Wednesday, July 01, 2015

LGBTQ Community and Marriage... and Rocky Road Ice Cream???

Well, typically as a mental health professional I stay out of subjects that are controversial on a social scale. Naturally, I see individuals and these subjects arise, though it is my ethical responsibility to work from their value system and perspective. However, as the subject of the Supreme Court ruling is being discussed heavily in the media (both professional and social), I felt that I may pipe in with my own two cents on the matter.

Firstly, as is discussed in my blog profile, I am a mental health counselor by trade and follow the American Counseling Association Code of Ethics. As such, I am required to provide services that are multiculturally sensitive, as well as to practice in my areas of competency. Being multiculturally sensitive does not mean what many think it means. I have heard some ignorantly say that it means mental health counselors must put aside their personal beliefs and values and advocate for values within the societal and individual system that may go against their own. Thus, it would make the profession amoral, as in it has no moral system that guides it on an individual basis as the professional would be required to give up their belief system. That couldn't be further from the truth. What it actually means is that we, as professionals and individuals maintain our personal value system, we work to become self-aware of our value system and how it may interact with other value systems that may not coincide with our own. Thus, we are able to skillfully competently control our value system and how it might influence others on a conscious or subconscious level. We are held accountable for our value system and how we essentially push it onto others. For example, on a simplistic level and only for the purpose of explanation, my value system may say that the best and most enjoyable flavor of ice cream is Rocky Road (which it is); however, my client's value system is such that Neopolitan is the most enjoyable and flavorful. Let's say my client is struggling with their spouse whose favorite ice cream is also Rocky Road. They have heated arguments about it and it results in marital discord. My natural inclination is to agree with the spouse as I also love Rocky Road. Without being aware of my bias, I can inadvertently side with the spouse, thus causing more stress and anxiety to the client and affecting the therapeutic relationship. On the other hand, if I am able to skillfully identify my own bias to Rocky Road, and to focus on my client and their struggle with their spouse and the resulting discomfort they have, then I can be empathetic to them and demonstrate my empathy through reflective listening and other skills. Thus, I would maintain the integrity of the relationship with my client, helping them work through their own struggles (which really have nothing to do with ice cream) while simultaneously maintaining my own personal conviction about the deliciousness of Rocky Road.

Now, I know that this is simplistic, and that many would argue that I am minimizing the importance of the public arguments about the Supreme Court ruling on the lawfulness of Gay Marriage. However, it is a likeness that I would like to use as a demonstration of the process that is going on. There are those who say that this Supreme Court ruling is Constitutional and others say it is not. By the way, this is not a political article. (If you want to argue politics, do it with someone who is much more adept at it). Those that say it is Unconstitutional may also say that it is wrong, and/or immoral or something else. Those that say it is Constitutional may say that it has nothing to do with being moral or immoral, but rather it is a person's right to show their love to an individual through marriage whether their orientation be straight, gay, bisexual, etc. Thus, the argument results in heightened levels of emotions and then philosophical, religious, and politically-lined debates to prove who is right and who is wrong; or to justify one's position in a logical manner. Either way, it ends in the same thing...judgment, anger, and hurt. Now, being a counselor, I would say that there is nothing wrong with being hurt. Hurt feelings and pain can be a breeding ground for change. My old boss used to say "Out of the ashes of pain, beautiful things can grow." I agree. I'm not justifying bullying or people being mean, because that is wrong. As you can see, I'm taking the side of the survivors and victims of hurt, and not the dealers of it. But, I digress. The point I am trying to reach is that one may have personal conviction and evidence to support their value that this decision was good/right or bad/wrong. And living in the US of A, and having their Freedom of Speech gives them the right to voice it. As such, they are accountable and responsible for the words they say. Furthermore, an individual has the right to have their opinion. Yet, it is possible for people to become aware of their values and biases and even though it may go against another, they can still support and love the individual WITHOUT compromising their own value. It is possible to love all people, yet not agree with an opposing belief systems and value. Yes, that may cause some discomfort, but once again, I believe (this is my value) that discomfort can be a growth-promoting tool. Once again, a person can maintain their own beliefs WITHOUT compromise and still love a person. Notice, I did not say that they must necessarily advocate or support the other person's belief system. I only mean to say that they love the other by simple virtue of them being of the same Human family. It does not mean you agree with, advocate for, or support compromising values. Just love or care for the person as that is a quality that does not require agreement. In fact, a person who can express love for someone that they don't agree with shows an even higher level of love, in my opinion.

That's all I have to say for now...

Friday, May 22, 2015

To Hate Or To Forgive...That Is the Question

Reality Show: 19 Kids and Counting

This reality show was recently brought to my attention, more specifically, the news that is rapidly spreading throughout social media regarding Josh, the older child of this family. It was indicated that a few years ago he had admitted to molesting a few of his siblings, and in turn, received counseling services. Furthermore, it was also stated that the survivors of the incident also received treatment. These types of scenarios are not ones that any one person enjoys reading about, as it opens up a realm of ridicule, doubt, judgement, and fear. I was amazed at many of the social media responses and comments made about Josh, as well as the survivors in addition to their family and religious beliefs. Therefore, I, like many others are undoubtedly doing decided to write a few remarks on scenarios such as these. 

It is difficult to be an outsider looking in when we hear about children having been sexually abused. As a counselor, I have heard over the years that one in four or even as high as one in three girls are sexually abused. One in four boys are, as well. It seems to be more commonplace than we know, yet it continues to be the frightening elephant in the room. Rather than look at it from a judgmental place, I’d rather look at it from a place of understanding. 

First, not all people who act out sexually in an inappropriate manner have been victims themselves. There can be a small correlation to this idea, but it is not a cause-effect relationship. There are many factors that play into a person acting out. Therefore, jumping to a conclusion that someone does this because it was done to them is not accurate. Also, religions that call for sexual purity or sexual abstinence do not lead to someone acting out. There is no cause-effect relationship, though on social media I have seen this said. Research does not support statements like these. Third, saying that the victims must come out into the open and tell their story is not always helpful, nor is it therapeutic. In fact, it can do the opposite. It can foster hate…and we all know what happens when hate is encouraged. 

Now, on to the victims or survivors of sexual abuse. Sexual abuse can be a developmental life changer. I want to reiterate what I just said—it CAN be a developmental life changer. That means and implies that other factors must be involved such as support, age of the individual, psychosocial stage of development, cognitive development, etc. Sexual abuse introduces a very mature idea into a small mind and body that is not cognitively or socially ready for it. It also introduces strong physiological responses in a small mind and body that may not be ready for it. This can lead to confusion about sex, relationships, identity, and much more. However, it doesn’t have to be a game changer. Again, it is not a cause-effect relationship. Much can be said about the victim/survivor who comes out and talks about it, though it doesn’t necessarily mean that they are more or less healthy than those who keep it quiet. Much can be said about those who keep it quiet and work on it on their own without creating an environment of anger. The reason I say that, is because one social media responder indicated that the victims need to have a voice and be represented and speak out loud. This type of behavior can actually lead to ongoing symptomatic and behavioral problems, as well as fostering self-loathing, hatred, and mistrust. Anger and hate beget more anger and hate. Helping a person find meaning in their life after the abuse can foster inner peace, healing, understanding, and forgiveness. Yes, forgiveness for the one who did the abuse. 

In the many hours I have spent working with people who have suffered through many types of trauma, I have yet to meet a person who fully healed that did not forgive. Forgiveness doesn’t mean that one is okay with what happened to them or what they did to someone else. Forgiveness means letting go of all hope of a better past (not my saying, but a good one), and allowing the pain, sorrow, and suffering to go. Holding on to the pain and suffering only brings more pain and suffering. Again, I return to my prior statement that we all know what happens when hate is encouraged.
Finally, true healing can happen for both the victim/survivor and the perpetrator. It requires empathy on both sides. Empathy is being willing to walk with the individual, side-by-side, and to support them, not to enable them. Empathy can empower a person to have hope for a better future. A better future does not mean that they will be free from the memory of what was done, but rather that they can grow and develop into something stronger. They can find meaning from the suffering (yes, that is a very existentialist statement—for more information read Victor Frankl’s “Man’s Search for Meaning). The path to recovery from victimization or perpetration is not comfortable, but it is doable. Most of the time, you won’t find those stories in social media. Those people keep their stories to themselves, because they are sacred and personal. If a story fosters hate and confusion, there won’t be much healing there. 

If anyone has questions or comments, feel free to leave them…if they are negative and degrading, they will be deleted. My blog is not a place for that.

Friday, January 09, 2015

Negative Psychology? Or Is It Focusing on People?

A few nights ago, I was up until a far too late hour with a sibling discussing various topics regarding mental health, addiction, trauma, etc. As can happen, I found myself going into a monologue about the subjects. This happens due to a passion that I have for them. Over the years I’ve had opportunities to attend trainings and supervision on various subjects. What I find fascinating is when two seemingly unrelated subjects or ideas come together in a correlational fashion. Therefore, I was discussing these types of experiences with him. As we continued our discussion, I did not find myself enlightened by the topic as I had heretofore experienced; but, rather, I found myself becoming saddened and despondent. I remember the moment when I was aware of my mood change when I had finished talking about the effects of pornography and other addictions on the brain and my brother asked, “Is it possible for the effects to be reversed? Or for the person to experience some kind of full recovery?” At that point was when I had realized that I had backed myself in a corner. I had been focusing on the psychological research that I had studied, which is very negative. In fact, that is one of the complaints of the psychology field is that it can be negatively focused, which is why Positive Psychology became a movement. We finished the conversation and I went to bed. The next morning I was still feeling despondent. I meditated on the “why” of my mood and realized that I had, once again, focused so heavily on the research that I forgot about the human aspect of this field. The study of people does not take into account the people as it looks for correlations in variables. Now, I’m not saying that research does not carry importance, as research is highly beneficial, but the people no longer become the focus as the variables and how they interact with other variables carry more weight. But, I digress. 

As I was reflecting on what we had discussed and the sense of sadness it brought due to the negative results of mental health problems I had a very strong impression come to my mind. It was simply put “What are you going to do about it, Jamison?” At that moment, the sense of hopelessness disappeared and I experienced a feeling of empowerment and I asked myself the question, “what can I do about it?” The answer, then, was simple. I can keep trying. I can keep trying to work with people to help them see that despite their struggles, traumas, addictions, disorders, negative experiences in all of their forms that they have inherent value just by virtue of being alive and being a member of the human family. Is that not what counseling is about? Our clients struggle with various maladies of the human experience which bring them to question their value. We call these struggles disorders as a means to classify and measure. But, at the end of the day, do we not all have moments of depression, anxiousness, traumas, addiction, behavioral outbursts, etc.? Therefore, what I can do is engage anxiously in a positive cause to try to help where I am able and hope that my interaction and interventions will result in an increase of self-awareness. I can provide treatments that are intentional and purposeful that help give others an idea of the direction they hope to go that they might liberate themselves from “disorders” with which they are plagued. And, maybe, along the way I too can learn more about myself, have more self-awareness, and learn (piece by piece) of my own value as a member of the human family.

Friday, November 21, 2014

Adolescents and Secrecy

You know (referring to all three of my readers), every so often I run across an article that gets my mind going. The reason I say that it's only "every so often" is because much of what I read seems to be repetitive; therefore, when I come across something that really catches my interest I like to talk about it.

In my job for the University I have the unending privilege to review dozens of student responses per week online. Most of them include article reviews. Today, I read one that reviewed an article on the correlation between parent invasion with adolescents and adolescent secrecy. It indicated that there is a positive correlation between the two behaviors. In other words, the more parents pry with their adolescents, the higher the chance that the adolescent will engage in acts of secrecy. Now, I did not follow through with reading what types of secrecy, so in the case of my comments that will not be addressed. It wasn't so much the results of the study that intrigued me or got me thinking. It was more the idea of why an adolescent feels or believes that secrecy must be used when a parent asks "what is going on?" Moreover, I would want to know what type of interaction the parents had with the child long before they progressed into adolescence and how that interaction played into the adolescents' perceived need for secrecy? What was being taught in the home? What kinds of principles were encouraged and modeled for them? Now, I do understand that a child, once they grow into an adolescent is trying to build an identity. Erik Erikson was very clear on that with his psychosocial stages of development. I am also not implying that if a child is taught principles of transparency and integrity that they won't "experiment" when they become an adolescent. That happens! I am simply curious what happened before the child became an adolescent and what would be considered statistically significant if deeper research were done.

My thoughts may seem archaic and maybe even a little outdated, but as a mental health clinician, and as a father myself, I prefer the idea that if you teach children and even adolescents correct principles to live by, then the likelihood of inter and intrapersonal integrity is increased. I do know that there are those out there that follow evolutionary and developmental models who might disagree with me. They may say that it is part of an adolescent's developmental and genetic make-up to experiment and make mistakes and that it is only by those mistakes that they will learn. Because I have only three readers or maybe even three-hundred, I argue that it is not necessary, but it does happen. One can learn how to live with integrity without the need for secrecy. Those are just my thoughts.

Dr Law

Sunday, November 16, 2014

Here We Go Again...More Trauma Thoughts...

Recently, while reviewing a few discussions with my job with Capella University, I came across a really great thread and it got me thinking. No one will ever read this, so I will leave it "as is" without editing it.

This discussion got me thinking about trauma, as a general area of study and treatment, and how my opinion and viewpoint of it has changed drastically over the years. I remember originally finding the trauma response as being an invasive and tragic experience for clients. Biochemically speaking, their lymbic system super-cedes their prefrontal cortex  due to the situation creating a survival response (freeze, fight, flight). Then, due to the severity or consistency of the trauma, their lymbic system tells the autonomic nervous system to remain in a hyper-alert response in order to prepare for possible traumas in the future. The experience thus results in poor sleep, anxiousness, avoidance, dissociation to some extent (sometimes), and intrusive symptoms such as nightmares, flashbacks, or even reliving the trauma.

However, as time went on and after I had worked with many clients, I began to see it in a different light. I didn't see it as invasive any longer. I realized that invasiveness was akin to a victim role that someone might not overcome. I began to see it in an existential light, in that "life sometimes throws things at us, every hour of every day, and asks us 'what are you going to do with this now?'" I realized that most of the strongest people in history have pasts that are wrought with pain and heartache, yet they survived and even thrived. It didn't mean that they didn't struggle. They almost began to find a purpose in their existence and even meaning from the trauma. I realized, in my view, that it had to do with viewpoint and mindset. Many of the clients I worked with that WANTED to overcome it succeeded. Those that didn't want to, or didn't believe they could, or didn't believe they were worthy of it had a harder time.

Additionally, I began to change my worldview on what is painful and what is fair when it comes to equality. Due to life's struggles I began to think that all people despite race, ethnicity, culture, SES status, country of birth, background, etc. had pain and happiness and that what made us equal was not any of the aforementioned things, but that we all came into this world in a similar fashion, we all strive for similar goals (some semblance of happiness or joy), that we all struggle in our own individual ways, and that we ultimately leave the earth in the same way (i.e. our heart stops beating, our lungs stop filling with air, our organs cease to function) and that it makes us very similar. Therefore, I had the capacity to help others in all kinds of pickles, because I understand it to some extent what it means to be happy and to struggle. Thus, trauma has taught me a lot and I hope to continue learning from it.
Dr Law

Tuesday, September 09, 2014

OCD: Obsessive Type and Scrupulosity

A few years ago I had the privilege of speaking to an expert in Obsessive Compulsive Disorder. I was informed that there are sub-types of OCD that the Diagnostic Manual did not address at the time. The two types that really stuck out to me were the "Obsessive Type" and "Scrupulosity."

In order to understand either, let's talk briefly about OCD. OCD is an anxiety disorder that has a few distinct symptoms: anxiousness (emotional, cognitive, and physical); and compulsion (can include rituals, outward and inward behaviors to decrease the anxiousness). There must be both of these symptoms in order to have a diagnosis. Anxiety is obsessive and continuous worry that has little or no foundation or reason to it (i.e. stressing over finances because you're broke does not count). It is worrying about things that may not be true or rational. However, to the person with OCD, it feels real in every sense and evidence is often sought to support the obsessive thoughts and worries. When the anxiousness increases, the individual can get stuck in an anxious thinking loop; then, the desire to decrease the anxiety begins and the individual engages in compulsive behaviors. We have all heard of the obsessive hand-washing, counting, touching objects, etc. compulsions; however, with the other two types, the compulsions may be different. The "Obsessive Type" is when the anxious thinking is tied to the compulsion. The individual gets stuck in a "thought loop" where they feel compelled to continue thinking about the anxious thoughts in order to control them or to change them--or perhaps to come to a new conclusion. The thoughts feed on themselves and the compulsion to think more and to analyze more feeds anxiousness. It results in heightened anxiety and can even lead to depression.

Scrupulosity is an interesting type as it can be a part of perfectionistic patterns of behavior and to spiritual and/or religious beliefs. For example, an individual can believe that if they do not pray enough or long enough or a specific amount of time, then God will smite them or harm someone else or will not bless them. This can lead to trying to live "perfectly" without flaw or fault, which ultimately can lead to disappointment, depression, and disillusionment with beliefs of who God is.

Now, the main issue is how to deal with OCD in all of its complexities. First off, if you struggle with it, remember that it is a diagnosis and not a label. It's interesting how people will say "I'm OCD" as if it is a name or an identifying feature. Typically speaking, obsessive thinking and compulsions actually have more to do with biological processes in the brain than the person or their personality. Secondly, when an individual is engaging in the obsessive and compulsive thinking and behaviors, it means that the brain is "stuck" in the loop and needs to be redirected. The expert I spoke to indicated that the brain can only focus on one thing at a time. Therefore, focusing on something else (such as reciting a long poem from memory) will pull the brain out of the loop. This may need to be done more than once, and that's okay! After the individual is out of the loop, then they can begin to think rationally through the process that has just occurred. Cognitive Behavioral Therapy can be a big help at this point, as well. OCD requires management and maintenance. The goal of treatment is to decrease the symptoms over time, but this requires consistent work on the individual.

If any of my three readers are interested in more information, feel free to leave a comment.

Jamison Law

Wednesday, August 20, 2014

A Brief Spiritual Reminder

For a short time I had the privilege of working as the director of a 12 step-based inpatient facility with clients who were in substance dependence recovery. I had never worked with the 12 steps before as I had been inundated with Cognitive Behavioral Methods for several years. What attracted me to working at this facility was the idea that I could combine a spiritual-based approach with trauma-focused treatment. The prior director had begun developing a trauma-focused spiritually-based approach for recovery. It was fascinating! What I found to be very helpful for clients was the following:

1. Client needed to learn to give up control and surrender themselves to a Higher Power. It didn't matter what their idea of a Higher Power was, either. This could result in a state of humility (i.e. teachability) and trust (in their Higher Power, the facility, the other clients, and the clinical/administrative staff). It was a fascinating process to see clients with severe problems, typically co-morbid disorders, to begin to progress and recover.

2. Clients focused on the 12 step process and were required to go through the steps in order to complete treatment. This forced them to focus on others rather than themselves. It's amazing what happens to people when they forget themselves and work to help others.

3. The trauma-focused portion involved multiple methods such as Eye-Movement Desensitization and Reprocessing; Ego-state-based therapy; Trauma-focused CBT; Mindfulness Meditation and more. The goal was to help a client recover from the trauma they had experienced which ranged from childhood abuse in all of its forms, domestic violence, rape, neglect, etc.

What I most enjoyed was the sense of peace that a client could experience, as well as the staff, in knowing that a Higher Power was in charge of their lives and that they could ultimately put their trust in a Being or Idea that was greater than themselves.

Just food for thought!

Dr. Jamison Law