Saturday, December 9, 2017

Substance abuse prevention programs work

This is an interesting video of how Iceland engaged in substance abuse prevention with its teenagers. The same type of programs have been developed and implemented in the United States.

The Genesee Council on Alcoholism and Substance Abuse (GCASA) developed and implemented a Drug Free Communities Coalition in the 2000s. It won the national CADCA award in 2006 for having the best Drug Free Communities Coalition in the United States.

The Drug Free Communities coalition was led at GCASA by Maryann Bowman, Shannon Ford, and Tom Talbot.

Friday, December 8, 2017

People with psychiatric illness more stigmatized by the health care system than by the public at large

Sisti says the stigma around mental health is "systematized" in our health care system, more so than in the public view.
Health care providers are "rather leery about these individuals because these people are, often at least according to the stereotype, high-cost patients who maybe are difficult to treat or noncompliant," he says. "I think the stigma that we should be really focused on and worried about actually emerges out of our health care system more than from the public."
For more click here.

Thursday, December 7, 2017

People with serious psychiatric problems now cared for in the criminal justice system

From NPR 11/30/17
"Many times individuals who really do require intensive psychiatric care find themselves homeless or more and more in prison," Sisti says"Much of our mental health care now for individuals with serious mental illness has been shifted to correctional facilities."
The percentage of people with serious mental illness in prisons rose from .7 percent in 1880 to 21 percent in 2005, according to the Center for Prisoner Health and Human Rights.
Many of the private mental health hospitals still in operation do not accept insurance and can cost upwards of $30,000 per month, Sisti says. For many low-income patients, Medicaid is the only path to mental health care, but a provision in the law prevents the federal government from paying for long-term care in an institution.
As a result, many people who experience a serious mental health crisis end up in the emergency room. According to data from the National Hospital Ambulatory Medical Care Survey, between 2001 and 2011, 6 percent of all emergency department patients had a psychiatric condition. Nearly 11 percent of those patients require transfer to another facility, but there are often no beds available.
"We are the wrong site for these patients," Dr. Thomas Chun, an associate professor of emergency medicine and pediatrics at Brown University, told NPR last year. "Our crazy, chaotic environment is not a good place for them."
For more click here.

Wednesday, December 6, 2017

Lack of psychiatric beds not the problem. Lack of funds for outpatient services is.

NPR has an interesting story about how the loss of psychiatric beds due to the era of deinstituionalization has led to a "mental health crisis" in the U.S. with people with psychiatric problems winding up in emergency rooms and prisons and jails.

The problem is not the lack of psychiatric hospital beds but the lack of outpatient services which has occurred because of a lack of funding. Health insurance payment systems for psychiatric disorders have led to difficulty accessing services with fewer providers available and people with problems winding up by default in other social systems whether it is criminal justice, social welfare, and health care services not equipped to manage people with mental illness.

For more on the NPR story click here.

Tuesday, December 5, 2017

How can you manage seasonal affective disorder (SAD)?

12/21 is the Winter solstice. In the Northern Hemisphere it is the shortest day of the year. Some people are affected more than others with the fewer hours of day light and they experience a mild depression. How can you best manage it?

Click here

Editor's note: When my clients complain to me about what sounds like seasonal affective disorder we explore what outdoor activities they might enjoy in the winter time like skiing, ice skating, snow shoeing, hiking, snow mobiling etc. Exposure to day light even when the days are short is the best remedy.

Sitting in a window during the daylight especially a window with a southern exposure is soothing and helps alot.

Monday, December 4, 2017

Stricter gun laws reduce domestic violence murders

THURSDAY, Nov. 30, 2017 (HealthDay News) -- More stringent gun laws might spur a decline in domestic violence murders, new research suggests.
Thirteen states and federal law prohibit people convicted of domestic violence from buying guns. But the study found that states that extended this ban to people convicted of any violent crime had 23 percent fewer domestic violence murders.
The researchers also found that larger reductions in these deaths were seen when gun restriction laws included dating partners in addition to spouses or ex-spouses, and a requirement that abusers turn in their guns.
"The evidence from this study and previous research highly suggests that firearm restrictions work to reduce intimate partner homicides, and that laws need to be comprehensive when we think about populations most at risk for committing intimate partner violence," said study author April Zeoli. She is an associate professor of criminal justice at Michigan State University.
In the study, the researchers analyzed 34 years of data (1980 to 2013) from 45 states. The 29 states with laws restricting guns in domestic violence cases when a restraining order had been issued had 9 percent fewer intimate partner murders, a finding similar to those in previous studies.

Saturday, December 2, 2017

Subscribe to Markham's Behavioral Health

Follow Markham's Behavioral Health by subscribing by email in upper right hand corner. Keep up with MH information relevant to the practice of a working mental health professional.

Smart phone addiction alters brain chemistry

From Health Day on 11/30/17:

THURSDAY, Nov. 30, 2017 (HealthDay News) -- Teens fixated on their smartphones experience changes to their brain chemistry that mirror those prompted by addiction, a new study suggests.

For more click here.

Friday, December 1, 2017

Hang in there

"English is hard. It can be understood through, tough, thorough, thought, though."

Monthly injections of buprenorphine approved for opioid addiction treatment

From the American Psychiatric Association Psychiatric News Alert on 12/01/17

The Food and Drug Administration (FDA) has approved Sublocade, the first once-monthly injectable buprenorphine product for the treatment of moderate-to-severe opioid use disorder (OUD) in adults who have initiated treatment with a transmucosal (absorbed through mucus membrane) buprenorphine-containing product. Sublocade is indicated for patients who have been on a stable dose of buprenorphine treatment for a minimum of seven days and is meant to be used as part of a complete treatment program that includes counseling and psychosocial support. 

For more click here.

Monday, November 20, 2017

Having a dog can extend a single person's life

From Health Day 11/17/17
FRIDAY, Nov. 17, 2017 (HealthDay News) -- Here's to keeping your health on a tight leash: New research suggests that having a dog might boost a single person's life span.
The study tracked more than 3.4 million Swedes, middle-aged and older, for 12 years. All were free of heart disease at the beginning of the study.
The researchers reported that dog owners who lived alone were 11 percent less likely to die of heart disease and a third less likely to die from any cause, compared with those who lived alone and didn't have a dog.
For more click here.

Tuesday, October 31, 2017

Wednesday, September 27, 2017

CBT (Cognitive Behavioral Therapy) helps children and adolescents with OCD (Obsessive compulsive disorder)

Children and adolescents with obsessive-compulsive disorder (OCD) who respond to cognitive-behavioral therapy (CBT) appear to continue to experience benefits from the therapy even after their initial course of treatment ends, according to a study published Wednesday in theJournal of the American Academy of Child and Adolescent Psychiatry.

Other research has suggested that CBT for pediatric OCD is a durable therapy, but these studies had been limited by either small samples sizes or having CBT combined with other treatments. 

For more click here.

183,000 Americans have died from prescription opioid drug overdoses in the last 16 years.

Between 1999 and 2015, more than 183,000 people in the United States died from prescription opioid overdoses such as OxyContin (oxycodone) and Vicodin (hydrocodone).

For more click here.

I provide clinical supervision for some substance abuse counselors working towards their licensure at a substance abuse agency in Western New York State. Last week on 09/21/17, in our meeting, one of the counselors shared with the group that two of her clients have died of overdoses in the last 10 days and another counselor shared that one of her former clients had died recently as well.

STDs hit all time high in U.S. in 2016

TUESDAY, Sept. 26, 2017 (HealthDay News) -- New cases of sexually transmitted diseases in the United States reached an all-time high in 2016, federal health officials reported Tuesday.
There were 1.6 million cases of chlamydia, 470,000 cases of gonorrhea and 28,000 of syphilis reported that year, the U.S. Centers for Disease Control and Prevention announced in its annual report on STDs.
And the diseases are on the rise in a number of groups, including women, infants, and gay and bisexual men.
For more click here.

Thursday, September 21, 2017

Gun surrender laws in domestic violence situations save lives

WEDNESDAY, Sept. 20, 2017 (HealthDay News) -- Obtaining a restraining order may not be enough to prevent domestic violence, but when state laws require the removal of firearms, risk of those violent crimes goes down, a new study says.
In states that require people with restraining orders against them to surrender their firearms, the intimate partner murder rate dropped by 10 percent. In states that don't require surrender, the rate went down less than 7 percent, the study found.
And the rate of these firearm-related crimes fell 15 percent in states that require surrender, researchers said.
But, just as laws restricting firearm surrender vary from state to state -- some have "possession" laws while others have "surrender" laws -- the protection for victims isn't always the same.
Currently, more than 1,800 people die from domestic violence in the United States every year. About half of these homicides are committed with firearms. Approximately 85 percent of victims are women.
For more click here.

E cigarettes better than tobacco but still not good for your heart if you don't smoke at all

WEDNESDAY, Sept. 20, 2017 (HealthDay News) -- The nicotine in e-cigarette vapor may cause adrenaline levels to spike in the heart, potentially increasing risk of heart attack and sudden cardiac death, a new study reports.
Electronic cigarettes have been promoted as a healthier alternative to tobacco cigarettes because they deliver vastly lower levels of carcinogens, researchers say.
Based on the results, Middlekauff said, current tobacco cigarette smokers still would be better off switching to e-cigarettes. They would avoid the carcinogens produced by burning tobacco, even though they could face heart health effects from nicotine.
At the same time, there's now evidence that e-cigarettes could pose a health risk to people who have never smoked tobacco because of the nicotine they contain, Middlekauff added.
"If you don't smoke at all, I would strongly recommend against using electronic cigarettes, because they're not harmless," she said.
The study was published Sept. 20 in the Journal of the American Heart Association.
For more click here.

Thursday, August 17, 2017

Spanking has negative effects on behavioral development 10 years later

From Psy Blog on 08/05/17:

Spanking can have negative consequences up to 10 years later, new research finds.
The study found that children spanked in infancy had worse behaviour and personalities in their teens.
For more click here.

Wednesday, August 16, 2017

7-Fold Spike Seen in Opioid-Linked Fatal Car Crashes

From Med Line Health Day on 07/31/17:

MONDAY, July 31, 2017 (HealthDay News) -- In yet another sign of just how deadly the U.S. opioid epidemic has become, researchers report a sevenfold increase in the number of drivers killed in car crashes while under the influence of prescription painkillers.
Prescriptions for drugs such as oxycodone (OxyContin), hydrocodone (Vicoprofen) and morphine have quadrupled, from 76 million in 1991 to nearly 300 million in 2014, so it's no surprise these medications are playing a growing role in highway deaths, the Columbia University researchers said.
"The significant increase in proportion of drivers who test positive for prescription pain medications is an urgent public health concern," said lead researcher Stanford Chihuri.
Prescription drugs can cause drowsiness, impaired thinking and slowed reaction times, which can interfere with driving skills, Chihuri said.
For more click here.

Tuesday, August 15, 2017

How lead impacts the mental health of children

From PBS on 08/01/17 Editor's note: This story is not only about the effects of lead on children's brains but also about the ethics of leaders in organizations when they are in government and schools. The government of Flint and Michigan is seriously dysfunctional and the superintendent schools in Flint is a hero whom we all would do well to emulate.

Sunday, August 13, 2017

Americans Taking More Prescription Drugs Than Ever: Survey

From Med Line Health Day:

Thursday, August 3, 2017
HealthDay news image
THURSDAY, Aug. 3, 2017 (HealthDay News) -- A new survey finds 55 percent of Americans regularly take a prescription medicine -- and they're taking more than ever.
Those who use a prescription drug take four, on average, and many also take over-the-counter drugs, vitamins and other dietary supplements, the survey done by Consumer Reports shows.
But many of those pills may be unnecessary and might do more harm than good, according to a special report in the September issue of Consumer Reports magazine.
Among those who take prescription drugs, 53 percent get them from more than one health care provider, which increases the risk of adverse drug effects. More than a third say no provider has reviewed their medicines to see if all are necessary.
Forty-nine percent of survey respondents who regularly take prescription medicine asked their prescribers whether they could stop taking a drug, and 71 percent were able to eliminate at least one.
"We can see that when consumers ask if they can stop taking at least one of their medications, in the majority of cases, their doctors agree," Ellen Kunes, leader of Consumer Report's Health and Food Content Development Team, said in a news release.
For more click here.
Editor's note:
Medications can be helpful tools to manage symptoms and underlying physical disorders, but the knee jerk reaction in the business model of delivering health care services is to prescribe a drug. It is quick and easy and gets the patient off the physician's back in 12 minutes or less. In other words, prescribing drugs is good business but can be questionable health care. 
Patient's feed into this dynamic believing that unless the physician prescribes a drug for their complaint they haven't been taken seriously. The problem of the overprescription and utilzation of pharmaceuticals is endemic to the corporate culture of modern health care delivery. As the old Latin expression Caveat Emptor states, "Let the buyer beware."

Saturday, August 12, 2017

Addiction Drug Underused by Primary Care Docs in U.S.

From Med Line Health Day 08/03/17 THURSDAY, Aug. 3, 2017 (HealthDay News) --

Many doctors aren't making full use of a medication that can wean people off addiction to heroin and prescription painkillers, according to results of a new survey. 

 Buprenorphine is the first drug for opioid use disorder that's approved for prescription by primary care physicians, allowing treatment in the privacy of a doctor's office. But many doctors aren't applying for the federal waiver that would allow them to prescribe buprenorphine, said researcher Andrew Huhn. He's a postdoctoral fellow with the Johns Hopkins University School of Medicine's behavioral pharmacology research unit. 

 Further, most who have obtained a buprenorphine waiver aren't prescribing the drug to as many patients as allowed, Huhn said. This reluctance to fully utilize buprenorphine is hampering efforts to combat the epidemic of opioid abuse in the United States, Huhn said. 

 For more click here.

Editor's note:

American's have been led to believe that their is a magic bullet and a magic key for addiction problems when in fact they are complex, multi-dimensional, and not easily addressed in a primary physician's office in a 12 minute office visit.

Addiction treatment requires not only medication but also a focus on the psycho-social, legal, and spiritual issues which addiction involves. This is not  an area of expertise for most primary care physicians nor do they have the time and energy to address these issues without them being a disruptive to their medical practice.

Bottom line is that treatment of addiction is best when it involves not only medication but a counseling component as well. Primary care offices are not equipped for this counseling component of high quality addiction treatment.

What are the symptoms of ADHD?

There was a very good article for lay people in the Guardian on October 28, 2008 entitled "What Are The Symptoms of ADHD?"

It is worth reading. It is clear, succinct, and straight forward. I recommend it. You can access it by clicking here.

Thursday, August 10, 2017

Current Strategies in the Diagnosis and Treatment of Childhood Attention-Deficit/Hyperactivity Disorder

Great article in the April 15, 2009 issue of the American Family Physician journal.

To access it click here.
In the same issue there is an editorial which addresses the need for a multi-modal approach to treatment. You can access it by clicking here.

Wednesday, August 9, 2017

Brain Development is Delayed in Attention-Deficit/Hyperactivity Disorder

 For more information, click here.

Editor's note: I often tell the parents of my young patient's that overall the best thing they can do for their child with ADD is give him/her "the gift of time" because of the cognitive, emotional, and social delays associated with ADD which cause the emotional  and social age of the child to be 2 - 4 years behind their chronological age. Now there is biological evidence that the cause of this is delayed brain development.

Tuesday, August 8, 2017

Children with ADHD do not recognize angry faces leading to problems in peer-relationships

From Science Daily on 09/25/14:

The characteristics of facial expression recognition of children with ADHD has been initially identified by researchers by measuring hemodynamic response in the brain. They showed that children with ADHD showed significant hemodynamic response to the happy expression but not to the angry expression. This difference in the neural basis for the recognition of facial expression might be responsible for impairment in social recognition and the establishment of peer-relationships.

For more click here.

Monday, August 7, 2017

Perfectionism more important characteristic in mental health problems than most behavioral health professionals recognize

From Science Daily on 09/25/14:

Experts are calling for closer attention to perfectionism's potential destructiveness, adding that clinical guidelines should include perfectionism as a separate factor for suicide risk assessment and intervention. 'There is an urgent need for looking at perfectionism with a person-centered approach as an individual and societal risk factor, when formulating clinical guidelines for suicide risk assessment and intervention, as well as public health approaches to suicide prevention,' says one researcher.

For more information click here.

In Schema therapy this schema is called "unrelenting standards."

Sunday, August 6, 2017

Doctors in collusion with Big Pharma to push drugs on Americans

From Robert Reich's blog: According to a new federal database put online last week, pharmaceutical companies and device makers paid doctors some $380 million in speaking and consulting fees over a five-month period in 2013. Some doctors received over half a million dollars each, and others got millions of dollars in royalties from products they helped develop. Doctors claim these payments have no effect on what they prescribe. But why would drug companies shell out all this money if it didn’t provide them a healthy return on their investment? America spends a fortune on drugs, more per person than any other nation on earth, even though Americans are no healthier than the citizens of other advanced nations. Of the estimated $2.7 trillion America spends annually on health care, drugs account for 10 percent of the total. Government pays some of this tab through Medicare, Medicaid, and subsidies under the Affordable Care Act. But we pick up the tab indirectly through our taxes.

Saturday, August 5, 2017

Problems can have multiple dimensions: physical, psychological, social, spiritual

Andrea was insecure and this is what Greg loved about her. Greg believed that Andrea would love him because he could take care of her and make her feel safe. As Andrea felt more secure and confident, Greg became increasingly anxious and depressed. Greg went to see his doctor who told him he was suffering from depression and gave him antidepressant medication. The medication helped a little bit, but Greg still felt "off" as Andrea seemed to be doing well and didn't need him anymore.

Greg's doctor told him his neurotransmitters were not working properly and were flooded with Serotonin. Whatever the cause, Greg was not feeling much better and decided to see a psychotherapist. The therapist asked Greg after a few meetings if Greg thought that maybe he was suffering from a spiritual problem? Greg responded that he had no idea what the therapist was asking him. What kind of a spiritual problem could it be?

The therapist offered the idea that Greg was dealing with a sense of shame, a sense of innate defectiveness and inadequacy which he tried to overcome by taking care of, what Greg called "love", people so that they would love him back.

Greg acknowledged that this unconscious dynamic may be at play. The therapist then asked Greg where he thought this sense of inadequacy and defectiveness had come from? Greg said he had felt this way since he was a child and his mom and dad divorced when he was three and he missed his father and his mother started drinking and leaving him with a sitter to go out with other men. Greg said that he always wished his mom and dad loved him more and were there for him. He found that by being very good and trying to be helpful seemed to make his mom and dad like him better. Greg said that maybe his whole life was based on a belief that if he was nice to people they would like him so he has striven his whole life to be what his best friend called "being a people pleaser."

The therapist suggested that his whole life has been based on this belief that he is inadequate and defective in some way and that he would be all alone unless he was able to take care of and please other people. The therapist asked if this was the basis of his "love" for Andrea? Now that she was more secure and confident rather than being happy for her, Greg was getting fearful and depressed believing that Andrea wouldn't need him any more and leave him?

Greg started to cry and said, "I'm really messed up, aren't I?"

The therapist said, "Not at all. You are perfect just the way you are, you're just learning that Life wants you to be happy and have a high quality life just because you are alive and part of this wonderful universe."

Greg smiled and said, "Thank you."

The spiritual problem is one of shame which is the innate belief and feeling that we are inadequate and defective in some way. Further we think that it is only a matter or time and circumstances before this supposed fact comes to light and we are found out to be the shameful creatures which we believe we are. As Christians tell us we all our sinners if not for what we have done, at least because of the sin of Adam and Eve in the Garden of Eden for which Jesus died on the cross to assuage the anger of the Father God who is mad about our disobedience.

This belief in our sinful natures which requires sacrifice and suffering for exoneration and redemption is the Great Lie of the ego. The spiritual fact is that God loves us unconditionally and it is we, humans, who create our own guilt and hell because we have separated ourselves from the unconditional love of God by our willfulness and drama.

If we could overcome and rise above our own drama, we could create heaven on earth. Greg has created his own hell believing that he is unworthy and can only be whole if he sacrifices and suffers, what he calls "love.". Nothing could be further from the Truth and it is Greg's false spiritual belief which has placed him in his own hell. Heaven, however, is within his grasp once he realizes that he is okay and will be okay just the way he is. He is loved by his Creator.


Friday, August 4, 2017

Families pay a key role in the treatment of addiction

Sociologist, Robert Ackerman, spreads the message that families play a key role in the treatment of addiction. Here is part of his message:

"Relatives need to understand the disease of addiction, learn skills for living with addiction, learn how to discourage excessive alcohol or drug use, and understand how to communicate with an abuser in a positive manner.Family counseling sessions should help addicted people and their relatives to lay out long-term plans and goals for recovery. Families also should learn that the recovery techniques don’t work the same way for everyone, Ackerman said. Some may take longer than others to respond, some will respond in different ways, and not all will reach the same level of recovery — a factor called recovery lag."

My experience has been that families struggle with four primary emotions when a family member is addicted: anger, fear, confusion, and love.

The confusion comes from a lack of understanding about what they are dealing with and the conflicted messages that our society sends about addiction. Even professionals and the health care system is conflicted.

The anger comes from being stolen from, injured, lied to, and mistreated and, of course, the underlying fears of being hurt again or our loved being harmed or harming someone else.

Because of these emotions of anger, fear, confusion, and love there is a tendency to enable, punish, or cut off. These managements strategies usually not only don't help, but make the situation worse in the long run. And so what does help?

What helps is detach with love, that is creating appropriate boundaries of what you can do and can't do to help. Providing appropriate help, but not rescuing. Helping means supporting the person's well being and ability to help him or herself by providing information, coaching for better life skill management, and providing opportunities for using that information and skills. Rescuing means bailing people out, covering things up, minimizing and denying so that the using person doesn't have to experience the consequences of their own use.

Getting help from a professional coach that can guide the family's development, implementation, and evaluation of their management strategy often is the best way to engage with the addicted family member in a consistently helpful way. While every person struggling with addiction and every family is different there are some basic principles that can be helpful for all families. These principles will be described in future articles.

For more about the article about Robert Ackerman click here.

Thursday, August 3, 2017

If you were terminally ill would you want to know?

A study reported on July 20, 2017 done with 250 terminally ill patients in Taiwan found that about 10% did not want to know about their diagnosis and prognosis. Would there be similar findings in the U.S.?

For more click here.

Tuesday, August 1, 2017

Coffee in moderate daily amounts helps you live longer

MONDAY, July 10, 2017 (HealthDay News) -- Here's news to perk up your day: Drinking coffee might help you live a little longer, two new studies suggest.
Researchers found that daily coffee drinkers were up to 18 percent less likely to die over the next 10 to 16 years, versus non-drinkers.
For more click here.

Monday, July 31, 2017

Cognitive behavioral therapy improves functioning for people with chronic pain, study shows

From Science Daily on July 11, 2017

Cognitive Behavioral Therapy (CBT) is the most frequently used psychological intervention for people with chronic pain, and new approaches for improving CBT outcomes may be found in the psychological flexibility model and Acceptance and Commitment therapy (ACT), according to research.

Editor's note:

There are many reasons why psychotherapy can help people suffering from chronic pain. Stress often aggravates pain and reducing stress may then decrease pain. Also, making a distinction between "pain" and "suffering" is helpful. Some people may have lesser amounts of pain but suffer greatly, while others have higher amounts of pain and suffer much less. Why would this be?

Sunday, July 30, 2017

Motivation through punishment may not work

From Science Daily on July 4, 2017

Parents scold their children to correct their behavior, hoping that their offspring will discontinue their misbehavior as a result. What's paradoxical about this kind of punishment is that it can have the opposite effect.

For more click here.

Editor's note:

There are many explanations for this finding that motivation through punishment may not work. The best explanation in my experience is that negative attention is better than no attention at all. Even though the punishment may be uncomfortable there is what is called "secondary gain" meaning that beyond the negative experience produced there is a positive one. So while the scolding or other hurtful punishment is somewhat painful, the reward of the parent's attention and engagement is positive enough to offset whatever negative experience was inflicted.

Punishment, also, is not enough to correct behavior and repair harm that has been done by the mistake without offering the child at least one alternative behavior.

Saturday, July 29, 2017

Misuse of psychiatric diagnoses

The misuse of psychiatric diagnoses in argument is usually an attempt at dismissal and marginalization of the person's position on things as in "Ahhhhhhhhhhhh, you're crazy!" or "He's nuts!." 

The use of psychiatric diagnoses inappropriately is an act of dismissal, disregard, and sabotage of credibility. In its essence, it is a prime example of the logical fallacy of an "argumentum ad hominem." The use of this logical fallacy is what got Donald Trump elected president as he attacked people of Mexican and Islamic heritage and his nicknaming of his political opponents, "Lying Ted", "crooked Hillary", "Little Marco." 

To an audience, there is an emotional exhilaration and enjoyment of such attacks because of the witnessing of acting out of projected emotions. The factor that makes the use of this logical fallacy successful is not the insult and attack in itself but the provision and enjoyment of the audience who witness such attacks and laugh or cheer as in "Lock her up, Lock her up." 

There is something sick in this dysfunctional behavior not so much because of the harm to the target but because of the effect on the audience which leads to a mob mentality whose behavior is motivated by unbridled emotion and not any kind of deliberate reason. The catharsis may be enjoyably mood altering until the harm of the consequences become apparent further down the line.

As psychotherapists we have taken on solemn responsibilities and commitments to appeal to the better natures of human beings. The kind of bullying behaviors evidenced by agumenum ad hominems which alarm us as therapists should lead us to not only focus on the bully and the bully's target but on the audience who provide the bully with a pulpit to do his/her dirty work. To name and label this destructive behavior is a significant public service and to encourage people not to provide an appreciative audience for it may be the most effective intervention for its diminishment.

The Handmaid's Tale by Margaret Atwood - Review

Handmaid’s Tale by Margaret Atwood is a dystopian novel about a future country in which religious, puritanical depots have taken over the government. Human reproduction is intensely regulated by setting up a system in which  procreating surrogates called “handmaids” are taken into the households of government officials called “commanders”. These commanders have wives who oversee the insemination of the maternal surrogates by their husbands in a highly controlled depersonalized manner. These handmaids are under almost constant surveillance to assure their obedience and compliance with the expectations and requirements of the commanders and their wives.

The premise for this narrative is highly contrived and unrealistic. The characters are stilted, robotic, and predictable. The tone of the narrative is paranoid, secretive and dark. This is not an enjoyable book to read because it is often tedious, unnecessarily detailed, and very slow in plot development with redundant scenes laboriously described.

There is little to learn from reading this story other than the preposterous possible consequences of puritanical sexual repression especially with its damaging consequences for females. Another interesting dynamic is how females participate in the domination and repression of their own sex. It is interesting how men in power use females to implement their own male domination in a patriarchal society to maintain their own male power and dominance.

The depiction of females in this story is not positive except for two female characters who rebel both of whom wind up being further repressed and subjugated. In the end, it is a male who saves the handmaid who is the narrator of the story.

What this story teaches about feminism is not positive but depicts a scenario of extreme female subjugation. What this story teaches about females is that they can be easily taken over and controlled by men who manipulate them for their own power aggrandizement.

In our post Dobbs era where women's bodies have been subject to legal regulation and reproductive decisions have been criminalized, the Narrative of The Handmaid's tale in slowly being implemented in the United States.

Veterinary social work opens outlet for grief, emotional stress

From the Pittsburg Post-Gazette on July 3, 2017


The veterinarian side
Every day, five to 12 euthanasias are performed at PVSEC, the region’s largest specialty and emergency veterinary center, seeing several hundred cases a day. The number of euthanasias is high because many pet owners cannot afford the complex medical intervention needed to save a pet’s life.
“It’s hard when they know the animal can be fixed but the process can’t be paid for by the family,” Ms. Harbert said.
The American Veterinary Medical Association, based in Illinois, reports that 1 in 6 vets struggle with thoughts of suicide. The Centers for Disease Control and Prevention found that veterinarians have a four times higher suicide rate than the general public and are two times more likely to commit suicide than dentists and medical doctors.
“We see the sickest cases, so its hard for us as doctors and nurses everyday to see deaths. We are sad every time,” said Christine Guenther, a PVSEC veterinarian.
As a result, some PVSEC veterinarians suffer from compassion fatigue, burnout and ethical exhaustion when trying to come up with an alternative way to save a pet, given an owner’s financial constraints.
“You empathize so much with patients that you take on the burden and it takes a toll on you,” said Michael San Filippo, spokesman for the American Veterinary Medical Association.
Ms. Harbert works with the veterinarian staff to emotionally process the cause of a pet’s death and help staff members cope with their own grief. She assesses how individuals are acting and then helps them reach a stable emotional state.
Training for this counseling is not typically taught in vet school.

For the whole article click here.

Friday, July 28, 2017

Most popular stress coping strategies for children

Freud said that you can either act it out or talk it out. Good parents ask upset children to calm down and "use your words." A key parental strategy to encourage child growth and development is to give children the words for things. As I like to share with my clients, if you can't name it, you can't manage it. Naming things, both internal affective states and external factors is 90% of good stress management.

Thursday, July 27, 2017

Good overview of the DSM - 5

The DSM - 5 is the fifth edition of the diagnostic and statistical manual of the American Psychiatric Association which lists the psychiatric diagnoses used in the United States.


Wednesday, July 26, 2017

Dopamine, the reward neurotransmitter

Learn about the limbic system and the biochemical processes that allow this key brain region to process rewards. The limbic system links together a number of brain structures that control and regulate our ability to feel pleasure. Feeling pleasure motivates us to repeat behaviors that are critical to our existence. The limbic system is activated by healthy, life-sustaining activities such as eating and socializing—but it is also activated by drugs of abuse, which is why they can hijack this circuit and lead to a compulsive cycle of drug use and, in many cases, addiction. In addition, the limbic system is responsible for our perception of other emotions, both positive and negative, which explains the mood-altering properties of many drugs.

Tuesday, July 25, 2017

The 4 tasks of grief

Editor's note:

While accepting the reality of the loss of the person's physical presence is necessary, the continuation of the person's spirit occurs in the stories we tell about the person's values, beliefs, opinions, preferences, and practices. The spirit of the person can accompany us through the rest of our life if we choose. Often it is very enriching to evoke the person's spirit in our memories and story telling.

Sunday, July 23, 2017

New research into the benefits of Omega 3 on anger management.

From Journeyman Pictures:

Every year 3% of us are physically assaulted. The scale of the violence is shocking. However, scientists may have found a solution to this peculiar problem: studies have shown that people who eat more Omega 3 are less likely to be violent.

Our reporters go into a prison where these theories are being carried out.

Saturday, July 22, 2017


When my therapist saw this bumper sticker on my car, she asked me if I thought co-dependency might be a problem for me?

Thursday, July 20, 2017

What is end of life or "palliative care" like? How can such care be improved?

Editor's note:

Both of my parents died in my home 30 years apart. My father died at 65 in 1983 and my mother at 91 in 2011.  Both experiences were interesting in the sense of the understanding or lack of understanding of family members and friends about what was happening. Health care professionals, in general, do a poor job in informing family because they don't want to take away "hope" of the family members even if it is false hope. While well meaning, this lack of explicitness leads to confusion, distrust, and conflict between family members and health care providers. The truth may hurt but it usually is better than false hope or denial of reality.

Saturday, July 15, 2017

Over controlling helicopter parents are avoided by their children as they get older

FRIDAY, Feb. 6, 2015 (HealthDay News) -- Helicopter parents, take note: A mother has a better relationship with her child if she respects the youngster's need for independence at a young age, a new study suggests.
Mothers who allowed children more freedom at age 2 were viewed more positively by their children later in childhood, according to the University of Missouri study.
The study included more than 2,000 mothers and their children. The researchers observed how much the mothers controlled the children's play at age 2 and then interviewed the children at fifth grade to assess how they felt about their mothers.
"When mothers are highly controlling of small children's play, those children are less likely to want to engage with them," Jean Ispa, co-chair of the department of human development and family studies, said in a university news release.
For more click here