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Saturday, October 27, 2018

Books - Crow Lake by Mary Lawson

What happens when parents suddenly die in a car crash and leave a 17 yr. old son, a 16 yr. old son, a 7 year old daughter and a baby daughter in a rural farming community in Northern Ontario, Canada?
Grown up Kate, now in her 20s tells most of the story.

It is a narrative full of love, sacrifice, loyalty, persistence, projection, and descriptions of attachment styles that are fascinating.

Kate certainly has become avoidant although she had been every attached to her brother, Matt the youngest son. This attachment dynamic is the plat of the book. While Luke the oldest, and Bo the youngest are interesting characters, the primary creative tension revolves around Matt and Katie, 16 and 7 when tragedy strikes the family.

This novel is an extraordinary description of sibling relationships and the significant role they play in our growth and development.

I give Crow Lake a 4/5 and recommend it if you are interested in family dynamics especially those between siblings who are thrown upon their own resources to care for one another.
I would recommend this book to students entering the helping professions especially for its depiction of attachment styles.

Friday, October 26, 2018

Books - The Underground Railroad by Colson Whitehead

There are plenty of slave narratives. Do we need any more?

Colson Whitehead's novel, The Underground Railroad, tells the story of a young slave woman, Cora, who escapes the Randall plantation in Georgia with a male companion Caesar and makes her way north and west on a literal underground railroad whose tunnels have been dug by abolitionists committed to undoing the bonds of slavery.

The scenes about slave torture and killings are terrible and offset to some extent by the kindness of strangers who help and conduct the slave escapees to freedom.

This is a story about the tenacity and perseverance of the human spirit against the evil of economic forces and power which exploit, subjugate, oppress, and terrorize to maintain power and dominion. It is a more extreme story of what is happening in America today with Trumpism and the championing of racism, mysogony, xenophobia, deceit and using fear and terror to undue civil liberties and the rule of law.

The Underground Railroad is an old narrative going back 300 years in the United States and continuing on in more subtle and insidious forms in our country today.

Cora and her companions seeking freedom and human development in the face of life threatening terror and domination is a souce of inspiritation and hope. The people who help her and her companions are the unnamed saints and martyrs for the cause of human dignity and respect. While a difficult book to read because of intentional pain and suffering deliberately inflicted to dominate and subjugate human beings, it is more importantly a book not only of resistance, but of endurance, hope, and triumph.

I give The Underground Railroad by Colson Whitehead a 4.5 on the Markham Behavioral Health 5 point scale.

Thursday, October 25, 2018

Fentanyl is a killer drug in 50% of opioid overdoses.

Fentanyl is 10 times more powerful than heroin. Gets mixed into street heroin and kills users by unintentional overdoses.

 

Wednesday, October 24, 2018

What is the importance of mentalizing in attachment informed psychotherapy?

Mentalizing

In psychotherapy, the activity of "mentalizing" is where the most benefit accrues.
"Mentalizing" is the making sense of things. Socrates said that an unexamined life is not worth living. This examining, to which Socrates refers, is what contemporary psychologists call "mentalizing."
Mentalizing is intimately linked to self understanding, the understanding of others, a sense of agency, and enhancement of social skills.
Mentalizing is a key feature of emotional intelligence which is made up of self knowledge, self regulation, empathy, motivation, and constructive and satisfying interactions with others.
In the model of narrative therapy, the narrative operates at three levels: the landscape of action, the landscape of meaning, and the landscape of identity.
The the landscape of action describes the cast of characters involved in certain activities and events over a period of time. The landscape of action is the plot line.
Superimposed on the landscape of action is the landscape of meaning. After the landscape of action is described, the story is told, one can ask, "What does it mean? What's the moral of the story? What's to be learned from this story? What do you make of it?" This is the therapeutic pay dirt.
At the third level, the landscape of identity, one can consider if this is what happened (the landscape of action), and this is what it means (the landscape of meaning), what, then, am I to think about myself and the kind of world I am living in?
Homo  sapiens are meaning making animals. We have a consciousness. This consciousness is more developed in some than in others. It is more highly developed in people with a secure attachment style. It is less developed in people with an anxious and avoidant styles, and least of all, in people with a disorganized style.
As I like to share with clients in my therapy sessions, "If you can't name it, you can't manage it. So what do you call the phenomenon (thing) we are talking about here." People with a secure attachment style can name it without much trouble. People with an anxious attachment style become flustered and bounce around looking for the right word. People with an avoidant style freeze, ponder, and have a great deal of difficulty finding the right words. People with a disorganized style often panic and become incoherent, change the subject, or rattle on about something unrelated to the topic under discussion.
The ability to reflect on one's own functioning, and the functioning of others, and to learn from the experience and adjust one's way of managing oneself and the interactions with others, is a sign of growth and what is often called "maturity." This ability to reflect and make meaning of one's experience is one of the major benefits of good psychotherapy.
This is article #2 in a series on attachment theory.

Tuesday, October 23, 2018

SNAP (Food stamps) works

Congress just cut back on SNAP and instituted work requirements. But what about people who are already working and not making a living wage? America can afford a safety net to maintain people's dignity. We owe it to one another.

 

Monday, October 22, 2018

Attachment In Therapeutic Practice by Jeremy Holmes and Arietta Slade

I just finished Attachment In Therapeutic Practice by Jeremy Holmes and Arietta Slade.


Attachment In Therapeutic Practice is about attachment theory and how this understanding of human development and behavior can be used in psychotherapeutic practice. Even with 49 years of experience in the mental health field as a Psychiatric Social Worker, I am still learning more every day. Many of the ideas that Holmes and Slade describe I have been familiar with, and their way of connecting the dots is very helpful.
A human beings attachment style gets set in the first two years of life and is determined by a number of factors. The primary factor is the interaction between the infant and the primary caregiver. This interaction contributes to four attachment styles: secure, anxious, avoidant, and disorganized. I have come to realize that I have an avoidant attachment style which was formed by a relationship with my father in which I was afraid of him, and a relationship with my mother which was somewhat secure but at times questionable.
There are many components of attachment styles and one of the most significant is trust. Here's how trust plays out in attachment styles:
  1. Secure - I usually trust that people will like me and I can depend on them.
  2. Anxious - I never know for sure whether people will like me and I can depend on them.
  3. Avoidant - I know that you can't depend on other people. The only person you can depend on is yourself.
  4. Disorganized - I know people won't like me and bad things usually happen to me.
These "internal working models" IMWs, are usually unconscious. They significantly affect our relationships with ourselves and other people. Which pairings do you think might be the happiest on long term committed relationships like marriage?
Also, the client's attachment style has significant implications for work with a psychotherapist which involves developing a helping relationship. A psychotherapist must be aware and skilled to develop different relationships with clients based on the client's attachment style.
This is article #1 in a series on attachment theory.



Sunday, October 21, 2018

Coffee is good for you

THURSDAY, Nov. 30, 2017 (HealthDay News) -- Drinking three to four cups of coffee a day is not only safe for most people, it might protect against heart disease or an early death, a new review suggests.
The finding, which applies to so-called "moderate" coffee drinking, stems from a review of more than 200 previous studies.
For more click here.
Other studies have found that people who drink moderate amounts of coffee report less depression.

Saturday, October 20, 2018

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.

Friday, October 19, 2018

Kinship Care



I see a few families in my private practice where grandparents and aunts and uncles are involved in kinship care.

Sunday, March 18, 2018

Psychotherapy Stories podcast, Episode #1, Overview

Psychotherapy Stories podcast. Episode #1 - Overview of the podcast with description of purpose, mission, vision, goals, activities, resources, and evaluation.