Improving race relations involves overcoming our fears of "the other" and learning more about "the other" with an attitude of curiosity and respect.

Dr. Kenneth Hardy speaks at the 2016 Psychotherapy Networker Symposium on March 18, 2016 on "The View Of Black America". He describes some very important ideas in this brief video clip which only lasts about 6 3/4 minutes.

 He describes the "assaulted sense of self" in which black parents described their children in terms of what they are not such as "not a bad kid," "not in a gang,", "doesn't wear baggy pants," instead of in terms of what they are as white parents do.

Hardy says that black kids are aware of race at age three while white kids may not become aware of race until they are 20 or 33. This early awareness annoys white people who ask black people, "Why to do you always bring up race?" It's because it has been a conscious issue for black people much longer in their lives than for white people and, as Hardy, says, black people bring up race because white people don't.

Hardy points out that with the brutalization of the black body by police, black people experience devaluation when they see Michael Brown's body left in the street in Ferguson for over 4 hours indicating a lack of dignity and respect not only for Michael Brown's corpse but for his family and community.

 I have, over the course of my career, been to plenty of workshops and classes on cultural diversity with the intention of enhancing the cultural competence of service providers. A lot of these efforts such as "sensitivity training" and "raising people's consciousnesses" has been well intended but also ineffective.

The most important thing I have learned over the years is what is called the Platinum rule as distinguished from the Golden rule. The Golden rule is "Do unto others as you would have them do unto you," while the Platinum rule is "Do unto others as they would have you do unto them." In order to practice the Platinum rule, the person must know the other person's values, beliefs, practices, and preferences. This requires curiosity and courage to put oneself into unfamiliar culture and relationships. Many people are too frightened to extend themselves outside their comfort zones and so the major challenge in improving race relations is overcoming our fears of "the other."

 

"We" instead of "me" creates a higher quality life

Do cultural norms and attitudes make a difference in the public health of populations? The answer to this question is clearly "yes." What are some of those cultural norms and attitudes that make a positive difference? Michael Moore describes the norms and attitudes in Norway and says that Norwegian attitude toward "we" instead of "me" is so different from the United States that most Americans wouldn't believe that Norwegians actually believe and behave in these healthier ways.


 

The problem of patient medical record - Treating records or treating patients?

From Medline Plus on 06/28/16:

TUESDAY, June 28, 2016 (HealthDay News) -- Doctors say they're drowning in electronic paperwork, feeling burned out and dissatisfied with their jobs thanks to countless hours spent filling out computerized medical forms, researchers report.

Electronic health records are a cornerstone in the effort to modernize medicine. But, new systems designed to chart a patient's progress and instruct their future care have proven to be very time-consuming, the study found.

"While some aspects of electronic records can improve efficiency, computerized physician order entry is a major source of inefficiency and clerical burden for physicians," explained lead author Dr. Tait Shanafelt, a Mayo Clinic hematologist and oncologist. "Tasks that used to be accomplished with a verbal or written order in less than 30 seconds can now take more than five minutes."

As a result, physicians using these electronic records reported higher rates of burnout and increased frustration with the amount of computerized paperwork they must do, Shanafelt and his colleagues found.

The survey of more than 6,300 active physicians found self-reported burnout among:

• About 57 percent of doctors using electronic health records, which serve as a computerized version of a patient's medical history. Only 44 percent of those who didn't use electronic health records feared burnout.
• Between 56 percent and 59 percent of doctors who use computerized physician order entry (CPOE), an electronic system doctors use to share instructions for patient care. Only 45 percent of doctors not using CPOE suffered from burnout.

The doctors also were more likely to be dissatisfied with their daily amount of clerical work if they used electronic records, the survey revealed.

Patients ultimately are the ones who suffer if doctors are constantly stressed out, Shanafelt said.

"Physician burnout has been linked to decreased quality of care and medical errors, as well as an increase in the likelihood physicians will cut back their work hours or leave the profession," he said.

Dr. Wanda Filer is president of the American Academy of Family Physicians. She said doctors find electronic health records to be a nuisance because the systems often have been designed to help bill insurance, rather than to aid medical care or help doctors manage their workflow.

For example, patients who go to a family doctor often need care for multiple health problems, requiring many different prescriptions, laboratory tests and care recommendations, Filer said.

"The EHR [electronic health record] is often designed for a quick clinical encounter like a head cold and becomes very clunky when you need to document more detailed information," she said.

"Trying to enter and manage vast amounts of clinical data has become incredibly time-consuming, pulling physicians away from their real purpose, which is patient care," Filer explained.

Paper work is a major stressor for behavioral health providers because documenting data regarding patient encounters and patient's situations takes so much time and often the requirements and expectations of different stakeholders are contradictory. The patient record first and foremost should be used as a clinical tool for good patient care, but increasingly, insurance companies, lawyers, regulators, criminal justice, child protective, disability claims evaluators have gotten in on the act. For whom is the clinician keeping the record? How can the information recorded be taken out of context and misconstrued for various purposes?

The advent of electronic health records, EHRs, have only accentuated the problems and potential harms that can be done with a patient record.

As stated in the quoted article above one of the major stressors and job dissatisfiers for health care providers is having to keep and maintain a patient record. These health record requirements directly affect the provider's mental health.

Over 47 years of practice, I have developed some of my own practices in regard to health records that have served me and my patients well. First, I keep very little information in patient records unless there is a clear reason that would serve my patient interests. Otherwise, I do not put anything in the record. This rule of thumb is "less is better," and "when in doubt, leave it out." I have other rules as well which I will share in future articles.

To access the Medline Article, "Doctors swamped by 'E-medicine demands." click here.

What are TRAP(Targeted Regulation Of Abortion Providers) laws?

How do TRAP laws negatively impact women's, and children's, and family's mental health? The Supreme Court did nullify the latest of Texas' TRAP laws.

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.

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.

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.