This year we are partnering again with the PA Wine & Spirits Stores to have  wine tastings AND spirits sampling at the Show. With the international theme- there are some many great things to try (full schedule will be posted in Feb). The tastings and store will be located at the Grand Hall, near the 12th and Market Streets entrance. Tastings are free with Flower Show admission. Must be 21 years old.

Beware of santas bearing bad news.

If you aren’t one of the 3% of shoppers who are actually done with the Christmas shopaganza, welcome to the club. My friend, you need a strategy. Timing is everything, and what you’re in the market for should determine where you go. Here are some things to consider when drawing up the Black Friday shopping game plan.

I’m going to jump ahead of myself in this discussion of pain management in groups, using a CBT approach, and cut to a description of therapist factors that can influence how well a group programme works. I should add at this stage, that I’m basing much of what I write on my own experience over …ermmm… a few years… but also from an extremely helpful book ‘Cognitive behavioral therapy in groups’ by Bieling, McCabe and Antony.  It’s published byThe  Guilford Press, New York, 2006, and is a hefty 452 pages long.  It’s a great book —- but it doesn’t have anything about chronic pain management, so I’m working on describing how the factors that are discussed in this book can apply in chronic pain management.

OK, so while I’ve been looking at group process and the benefits of conducting pain management in a group setting, one of the critical ingredients has to be the clinician or clinical team involved in the programme. Our team has six clinicians, and something we’ve worked on very hard is having a common model and developing consistent responses to various issues that different participants bring into our programme.  It only takes one clinician to say something ‘different’ for participants to become confused or worse, defensive and at times work to ’split’ a team.  Pain management often runs contrary to ‘common sense’  – chronic pain management doesn’t follow the rules of acute pain, so if someone is fearful of moving and one clinician reinforces this, however well-meaning, it can stall reconceptualisation and stop progress.

Group programmes using a CBT approach need facilitators who are not only confident in themselves (they’re ‘on show’!), but also be both confident in applying CBT in a one-to-one setting, and also work well with group facilitation (ie know how groups function).  They also need to be well-trained in chronic pain management.  Transferring generic CBT skills into chronic pain is a challenge – but transferring generic CBT skills into a group setting is impossible without some mentoring and opportunity to observe.  I’m glad to see that this point is made very strongly in the book I referenced above!

In fact, that book recommends the following:

1. Didactic coursework/training in CBT models and techniques
2. Direct (hour for hour) supervision on multiple individual cases of CBT
3. Observational participation in a CBT group led by another therapist
4. Taking on the role of a co-leader

Well I can’t quite see that being given to new people joining many public hospitals in New Zealand!

Therapists need to have some specific facilitation ’styles’ that work for group facilitation:

1. They need to model ‘active participation’ – in other words, really be involved in the processes of the group
2. They need to be tolerant and open to individual differences, there is no ‘correct’ way of responding, just varing consequences im both short and long term
3. Use collaboration and Socratic dialogue to guide participants through the process of discovery.  ‘Teaching’ doesn’t work well, ‘discovering’ works better, ‘experiencing’ works best.
4. Communicate that ‘we’ are all prone to the same thinking patterns and responses – never ever giving the impression that they ‘have it all together’ or that they wouldn’t be vulnerable to the same thoughts, feelings and behaviours that the participants have.  After all chronic pain is not choosy – it could be you, and it is me, that can have chronic pain!

I’ve not often had the opportunity to work with a cotherapist, but when I have, it’s been wonderful! A point made in many manuals for CBT in a group setting is that two therapists are preferable.  One can do the majority of the facilitation, while the second can be observing, noticing, listening and providing back-up when the primary therapist runs dry.  If two therapists are going to work together, though, they need to have some idea of who is doing what, and what the potential issues might be.  AND, more importantly, they need to debrief afterwards to see what they both saw during the session.

I’ve found that it’s great to have an email or some other system to share observations and notes from each session – especially when different therapists provide input over different sessions during the day.  And as the therapists hand over to the next person, a brief exchange of ‘what’s going on in the group’ makes a huge difference.  For example, if one person has had a flare-up and is having trouble, it’s good to know what has already been said or suggested so either the same approach is used, or the person isn’t faced with the same questions or process from the next therapist!

As the group develops, the participants can take on some of this ongoing monitoring and reminding process, but especially during the initial stages, it’s vital that therapists keep their eyes and ears open and share what they observe.

To help with learning, I’ve attended training on group facilitation (Zenergy in New Zealand is one provider I particularly respect), and I’ve also participated in personal growth courses, especially those using experiential learning methods.  I think these skills also help when facilitating group-based CBT for pain management.  One book I’ve found especially helpful is Open to Outcome which gives you five questions you can use to debrief from any experiential activity.  And of course, Thiagi has a huge resource of both brief and more complex experiential activities that you can use in groups.

As of late, my mind has been buzzing on why people group up together, and we may all see the easy and obvious reasons why we all do, at some point in our life, but I mainly wonder about the reason why we band together and at some point become agressive.

Well my own story may not be of much help, as I had a great adolscense, with mostly no negativity in it. I still stand by that statement, as my foot has been embedded in the spirit of positivity with a great tattoo. But as of late I have begun noticing group-voilence between people. Both Norwegian and immigrants have these tendenzies, but I mainly refer to immigrant youth societies. This is because we all tend to generalize these types of groups right from the start, which in most cases is overrated. As seen through my young eyes I feel that I can bring another view to the table, which older men and women can’t include themselves in. 

“We are strong together, we are one together” a friend said to me once, and I never really got that one, untill now. Alone we are nothing, only a mere chicken for the pickings, and when a young boy, white or black skin colour is of no importance, we all band toward eachother. We group up in fear towards the other man, who is different, in both colour and culture. things that are strange to us, like different views of religion especially a Religion which may include more gods than the one we are carrying, may feel strange, and even wrong. This is natural as when different viewpoints in Religion defines the culture. The Indian man may be more indifferent to things that we value and the other way around. We all claim to have the right lifestyle, and claim to best everyone in every aspects of life. This is problem number one.

Media also tend to blow up stories that include the minority in our Nation, even going as far as refering to gang-voilence or the persons skincolour. This creates this basic fear of the unknown, and suddenly we all spawn a terrorist out of the harmless Imam on the bus. You have all read that in an educational book somewhere, but I am not joking, this really affect all of us. This makes an ignorant and fearfull son-of-a-bitch out of us automaticly.

This makes us group up with like-minded persons, who share the same opinions. And when we are strong we tend to be braver that we would be when alone, and in some cases we become so brave that we neglect strange ways, even start to mutually hate it. We start to not tolerate it, rather pushing it away than facing it, fearing it even more. At this point there is no going back, and it all usually ends in voilence to some degrees.

This may be the cause that we all pit the other man against eachother so often, and even makes us “hate” the other man. The other man is not like us, invades our land, taking our work from us, and lives of what would be ours. This is bullshit, as we are all actually equals, in both heritage at some point, and righ to live the life we all want. But if we really are in a big family then why do we hate eachother so much? The older generation seem to be the blame in this. Ignorance and fear grips us all, but it is actually stronger in the older generation. Thank you mom for bringing me up to be this responsible, but I fear that you are overreacting! You have told me from the beginning to stay away from the scary world, in hope of shielding me from alle the “dangers” of this world, when in fact this world is my playground. I am glad that you brought me up not fearing the odd and new, but the “other man” was not the barberian that you would have me believe. There was no need to fear him, only embrace him, and his strange ways. For one day, his ways will not be that strange anymore, and rather familiar. I will not fear him, nor hate him. I will love the other man as my brother, and treat him with respect as I would my own kind.

“An individual has not started living until he can rise above the narrow confines of his individualistic concerns to the broader concerns of all humanity.”
Martin Luther King, Jr.

Written by:
Espen Dyrland

We moved to our first (rented) house last month. The most exciting part (for me at least) is that there is a basement, I will finally have a studio space all to myself!

The Berkeley Knitters all headed out to Meridian Jacobs Farm for another Shearing Day.

Will took a week off and went to Hawaii and he brought me back this fun sampler quilt kit as well as a very cute turtle pincushion.

There has been lots more but sadly the good camera died and my old digital eats batteries in about 10 min so all I have in the way of a camera is my phone which is less then ideal, but I will try to photograph stuff as I can and hopefully we will get the good camera fixed soon (hurray for warranties!)

In the mean time I hope everyone has a wonderful Thanksgiving!  (Or if you aren’t in the USA a wonderful day)

I have been a big opponent of the vanity twitter use (aka harvesting followers, hoping that “followers” equals “audience”).

In practice, this meant that from a point on,  I completely stopped looking who is following me, did not reciprocate at the cost of being perceived as arrogant and kept my follower/following ratio to 4.

Still not content, I unfollowed quite a number of twitterers (some of them pretty big names)  on the grounds that they were either producing too much noise, or were talking about things I found irrelevant to me.

For over two years now, I keep experimenting with twitter:

• In the beginning, it was conversations. But as people kept flocking around twitter, conversing became hard, if not impossible.
• Then it was news tracking which, although useful, it was far from complete. Yes, the news came to me, but not the news I was always interested. And with it came a lot of repetition and nonsense.
• Then, based on retweets, it was content discovery and evaluation.
• Occassionaly, it was polls, mini-crowdsourcing, asking questions etc
• Grouping people allowed to create filters: filters for news, for content, for community info.
• Finally, there came mindcasting. The most interesting use of twitter. The one I subscribe.

The grouping feature offered by many twitter clients, has, for a long time, being the single organizing factor that brought some order into chaos.

But, lately, we have another one, far too important: Lists!

Although lists look pretty much as the  groups of twitter clients, they are not the same: groups are for  the people we follow or those that follow us, while lists are for everyone! This difference is a game changer.

Already people use how often they are listed as a measure of importance, influence or popularity.

But lists have another function: they are metadata. The criteria we use to classify twitterers in lists, describe what they are or how we view them.

Also, lists, unlike groups, can be public, can be viewed and subscribed by others. And as such, they bring focus and attention from another angle.

“Ok”, you might say. “Lists bring new features. So what?”

Lists can bring back the sanity in twitter. They can undermine the follower fallacy, they can bring value to ordinary users as well as to businesses and marketers.

How?

By allowing us to make a fundamental distinction: following is an action of trust and, to some extend, intimacy. Subscribing to a list is  willingness to be informed.

So if you are on twitter to spread your message (be it news or offers or corporate messages) seek to be listed, not followed. Your very intention implies that you most likely want to use twitter for broadcasting and not for creating relationships. That is fine. You won’t have to pretend you are a ‘friend’ from now on. You aren’t. You never were. But  now message spreading can be done without undermining the everyday experience of ordinary users.

—– end of part I —–

My lists…

I’m spending a few days looking at practical ways for working with group CBT for chronic pain.  It’s the most researched form of CBT-based pain management, and offers some very helpful features for people with chronic pain.  I’ve looked at how groups can impart a sense of optimism and at how they help people with a sense of  inclusion (sense of commonality), and group-based learning.  Today it’s time to look at emotional processing and group cohesion.

I’m sure I’m not alone in feeling slightly awkward in some social settings.  I really hate meeting a group of people who already know each other (I’m the odd one out), or in a bar where I can’t hear well, or at times when I’m feeling less than sparkling (maybe worrying about what people might think…).  I know I’m not alone in feeling that when I’m with people I don’t know well, I am not exactly open to pouring out my woes and being emotional. It can take quite a while to feel comfortable about expressing feelings in a group setting - but at the same time there is something comforting in knowing that if I’m feeling wobbly there are probably a few other people also feeling the same way, so we may all reach for the tissues at the same time!

Processing emotional content in a group setting can be both an amazing experience and at the same time an opportunity to feel really weird.  It all depends on how the facilitator or therapist responds.  Through exposing emotional content, we have greater access to automatic thoughts, assumptions, beliefs and behaviours that are often otherwise well hidden underneath our protective cognitions.  It’s at times when we feel more emotionally vulnerable that we have access to underlying ‘rules of living’ that we may otherwise be completely oblivious to.

What should a facilitator take notice of?

- times when a participant appears disengaged, perhaps doodling, or closing the eyes, maybe rocking on the chair or fiddling with a pen.

What could a facilitator do? To illustrate one way of drawing out the emotional response and opening up an opportunity to talk about what is happening here and now, the therapist could say:

Therapist: ‘before we go on, I just want to check in with the group.  Tony I can see you’re looking a bit distracted, what’s going on for you right now?’

Tony: ‘Oh nothing’

Therapist: ‘Oh.  How does what we were talking about fit for you?’

Tony: ‘Well, I’m just thinking why do I have to be here? I mean, I don’t think my pain is really chronic, and I know I can have another injection if only I talk to the doctor again, so do I really have to do all this psychological stuff anyway?’

Therapist: ‘Does anyone else feel like it’s going to be a really difficult process to learn self management, and maybe there is an easier way other than looking at thoughts and emotions and things?’

Andrea: ‘Well, yeah.  I mean, some of the doctors have said that I can just increase my medications and then maybe my pain will go down and I’ll be doing more, but I just can’t handle the side effects any more.  Those side effects can be worse than having the pain, I think.’

Therapist: ‘Does anyone else feel like it might be easier to just carry on with a medical approach and not look at other things?’

Tessa: ‘I tried that for years, but in the end I still have my pain and my emotions go  up and down every time someone suggests another medication – but I’m still here because I am so fed up with that rollercoaster, and I want to take control again.’

Therapist: ‘ Tony, what is it like for you to hear that other people feel in two minds about doing this self management approach, and there are some appealing things about using medications, but also some not-so-good effects?’

Tony: ‘Well I guess it makes me feel more normal, after all I’ve been on that emotional rollercoaster for a long time, and I really hate the side effects from medications too.  And the doctor said that he wasn’t very keen to give me any more injections.’

This approach can feel risky if you’re not used to facilitating – it’s allowing people the space to feel ambivalent and to process that anxiety but also to recognise that others in the group have also had similar experiences and offer either the same insight (I’ve been here before…) or a new insight (She’s handling it by being open-minded) that can reassure the person.  Provided that the facilitator can trust the group that there will be someone else who has moved through this same thought and emotion before, and go with the flow (roll with resistance), it’s possible to allow people to air their worries or emotions and still be able to move towards the goal of sharing and normalising many of the experiences the group shares.

Group cohesion is that sense that the group are ‘bonded’. There has been much written about the stages of development within a group – the ‘forming, norming, storming etc’  stages amongst others.  What happens is that over time a group may move to the point where it’s OK to disagree with each other, to challenge each other and to risk being ‘real’ with each other.  This can happen quite quickly, but I find that groups often get to the ‘I feel comfortable with this group’ stage (ie they all ‘get along’) but may get stuck and don’t move to the ‘it’s OK to be honest and real and disagree with each other’ stage.  It’s only when groups move to this deeper level of cohesion, IMHO, that they start to ‘work’ each other.

The therapist or facilitator can encourage this deeper relationship and here are several strategies that can also help:

1. Choosing a group that has similar characteristics – eg stage of change or readiness to adopt self management, maybe diagnosis or pain site, perhaps compensation status or job status
2. Ensuring confidentiality and creating the group norms
3. Ensuring a climate of acceptance, empathy and promoting sharing of information
4. Connecting two or more participants experiences
5. Responding to group process as it happens

More about this last one tomorrow. Group process is all about the things I’ve raised over the last couple of days – disclosure, optimism, inclusion, group learning, shifting from self to others, and managing both emotional processing and group cohesion.

I’ll review these tomorrow and add in some specific strategies that can be helpful to elicit each one.

WASHINGTON?Five property/casualty insurance trade groups sent a letter Tuesday to House Financial Services Committee Chairman Barney Frank, D-Mass., reiterating their concerns about how their industry would be treated under the Financial Stability Improvement Act.

?We believe that any federal proposal to subject financial companies to heightened prudential supervision should start from the premise that property and casualty companies engaged in insurance activities should not be subject to such supervision,? the groups said in the letter about legislation that is under consideration by the committee.

?Because the discussion draft already exempts insurance company subsidiaries from the enhanced resolution authority, the draft should carry that exemption through the rest of its provisions,? they wrote. ?In addition, Congress should establish a mechanism that does not improperly assess exempted entities for the systemic failures of others. Failure to do so would generate added costs for the property and casualty industry and consumers, and potentially destabilize a healthy insurance marketplace. Moreover, if assessments are made to recover federal aid to a failing institution with property and casualty subsidiaries, we run the risk of distorting marketplace competition,? the letter says.

?Finally, we are particularly concerned about an amendment to be offered in committee that would subject insurers to pre-event assessments to fund a resolution mechanism. We strongly oppose the idea of pre-funding because it runs counter to our own resolution system, amounts to a tax and exacerbates the problems we have noted above.?

The American Insurance Assn., the Independent Insurance Agents and Brokers of America, the National Assn. of Mutual Insurance Cos., the Property Casualty Insurers Assn. of America and the Reinsurance Assn. of America signed the letter.

Copyright © 2009 Crain Communications, Inc.

NAIC Gains Revisions To Federal Insurance Office BillInsurance Jobs Fall for 12th Straight Month

Today, we investigated homomorphisms further. Recall that a homomorphism between two groups and is a function such that
for all .

This basically says that the function “understands the operations of the group” and maps elements in a way that is compatible with the operations of the respective groups. We saw many examples of homomorphisms, some of which we already knew. For instance:

• 
• by and
• by

are all homomorphisms between their respective groups. There are many more examples as well, and we will continue to investigate different homomorphisms.

Finally, we also noted that if are both groups, then there is always a homomorphism between them given by with where is the identity element in .

We noted that homomorphisms are not quite as strong as isomorphisms, but we will show how much information is actually carried through a homomorphism (as opposed to an isomorphism where all the information is carried through).

Groupie Wire is a social networking service that allows members to create unique personal profiles online with lots of cool features and ability that most website don’t offer for free.

Groupie wire is one of the most advance social networking tool online. How advance is groupie wire? Let’s just say as a member of our community, you can connect with facebook, twitter, playlist and youtube right from your groupie wire account. You can post twit directly to twitter from groupie wire. You can connect with your facebook friends from your groupie wire account. You can share your youtube videos by posting it to your groupie wire profile. You can create a music play list at playlist.com and add it to your groupie wire profile.

you can also start a group, create blog, post events, post classifieds for FREE.
www.groupiewire.com

I am submitting a proposal for a paper for a conference. (Association of Popular/American Culture)  My topic is about the eating disorder community on Facebook.  There has been research done about media, magazines, advertising, and pro-ana sites.  I think it’s time we look at how healthy Facebook is, whether it encourages recovery or not or whether it encourages an individual to stay stuck in his or her illness.

There are two parts to the survey, only because I only have a basic account and can’t have more than 10 questions on any one survey.  I am asking you to please take a few minutes and answer 20 questions, 19 of which are simple multiple choice questions.

Facebook and Eating Disorders:

Survey One

Survey Two