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Thursday, June 30, 2016

Pain does not mean, necessarily, suffering.

I meet with many clients who complain of pain of all types and in all parts of the body. Some of them are on pain medications which sometimes become abused and then sometimes the person becomes addicted. Once a person becomes addicted to pain medication, especially opiates, withdrawal from the drug causes pain all its own and it becomes difficult to discern how much of the pain the person is complaining about is generated by physical problems and how much from the medication withdrawal. At this point, pain becomes a viscous cycle because the easiest way to stop the pain of withdrawal is with more of the medication that is causing the addiction in the first place.

Sometimes I share, in therapy, the idea with the client that it can be helpful to make a distinction between pain and suffering. Some people have difficult pain but they do not suffer because they have found ways to cope with the pain. Other people have little pain but suffer a great deal because of their fears and resistance.

Studies have found, interestingly, that two of the best ways to cope with pain is acceptance and distraction. The more a person fights the pain and resists it, the more tense and anxious the person becomes and the worse the pain gets. Sometimes it is best to accept the pain, go with the flow, and relax as best you can. "It is what it is" as the Buddhists say.

Distraction also can help when the person can put their mind on something more interesting, engaging, and enjoyable. This takes some deliberate and purposeful intention and focusing. Practicing this distraction by refocusing is what I call "mind control." It is a skill which a person can get better at the more he/she practices. It is like a muscle that gets stronger with exercise.

I have found that relaxation techniques can also be very helpful using isometric exercises where the person deliberately tenses and relaxes the various muscle groups in the body.

For more information click here for an brief article entitled "Pain: The Two Best Psychological Techniques For Coping." on Psyblog.

Wednesday, June 29, 2016

Hovering (helicopter) parents may create "maladaptive perfectionism" in their children with increased anxiety, depression, and even suicidal ideation

From Medline Plus, June 26, 2016
SATURDAY, June 25, 2016 (HealthDay News) -- Children with "intrusive" parents who push too hard for good grades may be more prone to become highly self-critical or anxious and depressed, a new study suggests.
"When parents become intrusive in their children's lives, it may signal to the children that what they do is never good enough," said study leader Ryan Hong, an assistant professor in the department of psychology at the National University of Singapore.
The five-year study of primary school students in Singapore found that those whose parents acted intrusively, had high expectations of academic performance or overreacted when the child made a mistake were at increased risk of being overly critical of themselves.
The researchers also found that children who were highly self-critical had higher levels of anxiety or depression symptoms, although the study did not prove that parental pressure caused anxiety or depression.
"As a result, the child may become afraid of making the slightest mistake and will blame himself or herself for not being 'perfect,'" Hong said in a university news release.
For more click here.

Tuesday, June 28, 2016

Only Prozac, Fluoxetine, seem to provide benefits greater than risks in adolescents with depression.

According to a meta-analysis of antidepressant treatment for adolescents with depression published in the Lancet, the English medical journal in June, 2016, only Prozac (Fluoxetine) seemed to provide benefits which outweighed the risks.

You can access the journal article abstract by clicking here.

There are many studies which show the benefits of psychotherapy however.

Monday, June 27, 2016

Narrative Therapy and the danger of the single story

I have had a long interest in what is called Narrative Therapy. The basic premise in the Narrative Therapy model is that every person's life is worth a story. This story not only functions as a narrative of events, activities, and people who have been a part of the person's experience over time, but the story is also the lens and the filter through which further perceptions are observed and interpreted.

People come for therapy when they feel stuck in their lives. Their old story is not working any more, and a Narrative Therapist helps the client "re-author" the story of their life along a line that is more preferable.

In my review of narrative practice in an online course at the Dulwich Centre for Narrative Therapy in Australia I came across this wonderful TED talk by Chimamanda Ngozi Adichie which was given in 2009 entitled, "The Danger Of The Single Story."

The stories of our lives which influence us both positively and negatively often are not of our making but imposed on us by people in powerful positions in our lives who define and interpret "reality" for us. Often our assumption of "the truth" of these stories is unconscious until we sense that they might be wrong and what Alice Miller calls "an enlightened witness" comes into our lives invited by us, or sometimes uninvited, and helps us challenge them.

When we pour 6 ounces of liquid out of a 12 ounce glass and we are asked, "Is the glass half full or half empty," we begin to understand how our stories influence and shape our experience of the "reality" which we have created for ourselves.

I hope you enjoy Chimamanda Adichie's talk on "The Danger Of The Single Story."




I am developing a training on Narrative Therapy for Mental Health and Substance Abuse professionals. If you would like more information about this training, please email me at davidgmarkham@gmail.com

What's wrong with America's drug enforcement policies?

From the Pacific Standard, , March/April, 2015 

 And for the past century, our policymakers have responded to the challenge of managing public drug use in a manner that is, alas, riddled with contradictions: We have enforced strict bans on some intoxicants (cocaine, ecstasy, marijuana) and allowed the legal sale of other addictive substances (nicotine, alcohol, caffeine). Some legal substances are quite dangerous to public health; some illegal ones appear safe by comparison. Along the way, the United States has spent more than a trillion dollars enforcing anti-drug laws, and has imprisoned millions of people.

Risk factors in later adolescent alcohol abuse

Adolescent drinking

As former Executive Director of GCASA, the Genesee Council On Alcoholism and Substance Abuse, I am proud of the fact that we won the Drug Free Communities coalition of the year in 2006 out of 711 coalitions in the United States. I have continued to follow the prevention research and noticed today a study reported by Science Daily entitled, "Understanding Risk Factors Involved In The Initiation of Adolescent Alcohol Abuse" which was based on information provided by the Research Society On Alcoholism. 

The article highlights the findings that adolescent alcohol abusers tend to be male from higher socioeconomic groups, have poorer executive functioning, and who have begun dating at earlier ages under 14.

For more information click here.