Tuesday, May 22, 2012

Book Review: The Wisdom to Know the Difference

Some books just speak to you.  Some books are written in such a way that you feel the author is your buddy chatting with you in your living room.  Kelly Wilson is that buddy, and his humble but heartfelt words are recorded in this book.

I don’t want to sound cheesy or philosophical, but this is such a relief after reading 2 other therapy books where I felt I was being lectured.  This book is not telling you what is right.  It’s not telling you what will work, or even how to do it.  It is much like AA – this is what worked for us, come and see.  Use what you can, and forget the rest.

That is what makes this book so refreshing.  The author doesn’t assume to have a monopoly on knowledge about addiction rehabilitation and recovery.  He did it, he’s helped others do it, and he wants to share what worked for them.

Kelly Wilson was one of the developers of ACT therapy – and this is a workbook for substance abusers to use to guide them toward recovery.

Here are some of my favorite quotes:
"Just because behavior is understandable does not make it good or acceptable."
Humility does not mean humiliation. It is the dignified choice to willingly forgo status to offer resources for the good of others. - John Dickson
"Lots of things make us feel better that do not make us do better."
“Many people live their lives by circumstance rather than on purpose.”
“Values are intrinsically rewarding.”
“That year, life got a very firm grip on my ears, and jerked my head out of my ass.  And you know what?  Once you get the feces wiped from your eyes, you can see a lot of things.”
"If I ever get what I deserve, you do not want to be standing next to me." – Mick
"Raise our eyes toward perfection, and be ready to walk in that direction. It will seldom matter how haltingly we walk." - AA 12 & 12 book
"Do the next right thing."from Alcoholics Anonymous

Sunday, May 20, 2012

Ring of Fire - Annular Eclipse seen from Reno

These pictures were taken by my neighbor Katie Rossman.  It was an amazing sight from Reno.

Eponine Takes Valjean to Heaven?

Les Miserables is my favorite book.  It is also one of my favorite musicals.  The story is deep, and though very complex, the themes are simple.  Regret, Repentence, Love, Forgiveness, Justice, Mercy, etc.

I have read the book 6-7 times and have actually made my own abridged version because I didn't think any of the previous abridgments did it right. (but I digress)

The musical makes one huge mistake in my view.  Eponine comes with Fantine to take Valjean to heaven.

The musical changes parts of the story, and that's fine.  It embellishes Eponine's love story with Marius, but it works, so who cares. (and On My Own is an AMAZING song)

But why does Eponine come get Valjean when he's dying?  She has almost no interaction with him...ever.  In the book, in the musical, they almost never meet, and it's never meaningful.  There is no connection.

Why does she come to take him to heaven then?  Because the music sounded better with a female duet and they needed someone to join Fantine for that song.

Who would be a better choice?

#1 The Bishop.  No one makes more sense.  The Bishop was the one who helped ValJean turn his life around.  The Bishop was the entire crux upon which Valjean changed his life.  Valjean kept those silver candlesticks forever, and looked at them each time he had a moral dilemma.  The Bishop is a man of God, and who would be more natural to be sent to retrieve Val Jean.
Oh - and that's who does it in the Book.  Yes - Victor Hugo wrote the story, and he says the Bishop was with ValJean when he dies.  I think this is the one part of the musical that should be re-written.  I want to hear the duet of the Bishop and Valjean when they are equals, and share in the same sentiment.

#2 Javert.  Wouldn't it be amazing to see that Javert has realized his error, and has not only been forgiven, but is now reconciling with Valjean and they could be friends in heaven?  This wouldn't be as great as the Bishop, but it would be interesting.

If this wasn't esoteric enough - click here to read my comparison of Valjean with Tevye (from Fiddler on the Roof)

Friday, May 18, 2012

Positive Affirmations Cause Depression

How many of you have ever read a self help book that told you to look in the mirror and tell yourself something positive?

Kind of like the SNL skit with Al Franken saying: "I'm good enough, I'm smart enough, and doggone it, people like me."

It sounds like Peter Pan advice - just think a happy thought.

Has it ever worked for anyone?  I'm not talking about pumping yourself up at the beginning of a game or right before a public speech, I'm talking about just trying to change your self-esteem by telling yourself some positive affirmation.

There was Norman Peale’s book in 1952 called The Power of Positive Thinking.  Since then we've been told to chant: "I’m powerful, I’m strong, and nothing in this world can stop me’’ or "I am a lovable person."

In 2009 the University of Waterloo decided to test the theory.  They had 86 students take a self esteem test.  Then half of them were told to repeat the phrase "I am a lovable person" and then focus on ways in which this statement was true.  They then checked their self-esteem again.

Here were the results:

When people with low self-esteem repeated the statement,‘‘I’m a lovable person’’ or focused on ways in which this statement was true of them, neither their feelings about themselves nor their moods improved—they got worse. Positive self-statements seemed to provide a boost only to people with high self-esteem—those who ordinarily feel good about themselves already—and that boost was small.

WHY did this happen?  We don't really know, but here is my guess.  Those with high self-esteem believed it.  Those with low self-esteem never did.  In fact, when they were saying it their own minds were telling them it was a lie; that they weren't lovable.  This made them feel worse and worse until the exercise was over.

SO -  If Positive Affirmations work for you - Great!  Feel free to keep using them.

If they don't work no matter how much you try - you're normal.  Stop using them.  They're only making you feel worse.

If you want to know what actually works - here's a clue - you have to believe what you say.

My friend Yvonne wrote me in response to this post.  Here are her two cents:

Actually, when I WAS suffering from low self-esteem in junior high and feeling especially bad about myself, I happened to look in the mirror one day and noticed that I had FANTASTIC eyebrows. I FELT the gratitude for the great eyebrow shape I was blessed with and so I said it to myself out loud while looking in the mirror. Then EVERYTIME I looked at myself in the mirror I either thought or said to myself, "I have great eyebrows." Pretty soon I started to appreciate other parts of myself and my level of self-esteem rose and rose and rose.
Another time, when I was feeling discouraged in college and walking home under the starlight (only in Rexburg can you see the stars as clearly as I did that night), I happened to look up and see how crystal clear the stars looked and the cool halo around the moon. In that moment I felt GRATITUDE to my Heavenly Father for creating such a beautiful night sky for me to walk home under that night and then I thought of more and more things to be grateful for. And I continued to say them out loud as I walked home after midnight that night and my discouragement dissipated.
The problem with the SNL skit is that it leaves out the part about "affirmations" that is the MOST important - say things that you TRULY are GRATEFUL for. It is impossible to NOT feel positive emotions and energy when you are stating out loud what your blessings are and that IS what affirmations SHOULD be - sincere blessings you are grateful for!

Wednesday, May 16, 2012

Child Sex Trafficking

Today I heard a presentation by an FBI Victim Specialist.
These are some statistics she shared:
  • It is estimated that there are between 100,000 and 300,000 child victims of human trafficking in the U.S. alone (Ernie Allen, President of National Center for Missing and Exploited Children, reported in the LA Times)
  • 2.8 million children live on the streets (Shared Hope International)
  • Within the first 48 hours of being on the street, 1 in 3 children are lured into commercial sexual exploitation (National Incidence Studies of Missing, Abducted, Runaway, and Thrown-away Children)
  • 75% of minors engaged in prostitution have a pimp (Shared Hope International)
  • Pimps can earn up to $632,000 per year by selling 4 women or children (Shared Hope International)
  • The average age of entry into human trafficking for girls and boys ranges from 11-14 years old.  (Ernie Allen, President of National Center for Missing and Exploited Children, July 21, 2009
  • 90% of all children trafficked for sex in the USA are American citizens.
  • 70-90% of child sex trafficking victims were sexually abused before running away or being thrown out.
The problem is real.  The consequences are horrific. 
The problem is worse here in Reno for many reasons.  We have a huge interstate running through town.  We have tons of cheap motels downtown.  We have legal prostitution 20 minutes out of town, so "selling sex" is pretty much accepted and ignored.

I nearly vomited when thinking about this topic.  The presenter asked us: "how many of you ask your patients about prostitution?  (I've asked very few)
How many of them were sexually abused and have ever run away from home? (way too many)

I've been missing it.  Please help stop this horrific enslavement and abuse of our children. 

Visit: http://www.couragetobeyou.org/ to find out how.

She showed this video, it is not for the faint of heart.

Tuesday, May 15, 2012

Book Review - The Happiness Trap

It’s worth it in the end. - That is my first thought that describes this book.   When I began this book I did not enjoy it.  Honestly, it annoyed me.  

By the time I finished it I realized ways I could make substantial improvements in my life.

First: The annoying part.

The author (Dr. Harris) seems to assume that all his readers have the same thought processes, make the same mistakes, and can be fixed the same way.  

He begins by telling us we likely believe four myths.  

Myth 1: Happiness Is the Natural State for All Human Beings
Myth 2: If You’re Not Happy, You’re Defective
Myth 3: To Create a Better Life, We Must Get Rid of Negative Feelings
Myth 4: You Should Be Able to Control What You Think and Feel

I don’t think most people believe THESE myths.
  I think they believe truths that are very closely related to these that get twisted. 

1: Happiness is a possible natural state for all human beings (happiness, not pleasure)
2: You can learn to be happier by fixing your defective habits
3: You can create a better life, and you will have less negative feelings.
4:  You should gain better control of your thoughts and feelings as you progress.

Doctor Harris spends half the book teaching a useful but difficult lesson.  We have two ways of thinking or two minds.  We have the “observing” and the “thinking” mind.  The observing mind is always observing and recording.  It doesn’t interpret or judge, it just observes what’s there.  Then our thinking mind can interpret that information if need be, or think about something else entirely.  That’s why you can drive your car on the interstate and not remember the last 15 miles because you’ve been thinking about something.  Your observing mind always observed you were driving in your lane, so your thinking mind left it alone and pondered something else.

He teaches us how to stop beating ourselves up for the constant flow of thoughts we can’t really control.  Thoughts will come that we never wanted.  When we dwell on them or try to drive them out, we always seem to make things worse and end up angry or upset at ourselves.  He teaches us to simply accept the thought, and then move on.  Don’t dwell on it, not try to avoid it.  Acknowledge it – it’s just a thought.  It’s not an action, it’s not a destiny.  It’s a thought, you had it, it was there, and you can’t change that.  Accept it, then move on.

The end of the book is great.
  It teaches how to make real change that brings real happiness.  Happiness comes from living according to your values.  He urges us to spend REAL time discovering our values.  Not our goals, or what society tells us to care about, but what we REALLY care about.  Figure those values out, then set immediate, short medium, and long term goals that are congruent with your values.
I’m using what I’ve learned, and my life is getting better.  What more can I say?

Here are some of my favorite quotes from the book:

“Today’s middle class lives better than did the Royalty of not so long ago, and yet humans today don’t seem very happy.” – p. 2
You won’t change your life simply by reading this book.” – p. 35
“We have many thousands of useless or unhelpful thoughts every day.” – p. 49
“Letting the radio play on without giving it much attention is very different from actively trying to ignore it.” – p. 66
“Despite everything you’ve tried over the years, isn’t it a fact that your mind still produces unpleasant pictures?” – p. 75
“What would I attempt if thoughts of failure didn’t deter me?” – p. 79
“The fight-or-flight is often triggered in situations where it is of little or no use to us.” – p. 85
“Any search for a Pain-free existence is doomed to failure.” – p. 137
“What do you want your life to be about?” – P. 167
He who has the why to live for, can bear almost any how.” – F. Nietzsche – p. 170
“Never set as your goal something that a dead person can do better than you.” – p. 186
“If you’re living a goal-focused life, then no matter what you have, it’s never enough…find the values underlying your goals.” – p. 198
“Twenty years from now you will be more disappointed by the things that you didn't do than by the ones you did do. So throw off the bowlines. Sail away from the safe harbor. Catch the trade winds in your sails. Explore. Dream. Discover.” – Mark Twain – p. 216
“Commitment isn’t about being perfect, always following through, or never going astray.  Commitment means that when you (inevitably) stumble or get off track, you pick yourself up, find your bearings, and carry on.” – p. 219
“Success in life means living by your values.” – p. 221
“If you don’t decide where you’re going, you’ll end up wherever you’re heading.” – p. 232

Sunday, May 13, 2012

Chocolate = Lower BMI! (Happy Mothers Day)

Yes It's True!

We already knew chocolate is good for your blood pressure, cholesterol level, and insulin sensitivity - but now the news gets even better. 

Those who eat more chocolate, have a lower BMI.
But what about calories, and saturated fats?

Chocolate eaters do have a higher intake of both - but they still have a lower BMI.  Those eating chocolate didn't exercise more, or eat more fruits and vegetables, or anything like that.

It looks like it has something to do with the chocolate itself being a healthier source of calories that makes people lose weight.

SO - Happy Mothers Day - Go eat some chocolate!

Sources: Research Article,News Article

Wednesday, May 9, 2012

Book Review: Doing Dialectical Behavior Therapy

This is not an easy read, but it is worth it for all mental health workers.

DBT = a type of therapy designed for those people who are constantly in crisis.  I'm talking about people who harm themselves on purpose: cutting themselves with razorblades to release tension, repeatedly attempting suicide, etc.  These are often people who suffer from Borderline Personality Disorder.  Their life is a living hell, and usually it has become the same for their family and friends.

This book teaches a type of therapy that actually helps them.

I learned quickly through this book that DBT is not something you do on the side.  You are either a full blown DBT therapist, or you are not.  There is no halfway.  There is no dabbling.

Why do I appreciate this book?  Because it helps me be a better psychiatrist to all my patients.  I currently work on a DBT unit for kids who are so dysfunctional their families have sent them to live in a psych hospital for 3-9 months.  Many of them threaten to commit suicide every day, some try.  Many cut, all are difficult, all are taxing, and all are capable of recovering and are trying as hard as they can to get better.

This book did not make me a DBT therapist, but it showed me what my patients are learning, how they're being taught, what skills they are learning, and how I can help them too.

I learned to always question my assumptions, my diagnosis, and my treatment.  I learned to ask for help more often.  I also learned not to give up.  I'll get frustrated, angry, sad, and upset.  I'll be cussed out, threatened, and sometimes hit... and I always have to remember that it's even worse for my patients.  They live it all day every day.  I get to go home at night.

Thank you Dr. Koerner.  Your book reflects your caring and dedication to a population that many would prefer to forget about.