Markham's Behavioral Health

Will They Ever Trust Us Again?, the book

Will They Ever Trust Us Again: Letters From The War Zone by Michael Moore is a book of letters from soldiers in Iraq, from other US soldiers around the world, from US veterans, and from family and friends at home.

In postmodern philosophy there are jargon phrases such as "dominant discourse" and "local knowledge". This is a book of "local knowledge". The letters will break your heart.

I doubt this book will change any minds about the United States foreign policy of the Bush Administration. Those who support the President's policy will continue to support it and those that oppose it will be strenghtened in their opposition.

This is a book for future generations who will question what the heck the nation was thinking after 9/11. It is what Alice Miller, a Swiss Psychoanalyst who specializies in working with adults abused as children, calls an "enlightened witness." This book provides the witness that not only is war evil, but that the current Iraqui war is more evil than past wars because it was pre-emptive, based on lies, and was unnecessary.

While Bush claims that he is a Christian and that God talks to him, his policy flies in the face of centuries of Just War theory, and has been roundly condemned by the leader of the Christian Church, Pope John Paul II. While the Christian witness against the war has been marginalized, it is there if one cares to look and listen.

To hear the voices of soldiers who believe that they were misled, manipulated, lied to, and put into harm's way for less than noble causes is distressing and saddening. It also may become infuriating if the reader reflects on the unnecessary pain that is apparent in the letter writers' stories.

If you have the stomach for it, I recommend this book.

Stevie, the film

Stevie, released in 2002, is a documentary about the life of Stevie Fielding a troubled boy and man that Steve James, the director and producer of this film, mentored as a big brother back in the 80s.

After not seeing Stevie for about 10 years, Steve James tracks him down to find out what happened to the boy who is now a man at age 25. Turns out that Stevie is still a boy in a man's body and he has continued to get into a lot of trouble. The film takes an intimate look at Stevie and his family, his friends, the town he lives in. Unfortunately his life is all too familiar to us who work in mental health and criminal justice. There are hundreds of thousands of Stevie's in America. There are fewer big brothers like Steve James or foster parents like the foster parents that Stevie had for a few years in a residential treatment setting.

The creative tension is this documentary comes from the fact that you really get to know these people and can identify with their struggles. I even came to like Stevie Fielding even though he scares me when he is out of control. In the long run society lets him and us down. There are better programs to deal with people like Stevie Fielding other than incarceration. Some aggressive community treatment, or a mental health court might have helped Stevie as well as protected the community. There is a painful grief for all concerned when Stevie goes into prison knowing that no one's interests are being served.

I found this film quite poignant at times as these people struggle to cope with problems and issues they cannot name.

I highly recommend this film.

Stevie (2002)

Devil's Playground, the film

Devil's Playground is a very interesting documentary released in 2002 and directed by Lucy Walker about Amish teenagers. I never knew before that when an Amish adolescent reaches 16, he/she is set free to explore the world of the "English". They can leave home, dress in contemporary dress, drink, drug, have sex, party, and when they are ready, decide if they want to join the Amish church or not. This period of discernment and vision quest is called "rumspringa". It is a rite of passage during which a young person is allowed to explore the material world to determine whether they prefer to live in the world or the world of God.

"They live in a strict society, under tight control of their family and close-knit community. But when they turn 16, Amish teenagers are allowed the freedom to explore the customs of the outside "English" world -- including alcohol, drugs and sex -- before deciding whether to join the Amish church for life or leave the community altogether.

This tumultuous period, which the Amish call rumspringa -- the Pennsylvania Dutch word for "running around" -- is the focus of Devil's Playground, a documentary by filmmaker Lucy Walker, which premiers Thursday night on Cinemax.

"They can go to the mall, they can stay out all weekend long. There's no curfew," Walker tells Morning Edition host Bob Edwards. "Their parents are going to turn a blind eye to all kinds of stuff."

In making her documentary, Walker says she was shocked to find hundreds of teens from Amish settlements in 10 states congregating in "barn hops" and "hoedowns". "They all come together and there will be three fields filled with cars and horse and buggies... and these barns crammed with very drunk teenagers."

I highly recommend this film.

For an NPR review of this film click here.

Other components boost nicotine's effects

People in the sciences and the substance abuse field have known for years that tobacco companies add things to their tobacco mixture to make them more addictive and mood altering and thereby increasing appeal and dependence.

I have had people come out of rehab and tell me that their first cigarette was a bigger rush than any crack cocaine they ever smoked.

In the online journal, Neuropsychopharmacology there is a report that it is acetaldehyde that combines with nicotine that makes nicotine so addicting. This combination of acetabldehyde and nicotine is much more addicting than nicotine alone.

"Researchers report a chemical in tobacco smoke enhances the addictive properties of nicotine and teens are most vulnerable to the chemical combination.

Scientists doing animal studies were surprised to discover that nicotine by itself was not that addictive. However, when combined with acetaldehyde, one of the main chemical components of tobacco smoke, they found its addictiveness was increased."

MedlinePlus: Other components boost nicotine's effects

Quote of the day

I believe it was Hillary Clinton who said something like "Kerry changes his positions to fit the facts and Bush changes the facts to fit his positions." Kerry is called a flip flopper, and the other a delusional meglomaniac. Who do you want for President of the United States, a man of reasoned judgment or a mad man? You get to decide on election day. May God help us all.

Harry Holleywood

Quote of the day

"America is great because America is good, and it America ever ceases to be good, America will cease to be great."

Alexis de Tocqueville

How is the mental health of the people in your state?

How would you answer the following question? "How many days in the last month was your mental health not good?"

The people doing this survey counted the number of people in each state who said that they had at least one bad mental health day in the last 30.

Interestingly, 34% of people in the United States said that they had at least one bad mental health day in the last month.

Now click below and go to the Kaiser Family web site and see how people in your state did. In New York State where I live, 35% of people said they had a bad mental health day in the last month.

The state with the worse percentage was Utah with 43% and the best was Hawaii with 16%.

So what does this data tell you? I'm not sure. I think a sense of well being is probably a cultural thing to some extent influenced by many factors. It looks like most people in Hawaii feel that life is good. However, I have an article on this blog which deals with the fact that Hawaii has one of the highest crystal meth epidemics in the nation.

I welcome you comments.

Kaiser statehealthfacts.org: 50 State Comparisons: Percent Reporting Poor Mental Health during the Past Thirty Days, 2001

Quote of the day

"He that ruleth his spirit is greater than he that taketh a city."

Proverbs 16:32

Delusions and denial of fundamentalist Christians

There is an interesting article on North Coast Cafe entitled, "By Jove!, I think they've (finally)got it" posted on October 27, 2004 referencing an article in the LA Times which reports that many Evangelical Christians are finally admitting the contradictions in their beliefs such as being against abortion but for war. Another troubling contradiction is Jesus' commitment to the poor, and George Bush's tax cuts for the wealthiest of Americans while poorer people are loosing their jobs and health insurance.

It has troubled me for some time that people who profess to be more fundamentalist in their religious and political views seem to be unable to deal with facts that don't support their views. They seem to become even more vehement and repeat the expression of their views as if their certainty and the intensity of their belief was going to change reality. In the mental health field we call this fixed false belief a delusion, and in the substance abuse field we call it denial.

Now, I am not going to say that all fundamentalist, evangelical Christians are mentally ill, but there are times when I listen to their rhetoric that I worry about their mental health. It gives me hope that there seems to be a growing number of these folks who are seeing and admitting the incongruency of their beliefs. This is a healthy thing not only for the individuals and their churches but for our society.

I want to end this article by saying that I love Jesus and consider myself a Christian which makes it even more difficult for me to listen to some of the rhetoric coming from these people from the President on down. Follow the link to the North Coast Cafe and then to the LA Times article if you are interested.

Behavior Therapy Helps Kids with Mental Disorder

112 kids aged 7 - 17 were involved in a study for the treatment of OCD, Obsessive Complusive Disorder. As I have been saying for a long time on this blog, psychotherapy works, and psychotherapy combined with an SSRI like Zoloft seemed to get the best results in this small group. However, when psychotherapy alone or Zoloft alone were compared, it appears that psychotherapy alone gets the better outcomes.

The participants were randomly assigned to cognitive-behavior therapy (CBT) alone, Zoloft alone, CBT plus Zoloft, or inactive placebo treatment.

Eighty-seven percent of subjects completed the full 12 weeks of treatment, which shows that the active treatments were well accepted and tolerated, March and colleagues note in their report.

Children treated with CBT alone or with sertraline were substantially more likely to have an improvement in OCD symptoms, the team found, with some evidence that the combination had a slight edge.

"Sertraline alone proved statistically superior to placebo, confirming the efficacy of medication used to treat OCD in youth," they add.

However, CBT alone was more effective than Zoloft alone.

March's team concludes that the treatment of children and adolescents with obsessive-compulsive disorder should begin with the combination of cognitive-behavior therapy and a selective serotonin reuptake inhibitor, or CBT alone.

The report of this study appears in the October 27, 2004 issue of the Journal of the American Medical Association (JAMA)

MedlinePlus: Behavior Therapy Helps Kids with Mental Disorder