Friday, February 22, 2019
From JAMA 01/29/19
Emergency departments around the US are seeing a 39% increase in the number of visits related to sexually transmitted infections (STIs), according to a recent report from the CDC. The flood of patients ending up in the emergency department for STI care is just 1 symptom of a growing public health crisis.
After decades of progress at reducing sexually transmitted diseases (STDs), the United States is seeing a dramatic reversal of fortunes. The CDC has documented sharp increases in the number of cases of chlamydia, gonorrhea, and syphilis since 2013. Chlamydia remained the most common infection with 1.7 million—almost half of which affected young women. Total cases of STIs reached an all-time high of 2.3 million in 2017.
Thursday, February 21, 2019
A client visited my office for the first time shortly after the Christmas holidays and found in my waiting room a pamphlet about Advent.
He asked me about half way through our first interview, "Is this a religious place?'
I said surprised, "What?"
"Are you Christian or something?"
I said, "No, this is a private counseling office. I am not religiously affiliated."
"Oh," he said, "Good."
I was still uncertain about what had precipitated his question and concern. Later when I went out to my waiting room, I found the Advent pamphlet and a brochure about marriage encounter, Retrouvaille for couples considering divorce which is run by a Catholic group and wondered whether these materials had contributed to his concern.
I said further to my client that my office is not religiously affiliated, and I don't discuss religion with clients unless they bring it up. He seemed reassured and the topic was dropped and we moved on to other things.
I was trained in the bio-psycho-social model of Dr. George Engel which Dr. Engel developed in the late 60s and early 70s. Since the original formulation some practitioners have added "spiritual" so that we now have the "bio-psycho-social-spiritual" model.
How is spirituality connected to mental health? A great deal of research has demonstrated that people with a spiritual life live longer and happier. This being the case, a good psychotherapist is attentive to the client's spiritual life as the client experiences and conceives it.
Spirituality is different from religion and, while there may be some overlap, are often confused as being the same thing. Religion is about joining an organization and affiliating with some creed or set of beliefs, practices, traditions, norms, and values. Spirituality is about a relationship with a Higher Power whatever the individual understands the Higher Power to be.
I removed the Advent pamphlet from my office waiting room because Advent is over. Will I put another one out there next year? I certainly don't want to offend anyone or give the wrong impression. On the other hand it is a discussion starter which often leads to rich and worthwhile conversations. For now, we are approaching Lent and I probably will not be putting any lenten pamphlets in my waiting room.
Wednesday, February 20, 2019
Yesterday, I had a full roster of clients, and it seemed that a common theme came up with many of them: the lack of purpose in their lives.
It is easy to lose one's way in life and become depressed and anxious.
Doctors tell people that their depression is related to problems with the neurotransmitters in their brains and that anti-depressants will help. Sometimes they do somewhat, but anti-depressants do not get to the deeper issue which is a lack of purpose and meaning in one's life. What to do about that?
A lack of purpose and meaning in one's life is best addressed by a conversation with someone who is trusted, who understands, who can ask the right questions to help the person examine his/her life so the person can understand better what makes him/her tick, and what (s)he prefers in creating a more satisfying and fulfilling life.
This review and search takes a caring relationship. It is a process, not a technique or "interention."
With many of these clients, I ask them what they want to have gotten out of life in the next 1, 3, and 5 years. Usually they have no idea. They draw a blank.
It is this lack of hopes, dreams, and aspirations that is the problem.
As W. Edwards Deming said one time, "If you don't know where you're going, any road will take you there."
Without a sense of purpose, people are lost. They are wandering in confusion, perplexity, distress.
The three basic questions that we all struggle with throughout our lives whether consciously or unconsciously are: "Why was I born." "What is the purpose of my life?" "What happens when I die?"
The research clearly has shown that psychotherapy works. People do start to feel better and their functioning improves. In fact, research has shown that psychotherapy, in the long run, gets better outcomes than medication.
People often call the office for the first time and their presenting complaint is "I am looking for someone to talk to." What do you suppose they mean by this? They have plenty people to talk to, but they have no one to talk to more intimately about the deeper concerns about their life. It is in this deeper discussion that one often finds, clarifies, and begins to recognize one's purpose in life.
Tuesday, February 19, 2019
Monday, February 18, 2019
Sunday, February 17, 2019
Here at Markham's Behavioral Health we are interested in education, how people learn, the function of education in society, how it constributes to human development etc.
In 1986, my ex wife, Angela, and I started homeschooling four of our nine children. One of the big things I learned was the great variability in textbooks, how they are chosen by school districts, how teachers use them in their classrooms etc. I learned that some textbooks are very helpful in learning about a subject and some are garbage, yes, I wrote "garbage."
After the first year of homeschooling, I no longer used the text books used by the school district because of their inadequacies. Choosing curriculum materials back in 1986 is a completely different activity with the expansion of the ecology of curriculum materials now available with the internet.
If you are a parent, or a student yourself, the first very illuminating activity is to compare curriculum materials you can choose to study any given subject. The power to choose curriculum materials seems to me to be a major professional responsibility of teachers which, for the most part, is denied them by school boards, state ed departments, etc.
If students are to take responsibility for their own learning, the first step is choosing their curriculum materials wisely.