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Treatment often involves making some change in the way you think or behave, and that may be uncomfortable. Changing to something unfamiliar can be both scary and hopeful. It is scary because you are doing something different and perhaps a little uncomfortable, and hopeful because the purpose is to feel better. Psychotherapy may also stir up unpleasant emotions. Dealing with these emotions is important to your recovery. The media often distort the facts by focusing on personal accounts rather than scientific or statistical data. In 1994 stories about flesh-eating bacteria gobbled the media's attention, replete with graphic videos of disfigured patients. Even though medical authorities pointed out that you're fifty-five times more likely to be struck by lightning than to die from flesh-eating bacteria, the media dismissed that fact. As stated on ABC's 20/20, "Whatever the statistics, it's devastating to the victims."26 Flesh-eating bacteria is, no doubt, devastating to its victims. However, these vivid personal accounts make us worry about an event that has almost no chance of occurring. Similarly, during the summer of 2001, the cry was "Stay out of the water!" out of a heightened fear of shark attacks, and in 2002, the hot media story was child abduction. In each case, the facts did not warrant a greater concern, as there was little or no change in the frequency of these events as compared to previous years. But media coverage led many of us to conclude they were on the increase. With such biased reporting, it's no wonder that we form incorrect beliefs. While crime rates were actually dropping throughout the 1990s, two-thirds of Americans thought they were climbing. The number of drug users was cut in half by the late 1990s compared to a decade earlier, but nine out of ten people thought the drug problem was out of control.27 These incorrect beliefs can affect the decisions we make. For example, in a year when the number of deaths from violence in our nation's schools was at a record low, and only one out of ten public schools reported any serious crime, Time and U.S. News & World Report ran stories with headlines like "Teenage Time Bombs." As sociologist Barry Glassner indicates, these media accounts heighten public awareness, and result in spending considerable money to protect children from dangers that only a very few will experience. At the same time, about 12 million American children are malnourished and 11 million have no health insurance.28 And so, media coverage can affect our individual beliefs and our society's public policy decisions. Television producers, and newspaper and magazine editors often gravitate toward the sensational stories that grab their audiences' attention.

Unfortunately, many of the most sensational reports concern weird and erroneous beliefs. Therefore, we have to be vigilant in how we think to counteract the media barrage. We would be less likely to be taken in by such reporting if we didn't naturally make errors in how we think. A main problem lies in our tendency to rely on anecdotal evidence. Fear of change, even positive change, is a powerful restraint. The thought of deviating from the narrow path of fixed beliefs and the life script that contains them can be unbearable for some people. The point is that most fixed beliefs are also limiting beliefs: The things that we fixedly believe about ourselves are typically negative and so we tell ourselves that "it," whatever "it" is, is something we can't do, don't deserve, and are not qualified for. We imagine what our lives will be, regardless of what problems we have or what physical discomfort it affords. We select our environment based on our scripts. People script a life with a certain income, certain relationships, and a certain lifestyle and although we say we want more, we're very uncomfortable about taking any steps toward change. Amazingly, people will often opt for a familiar lifestyle that is admittedly unfulfilling, rather than an unfamiliar alternative, even though that alternative may be clearly superior. And remember that you are not the only one in your life who may be working from a set of fixed beliefs. Other people may also be working from a script or series of expectations about how you should behave, what you should say and do. When you make the decision to go off script, they may feel highly threatened and anxious. Be patient with yourself as you stop and listen for your tapes. Stop and take a breath before you make assumptions. Take time to question yourself and write your thoughts down.Assume that you are going to meet someone whom you respect tremendously, perhaps a celebrity, a very wealthy and powerful person, or someone whose values and beliefs you hold in high regard. This could be anyone you admire, for whatever reason. Normally you would not interrogate yourself before having this encounter; you would just do it. You might or might not be uncomfortable, but you would do it.

This time, as you consider this hypothetical meeting, I want you to question yourself very carefully. It will be important to be totally honest and extremely thorough. If you know you would be intimidated, then acknowledge that. If you would be scared, anxious, or feeling dumb or undeserving, then admit that to yourself. In anticipating this meeting, what specifically are you telling yourself? Take time to think about, and to write down, the words that underlie and describe however you would be feeling as you approached this encounter. What you write down will be very important content from your tapes about you, your adequacy, your value, and your worth. There are many different types of psychotherapy, each with a different name. The type you receive depends on your problems and your needs. Cognitive behavioral therapy (CBT) is a form of talk therapy that has been extensively tested and shown to be very effective in treating depression and reducing the risk of relapse (return of symptoms). Mindfulness-based CBT is a somewhat different approach that is also effective for some people. Another type of psychotherapy, dialectical behavior therapy (DBT), teaches concrete cognitive behavioral and mindfulness skills in four modules: mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. It has been shown to be an effective augmentation (additional) therapy to antidepressant medication, resulting in improvement in depression symptoms. Medication therapy and psychotherapy alone are each effective in treating depression and reducing the risk of relapse and recurrence. In combination, they offer an even greater benefit against relapse. They are seen as therapies that complement each other. Psychotherapy offers a broader range of benefits, such as improving your level of functioning, diminishing residual symptoms, targeting specific symptoms (such as guilt, hopelessness, and pessimism), teaching coping skills, improving interpersonal relationships, and targeting different brain sites than antidepressants do. The effects of psychotherapy are longer lasting and sustained beyond the end of treatment. Sometimes the symptoms of your mood disorder worsen to the point where treatment in an inpatient hospital setting is needed. Inpatient care is a more intense form of treatment, where you receive daily individual and group therapy as well as medication management.

Entering the hospital can be a scary experience the first time you are admitted, especially when you do not feel well and do not know what to expect. It can also be difficult if you do not feel the support of family or friends, who may not understand your illness or its treatment. However, an inpatient unit provides a safe environment during a rough time. This is especially important for those who have disorganized or suicidal thoughts. Most people treated in a hospital find it to be extremely helpful and even lifesaving. On the inpatient unit, you work with a team of mental health professionals who review your current treatment plan and may suggest modifications. The inpatient team usually includes a senior psychiatrist, psychologist, nurse, social worker, and sometimes an occupational therapist. A teaching hospital will also have psychiatry residents, medical students, and sometimes nursing students. Your inpatient treatment plan is a collaborative plan between you and your team; you have the right to decide what feels appropriate and helpful for you, as long as it is safe. In some cases, treatments such as ECT (electroconvulsive therapy, also called shock therapy) may be recommended as part of your plan. You will also receive the support and input of other patients in group therapy sessions. In addition to taking medications and participating in psychotherapy, taking steps to manage your illness in your everyday life is essential. Helping yourself in this way offers the best chance of recovery and of staying well. You can learn to manage your illness in this and the next few chapters. We live in an age of science, but as we've seen, many of us hold unscientific and pseudoscientific beliefs. Pseudoscience refers to "claims presented so that they appear scientific even though they lack sufficient supporting evidence and plausibility."37 Some refer to it as junk science, or voodoo science. Essentially, pseudoscience is an endeavor that pretends to be a science, but lacks the rigor of science. The conclusions of junk science are typically drawn from low-quality data, such as anecdotal evidence and personal testimonials, as opposed to carefully controlled studies. Most fields of science have a corresponding pseudoscience. For example, some may view the investigation of ancient astronauts to be archeology, tinkering with perpetual motion machines might seem to be physics, and the shared study of stars and planets links astronomy and astrology in some people's minds.

And, of course, there is the science of psychology and the pseudoscience parapsychology.38 Claims made in the pseudosciences have a couple of common features. First, the claim is controversial because, while people can point to some supporting evidence, the evidence is typically of dubious quality. Second, the claim is often at odds with current well-established scientific principles. As an example, consider the case for levitation. There are people who claim to have levitated, and some photographs show people apparently floating in midair. Supporters point to this evidence, but the quality of the evidence is quite flimsy, especially considering how extraordinary the claim is. Personal testimonials can be wrong and photographs can be tampered with. In fact, if levitation works, our entire understanding of how gravity operates would have to change.39 One of the foremost examples of pseudoscience is parapsychology. Parapsychologists test a range of phenomena that supposedly occur due to extrasensory perception, such as telepathy (reading another's mind), clairvoyance (perceiving things not present to the senses) and precognition (seeing the future).40 J. B. Rhine began investigating these phenomena at Duke University in the 1930s, using what are called Zener cards--five cards with different symbols on the back, such as a plus sign, square, or wavy lines. In a typical experiment, an assistant would select and observe a card, and a subject would try to identify the card by reading the assistant's mind. Rhine found greater than chance accuracy in identifying the cards, and coined the term extrasensory perception. However, a review of his methods revealed many other potential explanations for the accuracy achieved. In some cases, the subjects could get subtle cues from the experimenter. In other cases, the cards were printed with such pressure that the subjects could actually see or feel the indentations on the backs of the cards. While the evidence appeared to support ESP, the experiments were not tightly controlled, and so the credibility of the evidence is questionable. Numerous ESP studies conducted over the years point to one overriding conclusion. Studies supporting ESP consistently lack proper controls, and studies with proper controls consistently find no support for ESP. This has led prominent psychologist and parapsychologist Susan Blackmore, who has worked in the field of parapsychology for nearly thirty years, to reluctantly conclude that psi does not exist.