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Research Roundup 3: Writing Away Worries, Sleep Deprivation for Depression, and More

5 surprising findings that can inform how we do therapy

I love this old tale!

Once an elephant was brought to a town at night. No one in that town had ever heard of, much less actually seen, an elephant. This beautiful beast was stabled in an enclosure shrouded in darkness, yet still a few curious townsfolk managed to creep in. They wanted to discover the nature of this fabled creature.

One felt the leg and proclaimed, “Elephants are like living pillars!” Another felt the trunk and argued, “No, an elephant is like a serpent.” The next man felt the body, and proposed, “An elephant must be some kind of land-dwelling whale.” The last man, who felt an ear, shouted, “No! An elephant is like a living fan!”

All had found a part and assumed it was the whole. No one connected all the parts, and no one waited for the illumination of the morning sun to reveal the animal in its majestic entirety.

So what has that got to do with psychology research?

Parts of the puzzle

The great author Idries Shah, who brought this tale to the West, pointed out that a tale like this can work on many different levels. Certainly, for me it’s easy to relate it to the world of psychological research. Take the following example.

Research has found that mulling or rumination is the biggest predictor of the most common mental health problems in the UK, including depression.[1] It’s an important part of the puzzle of depression, certainly, though the researchers don’t really offer an explanation as to why rumination is so toxic to mental health.

Other researchers have noted that depressed people dream more than non-depressed people, and that waking depressed people during REM sleep seems to quickly lift some of the symptoms of depression.[2] (Check out research piece four for more on the sleep/depression connection.)

But these two ‘parts of the elephant’ – that is, these two stages in the cycle of depression – haven’t been linked, at least not by the researchers in question.

Irish psychologist Joe Griffin, a former colleague of mine, was the first to put all these parts together, to ‘switch the light on’, if you like. While other researchers continued to fumble around blind, he illuminated the elephant in its entirety.

We now have access to thousands of pieces of research, but we also need to see aspects of the human condition in larger contexts. What does the research mean in the wider scheme of what it actually means to be human (if anything)?

To be fair, the primary role of researchers is to report findings. They can only go so far in surmising what their findings might actually mean, or how they might relate to everyday life. But that doesn’t mean we shouldn’t.

The whole beautiful beast

In this research roundup series I want to make a bit of sense out of the seemingly disparate findings of recent psychological studies and see if we can’t make an elephant out of them.

Here are five recent research studies that have caught my eye of late. Have a feel of a leg, or a trunk, and just maybe you’ll catch a glimpse of the whole beautiful beast.

1. Close relationships lead to longer life

Isolation, and particularly the feeling of loneliness, has been associated with early death.[3] But observing an association can only take us so far. Recently we’ve seen a call for researchers to try to uncover more of this particular elephant (okay, no more elephant mentions, I promise) and reveal a bit more of the bigger picture.

The American Psychological Association has released a special issue reviewing scientific findings to date and encouraging collaboration between psychological scientists to find “the mechanisms by which social relationships and close personal ties affect health” and “to make close relationships a public health priority”.[4]

This is great! It’s not new research per se; rather a clarion call for all the research on the benefits of close social ties to be collated and for professionals to use the findings to spread and enhance close or intimate relationships in society for a healthier and happier population.

My take?

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Close ties offer us a sense of safety and a sense of control, both of which are vital human needs. When we meet these needs, we experience less stress and lower our levels of the stress hormone cortisol, which is linked to mental distress and physical disease.[5]

At the risk of sounding unromantic, we human beings are herd animals. Throughout our evolution we have had to herd together to reap the benefits of ‘safety in numbers’. There was a time when to be cast out from the tribe literally meant death. While those days are over, our instincts can’t be cast aside so easily. And nor should they be.

The more social connections we have, the more help we have available if something goes wrong. A friend of a friend just might know someone who can fix your freezer. A dedicated best mate will be ready with a spare bed when the landlord cuts the lease unexpectedly. A trusting, loving partner will be a pillar of support when your health takes a turn for the worse – or anything else, for that matter.

In one study, it was found that simply having someone to confide in helped 38% of formerly suicidal people make their way back to complete mental health.[6] A confidant, someone we can rely on and feel safe with, is good – maybe even essential – for all of us.

Relationships matter, and I suspect much of it has to do with our primal emotional needs for meaning, safety, challenge, a sense of control, and perhaps more besides. Through our intimacies and social connections, we can meet these needs.

It’s when we don’t meet these needs that we experience heightened stress: a signal the need isn’t being met. And, not surprisingly, long-term stress doesn’t seem to correlate with greater longevity.

Heightened stress is a signal a primal emotional need isn’t being met

Talking of stress…

2. Expressive writing cools the worried mind

Here’s a recent piece that also caught my geekish eye. I guess I’m as prone to confirmation bias as anyone else, but I have long felt that writing is a great way of processing difficult feelings. So I felt a little vindicated when I read this!

Recent research at Michigan State University has found that chronic worriers achieved better efficiency in stressful tasks if they had written about their feelings beforehand.

According to lead author Hans Schroder, this research “provides the first neural evidence for the benefits of expressive writing”.[7] The researchers muse that perhaps these benefits relate to the fact that worrying “takes up cognitive resources” so that there is less room in the mind for other tasks. Writing provides an outlet for these feelings, so that they become less distracting.

My take?

Clinicians don’t talk much about ‘imagination disorders’. In fact, I’m not even sure it’s a recognized term. We talk about ‘thought disorders’, yes, but often it’s not our thoughts we should be worrying about. It’s the way we use (or, more accurately, misuse) our imaginations that causes emotional problems.

By using the imagination as a tool, as with creative writing, we take control of our imagination rather than being the victim of it. And that will naturally make us feel better. Rather than letting our imagination run riot (the hallmark of worrying!), we channel it into a productive endeavour.

And if that’s not enough, the process of writing involves the left prefrontal lobe of the brain – the very part that is subdued during depression and anxiety.

Talking of worrying, the next piece really is!

3. Antidepressants may increase mortality

If this is true, it’s horrifying. And it’s especially upsetting when we consider how many antidepressants are prescribed and consumed annually.

Science Daily reports on a study published in the journal Psychotherapy and Psychosomatics which “reviewed studies involving hundreds of thousands of people and found that antidepressant users had a 33% higher chance of death than non-users” as well as “a 14% higher risk of cardiovascular events, such as strokes and heart attacks.”[8]

The researchers note that all the major organs of the body, including the heart, lungs, liver and kidneys, use serotonin from the bloodstream. Since selective serotonin reuptake inhibitors (SSRIs) interfere with this process, it’s reasonable to expect that they may interfere with the normal function of these organs.

It may be that the greater death toll in those consuming these products relates to an increased risk of multiple organ failure.

My take?

Many practitioners continue to believe the serotonin theory of depression. As it stands, there’s no way to directly measure levels of serotonin in the human brain. So it’s difficult to disprove the theory.

The jury is well and truly out on the extent to which serotonin levels actually contribute to the development and maintenance of depression. If you follow my blog, you’ll know I’m cynical. And plenty of studies are on my side.

A recent study showed that mice who were bred to have very low levels of serotonin had no signs of depression.[9] And people taking the antidepressant drug Stablon (tianeptine), which decreases serotonin levels at synapses, don’t become more depressed. In fact, they do just as well (or not) as those taking antidepressants that increase available serotonin.

So much of depression comes down to scary and hopeless expectations, so it came as no surprise to me when a meta-analysis of the efficacy of Prozac found that 80% of its effects could be put down to the expectations of those consuming it. In other words, a placebo effect.[10]

Whether SSRIs actually help – which, for about a third of those who take it, they do – may be much more to do with their impact on hope than any chemical effect. And this might be okay if it weren’t for the side effects and, alarmingly, the apparent increased mortality among those who take them.

It’s not our role as practitioners to tell our clients to take or not to take antidepressants, and we should definitely encourage them never to just stop taking them suddenly. But we can give them some facts they can think about.

There seem to be more natural ways we can decrease depressive symptoms – although I can’t in good faith recommend this next method.

4. Sleep deprivation helps nearly half of depressed patients

The latest glimpse of a small part of the elephant (I know I promised; I just can’t help myself), a meta-analysis published in the Journal of Clinical Psychiatry, shows that depriving depressed people of sleep can quickly lift symptoms of depression.

Science Daily reports the findings that sleep deprivation “rapidly reduces symptoms of depression in roughly half of depression patients” and that “partial sleep deprivation (sleep for three to four hours followed by forced wakefulness for 20-21 hours) was equally as effective as total sleep deprivation (being deprived of sleep for 36 hours)”.[11]

But the researchers say they don’t really know why this might be! Author Philip Gehrman, PhD, Associate Professor of Psychiatry and member of the Penn Sleep Center, said, “More than 30 years since the discovery of the antidepressant effects of sleep deprivation, we still do not have an effective grasp on precisely how effective the treatment is and how to achieve the best clinical results.”

My take?

Really? I would have hoped they would have at least had some sort of interpretation to offer. It’s been known for 60 years that depressed people dream more than non-depressed people and that time spent in REM sleep decreases as people lift from depression. The ‘cycle of depression‘ isn’t a new idea and accords with all available research.

A bit of joined-up thinking might be in order.

Finally, have you noticed what you didn’t know you’d noticed?

5. Your brain registers familiar faces, even if you don’t

Science Daily summarizes this recent research thus:

When people see an image of a person they recognize … particular cells light up in the brain. Now, researchers have found that those cells light up even when a person sees a familiar face or object but fails to notice it. The only difference is that the neural activity is weaker and delayed in comparison to what happens when an observer consciously registers and can recall having seen a particular image.[12]

This intriguing finding seems to suggest that consciousness isn’t an all-or-nothing phenomenon but rather a gradation of experience.

My take?

This points to the existence of an unconscious mind that can perceive and know things before you know them consciously – or even without you ever knowing them consciously.

This makes sense, as every second, we take in around eleven million pieces of information. How do we know this? Because scientists have actually counted the receptors on each of the five sense organs and their associated nerves. (Yep, years at university just for that!)

Yet we are only capable of consciously processing about forty bits of information a second. Large parts of our ‘experience’, then, are unavoidably unconscious.

We can know but not know that we know! Thanks, Donald Rumsfeld![13]

Hypnotic treatment is a way of harnessing our powerhouse of non-conscious potentialities. Instinct – feeling something without knowing why – may have to do with the kind of perception that occurs outside of conscious awareness. This connection with unconscious perception and knowledge is something that some people may be able to become much more attuned to.

I hope you have enjoyed my wonky take on recent research pieces and that it has helped a little in illuminating at least parts of the elephant in the room.

And if you’re ready to watch psychological principles in action, join hundreds of therapists, counsellors, and coaches inside Uncommon Practitioners TV. Read more here.

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Mark Tyrrell

About Mark Tyrrell

Psychology is my passion. I've been a psychotherapist trainer since 1998, specializing in brief, solution focused approaches. I now teach practitioners all over the world via our online courses.

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