Friday, March 13, 2015

Chronic Illness

Chronic ambivalence can affect the healing process.

Managing a chronic illness, either physical or emotional, requires resilience. Unfortunately, the nature of the illness can severely impair a person’s ability to apply the skills and the attitudes of resilience. For example, a severe emotional disorder, such as schizophrenia, makes communicating and connecting with others a difficult task. Distrust and paranoia often accompany the disorder. Instead of relationships being a source of support, they can be a source of fear and aversion.

Emotional control may be an extremely difficult chore for the patient, and feelings may fluctuate from one extreme to the other. Dr. Paul Meehl identified chronic ambivalence as one of the hallmarks of the disorder. These strong feelings may be extremely hard to manage. Even with antipsychotic medications, patients may still have difficulty thinking clearly and reasoning in a logical and rational fashion. Feeling confident in yourself and secure in a world that is distorted by a thought disorder is very challenging, to say the least.

But as I write this, I recall two of the patients that I worked with for many years who have been struggling with the disorder most of their lives. It has been an extremely rocky road for them, but both have learned to manage their illness in different ways. One has learned to do this by accepting the reality that the psychotropic medication can help in controlling his thought and should be taken as prescribed. He has also learned that he needs to have some basic trust and check reality out with a therapist on a regular basis. It has been a difficult process, but over the years he has gotten better at taking care of himself and feeling confident in his ability to manage his life.

My second patient, who is a very bright and creative woman, has learned to use her brightness and her thinking, although at times distorted, to better control her emotions. This has allowed her in the last few years to have less difficulty with the police and other authority figures in the community, to reconcile with her daughter and to live in a supportive relationship with her family. It is also worth noting that both patients have learned to use their sense of humor, admittedly somewhat bizarre at times by my perception, in dealing with the world.

In the next blog I will talk more about chronic illness; specifically, chronic physical illnesses and physical disabilities such as brain injury.

Dr. Ron Breazeale

Partisan Politics - Part 4

Government needs to be strong & resilient

So what’s to be done about the partisan politics that is destroying the system we depend on—our government? There are some hopeful signs, people. Politicians seem to realize that the American people may be getting tired of negative campaigning and the paralysis and gridlock of their government. People want something to happen. They want things to move in a direction and hopefully they will during the next two years. The American people need to realize that things are difficult enough without us inflicting more harm on ourselves and our government. Honestly holding people accountable for their behavior is a good thing. Lying about and blaming your opponent for all the negative things that are going on in this world is not a good thing.

We need for our government to be strong and resilient. We need for those in charge of our government to practice the skills and the attitudes of resilience with each other.  This means that opponents need to connect with each other and be willing to communicate in a positive fashion and that both sides need to be more flexible than they have been willing to be.

We need to develop realistic plans and carry them out. Communication needs to be constructive. Strong feelings are good and passion a very good thing, but venting them and discharging them in negative and destructive ways should not be tolerated.

The American people need to regain confidence in themselves and in their government. We need to get back to remembering and acting on the values that this country was built upon. We need to realize that what is going on now will pass, that this is temporary, not permanent, and that it does not have to be pervasive and affect all the aspects of our lives. Blaming is not going to be helpful in moving us forward. We need to develop a sense of humor and be able to look at ourselves and how outrageously we may have behaved in the past few years.

All of this should go a long way to reducing the level of stress that we feel and that we have inflicted upon others around us. This change should also allow us to take a broader view of our world and to be more with the needs of others. We are all in this together, and if we destroy the system and infrastructure that holds us together, serves us and protects us, we will all suffer that loss.

Dr. Ron Breazeale

Partisan Politics Part Three

Are we losing faith and confidence in the present political system?

Partisan politics and negative campaigning are often motivated by very strong negative feelings of anger and fear regarding the other side who are seen as the adversary.  These feelings are often vented not in a very positive way, but through negative behavior focused on discrediting and destroying the opponent.

Feelings of anger and frustration with those you disagree with need to be discharged and vented, but not in a negative fashion. Asserting your position in a positive way can be a good thing. Expressing it in an aggressive and hostile fashion often only results in more of the same, and the paralysis of the system and the organization in which it is occurring.

One of the things that was obvious in the mid-term elections was that people have lost faith and confidence in the present political system. They are tired of nothing being done. They’re fed up with gridlock and paralysis. Unfortunately, the American people have lost a good deal of confidence in themselves as well. Confidence in yourself and the organization that you are a part of is one of the best buffers against fear and anxiety. The loss of confidence explains to some degree the increase in anxiety and fear in this country.

Another thing that happens when paralysis and rigor mortis sets in is that people begin to question where they and their country are going. Nothing seems to be happening. There seems to be no point and no direction. This, again, undermines the sense of confidence that people have in the organization that they are working in and are a part of. People need to feel that they have a direction and that they and the organization or group that they are a part of is acting in a way that is consistent with their values.  Clearly, in the recent elections the feeling was that many of the politicians and both of the political parties were not doing this.

Unfortunately, all of the above encourages people to feel that what is happening is going to be a permanent state of affairs and that its effect is going to be pervasive on them and their government. Partisan politics, as we have said, encourages blaming.  All of this can end up with people feeling pretty pessimistic about the future and contribute to people feeling depressed and increasingly angry and unhappy with their government, their lives and each other.

There is also a lack of real humor in partisan politics. Political cartoons, although sometimes quite creative, are usually aimed at discrediting the opponent and making fun of the opposition. When Paul LePage, Maine’s controversial governor, was reelected, the political cartoonist at our local paper drew a cartoon of himself celebrating the election, indicating that he would have another four years of LePage antics to do cartoons about.

Partisan politics is stressful for everyone involved, both for those who are being attacked and those who are attacking. I don’t know that much good ever really comes out of attacking and putting another person down and being negative and saying no certainly doesn’t end up with us doing much to take care of others who need our assistance. Partisan politics is focused on me, me, me, and my side and no one else.  It does not encourage people to be inclusive or to be concerned with the needs or the feelings of others who differ from us. As I have said a number of times in this blog, taking care of others is one way in which we build and maintain our own resilience.

Partisan Politics Part 2

The 'with me or against me' mentality

The “you’re either for me or against me” mentality does not encourage people to connect with others who have a different opinion or idea about how to do things. It does not encourage compromise or constructive debate with people who see things differently. By doing this, it often prevents creative solutions from being found to problems that are common to both groups.

Planning often is stifled and nothing happens. Plans that are made are often rejected out of hand by the other side and never carried out. It doesn’t take much effort to say no.  Witness the Republicans’ stand on Obamacare. They have yet, however, to introduce a clear plan that would be an alternative.

Communication when the lines are drawn so tightly often consists only of  threats and accusations directed at the other side. There is little in the way of constructive communication. Team problem solving is not encouraged, but discouraged. Compromise is a no-no. Again, nothing happens. Paralysis.

The skills and the attitudes of resilience that we have just reviewed, making a connection with other people, flexibility, developing realistic plans and taking action and effective communication are all undermined or negated by the kind of  partisan politics that exists.

Dr. Ron Breazeale

Partisan Politics

Negative campaigning works

The mid-term elections reminded me of the old movie, Network,  in which the character television news anchor Howard Beale was "mad as hell and not going to take it anymore.” He managed to get a huge following of people who were also “mad as hell and not going to take it anymore.” And they, like Beale, found someone to blame for all of their problems.

Unfortunately, since 911 it seems that many politicians have decided that they can mobilize support by capitalizing on the fear and anger of the electorate. Witness all of the negative ads that millions and millions of dollars were spent on this time.

And, unfortunately, partisan politics and negative campaigning works. It works to get the politician elected. But at the same time, I believe strongly that it undermines the resilience of the system in which it is practiced. The “for me or against me” mentality doesn’t make the system work any better.  It paralyzes it and will eventually destroy it. If that’s your goal, then using these tactics works very well. If the organization that you’re destroying is a corporation, perhaps you can jump ship and find another host. However, the organization that we are destroying in this country is our government.

In the next few blogs, I would like to discuss how partisan politics and negative campaigning is counter to sustaining the resilience of the system - our government - that we depend on to fix our roads, deliver our mail, protect us from foreign foes, and so many other concerns.

Dr. Ron Breazeale

Single Parenting

The upside and downside of going it alone

First, let me make it clear that I do not feel that single parenting is aversive.  It doesn’t have to be, but it does have its challenges. It has a lot to do with whether single parenting was your first choice. If it was not your choice and you lost a partner, either through death or divorce, there is grieving that needs to be done, both by you and by your children. This is something that is especially difficult for a parent to do when they’re dealing with their own grief. Having a support network of friends or family that can help you with this and can provide support for you and your children can hopefully make the whole process less painful.

And there are certainly rewards to single parenting. Single parents and their children often develop closer relationships because they are forced to depend upon each other more. Children often learn to take more responsibility for themselves and for others through this process.

But parenting is a lot of work. It is certainly good to have someone who can share the burden and the load with you. And, yes, at times it feels like a burden. This doesn’t have to be a spouse or a partner. It can be a close friend or a relative.

I am certainly not suggesting that couples stay together for “the sake of the children.” The research on that one is pretty clear. If a couple is in constant conflict, even the children often support their parents’ separating and divorcing. But I am advocating that if you are married, especially a young couple, and are having difficulty, hang in there and try to work things out if you can. Get some help. If you do divorce, try to keep the channel of communication open between you and your ex regarding your children. In almost all cases, it is a good idea to encourage your ex to have contact with the children. Try not to become involved in endless legal tangles regarding custody and visitation. This will only put more stress on your children as well as you and your ex-partner.

No matter how much anger and hurt you may feel with your ex, it is wise not to talk your ex-partner down with your children. Even if what you’re saying is true, the messenger carrying the bad news is often the one who suffers in the end.

So, good luck, if you’re a parent, single or not, you will need it.

Dr. Ron Breazeale

Encouraging Resilience of Our Children In Difficult Times

Is media encouraging pessimism in our children?

As I discussed in my previous blog, these are difficult times and, unfortunately, much of the information that we have been being bombarded with through the different media outlets is not helpful, but encourages a sense of pessimism. These stories, whether through a blog or cable television or postings on websites, often seem focused on convincing us that what is occurring is going to have permanent, negative effects on our lives and that this will never change no matter what we do and that the impact will be pervasive. They also seem focused on blaming someone for what has occurred. Unfortunately, this only encourages people to become depressed and pessimistic and to give up.

Our children are affected by these same forces. We need to teach them that most things, whether good or bad, do not last forever. Children should be taught to expect change and, indeed, welcome it.

A second thing we need to teach our children is that few events in our lives will have a pervasive effect, either positive or negative, on the quality of our lives. Indeed, things will have a specific effect. Bad things that happen may make certain aspects of our lives worse, but seldom will it affect everything and change everything. The same is true for positive events. They will not make everything better. Getting that A in science is great, but it doesn’t change everything. It doesn’t mean you don’t need to study for the next test or that next year will not be more difficult as the subject matter becomes more difficult.

And last of all, we need to teach our children not to blame others or blame themselves. This does not mean that we do not teach them to be accountable for their actions or to hold others accountable for theirs. We simply teach them not to waste a great deal of energy and time in the emotional upheaval that goes along with blaming ourselves or blaming other people. This process is not helpful.

As I mentioned in the previous blog, the American Psychological Association has developed a number of brochures and information regarding how we can help our children deal with difficult times. There is a specific brochure available entitled, “Resilience in a Time of War,” tips for parents and teachers of elementary school children. The brochure is available from the American Psychological Association website by going to the help center on the website.

Here are briefly some of the things that the brochure encourages parents to do.

         1.      Talk with your child. Don’t assume that they’re not interested or they’re not thinking about or having feelings about what is going on.  Kids, in general, are more aware of things going on around them then most adults give them credit for.

         2.      Make your home a safe place emotionally for your child and limit the amount of news your child watches or sees over the Internet.

         3.      Keep things in a positive perspective with your child.  When you talk about bad times and bad things that are happening, make sure you also talk about good things that are happening and that there will be good times in the future as well.

         4.      Reassure your children that they will be okay.

         5.      As indicated in the previous blog, have an emergency plan and have an emergency kit.

         6.      Have a routine, both for you and the children, and stick with it.

         7.      And last of all, take care of yourself so you can take care of them.

Dr. Ron Breazeale