If you’ve been following the apparent outbreak of a tic disorder in a New York high school, you know that investigators there have ruled out environmental causes linked to the school itself. Parents, outraged by the Tourette’s sydrome-like symptoms that have plagued twelve teenage girls in the past several month, are demanding answers. Unsatisfied by the lack of results from school investigators, public health officials, and the victim’s own doctors, they recently brought in the Erin Brokovich team to explore the test the ground water and more.

Health officials are now calling the illnesses with which the young women are presenting conversion disorders. Conversion disorders are psychiatric illnesses in which a person experiences physical symptoms without a physical cause. People with conversion disorder can demonstrate things like blindness, lack of muscle function, paralysis, or seizures.

Parents are reportedly not satisfied with this explanation for their daughters’ and community members’ illnesses. Indeed, watching video of the young women unable to talk, write, or function normally is disturbing, and it’s easy to see how the Le Roy High School community would be frustrated.

As I watched the Today Show’s interview with a few of the young women and their mother’s, you could see the visible vehemence when Dr. Nancy Snyderman suggested that the root of these issues could be psychological. The parents and teenagers quickly denied that this was possible, their justification that they weren’t under any stress and that their symptoms were real.

The thing is, the symptoms in a conversion disorder are real too. The person truly is experiencing tics, or muscle weakness, or difficulty walking. They really do seize – anyone can watch. These individuals are not making up their symptoms (that happens when someone malingers), and their development is not in the person’s conscious awareness.

This last piece is the rub, of course. If it’s not under conscious control, the person isn’t aware that there’s a psychological cause, and so there’s no way for them to deny or disprove it. Patients sometimes say things like, “But I just know something’s really wrong. I just know!” And the thing is, they’re right. There’s something wrong, really wrong. The only difference between the symptoms of conversion disorder and the symptoms of a physical illness is in the treatment. Conversion disorder symptoms are not going to respond, at least not long term, without psychological help.

I admittedly have no idea about the origin of the symptoms among these New York teenagers, and I would never purport to know. But what I am very aware of is the cultural backlash against the idea that our minds can produce physical symptoms.

It’s actually a bit dismaying to see how negatively people react to this idea, and how vehemently they deny it. I want to ask these individuals where they think all physical issues originate – in our brains! Why is it so unimaginable to think that psychological stress could create physical symptoms?

Our brains regulate our hormones and every function of our body, and yet we tend to see our minds as distinct from our bodies. The effects of this disconnect are far-reaching. I think that this contributes to everything from fertility issues to the flu to problems with our sexuality to distorted relationships with food. This is not to say that that all of these things have only psychological bases – certainly, that’s not the case. But we often fail to see how our psychological functioning influences these processes, and in doing so miss out on a real chance of improving our health.

My hope is that, regardless of what is determined to be the cause of these Tourette’s sydrome symptoms in New York, the parents will encourage their children to seek psychological treatment. Even if the cause is environmental, these young women could likely benefit from support around the trauma of the past several months.

you might be as outraged as the community.

{image credit :: notsogoodphotography}

When the time had finally come for the exam, I suddenly understood fully the idea of one’s stomach doing summersaults. I had always thought this was an expression, and now I was quite certain that this organ was competing with Shawn Johnson for best all-around gymnastics performance.

As my body started signaling fight or flight – and I soon recognized that fleeing or throwing punches at my professors was not an option – my mind raced with all the ways in which I was about to royally screw this up. I was facing my clinical competency exam, a multi-part test that assesses one’s knowledge and acumen in the field of psychology – and a requirement of graduating. The scariest part involved sitting in front of two of the professors I had revered for years and stammering, I mean discussing, my rationale for huge reports I had written.

My mind told me that this was it. The moment that it would be all over. There was no more hiding. They’d soon know the truth.

I. Am. A. Fraud. Period.

But you got into graduate school! Don’t you remember? [That’s my rational, not so informed mind speaking.]

Yes, but that must have been a mistake! The numbers of applicants were low. Or they mixed me up with someone else and then didn’t have the heart to kick me out. Or, worse yet, they felt sorry for me.

But you’ve thrived here so far! You get good grades. Professors and supervisors like you. C’mon…

You c’mon! Sure I can schmooze. But when it comes time to buckle down and show ‘em what I’m made of… well, the proof is in the pudding. And my pudding ain’t crap.

Oh sure it is. You’re smart. You’re insightful. You’re responsible. You’re even a good therapist.

Where the heck do you get your information, missy?

… So you can see where this is going. More bantering until I was finally called in to show my stuff. You can figure out the ending (I passed – Yippee!), but the sad irony was that my fraud mind could justify even this. (“Oh, well, just wait until you try to defend your dissertation. You think you know research? Who are you fooling? No one soon…”)

Sad, huh?

Sadder still is just how many of us suffer from this conviction that we are actually a fraudulent version of ourselves. Psychologists actually have a name for this (this is actually how we spend our time – coming up with clever names for interesting phenomena!). We call it the imposter syndrome.

This happens when we can’t seem to internalize our accomplishments – when we’re convinced that no matter what fantastic things we achieve, it reflects a deception we have created rather than just how freaking talented we actually are.

This phenomenon runs rampant among women, particularly successful women (that’s not just my anecdotal evidence there – there’s data to support this).

For many high-achieving women, acknowledging that their success might actually reflect internal skills, knowledge, and talents is incredibly difficult. It’s kind of like what I was discussing when I told you about hiding my academic prowess in fifth grade.

This is sometimes considered a remnant of (or evidence of ongoing) sex stereotypes, in which, due to years of gendered socialization, it’s hard to wrap our minds around woman as powerhouse. For the sake of our not rocking the proverbial boat (which hasn’t even stopped to ask for directions), our sex roles stay firmly, albeit subtly, in place.

Another potential reason for the imposter phenomenon was explored back in the day by Clance and Imez. They suggested that women’s roles in their families contributed to this version of self as an imposter. Some of these women, they argued, were told that their sibling was the truly gifted one, and they never felt that any of their accomplishments really stood for anything. The other subset is full of women whom were told that they were so awesome (and smart and wonderful), that they felt they could never live up to the expectations established for them. They were always working so hard to live up this superhero version of themselves that others created, they came to believe it was just that – fictional.

Lending support to this idea, psychologist Carol Dweck found that when faced with novel and challenging tasks, the girls with the highest IQs were the quickest to give up. Bright boys, on the other hand, doubled their efforts when faced with the challenge. Could it be that it’s these stories, these perceived expectations of perfection and achievement, that rob girls and women of their sense of being capable?

However it’s defined and explained, the imposter syndrome is alive and well in classrooms, boardrooms, and even the blogosphere. Have you ever thought to yourself, “I’m not a real runner,”? Or, “If they really new me, they’d realize that I’m a total fake. I always use a calculator.” Or, “One of these days the world will figure out I can’t really write. I’ve just been getting by on people’s kindness.”

If these thoughts plague you, know that you’re not alone. You are also not really a fraud. It’s just your mind’s way of trying to hide you from your greatness – that sneaky little devil trying to slyly sabotage you. Lucky for you, you have a choice to make — buy into that thought or let it pass by you like a leaf on a stream. I choose the latter. And that’s 100% the real deal.

Disclaimer: The intent of this post is not in any way to diminish the real and important contributions of other fields and other professional counselors. On the contrary, it is intended to help consumers understand the role of a psychologist and the value added that psychologists may provide.

You have a general feeling of dissatisfaction with your life. You notice yourself avoiding certain places or situations. You seem to spend an inordinate amount of time looking in the mirror. You are constantly fighting with your wife. You find yourself eating lots of food in secret. You feel an odd sense of disconnection with your surroundings. People say you drink a little too much. Others say the things you believe are not true. You feel panic when you think about giving that presentation at work. You notice yourself forgetting things more than you used to.

There are likely thousands of reasons that an individual may require mental health intervention and probably almost as many means people use to acquire help. They read self-help books or talk to friends or consult their psychic… But how do you know when you need more intensive help, such as the assistance of a psychologist?

Common signs that one might benefit from consultation with a psychologist include,

• Less intensive intervention (e.g. talking to friends at church) has not helped.
• Feeling that things are “out of control”; you “just can’t handle it anymore.”
• Relationships, work, or other areas of life are being impacted by your thoughts, feelings or behaviors.
• Others who care about you are suggesting that you get help.

So, why a psychologist? Allow me to elaborate…

Licensed clinical psychologists are professionals with the highest degree in their field (a Psy.D or Ph.D), which means they have received intensive education and training in mental health. This usually includes courses in psychopathology, assessment and diagnosis, neuroscience, family therapy, and other subjects, as well as the completion of intensive independent research (i.e. a dissertation). In addition to this, psychologists have completed as many as six thousand or more of hours of clinical training in various mental health settings, such as hospitals, universities, clinics, etc. After all that, psychologists are required to take national licensing exam and state ethics and law exam in order to demonstrate their competence in all things psychology (and even some things not so psychology…). Thus, when you see a psychologist, you should be able to feel confident that you will receive the best possible care from individuals with the most rigorous training and who are under significant scrutiny to perform competently.

This is, of course, not to say that there are not significant differences among psychologists. And, in fact, “fit” is one of the most important factors, in my opinion, in the success of a therapeutic experience. Finding a psychologist with whom you feel comfortable and who has a style and approach that fits your needs and expectations is vital, and it may take some browsing. It’s important for you as a consumer to remember that you are just that – a consumer. You should remember that psychologists are working for you just like anyone else you hire. This means letting the psychologist know when your needs aren’t being met and taking your business elsewhere if problems aren’t resolved.

If you’re looking for a psychologist, check out locator.apa.org or www.findapsychologist.org, both of which offer free provider listings. And feel free to leave a comment below with any questions. Cheers to a healthy mind!