Learning From The Past and Planning For The Future
MENTAL HEALTH MOMENT May 31, 2002 "One man's way may be as good as another, but we all like our own best." - Jane Austen
Short Subjects
LINKS Mental Health Moment Online CONFERENCES AND WORKSHOPS:
Challenge the System: Open the Door to Victims with Disabilities
June 23 - 24, 2002
Parkway Plaza
Casper, Wyoming
Registration deadline:
June 14, 2002
Registration fee: $125 Limited Registration Scholarships Request
by phone only:
307-766-2761
Accommodations:
Parkway Plaza
Casper, WY
$50 + tax, available until June 9, 2002
Phone: 800-270-7829
Contact:
WIND Receptionist:
Phone: 307-766-2761
Fax: 307-766-2763
EMAIL:
wind-challenge@uwyo.edu
Mail:
WIND-Challenge the System
PO Box 4298
Laramie, WY 82071-4298
3rd Ibero-american Congress on Clinical and Health Psychology November 20 - 23, 2002 Caracas, VENEZUELA Contact:
Zuleyma Perez
Alcabala a Puente Anauco
Edificio Puente Anauco Piso # 2, Apartamento # 27
La Candelaria, Caracas (Venezuela)
Tel./Fax: (+58) 212-5713060
Email: apicsavenezuela@cantv.net; apicsa@attglobal.net Deadline: Submissions July 6th, 2002International Conference on Surviving Trauma With Dignity
Baku, AZERBAIJAN REPUBLIC
July 5-13, 2002
Contact:
Alexander M. Cheryomukhin
Director of the International Department
Azerbaijan Psychologists Association
18 Nizami str. 93, Baku 370000
Azerbaijan Republic
E-mail: alexcherpsy@yahoo.com2002 International Community Development Society Conference - Building Peace: Community and Diversity
July 20-24, 2002
Cleveland, Mississippi, USA
Contact:
Jerry W. Robinson Jr., PhD
Center for Community Development
Delta State University
PO Box 3134
Cleveland, MS 38733
Tel: 662-846-4359; Fax: 662-846-4359
E-mail: jrobins@dsu.deltast.edu
DIVORCE WEAKENS TIES WITH GRANDCHILDREN
Grandparents who have experienced a divorce, particularly grandfathers, do not have as much contact with their grandchildren and take part in fewer shared activities than those who do not divorce, says a Penn State researcher. In a study of divorced grandparents' attachments to their grandchildren and attitudes about grandparenting, Valarie King, assistant professor of sociology, demography and human development and family studies, found that divorced grandfathers tend to live twice as far away from grandchildren as divorced grandmothers. For the full story by William Harnish, visit: http://www.psu.edu/ur/2002/grandparentdivorce.html
PATHS TO EGALITARIAN GENDER ATTITUDES DIFFER
Men must grow up in nontraditional households to become forerunners, or people who foreshadow the easing of traditional gender attitudes, while women develop such attitudes later in life, researchers say. Forerunners are opinion leaders who are far ahead of members of both the previous generation and their own generation, explain Alan Booth, distinguished professor of sociology and human development and family studies at Penn State, and Scott Myers, of Washington State University, who examined the children of forerunner parents and published their results in the March issue of Social Psychology Quarterly. For the full story by William Harnish, visit http://www.psu.edu/ur/2002/forerunners.html
EL NINO
Anchovies as meteorological predictors? Who'd have thought!? Well, it seems that huge shoals of the salty little fish - one of the world's great fish stocks - have disappeared from the waters of Peru. Scientists say such a disappearing act is a classic indication of the onset of El Niņo, the climatic aberration that can bring chaos across the world. The reason? Well, the El Niņo phenomenon is the result of a reversal of ocean and wind currents across the equatorial Pacific. It happens when a pool of very warm water normally present around Indonesia spreads across the ocean. Anchovies are cold-water fish, and they don't like it when things get a little toasty. If the predictions are correct, 2002 could be the hottest on record worldwide - which will make things a little toasty for us humans, as well!
SCREENING FOR ABUSE IN SPANISH-SPEAKING WOMEN
Many tools have been developed to increase clinicians' ability to detect violence, however, all are written in English. J Am Board Fam Pract 15(2) 2002 http://www.medscape.com/viewarticle/432574?srcmp=psy-051702
SLEEP PROBLEMS MAY PREDICT POST-TRAUMATIC STRESS DISORDER
People who experience problems sleeping shortly after a traumatic event may be at risk for post-traumatic stress disorder (PTSD), Israeli researchers report. http://www.medscape.com/viewarticle/433517?srcmp=psy-051702
Canteen Provides Oasis From Stresses of Kuwait Military Base
For thousands of U.S. service members at Camp Doha in Kuwait, there is no escape from the dry desert heat. The American Red Cross canteen provides them with a refuge.
Another Wildfire Scorches Colorado Forests
The American Red Cross is responding to the fourth major wildfire to scorch Colorado in just one month.
At Least 7 Killed in Oklahoma Bridge Collapse
The American Red Cross is assisting affected families and recovery crews after a barge collided with an I-40 bridge in Oklahoma, killing at least seven people.
Psychotherapy and counseling are very complex operations. The moment to moment activity requires a complicated phenomenology of linguistic, paraverbal, semantic and contextual factors to merely describe the interaction. Beyond that are the descriptions that "explain" the process. Counseling/therapy consists of a series of encounters that unfold over a period of weeks, months, or years in which subtle and dramatic changes in behavior may take place. Regardless of the cultural context, counseling and psychotherapeutic procedures take place in a communicational matrix. They operate as agencies for change - i.e., for betterment or improvement. The expectation is that the interventions by the therapist will change objective behavior (adaptation, adjustment, achievement, as well as subjective behavior) in terms of conflict resolution, diminution of symptoms, and increased understanding. Procedures vary between nations, societies, and cultures, as well as within societies and cultures themselves. The definitions of deviance, normality, and abnormality vary significantly between cultures as well as within cultures. They also vary considerably among social classes. The belief that the psychotherapeutic procedure will "work" (positive expectancy) or the manner in which it will "work" also varies within a society. This is particularly true with regard to the accessibility or opportunity for therapeutic interventions. Psychotherapy and counseling are merely formalized and socially authenticated procedures for problem resolution. These procedures are sought by individuals who are defined either by themselves or by others as being in need of extraneous (i.e., professional) assistance. That need is present when naturally available resources inside and/or outside the client have been depleted or found inadequate in handling stress, preoccupations or other difficulties. Within American psychology there has been an increasingly critical examination of the auspices under which counseling and psychotherapy are conducted. In the past, some of this criticism has focused on failure to consider factors related to culture and/or class. Such criticisms have coincided with the recognition of increasing needs for therapeutic procedures among ethnic and non-ethnic Americans. These needs have been very well stated by Levine (1976) and summarized by King (1978). Levine postulated that if industrial society were to maintain its present set of conditions (weak social structures, diffuse and rapidly changing values, vague adult gender roles), the incidence of disorder will undergo a continuing and substantial increase (p. 420). King (1978) reviewed the research literature examining cultural variables regarding differential responses to the stress of changing conditions present in contemporary society.
SOME CULTURAL AND STATUS FACTORS IN COUNSELING There is some evidence that groups with structures or rituals for relieving guilt, anxiety and grief, that allow children to deal with supportive adults, and provide status for women and elderly persons have low depression and psychological disorder. There is also clear evidence that individuals or groups that are unable to maintain some continuity of change, but still maintain cohesion through custom, language, worship, life-style and ceremonies, develop a buffering against the breakdown characterized by persons without roots (p. 418).There are indications of increasing need for counseling and therapeutic procedures. This need is being expressed at a time when the differential effects of culture on psychological health and disability are becoming matters of common understanding. There is a promise of the importance of ethnicity that could lead to a more sophisticated understanding of the process of psychotherapy and counseling. This could also lead to setting up more relevant and responsive services for ethnic clients. Important Factors Luborsky, Auerbach, Chandler, and Choen (1971) reviewed outcome studies that looked into the quality of match between client and therapist. Generally, results have uniformly demonstrated that concordance in social class, education, and ethnicity is correlated with positive outcome in therapeutic situations. In spite of the need for commonality between the participants, the therapeutic situation itself requires a calculated asymmetry (i.e., imbalance) in the social roles, status, and objectives of the client and therapist. In all cultures, the therapist is a culturally authenticated healer whose social role is to provide help. In contrast, the client is identified as a person present in the role of needing help. The primary intention of the therapeutic encounter is to produce change (i.e., improvement and relief) for the client. Torrey (1972) placed the healer-client role asymmetry in cross-cultural perspective, demonstrating that these qualities of expectation are indeed universal. However, the particulars are extremely varied in regard to cultural differences. In all cultures, the "healing" procedure takes place in a distinctive physical setting. This is in order to differentiate the situation from similar but less auspicious encounters. In addition, some form of confidentiality or "secrecy" about what is discussed is implicit and may often be explicitly guaranteed. In contrast to ordinary conversational situations, the procedure seeks out rather than avoids areas of conflict, anguish, confusion, and heightened emotion. Unlike ordinary life situations, the procedure is not reciprocal in terms of ebb and flow of dialogue. The interaction is created to focus on the behavior and subjectivity of the client. The situation also fosters reflection and inaction (during the encounter) rather than reaction. However, some procedures (e.g., psychodrama or behavior modification) may focus on rehearsing particular actions. Psychotherapeutic procedures take place in the context of "past", "present" and "future". However, there are significant cross cultural differences in orientation to this chronological spectrum. Western psychotherapies generally stress past/present connections. Murase and Johnson (1974) described two Japanese procedures (Morita and Naikan) that only sparingly investigate the past. In contrast to Western traditions, concentration on the origins of ambivalence and replaying infantile conflicts would be regarded as "sick". In other words, this would be antithetical to Japanese cultural values, which extoll forgiving, forgetting, or even pretending to ignore the past in order to conduct contemporary relations. Kiev (1972) summarized a number of "culture specific syndromes" and contrasted them alongside analogous Western conditions. Emphasis on the past is often highly focalized and brief in treatment of these syndromes by indigenous therapists. Cross cultural differences and similarities are illustrated in two culturally contrasting situations described by Torrey (1972):FIRST CASE (Western "middle class) psychotherapy): The psychiatrist looked thoughtfully at his patient. "You looked angry when you were just talking about your father. You often look angry when you talk about him. I wonder if something happened to you once that made you angry at him." At this point the patient broke down sobbing, blurting out a forgotten history of neglect and deceit by a thoughtless father toward a little girl. Afterwards the patient felt better. SECOND CASE (Psychotherapy with an "indigenous" healer): The witchdoctor stared solemnly at the small shells. They had landed in a pattern resembling a large animal. He picked one shell up and examined it minutely. "You have broken the taboo of your family. It has offended the sacred bear that protects your ancestors. That is why you are sick." The patient and her family breathed a sigh of relief. It was as they had suspected. Now that they knew for certain what was wrong they could proceed with the necessary sacrifices. After these had been made, the patient began to get better. (p. 70)Each case illustrates a culturally authenticated healer having an effective transaction with his client through a consensually acceptable "explanation" of the client's difficulty. This action results in release of tension and an opportunity for change (i.e., improvement). The differences are that the cultural substantiation of the therapists are very specific and the causal/motivational explanations are very culture bound. It is not important to establish the veridical truth of whether a client is despondent because of offending a sacred bear, or because of a father's coldness. Neither statement is absolutely "true" or "false", except inasmuch as each of them can be legitimated as a plausible and consensual explanation of current difficulties. Given such arbitrariness, the need for "fit" between therapist and client is one of the most critical variables in the psychotherapeutic situation. Potential for distortion or misunderstanding is evident based on ethnic, gender, and class biases and the shifting nature of what may be held to be "true" and authentic for different persons coming from different cultures or class settings. In spite of superficial differences in techniques (cross culturally as well as within the same cilture), there are certain fundamentals which are pertinent to all therapeutic situations. Marmor (1971) discussed some of these "basics" when comparing behavior therapy with psychoanalysis. He listed the following as being generic to both methods of treatment:1. Release of tension through catharsis - Globally, "catharsis" refers to the tension relief that accompanies the divulging and sharing of information in a specialized context of trust and intimacy. Regardless of variations in technique or cultural setting, the joint communication between therapist and client constitutes a process through which an "intersubjective consensus" develops regarding the meaning of what has been told and said (Johnson, 1975). Berger and Kellner (1964) initially drew attention to the significance of such consensus in their analysis of personality support systems developing between marital partners. Berger and Luchmann (1967) later elaborated on the characteristics of the intimate sharing of communication which they defined as "the social construction of reality". According to their definitions, continuous and intimate communications in therapeutic as well as in specialized non-therapeutic situations uses a process which they termed "legitimation". They stated that:Summary There is a clear danger in focusing on specific ethnic status while ignoring the bicultural situation in which both the client and the therapist must navigate. This applies in many countries. However, both North and South American societies are particularly pluralistic. The importance of bicultural understanding in these situations is especially critical. Concentrating on a limited set of specific subcultural norms, both the therapist and the client may ignore the reality that behavioral adjustment in a pluralistic society must take into account the understanding of complex normative systems that situationally fluctuate depending on the context (e.g., work situation vs family situation vs in-law situation, etc.). An overemphasis on the cultural or subcultural "fit" between therapist and client may unintentionally promote an illusion of commonality, as if ethnic experience were uniform. It's obvious that, regardless of commonalities in gender, class, and ethnicity, there are striking variations in experience and subjectivity present within all subcultures. *************************************************************************************************The most important conceptual requirement for alternation (i.e., change in behavior) is the availability of a legitimating apparatus for the whole sequence of transformation. What must be legitimated is not only the new reality, but the stages by which it is appropriated and maintained. (p. 159)2. Cognitive learning, both through trial-and-error, as well as of the gestalt variety - Regardless of the cultural setting, the therapist reinforces (i.e., legitimates) interpretations and conclusions that have been implicit in the narrations of the client. The form of such legitimation varies according to differences in method, differences in cultural setting, and characteristics of the participants. It is universally accepted that aspects of the psychotherapeutic process can be productively understood by analogy to education and learning. The literature on behavior modification is based on a detailed explanation of the therapeutic situation in terms of highly specialized characteristics of the learning process. 3. Reconditioning by operant conditioning (through implicit or explicit reward or punishment) - Conditioning is generally acknowledged as a ubiquitous and essential factor in psychotherapy and counseling. Regardless of the technique, "school" of psychotherapy, or culture in which the procedure take place, the client is progressively conditioned through reinforcement and reward toward the acquisition of new understandings, insights, and techniques which can be applied to improved levels of performance and comfort. 4. Identification with the therapist - The relationship with the healer is generally regarded as a prominent component of psychotherapy and counseling. However, in some procedures, the relational aspects may be intentionally or ceremonially minimized. Most cultures outside the American accept the therapist as an authority figure, even with the potential for coercion. Indeed, they find such a situation desirable and consistent with status relativity within the culture (Murase & Johnson, 1974). The relational aspects of psychotherapy are generally acknowledged. However, the degree of importance and the explanations for such significance are often hotly disputed. Some of this dispute may be based on class, cultural, or subcultural differences in expectations connected to therapist/client interaction. Other differences in viewpoint relate to disputes concerning the operational, theoretical explanation of the therapeutic process itself. 5. Repeated reality testing as an equivalent of practicing in the learning process -Reality testing in the therapeutic situation is described by Marmor (1971) as a form of "practicing" which has to do with adjusting and accommodating to newly discovered ways of thinking and behaving. Operationally, "reality testing" refers to a process through which the social reality is repeatedly defined and legitimated.REFERENCES Berger, P. & Kellner, H. (1964). Marriage and the construction of reality. Diogenes, 46, 1-25. Berger, P.L. & Luchmann, P. (1967). The social construction of reality. Garden City, NY: Anchor Books. Johnson, F. (1975). Some problems of reification in existential psychiatry. In R.G. Geyer & D.R. Schweitzer (Eds.), Theories of alienation. Leiden: Martinus Nijhoff. Kiev, A. (1972). Transcultural psychiatry. New York: The Free Press. King, L.M. (1978). Social and cultural influences on psychopathology. Annual Review of Psychology, 29, 405-433. Levine, E.M. (1976). Psycho-cultural determinants in personality development. Volta Review, 78, 258-267. Luborsky, L., Auerbach, P., Chandler, M., & Choen, J. (1971). Factors influencing the outcome of psychotherapy. Psychological Bulletin, 73, 145-185. Marmor, J. (1971). Dynamic psychotherapy and behavior therapy. Archives of General Psychiatry, 24, 22-28. Murase, T. & Johnson, F. (1974). Naikan, Morita and Western psychotherapy. Archives of General Psychiatry, 31, 121-128. Torrey, E.F. (1972). What Western psychotherapists can learn from witchdoctors. American Journal of Orthopsychiatry, 42, 69-76. To search for books on disasters and disaster mental health topics, leaders, leadership, orgainizations, crisis intervention, leaders and crises, and related topics and purchase them online, go to the following url: https://www.angelfire.com/biz/odochartaigh/searchbooks.html ********************************************************************** ********************************************************************** Contact your local Mental Health Center or check the yellow pages for counselors, psychologists, therapists, and other Mental health Professionals in your area for further information. ********************************************************************** George W. Doherty O'Dochartaigh Associates Box 786 Laramie, WY 82073-0786 MENTAL HEALTH MOMENT Online: https://www.angelfire.com/biz3/news
