Boredom
9-1-10
by Dr. Lorin Bradbury
Question: I’m tired of hearing my children say, “I’m bored.” I wish someone would come up with more things for my children to do. We have a television in every room, several computers in the house, all kinds of electronic toys, and still they are bored. I find that I have very little time to myself, because they are constantly complaining about being bored. I buy them a new game or toy, and it seems within a few minutes the newness has worn off and they are bored. I almost feel guilty raising my children in our community because there seems to be nothing for them to do. Is this normal, or is it something I should be concerned about?
Your question is loaded with things for me to respond to, but my response might not be what you are expecting. My hunch is that your children’s boredom is normal, except for a possible addictive quality to it. But you may be looking for suggestions from me that include more forms of stimulation for your children. And if I state that I believe their boredom is not normal, you may very well be looking for me to suggest some form or therapy, or even a pill that might take away their boredom. I apologize if that’s a bit sarcastic, but please bear with me.
The complaint of boredom in children is normal. It’s probable that Adam and Eve’s children complained to them that they were bored. George Will recently addressed the subject in Newsweek with the statement, “Humanity can boast that it is capable of boredom, but there may now be an unhealthy scarcity of that particular brain pain.” He cited Adam Cox writing in the New Atlantis. “Fifty years ago, the onset of boredom might have followed a two-hour stretch of nothing to do. In contrast, boys today can feel bored after thirty seconds with nothing specific to do.” I agree with Mr. Cox, except that it’s not only boys that get bored after thirty seconds; girls are prone to the same.
What has changed? With the advent of television, and more recently, a barrage of electronic games and communication devices, we have come to expect to be constantly entertained. We fail to realize that the painful experience of boredom could spawn creativity.
National Public Radio (NPR) last year ran a series of stories on the loss of creativity that has been directly linked to children being in organized activities at a younger and younger age. Years ago, it was unheard of to put young children in organized sports and other forms of regimented activity. Instead, they kicked a ball around in their backyard and made up their own rules. This spawned creativity. In fact, when was the last time you saw a backyard fort? It was there that children made up club rules, established a pecking order, and learned either to work together cooperatively or submit to a dominant leader. What’s wrong with a young boy turning an empty 50-gallon oil drum into a bulldozer, or a group of young girls using empty cans to create a tea set and have a tea party?
I would suggest that your children don’t need more things to entertain them; they need less. The next time you are tempted to buy your child another electronic device, go ahead and buy it, but throw the electronic device away and give them the box. Better yet, save your money and go to the bin at AC and pick out some nice big boxes, take them home and pile them in your living room. When your kids complain of being bored, tell them to go play in the living room, but don’t give them any instructions. See what they do with the boxes.
Some of the constant complaining about being bored is analogous to the dry drunk—an addictive behavior. Years ago, Marie Winn wrote a seminal book on television watching, entitled “The Plug-in Drug.” Research showed that when children were withdrawn from television watching, they displayed behaviors similar to an alcoholic withdrawn from alcohol. For a period of time, they were irritable and often paced the floor, and were nonproductive. They were experiencing what I call psychic pain, an internal discomfort. The truth of the matter is that if given enough time, the discomfort goes away and people learn to be more creative with their time.
If you are really serious about getting help for your children, consider unplugging all forms of electronic entertainment, and try going without it for a week. Or, you might limit the number of hours of electronic input to one or two at the most. That includes all forms of electronic gadgetry, so you cannot move to the computer when the TV is turned off, or to another electronic game. Also, it means removing TVs and computers from all of your bedrooms. No cheating is allowed. Try it and see what happens after a week. Hopefully, you won’t want to go back to the old addictive behaviors.
Another thing I noted in your questions was the sense that you seemed to be looking for someone or something else to entertain your children. If you were not ready to be involved with your children, why did you have children? When you had children, you should have planned on at least eighteen years of your life not being your own. You are right when you say you don’t have time for yourself. That will come, and actually, if you play with your children, instead of looking for other people and things to do the entertaining, they will likely develop a higher level of creativity and be better able to entertain themselves.
Also, I feel compelled to address the topic of work for your children. All children should learn to share in chores around the house. Toddlers can be taught to drop their dirty diapers in the trash once you have changed them. Young children can be taught to make their beds with your help. Toys can be regularly picked up and put away before meals or naptime by the children. Then there is berry picking, fishing, etc. where children can be very involved with their parents’ activities. As children get older, they can become more and more involved in work around the house, and in some situations, join their parents on the job. This is particularly true when a parent is self-employed.
So, boredom might be a sign that your children have too many thing provided for them, instead of not enough. If your children are young, you might consider reading to them or looking at picture books together. Before long, they will be enjoying the books themselves, and may be telling the stories to the younger children. Teach them how to play board games and card games. Initially, that will require your involvement, but once they have learned, they will likely play among themselves.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
How to improve your love life
8-26-10
by Dr. Lorin Bradbury
Question: I don’t quite know how to ask this question, but how can I get my wife to be more loving to me? I try really hard to reach out to her, but it seems like my attempts are met with coldness. I don’t mean to be disrespectful, but it’s like she’s frigid or something. Am I doing something wrong, or does she need counseling. Please help me. I’m really feeling desperate right now.
One of the first things to recognize is that as time passes people change and as a result relationships change. It’s possible that there are things on her mind that are interfering with intimacy between the two of you. She may not be able to come right out and tell you, or she may not ye have figured out what is bothering her. From your question, it seems apparent that you are referring to not only intimacy between the two of you, but your sex life as well. There are some things you can do, and the first might be to make a commitment to being patient.
I recently read an article by sex educator Logan Levkoff, Ph.D. Though Dr. Levkoff’s and my moral values concerning the topic of human sexuality differ greatly, the article I read lists five suggestions that may be helpful to your situation. As a woman, she provides considerable insight into female thought processes that lead to sexual responsiveness. I will list the five suggestions in the article I read and add my own comments for your consideration.
1. Snuggle, Don’t Grope. Try hugging or kissing your wife. Reach out and take hold of her hand; give it a little squeeze. Dr. Levkoff explained why a gentle hug or squeeze of the hand might be so effective. “[S]tudies show that if you hug for partner for 30 seconds it raises her oxytocin levels. Oxytocin is a hormone that makes us feel loving and connected and helps put us in the mood. So start with a hug.”
2. Don’t Treat Your Wife Like a Porn Star. Due to the prevalence of pornography, many men today have been lied to by what they have seen. It’s true that women crave seduction, crave pleasure, and want a sexual relationship as well as men, but they also want to be treated with respect and gentleness. Dr. Levkoff wrote, “the brain is our biggest sex organ, and most women have fantasy lives that leave your porn sites in the dust.” Try a little chivalry. You may not have to rescue her from the clutches of a fire-breathing dragon, but maybe you could rescue her from the children while she takes a bubble bath. Or, maybe you could leave your negative thoughts outside your house and speak words of encouragement in her presence.
3. Do Unto Others, as You Would Have Them Do unto You. The Golden Rule applies to all relationships. Many men forget that it applies to their relationship with their wives. It’s not uncommon for a man to treat co-workers with respect, but treat his wife with disdain until inside the bedroom. How you treat your wife during the twelve hours prior to retiring to the bedroom will make a big difference in how she responds to you once behind closed doors.
4. Give Her Space. It may never have occurred to you, but letting your wife have some time to herself can help her recharge. Offer to watch the kids for a few hours so she can meet a friend for coffee, read a book, or relax in your own home. Giving her a break may result in her feeling much warmer toward you. And I think we would agree with Dr. Levkoff “watching your children isn’t ‘babysitting’.” Watching you romp with the kids may produce very warm feelings in her toward you.
5. Talk and Listen!!! Very few things pay greater dividends than sitting and listening to your wife while she shares her thoughts with you. And when she does, be careful not to try to fix the problems she presents. She’s not looking for answers. She just needs to be heard. Don’t burden her with your stressful topics. Your time is coming. Right now, listen! Reflect back what you hear her say, so she knows that you are listening. Don’t correct her. And as already mentioned, you don’t need to fix her problems. She’ll be even more impressed if you can remember what she told you twelve or twenty-four hours later, and you just may find that she is acting warmer toward you.
I encourage you to implement a plan of love-life restoration that includes the above five steps. And I would be interested in hearing from you after a couple of week’s practice.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Disorders of Sleep
7-27-10
by Dr. Lorin Bradbury
Question: I read your article on sleep and was wondering if you could write about various sleep disorders. There have been times when it seemed that I was awake, but my body was paralyzed. When this happens, it seems like I have to sort of fling my body in some direction and then I wake up. Is that a sleep disorder, and if so, is there something I can do about it?
What you are describing is probably Sleep Paralysis. It is believed that in normal individuals, Sleep Paralysis is closely related to the hypotonic state, or paralyzed state that occurs during Rapid Eye Movement (REM) sleep. Sleep paralysis occurs when the brain awakes from a REM state, but the body paralysis persists. This leaves the person fully conscious but unable to move. The paralysis can last from several seconds to several minutes. When this occurs, the individual may experience panic symptoms. For most healthy individuals, avoiding chronic sleep deprivation is enough to relieve symptoms. It is recommended that patients be evaluated for narcolepsy if symptoms persist.
And now I will move to your request for a description of sleep disorders. Probably, the most common sleep disorder is Insomnia. Insomnia is a symptom that can accompany several sleep, medical, and psychiatric disorders, and is characterized by persistent difficulty falling asleep and/or staying asleep. Insomnia is typically accompanied by functional impairment while awake, due to lack of sleep. Insomnia has a plethora of causes, including a rebound effect from sleeping medications.
Narcolepsy is a broad category of serious sleep disorders characterized by sleep at inappropriate times. The primary symptom of narcolepsy, an overwhelming urge to sleep, and that can happen at any time but occurs most often under monotonous, boring conditions. This urge to sleep is known as a Sleep Attack. It usually lasts for 2 to 5 minutes, and person wakes up feeling refreshed.
Another sleep disorder is Cataplexy, a sudden and transient loss of muscle tone, often triggered by emotions, such as while in the batter’s box batting a ball, or even while making love. It is a rare disease, but frequently affects people who have narcolepsy. During a catalectic attack, the person will suddenly wilt and falls like a sack of flour. The person will lie there, conscious, for a few seconds to several minutes. What apparently happens is that one of the phenomena of REM sleep—muscular paralysis—occurs at an inappropriate time.
A common sleep experience, though it’s not necessarily a disorder is a Hypnologic Hallucination. These are hallucinations that occur at the boundary between sleeping and waking. They can occur when people are falling asleep, or when they are starting to wake up, and they tend to be extremely vivid. In essence, the person dreams while lying awake, paralyzed. A person can come out of it by being touched, or by hearing someone call his name.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Sister On Your Mind
7-21-10
by Dr. Lorin Bradbury
Question: Dr. Bradbury, I really need your advice on how to deal with my sister. I feel like she judges everything I do. She never says anything, but I really feel like she disapproves of everything from how I keep my house to how I raise my children. I was wondering if I should try to get someone to talk to her for me?
What you describe is a very common problem. The frequency of the problem seems to vary from culture to culture and from area to area. However, I have found it to be a very common complaint since living and practicing in this area.
Before I address how you might deal with your sister, I would like for you to take a deep look inside. You mentioned that your sister has never said anything to you, and that you “feel” like she disapproves of everything you do. You may “feel” like you are very discerning, but in truth, our feelings can be very deceptive. They are often closely related to our own sense of self-doubt.
Your question brings me back to a training film I saw when in graduate school. In the film, Fritz Perls asks the client, Gloria, what she is doing. (She’s nervously bouncing one leg on top of the other.) Gloria becomes noticeably more self-conscious and asks, “What do you mean?” Dr. Perls asks again what she is doing. Her response is a very defensive, “You don’t like me, do you, Dr. Perls?” Dr. Perls looks at her puzzled and makes a rather profound statement, “It’s not Dr. Perls that doesn’t like you, but the Dr. Perls of your mind that doesn’t like you.”
What did Dr. Perls mean by such a statement? You stated that you “feel” that your sister doesn’t approve of your housekeeping, parenting, and etc., without any hard evidence to support your feeling. It’s very possible that it is not your sister that disapproves of you, but the sister of your mind—the image you have created in your mind of your sister.
This reminds me of a social psychology research project in which individuals who had agreed to participate were brought individually into a booth and had a scar put on their faces with makeup. No mirror was available in the booth until the ugly scar was finished. Then a mirror was produced to show each his scar and the mirror was put away. Before leaving the booth, each was told by the makeup artist that he wanted to put finishing powder on the scar so it wouldn’t smear. In truth, he removed the scar. Then the subjects were sent out into the public with a note pad to record how people treated them because of their scars. Of course, the interesting thing is that there were no scars, except in their minds. However, overwhelmingly, the subjects returned with reports of being stared at, shunned, and treated poorly because of the ugly scars that were only in their minds. So, how you feel about yourself may impact your belief of how others think of you.
You asked if you should have someone talk with your sister. Since you are asking my opinion, I do not believe that is the best approach. In fact, that approach has the potential to lead to division and gossip. Instead, go to your sister and tell her how you are feeling, but take responsibility for your feelings. You may find that she has had no such thoughts at all. If she does have thoughts about you that are congruent with your suspicions, talk with her about it and work toward a resolution. Relationships are too important to allow “feelings” to destroy.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
States of Consciousness
6-16-10
by Dr. Lorin Bradbury
Question: Are we conscious of what is going on around us at times other than when we are wide-awake?
“States of Consciousness” is a whole area of study within the field of psychology. Consciousness is defined as “a state of awareness.” The most well known state of consciousness is Normal Waking Consciousness, and the reason people are most acquainted with this state is because it occurs while we are awake.
However, there are three types of waking consciousness that most have never thought of as Waking Consciousness—Directed Consciousness, Daydreams, and Divided Consciousness.
Directed Consciousness is directed and orderly awareness. It is when you are fully focused on a topic, such as listening to a lecture, or even while reading this article. Some people have extreme abilities to focus on a topic. For example while reading or watching a movie, these individuals seem to have the ability to shut everyone and everything else out. You might find that calling that person’s name is insufficient to distract that person from the topic on which he or she is focused.
In contrast, there are those who are field dependent (sometimes referred to as field sensitive). If you were carrying on a conversation with a field sensitive person, you might find that person appearing to be distracted by everything else going on in the room. You might feel as though that person is not listening to you, because his eyes are darting around the room, taking in all present stimuli. That person’s consciousness is still directed, but it encompasses more than your conversation.
The second form of directed consciousness is Daydreams. Daydreams are relatively focused thinking about fantasies. Everyone daydreams, whether you want to admit it or not. Freud believed that daydreams reduced the tension left by our unfulfilled needs and wishes. Many believe that instead of reducing tension, daydreams may be merely a slightly distorted reflection or our current concerns and emotions.
A third form of directed consciousness is called “Divided Consciousness.” Though it may seem contradictory to refer to divided consciousness as directed consciousness, divided consciousness is still very directed. Divided consciousness is when two conscious activities are occurring simultaneously. Consider how many times you have driven from home to work and cannot remember the drive, but remember the things you were thinking about on the way. However, if the car ahead of you puts on its breaks, you are very much aware of the braking action occurring a few feet in front of you and you apply your breaks or take action to avoid an accident. If you safely braked, you may have returned to the things you were thinking about prior to seeing the braking taillights ahead of you. That’s divided consciousness.
A less obvious state of consciousness is sleeping and dreaming. Throughout the night, dreams are incorporating sounds of the night, the touch of sheets and nightclothes, odors, and etc. into your dreams.
Altered states of consciousness occur through medication, hypnosis, and the use of consciousness altering drugs. There are many different types of meditation. The simplest form can occur while a person is in a sitting or lying position and breaths deeply, slowly, and rhythmically. This is often used by clinicians to help clients reduce stress. Individuals more experienced with meditation are able to reach a state known as transcendental.
Another form of altered consciousness is a hypnotic state, reached through hypnosis. Hypnosis is defined as “an altered state of consciousness in which the individual is highly relaxed and susceptible to suggestions.” Today, hypnosis is used for hypnotic analgesia (pain reduction), relief of phantom limb pain, smoking cessation, and weight loss. Those who practice hypnosis emphasize that hypnosis cannot make you do something that you would not ordinarily be able to do, and cannot make you do something that you did not want to do.
Various forms of medication and drugs also can alter consciousness. Two major categories of consciousness-altering drugs are stimulants and depressants. Stimulants are drugs that increase the activity of the central nervous system, providing a sense of energy and well being. The most common stimulant is caffeine, and many reading this article experienced a sense of energy and well being from that cup of coffee you had earlier today.
Depressants, on the other hand influence conscious experience by depressing parts of the central nervous system (CNS). Probably the most common depressant is alcohol. So when people drink alcohol, they really don’t get “high;” in reality, they get “low.”
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
When someone is grieving
6-11-10
by Dr. Lorin Bradbury
Last week, I was approached and asked to respond to the following question: “What should you say, and what should you not say to someone who is grieving?”
Grief can result from any loss (i.e., loss of a loved one, loss of a job, divorce, rejection by children, the onset of dementia in an aging parent or spouse, the loss of a home by fire, the unfaithfulness of a spouse, and etc.).
Having been trained as a psychologist, and having pastored for the past 34 years, I believe I know how to react in situations where someone is grieving, but to respond to that question in writing was difficult. So, I researched the subject, and below are some of the responses I found. Keep in mind that no two people grieve the same way, and therefore, your response to the grieving person will be dictated by their need.
Things not to say:
• I understand.
• You must be strong.
• Be strong for the children.
• You must move on.
• Get a hold of yourself.
• Others have it worse than you.
Things Not to Ask:
• What did you do wrong?
Things Not to Do:
• Don’t attempt to minimize the other person’s pain.
• Don’t try to explain what God is doing behind the scenes.
• Don’t compare what the other person is going through to ANYTHING else or ANYONE else’s problem.
• Don’t use clichés and platitudes (i.e., empty words or statements).
• Don’t instruct the person.
• Don’t forget the person a week or two after the loss.
Things that may be helpful to say:
• I’m so sorry to hear about your loss.
• I can’t imagine what you are going through.
• I don’t know what to say, but I’ll be glad to listen.
Things you might ask:
• How are you really feeling?
• What can I do to help?
Things you might do:
• A wordless hug.
• A card that says simply, “I grieve with you.”
• Pray.
• Then pray some more. It’s the most powerful thing we can say or do.
• Remember to pay a visit to the person who experienced a loss during the weeks and months following the loss.
After reading the above suggestions, I would be interested in hearing from you. This is a subject we can all learn from. Please consider responding in the editorial section of The Delta Discovery and sharing your thoughts on the subject. That way, others can benefit.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Empty Nest Syndrome
6-3-10
by Dr. Lorin Bradbury
Question: My last child just graduated from high school and is going off to college this fall. What are some the empty-nest problems I should be aware of? For the first time in thirty years, it will be just my husband and me in our home.
Wikipedia describes the “Empty Nest Syndrome” as “a general feeling of loneliness that parents or guardians may feel when one or more of their children leave home; it is more common in women. The marriage of a child can lead to similar feelings, with the role and influence of the parents often becoming less important compared to the new spouse.
A strong maternal or paternal bond between the parent and child can make the condition worse. The role of the parent while the child is still living with them is more hands-on and immediate than is possible when they have moved out, particularly if the distance means that visits are difficult.”
There are a number of things you should be aware of—some that you should have been preparing for, and some that are likely to catch you off guard even if you have been looking forward to the time that you and your husband can again be a twosome.
Loss of Romantic Love. One of the most common occurrences is the sudden realization that a husband and wife no longer know one another. After years of meeting the needs of children and developing careers, empty nesters often themselves empty of love for one another. They find they are strangers living in the same house. Statistics show that there has been a steady increase in the number of divorces among couples married 30 or more years. Many long-term married couples divorce one another after the kids leave home.
They realize too late that their children kept them together.
The good news is that with good communication and preparation for this phase of life, the empty nest years can be tremendously enjoyable and full of new beginnings. So for those reading this who are not yet empty nesters, build time into your busy schedules to be a couple. Get alone on a regular basis. Try courting one another. Spice up your love life. Keep the romance burning. Be creative. You’re married; enjoy it.
On the other hand, if you are one of those who suddenly realizes that the person you have been married to for 30 or more years is now a stranger to you, it’s not too late. Renew your commitment, and renew the courtship process. Recognize that you are both going through a phase you have never been through before. Open communication can be helpful. Admit that you are both responsible for allowing the fires of romance to wane, and commit to rebuilding the relationship. It’s not time to throw in the towel. Treat each other with kindness and patience. Yes, rebuilding a relationship is hard work, but it’s even harder with someone else. So, appreciate the years you have lived and loved and worked together. Look for little ways to please the other person—to make the other person special, just like you did in the beginning.
Children’s Rejection of Parental Values. All parents have dreams for their children, but most importantly caring parents want their children to embody the values of the parent into the next generation. This is particularly true for parents who are deeply religious. Though children who are raised in homes with strong religious convictions are more likely to become respectable citizens, there are those who reject their parents’ values, at least for a season. During that time, parents feel as though they have failed. As a result, they often play the blame game. Parents may blame themselves and feel like failures, often becoming depressed. Or, they may blame one anther, citing minor things the other parent should or should not have done.
Recognize that you did the best you could with very little preparation for parenting. You may have had 12 to 16 years of education for your career, but received almost no instruction on how to parent. So considering the amount of training you received on the subject, you probably did pretty well. Recognize your job is done and move unto the next phase of life—being a twosome again. Have fun together. When your children, who have recently taken flight see how much fun you are having together, they may realize your values actually were quite good and want to emulate them. Also, don’t be too hard on those who have just left the nest; they’re really just learning to fly. Whatever you do, choose not to play the blame game.
Return from College. There is a possibility that your child may return from college on summer breaks. Before this occurs, you and your husband need to sit down and decide the expectation you have of your adult child living in your home before he or she arrives. It will be important to communicate your expectation to your child before arriving home, so that he or she has the opportunity to develop alternate plans if your child cannot live by your house rules. Too many parents fear if their child won’t come home if they talk about rules or guidelines. They figure they will deal with the issues when problems occur. It is much better to clearly communicate ahead of time. Also, it’s very important that when issues have to be addressed with an adult son or daughter that parents agree to present a unified front ahead of time. It’s not a time for you to side with your child against the other parent. That is terribly destructive to the marriage relationship. Remember, your job as a parent is done, and your relationship with your spouse is ultimately more important than the relationship with your child. By developing a relationship with your child that results in the exclusion or rejection of your spouse is analogous to an affair.
No doubt, there are many other problems that empty nesters encounter, but these are some of the more common problems I have confronted in my years of therapy.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Adjustment Disorder
5-27-10
by Dr. Lorin Bradbury
Question: What is the most common type of mental health problem you see as a psychologist?
As a psychologist, my practice is divided into psychological testing, forensic assessments, and psychotherapy or counseling. I am going to guess that when you refer to the most common type of mental health problem I see, you are referring to those seen in my counseling practice. Probably the most common type of problem seen in counseling is an Adjustment Disorder.
To diagnose mental disorders, mental health professionals use the Diagnostic and Statistical Manual – Fourth Edition (DSM-IV). The diagnostic criteria in the DSM-IV are:
A. The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within three months of the onset of the stressor(s).
B. These symptoms or behaviors are clinically significant as evidenced by either of the following: (1) Marked distress that is in excess of what would be expected from exposure to the stressor, (2) Significant impairment in social or occupational (academic) functioning.
C. The stress-related disturbance does not meet the criteria for another specific disorder and is not merely an exacerbation of a preexisting disorder.
D. The symptoms do not represent Bereavement.
E. Once the stressor (or its consequences) has terminated, the symptoms do not persist for more than an additional six months.
As you can see from the above description, at one time or another, most of us develop an Adjustment Disorder.
Adjustment disorders come in many flavors. Depression, anxiety, disturbance of conduct, a mixture of depression and anxiety, or a mixture of emotions and conduct can accompany Adjustment Disorders. Sometimes the Adjustment Disorder doesn’t fall into any the above categories and is simply unspecified.
The goal of psychotherapy is symptom relief and behavior change. Counseling or psychotherapy, crisis intervention, family therapy, and group treatment are often used to address the varied and specific issues. I often take a problem-solving approach to addressing issues associated with an Adjustment Disorder.
I find that most Adjustment Disorders resolve in six or less session. Most find the comfort derived from resolution of the problem is worth the time and monetary investment. If you believe you may be experiencing an Adjustment Disorder, you may want to consider calling for an appointment. My number is listed below. Other available resources for counseling are the YKHC Behavioral Health and Bethel Family Clinic.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Asperger’s Syndrome
5-20-10
by Dr. Lorin Bradbury
Question: My child has been diagnosed with Asperger’s Syndrome, and I just learned that in 2012, when the DSM-V is published, that diagnosis will not longer exist. What will my child’s diagnosis than be called, or will he no longer have a diagnosis?
It is true that on February 10, 2010, the American Psychiatric Association (APA) announced that when the Diagnostic and Statistical Manual – Fifth Edition (DSM-V) is published in 1012, what is no known as Asperger’s Syndrome will be incorporated into a broader Autism Spectrum Disorder. Incorporated into this spectrum will be the current diagnoses of autistic disorder, Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder (not otherwise specified).
Asperger’s Syndrome was first introduced in the DSM-IV in 1994, and has been controversial since its introduction. One of the members of the advisory board of the APA making the changes, Dr. Catherine Lord, was quoted in the New York Times on November 2, 2009. She stated, “Asperger’s means a lot of different things to different people, it’s confusing and not terribly useful.” She went on to explain, “Nobody has been able to show consistent differences between what clinicians diagnose as Asperger’s syndrome and what they diagnose as mild autistic disorder.”
Many who are not qualified to make diagnoses often tell parents their child has Asperger’s Syndrome when the child does not meet the criteria. The diagnostic process should include at the very least, a Clinical Interview, a psychological evaluation that includes an IQ test, and a standardized behavioral screen for autism, such as the Childhood Autism Rating Scale (CARS). Diagnoses without standardized measures are about equal to chance. To be diagnosed with Asperger’s Syndrome, the individual must meet the following diagnostic criteria of the DSM-IV:
A. Qualitative impairment in social interaction, as manifested by at least two of the following: (1) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction (2) failure to develop peer relationships appropriate to developmental level (3) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people) (4) lack of social or emotional reciprocity
B. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following: (1) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus (2) apparently inflexible adherence to specific, nonfunctional routines or rituals (3) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements) (4) persistent preoccupation with parts of objects
C. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.
D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years).
E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood.
F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.
If your child met the criteria, as described above, for Asperger’s Syndrome in the past, he will likely meet the criteria for Autism Spectrum Disorder.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Gestalt Therapy
5-5-10
by Dr. Lorin Bradbury
Question: What are some of the best-known counseling theories, and what would the experience be like if I were to be counseled by therapists holding the different theoretical orientations?
Over the past several weeks, I have attempted to answer the above question by presenting various approaches to counseling and psychotherapy. In this issue, I will attempt to describe the theoretical underpinnings of Gestalt Therapy, and then, provide you with some idea of what your experience would be like if you visited a therapist who worked from the perspective of Gestalt Therapy.
First, let’s begin with a view of human nature from a Gestalt perspective. Gestalt Therapy is rooted in existential philosophy. Individuals are believed to be able to deal effectively with their life problems themselves, especially if they make full use of awareness of what is happening in and around them. Clients are assumed to have the capacity to support themselves and take responsibility for carrying out their therapy.
Fritz Perls is credited with developing Gestalt Therapy and bringing it into the mainstream of therapeutic approaches. Gestalt Therapy emphasizes the “here and now.” The past is important when it is related in some way to significant themes in the individual’s present functioning. It is dealt with by bringing the past, as much as possible, into the present. Gestalt therapists ask “what” and “now” questions. For example, in the famous “Gloria Films,” the client, Gloria is sitting with her legs crossed, nervously bouncing the leg on top. Dr. Perls asks her in a very matter-of-fact way, “What are you doing?” It was an opportunity for her to make a connection between behaviors she was manifesting and how she may have felt internally.
The immediate aim of Gestalt therapy is helping the client attain awareness of what he or she is doing and feeling. The objective is to enable the client to become more fully and creatively alive, and to become free from the blocks and unfinished business that may diminish satisfaction, fulfillment, and personal growth. For this reason Gestalt therapy falls within the category of humanistic psychotherapies. A therapeutic goal is for growth in individuals and families to move beyond the narrow limits of adjustment, leading to a fuller life.
In Gestalt Therapy, the therapist challenges clients so that they learn to use their senses fully and get in touch with their body messages. The therapist pays attention to the client’s body language, and might direct clients to speak for and become their gestures or body parts. To keep therapy moving, the therapist gently confront clients.
The relationship between the therapist and the client is described as I/thou. The therapist gives feedback to the clients, especially about what clients are doing with their bodies. Clients’ manipulations are challenged without rejecting them as persons.
Gestalt therapists utilize a number of techniques and procedures that might seem a bit out of the ordinary. One of these is referred to as the “topdog/underdog.” The “topdog” describes the part of an individual that demands the individual adhere to certain societal norms and standards. These demands are often characterized by “shoulds” and “oughts.” The “underdog” describes the part of an individual that makes excuses, explaining why these demands should not be met. Often, these excuses act as an internal sabotage to ensure that the demands are never met. Gestalt therapists often guide their clients through an exercise where the client takes on both of these roles. With the guidance of the therapist, the client can come to gain insight about himself or herself, which can help the client have a healthier relationship with the environment.
When Gestalt work is done in a small group setting, a practice called “making the rounds” is sometimes used. In this exercise, the client gets up, walks to each member of the group, and says or does something related to what he or she is working on. It can be useful in discovering how the person makes contact, in deepening personal and interpersonal awareness, in learning to make contact in new ways, in testing questionable attributions about others’ thoughts and feelings, and in reestablishing a persons sense of wellness after an emotionally taxing working session.
Gestalt therapy stresses taking responsibility for all behaviors. One technique to practice taking responsibility is known as “I take responsibility for.” For example, if the client was bored, he or she would be encouraged to say, “I am bored, and I take responsibility for it.” Clients are encouraged to “Stay with feelings” and become aware of their bodily reactions to feelings.
Another technique that can be very powerful is the “empty chair technique.” This should not be undertaken by the inexperienced. In this technique the client is asked to put another person in an empty chair and tell that person anything they may have been wanting to tell that person for a long time. Roles can be reversed and the client can assume the role of the other person and speak back. At times, this can become a very emotional experience, and it may require skill on the part of the therapist not to overwhelm the client, resulting in undue distress.
Though Gestalt Therapy can be very helpful to some, it also has limitations. One limitation is that Perls’ style deemphasized cognitive factors of personality. Also, there is a danger that power-hungry therapists who are inadequately trained might be primarily concerned with impressing and manipulating clients. This could result in harm to the client.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Person-centered Therapy
4-15-10
by Dr. Lorin Bradbury
Question: What are some of the best-known counseling theories, and what would the experience be like if I were to be counseled by therapists holding the different theoretical orientations?
The above question was posed several weeks ago, and I presented to two theoretical orientations—psychoanalysis and individual psychology. In this article, I will attempt to describe what it might be like if the counselor held to a Person-centered theoretical orientation. The late Carl Rogers developed person-centered psychotherapy. At first, he described his orientation as Patient-centered, moved to Client-centered, and eventually settled on Person-centered. The motivation behind the name change for his counseling theory was an attempt to move from the sterile medical model of therapist/patient to something more personal and humanistic.
Like most humanistic psychotherapists, Rogers possessed a deep faith in the tendency of humans to develop in a positive and constructive manner if a climate of respect and trust is established. Therefore, the focus of therapy is on the person’s (client’s) responsibility and capacity to discover ways to more fully encounter reality. He believed that reality was subjective. Rogers put forth his theory at a time when behaviorism controlled psychology. Behaviorists described behavior from a distance as observed without involving or asking the individual “Why?” He believed you could learn more about the person by simply asking the person. Person-centered theory is not a set of techniques or dogma, but is rooted in a set of attitudes and beliefs that the therapist demonstrates.
The goal of Person-centered therapy is self-actualization, which is characterized by openness to new experiences, self trust, an internal source of evaluation, and a willingness to continue to grow. Openness to new experiences might include trying new behaviors that seem right for the individual. Self-trust could be described as trusting one’s ability to make decisions. Internal source of evaluation refers to paying attention to one’s own center. Rogers believed that each individual must decide one’s own standards of behavior and looks to oneself for the decisions and choices to live by. A willingness to continue to grow takes risks. This might be demonstrated by daring to change careers, go back to school, or do things that one has always wanted to do, but had been held back from by personally imposed regulations.
Therapy revolves around the relationship between the therapist and client. Rogers gave to psychology and the world of psychotherapy three necessary therapeutic factors—congruence, unconditional positive regard, and empathy. Congruence is genuineness on the part of the therapist. If therapeutic change is to occur, the therapist first must be congruent (i.e., genuine or real). Second, the therapist must provide the client with unconditional positive regard. In other words, no matter what the client has done, the therapist must not judge the client, but accept the client as a worthwhile human being. Third, the therapist must respond with empathy, or attempt to understand the individual from the other person’s point of view.
Time has shown that congruence, unconditional positive regard, and empathy are probably not sufficient to bring about therapeutic change, but they are very important in the process of developing a relationship with the client, which in turn may give the therapist power or credibility to work with the client.
One concept put forth by Carl Rogers that I believe is helpful to clients is his concept of “anxiety.” He defined anxiety as the difference between the Ideal Self and the Self. The Self is described as “who you know you are” and the Ideal Self is “the Self you want to present to the world.” The greater the distance between the Self and the Ideal Self the greater the level of anxiety. To reduce the anxiety, you have to either lower the Ideal Self, or find a way to raise the Self.
Initially, you might find that you enjoy working with a Person-centered therapist because you will feel understood. However, with time, you might become frustrated because when you ask for advice, a true Rogerian therapist would have to refrain from giving you an answer because you would know better than the therapist what you need. Many individuals come to therapy seeking answers, not desiring to be told that you already possess the answer.
New information on Antidepressants
4-9-10
by Dr. Lorin Bradbury
Question: What’s the latest scoop on antidepressants? I recently saw Dr. ______ because I was experiencing depression and he didn’t want to prescribe me medication and mentioned a new study that found antidepressants to be no better than placebos.
It’s likely that he was referring to a recent study published in the January issue of American Journal of the American Medical Association. In that study, a group of psychologists and psychiatrists found that antidepressants were no better than a placebo when treating patients with mild to moderate depression. However, the authors cautioned that it would be an overstatement to say that no patients with mild to moderate depression improve on antidepressant medication. And there may be certain subgroups, such as those experiencing anxiety in addition to depression that will benefit from antidepressant medication.
Based on the results of that study, if a person is experiencing mild to moderate depression and has never been on medication, it may be wisest to first consider psychotherapy, education about depression, or some other self-help approach, including exercise. It’s important for patients to become involved in their own care and treatment. Psychotherapy can be very helpful in finding the root cause of the depression, such as anger about some event or situation. However, effective psychotherapy is often hard and sometimes painful work.
Originally, when antidepressants became available, they were purported to be effective in treating patients with major depression who reported significant changes in eating and sleeping, or significant weight gain or loss. It’s likely that antidepressants are still most effective when the depression is severe and those symptoms are present.
Unless your depression is severe, the potential long-term outcome is probably better with psychotherapy because it should address the root of your depression. Also, once you have improved, you will be able to attribute improvement to something you did rather than what a pill did for you.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Individual Psychology
4-1-10
by Dr. Lorin Bradbury
Question: What are some of the best-known counseling theories, and what would the experience be like if I were to be counseled by therapists holding different theoretical orientations?
Several weeks ago, I began answering the above questions. I began with psychoanalysis, which was the earliest form of psychotherapy. Alfred Adler followed Sigmund Freud with what became known as Individual Psychology. Similar to Freud, he believed that adult behavior is largely determined by the first six years of life. Whereas Freud believed that psychological problems were the result of unconscious conflicts, Adler proposed that all behavior is purposeful and goal-directed. Life goals provide the source of human motivation, especially those goals that aimed at bringing security and overcoming feelings of inferiority. Individual Psychology posits that what we are born with is not as important as what we do with the abilities we possess.
In Individual Psychology, reality is viewed from the vantage point of the individual’s cognitions. Therapy focuses more on interpersonal factors rather than intrapersonal ones. Behavior is viewed as purposeful and goal directed. Adlerian therapists are interested in the future, without downplaying how one’s past affects the present. It is believed that one’s past influences one’s strivings in the present. Therapists who hold to an Adlerian perspective pay particular attention to themes running through a person’s life. They hold that decisions are based on past experiences, the present situation, and the direction in which the person is moving.
Individual Psychology promotes the idea that everyone is striving for significance and superiority. An interesting thought from Adlerian theory is that we are pushed by the need to overcome inherent inferiority and pulled by our desire for superiority.
Adlerians are interested in your Style of Life. Man is viewed as actor, creator, and artist of his life. All people have a lifestyle, and no two people develop the same lifestyle. Our lifestyle is learned from early interactions in the family. In essence, we create ourselves, as opposed to being passively shaped. It is not childhood experiences in themselves that are crucial, but our attitude toward these events.
The theory of Individual Psychology promotes a concept referred to as SOCIAL INTEREST. It is defined as an individual’s attitudes in dealing with the social world. If an individual is to “get better” one must look outside of self and become interested in the needs of others. Adlerians promote we must master five tasks: Our relationships with friends and family, work, sexuality, feelings about self, and the spiritual dimension (including life goals, meaning, and purpose).
The original question that spawned this undertaking of describing various theoretical orientations in psychotherapy asked what the experience would be like from those divergent perspectives. As with all theoretical orientations, there are therapeutic goals. Listed below are some of the therapeutic goals one might expect from a therapist who holds to an Adlerian viewpoint:
(1) A contractual and cooperative arrangement between counselor and client. (2) A contract that calls for identifying and exploring mistaken goals and faulty assumptions, followed by a reeducation of the client toward constructive goals. (3) There will be more concern with motivation modification than behavior modification. (4) Clients are viewed as discouraged rather than as “sick” or in need of being “cured.”
The role and the function of the therapist is eclectic in that the therapist may borrow from any number of other theoretical orientations that may be helpful to the particular client. Focus will be on cognitive aspects of therapy. Similar to other cognitive therapies, if clients hope to begin to feel better and act better, then they must learn better ways of thinking.
The first technique used by Adlerian therapists will be to establish a proper therapeutic relationship. They then explore dynamics operating in the client (intrapersonal). This may include the family constellation (Adlerians are big on birth order), early recollections, dreams, and priorities. An Adlerian therapist may ask you to bring family photos to the session. They may explore your relationship with other family members, and how you think about yourself in relation to other family members. Adlerian therapists will likely encourage the development of self-understanding (insight), and help you make new choices (reorientation).
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Psychoanalysis
3-2-10
by Dr. Lorin Bradbury
Question: What are some of the best-known counseling theories, and what would the experience be like if I were to be counseled by therapists holding the different theoretical orientations?
There is a famous set of films referred to as the “Gloria” tapes that provide us with some idea of what it would be like. In 1975 a young divorced mother named “Gloria” volunteered, in an attempt to find some answers to the problems in her life, to be videotaped while being a client to three rather new psychotherapies at that time: Person-Centered Therapy, Rational Emotive Behavior Therapy, and Gestalt Therapy. The respective founders of each therapy, Carl Rogers, Fritz Perls, and Albert Ellis provided her therapy.
It is not possible for me to answer your question in one article, so I will attempt to do so over a series of weeks. Probably the oldest theory of contemporary psychotherapy is Psychoanalysis. Though psychoanalysis is less commonly practiced today, it is often what people think of when they think of going to see the shrink. It was developed by Sigmund Freud and involved having the patient lie on a couch and talk to the therapist.
Psychoanalysis views human nature as deterministic. Irrational forces, unconscious motivations, and instinctual drives determine the patient’s current psychological problems. Those who practice psychotherapy from a psychoanalytic perspective put forth the idea that there are three levels of consciousness: The conscious mind, the preconscious mind, and the unconscious mind.
The conscious mind is that which we are aware of, the preconscious are those thoughts that we are not aware of at the moment, but can be retrieved. Psychoanalytic theory posits that we are unaware of the unconscious mind. It cannot be studied, but can be inferred from behavior. Evidence of the unconscious mind is dreams, slips of the tongue and forgetting, posthypnotic suggestions, material derived from free association, and material derived from projective techniques.
Therapeutic goals of psychoanalysis are to make the unconscious conscious and to strengthen the ego.
The therapist’s function in psychoanalysis is to foster a transference relationship. In other words, transference is the process of transferring one’s feelings and attitudes toward someone from the past to the therapist. Another goal is to help the client acquire the freedom to love and work. A third goal is to assist the patient in achieving self-awareness, honesty, and more effective personal relationships. It is to help the patient deal with anxiety in a realistic way, and to gain control over impulsive and irrational behavior.
Going back to your question concerning the experience of psychotherapy. In psychoanalysis, the patient must be willing to commit to intensive and long-term therapy. Patients are ready to terminate sessions when they have clarified and accepted their emotional problems, discovered the historical roots of their difficulties, and are able to integrate their awareness of present problems with their past relationships.
Some of the techniques used by psychoanalysts include: Free association, interpretation, dream analysis, analysis and interpretation of resistance, and analysis and interpretation of transference.
Free association is a therapeutic technique whereby the patient, while lying on a couch, tells the therapist anything that comes to mind. Over time, the therapist looks for themes and meaning from the free-associated material.
As one can imagine, the relationship between the therapist and patient is not warm and fuzzy. The therapist attempts to create a transference relationship in which the patient transfers negative feelings toward another person unto the therapist so that it can be analyzed and resolved.
I do not practice psychoanalysis, and in the past sixty years, it has fallen out of favor due to the length of time required to reach termination. One can expect to remain in psychoanalysis for two to five years. Insurance companies are not interested in funding therapy that takes that long to resolve a problem. I have never personally experienced psychoanalysis. However, I have talked with those who have gone through years of psychoanalysis, and they have told me that it was worth every penny that it cost.
One of the greatest contributions of psychoanalytic theory has been the provision of a psychological vocabulary. Terms such as id, ego, superego, defense mechanism, projection, sublimation, denial, rationalization, reaction formation, and repression, all came from psychoanalytic theory.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Traumatic Brain Injury
or Intellectual Disability
2-24-10
by Dr. Lorin Bradbury
Question: Dr. Bradbury, I read your columns regularly and a couple of times you have written about diagnosing someone with mental retardation, or intellectual disability. If someone experiences a head injury, and the results of testing are in the intellectually deficient range, how do you decide if the diagnosis is a traumatic brain injury or mental retardation?
That is a great question, and a very interesting question for a psychologist to answer when it is the referral question. If the individual is under 18 years of age obtains a Full Scale IQ of 70 or less, and has deficits or impairments in adaptive functioning two or more standard deviations below the mean in two or more areas, a diagnosis of Mental Retardation can be given, regardless of the cause. A psychologist must always be an investigator. It is extremely important that all records available are obtained and reviewed.
Let’s suppose a 21-year-old male is referred for a psychological evaluation following a closed head injury. Also, let’s suppose that an IQ test is administered and the Full Scale IQ obtained is less than 70. If I were doing the evaluation, I would probably administer an achievement test along with an IQ test. Let’s also suppose the scores obtained on the achievement test are consistent with the IQ test, and that an adaptive behavior scale completed by someone who knows the patient well produces similar results. With these three pieces of information, one might conclude that the head injury has significantly impaired the functioning of the individual being evaluated. However, to come to that conclusion without considering history would an improper use of obtained psychological testing data.
I would not give any opinion until educational, medical, and mental health records were obtained and reviewed. Since our patient is only 21 years of age, it is likely that testing data would still be available in the Special Education office of the school district attended if he had been in Special Education. If school records indicated that the patient was an average or above average student and that he had never been referred for Special Education services, there would be an increased likelihood the current subaverage scores are the result of the head injury. On the other hand, if it is found that the patient was in Special Education and there are a series of psychological evaluations throughout his school years that are consistent with the current testing, one might conclude that his current functioning is unrelated to the head injury and is an intellectual disability (Mental Retardation).
If the patient were older, it is unlikely that Special Education records would be available because it is required that school districts destroy Special Education records after a period of time (5-7 years). If that were the case, the psychologist must investigate medical records, mental health records, and any standardized testing available on the individual. If it were found that the patient obtained scores in reading and other subjects at the first percentile, that might suggest that the patient was functioning at the current level prior to the head injury. Sometimes, information can be found in medical and mental health records. Evidence of meningitis, FASD, or hypoxia might suggest brain damage at a time prior to the head injury, and the current subaverage scores are probably unrelated to the reported head injury. As you might conclude, the review of records is often much more time consuming that the testing itself.
There is one more thing that must be considered. Head injuries are often associated with litigation and the psychologist must rule out the possibility of malingering for purpose of monetary gain.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
A definition of love
2-11-10
by Dr. Lorin Bradbury
Question: With Valentine’s Day just around the corner, I was wondering if you could offer a good definition of love. My husband tells me how he expects me to love him and I tell him he doesn’t know what love is. In all honesty, I don’t know how to define love either. Can you point me to some good literature that might help me better understand love?
Love is one of those little mysteries in life that is sometimes hard to define. That is especially true since there are many voices attempting to define love. To try to find a psychological answer, I went to the research databases of the American Psychological Association (APA) and came up empty. The best definition of love to date is found in the Bible in the Apostle Paul’s first letter to the Corinthian church in chapter 13, verses 4-7. “Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It is not rude, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres.” Let’s see what we can learn by examining this classic definition of love.
“Love is patient.” The word “patient” may not be the best definition. The Greek language in which this definition was originally written states that love is “not short suffering.” In other words, it is “longsuffering.” Love will allow us to tolerate unbearable people and situations. This would eliminate such regrets as, “If only I had thought, or listened, before I spoke—or struck.”
“Love is kind.” When love is present, so is kindness. The Phillips translation of the Bible translates this clause as “looking for ways to be constructive.” This eliminates a spirit of brow beating, derision, or undermining self-confidence in family members.
“Love does not envy.” Love is generous. Envy and bitterness go hand in hand, and if left unchecked, are like cancer that will consume the whole body.
“Love does not boast; it is not proud.” Love is humble. It places others ahead of self.
“Love is not rude.” Love is courteous. Lyman Abbot describes courtesy as “the eye that overlooks your friend’s broken gateway but sees the rose which blossoms in his garden.” The ability to recognize and allow for another’s faults and shortcomings will prevent many arguments and hurt feelings.
“Love is not self-seeking.” You can never force someone to love you; you can only give and receive love. To attempt to force someone to love you is coercion and is no longer love. Manipulation in any form is not love. Parents often do without in order that children may have. We often hear of the need for the wisdom of Solomon. This is in reference to the demonstration of his wisdom. Two women gave birth to children at about the same time. One accidentally smothered her child while she slept. When she woke, she replaced her dead child with other woman’s living child. The mother of the living child wanted her child back. To settle the dispute they went to King Solomon. Knowing the strength of love, Solomon asked a soldier to bring a sword and cut the remaining child into two parts, and give each woman one half. Love identified the real mother when she pleaded for the child not to be cut in half, and offered to allow the other woman to mother the child.
“Love is not easily angered.” Love is not touchy, irritable, resentful, or easily offended. Love has a good temper.
“Love keeps no record of wrongs.” Love doesn’t keep score. This is the concept of forgiveness. Once one has asked forgiveness, the slate is wiped clean. If forgiveness is absent, whenever stress arises, old stones are thrown at one another. Love looks to the future and is uninterested in keeping score.
“Love always protects, always trusts, always hopes, and always perseveres.” Love is an optimist. It believes the best of all, even when there might be some dark appearances.
I hope this is helpful in providing you with a definition of love, and that both you and your husband not only understand the meaning of love, but also practice it.
For your benefit and the benefit of the readers of this column, I am including a story on love that I found years ago, written by Jane Lindstrom. It is entitled “Tommy’s Essay.”
A grey sweater hung limply on Tommy’s empty desk. A reminder of the dejected boy who had just followed his classmates from our third grade room. Soon, Tommy’s parents who had recently separated would arrive for a conference on his failing schoolwork and disruptive behavior. Neither parent knew that I had summoned the other. Tommy, an only child, had always been happy, cooperative and an excellent student. How could I convince his father and mother that his recent failing grades represented a broken-hearted child’s reaction to his adored parents’ separation and impending divorce?
Tommy’s mother entered and took one of the chairs I had placed near my desk. Soon the father arrived. Good! At least they were concerned enough to be prompt. A look of surprise and irritation passed between them, and then they pointedly ignored each other. As I gave a detailed account of Tommy’s behavior and schoolwork, I prayed for the right words to bring these two together, to help them see what they were doing to their son, but somehow the words wouldn’t come. Perhaps if they saw one of his smudged, carelessly done papers. I found a crumpled tear-stained sheet stuffed in the back of the desk—an English paper—writing covered both sides. Not the assignment, but a single sentence scribbled over and over. Silently, I smoothed it out and gave it to Tommy’s mother. She read it, and then without a word passed it to her husband. He frowned, then his face softened, he studied the scrawled words for what seemed an eternity. At last, he folded the paper carefully and placed it in his pocket. He reached for his wife’s outstretched hand. She wiped the tears from her eyes and smiled at him. My own eyes were brimming, but neither seemed to notice. He helped her with her coat and they left together. In his own way, God had given me the words to reunite that family. He guided me to a sheet of yellow, copy paper covered with the anguished outpouring of a small boy’s troubled heart. The words? “Dear mother, dear Daddy, I love you! I love you!”
Pseudoseizures
2-3-10
by Dr. Lorin Bradbury
Question: What are pseudoseizures?
The preferred term is “nonepileptic seizures”, “psychogenic nonepileptic seizures” (PNES) rather than pseudoseizures, though that term is still used in some professional literature. PNES are episodes of altered movement, sensations, or experiences resembling epilepsy, but not associated with the kind of electrical discharges in the brain usually detected during epileptic seizures.
The incidence of PNES is estimated to be between 5 and 25 percent of all persons treated for seizure disorders. And the leading epilepsy centers report that from 25 to near 40 percent of the patients referred for intractable epilepsy are found to be suffering from PNES.
PNES are psychogenic and are given the diagnosis of Conversion Disorder. If you are familiar with psychology, you will recall that Sigmund Freud made Conversion Disorder the focus of his study. At that time in history, many of the referrals that came to his neurology practice were suffering from a variety of unexplained physical symptoms including paralysis, contractures (muscles which contract and cannot be relaxed), and seizures. He viewed these patients presenting apparent neurological symptoms as a result of the conversion of intrapsychic distress in to physical symptoms. At one time, it was believed that this disorder had disappeared from the Western World, however, at present, it appears to be as prevalent as it ever was.
The cause of PNES is uncertain, but there is a higher rate of a history child abuse and posttraumatic stress among those diagnosed with PNES than those diagnosed with epilepsy.
To discriminate between PNES and epileptic seizures requires traveling to an epilepsy center, such as in Seattle, that has a video-EEG. Basically, a video-EEG video-records the patient’s manifestation of seizure activity while recording electrical activity in the brain. A normal EEG at the time of a physical manifestation of seizure activity is indicative of PNES.
Once a diagnosis has been made, the treatment of choice is psychotherapy to get at the cause of the underlying distress that produces the seizure-like behaviors. Approximately 15 percent of those diagnosed with PNES also have epilepsy, but that is usually controlled with medication. For the remaining 85 percent, they will no longer need to continue taking the antiseizure medication. The outcome for psychotherapy is relatively good with an estimated improvement in quality of life in 70 to 95 percent of the patients who undergo psychotherapy.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in The Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Waiver of Miranda Rights
1-29-10
by Dr. Lorin Bradbury
Question: I have a son who did not graduate from high school because his ability is very low and he was in special education throughout his years in school. He has been permanently excused from jury duty because he cannot read and really does not understand what goes on in the court. Recently, he was arrested and charged with a very serious crime. It is my understanding that he confessed to the crime, but I am very concerned that he did not understand his rights when they were read to him. Is there anything that you can do as a psychologist to show that he did not understand his rights when they were read to him and subsequently confessed?
The first thing you should do is to provide the evidence you have mentioned above to his attorney. His attorney may already be aware of his deficits and may be in the process of filing a petition with the court to exclude the confession as evidence because the confession did not occur as a result of a valid waiver of his Miranda rights. The challenge would likely claim that he was not capable waving his rights to silence or legal counsel “voluntarily, knowingly, and intelligently.”
If the challenge were successful, it would be at this point that his attorney might request the services of a psychologist to assess his capacity. If that were to occur, the psychologist would likely gather many types of historical data leading up to the event in which your son was interviewed by the police officer. The psychologist would attempt to obtain school records and special education records to establish the fact that you son’s cognitive functioning has always been impaired. Verification from the court that he had been permanently excused from jury duty would be an important piece of information. Medical records would be obtained to look for evidence of developmental delays and possibly prenatal exposure to alcohol or other teratogens, lack of oxygen at birth or at some time during the developmental period, or evidence of trauma to the central nervous systems, such as head injuries or meningitis, that might explain the cause of his low cognitive functioning. Mental health records would also be sought. In addition to records that might explain his functioning from birth to adulthood, police records and any available tape recordings of his waiver of Miranda rights and the initial police interview would be requested and reviewed.
The legal standard for waiving one’s rights is “voluntarily, knowingly, and intelligently. In essence, the confession must not have been coerced. In your son’s case, he must have understood what he was giving up and have had the capacity to weigh the costs and benefits of waiving those rights.
If your son’s attorney requests an evaluation of his ability to understand the Miranda waiver, there are three components that must be considered: (1) The functional component, (2) the causal component, and (3) the interactive component.
The functional component would include an assessment of your son’s current IQ and some achievement tests to measure his verbal comprehension. A specific set of tests would be administered to directly assess his understanding of Miranda rights. The assessment would attempt to determine his level of understanding the warnings, perceptions of the intended functions of the Miranda rights, and capacity to reason about the probable consequences of waiver decisions.
The causal component explores possible causes of his lack of capacity. As previously mentioned, educational, medical, and mental health records would be reviewed in an attempt to explain why he does not possess the capacity to “voluntarily, knowingly, and intelligently waive his rights. The possibility of feigning would also be considered at this level and testing would attempt to confirm it or rule it out.
The interactive component is the interaction of your son’s functional capacities with the way in which the Miranda warnings were presented. The evaluator must consider the words and phrases actually used to inform your son, the manner of presentation, the presence or absence of a consultative person, the time of day or night of questioning, where your son was held prior to the presentation of the waiver and questioning, the condition under which he was interviewed, opportunities for him to contact an attorney, or another supportive person, and police demeanor.
The most important thing you can do right now is to inform his attorney of your son’s history.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in The Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Chatroom affair
1-21-09
by Dr. Lorin Bradbury
It is with great shame that I write to you today. I suspect that what happened could be called an affair, but there was no physical contact with the other person. About four years ago, I spent more time on the computer than I should have and got caught up in a relationship with a man in a chat room. Though my husband said he forgave me, his forgiveness included many stipulations on my life. At that time, I was so ashamed that I would have agreed to anything. Now I really feel like he took advantage of the moment to increase his control.
Dr. Bradbury, I love my husband and want my marriage to continue, but I have reached a point that I feel like I can’t breath. He drops in on me at work, which would be nice if he really came to visit me, but it feels more like he’s stalking me than visiting me. He wants to know with whom I have been talking on the phone, and if it wasn’t against company policy for him to be snooping on my work computer, I believe he would be doing that also. I tried taking classes at the college, but he showed up there and made embarrassing remarks, so I dropped out of school. He snoops through my purse and tries to get to the post office before I do, so he can open my mail. I know I failed him, but some days I just want to die. What can I do?
Yes, you are correct in calling what you did an affair. What makes the chat room relationship an affair is that the energy that should have gone into developing intimacy with your husband went into an illegitimate relationship. Fortunately, you ended the illicit relationship and have tried to restore your marriage.
In the past, nonsexual affairs developed in a variety of settings. For example, a woman dissatisfied with her marriage, or experiencing marital discord, might happen upon a man in a similar situation while practicing in the church choir, at work, in break rooms, at sporting events, or in any number of other situations where someone of the opposite sex was understanding, caring, and would listen. Many of these nonsexual affairs were then continued by telephone. But with the advent of computers and the Internet, these kinds of affairs have increased, and the chat room is probably the most common way they are carried out.
I suspect that you are not alone in making the concessions you made to your husband at the time he discovered your chat room affair. The discovery of one’s darker side is often a very humiliating and frightening time. It sounds like you gave away the entire farm in order to keep your husband. It would have been wise for you to have obtained good counsel at that time, which might have resulted in exploration of the long-term consequences of agreeing to the terms your husband demanded.
From the information you have provided, it sounds like your husband took advantage of the situation and increased his control in your life. I don’t know you or your husband personally, but I would suspect that your husband was more controlling than the average individual before he discovered your chat room escapade. The affair just allowed him to take more control of the relationship. One must ask what kind of love would want to control another person. Your husband’s behavior toward you does not sound like love—love seeks to restore. “Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It is not rude, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres” (I Corinthians 13:4-7, NIV). Love should seek to restore your dignity. Love must let go and even allow you to fail. Hopefully you won’t, but love lets go. Love will treat you as an equal and not the lesser because you failed some time in the past. “It keeps no record of wrongs.”
Individuals who are very controlling are actually very insecure. They fear losing their “possession,” so they attempt to build walls around it and hem it in. Unfortunately, they can never experience true intimacy because they don’t respect the other person. They somehow see themselves as smarter and just a cut above the other person. It would be natural to feel heart-broken at the discovery of the unfaithfulness of a spouse. But love forgives; love restores; and love protects the dignity of the person who has failed as much as possible.
Your question concerned what you can do about your situation. You do have choices. The first possible choice is to live with the concession you made to your husband and continue to be miserable. A better choice might be to find a time to talk with him and tell him that you recognize you made many concessions to him at a very vulnerable time. Explain to him how you feel. Let him know that you would love for him to visit you when you are on a break, but not when you are working. If he presses you to know whom you have been talking with, be blunt—it’s really none of his business. You may have to be politely straight with him. If he were to push the boundaries even further and snoop on your work computer, you may want to involve your supervisor. To not do so might jeopardize your job. Also, I would suggest you ask him to respect your purse and your mail. It’s not unusual for a husband or wife to open all mail in a household, but in your case, you probably need to reaffirm boundaries.
If you implement the above suggestions, I predict your husband will not be happy with you initially because he is very afraid of losing you (his possession). However, if you will become more assertive and clearly define your boundaries, he may come to enjoy having an equal as a spouse, and as long as you don’t, in turn, become disrespectful and disparaging toward him, his fear of losing you may subside. Give it a try. You have little to lose.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Momentary Schizophrenia
1-6-09
by Dr. Lorin Bradbury
Question: I hope you don’t think I am crazy by what I am about to ask. But then, I believe that sometimes I am crazy. It seems that when I am making good progress in my life and in my relationship with my husband, I suddenly have a meltdown and become intensely jealous and angry. When I see myself going into one of these phases, I can sometimes short-circuit it by telling myself to stop. At other times, I blow right on past any stopping point until I have said many hurtful things, and have even been destructive. Sometimes I see my husband as very sincere and genuine; at other times, I see him as a fake. I have heard the term “Borderline,” but was wondering if it would be possible to experience momentary Schizophrenia. Is there anything I can do to help myself when I see myself going into one of these downward spirals?
Great question! I am not familiar with anything that might be referred to as momentary Schizophrenia, other than a Major Depressive episode with Psychotic Features. On the other hand, I am quite familiar with Borderline Personality Disorder (BPD).
It is interesting that you see a connection between BPD and Schizophrenia because that is how the term Borderline Personality Disorder came about. It was originally thought to be a subset of Schizophrenia and referred to as Borderline Schizophrenic tendencies. Today, individuals diagnosed with Schizophrenia probably have a biological/physiological disorder associated with brain chemistry, whereas BPD is thought to be more characterological.
I will attempt address a few of the more common traits associated with BPD. The traits I am about to describe revolve around an intense need for affection, an extreme fear of rejection, and controlling behaviors that often include manipulation.
One of the most common traits, which is associated with many personality disorders, is an extreme sense of entitlement. For example, in your question, you mentioned experiencing jealousy. Let’s suppose you perceive that your husband admires another woman. In reality, it is neither a sin nor a crime to admire another person.
Individuals with BPD, on the other hand, tend to act out by accusing their spouses of wrongdoing, embarrassing them (and others), and/or physically or verbally assaulting them. The interesting thing is that individuals with BPD seem to believe they have the right (entitled) to act out. They resist weighing or comparing their real behaviors with the perceived behaviors of others. In other words, they are “entitled” to act that way.
I’ve known individuals with BPD who would normally be thought of as respectable citizens use profanity, destroy their husbands’ property, and even physically assault them with little or no regret afterward. They believed they were “entitled” to do it.
When the BPD individual begins to act out, it’s not too hard for those looking in from the outside to see the exercise of high levels of control and manipulation at work. The fear of loss of the object of affection becomes so intense that control and manipulation are exercised in an attempt to bring the object of affection back in line. The problem is that these control attempts often drive the object of affection away, rather than bringing him closer.
Another characteristic is referred to as “splitting.” You mentioned that you sometimes see your husband as sincere and genuine, but at other times you see him as a fake. What you have done is created two boxes, and you perceive him as living in one box or the other at any given moment. It is a process whereby you either idealize him or devalue him depending on the day or the situation. A more rational view would be to put your husband on a continuum and recognize that overall he is probably a good person with some character flaws. Some men who are married to BPD wives have told me that when their wives love them, they love with such passion that it’s out of this world, but the next day they may despise them with equal passion. Other men have expressed how they thought they had settled an issue yesterday, but today it’s as if they had never had the conversation.
You asked if there is anything you can do prevent future “meltdowns,” or acting out. Fortunately, you are ahead of the game because you are already looking at your behavior, rather than the behavior of your husband. As with any characterological disorder, taking responsibility is the first step. You mentioned that sometimes you recognize what you are doing and force yourself to stop. That is referred to as “thought stopping” and is a good technique.
I believe one of the first things you can do though is get your husband out of the boxes you have put him in and put him on a continuum. He may not be perfect, but he’s probably not “all bad.” Recognize that good people have negative character traits. That does not make them bad; it simply lets you know they are still a part of the human race. Stop trying to control and manipulate your husband. Allow him the privilege to be responsible for his own thought life and behaviors. Let him wrestle with his own imperfections, while you work to perfect your own character flaws.
The words of Jesus are very true in this case, “Why do you look at the speck of sawdust in your brother’s eye and pay no attention to the plank in your own eye?” (Matthew 7:3, NIV). Remember, a few fleeting lustful thoughts may not be nearly as destructive as intense jealousy.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Psychoeducational Testing
12-9-09
by Dr. Lorin Bradbury
Question: I have a daughter in the third grade. She is performing poorly in school, and compared to our other children, she is falling far behind. I have asked her teacher about Special Education services, but have received reassurances that she will probably catch up. I’m not so certain. Is there someone outside the school who could test my daughter to see why she is having such a difficult time in school?
Answer: You raise a very important concern, and I’m sure you are not alone in being concerned about the achievement of a child. Since you have other children, and there is something different about how this child is learning, you probably have a keener sense of your child’s need than anyone else. The longer you wait to get an assessment, the further your child will fall behind.
If you cannot get your child’s teacher to make a referral for an assessment to determine if your child needs Special Education, you should speak with the site administrator or counselor. If you still cannot get a referral, the answer to your question is “Yes,” there is someone who can test your daughter. Any psychologist with training in psychoeducational testing and licensed in the State can test your daughter.
Another reason you may want to purchase the services of a licensed psychologist would be if you disagree with the results of testing by the school psychologist and you desire a second opinion. If you choose to purchase the services of a licensed psychologist, outside the school, you can expect to pay $1,200 to $1,500 for the evaluation and it may or may not be covered by insurance. However, if it was my child, and I saw her falling further and further behind, the cost of the evaluation would be minimal to the cost of her failing in school.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
33 Stages of Acculuturation
12-3-09
by Lorin Bradbury
Question: I have been in Bethel a couple of months. When I first arrived, experiencing a new culture was exciting, and I felt as though I had found a culture that was superior to the one in which I was raised. That was a couple of months ago. Now all I can see deficiencies, inefficiencies, and backwardness. What is happening to me? Am I depressed?
Answer: I cannot say whether or not you are depressed, but it is very common for people to experience some of the feelings you are experiencing when moving from one culture to another. In fact, someone moving from a village, or even Bethel, to a large city is likely to go through a similar experience.
Shepherd L. Whitman, in a booklet called, “Some Factors Influencing Communication Between Cultures,” and published by the Pittsburgh Council for International Visitors nearly thirty years ago described five stages people go through when they live in a culture foreign to them.
I will attempt to describe the stages of acculturation, and hopefully it will be helpful to you.
1. Enthusiastic Acceptance. When you first arrived, everything was new, and you were experiencing a great deal of novelty. All cultures are made up of a compilation of both good and bad characteristics. You may have been attracted to how people still subsist off the land and overlooked some of the more troubling statistics, such as alcoholism, child abuse, etc. It’s little bit like dating and the honeymoon. You saw only the good in him, or her. Somehow, you just overlooked the flaws.
2. Doubt and Reservation. The novelty begins to fade and you begin to recognize that the culture is not as perfect as you thought it was upon arrival. The absence of certain conveniences may be aggravating. You may have experienced what felt like prejudice toward you. Whether you realize it or not, you are experiencing a great deal of tension between the familiar and unfamiliar. This takes its toll and you may be withdrawing, rather than reaching out.
3. Resentment and Criticism. It is at this point visitors to a new culture begin to see buildings as dilapidated, people as unlearned, and workers as incompetent. If you are unaware of what’s happening, you may alienate those who could eventually become your friends. It might be best to think of yourself as a guest in someone else’s home during this stage. How would I treat the host, even if I didn’t like everything about the home setting?
4. Adjustment. Fortunately, most people don’t get stuck in the Resentment and Criticism stage and make the necessary adjustments. During this stage the newcomer recognizes that the unhappiness and critical attitudes that he or she has been experiencing are due to difficulties adjusting, rather than deficiencies in the newfound culture.
5. Accommodation and Evaluation. During this stage, the newcomer acquires a degree of comfort in the new culture, makes friends from the new culture, and begins to enjoy the experience.
Unfortunately, there are some who get stuck in one of the middle stages. These individual will likely move on to another culture, or return to the culture from whence they came.
I trust the awareness of the process of acculturation will be helpful to you. It has been very helpful to me through the years. On the other hand, if you believe you truly are depressed, I would be very interested in hearing from you with a description of your current symptoms. Also, I would recommend getting professional help.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in The Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Token economy
11-21-09
by Lorin Bradbury
Question: I have four children, ages 4, 5, 7, and 8. When they were babies, they were so sweet and cuddly, but now that they are older, I am pulling my hair out. They don’t listen to me when I holler at them. It seems that I have to scream for them to even notice that I am talking. The older children are now taking sides with the younger children against me. My husband tells me I am a lousy parent, but he does nothing to help. As of today, I would agree with him that I am a lousy parent. Can you give me any advice that might help turn our chaotic household around?
I wish I had an instant cure for your situation, but unfortunately I don’t. However, I have a couple of suggestions that may start the process of shaping your children’s behavior. First, it’s important to remember that parenting is hard work, but it’s easier if you have a goal for your children’s behavior.
If an animal trainer can get an elephant to sit on a little red box, it’s likely you can get your kids to do what you want them to do if you know what kind of behaviors you want from them and work to shape those behaviors.
Second, stop hollering at your children, go to the child you are addressing, and speak directly to him or her. Third, work to get your husband on board. He’s probably just as frustrated as you, but instead of pulling his hair out, he puts the blame on you and calls you a bad parent. If you can come up with a plan that works, he may want to be a part of it.
When I work with parents, I encourage them to implement a token economy and cost-response systems. To implement these, I encourage parents to create refrigerator charts (charts that can be hung on the refrigerator or other public place). This allows others to see your children’s progress. Once it’s working, it will allow you to brag about their good behavior, which is rewarding in itself.
Your children can be involved in the creation of the charts. Let them decorate them and get them excited about earning their own money. Create eight columns—one for each day and a wider one on the left side to write assigned chores. Then create rows. In the left column the chores are written and stars, smiley faces, money amounts, etc. are put on the lines following the chores in each daily column.
Determine age-appropriate chores for each child. Since your children range in age from 4 to 8, each child will have different chores. Keep the number of chores manageable (i.e., 4 chores). Each may be able to make his or her bed, but an older child may take out the trash while a younger child puts silverware in a drawer.
For sake of ease in explaining the process, let’s suppose you offer to pay your child $.25 for each chore completed at a predetermined acceptable level. (You determine the amount you want to pay.) If your child does all four chores acceptably, he will earn $1.00 per day. That’s $7.00 per week, but here’s the catch, you stop giving your children money for pop, candy, treats, etc. throughout the week. They must earn it. If their behavior is such that they didn’t earn the money, sorry, that’s life. They have to go without. This takes discipline on the part of the parent. The parent must not feel sorry for the child and give in. To do so sabotages the token economy.
So how do you deal with bad behavior? That is where you implement the cost-response system. Continuing with our $.25 per chore and a maximum possible $1.00 per day, charge your child $.05 per bad behavior. If your child sasses you, or picks on another child, simply ask that child to put a check mark in the column for that day. Add the money earned for the day and subtract $.05 for each check mark, but never go into negative numbers. That gives the child the opportunity to start fresh each day. The reason you want to charge a small amount for each infraction, rather than a larger amount is that it provides you with more leverage. A charge of $.05 per infraction allows the child to be penalized without losing all money earned for the day. This increases motivation.
At the end of the week, add the totals and pay the child. When you go to the store, if the child has enough money, he can buy a treat. It also allows you the opportunity to teach the child about saving money, giving to charity, paying tithes, etc. A very important rule is that you must have the money available to pay on payday. Like adults, they will expect their pay on time.
This program only works if the parent is disciplined to make it work. You must not be vindictive in the process. The goal is shaping behavior not punishing. You must address inappropriate behavior when it is occurring, even when you are busy. You must not give in to your child’s crying when the child does not have enough money for a treat because of not doing chores, or bad behavior. Don’t allow draws upon future payments. (By the way, that’s a bad idea for adults too.) To give in at this critical moment will teach your child that crying, misbehaving, or throwing a tantrum gets results.
When you implement a program such as this, be prepared for some initial bad behavior when the child does not get the allowance he wants, or has to go without treats, there will likely be a burst of bad behavior. That burst of bad behavior is referred to a “response burst.” Stick with the program and the behavior will improve.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in The Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Computer addiction
10-22-09
by Dr. Lorin Bradbury
Question: Is being on the computer all day long a disorder? If yes, how can someone get help?
Over thirty years ago (1977), Marie Winn wrote an influential book entitled The Plug-in Drug. In it she compared the experience of watching television to chemical dependency. She noted that television withdrawal symptoms parallel drug withdrawal symptoms, and the need to watch, coupled with a lack of concern over what is being watched, is similar to a chemically dependent person’s cravings and lack of discretion over the kind of behavior that results from drug use. Thirty-two years later, we are confronted with a new piece of hardware that has potential to be even more addicting. Little in written in the professional psychological literature about the computer itself, but much concern has been raised over Internet addiction.
Internet addiction is not yet recognized as a formal mental health disorder. However, mental health professionals who have written about the subject note symptoms or behaviors that, when present in sufficient numbers, may indicate problematic use. Symptoms of a possible Internet addiction include the following:
• Preoccupation with the Internet: The individual often thinks about the Internet while at work or in other settings where access is not available, or not allowed.
• Loss of control: The individual feels unable to get up from the computer and walk away. He or she sits down to check e-mail or look up a bit of information, and ends up staying online for hours.
• Irritability or moodiness when not online: Dependency on any substance often causes mood-altering side effects when the addicted user is separated from the substance on which he or she depends.
• Mood-altering drug: One common symptom of many Internet addicts is the compulsion to cheer one’s self up by surfing the Web.
• Dishonesty in regard to Internet use: Addicts may end up lying to employers or family members about the amount of time they spend online, or find other ways to conceal the depth of their involvement with the Internet.
• Loss of boundaries or inhibitions: While this often pertains to romantic or sexual boundaries, such as sharing sexual fantasies online or participating in cyber sex, inhibitions can also be financial or social.
• Damage to, or loss of, a significant relationship due to Internet use: Personal relationships are frequently neglected when users spend too much time on the Web. Just as alcoholics seemingly crawl into the bottle, Internet addicts crawl into the computer.
• Logging onto the Net while already busy at work: Individuals find themselves working overtime to make up for lost hours of work.
• Going without sleep: Whether it be viewing pornography or playing games around the world, addicted individuals may experience difficulties on the job due to impaired concentration and productivity related to sleep deprivation.
• Sneaking online: This may occur when spouse or family members are not at home, and the individual experiences a sense of relief.
• Unsuccessful efforts to quit or limit computer use: Individuals make repeated resolutions to limit computer use, or quit visiting certain web sites. However, they seemingly forget their commitments.
As you can imagine, the above list is not an exhaustive list of symptoms of an Internet addiction. If you are addicted, you have probably already added several symptoms while reading this article.
As with any addiction, it’s one thing to identify symptoms that may be problematic, but is there help and how can it be obtained? Yes, there is help, but it’s up to you to obtain it. If you recognize that you might have a problem with Internet usage, you’re one step closer to a healthier life. It’s very easy to rationalize or deny Internet addiction. The following are some steps to get your Internet use under control.
• Identify underlying mental health needs: If you are struggling with depression or anxiety, for example, Internet addiction may be a form of self-medication for a mood disorder. Have you had problems with alcohol or drugs in the past? Does anything about your Internet use remind you of how you used to drink or use drugs to numb out? Take a hard look at your needs. You may need therapy for the depression or anxiety, and 12-step meetings for the addiction(s).
• Increase your coping skills: Perhaps the Internet is your way of coping with stress or angry feelings. Or maybe you are excessively shy and feel like you cannot meet people in real life. Therapy may help build skills in these areas.
• Develop a support network: The more relationships you have in real life, the less you will need the Internet for social interaction. Set aside dedicated time each week for spouse and/or family. If you are shy, look for groups that pique your interest. It may be necessary to find several individuals to whom you can provide accountability. Add individuals to your support network who will ask you hard questions.
• Keep a log: Keep a log of how much you use the Internet for non-work related activities. Try to get a clear picture of your Internet use. Are there times of day that you use it more? Are there triggers in your day that make you stay online for hours at a time when you planned for 5 minutes?
• Set goals: Set goals for when you will use the Internet. You might try setting a timer for usage, scheduling use for certain times of day, or making a commitment to turn off the computer at the same time each night.
• Replace your Internet usage with healthy activities: If you are bored and lonely, resisting the urge to get back online. Have a plan for other ways to fill the time.
Don’t give up or give in. Get help. Therapy can help you learn healthier ways of coping with uncomfortable emotions, such as depression or anxiety. If your Internet use is affecting your partner directly, such as with pornography, cybersex, or online affairs, marriage counseling can help you work through these challenging issues. Marriage counseling can help you reconnect with your partner if you have been using the Internet for most of your social needs.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in The Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Employee Assistance Programs
10-15-09
by Dr. Lorin Bradbury
Question: I recently heard about Employee Assistance Programs. I have a very vague idea of what they are, but was wondering if you could explain what they are, who they cover, and how I, or others, might access one?
I would be happy to attempt to answer your question, since I serve as a provider for ComPsych, the largest Employee Assistance Program (EAP) in the world. Locally, ComPsych provides services to the employees and families of the Yukon-Kuskokwim Health Corporation (YKHC).
EAPs are employee benefit programs offered by many employers, typically in conjunction with a health insurance plan. However, they are separate from the insurance company. In our area, in addition to YKHC, the State of Alaska, the U.S. Postal Service, and the Lower Kuskokwim School District (LKSD) have EAPs available to employees.
The purpose of EAPs is to help employees deal with personal problems that might adversely impact their work performance, health, and well-being. Employees and their household members may use EAPs to get help managing issues that could adversely impact their work and personal lives.
EAP counselors typically provide assessment, support, and if needed, referrals to additional resources. The types of problems for which EAPs provide support may include substance abuse and related issues, emotional distress, major life events (i.e., births, deaths, or even termination of employment), health care concerns, financial or legal problems, family problems, parenting issues, relationship issues, issues related to work, and concerns about aging parents.
As can be seen from that list, it can include almost anything that might impede one’s ability to work. So if problems with your children, or marital problems, or financial problems are impacting, or have the potential to impact, your productivity on the job, you would likely qualify.
EAP services are typically free to the employee and household members, having been pre-paid by the employer. The clients for whom I provide assessment and counseling services under EAPs are usually approved for six sessions, and there is no charge to the employee. In all but one of the entities mentioned above, the employer contracts with a third-party company to manage its EAP (i.e., ComPsych, Ceridian, or etc.). One of the entities listed above contracts directly with a psychologist who provides EAP services to its members.
Confidentiality is maintained in accordance with privacy laws and professional ethical standards. The beauty of EAPs is that employers do not know who is using their EAPs, unless there are extenuating circumstances and the proper release forms have been signed.
Occasionally, an employee may be advised, or ordered by management to seek EAP assistance due to job performance or behavioral problems. The goal of these supervisory referrals is to help the employee retain his or her job and get proper assistance. Most importantly, any referrals for job performance issues or concerns are always confidential.
In these cases the EAP serves as a go-between. The provider reports to the EAP representative that the employee is in compliance with a treatment plan and the EAP reports to the employer that the employee is in compliance with treatment.
Getting back to your question, you can access an EAP only if your employer provides one. EAPs usually are very easy to access—as simple as a telephone call. If your employer provides an EAP, but you don’t know the number, contact the human resources department. Once you contact your EAP, someone will interview you telephonically and assign you a provider. I would recommend asking who the providers are so you have some control over who will provide your services.
Many employees are unaware of the kinds of problems that an EAP will cover, but keep in mind that typically you, your spouse, and your children are all covered under an EAP if provided by your employer. Any problem that may in some way impact your work is generally covered.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in The Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Counseling as a career
9-22-09
by Dr. Lorin Bradbury
Question: I am interesting in doing counseling, and I was wondering if I became a psychologist if I could do counseling?
If you are interested in a career in the counseling field, you may not want to invest the number of years required to become a psychologist. If you decide to pursue licensure as a psychologist, you should plan on approximately ten years from the time you begin college until you receive a doctoral degree. Then you will need at least one year of residency or post-doctoral supervised experience plus passing the State licensure examinations.
So if your goal is to become a counselor, you might consider obtaining a Master’s Degree in counseling or social work. Both of those disciplines require some form of practicum or internship plus passing the licensing exam. However, the length of time required to achieve those goals is significantly less than the time required to become a psychologist.
Licensure as a psychologist has advantages in employment and practice opportunities. For example, you may want to do counseling now, but as the years go by you may discover that your interests change. When I began the pursuit of a Ph.D. in psychology, I was interested in marriage counseling. However, today I practice both clinical and forensic psychology. That would not have been possible if I had not pursued licensure as a psychologist.
The one feature that distinguishes psychologists from other mental health professionals is their training in the area of administering and interpreting psychological tests. Because of this special training, psychologists are often called upon by physicians, attorneys, counselors, and other mental health professionals to assist in defining diagnoses by means of psychological tests.
Psychologists, like physicians, are more and more seeking credentials as specialists. In addition to licensure as a psychologist, many psychologists seek credentialing in specific areas of specialty. Some of the areas of specialty include Clinical, Clinical Health, Counseling, Clinical Neuropsychology, Forensic, Child and Adolescent, Couple and Family, Group, Organizational and Business, Psychoanalysis, Rehabilitation, and School Psychology. I expect that as the years go by even more specialties will be added. I will attempt to describe some, but not all, of the various specialties below.
CLINICAL PSYCHOLOGY: Clinical psychologists assess and treat people with psychological problems. They may act as therapists for people experiencing normal psychological crises or for individuals suffering from chronic psychiatric disorders. Also, clinical psychologists may administer tests to clarify diagnoses and assist with treatment planning.
COUNSELING PSYCHOLOGY: Counseling psychologists do many of the same things that clinical psychologists do. However, counseling psychologists tend to focus more on persons with adjustment problems rather than on persons suffering from severe psychological disorders. They often provide career counseling in university settings.
FORENSIC PSYCHOLOGY: Forensic psychologists work with psycholegal issues. They may be called upon by attorneys and judges to assess competency to stand trial, mental status at the time of an offense, civil guardianship, risk assessment, or to answer other psycholegal questions.
HEALTH PSYCHOLOGY: Health psychologists are concerned with the promotion and maintenance of good health and the prevention and treatment of illness. They may design and conduct programs to help individuals stop smoking, lose weight, manage stress, and stay physically fit. They are employed in hospitals, medical schools, rehabilitation centers, public health agencies, academic settings, and private practice.
INDUSTRIAL/ORGANIZATIONAL PSYCHOLOGY (ORGANIZATIONAL AND BUSINESS PSYCHOLOGY): Industrial/organizational psychologists are primarily concerned with the relationships between people and their work environments. They may develop new ways to increase productivity or be involved in personnel selection. They are employed in business, government agencies, and academic settings.
SCHOOL PSYCHOLOGY: School psychologists typically assess children’s psychoeducational abilities and recommend ways to facilitate student learning. They typically work in public school systems. They often act as consultants to parents, teachers, and administrators to optimize the learning environments of specific students.
NEUROPSYCHOLOGY: Neuropsychologists generally perform testing to assess brain-behavior relationships. They are often called upon to assess the degree of impairment following a head injury resulting in an insult to the brain. Neuropsychologists often work in the forensic realm and are called upon by attorneys in the event of lawsuits related to head injuries.
FAMILY PSYCHOLOGY: Family psychologists typically work with couples and families. In addition to therapy with families, they may administer tests to assess compatibility and develop treatment plans.
In addition to direct service to clients, many psychologists work in university settings, teaching and doing research. Other interesting specialties besides those listed above include experimental psychology, developmental psychology, educational psychology, and social psychology.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in The Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Married for over 20 years
9-16-09
by Dr. Lorin Bradbury
Question: My husband and I have been married for more than twenty years. We have three children, and from my perspective we have a good marriage. I have been faithful to him throughout our marriage and I have no reason to doubt his faithfulness to me. My only complaint is that he continually pressures me to make love to him. There have been times in our relationship that I enjoyed the sexual aspect of marriage, but overall, I have never had an extremely strong need for a sexual relationship. I really thought that by now his sex drive would wane. If I were to convince him to go to you for counseling, what could you do to help him?
Answer: From reading your question, and given the minimal information available in your question, I’m not sure that he’s the one who needs the counseling. It’s very possible that there is more to the story than you have provided above, but you indicate there has been no infidelity, and overall, you are happily married. It appears from what you have said that your husband has not been abusive to you and even in his desire for sex, he has not been overly pushy or manipulative. I am making some assumptions, but I’m working with the information you have provided. Based on that, my initial reaction is that you may have distorted view of the sexual relationship.
Since you have been married more than twenty years, it is likely that you are somewhere between 40 and 50 years old. To believe that he is going to lose interest in sex at that age is to lack understanding of human sexuality. Let’s get real; he’s still going to be interested at 80.
There are a number of questions that I would like to ask you. How long have you been rejecting him? Have you considered what it is like to be rejected by the one you have committed your life to and are willing to die for? You stated that you have never been unfaithful to your husband, but have you considered that refusing to make love to your husband, or doing it grudgingly, is the “moral equivalent of infidelity.” Dr. Laura Schlessinger boldly stated, “Intentionally depriving a spouse of his legitimate needs stems from being unfaithful to the intent of the vows.”
It’s very possible that your intimacy needs are being met through other legitimate means, but his needs aren’t being met at all. Recently, I came across a book written from a Christian point of view on this subject. It is written by Marla Taviano, and she entitled it, Is That All He Thinks About?: How to Enjoy Great Sex with Your Husband. In the book, she presents a conversation she had with a friend that sounds much like you. I will present that interchange between the two ladies for your consideration.
My friend Arin recently shared that she was completely uninterested in sex.
“So, what do you love?” I asked her. “And be honest You don’t have to tell me you love reading your Bible and being a mom.”
“Scrapbooking, shopping, and eating at nice restaurants,” she said without hesitation.
“What if you could only do those things if Jeff were willing to do them with you?” I asked her.
“That’s stupid,” she told me without batting an eye.
“Go with me here, girl. I have a point.”
“Okay,” she said, playing along. “I’d never get to scrapbook, I’d hardly ever shop, and we’d eat out once or twice a month. But we’d never go to my favorite two restaurants, because he insists he doesn’t like them.”
“So, let me ask you this—since your husband doesn’t enjoy scrapbooking, shopping, or eating out at nice restaurants on a frequent basis, do you go without these things?”
“Of course not. That’s what my girlfriends are for.”
“Hmm…okay. Let me get this straight. You like scrapbooking, but not sex. He likes sex, but not scrapbooking. Correct?”
“Uh, yes.”
“When you refuse to have sex with him, who does he call to satisfy that craving?”
“He better not be calling anybody!”
“Why not? You do.”
“Not for sex!”
“Right, but sex is not your deepest need. So, while you’re getting your deepest needs and desires met, your husband is going without. It’s perfectly acceptable for other people to meet these needs for you, but you are the only person on the face of this earth he is allowed to go to for sex.”
“You can’t tell me that sex is a need. I don’t need it… I think the real solution here is for my husband to find a hobby he can do without me. Maybe that would take his mind off sex.”
“Is that how you visualize your ideal marriage—you going off doing your thing, him going off and doing his? Two separate people going in two separate directions.” Why even bother getting married? We can’t use our differences as an excuse to avoid doing something our husbands want to do. And besides, sex is not just a hobby for your husband. Taking his mind off it isn’t the answer”
Further, the author stated for all the wives reading her book:
Your husband agreed to marry you with his sex drive intact, fully aware he would be entirely dependent on you to meet all his sexual needs. If, for some reason, you were unable our unwilling to meet those needs, he understood they would go unmet. Saying “I do” to you included placing his sexual needs and identity out on the table—naked and vulnerable—for you to do as you please.
According to God, I am the only one allowed to meet my husband’s sexual desires. An awesome responsibility, yes, but what a privilege.
I’m not sure I was able to provide you with the answer you were expecting, but I believe there is something in the conversation between Maria and Arin above worth considering. The answer to HIS PROBLEM is not me trying to convince HIM that HE SHOULD BURY HIS SEX DRIVE by finding a hobby or throwing all his energy into his work. Instead YOU ARE THE ANSWER TO HIS PROBLEM. He wants you and needs you. Consider a new hobby—getting to know your husband and attempting to meet his needs.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in The Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Research and treatment
for sex offenders
9-10-09
by Dr. Lorin Bradbury
Question: Since sex offenders always commit new sex crimes as soon as they are released from prison, why don’t we just lock them up and throw away the key?
Embedded within your questions is the myth that “once a sex offender always a sex offender” and that the recidivism rate for sex offenses is significantly higher than for other crimes.
Research studies over the past two or more decades have consistently shown that the recidivism rate for sex offenders is lower than for most other types of offenders. A ten-year follow-up study of 879 sex offenders in Ohio found that of the 34% of sex offenders who committed a new crime, only 8% were re-incarcerated for a new sex crime. An additional 3% were incarcerated for a technical violation that was judged to be related to a potential new sex crime. The other 22% were incarcerated for non-sexual offenses.
In a 2008 study, published in the peer-reviewed journal, Psychology, Public Policy, and Law, after the enactment of New York State’s Sex Offender Registration Act, found that first-time sex offenders committed 95% of all sexual offense arrests. The Bureau of Justice Statistics found that only 5.3% of the 9,691 sex offenders released in 1994 were rearrested for a sex crime within three years of their release. Compare that with 2002 statistics, in which 73.8% of property offenders and 66.7 drug offenders were rearrested. As a result of research, such as the 2008 study noted above, experts in the field have questioned the benefit of sex-offender registers and community notification laws.
What has been found is that the media seems to have a fascination with sex offenses. Research has shown that the media tend to over report sexual crimes by a factor of almost fourteen times their actual rate of incidence. Also, the media tend to report sex crimes in a manner that inspires fear more than when reporting other crimes, such as homicide, robbery, and assault.
However, having said all of that, there is one subgroup of sex offenders that does have a much higher recidivism rate and that is pedophilia. Pedophilia is defined as a psychosexual disorder in which there is a preference for sexual activity with prepubertal children. Pedophiles are almost always males. The children are more often of the opposite sex (about twice as often) and are typically 13 years or age or younger. They may be within or outside the pedophile’s family. Sexual abuse of a minor alone is not sufficient to establish a diagnosis of pedophilia. Pedophiles have a preference for and a propensity toward children less than 13 years of age. Sexual fantasies, looking, or fondling are more common than genital contact. Fortunately, pedophilia constitutes only small percentage of all sex crimes.
Another commonly held myth is that sex offenders cannot be rehabilitated. Cognitive-behavioral therapy has been shown to significantly reduce the recidivism rate of sex offending. Bethel and the YK Delta are fortunate to have such a program in our community.
Research in the area of sex-offender treatment has attempted to identify factors that are referred to as dynamic (changeable). Some of the factors that have been found to be changeable and make a difference in the risk of reoffending include (1) sexual self-regulation, (2) attitudes supportive of sexual assault, (3) intimacy deficits, (4) general self-regulation, (5) lack of cooperation with supervision, and (6) negative social influences.
Sexual Self-regulation: One of the most distinctive risk factors for sex offenders is a problem with sexual self-regulation. Sex offenders often view themselves as having strong sexual urges and tend to overvalue sex in their pursuit of happiness. In sex-offender treatment, offenders learn that by changing the way they think, they also can change the way they behave.
Attitudes Supportive of Sex Offending: There has been consistent evidence that men who admit to sex offending also hold attitudes supportive of such behaviors. Treatment attempts to get the offender to view life from the perspective of the victim. In other words, when treatment is effective, the offender develops empathy toward others. When treatment is successful, the offender will think in terms of how his behavior may have impacted the victim for a lifetime.
Intimacy Deficits: Many sex offenders lack true intimacy. With therapy and with time they can be taught to develop normal forms of intimacy. Sex can take on new meaning in relation to intimacy. A sexual relationship can be a celebration of true intimacy, rather than something performed in the absence of intimacy.
General Self-regulation: This is a very common trait among sexual offenders as well as nonsexual offenders. Many offenders are impulsive and fail to think before they act. As with other dynamic factors, the lack of self-regulation is an area that can be changed through cognitive-behavioral therapy.
Lack of Cooperation with Supervision: This is usually in reference to probation, but can be related to supervision within a sex-offender treatment program. Like other dynamic factors, this is a behavior that can be changed.
Negative Social Influences: As with other offenders, sex offenders often have developed negative peer associations. These peers may support the offender in his denial of sex-offending behaviors, or provide victim access. Treatment will address this factor and help the offender to disengage from these negative associations and develop new healthy relationships.
No, the answer is not to just lock people up and throw away the key. However, some recent legislation governing the length of sentences for sex offenders is not too far short of throwing away the key. The legislation was no doubt influenced more by public hysteria and media attention that empirical research. It may be time for the legislature to revisit the extremely lengthy sentences for sex offenders, the sex offender register, and some of the sanctions against treated and released offenders. However, like wolf control and oil exploration, when the legislature tackles these very emotionally laden subjects, it should be done in the light of empirical research.
What is a dry drunk?
9-1-09
by Dr. Lorin Bradbury
Question: What is a dry drunk?
A dry drunk is actually a condition that describes one who has quit drinking or drugging, but continues to manifest behaviors of alcoholism or drug addiction. In essence, the individual has not made the necessary emotional changes that should be characteristic of sobriety.
Being an alcoholic or drug addict sets up many thought patterns, attitudes, feelings, and actions that are immature. Simply removing the alcohol or drugs without changing these underlying factors produces the dry drunk syndrome. It’s often those around the non-drinking alcoholic or non-using drug addict that recognize a lack of progress toward recovery or a reversion back to the old ways of thinking and acting.
For some who have made progress, the dry drunk can be a precursor to a relapse. Some of the symptoms of a dry drunk are restlessness, irritability, moodiness, and general discontent. Below are some of the attitudes common with the dry drunk syndrome as described in substance abuse treatment literature.
Self-centeredness: This is adolescence at any age. It describes an attitude in which “the world revolves around me.”
Grandiosity: When this attitude is present, the individual is able to do anything, conquer any habit, and produce greater and better work than anyone else. However, grandiosity does not always mean that the individual believes he or she is the best. It can manifest as attention-seeking through playing the victim role.
Impulsivity: A common observable behavior of people with addiction problems is poor impulse control. They tend to do what they want when they want, with little regard for others around them.
Judgmental Attitude: This is a very destructive attitude for people in recovery. It is closely linked to grandiosity and tends to view everyone else judgmentally. But it may be a reflection of the individual’s view of himself or herself. When someone diminishes their own value, they may project that feeling unto others. Or, they may simply become very critical of everyone else in an attempt to elevate their own worth in comparison to others.
For those living around someone in a dry-drunk state, there are symptoms that are very noticeable. However, the individual in the dry drunk is likely to deny those symptoms, or turn a blind eye to them. Below are some of the behaviors that may manifest during a dry drunk:
1. The alcoholic/addict becomes restless, irritable, moody, and discontented.
2. The alcoholic/addict becomes bored, dissatisfied, and easily distracted from productive activities.
3. The alcoholic/addict’s emotions and feelings become listless and dull, and nothing seems to excite them anymore.
4. The alcoholic/addict starts to the engage in a euphoric yearning for the good old days of active use.
5. The alcoholic/addict starts to engage in magical thinking, fanciful expectations, and unrealistic dreams.
6. The last thing the alcoholic/addict wants is to engage in introspection of self.
7. The alcoholic/addict begins to feel unfulfilled, and has the feeling that nothing will ever satisfy the yearning or fill the hole in the soul.
Many alcoholics and addicts began drinking and using at a young age. When they began, emotional maturity was suspended. When I ran a treatment group, I would explain that the participants were 14 years old, not their chronological age. Similarly, individuals experiencing a dry drunk are only 14 years old. They are caught in a perpetual state of adolescence, and until they are willing to confront the immature, underdeveloped attitudes and emotions, there can be no forward movement toward real recovery.
You may be wondering, “What can a spouse or family member do when a loved one is experiencing a dry drunk?” In many respects, you must confront them as you would an active alcoholic or drug addict. Practice tough love.
1. Maintain healthy boundaries. Define yourself, and don’t allow the alcoholic/addict to violate your values.
2. Do not enable them to continue the dry drunk lifestyle. Do not lie for them, or make excuses for their inappropriate behaviors.
3. Do not rescue them from the consequences of their actions related to the dry drunk. If the individual goes to jail for assaultive behavior related to an angry outburst, don’t bail him or her out. Make him or her accountable for his or her actions.
4. Do not let them manipulate you by mood swings or inappropriate attitudes. If the person returns to active use because you didn’t respond to manipulation attempts, do not feel responsible for his or her moods or actions.
5. Look for opportunities to gently point out the dry drunk attitudes and accompanying actions. Confrontation at the wrong time is likely to lead to denial and an argument. You may feel like you are dealing with a young adolescent and in truth you are, so consider how you might approach a teenager.
Since egocentrism is a defining characteristic of both a teenager and an individual in a dry drunk state, there will come a time when the individual has a need. It may be at that time that you can confront and help the person to move forward in his or her recovery.
Marrying young
8-27-09
by Dr. Lorin Bradbury
Question: I am a Christian mother with teenage girls. We talk a lot about abstaining from sex and waiting to get married until they finish college and find just the right husbands. It is my impression that at this time my girls and I embrace the same values concerning maintaining their virginity until they marry. Recently, I read that 90% of Americans experience sexual intercourse before marriage and near 80% of conservative Christians experience first intercourse prior to marriage. Reading this frightened me. What happened to the message of abstaining until marriage?
Parents, churches, and in some cases, even the government have done a great job teaching young people to abstain from sex, but have failed to teach them how to marry. Instead, we have prolonged adolescence to nearly 30 years of age. During the American Revolution, 16-year-old men were guarding the Boston harbor. Today, 16-year-olds are considered immature, and need at least 6 more years of life skills training before being anywhere near an adult.
In 1970, the median age for marriage was 21 for women and 23 for men. Today, the median age for women is 26 and for men 28. Demographers refer to this flight from marriage as the “second demographic transition.” It has been found that in societies such as ours, which have experienced lengthy economic prosperity, men and women lose motivation to marry and bear children.
Americans, like the other industrialized nations of the world, want it all. Parents want their children to get a good education and a good job. They hope they will eventually marry, but only after they are secure in their careers and can provide a living that allows them to travel, go on vacations, and own a large home. Those who follow this course and marry usually want children. However, they may find that they are not able to conceive on schedule, and may even end up childless. There are many reasons for not being able to conceive, but one of them is that the most fertile period for a woman is between the ages of 20 and 25.
In a recent issue of Christianity Today, Read Mercer Schuchardt, Professor of Media Ecology at Wheaton College addressed this very subject. “Born into this vast technopoly, today’s child understands her world primarily through mass media. Thanks to media’s total-disclosure nature, she will be a world-weary 72-year-old by the time she reaches 12, but won’t have the maturity of a medieval 12-year-old until about age 36. Ages 12 to 22 will be spent in mandatory survival training called higher education. Regardless of her primary course of study, her secondary course, undertaken when she is biologically fittest and physically strongest to raise children, will be the ironic but ironclad dogma that she must never consider having a child until she is economically, psychologically, and spiritually a fully realized autonomous self. If, after a decade of ingesting this dogma, she still has the desire to become a mother, she can only have at most two children.
If life’s most meaningful work for couples is raising children, then it’s a cynical system that requires the false choice between having children young, when a large family is physically possible but financially hard, or waiting until they can afford a large family, when fertility has dropped. Technology, it turns out, is a harsher taskmaster than biology, offering a world where the best form of birth control is economics, the best predictor of income is education, and the best deterrent to having children is guilt over failing to give them the very best a consumer society offers.
Meanwhile, the ocean of sorrow continues to fill with the tears of those who are childless or heartbroken by the lie that tells a woman she is free to be anything she wants, so long as she’s a man about it” (August 2009, p. 30).
Much has been written about the increased likelihood of divorce among those who marry young. However, the “young” often referred to in the professional literature are teenagers, not those in their early 20s. It’s middle-class culture that has extended adolescence and promoted waiting to marry until later in life, or not marry at all. In the past, the church has been the flagship of cultural values, but in the past half century or more, the church seems to have bought into the values of the middle class and has done very little to create a counter culture that not only teaches abstinence until marriage, but sanctions marriage among the young.
I, for one, am supportive of young marriages. However, we need to prepare our children and teens for marriage by talking with them about getting married as seriously as we do about abstaining from sex until marriage. We need to work to eradicate adolescence, or at least return it to its original meaning. Remember adolescence didn’t exist prior to 1904. That’s when G. Stanley Hall coined the term. Also, if you study the history of education in America, you find that need for more years of secondary education was directly related to the rise of labor unions and their need to keep teenagers out of the workforce. This had an impact on how adults viewed teenagers and teenagers viewed themselves.
If we are to promote young marriages, our teenagers need to be instructed concerning love. They need to understand that love is commitment, not goose bumps running up and down the spine. They will probably figure out how to make love, but need instruction in how to make a living and provide for a household. As adults, we need to make certain that our finances are in order and talk with our children and teenagers about finances. This is an area that has the greatest potential for shipwreck for a young couple. They should be assured that it is not a terrible thing to go without many material things until they can afford them. There is great virtue in delayed gratification.
In response to the question that prompted this lengthy discourse, I believe the abstinence message is being promoted stronger than ever. However, marriage is being delayed at a time in life when the biological drive for sex is the strongest. In no way am I condoning premarital sex or changing my personal convictions, but I am confronted with a harsh reality. The longer you delay marriage, the greater potential for your children, who are now teenagers, to fail to maintain what are now strong values shared by you and the Christian community.
I know that promoting marriage at a young age is a very controversial topic, but I speak as one who was a 19-year-old bridegroom and married an 18-year-old bride. This week we will celebrate our 38th anniversary.
Infant Bonding
8-21-09
by Dr. Lorin Bradbury
Question: How important is it for a child to bond to a parent?
When you speak of bonding, you are speaking of the process of forming an attachment in what is called Attachment Theory. This theory originated in the work of psychiatrist and psychoanalyst John Bowlby. The essence of the theory states that children have a need for a secure relationship with adult caregivers. When this is not present, there is a strong likelihood that normal social and emotional development will not occur.
According to Attachment Theory, timing is critical. There are critical periods during which bonding experiences must be present for the brain systems responsible for attachment to develop normally. These critical periods appear to be in the first year or two of life and are related to the capacity of the infant and caregiver to develop a positive interactive relationship.
Infants become attached to adults who are sensitive and responsive in social interactions with them, and who remain as consistent caregivers during the period from about six months to two years of age. According to Attachment Theory, appropriate parental responses become internal models that guide the individual’s feelings, thoughts, and expectations in later relationships.
Instability or disruption in relationships between caregivers and the child during those critical months may result in major problems in a child’s ability to trust and attach to parents or caregivers.
The kinds of problems that are frequently displayed by children who have not properly attached to a parent or caregiver are lack of development of a conscience, poor impulse control, poor self-concept, dysfunctional interpersonal interactions, emotional problems, lack of comprehension of cause and effect, poor insight into the child’s own behaviors, and developmental delays.
Unattached children have difficulty learning to build and maintain relationships of any sort. Having received little love, they have trouble giving it. Having not learned to care for others, they are self-centered and act impulsively. They often have difficulty incorporating rules and laws into their worldviews, violating the rights of others to satisfy their impulses. If you were to study the lives of men such as Ted Bundy and Lee Harvey Oswald, you would find disruptions of early attachment.
Not all children with breaks in early attachment develop an antisocial personality. However, many never trust others, and display behaviors that keep others at a distance. These behaviors include poor eye contact, withdrawal, chronic anxiety, and lack of self-awareness.
Researchers believe the most important factor in creating attachment is positive physical contact. Factors crucial to bonding include time together, face-to-face interactions, eye contact, physical proximity, touch, and other primary sensory experiences such as smell, sound, and taste. The acts of holding, rocking, singing, feeding, gazing, kissing and other nurturing behaviors involved in caring for infants and young children are bonding experiences.
The most important relationship in a child’s life is the attachment to his or her primary caregiver, optimally, the mother. This is due to the fact that this first relationship determines the biological and emotional “template” for all future relationships. Healthy attachment to the mother built by repetitive bonding experiences during infancy provides the solid foundation for future healthy relationships. In contrast, problems with bonding and attachment can lead to a fragile biological and emotional foundation for future relationships. So as to your question concerning the importance of bonding, the old saying, “The hand that rocks the cradle rules the world” may be more than just an old saying.
Adult Attention
Deficit Disorder
8-06-09
by Dr. Lorin Bradbury
Question: Can adults be diagnosed with Attention Deficit Disorder?
The simplest answer is “Yes.” The diagnosis of ADHD in adults requires establishing whether the symptoms were also present in childhood, even if not previously diagnosed. There is no single objective test that determines if a person has ADHD. The diagnosis is established by a combination of historical symptoms, often corroborated by family members, a review of educational records, and a battery of psychological tests. The tests generally include tests that assess overall intelligence and achievement, and tests of sustained attention. Also, tests may be administered to rule out other possible diagnoses.
In order to be given a diagnosis of ADHD, the symptoms must have been present from childhood and persistently interfere with functioning in more than one sphere of an individual’s life (i.e., work, school, and/or interpersonal relationships).
Individuals with ADHD have problems with self-regulation and self-motivation, predominantly due to problems with distractibility, procrastination, organization, and prioritization. The overall intelligence of an adult with ADHD is no different from adults who do not have the disorder. It is estimated that up to 70% of children with ADHD will continue to have significant ADHD-related symptoms persisting into adulthood. Often these symptoms significantly impact education, employment, and interpersonal relationships.
Unlike teachers who are often attuned to the symptoms of ADHD, employers and others who interact with adults are far less likely to recognize such behaviors as symptoms of a psychiatric disorder. The reason employers have such a difficult time with adults who have ADHD is that they are often perceived as disorganized, and can be irritable and difficulty to manage. Though these individuals may be highly trained, and possess sufficient knowledge, they find themselves repeatedly terminated for being unproductive, having conflict with other co-workers, and even subordination. Also, research indicates that adults with a diagnosis of ADHD are far more likely than average to have automobile accidents, and less likely to complete their education.
The Diagnostic and Statistical Manual – Fourth Edition – Test Revisions (DSM-IV-TR) categorizes Adult ADHD into two subtypes—Inattentive Type, and Hyperactive/Impulsive Type. In adults, the characteristics of the Inattentive Type are as follows:
• Procrastination
• Indecision, difficulty recalling and organizing details required for a task
• Poor time management, losing track of time
• Avoiding tasks or jobs that require sustained attention
• Difficulty initiating tasks
• Difficulty completing and following through on tasks
• Difficulty multitasking
• Difficulty shifting attention from one task to another
The hyperactive-Impulsive Type presents with somewhat different symptoms:
• Chooses highly active, stimulating jobs
• Avoids situations with low physical activity or sedentary work
• May choose to work long hours or two jobs
• Seeks constant activity
• Easily bored
• Impatient
• Intolerant to frustration, easily irritated
• Impulsive, snap decisions and irresponsible behaviors
• Loses temper easily, angers quickly
Symptoms of ADHD can vary widely among individuals. Most adults with ADHD have the inattentive-type, but men exhibit a greater tendency towards the hyperactive/impulsive-type, but more often have a combination of the two. Research indicates that the symptoms exhibited by individuals with ADHD are due to problems with executive functioning. As a result, the individual has difficulty sustaining attention, planning, organizing, and prioritizing. Also, they frequently exhibit impulsive thinking and decision-making.
These symptoms result in poor performance in school and on the job, leading to academic underachievement and/or getting fired, a poor driving record with traffic violations and accidents, multiple relationships or marriages, legal problems, alcoholism, and substance abuse. Despite genuinely trying to avoid these problems, and knowing that they can get them in trouble, the symptoms persist.
Assessment of adults seeking a possible diagnosis can be easier than in children due to the adult’s greater ability to provide their own history and insight. Some believe that many individuals, particularly those with high intelligence, develop coping strategies that mask ADHD impairments and therefore they do not present for diagnosis and treatment.
Stimulant medication is still considered an effective treatment for Adult ADHD. On the other hand, because of potential of abuse, some physicians may recommend antidepressant drugs as the first line treatment instead of stimulants. Today, a combination of medications and behavioral, cognitive, or vocational interventions is considered the most efficacious form of treatment.
Because of a tendency to get frustrated and overwhelmed easily, and also because of the sheer amount of energy many ADHD individuals expend to live their daily lives, it is important to achieve balance between the mind and body. Regular, physical exercise can be an important component of treatment for individuals with ADHD.
If you have a history of difficulty maintaining relationships, and frequent job changes due to termination, you might benefit from an evaluation.
Münchausen Syndrome
7-30-09
by Dr. Lorin Bradbury
Question: What is Münchausen Syndrome?
Münchausen Syndrome is a very serious psychiatric disorder wherein an individual has a need to assume a “sick role.” This is accomplished by feigning a disease, illness, or psychological trauma in order to draw attention or sympathy to himself or herself. It is in a class of disorders known as factitious disorders which involve so-called illnesses whose symptoms are either self-induced or falsely reported by the patient.
In Münchausen Syndrome, the affected person exaggerates or creates symptoms of illnesses in himself or herself in order to gain treatment, attention, sympathy, and comfort from medical personnel. In some extreme cases, people suffering from Münchausen Syndrome acquire a high level of knowledge about the practice of medicine, and are able to produce symptoms that could result in multiple unnecessary operations. Some examples include injecting a vein with infected material, causing widespread infection of unknown origin, picking at the skin to cause ulcers, or preventing a wound from healing.
In a classic example of Münchausen Syndrome a patient was recovering from spinal surgery when the surgeon asked about the history of her amputated left leg. He found that the stump was ulcerated and inflamed. She explained to the surgeon that the amputation came about as a result of an accident in which her leg was burned. The patient eventually convinced her surgeon to amputate the leg because she believed that her leg was of little use to her. While hospitalized, she was instructed to keep her leg elevated due to the infection and edema. However, she did not comply with instructions. When the skin grafts of her stump did not heal, a search of her room revealed that she had possession of a diuretic, cathartics, and a rubber exercise band that could serve as a tourniquet to irritate the stump.
Münchausen Syndrome is differentiated from hypochondriasis in that patients with Münchausen syndrome are aware that they are exaggerating symptoms, whereas those diagnosed with Hypochondriasis believe they actually have a disease. Also, it is differentiated from Malingering in that the patient is motivated is to assume a “sick role,” rather than an attempt to avoid some unpleasant event, such as jury duty, or court.
Risk factors for developing Münchausen syndrome include childhood traumas, and growing up with caretakers who, through illness or emotional problems, were unavailable.
Medical professionals suspecting Münchausen Syndrome in a patient should first rule out the possibility of a physical illness. Medical and psychiatric treatment should focus on the underlying psychiatric disorder, rather than just treating the physical illness.
Training your children
7-21-09
by Dr. Lorin Bradbury
I am tired of screaming at my children. It seems they don’t even hear me any more. What can I do?
There is a lot that you can do to train your children to respond to you. First you must stop screaming. Screaming diminishes your authority. When you are out of control, you can’t expect your child to be in control.
Consider a police officer. Let’s suppose you are driving down the street a little too fast and you notice those red a blue lights in your rearview mirror. You pull over to the side of the road and wait patiently and nervously while he walks up to your window. He is very unlikely to beat on your car and scream in your face, asking the question, “WHY DO YOU DRIVE SO FAST?” Instead, he is likely to calmly walk up to your window ask to see your driver’s license. And, you will likely produce that piece of plastic with your mug shot on it, hoping that he is going to give you a warning, rather than a ticket. Even if he scolds you at that point, you are likely to conclude your remarks with “sir,” even if you don’t usually use the word. My point is this, you will respond to the request of the officer because he is in control of the situation.
A generation ago, Lee and Marlene Canter developed a model for discipline in the classroom. It was called Assertive Discipline and was so successful in the classroom that they expanded its use to the home setting. In fact, they wrote a book for parents called Assertive Discipline for Parents. Unfortunately, the book is now out of print, but is available online in used bookstores. The principles are simple, and effective.
After you stop screaming, dismiss the thought that there are any acceptable reasons for misbehavior. This changes your frame of reference and you will begin to think in terms of correcting bad behavior rather than living with it. Life with your children does not have to be a battleground.
Clearly define your expectations. This is absolutely essential. If you are making up rules as you go, or changing rules depending on your mood, you cannot expect your child to guess what your arbitrary rule is at the moment. In fact, your child is likely to develop what Martin Seligman termed Learned Helplessness.
In his research, dogs were shocked arbitrarily. There was no one place in the cage that was consistently free from shock. The place of safety continually changed. Finally, the dog would lie down in the middle of the cage and take the shocks. When rules are unclear, your child is likely to comply grudgingly, or not hear you at all. To avoid this, be very clear. If your child is old enough, have him or her write the rules and put them on the wall. If he is not old enough to write, explain your expectations very clearly and stick with them.
Clearly define consequences for violating expectations. As with rules, consequences should not be developed as you go along. Decide ahead of time what the consequences will be for violating your expectations, and communicate them very clearly. Make certain that the consequences fit the violation. Never threaten to harm your child, or make a consequence that you could not follow through with later.
Always follow through. This is so important. If you establish rules and consequences and don’t follow through, you would have been better to have never addressed the issue to start with. As a parent, you may be tired and don’t want to get up to follow through with a consequence, or maybe the unacceptable behavior is “cute.” To not follow through defeats the whole program of discipline. If you are too lazy to get out of your chair and take corrective action, you will probably resort to screaming at your child and you will be back where you began.
Catch them being good and reward them. By doing this, discipline will become self-discipline. Behaviorists have taught us that a child should not be rewarded every time he or she does the right thing. Instead, a variable rate or interval is more likely to result in the desired behavior becoming fixed. To start with you may need to reward or compliment your child for each good behavior, but then move to less frequent rewards. In this way, your child will own the behavior, rather than simply complying with your expectation.
Put these simple steps into action, and you will see change in your child’s behavior. You will be happier, and your child will be happier. Well-disciplined children are much more fun to be around.
Early Entry
7-15-09
by Dr. Lorin Bradbury
Question: My child turns 5 years old in October and I would like for him to enter Kindergarten early, but I was informed the he needs to have a psychological evaluation before the school will even consider entry. I believe my son is very smart and would him to benefit from the experience in Kindergarten.
Whether or not to enter a child into Kindergarten who misses the entry date by a few days to a couple of months is always a question that arises at this time of the year. Because the cut-off date for entry has changed through the years, it doesn’t make sense to many parents who believe their child would benefit from the learning environment that Kindergarten would provide. However, Kindergarten is an academic setting and readiness to learn and compete in that setting is important, not only for the younger child, but also for the children who are within the normal age range for Kindergartners.
Almost all parents believe their children are “smart,” but “smart” is a very subjective term. That’s why schools require a psychological evaluation, which is a measurement of a child’s cognitive, behavioral, and adaptive abilities. Psychologists use norm-referenced tests that compare your child to other children within an age range of approximately three months. In other words, if your child is 4 years 10 months old, he will be compared with other children within the age range of 4 years 9 months to 4 years 12 months of age.
Let’s suppose we average all the children who will be entering Kindergarten this August. The average age will be approximately 5 years 6 months. Let’s also suppose that psychological testing reveals that your child’s cognitive abilities are exactly in the middle of the average range (IQ = 100). That score means your child is perfectly “normal,” but six months behind the average child entering Kindergarten. That difference at that age puts your child at a terrible disadvantage. He will have to work extra hard to keep up and may become discouraged with school altogether. On the other hand, if you wait until next year, your child will be approximately six months older than the average age of the children in his class and he is much more likely to enjoy school and find school a fun and stimulating experience.
Some children benefit from early entry into Kindergarten and the challenge it provides. If a child’s ability level and maturity is significantly above average, Kindergarten may provide exactly the type of environment the child needs.
Some school districts have set criteria for early entry that make it easier to determine who qualifies and who doesn’t. The school districts in our area have not done so. Therefore, the decision is left to the recommendations of the psychologist, the discretion of school administrators, classroom size, etc.
The Matanuska-Susitna Borough School District is one school district that makes the early entry decision easier for everyone by clearly defining admission requirements for early entry into Kindergarten. Though the standards set by that school district are high, they are not unreasonable considering the impact of failure upon a young child, or the constant struggle to keep up with older children. The knowledge that he or she is at the bottom of the class academically can make school very unpleasant and set a negative tone for future learning.
In the Matanuska-Susitna Borough, a child must successfully meet all of the following criteria in order to be eligible for early entry to kindergarten:
1.Obtain a Full Scale Intelligence quotient (IQ) in the Very Superior Range (e.g. IQ of 125 or higher) on the Wechsler Preschool and Primary Scale of Intelligence – 3rd Edition (WPPSI-III). The top two percent of the population typically scores this high. Only the WPPSI-III is accepted as a measure of IQ.
2.Visual motor skills must be in the Above Average range as assessed by the Test of Visual Motor Integration-4th Edition-R.
3.Social/emotional skills must be commensurate with those of age-appropriate kindergarten peers as determined on the basis of a trial placement in kindergarten that may last up to, but depending upon the child’s behavior may be shorter than, four weeks. Only children unequivocally meeting criteria on items 1-2 are eligible for a trial placement in kindergarten.
When I test a child for early entry into Kindergarten, I use similar instruments. Like the Matanuska-Susitna School District, to assess IQ, I use the WPPSI-III. In addition, I administer the Wechsler Individual Achievement Test – Second Edition (WIAT-II) to assess achievement along with the Bender Gestalt Test to assess visual-motor skills. The results have been mixed. A few children are actually ready to enter Kindergarten. Some parents want their children in school regardless of the findings because it eliminates one year of day care. Other parents have decided against entering their children when the results are presented. In one case, a mother made the decision to quit her job and become a full-time homemaker in order to enrich her child’s learning environment. And in rare cases, developmental disorders have been detected and children have been referred for Special Education.
The one factor that often comes as a shock is the cost of the evaluation. Due to the number of hours required to administer the tests noted above and the time required to interpret the data and write the report, I charge approximately $600. Because of the cost involved, the strong possibility that a child may not qualify for early entry, and the potential negative consequences of entering early, I encourage parents to consider waiting the additional year. The maturation that occurs between 5 and 6 years of age is dramatic and can make a considerable difference in the child’s success in school.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in The Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Competency to stand trial
7-9-09
by Dr. Lorin Bradbury
Question: My brother was just sent to API for an evaluation to see if he is competent to stand trial. What does that mean, and how does someone at API determine if he is competent to stand trial?
Competency to Stand Trial is a legal question, and determination of Competency to Stand Trial is based on a legal standard. The legal standard for Competency to Stand Trial was articulated in the U. S. Supreme Court decision Dusky v. the United States (1960). In a one-page document, the Supreme Court ruled that to be competent to stand trial, it must be determined that a defendant “has sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding—and whether he has rational as well as factual understanding of the proceedings against him.” Alaska Statute expands the Dusky Standard slightly by stating that the defendant must be able to assist in his own defense. Also, Alaska Statute defines that the cause of incompetency must be a mental illness or mental defect (i.e., mental retardation).
The second part of your question asks how someone at API can determine if a defendant is competent to stand trial. In the case of your brother, a psychologist will evaluate him to determine if he (1) is able to consult with his attorney with a reasonable degree of rational understanding and is able to assist his attorney in developing a defense, (2) has a factual understanding of the proceedings against him, and (3) has a rational understanding of the proceedings against him. In other words, he must be able to make decisions with a reasonable degree of rational ability.
In the past twenty years, forensic assessment instruments have been developed to improve the accuracy in developing an opinion as to competency. Hopefully, the psychologist will use the most valid and reliable instruments available. To render a professional opinion that someone is competent when he is not has potential long-term negative consequences for the defendant.
One important factor was left out of your question, and that concerns who ultimately determines whether your brother is competent to stand trial. The judge, not the psychologist, decides the ultimate opinion after reviewing the report of the psychologist or psychologists and hearing oral arguments by the defense and the prosecution.
Surveys of public defenders indicate that they have concerns of competency in 10-15% of their cases, but raise the question in less than half of those cases. When the question is raised in court, approximately 30% of those evaluated are found not competent to stand trial. Based on those estimates, less than 2% of the total population of those charged with a crime will be found not competent to stand trial.
Broken Window Theory
6-17-09
by Dr. Lorin Bradbury
Question: My kids are out of control and my house is a mess. My husband complains that he is tired of a dirty house and wonders what I do all day. With crying babies and screaming kids, I feel like I am losing my mind. What can I do to bring some order to our household?
Your description of your current situation creates a picture of chaos in your household. George Kelling and James Wilson developed what has come to be known as the Broken Window Theory. They stated “crime breeds in chaos” and “one broken window attracts another broken.” The idea is that if you can bring order to a neighborhood, crime will diminish. Take care of the small crimes and you will eliminate the big crimes.
In the early 1980s, New York City, had one of the highest crime rates in the nation, but by the 1990s, it dropped to one of the lowest. What made the difference? They cleaned up the subways.
This theory has great application to parenting. In the question posed above, there are some key words: “Out of control,” “house is a mess,” “crying babies,” and “screaming kids.” All babies will cry sometimes, and all kids will make noise, but the question above presented a picture of chaos and disorder. New York City didn’t suddenly achieve the lowest crime rate in the nation. They cleaned up one subway station at a time. When your family life is out of control, it will require addressing one area at a time.
The Broken Window Theory can be applied to parenting by having a consistent bedtime for you and your children. You might start by putting the children to bed at and 8:30 and you and your husband going to bed at 10:00. That way you and your husband will have some time together alone each evening. Along with going to bed at a certain time, it’s equally important to have a certain time to get up. Life is much less chaotic when you get up early enough to not have to rush to work and school. Instead of losing your mind, you can bring sanity back into your life.
Closely associated with putting children to bed on time is requiring them to sleep in their own beds. Some mothers enjoy the intimacy they have with their children, especially if they are nursing, at the expense of intimacy with their husbands. If you truly want order in your household, put those babies in their own beds and in their own rooms. Husbands and wives need private time together.
Continue the process of bringing order to your home by establishing mealtimes. Research has shown that families that eat meals together have fewer behavior problems with their children when they are older. Turn the TV off and don’t allow electronic games at the dinner table. You might even go a step further and not answer the phone while eating. Why is this so important? Mealtimes are great opportunities for communication. They are times for learning values through discussion. But mealtimes are not good times to admonish the children for bad grades on their report cards, etc. Set aside enough time for the meal that no one is rushing to leave the table.
Don’t be afraid to challenge and correct bad behavior. Children are asking continually “Who’s in charge around here?” And if it’s not clear that the parent is in charge, there will be higher levels of anxiety, and there will be chaos. Reestablishing order does not mean that you have to exercise brute force. Instead, take back your home one subway station at a time.
Now look around your house. Is it orderly and clean, or is it messy and dirty. If you have children, houses will get messy, but they don’t have to be disorderly and dirty. If your children are old enough get them involved in the cleaning and maintaining order. Find places for every item in your house. When you sweep and mop the floor, clean the entire floor, not just the center. Not only will your children enjoy the orderly home you create, but so will your husband. And you will feel better about the environment you have created. That’s called self-esteem.
A few years ago, I presented to our church twelve rules for orderly living. Our church members found them very helpful because they were tangible and they could put them into practice. I will present them here for your perusal. Instead of memorizing the whole list, try implementing one rule per week.
GOD IS A GOD OF ORDER
#1: Wash your dishes before going to bed.
#2: Clean up spills immediately.
#3: Make your bed upon rising.
#4: Put toys away after playing.
#5: Go to Bed at a reasonable hour.
#6: Keep your bathroom clean (Deuteronomy 23:13-14).
#7: Never leave piles of dirt on the floor—finish the job—put it in the garbage.
#8: Always arrive at church on time.
#9: “Cleanliness is next to godliness.” Dress holy; dress clean. As much as possible, keep your person clean.
#10: Maintain Personal Devotions.
#11: Eat at least one meal together each day (except when fasting).
#12: Pray with your children before they go to bed each night.
Borderline, what does it mean?
5-19-09
by Dr. Lorin Bradbury
Question: What does it mean to be borderline?
In Psychology, the word “borderline” is used in two different ways—Borderline Intellectual Functioning, and Borderline Personality Disorder (BPD). Most likely, your question is in reference to BPD. The diagnosis of BPD is really a description of a cluster of behaviors. As researcher, Jerome Kroll writes, “The patient does not behave certain ways because he/she is a borderline, rather, the patient is a borderline because of the way he/she behaves in therapy and elsewhere.”
The cause of Borderline Personality Disorder is still unknown. However, it has been associated with childhood trauma, such as sexual abuse. The prevalence of BPD in the United States has been calculated as 1 percent to 3 percent of the adult population, with approximately 75 percent of those diagnosed being female.
The disorder typically involves unusual levels of instability in mood, such as “black and white” thinking, or “splitting.” Splitting is a behavior in which the individual sees another as either all good or all bad. This can be particularly confusing to a spouse who is adored one day and hated the next. As a result, individuals with BPD have a history of chaotic and unstable interpersonal relationships. These individuals have an intense fear of abandonment, and in their attempt to avoid abandonment, they will do the very things that lead to the abandonment or rejection they fear. In their frantic effort to avoid abandonment, they may turn to self-mutilations, suicide attempts, and berating their object of affection, including the use of vulgarity, and other control tactics.
Mason and Kreger, in their book, Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder, describe the projections of a borderline toward their object of affection. In parentheses is the real feeling underlying the projection.
• You’re a horrible person. No one will ever love you but me. (I’m such a rotten person that anyone who would love me must be defective, too.)
• I do not have BPD. You do! (The thought that I might have BPD terrifies me.)
• You made me do it. (I did it for reasons I don’t understand.)
• You think I’m controlling? You’re the one who’s so controlling! (I feel like I’m losing control right now and it scares me.)
• Stop screaming at me! (I am so angry that I need to scream at you right now.)
• You never consider my needs. You’re always thinking about yourself. (My needs are so overwhelming to me that I can’t think about yours.)
•You’re the one who left this marriage. (I’ve shown you my real, flawed self and it scares me so much that I have to reject you before you reject me.)
• If you had taken my calls at work, I wouldn’t have had to call you at three o’clock in the morning at home. (I need to talk with you so badly that I’ll do anything to reach you.)
BPD, like other personality disorders, is characterized by a sense of entitlement. In other words, the person with BPD feels entitled to threaten, tantrum, destroy another’s property, or even physically assault another because he or she perceived a potential abandonment. Facts are unnecessary because the borderline’s perception of the slightest rejection is sufficient evidence. As can be seen, the person with BPD has a tremendous need for affection and a horrible fear of abandonment.
Those who live with a person who has BPD often feel they cannot win. Mason and Kreger describe the desperation of man whose wife was diagnosed with BPD.
If I asked her about her unhappiness, I was told I was too sensitive and paranoid. If I ignored the unhappiness, I was told I didn’t care. If I praised her, she thought I was up to something. If I criticized her, I was trying to hurt her. If I spent time talking to her four-year-old, she wanted to know what I was asking him. If I played a simple game with him I was criticized if I won. If I wanted to have sex, she wanted it to be her idea—later. If I didn’t want to have sex, I was a homosexual. If I spent time alone, I was “up to something.” If I spent too much time with her, I was needy. If I wasn’t thirty minutes early, I was late. If she wasn’t ready and I sat down to read, I was rushing her.
As you can imagine, the person with BPD is in a lot of pain and there is help to relieve the pain. Psychotherapy is the standard from of treatment, but first the individual must come to recognize that the problem is not the other person. One treatment approach, which has gained prominence in recent years, is Dialectical Behavioral Therapy (DBT), a cognitive-behavioral approach developed by Marsha Linehan at the University of Washington. It teaches the patient not just to survive, but to build a life worth living. Another researcher and therapist who treats BPD is Dr. Jerome Kroll at the University of Minnesota. He reframes BPD as Post-Traumatic Stress Disorder (PTSD) as the result of childhood trauma, such as sexual abuse. Dr. Kroll believes the person with BPD has an inability to turn off a stream of consciousness dating back to the traumatic event. This consciousness is comprised of actual memories of traumatic events, distorted and fragmented memories of traumatic events, and intrusive imageries and flashbacks. It includes unwelcome somatic sensations, and negative self-commentaries running through the mind as fantasized and feared elaborations from childhood of abuse experiences.
If someone has suggested that you are displaying borderline features, or might be borderline, regardless of how frightening the thought might be, it would likely be worth an evaluation.
Finding hope after abuse
4-29-09
by Dr. Lorin Bradbury
Question: I was sexually abused as a child. I don’t think I can ever forgive the man who abused me. My husband berates me because he says I don’t give him enough affection. He says I am angry. I think he’s angry. My world is falling apart. Is there any hope for me?
There is hope, and the hope is in something called forgiveness. That may sound more theological than psychological, but it is a topic of research in psychology that has been studied for more than thirty years by Dr. Robert Enright and the Human Development Study Group at the University of Wisconsin-Madison. Results from many peer-reviewed studies indicate that Forgiveness Therapy is more efficacious than alternative therapies in addressing issues related to sexual, physical, and emotional abuse. Also, injuries and injustices that have occurred in marital relationships can be addressed through the same process, using the same model.
Before you stop reading this article and consider forgiveness quackery, let me explain that Forgiveness Therapy is significantly more than simply saying, “I forgive you.” Forgiveness Therapy entails four phases: Uncovering, Decision, Work, and Deepening. I will attempt to provide an overview of each phase, but I must caution that it is not a matter of step 1, 2, 3, 4, and then you are well. Therapy takes time, it is hard work and often painful, but worthwhile.
Instead of using the word “Abuse” as the precipitating event, I am choosing to use words like “Injury,” or “Injustice,” which may broaden the usefulness of the model. Also, for ease in reading, I am using the term client as the one who experienced an injury or injustice and is in therapy.
During the Uncovering Phase, the client gains insight into whether and how the injustice experienced has compromised his or her life. As a result of the trauma, it is likely that the injured person began to rely on unhealthy defense mechanisms to cope. During the Uncovering Phase, it is necessary to discover and examine those psychological defenses and the issues involved in the client’s current cognitive and emotional state. The goal will be to confront and release the anger, rather than harboring it. When appropriate, the client may need to admit shame that was experienced as a result of the injustice. At some point, the person will likely become aware of his or her depleted state of emotional energy and the time spent mentally rehearsing the injustice. It is possible that because of the trauma, the client may feel the world is unsafe, and therefore, be unable to trust anyone. During this phase the client may discover that even though he or she was hurt, it doesn’t mean that everyone is untrustworthy.
Then, during the Decision phase, the client recognizes that old strategies have not worked. It is during this phase that the client considers forgiveness as an option, and makes a decision to commit to forgiving on the basis of this newly acquired understanding. Again, I emphasize that this is not a matter of casually saying, “I forgive you,” and sweeping the injustice under the rug. Forgiveness becomes a conscious choice from a position of empowerment.
Further, during the Work phase the client gains a mental understanding of the offender. In other words, the wrongdoer is viewed in context. For example, maybe the perpetrator was also a victim. This can result in a positive change in affect toward the offender, toward self, and about the relationship. Because of being able to view the event in context, it is possible that empathy and compassion toward the offender may be experienced. The client eventually reaches a point of accepting and bearing the pain of the offense. At that point the moral gift of forgiveness can be given to the offender. That does not mean that contact has to be made with the offender. In some instances, the offender may no longer be living, or it may not be in the best interest of anyone to make the contact. But forgiveness can be offered as a gift.
Finally, during the Deepening phase, the client discovers meaning in the suffering, feels more connected with others, experiences decreased negative affect, and may experience a renewed purpose in life. During this phase, the client comes to accept that he or she also has needed forgiveness from others in the past. The person develops insight that he or she is not the only one who has experienced similar pain or suffering. Also, there may come a realization that a new purpose in life may develop as a result of the injury. During this phase, a reduction in negative affect and an increase in positive affect toward the offender may occur. If this occurs the client is likely to experience an awareness of an internal emotional release.
Unfortunately, there is not an organized Forgiveness Therapy group in Bethel. However, it may be time for someone to start such a group. At a minimum, I would encourage anyone who has an interest in this topic to purchase one of Dr. Enright’s books on the topic. I would suggest beginning with “Forgiveness Is a Choice: A Step-By-Step Process for Resolving Anger and Restoring Hope,” published by the American Psychological Association, and can be purchased at Amazon.com.
The work of a psychologist
4-22-09
by Dr. Lorin Bradbury
Question: As a psychologist, what is it like being able to psych people out all the time?
This is a common misperception of psychology and psychologists. I would suppose every psychologist has been in a group when someone warns everyone in the group that the psychologist is probably psyching them out at that very moment.
There is nothing mystical about psychology. Psychology is defined as the science of behavior and mental processes. Psychologists do not possess some supernatural ability to tell people what they are thinking and why they are behaving in a particular way. Instead the goals of psychology are to be as objective as possible. Psychologists work to describe, predict, understand, and influence behaviors.
In addition to being trained to provide counseling and psychotherapy, psychologists have very specialized training in the administration and interpretation of tests. These tests have what is called validity and reliability. Validity refers to the likelihood that a particular test measures what it claims to measure. For example, if a test claims to measure depression, does it really measure depression? Reliability refers to how consistent the test is over time.
Certain IQ tests have been shown to be very reliable. As long as the same type of IQ test was given at intervals throughout your life, you would find the scores to be similar each time you were tested. Because the test is reliable, the psychologist can state with relative certainty that the person’s true score falls within a certain range. For example, if you obtained a Full Scale IO of 100, the psychologist could state with 90% certainty that your true IQ is somewhere between 96 and 104.
As a result of well-developed and well-researched tests or instruments, psychologists are able to look into the thought processes of individuals. However, it is not because the psychologist possesses some mystical power, but it is based on the information provided by the individual being tested. Certain tests gather enough data that the psychologist can predict with a reasonable degree of certainty that an individual is experiencing depression, anxiety, or a psychotic disorder, such as schizophrenia. By using a combination of tests, a psychologist is often able to establish a diagnosis or to assist other mental health professionals and physicians in refining a diagnosis.
A behavior checklist is another kind of instrument that is helpful in defining behavior problems in children and adolescents. Generally, the items on the questionnaire are related to certain scales that have been developed to measure certain kinds of behaviors. The information obtained, either from the individual, or those close to the individual being evaluated are then compared with others. When enough items on a scale are answered in a certain way, it has been shown that the behavior is likely to be problematic. This allows parents, mental health professionals, teachers, and others to address that behavior and work to influence behavior change.
For purpose of predicting risk for harm or risk that an individual will commit a certain crime again in the future, courts like information that is referred to as actuarial. For example, insurance companies have determined through research that male drivers under the age of 25 pose a much greater risk for accident. In the same way, based on research, psychologists are able to predict that likelihood of someone committing the same crime in the future, or the likelihood of harming someone in the future.
So you can relax in the presence of psychologists; we really are not psyching you out. In fact, we prefer to leave our work at the office.
Schizophrenia
4-9-09
by Dr. Lorin Bradbury
Question: Do people with Schizophrenia have a split personality?
Contrary to popular belief, people diagnosed with Schizophrenia do not have a split personality, but when symptomatic, they have a split or break with reality. Severely impaired reasoning and emotional instability mark the onset of Schizophrenia. They imagine objects and events to be very different from what they really are. Most patients with Schizophrenia are diagnosed in their late teens or early twenties, but the disorder can appear at any time in a person’s life. However, it is rarely diagnosed in children.
Because the causes of Schizophrenia are still unknown, the illness is defined by a set of symptoms. Most patients have some, but not all of these symptoms. The most common symptoms are delusions and hallucinations, which may include hearing imaginary voices.
For example, some patients believe that God, the FBI, or alien beings talk to them and tell them how to behave. Another common symptom is called “thought insertion” or “thought withdrawal”. These terms refers to the patient’s belief that someone or something is putting thoughts into his head or taking them out. Disorganized thinking and behavior, such as having trouble completing a sentence, thinking through an idea, or answering a question clearly can occur. Sometimes the person may even have trouble carrying out routine tasks, such as tying shoelaces, washing, or getting dressed.
Schizophrenia is divided into the five different subtypes listed below.
Paranoid Type: Patients diagnosed with paranoid schizophrenia tend to suffer from delusions and hallucinations. A delusion is a belief about the world that is not consistent with the facts. For instance, a patient may believe he or she is someone other than who he or she really is. A patient suffering from a paranoid delusion may believe, without a basis for the belief, that someone intends to harm him. Hallucinations often take the form of hearing imaginary voices. Some may believe that they are receiving messages from a supernatural or unknown source.
Disorganized Type: Patients with disorganized schizophrenia have confused, disorganized patterns of speech, thought, and behavior. They may act silly or withdraw from the world around them.
Catatonic Type: Abnormal types of posture and movement characterize catatonic Schizophrenia. A patient may stand or walk in peculiar patterns, may repeat certain motions over and over again, or may become rigid and unmoving for long periods of time.
Undifferentiated Type: These patients show some symptoms of Schizophrenia but do not fit into any of the three categories described above.
Residual Type: Patients in this category have had at least one schizophrenic episode but no longer display the most severe symptoms of Schizophrenia.
Research shows that Schizophrenia tends to run in families. If a relative is diagnosed with Schizophrenia, a person is ten times as likely to develop the illness than someone who has no history of Schizophrenia in the family. One of the more accepted theories today is that it is caused by an imbalance of neurotransmitters in the brain. It is believed that too much, or too little, of a particular neurotransmitter may lead to Schizophrenia. Other researchers have argued that a virus attacks the brain causing Schizophrenia.
By this time, you may be asking, “Is there anything I can do to prevent Schizophrenia?” Interestingly, research published in the past five years suggests that there may be something you can do to prevent this very debilitating illness—abstain from using marijuana. An article published in the American Journal of Psychiatry in 2004 found that marijuana-using patients were significantly younger at the onset of psychotic symptoms than were patients who did not use marijuana. On average, male marijuana users were 6.9 years younger at the onset of Schizophrenia than nonusers. That same year research published in the British Journal of Psychiatry reported that marijuana resulted in a twofold increase in the risk for schizophrenia later in life. The researchers predicted that elimination of marijuana use would reduce the incidence of schizophrenia by approximately 8%. Marijuana use appears to be one of several factors leading to the onset of Schizophrenia. They concluded, “Cases of psychotic disorder could be prevented by discouraging cannabis (marijuana) use among vulnerable youths.
Care for the elderly
4-1-09
by Dr. Lorin Bradbury
Question: My mother is quite elderly, and I am concerned that she may be in need of a guardian. More specifically, I am concerned that my brother, who is an alcoholic, is exploiting my mother. I recently found that there are a number of bills that have gone unpaid, and my mother doesn’t seem to know where her money went. Throughout her lifetime, she has been a very competent person, and would have never allowed bills to have gone unpaid, or to have allowed any of us to manipulate and exploit her. It grieves me to think about the possibility of her basic civil rights being taken away, but we’ve got to do something. She still keeps a clean house, bathes, and cooks for herself. Is there some way that she can have a guardian and not lose all her civil rights?
Your situation is not unique, and it can be a very grievous time for adult children who see the slow deterioration in the mental capacity of a parent. If all family members work together and are able to provide the needed structure, a court-appointed guardian often can be avoided. However, in cases where a parent won’t allow you to help, or where there are family members, or others, who exploit an incapacitated individual, a guardian may be the only recourse.
I do not have statistics for Alaska, or for our region, but the professional literature indicates that frequently when a court orders guardianship, it is full guardianship. That is unfortunate because, as in the case of your mother, she appears to possess the capacity to care for her personal hygiene and maintain a clean and safe living environment, and possibly care for her health and safety, but seems to have lost the capacity to manage her money.
As with most states, the State of Alaska allows for partial guardianship. Anyone, including you, can petition the State for a finding of incapacity and the appointment of a guardian (AS 13.26.105). In the petition, state clearly what you believe your mother’s needs are. The court will schedule a hearing, and a court visitor will be appointed who will schedule an evaluation for your mother.
Medical personnel sometimes recognize the need for a guardian and a physician will recommend a Psychological Evaluation for purpose of determining the extent of the need. If a Psychological Evaluation is completed before the court is petitioned, the evaluation can be submitted along with the petition for guardianship.
In recent years, instruments for assessing the need for a guardian have been developed that allow for the assessment of specific areas such as Memory and Orientation, Managing Money, Managing Home and Transportation, Health and Safety, Social Adjustment, and etc. In this way the court has a better picture of the degree of incapacity when guardianship is considered. Psychologists with advanced training in this area will have the expertise to utilize these instruments, and recommend to the court the need for guardianship limited to specific areas, or full guardianship if necessary.
Psychiatrists and psychologists
3-26-09
by Dr. Lorin Bradbury
Question: What is the difference between a psychiatrist and a psychologist?
Psychiatrists receive medical training as a medical doctor (M.D.) or doctor of osteopathic medicine (D.O.), and complete a residency in psychiatry. Since psychiatrists have medical training, they are granted prescription privileges by the state in which they are licensed, allowing them to prescribe psychotropic medications. Though psychiatrists have training in psychotherapy, their role in modern medicine often involves diagnosing and treating mental illnesses with the use of psychotropic medications.
Psychologists, on the other hand, have graduate training in psychology, and have obtained a doctoral degree (Ph.D., Psy.D, or Ed.D.). Graduate training leading to licensure as a psychologist, usually includes approximately four years of graduate training, one year of internship, and one year of supervised post-doctoral training. Similar to psychiatrists, psychologists diagnose and treat mental illnesses. However, in most states, including Alaska, psychologists do not have prescription privileges, so they do not prescribe medication. Psychologists have advanced training in counseling and psychotherapy, but what clearly defines psychologists from all other mental health professionals, is the ability to administer and interpret psychological tests. Psychiatrists and other mental health professionals often use the results of these tests in defining diagnoses and treating their patients.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Insecurity and inferiority
3-18-09
by Dr. Lorin Bradbury
What is the difference between insecurity and inferiority?
Insecurity is a feeling of general uneasiness, or nervousness, in which you feel less than confident, and experience anxiety or apprehension. Inferiority, on the other hand, is a value judgment whereby you compare yourself with others and perceive yourself as less than the one, or ones, with whom you make the comparison. Insecurity is a normal state experienced by all at one time or another. Inferiority is pathological.
A psychologist by the name of Alfred Alder in his book titled The Neurotic Character first described the term “inferiority complex” in 1912. The term “inferiority complex” revolves around social status, power, ego, and dominance. You may have an inferiority complex if you feel inferior and believe that other people are significantly better than you.
The reason inferiority is pathological is that a distorted perception becomes reality to the person who feels inferior. An experiment was conducted in which subjects were told; “We want to see how strangers respond to you when you have a scar on your face. So we’re going to take each of you into a separate room and use make-up to put a big, red scar on your left cheek.” Subjects entered a room, and make-up was applied to their faces, creating a scar.
The people getting a scar on their faces couldn’t see what was happening to them. Once the scar was created, the make-up artist held up the mirror so the subjects could see their scars. The mirror was placed out of sight and the subjects were told; “Now I’m going to put a little finishing powder on your scar, just so it doesn’t smear.”
However, instead of putting finishing powder on their scars, the scars were actually removed. So now the scar-less people went out into the lobbies of doctor’s offices, hotels, and airports. Overwhelmingly, the scar-less subjects came back and reported that people were rude to them. They claimed people stared at their scars! In reality, it was all in their imaginations.
The following are possible signs of an inferiority complex: Sensitivity to criticism, an overly critical attitude toward others, an inappropriate response to flattery, a tendency to blame others, feelings of persecution, and a dislike for competition.
Overcoming an inferiority complex is not easy, but it can be done. First, you must accept that your inferior feelings are the result of irrational beliefs within you, rather than the fault of someone else. Then you must consciously take steps to challenge your irrational beliefs. Below are some steps that may be helpful:
Change your thoughts by changing your negative self talk: Whenever you find that you are using phrases like: “I know he won’t accept me because I’m dumb” or “I never have anything worthwhile to say,” stop and change that kind of self-talk.
Dismiss the foolishness of others: You are not of less value because you were told you would never amount to anything when you were a child.
Fix your corrupted self-image: If necessary, get help through counseling or psychotherapy.
Remove the labels (i.e., fool, idiot, stupid, etc.) that you have acquired.
Install new beliefs using self-talk.
Build your self-confidence: Remember, self-esteem is the result of what you do, not what you believe others think of you.
Lorin L. Bradbury, Ph.D. is a licensed psychologist in private practice in Bethel. For appointments, he can be reached at 543-3266. If you have questions that you would like Dr. Bradbury to answer in the Delta Discovery, please send them to The Delta Discovery, P.O. Box 1028, Bethel, AK 99559, or e-mail them to realnews@deltadiscovery.com.
Fear Dance
3-11-09
by Dr. Lorin Bradbury
Question: My husband and I have arguments that escalate in intensity as they progress. It seems that each of us are reacting to one another’s comments. There is so much emotion involved in the arguments that I am afraid someone is going to get hurt. What’s happening?
What you have described has been called the Fear Dance by Dr. Greg Smalley. Below is a model of the Fear Dance as presented by Greg’s father, Dr. Gary Smalley in the book, The DNA of Relationships.
