This Blog Is About

This blog is about---You! Each and every post is about you. Use it to challenge your usual patterns, as a tool for self-discovery, to stimulate your thinking, to learn about yourself and to answer your questions about others.

Wednesday, March 30, 2011


Inspiration engenders hope.
Hope allows action.
Action leads to transformation.

Saturday, March 26, 2011

Treatment of Autistic Spectrum Disorders

Some children who don't seem to bond normally to their parents and appear disconnected may be helped by being seen by a doctor and assessed for this disorder.

Some notes from a lecture I attended by Dr. Barbara Kalmanson, Clinical Psychologist on "A Developmental, Relationship-Based Approach to the Treatment Of Autistic Spectrum Disorders":

Often referred to by those in the field as DIR, Kalmanson has been one of the pioneers in working with ASD and looking at this disorder by viewing development through relationship.  The etiology of this problem is still unknown and there has been an evolving view in the field.  Treatment methods have been changing too.  Even now there is the school of thought called applied behavior analysis which is primarily a way of intervening with these children through behavior shaping alone.  In other words, they are taught, by rote, what appropriate interpersonal interactions are.
The method Dr. Kalmanson spoke about tries to coach the parent and uses the parent-child relationship as the route of intervention.
Current thought about how this syndrome comes about is that it is a combination of genetics, environment, some sort of trigger and the parenting relationship.  In normal development we have recent breakthrough research that tells us how much babies are capable of at a very young age.  For example, Elizabeth Spelks discovered that at 3 months old, babies already know that there is predictability in the world.  It has also been demonstrated that newborns are able to mirror some human behaviors.
In addition, babies are now understood to follow a gaze to try to understand what an adult is thinking or maybe going to do next. They know that gaze indicates the intentions of others.  Children who do a lot of this have been found to have more advanced language development by age 2.  One of the hallmarks of the autistic disorder is the absence of eye contact.  (Another is echolalia)
Some of the developmental capacities that Dr. Kalmanson listed as examples of what is looked for or worked toward in interventions are:
to be calm and regulated
ability of reciprocity
regulating sensory information
adapting to unexpected events
The parents' relationship with the child is seen as the most powerful for change to mediate experience.  The idea is not to teach behavior but to watch for the child's capacities and draw them out so they are not performing by rote but, spontaneously interacting.  She tries to help create co-regulation so that there's a shared experience with the parent and child not just an alone experience.  One of the methods is called Floortime which is play therapy that is trying to mobilize affect which gives meaning to learning.  There's an effort to move from the non-verbal to the verbal and to encourage self-initiation in the child. It is believed that if the child is motivated it will help the child to move up the developmental ladder.  There's an emphasis on keeping a continuous flow going, helping the child, again, to move from sensory-motor activity to symbolic.  This is done by following the child's interests and capitalizing on them.

This is a brief overview of current developments in the thinking about and treatment of Autism spectrum Disorder.  If you are interested in this topic, you may find it useful to read further-perhaps taking a look at the books on the link.

Monday, March 21, 2011

Commending Bravery

The current turmoil in the world.  What can we, as simple individuals do about it.

 This is a time in the world when there is intense suffering.  We have several places in the world where people are feeling afraid, shocked, and are sustaining huge losses.  This blog is read in so many different parts of the world, I wanted, not only to share my own feeling of concern for those who are in such harrowing and terrifying situations but also to call out to all of you.  Let's join hands in compassion for our sisters and brothers who are living these nightmares.
Maybe it's possible that we, from all our different directions can send some calming energy to these people who are already so hurt and continue to be hurt.
Whatever is your own spirituality---maybe it's prayer, maybe it's just holding a good thought, maybe it is doing a healing meditation, whatever it is for you, let's, today all do that thing for those who touch our hearts with their brave attitude in the face of such disaster and danger and distress.

Saturday, March 19, 2011

Blog Note

There are nearly 200 posts on the blog now (194 to be exact).  Most of those are as pertinent today as they were when they were written.  This blog is unusual in that regard:  You can roam around it almost as you would, a reference book.  The topics are timeless.
There are a few that announce an event, for example, that occurs at a certain time-usually an art event-and, there are posts on cutting edge psychology theory as I pass on to you what I learn at the presentations I attend that are by some of the most renowned researchers in the area.  These are a few exceptions.  But!  99% of the posts are as readable now as when they were written.

I've noticed that many of you take advantage of looking at the "Popular Posts" listed on the right of the blog which is great!  It does, however, have the effect of keeping the same posts on that list since each post read is kept track of in the statistics done by Google.
Maybe you would like to try accessing some of the posts listed under "Labels".  These are organized because at least one thing in the post qualifies for the label, such as  "Suggestions" or "Client Quotes".  Once you click on one of the label titles, you will be taken immediately to all of the posts that are so labeled.  You can find some interesting things that way.  Give it a try!

Friday, March 18, 2011

Our Malasian Friends

March 31, 2011:  This slide show has been replaced with one of the United Kingdom in recognition of their readership which comes in just under the Malaysians on the statistics.  I have visited England; it is one of my favorite countries!  Also, I really enjoy watching your British parliament in action on TV.  Delighted to have you visiting here, at my blog.  
 Malaysia lists just after Russia (almost even with Russia) as our fourth largest readership.  The new slide show represents the warmth and generosity of the Malaysian people.

Wednesday, March 16, 2011

An Homage to Nature

The cycles of nature bring to mind the cycles of our own lives
 "Dunes like standing waves.  Dunes like arcs and sickles, scythe blades and waning moons.  Virgin dunes untracked by machines, untouched by human feet.  Dunes firm and solid after rain, ribbed with ripple marks from the wind.  Dunes surrounding ephemeral pools of water that glitter golden as tiger's eye in the light of dawn...Sand and beauty.  Sand and death.  Sand and renewal."

---Edward Abbey American writer and park ranger

Friday, March 11, 2011

Marriage Counseling

"Imagine a couple trying to find their way through a maze of streets in an unfamiliar city.  The two of them are pouring over their map---no, wait, they've got two maps, two different maps.  For a time they seem to cooperate, comparing their maps to find some common ground between the two.  ...The conflict over whose map should prevail heats up.  When it starts to rain the battle is joined in earnest.  There's even the risk that the two will decide to go their separate ways. both trusting their own map and rejecting the map of the other."  Stephen Goldbart, Ph.D. & David Wallin, Ph. D.

Many people, if not most, enter couples' counseling with righteous indignation.  They are there for a purpose and that purpose is to be the one who was wronged!  They fully expect the counselor to see how misguided their partner is and to authoritatively tell him/her about their bad behavior.  It is almost as if they expect the therapist to reprimand their spouse.
Meanwhile, the therapist has two patients.  The therapist has two people to try to consider and to attempt to give equal attention.  The therapist is not there to 'point the finger' nor to decree who's right and who's wrong.  The therapist is not there to make a judgment.  (Therapists are helping professionals, not judges!)  The therapist is not there to vindicate anyone either.
In fact, the counselor really walks a tightrope in marriage counseling sessions, attempting to remain in the middle, not to take sides, and to try to give equal time and attention to each partner.  Often one or the other partner will leave a marriage counseling session feeling it was unfair.  And, of course, it is impossible to direct each session so that each person gets exactly equal airing of their gripes.  Over time, everything can be told.  But, the patient needs to be patient!

 It is understandable how people end up for the first time in a counselor's office (or the first few sessions, often), with this expectation.  Usually they are there, presenting their troubled relationship because they've been deeply disappointed or terribly hurt.  They want things put right---as they see it.  They are hoping to feel better and usually see the path to that goal as being through change in their partner.  A more likely scenario is that both will need to make some changes---changes in behavior, or thinking, or attitude, or understanding.
Often people enter marriage counseling not expecting how very painful it might be.  There may be some unpleasant surprises.  You don't know, going into counseling with your spouse what they may have to say.  It's very personal, very revealing, at times, and neither partner can control what happens.  

Another frustration that people new to marriage counseling will encounter is how long it takes, or how slowly it seems to go or how they don't get to say their side in a session.  When there are three people in the room-all trying to get a word in edgewise-it sometimes seems like there's 12 times as much happening!
Instead of one therapist focusing in on all the aspects of an individual person and what that person is presenting (as it is in individual therapy), there are not only 2 presenters but, there is also the, sometimes intense, reactions each has to what the other says.  In addition to these practical matters, of there only being so much time in each session, there is the question of just how many issues are there anyway?  Oftentimes, if a couple comes in, having not done any individual work, and having been inattentive to the issues that came up in their relationship as they went along, there can be quite a backlog.

In addition to being a manager, and a referee, trying to establish a personal connection with each partner, trying to begin to analyze what the source of the problems are, the therapist has to do 2 other things in these early sessions---attempt to give the couple some sort of helpful intervention, some reason to hope and, last but not least, to prevent them from leaving the office feeling shattered.  Most initial couples' counseling sessions are quite busy for the counselor.  Most counselors are, by necessity, more directive in couples' counseling than in individual sessions.
In individual therapy, the patient is the primary director of the course the counseling takes.  It can't be like that, in large part, in marriage counseling  simply because so many things can be thrown out by the couple that you would end up with a pile of problems and no movement in the process.  A free-for-all would be disastrous for some couples; the therapist must be in charge.

Naturally, every therapist is different in their approach:  My own answer to the question of what a therapist primarily does in couples' counseling is to work on defining and then improving the dynamics in the relationship between the two partners.  The role of the counselor is like that of a sports coach.  The relationship in individual therapy between the therapist and the patient is very important.  In couples' counseling the relationship between the couple is the focus.

The good news is that, for people who stick with it, couples' therapy can make a huge difference in their life together.  Misunderstandings can be resolved, structures for processing problems can be established, new information can be revealed to each partner, learning happens, the needed-to-be-said gets said, resentments get cleared, and, indeed, changes are made.

One of the most dramatic and gratifying couples' treatment I ever did was one in which the step-dad had developed terrible problems in his relationships with his step-kids and was full of resentment for them. By the time that he and his wife arrived in my office, he had inadvertently  put her in the position of choosing between them and him.  We worked together for a long time.  Eventually, they were each able to see and comprehend the other's position in the difficulty.  With the understanding came a change in attitude.  With the change in attitude came the gradual relief of a lot of hurt.  They were able to begin to relax and finally, to be comfortable and contented with each other.  That's putting a lot of work, in many weekly sessions, over several years, in a nutshell, but it was wonderful to see that success and I'll never forget it.

Related posts are titled, Design By Default and, Oh!  That First Visit: 

Do you have a marriage counseling experience you'd like to share something about here?

Thursday, March 10, 2011

Dietery Supplements & Mental Health

A few notes taken from a presentation by Edward R. Blonz, PhD, UCSF

Some of the most commonly used dietary supplements in self-treatment for mood and state of mind problems are:
  • St. John's Wort
  • Rhodiola
  • L-Tryptophan
  • Omega-3 Fatty Acids
  • Sam-e
  • L-theanine 
  • Valerian
According to Dr. Blonz, some of these have litttle-known side-effects (such as, photosensitivity in St John's Wort) and all of them, except the Omega-3 fatty Acids and Sam-e have been subjected to only very small studies or studies that have produced inconsistent results.  In this country, anyway, there is very little regulation so the preparation you purchase may or may not have in it what it says it does on the label.  Some, such as L-tryptophan, or 5-HTP, a pre-curser of L-tryptophan have, currently a safety question about them.  In that case, since they produce extra seratonin, it may be that seratonin will appear in parts of the body other than the brain and can lead to Seratonin Syndrome.
The main message of his lecture was to be cautious when opting to use these things.  They do have factors in them that, in some, have an effect of mood stabilization, some purport to alleviate stress, and some address anxiety or reduce depression; the problem is, you may be getting varied doses, regardless of what the label says.  Also, I would add, self-diagnosing can be a risky business; it usually helps to get the objective opinion of someone else, best if it be someone trained in the field.
The two exceptions on the above list are the fatty acids and sam-e.  The fatty acids, which are plentiful in fish, do lots of good things for our health such as reduce the risk of heart disease.  But they also seem to affect depression.  A real study was done on depressed children who were treated with the fatty acids and the result was a 50% reduction in depression!  Check clinical for more about this study.  By the way, the ALA produced in plants is sometimes touted as being the same as the DHA+EPA that is what is found in fish but, in fact, it has a very low conversion rate in the body to this form.
Sam-e is something our body makes itself.  Sometimes, some people have a disruption in this process, in which case, it would be a good supplement.  SAM-e is used in the body to make everything and it helps many problems, notably arthritis.  In addition, it seems to have a positive effect on mood.
I happen to be what some would (and have!) called a "health nut" and so I do avail myself of supplemental vitamins, minerals and herbs.  But, after this compelling lecture, I think I, myself, will be a little more judicious in my use of these things and will look more to my diet for these nutrients.  A couple of exceptions are Calcium which most people above age 30 will do well to supplement and, vitamin D which has been recently discovered to be epidemically absent in our systems (esp. in northern areas).
Dr. Blonz recommended Natural Medicines Comprehensive Database as a reliable site to use for information on these topics (be careful, there are a lot of salespeople on the internet posing as information sources) and I like it too.
Take care of yourself.  Take care of your health.  Just make considered choices.

Join the discussion-leave a comment-

Tuesday, March 8, 2011

Being Childlike

This English writer reminds of an experience many of us had as children.  How about taking a few minutes as an adult, to relive that privilege of musing in nature. "I lie on green bracken, amongst little yellow and magenta wild flowers whose names I don't know.  I lie so close to the ground that my only view is of tall corn, so crisp that in the breeze it stirs with a noise like the rustle of silk." 

Friday, March 4, 2011

Bored To Tears

A way of structuring your thinking that may lead to improved self-esteem

 "Success Cycle:
1. Goal Setting > 2. Goal Achievement > 3. Satisfaction and Pride > 4. Increased Self-Confidence

People who are bored with life or lack enthusiasm and zeal usually have goals that are vague or meager, or else they have none at all.  Most of us make the mistake of thinking that a zest for living is something beyond our control, and so we do nothing to pursue it.  We immobilize ourselves and do not realize that immobilization isn't the result of depression.  Rather it's the cause.  It is difficult, if not impossible to be absorbed in pursuing a meaningful goal and be depressed at the same time.  Just as there is a success cycle, there is a failure cycle and it looks like this:

1. Immobilization > 2. Non-Achievement >3. Boredom, Depression > 4. Feelings of Worthlessness"
Author unknown

I posted this (despite not being in total agreement with everything in the quote) because I think it is a useful way to think about managing your self-esteem.
The italics on the word meaningful are mine because that would make all the difference for most people.  Any old goal will not have the effect of engaging your creative energy and excitement.  It needs must be something important to you.

Also, in reality, undue fatigue and lethargy are, in fact, symptoms of depression, which is possible to suffer from, due only to a chemical imbalance.  Some people who suffer from depression need medication.  But there are certainly many who habitually decline into the doldrums who could use a concept such as the one presented above to alleviate much suffering.  The research shows that for the majority of patients with this diagnosis,  a combination of psychotherapy and medication is the most effective treatment.  When I am presented with a person who has this complaint, I usually try  therapy only, first.  Sometimes counseling alone will suffice.  However, if we just can't get anywhere and the patient doesn't feel any relief, then I consider trying a medication regimen along with the counseling.  Most depression can be relieved.