MCC 670 – Body & Emotions

Body & Emotion Hypotheses

These hypotheses are based on the idea that the body and mind are interconnected as two integral components of our overall well-being. “There are physiological causes for mental symptoms, psychological causes for physiological changes and psychological and biological factors that co-vary without our understanding the direction of causation.” (Ingram, 2012).  For example, anxiety can be a byproduct of a thyroid condition, or it can be a part of life stressors where the body/mind connection is at play.  This section talks about two hypotheses…

Biological Cause (BE1)

Overview and Key Concepts

“A wide range of physiological conditions can produce psychological symptoms. Psychosocial assistance is needed with coping with these issues” (Ingram, 2012). Examples of this might be strokes, brain tumors Alzheimer’s, fetal alcohol syndrome, endocrine disorders, vitamin deficiency, AIDS.  What follows is a listing of key ideas to keep in mind:

  1. Does the individual have a medical diagnosis.  Need to contact physician for purposes of care oordination.  
  2. Is there a medical emergency that can cause death, serious injury, or disability?
  3. Are there medically unexplained symptoms? (Somatization disorder?)
  4. is there a co-occurring medical illness and mental disorder 

Is this hypothesis a good fit?

Examples of problems that fit a biological cause hypothesis:

  1. Inadequate self-care
  2. Difficulties coping with health problem
  3. Compassion fatigue.
  4. Problem associated with terminal illness 
  5. Problems associated with drug addiction 

When should a therapist refer their case to a medical professional?

  1. “A need for medical referral is recognized by such data as impaired memory, concentration, consciousness, changes in appetite, weight, sleep patterns, mood and personality traits” (Ingram, 2012).
  2. “Events that require referral: poor grooming, neglect, loss of competence, delirium, dementia, amnesia, stroke, head trauma” (Ingram, 2012). 
  3. Finally, it is important to be aware of the fact that medical problems can masquerade as mental health issues

Finally, Ingram (2012), discussed two issues in detail that are an ideal fit for this hypothesis:  substance abuse and adapting to disability.

substance abuse.

An MSE, biopsychosocial assessment and CD eval are all essential.  Should assess history, quantity and frequency of consumption.  Also need to understand how addiction has affected life/relationships.  Keep in mind, the biological components:

  1. Intoxication: produces changes and impairments in client’s mental status.
  2. Dependence is a physiological and psychological  issue
  3. Affects of an addictive substance can mimic psychological disorders 

Coping with disability

Biological conditions can “affect an individual’s emotional, biological, spiritual and cognitive well-being” (Ingram, 2912).  How does this issue overwhelm an individual’s ability to cope? Acceptance, understanding and self-education are useful in learning to cope with irreversible medical issues.  Examining opportunities for prevention and healing require individuals to closely examine their lifestyle.

Treatment Planning

Assess the client’s understanding of the nature of their condition and prognosis.  Education and radical acceptance may be in order

  1. Do not forget ethical issues (I.e mandatory reporting laws) & remain within scope of care, utilizing referrals where necessary.
  2. Help client work through a system of self management that includes addressing ADL’s and making adaptations as needed.  
  3. Provide time for the client to work through psychological and relational and issues.
  4. It will be essential to function as part of an interdisciplinary team to coordinate care.  
  5. be aware of family involvement in treatment discussions.

with terminally ill clients:

  1. hospice or palliative care?
  2. Kubler-Ross stages
  3. spiritual & existential issues
  4. EOL decisions 
  5. assess/address quality of life.

Alcohol and Drug Treatment

Initial Phase requires detoxification under medical supervision.  Residential programs are the next phase.  Then client’s enter outpatient treatment and participate in 12-step programs

Finally, Ingram (2012) lists the following hypotheses as useful alongside this one:
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  • Limitations of Cognitive Map (C2) 
  • Antecedents and Consequences (BL1) 
  • Conditioned Emotional Responses (BL2)
  • Loss  and Breavement (CS4)
  • Spiritual Dimension (ES3) 

Medical Interventions (BE2)

Overview and Key Concepts

“The primary application of this hypothesis will be when the use of psychotropic medication is indicated for a psychiatric disorder” (Ingram, 2012, p. 78).  For example, someone has a gastric-bypass and needs help adhering to new diet and coping with lifestyle changes.  Ingram, (2012), caution against giving medical advice and stay with scope of practice.  What follows is a list of sample treatment considerations:

  1. Referral & coordination of care
  2. promote adherence with doctor’s recommendations 
  3. CBT (i.e. Cost-beneft analysis).
  4. Know basic psychopharmacology

Is this Hypothesis a good fit?

“…for severe disorders, such as Schizophrenia and Mania, psychopharmacological treatment is not considered optional, but is rather a part of the ‘standards of care'” (Ingram, 2012, p. 80). Referrals and care coordination are essential in such cases.  Ingram lists the following as reasons for seeking psychiatric referral:

  1. “symptoms are interfering with basic ADL’s
  2. The client is a suicide risk
  3. diagnosis exists which needs medication.
  4. The symptoms persist with medications.
  5. The client is self-medicating
  6. Psychotropic medication worked in the past.

Treatment Planning Ideas

The basics of treatment are discussion, psycho-education, assistance with decision-making, referral, and coordination of care with a medical practitioner.

DISCUSSING PSYCHOTROPIC MEDICATION:

  1. What are Side-effects r/t medications
  2. Reasons for non-compliance (why?)
  3. Problems emerging after symptom management increases.  (I.e. Suicide risk, ADL issues, & interpersonal problems).

Mind-Body Connections (BE3)

Overview and Key Concepts

“A holistic understanding of Mind-Body Connections leads to treatment for psychological problems that focus on the body and treatment for physical problems that focus on the mind. This hypothesis is a good fit for clients classified as somatizers, for many types of stress and tension complaints, and for sexual disorders. Clients often need to increase their awareness of and control over their bodies and to develop a somatic awareness of feeling” (Ingram, 20-2, p. 88).

  1. Healing mind also heals the mind
  2. Improvements in physical help improve psychological function.
  3. Stress is a mind-body issue.  

How you determine fit?

  1. “Stress and anxiety tension reduction 
  2. Problems with eating, sleeping and sexual function
  3. Medical complaints
  4. Chronic pain
  5. Body image problems
  6. Performance problems
  7. Restricted and rigid personality styles” (Ingram, 2912).

Treatment Planning Ideas

  1. SUD scale & mind/body awareness
  2. Relaxation and stress management
  3. methods that stress mind/body connection.

Emotional Focus (BE4)

Overview and Key Concepts

This hypothesis focuses on helping the “client improve awareness, acceptance, understanding, expression and regulation of feelings” (Ingram, 2012).  Key concepts

Emotions Defined:

“complex set of interactions mediated by neurons and hormones giving rise to affective experiences that generate cognitive processes, activate physiological adjustments, and lead to behaviors not always adaptive.” (Ingram, 2012).

Emotional Reactivity

how much affective arousal a client diaplays (i.e. Intensity & duration). Need to help canine a client’s emotional development.

Finally, Ingram, (2012) also discusses Carl Rogers’ Humanistic Psychology, culture & emotion as well as emotional competencies.

Treatment Planning:

“Bring in an emotionally connected relationship based on empathetic attunement and support enhances the person’s capacity to feel without needing to develop strategies to minimize or numb emotions. (Ingram, 2012).”  Client needs to develop an ability to accurately understand their feelings and express them in a healthy way.  Gestalt and EFT discussed here.

References

Ingram, B.L. (2012). Clinical Case Formulations: Matching the Integrative Treatment ​Plan to the Client. (2nd ed.). Hoboken, NJ: Wiley.

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