Markham's Behavioral Health

Confidence: Finding It and Living It by Barb DeAngelis

Confidence: Finding It and Living It by Barb DeAngelis is one of those self help books which always strike me as little schlocky. By schlocky I mean that the author takes some idea and then beats it to death for 300 pages and then charges the book buyer $8.95 or whatever to read the idea restated about 20 different times with tons of anecdotes thrown in to exemplify the point.

Barb DeAngelis keeps it fairly short as she redefines "confidence" as perserverence. She says that confidence is not based on the ability to do something but rather in the determination and committment to keep trying to do something. Cute, huh?

With her redefinition she says anybody can have confidence immediately. All you have to do is determine how bad you want something to happen, and to be willing to talk yourself into pursuing the goal no matter what and being willing to figure out how to achieve the goal as you go along.

I must admit I like her definition and it reminds me of one of the components of Emotional Intelligence as Daniel Goleman defines it in his book by the same name, perserverence. It seems that people who are "emotionally intelligent" and who become successful in life have the capacity to perservere in the face of obstacles until they achieve their goal.

Dr. DeAngelis's book is worth the read I think.

What You Can Change and What You Can't by Martin E. P. Seligman

What You Can Change and What You Can't by Martin E. P. Seligman is one of those rare self help books that are really helpful. He reviews the "nature/nurture" concept and points out that there are certain human problems which appear to be more nature than nurture and to try to change those things about yourself will drive you nuts because you probably will fail. On the other hand, there are human problems which we probably can change and it would be worthwhile to learn ways to do it.

Seligman deals with problems such as anxiety, depression, weight, sexual problems etc.

I liked this book which is ten years old, but still worth reading.

Quote of the day

"The only difference between sex and death is, with death you can do it alone and nobody's going to make fun of you."

Woody Allen

Multiple Mental Disorders Common in Detained Youths

The idea that kids in trouble with the law have psychiatric problems is not new. Over the last 30 years we have seen the criminalization of mental health problems in adults as well as in youth.

Here is more evidence in a study reported in the November, 2003, issue of the Archives of General Psychiatry done by Dr. Karen Abram of Northwestern University where 1829 detainees between the ages of 10 and 18 in the Cook County, Illinois Juvenile Detention Center were screened for behavioral health problems. 50% of the kids had at least one diagnosable behaviorl health disorder and a very high percentage had at least two.

"Previous studies have shown that up to 70 percent of youthful detainees have at least one psychiatric disorder, a much higher rate than that seen in the general population. This could mean that many young people may get into trouble as a result of a poorly treated mental health problem, Abram noted.

"There really is an amazing dearth of mental health services, and there certainly is a dearth of quality mental health services" available to young people, she said. "

When these kids are released from Juvenile Hall there are bound to be more problems unless their mental health problems are treated. But there is no treatment available in most instances. Those services have been cut by legislators at the county, state, and federal level. As a society we seem to favor criminal justice approaches to these problems rather than mental health approaches even though providing behavioral health services is much more cost effective and gets better results.

MEDLINEplus: Multiple Mental Disorders Common in Detained Youths

Quote of the day

"Life is not the way it's suppose to be. It's the way it is. The way you cope with it is what makes the difference."

Virginia Satir

Quote of the day

"Giving thanks is the purest form of prayer."

David G. Markham

Quote of the day

"Life is like a ten speed bike. Most of us have gears we never use."

Charles Schulz

Life and Debt, the film

Life and Debt is a documentary distributed in 2001 about the effect the the Intenational Monetary Fund, IMF, policies on the economy of Jamaica.

"This is the Jamaica the tourists see, says the narrator in Stephanie Black's documentary Life and Debt, a country of lush jungles, clear blue water, and sandy beaches. Beyond the luxury hotels, however, is a third world country fighting poverty, crime, and hopelessness. Based on the novel by Jamaica Kincaid A Small Place, Life and Debt, the film studies the effects of the policies of the International Monetary Fund (IMF) and the World Bank on the economy of Jamaica, focusing on the impact of economic globalization on the dairy farmers and factory workers. Backed by a soundtrack of native reggae music, Life and Debt is filled with economic facts that require some knowledge to fully understand. You don't need a master's degree in Economics, however, to understand the desperate faces of children in poverty, the agony of farmers who can't sell their crops, or the hopelessness of factory workers who earn the equivalent of thirty US dollars per week.

Black interviews former Prime Minister Michael Manley who explains how the current situation came to be. When Jamaica achieved its independence in 1962 after being a colony of Great Britain for 400 years, help was needed to build its economy. The International Monetary Fund (IMF) and the World Bank gladly supplied this money in the form of short-term loans. These loans though came with strings attached. Subsidies to local farmers were prohibited and tariff barriers were lowered to allow cheap foreign goods to come into the country, inevitably driving local industries out of business. What's remains is tourism, sweatshops and fast-food chains. Manley blames the big Western powers that have used Jamaica for cheap labor and easy sales. For example, thanks to huge subsidies other countries including the United States exported powdered milk to Jamaica at an excessively low price, forcing the local dairy industry to shut down. He also points out that big American businesses like Chiquita, Dole, and Del Monte have worked to stifle exports of local Jamaican bananas. Manley asks of the IMF, "You ask, 'In who's interest? I ask, 'Who set it up?"

Part of the conservative lie is the belief in "personal responsibility" and that life should be lived by the philosophy of every person for himself. Human welfare is simply a matter of markets and capital, and those markets are best left free and self regulating. However, policies about free markets get made by people and these people often make policies that are in their best interests, and less powerful people have little influence in how the game is played. It is little wonder then, when poorer and less powerful people loose.

Our mental health, our sense of well being, is very much influenced by the environment in which we function. Being able to influence our environment is an important aspect of good mental health. As this documentary shows, policies which force farmers to dump their dairy milk because milk powder can be imported from foreign countries cheaper, and workers being paid $30.00 per week for textile piece work and when they protest their working conditions their employment is taken away, leads to frustration and violence.

Perhaps we will get to a point of social evolution where we can develop policies which take the human costs into account and not merely the financial gain.

When Gandhi was asked what he thought of Western Civilization he said it might be a good idea for us to try.

I recommend this film if you are interested in how social policies at a macro level influence mental health of populations at a clinical level.

Life and Debt (2001)

Disorganization, poor time management skills, inability to plan may be "executive functioning deficits" brought about by brain dysfunction

"Children with attention-deficit/hyperactivity disorder (ADHD) often do poorly in school because they are disorganized, can’t manage their time, and fail to plan.

Researchers have found that many of these children have deficits in executive functioning. "This is a system in the brain that is responsible for managing processes that are needed to problem solve and attain future goals," according to principal investigator Joseph Biederman, M.D."

I always thought that disorganization, inability to set and pursue goals, and managing time well could be symptoms of Attention Deficit Disorder but this study seems to imply that utilization of "executive functions" may be above and beyond ADD.

Learning how to set goals, organize their work and projects, and manage their time are skills that every human being needs to learn. The fact that some people seem to have a harder time learning these skills seems obvious for people who work with children like teachers, coaches, and parents. The idea that these capabilities are located somewhere in the brain and that brain dysfunction may contribute to difficulties in learning these skills is an interesting idea.

We know that the brain is a very resilient organ and it remains to be seen as we learn more about this what kinds of "treatment" might be recommended if we were to enhance these functions. It would seem that a biochemical approach might be suggested as well as behavioral approaches, and, of course, both.

The important point for the time being might be that these difficulties are not misbehavior, but a problem with brain functioning.

Psychiatric News -- Lehmann 38 (22): 25-a

The Experiment, the film

This is a German movie with English subtitles distributed in 2001.

"The movie is based on the infamous "Stanford Prison Experiment" conducted in 1971. A makeshift prison is set up in a research lab, complete with cells, bars and surveillance cameras. For two weeks 20 male participants are hired to play prisoners and guards. The 'prisoners' are locked up and have to follow seemingly mild rules, and the 'guards' are told simply to retain order without using physical violence. Everybody is free to quit at any time, thereby forfeiting payment. In the beginning the mood between both groups is insecure and rather emphatic. But soon quarrels arise and the wardens employ ever more drastic sanctions to confirm their authority."

The experiment reminded me of the Stanley Millgram experiements done in the early 60s where subjects gave electric shocks to "students" under the supervision of "researchers" to understand the role of punishment in learning. The subjects gave increasingly large dosages of shock when coerced by the "researchers" because of their perception of the "authority" of the "researcher". This study is very reminiscent of the Germans who participated in the holocaust because they were "under orders".

This movie demonstrates the dynamics that ensue when some people are assigned as guards and other people are assigned the role of prisoner. It strikes me somewhat as an adult version of the Lord Of The Flies.
It is quite disturbing to see the lengths that people will go to in order to be in control and to be "right". In an adversarial situation this can escalate up to and including death. The will for dominance/freedom may be more of determining factor in human relations than our will for harmony, cooperation, and peaceful coexistance.

This movie is not "out there" science fiction. It is very believable and seems realistic. If you are interested in human nature, I highly recommend it.

Experiment, Das (2001)