Ways to Block Unwanted Thoughts

Many children and adults deal with unwanted thoughts on a continual basis. These unpleasant thoughts can often detract from school, work and personal relationships. Fortunately, there are some effective strategies that can free the mind from these negative thoughts.

One of the most effective ways to keep unwanted thoughts from plaguing the mind is to not think about blocking them. A concept known as the ironic monitoring theory explains how the mind is more likely to think about the unpleasant thoughts when trying to block them out of the mind. Many negative thoughts are automatically blocked after a while when the mind is not trying to think of ways to stay distracted from them.

Writing unpleasant thoughts on paper is another method to combatting this problem. Putting these ideas on paper can be cathartic for the mind, and seeing them in written form might make them easier to analyze. It is also a good idea to eventually cross off the thoughts on the list that no longer seem overwhelming.

Certain mental disorders also cause people to think of things that are negative. Anxiety, depression and obsessive compulsive disorder, in particular, often cause the mind to focus on unpleasant thoughts and feelings. Having these disorders treated through therapy can put the mind into a better state and help control thought processes.

Some people have even benefited from scheduling a time during the day to think about unpleasant thoughts. This helps establish a better sense of control over the thoughts, and thinking about them at designated times will likely cause less feelings of anxiety or grief.

Taking proactive steps to keep the mind distracted from unwanted thoughts can be further beneficial. Exercise has been scientifically proven to reduce stress levels, and focusing on working out can force the mind to concentrate on the tasks at hand. Other distractions that may be helpful include focusing on work, spending more time with friends and taking up new hobbies.

Blocking out unpleasant thoughts is possible, and some of the best ways to adopt a more positive mindset do not take a lot of extra effort. Gaining control over these thoughts can help anyone live a happier, more fulfilling life.

Health and Grades Will Come, First Focus on the Individual

Anxiety and uneasiness is more often than not a common experience in youth. Anxiety could be considered an inevitability for anyone and everyone, prolonged anxiety, for long periods of time, can be debilitating or taxing in one’s daily life.

Anxiety is not a necessary addition to life, though it can be hard to avoid, or hard to deal with when it strikes. In the life of an adolescent, anxiety can affect health, grades, and most importantly, a child or adolescent’s sense of well being. Paradoxically enough, Anxiety at this age can offer be a consequence of grades, while it is a surefire way to affect grades themselves.

At this point in an individual’s life, the adolescent must reconcile with changes in themselves, changes in their peers and social groups, and this stretch of the journey of life is often considered the most difficult, or the most riddled with stress and anxiety.

A common theme for individuals at this point in life, is a feeling that something is missing. True, that at the age of adolescence, the child is no longer an offshoot of his parents, but an independent entity who, whether actively or not, has a dormant desire to actualize this break, or an inner battle in which the individual must reconcile with the inevitability of this break if it causes anxiety or is unwanted. This “loss’ in itself is a legitimate experience as a part of the individuals coming of age.

How does this manifest in the life of an adolescent? It is as if each individual shoots off in their own direction at the point of puberty. While it was once a closer feeling of unity amongst the individual child and his or her peers before puberty, the individualization which occurs (or has not yet occurred for some) sends adolescents on their own paths to self discovery, on a journey to define themselves.

The real question, is how can we assist these individuals, how can we as a community help, and contribute to their becoming their own selves? It is my every joy and pleasure to be able to offer council and direction to youth, to guide them on this journey, and help each individual in the process.

What isn’t always clear for every person in the adolescent stage of life is what decisions can really define them, and how the impact of time and patience can truly benefit them in their individualization. It is not my duty or responsibility to impose a system of values on anyone, rather, I’ve found myself a listener, who through empathy and experience with so many others, can lead others to help themselves- to determine where their real interests and goals lay, to allow those individuals to realize these pathways and modes of thought which will inspire them, on their own, to make those “educated” decisions and life choices.

In a time and community which wants the best for its children, where “the best” is often measured by grades, school performance, and similar gauges from the adult perspective, and an entirely different lens for the youth themselves, it is one of the most difficult things for an adolescent individual to balance.

The weight may seem as if it is all on their shoulders, like no one understands their struggle, or that their peers and their family, and the posters on the side of the street all want to fit them into some category that simply doesn’t resonate with them. And how are those individuals to know that the values by which they themselves feel judged are not the only values on which to judge, and are perhaps not the best values for them individually?

Maternal Support Linked to Hippocampal Development

dr m david kurland mother and child

A study conducted by child psychiatrists of Washington University suggests that the children who were nurtured by their mothers during their preschool years were prone to stronger brain structure growth.

Joan L. Luby, the first author of the study says that their findings suggest that the human brain has a specific period in its early growth where it responds more readily and positively to the maternal support it receives. This research is part of a larger project that the researches are working towards, and builds on top of their previous study that suggests there was a link between maternal nurturing before school age and a larger hippocampus.

Luby and her fellow researchers analyzed brain scans that were taken of children between preschool age and early adolescence. 127 children were given three different MRI scans that documented their brains between preschool and “early adolescence”. They noticed some distinct differences in the children’s hippocampi.  During this analysis, the researchers were able to see a distinct increase in the hippocampus in children that received nurturing support during their preschool aged years. The children that did not receive as much support, had a much smaller hippocampus. The hippocampi remained small even if their maternal figures increased their amount of support during later developmental years.

Their findings have allowed the researchers to come to a few different conclusions. It has become increasingly clear that maternal nurturing is more important in the early stages of a child’s life than any other time; its effects decrease over time. The hippocampus’s growth is also directly related to the overall health of the child’s emotional function as teenagers. Teenagers that did not experience the early maternal nurturing were at a distinct disadvantage in terms of the benefits of hippocampal growth.

Co-author of the study, Deanna M. Barch, PhD of Washington University, was quoted saying,

“This finding highlights the critical importance of caregiving in sculpting aspects of brain development that are important to how children function as they mature.”

Understandably, what constitutes “nurture” is relative, but the researchers standardized what they counted as nurture by monitoring and observing recorded interactions between the children and the mothers. Nurture and support was based on the mother’s ability to “maintain their composure and complete assigned tasks while still offering emotional support to their children.”

The findings of this study have important implications because they shed light on what can be done to help children perform better in school and develop healthier emotional demeanors in the long term.


The materials sourced for this blog can be found here: Science Daily via Washington University


Exercise is an Important Part of Childhood Development

children playing football

Odds are if you’re feeling down, you probably won’t want to get out of bed, let alone put on your exercise clothes, take a run around the block. Succumbing to the feeling of wanting to do nothing will not help your case, however. Whether you’re feeling unwell already, or, say, if you feel normal but your days are packed with endless activities and no downtime, staying put will not contribute to your feeling of wellbeing. Engaging in any kind of physical exercise, however, can lift you out of those moods and allow you to look beyond it, or simply help you ensure that those moments are less likely to come on.

So, will taking your dog for a walk or jogging to your local market solve depression for you? Odds are, no… but engaging in a regular exercise routine can certainly help you work through difficult feelings. Studies show that people who engage in regular exercise enjoy a boost in mood and higher self esteem, versus those who do not.

The same holds true for children and young adults. Self Esteem is an essential element in the healthy development of children and adolescents. Self Esteem allows children to grow and gives them the confidence to try, and to continue trying, unbeaten, when they fail. Trial “and error” is an essential part of growing. Without the confidence or self esteem to try, children won’t give themselves the same opportunities to grow.

Along those same lines, playing sports is one of the perfect opportunities for children and adolescents to learn these values, and to learn to try and learn to fail in a certain safe environment. On the one hand, children will get the benefits of exercise: self esteem, a feeling of motivation… one of the main benefits of exercise is that it produces endorphins in the brain, which lead to a feeling of wellbeing which can help self confidence and self esteem, and generally, just contribute to a healthy lifestyle which can promote positive childhood development.

A balance of sports and exercise in a child or adolescent’s life can help them handle the changes coming on at those times. Endorphins have a stress relieving effect and help stave away feelings of depression or anxiety. Being able to constantly try, fail, and learn to work with a team will be a defining factor in any childhood development.


For more information about the importance of exercise and childhood development, look to the following resources: here and here

Individuals with Autism May Experience Difficulties When Transitioning out of Adolescence

There has been an increase in prevalence of Autism Spectrum Disorder in children psychiatry in recent years. However, the attention that the issue is paid decreases significantly as these children begin to age and transtition into teenage years and ultimately, adulthood. Anne Roux, M.P.H. a research scientist states that the current research, while worthy of praise, is leaving the entire population of aging people with Autism Spectrum Disorder “underserved”.


Autism is usually highlighted and focused on in early, developmental years, but the condition is life long. The heavy focus on children with autism leaves adults with autism in a world full of misconceptions about the disorder in adult years. The misconceptions within the medical industry specifically leaves a scaricty of resources for adults with autism as they age and continue to try to navigate through life.


It has been shown that while secondary schools are often equipped to provide counseling services and developmental programs, less that sixty percent of students with ASD are actually receiving the proper assistance from schools when it comes to transition planning.


The report “National Autism Indicators Report: Transition Into Young Adulthood” was created to track how young adults with ASD are actually living as they transition out of school, and the reality is unfortunately on the bleak side. When children with ASD leave high school, only thirty six percent of them actually make it through a post secondary education program and only fifty eight percent of them were able to acquire gainful employment. Even more astonishing is that individuals with ASD are only able to live independently nineteen percent of the time.


The findings of the report are able to clearly conclude that adults with ASD begin to suffer and lose direction immediately after completeling high school. People with Autism Spectrum Disorder are not developing function skills as quickly as their brain develops, which leads to difficulty with communication, speech, and social development. This directly effects their ability to adapt to their societal surroundings and to become self sufficient. Roux has outlined that there is a huge need for more study and data on adult-age individuals with ASD, to create a better measurement of progress, and ultimately more resources for adults with ASD.

To see the full article, click here.


Robot Therapists Enter the Realm of Child Psychiatry

The field of psychiatry is historically associated entirely with human interaction and empathy; it is a science and field that seems unlikely to be associated with the ever-increasing encroachment of technology and robots in the medical field. However, that is exactly what is happening. Robot therapy is becoming an increasingly growing area of study; it’s most prominent sector being the realm children with Autism Spectrum Disorder (ASD).


The use of robot therapy with children with ASD is a thriving area of research; studies have shown that children with autism prefer to interact with technology over interacting with humans. The medical and psychiatric realm is now working to determine how to optimize this preference for everyone’s benefit. Zachary Warren, Ph.D. poses the question, “How do we use this preference to boost early social skills, as opposed to having technology exacerbate the deficits in social behavior?” It’s a delicate line balance. Warren has been working on a creating an environment that tests a “robot therapist’s” ability to teach joint attention to children with autism. This inability to share the focus of on a common item is an early, telltale sign of autism spectrum disorder in children.


Warren and a team of engineers have created a system of cameras that track where a child’s focus is held. While the cameras are rolling, a robot provides prompts to the child to guide their gaze/focus. The robots are equipped to provide positive reinforcement to the children when prompts are received successfully. The use of robots in this scenario provide a very unique benefit: the physical presence of the robot allows it to be more than just a tool; children react with this technology creature more readily (and differently) than they would with simple 2D images on a screen.


This is not to say that the robots will be able to replace human interaction (at this point in time), but the robots do offer a unique, complementary addition to the care and treatment that a child can get from humans.


There is a huge potential for growth within the field of robotic therapy. Autism spectrum disorder is not the only disorder that can be addressed with the correct robot technology. There is the potential for robot therapists to work with children who are survivors of trauma or abuse, who may feel more comfortable being open with something that is not a person. There is also the potential to move away from children, and to work with older adults who suffer from Alzheimer’s or dementia.


To see the article that inspired this post, click here.


Best Medical Schools in Boston, MA

Crafting a list of “bests” for any category of entities can be difficult, especially when trying to remain objective, and all-inclusive. It’s important that a viewer of any such lists keep in mind that any standardized rubric will not focus most on factors that are most important to him. For this, it is important to review all the parts of the whole. Looking into the medical schools in and around Boston, I compile a guide for the top four according to a general consensus taking into consideration the most impactful components of a school. A small characteristic blurb follows each. In no precise order:

1. Harvard Medical School | Cambridge, MA

Harvard is the best known name in the game and that’s the case for a lot of things. But historicity, longevity, and popularity don’t make a school. Having the highest performing students in attendance and the most funding granted do. Harvard is one of the most selective school in the nation with only a 2% acceptance rate, and attracts and selects from a diverse pool of applicants with students from all over the country, and out of the country. That means the coals, if you will, of the highest quality are being turned into diamonds. Harvard also sees 

far more than double the average amount of funding provided to medical schools nationwide. 

2. Boston University School of Medicine | Boston, MA

BU started as the first institution to offer medical education to women and continues the tradition of progressiveness and innovation to this day. Students can apply as undergraduates as part of a program that shapes them to be better prepared for medical school after their study is complete. The flexibility and rather unorthodox nature of the school also gives students with a stronger proclivity toward the liberal arts the opportunity to merge a more humanities-based schedule with the classes required for medical school. Boston lands in the top ten schools with the most applicants with about 9,000–11,000 applying every year. For a cherry on top, the school is a magnificent castle in the heart of the city making it desirable as a place of study, and  easily accessible from all parts of the metropolis.

Visti my other website for the complete list of Massachusetts’ best medical schools.

Distinguishing Between Seasonal Affective Disorder and Depression

Dr. M David KurlandThis winter has been very tough on a lot of people, and even though we are on the last stretch, it’s still affecting mood changes and making our winter blues even worse. Each year, more than 10 million people in the US are diagnosed with Seasonal Affective Disorder or (SAD), a problem that is related to depression occurring in the winter months. This phenomenon is experienced more by populations in the Northeast, and it affects women more than man. However, it is difficult to distinguish if people are experiencing seasonal depression or if it’s a more serious problem.

Below are some signs that you could be experiencing SAD and  your blues are season related.

1. Sleeping in Late
Snoozing is a lot of people’s favorite activity during the winter months, especially during those snowy and chilling mornings. The science behind this is that SAD affects your melatonin levels, which eventually will disrupt your sleeping habits.

2. No Enjoyment in Fun Activities
SAD is a big factor in people retreating from normal social activities and becoming more closed off during the winter months. Experts in this field mention that even your work might suffer from this condition, as you begin to lose interest in routine daily tasks. Withdrawing from social circles is another primary measurement of depression.

3. Carbo Loading
According to a study conducted by the Mayo clinic seasonal depression is a big factor in consuming more than the normal amount of carbohydrates. During these months people also experience abnormal eating habits, while the summer is a time to be active.

The crucial distinction between Seasonal Affective Disorder and other types of depression is that people who experience SAD feel fine during the other seasons. In most cases, SAD is usually only present during the rough and long winter months. Once the cold is over, people are able to bounce back and return to their normal routine. If these symptoms are prevalent for longer than the winter months, you should reach out to a professional.

Valentine’s Day: Perks and Pitfalls

Two Hearts are better than oneValentine’s Day can be a double edged sword, straight through the heart. Either you are delighted, and enthralled to spend time with someone, or ever to communicate from afar, or on the other hand you may feel anxiety for lack of a true sweet heart, or someone to call your own.

For many children, Valentine’s day can be a source of anxiety. Yes, there are usually plenty of friends with whom young men and women can share their play affection, and celebrate in jest at the idea of the holiday, and many can even to make gestures attributing to their real friendship in homage to the holiday.

However, at a time when most youth, boys and girls, are figuring out their relationship with the opposite sex, Valentine’s Day can act as a point of pressure. The holiday can be wielded by others to single out another colleague and make him or her feel falsely inadequate. In the coming of age, a holiday that stresses affection for a significant other can put pressure on youth to feel or experience something they simply may have no interest or desire to feel at that moment. In fact, wouldn’t you say its the same for some adults?

I myself have felt simply comfortable to be alongside my spouse and read. That can be enough for me and I feel no remorse. We can smile at each other at the turn of a new chapter and be glad, or indifferent, to be spending such a day together.

I, however, am experiencing a privilege in my wiser days, that many a young man and women have no hope to experience for another 10 or 20 years: there is no bully around me telling me how I should feel or where or what I should be. Valentine’s Day is a perfect point of exploitation for many boys and girls who get satisfaction from prying and prodding their peers. This, of course is inevitable. What would I say in that case?

I ask you, whatever your age, or your children should a parent be reading this, to remember their life is their life. Take it slow. Enjoy. Things will come in time, and there is no real benchmark you should hold yourself to if you cannot find inspiration in it. If, after all, that were the case, what would be the use of such a thing?

I can’t tell you how grateful I am to see things from a perspective of greater time. I know not everything comes readily, and the important junctures in each one’s life will be different and important because they have come naturally in that one’s life.

So, in short, remember your family, their best side, on a day like tomorrow. For companionship and good company (even if infrequent) are the things you will remember forever.

Happy Valentine’s Day, All.

– Dr. M David Kurland

Antidepressant Medication

In the American Journal of Psychiatry (7/13), B.R. Rutherford and S.P. Roose reviewed the results of published antidepressant clinical trials.

Less than half the studies found the antidepressant medications superior to placebo. The overall indication remained, however, very strongly in favor of the use of these medications for many depressed people. Depression takes a devastating toll on the lives of afflicted individuals and on the functioning and quality of life of our population as a whole. Medication remains one of our strongest resources in treating it. Studies show that many depressed people will be greatly benefitted, that many will no longer be depressed.

The studies that don’t seem to show those benefits run into an unusual problem when the benefits are “compared to placebo”. The research problem is often not that the people who get medication don’t do well, but that those who get placebo also do well! Why should this be? When both groups do well, we don’t see much difference, and the advantage of the medication is less apparent.  Even in the studies that do demonstrate a substantial advantage in the medications, the size of the difference is often less than we’d expect. The research results seem less impressive than the results doctors see when actually treating patients. Why this “placebo issue”?

The studies consist of giving one group of depressed people the medication studied (“the active medication”), while giving another group pills (placebos) which look like the active medication but contain no active medication. The researcher then measures the difference between the results with active medication and the results with placebo. In these antidepressant studies, the high figures when using placebo have been unexplained and a cause of confusion.  In contrast, for example, in studies of antipsychotic medications, active medication figures are higher and, more to the point, placebo figures are lower. Understanding the reasons for these depression results seems critical to our understanding of the medications and to our understanding of depression.

The studies don’t indicate which depressed people will be helped and which will not. This may be a key to the answer.

In research studies, people receiving placebo are not receiving nothing. The researcher pays attention, listens, is “there”, acknowledges and more often agrees with what’s said. He or she may be engaging, may be empathic. In giving information about the study, information is often given about depression and about symptoms. Tests may be done. This all may involve more visits than many people get when actually seen in treatment in a doctor’s office. The researcher may convey enthusiasm about the study. There is a hopefulness factor- maybe the subject is in the group that’s getting the active medication and maybe the medication is great. But why should the placebo factor be so much greater in depression studies than in other studies, e.g. schizophrenia studies? The answer is important: we need to know as much as we can about when to give the medication and when not to.

The answer may lie in how the studies define depression. There’s evidence, for example, that the difference in effect between active medication and placebo is greater in cases where the depression is more severe. It may also be that the depression defined in the study is not a single disorder but a collection of different disorders which react differently to medication and may react differently to placebo. A classical depression (often called “monopolar”) may differ from the depression which occurs as part of a “bipolar” disorder. These may differ from the depression which accompanies (is “comorbid” to) a different disorder, for example, a traumatic disorder. All three may differ from the depression which is not a “disorder” but a “feeling very bad” reaction to “real” setbacks or losses. There are numerous other differences as well. Histories differ, personalities differ, family systems differ. In contrast, studies of schizophrenia may more clearly define the target of the antipsychotic medication. The more “depression” is a collection of different conditions, the more we might expect medication results to differ and, perhaps, placebo effects as well. Perhaps medication benefits the more “clinically” depressed and placebo benefits many unhappy people with less “clinical” depression. This would narrow the gap between medication and placebo results.

If this is true, it’s a strong indication for better definition in research studies. The Hamilton and other scales and DSM itself may poorly define depression. They may lack “specificity”. They may too roughly detect some assembled group of disorders and the result may be rough and not nearly helpful enough. Studies can surely be done that would better differentiate, better define. These would not only teach us about medication and its best use, but teach us more of what depression is really all about.

All of this surely tells us that an able psychiatrist, when treating his very specific individual with depression, must do a better evaluation and individualize both the treatment and the ways in which he or she works with that person. When research doesn’t tell us enough, we must use any and all the ability, training, and experience we have, to form our approach to the depressed person we work with. When our efforts are under way, we must see him or her often enough and use all we can gather in each visit to learn how to go further.

We may decide to medicate or not. In either case, we must have the ability, the personal professional resources, to work with the person in our office as an individual with his or her own personality and history and a member of his or her own family system.