In college I could take a tune deeper than the next girl, but something happened to this ability after working in the industry.  People often say if you work in an industry that you become numb to it, but I tend to think if you’re in something every single day you become numb to it anyway.  Maybe it was the Phish‘ers sitting with their oversized beanies, patchouli stench, and communal joint, that got me thinking of musical depth, or perhaps it was my second-hand high that just set me into an astral thought.

Maybe it’s Jeff Buckley’s secret chord, but I’m present.  My new therapist, yes I’m working on another book.  This has become my rite-of-passage during the write-myself-into-therapy seasons.  Luckily, this season was quality over quantity so it takes much less longevity to tattoo into my soul.  The new Psychiatric buzz is ‘disassociation‘, so I’m quite pleased that the tag was placed upfront.  I simply don’t have time to be looking up diagnosis codes in the DSM,  I really don’t.  Nonetheless, my therapist…we’ll call her Spinner (due to confidentiality I’m not allowed to use her real name.  You understand.)…Spinner told me I was damn lucky to have a writing outlet otherwise I would be a multiple.  We’re talking United States of Tara.  I wish I would have known this years ago because I could have been Diablo-fucking-Cody!  Smart bitch, stealing my could be story.  I think Spinner and I connected enough that I’ll be seeing her steadily, and she’s been in it so long that she’s heard it all so my shock-value dilvulges only made her fingers shimmy in delight.  I must be secretly narcissistic too because she suggested someone write a book about me.  Hey, she’s the professional, not me.

Jeff Buckley’s voice makes me feel refined and appreciative of the vocal instrument, and for many years I have to admit to vocal discrimination; the voice is NOT an instrument.  I’ve long since changed my tune, though I still sing out of key; always a backup but never lead. 

The Phishers, tonight at Madison, reminded me of myself and a few good hippies I met at school; the Carols, Matts, Michals, Buddhas, and Melissa.  I still listen to the music; just a little lower decibel, manifactured not natural additives, and on mute.  The real experience is catching the wave of feeling long enough to remember the view.

The Chinchillas have had more babies, Jan’s hot-footed it back to Sweden and J is playing hard to get. I check out Facebook to see if he’s on a trip too. Come on, you all do it! Aggh, he’s got messages from women with all kinds of strange profile pics. There’s one from Angel whose bottom is sticking out of bubble bath. I see another from a vixen with a stiletto heel unhooking her G-string and a lady with a Catwoman mask licking latex. This guy is clearly some goddang Pornmeister on sabbatical to fantasy land.

You can tell a lot about a person’s facebook profile so beware what you put out in the ether boys and girls. My friend Angie once lost a contract after someone saw her being rude about them on the social networking site. She had foolishly forgotten she had added them as a friend a few months before. I know we all spy on people these days but I still get freaked out on dates when the person knows my CV better than I do. I think, “I never told you that.” Even my 58yr old singing teacher, who, I might add, I would NEVER date, told me he knew everything about me through the Internet, although he rather creepily pretended he could read me like a book first. I gave up the lessons after that. My favourite story of Internet outing was told to me by my mate Allen who found out a guy was pissing him around with the sale of his house by googling him. After being told the guy could not complete (he was too busy mourning the death of his aunty) Allen found him in some online chat-room saying he was having a great day and about to head off to the pub for a few pints. A few minutes later Allen sent out a rocket of a chat message and within minutes the house sale was back on track and the guy had been publicly humiliated online.

Talking of rockets. I had better make like one as I am off to my first live pole-dancing performance in a few hours. I got into the art of tease to get rid of my cellulite. I also wanted to make my lower half move again after years in the sexual Gobi. Little did I know it would take me to another dimension with all sense of space and time disappearing after 10 minutes on the pole. Music does it to some people, art to others, well pole-dancing does it for me. Of course, I daren’t mention my hobby at Sid and Nancy’s catholic school; most of the Mums and Dads there really are too good for this world. When Sid blurted out “Mummy’s going pole dancing” to one Mum in the park the other day I had to tell a porky (thankfully I am a Buddhist if anything so I won’t need to head for the confession booth). I told her I do folk dancing in Ealing following recommendations from my Polish mum in law.

It’s a full moon tonight and, being a bit of a lunar loony, I know this is not only going to affect me but the audience as well. There’s a reason why Full Moon festivals came into being. Hardcore festival-heads know too well that we all have an urge to to bang a drum and wave a glow stick when the moon is in full glow. But feeling in more of a party mood is not the only side effect. We have problems sleeping, the police have more trouble dealing with anti-social behaviour and psychiatric hospitals report patients get that little bit more crazy when the moon is a balloon. Even the most avid disbeliever can see the Science bit. If the moon changes the way the sea works it must have some kind of effect on our own bodies of water.

I have a diary which charts the phases for me. Moon diary tells me that the waxing phase, from new moon to full moon, is the time that we are at our most outgoing and positive but as the moon then wanes we should put our more quiet and reflective heads on. It was Lovely Liz who got me into moon phases. One morning when the St John’s Wort and meditation was having about as much effect as a smile on a traffic warden, I did what I normally do when I feel low and trotted off to her flat to dump my troubles at her door.

“It’s the double moon, she said. It’s been happening to everyone.” No hint of a “Come on in, sit down, have a cuppa and tell me about the bastard,” oh no, let’s just get straight to the heart of the matter and blame the moon. In myth the Moon is said to rule things like feelings, intuition, fertility and creativity and nowadays even those who come up in hives at the mere mention of crystals, can appreciate there’s truth in what my friend says. Many winemakers, fishermen and hunters go by the lunar calendar and women’s cycles are synchronised with madame moon. So why don’t we pay more attention to it?

“Listening to feelings and hunches requires quiet time, something we rarely give ourselves these days, Abi,” sighs Liz.

Quiet time is something I value more than anything since I had children. Anyone who knows me well will have heard that I meditate for half an hour every day. They might even say, as they do to me, that it has made me a more relaxed person and seems to have halted the ageing process. But heading off into an altered state is not on my to do list today as I sashay off to wow a small crowd of full moon crazed punters with my fireman, carousel and trapeze moves. Power to the moon and power to the pole! Wish me luck tonight…

I’m feeling slightly unwell today. My Mind Cook has added too much paprika into the soupy mess that I call my Brain Chemistry. That sentence does not make much sense, but it seems to be the only way to describe my state at the moment. I got 4 minutes of sleep last night, and just managed to get a half-hour nap in before I’m off to therapy at 3:30. I don’t know why I bother looking sane for my appointments with her. I think it might be something my mother taught me about going to the doctor’s offices and how you have to keep up appearances. She had me thinking that every time I went to a new doctor, I was going to get some sort of psychiatric evaluation, which they actually do sometimes. But not every time. Anyways. The idea just kind of carried over to the mental health field, and I wonder if it actually hurts my chance of getting the right treatments.

I feel like some sort of cave creature who has not seen the sun in about fifteen years. I look outside from my window and see the sun…it is far too bright, but it really is refreshing to see a beautiful, clear(ish) sunny day in December. I’m too scared to go outside for fear of spiders. I get so mad at myself for that. I’m pretty sure I have true arachnophobia, not just a fear of spiders. I’m avoiding situations where I might see a spider, including situations that would be good for my health and that’s probably not a good thing.

The reason I only got a 30 minute nap is because my thoughts would not slow down. That’s one of the hard parts about mania, when you want it to stop it seems to hold on to your mind in an even tighter grasp than before. I think that I would rather be in the hideous throes of depression—at least I stay in one place. I might be thinking about death all the time, but I’m too depressed to kill myself. My self esteem drops to such a level where I don’t believe that I am worthy of the relief that death could bring to me. Silence is only a fantasy.

When I’m manic, I want change. I want to go out. I don’t care who it’s with. I think of the nastiest things, I even consider them. I’ve done some of them. A lot of the things I do when I am manic go against my moral code to such an extent that I could be a different person. But I’m not. I think everything I do is important. I do a lot of things when I’m manic. For instance, I finished nearly my entire online math course in 2 weeks at the beginning of the fall quarter this year. I also become agitated. I start to feel this urge to make money. I always think that I am a burden on someone’s wallet (which technically I am). Sometimes I do things that put my family in potential danger. I laugh at inappropriate times. I say inappropriate things. I am hypersexual. I am paranoid. I eat too much or not enough. I sleep 3 hours tops…and that’s only if I pass out from exhaustion. My heart, my poor heart, has to deal with me taking Ritalin and Focalin all night long. My cardiologist would throttle me if he knew I did this.

There’s more, but I can’t think very well right now. I currently have at least 3 streams of thought going on at the same time, one of them involving that well known tune “Mary Had A Little Lamb”.

Kill me now, before I lose my head completely.

Thresholds’ CEO, Tony Zipple, is on the cover of this month’s Behavioral Healthcare Magazine, and he’s featured in a story about leaders in the industry.

You can check out this month’s edition here.

Congratulations, Tony!

I just ran across an article in the WSJ on how to keep away the winter blues. Check it out!

Here’s the link.

http://www.nytimes.com/2009/11/27/health/research/27brain.html?pagewanted=3&_r=1&sq=surgery%20mental%20health&st=cse&scp=1

One was a middle-aged man who refused to get into the shower. The other was a teenager who was afraid to get out.

The man, Leonard, a writer living outside Chicago, found himself completely unable to wash himself or brush his teeth. The teenager, Ross, growing up in a suburb of New York, had become so terrified of germs that he would regularly shower for seven hours. Each received a diagnosis of severe obsessive-compulsive disorder, or O.C.D., and for years neither felt comfortable enough to leave the house.

But leave they eventually did, traveling in desperation to a hospital in Rhode Island for an experimental brain operation in which four raisin-sized holes were burned deep in their brains.

Today, two years after surgery, Ross is 21 and in college. “It saved my life,” he said. “I really believe that.”

The same cannot be said for Leonard, 67, who had surgery in 1995. “There was no change at all,” he said. “I still don’t leave the house.”

Both men asked that their last names not be used to protect their privacy.

The great promise of neuroscience at the end of the last century was that it would revolutionize the treatment of psychiatric problems. But the first real application of advanced brain science is not novel at all. It is a precise, sophisticated version of an old and controversial approach: psychosurgery, in which doctors operate directly on the brain.

In the last decade or so, more than 500 people have undergone brain surgery for problems like depression, anxiety, Tourette’s syndrome, even obesity, most as a part of medical studies. The results have been encouraging, and this year, for the first time since frontal lobotomy fell into disrepute in the 1950s, the Food and Drug Administration approved one of the surgical techniques for some cases of O.C.D.

While no more than a few thousand people are impaired enough to meet the strict criteria for the surgery right now, millions more suffering from an array of severe conditions, from depression to obesity, could seek such operations as the techniques become less experimental.

But with that hope comes risk. For all the progress that has been made, some psychiatrists and medical ethicists say, doctors still do not know much about the circuits they are tampering with, and the results are unpredictable: some people improve, others feel little or nothing, and an unlucky few actually get worse. In this country, at least one patient was left unable to feed or care for herself after botched surgery.

Moreover, demand for the operations is so high that it could tempt less experienced surgeons to offer them, without the oversight or support of research institutions.

And if the operations are oversold as a kind of all-purpose cure for emotional problems — which they are not, doctors say — then the great promise could quickly feel like a betrayal.

“We have this idea — it’s almost a fetish — that progress is its own justification, that if something is promising, then how can we not rush to relieve suffering?” said Paul Root Wolpe, a medical ethicist at Emory University.

It was not so long ago, he noted, that doctors considered the frontal lobotomy a major advance — only to learn that the operation left thousands of patients with irreversible brain damage. Many promising medical ideas have run aground, Dr. Wolpe added, “and that’s why we have to move very cautiously.”

Dr. Darin D. Dougherty, director of the division of neurotherapeutics at Massachusetts General Hospital and an associate professor of psychiatry at Harvard, put it more bluntly. Given the history of failed techniques, like frontal lobotomy, he said, “If this effort somehow goes wrong, it’ll shut down this approach for another hundred years.”

A Last Resort

Five percent to 15 percent of people given diagnoses of obsessive-compulsive disorder are beyond the reach of any standard treatment. Ross said he was 12 when he noticed that he took longer to wash his hands than most people. Soon he was changing into clean clothes several times a day. Eventually he would barely come out of his room, and when he did, he was careful about what he touched.

“It got so bad, I didn’t want any contact with people,” he said. “I couldn’t hug my own parents.”

Before turning to writing, Leonard was a healthy, successful businessman. Then he was struck, out of nowhere, with a fear of insects and spiders. He overcame the phobias, only to find himself with a strong aversion to bathing. He stopped washing and could not brush his teeth or shave.

“I just looked horrible,” he said. “I had a big, ugly beard. My skin turned black. I was afraid to be seen out in public. I looked like a street person. If you were a policeman, you would have arrested me.”

Both tried antidepressants like Prozac, as well as a variety of other medications. They spent many hours in standard psychotherapy for obsessive-compulsive disorder, gradually becoming exposed to dreaded situations — a moldy shower stall, for instance — and practicing cognitive and relaxation techniques to defuse their anxiety.

To no avail.

“It worked for a while for me, but never lasted,” Ross said. “I mean, I just thought my life was over.”

But there was one more option, their doctors told them, a last resort. At a handful of medical centers here and abroad, including Harvard, the University of Toronto and the Cleveland Clinic, doctors for years have performed a variety of experimental procedures, most for O.C.D. or depression, each guided by high-resolution imaging technology. The companies that make some of the devices have supported the research, and paid some of the doctors to consult on operations.

In one procedure, called a cingulotomy, doctors drill into the skull and thread wires into an area called the anterior cingulate. There they pinpoint and destroy pinches of tissue that lie along a circuit in each hemisphere that connects deeper, emotional centers of the brain to areas of the frontal cortex, where conscious planning is centered.

This circuit appears to be hyperactive in people with severe O.C.D., and imaging studies suggest that the surgery quiets that activity. In another operation, called a capsulotomy, surgeons go deeper, into an area called the internal capsule, and burn out spots in a circuit also thought to be overactive.

An altogether different approach is called deep brain stimulation, or D.B.S., in which surgeons sink wires into the brain but leave them in place. A pacemaker-like device sends a current to the electrodes, apparently interfering with circuits thought to be hyperactive in people with obsessive-compulsive disorder (and also those with severe depression). The current can be turned up, down or off, so deep brain stimulation is adjustable and, to some extent, reversible.

In yet another technique, doctors place the patient in an M.R.I.-like machine that sends beams of radiation into the skull. The beams pass through the brain without causing damage, except at the point where they converge. There they burn out spots of tissue from O.C.D.-related circuits, with similar effects as the other operations. This option, called gamma knife surgery, was the one Leonard and Ross settled on.

The institutions all have strict ethical screening to select candidates. The disorder must be severe and disabling, and all standard treatments exhausted. The informed-consent documents make clear that the operation is experimental and not guaranteed to succeed.

Nor is desperation by itself sufficient to qualify, said Richard Marsland, who oversees the screening process at Butler Hospital in Providence, R.I., which works with surgeons at Rhode Island Hospital, where Leonard and Ross had the operation.

“We get hundreds of requests a year and do only one or two,” Mr. Marsland said. “And some of the people we turn down are in bad shape. Still, we stick to the criteria.”

For those who have successfully recovered from surgery, this intensive screening seems excessive. “I know why it’s done, but this is an operation that could make the difference between life and death for so many people,” said Gerry Radano, whose book “Contaminated: My Journey Out of Obsessive-Compulsive Disorder” (Bar-le-Duc Books, 2007), recounts her own suffering and long recovery from surgery. She also has a Web site, freeofocd.com, where people from around the world consult with her.

But for the doctors running the programs, this screening is crucial. “If patients are poorly selected or not followed well, there’ll be an increasing number of bad outcomes, and the promise of this field will wither away,” said Dr. Ben Greenberg, the psychiatrist in charge of the program at Butler.

Dr. Greenberg said about 60 percent of patients who underwent either gamma knife surgery or deep brain stimulation showed significant improvement, and the rest showed little or no improvement. For this article, he agreed to put a reporter in touch with one — Leonard — who did not have a good experience.

The Danger of Optimism

The true measure of an operation, medical ethicists say, is its overall effect on a person’s life, not only on specific symptoms.

In the early days of psychosurgery, after World War II, doctors published scores of papers detailing how lobotomy relieved symptoms of mental distress. In 1949, the Portuguese neurologist Egas Moniz won the Nobel Prize in medicine for inventing the procedure.

But careful follow-up painted a darker picture: of people who lost motivation, who developed the helpless indifference dramatized by the post-op rebel McMurphy in Ken Kesey’s novel “One Flew Over the Cuckoo’s Nest,” played by Jack Nicholson in the 1975 movie.

The newer operations pinpoint targets on specific, precisely mapped circuits, whereas the frontal lobotomy amounted to a crude slash into the brain behind the eyes, blindly mangling whatever connections and circuits were in the way. Still, there remain large gaps in doctors’ understanding of the circuits they are operating on.

In a paper published last year, researchers at the Karolinska Institute in Sweden reported that half the people who had the most commonly offered operations for obsessive-compulsive disorder showed symptoms of apathy and poor self-control for years afterward, despite scoring lower on a measure of O.C.D. severity.

“An inherent problem in most research is that innovation is driven by groups that believe in their method, thus introducing bias that is almost impossible to avoid,” Dr. Christian Ruck, the lead author of the paper, wrote in an e-mail message. The institute’s doctors, who burned out significantly more tissue than other centers did, no longer perform the operations, partly, Dr. Ruck said, as a result of his findings.

In the United States, at least one patient has suffered disabling brain damage from an operation for O.C.D. The case led to a $7.5 million judgment in 2002 against the Ohio hospital that performed the procedure. (It is no longer offered there.)

Most outcomes, whether favorable or not, have had less remarkable immediate results. The brain can take months or even years to fully adjust after the operations. The revelations about the people treated at Karolinska “underscore the importance of face-to-face assessments of adverse symptoms,” Dr. Ruck and his co-authors concluded.

The Long Way Back

Ross said he felt no difference for months after surgery, until the day his brother asked him to play a video game in the basement, and down the stairs he went.

“I just felt like doing it,” he said. “I would never have gone down there before.”

He said the procedure seemed to give the psychotherapy sessions a chance to work, and last summer he felt comfortable enough to stop them. He now spends his days studying, going to class, playing the odd video game to relax. He has told friends about the operation, he said, “and they’re O.K. with it — they know the story.”

Leonard is still struggling, for reasons no one understands. He keeps odd hours, working through most nights and sleeping much of the day. He is not unhappy, he said, but he has the same aversion to washing and still lives like a hermit.

“I still don’t know why I’m like this, and I would still try anything that could help,” he said. “But at this point, obviously, I’m skeptical of the efficacy of surgery, at least for me.”

Ms. Radano, who wrote the book about her recovery, said the most important thing about the surgery was that it gave people a chance. “That’s all people in this situation want, and I know because I was there,” she said while getting into her car on a recent afternoon.

On the passenger seat was a container of decontaminating hand wipes. She pointed and laughed. “See? You’re never completely out.”

SUICIDE RISK Assessment: 6 Steps to a Better Instrument, Brenda Hermes, Kathy Deakin, Kathy Lee, Sherry Robinson. Journal of Psychosocial Nursing & Mental Health Services. Jun 2009. Vol. 47, Iss. 6; p. 44-50

Abstract:

Recent research indicates that commonly used instruments to assess suicidal ideation identify patients at chronic risk for suicide but do not identify those who are at acute (imminent) risk for suicide while hospitalized. Items to measure anxiety and agitation, identified as more appropriate risk factors, should be incorporated into suicide risk assessments. The purpose of this article was to develop an evidence-based imminent suicide risk instrument for an inpatient psychiatric unit. The Iowa Model of Evidence-Based Practice to Promote Quality Care guided development. Two validated instruments, the Hamilton Anxiety Scale (to measure anxiety) and the Behavioral Activity Rating Scale (to measure agitation) were applied to 75 patients to help create an evidence-based instrument, which should more accurately identify hospitalized patients at risk for imminent suicide.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

What comes to mind when I say the word, “psychiatrist?”

I asked several people this question and answers ranged from “drugs” and “medications” to “a person who helps with psychiatric problems.” Absent from people’s responses was any mention of physical health care.

Persons with serious mental illness (SMI) have high rates of physical illness which often goes undiagnosed and untreated. They are less likely to report physical health problems. Due to the nature of mental illness, they may be suspicious of doctors or unable to clearly state their physical health care needs. Last, there are a host of physical problems that arise from using psychiatric drugs; including diabetes and metabolic syndrome.

If we are to reduce early mortality for persons with SMI, psychiatrists must play a key role in addressing the physical health needs of their patients.

Thresholds’ psychiatrists agree and will now be writing referrals for physical checkups on an annual or as needed basis for Thresholds members. They are also very willing to get on the phone and make an appointment for them.

The psychiatrists’ actions speak much louder than words about the importance of providing integrated healthcare services to persons with mental illness.

Thanks Docs!

198251     สุขภาพจิตและการพยาบาลจิตเวช I     Mental Health and Psychiatric Nursing I

แนวคิด หลักการและทฤษฎีการพยาบาลจิตเวช บทบาทหน้าที่ความรับผิดชอบของพยาบาลจิตเวช มโนมติเกี่ยวกับตนเอง ปัจจัยที่มีผลกระทบต่อสุขภาพ การใช้ตนเองเป็นเครื่องมือการบำบัด กระบวนการพยาบาล แนวทางในการช่วยเหลือและการสร้างสัมพันธภาพกับบุคคลที่มีปัญหาสุขภาพจิต ฝึกประสบการณ์การใช้กระบวนการพยาบาล ในการดูแลบุคคลที่มีปัญหาสุขภาพจิตและการปรับตัว

(Concepts, principles and theories of psychiatric nursing, roles and responsibilities of psychiatric nurses, self concept factors that has effect on health, self therapy, nursing process, guidance in helping and creating relationship with a person who has psychiatric problems, practice using nursing process in caring of the person who has psychiatric problems and adaptation.)

(198251 มหาวิทยาลัยเกษตรศาสตร์)

198352     สุขภาพจิตและการพยาบาลจิตเวช II     Mental Health and Psychiatric Nursing I

การดูแลบุคคลที่มีพฤติกรรมผิดปกติทางจิต การจำแนกโรคทางจิตเวช การบำบัดรักษาทางจิตเวช หลักการจิตเวชชุมชน แหล่งทรัพยากรในชุมชนเพื่อการส่งเสริมสุขภาพจิตการป้องกันโรคจิต โรคประสาท การรักษาและการฟื้นฟูสภาพ แนวทางการช่วยเหลือผู้ป่วยจิตเวชฉุกเฉิน

(Care of individuals or groups who have mental and emotional disorder; using nursing process in helping and curing individuals, families, and groups who have mental disorder focussing on rehabilitation.)

(198352 มหาวิทยาลัยเกษตรศาสตร์)

198353     สุขภาพจิตและการพยาบาลจิตเวช III     Mental Health and Psychiatric Nursing II

ฝึกประสบการณ์การใช้กระบวนการพยาบาลในการดูแลบุคคลที่มีพฤติกรรมผิดปกติทางจิต และจิตประสาททุกระยะ และการส่งต่อ

(Practices using the nursing process in providing care to and build up relationship with the person who has mental disorder, psychiatric therapy, work collaboratively with psychiatric staff, plan and implement or promote the work of community psychiatry.)

(198353 มหาวิทยาลัยเกษตรศาสตร์)

The contribution of active medication to combined treatments of psychotherapy and pharmacotherapy for adult depression: a meta-analysis , Acta Psychiatrica Scandinavica, 2009

P. Cuijpers, A. van Straten, S. D. Hollon, G. Andersson

Abstract:

Objective: Although there is sufficient evidence that combined treatments of psychotherapy and pharmacotherapy are more effective for depression in adults than each of the treatments alone, it remains unclear what the exact contribution of active medication is to the overall effects of combined treatments. This paper examines the contribution of active medication to combined psychotherapy and pharmacotherapy treatments.

Method: Meta-analysis of randomised controlled trials comparing the combination of psychotherapy and pharmacotherapy with the combination of psychotherapy and placebo.

Results: Sixteen identified studies involving 852 patients met our inclusion criteria. The standardised mean difference indicating the differences between the combination of psychotherapy and pharmacotherapy and the combination of psychotherapy and placebo was 0.25 (95% CI: 0.03–0.46), which corresponds to a numbers-needed-to-be-treated of 7.14. No significant differences between subgroups of studies were found.

Conclusion: Active medication has a small but significant contribution to the overall efficacy of combined treatments.

Lancashire Care staff can request the full-text of this paper, email: susan.jennings@lancashirecare.nhs.uk

Pra animar o povo que deve tá bem louco já na véspera de feriado e ansioso pelo fim do dia!

Via

Jeremy Swanson, a Canadian fathers movement leader believes he was unfairly denied contact over owning guns.

Quoted on Angiemedia,  Mr Swanson stated:

On Otwatta mens centre, is his version of his story on why he believes that he was withheld contact with the children:

Then this:

Jeremy Swanson can be found on Facebook wearing a military type outfit in a hostile pose.  He describes his obsession with props and roles associated with violence as “normal”.

Whilst the rest of the intelligence community catches on slowly, Britain has officially classified fathers rights groups as “domestic extremists”.   Below is an email  from Mr Swanson posted to an online fathers rights group:

Mr Swanson also appears to have a drinking problem:

3301688    การบริบาลทางเภสัชกรรมในโรคจิตเวช    Pharmaceutical Care in Psychiatric Disorders

เภสัชบำบัดในโรคจิตเวช การประเมิน ป้องกัน และแก้ปัญหาที่เกี่ยวข้องกับยา การติดตามการรักษาด้วยยาในโรคจิตเวช

()

(3301688 จุฬาลงกรณ์มหาวิทยาลัย)

Book Six — Chapter One Adam Returns to New York City, Punching A Clock, Hanging Out With Willie and Oliver, Electroshock

CONTENTS NEXT

Within a week of his visit to Norbert, Adam was once again getting used to the smells and sounds of Manhattan, He had a summer job as an attendant in the children’s ward at the New York State Psychiatric Institute. His first act was to get reestablished on 86th Street. Though Mechizedek might be in and out on weekdays, Adam was pretty much the sole occupant of the Panflick apartment. He settled in the room the twins had once occupied. It was large compared to the adjacent maid’s room Adam had occupied as a child. It had its own full bathroom. Air conditioning had been installed and Adam flipped various units off and on to establish comfort levels.

The Institute was by the Hudson at 168th Street, Adam had sold the Dodge, anticipating some years in the city. So he got to the Institute by taking a crosstown bus and then a subway uptown. It took up to an hour each way.

The head nurse on the ward was Louise Verme, crisp, affable, authoritative. Thirty-something and New York to the bone. Adam liked her. There was a balding, rotund younger assistant named Doroff. He was equally pleasant.

Adam had to punch a time clock when he came in and on leaving. He worked all manner of shifts. He took the elevator up to the children’s ward. The Institute was a teaching hospital. There were never more than 10 children on the ward at any one time.

Adam’s job was to relate to children as opportunities presented themselves. There were girl twins no one could relate to. They occupied a padded room. They spread feces on the wall. They did not speak. They were identical. Adam looked them in the eye and they looked back. But their expressions did not change.

Adam never knew the cases behind the kids. Adam related most to two boys. Willie, a normal-seeming eleven-year-old with a shock of black hair and a ready smile. And a more taciturn fellow named Oliver who was the same age. Adam could walk with Willie on Riverside Drive and talk back and forth with ease. Willie was hardly a Boyd, full of laughter. But he was cheerful enough and did not appear to be an obvious candidate for psychiatric study. Adam had no idea why he was there.

Oliver came from Staten Island and looked rather ageless. His face had an almost permanent questioning air as if he was asking, with a mixture of curiosity and fear, What is that? Adam was told he had a damnably high IQ. He seemed happy to be around Adam. Adam did very little talking. He was just there. Oliver would sometimes initiate things.

“What makes those cars run?”

“I don’t know,” Adam said. “What do you think makes them run?”

“Energy. Energy can kill you.” After such bits of dialog Oliver would clam up and go inside himself.

One day, Adam was asked to help hold down a patient who was receiving electroshock. He took the elevator to an adult floor. The man was wheeled into a room, already strapped down. Adam leaned heavily on the man’s shoulder. Other men tended to the rest of him. The current surged through. The man jolted big time. A little mouth foam. No sound. Then a body thud. Body limp.

“What does this do?” Adam asked.

“Calms ‘em out,” said one of the other men. “Makes ‘em easier to handle.”

There was a cafeteria. Adam ate with a young doctor and described his reading in Freud at Williams.

“You know a lot more Freud I ever will,” the young psychiatrist said.

The days passed quickly. By the end of the summer nothing had changed. The same children remained. Adam felt satisfied with his choice of a summer job. He gave thought to the idea of continuing similar work. He was reminded of how he felt at Parousia North, more or less on his own normal. Odd that a psychiatric hospital would give rise to that.

*

The summer also re-acclimated Adam to the solitude he associated with Manhattan. On the subway, on the bus, in the apartment, he was alone. He preferred it that way. He thought he lacked the personality to reach out much, to take initiative. He could do these things sometimes, but not all the time.

Things would become substantially more social in a short time. Seminary loomed. Union Theological Seminary was a few miles south of the Institute. adjacent to Barnard and Columbia. To Adam it would be entirely a new world.

CONTENTS NEXT

Twenty five years ago I walked out of a hypnotist’s office $40 poorer and a thousand ways richer. With the help of some guided imagery I had quit smoking.

The hypnotist suggested I drink a lot of cranberry juice in the next few days to clean the nicotine out of my system. I followed the advice and never picked up a cigarette again. I went from being a 4 pack a day smoker to becoming a much happier, healthier human being that afternoon.

Quitting smoking was possibly the best decision I ever made. I set and achieved an important life goal and, in the process, took a serious step toward improving my health and self-image. It was a very real turning point in my recovery from mental illness.

Depending on how you look at it, smoking can be a state of nirvana – a brief and beautiful vacation from the terrifying voices and images of schizophrenia – or a form of slow suicide. Maybe it’s something of both.

Regardless of how you view smoking, the reality is that it cuts life short – maybe 10 years short. And if we’re going to make any serious progress towards reducing early mortality for those with severe mental illness, smoking becomes the unavoidable issue.

This week I signed up for an on-line course in learning how to help others to quit smoking. The course, Basic Skills for Working with Smokers, is offered by the University of Massachusetts Medical School. You can learn more about it at http://www.umassmed.edu/tobacco/training/basicskills_online.aspx

Signing up for this course may not be the best decision I ever made…but it could be the second best!

When I was an undergraduate, I went through a period of being clinically depressed.  I met regularly with a Psychologist, and she helped me to understand what I was going through and how I could work on getting better.  Though it was a four-month period of my life that I hoped I would never have to re-live, it was also a time of great healing and self-discovery.  I almost cherish that time in my life because I was able to work through something that I thought would never end.  As a result, I have such empathy for people who experience depression or who are simply having a difficult time coping with the stressors of life.  It’s a difficult battle to fight.

This week, as I have been doing my Inpatient Psychiatric fieldwork, I have had many opportunities to reflect on that difficult period of my life.

Throughout the day we have several interactions with many different patients.  Typically, we first interact in a group with patients who are dealing with issues such as major depression or bipolar disorder or schizophrenia (to name a few).  Then we document what they did and what we saw.  Some of the documentation is narrative.  But most of it involves simply checking off a bunch of boxes.  Type of participation.  Type of affect.  Type of psychotic symptoms.  Amount of assistance given. After a few times of filling out these forms, I began to wonder.

What if I had gotten so depressed that I couldn’t function, and I had to come to a facility like this?  What if someone had filled out forms like these about me when I was depressed? I would really be reduced to a bunch of check boxes?  I would hate that!

Now I know what you may be thinking. They have the check boxes in order to standardize the forms and make them quicker to fill out, since healthcare staff always have so many forms to complete.

I understand that.

But it doesn’t change the fact that, if I was depressed and was staying at an Inpatient Psychiatric unit, and I was able to see the boxes that were checked off as a reflection of my group participation that day, it would make me feel weird.  I would feel like an animal in the zoo.  Or an experiment.

Maybe nobody has thought about psychiatric documentation like this before.  Maybe they have.  But I just found it very interesting how my personal experiences from the past were able to profoundly impact my visceral reaction to how OT’s document the performance of patients in psychiatric settings.

I suppose these are feelings that will shape my perception of many other things besides psychiatric documentation in the future.  But I at least hope that they will serve as a personal reminder that people are people – not boxes to be checked – no matter what they are going through.