Where Have I Been???? SELF-CARE!

It's been, undoubtedly a long time since I posted anything. I am certain that my three readers have been biting their nails while checking their blog feeds and emails just waiting for my next comments. Well, here it is...

Over the past 16 months I have had the opportunity to see many clients, attend great conferences (i.e. The Evolution of Psychotherapy 2017 convention), teach multiple classes, provide supervision to 24 different students, road over 1500 miles on a mountain bike, went on several trips (some successful, some not), and much more. In other words, I got even more busy. But, I digress...

Today's brief message is about the results of professional counselor burnout and secondary trauma, and how to work through it. A counselor who works with trauma is at risk for developing pathological symptoms by virtue of exposure to clients with trauma and difficult life scenarios. This can happen due to the severity of the situations and stories shared in sessions, or even because of similarities of the clients' stories and experiences to the counselor's own life. The signs for secondary trauma are not unlike post-traumatic stress, anxiety, depression, and more. Ultimately, a professional counselor can begin to feel tired at the thought of seeing clients. Sessions may be interrupted by internal counselor struggle (countertransference). Ultimately, it can lead to compassion fatigue and/or burnout. Cynicism tends to be the final stage of burnout, which ultimately affects the client's ability to remain objective and to demonstrate empathy or compassion to their clients or even personal relations.

I know what you three readers are asking--how can I avoid this? The answer is very simple. Self-care. This means putting yourself personally and professionally at the forefront. Take time off periodically rather than waiting until you're exhausted. Focus on personal spirituality by maintaining a relationship with God or the Divine. Be physically active in any way. Check your attitude to see if it is adjusting towards being negative towards others. If it is, engage in your own personal introspection and practice for change. Or, see a counselor for yourself. Try to see people from a person-centered perspective--that all people are inherently good and trying their best; that they are worthy of affection and attention (yourself included); and be congruent and genuine with yourself and others.

Hopefully, you three will find some of this helpful. If not, file it away for a time when things feel rough.

Until next time...

SELF-CARE! It's What's for Dinner!

I know, I know....

It's been quite a long time since I've posted anything in this blog. I'd like to chalk it up to being very busy with Faculty work, Counseling work, writing a fictional novel, or spending time with family...and while that's true, I know there have been many times over the past few months where I thought to myself, "Hey, I just got a great idea to blog about...I'll do that tomorrow." I say the same thing about exercising, too. So, as a comeback message, I want to talk briefly on the value of selfcare. Yes, I made those two words one word, because it fits the need for it. The idea of selfcare is so paramount as a mental health practitioner that it deserves notoriety.

What is selfcare? I'm glad you asked. It is the time out of every day that you take or set aside to selfishly care for your mental, emotional, physical, or spiritual self. It is what recharges your batteries, fills your emotional bucket, aligns your Chi, etc. It is also one of those things that many of us just don't do. Why, you ask? Because, that whole "practice what you preach" thing for mental health counselors is not a strong point. We tend to follow the Westernized value of "work, work, work" for tomorrow we die. One might say that we can be the antithesis of the 7 Dwarves who try to whistle their way through working to make the day a little brighter. We forget the whistling and just work. What can it result in? Burn-out. Compassion fatigue. Bitterness. Loss of relationships to name a few. Or, it can lead to a feeling of drudgery.

Oh, this doesn't just happen to counselors. It can happen to anyone who doesn't take the time to care for themselves. So, whether it's reading a book, watching your favorite show on Netflix at night, taking a hot bath, or just relaxing, make sure to put as much effort into your selfcare as you do your work. Do it every day, even if you don't believe you have the time. Then, after doing it for a few days, reflect on how it affects your day-to-day. You may see the difference.

Until next time...

Dr Law

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...

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

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

Post-Modern Prometheus and Apocalyptic Premeditations

Truthfully, the title has nothing to do with this blog-article (or blarticle as I like to call them). However, it made you wonder "Hmm, what the heck is this about?"In that case, if you're already reading, you may as well finish. I had an interesting conversation today with a peer. She is an excellent clinician and has wonderful insight. She reminded me how much I still have to learn in the field as a counselor, a supervisor, and an educator and I'm grateful for that. We were discussing how people have gifts, talents, and strengths that sometimes go untapped. She brought up the idea that at times individuals may have gifts that are untapped--that perhaps they recognize them, yet do not wish to recognize them; therefore, they avoid exercising them and may even go to the point of denying they have them. My response to her was something like this: "Well, that would make sense. If someone has an innate gift of capacity and they are not using it, then they are not accountable to it and they have less responsibility, because less is required of them." I'm sure my words were less than this with her, but it was something to that extent. The conversation was short and it made me reflect on myself and what talents I keep "hidden" or "dormant" and why. It also left me wondering what would happen if I did awaken them and used them. What would the result be? I suppose that it would result in more requirements; however, it might also mean that I feel or believe that I am feeling more fulfilled; thus, moving towards a higher level of self-actualization (to speak in Maslow's words). Furthermore, it caused me to realize that in order to do this, it would require me to pursue a higher level of vulnerability with others, which is something that is uncomfortable to me, and to many others. Therefore, do I forget my discomfort and/or lean into it or don't I? I guess one would lean into the discomfort and pursue a higher plane if they had a belief that it did lead to self-actualization. Or, it could mean that they believe that the Universe or a Higher Power has afforded them the gifts for the betterment of others and themselves. Ultimately, all of these things mean the same thing and require the same effort--i.e. a forgetting of one's discomfort, a trust in the existential process of life, and a hope that something fulfilling will come of it. Therefore, leaning into the discomfort would be a positive, yet uncomfortable means to an end--that end meaning the growth of the untapped gift, talent or capacity that would otherwise remain dormant, unused and/or completely lost; not doing anything positive or negative for others or oneself. I suppose that this may just be a brief rambling, but I wonder what others think about this subject…let's see if anyone responds. Also, it could just mean that I read too much and think too much and should spend more time watching TV and vegging out. Dr Jamison Law

Hello Subconscious! Pull Up A Chair and Let's Have a Chat!

The Merriam-Webster dictionary describes the subconscious as "existing in the mind, but not immediately available to the conscious." Sigmund Freud used the term subconscious and unconscious interchangeably, though he meant it to be the part of our mind that we're not aware of. At times, I have described it as the part of our mind that is running everything in the background. It may be made up of our personal experiences, our culture, our perceptions of the world around us, our emotions at times, and many more things. It may include even the parts of our environment that we are not paying attention to (i.e. sounds, smells, etc.). I wonder at times what would happen if our subconscious was able to slip fully into our conscious. What might we be aware of? I imagine sitting with a client who is comfortably on my office couch (as comfortable as it could be--it's kind of worn-out). I tell them that in order to proceed with therapy, we must look into their subconscious and that I have invented a machine that can open it up like a computer file and project it all onto a screen in front of them. The purpose is to discover everything about them that they cannot remember and the things that they might not even want to know; and that by opening everything up, they can learn to accept and/or reject things about their beliefs, culture, values, cognitive processes, emotional responses, and behaviors that do not fit into the person they wish they were, or think they are. Therefore, after receiving their written consent and reviewing the possible discomforts they might encounter (of course, I use an informed consent as I am an ethical clinician), I press the tell-tale button on my desk and there is a whirring sound that slowly crescendoes as the machine (use your imagination) begins to open up their mind and project it onto the screen. The machine interprets the subconscious and separates the scenes and words into subtypes so that the screen shoes a series of files. They might be separated into childhood stages (this is psychology after all), ages, or maybe even into emotional responses such as "happy memories," "shame-based memories" or something along those lines. At first the client might want to review memories he/she doesn't remember. The images might be of early infancy and childhood. Those memories that very few of us have due to a lack of awareness, or whatever reason our minds don't hold on to them. Many of these memories might come out as a "Aaaawww, that is cute" or "Wow, I didn't know that happened." Some memories might bring up positive emotions and others might bring on feelings of shame. After a few minutes of nostalgic reflection, it's time to do some work. I might say to the client, "Well, it looks like the technology is in-sync with your neural net (sounds Star Trek-like, doesn't it?), we can proceed with the reason you came to counseling." I then review the things the client said in the intake interview, which usually aren't happy. I mean, who hires a therapist when life is going great? Let's say that this client had one or several difficult experiences that they cannot get out of their mind, or that replay over and over in their dreams, when they're awake, or they replay them behaviorally. They can't quite figure out why, either. So, I ask the client, "If we could classify all of these things you're struggling with, what work or set of words would you use to describe them?" The client takes a moment and responds "Ashamed" or "Weak" or "Scared." Again, these are just words, but they mean something to him/her. So, I review the files and pull up all information on those words along with any associations. I then say, "Well, if you'll remember, we already went over how to breathe and calm your emotions when they feel too strong. We will use those, now. We will move at your pace. Are you ready?" The client pauses and responds that he/she is. "Okay, here we go." At this point, I am not going to impose my ideas on how it would go, necessarily. I can't predict with perfect accuracy and experience with clients has demonstrated that my predictions can be wrong. The reader's guess is as good as mine that the emotional response will not be one of comfort and warmth. However, at the end of the review, I would then say to the client that we are not quite done, yet. I would tell them that they did great and commend them for their courage. Then, I would say that we had only reviewed the memories, but that the subconscious part of him/her was not present. I would open then point to a toggle on the underside of my desk and explain that when I flip the toggle, their subconscious will appear and tell them what all of the memories mean. What the client believes the memories say about themselves. How it affects their worldview, and how it has affected their belief in their own value and self-worth. Personally, I think this is the scariest part, and yet the most important. The memories may be painful, but it's how they changed the person that results in continued pain. Again, with their permission, I flip the toggle and there is the sound of static (or maybe the sound that the Transporter makes on The Starship Enterprise--I don't know), and seated next to them appears their subconscious. At first, it is somewhat surprising. Maybe the subconscious looks just like the client, or maybe not. Maybe it takes the appearance of a wise old Chinese Man sitting lotus style. I can only guess. At that point, the client and subconscious begin to talk and the subconscious speaks to him/her about the "truth" they believe in as a result of their bad experiences--maybe even about the client's own decisions/choices that were affected by the bad experiences. Everything is laid open and naked in its raw and primal form. My guess is that there would be some tears. There might even be some yelling. Denial might occur along with depression, anger, bargaining and finally acceptance. At the end of it, I wonder if the client would feel exhausted, but at peace. Of course, this is just my ramblings while sitting in my office. However, I wonder how we might respond if our subconscious sat down for a while. Would we accept it, or reject it? You can decide, I suppose.

A Place at the Proverbial Therapist Table for Everyone

I recently had an interesting experience that made me reflect on why people choose the mental health field, and how they see people in relation to themselves. In counselor training, we work to help trainees become more self-aware. The purpose is so they do not allow their own biases, personal issues, judgements, etc. to cloud their view of the client's worldview and experiences. It happens at times and is called countertransference. Countertransference is a normal process that we all experience. It can be related to, though not necessarily equal to empathy. Empathy is putting ourselves in other people's situations. Countertransference is when a therapist's personal issues are triggered. A person in the helping field can lose their objectivity and capacity to help when their own countertransference clouds their judgement. Naturally, I see it in myself from time to time. What is interesting is to observe it with students who begin to conceptualize their clients, whether real or role-played, from their own point-of-view. This can be expected when starting out. What can become concerning is when a student or individual is unable or unwilling to look at themselves and begin to modify their perspective to help themselves help others. It may be difficult for them to help people from their point-of-view. However, there are theorists such as Albert Ellis (Rational-emotive behavioral therapy), and Fritz Perls (Gestalt Therapy) who worked from this point-of-view and were very successful. I guess it boils down to therapists finding a theory that fits their world-view. Therefore, even those who are unable and unwilling to change their view, as long as their approach is effective and ethical have a place at the table. This was much more of a reflective article than educational for readers. Maybe someone will find some benefit. Dr. Jamison Law

Children Stuck In Between Parents

Over the past several years I have had the opportunity to work with children and teens who are stuck in between their parents. The parents have either gone through and completed a custody and divorce battle or they are still in the thick of it. The one thing I have witnessed as a therapist is how it affects children. It does not matter the reason for the divorce, the children still feel fiercely loyal to both parents. When one parent speaks poorly of the other and vice-versa, it does not create a stronger alliance between child and parent, it creates confusion and existential anxiousness for the child. They can begin to exhibit symptoms of mental health disorders such as isolation, anger and behavioral outbursts, aggression, sadness/melancholy, grades drop, etc. In some cases, there were situations of abuse that resulted in the divorce. This can create even more confusion. An abuser can speak poorly of the survivor and vice-versa. When the situation is already highly emotional, and the environment has been emotionally and possibly verbally unsafe, the added stressors of witnessing parents can increase the pathological problems the child is experiencing. It can affect their psychosocial development (see information on Erik Erikson's theory of psychosocial development), change the direction of their attachment style (see info by John Bowlby and attachment), and possibly cause the child to feel alienated in the family. All of these sound very negative and damaging, and they can be. There is always, in my mind, a silver lining to struggles. Children can grow up and with or without professional or social help, they can recover and be stronger. Existential crises can lead to resiliency and personal growth (see info on Martin Seligman's theories of Positive Psychology). In the end, I would prefer to see children treated gently when there are battles raging in the family so that they can grow up and decide for themselves what to believe about their parents. As children, they might not be cognitively ready to make those decisions, yet. Just my thoughts on the subject... Dr. Jamison Law

Leadership from an Astronaut

I attended the ACA Institute of Leadership Conference in Alexandria, VA. It was one of the most enjoyable conferences I have attended as a professional. The keynote speaker was Mike Mullane, a retired Astronaut with NASA. He gave a great speech on teamwork and leadership fundamentals. Some of them are as follows: 1. Avoid Normalization of Deviance Human tendency is to rationalize shortcuts. This happens due to budget cuts and schedule problems, at times. To avoid it, PLUS everything. Figure out a plan, and PLUS it (that is from Walt Disney, not from Mike Mullane). Deviance can become the norm if you're not careful. The Space Shuttle Challenger's explosion was predictable. The problems with the O Rings were known, but not addressed. The team accepted it due to high schedule and budgetary demands and it resulted in the deaths of seven astronauts and the loss of property. Rather than address the issue and slow things down, they decided to fix the problem on the fly. They began to tolerate a problem that was previously intolerable. In order to avoid normalization of deviance, one must defend against it. Recognize that you are vulnerable. Plan the work and work the plan. Leaders must maintain "best practice." The team must be trained in "best practice." Do periodic "re-sets" which demonstrate the best practices. Also, review past failures. There must be a free-flow of information from those who have experience to those who have less. 2. Responsibility Always be a team member. Don't be a passenger. Your opinion and experience is valuable no matter how much experience you have. Weaknesses can come from position and longevity. Everyone must always have a say. Weakness also comes from the need for acceptance; fear of rejection; fear of the boss, etc. Remember that "One person with courage forms a majority" Andrew Jackson. 3. Courageous Self-leadership Expand your performance envelope and have tenacity. Set goals and do them. For more information on Mike Mullane: see http://www.mikemullane.com/

Disney, Service, Compassion, and other things...

It’s amazing what you learn from the people you are trying to serve. You may approach a task with the idea, like most, that you are an expert at the task, and that you might know best. However, the point of serving is to exercise an empathetic eye and ear to those who are receiving your services. This thought has come to my mind as I have been reading “How to Be Like Walt.” I already wrote a small blarticle (blog+article) about this book, but the further I delve into the author’s information and humor about Walt Disney, the more I see the innovation behind Disney’s approaches to business and human beings. First, the author indicated that Disney was never trying to make money. He loved what he did, he believed in it, and it required money to do it; therefore, it was only a means to an end. We all know who Walt Disney was, and we know that he was no slouch when it came to money, as well. Then, why do we seek after money in trying to serve? It doesn’t make sense. I’ve tried it and I was miserable. I tried it the way others said to do it; the way the universities told me I had to do it; and the way that the “experts” said. I wonder if it is the incorrect way, though. Therefore, these are just my thoughts on some observations I’ve been thinking about. I began my career path as a mental health counselor about 12 years ago. I had spent two years as a volunteer for my church in another country where I served others. My parents paid my way for the experience and I worked hard. During that time, I found that I enjoyed working with people, getting to know them, learning from them, and teaching them. Therefore, when I returned back to the States, I decided to pursue a service-oriented career. I talked at times with my dad and others about opening up a ranch for at-risk youth. The focused activities would include learning how to care for and ride horses, as well as do cattle drives. Other activities would include care for their camp and cabins as an attempt to instill a desire to work hard and to find the joy that work can bring. Alas, it did not happen, but it was the beginning of my pursuits. Now, I have been working as a clinical director for a residential treatment facility for addictions for the past year. It was a great career move and I have spent the past 12 months learning, a lot. During my time there I began doing exit interviews with residents during their last day of treatment. I would ask them a few questions at first, but then narrowed it to one: “If you returned here a year from now, what would you like to see change and what would you like to see remain the same.” Almost always, and I don’t exaggerate this, they would say that they do not want the atmosphere and environment to change. They said that the front-line staff and the therapist staff members worked well together. They treated each other as equals. Most importantly, they felt the compassion that the staff members have for them and the other residents. They felt welcome and a part of a community. They felt on equal ground with the other residents, the line staff, the therapists, the administrators, etc. The residents said that the therapy was good (whatever that means) and that they learned a lot, but the emphasis was on equality and compassion. It makes me wonder if that is a catalyst for change. Is it possible that having compassion for your fellow man is a huge piece of successful change? My guess is yes. There is plenty of evidence to demonstrate such whether its from Christian texts, Buddhist beliefs, or psychological texts by Carl Rogers. Therefore, I would make a few suggestions to those who are in the service-oriented field. 1. Get to know your clients on an individual basis (by clients I mean anyone you serve whether you are a therapist, scout leader, parent, parishioner, or music teacher). 2. Do not be afraid to be human with your clients. Many people see us (therapists, etc.) as being an expert, and therefore, there is a power differential, which can lead to defenses and resistance in clients or ourselves. Don’t forget that you eat, sleep, and that your heart pumps red blood just as your clients. Be a vulnerable human. For more information on vulnerability, see http://www.ted.com/talks/lang/en/brene_brown_on_vulnerability.html 3. Holistic approaches: Not every client is the same. Be open and willing to help the client from their viewpoint, not yours. At times, yours may have to be the voice of the expert, but most people are an expert at their own lives. If you don’t know how to help a person, ask someone who does. You don’t know everything and you’re not supposed to. Be bendable and ethical. 4. Watch for patterns of behaviors that are indicators of your clients’ needs. They will show you what they need if you just pay attention. 5. Be equal with the people you serve. 6. Have fun with your service. If you don’t know how to live after the manner of happiness, it is hard for others to want to follow you. A. Bandura indicated that people need social models to follow at times. Social models are people with similarities of a others that provide a model or likeness that others can follow. These are just my ideas for now. Until next time.

Dracula is and Addict!

The following link has a creative and innovative adaptation of Bram Stoker's Dracula as a metaphorical description of alcoholism and drug addiction. I thought that it was a definite "thinking out of the box" description that may have information beneficial to some of our clients. http://robertchapman.blogspot.com/ Jamison

Business and Mental Health...Do They Coexist and Can They?

Over the past few years, I have worked for several business owners who were clinicians and even fewer who were not clinicians. It is understandable that a business must focus on the "bottom line" in order to maintain itself. I have seen poor marketing result in a decline of client flow, which then resulted in budget cuts, lay-offs, or loss of benefits. I have seen bosses who consider penny pinching the only way to run a business and it affect the clients and the workers, thus affecting the environment. I have yet to see a healthy balance of employee and client-focused business practice that creates an environment of trust and safety for all involved. I find it ironic that the mental health industry focuses heavily on aiding the individual, family, and society to learn how to maintain a sense of interpersonal and intra-personal safety, and yet the business practices may not match. I'm not saying this as a global problem and I'm not trying to overgeneralize. Simply put, my experiences are on the negative end and I am curious if business practices can match person-centered styles that we as clinicians attempt with our clients? My belief is yes. I have recently been reading a book called "How To Be Like Walt" by Pat Williams. There are many books about Walt Disney, his life, his profession, his personality, and his follies. I am enjoying this one, because it appears to embody the American Dream that Walt Disney attempted to live. It certainly does not say that he was by any means a saint. Appropriately, the book reviews his personality and behavioral flaws that negatively affected his employees and relationships. On the other hand, it reviews the story of a man with a dream to provide entertainment with a high level of excellence and to keep pushing the limits of the field of animation and family-oriented entertainment. It is interesting that he was willing to sacrifice so much of his own personal comfort to, at times, pay his staff more than he was making. His brother, Roy, would focus on the books and the "bottom line," but Walt pushed those limits to make his dreams come true. There were many failures. I appreciate reading about those. However, it appears in the end that he was very person-focused and person-oriented and sacrificed his own bottom line. Again, I am not endorsing him or his business models as the be-all end-all; just simply one example of many that demonstrates that the bottom line is important, but it does not have to be what drives a business. In mental health, there needs to be a similar approach. Seek for excellence as a clinician or clinical practice with the desire to be better for the sake of being better, all while attempting to be client and employee-focused even at the expense of the owner's pocket. This can create a sense of unity and appreciation for all employees involved and then the client-care quality can increase.

Mental Health Change: The Knight in Rusty Armor

"The Knight in Rusty Armor" is a metaphorical story about change and the simplicity and complexity of it. I know that sounds dissonant, because it is. The main character is a Knight who spends his days fighting dragons, rescuing damsels in distress, and buying castles for his wife and son. He dons himself with the shiniest and strongest armor money can buy. He likes it so much he never takes it off. Eventually, he leaves it on for so long that his own child doesn't know what he looks like, his wife misses seeing him, and he is afraid to take it off. When he decides to remove the armor, he finds that it cannot be removed. Therefore, he goes on a journey to find Merlin the Magician who teaches him how to remove it which requires him to go on a quest. It's a fun book about change and the difficulties and simplicity of it. I recommend all to read it.

Jamison

Expressions of Addiction in Art

I am no art connoisseur. However, a few years ago my wife tied me to a chair and duct-taped my eyes open forcing me to watch "So You Think You Can Dance." Humiliated, I succumbed to watching and found myself moved by a dance (see the link below) that described addiction. I was blown away at how the dance described through movements and music the experiences my current clients go through. Watch it!

http://www.youtube.com/watch?v=_FlkY5F85Lc&feature=fvwrel

Addictions, ADD, Mental Health, and the DSM V Concerns

I read an article by the Huffington Post this morning that discusses the problems with diagnosing using the DSM, over-diagnosis of many disorders such as ADHD, bipolar disorder, depression, etc. and the overuse of psychotropic medications. The article is written by a psychiatrist who was on the task force for the development of the DSM-IV. He reports that diagnosis is often done by general practitioners, rather than psychiatrists who may have insufficient training in mental health diagnostics and treatment. Furthermore, he reports that the the upcoming DSM V may cause an increase in similar aforementioned problems. It is an interesting read that also includes the difficulties in studying the human brain and bridging the gap between psychology and neurology. The link below will take you to the article. Enjoy!

Jamison D. Law, LPC, NCC

http://www.huffingtonpost.com/allen-frances/america-is-over-diagnosed_b_1157898.html

"Richard...Is There A Mark On My Face? It Hurts."

The title of this article may or may not have anything to do with the article, but I liked it. It comes from a scene in the movie "Tommy Boy" after David Spade hits Chris Farley in the face with a 2X4. The clincher is that they are friends, or at least trying to be friends and they get in a fight. How often do we do similar things?
I am not saying that we get hit in the face by others, at least I hope that does not happen. Rather, we invest our time, energy, and emotions into a relationship and get the proverbial slap in the face...or we get burned. These very situations came to mind recently when a friend approached me and asked for my thoughts on professional burnout. Burnout is a mental state of exhaustion and can be observed by "emotional depletion and a loss of motivation and commitment" and are usually associated with job factors rather than biological reasons" (Schaufeli, DATE, p. 7). It leads to physical symptoms (fatigue, muscle tension, G.I. distress, etc.), absenteeism, and job turnover. It can also be affected by a lack of social support in the work place. It happens due to job stress that exceeds an individual's resources. It results ultimately in the professional demonstrating behaviors of cynicism, apathy, and rigidity in the workplace. Overall, it affects the professional's capacity to function, especially in the helping profession.
It is a tiring place to be. My friend described his situation and it sounded similar to the definitions above. I can relate as I have experienced "burnout" or "compassion fatigue" as they now call it. Trust in human beings is depleted, you question your own self-worth, etc. But, rather than go into a slow spiral into the abyss of burnout, I'd rather talk about how to work through it.
By definition, it relates to stress and one's own personal resources. Therefore, it stands to say that if the resources were not sufficient or failed, then they need to be looked at. It may require a break from the career field, if possible, the professional will need to seek their own help (i.e. counseling). One has to make self-care the priority, rather than work. Activities, recreation, reading a good book, exercise, setting goals and completing them, and many more are just some examples. I know with myself, I have had to rely on others for a time to pull out of the burnout. I have had to take a good look at my own belief system regarding my role as a professional, a father, a husband, a friend, etc. and see what beliefs were adding to the burnout. The results can be liberating, but the climb out is uncomfortable, yet possible. It is easy to get stuck in it and become a victim of it, but relying on a Higher Power (to use the AA verbage) or God can result in fostering a sense of hope. Most importantly, relying on close family and friends as a resource can be the difference between success and continued burnout.

I hope this helps!

Jamison

The above reference comes from:
http://books.google.com/books?hl=en&lr=&id=4kEbMr8B4NMC&oi=fnd&pg=PR11&dq=professional+burnout&ots=edQawU-et5&sig=Vmin7zc_uhf8YazlTJOvEWX69IM#v=onepage&q&f=false

Trauma and Resiliency, Responsibility, and Agency...What a Boring Title!

The following is an excerpt from an unpublished paper I wrote on psychological resiliency after enduring a difficult or traumatic event. I would love to hear anyone's thoughts

Focus on responsibility and agency.

Several clients come into our offices talking about their individual traumas and how they have made things difficult for them. They also talk about how it has affected their relationship with the perpetrator(s), other close people, the community, and God. Many of them have guilt and blame themselves and/or hold severe grudges and harbor anger and hate towards the perpetrators. At times they question why life has been more difficult for them than for others and how they were dealt such a poor hand. The following is going to be more of an explanation based on psychology and spirituality in hopes to answer some of the questions.

Traumatized clients’ relationships change and function on a level that deviates from the norm. Much of that is due to the trust that has been broken time and time again. In Maslow’s heirarchy of needs, their level of safety, love, and esteem have not been established or maintained. Therefore, their ability to self-actualize (Maslow’s hierarchy) is not possible. The only level that is actually, at times, maintained is their physiological needs (i.e. food, water, shelter, etc.), though that can be in question with neglected children/childhood as well. On the level of safety, an individual must feel comfortable and secure in their environment with minimal attack on their physical, mental, emotional, and spiritual self. If attacked, their capacity for moving to the higher hierarchical needs is diminished. They may struggle with giving and receiving love or having esteem for themselves and others. Thus, can be a large factor with esteem. When a client has been traumatized time and time again they begin to lose trust with initially the perpetrator, and then it can spread to others who are close to them, the community, and to God (depending on their beliefs). Recently, a client (whose name we’ll call Matthew) disclosed horrific traumas from his childhood. Much of it involved abuse and neglect from his family and a large part involved a neighbor who befriended then molested him time and time again. He did not trust his family for help so endured the continued abuse. He described other economic difficulties, physical health problems, and general loneliness. He asked why it is that he was given a difficult life. He felt that it must have been something he did to deserve the pain and suffering without much respite. To try to escape the pain he had attempted suicide many times, though without success. When asking why he had to suffer I explained something to him, that I hope will help others. First and foremost, everyone has the right to act (free will). Anyone can do what they want. Whether they are conscious of the results depends on each individual. Some people, however, have made the choices to act against others in a way that is harmful, degrading, and usually self-serving. Such acts can be considered abusive, because it is in an attempt to remove or negate another’s free will and control them or change their acts. Such self-serving acts do not serve the victim (the receiver of the self-serving acts) in any positive ways. It can change the victim’s life perspective (specifically on relationships) and attacks their general need for safety (Maslow’s hierarchy). Therefore, the abuser (the one who acts self-servingly) is responsible for their acts and how it affected the victim. Responsibility lies solely with them and none other, especially the victim. Therefore, the victim is not the guilty party. The guilty party in the technical sense is only the abuser. Guilty signifies “1 : justly chargeable with or responsible for a usually grave breach of conduct or a crime. 2 obsolete : justly liable to or deserving of a penalty” according to the Merriam-Webster online dictionary. Therefore, it is not possible for the victim to be guilty for the self-serving act when they were the individual being acted upon rather than acting. Matthew blamed himself as that was the only logical reason he could come up with. Why else would it happen if there wasn’t something so terribly wrong with him or his character–something innate that called to abusers “Here I am! Hurt me! That’s what I’m here for!” The truth of the matter is that each person can act in whichever way that they please, selflessly or selfishly.
That brings us to the next point that Matthew brought up, which is also a point other clients have made regarding God. If God was a merciful and a just God, how is it that he could let such terrible things happen to undeserving people and let the abusers go unpunished? At that point one can revert back to free will. If free will is truly something that exists, an ability given to all to act; and God is God–all powerful and all knowing with the ability to do what He wants, would he not allow the individual to exercise their free will “according to the dictates of their own conscience?” Any other way would be tyrannical, dictatorial and contraindicative of what free will is.

The power of free will is that many can exercise it in a way achieve Maslow’s highest achievement which is self-actualization. In spite of the difficulties one has faced, or the traumas caused, one can utilize and strengthen their ability to act to achieve safety and overcome the trauma–thus developing resiliency.

There are no guarantees with behavior, thoughts, or emotions. There can be guarantees with action due to agency and responsibility.