the neuropsychotherapist volume 5 issue 12, December 2017 neuropsychotherapist.com From the Editor n what seems like a flash, I find I am introducing my second issue of The Neuropsy- chotherapist—and, I can confess, I am loving every moment. As I take over the reins of content management, I look forward to receiving your submissions and Richard Hill suggestions for upcoming issues—an article, something short and fascinating, a Managing Editor Ibook review, or perhaps a person who you believe deserves a spotlight. In this issue, we continue to cover the serious problem of PANDAS. Micaela Monteiro-Haig helps us understand the neurobio- logical details, and she also covers treatments that, among other things, include recommendations for following an anti-inflammatory diet and guidelines for maintaining gut health. Micaela’s view as a naturopath widens our perspective. We have so much to learn about how to recognise and treat this difficult paediatric condition. We will continue our exploration in future issues. Bob Shebib’s article “Neuroscience and Counselling” takes us on a walk through the brain. It is a great introduction for those beginning to learn and an excellent review for others, including myself. I love the way he creates conver- sations from clinical practice to illustrate the context and application of the neuroscience he describes. And what do we know about smiling? Our neuroscience short-take gives us a surprising research insight that you might not be expecting. Finally, our last Last Word for the year comes from Terry Marks-Tarlow who reflects on time, which is entirely fitting for our year-closing issue. The Neuropsychotherapist is a great fan of Terry’s work on play, art, and creativity. Take some time to search it out. Which leaves me a few lines to wish everyone connected to The Neuropsychotherapist—whether the editorial team, contributor, or reader—a very happy and relaxing end of year break. We hope that you are encouraged and strengthened as you celebrate your personal, cultural and religious traditions, whatever they may be. May you and your families be well and full of good heart, and may the New Year be all that it can be. Richard Hill 06 16 2 The Neuropsychotherapist Vol 5 Issue 12, December 2017 the neuropsychotherapist™ CONTENTS Volume 5 Issue 12, December 2017 Features UNDERSTANDING PANS & PANDAS: THE 06 INTERPLAY OF IMMUNE SYSTEM AND MENTAL HEALTH Naturopath and expert in how body sys- tems affect mental health Micaela Monteiro-Haig takes a look at a group of autoimmune disorders that have a profound impact on mental wellbeing— paediatric acute-onset neuropsychiatric syndrome (PANS). Micaela Monteiro-Haig NEUROSCIENCE AND COUNSELLING 16 Bob Shebib, Faculty Emeritus at Douglas College, New Westminster, British Columbia, Canada, is an educator and counsellor with broad experience in child welfare, corrections, mental health, and ad- dictions. This month he gives us a comprehensive overview of neuroscience as it pertains to counsel- ling from his book Choices: Interviewing and Counsel- ling Skills for Canadians (7th Edition) EDITOR IN CHIEF MANAGING EDITOR Bob Shebib Matthew Dahlitz Richard Hill ASSOCIATE EDITOR COPY EDITOR Geoff Hall Tina Pentland Departments ADVISORY BOARD Jack C. Anchin, PhD; Malek Bajbouj, MD; Louis J. Cozolino, PhD; Short Cut ................................04 Todd E. Feinberg, MD; Richard Hill; Stanley Keleman, PhD(hc); The Last Word ..........................62 Jeffrey J. Magnavita, PhD, ABPP; Haley Peckham, PhD; Iain McGil- christ, MD, MRCPsych; Robert A. Moss, PhD, ABN, ABPP; Judith A. Murray, PhD; Georg Northoff, MD, MA, PhD; Pieter J. Rossouw, MClinPsych, PhD, MAPS, CCLIN; Allan N. Schore, PhD; Paul G. Swingle, PhD; David Van Nuys, PhD ISSN: 2201-9529 The information in this magazine is not intended to be fully system- atic or complete, nor does inclusion here imply any endorsement or recommendation by the publisher, or its advisors. We make no war- ranties, express or implied, about the value or utility for any purpose of the information and resources contained herein. This magazine does not presume to give medical or therapeutic advice. The Neuropsychotherapist™ is a trademark of Dahlitz Media Pty Ltd. This PDF version of The Neuropsychotherapist is best viewed on Adobe Reader. Other PDF readers may not support the Copyright © Dahlitz Media 2017 ACN: 139 064 074 interactivity incorporated in this publication. To download the free reader go to Cover Image: digitalista/Bigstock.com http://get.adobe.com/reader/ www.neuropsychotherapist.com The Neuropsychotherapist 3 short cut No One Expects the Smiling Inquisition! Smiling has to be a good thing, and broadly speaking, it is, but Aparna Labroo and colleagues have conducted research that shows it rather depends on what you are ex- pecting (Labroo, Mukhopadhyay, & Dong, 2014). Despite the title above debasing the infamous doing anything meaningful. This proved a strong line from Monty Python, the research examined the correlation. So, if wasting time is a major creator of principle that the more people smile, the happier negative mood, why do people keep going back to they will be. This concept was given weight by the using Facebook? The answer was that many users work of Addelmann and Zajonc (1989) where they committed an “affective forecasting error”, in other showed that smiling, even involuntary lifting of the words, they expected to feel better. mouth by producing smile-like sounds, improved Expectation can be a driver of motivation even mood. However, their work did not show that this when the result proves to be wrong. What is sur- resolved a negative mood—only that it tended to lift prising is that some people will persist with push- a neutral mood. There is also some support for the ing for the expected result regardless of evidence idea that afferently stimulating the seventh cranial to the contrary. Expectations can be a motivation, nerve by smiling (the cranial nerve controls muscles but they can also be the source of disappointment used for facial expressions like smiling) can stimu- and dissatisfaction. The trick is to find something late elements of the social engagement system and to smile about and then smile about it frequently, interpersonal relating (Porges, 2013; Siegel, 2009). without an expectation of anything. But is there a proviso? Addelmann and Zajonc (1989) found that if smil- - Richard Hill ing was seen as reactive, or a reflection of personal happiness, then smiling was beneficial for well-be- ing. Conversely, if smiling was seen as proactive, Addelman, P. K., & Zajonc, R. B. (1989) Facial ef- and causing happiness, then frequent smiling re- ference and the experience of emotion. Annual sulted in less well-being. You might interpret that Review of Psychology, 40, 249–280. doi:10.1146/ as showing the need for meaning and relevance annurev.ps.40.020189.001341 for our bodies to respond in more than superficial ways. Smiling to become happy is not an effective Labroo, A. A., Mukhopadhyay, A., & Dong, P. (2014). method; but smiling when you are happy is a tonic Not always the best medicine: Why frequent smil- for you and for those around you. ing can reduce wellbeing. Journal of Experimen- tal Social Psychology, 53, 156–162. doi:10.1016/j. The counterintuitive implication of expecta- jesp.2014.03.001 tion was also found in an interesting study on the emotional consequences of using Facebook by Sa- Porges, S. W. (2013). The Polyvagal Theory. New gioglou and Greitemeyer (2014). The authors were York, NY: Norton. interested in finding out why so many people spent Sagiogiou, C., & Greitemeyer, T. (2014). Facebook’s large amounts of time on Facebook, even though emotional consequences: Why Facebook caus- their research showed that it created negative es decrease in mood and why people still use mood. They first looked at the time spent on Face- it. Computers in Human Behavior, 35, 359–363. book and found that the longer people were active doi:10.1016/j.chb.2014.03.003 on Facebook the more negative their mood was Siegel, D. J. (2012). The Developing Mind (2nd ed). afterwards. They then looked at the relationship of New York, NY: Guilford Press. negative mood to the feeling that the user was not 4 The Neuropsychotherapist Vol 5 Issue 12, December 2017 short cut The Psychotherapist’s Essential Guide to the Brain The Psychotherapist’s Essential Guide to the Brain is a 147-page, full-colour illustrated guide for psychotherapists describing the most relevant brain science for today’s men- tal health professionals. Taken from the best of the series published in The Neuropsy- chotherapist, and completely revised, this book represents an easy to read guide for anyone working in the mental health arena. “This book presents a thorough and clear introduction to the neuroscience that’s essential to to- day’s psychotherapist. Matt Dahlitz has done so much with The Neuropsychotherapist journal and this book takes a next step. It is an excellent resource. It truly is exactly what it says on the cover and provides engaging discussion on the pathology of oft-encountered disorders and their brain basis together with insights into how awareness of the neuroscience underpinning effective therapy can guide a therapist.” – Amazon UK Reviewer “Beautifully illustrated and filled with The Psychotherapist’s Essential Guide to the Brain cutting-edge understanding of the interface the psychotherapist’s of brain, body, mind, mental illness and psychotherapy, I can highly recommend this essential guide to the brain book. I feel I am pretty well-versed in neurobi- Matthew Dahlitz ology and yet this book had much to teach Edited by Geoff Hall me, from the “default mode” in the brain to the complexities of approach and avoidance and the circuits at play in depression and OCD, I feel I have deepened my understand- ings of the neurological underpinnings of mental illness and how to engage these in psychotherapy.