The results of a new study suggest that a significant number of people with anxiety disorders, such as panic disorder or social phobia, have sexual problems as well. The study's authors report that these findings may have implications for therapeutic treatments involving medication.

Over the past few years, the medical field has become increasingly aware that certain drugs commonly prescribed for psychological disorders can cause sexual side effects. For example, selective serotonin reuptake inhibitors (SSRIs), which include Prozac, are known to delay orgasm in many males.

SSRIs are widely considered the best medication treatment for social phobia and panic disorder. People who suffer from social phobia experience severe anxiety in a number of social situations and typically experience shyness so severe it interferes with their daily life. Panic disorder is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress.

Little is known about how many of the people with these anxiety disorders experienced sexual problems before they began treatment for their psychological distress. In an effort to find out how common sexual dysfunction is among people with these disorders, Dr. Ivan Figueira, of the Federal University of Rio de Janeiro, and colleagues reviewed the records of 30 patients with social phobia and 28 with panic disorder.

As detailed in the researchers' report in the journal Archives of Sexual Behavior, about 75% of patients with panic disorder also had sexual problems, compared with approximately 33% of patients with social phobia. Among individuals with panic disorder, sexual aversion disorder--a strong desire not to have sex--was the most prevalent type of sexual problem, affecting about 36% of men with the disorder as as many as 50% of the women. Among men with social phobia, premature ejaculation was the most commonly experienced sexual problem.

Figueira's team concludes, "These results suggest that sexual dysfunctions are frequent and neglected complications of social phobia and panic disorder." The report indicates that for patients who have anxiety disorder and premature ejaculation, SSRIs may be a good medication treatment choice. Not only are the drugs effective at relieving anxiety, they also can help prevent premature ejaculation by delaying orgasm.

According to the researchers, antipanic drugs may be appropriate for people with panic disorder who also suffer from sexual aversion disorder since the drugs that keep panic attacks under control can have the beneficial side effect of relieving the sexual problems.

Sources:

• Archives of Sexual Behavior, Feb. 2007.

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Americans Have New Options for Their Own Mental Health

(Los Angeles, California): With the growing concern nationwide about violence, drug abuse, illiteracy, and other pressing social ills, people turn to their friends, their church, their doctors, school counselors and often, as a last resort, to the psychiatric industry for answers. But a new movement is rapidly developing. Similar to the popular trend to choose natural healing over orthodox medicine, people are doing the same for their mental health.

Actress Margot Kidder of Superman fame decided this week to lead the campaign to introduce a new voice for mental health care. On April 10, Ms.Kidder was appointed as the national spokesperson for AlternativeMentalHealth.com, the world's largest Internet site on non-drug mental health treatments.

"The number of people looking for help without medication is staggering, she said. Sometimes I am on the phone three to four hours a day with people asking me how I did it. Now I can refer them to AlternativeMentalHealth.com.

After years of searching for answers to her own health problems, Kidder finally resolved her troubles through nutrient therapy. I got a hold of a 900-page medical book on manic depression, sat down with my dictionaries and worked it out for myself, said Kidder.

Among other things, it said that certain amino acid deficiencies were common in manic depression. But the recommended treatment was drugs! Kidder continued. I thought, ~Heck, why not just take the amino acids? I did and that was the starting point on my road to wellness.

The actress, who has appeared in 55 feature films and over 100 television shows and continues to work steadily, has since become a passionate spokesperson on behalf of people seeking nutritionally oriented drug-free mental treatments. She was in Los Angeles in January of this year to receive the Courage in Mental Health Award from the California Womens Mental Health Policy Council.

AlternativeMentalHealth.com is a much needed presence on the internet, she said. It has a directory of alternative mental health practitioners around the world and many, many articles on the various causes and drug-free treatments for mental problems.

A recent Harvard study confirms a dramatic increase in the public's interest in non-drug mental health treatments. Reporting in the February 2001 issue of the American Journal of Psychiatry, the study authors claim, Complementary and alternative therapies are used more than conventional therapies by people with self-defined anxiety attacks and severe depression. Most patients visiting conventional mental health providers for these problems also use complementary and alternative therapies....Use of these therapies will likely increase as insurance coverage expands.

AlternativeMentalHealth.com is sponsored by Safe Harbor, a Los Angeles-based nonprofit organization dedicated to educating the public, the medical field, and government agencies on drug-free alternatives for mental health problems. They emphasize the role of physical causes such as medical problems, allergies, toxic conditions, and nutritional imbalances.

Safe Harbor was founded by L.A. businessman, Dan Stradford, who saw his father crippled by electroshock therapy and heavy medication in the late 1950s. He was unrecognizable after that, Stradford says. But 42 years later, through nutrient therapy, we have been able to free him from taking antipsychotic drugs. He regained dignity by getting that part of his life back.

A wide variety of physical ailments can cause mental upheaval, yet these often are not looked for by physicians, who can be quick to prescribe antidepressants or other medications. Even when a full physical exam is done, many causes, such as a zinc deficiency or copper excess, could remain hidden because few doctors consider looking for them, usually due to a lack of education in the area of nutrition or a limited understanding of the dangerous effects of the psychotropic drugs they prescribe.

AlternativeMentalHealth.com includes numerous informative articles on specific symptoms and possible natural remedies. Ms. Kidder has recently included an article on amino acids, a natural substance research has shown to have powerful benefits without non-optimum side effects.

The simple fact, says Kidder, is that an extraordinary number of people dislike the effects that psychiatric medication has on them. It can dull the senses and cause all kinds of emotional and physical reactions. I know I was very upset to find out that very simple and logical alternatives existed but no doctor ever told me about them.

Psychiatric drug use has increased sharply in recent decades. In the 1960s, when tranquilizers first came on the market, Valium rapidly became the most prescribed drug in medical history.

Antidepressants and anti-anxiety agents are still widely in use. The Family Research Council estimates that 6 million American children are currently taking psychiatric drugs, primarily for Attention Deficit Disorder. Newsweek reports that prescription drug sales have doubled to $145 billion in the past five years.

The use of nutrient therapy for mental disorders has been around since the 1940s. Double-Nobel-prize-winner Linus Pauling was a champion of it and referred to it as orthomolecular (correct molecule) treatment. Research concentrates on extensive lab testing of subjects to determine what metabolic abnormalities they have in common.

One pioneer of nutrient therapy, Dr. Abram Hoffer of Canada, has used a nutrient protocol on schizophrenia, which has proven highly effective in six double-blind studies. The protocol is available free at AlternativeMentalHealth.com.

AlternativeMentalHealth.com. is here to give Americans of all ages a choice through education and access to doctors nationwide who are experts in fields such as nutritional deficiencies, hormonal and metabolic disorders, and other things that can cause mental suffering, said Stradford. Many people are seeking alternatives to the often devastating effects of electroshock therapy or years on drugs. If we help one of them, then we have accomplished our goals.

For further information on http://alternativementalhealth.com/ contact Dan Stradford at 818-890-1862 or Christie Communications at 805-969-3744.

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By SONJA BISBEE WULFF
The Coloradoan
Dec. 1, 1999

Dr. Christian Hageseth III has closed his longtime practice under order from the Colorado Board of Medical Examiners.

For more than a year, the state regulatory board has been investigating a formal complaint filed by the ex-husband of former patient Laurel Burson, who is now Hageseth's wife.

Last week, the board permanently revoked his medical license, effective immediately.

"They've taken away my ability to care for people," said Hageseth, who's practiced in Fort Collins for 21 years. "It's immensely painful."

Paul Burson, who won a civil suit against Hageseth in Larimer District Court, claims the psychiatrist counseled his wife to leave him and then developed a sexual relationship with her.

Hageseth, 58, denies the charges, saying he didn't "become intimate" with Burson until a year after her therapy ended.

A local jury awarded Paul Burson $217,373 in damages in April 1998. Last fall, the American Psychiatric Association expelled Hageseth from its roster for "unethical conduct."

Hageseth married Laurel Burson on Oct. 30, 1998, and continued his local practice - until last week when he lost his license. Hageseth said he feels "bad that people got hurt," but he called the board's decision "irregular and highly unfair."

"I have had four experts evaluate me," he said. "All four say I'm safe to practice, and there's no danger."

Hageseth said he's seen other psychiatrists get romantically involved with patients yet receive only a slap on the wrist from the medical board.

Hageseth, who's already spent $50,000 in legal fees plans to plead his case to Gov. Bill Owens.

"All I did was love this sweet woman," he said.

Loss another crisis for those who need help

By SONJA BISBEE WULFF
The Coloradoan

The Fort Collins mental health community is reeling from the abrupt loss of psychiatrist Dr. Christian Hageseth.

In a community already short on psychiatrists, Hageseth has maintained a full practice, including a large number of indigent patients, for the past 21 years. Recently he has handled almost a third of patients hospitalized at Mountain Crest.

But now when these patients call his office, they get a recording directing them to the Yellow Pages.

The Colorado Board of Medical Examiners, has revoked Hageseth's license, his patients are learning this week through the mail.

"We felt it immediately," said Dr. John Nagel, medical director at Mountain Crest, who has been deluged with calls from panicked Hageseth patients, some in urgent need of medication.

Nagel criticized the state medical board for not giving Hageseth the two or three months needed to transition psychiatric patients smoothly to new physicians.

"It puts a lot of people and a lot of lives at risk," he said.

The most vulnerable patients are those among the low-income population, said Joan Cmar, a therapist with Poudre Health Services District's Mental Health Connections.

With the shortage of local psychiatrists, people with health insurance have trouble accessing care, said Cmar, who's also received numerous calls from Hageseth's patients. For people who can't pay, it's next to impossible, she said.

"(Hageseth) connected to the indigent population more readily than any other psychiatrist in town, Cmar said. "It's going to be a huge loss for the community."

The other major concern is for psychiatric patients who require hospitalization.

Only four psychiatrists - including Dr. Cliff Zeller, who was recruited this fall - remain on staff at Mountain Crest.

"We have been in something of a scramble to cover all the bases," Nagel said.

The result will be more instability, Cmar said.

Untreated mental illness can lead to family difficulties, unemployment, violence, suicide and a host of other problems, she said.

Mountain Crest is actively recruiting psychiatrists, with a couple of possibilities in the works. However, since the candidates are not from Colorado, they would have to go through a lengthy licensing process.

"It's probably months off," Nagel said.

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Discover how therapy and medications are used in the treatment of phobias - agoraphobia, social phobia, specific phobias.

Treatment of phobias involves behavior therapy, medication, and counseling.

Agoraphobia

Treatment of agoraphobia involves

• patient education,
• behavior therapy (exposure with response prevention), and
• medication.

Patients need to understand their condition and receive reassurance that they are not "going crazy" and that their condition can be managed. Because they may have received some explanation that their symptoms are caused by a medical disease, they need to be educated about agoraphobia.

Exposure with response prevention is a very effective behavior therapy for people with agoraphobia. In this treatment, the patient (1) is exposed to a situation that causes anxiety or panic and then (2) learns to "ride out" the distress until the anxiety or attack passes. The duration of exposure gradually increases with each session. This treatment works best if the patient is not taking tranquilizers because tranquilizers can prevent the experience of anxiety.

Antidepressant medications (except bupropion, Wellbutrin ®) have been shown to reduce the occurrence of panic attacks. Some studies have shown paroxetine (Paxil ®) to be quite effective.

Benzodiazepines are effective in treating anticipatory anxiety as well as symptoms of panic attacks.

Social Phobia

Treatment of social phobia involves

• behavior therapy (exposure with response prevention)
• social skills training, and
• medication.

Most people benefit from combining medication with supportive counseling or group therapy. Also, avoiding alcohol and drugs is of particular importance for people with social phobia, because social withdrawal and isolation typically accompany substance abuse.

Exposure with response prevention is an effective treatment for social phobia. It is particularly useful in a group therapy setting, which can provide a social or performance situation for the patient.

In social skills training, first, the sills lacking are identified. The patient is then taught appropriate skills. They practice skills in a group therapy setting and then practice them in social situations they encounter in their daily activities.

Medications used to treat social phobia include:

• Paroxetine and other SSRIs
• Beta-blockers
• Monoamine oxidase inhibitors (MAOIs)
• Benzodiazepines

Paroxetine (Paxil ®), an SSRI antidepressant, has been shown to be particularly beneficial to adults with social phobia. This class of drugs is also used to treat generalized anxiety disorder and panic disorder. These drugs work by altering levels of serotonin (a neurotransmitter that affects many behavioral states), which helps reduce anxiety.

Beta-blockers prevent norepinephrine from binding to nerve receptors in many areas of the body. They slow the heart rate and are effective in reducing physical symptoms such as nervous tension, sweating, panic, high blood pressure and shakiness. Although the FDA (food and drug administration) has not approved beta-blockers for the treatment of social phobia, psychiatrists may prescribe them. They are effective in reducing symptoms performers experience with "stage fright."

Some small studies have shown monoamine oxidase inhibitors (MAOIs) to be helpful in treating social phobia. They are used to treat other psychiatric disorders, including major depressive disorder.

Benzodiazepines may also help control social phobia. They are used frequently to treat many anxiety disorders, including generalized anxiety disorder.

Specific Phobias

Treatment of specific phobias involves:

• exposure and response prevention,
• progressive desensitization, and
• medication.

There is a wealth of evidence that suggests that exposure and response prevention is the most effective treatment for specific phobias. This form of treatment is used to treat other anxiety disorders, including obsessive-compulsive disorder.

Progressive desensitization is not as effective as exposure and response prevention, but is used in people with specific phobias who have great difficulty facing the object or situation that causes their fear. This treatment involves learning relaxation and visualization techniques. The patient is exposed to the source of fear gradually. For instance, a person with fear of heights looks down from a second-story window of a skyscraper. Once the person begins to experience anxiety, they are removed from the situation. They then learn to visualize being in the situation without experiencing anxiety. Once they are able to look out that window without experiencing anxiety, they move up to the third-story window, and so on.

Benzodiazepines have been known to reduce anticipatory anxiety in people with specific phobia. For example, people who are afraid of flying may find that these drugs help control their fear and make flying possible.

SSRIs, like Paxil (Paroxetine), can be effective in controlling specific phobias. These drugs may be particularly helpful in people whose phobia interferes with their ability to function in normal daily activities, like riding the train to work or speaking in front of groups.

Sources:

• Hahlweg, K., W. Fiegenbaum, M. Frank, and others. "Shortand Long-Term Effectiveness of an Empirically Supported Treatment for Agoraphobia." Journal of Consultative Clinical Psychology 69 (June 2001): 375-382.
• Walling, Anne D. "Management of Agoraphobia." American Family Physician 62 (November 2001): 67.
• National Institute of Mental Health (NIMH). Anxiety Disorders. NIH Publication No. 00-3879 (2000).
• Zoler, Mitchel L. "Drug Update: SSRIs in Social Phobia." Family Practice News31 (February 1, 2001): 28.
• Bourne, Edmund J., Ph.D. Beyond Anxiety and Phobia: A Step-by-Step Guide to Lifetime Recovery.Oakland, CA: New Harbinger Publications, 2001.
• Antony, Martin, M., Ph.D., and Richard P. Swinson. Phobic Disorders and Panic in Adults: A Guide to Assessment and Treatment.Washington, DC: American Psychological Association, 2000.

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Panic attack sufferers engage in catastrophic thinking. Remember, people get over panic attacks.

Now we are continuing the "thinking" part of the relaxation work. Remember how we explained that clear thinking can lead to calm breathing and vice versa? We're now going to demonstrate an essential component to controlling your thoughts in order to empower you to control your bodily responses.

Although not a relaxation technique per se, there is one simple thought that will calm you down immediately:

Your panic attack is not a catastrophe

This panic attack or anxiety state in which you find yourself feels like a catastrophe, but in reality, it is not.

If you think about it, a catastrophe is a situation which won't get better or which will drastically alter your and your loved one's lives in a profoundly and perhaps chronically negative way.

In contrast:

• Panic attacks end, usually within ten minutes.
• People get over panic attacks; you don't have a life sentence of panic.
• Your panic attack is not effecting the safety or health of someone you love.

Therefore, your panic is NOT a catastrophe. It certainly feels bad, but it will end; you will not suffer for the rest of your life.

People's tendency to feel like they are in the midst of a catastrophe in situations that are serious and upsetting, but not necessarily catastrophic, is called "catastrophizing" by psychologists. Beyond helping to achieve some perspective on the reality of panic attacks, understanding the concept of "catastrophizing" is also a useful tool when you are not feeling panicked, but need to cope with an unpleasant situation.

People tend to catastrophize when they lack mature coping skills. This is not a criticism. Many, many people manage to make it to adulthood without ever developing the coping techniques they will need to face adversity. Whatever the reasons that might have caused a given person to grow-up without coping techniques, the good news is that they can be learned. In the meantime, learning to get a hold of catastrophic thinking is a first step in banishing your panic and putting you in the position to develop functional coping mechanisms.

People catastrophize because of a phenomenon known as "regression." When we are upset and we lack coping techniques, we regress: go back to a time in our lives (childhood) when our thinking was very black and white. Black and white leaves no room for gray, so something is either perfect or else it is a catastrophe -- there is no room for the middle ground of experience. In the next two lessons, we will be discussing regression and healthy ways to overcome the instinct to regress.

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While depression in older adults is the mental health problem most often discussed, anxiety is the most common disorder they actually face.

In older adults, anxiety is twice as likely to strike as depression

Sometimes James Coats would wake his family in the darkness of a quiet night because he was sure he was about to die. His chest hurt, he felt dizzy, and he had an overwhelming sense of doom."I'd haul my wife and children off to the emergency room at two or three in the morning, because I thought I was having a heart attack," says Coats, 56, a semi-retired construction contractor who lives near Raleigh, N.C. "I'd find out it wasn't a heart attack, but it sure felt like one."

Coats had other unexplained symptoms. His heart rate and respiration would suddenly increase. He would begin to perspire excessively, and tremble. But most of the time he would be filled with a pervasive anxiety that left him incapable of doing such simple things as leaving the house.

It took nine years for Coats to find out that he has an anxiety disorder, and only after the proper diagnosis did he get the help he needed.

The Other Mental Health Problem

While depression in older adults is the mental health problem most often discussed, it is not the most common one faced by older adults -- a fact publicized in a new government report, Mental Health: A Report of the Surgeon General, released in December 1999.

Anxiety disorders, like the kind experienced by Coats, are the most common form of mental illness among adults, including those age 55 and older, according to the report. These conditions -- such as panic attacks, phobias, and obsessive-compulsive disorder -- are "important but understudied conditions in older adults," according to the report.

People age 55 and older are more than twice as likely to suffer from anxiety as depression. According to estimates in the report, during any one year, about 11.4 % of adults age 55 and older have anxiety, compared to 4.4% who have a mood disorder such as depression.

The 458-page report - the first-ever on mental illness from the U.S. Surgeon General - incorporates reams of recent research from all age groups. Like past reports on such health issues as smoking, this one tries to enlighten the public about a health problem so they can "confront the attitudes, fear, and misunderstanding that remain as barriers [to treatment] before us," Surgeon General David Satcher, M.D., Ph.D., writes in the preface.

R. Reid Wilson, Ph.D., who treated James Coats, is a psychologist at the University of North Carolina, Chapel Hill, and also has a private practice. "Anxiety disorders in the older population appear to be an unrecognized and unaddressed problem," he says.

Defining the Problem

The umbrella term "anxiety disorder" is used to describe a range of mental health problems, including:

• Phobias, such as fear of flying, heights, or public places
• Panic disorder, or the sudden feeling of impending doom
• Obsessive-compulsive disorder, in which people experience senseless or distressing thoughts that lead them to repeat actions, like hand washing multiple times in rapid succession
• Generalized anxiety disorder, often described as "a constant state of worry"

Occasional feelings of anxiety are a normal part of life, but anxiety disorders cause people "to become preoccupied with their thoughts to such an extent that it disrupts their everyday lives and drains their mental energy," says Wilson.

Like Coats, many older adults suffer for years without knowing what is wrong with them, Wilson says. Only a third of those afflicted seek treatment. Some may feel stigmatized; others may not be aware that the symptoms they are experiencing are part of a treatable mental health condition. According to the Surgeon General's report, anxiety disorders usually first appear when people are younger, but the stress of aging -- deteriorating health, bereavement over the loss of a spouse -- can cause their reappearance in later years.

Help Is at Hand

Today, more is known about treatment for anxiety, and according to mental health experts and research studies, the success rate is usually high, with obsessive compulsive disorder often the only exception. Individual counseling and group therapy can help people understand their anxiety disorder and situations that can trigger it. They can also learn coping methods, such as relaxation techniques. While medications like benzodiazepines have been tried, according to the Surgeon General's report, such drugs are more effective for episodes of acute anxiety in older adults than for the treatment of chronic, or ongoing, anxiety.

After two years of group therapy, Coats learned how to use such techniques as exercise, self-help groups, and relaxation tapes to help him cope with his anxiety. "I'd say I was plagued by it for 16 years,'' he says. "I used to keep it all to myself and not talk about it. But now I find the more I talk about it and face my anxiety, the better I feel."

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What Psychiatrists Hate: (A Unique Poll)

Among these: Ritual abuse legends, Multiple Personality theory, Repressed memories of childhood sexual abuse trauma, The APA's DSM IV, Psychodynamics, Psychoanalysis, Shock treatment, Freud, Laing, Frontal lobotomy, anal personality tests.

THE INDEPENDENT (London)
March 19, 2001, Monday; Pg. 5
BY Jeremy Laurance Health Editor

DOCTORS TEND to bury their mistakes but a group of the world's leading psychiatrists has chosen to dig them up and put them on display - in the hope of avoiding similar mistakes in the future.

A unique poll of 200 specialists in mental health from around the globe has produced a selection of the worst publications in the history of their discipline.

The results of the poll, carried out on the eve of the millennium 14 months ago, have been seen by The Independent. They show a psychiatric profession at the start of the 21st century throwing off the shackles of the past and dismissing some of the greatest names of the last century.

Among the nominations for the worst research paper ever published were: Sigmund Freud, father of psychoanalysis, nominated for his complete works; R D Laing, leader of the 1960s anti-psychiatry movement, nominated for The Divided Self; and Egaz Moniz, inventor of psychosurgery (the frontal lobotomy) and one of only two psychiatrists to win the Nobel prize.

The exercise, to mark the millennium, was partly tongue in cheek but partly intended to highlight where psychiatry had almost run off the rails. It shows psychiatrists dismissing the "shock 'em and slice 'em" brigade as well as challenging the psychoanalytic movement.

"They show we are ruthless iconoclasts," said Simon Wessely, professor of psychiatry at King's College and the Maudsley Hospitals, south London, and organiser of the poll.

The poll was followed by a meeting held at the Maudsley hospital attended by 150 psychiatrists at which a votes were cast to decide the ten worst papers of the millennium from over 100 nominations. The inclusion of Freud in the final list, at number six, was "slightly tongue in cheek" but also reflected the widespread view that despite having a major literary and cultural impact he had done nothing for patients, Professor Wessely said.

R D Laing, the charismatic and influential psychiatrist who argued in the 1960s that it was not schizophrenics who were mad but society, was included for the harm his misguided theories had wreaked. "It was bad enough for parents having a child who was schizophrenic but being told it was their fault was even worse. It is true parents can influence the outcome of the illness but no one now thinks they are the cause," Professor Wessely said.

Egaz Moniz, the most nominated individual in the poll, was shot dead by a disgruntled patient. The surgery he invented turned people into automatons and is now rarely performed. After winning the Nobel prize in 1949, he went on to write a history of playing cards.

Professor Wessely said that the selection was "utterly unscientific" and that nominations from the Nazi era were excluded because they would have swept the board. Despite that, research carried out in the name of psychiatry over the last century reached in some cases bizarre and disturbing limits.

The accolade of worst research paper went to a brutal experiment carried out in the early 1940s. Scientists stopped the blood flow to the brain in 100 prisoners and 11 chronic schizophrenics by pressing the carotid artery in their necks - to see what effect it would have.

They measured the time before the unfortunate subjects lost consciousness and started fitting, observing in a paper published in Archives of Neurology and Psychiatry in 1943 that "no significant improvement in the psychiatric status of the schizophrenia patients was noted after repeated and relatively prolonged periods of arrest of cerebral circulation."

Professor Wessely said: "Wasn't that a surprise? It was a worthy winner."

THE TEN WORST PUBLICATIONS IN THE HISTORY OF PSYCHIATRY

1. Ralph Rossen: Acute arrest of cerebral circulation in man,1943. An extreme experiment involving almost strangling 100 prisoners and 11 chronic schizophrenics to test the effects of stopping blood flow to the brain. Scientifically dubious and ethically beyond the pale.

2. Valerie Sinason: Treating the Survivors of Satanic Abuse, 1994. Reopened controversy about ritual abuse of children. "Credulous, superstitious, iatrogenic illness-inducing , self-righteous, incendiary garbage," a nomination read.

3. Luke Warm Luke homicide inquiry, 1998: Inquiry into the killing of Susan Crawford, above, a mother of four and girlfriend of a schizophrenic patient, Michael Folkes, who stabbed her 70 times (he had changed his name to Luke Warm Luke). The high point of the blame culture and the stigmatisation of schizophrenics as random murderers. One psychiatrist said: "It implied that whenever anything bad happened it was somebody's fault and these very rare events can be prevented. But they can't."

4. Rosenwald G C et al: "An action test of hypotheses concerning anal personality", Journal of Abnormal Psychology, 1966. Subjects put hands in tubs of soil and slime; speed of action equated to personality. A psychiatrist said: "Shows how silly highly educated people can be."

5. Henry Miller: "Accident compensation neurosis", BMJ, 1961. Argued that people seeking compensation got better as soon as it was paid - shown since by much other research to be wrong. Hugely influential and still cited by neurologists in court cases.

6. The complete works of Sigmund Freud: 1880-1930. Nomination said: "His teaching led to the great psychodynamic movement with its tribalism and hostility to other models of mental illness and treatments. From this root we could select the mish-mash of persons excited about multiple personality disorders, sexual trauma in infancy and other nonsense."

7. Egaz Moniz: Invention of psychosurgery. Portuguese diplomat, present at the First World War armistice, introduced the idea of brain surgery - the lobotomy - to cure mental disorder. A nomination read: "His efforts were useless; his work should have died an aborted death."

8. William Sargeant and Elliott Slater: An Introduction to Physical Treatments in Psychiatry, 1946. Advocated shock treatment, psychosurgery, and more. "Epitome of the mindless period of psychiatry during and after the war."

9. RD Laing: The Divided Self, 1960. Argued that it was not schizophrenics who were mad but society, and the cause lay within the family. "Hugely influential among the chattering classes": "Arrogant, infuriating, confusing philosophy for psychiatry... just plain wrong."

10. DSM-IV - Diagnostic and Statistical Manual: (4th ed). Containing every psychiatric diagnosis, it is criticised for reducing psychiatry to a checklist. "If you are not in DSM-IV, you are not ill. It has become a monster, out of control."

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Difference between night terror and nightmare explained. What causes a child to have night terrors and how parents can help.

It's 10 p.m. As your head hits the pillow, a blood-curdling scream from your toddler's bedroom propels you like a shot down the hallway. You find her sitting up in bed. Wide-eyed, she's screaming and flailing her arms. It's one of the scariest things you've ever seen. As you rush to her, you see she doesn't appear hurt or sick. It must be a nightmare, you think. "I'm here," you say as you put your arms around her wriggling body. But the more you try to calm her, the more upset she gets.

What's going on?

Most likely, your child is having a night terror - a relatively common occurrence that appears mostly in young children, typically between the ages of 3 to 5 years. Two to 3% of all children will experience episodes of night terrors. By the time they reach school age, most of these children will have outgrown these generally harmless events.

"It's frightening but is not unusual or dangerous to a child," says Harry Abram, MD, a pediatric neurologist. "As the brain matures and a child's sleep pattern matures, the terrors go away."

Night Terror or Nightmare?

A night terror is not the same thing as a nightmare. Nightmares occur during the dream phase of sleep known as REM sleep (this stands for Rapid Eye Movement; also known as "dreaming" sleep). The circumstances of the nightmare will frighten the child, who usually will wake up with a vivid memory of a long movie-like dream. Night terrors, on the other hand, occur during a phase of deep non-REM sleep - usually an hour or two after the child goes to bed. During a night terror, which may last anywhere from a few minutes up to an hour, the child is still asleep. Her eyes may be open, but she is not awake. When she does wake up, she'll have absolutely no recollection of the episode other than a sense of fear.

Why Does My Child Have Night Terrors?

Several factors may contribute to your child's night terrors. It's likely that if you or your spouse had night terrors, your child will, too. Fatigue and psychological stress may also play roles in their occurrence. Make sure your child is getting plenty of rest. Be aware of things that may be upsetting to your child, and to the extent you are able, try to minimize the distress.

Children usually have night terrors at the same time each night, generally sometime in the first few hours after falling asleep. Doctors suggest you wake your child about 30 minutes before the night terror usually happens. Get your child out of bed, and have her talk to you. Keep her awake for 5 minutes, and then let her go back to sleep.

Night terrors can be a frightening phenomenon of childhood but they are not dangerous. If they occur frequently or over a long period of time, however, discuss this with your child's doctor.

What Can I Do?

It's helpful to know that although these events may be disturbing for you, night terrors themselves are not harmful to your child. But because a child may get out of bed and run around the room, doctors do advise parents to gently restrain a child experiencing night terrors. Otherwise, let the episode run its course. Shouting and shaking your child awake will just agitate her more. Remember to warn babysitters and other family members who may be present overnight so that they will understand what is happening and won't overreact.

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USA Today Series
12-06-1995

Dick Cavett, talk-show host. "In my case, ECT was miraculous. My wife was dubious, but when she came into my room afterward, I sat up and said, 'Look who's back among the living.' It was like a magic wand,'' he wrote in People in 1992.

Lou Reed, rock musician. "Lou's conservative parents, Sidney and Toby Reed, sent their (17-year-old) son to a psychiatrist, requesting that he cure Lou of his homosexual feelings and alarming mood swings. . . . Lou suffered through eight weeks of shock treatments haunted by the fear that in an attempt to obliterate the abnormal from his personality, his parents had destroyed him,'' according to Transformer: The Lou Reed Story.

Thomas Eagleton, former Democratic senator. He lost the Democratic vice presidential nomination in 1972 when it was revealed that he received shock treatment for depression.

Ernest Hemingway, writer. He had shock therapy at the Mayo Clinic in 1961, shortly before committing suicide. He told biographer A.E. Hotchner, "What is the sense of ruining my head and erasing my memory, which is my capital, and putting me out of business? It was a brilliant cure but we lost the patient.''

Sylvia Plath, poet. She wrote a shock therapy scene in her autobiographical novel The Bell Jar: "I wondered what terrible thing it was that I had done'' to get shock therapy.

By USA TODAY

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