. I just shake my head at her and plump for O Freedom, but sure enough Rod Stewart shoves the Spiritual out of the way before it has time to draw a second breath.

From there, Romy shifts up a gear to the Canon in D ­– or is it really Pachelbel’s masterpiece? With a deft flick of her little finger up to a high A, she seems to suggest that she wants Streets of London instead (which uses the same harmonies). I opt for Ralph McTell, but another flick, this time aimed partly at me as well as the keys, shows that Romy actually wants Beethoven’s Pathetique theme – but again, in the wrong key (D). Obediently I start to play, but Romy takes us almost immediately to A flat (the tonality that Beethoven originally intended). As soon as I’m there, though, Romy races back up the keyboard again, returning to Pachelbel’s domain. Before I’ve had time to catch up, though, she’s transformed the music once more; now we’re hearing the famous theme from Dvorak’s New World Symphony.

I pause to recover my thoughts, but Romy is impatiently waiting for me to begin the accompaniment. Two or three minutes into the session, and we’ve already touched on 12 pieces spanning 300 years of Western music and an emotional range to match.

Yet here is a girl who in everyday life is supposed to have no ‘theory of mind’ ­– the capacity to put yourself in other people’s shoes and think what they are thinking. Here is someone who is supposed to lack the ability to communicate. Here is someone who functions, apparently, at an 18-month level.

But I say here is a joyous musician who amazes all who hear her. Here is a girl in whom extreme ability and disability coexist in the most extraordinary way. Here is someone who can reach out through music and touch one’s emotions in a profound way.

Click here to view the embedded video.

Romy playing piano with musical savant Derek Paravicini and Adam Ockelford

I explore the science of how Romy and her peers are able to do what they do in my new book Applied Musicology, which uses a theory of how music makes sense to all of us to explore intentionality and influence in children who use little or no language. If music is important to us all, it is truly the lifeblood of many children with autism. Essential brain food.

Adam Ockelford is Professor of Music and Director of the Applied Music Research Centre at the University of Roehampton in London. He is the author of Applied Musicology: Using Zygonic Theory to Inform Music Education, Therapy, and Psychology Research (OUP, 2012).

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18. Pushing the Limits - Review & Giveaway

Publication Date: 31 July 2012 by Harlequin Teen
ISBN 10/13: 0373210493 | 9780373210497
Category: Young Adult Realistic Fiction
Keywords: Therapy, amnesia, romance, family
Format: Hardcover, eBook
Source: Review copy, also purchased for Kindle


No one knows what happened the night Echo Emerson went from popular girl with jock boyfriend to gossiped-about outsider with "freaky" scars on her arms. Even Echo can't remember the whole truth of that horrible night. All she knows is that she wants everything to go back to normal. But when Noah Hutchins, the smoking-hot, girl-using loner in the black leather jacket, explodes into her life with his tough attitude and surprising understanding, Echo's world shifts in ways she could never have imagined. They should have nothing in common. And with the secrets they both keep, being together is pretty much impossible.

Yet the crazy attraction between them refuses to go away. And Echo has to ask herself just how far they can push the limits and what she'll risk for the one guy who might teach her how to love again.

Alethea's review:

I'll be frank. I didn't like this book. I didn't like the bad attitudes of the main characters or the dramarama from their lunchroom "friends". I didn't like the requisite romance between Echo and Noah, which bordered on insta-love. Except for Mrs. Collins, their special therapist/guidance counselor, I didn't like most of the adults in the story, who I felt contributed so much to the problems that the teenagers faced, instead of helping them. However, Katie McGarry managed to push all the right emotional buttons to make me feel engaged in their story despite all that dislike. 

The cast of characters is very well-drawn and diverse. It's helpful that the author is able to differentiate everyone so well, as there are a lot of characters. Getting to know Echo and Noah through their interactions with family, friends, and virtual strangers is where McGarry excels, as the reader learns about the main characters' personalities organically. At times though, I felt like the author was hedging her bets by providing so many characters that any reader is bound to like someone in the ensemble. And when I really look at it, the romance between Noah and Echo does develop over some time; however, I still really felt like the beginnings were awkward and unbelievable. Perhaps love is just like that sometimes.

The story is told by Echo and Noah in alternating POVs. It was a bit exhausting, but in the end I think it was the clearest way to tell the story--there was so much going on between Echo's traumatic memory loss and grief over her brother's death, and Noah working himself to the bone to get his little brothers back from their foster parents... McGarry deals in details, lots and lots of details, sometimes to the point of confusion. There were times I felt like that friend who's not quite close enough to tell all your secrets to, but you do anyway because you need to tell someone.

There's language and some steamy, but not too graphic love scenes, for those of you that care about that kind of thing. I'd probably recommend it for juniors/seniors in high school (the main characters are just a few months from graduation at the start of the novel). I would have rated this one star less, but I read the whole thing in just a few hours--couldn't put it down--so I reckon I liked it more than I am willing to admit. 

If you're going to read this, bring tissues. It's definitely a tear-jerker. 

Find out more about the author at www.katielmcgarry.com and follow @KatieMcGarry on Twitter.

One lucky duck gets to win my copy of Pushing the Limits.

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19. When time is suspended

One year ago last spring, I discovered a place where time was entirely suspended. There was no beginning to anything. There was no ending to anything. I could not feel the breeze on my skin. I could not taste the food I tried to eat. Simply attempting to drink a glass of water usually resulted in feeling like I would lose my stomach. The hour, the day, the week, all were lost into a category of being so unimportant they began to lack all substance. Entire days could arrive and disappear, without ever being noticed by me. Several times I crossed railroad tracks in front of trains. Not because I intended to do such a dangerous thing, but because I never saw the trains. And you would have to agree, trains are very large and loud and hard not to see. But when you are suffering major depression, you seldom see anything, regardless how immense in size, regardless how solid it surrounds you. There were multiple events, each filled with its own enormity of sorrow, which resulted in my arriving at such a state of non-being. The vacancy in my mind and soul was so real, I cannot even remember when, why or how I decided to set first one foot and then the other on the path toward recovery. I do recall taking an evaluation to determine degree of depression. On a scale where any score above 25 indicated I needed to be hospitalized, I scored 41. Being a therapist, I already understood that "therapist heal thyself" is not good advice. Yet because I am a therapist, I also knew I had the tools. I had the skills. I could navigate the darkest night of my soul, if I could grab a good rope and haul myself into even a small patch of light, and if I could find a competent guide to walk with me, give me discipline, keep me heading in the correct direction. I did heal myself. I did have an excellent guide. And I also forged several genuinely therapeutic friendships along the journey. Depression therapy and group participants are very confidential things, and I would never say more about my experience than this: I will forever be grateful to my guide, to the friends who worked with me and helped me. I hope I helped them a little bit, as well. I hope a few of them will read this and know how valuable they were in helping me find the light out of that dark night of my soul. It can be done.

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20. Eastern and Western Approaches to the Treatment of Cholera


Joanna Ng, Intern

Christopher Hamlin is Professor of History and of History and Philosophy of Science at the University of Notre Dame, and Honorary Professor at the London School of Hygiene and Tropical Medicine. His book, Cholera: The Biography, is a volume in our series Biographies of Disease, which we will continue to explore after the new year (read previous posts in the series here). Each volume in the series tells the story of a disease in its historical and cultural context – the varying attitudes of society to its sufferers, the growing understanding of its causes, and the changing approaches to its treatment. In the excerpt below, Hamlin compares European and Asian cholera therapies.

When East India Company surgeons began in the eighteenth century to practice their craft among the troops and traders in South Asia, they encountered new diseases, some of which affected delicate Europeans differently from locals – 9780199546244though that was hard to gauge, since their practice among these others was occasional and unrepresentative. Within the dominant Hippocratic framework, it was assumed that place modified bodily processes; it made sense to think that local practitioners knew best how to respond. Throughout the eighteenth and well into the first half of the nineteenth century European practitioners, French as well as English, would seek local knowledge of cures. They found multiple communities of healers, Muslim and Hindu, familiar with a disease that was most commonly known in Arabic as haiza, or as mordesheen in Mahrattan. (The latter term evolved into mort du chien, though it had nothing to do with dying dogs, and even into Merde chi – it certainly did have to do with merde.) In many cases, their techniques, and the principles that apparently underlay them, were similar to European therapies for cholera morbus. Calomel, the “Sampson of medicine,” that would become the mainstay of mid-nineteenth-century cholera cures (”the only remedy that can cope with that enemy of life”) was already well established in India. And hardly surprisingly. The familiar humoral framework, the uses of mercurials and other heavy metals, reflected millennia of medical syncretism, of both theory and technique, from south-eastern Europe across most of Asia, and including China, a topic that would fascinate the cadre of late-nineteenth-century German philologists.

Strategies to redress the balance of humors, stop spasms, and support recovery were also similar. Tastes and smells were more central in Indian than in European medicine, evident in the use of spices and camphor. Essential oils were also much used, and seemed strikingly effective as specifics. They would be studied in twentieth-century clinical reviews but dismissed: their effectiveness seemed impossible to square with a bacteriological paradigm. External treatments to restore heat and ease spasms were also prominent. Mainly these were warm baths and friction, but they also included cauterizing the callused heel and ligating the limbs. That therapeutic theme would continue to be expressed in the issuing of flannel cholera belts to British Indian army. To promote recovery, Indian healers gave acidic dri

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