Wednesday, January 23, 2013

What Treasures are you Hiding?


© Dariusz Sas | Dreamstime.com
When was the last time you took an inventory of all your accomplishments and talents rather than your failures and shortcomings?  

Does the time it takes you to list your short comings equal the time it takes to list your talents and accomplishments?  And, does the list of your accomplishments flow as easily as the shortcomings? 

Fear, self judgment, and self criticism conspire to have us believe that we are not smart enough, good enough, strong enough, kind enough, brave enough, cool enough, insert your own judgment here  enough.  These forces unite, forming a powerful alliance, and inserting themselves into our daily self-talk.  Its presence in our internal dialogue causes us to bury or fail to develop the treasures we have; treasures, which were meant to be shared.

Often our friends, family members, co-workers, and even those who barely know us, bear witness to our strengths and areas of excellence, we just have to stand still long enough to listen and have the courage to believe.

Sunday, January 13, 2013

It Takes a Village: A Community in Mourning


Photo taken by J. Langley, 2008
It has been one month since the devastating events at Sandy Hook Elementary School.  Knowledge of the horrific details of the shooting shook the residents and families of the community in Newtown, Connecticut and sent reverberations that could be felt throughout the nation.  Traumatic events may lead to changes in our lives for which we cannot truly prepare.  

Who’s to Blame?


When a tragedy occurs we tend to have number of “what if” thoughts about events leading up to the unwelcome change in our lives.   We may find ourselves thinking maybe if I had done this or that, this would not have happened.   

In cases where the individual who committed the act of violence had a documented mental health history, one of the places the community turns for both answers and support is the mental health community.    

In a recent New York Times article, the author references a study published in JAMA Psychiatry indicating that most teens who commit suicide have had therapy prior to planning or committing suicide (Carey, 2013).  

According to Stanton Peele, PhD, J.D.,   “the best interpretation of these data is that therapy -- as it is currently administered and experienced -- is a cultural excuse for not addressing family, social, and life problems that we as individuals, family members, and a society face but cannot deal with (2013).”  This comment, perhaps suggests that it takes all of us, not just those in the mental health community, to address serious mental health issues.

 

What IS the Responsibility of the Mental Health Community? 


To start, the mental health community is made up of a variety of professionals who provide services to individuals struggling with a wide range of mental health problems (Grohol, 2006).   The general rule is that communication between a mental health professional and her client is confidential. However, the law allows mental health professionals to break confidentiality in cases where an individual is at risk for hurting himself and/or others.  

Specifically, the law requires mental health professionals to assess the dangerousness of the individual and take appropriate action.  One such action may be the involuntary confinement of the individual who has been found to be a danger to himself and/or others, in a process called civil commitment.   

The criteria for determining whether a person may be committed is different in each state (see, Treatment Advocacy Center, 2011)Generally, state laws allow commitment if:
  • The individual is a danger to himself or others and this danger is clear and immediate.
  • The evidence that supports this conclusion is convincing.   
  •  
Additional criteria include being unable to care for oneself and lacking the support to care for oneself; being unable to 
make responsible decisions about treatment/hospitalization and being in an unmanageable state. 

Can We Predict Dangerousness?


Predicting dangerousness has proven to be a challenge for mental health professionals and we are seeking ways of improving our accuracy at assessing and predicting dangerousness.   However, addressing mental illness takes a village.  

As parents, immediate or extended family members, teachers, peers, neighbors, and clergy, we can do our part by: ending the stigma associated with mental illness, communicating with others about troubling behaviors we have seen, communicating with our loved one about our concerns, taking steps ourselves to have a loved one civilly committed by calling 911 or try to persuade our loved ones to enter an inpatient or residential facility voluntarily.  

References
Carey, B. (2013, January 8).  Study questions effectiveness of therapy for suicidal teenagers.  The New York Times.  Retrieved from http://www.nytimes.com/2013/01/09/health/gaps-seen-in- therapy for-suicidal-teenagers.html

Grohol, J. (2006). Types of Mental Health Professionals. Psych Central.  Retrieved on January 13, 2013, from http://psychcentral.com/lib/2006/types-of-mental-health-professionals/

Peele, S. (2013, January 10). Therapy as a cultural cop out.  Psychology Today. Retrieved from http://www.psychologytoday.com/blog/addiction-in-society/201301/therapy-cultural-cop-out

Treatment Advocacy Center (2011). State standards for assisted treatment-Civil commitment for inpatient and outpatient psychiatric treatment.  Treatment Advocacy Center.org. Retrieved on January 13, 2013 from http://www.treatmentadvocacycenter.org/storage/documents/Standards-TheText-June_2011.pdf

Saturday, January 5, 2013

Change is a Process




With the start of the New Year, many of us resolved to make life changing alterations in our behavior.  However, after a few days into the New Year we may already be feeling frustrated, discouraged, disillusioned and even deflated, questioning whether we can truly incorporate these new behaviors into our daily lifestyles. Sometimes, we give up on our goals too early in the process because we are afraid that change is not possible or that we are not capable of changing. 

© Michel Paller | Dreamstime.com
One challenge that many of us face when trying to change is that we often expect the changes we envision to occur immediately and all at once.  However, lasting change requires commitment, a willingness to be compassionate with ourselves when we falter, and an understanding of process of change.

Change Happens in Stages

 

Change, though we love to hate it, is an important part of the human existence; and, often occurs whether we want it or not.  Our notions of self-determination and free will may lead us to conclude that change will occur simply by our desire to make it so.  While a strong desire for change is key, it is also important that we remember that change is a process.   Approximately 2 decades ago, researchers Carlo C. DiClemente and  J.O. Prochaska introduced a theory for understanding the process that we go through when trying to make a change.  The theory of change suggests that we go through 5 stages when trying to change our behavior.

While the theory of change was initially applied to understanding the process of changing addictive behaviors, the stages, which include pre-contemplation, contemplation, preparation, action and maintenance (See e.g.  http://psychcentral.com/lib/2006/stages-of-change/all/1/) have been applied to understanding the processes of changing other behaviors.


“I know what to do, so why can’t I just do it?


Depending on where you are in the stage of change your efforts at trying to change your behavior may be met with a variety of defeating thoughts including:
·         I feel stuck.
·         Is this change really worth the effort?
·         Can I really change?
·         Do I have what it takes to change?
·         Will the changes I make last?
·         Will others like me if I change?
·         Will I like me if I change?

We Have to Expect Push Back


On the journey to change, we have to expect that we may encounter push back from our own internal discomfort. Sometimes when trying to incorporate healthy behaviors or discontinue unhealthy ones, we may encounter the obstacle of self sabotage.  

Self sabotage, our tendency to continue to engaging in unhealthy behaviors despite the negative impact it may have on our lives, is an important “pop-up” in our process of change, one that we must learn how to block effectively.  

© Gfadel | Dreamstime.com

Change is Possible!


Understanding the obstacles we may encounter is an important tool for navigating the path toward change.  By preparing ourselves for the internal obstacles we may encounter  we can begin to greet each obstacle with a “Hey, I’ve been expecting you, and I have just the thing for you” rather than “What do I do now?”