Song of the Week: It's Going To Be Alright by Sara Groves

Another regular feature that I’ll try to do is post songs each week that really mean something to me and apply to my life during this week. One of my favorite artists is Sara Groves who writes so many songs that have helped me through different periods in my life.

This past week, I suffered from severe social anxiety on Tuesday and ended up having a panic attack. (I thought I was going to die; I couldn’t breathe!) My husband and I were on our way to counseling that night and Sara’s song “It’s Going To Be Alright” came on. I sang along with the song, fighting back tears the entire time. Finally my husband asks, “What does that song mean to you?” Immediately I burst into tears and told him I was fighting back tears, especially toward the end of the song where she urges the listener to “cast your cares.” That specific line is based on I Peter 5:7 where Peter writes, “Casting all your care upon Him, for He cares for you.” I’ve been really struggling with trusting God in the midst of all this, freaking out about what my coworkers think of me. I’ve been going through a “Are You There God? It’s Me, Margaret” phase. Where is God in the midst of my social anxiety? Where is he when I’m feeling alone and abandoned because my coworkers go out to lunch and don’t invite me? Where is God when I’m on the outskirts of forming close bonds with my coworkers just like they’ve formed close bonds with each other? Why am I the weirdo and the freak? What makes me so socially repulsive?

Then I hear Sara sing to me (it felt like it anyway), “I believe you’ll outlive this pain in you heart, and you’ll gain such a strength from what is tearing you apart” and those lyrics just GOT to me. It was as if God was speaking to me through the song and said, “Hey, it’ll be okay. I’m here for you and you’ll only get stronger from this situation. Marissa, you’ll be fine. It’ll be alright. Just talk to me. Tell me what you’re feeling. Tell me all about your pain. I’m here to listen and give you strength each day.” After feeling like God’s been like my dad for the past few years—not alive but up in the heavens somewhere, it’s like the silence was broken and He finally just communicated to me to turn to Him instead of running straight to my husband first. Talking to God is easier (and cheaper!) than talking to my husband.

Enough of the backstory. But now you know why I’ve chosen this particular song for Song of the Week. It seems like a good way to end the week on a good note. You can listen to the full song here. The lyrics are included below the cut.

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Christian counseling: Nouthetic vs. Biblical

Last night, I spent some time on the phone with my husband’s friend’s sister (aka my former pastor’s sister). We’ll call her Natalie.

Natalie was very sweet and kind, really encouraging and strengthening me by sharing her testimony of faith in God. She suffers from anxiety and panic attacks, which has led her to take Paxil (on and off) for the past 7 years. She says the drug has helped her tremendously and who am I to knock the drug (knowing what I know about Paxil/Seroxat) when she has seen the wonders that it has worked in her life?

I briefly explained my story of depression, history of suicide, and diagnosis of bipolar disorder. Although she couldn’t fully relate, she was very sympathetic and understanding. In fact, our conversation was so fruitful, I ended up taking notes!

Jay AdamsWe briefly touched on the issue of Nouthetic counseling (NC). She has undergone the course and simply needs to be certified. The counselor I currently see is associated with the Christian Counseling Education Foundation (CCEF), which has roots in NC and was founded by the man—Jay Adams—who developed the method. However, CCEF is now known for what is called biblical counseling. The organization has since moved away from pure Nouthetic methods and become more a bit more varied, taking bits and pieces of psychology (and perhaps psychiatry) that line up with the Bible. Adams, disagreeing with the organization’s approach, founded the Institute for Nouthetic Studies and uses the Bible as the sole counseling textbook. According to the wiki entry on Nouthetic counseling, Adams developed the word Nouthetic based on the “New Testament Greek word noutheteō (νουθετέω), which can be variously translated as ‘admonish,’ ‘warn,’ ‘correct,’ ‘exhort,’ or ‘instruct.'”

NC was developed back in the ’70s as a response to the popularity of psychology/psychiatry. Many Christians reject some of the teachings of such popular psychologists as Freud, Jung, Adler, Maslow, etc. Adams’ highly successful book, Competent to Counsel, criticizes the psychology industry and counters its teaching with a Nouthetic approach.

But NC has its Christian critics.

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Today's lesson: Paxil and Lexapro are not great antidepressants

Dawdy at Furious Seasons wrote a post on an editorial in the LA Times by Summer Beretsky’s experience with Paxil. After reading her editorial, I’m reminded that my own experience with one antidepressant wasn’t all that unique. Her drug was Paxil for panic attacks; mine was Lexapro for depression following a 3-month (on-and-off) stint with Paxil. I’m struck by the similarity of our experiences; not only did the same thing happened to me but I was also a communications major in college as well.

Paxil had one pretty undesirable effect on me: I started to lose interest in just about everything. I stopped initiating social activities (who needs that sort of thing?) and was no longer motivated to perform well academically.

My emotions had flat-lined: I hadn’t cried in months, nor had I proverbially jumped for joy. I felt — nothing.

I can still remember sleeping in bed at home on a weekday when I should have been at class. It was 2 in the afternoon, around the time my copy editing class was to begin. My boyfriend at the time (now my husband) lived in Kentucky while I attended college in New York. He planned to visit me that weekend but was getting fed up with my depression and listlessness. He called from work to tell me to get up and go to class. I mumbled on the phone, half-confused, and said no. He demanded, “Why not?” I said quite plainly, “Because I don’t care.” He said, “If you don’t get up and go to class, I won’t visit you this weekend.”

I replied, “I don’t care.”

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Panic disorders relieved by talk and behavioral therapies

The NYT published a story on Feb. 6 about how talk therapy aids panic disorders.

The study seems interesting. The psych world is excited because of its promising results. The results do seem hopeful but give the sample size, it's too early to tell.

"A team of New York analysts published [in The American Journal of Psychiatry] the first scientifically rigorous study of a short-term variation of the therapy for panic disorder, a very common form of anxiety. The study was small, but the therapy proved to be surprisingly effective in a group of severely disabled people… The brand of therapy tested relies on core tenets of analysis, like the search for the underlying psychological meaning of symptoms. But unlike traditional psychoanalysis, it focused on relieving symptoms quickly, and was time-limited. Previous studies of similar approaches have shown some promise for other disorders, like depression."

Perhaps Dr. David H. Barlow, a psychologist at Boston University, had the best insight:

"[He] said… that the study was too small to be conclusive but that 'the authors should be congratulated for actually  taking the first step in doing the hard work of beginning to evaluate treatments” that are widely used without good supportive evidence.

The researchers tested a pared-down version of analysis tailored specifically for panic attacks, the breathless, paralyzing dread that strikes some 1 percent to 2 percent of people, seemingly out of nowhere. Previous studies had found that other kinds of therapy — including exposure techniques, in which people learn to diffuse their anxieties by facing them one small step at a time — can relieve panic attacks in half to two-thirds of patients, depending on the severity and type of anxiety."

The article doesn't mention where the estimated "some 1 percent to 2 percent of people" comes from so I'll probably do some digging around to find out how many people are estimated to suffer from anxiety disorders and panic attacks. It's also interesting to note that studies used a form of psychological behavioral therapy to help patients manage their symptoms.

"Half of the group received a form of relaxation training, in which they learned how to moderate their arousal by tensing and relaxing specific muscle groups. The other half received psychodynamic therapy, working with their therapist in two weekly sessions to understand the underlying meaning of their symptoms — when the reactions first started and how they might be linked to loss, broken relationships or childhood experiences that unconsciously haunted their current lives."

Relaxation techniques — don't Ativan and Klonopin achieve the same result except much faster?

"After 12 weeks, 39 percent of those working with relaxation techniques improved significantly on standard measures of anxiety and reported fewer panic-related problems in their relationships and work. But almost three-quarters of those receiving psychodynamic therapy reported similar benefits. "

Thirty-nine percent of 49 patients equals about 19 patients who "improved significantly." It's not brain science, but you've left with another 30 who didn't. However, nearly 75 percent of the sample size "reported similar benefits" from psychodynamic therapy. Perhaps it wasn't revealed in the American Journal or it's a shoddy article thrown together at the last minute, but I'd like to know what "similar benefits" the study is speaking of.

Also, isn't 12 weeks longer than most clinical trials funded by drug companies? Perhaps I'm thinking that's just the first phase of a clinical trial…?

"One former patient treated with this therapy began to have panic attacks after witnessing a young woman die of an illness, said her doctor, Fredric N. Busch, a Cornell psychiatrist and a co-author of the new study.

The patient, who was not a part of the study, described the death as deeply unfair, and in sessions explored perceptions of unfairness in her work and her life, including her childhood. “Once she was able to understand this pattern, the panic became less frightening, she felt safer and was eventually able to get rid of the symptoms,” Dr. Busch said."

I'm no doctor, but this sounds more like Post-Traumatic Stress Disorder. This example makes PTSD sound less like a mental illness and more like a behavior to be unlearned. Perhaps it's true? How do events "trigger" a mental illness? Is it inherited or can it be acquired? What a debatable topic. Oy.

"The researchers said that even if this approach was not for everyone, it appeared to be especially beneficial for a particular group. In an analysis of individual patient’s responses, the researchers found that those who also had a personality disorder, like avoidant personality, showed significantly greater improvement than those whose symptoms were related solely to anxiety. Patients with multiple diagnoses are usually more difficult to treat. "

It's nice to think that these techniques could replace anti-anxiety meds. But alas, they won't; Big Pharma wouldn't allow it. But a girl can dream, can't she?

(The boss won't let me skip lunch and leave early so… here are your updates…)