The history of psychology, not unlike many other social and natural sciences, has gone through growing pains over the last hundred or so years. During this time, the theories of great men and women have been used both to define normal and abnormal and use those distinctions inappropriately.
For the purposes of this post, we start in 1952 and the release of the first Diagnostic and Statistical Manual of Mental Disorders (DSM-I) partially in response to the Sixth Edition of the International Statistical Classification of Disease (ICD-6) and also in response to a new understanding of the effects of social and personal distress on the internal concept of psyche following World War II. In fact, the structure of the DSM-I was structured in many similar ways to military classifications. Within the pages describing the 106 mental disorders was Sociopathic Personality Disturbance, a section describing individuals who are "ill primarily in terms of society and conformity with the prevailing cultural milieu, and not only in terms of personal discomfort and relations with other people" (DSM-I, p. 38, 1952). Among the handful of sociopathic disturbances was Sexual Deviation which included homosexuality, transvestism, pedophilia, fetishism, and sexual sadism (including rape, sexual assault, and mutilation).
It's important to note that, at the time, there need not be discomfort caused by any of the Sociopathic Disturbances (Antisocial Reaction, Dyssocial Reaction, Sexual Deviation, Addiction, and "Special Symptom Reactions") internally; instead, only the existence of the thought or behaviour would be enough for these diagnoses. It is also important to keep in mind that the majority scientific understanding revolved around a combination of competing and correlating systems, most predominantly psychodynamic and emerging neurobiological psychological theories. Overall, these were exceptionally useful ways of understanding mental illness at the time but were often in opposition to many day-to-day behaviours even in the 1950s and 60s. One aspect of that was the incongruence between homosexuality and psychodynamic principles. Sigmund Freud, largely considered the founder of this particular school of thought, and his contemporaries saw homosexuality as an immature sexuality founded in an inappropriate attachment or a psychosexual trauma in childhood which, additionally, went against the basic motivation of any species: reproduction.
The Diagnostic Manual also led to an explosion of treatment methodologies, as I'm sure you can imagine. Within the year there were hundreds of treatments being attempted at any given time and not enough work was being done to really dig in and study those methods. Unsurprisingly, this led to the beginning of a large (and ongoing) anti-psychiatry movement as dangerous treatments were being used largely without informed consent (not a requirement in research or medical practice until 1980), if at all voluntarily (using the concept of assumed consent: that an otherwise mentally competent person would consent to treatment).
One of the treatment approaches used to "help" those "suffering" from homosexuality was called Conversion (aka Reparative) Therapy. The early use of Conversion Therapy was messy because literally any idea was good as long as there was a plan and a theory to back it up. Some of these methods included using psychoactive drugs, electro-convulsive therapy, lobotomies, chemical castration, hormone treatments, spiritual counselling approaches, cognitive therapy, behavioural therapy (reconditioning or aversion treatments), or some combination of all or any of the above depending on the practitioner's skill (little or nothing to do with the clients' wants earlier on). To this day, almost none of the treatment methods used had any true effect; that is to say, a homosexual person who underwent aversive conditioning may not continue to want to follow through on his or her sexual attractions but this would be due to a phobic reaction from the aversive conditioning and not from a genuine desire for heterosexual sexual intimacy.
The good news: People revolted. By the 1960s, in conjunction with the anti-psychiatry movement, gay rights activists protested against the American Psychological Association with the help of published research authors to show that homosexuality is not, in fact, a mental illness. In 1974, in the Sixth Printing of the DSM-II (originally released in 1968), homosexuality was removed as a category of a disorder and replaced with the category of Sexual Orientation Disturbance.
This may still seem like an attack on homosexuality but the difference here is that a person must now be under some kind of clinical distress or impairment because of an anxiety caused by opposition between their perceived sexual orientation and their ideal self (later called ego-dystonic in the DSM-III).
So where does that leave us in 2018 (and why is this April's blog post)?
Back in February, the California state assembly introduced Bill 2943 related to unlawful business practices specifically targeting those who practice modern forms of Conversion Therapy, now called Reparative Therapy, which do not involve invasive practices and are fully consented by the client. Though there are certainly questions related to the efficacy of this therapeutic modality, to outlaw it does more harm to client rights than those of practitioners'. Further, this bill prohibits the use of therapies that seek to change sexual orientation for those under the age of 18 which is in complete disregard to the fact that youth under 18 are the ones who are most often seeking psychotherapy related to their sexuality/sexual orientation. To be a participant in this practice, even to assist with the anxiety related to sexuality, can be construed as harm against the client.
Let's use a hypothetical to illustrate: Let's say that I was referred a client who lives in California. Let's call her Sarah. She is 16 years of age, good family life, participates in extra-curricular activities, drinks socially, and is struggling with her sexuality. She wants to want to have a boyfriend and later a husband but she is currently attracted exclusively to her female peers. She feels more distracted in class and some of her grades have slipped while, in the pool, she has found her lifeguard training classes to be more difficult. The anxiety she feels is more than she can take and she has considered self-harm as a way to ground herself. I discuss with her four directions that we can go in therapy focusing on the anxiety and developing better distress tolerance and emotion regulation. Though she definitely wants those coping skills, she also wants to know more about her sexuality and how she can come to get what she truly wants (her current concept of her ideal self).
Though I am practicing out of Ontario I have to be mindful that my client is in California and anyone, including her parents, could misconstrue any plan developed with Sarah having to do with her sexuality as an affront to AB-2943 and I could face disciplinary action from the College of Registered Psychotherapists of Ontario if legal action is taken. That in mind, my client's wishes come first - ethically, professionally, and personally.
This is where practice and government run into a powerful impasse. Technically, we're both in the right! Conversion Therapy practices have rarely shown any true effect (some anecdotal evidence and a handful of clients who claim to be cured) and Reparative therapy is basically just a combination of other techniques (CBT, DBT, Psychodynamic, Attachment, etc.) used in a mix-and-match way according to the client needs and informed consent is required for any therapeutic process to be ethical and licit. By meeting the client's needs and using effective approaches and acknowledging the goals of treatment I am keeping my ethical standards in check.
Why write this blog post up only to come to such a conclusion? Essentially this law allows the California legislature to pander... actually mock... a valid constituency while also fueling an anti-psychiatry fire that is already fully lit (though oddly citing the APA in the script of the bill...).
For more information on the practice of psychotherapy as it relates to sex and sexuality please do not hesitate to contact Parker Psychotherapy for more details.
Services for those who have been victims of crime are constantly under some kind of distress. Whether it be the consistent underfunding for the services provided or the fact that they are very underused, there is a near-permanent concern that they could be cut from professional services funding at any time leaving the work of servicing victims to volunteers, already stretched organizations, and private practitioners like myself.
As it stands, victim's services programs are largely successful due to the work of a large volunteer task force managed by a handful of full-time or part-time staff. Renfrew County Victim's services is one such organization answering the call to assist when there has been a sudden death, homicide, suicide, abuse, property crime, fire, community disaster, and a long list of other scenarios where a person's life has suddenly changed. Connected to regional Victim's Services agencies is the Victim Quick Response Program which provides funding for victims of violent crime, such as homicide, domestic violence, and other emergency situations.
To help sustain funding for this service model the federal Conservatives under the leadership of then-party leader and Prime Minister Stephen Harper made a Victim Surcharge mandatory following the conviction of a crime. In the case of minor offences the offender would pay $100.00 while major offences would see the surcharge pushed to $200.00. Since its establishment in 1989, judges had some discretion over the amount of the fine and whether or not the fine would be levied depending on the income earning of an offender. The current Liberal government, headed by Justin Trudeau, is seeking to restore judiciary discretion.
The reason I am writing about this today has little to do with the political work conducted by the last two governments but instead focuses on the efforts of a handful of offenders who are questioning the constitutionality of the surcharge on the grounds that it is a cruel and unusual punishment or violation of their right to liberty and security of the person. To-date, the Supreme Court has upheld the surcharge as offenders may seek payment extensions allowing them to take as long as 99 years to pay.
The case brings up a few very important points on either side. The more visceral reaction to this case is that offenders really shouldn't get a say - which is, of course, ridiculous considering the style of justice system currently in place (which, I'll admit, needs an overhaul). If we truly uphold a restorative style of criminal justice - which focuses on the rehabilitation of offenders and the healing of victims - then the surcharge should have some manner of discretion made available by court justices. There also is the matter of demographic and statistical analysis of offenders to be considered. Lawyer Delmar Doucette brought forward 24 surcharge cases and the ones they used for the point included 12 offenders with mental illness; 6 aboriginal offenders; 5 who had suffered serious neglect and abuse as children; 18 currently struggle with addictions; and, 7 are homeless, with surcharges levied against them while their income ranges from $100 to $1,200 per month (Globe and Mail).
On the other hand, victim services must remain a priority. There already is a powerful mentality that the criminal justice system favours the comfort of those convicted over the healing of victims and this type of case, almost regardless of the outcome, will not quell that angst. As it already stands, spouses of domestic violence who leave their abuser often have to choose between levying all possible charges against their spouse or acquiring some income from their former spouse. If their spouse is imprisoned or indicted with serious offences that offender could lose their job or a portion of their income which only agitates the power struggle further.
Let us hope that the government, which has already proven itself to be soft on serious crimes, backs off and lets the courts do their best work and hope that it works out for all of those who are less fortunately, victim or perpetrator.
Extending from the brief post about the importance of Christian Unity, I wanted to drive home the importance of culture as it relates to the practice and perception of psychotherapy inspired by CBC's The Current episode found here.
There are two foundational concepts to this entry. First is understanding that our working definition of culture refers to the beliefs, ways of life, language, customs, expressions (art/music/literature), and behaviour of a particular group. The second is understanding that the conceptualization of mental illness is founded in behaviour in that the group in question has established a base practice of expression and that there are those who behave against that norm - literally, "abnormal behaviour". In order to diagnose a person with a mental illness, they must be behaving in ways that go against the norm usually caused by an underlying cognitive distortion (they aren't thinking properly and therefore they aren't acting properly). This is the entire focus of Cognitive Behavioural Therapy: change maladaptive behaviour by changing the maladaptive thoughts.
As you can already imagine, this can make the diagnostic and practical aspects of psychology (psychiatric and psychotherapeutic, respectively) extremely difficult and explains why a person has to be convinced that they are suffering before anything can be started, much less accomplished. Caucasian people, in particular, have this notion - generally speaking - that mental illness exists and that there are systems in place to assist once they are ready to seek and find treatment. In contrast, many cultures (ie. many Asian cultures) see depression, anxiety, and grief, especially, as being processes that need to simply be ignored ("swallow your bitterness"). There is also a deeper conceptualization of mental illness (in contrast to mental health) implying that there is something deeply wrong with you if those cognitive processes are occurring and admitting to such issues can create a sense of ostracization. Even the concept of emotional or cognitive vulnerability is taken in many cultures to be one of weakness.
And those are just from the clients' points of view. Few programs and even fewer practitioners really take the time to dig into these issues so they can be faced better when they are presented in the office. Despite what many believe, it's not as simple as accepting the client in a broad humanitarian perspective - an improper offshoot behaviour of Rogerian Humanism. Odds are, and I find this in my practice, that the individual does need some level of radical acceptance but it fails to recognize the necessitated level of introspection for effective counselling.
Okay, Dan, what do you mean by that? Call out the elephant in the room and work together to tailor unique care for that individual. I have dug into a wild amount of research on this specific topic and have come to the conclusion that colour-blind approaches, such as those called out in this episode of The Current, do not work because - despite what the social-left wants you to believe - individual, language, cultural, religious, and behavioural differences (just to name a few) matter deeply in the realm of practical psychology.
For example: Let's say a 37-year old Chinese-Canadian woman walks into your office and during your intake conversation you identify a strong accent, that she is a recent immigrant, that she brings with her a Catholic faith that she takes very seriously, symptoms of depression and anxiety, and that she was "orphaned" (her finger-quotes) shortly after birth. Where do you begin? What do you inquire about first?
The correct answer is: Her goals for treatment. Short of her saying that she doesn't know (which could happen), her goals will tell you what she wants inquired about first. Each of the surface points carry implications that most unacculturated therapists wouldn't understand making her goals that much more important in the process. In China, the Catholic Church is the most reviled of all religious sects and is difficult, if not impossible, to practice faithfully; her being orphaned is likely due to her being born a female in a time when or in a region where the One-Child Policy was not relaxed (natural disasters and parents being single-children, themselves, are relaxation components of the policy); her recent landing in Canada could have wide-spanning concerns; and, her symptoms of mental illness could literally mean nothing considering her cultural background.
Turns out, she's grieving her loss of culture and wants to be connected to a local Chinese cultural group in the area but doesn't know that her emotions and thoughts on that issue are related to what we call "Grief".
[This is part of the reason I have 25 symptoms (and an "Other" line) on my intake sheet. It's basically saying, "Here are my recent symptoms," but also inviting the, "Here's what I actually want to discuss."]
Now, given, that's an extreme example but reflects the importance of the practitioner's need for self-reflection - a behaviour that is required of practitioners but has been largely misinterpreted. In Canada, as a mosaic-Nation, we have macro-, micro-, and sub-cultures. A macro-culture can typically be defined as one of the dominant, if not the most dominant, of the practiced culture(s) in the region. It doesn't necessarily have to be practiced at all times but it is distinct from other cultures and is practiced autonomously with its own rules, regulations, norms, and alike. A micro-culture is typically defined by the distinct practices that take place inside the macro-culture(s) and moves autonomously as a result. A sub-culture is built in behind both of these forms. Equally distinct in terms of their behaviour, language, and norms, sub-cultures push the micro- and macro-cultures in many ways (ie. special interest political groups). In no way should a therapist be expected to know all of these concepts or who fits into what categories (that's in your capable hands sociologists, anthropologists, and politicians... well, two out of three) but there should be a stronger capacity to know how to indulge a client in the conversation about whether or not their cultural background matters and how to commit to a cultural appropriation (in contract to misappropriation).
Looking at the case of the 37-year-old Chinese Canadian woman, above, after identifying her goals for treatment I would have both her and I go back home and do research and see what is available in the area as a homework assignment and come back to the table and discuss what each identified option has to offer. In the 2016 Canada Census, 665 people in all of Renfrew County (approximately 102,000 people) identified themselves as being of Chinese ethnic origin (and that's actually an estimate extrapolated from acquired Census data) which automatically means that this will be no small task - well, that and when you do try to do a search you find out that Renfrew County probably has enough collective seating room in their Asian-inspired restaurants for all Asian-Canadians with room to spare.
BUT, at 402 Chamberlain Street in Pembroke and reachable at (613) 735-0368 you can find the Renfrew County Chinese Cultural Society. As the therapist, I would give them a shout myself and see what services they provide before sitting back down with my client.
And the same thing goes in other intrapersonal concepts in subcultures, too. Let's focus on this woman's Catholic faith for a moment. She is now able to practice her faith more freely than ever (unless she wants to hire someone under the Summer Jobs Grant) and so getting her in contact with the Diocese office may also be a wise decision, as would brushing up on your understanding of the connection between faith and mental health. Knowing the distinctions between denominations and faith practices inside the Christian faith and having a little bit of comparative theology is always useful (one good book here). In general, it would also be wise to help her improve her emotional vocabulary, emotion regulation, self-care, and distress tolerance, but her goals come first.
And this doesn't even dive into the micro-cultures, sub-cultures, and counter-cultures that have to do with forms of identity - such as gender and sexual, indigenous peoples, inter-culture languages, poverty, criminality, organizational/industrial, education, and alike that are consistently growing and persistently being advocated for and by those who are never caught-up on the issues or those who ignore the history of cultural competency in favour of what I typically deem as either pop- or fad-therapy (either/or because they aren't going to last without anchor points). You have to start at Mile Marker Zero: What are the sociological underpinnings inside the practice of mental health? and, What are the determinants of mental health?
If you don't start with these components you are guaranteed to fail.
It is both my personal and professional opinion that now is as good a time as any to completely overhaul the American Constitution as well as other constitutions and charters worldwide considering the level of ignorance that comes with the culture of entitlement that proceeds from it.
Ya, I know. Another ignorant Canadian pointing to the Right to Bear Arms saying that it has to be repealed. Well, yes and no. While it would be great to see the right repealed - especially as the British are your allies now - I was thinking more along the lines of making sure that anything other than hunting rifles and hand guns must stay at a gun range when not in use (and can only be used at the range, if that wasn't obvious).
The term used to describe the AR-15, and most other guns used in mass shootings, is assault rifle. Any speaker of the English language would say that you use hunting rifles to hunt so by any stretch of logic assault rifles are used to assault. Not sure where handguns would fit in that phrase, admittedly, but you get the image.
And the only thing Americans seem to love more than guns (and fast food) is the Right to own those guns (which, by the way, "bearing" arms doesn't necessarily mean you own them. Google it). Unfortunately when the American Constitution was written there was no concept of anything other than "Rights". By the time Canada made it's Charter in 1960 (the Charter as we know it know was made in 1982 and before 1960 we used variations of the British Charter even though we gained our independence in 1867. Google it) constitutional law had developed and we expanded the concepts of rights, freedoms, and privileges.
Rights are guaranteed by government in some way, shape, or form; Freedoms are opportunities to exercise your rights; and, Privileges are conditional opportunities granted under specific circumstances (typically provided as long as you are obeying the law). For example, in Canada we have more-or-less free health care (paid for in taxes and through expenses not covered by provincial health insurance) but that is only a privilege. The government can limit access and even change the cost of health care without a true referendum. Freedoms of speech, religion, and alike are guaranteed but the government may justify - with the support of the Supreme Court - to limit or restrain certain activities if they impede on others' rights. The government may also restrict or limit activities listed as "rights" even though they are guaranteed in the Charter (or Constitution [USA]) under justifiable circumstances (like, I dunno, using guns to kill people).
It's important to understand these distinctions in order to limit emotional dysfunction around these concepts. For example, people become enraged when the prospect of restricting abortion arises. Abortion is tied to health care and is therefore subject to limitations (that, and if you actually read the R. vs Morgentaler SCC ruling the court has an ongoing request of the government to set limitations on abortion). In the US, although there are hundreds of examples justifying the limit of the sale and access of guns the government won't do it because 2nd Amendment supporters will go crazy (people will likely and ironically be shot).
And this is an ongoing problem as part of the cycle of violence. There is a gross ignorance - somehow in 2018 (I hate using the number of times the earth has rotated around the Sun as a reason for something to have happened, but here we go) of the cycles that keep violence occurring in our society. I still say that Emile Durkheim's (French sociologist) concept of anomie explains it best. As we become assimilated into a culture, or aspects thereof, we lose our sense of responsibility for our fellow man. If I assimilate the concept of the universality of accessibility to weapons of violence in a culture that accepts violence under certain circumstances, assuming it to be correct, then I can also lose responsibility for my actions and act against those around me. I don't need to justify my actions because you cannot judge me.
Think about the cycle of domestic violence as an example: Tension -> Violence -> Honeymoon all circling denial. As long as I stay under the radar I can act out whenever I want and nothing has to change.
In doing some fairly informal research on this topic as part of this post I learned that this issue goes WAY back...
Many people may be surprised to know that there have been large schisms taking place in the Christian community basically since its institution nearly 2000 years ago (subtract the time it took for Christianity to actually be practiced legally in the Roman Empire); hence, the various councils that have taken place since (first being the First Council of Nicea in 325 AD). The largest and most relevant to today's post occurred in 1517 with Martin Luther and the Protestant Reformation, a revolution that led to tens of thousands of Christian sects forming ever since.
The practice of counselling has been around even longer. Hippocrates, (460-370 AD) ancient Greek physician known today through the Hippocratic Oath, wrote several times about treating what we would now call anxiety and depression. The Greek philosophical traditions of Stoicism and Epicureanism were developed in direct response to anxia corda (anxiety of the heart). In the Bible we see many expressions of what could be called sustained periods of anguish (Job 3:10: narrowness of spirit).
I would like to take this moment to thank the Ontario Association of Social Workers for completing their 10 year goal of making it EVEN HARDER TO DISTINGUISH BETWEEN OUR PROFESSIONS.
I do not enjoy using my blog as a platform to complain; in fact, I recently started my old blog back up for that reason, but this is a HUGE issue that the general public has an incredibly difficult time understanding as it is and all for - what I can only assume anyway - to be able to garner more billing and/or reimbursement from insurance companies.
So, to provide context: Starting back in 2007-ish the OASW embarked on their mission to grant Social Workers who have completed the "proper" education and training - specifically in mental health counselling - the title of "Psychotherapist". At the time this was a venture worth pursuing. At the time, social workers were heavily involved in assisting with the treatment of mental illness and there were hundreds of opportunities for education specifically to become a therapist: A person capable of not just assisting in the treatment plan but also formulating - with their clients - treatment plans, identifying and assessing specific symptoms (still without diagnosis), and other activities that folks like myself do on a regular basis.
The necessity for the OASW's work was extinguished when the College of Registered Psychotherapists of Ontario stepped into the picture. This new governing body was established for the specific purpose of identifying, regulating, and accrediting educational programs that were producing practitioners in the then-unregulated profession of psychotherapy. The College has the legislative power to entrust the title of Psychotherapist (Registered or otherwise) onto its members in practice according to their training either in formal education (Master's degree programs) or informal education (non-diploma trainings).
Apparently the OASW didn't get the memo.
I want to draw a few necessary distinctions here and now:
Psychiatrist: A medical doctor who has completed their residency training in psychiatry - the medical field of psychology - and who is capable of diagnosing mental illness and prescribing medication. Psychiatrists often inform treatment planning and assist psychologists and psychotherapists in their practice depending on their practice area (many work in hospitals).
Psychologist: An individual who has completed their Doctorate - either a Doctor of Philosophy (Ph. D) or Doctor of Psychology (Psy. D) - in Psychology or Psychology-related fields (ie. Counselling Psychology). Psychologists can assess and diagnose mental illness but generally practice psychotherapy at the highest level.
Psychotherapist: An individual who has completed their Master's Degree (or higher) in a mental health counselling-related field. Psychotherapists perform assessments and treat cognitive, emotional, or behavioural disturbances through a combination of specialized techniques in conjunction with the building therapeutic relationship. No diagnosis or prescriptions can be provided by a psychotherapist. Psychotherapists employ various techniques in order to freely engage exploration and expression of presenting problems. (Definitions provided by College of Registered Psychotherapists of Ontario and Ontario Association of Consultants, Counsellors, Psychometrists, and Psychotherapists)
Social Worker: An individual who collaborates with their clients and those within the client's circle of care to address challenges through the process of assessment, diagnosis, treatment, and evaluation as social support in order to help clients achieve psychosocial functioning. With various specific training a Social Worker can do many of the activities of a Psychotherapist however the title is (or was) reserved for those with formal education in counselling and/or psychology fields. Social Workers hold either a Baccalaureate or Master's Degree in Social Work. (Definition provided by the Ontario College of Social Workers and Social Service Workers (OCSWSSW))
Social Service Worker: An individual who assists clients in dealing with personal and social problems by delivering counselling, community services, and social support programs. These professionals hold a specialized post-secondary diploma or degree (depending on region where education was completed). (Definition provided by OCSWSSW)
Counsellor: An individual whose practice involves informing, advising, guiding and educating clients in various settings and in concordance to their training. There is currently a series of task forces studying the specific role and education of the profession and practice of Counsellor in order to improve the regulated title.
I completed my Master's program with many Social Workers (those who had completed their BSW programs and/or were members of the OCSWSSW) who then carried that title into their practice as Registered Social Worker (RSW) and Registered Psychotherapist (RP) as they were qualified members of both. However, the landmark conclusion made on the behalf of the OASW reopens the debate into the use and scope of these regulated titles in a way that is bothersome, if not insulting, to those of us currently in the field AND carries the added bonus of making things difficult for consumers.
The provinces of Ontario (Oct 2017) and Quebec (Dec 2017) have made their opening pledges to invest in their respective province's mental health infrastructure. Ontario pledged about $73 million over 3 years and Quebec has started the ball rolling with $35 million but what does that mean for you?
At this point the short answer is: Not a whole lot - as many of my readers may suspect right off the bat. The $73 million in Ontario has already been earmarked for use in the province's 4 largest community-based mental health providers - Centre for Addiction and Mental Health (CAMH), Waypoint Centre for Mental Health Care, Ontario Shores Centre for Mental Health Sciences, and the Royal Ottawa Health Care Group. CAMH will also be receiving almost $633 million as part of an expansion to their campus which is basically a nearly-self-sustaining village designed to promote mental wellness.
As for the Quebec government, they have some work to do yet. As of right now there is no governing body for psychotherapists (Ontario has the College of Registered Psychotherapists) which means practicing psychotherapy in the province is (potentially dangerously) unregulated. To that end, Quebec is planning on building a governing body and then forming policies and procedures around the prospect of government-billing for practitioners. The statement was brief so I have no intentions pf extrapolating beyond that point.
My light-hearted pessimism aside this is a great time to be in need of mental health services. The pushes being made by the government highlight a very real need across the country even if they continue to show a lack of understanding of need on their part.
While we wait for something tangible to happen on the part of the regional governments here's what I am asking you - as a current or potential consumer of mental health services - to do:
Check your insurance coverage (if you have any) and see if Registered Psychotherapists (RPs) are covered. If so, ask for a receipt from your therapist and process your reimbursement accordingly.
If you do not have coverage:
I spend more time than any person ever should on social media and that includes seeing 'Suggested Pages' and their respective posts. From time to time I will read the comments and see what people are saying about the page and the post.
Most of the time, I am disturbed by what I read. Best example is reading through the posts on a suggested page called Parachute Canada - now listed in the Helpful Links page - where I discovered that, even with clear and decisive evidence available, ignorance is alive and well.
Parachute Canada is an organization that provides education and resources to the public regarding concussion and other neurological traumas. They recently released guidelines regarding concussion in sport and an app called Concussion Ed which is used to help promote their goal of injury prevention. The post on Facebook was one of a series of 4 images referencing their steps for Return to Play once it has been recognized that there may be a concussion. The comments section was filled with people who were spattering on about how you can just "walk it off" and that organizations need to stop enabling "umbrella parenting" (on the PG side of the discussion).
Let's start with what a concussion is and is not:
IS: A contre-coup injury that occurs when the brain moves within the skull. There is fluid surrounding the brain to make simple and even agile movement possible but a sudden jolt - like something falling on your head, being checked against the boards, and falling the wrong way on a field - can be dangerous. Mild damage cannot be seen on an MRI, CT, or x-ray while the more severe may be picked up because of structural damage.
IS NOT: Something to be ignored even one time. Symptoms of a concussion are extremely broad and do not always appear right away.
What Parachute Canada, and similar organizations, are trying to do is help teach parents, kids, coaches, and the population at large how to better approach a concussion. One thing I have noticed is that young people are not being taught how to make a clean hit, take a hit (of any kind), or how to fall. Back when I played soccer as a child my coaches spent several practices on how to brace for a fall so that your shoulders, neck, and head were less likely to be in danger. The same thing used to happen much more often than it does today. I know that very few coaches do those types of practices at schools - which in my mind is even more absurd than elsewhere considering the clear impact on the quality of the students' learning.
As the infographic above shows the symptoms of a concussion include emotional/psychological/cognitive issues. Again, these are not to be taken lightly. Parker Psychotherapy does work with victims of traumatic brain injuries, including mild to severe concussion symptoms, and can help assess post-concussion symptoms.
So for anyone reading this blog post this is my recommendation, which has been made based on the scientific and medical evidence presented by not-for-profit organizations, the various levels of government, and in the classroom (undergraduate and graduate level):
For parents of young children (0-6): Learn prevention and intervention basics ASAP. Parachute Canada provides short 'courses' on the topic of injury prevention for this age group here and provides these guidelines about Return to Play and Return to Learning protocols if a concussion is suspected. Parachute's resources page contains other prevention information over and above sport if you are interested.
For parents of older children (6 to teen): Same as above plus talk with your children about their comfort level after a fall more closely. As their vocabulary increases they are able to tell you more clearly if something is wrong. If they say that they don't feel well, follow the above linked protocol. Don't challenge them to get back on the field. Tip sheets for most sports as well as for the prevention of other injuries can be found on Parachute's resource page.
Coaches and Teachers: Should go to Parachute Canada's resources page and get familiar with the material. You could save a life. As a group, you may also want to go to Parachute Canada's e-Learning portal and take a course to help improve your ability to assess and intervene on top of improving your awareness.
Have fun. Responsibly.
Any links and information presented above are Copyright Parachute Canada 2013.
Back in 2002 - I want to say - I was lucky enough to be introduced to Linkin Park. First song I remember hearing from the band was "Crawling" from their Hybrid Theory album (released in Oct 2000) and I was immediately addicted. The primal sound combined with emotional lyrics pulled me in and I couldn't wait to hear more of what these guys had to offer.
If you are only really hearing about Linkin Park since the loss of Chester Bennington then you really missed out, sorry to say. The history of the band is one of my favourite points of trivia. Linkin Park started off as a fairly random collaboration of musicians under the name "Xero" which fell apart when they couldn't get signed on to a record label. On the recommendation of Jeff Blue - then-VP of Zomba Music - Xero recruited Chester who was the former vocalist for "Grey Daze". Suffice to say, Jeff nailed it. Mike Shinoda - an exceptionally talented musician in his own right - and Chester combined to create an extraordinary new sound and using the talents of Joe Hahn (turntables), Rob Bourdon (drums), Dave Farrell (bass), and Brad Delson (lead guitar) the newly formed Linkin Park would become one of the most successful bands of all time.
One of the things I believe led to their overall success was their ability to experiment with and recreate their music. Following the success of Hybrid Theory in 2000 - which on its own contained some great mixes - LP teamed up with various other artists in 2002 to release Reanimation which reimagined the original cut of Hybrid Theory and was almost as successful even without the ability to grab radio air time.
Which brings me to the point of this post. One of the things I have noticed is that we love to hate celebrities. This group of people are seen as the fortunate - or downright lucky - as they make a living off of our entertainment although many times I would heartily disagree with that assessment.
One example of that disagreement would be what happened with Bennington. He was well known to have lived a tumultuous life. He was abused as a child, was bullied as a kid as he - not unlike his adult frame - was skinny and small, was a heavy user of drugs and alcohol, and recently lost a friend and mentor in Chris Cornell (Soundgarden) just a few months ago - also to suicide. Over the last few years he was on a notable upswing after appearing to be in a successful relationship, having sworn off alcohol (left the drugs behind many years earlier), and with the band having just released a new album.
The fans, though, were stuck in the past.
As I mentioned, I have been a fan of Linkin Park's work since about 2002 (maybe even sooner) and I love watching them evolve. Many "fans" disagree. In my mind, if an artist or band isn't going to evolve then they don't release a new album or don't release a new album with any kind of regularity. Linkin Park released 7 albums over a period of 17 years not including Reanimation (various artists) and Collision Course (Jay-Z). Fans know that each album will bring change and yet, as this video shows, "fans" continue to be caught off guard. What really bothers me, as a fan and as a professional, the lyrics for "Heavy" are a clear sign that something isn't right in the writers' world(s) - a thought reinforced in a February 2017 interview. And yet, a paying "fan" through something (looks like a plastic container) at Chester during the show (back to the video in the link a few lines above).
Over 100 celebrities have committed suicide (intentional means of taking one's own life) since 2000. Some dozens more have died from accidental overdoses of various drugs or combinations of various drugs. Clearly, they still hadn't found what they were looking for (paraphrase intended) - and in many cases, the entertained (as opposed to adoring) public didn't help.
Everyone should be taking a step back when another light goes out (paraphrase intended, again) and re-evaluate their actions, motivations, perceptions, values, and sense of meaning (spirituality) and, if need be, find someone who will help in that evaluation. Can we honestly say that we seek the best of and for other people? What do we expect of ourselves and those around us? Are we giving others and ourselves the room to grow? Do we live compassionately or commandingly? Do I use my words to help or to hurt?
And, do you recognize the meaning of this new logo?
Just a way to get a few thoughts across outside of the office. In this blog you may even find entries that assist in your healing without needing a session