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Scientific American, April 14, 2011
Scientific American Mind May/June 2011

Distance Therapy Comes of Age (p. 60)
What happens when your therapist moves 2,000 miles away? Not a problem, writes Robert Epstein in the May/June issue of Scientific American Mind . Research demonstrates that psychotherapy delivered via e-mail, video, chat, voice or texting can effectively treat cognitive, emotional and behavioral disorders.

Long-distance therapy can be a convenient and low-cost method of helping people who are either too far away for in-person sessions or require more confidentiality when seeking mental health treatment. Furthermore, it allows for quick therapy boosters between regular sessions for problems such as eating disorders, alcohol abuse and cigarette smoking. "Imagine helpful periodic tweets from your therapist arriving within hours or even minutes of when you might have lost your temper or reached for a cigarette," Epstein explains.

But therapy at a distance has some limitations. Psychologists who have never met their patients may not be able to adequately respond to an emergency situation, and similarly, patients cannot be certain that the therapist they have signed up with is not a fraud. But Epstein is optimistic-this is the first step into modern technology for the ever evolving field of psychotherapy.

Obsessions Revisited (p. 36)
Scientists are challenging the notion that obsessive-compulsive disorder (OCD) is primarily an anxiety disorder. Instead, they are starting to classify OCD as a problem based on urges that cause repetitive thoughts and behavior, Melinda Wenner Moyer writes in this month's Scientific American Mind .

OCD affects 2 to 3 percent of Americans, although the severity of symptoms can vary widely. Elizabeth McIngvale, a 23-year-old Ph.D. student and spokesperson for the International OCD Foundation, used to have an "exhausting and grueling" obsession with the number 42, rinsing her hands and putting her leg in and out of her pants 42 times, for example. "I was probably doing 12 to 13 hours a day of rituals," she says.

Thanks to exposure and response prevention (ERP) therapy, McIngvale's symptoms have improved. During ERP, patients are exposed to stimuli that trigger their repetitive behaviours, but they are not allowed to perform their associated compulsions. Drugs known as serotonin reuptake inhibitors (SRIs) can help some patients but can take several months to start working-if they ever do-and usually work better if the patient is also undergoing ERP.

The effectiveness of SRIs suggests serotonin may have a role in the disorder, and genetic studies have indicated that glutamate may also be important-this neurotransmitter is thought to be critical to a neural circuit involved in making rewarding decisions, which often malfunctions in patients with OCD. It is hoped that treatments stemming from better understanding of OCD will improve the quality of life of individuals with the disorder.

The Unleashed Mind (p. 22)
Highly creative individuals are commonly perceived as being eccentric. Work reported in this month's Scientific American Mind provides a scientific explanation for the apparent connection between oddity and innovative thinking.

Creative people often have unconventional modes of thinking and of perceiving the world. People who display such unusual points of view can often be classified as having a schizotypal personality, a set of traits related to, but milder than, symptoms of the clinical psychiatric condition schizophrenia. Schizotypal traits can include paranoia, social anhedonia (a preference for solitary activities over social interactions), paranormal beliefs and perceptual distortions. These peculiarities may foster eccentric behaviors but do not necessarily create incompetence. Many schizotypal people are very high functioning, talented and intelligent.

Shelley Carson theorizes that both creativity and eccentricity result from genetic variations that increase cognitive disinhibition, a failure to filter out extraneous information in the environment. Brain imaging and electroencephalography (EEG) studies find that highly creative individuals tend to more porous cognitive filters, letting more information into their brains. According to this idea, a schizotypal personality does not itself spawn creativity; rather, certain cognitive mechanisms that may underlie eccentricity could also promote creative thinking. To boost and encourage creativity, businesses, schools and other institutions are increasingly making room for the "square pegs" that make such valuable contributions to our society, a trend that Carson applauds.

About Scientific American

Founded in 1845, Scientific American is the oldest continuously published magazine in the US and the leading authoritative publication for science and technology in the general media. Together with and 14 local language editions around the world it reaches more than nine million readers. Other titles include Scientific American Mind and Spektrum der Wissenschaft in Germany. Scientific American is published by Springer Nature, a leading global research, educational and professional publisher, home to an array of respected and trusted brands providing quality content through a range of innovative products and services. Springer Nature was formed in 2015 through the merger of Nature Publishing Group, Palgrave Macmillan, Macmillan Education and Springer Science+Business Media.

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