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?

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.

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

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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.

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For the whole article click here.

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.

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.