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Caregiver study focuses on the challenges of caring for a partner

Caregivers need to consider their own health as important as their spouse

Study participants had levels of depression symptoms serious enough to suggest a need for treatment

When they said their wedding vows, many of them promised to stand by one another in sickness and in health. But a new study suggests that as married couples age and develop chronic conditions, the daily demands of coping with their own health demands and those of their spouse may take a mental toll.

Depression symptoms increased over time among married men and women who themselves had two or more chronic conditions that need different types of self-care -- such as a special diet and medications for heart disease or diabetes along with pain-reducing therapy for arthritis. When husbands and wives both had chronic health conditions, and needed different kinds of self-care from their partners, husbands fared worse. Their depression symptoms were significantly higher, but this effect was not found for wives.

The new findings, made by a team from the University of Michigan using data from a long-term study of more than 1,110 older opposite-sex married couples from 2006 to 2014, are published in Journals of Gerontology Series B: Psychological Sciences and Social Sciences. While less than 10% of the women and less than 7% of the men in the study had levels of depression symptoms serious enough to suggest a need for treatment, lower-level depression is important for older people, clinicians, caregivers and adult children to understand, says Courtney Polenick, Ph.D., who led the study.

In both husbands and wives, the rise of depressive symptoms didn't begin until a few years after the first assessment of their health and well-being. "Our results suggest that there's a window where, if one or both of you are managing complex conditions that don't have similar self-management goals, it may be possible to intervene and prevent the development or worsening of depression," says Polenick, who is part of the U-M Department of Psychiatry and Institute for Social Research. "This might be the time for couples, and those who care for them, to emphasize broadly beneficial lifestyle behaviors that help to maintain both mental and physical health."

For instance, a woman coping with both high blood pressure and arthritis needs to make changes to her exercise routine, but her husband without such conditions could commit to making those changes along with her. Or a wife with diabetes who does most of the cooking and has a husband with prostate cancer could adopt a healthier menu for both of them. Polenick and her colleagues from U-M's Institute for Healthcare Policy and Innovation looked at data from the Health and Retirement Study, which repeatedly interviews and surveys thousands of American adults in their 50s and beyond over time.
They focused on conditions that have similar treatment goals focused on reducing cardiovascular risk -- diabetes, heart disease, hypertension and stoke -- and those with treatment goals and needs that are different from each of the other conditions- cancer, arthritis and lung disease.

When one person in the couple had at least one condition with different treatment goals and needs, they're considered to have "discordant" conditions. When one member of a couple had at least one condition that has different treatment goals and needs from the other partner, the couple is considered to have discordant conditions. "Research has focused on how individuals with multiple conditions, also called multimorbidity, manage their chronic health needs," says Polenick. "But most people in later life are partnered, with similar health-related habits, and we need to understand how changing health affects the couple dynamic." The fact that both wives and husbands experienced significant increases in depressive symptoms as the years passed, when they were coping with discordant conditions in themselves, is by itself important to understand, Polenick notes. But the fact that wives whose husbands' health needs differed from their own didn't experience an even greater rise in depression is a bit surprising, she adds.

Meanwhile, husbands whose conditions had self-care needs that were different from their wives' conditions did experience an additional rise in depression symptoms. Among individuals who are baby boomers or older, wives may be more used to taking the lead in caring for the health and emotional well-being of both themselves and their husbands, she says. But when husbands have wives who are coping with different health demands than their own, the husbands may experience less of this support than usual, worsening their stress and mental health.

Polenick and her colleagues continue to explore these intra-couple dynamics, and their consequences for mental and physical health. They also hope to expand the range of chronic health conditions they examine, and to look at shorter time frames in conditions that can be managed with lifestyle changes. But in the meantime, she notes that middle-aged and older couples may want to do more now to understand the factors that they can control as they age, and those they cannot, and talk about how they feel as a result.

"This is a reminder to step back and look at what your partner is coping with, to learn about their health conditions, to be conscious of it on a daily basis, and for grown children and clinicians to do the same," she says. "Having that awareness, and helping one another manage health problems while watching for signs of depression, may help both members of a couple over time."


Story Source: Content provided by Science Daily and Michigan Medicine - University of Michigan. "In sickness and in health: Study looks at how married couples face chronic conditions." ScienceDaily. ScienceDaily, 3 December 2019. www.sciencedaily.com/releases/2019/12/191203104756.htm.


Dr. Jenny Holland
Dr. Holland

Caregivers often report feelings of exhaustion and overwhelm. While caring for a loved one can be very rewarding, it also comes with distinct elements of stress. When dealing with a long-term challenge it's extremely important to also provide for your own emotional and physical well-being. When the challenges associated with care giving are not taken into consideration the caregiver's physical health, relationships and mental health can deteriorate over time — eventually leading to burnout and exhaustion. And when it reaches that point, both the caregiver and the person being cared for suffer. Caring for yourself is equally if not more important as making sure your family member gets to their doctor’s appointment or takes their medication on time.

Focused Therapy for Caregivers

If you are having trouble with accepting or adjusting to life's challenges, Dr. Holland can help you find healthy ways of coping. The simple act of expressing what you’re going through can be very cathartic. Dr. Holland will tailor treatment to meet your specific needs. Contact Dr. Holland to learn more and to schedule an appointment or call 707-479-2946.

Report finds burnout prevalent in health care community

Addressing clinician burnout will require a deliberate and substantive health care system redesign

Clinician burnout is affecting between one-third and one-half of all of U.S. nurses and physicians, and 45 to 60% of medical students and residents, according to a National Academy of Medicine (NAM) report.
Vanderbilt University Medical Center is among 32 institutions and foundations that sponsored the 296-page report, "Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being," which investigates the causes of widespread clinician burnout and offers solutions to address the problem at its source.

"There's an all too direct connection between clinician burnout and health care safety and quality. While clinician burnout isn't a new problem, its worsening prevalence and impact are due to system factors inherent in the modern health care system," said Matthew Weinger, MD, professor of Anesthesiology and Norman Ty Smith Chair in Patient Safety and Medical Simulation at VUMC, and a member of the NAM authoring committee for the new report.

"The Committee came to realize that addressing clinician burnout will require a deliberate and substantive health care system redesign with a focus on those activities that deliver the most value to patients while enabling and empowering clinicians to deliver high-quality care," he said.

The report discusses key issues that need to be addressed:

  • Clinician burnout needs to be tackled early in professional development and special stressors in the learning environment need to be recognized. Leaders in health care and health professions education have a responsibility to foster, monitor and continuously improve work and learning environments.
  • While some health care technologies appear to contribute to clinician burnout (poorly designed electronic health record systems, for example), there is real potential for well-designed and implemented technologies to help reduce burnout.
  • Federal and state governments, other payors and regulators and the health care industry itself have important roles to play in preventing clinician burnout. Increasing administrative burdens and distracting clinicians from the care of their patients can directly affect burnout.
  • Medical societies, state licensing boards, specialty certification boards, medical education and health care organizations all need to take concrete steps to reduce the stigma for clinicians seeking help for psychological distress and make assistance more easily available.

The report concludes with goals and recommendations centered on creating more positive work and learning environments, reducing administrative burden, enabling technology solutions, providing more support to clinicians and learners, and investing in research to address clinician burnout.


Story Source: Materials provided by Science Daily ---> Note: Content may be edited for style and length. Vanderbilt University Medical Center. "Consensus report shows burnout prevalent in health care community." ScienceDaily. ScienceDaily, 23 October 2019. www.sciencedaily.com/releases/2019/10/191023172121.htm.


Dr. Jenny Holland"On the job burnout reduces productivity and saps energy, causing feelings of being helpless, hopeless, cynical and resentful. The negative effects of burnout will eventually spill over into every area of life—including home, work and social life. Burnout can also cause long-term physical changes and increased vulnerability to illnesses like colds and flu. Because of its many consequences, it’s important to work through feelings of burnout with a counselor."

Dr. Holland works with professionals suffering from burnout by connecting the dots between symptoms and the root of the problem. She will help you to creatively work with your situation to help you discover new meaning in your work and offer ways you can stay healthy. Dr. Holland will help you learn how to help yourself so you can continue to do the work you love of helping others.

Contact Dr. Holland to get help with these problems today.

Grief Support Group Available

Support group meeting

After the loss of a loved one, a wide variety of feelings and emotions naturally emerge. While family and friends are important during the grieving process, unless they have experienced a close personal loss, they most likely don’t fully “get it.” This is where a support group can become a valuable resource. Grief support groups offer companionship and understanding from others who have experienced a similar loss and are experiencing similar challenges that living with grief brings.

Dr. Jenny Holland, PsyD announces a new weekly support group for those who are grieving the death of a loved one. This group is open to anyone who has lost someone they love. Together we will explore, validate and support feelings and experiences that often accompany loss. Dr. Holland will guide the group through techniques that help to ease emotional pain.

Each group member will have time to share memories while discovering new ways to honor their loved one and themselves through the process. This group is limited to a small number of participants, to facilitate intimate conversation and safe sharing.

The Grief Support Group starts November 8, 2019 and will be held every other Friday from 10:30 a.m. to 12:00 p.m. at Dr. Holland’s office located at 621 Cherry St., Santa Rosa, California. To reserve your seat call Dr Holland at 707-479-2946. Participants will be pre-screened to qualify, and a sliding scale fee is offered.

Poor sleep and job stress even more toxic than predicted

Employers should provide stress management and sleep treatment in the workplace

Stressed at work and trouble sleeping? It's more serious than you think

Work stress and impaired sleep are linked to a threefold higher risk of cardiovascular death in employees with hypertension. Study author Professor Karl-Heinz Ladwig said: "Sleep should be a time for recreation, unwinding, and restoring energy levels. If you have stress at work, sleep helps you recover. Unfortunately poor sleep and job stress often go hand in hand, and when combined with hypertension the effect is even more toxic."

One-third of the working population has hypertension (high blood pressure). Previous research has shown that psychosocial factors have a stronger detrimental effect on individuals with per-existing cardiovascular risks than on healthy people. This was the first study to examine the combined effects of work stress and impaired sleep on death from cardiovascular disease in hypertensive workers. The study included 1,959 hypertensive workers aged 25-65, without cardiovascular disease or diabetes. Compared to those with no work stress and good sleep, people with both risk factors had a three times greater likelihood of death from cardiovascular disease. People with work stress alone had a 1.6-fold higher risk while those with only poor sleep had a 1.8-times higher risk.

In the study, work stress was defined as jobs with high demand and low control -- for example when an employer wants results but denies authority to make decisions. "If you have high demands but also high control, in other words you can make decisions, this may even be positive for health," said Professor Ladwig. "But being entrapped in a pressured situation that you have no power to change is harmful." Impaired sleep was defined as difficulties falling asleep and/or maintaining sleep. "Maintaining sleep is the most common problem in people with stressful jobs," said Professor Ladwig. "They wake up at 4 o'clock in the morning to go to the toilet and come back to bed ruminating about how to deal with work issues."

"These are insidious problems," noted Professor Ladwig. "The risk is not having one tough day and no sleep. It is suffering from a stressful job and poor sleep over many years, which fade energy resources and may lead to an early grave." The findings are a red flag for doctors to ask patients with high blood pressure about sleep and job strain, said Professor Ladwig. "Each condition is a risk factor on its own and there is cross-talk among them, meaning each one increases risk of the other. Physical activity, eating healthily and relaxation strategies are important, as well as blood pressure lowering medication if appropriate."

Employers should provide stress management and sleep treatment in the workplace, he added, especially for staff with chronic conditions like hypertension.

Components of group stress management sessions:

  • Start with 5 to 10 minutes of relaxation.
  • Education about healthy lifestyle.
  • Help with smoking cessation, physical exercise, weight loss.
  • Techniques to cope with stress and anxiety at home and work.
  • How to monitor progress with stress management.
  • Improving social relationships and social support.

Sleep treatment can include:

    • Stimulus control therapy: training to associate the bed/bedroom with sleep and set a consistent sleep-wake schedule.
    • Relaxation training: progressive muscle relaxation, and reducing intrusive thoughts at bedtime that interfere with sleep.
    • Sleep restriction therapy: curtailing the period in bed to the time spent asleep, thereby inducing mild sleep deprivation, then lengthening sleep time.
    • Paradoxical intention therapy: remaining passively awake and avoiding any effort (i.e. intention) to fall asleep, thereby eliminating anxiety.

Story Source: Materials provided by Science Daily. Note: Content may be edited for style and length. European Society of Cardiology. "Stressed at work and trouble sleeping? It's more serious than you think." ScienceDaily. ScienceDaily. www.sciencedaily.com/releases/2019/04/190428143520.htm.


Every job situation will come with varying degrees of stress and frustration that ebb and flow. Burnout, however, is more than that. It is an all-encompassing feeling that you are being pulled in every direction at once and that no matter what you do, you are unable to make progress or move forward. If chronic burnout is left untreated, it can lead to issues with physical and mental health.

Dr. Holland understands that successful people are not immune to symptoms like depression, anxiety, and addiction. Yet, many successful people are often hesitant to seek treatment because of their high-profile statuses and stressful career responsibilities. For this reason, Dr. Holland takes great pride in offering a private environment that caters to the needs of these individuals, providing them with a therapeutic atmosphere that offers a sanctuary where they can step away from the stresses of their everyday lives.

A good first step for healthcare providers and other professionals suffering from burnout and exhaustion is to acknowledge those feeling and to talk about it with a trusted counselor. Dr. Holland works with professionals suffering from burnout by connecting the dots between symptoms and the root of the problem. She will help you to creatively work with your situation to discover new meaning in your work and discover ways to stay healthy. Dr. Holland will help you learn how to help yourself so you can continue to do the work you love of helping others.

Contact Dr. Holland to get help with these problems today.

Physical activity found to be protective for people at risk for depression

Physical activity can influence depression in a positive way

Scroll Down for Dr. Holland's Perspective on this article

Increased levels of physical activity can significantly reduce the odds of depression, even among people who are genetically predisposed to the condition, according to a new study from researchers at Massachusetts General Hospital (MGH). In a paper published in the journal Depression and Anxiety, the team reported that individuals who engaged in at least several hours of exercise each week were less likely to be diagnosed with a new episode of depression, even in the face of high genetic risk for the disorder.

Drawing on genomic and electronic health record data from nearly 8,000 participants in the Partners Healthcare Biobank, the new study is the first to show how physical activity can influence depression despite genetic risk. Researchers followed patients who filled out a survey about their lifestyle habits (including physical activity) when they enrolled in the Biobank. They then mined millions of electronic health record data points over the next two years and identified people who received diagnoses related to depression. They also calculated genetic risk scores for each participant, combining information across the entire genome into a single score that reflects a person's inherited risk for depression.

What they found was that people with higher genetic risk were more likely to be diagnosed with depression over the next two years. Significantly, though, people who were more physically active at baseline were less likely to develop depression, even after accounting for genetic risk. In addition, higher levels of physical activity were protective for people even with the highest genetic risk scores for depression.

"Our findings strongly suggest that, when it comes to depression, genes are not destiny and that being physically active has the potential to neutralize the added risk of future episodes in individuals who are genetically vulnerable," says Karmel Choi, PhD, of MGH and the Harvard T.H. Chan School of Public Health, and lead author of the study. "On average, about 35 additional minutes of physical activity each day may help people to reduce their risk and protect against future depression episodes."

The researchers found that both high-intensity forms of activity, such as aerobic exercise, dance and exercise machines, and lower-intensity forms, including yoga and stretching, were linked to decreased odds of depression. Overall, individuals could see a 17 percent reduction in odds of a new episode of depression for each added four-hour block of activity per week.

Depression represents the leading cause of disability worldwide. Despite its massive health burden, strategies to combat depression remain limited and the public's understanding of robust and modifiable protective factors is incomplete. "We provide promising evidence that primary care and mental health providers can use to counsel and make recommendations to patients that here is something meaningful they can do to lower their risk even if they have a family history of depression," says Choi.

Senior author Jordan Smoller MD, added, "In general our field has been lacking actionable ways of preventing depression and other mental health conditions. I think this research shows the value of real-world healthcare data and genomics to provide answers that can help us to reduce the burden of these diseases."

Beyond physical activity, the MGH team continues to leverage the Partners Biobank and other large-scale studies to explore modifiable ways that individuals might reduce their risk of depression. "We believe there may be many factors could be part of an overall strategy for improving resilience and preventing depression," emphasizes Choi. "The magnitude of depression around the world underscores the need for effective strategies that can impact as many people as possible."

Materials provided by Massachusetts General Hospital. Note: Read this article on Science Daily ---> Massachusetts General Hospital. "Physical activity may protect against new episodes of depression." ScienceDaily. ScienceDaily, 5 November 2019. www.sciencedaily.com/releases/2019/11/191105113510.htm.


Dr. Holland's Perspective

"Studies have repeatedly shown that the most effective treatment for depression is cognitive behavioral therapy. This type of therapy addresses problematic thought patterns by effectively disengaging attention from the repetitive negative thoughts that often set in motion the downward spiral of mood. Certainly, physical activity combined with cognitive therapy is a positive way to approach depression. In addition to the positive effects of exercise mentioned in this study, evidence also shows that regular mindfulness meditation, on its own or combined with cognitive therapy, can also help stop depression before it starts."

Therapy for Depression

  • Do you find yourself feeling sad, empty tired, guilty or hopeless. Are you to the point where nothing makes you happy?
  • Have you become more isolated or lonely than usual, and feel like you can’t reach out to people?
  • Does life seem like more trouble than it’s worth?

Everyone experiences the blues sometimes. But clinical depression is more than just feeling down, unhappy or a sad feeling. Major depression is not a simple emotion. It is a medical disorder that affects more than 10 percent of adults annually. Women are twice as likely to get depression as men. The earlier treatment can begin, the more effective it is and the greater the likelihood that recurrence can be prevented.

With depression, you may feel sad and hopeless and you may not understand why you feel this way. Unlike sadness or the blues, depression is actually a biochemical disorder that can affect just about every area of a person's life. Some people with depression may even have had self-destructive or suicidal thoughts. If this is your experience, it is crucial that you seek help.

Contact Dr. Holland for more information and to get help with depression.

Unresolved childhood trauma linked to poorer health for women

Researchers have long known that childhood trauma is linked to poorer health for women at midlife.

Researchers identify one specific way childhood trauma can affect women

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The national study of more than 3,000 women is the first to find that those who experienced childhood trauma were more likely than others to have their first child both earlier in life and outside of marriage -- and that those factors were associated with poorer health later in life. The findings have implications for public programs to prevent teen pregnancy, said Kristi Williams, lead author of the study and professor of sociology at The Ohio State University. These results suggest that early trauma -- such as the death of a parent, physical abuse or emotional neglect -- may affect young people's decision-making in ways that they can't entirely control.

"It's easy to tell teens that they shouldn't have kids before marriage, but the message won't be effective if they haven't developed the capacity to do that because of trauma they experienced in childhood," Williams said. "It may be necessary to do different kinds of interventions and do them when children are younger." Williams conducted the study with Brian Karl Finch of the University of Southern California. Their results were published today (Sept. 17, 2019) in the Journal of Health and Social Behavior.

Early childhood trauma is "shockingly" common in the United States, the researchers said in the study. One national study conducted between 1995 and 1997 found that only 36 percent of respondents reported having no such adverse childhood experiences. Other research has shown that childhood trauma is strongly associated with multiple health risks, including cancer, diabetes, stroke and early death, Williams said. Much of this work has focused on how early adversity may have biological and neurological effects that would lead to worse health throughout life. "But there hasn't been any attention given to how childhood adversity may affect social and developmental processes in adolescence and young adulthood -- factors that we know are also strong predictors of later health," she said. One of those factors in women is the timing and context of first birth.

Data for this new study came from the 1979 National Longitudinal Survey of Youth, which includes a representative sample of people who were aged 14 to 22 in 1979. The NLSY is run by Ohio State's Center for Human Resource Research. Participants were interviewed every year through 1994 and once every two years since. The final sample for this study included 3,278 women. Each participant reported whether she experienced one or more of six adverse childhood experiences before age 18: emotional neglect, physical abuse, alcoholism in the home, mental illness in the home, death of a biological parent and parental absence. The researchers examined data on how old each participant was when she first gave birth and whether she was married, cohabiting or neither at the time. Finally, participants rated their health at or near age 40.

Findings showed that each additional childhood trauma experienced by the participants was associated with earlier age at first birth and a greater probability for a first birth during adolescence or young adulthood compared to later (age 25 to 39). In addition, each additional trauma was associated with a 24 percent increase in the probability of being unmarried and not cohabiting at first birth compared to the likelihood that they were married when their first child was born. The researchers then conducted statistical tests that showed early and non-marital births were a key reason why children who experienced trauma were more likely to report poorer health at midlife.

"It is the idea of 'chains of risk' -- one thing leads to another," Williams said. "Childhood trauma leads to social and biological risks that lead to early and nonmarital birth which can lead to health problems later in life." The findings also cast doubt on the notion that childbearing decisions are the result only of the culture in which children grow up, she said. Some policymakers have claimed that some people don't value marriage enough, and if they were just encouraged not to have kids until after they're married, they would be better off, Williams said. "You can promote this 'success sequence' -- go to college, get a job, get married and have a child -- exactly in that order. But the reason some people don't do that isn't just cultural, it is structural," Williams said. "When people experience traumas early in life, it makes it less likely that they will be able to make those positive choices."


Dr. Holland's Perspective

"If we experience an extremely stressful or disturbing event, it can us feeling helpless and emotionally out of control. Psychological trauma can cause a person to struggle with upsetting emotions, recurring memories and every day anxiety. Unresolved childhood trauma can also cause feelings of being numb, disconnected and unable to trust other people. Whether the trauma happened in your childhood or just yesterday, it is important to understand that you can make healing changes and move on with your life in positive ways."

Experiencing trauma in childhood can result in a severe and long-lasting effect. When childhood trauma is not resolved, a sense of fear and helplessness carries over into adulthood, setting the stage for more trauma. There are steps you can take to overcome the pain, learn to trust and connect to others again, and regain your sense of emotional balance. To learn more or to schedule an appointment with Dr. Holland call 707-479-2946.

New study reveals art therapy benefits for stressed caregivers of cancer patients

A recent study showed coloring and open-studio art therapy benefits stressed caregivers of cancer patients.

A cancer diagnosis is incredibly stressful for the person receiving the diagnosis. But those caring for the patient, both informally and formally, also experience stress, which can affect their own health and the patient's outcome. A study, led by researchers from Drexel University's Creative Art Therapies department in the College of Nursing and Health Professions, as well as researchers in the Perelman School of Medicine at the University of Pennsylvania, showed coloring and open-studio art therapy benefits stressed caregivers of cancer patients.

"Families of cancer patients experience emotional trauma around the diagnosis, stress of treatment, financial concern, among others," said lead author of the study, Girija Kaimal, EdD, an assistant professor in the College of Nursing and Health Professions. "While addressing their needs understandably comes second to the patient's needs, the stressors families experience often go unaddressed." Kaimal also added oncology professionals, such as nurses, therapists and physicians, experience their own set of negative effects, like compassion fatigue and not taking time for self-care. This can lead to avoidance of empathetic care, mistakes in patient care, high turnover, health problems and burnout.

As important as their own health is, addressing the caregivers' and oncology professionals' psychosocial needs also helps to improve the patient's treatment compliance and outcomes. The mixed-methods study, supported through a cooperative agreement with the National Endowment for the Arts Research Labs program, was conducted in Penn's department of Radiation Oncology. Researchers compared two arts-based approaches for caregivers -- single sessions of coloring and open-studio art therapy. A total of 34 caregivers (25 healthcare professionals and nine family caregivers) were randomly assigned to 45 minutes of an independent, open-studio art therapy or an active-control coloring session, with all sessions run by trained art therapists.

A variety of art materials were available to participants in the open-studio session. The art therapist facilitated the session, offering guidance and interacting with the participant. With five minutes left in the session, the art therapist would process the artwork created by the participant, giving them an opportunity to discuss their work and reflect on the process. In the coloring session, participants chose a coloring sheet and were provided with markers and coloring pencils. The art therapist did not interact with the participant while they colored.

Before and after each session, participants were given surveys to self-report their positive and negative feelings, such as stress and anxiety. After both the art therapy and coloring sessions, participants expressed increases in positive affect, pleasure and enjoyment and decreases in negative affect, anxiety, perceived stress, and burnout. Many expressed a desire to continue to make art in the future, as taking time out of their busy schedules to engage in art helped them to focus on something other than their caregiving.

These findings suggest that even brief art-making interventions can be beneficial for stressed caregivers of cancer patients. The study's senior author, William Levin, MD, an associate professor of Radiation Oncology at Penn, also points out that creative activities like art-making are mindful practices, allowing patients and caregivers to stay in the moment, which by definition can free them from the stress that cancer brings. "These results show the importance of treating the mind as well as the body of cancer patients, and it is further evidence that we're on the right track as we continue our push toward a more holistic approach to cancer therapies," Levin said.

Penn recently opened a dedicated multi-purpose room to expand its ability to offer these kinds of interventions to patients, something the study's authors point out is now further supported by science. "We recommend that oncology units have similar, dedicated studio spaces with therapeutic support and different forms of art-making available to meet individual caregiver needs," said Kaimal.


Story Source: Materials provided by Drexel University. Note: Content may be edited for style and length. Chicago Drexel University. "The art of cancer caregiving: How art therapies benefits those caring for cancer patients." ScienceDaily. ScienceDaily, 21 October 2019. www.sciencedaily.com/releases/2019/10/191021094020.htm.


Providing Compassion with Life Transitions Therapy

Life Transitions Therapy is helpful for adults with serious, life-limiting medical illness, life-threatening illness as well as caregivers and those who are bereaved. Change is hard, even in the best of circumstances. Adjusting to major life transitions can be difficult. Coping and navigating the stress of a major change can cause depression and anxiety, evoke fear and confusion.

If you are having trouble with accepting or adjusting to life's challenges, Dr. Holland can help you find healthy ways of coping.

Art Therapy with Dr. Holland -- Art therapy involves the use of creative techniques such as drawing, painting, collage, coloring, or sculpting to help people express themselves artistically and examine the psychological and emotional undertones in their art. As a credentialed art therapist Dr. Holland assists clients to understand the nonverbal messages, symbols, and metaphors often found in the unique art forms they create, which often leads to a better understanding of feelings and behavior so they can move on to resolve deeper issues.

Contact Dr. Holland to learn more and to schedule an appointment or call 707-479-2946.

New study says narcissism diminishes as a person matures

Level of narcissistic trait development depends on early career and relationship choices

The belief that one is smarter, better looking, more successful and more deserving than others -- a personality trait known as narcissism -- tends to wane as a person matures, a new study confirms. But not for everyone, and not to the same extent.

The study, reported in the Journal of Personality and Social Psychology, finds that the magnitude of the decline in narcissism between young adulthood and middle age is related to the specific career and personal relationship choices a person makes.

The research tracked participants across two time points. The first occurred when they were 18 and just starting out as freshmen at the University of California, Berkeley. The second was 23 years later, when participants were 41 years old. Of the original 486 participants, 237 completed a new round of evaluations.

Participants at both time points answered questions from a survey designed to assess their narcissistic traits. For the follow-up study, researchers also asked about relationship and employment history, job satisfaction, and health and well-being.

"We looked at the different facets of narcissism in adults at age 18 and again at 41," said Eunike Wetzel, a professor of psychology at Otto-von-Guericke University in Magdeburg, Germany, who led the research with University of Illinois psychology professor Brent Roberts; Emily Grijalva, an organizational behavior professor at Washington University in St. Louis; and Richard Robins, a psychology professor at the University of California, Davis. "We focused on participants' vanity, the belief in their own leadership qualities and their tendency to feel entitled."

Each facet of narcissism was associated with several negative -- and in a few cases, positive -- outcomes for the individual, the researchers found. Those who had higher levels of vanity at age 18 were prone to unstable relationships and marriages, and were more likely to be divorced by middle age. But they also reported better health at age 41. In contrast, those who felt the most entitled as young adults reported more negative life events and tended to have lower well-being and life satisfaction at middle age.

"We originally hypothesized that the leadership facet of narcissism would increase," Roberts said. "In fairness to my co-authors, that hypothesis was mine, and it turns out I was wrong."

Leadership is associated with goal persistence, extraversion, self-esteem and a desire to lead. It is considered one of the least pathological elements of narcissism, Roberts said.

"We know from past research that another component of personality, assertiveness, tends to increase during this time of life," he said. "So, I thought it was reasonable to hypothesize a similar increase in the leadership facet. This either means the past research is wrong, or our read of the leadership component of narcissism is wrong -- it may actually be more negative than we thought. We have to figure this out in future research."

Vanity appeared to be most strongly linked to life events, the researchers found. For example, vanity declined more in those who entered into serious romantic relationships and those with children. But vanity declined significantly less in middle-aged adults who had experienced more negative life events than their peers.

"We also found that narcissistic young adults were more likely to end up in supervisory jobs 23 years later, suggesting that selfish, arrogant individuals are rewarded with more powerful organizational roles," Grijalva said. "Further, individuals who supervised others decreased less in narcissism from young adulthood to middle age -- meaning that supervisory roles helped maintain prior levels of narcissism."

Despite the differences between individuals, most of the participants who responded to researchers' questions again at age 41 saw a decline in narcissism as they matured, the researchers found.

"Very few people, only 3% of participants, actually increased in overall narcissism between the ages of 18 and 41," Wetzel said. "And some remained just as narcissistic at age 41 as they had been when they were 18 years old."

"The findings should bring comfort to those who are concerned that young people are problematically narcissistic," Roberts said. "With time, it seems most people turn away from their earlier narcissistic tendencies."


Read this article on Science Daily: Materials provided by University of Illinois at Urbana-Champaign, News Bureau. Note: Content may be edited for style and length. University of Illinois at Urbana-Champaign, News Bureau. "Narcissism tracked from young adulthood to middle age." ScienceDaily. ScienceDaily, 11 September 2019. www.sciencedaily.com/releases/2019/09/190911113019.htm.


Companion Pets Help to Ease Symptoms of Grief

Florida State University researchers have found the companionship of a pet after the loss of a spouse can help reduce feelings of depression and loneliness in older adults. The study, funded by The Gerontological Society of America and the WALTHAM Centre for Pet Nutrition and published in The Gerontologist, examined depressive symptoms and loneliness among people age 50 and older who experienced the loss of a spouse through death or divorce.

"Increasingly, there's evidence that our social support networks are really beneficial for maintaining our mental health following stressful events, despite the devastation we experience in later life when we experience major social losses," said Dawn Carr, lead author and FSU associate professor of sociology. "I was interested in understanding alternatives to human networks for buffering the psychological consequences of spousal loss."

Carr and her team compared individuals who experienced the loss of a spouse to those who stayed continuously married. Then they explored whether the effects of spousal loss differed for those who had a pet at the time of the death or divorce.

They found all individuals who lost their spouse experienced higher levels of depression. However, people without a pet experienced more significant increases in depressive symptoms and higher loneliness than those who had pets. In fact, those who had a pet and experienced the death or divorce of their spouse were no lonelier than older adults who didn't experience one of those events.

"That's an important and impressive finding," Carr said. "Experiencing some depression after a loss is normal, but we usually are able to adjust over time to these losses. Persistent loneliness, on the other hand, is associated with greater incidents of mortality and faster onset of disability, which means it's especially bad for your health. Our findings suggest that pets could help individuals avoid the negative consequences of loneliness after a loss."

Carr's team used data from a sample of older adults who participated in an experimental survey about human animal interaction as part of the University of Michigan's Health and Retirement Study in 2012, and linked the data with additional data collected between 2008 and 2014. They identified pet owners as those participants who either had a cat or a dog.

"In everyday life, having a cat or dog may not make you healthier," Carr said. "But when facing a stressful event, we might lean on a pet for support. You can talk to your dog. They're not going to tell you you're a bad person, they're just going to love you. Or you can pet your cat, and it's calming."

The researchers noted that additional studies should be conducted to explain why having pets helps maintain mental health better. However, Carr suggested part of it may relate to whether you feel like you matter to someone.

"Oftentimes, the relationship we have with our spouse is our most intimate, where our sense of self is really embedded in that relationship," Carr said. "So, losing that sense of purpose and meaning in our lives that comes from that relationship can be really devastating. A pet might help offset some of those feelings. It makes sense to think, 'Well at least this pet still needs me. I can take care of it. I can love it and it appreciates me.' That ability to give back and give love is really pretty powerful."

The findings have potential consequences for social policies. For instance, it may be beneficial to include companion animals in the treatment of people residing in senior-living facilities, or reducing barriers to pet ownership in such settings.


Read this article on Science Daily:  Materials provided by Florida State University. Florida State University. "Furry friends ease depression, loneliness after spousal loss." ScienceDaily. ScienceDaily, 5 September 2019. www.sciencedaily.com/releases/2019/09/190905102549.htm.


Dr. Holland offers Canine Assisted Therapy

Connecting with a dog can be powerfully healing and comforting for individuals of all ages and walks of life. In some cases, it can help an otherwise “stuck” patient overcome hurdles in treatment and begin making progress again. The friendly, accepting nature of these beautiful animals makes them ideal “co-therapists”. Canine-assisted therapy has been around for several decades, and will continue to be used for years to come due to its many benefits. The use of dogs as part of therapy and other forms of treatment can be beneficial for a wide range of disorders, issues, and conditions. Learn more ....

Grief & Bereavement

Clients who are facing significant life changes and ongoing adjustment due to  death of a loved one benefit from Dr. Holland Grief Therapy Services. Life Transitions Therapy is also beneficial for friends and family members of one who may be confronted with serious or terminal illness or injury, or friends and family of someone who has passed away after a long illness, or sudden death. Learn more ...

Contact Dr. Holland to learn more and to schedule an appointment or call 707-479-2946.

Smartphone Use Not Associated with Mental Health Issues in Teens

Study of 400 teens finds little evidence linking excessive smartphone use and mental health outcomes

A new study, published in the journal Clinical Psychological Science, suggests that the time adolescents are spending on their phones and online is not that bad. The study tracked young adolescents on their smartphones to test whether more time spent using digital technology was linked to worse mental health outcomes. The researchers -- Candice Odgers, professor of psychological science at the University of California, Irvine; Michaeline Jensen, assistant professor of psychology at the University of North Carolina at Greensboro; Madeleine George, postdoctoral researcher at Purdue University; and Michael Russell, assistant professor of behavioral health at Pennsylvania State University -- found little evidence of longitudinal or daily linkages between digital technology use and adolescent mental health.

"It may be time for adults to stop arguing over whether smartphones and social media are good or bad for teens' mental health and start figuring out ways to best support them in both their offline and online lives," Odgers said.
"Contrary to the common belief that smartphones and social media are damaging adolescents' mental health, we don't see much support for the idea that time spent on phones and online is associated with increased risk for mental health problems," Jensen said.

The study surveyed more than 2,000 youth and then intensively tracked a subsample of nearly 400 teens on their smartphones multiple times a day for two weeks. Adolescents in the study were between 10 and 15 years old and represented the economically and racially diverse population of youth attending North Carolina public schools.

The researchers collected reports of mental health symptoms from the adolescents three times a day and they also reported on their daily technology usage each night. They asked whether youth who engaged more with digital technologies were more likely to experience later mental health symptoms and whether days that adolescents spent more time using digital technology for a wide range of purposes were also days when mental health problems were more common. In both cases, increased digital technology use was not related to worse mental health.

When associations were observed, they were small and in the opposite direction that would be expected given all of the recent concerns about digital technology damaging adolescents' mental health. For instance, teens who reported sending more text messages over the study period actually reported feeling better (less depressed) than teens who were less frequent texters.


Story Source:

Materials provided by University of California - Irvine. Note: Read this article on Science Daily --> University of California - Irvine. "Tech time not to blame for teens' mental health problems: Study of 400 teens finds little evidence linking excessive smartphone use and mental health outcomes." ScienceDaily. ScienceDaily, 23 August 2019. www.sciencedaily.com/releases/2019/08/190823140736.htm.


Each phase of a child's development brings specific challenges as children mature. They tend to work through these as normal a part of growing up. Mental health conditions can make these challenges harder. They may come up due to events in a child’s life. These could have been traumatic events, such as being bullied. They can also be routine, like moving to a new home.

Therapy is a place for you to connect and process your thoughts and feelings in a safe place. Dr. Holland can help you develop effective tools to cope with what is going on. However bad you think it is right now, we can face it together.  I believe that forming a strong personal identity is an important aspect of your growth and development, leading to a brighter future.

Contact Dr. Holland to learn more and to schedule an appointment or call 707-479-2946.