Tuesday, August 23, 2011

Symptoms Part I

Respecting Symptoms
One of the major contributions modern psychiatry has afforded individuals, couples, families and groups in clinical settings is the reduction of symptoms through psychopharmaceutical drugs. One of the tenets of modern medicine is the relief of symptoms. In fact, this is a multibillion-dollar industry. The slightest ache or pain sends people scurrying to the medicine cabinet, doctor’s office, or pharmacy in search of something to make it go away.
There are over-the-counter medications, prescription drugs and illegal drugs that can be obtained to relieve pain, reduce anxiety and depression and even speed one up as in the stimulant medications.

People want instant gratification and they don’t want to do the hard work which would be working with the symptoms, working through the thoughts and emotions.
The trouble with the widespread use of many such drugs is that the underlying problems that are producing the symptoms may not be getting addressed just because the symptoms are temporarily relieved. Don't forget about the dire "side effects" these drugs often induce.

The practice, or as I would label it, the habit or compulsion, to reach for a drug to relieve a symptom reflects a widespread attitude that symptoms are inconvenient, useless threats to our ability to live life the way we want to live it and that they should be suppressed or eliminated whenever possible.
There are two major problems with this perspective:
1.   First is the common human error of causation which states that because my brain chemistry is out of balance, I am depressed. This has not been proven. Our mind-body-brain system is integrative and complex. It is much more likely that because we are experiencing symptoms of depression due to some sort of loss, denial, etc. the chemicals in the brain reflect that and adjust accordingly.

2.   The second problem with this attitude is that what we call symptoms are the body’s way of telling us something is out of balance. They are feedback about dis-regulation and dis-ease. Ignoring our body’s messages, or worse, suppressing them, may only lead to more severe symptoms and more serious problems later on. The person doing this is not learning how to listen to and trust his own body. Our bodies are wise and will always tell us what we need.
Thanks for reading “Is It Just Me Or…?”
Best,
Rae



Thursday, August 11, 2011

Amy's Winehouse Part III - Playing Games

Amy’s Winehouse Part III - Playing Games
The Role of the Substance Abuser
If all behavior is goal-oriented and all behavior (including substance abuse) serves a purpose, we can view the individual who abuses substances as playing a particular role in a game. Eric Berne, founder of Transactional Analysis, believed that all games have an important and probably decisive influence on the destinies of the players under ordinary social conditions; but some offer more opportunities than others for lifelong careers and are more likely to involve relatively innocent bystanders. This group is called Life Games and includes the game of “Alcoholic.”
In game analysis, as in Choice Theory, there is no such thing as alcoholism or “an alcoholic” but there is a role called Alcoholic in a certain type of game. Because it has not been proven that biochemical or physiological abnormality is a prime mover in excessive behavior its study belongs in the field of internal medicine. No behavior is disease – including compulsions or addictions. Game analysis interested in something quite different – the kinds of social interactions that are related to such excesses, hence the game “Alcoholic.”
The treatment of a substance abuser lies in getting her to stop playing the game altogether, rather than simply change from one role to another. In some cases this is feasible, although it can be a difficult task to find something else as interesting to the substance abuser as continuing her game. Because she is classically afraid of intimacy, the substitute may have to be another game rather than a game-free relationship. The criterion of a true game cure is that former substance abuser should be able to drink socially without putting herself in jeopardy. The usual total abstinence cure will not satisfy the game analyst – or the Choice Theorist.
From a transactional point of view, after careful preliminary groundwork, the correct therapeutic procedure is to take the “Adult” contractual position and refuse to play any of the roles, assuming that the client will be able to tolerate a new game.  The therapist’s role in playing “Adult” is to break up the game rather than play “Rescuer” with the client.
In the “Adult” contractual position, the therapist can guide the client toward awareness, spontaneity and intimacy. Awareness requires living in the here and now and not in the elsewhere i.e., the past or future. Spontaneity means option, the freedom to choose and express one’s feelings from the assortment available. It means liberation from the compulsion to play games. Finally, intimacy means the spontaneous, game-free candidness of an aware person, the liberation of living in the present moment.
For a clever and witty introduction to Transactional Analysis, please read Berne’s Games People Play.
Thanks for reading “Is It Just Me Or…?”
Best,
Rae

Monday, August 1, 2011

Amy's Winehouse Part II - Psychology

Mental Illness as Metaphor
In my last post regarding Amy Winehouse’s demise I discussed philosophy; in particular, a philosophical perspective on happiness. Seeking happiness from an external entity, whether it comes in the form of  a person, relationship, work, money, alcohol, drugs, food, sex, gambling, shopping etc. may achieve a fleeting high, but  as soon as that high fades the individual will set on yet another quest.  
If the search for happiness is one of the chief sources of unhappiness, perhaps wise living consists less in acquiring good habits than in acquiring as few habits as possible.

People use mental illness as a language because they have not learned to use any other or because it is especially useful for them in their situation. How is mental illness learned? What does it mean to the person? Among a diversity of communicative forms each has its own reason and because of the particular circumstances of the communicants, each may be as valid as any other.

In discussing the clinical treatment of addiction (chemical or process addiction) the perennial frustration of therapists as well as the client’s partner, family, friends, coworkers, etc. comes down to the simple fact that they often try to teach new languages to people who have not the least interest in learning them, i.e., “resistant to treatment.” Recall Winehouse’s lyrics from one of her most popular songs…”They try to make me go to rehab I said no, no, no!”

For many people, playing psychological games is a perfectly reasonable and acceptable thing to do. There are moral choices inherent in psychiatric symptoms and syndromes. Game-playing habits should be seen more as habits clients actually want to keep rather than as happenings they want to lose.

The aim of psychotherapy is three-fold:

·         To illuminate behaviors and the thoughts and emotions which trigger them
·         To understand behaviors are goal-oriented and serve a purpose
·         To maximize the client’s choices in the conduct of her life         

The goal is not to indiscriminately enlarge the individual’s choices but to enlarge her choices by enhancing her knowledge of herself, others and the world around her and her skills in dealing with the important people in her life, her thoughts, emotions and behaviors.

The concept of “mental illness” undermines personal responsibility and precludes an inquiring attitude toward conflicts which her symptoms at once conceal and reveal.

Thanks for reading “Is It Just Me Or…?”
Best,
Rae