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SCIENCE+HEALTH Is therapy forever? It’s enough already Close laundry detergent right after use, says expert
NEW DELHI MONDAY 23 | APRIL 2012 50 YEARS AGO IN
Algeria coup against De Gaulle Paris: French troops led by retired generals revolting against President de Gaulle’s Algerian policy seized Algiers in a dramatic bloodless coup today. They said they had acted to “keep the army oath of May 13, 1958, to keep Algeria within French sovereignty.” But in Paris the Government said it was taking the “necessary steps” to deal with the revolt. M. Michel Debre, French Prime Minister said that Generals in Oran and Constantine had rejected an ultimatum to join the rebels. He announced in a broadcast that M. Louis Joxe, minister of state for Algerian Affairs, had left for an undisclosed destination in Algeria accompanied by Gen. Jean Olie, named as new Commander in Chief in Algeria, General Olie is Chief of Staff of National Defence. M. Debre urged “all those who have a responsibility” not to sink into an adventure which could only have a tragic tomorrow for the nation. Mr Debre made his broadcast after two talks with President de Gaulle. An emergency Cabinet meeting is to be held later today. Police swooped on rightwing activists in Paris and made some arrests, but a number of people sought by police have disappeared from their homes. — AFP
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‘FAULTY GENE UPS PROSTATE CANCER RISK AMONG MEN’ London: A faulty gene that increases breast cancer risk in women also quadruples the chances of prostate cancer among men, says a recent study. “Until now, there has been some doubt as to whether mutations in the BRCA1 gene increase the risk of prostate cancer,” said Ros Eeles, professor at the Institute of Cancer Research in London, who conducted the research. “Our study has shown that men with prostate cancer have a one in 200 chance of having an alteration of this gene and men with this alteration have a 3.8 fold increased risk of developing the disease,” said Eeles, the British Journal of Cancer reports. Men carrying a faulty BRCA1 gene have a one in 11 chance of developing prostate cancer by 65 years, the study said. — IANS
IT’S NOW OFFICIAL: NAGGING IS GOOD FOR YOUR HEALTH London: It appears that nagging is good for your health, especially if you are above 30, as it acts like a constant reminder for people to lose weight or become more active, a new study has found. The study, which was based on a series of interviews from the UK, showed that the least active people felt that constant nagging from their family — spouse or children — affected their health in a positive way. In the study, researchers from the University of Lincoln focused on modifiable social influences on motivation towards physical activity, rather than fixed factors used to predict health such as gender and ethnicity. These included giving impetus; supporting progress with emotional and moral support; logistical support like looking after the kids for some time; and making activity itself a social endeavour, such as going with friends. “The aim of this study was to help people examine their lifestyle as a whole and establish what the key factors are in influencing their activity levels,” study author Dr Richard Keegan was quoted as saying by the Daily Mail. — PTI
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Anorexia may be triggered by a defect in the brain
In my experience, most people seek therapeutic help for discrete issues: they are stuck in unfulfilling jobs or relationships, they can’t reach their goals
Jonathan Alpert
health ■ Therapy should focus on goals and outcomes, and people should be able to graduate from it y therapist called me the wrong name. I poured out my heart; my doctor looked at his watch. My psychiatrist told me I had to keep seeing him or I would be lost. New patients tell me things like this all the time. And they tell me how former therapists sat, listened, nodded and offered little or no advice, for weeks, months, sometimes years. A patient recently told me that, after seeing her therapist for several years, she asked if he had any advice for her. The therapist said, “See you next week.” When I started practising as a therapist 15 years ago, I thought complaints like this were anomalous. But I have come to a sobering conclusion over the years: ineffective therapy is disturbingly common. Talk to friends, keep your ears open at a cafe, or read discussion boards online about length of time in therapy. I bet you’ll find many people who have remained in therapy long beyond the time they thought it would take to solve their problems. According to a 2010 study published in the American Journal of Psychiatry, 42
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A recent study by the National Institute for Health and Welfare in Finland found that “active, engaging and extroverted therapists” helped patients more quickly in the short term than “cautious, nonintrusive therapists”. — MCT per cent of people in psychotherapy use 3 to 10 visits for treatment, while 1 in 9 have more than 20 sessions. For this 11 per cent, therapy can become a dead-end relationship. Research shows that, in many cases, the longer therapy lasts the less likely it is to be effective. Still, therapists are often reluctant to admit defeat. A 2001 study published in the Journal of Counselling Psychology found that patients improved most dramatically between their seventh and tenth sessions. Another study, published in 2006 in the Journal of Consulting and Clinical Psychology, looked at nearly 2,000 people who under-
went Counselling for 1 to 12 sessions and found that while 88 percent improved after one session, the rate fell to 62 percent after 12. Yet, according to research conducted at the University of Pennsylvania, therapists who practice more traditional psychotherapy treat patients for an average of 22 sessions before concluding that progress isn’t being made. Just 12 per cent of those therapists choose to refer their stagnant patients to another practitioner. The bottom line: Even though extended therapy is not always beneficial, many therapists persist in leading patients on an open-ended, potentially endless, therapeutic
course. Proponents of long-term therapy have argued that severe psychological disorders require years to manage. That may be true, but it’s also true that many therapy patients don’t suffer severe disorders. Anxiety and depression are the top predicaments for which patients seek mental health treatment; schizophrenia is at the bottom of the list. In my experience, most people seek therapeutic help for discrete, treatable issues: they are stuck in unfulfilling jobs or relationships, they can’t reach their goals, are fearful of change and depressed as a result. It doesn’t take years of therapy to get to the bot-
tom of those kinds of problems. For some of my patients, it doesn’t even take a whole session. Therapy can — and should — focus on goals and outcomes, and people should be able to graduate from it. In my practice, the people who spent years in therapy before coming to me were able to face their fears, calm their anxieties and reach life goals quickly — often within weeks. Why? I believe it’s a matter of approach. Many patients need an aggressive therapist who prods them to face what they find uncomfortable: change. They need a therapist’s opinion, advice and structured action plans. They don’t need to talk endlessly
about how they feel or about childhood memories. A recent study by the National Institute for Health and Welfare in Finland found that “active, engaging and extroverted therapists” helped patients more quickly in the short term than “cautious, nonintrusive therapists.” This approach may not be right for every patient, but the results described in the Finnish study are consistent with my experience. If a patient comes to me and tells me she’s been unhappy with her boyfriend for the past year, I don’t ask, as some might, “How do you feel about that?” I already know how she feels about that. She just told me. She’s unhappy. When she asks me what I think she should do, I don’t respond with a return interrogatory, “What do you think you should do?” If she knew, she wouldn’t ask me for my thoughts. Instead I ask what might be missing from her relationship and sketch out possible ways to fill in relationship gaps or, perhaps, to end it in a healthy way. Rather than dwell on the past and hash out stories from childhood, I encourage patients to find the courage to confront an adversary, take risks and embrace change. My aim is to give patients the skills needed to confront their fear of change, rather than to nod my head and ask how they feel. In graduate school, my
Open access movement: Towards making scientific research public Aashima Dogra
science t seems the irony in scientific publishing will not go unnoticed anymore. Everywhere, people are asking the same question: how come results of new research and experimentation are kept behind a paywall, away from the people that funded it in the first place? It is only fair that publicly funded projects and those paid for by charities are made available to everyone free of cost. Traditionally, subscription journals charge a large amount for access to their content, in print and online. Universities and libraries pay for this access while the ones that can’t afford it stay uninformed, subsequently uninitiated to contemporary work in science. This is a highly deprived state in countries like India where the scientific community is not budging from its primitive place despite more and more investment. “Quite a few international journals charge $20,000 or 25,000 per year. Obviously in our country this is unaffordable,” said Subbiah Arunachalam, a long-time expert of the international open access movement, influential activist in the scientific community and India’s open access go-to man. “At universities like Harvard, several tens of thousands of journals are
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sustained in the library. Whereas, about 12 years ago the best library in India — the Indian Academy of Sciences in Bengaluru — subscribed to only 1,800 journals. This number was reduced to 1,200 at some point due to the costs.” Even more unfair is the fact that scientific institutions at large, where this work is being done, however established, end up paying for continued access to content they themselves are creating and editing through mostly volunteered peer review. Big publishers like Elsevier house thousands of discipline specific journals whose access can be bought in bundle prices, making them a large profit. Their disproportionate margins along with no commitment to the principle of open access has angered scientists. Nearly 10,000 academics have joined a campaign called Cost of Knowledge that pledges to boycott Elsevier. One of the signatories, Manindra Agarwal, professor of computer science at IIT Kanpur and editor of many academic journals explained: “The campaign is an expression of the uneasiness the academic community has with many publishers. Academic publishing is a peculiar business: the academicians produce the content, academicians review it, both for free, and then academicians pay the publishers to read it!” Agarwal thinks that paid subscription would make
Subbiah Arunachalam sense if they “1. charge reasonable amounts and 2. take a lead in promoting knowledge.” He noticed Elsevier does not take any of this seriously while on the advisory board of their India operations, but that relationship has now ended. Individual scientists are not the only ones putting their weight behind the OA movement; joining them are some major funding bodies that have the power to mandate a policy of open access publishing. From July 2012, World Bank’s bank research outputs and knowledge products will be freely available from its open repository — a “natural evolution” step as described by the President Robert B. Zoellick. Welcome Trust, one of the world’s largest private medical research funders, recently declared it wanted to make sure any literature form the research it funds is available free within six months of its publication. The UK sci-
ence ministry also nodded in support. The launch of a new OA journal called eLife is awaited — a scientific journal on par with market leaders like Nature and Science but completely free to access from anywhere in the world by anyone. There are many OA journals already out there, about 7,800 and the numbers are growing. In 2000, a CoK like campaign but much larger (34,000 signatures from 180 countries) instigated by a Nobel Laureate and his friends led to the founding of Public Library of Science journals. These journals are completely free to access and the cost of publishing comes from the authors whose papers are being published, expenses are pulled out from the research funding rather than charging readers. Today PLoS journals are very popular, “hotcakes” Mr Arunachalam calls them, a beacon in OA movement, leading the way in exploring new business and publishing models for academic literature. Another big aspect of the OA movement are the repositories. Academics self-archive their paper and add it the stream of research literature flowing through a virtual place on the web. These can serve two purposes. Firstly, it can turn paid-for inaccessible content into OA, for example the US government funding body NIH dictates any research it funds to be deposited into PubMed central repository 6 months after its acceptance into any journal.
Secondly, like in the case of arXiv.org, they provide a space for any academic to put forth their work without any formal refereeing process and ask for reviewing suggestions. The focus appears to be shifting from journals to individual research papers. Nonetheless everyone agrees that OA does not mean the death of journals. “Publishing” in a journal is very different from “placing” in a repository for various reasons. Excerpts from an interview with Chennai-based scientometrist Subbiah Arunachalam, retired fellow of the M.S. Swaminathan Research Foundation and former secretary of the Indian Academy of Sciences. Q. Why is open access important to researchers in India? A. The OA movement started in the West it is of much more importance to us. Science builds on the information that is available, and journals are the source. In this scenario, open access facilitates free availability of journal content. OA is far more important to you and me in the developing world than people in the West. Because their libraries subscribe to several thousand journals, more than any library in India or all libraries put together can sustain. They have money and they sustain. Q. How, then, do Indian researchers access inter national science? A. Then University Grants
Commission and the government stepped in and formed consortia, several institutions joined in together and subscribed to a bundle of journals from major publishers. Any Indian scientist at these institutes can access, if they want to, about 8,000 journals. UGC’s consortia is called INFLIBNET, there are other groups like the CSIR-DST joint consortia. But several million dollars are spent on this. If international research had open access, this money could have been saved. Q. How prevalent is OA in India? A. Today there are more than 360 open access journals in India. None of them charge a paisa for reading or publishing. I have been sending out hundreds of emails trying to engage Indian institutes in open access for most part of my professional career. No one wants to take the initiative. Now they are all being forced literally. The first thing to happen was at CSIR. The director general instructed all the laboratories to set up a freely accessible repository. This has been successful in recent years. My efforts in persuading the director of the CSIR to have an open access policy also paid off two years ago when all its 17 journals were made open-access. Further, more than 80,000 papers are held in the repository of Indian Academy of Sciences. It is the first academy in the entire world to have a repository for all its fellows, the first in the world.
classmates and I were taught to serve as guides, whose job it is to help patients reach their own conclusions. This may work, but it can take a long time. I don’t think patients want to take years to feel better. They want to do it in weeks or months. Popular misconceptions reinforce the belief that therapy is about resting on a couch and talking about one’s problems. So that’s what patients often do. And just as often this leads to codependence. The therapist, of course, depends on the patient for money, and the patient depends on the therapist for emotional support. And, for many therapy patients, it is satisfying just to have someone listen, and they leave sessions feeling better. But there’s a difference between feeling good and changing your life. Feeling accepted and validated by your therapist doesn’t push you to reach your goals. To the contrary, it might even encourage you to stay mired in dysfunction. Therapy sessions can work like spa appointments: they can be relaxing but don’t necessarily help solve problems. More than an oasis of kindness or a cozy hour of validation and acceptance, most patients need smart strategies to help them achieve realistic goals. I’m not against therapy. After all, I practice it. But ask yourself: if your hairstylist keeps giving you bad haircuts, do you keep going back? If a restaurant serves you a lousy meal, do you make another reservation? No, I’m sure you wouldn’t, and you shouldn’t stay in therapy that isn’t helping you, either.
Jonathan Alpert is a New York psychotherapist and the author of Be Fearless: Change Your Life in 28 Days By arrangement with the New York Times
SCIENTISTS MAKE NEW DISCOVERY IN MALARIA CURE London: Scientists have identified a key protein common to malaria parasites, opening the way to more effective vaccines or drugs against the lifethreatening infections caused by the micro-organisms. The protein has sticky properties that enable it to bind to red blood cells among humans and other animals and form dangerous clumps that can block blood vessels. These clumps can cause severe illness, including coma and brain damage. Scientists from the University of Edinburgh worked with researchers from Cameroon, Mali, Kenya and the Gambia to test their antibodies against the parasites collected from patients, Public Library of Science Patho-gens, reports. Alexa-ndra Rowe, professor at the Edinburgh School of Biological Sciences, who led the study, said: “We knew that clusters, or rosettes, of blood cells were found in many cases of severe or life-threatening malaria, so we looked at rosette-forming parasites and found a common factor that we could target with antibodies.” “We hope this discovery will inform new treatments or vaccines to block the formation of rosettes and prevent many lifethreatening cases of malaria,” added Rowe, according to an Edinburgh statement. Presently, between 10 and 20 per cent of people with severe malaria die from it, and the disease, kills one million people every year. The parasites, once in the bloodstream, are able to alter the protein molecules on their surfaces to evade attack by the immune system. — IANS