Preparing for Specialist

     I am in the process of writing my final paper and then I have one more process using tapes and editing and summary.   After that it is all the preparation of endoresements etc....I would call that networking, photocopying in abundance and conducting quite a bit of searches.  So I am in the end.
     It has been a long five years of study, internships and counselling.  It is nice to get another chapter in life done to go into the next chapter where there is new growth, opportunities and professional develpments.  I have read galore, I have thought galore, I have written galore and I have and still question galore.  I even wrote one book in there purely for fun which was not considered too amusing by some in my circles of education.  But, I shall continue to write as I please because we eventually all do need to be ourselves.  If I want to write about dating satire, or a book based on facts or about a  serial killer, I shall.  That is fun for me.
     When I was in high school, a very young new teacher took an interest in me in my English class.  She enjoyed my stories.  She said I reminded her of the works of Edgar Poe.  I was shocked and thought that perhaps she confused my paper with someone else.  Actually, I did not think that at all, however, I knew I was no Poe.  I have always enjoyed English as a topic I could play with and relax, yet I never took it too serious as a subject.  That teacher taught me that I did not have to read to fulfill a subject requirement, but to read for the pleasure of reading. 
    I realize that I have quite a pile of books sitting on a kitchen platform which I normally pick from to read a bit from with my highlighter and sticky things ready to insert.  Mostly it something which has to do with my work.  I have a Bible in there to try to anaylize more than inspire me, I am afraid.  I also have a journal if I feel like writing.  On top of all that is a Dean Koonz book I just added.  When I read too much of the heavy stuff, I want to read something for fun.  It was that young teacher who inspired that during a time when teachers did not do too much for me at all.  I normally butted heads with them.
     In University I continued in my undergrad to take an English course for fun when I became too consumed with psychology.  I think what all this did for me was give me the balance that I need.   So I shall continue to write what I want which I think is quite mild.  "Hey Guy Buy Me" was fun to write.  I think it is cute.  I have had interesting feedback and in one case I had to report to the Police because I became concerned with one reader's reaction.  That reaction got under control very fast.  What I also learned from writing one book how diverse the reaction can be.  I do not know why I was so surprised.  I do counselling.  I realize that we look at life with different lens.  What I may write quite innocently and naively about may have an impact.  So be it.  I have been writing stories since I was a child in the kitchen and I would read them out to my mom who loved and encouraged them all.  So, I shall upon completion of this Specialist process get back to my second book which I think is deep before I  continue with the Serial Killer.
     So today and this weekend, why not take the time to examine what your work does for you and what do your hobbies do for you?  Are you encouraged to express yourself as you like and feel or are you hindered?  Do you feel satisfied at work?  If not, why are you stuck in that place?   What can you do to grow?  Do you feel the need  to do or live differently than you do.  Why not begin to record how you feel when you are at work, at home, at play?  What are the differences.  How can you balance your life more?  Have a wonderful weekend.  Thank you for reading my blog.  I appreciate it and value the comments I have received (to date).  Why not begin to be true to yourself?  What do you think?    

Everyone has an opinion.

     One day when I was rushing off to a meeting, I asked a professor who was walking past me if he was going to the same meeting.  He replied,"No.  Everyone has an opinion!"   I laughed it off, chuckling how right he was.  It appears nowadays that everyone has meetings and then sub-meetings and then more meetings about the same thing.  Everyone does have an opinion and often it clashes with someone opposing it.  So who is right?  Is there a right and wrong way of thinking?  How does one know, if one is off track?  Look at politics, religion and views about sex.  Are these three little words not something that people are often informed at important social gatherings not to discuss because it may cause disturbances?  I like breaking rules and so I always talk about what I like, because I believe in democracy.  I would have already been killed in some countries where men with big egos and very little else run rampant silencing those much smarter than they could dream of being.  I am not going to even mention the Taliban.  I shall leave that for another time.  Please leave my head intact, sir.  Me needs it, me thinks.  Anyhow, I suppose I am a bit annoyed because there is an opinion and then there is an informed opinion.  I had a young woman once remark that a psychotherapist from the States had made an opinion about what she thought  regarding an issue in her field. This young woman without any training whatsoever stood firm in her uninformed opinion about something that actually is common knowledge but not known to her because of her lack of training.  I was amazed and stunned, into silence.  It was not because she did not know.  That is always forgiving.  We cannot know everything because there is just toooooo much.  Something as simple as one and one, is two, became three to her.  Her argument simply an anology which did not apply to her.
      Sometimes people become more bold and think they know the answers to people's problems and it is no laughing matter.  They demean others giving them diagnostic labels and telling them how they can be cured.  I have a low tolerance for such labels and the damage it does when not diagnosed by one with the proper training.  In my undergrad, I learned in Personality Psychology that it was called "naive psychology".
     I was annoyed by someone who told me that homosexuality is wrong and that I as a Catholic should "cure" them.  I replied that I was raised in a homophobic home, and understood her "phobia" (I did not call it that).  I also knew that it was removed from the DSM because of pressure from the gay community (she referred to a psychotherapist from the States using that as an example that homosexuality is wrong) which surprised me because that would be unethical here (bashing that is).  I informed her that I attended a workshop for counselling gay people in the Catholic Church and they are to be treated with respect (like anyone else) according to the Catechism. They also have masses for the gay community at Our Lady of Lourdes.   I also continued that there are difference due to research and continued that gay men as women use both sides of the brain in the same way.  I am no expert in homosexuality and have no interest in specializing.  I enjoy counselling everyone regardless of the issue.  I enjoy helping all people and keeping up with the data to help them.  Initially, I thought I would not counsel drug addicts, nor pedophiles but I have changed my mind.  Keep in mind that I have a duty to report.   After my studies and because I am worth it,  I will be more restrictive with probono or sliding scales.  I too need to pay off student debt, etc.....   Am I venting today?
     Last night I had a dear friend bring me an art piece and then he informed me how the clients will see it because he wanted me to hang it on my office wall.  What he was doing is called "projection".  Because he viewed his piece of art as brokenous and a hope for a better future, he believed that clients would see it as such, and that I should inform them as such.  As he spoke, I began to see his art as depressing and told him that I would hang it up for a while and depending on any feedback I receive remove it if it caused a negative result.  I was annoyed once again that someone had the adaucity to even suggest what I should say to any client.  Even though I respect this man, he is not a therapist.   He placed it on my mantel and asked me to just look at it.  This morning I was eating a blueberry toasted bagel before going off to start a day and I looked up at the mantel and remembered his painting as it stared back at me.  What I saw was a tired looking cabin (which I would live in by the ocean) surrounded by trees and flowers.  The flowers were bright in colour and as I continued to look at the picture more carefully with my untrained eye,  I thought of the contrast of nature which is so beautiful even in its chaos than anything we can build.  I saw God vs man.  I saw love and beauty.  I saw no brokenous.  I cringe when I hear that a person is broken, by someone who has no idea what that means.  We live in a world full of wars (I was told in a social science class once that there were 22 in any given time), full of poverty, full of extemes.  I also believe that we don't have to live this way, though my remedy may not be considered very social.  After all, that is my uninformed opinion in areas I know not too much about.  But what the heck.  Who am I to be different than anyone else?  What do you think?  And for people out there, MYOB.            

Couple therapy

Couple therapy can be started at any time, even before commiting to a long term relationship.  Our family of origin has a great influence on our persona and we bring it into our relationships.  One thing that often happens is that there is an expectation that our partner is an extension of ourselves.  In realtiy there are two different people with two different backgrounds and sometimes the unmet needs from the family of origin is looked for in the mate.  The good and bad qualities of our parents is what we also connect with in our partners.  That is why you feel you have known your partner all your life.  It is those qualities that you have known all your life from your parents or caregivers. 
     In couple therapy what is worked on is the relationship.  It is diffusing the emotions that arrise that prevents one partner from really listening to the other.  Helping the couple listen to the other and focusing on the other give each a new perspective of their partner.  All too often it is assumed how one is supposed to be.  When the other person does not behave the way one feels the other is supposed to behave, there is friction.   One partner does not need to be bad or good, but just different from the assumptions that have develped. 
     This is just touching the surface of couple therapy.  What is required is a commitment of a few months because often time the therapy is difficult because it does trigger emotions that are difficult to deal with.  All too often, one party thinks it is the other party that is at fault and thinks there is no need for self awareness.  "It is not me with the problem, it is her."  Remember that couple therapy is about the therapy of the relationship. Each partner has his/her own perspective of what is happening that does not necessarily be on par with the other.
     Many think that two people are required for the couple therapy but that is not so.  One person may attend alone for couple therapy especially when the other partner does not want to participate.  Therapy changes the dynamics of the relationship.  We need to remember that we cannot force others to change but we can certainly work on ourselves.  How?  By examining ourselves and our relationships, by examining our family of origin and how we are connected to it now and by stepping outside of ourselves and taking another look at ourselves with perhaps a fresh perspective.  It may be a time to re-think our situation.  It may be a time to change a behaviour.  It may be a time to step outside our box and look inside to examine why we do the things we do, why we are unhappy etc......Maybe it is just time!  What do you think?

Fetal Alcohol Synrome cont.......

 Fetal Alcohol Syndrome  (FAS)  continued     Psychology notes

In my last notes, I indicated I was to continue with Animal Models:  However I have decided to skip that part of my notes.  Many people are offended by the research used with animals.  I will record the notes of a case study from a Canadian Film we watched in class.  I am so sorry that I do not have more info than the boy’s name is David.  I think it is important to know how terrible the effects of alcohol can have on the baby and what can happen when that baby grows up.  

Fetal Alcohol Syndrome   -  David with FAS is 21 years old (when this was filmed)

- no internal clock.  David can sleep 24 hours and still need more sleep.  He is not tired or lazy.

David gets up, puts on his clean clothes and shower and shaves.  He works on time, eats well and receives emotional support.  He is depressed and suicidal.  Recreationally, he enjoys movies and playing pool.  He thinks he would be dead if his care giver wasn’t there.

------------------------

Information goes  into brain, retrieved, sorting is different.  Making sense out of life is different.

Alcohol concentrates on the developing brain “Hangover lasts a life time” can disrupt migration –smaller, full of holes.  When mother wasn’t drinking, brain tried to catch up causing this.  It is in a negative state.

---------------------------------------

Parent may re-enforce negativity referring to his child as stupid or lazy because he does not know his son’s condition.  Social stigma is depicted. 

In David’s case, his mom is a social worker who adopted him.  David’s brain has been damaged.  MRI looks like swiss cheese- different- delays, years behind.  He could not organize himself without coaching and therefore it was heartbreaking for him.  His father thought there was a lack of effort and now believes he was abusive and feels guilt.  It is hard for him to be in a relationship with his son.  He is still needed as a dad.

David was “born an alcoholic”.  It was not a choice for him.  It is not easy for a sibling.  The sibling deals with this by withdrawing.

There is a loss of human potential.

              Effects of Ethanol on the Brain

-Reduced whole brain weight.

-  Reduced neural proliferation or cell loss:

   . Neo cortex – evidence in animals – may be reduction of neurons

   .  Hippocampus – behaviorally and anatomically

   .  Cerebellum (purkinje cells)

   .   Impaired migration

   .   Impaired or abnormal axon growth

       

Anatomical effects of Ethanol in hippocampus (summarized in Uecker and Nadel)

    - reduced number of CA1 pyramidal cells (correlated with behavior)

    - abnormal morphology of  CAI pyramidal cells

    -  mossy fibre pathway hypertrophy (input from dentrate gyrus to body of the hippocampus

Behavioral Effects of Ethanol

- Morris maze performance

- third trimester model

- binge vs uniform vs control (more effect than amount of alcohol, throughout the days spread out.

Cerebellar effects

- reduced cerebella size

-reduced numbers of Purkinje and granule cells

EFFECTS IN INFANCY

“jittery babies”

poor Braselton scores (extensive test looks at broader things)

delayed reflex and motor development

poor habituation (repetitive pattern of stimulation) eg. sucking

Long term outcomes of FAS

1)  sensory development (hearing problems, middle ear infections).

2) Intelligence

           - Streisguth (1991)

                    . 61 FAS cases – mean IQ = 64

            - Aronson(1985)

               . children of alcoholics > 15 points below normal

31 visual  -  spatial and spatial memory problems (Uecker & Nadel)

  Some important notes: Were the studies conducted well or not?  Did they control the groups?

Attentional and Behavioral problems  

Early childhood

  . hyperactivity

  . impulsiveness

Adolescence and early adulthood

   . less hyperactive,  more distractible

   . social control problems (such as with David)

Prospective Studies

    Are there effects of moderate drinking?

    . Comparison of 6 prospective studies using the Bayley scale – no consistent effect

    .  some evidence of modest effects on attention in children

CONCLUSIONS

Are there direct effects on the brain?  - Yes, provided it is in high doses, critical periods of brain development.  Probably has a long critical period.

 Are they dose related? -  Yes

Is there a critical period?  - Probably multiple critical periods.

Are there genetic differences in susceptibility? – Yes (at least in animals).

Is there a threshold?  Not yet clear (at least not when I was taking these notes)

When I write about the brain again it will be about the effects of mercury. 

Fetal Alchohol Syndrome CONT....psychology notes

 Fetal Alcohol Syndrome  (FAS)  continued     Psychology notes

 Brain anomalies

. neuroglial heterotopias (3/4 cases) [migration problem, when migrated up didn’t stop at the right place.

. underdeveloped cerebellum (4/4 cases)

. ectopic neurons in white matter (lost on way)

. agenesis of corpus callosum (also seen in imaging studies)[split brain – usually cognitive problems

This was in severe alcoholics – gallon of wine or case of beer.

Central Nervous System effects of ethanol (has quite wide spread effects in the brain)

.GABA system

.Dopamine system

.Opioid mechanisms

Alcohol Facts

.absorption of Ethanol:

-thru stomache wall (30%)

-thru small intestine (70%)

                  Breakdown of Ethanol (thru liver)

Ethanol …….>   acetaldehyde…………..>

        Breaks down to acetate

    Probably more toxic than Ethanol

Absorb alcohol -  crosses placenta if more on mom’s side will cross to fetus and is there longer and not broken down as efficiently.

Blood  alcohol level (BAL)

0.5 oz absolute alcohol (AA) in 130 lb person.

.043 g/100 ml

Legal limit for driving 0.08 – 0.10

0.5 oz AA= 1 beer, 4 oz of wine, 1 oz liquor

Question about fetal alcohol exposure -  Are there behavioral consequences?

Is there a threshold?   A line above which is effect and below no effect.  Low dose no effect and more as increase an amount or has an effect and gets smaller and smaller.

Does the pattern of drinking matter? Eg. 3 ½ of alcohol – 1 drink a day or no drinks until Saturday night and have 7 drinks - Same effect?

      Is there a critical period for FAS- Yes, multiple critical periods face early embryological growth, later gestation

Is there a genetic component?  Not everyone who drinks in pregnancy or alcohol produced a child with FAS.  Why some yes and why not?

What is the role of nutrition?  Mothers drinking to access and most calories from alchohol—note don’t see face amolities in malnutrition.   Can’t absolutely rule out nutrition.  Is alcohol really the culprit?  Some anti-convulsives also cause facial dysmorphology.  fore Also, alcohol goes with other things eg. alcohol/cigarettes/drugs/prescription or illicit and might not volunteer information.  Less likely to admit therefore need animal studies so can control exposure.

Is rehabilitation possible?  Maybe not in extreme cases.  Children from early study environment did not reverse it or cause it.

Genetic, Individual differences

4 % of alcohol – dependent women have affected (FAS/FAE) children.

Study of  twins (Streissguth):

-monozygotic twins : both affected 5/5

-dizygotic twins: bothaffected 7/11

Critical Periods?

-Facial features

-growth retardation

-CNS effects (mid gestational to second half, maybe even later.

(early embryonic period 4 ½ to 7, 8, wks, may go longer.  All the way through gestation there is a risk.

To be continued with Animal Models

My day at Fenelon Falls. Where can I find home town hospitality out of the city? Does it exist?

 
  I am used to people bashing Toronto.  Sometimes, it even hits the news.  People from towns love to criticize Toronto shamelessly.  Toronto this and Toronto that.  I always hear about that "home town hospitality."  Yesterday, I questioned if it exists to out of towners?  Is there a select group of home town hospitality for people who have lived in the town for a hundred years?  What is home town hospitality?  I found it in New York.  I find it in Toronto.  I even found it in the cities of Europe.  But, I have yet to find this "home town hospitality" in the towns.  Actually, I have found Port Perry to be very nice and friendly.  Now that my car has become unreliable, I sample bus trips and so yesterday I did just that with a senior community centre near where I live.  I have come to know the people there fairly well and some of them are quite elderly.  They are enjoying their senior years.  They are active, some are very frail and have chronic diseases but one thing I notice that they all have in common is love of life.  The centre keeps them strong and alive.  Take the latter any way you wish.
      I know that I am not the most patient person.  I have mentioned that on occasion but yesterday, my day off to relax in the country and take a nice cruise did not relax me as much as I had hoped.  It started off well.
     Yesterday we went to Fenelon Falls.  I have been there before and felt that cottagy feel I miss from my childhood days when as a family we would rent a cottage for two weeks every years.  My parents loved short road trips and going to different locations so more than two weeks in one location would not have been suitable.  After my second retirement I pondered if I should actually retire and saw a cute cottage on Lake Schugog (I am sure I am spelling it wrong) on the waterfront.  It was rustic, not too big and it had large windows which I like facing the water.  I could be there now writing books for fun, but I decided to go to grad school full time,  and do what I am doing now.   I always check out the prices of what I think is a nice hideaway near the water when I venture out of the city.  I imagine myself with my laptop facing out at the water with a nice doggy by my side or doggy playing in the water while I stretch out admiring nature in its' glory, or swimming.
        I saw a house for sale yesterday which I consider a steal in comparison to the homes in Toronto.  It was right across from the ferry we were boarding.  I liked the blue smaller building with a second floor balcony adjacent to the main house.  But you had to buy the main house to get the other. 
      People were friendly in general.  We waved at everyone and everyone waved back.  Many were floating on plastic rafts and I thought that would be very affordable for me compared to an actual boat.  My mind soaked in the sun and the possibilities.  Then it was lunch time.  The first thing that annoyed me but not too much was that there was no alternative dish for meat.  I accepted that but when I asked for an alternative, I was told that the potatoes and carrots were.  Was that sarcasm?  Did I get extra potatoes or carrots?  Of course not.  I let that slide and sat down and one sweet Lady from the tour feeling sorry for me insisted that I take a slice of her bread and soy cheese to give me the protein she thought I needed.   I heard a growing man from an adjacent table ask for seconds and he was turned down.  The same server who had told me about the "alternative" was refuting him any more food, so I told her to give him my chicken.  "It's put away.  You should have given it to him before."  I was really beginning to find this woman annoying.  She came and gave us our desserts.  It was a brownie that stayed with me for hours.  She said she only had three left and who wanted them.  There were four of us.  I told her that it was not acceptable.  To which she replied she was just joking.  That had actually happened on our last cruise.  The people there had given my apple pie to the bus driver but they gave me a glass of wine for free.  Now that is hospitality!   Give away my apple pie to the driver any time.   
We didn't get any beverage at all until we had finished our dinner.  Not even water.  After lunch I sat with another woman I know on the open second floor of the boat, enjoying the water views.  My friend pointed out that the staff on board including my server had large plates of food and they were beginning their own dining experience.  “Looks like they found the extra chicken” she commented.  I was confused.  Did they not have enough food for their staff and that is why everything was so stringently portioned?  I had been on a cruise boat before in Fenelon Falls but we had dined at a restaurant.  This cruise boat was going to another location soon and I thought that was a good idea.  Hopefully, I would not accidently take that boat again.  I thought of how one server could really be so annoying that I would automatically not want to have anything to do with the boat again.  Maybe they were struggling?  The sink bowl leaked in the bathroom and one of the men mentioned something swinging on the sink and water running off in the men's room.
     "Maybe it is me not being patient?"  I said to my friend.  However, my friend did not seem impressed either though she was quieter about it.  After all she did point out the massive plates of the servers and rest of the staff.
     We left the delightful tour and were told to meet at the ice cream parlor and pizza place in one hour and 15 min max.  After that we would be getting back on the bus and heading to Toronto.  I  hustled to see the rest of the town.  I did not realize how small it was and actually had time to have a ginger ale at the ice cream place.  I like ice cream parlors and this was a bonus because it has a massive verandah.  I couldn’t eat anything though because the brownie was still in my stomach and my inners were crying “foul”. The parlor had quite a few people, many who I recognized and a doggy too.  I thought it all quite wonderful and there was still lots of room.  I noticed one elderly man leave and I asked him where he was going.  "I got kicked out " he said sadly with a hint of surprise.  Of course I thought he was kidding and started to laugh.  "No, I did get kicked out." This World War Vet in his nineties repeated.  I stopped laughing.  An elderly couple who I had been talking to not too much earlier was also leaving.  They belonged to an era when people with dark skin colour were not given the same respect as those of white skin.  There was a time when they would have been asked to leave just as politely as this day.  I saw the pain in their eyes as my blood began to boil.  "We ordered something."  They said clearly shaken by the experience.  I looked up at the tall man who had been the cause of this upset.  He began explaining that these people were part of a bus group and they were taking up the space of customers.   He did not realize I was with them.
       "I don't see anyone waiting" I calmly replied.  My friend too had risen and was resting on the porch edge by the exit.  The owner went back inside.  He had no answer for my comment.  There had still been plenty of room so what was the real reason?  It did not matter as the damage was done.  He had offended the mother of a policeman, the sister of a physician and dentist and a woman who was too aware of the pain the holocaust had caused her family.  He had offended a veteran who had kept our country safe and democratric.  He had been mean and for what?  What I also noticed was that these frail people walked across to the water’s edge to find some shade and a place to sit away from the hot humid day.  They were so compliant and nice.  They did not say anything unkind.  They had been so hurt, these people who have lived such a long time, contributed so much to a society who now at times would shun them.  You bet I said something but I think it was my own expression of wonder that made that man just disappear into his own ice cream pizza parlor.
    I wondered how I would ever fit in with these small towns and their home town hospitality? 

     Last night my neighbor knocked on my screen door as I was watching TV.  She apologized for knocking at 10:00 pm plus, but said her dog kept going to my front steps for his treat and refused to leave.  I gave elderly Sneakers his treat and petted him for awhile and another neighbor approached.  I told them about the seniors getting kicked out of the ice cream parlor in Fenelon Falls.  "What?  The second neighbor cried out.  "You should have called the police!" 
    "It wasn't a criminal offence."  I replied.
      We gathered for a bit and talked casually before I went back in.

    I am grateful that I have great neighbours.  Now that is what I call home town hospitality.    Maybe my best friend is right.  I am a city gal with particular values I may not be finding in the small towns I venture to.  Or, is my opinion skewed? 

      That ice cream parlor didn't even have peanut butter ice cream?  And I could not see a Starbucks as we were leaving town. 

       Home town hospitality I find right here at home.  I have not ever been kicked out of a restaurant in Toronto since I was a high school kid and after four hours of hanging out with my school mates we would be asked to leave.  We expected that.  Our soda stretched for a long time.  Maybe I needed to go a little bit further away, maybe that is it?  What do you think?