Friday, June 17, 2011

Making Realistic Plans and Taking Action

Dealing with adversity requires that people be able to think clearly. For most of us, this is difficult in a crisis. Emotion may cloud our thinking. It may act as a filter through which we view our world. For those in this society with a severe emotional illness, the filter seldom comes off. Being able to see what is, rather than what we would like or what we fear, is part of the skill. Being able to take action proactively rather than reactively or impulsively, being able to behave assertively rather than aggressively or passively are critical to our ability to survive adversity and to bounce back from tragedy.

One of the characters in Reaching Home, Howard, illustrates the impact that a chronic mental illness can have on an individual's life. In the story, Howard is homeless. Thirty years ago he would have been a patient in the State hospital. But Howard receives no treatment. He has consistently rejected efforts to involve him in community-based treatment.

Howard wears large glasses with black plastic frames. He is slightly balding. He is dressed in gray coveralls and a pair of old workboots. A long chain runs from his belt to his wallet in the rear pocket of his coveralls. A toothbrush, a tube of toothpaste and an assortment of pens and pencils are tucked tightly into the coveralls outer breast pocket. Howard has been on the street for years.

Most of Howard's family is either dead or will have nothing to do with him. Howard has been diagnosed a number of times as being mentally ill. He has been treated in institutions and placed on medication, which upon leaving the institution, he has refused to take. He once had a wife and children, but they are gone now. The children are in foster care or adopted - he's not sure which. He just knows he doesn't see them anymore. He doesn't know where his wife is.

In the story, Howard has spent the night on the floor of the Good Will store. When the bus came to the shelter yesterday to evacuate its residents, he refused to leave. He ran away. Most of the residents of the city in which Howard has lived most of his life are gone. They have left because of a nuclear accident at a facility near the city. At least, that's what the police are saying, but Howard doesn't believe them. He thinks they're just trying to scare people to get them to leave and not come back.

Howard's paranoia and his mental illness have compromised his ability to make plans and take actions based on reality, yet his intelligence and street smarts have helped him to survive, even when acting on a perception of reality not shared by those around him. As the story unfolds, we learn that Howard, despite his mental impairment, is much more resilient than he first appears. Howard, in his way, plans for the future and takes action. He also communicated and attempts to solve problems. He tries to find meaning in what is happening and to make sense out of his world.



Dr. Ron Breazeale

Author, Duct Tape Isn't Enough

Testing for PTSD & Other Disorders

Testing for and treating Posttraumatic Stress Disorder’s, as well as other related disorders, has become a norm in the military. Military personnel in Iraq and Afghanistan often experience traumatic events such as being shot at, taking a life, witnessing a colleague be injured or killed etc. The traditional response has been to treat PTSD and similar disorders after testing for it. As such, screening for these disorders has developed rapidly.
However an article in the January 2011 edition of American Psychologist entitled ‘Comprehensive Soldier Fitness’ suggests an alternative approach in dealing with the mental heath of military personnel and their families: The Comprehensive Soldier Fitness Program (CSF). The program is designed to assess and teach mental toughness. There are four components: Assessment, Universal Resilience Training, Individual Training, and Master Resilience Trainers.
The assessment consists of a physical and a psychological component. The Army Physical Fitness Test is taken twice a year and involves a two-mile run, sit-ups, and push-ups. Meanwhile, the Global Assessment Tool measures emotional, social, family and spiritual fitness. Current plans call for a reassessment at least once every two years to allow time for maturity and learning. As such and to promote honesty, the GAT score is only available to the individual who takes it. The second component, universal resilience training, involves instruction on specific mental and physical skills to enhance well-being in the personal and professional lives of military personnel. The third component involves working with the individual to improve each component by offering a menu of self development opportunities based on his/her score. The last component focuses on training military personnel to be resilience trainers within their own units.
The rise in PTSD, suicide and divorce rates along with many other reasons have created an opportunity to, for the first time, insert positive psychology into a large organization in order to improve the well being of the individuals, as well as the well being of the organization as a whole.
For more information about the Comprehensive Soldier Fitness Program please visit APA website.


Rosalba Breazeale

Wednesday, June 8, 2011

No One's Perfect

We are a product of the genetic patterns we have inherited and the learning experiences that we have encountered throughout our life. We have learned both good and bad things from our role models, things that work in some situations and don't work in others. We've learned from watching ourselves deal with adverse situations and difficult times, thus we are a mix of attitudes and skills that have been shaped through this process. We aren't solely optimists and we aren't solely pessimists. We are a mix of both. Sometimes we can see the bigger pictures, and sometimes we can't. We may try to think of things both good and bad as being temporary and as only having a specific rather than a pervasive impact on our lives. But it's easy to slip back into thinking things will never change or into believing that one event can make everything better or will make everything worse. And, of course, it's easy to play the "blame game." In recent years, the political system in our country and the media have taught us how to be even better at doing this.

Resilience is the ability to adapt well to adversity, to bounce back from difficult times, to deal with tragedy, whether it be a national disaster like 911 or a personal one like the loss of someone close, such as a spouse, parent, or child. Resilience is not inherited. It is a set of skills and attitudes that can be learned.

Storytelling is, I believe, one of the best ways to identify and examine resilience skills in yourself and others and to learn them. My novel Reaching Home tells the story of a number of different characters facing adversity from a number of different quarters - from the death of a child to a nuclear accident. I have used it over the last few years as part of the Duct Tape Isn't Enough program, a multi-session workshop focused on conquering fear and building resilience. The characters through their thinking and their actions often demonstrate, and in many cases fail to demonstrate, the skills and the attitudes of resilience.

Meet Lee: Lee is the main character in Reaching Home, - a quiet man, an ordinary man in most ways. He has, as the Census Bureau counts such things, a disability. He was born with only one hand. His "other hand" isn't really a hand, it is an ugly stump, a wrist, no fingers or thumb. In many ways a useless appendage. As a child, Lee hid it in his pocket or under his arm when he could, before, that is, he had the hook. He is not tall in stature but has always tried to stand up for what he believes. For most of his life, he has had what he calls a "love/hate relationship" with his first home, the South. He is a Southern refugee and a storyteller.

The story he tells in Reaching Home began when he was sixty-six years old. He was alone on a road near Pine Grove Labs - an area where the nuclear bombs that were dropped on Japan in World War II were created, where research and development of nuclear devices continued into the morning of that first day of Passover 2013. He was driving back to his hotel after meeting with a group opposing a nuclear incinerator that was to be built in a nearby town. He had just glanced at the car's clock. It was 9:21. That's when it happened. A blue flash of light. The entire sky lit up. The sound of an explosion followed.

Throughout the story Lee demonstrates many of the skills of resilience that will unfold in this blog series. Like all human beings, sometimes he is able to apply them to situations and sometimes he isn't. At times he acts totally out of emotion, assuming that things will never change, that the situation is hopeless. At other points in the story, his ability to communicate, to think clearly under stress, and to connect with others allows him and others to face adversity and survive.

As I share these characters journey it should help you identify and integrate the skills and the attitudes of resilience in your life.



Dr. Ron Breazeale, Ph.D
Author of Duct Tape Isn't Enough

Original blog can be found at www.psychologytoday.com/blog/in-the-face-adversity

Getting through the loss of someone dear to you

When I think of those weeks before my mother's death, I think first of the night I called my wife who was out of town. I had nothing really new to report. My mother wasn't better. She wasn't worse. I told my wife that I wanted her to come home as soon as possible because I just wanted her to be physically near me. We didn't have to talk. In fact, I felt a little bit talked out. I just wanted her to be physically near me. I wanted to feel that connection with her.

In the last weeks before her death, things seemed to change every day. What I had planned never seemed to work out the way I had planned it. Being able to change plans and staying flexible was a daily requirement.



On the really difficult days, the days when my mom was losing ground, every sip of water she took was a triumph and every bite of food a victory. Time seemed to move so slow. I had done what I could do. I couldn't change what I knew was coming. "This too will pass," I muttered to myself on more than one occasion.



In the weeks before and after her death, my feelings were a mix of sadness, anger and relief. I felt on edge most of the time. Some days I felt a bit of guilt. Had I done everything I could do to care for her in her final weeks, months? I felt guilty that I had not wanted her to die during the holidays. I found it hard to be on top of what I was feeling from one day to the next, and sometimes from one minute to the next. But I tried to take time for the feelings. It was tempting to throw myself into the details of the things that had to be done, to arrange her funeral or to plan for my clinical practice in my absence. Some days I gave in to this urge just to get through and make it easier for me. But it was important through this process to talk with others about the feelings I was having and, again, to simply take time to feel the feelings.


During the weeks before and after her death, I didn't take care of myself very well in terms of diet and exercise. Those things were not on the top of my list. I often ate too much and often ate the wrong foods. And I seldom exercised. I gained some weight, which I am only now beginning to lose as I get back into the routine of taking care of myself.



During this period, talking with others about what was going on with me was often hard. I am someone who has a need at times simply to be by myself. Many of us do. Sometimes you can have too much support. Too many people wanting me to talk. Too many people offering their condolences.

As I informed others of my mother's death or talked with her friends at the funeral service, I tried to help them deal with their loss. It was easy for me as a therapist. It felt familiar. But it also was a way for me to take care of myself.



I found a sense of purpose in helping my mother out of this world and seeing that the contribution that she had made to my life and to others was recognized. Making phone calls to her friends, talking with other people about her and planning and executing the service gave me strength. I felt comfort in knowing that I was doing what she had wanted and certainly deserved.



Through it all, she and I kept a sense of humor. I remember her joking with staff at the nursing facility about their plans for New Year's Eve and how they should take her with them so they could be assured of having a really good time. I will miss her smile and her laugh.



Dr. Ron Breazeale, Ph.D
Author of Duct Tape Isn't Enough

Original blog can be found at www.psychologytoday.com/blog/in-the-face-adversity