Substance Abuse - psych lecture notes

Substance Abuse Major problem. All sorts of drugs people use commonly: coffee (me) colas etc have substances of addictive properties. Prevalence rates of drug usage - Some have widespread use eg. alcohol. 52% of people have used it in the last month, cocaine under 1%; heroin 1 in 1000. There are many philosophical debates. Two basic positions: 1. Drugs are natural part of life. If good and doesn’t harm them what is wrong with that? 2. Opiates - no studies show the problem when used for long time (at time of note taking) - when used lived long term - ages. Legal drugs in this country are legal and have harmful effects - cigarettes; alcohol. What is and what is not an abuse substance is a social construct. More reinforcing a drug is, an acute effect, the greater the potential of addiction. If heroin is legal Prof would not take it. Yes, get a high, but if for any reason there is no access to the drug, day or day three would go through withdrawal ( terrible). Even if there is no physical dependence, there is still developed psychological dependence. Animal world - electronics self stimulation - septum in rat and similar structures in other animals. Press bar and gets joint of electricity- natural opiods release produces same effects as many of the opiots. Strange thing is common sense goes out the window - food and all become unimportant- die happy? Reasons beyond strictly legal to avoid substances. 1. Tolerance - re-enforcing effect pretty immediate. After a while smoke more for the same effect to get the relax feeling. Dose required more frequently. pre-synaptic (4 received) post synaptic _______( ) o o after a while will not have same receptor. _______( ) o o have some receptors. So to get more (ox8) o receptors (5) increase dosage and then o don’t need all dosage and increase dosage again for same pleasurable effect. Agonist will intensify effects; will get more finding ( 5 maybe instead of 4) 2. Withdrawal Reverse process - that occurs when without drugs (few of these will bind without drug - don’t get the high but get the low - high rate of anxiety, unpleasureable, want drug to alleviate negative symptoms. Physical withdrawal. Psychological withdrawal is participation of withdrawal even before physical withdrawal. If no money, B & E, etc… 80% of all crimes are drug related. 3. Dependancy - exists when tolerance and withdrawal is established. Can get it without tolerance but normally the physiological dependency but also psychological is re-enforcing focus of people’s lives. There appears to be a biological because rate much higher in M than D twins; higher than just adoptive. However, if entirely genetic, than why only 52%?

Chike Use - In memory

Yesterday I received an email from a cousin telling me that Chike had died and his funeral is today. I immediately checked map quest to determine if my 19 year old baby car would be able to travel the distance. It would not. It was too far. So, I called to order flowers from within the town. To my surprise in this day and age, 2015, someone in a small town trusted me to send them a cheque at their request, for an arrangement of flowers. I wondered if I had dialled a wrong number and someone wanted my money. Was I going to take the chance? However, I was even more surprised that someone in this day and age would trust a stranger from Toronto to send a cheque after the flowers were delivered. I immediately went to the post office to mail the cheque, wondering how in this day and age when at least once a week someone is trying to rip me off, either by email, at the front door, or on the telephone innocence can still exist? Could it be that in some town in Ontario, honesty is the norm? Could it be that in some town where Chike died there is a community of people who do not need to be suspicious that someone will not do what they say they will do, when it comes to money? It had been years since I had been in that town. Is this why I like small towns I wonder, as I type away in the city? I remember Chike’s mother. She was a Matriarch sponsoring many Italians who came to Canada, my father one of them. He in turn worked hard so his wife and daughter (tiny me) could come to this new land, the land of opportunity. Zia Carolina was her name and she was bigger than life. She owned a farm on top of a hill that I thought was a huge estate with a grand house. My mother respected this woman and used to tell me stories of how many people she sponsored, an entire generation of immigrants that exists here now because of her. I would roam through her big house in awe of everything I saw. I would dream of growing up and buying this grand property. I knew that one day I wanted this to be mine. Zia Carolina had a steady stream of relatives at her house on weekends and any weekend we were there she showered us with attention. She didn’t say too much to me. She spoke mainly to grownups. However, as soon as I walked in and sat down, she would bring out a feast and I would indulge to my heart’s content. Good meals were always important in my household. Chike was her son. He was already an adult when I first met him and I believe that when I first met him, he terrified me by taking out his teeth and stretching his arm out towards me, a full set of teeth exposed. I was horrified and screamed. He would be chastised and then all was normal. I still do not like false teeth to this day when I see them. Is that why? However, Chike was a very nice man and always helping his mother. This is what I was told. He always had a grin and was very funny and playful. I never quite knew what to expect from him and was always cautious that he might remove his teeth again. When I was older, I drove there to see my aunt and Chike was there feeding the chickens. They were all free to wander. They sold the eggs and again I marvelled at watching all this. Zia had a lot of trees with fruit and during the summer my dad would help her to pick the fruit so she could sell them (I presume). Chike looked intently at me, his blue eyes sparkling letting me know that I should be going to the farm more often. I was busy as we all are in the city. I had a career that took me places and time at home was not always consistent because of that. He knew better than I did. So that last time, I helped pick from so much land full of delicious pears, her harvest. That year I went to visit and in my older eyes, the house was big but now as big as when I was young. As I walked through the manor, I realized that there seemed to be more grey than I remembered and the rooms seemed less and smaller. Zia had difficulty walking. There had been deaths in the family. There was one woman who had died when I was a child. I think her name was Rosy and she was getting married. Her young death was tragic. Chike had a brother, I believe who lived in Ottawa and I remember him visiting me when I was working there. He was the calmer one, the older one, the more serious one. He had died years earlier and I remember going to visit his brother shortly before his death, with my dad and another relative. As, I type this, I marvel at how lucky I have been to be surrounded by such wonderful men in my youth, who aside from playful pranks, never once hurt me. They all were wonderful towards me, and there were many. After Zia had died, I went one more time to her farm years later. It was for sale. That once beautiful house now stood crippled on top of the hill. Hoodlums had broken the windows and weeds and bush had grown throughout the property. Only the elegant door remained firm and solid, a reflection of the beauty this manor was. As I drove up the hill, the once manicured hills, with fruit trees lined up as soldiers, stood no more. The barn no longer held life. In my younger self, I felt a loss and if I had the money, I would have bought that house on the hill with its many acres, and would have wanted nothing more than to restore it to its former place. I would have wanted to be able to furnish it and garnish it and love it, with all the memories it provided in my childhood. However, it was not possible. I certainly did not have the money and I had a career that fulfilled me. Could I really live in the country? As I drove back down the hill, this place no longer felt safe. It had been vandalized, something it had never known, because this manor had been filled with love and food and lots of people, when relatives meant something huge. In an hour distant relatives, many who I do not know and would walk by without recognizing them will be gathering around to celebrate his life. I am sorry Chike that I cannot go. I can see your blue eyes twinkling that you know better, that you do not believe me any more than when I was younger. Chike, I have been thinking of you, and you are a great loss. I think you have seven sons. Again, I may be wrong. It was always my mother who clarified everything for me and by now you should all be having a wonderful celebration in heaven within a grand heavenly manor. So, as you look down at how people celebrate you today, you will only have some flowers there representing myself. I was assured by the lady who trusted a woman from Toronto, that the arrangement would be wonderful. Forgive me for not being there, because I would have been if my car was not as tired as the old manor, I could not buy. God speed!

I don't do the chat thing - nothing personal

Every once in a while I get an invite to chat. Sorry, I do not do that. If someone wants to talk, talk on the comments section and I will read it with the rest of the world and answer with the rest of the world, being able to do so as well. I am here to promote my two businesses and to eventually type out all I think is relevant of my studies. Why should I hog all the knowledge? Why should you have to spend the small fortune I had to? So no offence but you can chat on those chat lines that invites that attention. I do not. If you need to see me professionally, you can ask for an appointment and you can chat all you want. Just saying! Have a nice weekend. Spend time with wonderful happy people and watch out for the chatters! What do you think?

Looking forward to all my seminars and conferences this year. Here is a preview

It has been an exciting year. One of my main interests is PTSD. I have briefly talked about it and this year the conference will be examining the impact that Trauma, Violence, Civil War, Mass Migration and Environmental Disasters have on our work in the field of mental health. What will be even more exciting is that I will be among therapists from other countries. I always enjoy meeting new people and it is always a learning experience for us to share. It is clear and the message is finally getting across that climate change will eventually impact us all. I am also excited about spending a full day conference examining how the changes in the law regarding assisted suicide will affect us as therapists. I have been reading about the topic and preparing myself to understanding what the needs will be. I have also been watching segments from a program regarding "Athiesm". It is a two part documentary type and begins with group therapy of people indicating that they are Athiests. I was surprised that the group had bad experiences with the concepts of religions from their family of origin. For example one person felt relieved that he no longer believed in God, because he now no longer suffers from viewing himself as a sinner. A woman was upset because the last time she had any interaction with her mother she was told she would pray for her. Had her mother left it at that it would not have been too bad, but the prayer held a negative notation. The group had not suffered because of the belief in God, but because of the concepts from people who believed in God. Therefore, I deduced that if people who believe in God judge and are mean to others than their actions and cruelty are seen as coming from God. If God is good, how could people who believe in God be so cruel, so therefore God is cruel. I found this very interesting because I could not understand why there is a movement against God, rather just dismissing God, if one does not believe. However, this now makes sense to me. What was also clear was the misunderstanding of the Bible. Contradictions were brought forth indicating the irrevalence of the gospels but it is so much more complicated. So, I will be including more information regarding that. My next topic for Abnormal Psychology will be Addiction. The DSM has been amended as I have previously stated and what is considered "addiction" has been altered to only one addiction. However, in my experience patterns I have seen in alcohol addiction, sexual addiction, drug addiction, gambling addiction etc... have several characteristics shared. Addicts lie, addicts feel shame, addicts deny their addiction, addicts cannot be reasoned with about why they should stop their addictions. Addictions affect the whole family. No addict wants to be an addict. However, I do work with addicts and try to lead them to rehab for recovery. Though addiction has never been my interest, I have learned that it is a major problem and therefore needs to be addressed. So my next topic from my psychology notes will be about addiction. One thing I will recommend to any family member who is dealing with an addict is not to give them money. They will use that money to support their addiction. If you are a family member and want to give them money for therapy, I would recommend not to. What I would recommend is that there is an agreement between the client, family member and therapist for some transparency regarding payment directly to the therapist rather than to the client. A therapist has a strict obligation to protect their client's privacy. However, this privacy is meant to protect the client, not encourage fraud or crime. The only way I can think of protecting all parties is with some agreement so that funds are never used to nurse the habit. Please feel free to comment. What do you think?

Complaint about postage to States for Book 2 - Thank you. Plus not wanted at festival in the city of York, Eglinton and Marlee

I received my first complaint and I am pleased. I had a 20.00 surcharge for the States and I reduced it by 10.00. I think I have it right. I do not know if I am on the right track unless I get complaints. So, far I have no complaints from Canadians and one from an American. Please be patient with me while I get this all sorted out. Book Two, For Love of Country Military Policewoman stirs a lot of emotion just by the title (actually my first book did too, come to think about it). As I had mentioned, one woman sneered as she walked by my table where I was signing as she read out the title. They are having a festivity in the City of York which is the old, Toronto 10. I contacted the organizer to see if I could have a spot by email. She wanted to know what my books were about and then I had no more replies. I debated pushing this and decided not to. I like to pick my battles and this will not be one of them. However, I am always interested in human behavior. The more different concepts are between people, the more one is tempted to avoid the other. I consider this bias. You are not like me, you do not think like me therefore stay away please. As a therapist I need to always examine my self. I am always growing and learning from those around me and through education. Even when I think that something completely revolts me, I find that my compassion and empathy over powers the revulsion and that is how I am growing. I understand that many people have a complete hatred for the military and all it stands for. I understand that others have a powerful respect. There are people who hate police. Hate is very powerful and when emotions are stirred I suggest you ask yourself why? Why do I feel this way? Why do I hate this? This all takes work. Recently, I was asked why a person cannot let go their hatred for a person. I cannot simply answer such a complicated question from a casual encounter. However, when one wants revenge, to hurt, to humiliate it is rather difficult to let go. Hate does not magically disappear with a magic wand. It takes more time than a casual remark. However, when people are in charge of anything they need to be able to keep their minds open. When people want to censor books based on titles or anything they hate or dislike, they should keep in mind that perhaps if they cannot be open to everyone in a community it may be time for reflection. It is so easy to look at the other person as the bad guy. So, if my book merely provokes by its title without even knowing its contents, so be it. I have accomplished something. You do not even have to read my book to be completely annoyed with it. However, remember that we do live in a free country and if I wanted to make a thing out of this, I could. You have the choice to buy or not buy but you don't really have a choice to decide who can be banned because you do not like the topic. What do you think? My books are not restricted. Have a wonderful weekend. Enjoy your freedom and read what you consider is a good book.

PTSD comments

I suppose you are aware that I am interested in PTSD as it pertains to the military, police and other emergency personnel. Of course I have an interest in all persons but why I like to reach out to emergency personnel, is because I understand the mindset, which reduces the time of trying to understand that portion. If you are suffering from PTSD, know that you do not have to suffer alone. There is help. You are not alone. The worse that one can do is keep all the feelings within. I understand that there is a stigma. I understand that working among people who consider suffering a weakness can be traumatic in itself. Know that as a therapist in a private practice I do not report to your workplace. What is said between therapist and client is kept confidential. The only time I would have to report is if there is harm to a child, a physical threat to another or if I believe you are going to commit suicide. I have to really believe it and what I may do is ask for a contract where you promise me that you will not commit suicide while seeing me. That is the first move towards moving forward to healing. The only other way I have to report is if there is a court order. I do not report to any organization. No one needs to know that you are seeing me. Why not begin to change your life. Take that first step. What do you think?

PTSD brochure from CAMH - For your info

DO YOU NEED MORE HELP? Contact a community organization like the Canadian Mental Health Association to learn more about support and resources in your area. Founded in 1918, The Canadian Mental Health Association (CMHA) is a national charity that helps maintain and improve mental health for all Canadians. As the nation-wide leader and champion for mental health, CMHA helps people access the community resources they need to build resilience and support recovery from mental illness. Visit the CMHA website at www.cmha.ca today. Development of this brochure generously supported by © 2014 56315-05/14 www.cmha.ca POST-TRAUMATIC STRESS DISORDER Frightening situations happen to everyone at some point. People can react in many different ways: they might feel nervous, have a hard time sleeping well, or go over the details of the situation in their mind. These thoughts or experiences are a normal reaction. They usually decrease over time and the people involved can go back to their daily lives. Post-traumatic stress disorder, on the other hand, lasts much longer and can seriously disrupt a person’s life. WHAT IS POST-TRAUMATIC STRESS DISORDER? Post-traumatic stress disorder (PTSD) is a mental illness. It involves exposure to trauma involving death or the threat of death, serious injury, or sexual violence. Something is traumatic when it is very frightening, overwhelming and causes a lot of distress. Trauma is often unexpected, and many people say that they felt powerless to stop or change the event. Traumatic events may include crimes, natural disasters, accidents, war or conflict, or other threats to life. It could be an event or situation that you experience yourself or something that happens to others, including loved ones. PTSD causes intrusive symptoms such as re- experiencing the traumatic event. Many people have vivid nightmares, flashbacks, or thoughts of the event that seem to come from nowhere. They often avoid things that remind them of the event—for example, someone who was hurt in a car crash might avoid driving. PTSD can make people feel very nervous or ‘on edge’ all the time. Many feel startled very easily, have a hard time concentrating, feel irritable, or have problems sleeping well. They may often feel like something terrible is about to happen, even when they are safe. Some people feel very numb and detached. They may feel like things around them aren’t real, feel disconnected from their body or thoughts, or have a hard time feeling emotions. People also experience a change in their thoughts and mood related to the traumatic event. For some people, alcohol or other drugs can be a way to cope with PTSD. WHO DOES IT AFFECT? While most people experience trauma at some point in their life, not all traumatic experiences lead to PTSD. We aren’t sure why trauma causes PTSD in some people but not others, but it’s likely linked to many different factors. This includes the length of time the trauma lasted, the number of other traumatic experiences in a person’s life, their reaction to the event, and the kind of support they received after the event. Some jobs or occupations put people in dangerous situations. Military personnel, first responders (police, firefighters, and paramedics), doctors, and nurses experience higher rates of PTSD than other professions. Trauma is not always a single event in the past. Some trauma, particularly repeated acts like abuse or trauma during wartime, can impact a person’s life far beyond the symptoms of PTSD. Some use other terms like ‘complex PTSD’ to describe these experiences. WHAT CAN I DO ABOUT IT? Many people feel a lot of guilt or shame around PTSD because we’re often told that we should just get over difficult experiences. Others may feel embarrassed talking with others. Some people even feel like it’s somehow their own fault. Trauma is hurtful. If you experience problems in your life related to trauma, it’s important to take your feelings seriously and talk to a health care professional. Counselling A type of counselling called cognitive-behavioural therapy (or ‘CBT’) has been shown to be effective for PTSD. CBT teaches you how your thoughts, feelings, and behaviours work together and how to deal with problems and stress. You can also learn skills like relaxation and techniques to bring you back to the present. You can learn and practice many skills in CBT on your own. Exposure therapy, which can help you talk about your experience and reduce avoidance, may also help. It may be included in CBT or used on its own. Medication Medication, such as antianxiety medication or antidepressant medication, may help with anxiety itself, as well as related problems like depression or sleep difficulties. Talk to your doctor if you’d like to learn more about medication options. Support groups Support groups can also help. They are a place to share your own experiences and learn from others, and help you connect with people who understand what you’re going through. There may also be support groups for loved ones affected by PTSD.