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Eclectic therapy is an approach that draws on multiple theoretical orientations and techniques. It is a flexible and multifaceted approach to therapy that allows the therapist to use the most effective methods available to address each individual client’s needs. It is also sometimes referred to as multi-modal or integrative therapy.

In the early part of the 20th century, many therapists rigidly adhered to a single style of treatment. Over the last decade, more therapists started to draw ideas from different therapeutic approaches.

Types of Eclectic Therapy

A number of specific types of eclectic therapy have also emerged. In each case, these approaches draw from a range of techniques in order to address the unique needs of the individual. Some of these types include:

• Brief eclectic therapy: As the name suggests, this is a short-term form of eclectic therapy that often incorporates aspects of psychodynamic and cognitive behavioral treatments that are applied over a limited number of sessions, often to address a specific problem. This approach has been used to treat PTSD by helping people make meaning out of their traumatic experience and develop new coping strategies.
• Cognitive-interpersonal therapy: This approach utilizes aspects of cognitive behavioral therapy to help people understand how their thoughts influence their relationships.
• Multi-modal therapy: This type draws on elements of social-cognitive learning theory and integrates a number of techniques from other therapies. An individual’s specific needs are assessed by looking at their behavior, affect, senses, visualizations, cognition, relationships, and physical health. 
• Transtheoretical therapy: This approach focuses on understanding the stages and process of making a change. Using this knowledge, people are then able to work on achieving their goals, improving their relationships, and creating positive changes in their lives.

Techniques

While eclectic therapy is flexible, therapists carefully create an intentional, individual plan for each client based on that person’s unique needs. Theoretical approaches that an eclectic therapist might draw on include:

A therapist will also choose specific techniques from within that theoretical approach. Some examples of such techniques include exposure therapy, sensory therapy, relaxation therapy, acceptance and commitment therapy (ACT), and mindfulness.

What Eclectic Therapy Can Help With

Eclectic therapy can be utilized to help people with a wide range of needs. Some conditions and problems it can successfully treat include:

Benefits of Eclectic Therapy

Eclectic therapy can have a number of important benefits. These include:

• Individualized approach: Because this approach to therapy is so adaptable, your therapist can design a treatment plan that is suited to your specific, unique needs.
• Engagement: The use of multiple techniques may help people feel more interested and engaged in the therapy process. 
• Flexible: Because your therapist can assess your needs and select the approaches and techniques they think will help you the most, it is possible to switch between techniques to address one or more needs. For example, your treatment might involve treating a phobia but also address problems with chronic stress.

Effectiveness

Research suggests that eclectic therapy can be both a safe and effective treatment:

• Eclectic therapy has been described as an effective therapeutic approach to address selective mutism, an anxiety disorder in children in which there is a consistent failure to speak in specific social situations. This treatment involved drawing on psychodynamic, behavioral, cognitive-behavioral, and family theories and interventions.
• In a study published in the European Journal of Psychotraumatology, researchers integrated elements from psychodynamic and cognitive behavioral approaches to create a successful eclectic treatment program for PTSD.
• A 2017 study found that an eclectic approach using art therapy and CBT was effective for improving mental health and reducing anxiety in children.

Things You Should Know About Eclectic Therapy

While eclectic therapy can be effective, there are some potential downsides to consider. Some issues you might encounter during eclectic therapy include:

• Lack of structure: If you tend to prefer a more structured, easy-to-follow approach, you might find eclectic therapy more difficult. In such cases, talk to your therapist about devising a more predictable structure.
• Trial-and-error: It may also seem at times that you are following a trial-and-error approach. While trying different tactics can help you find what works for you, it can also be frustrating and time-consuming.
• Not ideal for some conditions: For certain conditions that tend to respond best to a specific type of therapy (such as exposure therapy for phobias or dialectical behavioral therapy for borderline personality disorder), it is often a better idea to primarily stick to that specific treatment modality.
• Insurance coverage: The rise of HMOs (Health Maintenance Organizations) and managed care approaches to healthcare has furthered the eclectic therapy movement. In order to receive insurance reimbursement, therapists may have to document a variety of empirically supported techniques often drawn from different theoretical orientations. Insurance concerns may play a role in the type of treatments your therapist utilizes. Since eclectic therapists focus on using research-validated techniques, however, it is still likely that many treatments will be covered by your insurance.
• Therapist training: Some therapists adhere largely to a single orientation, such as ​psychodynamic or cognitive behavioral theory, but may actually use a variety of techniques rooted in other theories as needed. Others self-identify as eclectic in their treatment orientation. Either way, it is important that the therapist possesses a solid understanding of each theory for the techniques they use.

How to Get Started

If you are interested in trying eclectic therapy, consider asking your doctor for a referral or look at an online therapist directory. Eclectic therapists often refer to themselves as integrative therapists or multi-modal therapists, so you might consider searching for those or similar terms. You might also consider online therapy as an option.

During your first appointment, your therapist will ask you questions to help get to know you and understand your goals. This initial discussion might involve talking about your background, work, personal life, support system, and current life satisfaction. 

As you build a therapeutic relationship, you can then delve deeper toward making goals and deciding which techniques might be the most effective for what you want to accomplish. Because eclectic therapy is adaptable, these goals and strategies can change when needed.

Imago therapy or Imago Relationship Therapy (IRT) is a specific style of relationship therapy designed to help conflict within relationships become opportunities for healing and growth. The term imago is Latin for “image,” and within the context of IRT, it refers to an “unconscious image of familiar love.”

Imago Relationship Therapy was developed by Harville Hendrix, PhD and Helen LaKelly Hunt, PhD. In the late 1970s, both clinicians had experienced divorce in their relationship history. After looking for effective and evidence-based support for understanding relationship dynamics, they found very little in the way of helpful resources.

As a result, they chose to build from their own experiences to research and develop an evidence-based model of counseling that would help facilitate healing and growth in committed relationships.

Types of Imago Therapy

There are two ways that Imago therapy may be used. While primarily used within the context of committed relationships, it may also be utilized in individual therapy.

Imago Therapy for Relationships

The concept of Imago as an image of familiar love suggests that your early relationships teach you something about love and about yourself. Through these early experiences, you develop a sense of an identity related to love, such as what love is and what you need to do in order to experience love from others and feel safe.

For example, if growing up you only received praise and feelings of love from your caregivers when you performed well at a task, you may move into your adult life believing that you must perform well in order to be worthy of love and to receive care and comfort from your partner.

If your partner turns away or shuts down on you, leaving you feeling unloved, you might quickly start to reflect on your own behaviors, replaying things and looking for what you may have “done something wrong” for the person to treat you this way.

Our intimate relationships are prime ground for bringing up raw spots, old wounds, and patterned behaviors. These connections can leave us feeling close and cared for or lonely and abandoned. It is not surprising that our intimate relationships often tend to bring up old, familiar emotional wounds since Imago therapy suggests that you pick partners who feel “familiar” to you.

When these old wounds come up in relationships, however, IRT holds that they can give us a chance to heal and grow. As Dr. Hendrix stated in his best-selling book “Getting the Love You Want,” “We are born in relationship, we are wounded in relationship, and we can be healed in relationship.”

Imago for Individuals

Although Imago relationship therapy is a model of counseling designed to effectively work with couples in committed relationships, you certainly do not need to be in an active relationship to benefit from Imago therapy. In fact, many people who are dating may find this type of therapy very useful for examining their own history and how it might be influencing their dating patterns and choices in partners.

By participating in Imago therapy by yourself, you can learn about some of your old wounds or emotional raw spots that might be impacting your relationships. Finding a sense of healing around these raw spots can be valuable in helping you move forward with more confidence and learning how to be a great, compassionate partner in your next relationship.

Imago Therapy Techniques

One core aspect of Imago Relationship Therapy is the Imago dialogue. This dialogue is a structured method, facilitated by a trained Imago therapist, which allows partners to gain understanding and increase empathy. The goals of Imago dialogue are to:

• Remove negative, hurtful language from communication
• Create a safe emotional environment for both partners to openly share
• Allow both partners equal space and eliminate the idea that one partner has more power over the other

Within this dialogue there is a “sender” and a “receiver,” the sender being the one to share thoughts and feelings openly with their receiver. The “receiver” practices the following three steps during the Imago dialogue:

1. Mirroring: Repeating back what you have heard your partner say in order to gain clarification and understanding. The receiver does this with no judgment, criticism, or response, but simply repeating back what they have heard their partner say. For example, the receiver might say, “So what I’m hearing you say is…” and then follow by paraphrasing the sender’s original words.
2. Validation: The receiver works to validate parts of what their partner (the sender) has shared, what makes sense to them. As they are doing this, they are letting their partner know that they “get it” and are actively trying to understand. If there are parts that the receiver does not yet understand, they can ask the sender to share more. For example, the receiver might say something like, “I can understand how that would make you feel that way.”
3. Empathy: At this point in the dialogue, the receiver shares with their partner what they think the other might be feeling. Sharing on this level is a way to let their partner know they are gaining a deeper understanding of their emotional experience, allowing the partner to feel seen and heard. For example, the receiver might say something such as, “I imagine you must be feeling disappointed.”

What Imago Therapy Can Help With

Imago therapy was developed specifically for the understanding and healing of relationships. Some of the issues that Imago therapy can help with include:

You do not have to necessarily be in distress to participate in Imago Relationship Therapy. In fact, couples who are not in distress can significantly benefit from participating, learning about these dynamics within the relationship, and gaining a better understanding of themselves and their partner.

Who Can It Help?

Those in committed relationships with a significant other would be excellent candidates to benefit from Imago therapy.

• Couples at all stages and seasons of their relationship are encouraged to participate, from dating and premarital couples to those who have been together for many years.
• Individuals can also participate in imago relationship therapy.
• People who are dating can certainly benefit from learning about their relationship patterns, choices of partners, and how to find and connect with someone who is a safe person and a healthy partner.

Benefits of Imago Therapy

Imago Relationship Therapy offers a number of key benefits that may make it a good choice for couples that are facing problems.

Understanding Early Attachments

Although these concepts are utilized in different types of dynamic psychotherapy, Imago therapy emphasizes that your early attachment experiences with caregivers may directly influence your choice of partner as an adult. As you date, you may come across someone who seems all too familiar and easy to connect with, almost as if you have known them before or for a long time.

What Imago therapy suggests is that these people feel familiar because they parallel relationship dynamics you have been in before with caregivers in your early life experiences. When you feel comfortable and familiar with someone, you begin to let your guard down and grow closer, which makes it easier to build a romantic relationship.

Conflict as an Opportunity for Growth

Another thing that makes Imago therapy different from other styles of therapy is that it is focused on using conflict and distress and opportunities for healing and growth. Rather than teaching people how to simply “fight better” or find ways to avoid conflict within your relationship, Imago therapy encourages couples to lean into those moments of distress and use them for exploration, curiosity, and learning.

Collaborative Approach to Treatment

Imago therapy is collaborative, meaning that there is not a distinct role of a therapist as an advice-giving authority but, rather, the therapist works together with the couple to take a look at what is happening for them and healing the relationship as a whole. The therapist allows for the couple to be the experts of their dynamic, facilitating the conversation in a way that allows partners to learn from each other.

Effectiveness

Because this therapeutic approach is relatively new, there is not a great deal of scientific evidence supporting its effectiveness. However, there are some studies that have explored the efficacy of Imago therapy.

• One small 2011 study found that people who participated in Imago therapy saw improvements in self-awareness and gained a better understanding of their own and their partner’s childhood experiences. Couples were able to also achieve better communication with one another.
• A 2017 study published in The Family Journal found that Imago therapy helped improve empathy levels in relationships. Empathy plays an important role in the satisfaction people feel with their partner, so increasing empathy may contribute to positive changes in a relationship.
• Another study published in 2017 found that 12 weeks of Imago therapy was linked to improvements in relationship satisfaction.

Things to Consider

As with other types of relationship therapy, there are times when Imago therapy might not be a good fit for your relationship. These times might include situations such as domestic violence, active substance abuse, or other addictive behaviors that can get in the way of a successful relationship therapy experience. Imago therapy may only be effective when issues like this are resolved first. 

People who dislike structure may also find the Imago dialogue overly restrictive and unnatural. It may also not be the best choice if you aren’t sure that you want to preserve the relationship in the first place.

How to Get Started

Two main ways to start learning more about Imago therapy and how it can help your relationship include workshops and therapy sessions. There are several varied workshops available, all based on the model of Imago therapy. Some of the workshops available are tailored specifically to:

• Premarital couples
• Couples in distress
• Couples with children
• Christian couples
• Same-sex couples
• Individuals

Workshops are offered around the world and it is likely that there are workshops available in your area or region.

The other method of participation is in counseling with an Imago-trained therapist. Sessions are traditionally offered one hour at a time, although there are often additional services available such as intensives that last a few hours or retreats that might last for a few days.

Having face-to-face time with an Imago-trained therapist allows you and your partner to actively dig into the dynamics of your relationship. During that time you will be using dialogue, facilitated by the therapist, to explore and learn what happens for your partner when there is distress or conflict in the relationship.

How Can I Find an Imago Therapist?

Many therapists who work with couples have likely had some training in—and basic understanding of—Imago Relationship Therapy. You can find resources in your area, such as trained and even fully certified Imago relationship therapists, at sites such as Imago Relationships International.

There you can search a database of trained Imago therapists from around the world, searching by your location and type of relationship need. You can also discover locations for a variety of workshops available, which are based on the principles of Imago Relationship Therapy.

Have you ever felt like you don’t deserve your success and others will soon discover you’re not as capable as they think? Do you brush off your accomplishments as flukes? Does your inner voice tell you you’re a fraud? If so, you may be experiencing a case of imposter syndrome. 

“Imposter syndrome is a persistent belief that your success is undeserved, attributing accomplishments to luck rather than ability or hard work. You might experience a chronic fear of being exposed as a “fraud” despite evidence of your competence,” says Christina Kayanan, LMFT, LAADC, a licensed therapist and executive director of AMFM Healthcare.

If this sounds familiar, take the quiz below to determine whether you might have a case of imposter syndrome.

The Imposter Syndrome Quiz

This quiz is designed to help you identify whether imposter syndrome is whispering in your ear and causing you to doubt your accomplishments. Answer honestly, choosing the answer that best reflects your experience.

Who Is This Quiz For?

This quiz is for anyone who doubts themselves and wonders whether it might be due to imposter syndrome. While it is not a diagnostic tool, it is based on the definition and description of imposter phenomenon outlined by the American Psychological Association. It can help you understand what imposter syndrome feels like and the thought patterns it can cause.

Understanding Imposter Syndrome

Imposter syndrome is a psychological pattern where you doubt your skills, talents, and achievements, often attributing your success to luck or other external factors.

Imposter syndrome can be a paradoxical experience, because on one hand, you achieve, succeed, and are recognized for your accomplishments, says Kayanan. “On the other hand, you are haunted by an internal narrative that dismisses these achievements as luck, timing, or as a result of deceiving others into thinking you are more competent than you actually are.”

Why We Struggle With Imposter Syndrome

These are some of the potential causes of imposter syndrome, according to the expert:

• Personality traits: Traits like perfectionism and neuroticism tend to make us more prone to imposter syndrome, says Kayanan. Perfectionists may never feel like they’ve done something well enough and people who live with neuroticism may be more prone to anxiety and self-doubt.
• Low-self worth: Having a poor sense of self-worth can make it hard for you to see your accomplishments for what they really are. You may always attribute your success to external factors, like luck or others’ contributions, instead of acknowledging your own talent and hard work.
• Family dynamics: Family dynamics where praise is highly contingent on achievements or, conversely, where achievements are never quite celebrated enough, can lead to imposter syndrome later in life, according to Kayanan. For example, if your parents never acknowledged your accomplishments, you might also start to doubt them.
• Cultural and social factors: Societal pressures, especially in environments that emphasize competition and compare accomplishments in a zero-sum game, exacerbate feelings of self-doubt, Kayanan explains. “Those belonging to underrepresented or marginalized groups may experience it more acutely, grappling with stereotypes and a lack of role models, further fueling their internal narrative of not belonging.”
• Social media: The curated perfection that is often portrayed on social media can fuel feelings of inadequacy and make you feel like everyone else has it together except for you.
• Major life changes: Starting a new job, entering college, or being in any other situation where you don’t have a lot of experience can trigger imposter syndrome. The pressure to succeed combined with a lack of experience can make you feel like you’re in over your head.
• Work environment: Toxic work environments, where feedback is primarily negative or where your achievements are not recognized, can foster feelings of imposter syndrome.

Imposter syndrome does not have a one-size-fits-all cause; its origins are as multifaceted as the individuals it affects, Kayanan says.

Coping With Imposter Syndrome

These are some strategies that can help you cope with imposter syndrome:

• Challenge your thoughts: When you start to feel like a fraud, question those negative thoughts. Are they based on reality or just your inner critic? Remind yourself of all your positive traits, strengths, and accomplishments.
• Collect positive evidence: One strategy is to become a collector, not of fine art or baseball cards, but of positive feedback and achievements, says Kayanan. “Make it tangible—write it down in a reality check journal that serves as evidence against your inner critic.”
• Focus on growth: Instead of aiming for perfection, focus on learning and growing. Everyone makes mistakes, and those mistakes can be valuable learning experiences.
• Celebrate your wins: Don’t downplay your successes! Take the time to celebrate your accomplishments, whether big or small. This will help build your confidence and make you less susceptible to imposter feelings.
• Practice self-compassion: Be kind to yourself and treat yourself with the same compassion and empathy you would offer to a friend facing similar challenges. 
• Share your feelings: Talk to trusted friends, mentors, or colleagues about your feelings of imposter syndrome. If they too have faced similar experiences, they can provide valuable insights, support, and encouragement.
• Find your cheer squad: Kayanan recommends cultivating a squad of honest people who will cheer for you and call you out (nicely) when you’re being your own worst critic. “Use others as a way to shed truth in a situation where you feel small.”
• Seek professional support: If you’re struggling with your feelings, it may be helpful to seek the support of a mental healthcare provider, such as a therapist. “Clinically, cognitive-behavioral therapy (CBT) strategies can be particularly effective in reshaping the cognitive distortions that underpin imposter syndrome,” says Kayanan.

When two people feel close and connected, their participation in sexual acts can be deemed as intimate sex. While casual sex (which doesn’t involve future expectations or a romantic, emotional commitment) has merit, adding intimacy can improve a person’s sexual experience.

Here we explore the many benefits of being intimate with a partner sexually, along with both non-physical and physical ways to create more intimate sex. We also discuss help available for individuals and couples who seek greater sexual intimacy in their relationships.

Benefits of Intimate Sex

Being involved in an intimate romantic relationship has been linked to several benefits, some of which include:

• Better mood
• Boosted immunity
• Fewer somatic symptoms, such as pain and fatigue
• Greater satisfaction with the relationship
• Greater sexual satisfaction
• Higher level of life satisfaction
• Improved healing
• Improved heart health
• Increased longevity
• Lower blood pressure
• Lower risk of depression
• More happiness
• Reduced age-related disease risk
• Reduced stress

Non-Physical Ways to Increase Sexual Intimacy

Achieving sexually intimate experiences starts outside the bedroom. Here are a few non-sexual ways to boost sexual intimacy with a partner.

Make Time to Be Together

When our calendars are packed, it’s important to schedule time for intimacy. We can do this by setting aside quality time regularly, as we would for any other priority in our lives. During this time, turn off the cell phones and get rid of other distractions to better concentrate on each other.

Make It Okay to Enjoy Sex

Sometimes we have to remind ourselves that it’s okay to want sexual pleasure. This reminder can help us initiate sex more frequently, and having more sex with our significant other can make our bond stronger—potentially even contributing to a longer relationship.

Communicate Openly

If the goal is more intimate sex, it’s also helpful to truly listen to our partner.  Some people need intimacy before becoming sexual while others want sex before they can become intimate. Misunderstandings can ensue if we don’t talk to our partners to understand their needs.

Strengthen Emotional Intimacy

Sharing our emotions and being vulnerable can sometimes be challenging, especially when it comes to sexual relations. But greater emotional intimacy leads to stronger trust, and when trust is established in a relationship, we are often willing to take greater risks.

For instance, we might be more open to indulging in playfulness or acting out sexual fantasies. A willingness to try new things can increase excitement and satisfaction, resulting in a closer bond and enhanced sexual pleasure.

Be Appreciative

Another way to increase sexual intimacy is to express thanks for our partner’s loving gestures. If they drove the kids to sports practice or cooked a special dinner, tell them that their actions are appreciated.

It’s easier to be in the mood for sexual activities when we feel appreciated. Plus, when we express gratitude to our partners, they are also more motivated to fill our sexual needs. That makes this sexual intimacy tip a benefit for both parties involved.

Physical Ways to Increase Sexual Intimacy

There are also several physical ways to spice up our relationship. Exciting activities that can lead to intimate sex run the gamut from kissing to oral sex. Here are some other physical things we can do.

Be Flirty

When we’re in a long-term relationship, we sometimes forget the value of being flirty with our partner. But taking this approach is one way to promote their desire for sex, leading to greater sexual intimacy.

Research indicates that the type of flirting that is most effective can vary based on sex. While flirtatious acts that suggest greater sexual access tend to work better for men, those that suggest an emotional commitment and/or exclusivity are often more effective for women.

Engage in Foreplay

Some couples may feel as if there’s not enough time for foreplay before sex, especially if they have kids or a busy home and work life. But foreplay can increase sexual enjoyment while also leading to easier orgasm. So, there are benefits to allowing time for arousal.

Foreplay is an important step in warming up to intimate sex. Simply kissing our partner tenderly or giving them a sensual massage can set the mood for what’s to come.

Lock Eyes

Prolonged eye contact from across the room or during foreplay is another way to physically engage with our partners, increasing their desire for intimate sex. Looking intently at the person we love can show our readiness to move forward intimately.

Express Physical Affection

Physical affection can be expressed through multiple gestures. We can cuddle on the couch, massage our partner’s shoulders, or hold their hands. Sensual forms of intimacy are important too, like sharing a delicious, decadent dessert or having our partner massage our body with oils.

Don’t Forget Orgasms

In one study about partner intimate touch and interpersonal closeness, scientists measured closeness after orgasmic meditation, a partnered non-verbal practice that includes genital touch. Researchers found that partner-intimate touching increased feelings of closeness.

Getting Help for More Intimate Sex

A warm and intimate sex life supports greater health. For individuals who are having difficulties in their sexual relationships or can’t find closeness and connectedness with the people they are dating or living with, it can be helpful to seek help about this matter.

Both in-person and online sex therapy practitioners can help uncover issues, and then work to turn them around. Don’t be embarrassed about looking for such assistance. These well-trained specialists can offer guidance on how to find the loving and satisfying relationships we seek…and truly deserve.

Catatonia is marked by a significant decrease in someone’s reactivity to their environment. This can involve stupor, mutism, negativism, or motor rigidity, and even purposeless excitement.

Although you may have heard the term “catatonic schizophrenia,” this diagnosis no longer officially exists in the current “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5-TR). It was previously one of the subtypes of schizophrenia.

Currently, it is used to describe someone who is diagnosed with schizophrenia and who also meets the diagnostic criteria for catatonia. Catatonia can also occur in other conditions.

While these symptoms can be scary and extremely debilitating, knowing more about them (and what treatments are available) can help you better manage them or help a loved one.

Characteristics of Catatonic Behavior

According to the DSM-5-TR, catatonia is characterized by:

• Agitation: Feeling upset and irritable
• Catalepsy: Holding the body in the same position
• Echolalia: Echoing what others say
• Echopraxia: Mimicking other people’s movements
• Grimacing: Holding the same tense facial expression
• Mannerisms: Making exaggerated movements
• Mutism: Being unable to speak or unusually quiet
• Negativism: Not responding to environmental events
• Stereotypy: Repetitive movements that occur without a purpose
• Stupor: Being awake but non-responsive
• Waxy flexibility: Resistance to changing body positions followed by slow responses

Catatonia can also cause a person to perform strange movements. They may also experience catatonic posturing where they stay in uncomfortable-looking positions without attempting to shift into more comfortable or natural ones.

In addition to a lack of mobility, erratic and extreme movement is possible in catatonic behavior. For example, a person might pace in a repeated pattern and make loud exclamations for no reason (i.e., not in response to an environmental stimulus or event).​ Parrot-like repetition or echoing of words, known as echolalia, is also a common catatonic behavior.

While a person who is catatonic may not be able to speak or move, they are still conscious and aware. A person in a catatonic state may also experience intense emotions and feelings of anxiety but not be able to express what they are experiencing.

How Is Catatonic Behavior Diagnosed?

There are no labs or tests to diagnose catatonic symptoms. Catatonic behavior can also occur in conditions such as autism and mood disorders, so a doctor will evaluate symptoms to determine what is causing them. 

A doctor will perform a series of medical exams and psychological evaluations to assess the individual’s physical and mental health, as well as rule out other conditions.

Depending on the results, a doctor may order a magnetic resonance imaging (MRI) scan or an electroencephalogram (EEG) to check for any lesions or unusual brain wave patterns. A test may also be given to check for drugs and alcohol.

During the psychiatric evaluation, the individual will be asked questions about their thoughts and behaviors. A psychiatrist will attempt to discover how long they have been experiencing the symptoms in question.

What Causes Catatonic Behavior?

The exact causes of catatonic behavior are not clear. There is also no single cause of schizophrenia or other conditions that are sometimes accompanied by catatonic symptoms.

Causes of Catatonic Behavior

• Brain abnormalities: These include unusual activity in the brain, including irregularities in neurotransmitter systems involving dopamine, glutamate, and gamma-aminobutyric acid (GABA). Brain imaging suggests that catatonic symptoms are associated with brain abnormalities in most cases.
• Psychiatric conditions: Catatonia or catatonic behavior is a serious psychiatric condition that has historically been associated with schizophrenia, but it can be present in various psychiatric conditions, including schizoaffective disorder, bipolar disorder, and major depressive disorder. Depression that includes catatonia as a symptom is sometimes referred to as catatonic depression.
• Substances and other medications: Catatonic behavior may also result from drugs, alcohol, and certain medications.
• Medical conditions: Some other medical conditions can cause catatonic behavior or behaviors that can be mistaken for catatonia. Dystonia, encephalopathy, HIV, and renal failure are conditions that can potentially cause catatonia.

Catatonic symptoms like facial contortions, strange limb movements, or unusual body positions can lead to a misdiagnosis of tardive dyskinesia or other movement disorders. Similarly, Tourette’s syndrome may be confused for catatonia due to some of the vocalizations that can be part of the syndrome.

Causes of Schizophrenia

While the exact causes of schizophrenia are not fully understood, it is believed that a combination of genetic and environmental influences may play a role. Genetics appear to make people more vulnerable to the condition, but other factors, including viral infections, exposure to toxins, neurochemical irregularities, stress, and trauma, can also play a role. 

Treatment of Catatonic Symptoms

Treatments for catatonic behavior can vary depending on the individual’s needs and diagnosis. Schizophrenia is a lifelong, chronic condition, which means people must take steps to stay ahead of and manage their catatonic behaviors and schizophrenia.

Medication

Benzodiazepines like Ativan (lorazepam) are perhaps the most common approach to treatment. These drugs act as depressants on the central nervous system, which is why they are often used to treat anxiety.

There is some debate around the use of antipsychotics in catatonia. In some cases, antipsychotics can worsen catatonia and are often discontinued in its acute management. However, they are generally reintroduced to treat and prevent the symptoms of schizophrenia.

Electroconvulsive Therapy (ECT)

ECT, formerly known as electroshock therapy, is increasingly used to effectively treat catatonia in schizophrenia and other psychiatric conditions. Research has shown that ECT has an 80% to 100% efficacy rate in treating catatonia.

Coping With Catatonic Behavior

Witnessing someone experience catatonic behavior with schizophrenia is certainly scary. Steps people can take to help cope:

Stay Informed

Perhaps the best thing friends and family members can do is to stay educated about diagnosis, symptoms, and effective treatment. By staying informed, loved ones can get help immediately if they notice any signs of catatonia like rigidity or stupor, or erratic extreme movements.

Be Prepared to Describe Symptoms

Depending on the severity and type of symptoms, people may need to step in to describe the catatonic behaviors to their loved one’s doctor.

Offer Encouragement and Support

People can also help by doing their best to encourage someone experiencing catatonic behavior to work with their mental health professionals. Sticking to the treatment plan will help ensure that schizophrenia is well-managed and controlled.

Care for Yourself

Self-care is also essential for sustaining the mental energy required to support someone with a mental illness. Caregivers should try to get ample sleep, eat right, exercise, and make time for relaxation and fun.

You have to make decisions both large and small throughout every single day of your life. What do you want to have for breakfast? What time should you meet a friend for dinner? What college should you go to? How many children do you want to have?

When faced with some decisions, you might be tempted to just flip a coin and let chance determine your fate. In most cases, we follow a certain strategy or series of strategies in order to arrive at a decision.

For many of the relatively minor decisions that we make each and every day, flipping a coin wouldn’t be such a terrible approach. For some of the complex and important decisions, we are more likely to invest a lot of time, research, effort, and mental energy into coming to the right conclusion.

So how exactly does this process work? The following are some of the major decision-making strategies that you might use.

The Single-Feature Model

This approach involves hinging your decision solely on a single feature. For example, imagine that you are buying soap. Faced with a wide variety of options at your local superstore, you decide to base your decision on price and buy the cheapest type of soap available. In this case, you ignored other variables (such as scent, brand, reputation, and effectiveness) and focused on just a single feature.

The Additive Feature Model

This method involves taking into account all the important features of the possible choices and then systematically evaluating each option. This approach tends to be a better method when making more complex decisions.

For example, imagine that you are interested in buying a new camera. You create a list of important features that you want the camera to have, then you rate each possible option on a scale of -5 to +5.

Cameras that have important advantages might get a +5 rating for that factor, while those that have major drawbacks might get a -5 rating for that factor. Once you have looked at each option, you can then tally up the results to determine which option has the highest rating.

The Elimination by Aspects Model

The elimination by aspects model was first proposed by psychologist Amos Tversky in 1972. In this approach, you evaluate each option one characteristic at a time beginning with whatever feature you believe is the most important. When an item fails to meet the criteria you have established, you cross the item off your list of options. Your list of possible choices gets smaller and smaller as you cross items off the list until you eventually arrive at just one alternative.

Decision Making

The previous three processes are often used in cases where decisions are pretty straightforward, but what happens when there is a certain amount of risk, ambiguity, or uncertainty involved? For example, imagine that you are running late for your psychology class.

Should you drive above the speed limit in order to get there on time, but risk getting a speeding ticket? Or should you drive the speed limit, risk being late, and possibly get docked points for missing a scheduled pop quiz? In this case, you have to weigh the possibility that you might be late for your appointment against the probability that you will get a speeding ticket.

When making a decision in such a situation, people tend to employ two different decision-making strategies: the availability heuristic and the representativeness heuristic. Remember, a heuristic is a rule-of-thumb mental short-cut that allows people to make decisions and judgments quickly.

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The Availability Heuristic

When we are trying to determine how likely something is, we often base such estimates on how easily we can remember similar events happening in the past. For example, if you are trying to determine if you should drive over the speed limit and risk getting a ticket, you might think of how many times you have seen people getting pulled over by a police officer on a particular stretch of highway.

If you cannot immediately think of any examples, you might decide to go ahead and take a chance, since the availability heuristic has led to you judge that few people get pulled over for speeding on your particular route. If you can think of numerous examples of people getting pulled over, you might decide to just play it safe and drive the suggested speed limit.

The Representativeness Heuristic

This representativeness heuristic is a mental shortcut that involves comparing our current situation to our prototype of a particular event or behavior. For example, when trying to determine whether you should speed to get to your class on time, you might compare yourself to an image of a person who is most likely to get a speeding ticket.

If your prototype is that of a careless teen who drives a hot-rod car, and you are a young businesswoman who drives a sedan, you might estimate that the probability of getting a speeding ticket is quite low.

Brain zaps are electric-like sensations in the brain perceived to happen in the brain when someone is discontinuing a antidepressant. It’s a term that likely became popularized on internet discussion boards among people who were describing their experiences after discontinuing antidepressants.

Brain zaps are one of several physical sensations experienced during antidepressant discontinuation syndrome, a condition common among people who are tapering off antidepressants.

What Causes Brain Zaps?

Although the term “brain zaps” may be used to describe a variety of experiences—including the physical sensations associated with anxiety, or the experience of taking the drug ecstasy—the term is most closely associated with discontinuing antidepressants, and has been studied as a symptoms of antidepressant discontinuation syndrome.

According to a 2017 study published in CMAJ, roughly 20% of people develop antidepressant discontinuation syndrome after ending the use of antidepressant medication. The syndrome is most likely to happen when going “cold turkey” or reducing your medication intake substantially in a short period of time.

Experts aren’t entirely sure why weaning from antidepressants can cause unpleasant bodily sensations for some people. According to a 2018 study, it might have something to do with the alteration of serotonin receptors that happens when you stop taking an antidepressant, and the impact this has on neurotransmitters. Additionally, certain people may just be more sensitive to the effects of stopping antidepressants, the researchers suspect.

Besides “brain zaps,” antidepressant discontinuation syndrome can cause:

• Flu-type symptoms, such as feeling overheated and exhausted, and having headaches and muscle aches
• Trouble sleeping, including nightmares
• Nausea and vomiting
• Dizziness
• Tingling and burning sensations
• Feeling anxious and “on edge”
• Feeling angry and agitated

How Do Brain Zaps Feel?

Everybody experiences brain zaps a little differently. But in a nutshell, they are usually described as an electric-like sensation felt in the brain. They have also been described by some people as tingling, shock-like, and burning.

Researchers looked at almost 600 online posts between 2014 and 2016 by users describing their experience with brain zaps. These findings were shared in the study published in The Primary Care Companion For CNS Disorders. Here’s what they found:

• Most described brain zaps as lasting a second or two, rarely longer
• The majority described brain zaps as “electric shocks”
• Many people felt like they blacked out for a second during a brain zap
• Many people felt like brain zaps were like the brain “rebooting”
• Some people shared that brain zaps were more likely to happen when they moved their eyes side to side
• Some people felt or heard buzzing
• Some people felt pain during the brain zap
• Some people had several zaps in a row
• A small number of people described brain zaps as “like seizures”
• A small number of people described brain zaps as similar to an orgasm

How to Get Rid of Brain Zaps

In most cases, brain zaps, along with other symptoms of antidepressant discontinuation syndrome will go away within a week or so. For people who have mild, temporary symptoms, the “wait it out” approach works fine. But for some people, brain zaps and other sensations are extremely uncomfortable and disturbing, and may last for longer periods. These people may be looking for relief.

Thankfully, you are not helpless when it comes to managing your symptoms. There are things that can be done to treat, prevent, and cope with brain zaps. Here’s what to know.

Treatment

If you are experiencing unpleasant symptoms after stopping antidepressants, you should contact your healthcare provider. They can discuss how quickly you have tapered off your medication, whether you should wean from the medication at a slower pace, and whether substituting a different medication while you wean may be appropriate.

Here are some tips to keep in mind when it comes to tapering off an antidepressant:

• It may be more possible to wean faster if you have been taking the antidepressant for a shorter period of time.
• If your antidepressant has a short half-life, you will likely need to wean more gradually
• It can be helpful to keep in mind that the symptoms you are experiencing are temporary and won’t affect your long-term health
• For some people, switching to the antidepressant like fluoxetine (Prozac) which has a long half-life can be helpful for a period after you’ve stopped your antidepressant
• If your symptoms are severe, you may need to start taking your medication again, and then do a slower tapering off period in the future

Coping

People who are stopping antidepressant and experience uncomfortable symptoms need support. Research published in Psychiatry Online surveyed 250 people who had discontinued their antidepressant. The researchers looked at what support helped the most. Here’s what they found:

• Self Education: 76% of people found that self-education on the topic of discontinuing medication was very helpful; this included reading books and doing web research on the subject
• Self-Care: Spending time outdoors, sharing how you feel with others, exercise, and spending time with pets all were helpful when it came to coping with medication discontinuation
• Social Support: More than half of respondents said that having at least one trusted support person was important, and having a support person who had experienced mediation discontinuation themselves and could empathize was helpful.

Prevention

Not all instances of brain zaps can be prevented, but having a solid plan for how to taper off your medication and doing so gradually can prevent many cases of antidepressant discontinuation syndrome or at least lessen your symptoms.

Reducing the risk of brain zaps starts with having a detailed discussion with your provider or psychiatrist before stopping your antidepressant. Not all antidepressants are the same, and your provider can tell you what the best schedule is for weaning off your particular antidepressant. In some cases, it may take 6-8 weeks to wean off an antidepressant to minimize side effects. Your provider may also suggest switching to a different antidepressant while you taper off.

When to See a Healthcare Provider

You should contact your healthcare provider before you begin the tapering off process, to get a healthy plan in place. But you should also contact your doctor if you are having challenging symptoms during the weaning process.

Symptoms that are severe or that last more than one to two weeks should be reported to your doctor. You can also talk to them if you want alternative medications, a different weaning plan, or if you wish to go back to taking your old medication.