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My thoughts may seem archaic and maybe even a little outdated, but as a mental health clinician, and as a father myself, I prefer the idea that if you teach children and even adolescents correct principles to live by,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

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

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

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

THE ADVENTURES OF SANCHO AND RUSIMUS: A KICKSTARTER CAMPAIGN!

Hello fellow readers (all 3 of you)! 

I am not typically one to toot my own proverbial horn, but over the past two years I've had the crazy opportunity to develop a puppet show called The Adventures of Sancho and Rusimus. I've been doing it with my best friend, Russ Francis and we created two characters (Sancho del Chayito and Rusimus von Rusimus) who have crazy adventures. We have performed at Comic Con SLC in 2013, Comic Con SLC in 2014, The Art Festival 2014, and a few shows at The Pony Express Elementary School. What I have enjoyed the most is seeing how children, adolescents, and even adults lose themselves in their interactions with the characters. I have even used Sancho to talk to children who have lost pets or otherwise experienced some kind of emotional upheaval. We want to share them with the world! Now, we are creating an adventurous video game about their various fun activities. Please, look at the link below on Kickstarter and make a pledge today! We need the funds to pay for the back end of the programming. The game is also a part of a new curriculum with Broadview Entertainment Arts University (BEAU) where students will participate in the art development, story line development, and work with Track 36 Studios with motion capture and other various activities. Therefore, the campaign will cover entertainment, education, and many areas that can benefit students and consumers alike! Thank you for your time and your support! 

Cordially, 

Dr. Jamison Law

(AKA the heart and soul of Sancho del Chayito)

Kickstarter Campaign Link

Facebook Page Link

Youtube Page Link

Jamison Therapuetic Services | Counseling & Therapy in Saratoga Springs

Anxiety, OCD, Depression, Panic Disorder: An Alternative Homeopathic Treatment!

Several years ago I had the privilege of speaking to an expert on obsessive compulsive disorder. Her name was Suze Harrington, LCSW and she had a small clinic in Salt Lake City, UT. She provided bio-behavioral mental health counseling for people who struggled with anxiety, OCD, and other related disorders. Those of you out there who struggle with obsessive thinking and compulsions understand well how difficult it is to be plagued by something you feel very little control over. Ms. Harrington informed me of a homeopathic treatment that had received medical trials called Inositol. Naturally, I went home and logged on to the medical journals and found a few articles. Sure enough, it had been reviewed and even had a few double-blind studies where it was one of the treatment methods along with Luvox and a placebo. The results were very promising and had little to no side-effects. Typically, when you review the dosage on a bottle of Inositol, it will say to take 250 mg per day. In the medical studies, it said that a therapeutic dose was 12-18 grams per day. Therefore, Ms. Harrington recommended that a person take 1-1.5 tbsp X 3 per day. That can bring it up to a full therapeutic dose. The medical studies agreed with the amount. Ms. Harrington turned my attention to www.iherb.com where it can be purchased for a fairly reasonable price. She indicated that Insoitol Powder, Jarrow Formula (8 oz. bottle) is what she recommended to her clients. Though this brief article is not a plug for iherb nor for Ms. Harrington, I have seen people have very positive results in using Inositol Powder as an alternative for a Selective Serotonin Reuptake Inhibitor (SSRI) for depression, anxiety, OCD, or panic disorder.


Until next time...

Dr Jamison Law

P.S. When reading the medical journals, it indicated that the liver breaks down Inositol (which is derived from rice bran) into inositides. Inositides are involved in many functions, but in this case, their job is to help with cell-to-cell communication. It is also good for liver detoxification. If you want to learn more, here is a good blog article written simply to help people like you and I understand what it can do and how it works.

http://evolutionarypsychiatry.blogspot.com/2011/05/inositol-nervous-systems-pony-express.html

Psychodynamic Therapy, Narcissism and Shame

I have been slowly reading a book on Skills of Psychodynamic Counseling. Psychodynamic counseling theories and methods stem originally from Freudian Psychoanalysis; however there are some inherent differences. The book is interesting as it focuses on the foundations of the theory. One really great quote about this style of therapy is "Psychodynamic therapy involves the interaction of two minds which influence each other both consciously and unconsciously" (Howard, 2010, p. 15). The book talks about the therapeutic alliance being important to the method, just as it is in other methods such as Person-Centered Therapy. The difference is, that it indicates that there are two relationships occurring simultaneously. The first is the relationship between the counselor and client as adults. The counselor honors the client for coming to them and provides an environment where trust can be encouraged and fostered. The second is the subconscious relationship which involves the counselor as an adult and in a position of authority and the client's subconscious, which can be likened unto a child. In order for the client to have a positive counseling experience and to process childhood subconscious issues, the adult-adult relationship must be well-established. Where narcissism and shame come into play has to do with the relationship. A client who comes to me may have feelings of shame due to the fact that they have not been able to deal with their problems on their own. This can result in a hurt ego, and narcissism itself, is damage to the ego which resulted in shame; then, the ego overcompensates for the shame by inflating itself and becoming grandiose. Therefore, in order to heal, the issues of shame must be addressed at a child-like level which cannot happen unless the first relationship is established. I find these ideas fascinating and wonder how often we try to exert power over others due to our positions of authority and how it affects their own childlike egos. Just some food for thought. Dr. Jamison Law Howard, S. (2010). Skills in psychodynamic counselling & psychotherapy. California: Sage Publications, Inc.

What Do Counseling and Heavy Metal Have In Common?

Hello everyone, The title, this time, does have something to do with the article! A recent situation got me thinking about the use and necessity of therapeutic confrontation. Much of it stems from having been at a training where individuals are trained in therapeutic relationship skills. One of the techniques that is taught is therapeutic confrontation. This technique means to demonstrate discrepancies or to point out discrepancies or dissonance that a client is experiencing. I particularly like the term dissonance, as it is a musical term. When two notes that are typically 1/2 or one step from each other are played together, it sounds “off.” They don’t fit together like a typical chord and it can sound “grating” on the ears. A lot of music such as heavy metal uses dissonance as a means to excite or bring an anxious response to the crowd. If you've been to a concert before, you know what I’m talking about! People do the same thing internally. They may believe one thing, but behave in an opposite fashion. This creates anxiousness. Or, a client will feel one way about one thing, and yet go against it. I.e. An abuse survivor may be afraid of the abuser, but seek out love and affection from abusers as a means to compensate for a feeling of unworthiness or inferiority. As a counselor, we can point out the discrepancies in a following manner: Counselor: “For the past few minutes you’ve been describing to me quite a difficult event. You reported feeling guilty for what happened and for how you responded, yet on the otherhand, you continue to do it. What can you tell me about that?” The point is to bring the client to a greater level of awareness of their behaviors, cognitions, and affects that are not adding up. Many counselors believe pointing out the client’s flaws is a means of confrontation; however, pointing out flaws can actually increase the client’s anxiousness, guilt levels, and even cause damage to the therapeutic relationship; thus, slowing down the process with the client and inhibiting growth and change. Therefore, it is important to learn appropriate methods of confrontation before engaging a client in their discrepant behaviors. Motivational Interviewing can be a good method to help with confrontation. Youtube has multiple examples of what it looks like. If you have any questions, let me know! As always, it is a pleasure to chat with you all! Dr Jamison Law

The Psychology of Brer Rabbit: Psychological Resiliency

I know for all four of my readers out there, it is obvious that I have an affinity for many things, Disney. Much of that has to do with its capacity to remind me of childhood, and for the positive memories I have with family and friends. I grew up watching old Disney cartoons on Sunday evenings with my siblings. They were good times and I remember them fondly and hope to give my children similar memories. Today, I was reviewing the old movie, "Songs of the South" made by Disney. It has been years since it was shown on TV. Despite the reasons for its discontinuation, I find the story of Brer Rabbit to be helpful. You have the main character, Brer Rabbit who was born and bred in a briar patch. When he got to the point where he didn't like it anymore, he left his home and went off to explore the world for himself. He eventually finds himself caught in the middle of a "Tar Baby," or a trap set for him by Brer Fox and Brer Bear. Brer Fox hopes to make a quick meal of him and Brer Bear wants to "knock his head clean off." Though it appears that he is about to meet a gruesome ending, Brer Rabbit convinces the Fox to throw him back into the briar patch where he was born. Though it is a harsh environment, he is familiar with it and able to handle it. We can look at this in a metaphorical sense. Many people are born into situations that may not be exactly optimal. Life gave them their own "briar patch" to be raised in. However, research demonstrates that life's difficulties can result in a type of psychological hardiness that would not be present if the person had not been otherwise exposed to hardships. That is not meant to say that some difficulties are harder than others, because they are. Simply put, many of life's challenges can become the stepping stones by which we can survive later difficulties. If you buy into Victor Frankl's ideas in "Man's Search for Meaning," he said that it does not matter what we ask of life, but rather what life asks of us. At times, life gives us things that are challenging as if to ask us "what are you going to do with that, now?" We can use our prior experiences, whether they were easy or difficult to work through our own personal "Tar Babies." Therefore, when in difficult situations, it can be beneficial to think through prior struggles and come up with a plan with reasonable steps to work through it. And, if there are no steps, then leave it alone and see if things will resolve themselves. Of course, if you don't know the answer, that's when you turn to others such as family, a friend, a counselor, and/or your spiritual beliefs to work through them. Dr Law

Carl Rogers' Counseling Skills CAN WORK!

I just returned from a week long Residency experience with a National University. During this Residency faculty members are assigned to train Mental Health Counseling students in basic counseling skills. Many of the skills are based on, though not limited to, skills that Carl Rogers suggested. Much of Rogers' Human Centered counseling approach was based on the idea that all people are inherently good, and that if individuals are provided the opportunity to receive unconditional positive regard from a professional, then the chances of personal growth increases. Carl Rogers also said that the therapeutic relationship is necessary and sufficient for change. Therefore, counselors are trained to utilize methods such as reflective listening (i.e. being an emotional mirror), echoing, paraphrasing, summarizing, appropriate use of open/closed-ended questions, validation, etc. to help clients feel that they are receiving an empathetic ear to their problems; thus having the environment to promote change. If you want to learn more about it, click on this youtube link to see Carl Rogers talking about his method and demonstrating it in the all-too-familiar case of Gloria. What I find to be interesting is that the basic counseling skills can transcend just the counseling office. There have been times that I have worked with couples where they have an issue with communication. It is interesting to see what can happen if they are taught how to use these basic communication skills in their relationships. They can learn how to talk with their significant others and be able to come to a better understanding of one another. They can also be used as a teacher or instructor communicates with learners. As counselors begin their training in the field, I would strongly suggest that they study the methods that Carl Rogers and other humanist psychotherapists utilized as a means to understand how a therapeutic relationship can help a person change. Think about it, how often do we need an understanding ear to work through our own problems? Being skilled in these methods allows that to happen and can often lead to a person discovering the answer to their own questions. Thus, the client is left empowered and accountable to themselves for their own change and growth. The counselor then becomes a willing observer and partaker in their process, though they do not provide the answers, which strengthens the counseling relationships and maintains ethical boundaries. When I began as a counselor, I remember being overwhelmed with how many clients who wanted the "answer" to their problem. Can you imagine how much knowledge one would need, as well as how much responsibility one would have if they truly did have all of the answers? Also, can you imagine the liability and accountability one would have if their answers are not "correct" for the client? Therefore, a person who can competency use basic counseling skills can provide a means to help their client/learner find their own answers. See you later. Dr Jamison Law