Markham's Behavioral Health

Unproven therapies used on traumatized kids

Reuters reported on September 9, 2008 on a CDC report which will appear in the American Journal of Preventive Medicine that a lot of therapies provided to kids with PTSD are not proven. Here is a snippet from the article:

Many doctors and therapists use unproven approaches such as drugs, art or play therapy on children suffering trauma when old-fashioned talk therapy has been shown to work, a report released on Tuesday said.

A review of a dozen different studies showed no evidence that alternative therapies helped children traumatized by violence or abuse, even though more than 75 percent of U.S. mental health professionals who treat children and teens with post traumatic stress disorder may use them.

But cognitive therapy -- a type of talk therapy aimed at changing negative thoughts -- does work, the group at the U.S. Centers for Disease Control and Prevention said.

"The good news is there is substantial research showing the effectiveness of group or individual cognitive behavioral therapy in treating children and teens experiencing the psychological effects of trauma," the CDC's Robert Hahn, who led the study, said in a statement.

"We hope these findings will encourage clinicians to use the therapies that are shown to be effective."

Children can be traumatized by many things including physical or sexual abuse, witnessing domestic violence, community violence or natural disasters.

In my office, I use cognitive based therapy and, when relevant, include parents and/or caretakers in on the sessions. I find that children and adolescents usually do very well. I am chagrined to hear about the play therapies, sand tables, EMDR, and other things my colleagues are doing with kids which they usually learned at some workshop and now have become born again disciples of the technique. I have often wondered, as the research report above suggests, why they didn't take a workshop and learn how to do therapy that works instead of the latest fad? Like many things in life we are enamored with the new, the novel, the gimicky approach which promises quick and almost miraculous success.

I find it increasingly difficult to find good therapists to refer people to. The mananged care system and the atrophy of the community mental health centers have made it difficult for young therapists to find adequate training environments.

MedlinePlus: Unproven therapies used on traumatized kids -study.

The collective unconscious and net neutrality- the connection

Andrew Boyd in his book, Daily Afflictions, defines "The Collective Unconscious"  this way: "An unspoken, consensual hallucination of social order that permits the individual to mask any responsibility he or she might feel for government wrongdoing or social ills in a web of numbed-out apathy and mass denial." p.91

Having read Rick Shenkman's book, Just How Stupid Are We?, I have thought a great deal about what is wrong with "We, The People". I am coming to the conclusion that we are not stupid in the intellectual sense although there is plenty of evidence that we are, but rather than we are unaware as a people and that, in this age, is causing great problems.

The problem that The People face is not an intellectual one but rather a psychological and spiritual one.

In a sense, Americans have been brainwashed and we are in denial because of the soporific effect of our materialism and greed. Because of materialism and greed we are willing to allow Wal Mart to come into our communities and destroy our local economies, we are willing to destroy the planet driving gas gussling vehicles, we are willing to discard tons of plastics and garbage that pollute our lands and seas, we are willing to let our children become obese and narcissistic in ways that would leave their grandparents and great grandparents horrified, we are willing to elect leaders who promise us the moon and then wreak havoc on the world for spurious reasons while forcing us and future generations to pay for their exploitive policies.

The collective unconscious allows us to continue to live in a delusional world that becomes increasingly dysfunctional because of the collusion of political and corporate power used to keep Americans anesthetized on cheap material goods, fast food, and entertainment.

There are pockets of awareness but no social institutions which nurture it except perhaps blogs on the Internet. Net neutrality is a huge issue upon which the future of the soul of America is based. Without the Internet, the information, encouragement, and inspiration for we The People to become conscious is severely constrained.

One of the most important campaign issues for 2008 is net neutrality. Let's bring this issue to the fore for once and for all. The soul of America depends on the net staying free. It is the hope of awakening the slumbering masses who have been sedated by shopping.

Video well worth watching lasts 10:24

Catholic church has got it wrong on birth control - catholic critics ask pope to lift contraception ban

Yahoo News, using a piece from Reuters, reports on July 25, 2008, about a paid advertisement in a major Italian newspaper placed by 50 Catholic organizations to lift the Vatican's ban on birth control. Here is a snippet from the article:

More than 50 dissident Catholic groups published an unusually frank open letter to Pope Benedict on Friday saying the Church's ban on contraception has been "catastrophic" and urging him to lift it.

The letter was published as a paid half-page advertisement in Corriere della Sera, Italy's largest newspaper, on the 40th anniversary of the late Pope Paul VI's controversial encyclical "Humanae Vitae," which enshrined the ban.

While criticism of the Vatican and its views is fairly common in articles and editorials in Italian newspapers, it is unusual for a group to take out paid advertising against the pope, particularly in a large-circulation mainstream newspaper.

The letter, written in Italian, said the Church's anti-contraception policy "has had a catastrophic impact on the poor and powerless around the world, endangering women's lives and leaving millions at risk of HIV."

Of course, changing the teaching is long overdue. The church has been wrong about this teaching for decades since Humanae Vitae, the encyclical in the 60s by Paul VI, that started the controversy and dissent by the laity. Since that time the church has lost credibility and the faith of the people it professes to lead.

How about considering the standard discernment question, What Would Jesus Do? I think Jesus would fully support the use of birth control.

Print Story: Catholic critics ask pope to lift contraception ban on Yahoo! News.

Pennsylvania Injuries Rise After Repeal of Helmet Law

I have argued this point with various people over the last few years that motorcyle helmets and bicycle helmets save lives and traumatic brain injuries. Only 20 states require motorcyle helmets, New York where I live, being one of them. Two years ago, Pennsylvania stupidly rescinded its helmet law and guess what? Right. Head injuries and deaths have gone up dramatically. Here is a snippet from the June 11, 2008 Reuters HealthDay article based on an article which will appear in the August issue of the American Journal of Public Health:

In the two years after Pennsylvania repealed its universal motorcycle helmet law, there was a 32 percent increase in motorcyclist head injury deaths and a 42 percent increase in head injury-related hospitalizations, a University of Pittsburgh study says.

The state's universal helmet law was repealed in 2003. Currently, only riders under age 21 and those with less than two years' experience who haven't taken a safety course are required to wear helmets.

The researchers analyzed data from the state's health and transportation departments for the years 2001-02 and 2004-05 and found helmet use by motorcyclists involved in reported crashes decreased from 82 percent to 58 percent in the two years after the helmet law was repealed.

While the head injury death rate increased by 32 percent, there was no increase in the non-head injury death rate.

Along with the 42 percent increase in head injury-related hospitalizations after the repeal of the helmet law, there was an 87 percent increase in the number of head-injured, hospitalized motorcyclists who required further care at facilities specializing in rehabilitation and long-term care.

Total acute care hospital charges for motorcycle-related head injuries increased 132 percent in the two years after repeal of the law, the study found.

I was talking to a young 16 year old client of mine who is a true libertarian and who advocates for goverment to stay out of people's lives and let people to do as many stupid things as they like such as drink alcohol, drug, have promiscuous sex, ride motorcyles helmet free, etc. His point is that it would be an exercise in social darwinism, that is, the stupid will die young and not reproduce. In a way I think he has a point. It could be that New Yorkers are a little smarter when it comes to public health than Pennsylvanians. Certainly our auto insurance and health insurance companies prosper while Pennsylvanian insurance companies are paying the price of stupidity as well as individuals and their families.

MedlinePlus: Pennsylvania Injuries Rise After Repeal of Helmet Law.

McCain gets it wrong on birth control

Many insurance companies cover prescriptions for Vigara but not for birth control. John McCain doesn't know what he thinks about the issue, needs to check with his handlers, before he takes a position.

This is not a difficult issue. Birth control definitely should be covered by health insurance. It clearly is in the patient's interest and society's interest for people to be able to control their fertility. McCain gets it wrong.

Video lasts 2:14

Pharmaceutical companies disease monger to detriment of society

Catherine Arnst had an interesting article published in the May 8, 2006 issue of Business Week entitled "Hey, You Don't Look So Good: As Diagnoses Of Once-Rare Illnesses Soar, Doctors Say Drugmakers Are 'Disease Mongering' To Boost Sales".

Here is a snippet from the article:

Click on article to enlage for easier reading.

 

Should psychological fitness be a standard for holding public office?

I wonder how Dick Cheney, George W. Bush, Don Rumsfeld, Condoleeza Rice, Richard Pearle, Paul Wolfawitz, Colin Powell, George Tenant sleep at night?

Either they knew better and lied to the American people, or they were fooled and made huge errors in judgment. In either case the American People, the Iraqi people and other people around the world deserved much better leadership than what they got and what they are getting.

Is this kind of error in judgment and/or deceptiveness a sign of mental illness? Are these people examples of personality disorders or Axis I diagnoses?

The fact that Bush and Cheney have substance abuse disorders is well documented even if disregarded by the American people for holding the jobs they were elected to. People who would be red-flagged for employment at my agency were elected to the two top positions in the American government which makes me question the mental health of the American public as well.

When people with mental illness reach high levels of public office and have concomitant power to make policy and engage in actions which affect millions of people, it would seem that psychological fitness might be a standard to use in the selection process. Police officers in major cities go through more psychological evaluation for their jobs than politicians who make policy to govern the police officers' actions.

Could a standard of psychological fitness be politicized and misused and abused? Yes, there is a huge potential there, and yet if we see psychological standards being increasingly used in other human service professions in criminal justice, ministry, counseling and mental health, education, would it be too much to ask that our political leaders also be subjected to such evaluations?

Had they been in place, I doubt that George W. Bush and Richard Cheney would have passed. Of course, I doubt if the loonies on the far right and far left could pass either.

It appears that John McCain has some significant mental health issues given the various reports about his functioning. Connecting the dots about his temper, his unusual marriages, his current wife's history of substance abuse problems, his flip flop on the issues, his synchophancy with George W. Bush, his malaprops, you have to wonder.

McCain gets it wrong on H.I.V.+ prevention

McCain was asked about using condoms to prevent HIV+ transmission by Adam Nagourney at the New York Times. Here is the interchange.

Click on image to enlarge for easier reading.

Adam Nagourney, McCain Sumbles Upon H.I.V.Prevention, The New York Times, March 16  , 2007

Wartime PTSD cases jumped roughly 50 pct. in 2007

Yeah, well, just as Bush, Cheney, Petraeus, and McCain say that things are hunky dorey in Iraq and Afghanistan it looks like the troops are imploding.

2007 was the most violent year of the war ever, and the psychiatric damage of soldiers seems to be growing daily with longer deployments.

The Associated Press story was written by Pauline Jelinek and published today 5/27/08. Here's how it startes off:

The number of troops with new cases of post-traumatic stress disorder jumped by roughly 50 percent in 2007 amid the military buildup in Iraq and increased violence there and in Afghanistan.

Records show roughly 40,000 troops have been diagnosed with the illness, also known as PTSD, since 2003. Officials believe that many more are likely keeping their illness a secret.

"I don't think right now we ... have good numbers," Army Surgeon General Eric Schoomaker said Tuesday.

Defense officials had not previously disclosed the number of PTSD cases from Iraq and Afghanistan.

Army statistics showed there were nearly 14,000 newly diagnosed cases across the services in 2007 compared with more than 9,500 new cases the previous year and 1,632 in 2003.

A little further down, Ms. Jelinek writes further:

Factors increasing troop exposure to combat in 2007 included President Bush's troop buildup and the fact that 2007 was the most violent year in both conflicts.

More troops also were serving their second, third or fourth tours of duty — a factor mental health experts say dramatically increases stress. And in order to supply enough forces for the buildup, officials also extended tour lengths to 15 months from 12, another factor that caused extra emotional strain.

She writes further:

The accounting of diagnosed cases released Tuesday shows those hardest hit last year were Marines and Army personnel, the two ground forces bearing the brunt of combat in Iraq and Afghanistan.

The Army reported more than 10,000 new cases last year, compared with more than 6,800 new cases the previous year. More than 28,000 soldiers altogether were diagnosed with the disorder over the last five years, the data showed.

The Marine Corps had more than 2,100 new cases in 2007, compared with 1,366 in 2006. More than 5,000 Marines have been diagnosed with PTSD since 2003, the data showed.


Wartime PTSD cases jumped roughly 50 pct. in 2007 - Yahoo! News.

SSgt. Travis Twiggs, The War Within, PTSD, video lasts 3:44

The majority of Americans say that abortion should be legal under some circumstances

According to a recent Gallup poll the majority of Americans (54%) say that abortion should be legal under some circumstances. More women than men say that abortion should be legal and there is no difference in opinion between Catholics and other Americans even though the Catholic Church officially teaches that abortion is a sin.

Dr. Frank Newport summarizes the data on the recent poll in a video that lasts 2:15 minutes.