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New website

You may have noticed if you’ve visited the blog recently that I’ve moved the blog over to my new website: authordawnbarker.com

I’m trying to transfer my subscribers/followers over to the new blog but at this point I’m not sure if it’s possible, so please visit the new website and resubscribe if you’d like to continue to follow this blog.

Thanks, and hopefully see you on the new website!

Dawn

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My book title…

Now that my third baby is eight weeks old, life is beginning to be a little more predictable and the urge to write has returned. It’s a great feeling when life around me nudges me towards potential stories. The last eight weeks has been busy for me, but the benefit is that I have lots of notes ready to turn into stories. When I get the time…

The good news is that the title of my novel has been finalised, and I’m thrilled to say that “Fractured” is due for release in March 2013 by Hachette Australia!

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I’ve been quiet here recently, but I do have some pretty good excuses I think…

A couple of weeks ago I sent back the structural edit of my manuscript to my publishers after a pretty intense month or so of working on it. While the process was all-consuming, I really enjoyed it. It was fantastic to have professional editorial feedback on the big picture of the story and suggestions on how to improve it. It was encouraging to see that most of the comments were around issues that I knew weren’t quite right anyway. There comes a point in writing when you lose objectivity – you know your story so well that it’s hard to step back from it and see how others view it. That was what was so useful about this process, and I hope the manuscript is better for it.

Since then, I have been preparing for the impending birth of my third baby, who is due very soon. So it may be quiet here for a little while longer until I emerge from the fog of life with a newborn…

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I’ve kept a list of all the books I’ve read in 2011, and on skimming through them, there were a few that stood out as exceptional reads. I’d love to hear of you agree or disagree with them, or if there are any that you think should be on the list…

Traitor by Stephen Daisley

The Family Law by Benjamin Law

Bereft by Chris Womersley

Past the Shallows by Favel Parrett

Rocks in the Belly by Jon Bauer

Caribou Island by David Vann (this is probably my favourite book of last year)

A Visit from the Goon Squad by Jennifer Egan

The Sense of an Ending by Julian Barnes

 

Now I’m clearing out the 2011 books and starting a new list for 2012…

 

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Chiropractic Activator Device by Michael Dorausch

There was a great article in The Weekend Australian magazine this weekend about chiropractors treating children for  conditions other than mechanical spine issues (note that it does say that only some chiropractors do this). It grabbed my attention because the article stated that some parents take their children to chiropractors to treat autism and ADHD – conditions that I see in clinical practice.

Wow.

I have never been to a chiropractor but know many people who swear by them, and I have absolutely nothing against alternative health practitioners. But there are two issues that worry me. First, when practitioners say they can treat conditions with no evidence to back it up, and second, when there is a risk of harm from the treatment – either directly or indirectly.

Lack of evidence

I will point out that the chiropractor in the article above says that he never claimed to be able to cure autism, but rather, a parent was convinced that the chiropractor cured her son’s condition.The practitioner quoted in the article does imply that chiropracty – through realigning the spine – can help with colds, ear infections, bed wetting, ADHD, and can even ‘repair’ DNA.

In clinical medicine, we are taught to look for evidence that the treatments we use work. Some treatments are straightforward: we can see in the lab that a particular antibiotic will kill certain bacteria. I know that in my own speciality, psychiatry, some of the evidence for treatments (particularly psychotherapy) is less strong because of difficulties in measuring what we do. However, the vast majority of treatments – physical and behavioural – have good scientific evidence to back them up. In the case where the evidence is lacking, but we have reason to try a particular treatment, we explain the risks and benefits to patients and come to an informed decision together.

I am not aware of any scientific evidence (randomised placebo controlled trials with statistically significant results) that chiropracty can cure asthma, allergies, reflux or autism.

Risk of harm

Many of my patients ask my opinion about unproven remedies for various disorders and I always encourage them to try anything they want to – as long as it’s in conjunction with proven treatments, and that it does no harm. And in the vast majority of cases, alternative medicine doesn’t do any harm, and may help. I don’t know of any direct risks from chiropracty.

I have seen ‘harm’ caused by other alternative medicines: I have once seen a woman who became pregnant after using St John’s Wort to treat mild depressive symptoms, because she wan’t aware that it interacted with her contraceptive pill and made it less effective. She had the idea that because St John’s Wort was ‘natural’ it didn’t have any side effects or interactions.

In the article above, parents say that they see their chiropractor before their GP, and one mother lists her chiropractor on forms as her family doctor. In my mind, this is risky. A chiropractor is not medically trained and cannot diagnose medical illnesses, and there is a risk that children will be wrongly diagnosed, or that illnesses will be missed. Children may therefore miss out on proven treatments, and in the case of disorders such as asthma, allergies or autism, this can have grave  consequences. Some believe that chiropractors can replace immunisation in children – again, this has potentially serious consequences.

What to do?

Overall, my advice to parents and patients won’t change: by all means try alternative medicine if you want to. But make sure that you have a medical diagnosis and treatment plan, and that your medical doctor knows what other treatments you are having. Ideally, medically trained and alternative health practitioners can work in tandem to treat each individual patient.

Reputable health practitioners – medically qualified or not – will always explain risks and benefits of their treatments.

One sad fact is that the parents quoted in the article  feel that they get much more holistic and empathic treatment from their chiropractor compared with their GP. It’s an important point: our medical system is busy and understaffed, and perhaps sometimes the patient as a person gets lost in amongst the science. That is one thing that medical professionals need to take note of.

I would love to hear from anyone with any experience or comments…

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I just wanted to say thanks to nursingschool.net who have listed this blog as one of ’50 Excellent Therapists Who Blog” which can be found here. It’s also been helpful for me to find a list of some other therapists who write blogs, and I’ll certainly be reading a few of them!

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Can you tell us how we should be going about developing a secure attachment? I’m also interested to read how the insecure – avoidant and insecure – ambivalent types come about.

This question was posted in response to my blog post on attachment, and I wanted to respond to this, as it’s probably a question that all parents who read about attachment theory are interested in.

Studies show that the attachment style that we had with our own mother (again, mother can be substituted for primary caregiver) is generally predictive of the attachment style that we have with our own children. We generally parent in the way in which we were parented. There is evidence of neurobiological brain changes in infants and children which relate to their early experiences, and there is therefore an argument that our attachment style is hard- wired from a very early age.

Most children — and adults — are securely attached, so for the majority of people, we can just do what comes naturally when it comes to parenting and our children will develop secure internal working models. The factors which help this are parents being warm, empathic and consistently responsive. Parents respond to their children when their attachment behaviour is activated (crying, trying to get close to mother), and are able to empathise ie put themselves in the child’s shoes and recognise what they need at that time, and provide it.

Parents with insecure attachment styles  with their infants will generally have had that pattern with their own parents(analysed with an interview called the Adult Attachment Interview). Other factors which may influence the development of an insecure attachment include maternal mental illness (postnatal depression, psychosis), trauma, illness of the child, separation of the pair in early life etc – basically anything which affects a parent’s ability to respond to their child as above.

For this group of parents, there are things that can be done to promote secure attachment at-risk groups and individuals. The aim is to help parents develop an awareness of both their own and their child’s internal mental experiences — their reflective functioning –(Slade, 2005); to be able to put themselves in their child’s shoes; and to help with basic parenting skills.

I think that the most important thing to remember that the vast majority of parents are doing the best that they can with what they have. It’s such an important area of intervention for infants that has huge implications for the future health of our communities., and is still under-recognised and under-funded.

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