Friday, April 23, 2010

Mindbody

In his book, When the Body Says No, Gabor Mate writes, "...mind and body are not separable."

He makes a case that "when we have been prevented from learning to say no, our bodies may end up saying it for us."

He tells the story of a woman, Mary, who described herself as 'so scared all the time, but as a seven-year-old I had to protect my sisters. And no one protected me.' As a consequence, "she never revealed these traumas before, not even to her husband of twenty years. She had learned not to express her feelings about anything to anyone, including herself. To be self-expressive, vulnerable and questioning in her childhood would have put her at risk. Her security lay in considering other people's feelings, never her own. She was trapped in the role forced on her as a child, unaware that she herself had the right to be taken care of, to be listened to, to be thought worthy of attention."

So this is how we learn to keep it to ourselves, pretend to know, never question. No wonder it feels so wrong.

If you have a voice, then use it. It was your birthright. You have a right to do this now.

Through stories and a review of medical literature, he writes about "the effects of stress on health, particularly of the hidden stresses we all generate from our early programming, a pattern so deep and so subtle that it feels like a part of our real selves."

The biological call and response system between child and parent called attachment, teaches us so much about self in relation to others and the world. We learn this without words, before verbal language develops. Beliefs we take for granted and without question. Unless...we stop to reflect...but when? how? There are so many distractions, marketed very well.

"The new discipline of psychoneuroimmunology has now matured to the point where there is compelling evidence, advanced by scientists from many fields, that an intimate relationship exists between the brain and immune system...An individual's emotional makeup, and the response to continued stress, may indeed be causative in the many diseases that medicine treats but whose origin is not yet known..." Immediately, that resonates. Science is systematic, incremental and slow. Inuition and grandmothers seem to get there faster. When both agree, we've really got something.

"Emotions are deeply implicated in the causation of illness or in the restoration of health."

"Physiologically, emotions are themselves electrical, chemical and hormonal discharges of the human nervous system. Emotions influence - and are influenced by - the functioning of our major organs, the integrity of our immune defences and the workings of the many circulating biological substances that help govern the body's physical states. When emotions are repressed, as Mary had to do in her childhood search for security, this inhibition disarms the body's defences against illness. Repression - dissociating emotions from awareness and relegating them to the unconscious realm - disorganizes and confuses our physiological defences so that in some people these defences go awry, becoming the destroyers of health reather than its protectors."

"In important areas of their lives, almost none of my patients with serious disease had ever learned to say no."

"...To have the ability to respond with awareness to the circumstances of our lives rather than just reacting. We want to be the authoritative person in our own lives: in charge, able to make the authentic decisions that affect us. There is no true responsibility without awareness."

Knowing this, how can we develop a wellness-oriented lifestyle, family culture, school culture and society (instead of a primarily stress-driven one). How do we bring about personal and structural transformation?

Friday, April 16, 2010

Characteristics of Resilient People

  • View change or stress as a challenge/opportunity
  • Commitment
  • Recognition of limits to control
  • Engaging the support of others
  • Close, secure attachment to others
  • Personal or collective goals
  • Self-efficacy
  • Strengthening effect of stress
  • Past successes
  • Realistic sense of control/having choices
  • Sense of humor
  • Action oriented approach
  • Patience
  • Tolerance of negative affect
  • Adaptability to change
  • Optimism
  • Faith
From Development of a New Resilience Scale: The Connor-Davidson Resilience Scale (CD-RISC) by Connor & Davidson, 2003 in Depression and Anxiety

Wednesday, April 14, 2010

Staying Healthy Even When Highly Stressed

Kobasa (1979) hypothesized the following:

Highly stressed persons who stay healthy possess to a greater extent than highly stressed persons who get sick:

(a) the belief that they can control or influence the events of their experience

(b) an ability to feel deeply involved in or committed to the activities of their lives, and

(c) the anticipation of change as an exciting challenge to further development. (Kobasa, 1979, p. 415)

It breaks my heart that Kobasa (I want to french kiss Kobasa for these words) came up with this in 1979. Why have we not been shouting this from the rooftops?! Can you feel the powerful vibrations from the truth of these words?

You Can Do It!

By encouraging individuals to 'go the extra mile,' a person can practice calling up emotional reserves until they trust that they have a stockpile of conviction and resiliency.

Monday, April 12, 2010

Resiliency Characteristics

I am an avowed nerd that loves to read for the inspiration and insight. When I come across amazing articles, I love to share them. This one is a lecture given by Carl C. Bell, M.D., titled Cultivating Resiliency in Youth in the Journal of Adolescent Health.

It identifies the following characteristics of resiliency as:

(a) having curiosity and intellectual mastery; (I have lots of questions!)

(b) having compassion — with detachment; (love this one!)

(c) having the ability to conceptualize; (my imagination is my favorite playground!)

(d) obtaining the conviction of one’s right to survive; (speak it, brother!)

(e) possessing the ability to remember and invoke images of good and sustaining figures; (attachment!)

(f) having the ability to be in touch with affects, not denying or suppressing major affects as they arise; (love this one too!)

(g) having a goal to live for; (I'm living it!)

(h) having the ability to attract and use support; (my social support keeps me sane)

(i) possessing a vision of the possibility and desirability of restoration civilized moral order;

(j) having the need and ability to help others; (hello! I'm a school social worker!)

(k) having an affective repertory; (I get to feel all my feelings!)

(l) being resourceful; (I'm not afraid to ask for help!)

(m) being altruistic toward others; and

(o) having the capacity to turn traumatic helplessness into learned helpfulness. (from client to change agent!)

All these characteristics resonate for me. What resonates for you?

With additional gems in the article like:
"...support the transformation of traumatic helplessness into learned helpfulness" and

"Another esoteric aspect of developing resiliency is referred to as 'building heart' or developing an 'indomitable fighting spirit.' 'Heart' creates a goal to live for and helps develop the conviction of one’s right to survive. The concept is a simple one. By encouraging individuals to 'go the extra mile,' a person can practice calling up emotional reserves until they trust that they have a stockpile of conviction and resiliency. Building 'heart' in individuals is a preventive public health strategy designed to inoculate against the potentially negative effects of stress and trauma. 'Heart' can be built in sports or other spiritual endeavors."

In the article, he also explains the neuropsychiatry of traumatic stress in simple terms, if you would like to read it and learn more.

I am grateful to Mrs. Moreno, my first grade teacher at Rowan Avenue Elementary, who taught me to read. She gave me the tools to access these wonderful strings of letters and words with transcendent meaning.

Sunday, April 11, 2010

Tennis, Learning and Change

I am playing tennis again. It is flow disguised as exercise or vice versa. It involves focus, chasing the ball - like a dog chases a squirrel - and hitting the ball as hard as you'd like. About 30 minutes into play, my body warms up and feels flexible and adaptable - ready to respond.

Steve is teaching me a new way to serve. He is a sophisticated and strategic player and the serve has many elements and micro-movements. I have to unlearn how I used to serve and replace it with the new way. Racquet grip to the right, left foot pointed up, gangster lean back, toss the ball with hand on its side (vs. open palm facing up) to reduce spin on the ball, butterfly arms with only slight racket drop, add a slice to the ball on impact, and hammer it to the other side of the court, following through with your whole body.

After two practice sessions, it still feels really awkward. I forget a lot of steps and the results are nowhere near the serve box. Learning can be so difficult, I see why we would want to give up. I can hear voices saying, "This is dumb. I can't do it. Go back to the old way. I will never get it. Why am I wasting my time? Let's just play." With Steven patiently standing there and modeling the movements, I ignore the voices and keep doing it over and over again. Never really believing that I will improve but figuring I will humor him and hoping that my faith in developing neuron pathways will take over and save the day.

He has so much feedback - change the grip for the forehand and the backhand - and I can't imagine how or when I will get it, can't remember ever doing that (I have been playing on and off since I was seven). Then it happens. I find a micro-second hole in time when the ball is racing towards me and adjust my grip to the right on the forehand and left on the backhand and it makes my strokes more consistent and powerful. Little victories that motivate me to keep trying.

With tennis, my primitive reptilian brain takes over. No words, no thoughts, just instinct and action. It's a welcome break for my overloaded prefrontal cortex. My body gets to move and run and stretch instead of sitting for hours in front of a computer screen or text - endless text.

Thrown back into the role of learner, I understand the tension - the constant desire (anxiety and yearning) to reach competence and mastery - when the voices (internal critic) let up. With change guaranteed, we are all thrown into the role of life-long learners whether we love it or not, whether we choose to accept, resist or reject that stance. Rose Monteiro said we all need to learn how to grieve (because loss is inevitable). Buddhist psychology talks about impermanence and detachment. Just as we get used to this moment, it changes. Adopting, or accepting the stance of a beginner's mind, we step into the next moment with an open hand. Humbly wondering, what will the next moment teach me? How will I cope with the loss inherent in change and take advantage of the opportunity?

Tuesday, April 6, 2010

Addiction, Abuse and Attachment

Excerpt from a Democracy Now (KPFK) interview with Dr. Gabor Mate, staff physician at a safe injection site in Canada and author of, In the Realm of Hungry Ghosts: Close encounters with addiction.

"The hard core drug addicts that I treat, and according to all studies in the States, are people that without exception have had extraordinarily difficult lives. The commonality is childhood abuse. They entered life under extremely adverse circumstances. Not only did they not get what they need for healthy development, they got negative circumstances of neglect. I don't have a single female patient on the downtown eastside who wasn't sexually abused for example, as were many of the men neglected, abandoned serially or abused. That's what sets up the brain biology of addiction. In other words, the addiction is related both psychologically in terms of emotional pain relief and neurobiological development to early adversity.

In the realm of hungry ghosts is a buddhist phrase. In the buddhist psychology there are a number of realms that a human being cycles through, all of us. One is the human realm which is ordinary cells. The hell realm is that of unbearable rage, fear, these emotions that are difficult to handle. The animal realm is our instincts, our id and our passions. Now the hungry ghost realm, the creatures in it are depicted as people with large empty bellies, small mouths and scrawny thin necks. They can never get enough satisfaction. They can never fill their bellies. They are always hungry, always empty, always seeking it from the outside. That speaks to a part of us that I have and everybody in our society has, where we want satisfaction from the outside. Where we're empty and where we want to be soothed by something in the short-term but we can never fill or fulfill that insatiety from the outside. The addicts are in that realm all the time, most of us are in that realm some of the time. My point really is that there is no clear distinction between the identified addict and the rest of the us. There is just a continuum on which we all may be found. They are on it because they have suffered a lot more than most of us."

24 Months

Many social and recovery aid programs provide a maximum of two years support. Dr. Iglehart wonders, "what is the magic in 24 months?"

She asked our class a very provocative question:
How long would it take you to get back on your feet if you lost everything?
Could you get back on your feet within two years (assuming a high school education)?

Three PhD students said no or I don't know and three said yes. How would you answer?

I said yes because I figured I could get a job (any job) and at least a studio apartment in two years. I think that my core belief (I am competent) and persistence and natural thrust to grow, develop and survive would not let me fall lower than this basic standard in the US. If I were severely mentally ill or otherwise disabled, then I don't know. But that wasn't the question, she just said how would you do.

Reflection and Self-Efficacy

From the article, Reflection and Self-Efficacy: Enhancing the Retention of Qualified Teachers from a Teacher Education Perspective...

"In a review of the Department of Education literature on teacher resiliency, Bobeck (2002) contends that five primary factors are responsible for teachers remaining in the field despite the challenges they face:

(1) relationships (mentoring programs, administrative and parental support)
(2) career competence and skills
(3) personal ownership of careers (ability to solve problems, set goals, and help students)
(4) sense of accomplishment (experiencing success)
(5) sense of humor"

Monday, April 5, 2010

Racial Stereotypes In the Air

"It takes a critical mass of people committed to changing the air."

"The reference about 'in the air' has to do with the pervasiveness of racial stereotypes and is mentioned in the article, Becoming American: Stereotype Threat Effects in Afro-Caribbean Immigrant Groups. Claude Steele, one of the authors, has written about this."

--Dr. Alfreda Iglehart

Policy Evaluation

SW 225B Policy Implementation and Evaluation with Dr. Alfreda Iglehart

"Social workers are the implementation arm of public policy. We support and carry out the values of the larger society.

(Hmm, this makes me wonder how we can play a bigger role in influencing the values of the larger society. Marketers and Madison Avenue seem to do this well - they make us believe that we need things that we don't, that in fact may harm us. What about a counter-movement or marketing strategy that "sells" love, hope and compassion?)

We work with people to beat the odds instead of trying to change the odds (that is, change the social structure), partly because we benefit from the social structure as it is. Karen Seccombe has an article on 'beating the odds' versus 'changing the odds.'

Do we feel the social structure is in need of change? If we think the structure is oppressive, do we have the tools to achieve social change and reform?

If we are funded by the federal government, then it limits our opportunity to challenge it. As a contractor, we become an extension of the public agency - we are an extension of government.

As an example of this, social workers were involved in the Mexican-American repatriation process of the 30s and 40s and the processing/screening of Japanese-Americans in interment camps.
(How on earth did this happen and how do we make sure that it does not happen again? Would a culture of critical thinking and reflection across our profession help to prevent or challenge our involvement in social injustice perpetuated by the state in the future?)

Professions exists to advance members."

Concepts & Methods in Community Interventions

Psychology 298 - Conceptual and Methodological Issues in Community Interventions with Dr. Hector Myers

"There are no simple answers or solutions. Social psychology assumes multiple levels of analysis and puts the individual in a context. As a scientist, we can choose to focus on one level, but there are multiple levels to phenomenon.

Community research includes...
...research in the community which requires a certain skill set and politics
...research with the community, a trend in public health, where the researcher is not in control in the usual way because now the community is a partner (community-based participatory research)
...research on the community where the unit of analysis is the community as an entity (dynamics, risk factors, etc.)

Community consultation (asking community for feedback and support) vs. collaboration (shared ownership)

Multi-level analysis - examine factors that contribute to the development and maintenance of social problems and understand behavior at all levels (individual, groups, community, societal, institutional, etc.). Individual behaviors contribute to problem, but didn't cause the problem.

Treating the consequences of the problem vs. the causes

Why is violence clustered in poor communities? Guns are not produced or manufactured by communities - they are coming in from the outside! Gun distribution and consumption is prevalent in these communities, but not manufacturing. Who is benefiting by marketing guns to the poor? Demand is manufactured and created by outside forces. If community members feel threatened, then they will buy guns to protect themselves. Manufacturing fear is profitable, powerfully effective and oppressive politically. Competition makes guns bigger, that is kids will always try to outdo each other. If you're in the gun business, who is your ideal market? Saturday night specials are cheaply made and sold guns developed specifically for the poor.

Consequences clustered around poor communities are produced and maintained outside of the community.

So what is holding how low communities, families and students are going to fall? What is going right? Someone steps up. There are individual/family/community resources that we need to identify, understand, and tap into. For example, South LA churches created health ministries to address HIV/AIDS needs in the community.

People are vulnerable to anxiety disorders (including PTSD) given the conditions in which they live. Poverty predicts a lot of variance. Worst health and functioning exist in communities of poverty.

Something is consistently shaping patterns in the brain. The effect on brain of exposure to particular experiences is well documented. If you change the context, then you can change patterning of brain functioning."