Author Archives: No symbols where none intended

(DIM) Developmental Integration Malfunction, or, Distraction Gone Wild

Recently I have been developing something I call (DIM), Developmental Integration Malfunction.

This occurs when one’s main drives are fueled by fear of rejection and its twin, need for acceptance. When a person experiences powerful rejections such as a job termination, or death of a loved one I have observed that he or she will display a lack of any genuine positive emotion. Of course, if such a person experiences this at an early age, elaborate defense mechanisms become integrated within the developing ego, the survival mechanism.

Often this is noticeable when in spite of the fact that one’s life is in a mess, and the individual is not happy, he or she maintains an iron-clad rational for everything. Fear is highly motivating and almost always will castrate one chances for fulfillment and love. Ultimately, it can cause a person to self-sabotage as fear drives such a person to live by default. What I mean by that is one moves away from feeling experience to looking at the experience cognitively and intellectually. This is not the same as feeling. Many so called “do-gooders” are overly obsessed with how they are perceived and the need to feel accepted. They have dodged their paths or purpose in favor of external distractions. Even when one’s personal and professional life comes crashing down, he or she persists in sidestepping with worn-out behaviors. This is my definition for “Developmental Integration Malfunction.”

When one is hurt and or traumatized emotionally, the common reaction is to protect oneself from future attacks. Deep trauma causes dysfunction of awareness. If left unchecked, much of one’s subsequent developmental behavior is designed to avoid personal feelings. It is ironic to me that this defense mechanism will rob a person’s quality of life thus creating meaninglessness and no fulfillment. Additionally, it is highly insidious. However, and like addiction, it is very effective at creating a sense of safety… for a while. As emotions attempt to move towards awareness, which is what they are designed to do, the individual with DIM, Developmental Integration Malfunction, requires progressive and more effective external distractions. Ultimately, the inner self is unknowable. The fortress is defended by a host of behaviors such as aggression, anger, obsessive behavior, co-dependency, depression, manipulating behaviors and lying, thus pulling the body away from self-awareness.

The cost of this to the individual is huge. The need for acceptance is born out of a fear of rejection. Without the cultivation of awareness, this individual cannot see or change the pattern. This leads to years of living an inauthentic life which is the foundation for failure. As he or she is sinking and recoiling to the bottom of the little pond he or she once felt was theirs to control, he or she commonly thinks that it is temporary.

There is nothing sudden or temporary about it. It is the natural result of years of self deceit and pushing away behaviors. The flow of emotions is the mechanism by which we connect the physical body with the sense of self. Without this function, the individual sets up a vicious cycle resulting ultimately in failure.

The cause of fear of rejection can stem from a range of experiences such as being teased as a child to the death of a loved one. It wreaks havoc in a person’s life at some point. Unfortunately, it is often not until everything falls apart, combined with his or her ability to accept that this has happened, that answers are sought.

The more one understands their fears the better he or she can learn to unravel their tiers of defensive behaviors and live a healthy life. Recovery and a joyful life are possible. I am living proof that all the abundance of life is yours for the asking.

Synapse and the Art of Relationship

Before I post Joyce Marter’s article, I just want to remind you that:

Evil is boring.
Cynicism is idiotic.
Fear is a bad habit.
Joy is fascinating.
Love is an act of heroic genius.
Receptivity is a superpower.

…now for relationship wisdom…

25 Simple Ways to Improve Your Relationships at Work & Home
By JOYCE MARTER, LCPC

Smile. Put a smile on your face and in your eyes, voice and heart as often as possible.
Make eye contact. Look people openly, warmly and squarely in the eye.

Open your body language. While facing the person with whom you are talking, open your chest, your heart and your arms.

Address people by name. Honor people by calling them by name as you greet them, give them thanks, ask a question or bid them farewell.

Speak with a friendly tone. Warm your tone of voice with love and kindness.

Be present. Give your complete and undivided attention to others when they are speaking to you.

Express gratitude. Focus your attention on the goodness in others, verbalize all that you appreciate and give thanks.

Slow down. Breathe and gift yourself and others with time to properly address situations and transition from them.

Reflect empathy and compassion. Honor people’s emotional experiences. Normalize and validate their feelings so they feel heard, known and understood.

Have integrity. Keep your word. Do what you say you are going to do. Live according to your values.

Have good manners. Be polite, conscientious and gracious.

Demonstrate thoughtfulness. Get out of your own head and be of service to others. Consider their feelings and experiences.

Give genuine compliments. Tell others their strengths, give positive feedback and express what you admire about them.

Give salutations. Make the effort to open and close verbal and email interactions with a nice greeting or closure, rather than abruptly asking for something with neither a hello nor goodbye.

Be generous. Give and share whatever you can, whenever you can.

Be kind. Be the bigger person. Kindness is a choice.

Show compassion. Demonstrate self-compassion by cutting yourself some slack extend this same compassion to others. Let go of criticism.

Be patient. Breathe and breathe out. Patience is a virtue. There is great value staying in the present moment and not hurrying our minds or bodies onto the next task.

Demonstrate self-awareness. Consider how what you are saying will feel to them and how it will impact them. Notice the impact you have on others by paying attention to their facial expressions, tone and body language. Make adjustments accordingly.

Be truthful. The truth has different layers and sometimes the deepest layer is hurtful or inappropriate. Speak the truth from the deepest layer that is appropriate. Speak from a place of kindness.

Be reliable. Follow through with responsibilities and commitments with competency and effective communication.

Be forgiving. Each time somebody else makes a mistake it is an opportunity for you to extend kindness and compassion. Let go of resentments that keep you tethered to the past.

Apologize. We are human and nobody is perfect. When you make a mistake, make an amend or extend a sincere and timely apology.

Take responsibility. Drop the defensiveness and the excuses and accept responsibility for yourself, your actions and your behaviors.

Express love. Be open-minded and non-judgemental. Extend love to yourself and to others. Choose to be loving whenever possible—it is always possible.

Schizophrenia

He Forgets His Medication
by
Pathways

Schizophrenia is a chronic illness that affects nearly every aspect the client. Treatment planning should focus on reducing or eliminating symptoms; maximize the quality of life and adaptive functioning, and advance and retain recovery as much as possible. The implications of an inaccurate diagnosis are potentially enormous. Thus, it is very important that the diagnosis be a process, and not the one-time result of a fixed moment in time. The treatment plan must be looked at as a work in progress especially as the diagnosis is reevaluated or because of new information becoming available concerning the symptoms, or the client.

The case study “He forgets to take his medication”, a 45-year old male with chronic schizophrenia who continually relapses after two weeks or so due to forgetting to take his prescriptions. The client does keep his appointments. Although the medications do alleviate his symptoms, he is non compliant to his prescription therapy. Therefore, his psychiatrist adjusts the therapy to biweekly injections.

According to Butcher, Mineka and Hooley (2007) “anti psychotic medications are usually administered by mouth. However some patients, particularly those with chronic schizophrenia, are often not able to remember to take their medications each day” (pp. 609-610). Therefore in treatment planning the clinician is wise to identify barriers that may prevent the client’s ability to carry through with the directions of the therapy. For example if the client is severely cognitively impaired or disorganized or less than optimal environmental circumstances.

My choice of a therapeutic approach is multifaceted for this client. First, I would recommend performing a medical and mental evaluation and history of these including a mental status examination, neurological, and laboratory examinations with vitals such as heart rate, blood pressure and temperature. I would also recommend a toxicology screening. If possible, and if the client gives permission, interviews with family or associates could be conducted especially if the client’s accounts are unreliable. Because he has been unsuccessful at self administering his medication, the reason for this should be assessed and included in the treatment plans. As soon as possible, so long as the diagnosis is not interfered with, pharmacological treatments should be administered because of the risks associated with the symptoms of schizophrenia such as emotional trauma, the stress and disruption of the client’s life, and the possibility for self-harm.

Butcher et al. (2007) have stated: “Not all prospective clients, regardless of their need for treatment, are ready for the temporary discomfort that effective therapy might entail. In particular, a client with chronic schizophrenia and who is recently off medication or only taking it intermittently, may be too unstable for traditional psychotherapy because facing past experiences or simply to undergo any additional emotional pain could traumatize the client further. An integrated treatment program for this client will combine medications with a range of psychosocial services, social skills activities, community-based care, and possibly cognitive behavior oriented and eclectic therapy. Several factors to consider include the possibility for substance abuse, depression, and aggressive behavior. Craighead, (as cited by Butcher, et al., 2007) states Beck’s cognitive treatment therapies are highly documented to be efficacious for long-term alleviation of symptoms and relapse which for this particular case study could be promising. Cognitive behavior may help him cope with and process stresses so that full blown feelings of anxiety or panic may be averted.

In addition to educating clients and their families about schizophrenia, and dispelling unhelpful attitudes, cognitive behavior therapy could uncover false beliefs. In this regard, educating the client about the importance of participating in treatment, including medication and the relationship to stated personal goals might be able to be achieved because the client could see how behavior, cognition and emotions are directly impacted by medication. Awareness of the relationship between the consequences of schizophrenia and how it interferes with normal functioning will build connections that may improve the life experience of the schizophrenic client.
Finally, I think that treatment should involve highly structured behavior techniques and skills building, because these may positively influence the client’s increased chances of stabilization.

References:
American Psychiatric Association. (2000). DSM-IV-TR. Arlington, VA: Author.

Butcher, J. N., Hooley, J. M., & Mineka, S. (2007). Abnormal psychology (13th ed.). Boston: Pearson Education.

Depression & Dysthymic Disorder

Depression & Dysthymic Disorder~ What’s the difference?
pathways March 3rd, 2010
The associated symptoms of Dysthymic Executive disorder are similar to those for a Major Depressive Disorder (DSM-IV-TR, 2000). In Dysthymic Disorder common symptoms include feelings of inadequacy; generalized loss of interest or pleasure; social withdrawal; feelings of guilt or brooding about the past; subjective feelings of irritability or excessive anger and decreased productivity (including activity and effectiveness). Vegetative Symptoms are less common for Dysthymic Disorder than for clients in a Major Depressive Disorder. Additionally, up to 75% of clients with Dysthymic Disorder for more than five years will develop into Major Depressive Disorder (DSM-IV-TR). The differential diagnosis between dysthymic Disorder and Major Depressive Disorder is made “particularly difficult by the facts that the two disorders share similar symptoms and that the differences between them in onset, duration, persistence, and severity are not easy to evaluate retrospectively” (p.379).

According to the DSM-IV-TR it seems to be a matter of severity and interference in a person’s life that most distinguishes the difference between the terms Dysthymic and Major. “Dysthymic” is like a starting point, whereas “Major” implies great, significant and deeply important. The symptoms of Major Depressive Disorder are cognitive, behavioral and physical and can derail a person’s normal functioning. The symptoms for Dysthymic disorder are less persistent, and not so interwoven within the client’s worldview and experience of self.

Aside from overlapping cluster symptoms, additionally to further complicate the creation of an accurate diagnosis other associative disorders, such as anxiety, can be present and occur co morbidly. “At the diagnostic level there are very high levels of co morbidity between mood and anxiety disorders” (Butcher, Mineka & Hooley, 2007, p.231).

Overlapping symptoms are associated with milder forms of depression and Major Depressive disorder. The client may show many severe symptoms such as feeling physically tired having: trouble concentrating, feelings of worthlessness, low energy and feeling somewhat estranged from normal activities, and/or responsibilities.

In truth, the etiology of depression is complicated and multidimensional, thus offering a distinction between Dysthymic and Major Depression that is blurry at best. Without the distinguishing criteria of severity, interference, and losing all interest in what previously brought pleasure, up to a point the symptoms are almost interchangeable.

Depression can occur during any stage throughout a person’s lifespan. The main symptoms of Major Depression Disorder are depressed mood (persistent sadness and depression, and /or feeling down); crying; sleep problems; weight loss or gain; psychomotor agitation or retardation; suicidal ideation; poor concentration; low self-esteem, and feelings of worthlessness or guilt; fatigue and several subtypes like melancholic, catatonic, or psychotic features (Spark Chart, Abnormal Psychology, 2004).

Dysthymic disorder has similar symptoms; only they are much less severe.

References:

American Psychiatric Association. (2000). DSM-IV-TR. Arlington, VA: Author.

Butcher, J. N., Hooley, J. M., & Mineka, S. (2007). Abnormal psychology (13th ed.). Boston: Pearson Education.

SparkChart, 2004. “Abnormal Psychology”. Barnes & Noble : USA

Top 10-Reasons your life may not be as you want it to be: (another re-post)

  1. Resistance
  2. Believing in and telling lies
  3. Setting yourself up
  4. Not being in charge
  5. Listening to and believing in fear
  6. Over identifying in false states of awareness (trances)
  7. and Forgetting your true nature and origin
  8. Low self esteem
  9. Harboring delusions about attachment and surrendering
  10. Maintaining a toxic mind and body