B.P.S. - BEST YET POWER POINT OF BPS TALK - JAN 2011.

 

Watch with sound track here.

https://www.youtube.com/user/Humanagement2011

B.P.S. - QUESTIONS FOR SOCIETY - from BPS Talk 13-1-11

Seminar at BPS,DECP. 13-01-11

https://www.youtube.com/user/Humanagement2011 
See with sound track of BBC radio programme or music by clicking on hyperlink above.

http://www.youtube.com/user/Humanagement2011

B. P. S. CONFERENCE - SHORT VIDEO OF POWER POINT.

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See another version with sound track of music or BBC Radio programmes.

VIDEO OF POWER POINT AT DECP CONFERENCE JANUARY 13TH 2011.

HEADTEACHERS COMMENTS - BEFORE AND AFTER PSYCHOTROPIC DRUGS -

Watch the video below slide by slide to see why there is before and after concerns from headteachers.

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for more ideas about alternatives to medication just by clicking on hyperlink or title.

AFTER MEDICATION FROM HEADTEACHERS

BEFORE MEDICATION FROM HEADTEACHERS

ALTERNATIVES TO DRUGGING CHILDREN -7 - 11 breathing (Mindfields College)

https://www.youtube.com/user/Humanagement2011 

 also has information on alternatives to drugs + BBC Radio programme commentaries.

The 7:11 Breathing Pattern - the opposite of hyperventilation

Finally you can practice a special type of breathing, not into your chest but deep into your tummy or diaphragm which is below your chest. The important thing here is that the out breath must be longer that the in breath. This causes stimulation of the part of your nervous system responsible for relaxation. This is a basic law of biology and if you breathe in this way then your body will have no choice but to relax due to a marginal increase in your bloods level of carbon dioxide.Once that blood gets to the brain the brain tells the rest of the body to calm down sending nerve messages to the muscle groups.

It may take a few minutes but the body will respond regardless of what your mind is thinking. Experience this now. Sit down and close your eyes for a little while. Just become aware of your breathing.and breathe in to the count of seven. and breathe out to the count of eleven. You can hold for a couple of seconds at the bottom of the out breath if that’s comfortable for you.

It may be a little difficult at first, but doing this regularly causes your general anxiety level to come down. You may also find that you begin to breathe this way automatically if you feel anxious. Regular relaxation actually starts to inhibit the production of stress hormones in the body so it actually becomes harder and harder to panic. As you become more generally relaxed the ‘baseline’ of arousal from which you are starting lowers. It actually becomes harder to get stressed!

Hyperventilation responds very well to this technique. If you practice this daily, hyperventilating should cease to be a problem very quickly. It can also give you much more control over panic attacks and/or help to train you to reduce your own levels of anxiety which in turn helps you to control your behaviour.



Self-management is the best management of a situation.

 

ALTERNATIVES TO DRUGGING CHILDREN -The Benson Technique - Effective Relaxation.

https://www.youtube.com/user/Humanmagement2011 

  click on hyperlink for more information on alternatives to drugs for Children + BBC Radio programme commentaries.


 As you may have guessed, it was developed by a psychologist called Herbert Benson, and it incorporates distraction techniques.

This is how you do it:


There are three components.

Firstly, focus on your breathing. Breathe deeply rythmically and slowly.

Secondly, hear yourself saying silently in your head  "r e l a x", or if you prefer the neutral mantra "one" then take a breath

Thirdly, you visualise something that keeps rhythm with your breathing. The image Helen used is a curtain in front of a window. Many of her clients visualise the tide coming in, lapping on the shore, and then going out.

We can use water as an example. Make yourself comfortable, then close your eyes. Feel your breath going in and out.

Focus just on that breath.

I want you to then hear a quiet wind in your head." Relax" or "one". Be aware of your breath and feel the quiet wind until you start to relax.

Say in your mind:" r e l a x" or "one", Breathe in.


"Relax" or "one", breathe out.

Now visualise yourself as vividly as you can on a beach.

It is the most beautiful day; just perfect.

This is your visualisation so it can be hot, warm or even cool; whatever you want.

The perfect day.

Visualise the water. No crashing waves, just those beautiful waves that break on the sand like a big shawl of lace, spreading outwards, covering the sand.

The waves comes in, as your breath comes in.                            
"R e l a x." or "one" breathe in.

The wave goes out as your breath goes out slowly with it.

Wave comes in…"r e l a x"…or "one"

Wave goes out.
Take two more breaths, two more waves…

Herbert Benson wants you to concentrate on three sensations.

First, feeling your breath is known as the kinaesthetic or feeling part of ourselves.

The word 'r e l a x' or 'one' is an auditory signal, and

The visualisation calls on the visual powers of our mind.

If we keep our mind busy on our feelings, and on hearing and seeing, then your brain is kept busy on those three levels. That gives it time away from being aware of other sensations - like pain, or the
tension you feel when you are beginning to be anxious.

Your mind is distracted from negative tendencies related to your anxiety and panic. That includes some of the things we have mentioned already, such as visualising, or imagining the very worst case scenario happening. It also distracts you - your mind - from that incessant negative self talk: this is terrible, I can't cope with this.

The Benson technique is a very specific strategy to move those three senses into an area where we have more control. We use our feelings, our auditory sense and our ability to visualise, to reduce the clutter and confusion in our mind.
Feelings of anxiety, panic and stress automatically reduce in intensity and so we achieve more balance and control.

Your Automatic Relaxation Trigger

It has been found that if you practise this technique for just one hundred minutes, it becomes paired with, or locked into, the back part of our brain in a section called themedulla. That hundred minutes is only ten minutes practice each day for ten days.

Themedulla controls all the things we don not have to think about, that we do automatically. Like breathing itself, or riding a bicycle once we have learned how.


If you practise the Benson technique for only one hundred minutes on average (fewer for some and maybe 120 minutes for others), the automatic message to relax gets locked in the medulla. Then, all you need are some cues and it will kick in. For instance, the cue to relax and distract yourself from stress might be the very act of saying," r e l a x" in your mind when you breathe in, then out.

It becomes like a mild post hypnotic suddestion of which you are totally in control.

"SHYNESS-HOW NORMAL BEHAVIOUR BECAME A SICKNESS "- interview + Author Professor Christopher Lane - The book that has taken Australia by storm to review it's practice.

Should this be happening for shyness.

https://www.youtube.com/user/Humanagement2011 

For more information on how DSM5 will affect us all.

Christopher Lane's Highly commended  tour de force(2007)

In Oren Rudavsky's recent film, The Treatment, a wealthy Manhattan widow is baffled that a schoolteacher might be so anxious about speaking in public that he can't eat and suffers from stomach cramps and diarrhea. After all, surely he must speak in front of others every day. His reply is, in effect -- well, yes, but only in front of students. The schoolteacher probably wouldn't take any comfort from the popularity of his fear: According to one notorious statistic, Americans are more afraid of public speaking than of death.

I've begun with this example it points up a real enigma about our minds: How can a purely cultural experience such as public speaking translate into brain chemistry? After all, neither term in "public speaking" is straightforward. How big a group counts as "public"? Are they friends, colleagues, strangers, or a mix? Am I drunk or sober? Am I reading a prepared speech? fielding questions? participating in a judicial, civic, or religious ritual? How is it that our serotonin levels are able to make such finegrained judgments? Even if one focuses just on physical responses -- mild sweat, an elevated heart rate -- people may well attribute different meanings to those responses. (I was scared / I was in the zone / I was angry.) Despite these difficulties, some psychiatrists have proposed that "public speaking phobia" ought to receive its own diagnostic classification.

By focusing on the intersection between culture and chemistry, Christopher Lane's wonderful new book, Shyness: How Normal Behavior Became a Sickness (Yale UP, 2007) shows why we ought to be more skeptical of the rush to medicate "social phobias" -- Psychology Today's "disorder of the decade"! -- with powerful drugs, especially in children and adolescents. Despite the alleged precision of recent editions of the Diagnostic and Statistical Manual of Mental Disorders, "social phobia, the most enigmatic and poorly-defined anxiety disorder, became the psychosocial problem of our age." It is as if the very vagueness of the definition allows its meaning to expand, until the "unavoidable conclusion is that we've narrowed healthy behavior so dramatically that our quirks and eccentricities -- the normal emotional range of adolescence and adulthood -- have become problems we fear and expect drugs to fix." What's worse, he suggests, the drugs we expect to fix our problems all too frequently fail to do so, and in many cases actually make matters worse.

Shyness's argument has three main parts: first, Lane exposes the shaky conceptual foundations of such modern diagnoses as "social anxiety disorder," which simultaneously purport to replace vague psychoanalytic categories ("anxiety neurosis") with more precise, evidence-based ones -- and yet which cover a spectrum of behaviors ranging from discomfort over speaking in public to a genuinely crippling aversion to others. This portion of the book, drawing as it does on archival documents from the American Psychiatric Association as well as interviews and published research, ought to worry anyone hoping to find coherence or rigor in the diagnosis of mental illness. The second part of the book focuses on the tight fit between the turn to neuropsychiatric models of diagnosis and the marketing demands of big pharma. The side effects of these powerful drugs make a mockery of the word "selective" in selective serotonin-reuptake inhibitor (SSRI). As we are beginning to understand more fully, SSRIs are a decidedly mixed blessing, and their consumer-orientated marketing is unseemly at best. The final part of the book looks at novels and movies resistant to the dominant psychopharmacological perspective in our culture.

Throughout the book, Lane suggests that the conceptual problems of the DSM arise in part from its weird eagerness to break decisively with Freud. Lane has vividly reconstructed the decision-making process of the DSM-III in the 1970s, showing how scoring points over rival theoretical schools frequently trumped logic or consistency. Insisting on the biochemical nature of all mental suffering leads psychiatrists to turn away from the vicissitudes of the mind -- what Lane calls "the strange, unusual turns of consciousness, themselves in thrall to vivid memories, irrational fantasies, persistent associations, and sometimes-inexplicable impulses." By reducing the complexity of these "turns" into "disorders" -- no matter how "multiaxial" -- modern psychiatry seems to drain the life out of the mind. Shyness is passionately and compellingly argued, in clear prose that is in turn scathing, hilarious, and sympathetic.

In the interview below, Lane discusses the origins of the book, the implications of shifting from a "reaction-based" to a "disorder-based" model of diagnosis, the differences between psychoanalysis and neuropsychiatry, and the problem of emotional blunting.

Christopher Lane is the author of three additional books: Hatred and Civility: The Antisocial Life in Victorian England (Columbia UP, 2003); The Burdens of Intimacy: Psychoanalysis and Victorian Masculinity (U of Chicago P, 1998); and The Ruling Passion: British Colonial Allegory and the Paradox of Homosexual Desire (Duke UP, 1995).He also is the editor of The Psychoanalysis of Race (Columbia UP, 1998) and, with Tim Dean, co-editor of Homosexuality and Psychoanalysis (U of Chicago P, 2001). He is currently the Herman and Beulah Pearce Miller Research Professor at Northwestern University. (In the interests of full disclosure, I should say that Chris Lane directed my doctoral dissertation, and that I have an essay in Homosexuality and Psychoanalysis.)

Let's begin with your most serious claims. You argue that social anxiety disorder is conceptually overbroad and overdiagnosed, while Paxil and the other drugs prescribed for this disorder are ineffective, if not outright dangerous, for many patients. But you also argue that the role of serotonin in mental illness is vastly overstated, and in fact has no direct causal relation. At the risk of sounding naïve, how did the mythology around serotonin take hold?

I think a lot of the mythology about low serotonin sprang up when neuropsychiatrists in the 1970s and '80s championed biological explanations for mental illness. Their goal was really to help us think that such distress stemmed from the brain rather than the mind. In June 1976, for example, Robert Spitzer, then chair of the task force overseeing major revisions to DSM-III (the third edition of the Diagnostic and Statistical Manual of Mental Disorders), tried to get approved a very bold claim: “A mental (psychiatric) disorder is a medical disorder.” He wasn’t successful, because so many pointed out the enormous influence of psychological and social factors in shaping mental distress. But Spitzer’s argument has since gained momentum because it’s appealingly straightforward and has so much financial support. If we can say that the cause of distress is a “chemical imbalance,” then the solution points logically to drug treatments rather than therapists focusing on the mind by, say, encouraging a shift in perception.

But just one of many problems with the “chemical imbalance” argument is that it oversimplifies so much. No one can establish conclusively what a chemical balance is because it varies so much from one person to the next and, indeed, from one day to the next.

Another thesis you advance is that modern psychiatry has essentially "rebooted," deliberately going back to a kind of pre-Freudian indifference to subjective experience. Has the purging of subjectivity yielded significant fruit in treating mental illnesses?

The “rebooting” of modern psychiatry stemmed, I think, from a widespread effort to eliminate all trace of psychology from American psychiatry. This was not without serious intellectual and clinical consequences. Some of the psychiatrists responsible for this wholesale debunking of Freud, in particular, later twigged that they had thrown out the baby (in this case, interest in consciousness) with the bathwater. So in some cases they needed to start again almost from scratch: They had to find new ways to discuss perception that wouldn’t at the same time sound Freudian.

In my opinion, the whole exercise was immensely self-defeating for psychiatry. Experts pointed out at the time that it was rather arrogant to believe that one could simply trash 70 years of carefully argued analysis, itself tied to clinical experience, but few at the time were willing to listen. They were on a mission to turn psychiatry into a study of the brain, and thus a hard-boiled science. It’s unfortunate, then, that Ted Millon, one of their consultants, came forward in 2005 and told the New Yorker, “There was very little systematic research [informing DSM-III], and much of the research that existed was really a hodgepodge -- scattered, inconsistent, ambiguous.”

I’d say the “purging of subjectivity” from discussions about anxiety ended up impoverishing what we do know about anxiety, and have known for a very long time, which is that it crosses biology and perception, rather than being reducible to one or the other. Put another way, while the effects of anxiety are obviously biological -- a racing heart, sweaty palms, shortness of breath, and so on -- what triggers those effects is necessarily tied to consciousness.

What does it matter if we call something a "disorder" as opposed to a "neurosis"?

This partly connects with your opening question. To call something a “disorder” is to say that the malady is biological, even genetic. If anxiety were still known as a “neurosis,” by contrast, then doctors and psychiatrists would be signaling that the problem is chiefly one of psychological conflict and should be addressed accordingly.

Until 1980, the language in the DSM was very much about calling mental distress “reactive” and situational. And, actually, this included even the psychoses, which were known then as “paranoid reactions” and “schizophrenic reactions.” This makes perfect sense for anxiety, as well: people may be anxious about speaking in public, but rarely or never feel so on other occasions. Yet the word “reaction” was deleted from all later editions of the DSM, in a way that totally changed the way we think about illness. Instead of being able to say, “you had an anxious reaction” to a particular event, we moved almost overnight into implying, “You have social phobia” or even, “You are socially phobic.” That suggests that the conflict is life-long and essentially beyond the patient’s control. So whether you agree or not with the outcome, it’s definitely a serious shift in approach that needs acknowledging.

By coincidence, I happened to teach Mrs. Dalloway this past week, and was struck by the way Virginia Woolf's critique of Sir William Bradshaw's "Proportion" and its cruel sister, "Conversion," anticipates many of the concerns you raise here about how quickly good intentions tip into a ferocious coercion: "If you won't take these pills..."

Yes, that’s a powerful moment in the novel. And, sadly, it’s the very effort on Dr. Bradshaw’s part to make Septimus rest that intensifies the latter’s sense of being persecuted. But, ironically, Dr. Bradshaw firmly believes he’s acting in Septimus’s best interests. And that would remain so today: everyone’s fundamentally trying to act in the best interests of the people they treat.

But that doesn’t mean the treatments aren’t occasionally harmful, because full of so many side effects. Nor does it mean that every diagnosis is accurate and every remedy necessary or appropriate.

What concerns me most is that the alleged cure for social anxiety disorder is often a great deal worse than the disease. Honestly, what good does it do people who dislike speaking in public if they take an anti-anxiety pill such as Paxil and, as the drug maker forewarns, one of the drug’s side effects is... anxiety?

You're a professor of English, with three books out on Victorian and Edwardian literature, as well as edited collections on psychoanalytic theory. What drove you to this more explicitly medical project?

My last book, Hatred and Civility: The Antisocial Life in Victorian England, tried to cross disciplines by putting literature in dialogue with psychology and psychiatry. I was (and remain) fascinated by how differently the Victorians thought about antisocial behavior. Above all, I wanted to find out what had happened to misanthropes in the 20th and 21st centuries. When I raised this issue with one of the leading psychiatrists I interviewed for Shyness, he responded, a bit matter-of-factly, “I suppose they all got medicated.” That response revealed a certain truth, I think, but also a worrying one. We tend to think that we can medicate away extreme emotions and states because our tolerance for them, as a culture, almost certainly has diminished. I wanted to find out why.

Is there a connection between Hatred and Civility -- which in part defends misanthropes -- and Shyness?

One of the threads uniting the two books, I’d say, is that individuals aren’t adequately represented by the cultural categories and diagnostic terms that try to sum them up. Shyness and anxiety are of course very complex terms that have different shades of meaning from one culture and generation to the next. The DSM in my opinion is quite incapable of capturing those inflections, because its rule-bound criteria try to slot people into pre-existing diagnostic grooves. Humanity -- and human suffering -- is far more complicated than that.

One of the striking features of Shyness is its rich engagement with the APA archives, and its extensive interviews with the framers of DSM-III and DSM-IV, especially Robert Spitzer. How did you convince them to grant you such access?

Well, when I first approached the APA and Robert Spitzer, each of them said that the papers probably had been lost when the APA moved from downtown Washington, D.C., to its present location nearby in Arlington, Virginia. That was worrying for several reasons: the documents are really vital to understanding what happened to American psychiatry in those crucial years.

In the meantime, I managed to track down Mitchell Wilson, author of a wonderful essay on the history of the DSM, which quoted several DSM-III memos. I was intrigued. Spitzer apparently had given him copies of the papers when he’d pegged Wilson to be the man who would write his biography. But things hadn’t worked out that way. Mitchell kindly said that I could copy his papers if I flew out to Berkeley, so I got on a plane. When I returned to Chicago and began reading the memos, I contacted the APA and Spitzer again, saying I had many of the papers, but that I really wanted the book to be exhaustive and complete. At that point, the papers turned up -- it was great to know they hadn’t been lost -- and the APA’s librarian kindly told me I could access them because the statute of limitations on them had expired. Shortly after that, Spitzer graciously invited me to his house just north of New York City, where I interviewed him intensively one afternoon. It was really a most pleasurable afternoon -- very focused on events in psychiatry that had occurred almost three decades earlier, but Spitzer was incredibly sharp and had amazing recollection. I tried to capture what he relayed to me that afternoon.

At the same time, a significant portion of your argument -- especially the part about the marketing of Paxil -- has been "hiding in plain sight." Why haven't we faced these questions openly before?

Yes, that’s partly true, though several pieces of fine investigative journalism have certainly helped document the Paxil story: Brendan Koerner wrote a superb article about it for Mother Jones (“Disorders Made to Order”), July/August 2002; and Beth Hawkins followed up a couple of months later, in City Pages, with “Paxil Is Forever.” Both focused on the marketing of social anxiety disorder as a prelude to representing Paxil as its remedy, but neither had access, I believe, to the poor early trials of Paxil, and doubtless hadn’t space to write about how the marketing interfaced so cleanly with the DSM revisions.

Overall, though, I think there are several explanations for our slowness to piece together these complex stories: First, the drug companies are quite canny in how they release new information about side effects. They add the details to healthcare providers over the course of several weeks, even months, so the revelations don’t come all at once, as a shock. I guess we just learn to say, “Oh, okay, now they’ve put in bold that one side effect of Paxil is renal failure.” Next week it’s platelet aggregation problems, and so on.

Plus, despite what the drug companies say, it remains incredibly difficult for the general public to find out all it needs to about the drugs themselves because, as the New York Times reported on May 31, 2005, Eliot Spitzer, then Attorney General of New York, may have succeeded in getting the drug companies to settle over his class-action lawsuit, but, as the article’s title put it, “Despite Vow, Drug Makers Still Withhold Data.”

What about the DSM-III task force itself? Did it face any self-imposed conceptual dilemmas?

I’d say so, yeah, because Spitzer selected only “kindred spirits” to join him -- friends and colleagues whom he knew shared his interest in “criteria-based diagnoses.” There were two consequences to this that are worth noting. First, the DSM-III task force met for four years before it even occurred to a participant that their perspective might be a bit, you know, slanted toward neuropsychiatry and thus a fraction unlikely to factor in other approaches. Second, most of those involved recall their discussions are stringent and completely fair. Spitzer actually said in another interview some years ago, “We didn’t want anybody to feel that their diagnostic concepts were being excluded.” Unfortunately, that generosity extended only to those who’d already been invited to participate. It rather magnificently overlooked those who’d been shut out of the process for four years. So there were very few checks and balances.

My "favorite" -- if that's the right word -- potential diagnosis that you reveal is "chronic undifferentiated unhappiness disorder," where "kvetching" and saying "Oy vay, don't ask" were proposed as signs of sickness. Were there particular discoveries that stand out to you as "favorites"?

That was certainly one of them! Another was that DSM-II actually included a code (318.00) for those who should be diagnosed as having “No Mental Disorder.” Imagine the illogic! Eavesdropping on the correspondence between Spitzer and Don Klein, his sometime ally and occasional nemesis at Columbia, was also quite a revelation. They would fire back-and-forth these extremely aggressive memos, trading diagnostic barbs as a way of insulting each other under the guise of completing their work. So, for example, Spitzer wrote at one particularly tense moment over the criteria for avoidant personality disorder, “Does the reference to ‘hypersensitivity to rejection’ get too close to Hysteroid Dysphoria for your personal comfort?” That’s got to be a classic!

You have a great deal of fun with the psychiatrists for their penchant for wildly ahistorical diagnoses, such as Samson's antisocial personality disorder. How does this differ from Freud's use of figures such as Oedipus or Moses, or, on a less rarefied plane, Jones's interpretation of Hamlet?

I’d say there are major differences and, alas, painful similarities here. First the differences: The literal-mindedness of many neuropsychiatrists today really doesn’t equate with the willingness of psychoanalysts and literary scholars to cite Oedipus, Moses, or Hamlet as analogies, to form metaphorical comparisons. When neuropsychiatrists try to diagnose a Biblical figure like Samson as suffering from ASPD, by contrast, they’re neither joking nor have much sense of irony about their assertions: they’re trying to shore up the prevalence of a disorder by saying it recedes far into antiquity, though people just didn’t have the tools to recognize it then.

But there’s definitely some similarity, too. There’s still a tendency among some psychoanalysts and psychoanalytic literary critics to treat fictional characters as if they were patients awaiting a diagnosis. I don’t personally find that approach persuasive or appealing, but I recognize it’s been a strong current of the complex, varied history of psychoanalysis, going back through Ernest Jones’s work to Freud’s own. After all, Freud’s own essays on literary criticism are very much about asserting the validity of his theories through fiction and myth. Nowadays, by contrast, psychoanalytic critics tend to be more interested in signaling how literature fails to sustain meaningful diagnoses of characters, not least because that approach is in the end far more psychoanalytic (it’s truer to a theory of the unconscious).

You sometimes seem to argue that the faux-medicalization of Freudianism in the United States contained within it the seeds of its own destruction at the hands of someone like Spitzer. Is that a fair characterization?

Partly so, yes, but psychoanalysts at the time also were on the horns of a real dilemma. To some, it must have seemed logical that the narrower the divide between them and neuropsychiatrists, the closer they would be to resolving a standoff over diagnosis and rising health costs. They could, in theory at least, present a united front before the HMOs and insurance companies. But these, in turn, were understandably concerned about costs and looked for the most efficient way of cutting them. They latched onto psychoanalysis as a culprit and made it an unfair target, I’d say, because in-patient hospital costs are always the leading factor in healthcare costs. Beyond this, the HMOs and insurance companies weren’t interested in psychoanalysts and neuropsychiatrists getting along; they soon saw that they’d get furthest, in terms of cuts, if they kept the two sides at odds, because that way the battling psychiatrists would be more likely to compromise independently.

And that’s in effect what happened. The neuropsychiatrists knew that their lists of criteria, statistics, numbered axes, and commitment to rapid empirical results put them at an apparent advantage relative to psychoanalysts who refused to play ball. Among psychoanalysts I have sympathy for the pragmatists and the idealists. It’s easy to heroize the idealists for refusing to compromise, but in the end I’m not sure their approach would have been more successful.

A subtle moral claim emerges near the end of the book, when you cite Satel and Sommer's point that "suffering can be edifying," and note that this view is "anathema to the psychiatric literature." If we really could medicate away suffering -- if the pharmacological dream really could somehow be realized -- why wouldn't that be ok?

This complex issue doubtless belongs in the realm of ethics rather than morals. I’m trying to talk about something that’s very easy to misinterpret, so I should also try to say what I’m not arguing. I’m talking here about the experience and the confidence that are gained from working through a problem. With a discussion very particularly about anxiety, I’m also arguing -- as I do throughout the book -- that medication can be an ersatz solution to the problem, because it frequently does not address the underlying causes of anxiety.

Caring or abusing or confusing.

The issue, for me, is mostly that psychiatric medication for mild disorders can’t deliver on its promise. For starters, with its litany of side effects it can in fact create more anxiety and suffering than less. It also can lull us into the belief that there’s a quick-fix solution to our problems, when frequently, alas, there is not. When the drug companies hold out the promise of so many treatment options, they’re doing much more than hinting that we can end suffering, a worthy and very understandable goal. They’re also holding up an ideal of contentment, even bliss, that’s unrealistic, and that can in turn create yet more distress, because we can’t possibly measure up to such perfection. As one New Yorker cartoon put it, in an exchange between a doctor and patient that I reproduced in the book, “I think the dosage needs adjusting. I’m not nearly as happy as the people in the ads.” I think that’s so true.

The APA was scheduled to start laying the groundwork for DSM-V this year. Have you heard anything about those plans?

I gather from Spitzer and from the writings of key figures (for instance, Ronald Kessler at Harvard) that the trend of including more-and-more mild problems in the DSM is almost certain to continue. There’s talk of including apathy disorder in DSM-V. There’s also a lot of momentum behind including, as disorders, overuse of the Internet and excessive shopping. Finally, there’s a strong desire to formalize “Premenstrual Dysphoric Disorder,” which right now exists only in the appendix to DSM-IV, though, even so, it strangely was still given that all-important diagnostic code to authorize drug treatment. What Eli Lilly did, incidentally, after the code was created, was simply to repackage Prozac as Sarafem. As one of the people involved in the new marketing campaign said quite openly, Lilly took the green-and-yellow pills that make Prozac so distinctive and decided they should henceforth be lavender, while “promoted with images of sunflowers and smart women.” I think he caught the message of that campaign very well.

At various points in the book, you lament the potential passing of certain emotions/attitudes. Introspection is one; love is another that you touch on repeatedly. Why shouldn't we simply see these deep, turbulent emotions as atavistic?

Fortunately, introspection hasn’t completely disappeared! Nor, indeed, has love. The major issue here is “emotional blunting,” an increasingly recognized and well-described side effect of antidepressant and anti-anxiety medication, whereby people can feel as if they’re living in a fog, largely numb to their reality. That’s a very undesirable place to be; it’s another example of the suffering I was alluding to above. I can only speak personally about such things, but I’d certainly prefer the emotion to the risk of its being distorted by medicine.

Daily Mail on Line( Feb 2010) : Drug growth for shyness
SHYNESS

We all feel shy when entering a room full of strangers. But in the past two decades, shyness has become a disease - social anxiety disorder - treatable with antidepressant-type drugs.

Back in 1993, Roche developed the drug Mannerix to treat 'social phobia'. It claimed that about 10 per cent of us suffer crippling bashfulness.Marketting was targetted at "Are you anxious in this queue?"(at airports etc)

But the company could not find enough sufferers for clinical trials.

Drugmakers were not deterred and in the following years successfully lobbied for social phobia to become accepted as a condition after launching new sets of trials.

Pfizer markets the drug Zoloft in America as a cure for Social Anxiety Disorder.

Figures compiled for the Daily Mail by independent health data firm IMS Health show the amount spent on prescriptions for social phobia by the NHS more than doubled between 1997 and 2002, from £ 84 million to almost £189 million.

Seroxat has emerged as a popular drug for social phobia.

SIDE-EFFECTS: Seroxat has been dogged by controversy over its safety and was banned from use for children in Britain in 2004 because of fears that withdrawal might trigger suicidal thoughts.

Read more: http://www.dailymail.co.uk/health/article-1262136/Can-pill-cure-Bashful-As-Britons-pop-tablets-drugs-companies-turning-personality-traits-ailments.html#ixzz1JFhkIWmq

SOCIAL PEDAGOGY - A VIABLE ALTERNATIVE TO DRUGGING CHILDREN -A Progressive European(from Denmark) discipline that could reduce the need to drug children in our schools - with excerpts from 'themprauk' from goodenoughcare.com

http://www.goodenoughcaring.com

CLICK ON LINK TO THIS WEBSITE
THEN GO TO 'THERAPEUTIC CARE AND SOCIAL PEDAGOGY' ON TOP TOOL BAR

Early Attatchments are crucial to healthy development and psychological models underpin this progressive approach.

https://www.youtube.com/user/Humanagement2011 


For more alternatives click on hyperlink to video. 

See also new post(April 2011):"Denmark an European Exemplar of Good Practice."

THEMPRA.UK

http:www.youtube.com/user/Humanagement2011 

If you want more information on alternatives to drugs for YP.

The core values of the Social Pedagogy approach from Northern Europe.

 What 'social pedagogy' means:

Social pedagogy is an academic discipline that draws on core theories from various related disciplines, such as education, sociology, psychology and philosophy. Social pedagogic practice is concerned with human beings' learning, well-being and inclusion into society. The term pedagogy is derived from the Greek pais (child) and agein (to lead, to bring up). As a concept, social pedagogy is founded on humanistic values and an image of children as active agents and competent, resourceful human beings. Cameron (2005) translates pedagogy as 'education in its widest sense', a holistic approach towards children's experiential learning with head, heart, and hands. Particularly in the context of residential child care the terms social pedagogy and pedagogy are often used synonymously. Kornbeck (2007) illustrates the close relationship of the two terms by describing social pedagogy as the provision of social welfare based on pedagogic principles.

How social pedagogy emerged:

It is worth noting that social pedagogy has emerged in order to address culturally specific social problems through educational means (see Hämäläinen, 2003), and as every culture encounters their own unique problems, solutions to social problems are highly context-dependent. As a result, there is no agreed definition for social pedagogy - its meaning is specific to the context, the culture and the time. In this sense we can speak of social pedagogy as socially constructed.

Accordingly, social pedagogy is a 'function of society' (Mollenhauer, 1964). This means that it describes how a given society thinks about children's upbringing, about the relationship between the individual and society, and how it supports disadvantaged or marginalised members of society. Throughout history, different cultures have therefore constructed varying meanings of social pedagogy. If you are interested in exploring the development of social pedagogy further, please contact:

THEMPRA.UK WEBSITE 

 The Relevance of Social Pedagogy in Working with Young People in Residential Child Care - COURTESY OF THE - goodenoughcare.com website

By Gabriel Eichsteller and Viki Bird

Viki Bird worked as an Learning Support Assistant for 2 years in mainstream education and then moved into mainstream residential child care work where she has worked for 4 years. For the last 3 years Viki has been heavily involved in the implementation of Social Pedagogy which has been a great source of inspiration for her.

Gabriel Eichsteller is a director of Thempra, an organisation that provides personal and professional development courses in social pedagogy and works together with organisations on systemic implementation projects and promotes social pedagogy across the UK.


"All children are artists. The problem is how to remain an artist once growing up.” Pablo Picasso



The art of being a social pedagogue

In many European countries social pedagogy has historically evolved as a profession and discipline concerned with holistic education and well-being. As such it has roots in youth work, social welfare, early years, formal education, and care settings. Therefore, social pedagogues usually work in a wide range of settings across the lifespan – working in children’s centres, schools, youth clubs, children’s homes, with disadvantaged groups of adults (asylum seekers, adults with disabilities, drug users, homeless people, delinquents, or whole communities), or in older people’s homes and hospices. Whilst the meaning of social pedagogy in practice will differ depending on the setting and context, there are common principles underpinning social pedagogy.

Social pedagogy, it could be argued, is all about being – about being with others and forming relationships, being in the present and focussing on initiating learning processes, being authentic and genuine using one’s own personality, and about being there in a supportive, empowering manner. As such, social pedagogy is an art form: it’s not just a skill to learn but needs to be brought to life through the social pedagogue’s Haltung(her attitude or mindset)[1]. In other words, social pedagogy is not so much about what you do, but more about the ‘how’. This perspective of social pedagogy means that it is dynamic, creative, and process-orientated rather than mechanical, procedural, and automated. It demands from social pedagogues to be a whole person, not just a pair of hands. The art of being a social pedagogue can be illustrated by many practice examples we have come across as part of our work with children’s homes in England, Scotland and Northern Ireland. The narrative of one of Essex County Council’s residential workers, Viki Bird, aims to provide you with inspiring insights into what it means to be social pedagogical, so that you can explore and reflect on how your practice connects to social pedagogy. In doing so, we hope that you can see the potential which lies in social pedagogy, the learning opportunities it offers us all to become even better and realise our own potential.

Social pedagogy is not about good practice – it is about better practice. Rather than having a good-enough approach, social pedagogy encourages us to be aspirational, to constantly look for ways to improve our work. After all, it lies within our human nature that we can always learn more, further enhance our well-being and develop even stronger relationships. If we as professionals show such aspirations in our practice we’re not only becoming better through our own efforts; we also set a positive example to the children and young people we work with, an example that can encourage them to be more aspirational too.

What becomes apparent in Viki’s account is the journey which Viki and her team have been on, their eagerness to question, reflect upon and develop their practice and make things even better for the young people in their care. Social pedagogy has given them a framework, which guides them on their journey and helps them identify areas of development. In this process they have mainly built on the resources and potential within their team, and their ability to relate their practice to social pedagogy as well as their persistence to work on some of the more difficult and challenging issues have led to an impressive journey for the team and the young people in their care. Here is Viki’s account, which is based on a presentation she gave at a care leavers’ conference at London City Hall [2] :


Social pedagogy in practice – Viki’s journey

I've been asked to share with you a brief insight into social pedagogy and the impact it has on our relationships with the young people in residential care. I'll begin with providing you with a short background of our social pedagogy journey, followed by an overview of how social pedagogy has helped us support young people in developing their identity, build positive relationships with them and challenge social stereotypes about young people in care. These three aspects are at the heart of what’s important to young people in our homes and explain why the implementation of social pedagogy has become so relevant to our work.

In September 2008 Essex County Council began to implement social pedagogy across its children’s homes. This began with the organisation, ThemPra Social Pedagogy, introducing itself at conferences and visits to our homes, followed by 6-day training courses on social pedagogy, 2-day residential courses to develop social pedagogy change agents, team days to develop a social pedagogic culture and follow-up degree level course work. But it doesn't stop there...

I speak as one of many Social Pedagogy Agents and residential workers who have fully engaged with this holistic and solution-based approach to working with young people, and as one who seeks to enthuse and motivate my colleagues and others across Essex and beyond to recognise the benefits of working with social pedagogy. In my experience social pedagogy enables confidence, backed up by theory and experience to best support young people in our care in their learning and development.

For us in residential child care the framework social pedagogy provides is most importantly seen to complement our already established best practice and not replace it. This is vital to its success, so individual homes and individual practitioners can adapt and evolve its methods using key elements suited to the current culture and the dynamics of a particular environment.,/p>

My personal workplace is in a long-term, teenaged, mixed gender, 8-bed residential home, and this is where I am drawing my experience from. And it is my understanding that the crucial factor in social pedagogy is exactly the 'social' aspect.


Developing positive relationships

By concentrating our efforts towards forging authentic relationships with our young people, we can substantially improve their outcomes. We have therefore wholly taken on board the 'Common Third' element,[3] which promotes the use of actively creating opportunities for shared learning experiences within and outside of the home. The Common Third is best explained by visualising an equal triangle with the young person at one point, the pedagogue at the next, and the task being the third point. We are encouraged, then, to translate every available opportunity when working with our young people as a means of building common ground through shared experiences. This crucial foundation in relationship building has had a massively positive impact in our home, and this has been achieved by providing learning environments where participation becomes almost a natural desire for all involved.

The resulting outcomes of focusing our attention on our relationships sees more and more of our young people having the confidence to develop their personal relationships with family, carers, friends, teachers, health professionals, and others. Equally this gives them a future outreach base, with which they know they can comfortably revisit us and continue to gain support and guidance beyond their time in care.


Changing approaches to risk-taking

To give you an understanding of how far we've come in a short time I ask you to consider how prior to the implementation of social pedagogy we were almost considered to be 'risk-obsessed' and of having a 'cotton wool' approach to care.

For example, our young people were only allowed to go to the beach if an extensive risk assessment was written, then the area was combed for dangerous objects, and subsequently, if all was ticked and approved ... they were only allowed to paddle in the sea up to knee height anyway! A somewhat limited experience as I'm sure you'll agree. Yet where we were previously restrained by particularly strict risk-assessment factors such as this, we have now successfully moved towards a growing confidence in our own judgement, by questioning and challenging practice and procedures in order to better socialise and equip our young people in today's society.

Now I personally bounded into my role as a residential worker 3 years ago full of enthusiasm and ideas to generate activities and experiences, which were often considered 'too risky' to undertake. However, by expanding our knowledge and drawing on social pedagogy concepts such as risk competence [4]we have found we can shift the expectations, norms and procedures to help us provide worthwhile opportunities which enhance our relationships and the care experience.


Supporting young people’s inclusion and identity formation

This progressive shift has seen improved inclusion through reviewing and updating the consideration towards risk whilst allowing for the beneficial factors to be given equal priority. I'm not talking about throwing caution to the wind, but simply enabling a confidence to make a professional judgement towards developing our young people’s competencies in identifying and managing risks themselves instead of having to rely on adults to do it for them.

From this we have been introducing various new ideas such as having therapeutic campfires in our grounds, embarking on graffiti projects; young people are taking ownership of their home by being involved in the decoration and maintenance; they are planning their own activities for the holidays; we have themed events, activity-based group gatherings and many, many more simple and effective tasks that occur on a group or one-to-one basis. Even a basic washing-up chore becomes a valuable learning opportunity where communication is vital to gaining a deeper understanding of the young people we work with, their inner worlds, what they’re thinking and who they are.

We recognise then, the value of quality time spent introducing new ways to engage and communicate with our young people by simply making the most of the time spent in their company. These shared experiences are then crucial to building the firm foundations upon which the relationship can then explore the many issues facing our young people.

In terms of identity we are empowering them with the confidence to develop this aspect by individualising their care plans to convey an in-depth understanding of the whole person, their strengths, their achievements and their aspirations and not just how to manage their behaviour.

A good case in point would be one of our long-term school refusers who had low self-esteem, was insecure with her family's unconventional lifestyle and was continually reminding us 'You don't know what it's like to be a kid in care!' (minus the expletives).

Her transition back into full-time education and the plan to return her back to the family home in the very near future has been the result of extensive work around our relationships with her and her family, and from this, building her self esteem and helping her to feel secure enough with her identity to engage with outside assistance and not remain in the sheltered confines and comfort zone of the care home.

The contributing factor here saw us move away from the expectation we should not engage with young people who refuse school in order that it may seem more exciting to remain at home, but instead using those opportunities as a platform to encourage independence, motivation and self-worth to achieve a positive outcome.

Here it is important to add that carers, social workers, family and the wider community are all stakeholders in a young person's life and we are increasingly inviting opportunities for communication and inclusion in order to enhance their care experience.

We have seen the benefits of inviting all those involved in regular BBQ events, where our young people are fully involved with the preparation and everyone has enjoyed a day of participation in activities and guests have been presented with a showcasing of talent.

This extension of the Common Third doesn’t only have a tremendous impact on the self-esteem of our young people but brings about yet another valuable opportunity to forge strong relationships with those involved in looking after them.


Building bridges into the community

Whilst it's fantastic to bring the community in, it's equally important to encourage our young people to go out and contribute to the wider community, and this has been evidenced via articles of achievement being reported in the local newspaper, contributions being made to the Care Matters magazine and project work such as with the local Carnival Organisation, all of which help to promote positive publicity and a sense of acceptance.

A recent example highlights this: one of our young people actually wrote a letter of complaint to a sports organisation after having had his place withdrawn due to the behaviour of another resident at our home who attended the same club. He challenged their discrimination, successfully and quite rightly, and was sent a substantial letter of apology and invited back with immediate effect. His talents have since awarded him a special mention in the paper for fastest lap time despite being the youngest member of the club! A great outcome, I'm sure you will agree.

But this is just one of many recent examples whereby our young people are confidently contributing to their development and to society by making their voice heard and by making their voice count. However, whilst we strongly encourage participation by our young people, we cannot do this effectively without increasing our own participation by way of looking at ourselves and consistently reflecting on our practice.


Being professional and personal

The core of our work focuses on the ‘3Ps’ element[5] of social pedagogy: the Personal Pedagogue – what we give of ourselves, the Professional Pedagogue – our knowledge and conduct, and the Private Pedagogue – our lives outside of work. It is through this means that we are able to consider how we as workers can approach our young people and become authentic practitioners by working with their best interests in mind. Through constant reflection on our own experiences in life and not just in the working environment we learn an awareness of how our Personal, Professional, and Private involvement affects our practice and our approach towards our young people.

To convey this better I'd like you to picture, if you will, the London Underground network with the care system being the circle line and the many routes to and from this central hub being different stages in the young people's journey through care. Both the young people and their carers all need maintenance, direction and a network from which to make their journey through care as comfortable as possible.This network has to cater for the individual traveller as well as transporting whole groups towards positive outcomes and desired destinations. I, for one, strongly believe that social pedagogy provides us with the network to do this.


Concluding thoughts

Given the scope of social pedagogy, I have only been able to touch upon a mere fraction of the wealth of knowledge and evidence that backs up this insightful approach, which can forward our thinking and support us to responsibly consider the future of care. But essentially, social pedagogy encourages us to be an artist and think creatively and imaginatively, to challenge ourselves and overcome barriers to communication within our homes and out into the wider community. It also teaches us to be adaptable and resourceful, which is a necessity in today’s current climate. That said, we do, however, have an appreciation for social pedagogy not having a ‘magic wand’ effect, but indeed a profound effect on positive outcomes nonetheless. And when I said at the beginning 'It doesn’t stop there!', it is vital to recognise that our momentum continues to gather pace as we pro-actively contribute to the practitioners forums within Essex Residential Services, host our own pedagogy team days and reflect on and share our practice as an extension of the training that was initially given. The aim is to become a suitably self-sufficient, holistic, flexible and well-educated workforce within the Children's Service.

So having been provided with a cleverly adaptable framework and a complementary approach to our practice I hope you can appreciate why we are hugely enthusiastic about exploring, evolving and improving our future role in caring for and meeting the needs of our young people.

And finally, we also hope that by sharing this brief insight you have gained an understanding of the relevance of social pedagogy in residential work. If you wish to find out more please get in touch with us ("victoria.bird@essex.gov.uk"; "gabriel@thempra.org.uk) or visit www.thempra.org.uk".

DR JOANNA MONCRIEFF - "THE MYTH OF THE CHEMICAL CURE," BBC-Today programme - July 2009

Dr Joanna Moncrieff - University College London.

Taking a pill to treat depression is widely believed to work by reversing a chemical imbalance.
The pill is the answer for psychiatry.
Medication is a mainstay of mental health therapy

 

But in this week's Scrubbing Up health column, Dr Joanna Moncrieff, of the department of mental health sciences at University College London, says they actually put people into "drug-induced states".

If you've seen a doctor about emotional problems some time over the past 20 years, you may have been told that you had a chemical imbalance, and that you needed tablets to correct it.

It's not just doctors that think this way, either.

Magazines, newspapers, patients' organisations and internet sites have all publicised the idea that conditions like depression, anxiety, schizophrenia and bipolar disorder can be treated by drugs that help to rectify an underlying brain problem.

People with schizophrenia and other conditions are frequently told that they need to take psychiatric medication for the rest of their lives to stabilise their brain chemicals, just like a diabetic needs to take insulin.

The trouble is there is little justification for this view of psychiatric drugs.

Altered states

First, although ideas like the serotonin theory of depression have been widely publicised, scientific research has not detected any reliable abnormalities of the serotonin system in people who are depressed.

Second, it is often said the fact that drug treatment "works" proves there's an underlying biological deficiency.

    
Psychoactive drugs make people feel different
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But there is another explanation for how psychiatric drugs affect people with emotional problems.

It is frequently overlooked that drugs used in psychiatry are psychoactive drugs, like alcohol and cannabis.

Psychoactive drugs make people feel different; they put people into an altered mental and physical state.

"Take it because the man in the white coat tells you to!!"Look up the Millgram Experiment from 1969,which conclusively established the "white coat phenemenon" based on authoritarian societies..

 

They affect everyone, regardless of whether they have a mental disorder or not.

Therefore, an alternative way of understanding how psychiatric drugs affect people is to look at the psychoactive effects they produce.

Drugs referred to as antipsychotics, for example, dampen down thoughts and emotions, which may be helpful in someone with psychosis.

Drugs like Valium produce a state of relaxation and a pleasant drowsiness, which may reduce anxiety and agitation.

Drugs labelled as "anti-depressants" come from many different chemical classes and produce a variety of effects.

Prior to the 1950s, the drugs that were used for mental health problems were thought of as psychoactive drugs, which produced mainly sedative effects.

'Informed choice'

Views about psychiatric drugs changed over the course of the 1950s and 1960s.

 
    
FROM THE TODAY PROGRAMME

More from Today programme

They gradually came to be seen as being specific treatments for specific diseases, or "magic bullets", and their psychoactive effects were forgotten.

However, this transformation was not based on any compelling evidence.

In my view it remains more plausible that they "work" by producing drug-induced states which suppress or mask emotional problems.

 

    
If we gave people a clearer picture drug treatment might not always be so appealing

This doesn't mean psychiatric drugs can't be useful, sometimes.

But, people need to be aware of what they do and the sorts of effects they produce.

At the moment people are being encouraged to believe that taking a pill will make them feel better by reversing some defective brain process.

That sounds good. If your brain is not functioning properly, and a drug can make it work better, then it makes sense to take the pill.

If, on the other hand, we gave people a clearer picture, drug treatment might not always be so appealing.

If you told people that we have no idea what is going on in their brain, but that they could take a drug that would make them feel different and might help to suppress their thoughts and feelings, then many people might choose to avoid taking drugs if they could.

On the other hand, people who are severely disturbed or distressed might welcome these effects, at least for a time.

People need to make up their own minds about whether taking psychoactive drugs is a useful way to manage emotional problems.

1. Methylphenidate causes a build up of dopamine which blocks synaptic transmission.Add caption

 

To do this responsibly, however, doctors and patients need much more information about the nature of psychiatric drugs and the effects they produce.

Dr Moncrieff's book "The Myth of the Chemical Cure", published by Palgrave Macmillan, will be available in paperback from September.

http://www.youtube.com/user/Humanagement2011

 For more information on topic and BBC radio programmes.