Media literacy - When can you believe your eyes?

Editor's note:
One of the positive things that President Trump has done for the American people and people around the world is make them aware of the prevalence of fake news. Scott Adams, the cartoonist who created Dilbert, and an expert on "persuasion techniques" teaches that 80% of news is fake.

One of the definitions of mental illness is to be out of touch with reality. There is "fundamental reality" which is our experience based on the laws of nature wherein we manipulate phenomena and there are consequences apart from our human interpretation, opinions, and meaning making. And then there is "constructed reality" which based on social consensus, norms, selective perception, confirmation bias and projection.

Most images and videos fall into the area of "constructed reality" and what is depicted is not "real" in any tangible, concrete sense. Images, as in the case of the map is not the territory, are always fake and not the real thing. The finger pointing to the moon is not the moon.

Being able to tell the difference between "fundamental reality" and "constructed reality" is a higher level cognitive function that most people have not attained, but, with effort, can learn.

Care plan for child after a suicide attempt

From Social Justice Solutions on 02/11/19

During the last decade, the number of emergency room and hospital visits linked to suicidal thoughts and suicide attempts among children nearly doubled, according to a study in Pediatrics. This was especially true among youth 15 to 17 years of age. Experts say that bullying, trauma, and abuse are often underlying factors.

Fortunately, with the right type of support from health care providers and others, children and their parents can find the resources they need to heal and prevent mental health crises in the future. If you are a parent whose child has attempted suicide, hope and help are available—and creating a plan to move forward is an important place to start.

For more click here.

Editor's note:

Over the course of my career I have done over 15,000 suicide evaluations. It is a myth that if you talk about it the suicidal person will be triggered to engage in suicidal behavior. Just the opposite is the case. Talking with a caring, concerned, trusted person decreases the liklihood of suicidal behavior.

Evaluation by a trained professional is always appropriate. This is best done in person. Calling a "crisis hot line" or "support line" can be helpful but is no substitute for personal clinical evaluation and care.

STD cases on the rise in U.S. - 39% 2013 - 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.

Religion in the psychotherapy office

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.

How the sociologists define generations

What's your purpose in life?

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.

Should cannibis be used as harm reduction treatment for opioid addiction?

From Medscape Psychiatry, 02/12/19, by Alicia Ault

Thirty-three states, Washington, DC, Guam, and Puerto Rico have legalized cannabis for medical use, and 10 states and Washington, DC, have legalized it for recreational use, according to the National Council on State Legislatures.

Both New York and Illinois recently amended medical marijuana laws in favor of cannabis as a substitute, which was another factor in writing the article, said Saitz.

New York issued emergency regulations in July 2018 allowing opioid users to become certified to use medical marijuana instead. In August 2018, the Illinois governor signed a bill allowing individuals over age 21 with conditions for which opioids might be used to apply for the medical marijuana program.

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