Wednesday, April 12, 2023

Mental health of populations should be an indicator in measuring a countries gross domestic productivity, GDP

 Here is an interesting short article on about the addition of "mental health" as an indicator of well being in a country's GDP.

While Indonesia’s economic prospects seems promising, an essential factor of productivity needed to sustain growth is often overlooked: mental health.

How mental health affects the economy

People with moderate to high distress levels typically demonstrate reduced productivity and need higher levels of healthcare. This increases the societal economic burden.

The World Health Organization (WHO) found a 25% increase in the prevalence of anxiety and depression worldwide in 2020, the first year of the pandemic.

Tuesday, April 4, 2023

New York State legislature considers changes to Child Protective Services laws

From the Public News Service

bill in the New York state Legislature would implement new standards for Child Protective Services. The bill requires CPS workers to get a court order and inform parents and caregivers of their rights before searching homes.

ProPublica/N-B-C News investigation found New York City's Administration of Child Service has a warrant less than 0.2 percent of the time it conducts searches.

Jasmine Wali, director of policy and advocacy for JMAC for Families said it is time for these agencies to abide by the Fourth Amendment of the U-S Constitution. She describes what CPS workers would need to do.

"At the first point of contact, Child Protective Service workers would notify them of their rights. You do not have to let me in, you have the right to an interpreter, you have the right to legal counsel, you have the right to do preventive services. If you want, you have the right to refuse entry," she said.

She added this bill is not creating any new rights, but aims to inform parents of the ones they already have. The bill was introduced in the state Legislature during the past two sessions. Competing issues took precedence over this one, Wali said, but added additional public education done on the issue has bolstered its support. The bill is currently under review in the Senate Children and Families Committee.

Wali added there are numerous other ways child protective services can be improved, and said the practice of mandated reporting needs to be re-examined.

"Thousands of reports are coming in that are later found to be unsubstantiated, but the family is still experiencing all this trauma and this stress from this investigation, because, once a CPS worker enters the home, they search all the cabinets, they can sometimes strip-search children," she said.

Wali added a different bill has been introduced to change the current system of anonymous reporting to confidential reporting, and said survivors of domestic violence she has worked with have had their perpetrator use the CPS system to harass them. This bill is also under review by the Senate's Children and Families Committee.

Editor's note:
In my experience as a family therapist these changes are long overdo. 

Sunday, April 2, 2023

What are common problems of couples in their 40s and 50s?

The usual things that couples in their 40s and 50s are facing are:

Midlife crisis:  Many people experience a midlife crisis in their 40s, which can lead to feelings of uncertainty, anxiety, and depression. This can put a strain on relationships.

Empty nest syndrome: When children leave home, couples may experience a sense of loss and emptiness. This can lead to conflict and resentment.

Career changes: Many people make career changes in their 40s, which can add stress to relationships.

Health problems:  Health problems are more common in middle age, which can impact relationships.

People have a tendency to blame their partner or their relationship for their unhappiness rather than take responsibility for themselves. This stage of the marriage is what is sometimes called "the do your own thing stage of the marriage" because the individual needs to take responsibility for their own unhappiness and not expect other people to make them happy. They need to realize that they are not a victim but an agent in creating a life of satisfaction and fulfillment. 

Finding a way to do one's own thing and yet still stay connected takes patience, persistence, negotiation, assertiveness, and compassion which are qualities not always easy to develop without coaching and support.

Being able to give one's partner the space to do their own thing without jealousy and withdrawal takes a high degree of security, curiosity, and self sufficiency. It is what the people who apply Bowen theory call the "differentiation of self", DOS.

Finding an experienced mature therapist who can help the couple navigate this transformation in their relationship can be a challenge. The best way to find such a person is to ask friends who have seen counselors themselves.

Integral model of stages of psychosocial development video.



 Feel free to distribute and republish.

Saturday, April 1, 2023

Integral stages of psychosocial growth.

Integral Philosophy, developed by Ken Wilber, outlines a model of human development that includes multiple stages of psychosocial growth. These stages are often referred to as "Integral Stages" and include:

  1. The Archaic Stage: This is the stage of early childhood, where the child's focus is primarily on survival and basic needs such as food, warmth, and safety.

  2. The Magic Stage: This stage is characterized by a child's growing imagination and the development of magical thinking. Children at this stage may believe in imaginary creatures and may have difficulty distinguishing between fantasy and reality.

  3. The Mythic Stage: This stage is marked by the development of a sense of identity and an awareness of social norms and values. People at this stage may be strongly influenced by traditional cultural and religious beliefs.

  4. The Rational Stage: This stage is characterized by the development of critical thinking skills and a focus on logic and reason. People at this stage may value scientific inquiry and evidence-based decision making.

  5. The Pluralistic Stage: At this stage, individuals become more open to multiple perspectives and worldviews. They may be more tolerant of diversity and may place a greater emphasis on personal growth and self-expression.

  6. The Integral Stage: This stage represents the integration of all previous stages and the ability to see the world from multiple perspectives. People at this stage may be more empathetic and compassionate, and may seek to make a positive impact on the world.

It is important to note that these stages are not necessarily linear and that individuals may move back and forth between stages throughout their lives. Additionally, not everyone may reach the Integral Stage, as it represents a high level of psychosocial development that requires significant personal growth and introspection.

Most MAGA voters are at the Magic and Mythic stages of development.

Good enough

Wednesday, March 29, 2023

What is Narrative Therapy?

Narrative therapy is a form of therapy that assumes that people are separate from their problems and that they have the ability to change their stories. It is a non-blaming, non-pathological approach that aims to empower people to become the experts in their own lives.

The main ideas of narrative therapy are:

Problems are separate from people.

People have the ability to change their stories.

Narrative therapy is a non-blaming, non-pathological approach.

Narrative therapy aims to empower people to become the experts in their own lives. Narrative therapy is based on the idea that people's lives are made up of stories. These stories can be positive or negative, and they can shape how people see themselves and the world around them. Narrative therapy helps people to identify the stories that they are telling themselves and to explore whether they are helpful or unhelpful. It also helps people to develop new stories that are more positive and empowering.

Narrative therapy is a collaborative approach, and the therapist works with the client to co-create a new story. The therapist does not offer advice or solutions, but rather helps the client to explore their own resources and to find their own solutions.

Narrative therapy has been shown to be effective in treating a variety of problems, including depression, anxiety, and substance abuse. It has also been shown to be helpful in improving relationships and increasing self-esteem.

The Narrative Therapy model as pioneered by Michael White and David Epston has been one of the maps I find helpful in serving people in psychotherapy.

Tuesday, March 28, 2023

Lack of proximity is a barrier and obstacle to maintaining friendship.

Were friendships always so fragile? I suspect not. But we now live in an era of radical individual freedoms. All of us may begin at the same starting line as young adults, but as soon as the gun goes off, we’re all running in different directions; there’s little synchrony to our lives.

  “It’s Your Friends Who Break Your Heart,” by Jennifer Senior, Atlantic, March, 2022

The factor influencing friendships that has changed dramatically over the last 100 years has been geographical mobility. Carole King’s song, “So Far Away” plaintively expresses the problem when she sings, “People don’t stay in one place any more.”

People are no longer constrained by physical proximity and so they can go off from their geographical orbit and explore other places and relationships. Even in the same room people are exploring virtual spaces and relationships. These opportunities and capabilities require that people be much more intentional in their engagement and maintenance of friendships.

To what extent do people invest intentional effort into being a friend and maintaining the relationship especially when there are barriers and obstacles to its maintenance? Is the effort worth it? The research seems to indicate that it is for the improvement of mental health and spiritual growth.

Monday, March 27, 2023

We lose half our social network in 7 years.

In 2009, the Dutch sociologist Gerald Mollenhorst published an attention-grabber of a study that basically showed we replace half of our social network over the course of seven years, a reality we both do and don’t intuit.

  “It’s Your Friends Who Break Your Heart,” by Jennifer Senior, Atlantic, March, 2022

Studies repeatedly demonstrate that social connections are a key factor in mental health, and yet studies also show that loneliness is a major problem especially as people get older. Therefore, this is the first in a thread of articles on friendship that are tagged friendship.

In Jennifer Senior’s article in the Atlantic in March of 2022 just as the quarantine and social distancing required to mitigate the spread of the Covid virus were starting to diminish, she points to Gerald Mollenhorst’s study which showed that half of our social network is replaced over a seven year period. There are many factors that influence this dynamic such as geographical relocation, divorce, and death.

Another factor which is huge is changes in the family life cycle. Children are born, raised, and separate from their families of origin. The “empty nest” is not only about the loss of the child but the parents of their childrens’ friends. The time and energy spent in facilitating children's involvement in social activities is no longer required or desired and so the social fabric of the parent diminishes and loneliness and ennui set in.

In their 50s and 60s an intentional effort is often necessary to cultivate and maintain a new social network that has some purpose and meaning. The old social institutions such as church, and community organizations no longer serve this purpose in the digital age where more time and energy is spent in digital and virtual reality than in personal connection.

How has this dynamic manifested in your life or the lives of people you have observed?

Sunday, March 26, 2023

The parts of ourself that we hide


There are parts of our selves that we hide because we are ashamed, we are fearful of exposure, and we are guilty and desire to avoid accountability. These motivations lead to estrangement not only from others but from our ego self which we put forward for other people to see. After a while we forget about the parts of ourselves which we have disowned but they have a way of leaking out from time to time much to our chagrin and horror.

Wednesday, March 22, 2023

Music therapy - You don't need a weatherman to know which way the wind blows.


In my psychotherapy sessions this is a common scenario:

Client describes the situation sometimes for 10, 15, 20 minutes.

I say, "What do you make of that?"

They say, "I don't know."

I say, "I know you don't think you know, because you have come here to talk about it to try to sort it out, but I think you do know."

There is a pause and then they tell me.

I think to myself, "You don't need a weatherman to know which way the wind blows."

 For Subterranean Homesick Blues by Bob Dylan Click here.

Tuesday, March 21, 2023

Childrens' exposure to domestic violence increases liklihood of depression, anxiety, and substance misuse disorders as adults.

Did you know that children exposed to chronic domestic abuse between their parents even if not the target themselves have an increased chance of depression, anxiety,  and substance misuse later in their adult lives?

For more click here.

Monday, March 20, 2023

Talking to strangers

 Many studies show that talking to strangers is good for mental health and well being. Talking to strangers provides a sense of connection with others which is a skill in spiritual intelligence.

Sunday, March 19, 2023

Self-determination theory


In psychotherapy self determination theory is an underlying understanding of what makes people tick. It helps the therapist and the client to understand what motivates the clients to engage in psychotherapy. Often the initial motivating factors are extrinsic, but as the client becomes engaged in the process hopefully the motivation becomes intrinsic.

Tuesday, March 14, 2023

What do you really like to do?

 Cinema Therapy has a great video about movies about happy marriages.

This clip shows Julia Child sharing with her husband that she would like to find something to do that she loves. At first he tells her she should make hats, but then he asks, "What do you really like to do?" and she says, "Eat."

In happy marriages, partners know and encourage each other's pursuit of their hopes, dreams, and aspirations.

Sunday, March 12, 2023

What does the term "walking well" mean in the community mental health model?

 The term "walking well" is often used to refer to individuals who do not have a serious mental health condition, but who seek mental health services for a variety of reasons such as stress, relationship issues, work-related problems, or personal growth. These individuals may be experiencing some distress or difficulty in their lives, but they are generally functioning well and able to carry out their daily activities.

Some people use the term "walking worried" or "worried well" to describe this population as well. The term "walking well" has been criticized by some mental health professionals because it can be seen as stigmatizing and dismissive of the real struggles that these individuals may be facing. It is important to remember that seeking mental health services is a sign of strength and self-awareness, and anyone who feels they could benefit from therapy should feel comfortable seeking it out regardless of their level of distress.

Saturday, March 11, 2023

Cinema Therapy - This is Where I Leave You

 "This Is Where I Leave You" is a 2014 American comedy-drama film directed by Shawn Levy and based on the novel of the same name by Jonathan Tropper.

The movie revolves around the Altman family, who reunite for their father's funeral and spend seven days sitting shiva (a Jewish mourning tradition) together in their childhood home. The family consists of four adult siblings: Judd (played by Jason Bateman), Wendy (played by Tina Fey), Paul (played by Corey Stoll), and Phillip (played by Adam Driver), as well as their mother Hillary (played by Jane Fonda).

During the seven-day shiva, old conflicts and secrets arise between family members as they deal with their grief and struggles in their personal lives. Judd, who has just discovered his wife is having an affair with his boss, is particularly struggling and is also dealing with the loss of his father. Wendy is dealing with her unhappy marriage and the stress of being a mother to two young children. Paul is struggling with the pressures of running his father's business, and Phillip is struggling with his own relationship issues.

Throughout the film, the characters confront their past, their relationships with each other, and the reality of their present lives. They all have to come to terms with their own issues and find a way to move forward, both as individuals and as a family.

The film is a poignant and often humorous exploration of family dynamics, grief, and the complexities of relationships. It features a talented ensemble cast, including some of the biggest names in comedy, and is both heartwarming and thought-provoking.

Families are messy and life is not easy. Grief in families sometimes leads to regression as family members revert back to old roles and rules when the key event, the death of a significant family member, throws the family system into disequilibrium which will eventually restabilize for better or worse after the loss.

What are the key losses in your family system over your life history and what have been the changes in family functioning since? Families can be reactive or they can be responsive to the loss. Reactivity often leads to a deterioration in functioning while responsiveness can contribute to enhanced functioning.

Families can reorganize as a new person steps in to play the leadership role or they can disorganize and die. The Altman family reorganizes in a positive way even with the significant changes that have occurred. They all eventually step forward to evolve their relationships to new and enhanced levels of functioning in spite of the multiple traumas.

For more click here.

This is Where I Leave You as of 03/11/23 is streaming on Netflix.

Wednesday, March 8, 2023

EQ begins with understanding what makes you tick.

What can we change that will help our children fare better in life? What factors are at play, for example, when people of high IQ flounder and those of modest IQ do surprisingly well? I would argue that the difference quite often lies in the abilities called here emotional intelligence, which include self-control, zeal and persistence, and the ability to motivate oneself. And these skills, as we shall see, can be taught to children, giving them a better chance to use whatever intellectual potential the genetic lottery may have given them.

Goleman, Daniel. Emotional Intelligence (p. xxi). Random House Publishing Group. Kindle Edition. 

We have come to understand in the last 30 years that EQ, Emotional Intelligence, is more important than IQ, Intellectual Quotient, for life success.

What is EQ? EQ can be thought of as skills in four categories: Self awareness, Self management, Social awareness, and Relationship management.

Over the coming weeks, these components of EQ will be described here on Markham’s Behavioral Health with suggestions about how to practice and further develop these skills.

Does EQ matter? The research increasingly shows not only that it matters but that it matters a lot to the quality of one’s life and one’s relationships and functioning with others.

Can EQ be measured? Yes, we have indicators that allow us to measure the skill level that individuals possess so they can recognize and acknowledge a baseline from which they can practice the further development of the skills involved to become more competent.

Are there practices that will enhance EQ skills? Absolutely, and they are multiple depending on the person’s developmental stage in their life cycle.

Today it is suggested that you rate on a scale of low, medium, high the degree to which you are articulate what makes you tick? What makes you think what you think, feel what you feel, do what you do?

Monday, March 6, 2023

Donna's Law would voluntarily block a person with suicidal thoughts from buying a gun.

 From YouTube:

In any given year, suicide accounts for between 60-65% of all gun deaths in the United States (approximately 25,000). So far, three states have passed legislation called Donna's Law, which would allow people who fear that they may become suicidal to place themselves (voluntarily and confidentially) on a "do not sell" list, to block their purchase of a gun. Correspondent Susan Spencer looks at an innovative way to save lives. [If you or someone you know is in crisis, get help from the 988 Suicide and Crisis Lifeline by calling or texting 988.]

As a Psychiatric Social Worker I have done over 15,000 suicide evaluations in my career. One of the questions asked as part of an assessment is "If you were to attempt to end your life, how would you do it.?"

If the person responds they would do it with a gun, the next question is "do you have one?"

If the person responds that they do, this is a very high risk situation and steps must be taken to block the person's access to guns until the suicidal thoughts are diminished or eliminated.

Donna's Law is one way that a person can take to block such access. Passing Donna's law would be a wonderful idea that could save lives.

Sunday, March 5, 2023

Purpose and meaning in life.

One of the main attributes of well being is a sense of purpose and meaning in one’s life.

Sometimes I ask my clients to answer this question “The three things that matter the most to me in my life are __________. _______________. And ___________.

I also ask them to say what they would like to have gotten out of life in the next 1, 3, and 5 years, or 2, 5, and 10, short term, immediate, and longer term?

For more click here.

Saturday, March 4, 2023

Studies and experience show that quality conversations increase an individual’s sense of well being.

Across three studies, researchers recruited over 900 students for a one-day experiment. During that day, they were asked to connect with a friend in one of seven different ways:
  • Catch up about how you’ve been

  • Have a meaningful conversation

  • Laugh and joke around

  • Show care, affection, and support

  • Be a good listener

  • Show you value them and their opinions

  • Give them a compliment

At the end of the day, everyone filled out surveys about their emotions and their day overall, including how lonely, anxious, stressed, and connected they felt.

Ultimately, people who had just one interaction with a friend felt less stressed and more connected at the end of the day than those who didn’t. And it didn’t matter what they did together—whether it was being silly or having a deep discussion.

For more click here.

Many of my clients report to me that they are isolated and don’t have anyone to really talk to and have become anxious and depressed. I share with them the information above and ask who they might reach out to and interact with? Try it once every day for a week and report back on the effect this activity has had on their mood.

Working a four-day week boosts employee wellbeing while preserving productivity, major six-month trial finds

Now, results from the world's largest trial of a four-day working week reveal significantly reduced rates of stress and illness in the workforce -- with 71% of employees self-reporting lower levels of "burnout," and 39% saying they were less stressed, compared to the start of the trial.

There was a 65% reduction in sick days, and a 57% fall in the number of staff leaving participating companies, compared to the same period the previous year. Company revenue barely changed during the trial period -- even increasing marginally by 1.4% on average.

For more click here.

Editor's note - Productivity does not depend on hard or how long you work but on how smart you work. The "work" often expands to the amount of time allocated and expected rather than outcomes and deliverables.

Thursday, February 2, 2023

Music therapy - You're So Vain by Carly Simon

Narcissism seems to have entered the lexicon of pop psychology with all kinds of articles and books written about this personality style.

The concept of narcissism is nothing new. Over the decades and centuries it has been called different things like “vanity,” “selfishness,” “stuck on oneself”.

Before you can manage a relationship with a person with narcissism you have to know what you’re dealing with. If you would like to increase your ability to spot narcissism listen to Carly Simon’s great song, You’re So Vain.

Music therapy appears on Markham's Behavioral Health most Thursdays.

Tuesday, January 31, 2023

Cinematherapy - Hunt For The Wilderpeople

 Hunt for the Wilderpeople, Movie on Neflix streaming.

Plot - From IMDB - Reclusive country folk Bella and Hector become foster parents to Ricky, a problem child from the city. After some adjustment, things go reasonably well. However, Bella's death means that Hector must now look after Ricky himself, and they haven't been getting along. Moreover, her death causes Child Services to decide to send Ricky back to the orphanage. Ricky refuses to go back and runs away, ultimately sparking a national manhunt for him and Hector.—

Audience - The movie is intended for a general audience. It can be enjoyed by all ages from 10 and up. This review is written though for human service professionals.

Creative tension - The creative tension in Hunt for the Wilderpeople is derived from two sources. First Ricky Baker is a foster child, 13, who has been difficult to place and retain in a foster care setting.. How will he adjust to this new foster home, way out in the country, with Bella and Hector, a childless older couple. Bella is very motherly, almost grandmotherly, while Hector is antisocial and a curmudgeon. The second source of creative tension arises when Bella dies and Child Welfare Services writes a letter to Hector informing him that they will be coming to remove Ricky from his home now that Bella is dead. Ricky refuses to go back to child welfare,  and Hector is upset that they don’t think he can raise a child without Bella. Hector and Ricky escape to the bush to avoid capture by Child Welfare authorities.

Moral of the Story - Family comes in multiple forms and Ricky and Hector have formed theirs no matter how unlikely and mismatched. Does their form of family coincide with community norms? No. But does it work and is it filled with love and caring? Yes.

Utility of the movie for human service professionals - To learn an appreciation for diversity in all its multiplicities. What conforms with social convention might not always be the best. In such cases do the nonconformists become outlaws? As outlaws do people evade, resist, and attack the forces of subjugation and oppression? As witnesses do we side with the conventional authorities or with the right to self determination of those the system would subjugate? In these dilemmas what is the appropriate ethical stance of the human service worker?

Recommendation - This film is highly recommended for its entertainment, and for its presentation of deeper ethical dilemmas. It earns a 5 out of 5.

Articles about Cinematherapy appear on Markham's Behavioral Health on most Tuesdays.