When I studied psychology in school my professors breezed over what is termed - Dissociative Disorder (formerly known as Multiple Personality Disorder). In the industry it is difficult to prove this ailment, as it is to prove Fibromyalgia - a chronic pain disorder. Trust me, the two ailments do exist.
I wrote my doctorale dissertation on a client I treated who had ten alter personalities. What is an alter personality? It is another aspect within ourselves that simply takes over without our knowledge. How do people become aware of their aspects? Others will fill them in on the blanks in their mind, or a remnant of a memory will suddenly come to consciousness. Ten alters? Yes, let me explain.
When the mind is developing - usually in the first eight years of life, any traumatic experience that are too intense for a person to handle can fragment the mind. This is why I am an advocate of shielding children from any type of violence, especially the type that is often shown on television. With the mind shattered, a part may hide deep in our subconsciousness and may surface time to time - especially when a person is under incredible stress and the other fragments of the mind fail to function. People who have split personalities often describe periods in which they lose time, wake up suddenly out of a fog, and try to put the pieces back together. These time periods can last a day, a week, a year, or even longer. In a "Fugue state", people in an alter state can create a new persona. They can take on a new name, a new job, and move to a new town. They have literally become a new person! All it takes is for somebody to recognize them and their new identity comes crashing to the ground.
Yes this is a real phenomenon. In my private practice I have treated three people with this ailment with good success. At the crisis center I have seen maybe twenty in eight years. How do we treat somebody with this disorder? It takes handling somebody with this horrific background a certain sensitivity and gentle touch. On the client side, they need to learn to trust somebody fully. In order for us to piece somebody back together, they need to be willing to let us in. Treating somebody with this ailment is humbling. It is an honor to work with somebody who is willing to address the pain of the past and be willing themselves to honor, love, and listen to the desires of their submerged parts.
Today a client came in with this ailment. The stories of the horrors they faced in their youth was difficult to imagine. A huge part of me opened my heart to what they went through. It isn't therapuetic to get angry and want revenge. I used to take that route and found it was fruitless. Now I focus only on the part inside of them that went through it, honor it, love it, and create a format for the client to openly dialogue with it in a place of care and love. If the client latches onto the tools, the healing that results is unsurpassed!!
God bless everyone with this ailment that has gone untreated. Please, please, please let a professional help end your suffering. When love is applied to hurt, even the most difficult issues can heal.
Peace.
Thursday, February 25, 2010
Wednesday, February 24, 2010
TIME OUT!!!
If I described today as busy this wouldn't even touch the surface. In current lingo today was off the hook! We had to shut our doors before noon because too many people were already looking for services! It felt like a bus of mentally ill had dumped its load and a sea of people, all demanding services - NOW - had filled the room. I am reminded of a chicken nursery with all the baby chicks screaming for the mushed up worm. Like a good mother hen I tried my best to feed them.
What happened? Why are so many people coming in for treatment? A few were there because of lazyness - as is always the case. They failed to follow up with our referrals and rushed back to their familiar pill pusher. So we wave our finger at them, and tell them this will be the last time we treat you, and fifteen visits later we hope they follow up. Well not really but often it feels that we see the same person that many times.
Our job is to of course assess somebody for the proper medication. My job is to help stablize those people who are in a crisis and feel there is no more hope for them. When we have the proper number of clients in a day - usually fifteen to sixteen, our system flows nicely. When one more person shows up, it is as if our system flops and people can be at our facility upwards of six hours! You think this is a lot, at Harbor UCLA people can be there for more than ten hours and might still be turned away.
Mental health to the multitudes is new to us. Eight years and 15,000 plus people has taught us a few good lessons, especially to try to get the clients out in the shortest amount of time. Before the average stay was maybe one hour and fifteen minutes. Today we bogged down to a snails 6 hour pace. When you are working with the mentally ill, fifteen seconds can seem like a lifetime.
Friday it was just like this and a staff member got attacked. Having no security for budgetary reasons the whole staff is more at risk than ever. Today we tried to keep the patrons educated. "The doctor is going on a break." "You are third on the list and will be seen in about a half hour." "Do you need a piece of paper and crayons?" "Johnny stop talking to that lady." I felt more like an elementary school teacher than a crisis therapist.
Why are people showing up to a mental health emergency room in droves right now? Is it the economy? More people have come in due to losing their jobs and home. Is it because they had tried to resist getting the proper help for so long that they are forced to do so because their symptoms are too great? Yes and yes. And more and more. We all live in a mentally ill world and have not made it a priority to treat. There are simple coping methods that can be taught in school. In our families we can teach our children the methods we use to get through the uncomfortable things in life. We can ask our children what is bothering them. We ourselves can open our mouths and speak our truth.
Why is counseling so taboo? Many clients tell me they just don't want to talk about the unmentionable things that had been done to them so many years ago. So they try to box it up and toss away the key, all the while they dream about it, drink because of it and damage their body and mind because of the detrimental tools that are using.
I am not proposing some big governmental program. This is an individual, a family, and sometimes a group problem. With problems, solutions can be found if we all put in the effort. I am doing mine, one person at a time. Though I have a few others daily meaning myself, and my family. Still we can solve the mental health problem if we learn the proper tools of the trade.
Stay tuned.
What happened? Why are so many people coming in for treatment? A few were there because of lazyness - as is always the case. They failed to follow up with our referrals and rushed back to their familiar pill pusher. So we wave our finger at them, and tell them this will be the last time we treat you, and fifteen visits later we hope they follow up. Well not really but often it feels that we see the same person that many times.
Our job is to of course assess somebody for the proper medication. My job is to help stablize those people who are in a crisis and feel there is no more hope for them. When we have the proper number of clients in a day - usually fifteen to sixteen, our system flows nicely. When one more person shows up, it is as if our system flops and people can be at our facility upwards of six hours! You think this is a lot, at Harbor UCLA people can be there for more than ten hours and might still be turned away.
Mental health to the multitudes is new to us. Eight years and 15,000 plus people has taught us a few good lessons, especially to try to get the clients out in the shortest amount of time. Before the average stay was maybe one hour and fifteen minutes. Today we bogged down to a snails 6 hour pace. When you are working with the mentally ill, fifteen seconds can seem like a lifetime.
Friday it was just like this and a staff member got attacked. Having no security for budgetary reasons the whole staff is more at risk than ever. Today we tried to keep the patrons educated. "The doctor is going on a break." "You are third on the list and will be seen in about a half hour." "Do you need a piece of paper and crayons?" "Johnny stop talking to that lady." I felt more like an elementary school teacher than a crisis therapist.
Why are people showing up to a mental health emergency room in droves right now? Is it the economy? More people have come in due to losing their jobs and home. Is it because they had tried to resist getting the proper help for so long that they are forced to do so because their symptoms are too great? Yes and yes. And more and more. We all live in a mentally ill world and have not made it a priority to treat. There are simple coping methods that can be taught in school. In our families we can teach our children the methods we use to get through the uncomfortable things in life. We can ask our children what is bothering them. We ourselves can open our mouths and speak our truth.
Why is counseling so taboo? Many clients tell me they just don't want to talk about the unmentionable things that had been done to them so many years ago. So they try to box it up and toss away the key, all the while they dream about it, drink because of it and damage their body and mind because of the detrimental tools that are using.
I am not proposing some big governmental program. This is an individual, a family, and sometimes a group problem. With problems, solutions can be found if we all put in the effort. I am doing mine, one person at a time. Though I have a few others daily meaning myself, and my family. Still we can solve the mental health problem if we learn the proper tools of the trade.
Stay tuned.
Tuesday, February 23, 2010
Language Barrier
In order to provide the best possible care, it is important for a clinician to really listen. When the information that is given is received, proper help can be provided - hopefully. Then there are the times people who speak different languages come in for care. Interpreters can help, but when people speak dilects that can't be interpreted this becomes a major problem if there grasp of the english language lacks. I once saw a person who was deaf and had to use an interpreter who read sign language - that was different. What shocked me was this person told me they heard voices. This was the time I really grasped that people actually had psychosis!
It is imperative that we understand what a person tells us in order to treat them properly and avoid hospitalizing somebody that doesn't need it.
"Do you want to go into the hospital?" "Did you tell me you tried hanging yourself yesterday?" Broken english has caused me headaches.
The county of Los Angeles has a county access service that provides interpreters of many languages. We call them up, put them on a speaker phone, and communicate away. Hopefully this does the trick. Often times, even with interpreters the message sent in even their primary language gets turned around, jumbled, and confused.
Hopefully this will do the trick tonight because I am on hold awaiting my translater.
Wish me luck.
It is imperative that we understand what a person tells us in order to treat them properly and avoid hospitalizing somebody that doesn't need it.
"Do you want to go into the hospital?" "Did you tell me you tried hanging yourself yesterday?" Broken english has caused me headaches.
The county of Los Angeles has a county access service that provides interpreters of many languages. We call them up, put them on a speaker phone, and communicate away. Hopefully this does the trick. Often times, even with interpreters the message sent in even their primary language gets turned around, jumbled, and confused.
Hopefully this will do the trick tonight because I am on hold awaiting my translater.
Wish me luck.
Monday, February 22, 2010
Stress!!!
Stress is an everyday occurance to millions and millions of people in the world. Stress can be a motivator and propel us into new relationships, new jobs, and a more functional life. On the other hand stress can wear us down, create hopeless and helplessness, and can ultimatly kill us.
When stress is blocking you from living a positive and functional life what can you do?
Here is a top ten list for stress reduction.
1. Breathe
Slow down, take in a deep relaxing breath and connect to the innermost you. As the external stressors start to fade away, reconnection with yourself, which is the key to becoming calm.
2. Relax
It is proven we can not be anxious and relaxed at the same time. I teach my clients "Progressive Relaxation" which works on relaxing muscle groups from the top of the head to the bottom of your feet.
3. Positive Self Talk
Our mind is very powerful and when the brain latches onto something - good or bad - we will create the emotional experience of the thought. With positive self talk, we create a statement for ourselves that creates the opposite of stress.
For example: "I am calm, relaxed, and safe."
4. Spiritual Connection
The feeling that there is no God can create extreme panic. If we are overwhelmed and feel that our resources are ineffective towards what is transpiring in life - and there is no God for additional support stress ensues. Prayer, letter writing to God can be of great benefit.
5. Core work.
If you have experienced a trauma or witnessed something traumatic, there can be a part of you emotionally stuck at that time period. Addressing the core injury with love and compassion is the key to not only healing that part, but growing emotionally, mentally, and even spiritually in the process.
6. Psychiatric Medication.
Under stress the mind, emotions, and body tear down. If you are depressed or anxious all of the time, it is important to support your brain. Psychiatric medication has helped those with acute stress, live functional lives.
7. Alternative treatment.
Vitamin, herbal, and even whole food can be used as medicine. Not licensed as a nutritionist, I can not prescribe any suppliments but rave about the effect Gaba has had on my own anxiety. There is plenty of information on the positives that can be found in suppliment and whole food use.
8. The Chi Machine.
There is a machine that shakes your body back and forth that can work miracles! It is called a Chi Machine. It loosens your joints, helps you calm your mind and you feel fantastic after the first use.
9. Massage.
Being a Certified Massage Technition, I am well aware of the benefits of a relaxing massage. As the body calms, so do the nerves.
10. Accupuncture.
Accupuncture has been around for thousands of years. I have experienced unbelievable results from it! This ancient art treats ailments at their root. Find out what is the ultimate cause and treat it properly. Is stress caused by a deficent Kidney? Spleen? Liver? Treat yourself to an amazing healing technology.
The key to stress management is covering as many bases as possible. Stress can be managed successfully.
When stress is blocking you from living a positive and functional life what can you do?
Here is a top ten list for stress reduction.
1. Breathe
Slow down, take in a deep relaxing breath and connect to the innermost you. As the external stressors start to fade away, reconnection with yourself, which is the key to becoming calm.
2. Relax
It is proven we can not be anxious and relaxed at the same time. I teach my clients "Progressive Relaxation" which works on relaxing muscle groups from the top of the head to the bottom of your feet.
3. Positive Self Talk
Our mind is very powerful and when the brain latches onto something - good or bad - we will create the emotional experience of the thought. With positive self talk, we create a statement for ourselves that creates the opposite of stress.
For example: "I am calm, relaxed, and safe."
4. Spiritual Connection
The feeling that there is no God can create extreme panic. If we are overwhelmed and feel that our resources are ineffective towards what is transpiring in life - and there is no God for additional support stress ensues. Prayer, letter writing to God can be of great benefit.
5. Core work.
If you have experienced a trauma or witnessed something traumatic, there can be a part of you emotionally stuck at that time period. Addressing the core injury with love and compassion is the key to not only healing that part, but growing emotionally, mentally, and even spiritually in the process.
6. Psychiatric Medication.
Under stress the mind, emotions, and body tear down. If you are depressed or anxious all of the time, it is important to support your brain. Psychiatric medication has helped those with acute stress, live functional lives.
7. Alternative treatment.
Vitamin, herbal, and even whole food can be used as medicine. Not licensed as a nutritionist, I can not prescribe any suppliments but rave about the effect Gaba has had on my own anxiety. There is plenty of information on the positives that can be found in suppliment and whole food use.
8. The Chi Machine.
There is a machine that shakes your body back and forth that can work miracles! It is called a Chi Machine. It loosens your joints, helps you calm your mind and you feel fantastic after the first use.
9. Massage.
Being a Certified Massage Technition, I am well aware of the benefits of a relaxing massage. As the body calms, so do the nerves.
10. Accupuncture.
Accupuncture has been around for thousands of years. I have experienced unbelievable results from it! This ancient art treats ailments at their root. Find out what is the ultimate cause and treat it properly. Is stress caused by a deficent Kidney? Spleen? Liver? Treat yourself to an amazing healing technology.
The key to stress management is covering as many bases as possible. Stress can be managed successfully.
Friday, February 19, 2010
Coworker Attacked
In eight years at the crisis center I've dodged a bullet. It is accurate to state that when you work in a mental health facility there is the likelihood of being attacked by psychotic clients. So was the case today when a paranoid client who was hearing voices in their head to attack did. Thank God the target was a coworker standing right next to me.
There is a rule for mental health workers that if a client attacks you, you can not attack back. These clients aren't in their right minds and attacking them is viewed upon as abuse. Unfortunately I have seen coworkers fight back in their own anger and hurt. Today however was a doozie!!! Chairs were flying blood being poured and a room of awaiting clients were in a tizzy!
About four years ago I had my only incident. A large man the size of the guy from the "Green Mile" complained that he had slept through his lunch and wanted it! In fact he demanded it!! I placed two dinners in front of him to replace whatever he missed out but this was not acceptable. He stood up as if to sit down to eat and from six feet away slugged me in the jaw! I stood there dumbfounded. How could somebody so far away from me do that? My taking his best punch got him riled, so he picked up a chair and went after me. I did the only thing I could - I hid behind a couch as he thrashed the chair at my barrier for five minutes. The clients scattered, my workmates were nowhere in sight and I was trying to perserve my life. Luckily the door opened, it distracted him and I was out like a flash. I was lucky.
Work place injuries do happen in the mental health industry as my coworker today can contest to. This person had to go to the hospital to get checked out. The client obviously connected with a number of blows and the tumble to the ground also didn't help.
I just want to help people - bottom line. I am not the only person who feels this way in this industry. We all know the risks. So do firefighters, the police, and even people in the clergy. When you try to help people, some people get aggressive and go on the assault.
As a staff we have to go through self defense training but it is in slow motion and only once a year. In a crisis do you think we remember the right thing to do? Learning Karate in which we can block punches and subdo somebody would be more practical. In doing this we don't attack but block. Unfortunately even if my coworker did know martial arts the blow came out of nowhere and anybody would have suffered the same effect.
What a way to end the week. Lots of clients, a slow pace by our psychiatrist, a psychotic person hearing voices to harm set up something ugly into motion.
Be safe and for those who have psychosis - please stay on your medication.
Peace.
There is a rule for mental health workers that if a client attacks you, you can not attack back. These clients aren't in their right minds and attacking them is viewed upon as abuse. Unfortunately I have seen coworkers fight back in their own anger and hurt. Today however was a doozie!!! Chairs were flying blood being poured and a room of awaiting clients were in a tizzy!
About four years ago I had my only incident. A large man the size of the guy from the "Green Mile" complained that he had slept through his lunch and wanted it! In fact he demanded it!! I placed two dinners in front of him to replace whatever he missed out but this was not acceptable. He stood up as if to sit down to eat and from six feet away slugged me in the jaw! I stood there dumbfounded. How could somebody so far away from me do that? My taking his best punch got him riled, so he picked up a chair and went after me. I did the only thing I could - I hid behind a couch as he thrashed the chair at my barrier for five minutes. The clients scattered, my workmates were nowhere in sight and I was trying to perserve my life. Luckily the door opened, it distracted him and I was out like a flash. I was lucky.
Work place injuries do happen in the mental health industry as my coworker today can contest to. This person had to go to the hospital to get checked out. The client obviously connected with a number of blows and the tumble to the ground also didn't help.
I just want to help people - bottom line. I am not the only person who feels this way in this industry. We all know the risks. So do firefighters, the police, and even people in the clergy. When you try to help people, some people get aggressive and go on the assault.
As a staff we have to go through self defense training but it is in slow motion and only once a year. In a crisis do you think we remember the right thing to do? Learning Karate in which we can block punches and subdo somebody would be more practical. In doing this we don't attack but block. Unfortunately even if my coworker did know martial arts the blow came out of nowhere and anybody would have suffered the same effect.
What a way to end the week. Lots of clients, a slow pace by our psychiatrist, a psychotic person hearing voices to harm set up something ugly into motion.
Be safe and for those who have psychosis - please stay on your medication.
Peace.
Thursday, February 18, 2010
Bipolar
What is bipolar? It used to be called Manic Depression but nobody really understands the dynamics involved in a mental illness that on the whole everybody has a taste of it. Yes, that's right, to some extent everybody has experienced some time or another mental illness. What are the dynamics of bipolar?
Bipolar is actually a brain ailment. The Hypothalimus in the brain is the center of all our cycles. It regulates sleep, rest, appetite, energy level. When the Hypothalimus is in good working order our cycles function beautifully. We get eight hours of sleep, have good energy throughout the day, have a normal appetite, and even our thoughts are positive.
When the Hypothalimus is not functioning properly, major problems can result. Since the main function of the Hypothalimus is regulating the amount of adreniline released into the blood stream, if that valve is stuck open Adreniline flows out unchecked, this is when there is an abundance of energy, the mind has a flight of ideas and begins to race, appetite is supressed, sleep is out of the question, we feel elated! We believe we are superhuman and can do anything!! The valve can remain open for days at which time voices may be heard, objects are seen, paranoid feelings may exist, and there is a feeling that someone or some organization is keeping close watch on you.
Then slam! The valve suddenly shuts. No energy, depression, sleeping for days, no motivation, hopelessness, and at the extreme suicidal thoughts.
People can have rapid cycling in which the mood can shift back and forth from elation to homicidal. The cycling can be lengthy as in every month or two. Know this - we all cycle to some extent. When the cycling gets too much we need a professional intervention.
Since this is a brain ailment psychiatric medication becomes a necessity. Denying this is a problem can get people in a real predicament and this happens when people have suicide attempts, go off in a rage at home, or confront others in public.
Alternative medications, vitamins, herbal suppliments can assist the Hypothalimus. Counseling can be of aid in helping a person befriend the high and low aspects within themselves.
The first step is to have a psychiatric evaluation to see if medication is encouraged, if not research the alternatives, or learn mood calming processes. Bottom line - this will not go away on its own and needs daily vigilance. Learning how to take care of your internal affairs can bring Bipolar into proper balance.
Bipolar is actually a brain ailment. The Hypothalimus in the brain is the center of all our cycles. It regulates sleep, rest, appetite, energy level. When the Hypothalimus is in good working order our cycles function beautifully. We get eight hours of sleep, have good energy throughout the day, have a normal appetite, and even our thoughts are positive.
When the Hypothalimus is not functioning properly, major problems can result. Since the main function of the Hypothalimus is regulating the amount of adreniline released into the blood stream, if that valve is stuck open Adreniline flows out unchecked, this is when there is an abundance of energy, the mind has a flight of ideas and begins to race, appetite is supressed, sleep is out of the question, we feel elated! We believe we are superhuman and can do anything!! The valve can remain open for days at which time voices may be heard, objects are seen, paranoid feelings may exist, and there is a feeling that someone or some organization is keeping close watch on you.
Then slam! The valve suddenly shuts. No energy, depression, sleeping for days, no motivation, hopelessness, and at the extreme suicidal thoughts.
People can have rapid cycling in which the mood can shift back and forth from elation to homicidal. The cycling can be lengthy as in every month or two. Know this - we all cycle to some extent. When the cycling gets too much we need a professional intervention.
Since this is a brain ailment psychiatric medication becomes a necessity. Denying this is a problem can get people in a real predicament and this happens when people have suicide attempts, go off in a rage at home, or confront others in public.
Alternative medications, vitamins, herbal suppliments can assist the Hypothalimus. Counseling can be of aid in helping a person befriend the high and low aspects within themselves.
The first step is to have a psychiatric evaluation to see if medication is encouraged, if not research the alternatives, or learn mood calming processes. Bottom line - this will not go away on its own and needs daily vigilance. Learning how to take care of your internal affairs can bring Bipolar into proper balance.
Wednesday, February 17, 2010
A Positive Attitude Goes a Long Way
The law of attraction - popularized in the book / movie "The Secret", has been well documented in psychological journals. When we are in a negative mood, it is natural for others to kick us when we're down. Why is that? Do people feel inately that our guard is down and the negative message they have been holding onto for years finally has an avenue it? Who knows? On the flip side when we are in a positive frame - magic takes place.
I see people in a fog all day, everyday. It can be easy to lower myself to that level and get swept into the pity party they are in the midst of. The role of a therapist is to set a tone - a positive one in which clients shift up to. When perfected therapists can handle the most difficult clients with compassion, and this ignites the dormant compassion within them!!
I have had clients in the midst of a crying spell, or in the midst of panic suddenly stop, look up at me, and ask: "How did you do that?" It is called "Containment". Yes, us therapists have our own secret language. Containment means creating a holding enviroment to release bad feelings in order to replace it good.
Today was amazing. I have been in a pretty good mood lately with the upcoming release of my first novel. I had just received a proof of the book by the publisher and even though there were a few flaws that needed addressing, it was exciting seeing my vision. No - - actuallying feeling and holding my vision in my hands. With this going on, it was natural for me to feeling positive. In my feeling positive, I was more available, more connected, and more sensitive to the clients I interacted with all day long. Plus - and this is a big plus - I actually enjoyed my own company too.
It isn't a big mystery that if a person is happy, others in close proximity will also feel happier. Why not just teach this in school, have company meetings about happiness, and make it an emphasis in this world to focus on creating more joy and less sorrow.
I saw an interesting presentation on positive psychology today. Being licensed I need to take continuing education courses and often opt to study something that is uplifting. The number one premise was for people to focus on happy, do happy things, and keep a log of the joys for the day. I hate journal writing, though understand the benefits.
In staying positive for longer and longer periods, my clients improve without me working so damn hard. Work becomes easy and joyfilled!
To my fellow therapists test this out, see how long you can remain upbeat - especially in therapuetic sessions. I think it's a whole lot better than Prozac.
:-)
I see people in a fog all day, everyday. It can be easy to lower myself to that level and get swept into the pity party they are in the midst of. The role of a therapist is to set a tone - a positive one in which clients shift up to. When perfected therapists can handle the most difficult clients with compassion, and this ignites the dormant compassion within them!!
I have had clients in the midst of a crying spell, or in the midst of panic suddenly stop, look up at me, and ask: "How did you do that?" It is called "Containment". Yes, us therapists have our own secret language. Containment means creating a holding enviroment to release bad feelings in order to replace it good.
Today was amazing. I have been in a pretty good mood lately with the upcoming release of my first novel. I had just received a proof of the book by the publisher and even though there were a few flaws that needed addressing, it was exciting seeing my vision. No - - actuallying feeling and holding my vision in my hands. With this going on, it was natural for me to feeling positive. In my feeling positive, I was more available, more connected, and more sensitive to the clients I interacted with all day long. Plus - and this is a big plus - I actually enjoyed my own company too.
It isn't a big mystery that if a person is happy, others in close proximity will also feel happier. Why not just teach this in school, have company meetings about happiness, and make it an emphasis in this world to focus on creating more joy and less sorrow.
I saw an interesting presentation on positive psychology today. Being licensed I need to take continuing education courses and often opt to study something that is uplifting. The number one premise was for people to focus on happy, do happy things, and keep a log of the joys for the day. I hate journal writing, though understand the benefits.
In staying positive for longer and longer periods, my clients improve without me working so damn hard. Work becomes easy and joyfilled!
To my fellow therapists test this out, see how long you can remain upbeat - especially in therapuetic sessions. I think it's a whole lot better than Prozac.
:-)
Tuesday, February 16, 2010
Controversy
Should we force medication on those who need it desperately, but oppose it vehemently?
So often people are brought in (or should I say dragged in) by their family in hopes of obtaining medication to "fix" their problem. At this point it is a family problem, often it is a neighborhood problem, and if the person drives it becomes a societal problem. Plainly stated, people with certain mental health ailments are in such a state of denial, they refuse to acknowledge the obvious - there is something wrong and instead of it going away, it is actually getting worse.
It is freightening to see somebody who is paranoid, who's voices in their head are battling to keep others at bay. Families and close neighbors are acutely aware of the problem and the police are often called in, but their hands are often tied. Are they a danger to others or themselves is the criteria and anything outside of the is outside their realm of intervention. Same as us. Families can bring the horse to our water, but even the most incredible psychiatrist or therapist can't make them drink.
Do we force medication on those we know are obvious candidates for medicine? It seems cruel to the courts to even consider this. Then what? Do we have to wait until they attempt to harm themselves or others? To the family members who live with them, it is a daily / hourly nightmare. Try to walk on eggshells all day long, trying not to trigger an outburst, or try debating that the FBI isn't really trying to plot against them. These drawn out conversations with somebody so fixated on their position on a daily / hourly basis can run you ragged to say the least. Forced medication seems more logical to these people who suffer emotional abuse constantly.
I am in favor of a specialized group of clinicians whose job it is to assess people for injectables on a monthly basis if they deem it is needed. These people would need specialized training and have to all be in agreement for forced medication. Is this cruel? I don't think so. The people that slip through the cracks that would respond favorably to the medication would now get the help they desperately need.
Your comments are appreciated.
So often people are brought in (or should I say dragged in) by their family in hopes of obtaining medication to "fix" their problem. At this point it is a family problem, often it is a neighborhood problem, and if the person drives it becomes a societal problem. Plainly stated, people with certain mental health ailments are in such a state of denial, they refuse to acknowledge the obvious - there is something wrong and instead of it going away, it is actually getting worse.
It is freightening to see somebody who is paranoid, who's voices in their head are battling to keep others at bay. Families and close neighbors are acutely aware of the problem and the police are often called in, but their hands are often tied. Are they a danger to others or themselves is the criteria and anything outside of the is outside their realm of intervention. Same as us. Families can bring the horse to our water, but even the most incredible psychiatrist or therapist can't make them drink.
Do we force medication on those we know are obvious candidates for medicine? It seems cruel to the courts to even consider this. Then what? Do we have to wait until they attempt to harm themselves or others? To the family members who live with them, it is a daily / hourly nightmare. Try to walk on eggshells all day long, trying not to trigger an outburst, or try debating that the FBI isn't really trying to plot against them. These drawn out conversations with somebody so fixated on their position on a daily / hourly basis can run you ragged to say the least. Forced medication seems more logical to these people who suffer emotional abuse constantly.
I am in favor of a specialized group of clinicians whose job it is to assess people for injectables on a monthly basis if they deem it is needed. These people would need specialized training and have to all be in agreement for forced medication. Is this cruel? I don't think so. The people that slip through the cracks that would respond favorably to the medication would now get the help they desperately need.
Your comments are appreciated.
Friday, February 12, 2010
Insight
Every so often a person comes to the crisis center not understanding why they need to take medication. So was the story of a client that came in today. Multiple hospitalizations, been on strong antipsychotic medication for years but didn't understand why. You would think that these people would know the obvious reasons for why they undergo regular psychiatric interviews and take daily medication but that just isn't so.
In one of my placements as an intern I worked with the Learning Disabled. These clients were young adults and on the surface looked normal. In fact they could carry on a pretty good conversation to a point. The conversations seemed to flow normally but something was just lacking. I learned that the learning disabled knew their limitations and did everything to avoid talking, thinking, or even dealing with it. When a counselor like myself made them look at their frailities, it didn't make them too happy.
Perhaps it is natural to cover up our frailities, but to not even being aware of them, when it is obvious to everybody else we say they lack "Insight." Being self aware is the first step towards enlightenment. In the school of Spiritual Psychology, everything centers on self awareness. "Everything outside of us is just an illusion". This focus is an inside out focus on change. In fact if you want more peace in the world, foster more peace within you. In doing so, as you wander out into the exterior world (being peaceful on the inside), like a magnet other people can get swept into your peacefulness and will follow suit. If you were alive in the 1960's this way of thinking was popularized in commercials and in theater.
As a therapist, our hands are tied. We can only work with a person at where they are at. If somebody has no insight, they are this way for a reason. This could be a brain ailment, a result of an extreme trauma that has been supressed into the unconsciousness. Or, as Freud would say, "the person is in denial" and doesn't want to acknowledge it.
Oh yes, the vast percentage of people admit that they don't want to deal with past issues. They figure if they box it away and avoid thinking about it, it will just disappear. But will it? If we continually sweep things under the perverbial rug, after a while all you see is rug. This is when you are constantly anxious, panicking, or angry all the time! The key is removing the old baggage you believe isn't there at all, or have no clue about as this client portrayed.
One final thought: Baggage can be viewed as a blessing. In working through our past hurts and trauma, we become better and grow spiritually. Pay attention to more on this in future blogs.
In one of my placements as an intern I worked with the Learning Disabled. These clients were young adults and on the surface looked normal. In fact they could carry on a pretty good conversation to a point. The conversations seemed to flow normally but something was just lacking. I learned that the learning disabled knew their limitations and did everything to avoid talking, thinking, or even dealing with it. When a counselor like myself made them look at their frailities, it didn't make them too happy.
Perhaps it is natural to cover up our frailities, but to not even being aware of them, when it is obvious to everybody else we say they lack "Insight." Being self aware is the first step towards enlightenment. In the school of Spiritual Psychology, everything centers on self awareness. "Everything outside of us is just an illusion". This focus is an inside out focus on change. In fact if you want more peace in the world, foster more peace within you. In doing so, as you wander out into the exterior world (being peaceful on the inside), like a magnet other people can get swept into your peacefulness and will follow suit. If you were alive in the 1960's this way of thinking was popularized in commercials and in theater.
As a therapist, our hands are tied. We can only work with a person at where they are at. If somebody has no insight, they are this way for a reason. This could be a brain ailment, a result of an extreme trauma that has been supressed into the unconsciousness. Or, as Freud would say, "the person is in denial" and doesn't want to acknowledge it.
Oh yes, the vast percentage of people admit that they don't want to deal with past issues. They figure if they box it away and avoid thinking about it, it will just disappear. But will it? If we continually sweep things under the perverbial rug, after a while all you see is rug. This is when you are constantly anxious, panicking, or angry all the time! The key is removing the old baggage you believe isn't there at all, or have no clue about as this client portrayed.
One final thought: Baggage can be viewed as a blessing. In working through our past hurts and trauma, we become better and grow spiritually. Pay attention to more on this in future blogs.
Thursday, February 11, 2010
Intoxication
There is a trend this week. People showing up for treatment, drunk and smelling like booze. It is hazardous for us to treat people intoxicated because the mix of alcohol with psychotropic medicine can cause serious damage to the internal organs and to the brain. Still people flock to us because they can't sleep, hear and see things that aren't there, and have horrible depression and anxiety.
I've tried to counsel these people and am almost losing hope. When somebody is hell bent on continuing to use even if their mind is on the blink and their liver is about to burst, it seems ridiculous to try to sway them to sanity.
When I was seven years old my best friend's mother said, "Don't try to reason with a crazy person." Oh my God was she on the mark. These people are not in their right mind if they think that psychiatric medication will stablize them so they can keep on drinking and using.
This is why Rehab centers were created. Without access to the substance, then work can be done on the inner person. Without repairing our core wounds it is natural to just keep on using. How do we work on our wounds? The first step is to check into a facility and stop using so your mind can clear. Then come see me and I'll give you exercises that will last through rehab and continue into your life.
With the mind fogged and the body damaged from using, what legacy are you leaving to your kids if you have them, or society as a whole?
Obviously you can read my frustration. In interviewing empty people, not themselves, there is not much help I can provide internally. Oh yes I can provide referrals to services but a mind altered can not grasp the gems of insight I often provide.
I've tried to counsel these people and am almost losing hope. When somebody is hell bent on continuing to use even if their mind is on the blink and their liver is about to burst, it seems ridiculous to try to sway them to sanity.
When I was seven years old my best friend's mother said, "Don't try to reason with a crazy person." Oh my God was she on the mark. These people are not in their right mind if they think that psychiatric medication will stablize them so they can keep on drinking and using.
This is why Rehab centers were created. Without access to the substance, then work can be done on the inner person. Without repairing our core wounds it is natural to just keep on using. How do we work on our wounds? The first step is to check into a facility and stop using so your mind can clear. Then come see me and I'll give you exercises that will last through rehab and continue into your life.
With the mind fogged and the body damaged from using, what legacy are you leaving to your kids if you have them, or society as a whole?
Obviously you can read my frustration. In interviewing empty people, not themselves, there is not much help I can provide internally. Oh yes I can provide referrals to services but a mind altered can not grasp the gems of insight I often provide.
Wednesday, February 10, 2010
Family History
Yep it happened again! How many times have we seen somebody with a family history of Schizophrenia use a drug like XTC and go psychotic? What can we do to stop this trend? Do we go to schools? Do we have mental health individuals send home flyers with their clients with this disorder for their children to read? Do we do a television campagne? I literally hate seeing somebody, who is 18 to 20 years old suddenly cut down in the prime of their life. We as a people have to stop this trend. I know there is a pull for teenagers to experiment with mind altering substances. Yes, I too dabbled in a few contraband substances myself and was lucky I kept my right mind. Though some would argue on the contrary. Still we need to protect the future of our country, our world from succumbing to psychosis when they don't have to experience it. Well at least not at such an early age.
Psychologists are well aware of a hereditary factor with mental illness. Though identical twins are not 100% assured to have the same ailment. I believe it was in the 40 percentile. Still if there is something going on in the family - whether it is a physical ailment (cancer, diabetes) or a psychiatric one, a person has to be aware of the fact that they too are vulnerable to the same and must take the proper preventative measures.
We had a 20 year old come in and had a recent hospitalization. They knew it was drug related and prayed that medication would bring back their old life to them. We don't know if this is possible. Some of the psychiatric medications are incredible and people who would have filled "insane asylums" years ago can lead a high functioning life because of them. However some are not so lucky.
Please talk to your family about any hereditary issues. Educate them about the use of substances that may cause them perminant damage. If we can save one person from a life of psychosis and misery, it would be well worth it.
Dr. Scott
Psychologists are well aware of a hereditary factor with mental illness. Though identical twins are not 100% assured to have the same ailment. I believe it was in the 40 percentile. Still if there is something going on in the family - whether it is a physical ailment (cancer, diabetes) or a psychiatric one, a person has to be aware of the fact that they too are vulnerable to the same and must take the proper preventative measures.
We had a 20 year old come in and had a recent hospitalization. They knew it was drug related and prayed that medication would bring back their old life to them. We don't know if this is possible. Some of the psychiatric medications are incredible and people who would have filled "insane asylums" years ago can lead a high functioning life because of them. However some are not so lucky.
Please talk to your family about any hereditary issues. Educate them about the use of substances that may cause them perminant damage. If we can save one person from a life of psychosis and misery, it would be well worth it.
Dr. Scott
Tuesday, February 9, 2010
Unemployment
As a therapist, I wear many hats. I am a coach, a friend, a parent, a fan, and someone who may have never cared before. Today I was a job coach.
Being jobless in a large city can be frustrating. Lots of postings, lots of resume's to write and deliver, and hopefully lots of interviews. Why do so many get turned away?
Having gone through lots of seminars on gaining employment, they key I've learned has been attitude. When we are desperate for work how does the interviewer feel about the energy we put out? This may be overbearing, wouldn't you think? What a perspective boss is looking for, number one - can the person handle the job? Number two - can they fit into the emotional mix.
Let's face it, a good work environment is ideal for maximum productivity. If an interviewee for a job seems intense, it's not to appealing for overall wellbeing of the work environment. On the other hand, if a person is calm, happy, and apparently intelligent, well they will most likely get the job.
For people who are homeless, have a mental illness, or may even have a learning disablity their only detriment is their attitude. So many mentally ill people judge themselves so badly they have lost any prospective job before they have entered the front door. It doesn't matter what ails you, keeping yourself upbeat is the number one priority. Try these few suggestions.
Create a positive self statement - These are small statements with two to three emotional states you want to experience more fully in your life.
For example: "I am happy, confident, and relaxed."
During your everyday life and especially during job interviews repeat this statement internally to keep you centered and in a positive frame of mind.
I recommend repeating these statements a minimum of one hundred times daily for a minimum six month period to reprogram your thinking patterns.
Be prepared. Research the company. Learn who the owner is, what the company does, and come up with a reason why you want to work there. Of course we all want to make money, but what makes the job rewarding is if it is emotionally fulfilling.
For example: The company Simple Green sells products that are environmentally safe and are great at cleaning. Working for them would feel comforting while making the big bucks.
Do you have any other suggestions?
Being jobless in a large city can be frustrating. Lots of postings, lots of resume's to write and deliver, and hopefully lots of interviews. Why do so many get turned away?
Having gone through lots of seminars on gaining employment, they key I've learned has been attitude. When we are desperate for work how does the interviewer feel about the energy we put out? This may be overbearing, wouldn't you think? What a perspective boss is looking for, number one - can the person handle the job? Number two - can they fit into the emotional mix.
Let's face it, a good work environment is ideal for maximum productivity. If an interviewee for a job seems intense, it's not to appealing for overall wellbeing of the work environment. On the other hand, if a person is calm, happy, and apparently intelligent, well they will most likely get the job.
For people who are homeless, have a mental illness, or may even have a learning disablity their only detriment is their attitude. So many mentally ill people judge themselves so badly they have lost any prospective job before they have entered the front door. It doesn't matter what ails you, keeping yourself upbeat is the number one priority. Try these few suggestions.
Create a positive self statement - These are small statements with two to three emotional states you want to experience more fully in your life.
For example: "I am happy, confident, and relaxed."
During your everyday life and especially during job interviews repeat this statement internally to keep you centered and in a positive frame of mind.
I recommend repeating these statements a minimum of one hundred times daily for a minimum six month period to reprogram your thinking patterns.
Be prepared. Research the company. Learn who the owner is, what the company does, and come up with a reason why you want to work there. Of course we all want to make money, but what makes the job rewarding is if it is emotionally fulfilling.
For example: The company Simple Green sells products that are environmentally safe and are great at cleaning. Working for them would feel comforting while making the big bucks.
Do you have any other suggestions?
Monday, February 8, 2010
Chronic Homelessness
What is the makings of homelessness? There are millions of people on the street, in transitional housing, in shelters, many live in their cars and sometimes live like this for years. Part of my job is interviewing the homeless who are in crisis, need medication, or simply need to make a connection with somebody. Today was no exception. A gentleman came in who had been living in a make shift camp for over ten years! When he told me his age I was shocked! He was a few months younger than me and looked fifteen years older!
Living on the street, abusing substances can take their toll. We see it at the crisis center on a daily basis. The common thread - no social support. In fact the social support system tends to get blown apart in the chronic population because social intimacy tends to be feared.
The stories seem to be the same. A tragedy in childhood. A death of a parent or caregiver. Abuse. Living in foster homes or group homes. Turning to substances for relief and suddenly they are 18 years old and out on their own. What can a person who is adult on the outside and an angry, abused kid on the inside do at this point? Many turn to drugs / alcohol, steal, go to jail - my client talked about numerous encarcerations. If work is found it is natural to feel judged, paranoid that people are plotting against them, and get in arguments with authority figures.
There are programs around the Los Angeles area for the homeless to go but going to shelters, and other facilities takes courage. Some are so crowded and so much violence happens around the area that many people avoid the care they require.
I admire facilities like "The Village" in downtown Long Beach because their first priority is giving each person the dignity they deserve. Dignity? For the homeless? Absolutely. You try living their life for one day. No home, no food, no social support. Many haven't eaten a hot meal for months! And bathing - that is a huge luxury. Anything that is valuable most likely will be taken from you. Everyday is a fight for survival.
My client survived by being angry and drinking. However his health was faultering and has to stop. Now add into the mix the cravings of the substance that is trying to kill you.
I was homeless for a weekend. Yes, that's right. I had lost my home, stayed with a friend who was the exact opposite of supportive. Let's just say when the going was bad this person loved to stab at wounds and turn the blade. So I decided to find a friend I knew in Hollywood who owed me money and I could crash on his couch for a month. Well, since he was not at home the first night, I camped out on his doorstep. I knew he would show up shortly then woke up in the morning in shock. The next night was the same until somebody woke me, asked me why I was there and ultimately told me my friend had been evicted.
Whether we are homeless or high functioning executives people are all the same. What makes us different is only in the mind. As a past girlfriend told me, "We are magical poofs of dust for a mere lifetime and then we are gone." We all eat, shit, bleed red, and then die. Period. All in a magical poof I guess. Circumstances create homelessness and the desire to just give up. Other circumstances can spark something deep inside somebody who has lost hope and lives in a cardboard box. My job is to do the latter.
Peace.
Living on the street, abusing substances can take their toll. We see it at the crisis center on a daily basis. The common thread - no social support. In fact the social support system tends to get blown apart in the chronic population because social intimacy tends to be feared.
The stories seem to be the same. A tragedy in childhood. A death of a parent or caregiver. Abuse. Living in foster homes or group homes. Turning to substances for relief and suddenly they are 18 years old and out on their own. What can a person who is adult on the outside and an angry, abused kid on the inside do at this point? Many turn to drugs / alcohol, steal, go to jail - my client talked about numerous encarcerations. If work is found it is natural to feel judged, paranoid that people are plotting against them, and get in arguments with authority figures.
There are programs around the Los Angeles area for the homeless to go but going to shelters, and other facilities takes courage. Some are so crowded and so much violence happens around the area that many people avoid the care they require.
I admire facilities like "The Village" in downtown Long Beach because their first priority is giving each person the dignity they deserve. Dignity? For the homeless? Absolutely. You try living their life for one day. No home, no food, no social support. Many haven't eaten a hot meal for months! And bathing - that is a huge luxury. Anything that is valuable most likely will be taken from you. Everyday is a fight for survival.
My client survived by being angry and drinking. However his health was faultering and has to stop. Now add into the mix the cravings of the substance that is trying to kill you.
I was homeless for a weekend. Yes, that's right. I had lost my home, stayed with a friend who was the exact opposite of supportive. Let's just say when the going was bad this person loved to stab at wounds and turn the blade. So I decided to find a friend I knew in Hollywood who owed me money and I could crash on his couch for a month. Well, since he was not at home the first night, I camped out on his doorstep. I knew he would show up shortly then woke up in the morning in shock. The next night was the same until somebody woke me, asked me why I was there and ultimately told me my friend had been evicted.
Whether we are homeless or high functioning executives people are all the same. What makes us different is only in the mind. As a past girlfriend told me, "We are magical poofs of dust for a mere lifetime and then we are gone." We all eat, shit, bleed red, and then die. Period. All in a magical poof I guess. Circumstances create homelessness and the desire to just give up. Other circumstances can spark something deep inside somebody who has lost hope and lives in a cardboard box. My job is to do the latter.
Peace.
Friday, February 5, 2010
High Anxiety
Have you ever been in the presence of a person in the midst of a panic attack? In a crisis setting we see people like this all the time. When our personal resources are unable to cope with a stressful situation the mind can become overwhelmed and our emotions plus body react. Shortness of breath, numbness, tightening of the chest, dizziness. Many people feel like they are having a heart attack!!
As a therapist the first order is to keep yourself centered. There is not much help we can provide if we rush around for a doctor or call 911. Though I admittently have done both. With experience it is easy to remain calm and talk to the part within the person that got triggered in the first place.
What causes panic? To Object Relations therapists, they believe mental illness begins with early childhood experiences. Most of the people who show up in our crisis center who suffer from panic have had horrific experiences in their youth. When we are small our mind hasn't fully wired till we reach eight years of age normally. Experiences on and before this period if not worked through in therapy can cause debilitating mental illness in later years.
What can somebody do in the midst of high anxiety?
The first thing is to keep breathing and relax the tense areas in your body. It is proven that relaxation is the number one antidote for anxiety. However this is only the starting point. There is a core issue that needs to be addressed. Talk to the afraid part by using a pillow to represent the freightened part within. Assure that part you will take care of him/her. Lastly ask questions within. Try to find out what the scared part inside of you needs in this very moment.
For more information self help books, counseling, and clergy can be a huge help.
Emotional panic can represent the feeling that there is no God and as a human being we feel alone and unable to handle life's difficulties. With God back in the mix all things are possible.
As a therapist the first order is to keep yourself centered. There is not much help we can provide if we rush around for a doctor or call 911. Though I admittently have done both. With experience it is easy to remain calm and talk to the part within the person that got triggered in the first place.
What causes panic? To Object Relations therapists, they believe mental illness begins with early childhood experiences. Most of the people who show up in our crisis center who suffer from panic have had horrific experiences in their youth. When we are small our mind hasn't fully wired till we reach eight years of age normally. Experiences on and before this period if not worked through in therapy can cause debilitating mental illness in later years.
What can somebody do in the midst of high anxiety?
The first thing is to keep breathing and relax the tense areas in your body. It is proven that relaxation is the number one antidote for anxiety. However this is only the starting point. There is a core issue that needs to be addressed. Talk to the afraid part by using a pillow to represent the freightened part within. Assure that part you will take care of him/her. Lastly ask questions within. Try to find out what the scared part inside of you needs in this very moment.
For more information self help books, counseling, and clergy can be a huge help.
Emotional panic can represent the feeling that there is no God and as a human being we feel alone and unable to handle life's difficulties. With God back in the mix all things are possible.
Thursday, February 4, 2010
Trauma Relief
Every once in a while I hear stories from clients that absolutely turn my stomach. I am a positive guy who sometimes lives in a rosie world where everybody is caring and loving towards each other, when I hear evidence of the contrary, my rosie bubble bursts.
A person came in who's parents did the unthinkable to her, and as a young adult was brutilized - I am trying to spare all the gorey details. For years she used drugs to keep the flashbacks away. Now sober all the memories are flooding back to her with one exception - the early abuse in her childhood.
The mind is an amazing thing. It tends to numb itself out during extraordinary times - especially when the brain is maturing. It is normal for those who suffered abuse in their early years to blank it out of memory to a certain extent. Another client today told me on their 18th birthday, memories of abuse surfaced and his mental illness began.
What can a person do when they suffered horrible abuse? For this particular person it had only been drug abuse and psychiatric medication. As I went step by step on what he/she needed to do I was met with amazement! They couldn't believe that somebody took the time to explain the dynamics of mental illness and the steps on how to heal.
There are wonderful therapies created to handle trauma. The brief therapy model was created at the end of world war II for the thousands of veterans returning from war. Object Relations and Gestalt therapies are targeted for emotional work. My speciality is Spiritual Psychology in which Love becomes the ultimate healing force. "When Love is applied to our hurt, we heal."
Check out "Crisis Management: Step by Step" on Amazon.com a book written by myself. It breaks down the steps to trauma relief.
As for the two patients I met with today, they had renewed hope and left with a smile.
A person came in who's parents did the unthinkable to her, and as a young adult was brutilized - I am trying to spare all the gorey details. For years she used drugs to keep the flashbacks away. Now sober all the memories are flooding back to her with one exception - the early abuse in her childhood.
The mind is an amazing thing. It tends to numb itself out during extraordinary times - especially when the brain is maturing. It is normal for those who suffered abuse in their early years to blank it out of memory to a certain extent. Another client today told me on their 18th birthday, memories of abuse surfaced and his mental illness began.
What can a person do when they suffered horrible abuse? For this particular person it had only been drug abuse and psychiatric medication. As I went step by step on what he/she needed to do I was met with amazement! They couldn't believe that somebody took the time to explain the dynamics of mental illness and the steps on how to heal.
There are wonderful therapies created to handle trauma. The brief therapy model was created at the end of world war II for the thousands of veterans returning from war. Object Relations and Gestalt therapies are targeted for emotional work. My speciality is Spiritual Psychology in which Love becomes the ultimate healing force. "When Love is applied to our hurt, we heal."
Check out "Crisis Management: Step by Step" on Amazon.com a book written by myself. It breaks down the steps to trauma relief.
As for the two patients I met with today, they had renewed hope and left with a smile.
Wednesday, February 3, 2010
Insurance Reinbursements
I have a private practice and for years have only accepted payment by cash or check. Not wanting to weave through the paperwork and the red tape of insurance companies and the state government - in regards to Medical.
I had a crafty one today. A former cash client called me excited that she could continue our sessions now that she has MHN insurance. Looking up this unknown insurance plan I found out it was a medical HMO insurance that reinburses doctors around $13.00 a session. Well let me see... I see a client for an hour which includes drive time to the office and back, paperwork that takes maybe 15 minutes and storage of the file, not to mention the telephone time to schedule appointments, contact my insurance biller, so let's say for two hours I'd make an amazing $6.00 an hour.
I am a Doctor. I went into this business, of course to help people out, but it doesn't mean not helping myself out in the process. How do therapists survive on these piddly wages? This is a crime. Perhaps if I gathered all the clients I could at one time and create a seminar for an hour and see maybe fifty people at a time I might survive the Medical HMO route. That is only if I could photocopy notes, keep them generic, but knowing me I'd be detailed as hell and still make $6.00 an hour or less.
Too bad. The population that needs my help the most can't afford my services. In school that told me it would be important to offer my services to people that can't afford to pay as a way to give back to the greater society. That sounded great on paper to me, but after I pay all my bills at the end of the month and barely can afford to feed my family, I need to ask myself if I need to put mentally ill people ahead of my own family. There has to be a way that we can take care of the population that needs the services I can offer.
The county of Los Angeles does have numerous Mental Health Offices to care for the needs of people with debilitating mental illness. This is great and I work with many of them on a given day. It is the people that don't quite fit their criteria that want help but have to pay for it out of pocket that is a concern. Do I charge ten dollars for an auditorium filled with these people? Maybe. But insurance and the hoops and fences I have to hop through are now a detriment.
I had a crafty one today. A former cash client called me excited that she could continue our sessions now that she has MHN insurance. Looking up this unknown insurance plan I found out it was a medical HMO insurance that reinburses doctors around $13.00 a session. Well let me see... I see a client for an hour which includes drive time to the office and back, paperwork that takes maybe 15 minutes and storage of the file, not to mention the telephone time to schedule appointments, contact my insurance biller, so let's say for two hours I'd make an amazing $6.00 an hour.
I am a Doctor. I went into this business, of course to help people out, but it doesn't mean not helping myself out in the process. How do therapists survive on these piddly wages? This is a crime. Perhaps if I gathered all the clients I could at one time and create a seminar for an hour and see maybe fifty people at a time I might survive the Medical HMO route. That is only if I could photocopy notes, keep them generic, but knowing me I'd be detailed as hell and still make $6.00 an hour or less.
Too bad. The population that needs my help the most can't afford my services. In school that told me it would be important to offer my services to people that can't afford to pay as a way to give back to the greater society. That sounded great on paper to me, but after I pay all my bills at the end of the month and barely can afford to feed my family, I need to ask myself if I need to put mentally ill people ahead of my own family. There has to be a way that we can take care of the population that needs the services I can offer.
The county of Los Angeles does have numerous Mental Health Offices to care for the needs of people with debilitating mental illness. This is great and I work with many of them on a given day. It is the people that don't quite fit their criteria that want help but have to pay for it out of pocket that is a concern. Do I charge ten dollars for an auditorium filled with these people? Maybe. But insurance and the hoops and fences I have to hop through are now a detriment.
Tuesday, February 2, 2010
Slipping through the Cracks
The other day a woman in her forties came in for treatment for the very first time. She had avoided the voices in her head, the visions she was seeing, and the extreme paranoia that dominated her day. She hid in her house, felt the FBI was keeping close watch on her, but this didn't send her scurrying to treatment - not able to sleep at night did. Is this uncommon? Not really.
Every year I see four to five of these individuals who slip through the cracks. They can function just enough, their support system gets used to their being sick, and they live in turmoil avoiding the treatment they desperately need. So they get used to the voices and the visions. Even the paranoia is a familiar friend. This is their normal. When does their normal affect the greater society? Is when they become dangerous to themselves or others, or are gravely disabled.
"The voices are now keeping me up at night. Why can't they stop?"
Many voices tell people to do bad things, named command hallucinations. It is not unlikely for command hallucinations tell people to steal, stab, or run into oncomming traffic.
I got quite an education when I began working here eight years ago. I had learned about psychosis in graduate school. In real life there is a real person, with real feelings, compassion, and a willingness to change for the better. In putting a face on mental illness it is easy to find compassion for the person upset and yelling at an invisable person next to them.
How did this person avoid treating the malady she has endured since her teen years? Fear of the unknown perhaps. Would you take a pill from somebody at a government facility if you felt the government was plotting against you? Sad but true. Mental illness is difficult for the average person feeling "Down in the dumps". This woman was at the other end of the spectrum, so wracked with internal abuse that her time had come for change. She had reached her bottom.
For drug and alcohol abusers hitting bottom refers to getting to such a low place in life, the only way to go is back up. This is when treatment becomes successful, people get motivated to change, and positives suddenly show up in their lives.
We gave her some medication and observed her reaction to it. A small grin could be seen on her face as she left our facility. A whole new world awaited her. My prayer is she continues to react favorly to the medicine and keeps her regular appointments with the mental health facility we referred her to.
Every year I see four to five of these individuals who slip through the cracks. They can function just enough, their support system gets used to their being sick, and they live in turmoil avoiding the treatment they desperately need. So they get used to the voices and the visions. Even the paranoia is a familiar friend. This is their normal. When does their normal affect the greater society? Is when they become dangerous to themselves or others, or are gravely disabled.
"The voices are now keeping me up at night. Why can't they stop?"
Many voices tell people to do bad things, named command hallucinations. It is not unlikely for command hallucinations tell people to steal, stab, or run into oncomming traffic.
I got quite an education when I began working here eight years ago. I had learned about psychosis in graduate school. In real life there is a real person, with real feelings, compassion, and a willingness to change for the better. In putting a face on mental illness it is easy to find compassion for the person upset and yelling at an invisable person next to them.
How did this person avoid treating the malady she has endured since her teen years? Fear of the unknown perhaps. Would you take a pill from somebody at a government facility if you felt the government was plotting against you? Sad but true. Mental illness is difficult for the average person feeling "Down in the dumps". This woman was at the other end of the spectrum, so wracked with internal abuse that her time had come for change. She had reached her bottom.
For drug and alcohol abusers hitting bottom refers to getting to such a low place in life, the only way to go is back up. This is when treatment becomes successful, people get motivated to change, and positives suddenly show up in their lives.
We gave her some medication and observed her reaction to it. A small grin could be seen on her face as she left our facility. A whole new world awaited her. My prayer is she continues to react favorly to the medicine and keeps her regular appointments with the mental health facility we referred her to.
Monday, February 1, 2010
Pros and Cons of Psychiatric Medication
On a daily basis, people who are in a crisis have an interesting dilema - do they take psychiatric medication or control their symptoms through alternative methods. This is a major issue for people who are psychotic and don't trust medication, people, or even themselves. Plus the voices in their head are screaming at them to get away and never return!!!
If you had a choice would you take medication never taking it before? How do we avoid the use of medication anyway? Well if you had the perfect diet, used the perfect nutritional and/or herbal suppliments, had eight hours of restful and energizing sleep, and kept this routine everyday - this would lower your need for medication if you were on the cusp. For many with debilitating anxiety, depression, mood swings, and psychosis medication is the only alternative.
Many people believe on the other hand believe medication is the only way to treat mental illness. These people laugh at counseling, think working through emotional scars of the past is something ridiculous! Why open up old wounds when they are neatly covered up by psychiatric medication? But are they? Do you yell at the kids? Kick the dog? Do you get into road rage? Monks are well known abusers of their students. If we don't pay attention to our core issues, they have a way of gaining our attention through interesting means.
For optimum mental health, we recommend a multilayered approach that addresses the Physical, Mental, Emotional, and Spiritual aspects.
Physical: Take suppliments, exercise, get adequate sleep/rest
Mental: Turn negatives into positives. As Monty Python would say: "Look at the Bright side of life.
Emotional: Address core issues with gentleness and compassion.
Spiritual: Nurture a bond with the God of your understanding.
If you had a heart ailment, wouldn't you take heart medicine? Diabetics have to take insulin on a daily basis. Mental illness is often a brain ailment that can only be stablized with proper medication. The key is having a psychiatric evaluation to see if you need medication in the first place. If therapy is recommended you may want to try that route first. If you are debilitated and need a little bit of a jump start, Psychiatric medication may be the first step towards symptom relief.
If you had a choice would you take medication never taking it before? How do we avoid the use of medication anyway? Well if you had the perfect diet, used the perfect nutritional and/or herbal suppliments, had eight hours of restful and energizing sleep, and kept this routine everyday - this would lower your need for medication if you were on the cusp. For many with debilitating anxiety, depression, mood swings, and psychosis medication is the only alternative.
Many people believe on the other hand believe medication is the only way to treat mental illness. These people laugh at counseling, think working through emotional scars of the past is something ridiculous! Why open up old wounds when they are neatly covered up by psychiatric medication? But are they? Do you yell at the kids? Kick the dog? Do you get into road rage? Monks are well known abusers of their students. If we don't pay attention to our core issues, they have a way of gaining our attention through interesting means.
For optimum mental health, we recommend a multilayered approach that addresses the Physical, Mental, Emotional, and Spiritual aspects.
Physical: Take suppliments, exercise, get adequate sleep/rest
Mental: Turn negatives into positives. As Monty Python would say: "Look at the Bright side of life.
Emotional: Address core issues with gentleness and compassion.
Spiritual: Nurture a bond with the God of your understanding.
If you had a heart ailment, wouldn't you take heart medicine? Diabetics have to take insulin on a daily basis. Mental illness is often a brain ailment that can only be stablized with proper medication. The key is having a psychiatric evaluation to see if you need medication in the first place. If therapy is recommended you may want to try that route first. If you are debilitated and need a little bit of a jump start, Psychiatric medication may be the first step towards symptom relief.
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