What is Health Psychology?

hello I'm Julianne good and this is psych one on one we are here to make psychology understandable with tips for you and your family and friends to make your life easier tonight my special guest is dr. Jennifer DeFeo welcome dr. Jennifer thank you how are you good how are you wonderful thank you so tonight our subject is going to be on health psychology and what exactly is health psychology so health psychology is this study and focus on individuals who have health issues so things like what do you do when you first get diagnosed with breast cancer or a chronic illness and so what we do is we work alongside of medical professionals and sort of help individuals transition cycle psychologically through some of these harder issues that they're faced with so yeah and many more people it seems are coming down with more illnesses that are going to need some psychology needs some counseling work how do you come into play during the situation like that okay so oftentimes if I get a referral or say from a medical physician which is rare because one of the issues that we have in the field is that individuals be diagnosed with breast cancer or whatever cancer whatever it may be and they're often from a medical model like okay this is what you need to do to get better but they don't say here go to go to a psychologist go to a therapist and talk about some of the issues that's going on so for example chronic pain patients who come in I will look at what is specific to the chronic pain so for example fibromyalgia is a big one now and so my first goal is to find out what medications they're taking what doctors are they seeing what kind of medical health link are they working with are they working with a physical therapist what kind of treatment is going on and then the goal is for me to connect with these individuals so that I can advocate for the patient not only in the perspective of let's make sure that everything is solid with you that you're getting all the help that you need but then I can get feedback from those individuals on what is the progression what is the severity and compare it to the individuals actual functioning in fibromyalgia is a really tricky medical diagnosis to be working with when I was in the medical field I was working with fibromyalgia patients also as being a licensed massage therapist and it was almost like the body was holding on to a lot of tension and pain and it felt a lot like armoring now yes do you work with that armoring mechanism when you're doing psychology with these patients yes I actually have a client that I work with who has that who is sort of guarded who will be stuck in bed for seven days not eating not doing anything which borders can they care for themselves right so they go into the depression and so part of that is lifting that armor because they're so afraid of if I do one little thing that will trigger the fibromyalgia then I'm gonna be bedridden and they will essentially some people have frozen shoulder I'm sure you've seen that where they're literally stuck and so part of my thing is to one not only work with what's in the moment but work on what can you do what kind of coping skills can you do so that if you do have an issue you can bounce back quickly because it's you cannot cure fibromyalgia you cannot cure many of these issues but psychologically they're going to become more depressed or more anxious and so knowing that that's never going to be something that's cured and so from that standpoint I work with them on not only do you have to deal with the guarded the armor but also letting go relaxing and looking at those key features of the depression anxiety or whatever else may come because of it and the depression and anxiety and any chronic illness is going to make it worse yes it's going to compound almost feeling like maybe a victim yes you have to work also with that sort of mindset is that you know I have this chronic illness and now I don't know what to do with it yes and therefore I am at this illnesses mercy yes and one of the there's two things I want to comment about that which is a really good point that you bring up the first is the biggest key that I work on is let's externalize whatever it is say for example fibromyalgia let's externalise that from you you are this person you are this individual let's take fibromyalgia or cancer or whatever it is away and look at your identity because what happens is individuals now go from I am a mother I am a father I am whatever I am - I have fibromyalgia I am cancer I am whatever the disease may be on the second issue with that as far as pulling apart and sort of separating the illness from them is how do you want to approach that now talk to it tell it what you want to say to it because many people are disabled they have kids that they can't go and play with you know little ones and the kids are going you know I want to play with you I want to play with you I want you to be active and they can't do it and the reason being is because they're held back a bunch so they essentially what I work on is I use a lot of the grief and loss model to say alright right now you're grieving the loss of what your identity was to being diagnosed and what's that like for you when they can process it and understand that then they're able to sort of recognize that they've been grieving and what can we do now so that you can get yourself back to where maybe not where they fully were but where they can be exactly that's a great way to be processing out some very deep emotions and from they almost have to look at it from who am I now Who am I with this chronic illness yes and I think you brought a very good point doctor to fail in that a lot of patients once they get into the medical model and medical system on a chronic basis the clinicians also may be saying this diabetic woman or this you know cancer ridden man or whatever and then start identifying them by their diagnosis so it's also components into you know them taking on that label yes of being that diagnosis yes exactly it's interesting because when I have individuals who have some sort of medical illness and and they come in usually the first session they leave lifted and what I mean by lifted is they feel hope because all they want is for somebody to get them to say I understand what you're going through I understand what this must be like for you and in the medical field it's like here you go this is what you need to do and you're not going to be able to do everything you used to be able to do you need to learn to just get over that give them a bunch of pain pills and send them on their way whereas when they come in I say there is hope there is you can still go out there maybe not depending on if they were extreme sports person or whatnot but there are ways that you could still find quality of life you just have do we need to sit down and figure out how that won't work they'll be modified yes and they leave feeling this sense of relief and a sense of hope because oftentimes they say nobody has ever gotten me nobody has ever understood me do you think from a psychological standpoint that that could have contributed to the process of establishing that disease in that person definitely definitely I think especially for research shows that for individuals who have chronic illness oftentimes the depression is what makes them because they get depressed maybe because the grief and loss maybe because they can't do things they used to be able to do but that the pain itself increases based on the depression so if you lift the depression they don't experience pain as severe not saying it's not there but they're more focused on that pain so it becomes more severe to them so if we can sort of essentially lift the depression or lift whatever's underneath them whether it's hope whatever they tend to be able to see things in a different light and the pain actually lifts that's phenomenal yes do you deal also with elements of hypochondriasis yes and I'm glad that you bring that up because I have and have had patients where they've come in with chronic illness and it's legitimate and then all of a sudden another illness is coming up or another things come is coming up and I'm going is this somatic is this hypochondriasis is this what else is the body manifesting due to the fact that they have this one thing and now they're very sensitive because research again shows and I've seen it depression anxiety anybody with a chronic mental illness or physical illness are the ones that are most tuned into their body so constantly they are being coming aware or they're aware of all right today am i happy today am i said today am I in pain today am I not in pain so they're so super aware of their body then any little thing pops up and it's like what could this be is this a brain tumor no joke is this a brain tumor because I have some sort of tingling in my hand is this you know whatever it may be and so they're super hyper sensitive about their body and the awareness so they're almost analyzing themselves then and getting over-concerned so there you have another element to deal with this the the chronic warring yes it's going to get worse is this going to trigger off another illness yes you know and what about when you add in the like taking pain pills taking antidepressants I mean that can almost either help or mask the symptomatology so how do you work when that is also a component of having to deal with the therapy work um looking at I'm a I'm a big proponent of medications as far as if they're needed for antidepressants and the anti-anxiety meds or whatnot okay one of the issues though is I will have somebody come in and they'll say and they'll just list tons of different pain pills and I'm saying this is part of why you can't get out of bed this is part of why you're having such a difficult time doing the things that you may have done in the past because these medications are making you extremely tired and many individuals that I will actually work with or treat will say they've gone to rehab because they got addicted to the pain pills because not only did it help them with the pain but it helped them become emotionally numb and so there's that addictive factor so our this is the big question in our field our pain meds over prescribed are they under prescribed what is what do we can consider too much or too little and it's a case-by-case basis it really is yeah and you can never know unless you're again working with the doctor and then hopefully you have a good rapport with their main physician and then you can talk about are these medications helping are they you know are they contributing to some anxiety you know some some more elements to the psychological picture then you know then need be yes it's just it's very complicated situations for a lot of the patients yes so where would you go with a patient that has multiple symptoms multiple medications and maybe even multiple doctors where do you even begin to approach that patient for starting the healing process psychologically that's really good one of the first situations to see who is the primary care physician once you know who the primary care physician is then the the primary supposed to be in charge of everything so if it's a neurological issue they should have a neurologist if it's whatever it may be who these oncologists for cancer whatever it may be and so they should all be sending records to the PCP primary care physician so the the PCP is the first person that we want to start with and say hey so my client has told me that you are the primary care physician I also know that they're seeing this neurologist I also know that these are the prescriptions prescribed by this person by this person are you aware of and sometimes you will see where the PCP does not know and that could be one an issue with well the neurologist still give the pain medicine but the PCP knows more information about that client shouldn't be taking this anymore because of addictive factors so sometimes they may clients could in fact if they believe that the medications are what's making them better go to other doctors and seek it from other people and not tell the PCP so the first spot to start is with the primary care physician contact the neurologist and find out what are the treatment plan send me your treatment plan tell me what X Y & Z what is your goal for the client what have you referred to what haven't you referred to or they're already at any other sorts of outlets depending on the issue of chronic pain clinic what have you done what has worked what hasn't worked and that's the biggest piece it's it's a lot of essentially case management as well and then you need to rely on the patient being completely honest with you and sometimes that may not happen yes so how when you're working with clients and you're feeling a resistance of them telling you exactly what kind of medications they're taking and how many different doctors they're seeing how would you approach that with a client one of the things that I do is I tell them about in order for this to work you have to be honest with me you're coming to me because you want help I'm here to help but the only way it can help is if you're honest with me I mean that's as far as I can go the other piece is having them list everything out and putting the pieces together and that is important for medical patients any medical patient to do a comprehensive assessment so that I could put the pieces together like a puzzle and if something's missing you know talking to the page saying you know what you told me you were taking this however I'm not seeing that this has been prescribed I've talked to this doctor I've talked to that doctor so tell me a little bit about where you're getting this from because sometimes like for example fibro fog I don't know if you've heard of fibro fog why do you explain that please yeah what that is is for individuals with fibromyalgia it's called fibro fog and they get very disoriented confused it's almost like they're in a fog okay and so what happens is they have decreased attention span decreased ability to remember things and so what happens is sometimes they'll have medications and don't forget what they're supposed to stop taking and what they're supposed to start taking like it's dangerous yes and so that's part of the illness which is fibro fog one of them many depending on some of the other illnesses there may be a lapse in memory and judgement and so their day-to-day they forget that I take this medication that I take this medication was I supposed to take this and don't just pop it and so sometimes it's not them being I don't want to say malicious about it or not wanting to tell me the truth it's just that they are confused I don't have a good tracking system to be able to tell a wife already taken this I don't need to double dose on this or whatever and that again that could be really dangerous yeah so is that part of your case management also is is keeping track of where you know the times of the medications the administration may be having a good support system in all ways that they can also track that yes definitely especially when it comes to dementia patients Parkinson's patients aids dementia patients to where the family system needs to be involved to help them recall or place everything in order because they forget it's called prospective memory which means their memory of understanding what they have planned for the day decreases significantly in dementia patients and also in patients who are older we consider it elderly above the age of 65 so that starts to diminish on a normal process not only that but for significantly for dementia patients and so they will forget to take their pills they will forget these things and so they need either a nurse or somebody there who's gonna say okay here's your reminder here's what you need to take this is your doctor's appointment for the day so many times they look non-compliant but it's just that the memory is not intact and so again the tracking system would be a really good thing to do yes and also taking into consideration that some of these medications may also play into their memory yes it may diminish it yes so or impairment especially pain medication mm-hmm significantly it impairs judgment it impairs memory and it appears a lot of things so it's very important that they understand the side effects as well yeah and that is important to talk to them about that several times about what some of the side effects that may occur so that when it happens they understand they can call you up they can call their Dodgers and say hey this is what's going on here and I think I need some help with this yes so you know just keeping everybody aligned in the team for the benefit of the patient yes what is one of the hardest patient populations that you've had to work with medically so far I would say probably fibromyalgia and the reason why I pick that one is because this fibromyalgia used to be a mess so many individuals many medical practitioners a lot of people are now understanding it and saying it exists but you can't really tell from imaging or different things like that like x-rays you know any type of an imaging and so these individuals used to be told it's in your head so when you or when I get long-term chronic fibromyalgia patients who come to me and say you believe me you believe that I have this pain and they're symptom ology is there yes this is real and so that's been a difficult sort of approach that was a big focus of mine in my my program I have my PhD in clinical psychology with a health track so we focused on a lot and that was a big focus of our program for the reason being that it was developing back then it was something that many people said it's in your head so they thought they had psychological issues and then that would take them down as well so I think that probably is one of the largest I think the second largest is male breast cancer and working in clinics before I've never had a patient in in my private practice but working in clinics where this existed for a man to have a female sort of problem or issue so to speak they were very reluctant to treatment it was very embarrassing and things like that so I would say that would be the second the second largest or hardest population so it seems like the health issues that are highly misunderstood yes are the most difficult to treat because people are going tell me what is wrong with me tell me tell me what's wrong with me so I can fix it and when there's no diagnostic tests that can help these individuals figure out what's wrong here is where the anxiety and everything and my crazy and my this is it just in my head and and and these poor people aren't beating being effectively treated because they don't know what the issue is it's called idiosyncratic so idiosyncratic is when say for example somebody says they have stomach pains and they go to the hospital and they say we can't find anything but we're gonna say that you have some stomach inflammation or or something around the stomach and it consistently happens and they can't figure out what it is but it's very real to the client and then eventually they figure out a diagnosis down 810 months down the rock down the road that person's like I've been suffering because nobody could figure it out for me and so my job as a psychologist is to work with the coping skills to deal with the pain and also help them to make necessary connections of individuals that can help them further and be accepting and non-judgmental yes they're at yes and say this is real this is very real to you and so let's talk about that let's talk about how it's impacted your life and what's it like to be in the unknown because that's anybody in the population if they're in the unknown they're scared and and their mind is gonna go wherever it may be - from stomach pain to cancer because they're going what's wrong with me what if it is cancer and they're thinking the worst so are my job is to sit down with them and go let's take it step by step let's not go all the way to the dark place yet let's talk about where you're at and and how we can link you yes yes so doctors do fail what could you recommend to our viewers if they're going through chronic pain problems and want to get help from a psychological standpoint I would say one see if any psychologists are connected or therapists are connected to the hospital where they may be or doctor whether it be being treated I would say look you know you can go to psychology today.com and search for individuals who focus on specifically chronic health issues or chronic pain issues because it's a different Forte right we're trained in a different way than then a regular clinical psychologist so there's a different aspect so you want to find somebody who may be focused or has experience working with that specific population they can also contact me and I can no matter where you are you can contact me and I can try to find somebody in your area that I may know of so that that's where I would start okay in your contact information doctor to fail yes so my contact information they can go to my website it's WW Jennifer DeFeo PhD comm and all of my contact information is on that website thank you doctor - fela that was some very helpful information and I hope that was helpful for you viewers if you are experiencing any chronic pain problems or health issues please consider getting psychological help along with your medical help and use it as a team approach and get some help it's very important to your healing process I am Julie Ann good this has been psych 101 thank you so much for watching take care of yourself take care of each other bye now [Music] you [Music]

Channel: TherapyVideos

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Keywords: What is Health Psychology?, health psychology, health, psychology, psychology (field of study), Physical Illness, Health Psychology, Diabetes, Stroke, Heart, Motivation, Therapy, Counseling, Pain, Cancer, Wellness, Psychotherapy, Psychology, Mental Health, Illness, Stress, Eating, Educational, Depression, Bipolar, psychology videos, psychology youtube, psychology online, therapycable, therapy videos, online therapy

Id: FioUOGpO0GY

Length: 28min 7sec (1687 seconds)

Published: Wed Jan 04 2017