Today's Sacramento Bee reports on a new and controversial treatment for depression, Vagal Nerve Stimulation (VNS). According to the Bee's report, the treatment has been approved by the FDA in spite of minimal evidence that it actually works.

It's an interesting read, and I'll admit, one that left me puzzled. While it's great to have any additional treatments available that even might work to treat otherwise unresponsive depression, is it justifiable to ask such patients (or their insurers) to spend $40,000 on an unproven treatment? From the outside, I would say no, of course not; but if I were suffering from such a depression, I suspect I'd pay anything for even a little bit of hope.

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Posted May 1, 2006 @ 11:50 am
Paying couples to get married?

In an effort to motivate poorer couples to get and stay married, Kansas Sen. Sam Brownback has helped institute a pilot program in the District of Columbia that actually pays couples up to $9,000 for getting married. Brownback has said he hopes the program will eventually be implemented nationwide. The money isn't simply a handout--couples in the program are required to take additional steps like buying a home or expanding a business to qualify for federal matching funds. Nonetheless, it's designed with the goal of supporting marriage. "The welfare system penalizes marriage," Brownback tells USA Today, and that's hard to argue with. But is this the right solution? In context with Brownback's other efforts to reduce or eliminate social service programs, it looks like part of a broader plan to go back in time--to an era when money was much more of a motivator for marriage, an era when women got married less because they wanted to and more because, financially, they had to in order to survive.

Look, I agree that some of the financial disincentives to marriage should be removed. And that poverty adds strain to marriages. But tackling this without tackling the more systemic causes of poverty seems shortsighted. You really want to support marriages for poor families, senator? Show your support for federally-funded day care.

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Posted March 2, 2006 @ 4:56 pm
Combat veterans seek mental health care

...and sometimes they don't find it. According to a study in the current Journal of the American Medical Association, more than a third of Iraq veterans seek mental health services in the year after returning from deployment. The study links combat experiences with the need for post-deployment services. But what's most interesting in the article is what it doesn't say.

Consider this quote in the article's summary: "More than 50% of those referred for a mental health reason were documented to receive follow-up care." Though it's presented in positive terms, what it actually says is alarming: Almost half of those who seek help for mental health issues aren't getting it.

If you or a friend or family member are a combat veteran and need mental health services, this information may be useful to you: First of all, many local therapists (myself included) and agencies offer reduced-fee services for clients with lower incomes. This way everyone can benefit from counseling, even those who think they can't afford it. Second, for combat veterans who have experienced trauma and have spouses or significant others, there is reason to believe couples therapy may be the best treatment. Creating a safe and supportive couple relationship can serve to both reduce the impact of trauma on the survivor, and decrease the chances that the survivor's partner will be secondarily traumatized or feel excessively burdened by living with the survivor. Emotionally Focused Therapy has been specifically developed and studied as a couple-based response to trauma, and works well; I'd recommend seeking out a therapist who offers this approach. (And--surprise--I'm one of them. But I'm not the only one, and am happy to make referrals if you wish.)

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Posted February 13, 2006 @ 4:10 pm
Sick of bad relationships? Well, yeah, you might be

Sorry for the delay in posts here--I've been sick. I'm better now, but the whole experience reminded me to post this article to anyone wondering how they can further help--or hinder--their chances of staying healthy over the flu season. Turns out all the kissing can help, if you're doing it with the right person:

Birmingham Post (Australia)
November 9, 2005, Wednesday
Copyright 2005 Midland Independent Newspapers plc

WEDDED BLISS CAN HELP BEAT FLU BUG

Marital happiness is key to fighting off flu, a study by university researchers has found.

The study by the University of Birmingham's School of Sport and Exercise Sciences also discovered that bereavement has a negative effect on the body's immune response to the annual flu jab.

Dr Anna Phillips, the lead investigator on the study, said: "We know that those aged over 65 are more at risk of the impact of flu, but this research shows that within that group, those that have been recently bereaved, or those that are single, divorced or widowed are more at risk that those who are in a happy marriage.

"It is especially important for these at-risk groups to get their flu jabs."

The study looked into whether stressful life events and other related factors had an effect on the immune system's response to the flu vaccination, which gives a good indication of how well the body would fight off a real attack of flu.

The research team looked at the levels of antibodies in the blood, which are produced by the body to combat disease.

The team found that those who reported having happy marriages had a much higher level of antibodies in the blood than those reporting lower marital satisfaction.

Those who had suffered a bereavement in the year prior to vaccination had a poorer response than those who had not suffered such a loss.

More than 180 pensioners from across Birmingham took part in the study, the first of its kind to examine the impact of general psychological factors on immune response to the flu jab in older adults.

Participants gave a blood sample prior to vaccination, then further samples at one month.

Dr Phillips added: "We would like to take this research further, to see whether interventions such as bereavement counselling or marriage counselling can improve the immune response in at-risk groups."

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Posted February 3, 2006 @ 12:02 am
A step in the right direction

The health care system in the US relies largely on a "disease model," where the essential message is "bring in what's wrong with your body, and your doctor will try to fix it." This is an incomplete picture of health at best, since it largely ignores relational and environmental issues. It ia also an entirely wrong way to encourage more proactive steps toward a healthy, happy life.

So I'm glad to see the World Health Organization is working on an International Classification of Functioning, Disability, and Health. It's a classification system that gives as much weight to activities and environmental factors as it does to the body itself in developing a picture of functioning. It's a way of examining the whole person in their environment.

Imagine that.

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Posted January 26, 2006 @ 8:11 am
Is this what the future holds for marriage?

The San Francisco Chronicle tossed out an interesting idea Sunday: privatize marriage. I think it's ludicrous, but maybe not for the reasons you'd expect.

Marriage is a lot of things: A social contract, a religious bonding (for some), a legal contract, and so on. While its meaning and significance are frequently debated, the vast majority of adults in the US and around the world will marry at some point in their lives, and marriage is--more or less--a common experience we share as people, a bonding of two people as romantic partners for life. That serves a valuable purpose for communities and cultures, linking their members together in a way that few other rituals or contexts of life do.

The Chronicle's proposal would fracture marriage into, essentially, different kinds of commodities. ("What's that? You got the Lexus Wedding presented by TD Waterhouse? Wow, that's great! My wife and I went for the McMarriage instead. Yeah, it was all we could afford. What your life must be like!") Privatization as proposed in the article would surely create rich and poor classes of marriage, which would only increase the kind of polarization we're experiencing too much of already. And if you're expecting an anti-gay, "protect marriage for the children!" rant here, hardly; I wholly support efforts toward marriage for all. No one should be shut out of that valuable cultural and human experience because of their sexuality.

All that said, I will give credit to the Chronicle for attempting to inject some creativity into the discussion of the future of marriage. That absolutely is welcome, and it enlivens a discussion that more of us should be having.

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Posted January 25, 2006 @ 12:04 am
Welcome to the blog at BenCaldwell.com!

It's my great pleasure to welcome you to my new, rapidly-growing website. While many of the pages are still under development--and yes, I'm bothered by that too--there's already plenty here to offer, from my Theory of Therapy page to a substantial directory of national information on the links page.

But the blog isn't about all that.

The blog is a chance for you to get to know me a little better. I fully believe that if you're seeking out a therapist, you have a right to know just what you're getting--that includes the therapist's stand on social and political issues, at least so far as they're relevant to whatever you're going through.

And if you're not seeking out a therapist, at least I may occasionally be good for a laugh. I hope so.

There's much more coming to this site in the days and weeks ahead. I certainly welcome your suggestions for what you would like to see here. It is my sincere hope that this site will have offerings that make it unique and give it a personality. I look forward to hearing from you!

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