Virtual Book Tour: Dr. Gary Small

Today we are delighted to welcome Gary Small, M.D., director of the UCLA Memory and Aging Center and professor of psychiatry at UCLA's David Geffen School of Medicine. He'll be answering our questions - and yours as well - about the book he recently wrote with his wife, Gigi Vorgan, "The Naked Lady Who Stood On Her Head: A Psychiatrist's Stories of His Most Bizarre Cases."

Nourishing Relationships: Several of the stories in your book deal with how the mind affects the body. One of them gets into your experiences with the “Fainting Schoolgirls.” What is mass hysteria? Is it a common phenomenon?

Gary Small: In the “Fainting Schoolgirls” incident, I was investigating an outbreak of illness in a suburban grade school. The kids were rehearsing a performance, when suddenly 30 of them grabbed their stomachs and fainted. The principal told me that it started with one popular child who fainted and suddenly the rest of them went down like dominoes. The health department couldn’t find a cause and gave the “all clear,” but the community was in an uproar. The school seemed to be blocking my efforts to get to the bottom of things, and the parents took offense that a psychiatrist was suggesting that their kids might have had a psychosomatic illness. I nearly gave up my study until I attended the actual show – a little worried that the outbreak might recur – when one of the mothers sought me out and supported my theory of mass hysteria – she was convinced that her daughter’s physical symptoms were in fact psychological. My subsequent research proved my theory that when stressed out, the mind can make the body sick, and in a group setting, it can really get out of control.

When we face uncertainty, our minds crave explanations. If we have no way to account for symptoms, we feel out of control and our fear escalates. And, if we learn that our own minds may have caused these very real symptoms, we tend to feel more anxiety about what our minds might do next. People may worry that their brains are possessed by some outside spirit, or perhaps a poltergeist has taken charge of their willpower. They’d rather latch onto something like the mysterious poisonous water theory. In all the mass hysteria episodes I’ve studied and written about over the years, the lingering question for me is why they don’t happen more often. The essential ingredients – groups under psychological and physical stress, often hungry, tired, or both – come together almost daily all around the world.

NR: Why are people afraid of psychiatrists?

GS: There is clearly a stigma about “seeing a shrink” and admitting one has a problem. Sometimes people are in denial about their mental struggles and avoid or even attack psychiatry in an attempt to avoid anyone discovering their secret psychological issues. Also, mental illness is often perceived as a weakness. Many people still believe that they should be able to solve their problems on their own. Yet, in any given year, an estimated one of four adults—nearly 60 million people in the U.S—suffer from a mental disorder and most of them don’t get help, which is why it is so important for people to try to get beyond their fears.

Psychiatrists are sometimes viewed as probing mental detectives who take control of their patients’ minds rather than heal them. In my book, I attempt to debunk such misconceptions and demystify the treatment of mental illness. Despite the public’s misconceptions, psychiatric treatments diminish and often eradicate symptoms of psychosis, depression, and anxiety. Systematic studies have shown that often combining medicine and psychotherapy results in significant improvement.

NR: Why do you need a therapist if you can talk to a good friend?

GS: A psychiatrist or therapist, unlike a friend, has no agenda of their own when listening. When a friend gives you advice, he may be thinking about how your actions will affect him, as well as you. When you’re in therapy, it’s all about you, not the therapist. Also, anything you tell a therapist is strictly confidential, and unless your friend has the training, you may not be getting the greatest advice. Having good friends is important to our mental health, but if you need it, don’t hesitate to call a professional.

NR: In your book, one of the cases involves a woman who develops a so-called “serial addiction.” What exactly is that and is it really possible?

GS: When we think of addition, alcohol or drugs usually comes to mind, but a person can get addicted to almost anything they enjoy: food, tobacco, sex, gambling, the Internet, or even video games. Some people have addictive personalities. When they “kick the habit” of one thing, they simply move on to something new and get addicted to that. In The Naked Lady Who Stood on Her Head, a woman who has an eating disorder overcomes it. Then, her shopping gets out of control, and she just can’t stop until she moves on to something else. This kind of serial addict usually exhibits the same behavior patterns regardless of the object of their current addiction: They crave the experience all the time, have withdrawal when they can’t get it, are secretive and defensive about the behavior, and the addiction interferes with everyday life. Anyone who’s struggled with addiction or dependency, should be aware of the possibility of becoming hooked on something new.

NR: Another case involves a patient who discovers that her husband has a second wife and family. You give that as an example of a sociopath. How do you define sociopath and how can we tell if someone has that personality disorder?

GS: Sociopaths are people who think only of themselves. They have no conscience or empathy. Whether it’s an Bernie Madoff, Adolf Hitler or Charles Manson, they wreak havoc on other people’s lives. But what about the everyday sociopath who sneaks into your life and befriends you? When you discover his true colors, you’re shocked, you feel violated, and you often blame yourself for being duped. How can you spot these predators before they gain your trust?

First impressions count. If someone does not seem genuine, your impression may be accurate. Also, watch out for people who seem too good to be true. Sociopaths often anticipate your needs in order to get what they really want. Finally, look for typical character traits: no sense of remorse, short-tempered and quick to blame others, and few or no long-term relationships. Remember, sociopaths can be smart and even when you’re on alert, they can slip into your life. Don’t blame yourself, just cut them out and move on.

Thanks so much, Gary! You've given us bites of a delicious idea feast. Now, readers, it's up to you if you want more - he's ready to answer your questions. Just click on 'comments' at the bottom of this post and follow the prompts. If you don't have an account you can sign in as 'anonymous' - it's as easy as that!

Menopause Brain?

Last week we looked at ways to activate your brain and keep it young. But recent studies at UCLA indicate that women's brains may not function as well during the early stage of the menopause transition - women do not learn as well shortly before menopause as they do earlier or later. So if you are one of the 60% of women who notice that you have memory problems during your menopausal transition, take heart - your memory will come back once you are postmenopausal.

Menopause may bring many additional changes, emotional as well as physical. The meaning of "the change" may be different for each of you. For some, the aging process may signify the loss of physical beauty, even if you've not been overly concerned with looks before. Arleen loves the challenge of teaching and shares a close relationship with her husband and children. She participates as a volunteer in community activities. Even with her satisfaction with these roles, menopause is a reminder that she is getting older. "I hate looking in the mirror so I avoid it. I see things more magnified now with menopause – I look wrinkled, grayer, fatter and with a turkey neck. I hate it – looking old. I am constantly complaining about it."

It can bring the end of childbearing to the forefront even if you enjoy numerous other meaningful roles in your life. Sometimes the finality of the impossibility of pregnancy brings reductions in the amount of energy you want to invest in childrearing. Diane, who combines her career as a hairdresser with that of an involved parent, feels herself taking a step back from a daughter just entering her twenties. "I like not having a period. But it feels like the end of my motherhood thing. I feel that I’ve done a good job – she’s a good person and will turn out ok. So I am feeling some freedom."

You may also enjoy the freedom that comes from not being able to become pregnant again. Sue was frightened when she started missing her menstrual period. She thought that she might be pregnant with her fifth child. When she learned that her symptoms were the beginning of menopause, she remembers the moment. "I was relieved that’s all it was! Now I am more relaxed with intimacy because I am not worried about getting pregnant. I feel freer now to let myself experience my sexuality."

Menopause can also mark the beginning of thoughts about the finite nature of life, especially for Sandwiched Boomers. This can lead to fears about death or more motivation to accomplish goals. Janet is now thinking about changes she anticipates making in her life in the near future rather than the distant future. "Menopause pushes me to think about the future now and what I can look forward to. The years have passed too quickly. I realize if I want to accomplish things in life, I need to start now."

Has menopause changed your outlook on life? Karen, who has raised four children, has been able to cope with the issues of menopause because, "All of my life experience gives me a certain stability, understanding and strength in dealing with my aging. I don’t want to be a twenty-year old. I feel comfortable being fifty."

The realization that you have the freedom to 'wear purple' and be who you are without any need to please others can be invigorating. Carol, a teacher, is learning to trust herself and be who she is. "Now I have more authenticity – walking my walk, talking my talk – not needing to be so admired or wonderful at any price. There is some loss in coming off the pedestal but I can be selfish and a pain in the ass if I want."

What does menopause mean to you? What emotions are you feeling at the loss of your physical fertility? What does it feel like to know that some parts of your life are now over? What will you leave behind? How do these losses give you the freedom to move in new directions? How are your roles changing? What new opportunities are now opening for you? How will you pursue these? This would be a good time to reflect on your losses and on the new possibilities open to you.

Think about how you want to redefine your role. Click on the post title to take you to our website, www.HerMentorCenter.com where you can read one of our Stepping Stones newsletters. Let us hear from you. And tune in tomorrow when we'll give you some suggestions for coping with menopause.

Brain Exercises for Sandwiched Boomers

Yesterday we highlighted a recent study that found conducting Internet searches enhances brain function. Today lets look at additional means of exercising your brain to keep it active and dynamic. Here are some tips to follow:

Exercise your brain with mental aerobics just as you do your body. The Seattle Longitudinal Study found that 66% of older Americans doing brain exercise activities had significant cognitive improvement. Learning new skills increases the number of neural connections in the brain and keeps them firing.

Explore new areas and interests. Have you wanted to learn to play the piano? Take Spanish or learn computer graphics? Check out your neighborhood center, school district or extension courses at a college or university near you. Traveling to new places? Surf the web for information about educational travel in America and throughout the world.

Play word or number games and do crossword or jigsaw puzzles to keep your mind sharp. Researchers believe that these kinds of mental challenges build new neural pathways that help buffer the brain against age-related losses. Injecting novelty into your everyday tasks can have a similar affect. AARP has compiled a list of suggested tasks - for example, you could use your non-dominant hand for brushing your teeth, rearrange the furniture in your rooms, or carry out activities blindfolded.

Dr. Gary Small of UCLA has developed a technique for improving memory - Look, Snap, Connect. First, actively observe what you want to learn; next, create mental snapshots of your memories; finally link your mental snapshots together. This technique can help you remember information ranging from the names of new people you meet to where you parked your car or left your keys.

Develop your creative talents. Scientists have found that, as you challenge yourself to look at things in a new way and try novel behaviors, you exercise important parts of your brain. Women in their middle years have taken up a wide range of creative activities such as painting, acting, writing poetry, photography, making jewelry.

And don't forget that physical activity helps keep your mental powers sharper too. Plan your schedule so that you can participate regularly. Choose an activity that you enjoy and find engaging -- walking with a friend, working out at the gym, biking with your partner. A daily brisk 20 to 30 minute walk will allow you to feel better emotionally and think more clearly.

Increase your physical activities to include aerobics, flexibility and strengthening exercises. Fast walking, jogging, dancing, biking or climbing stairs are all good. Studies indicate that aerobic exercise brings more blood and oxygen to your brain cells, encouraging the growth of new nerve cells and connections between them. Improve your mood, control your weight and protect yourself against cognitive loss all at the same time!

For some ideas about how to identify your strengths and talents, click on the post title above. You will be connected with our article, How to Inventory Your Assets, found on our website, www.HerMentorCenter.com.