Intuition in the Formation of Identity and the Scientific Questioning of Intuitive Knowing

 “…because we live in a culture that doesn’t respect intuition, and has a very narrow definition of knowledge, we can get caught into the trap of that narrowness. Intuition is another kind of knowledge—deeply embodied. It is knowing just as much as intellectual knowing.”

Judy Luce, 1989

There is no doubt that the formation of identity is a creative process in which intuition plays a major role, although the question of how much one can rely on intuition underlies and fuels much of the concern regarding its functions as a valid source of self knowledge. Traditionally, western science has tended to stress the importance of empirical data and objective reality (sensation) on the one hand, and a systematic, impersonal method (thinking) on the other hand. As a result, feelings and intuition have been under-emphasized as a valid source of knowledge because they have been perceived as antithetical to the notion of science since they are vague, inherent, subjective qualities of thinking (Krieger, 1991; Jaggar, 1997; Shepherd, 1993).

In fact, “some extreme materialists see intuition as the foe of reason, or as a kind of quackery, and eschew as superstition anything they cannot measure with the five senses” (Shepherd, 1993: 221). This belief holds that “there is an authentic division between intuition and intelligence, where intellect wears the white hat and intuition the black hat, or no hat at all” (Laughlin, 1997:23).

Although there is no doubt that intuition occurs in all of us all of the time and is fundamental to the formation of identity, the experience of intuition is private, which makes it an unverifiable or ineffable kind of knowledge that can’t always be quantified and tested over time. The unpredictable, spontaneous, and subjective nature of intuition, coming as sudden flashes, can’t always be broken down into its component parts to be studied. In addition, just as an excessive reliance on too much rationalism can misconstrue reality, so can an excessive reliance on too much intuition. Like any quality carried to an extreme, intuition has a tendency to distort reality.

Carl Jung stressed that we must never passively accept the revelations of our intuition as absolute truth, but rather we must interact with them, raise questions, and present objections (Jung 1958). In other words, both reason and intuition have the tendency to distort reality when they are in isolated positions. Linda Shepherd writes, “neither sensation nor intuition are relational or evaluative functions. Sensation gives us information about the world and intuition reveals possibilities and provides insight about the nature of things. But neither can be isolated or substituted for the other because they work together as a whole” (1993: 213).

There is now evidence that modern society is moving beyond a purely either/or perspective on the issue of valid knowledge (Boucouvalas 1997). Researchers have asserted the indispensable unity between reason and intuition in all creative acts (Koestler 1959; Bastick 1982; Jung 1971). Some have even argued that science itself, with all its supervaluation of left brained deductive reasoning, could never have proceeded without the creativity of intuition (Bastick 1982; Jung 1971; Vaughan 1979). Carl Jung acknowledged the important functioning of intuition in the creative process as well as in the development of self. He maintained that:

It is almost absurd prejudice to suppose that existence can only be physical. As a matter of fact, the only form of existence of which we have immediate knowledge is the psychic. We might well say, on the contrary, that physical existence is mere inference, since we know matter in so far as we perceive psychic images mediated by the senses (Jung, 1958: 12).

Various feminist scholars have also acknowledged the value of intuition in the creative process, particularly its ability to provide a connected and holistic understanding of ourselves and the world around us (Chodorow, 2000; Luce, 1989; Kreiger, 1991). For example, Linda Shepherd writes, “the acceptance of intuition can give us greater access to information, augment the limited perspective of the five senses, and prompt us to transcend our linear view of time and space. Intuition can help bridge the boundaries that seem to separate us from others and from nature” (1993:223). In other words, when we deny the validity and importance of intuition, we are essentially denying our sense of relatedness to others, to nature, and to our inner selves.

In our age of diversity, it seems essential to transcend the either/or way of thinking that previously juxtaposed in an antithetical manner the rational and intuitive modes of knowing. Perhaps now with all the current research on intuition, outer knowing, with no need to further prove itself, can take its rightful place as a partner alongside inner knowing. Still, a total acceptance of the validity of psychic phenomena by the scientific community has yet to be established and will most likely require us to redefine and expand our current understanding of physics and psychology. The study of intuitive phenomena calls for a different approach to research that has yet to be determined. New methods need to be found that handle reports of subjective experiences to cope with the difficulty of replicating psychic phenomena and to deal with the uniqueness of individual experiences.

Exerpt from Thesis Research: Women Artists: The Transformation of Identity as Self Created and Socially Contructed, 2001.

Interpersonal Neurobiology, Attachment Theory, and the Use of Self in Psychotherapy

There have been a number of psychological theories that have influenced the Social Work and Counseling Professions.  However, I will only discuss some of the primary concepts of Interpersonal Neurobiology and Attachment Theory.  In addition, I will explain my “use of self” as the therapist in each theory, which relinquishes the social worker as an “expert” and replaces it with a more collaborative approach that involves using one’s self as a reparative object. Being able to be present therapeutically on behalf of another person requires a range of skills and abilities, including the intentional and disciplined use by the counselor of his or her experience, relational skills, and knowledge/wisdom in the benefit of the client. 

Interpersonal Neurobiology:

Interpersonal Neurobiology is an interdisciplinary field which brings together many disciplines in science including but not limited to anthropology, biology, linguistics, mathematics, physics and psychology to determine common findings about the human experience from different perspectives. Daniel J. Siegel, M.D. is a pioneer in the field called Interpersonal Neurobiology, which seeks the similar patterns that arise from separate approaches to knowledge.  Aside from Siegel, some of founding theorists are Stephan Porges, Edward Tronick and several more.

One of the primary concepts of interpersonal neurobiology approach is “Integration,” which ultimately promotes a flexible and adaptive way of being that is harmonious as opposed to chaotic. The brain is always in a process of working towards integration. According to Dr. Siegel, integration is viewed as the core mechanism in the cultivation of well-being and healing.  He writes:

In an individual’s mind, integration involves the linkage of separate aspects of mental processes to each other, such as thought with feeling, bodily sensation with logic. For the brain, integration means that separated areas with their unique functions, in the skull and throughout the body, become linked to each other through synaptic connections. These integrated linkages enable more intricate functions to emerge—such as insight, empathy, intuition, and morality. A result of integration is kindness, resilience, and health. Terms for these three forms of integration are a coherent mind, empathic relationships, and an integrated brain (Siegel’s website, 2014).

Another major concept in the emerging field of Interpersonal Neurobiology is the concept of “neuroplasticity,” which entails the rewiring of the brain through the use of mindfulness practices, or, what Dr. Dan Siegel refers to as “Mindsight.”   At its core, interpersonal neurobiology holds that we are ultimately who we are because of our relationships. We simply can’t grow and evolve without intimate relationships (Seigel’s website, 2014).  

Some of the assumptions of the nature of the problem are similar to attachment theory, such that the lack of early childhood attachment with a caregiver leads to an insecure attachment, which inevitably causes neural disintegration—a chaotic or fragmented sense of self and mind.  According to IPNB, the nature of the problem is both biological and social. An individual is born into the world with a genetic imprint (DNA); however, in the process of human development one can either experience secure attachments with very little trauma’s, or, insecure attachments with several stressors and trauma’s in early life and throughout one’s life span.  If the later occurs, an individual’s brain has a greater risk of becoming wired in a way that is unintegrated and may hold dissociated traumas, losses, and chemical loads that are toxic to the growing brain.

According to IPNB, our relationships have the potential to literally change the brain, particularly the most intimate ones, for example, with our primary care givers or romantic partners. While it was once thought that our early experiences defined who we are (social constructionism), interpersonal neurobiology holds that our brains are constantly being reshaped by new relationships.  This offers tremendous hope to all trauma survivors, psychotherapists, psychiatrists and their patients. Thus, positive relationships produce positive changes, which yields healing for those who have suffered from trauma (Badenoch, 2010).

Integration requires the implementation of a practice referred to as “mindsight,” another major concept of IPNB.  According to Dr. Siegel’s website, “Mindsight describes our human capacity to perceive the mind of the self and others. It is a powerful lens through which we can understand our inner lives with more clarity, integrate the brain, and enhance our relationships with others. Mindsight is a kind of focused attention that allows us to see the internal workings of our own minds” (Siegel, Website). What is particularly fascinating is that when an individual develops the skill of mindsight, they actually change the physical structure of the brain.  And we can grow these new connections throughout our lives, not just in childhood.

The emerging field of neurobiology is also changing the way in which therapist think about therapy, what they think happens during therapy, and how they think they should engage in the joint project together.  Bonnie Badenoch’s book Being a Brain-Wise Therapist, brings IPNB into the counseling room, weaving the concepts of neurobiology into the ever-changing flow of therapy.   She uses examples from her own therapeutic practice, which involves inculcating mindfulness practices into therapy.   Implementing the use of mindfulness practice aids in the building of neural intregration and mental health.

In the book she clarifies her “use of self” as a reparative secure attachment in the therapeutic process with clients.  According to Bonnie, one of the unfolding processes in therapy is the reactivation of the attachment system, often accompanied by anxiety and vigilance, since for most patients, the initial attachment process did not go well.  

In the therapeutic process, attachment seeking behaviors are activated.  As the longing for attachment dawns, therapist have the “precious opportunity to help their patients mend/rewire even the earliest relational fears, adding the new information of compassion, care, safety, stability, and warmth that is our contribution to the interpersonal system. ” (Badenoch, 2010: 54).   Supposedly, human’s neurologically regulate each other right brain to right brain. The Therapist acts as the central nervous system regulator, which allows for the healing to take place.

Bonnie further explains that “The very heart of secure attachment is contingent communication, which involves receiving people’s signals (nonverbal more than verbal) and responding in a way the lets them “feel felt” (Badenoch , 2010: 57). It is important to commit deeply to going into a patients world, no matter how painful. Being able to provide a sense of safety for patients is central to providing regulatory experiences.  Bonnie writes “When this wish to comfort is accompanied by streams of accurate empathy, the stage is set for profound healing. This kind of connection is at the heart of helping our patients develop balance through dyadic regulation (which leads to the capacity for self regulation” (Badenoch , 2010: 92).

Through repeated experience, the client will internalize a warm, caring presence that can comfort them when the therapist is not physically available.  This builds confidence and self-reliance in the client. According to Bonnie there is an increased neural integration as a result of the comfort, empathy and bonding in the therapeutic alliance. Overtime, the patient moves from insecurity to an earned secure attachment (Badenoch, 2010).

Attachment Theory:

Attachment Theory is focused on the relationships and bonds between people, particularly long-term relationships including those between a parent and child and between romantic partners. According to attachment theory, “the presence of a principal attachment figure as a source of emotional security significantly affects human development.  During infancy, the caregiver’s role is to provide a secure base from which the child can explore his/her surroundings. The caregiver’s response to this need will affect the child’s attachment behaviors” (Bettman & Jasperson, 2010: 98).   

The theory of attachment was originally developed by John Bowlby (1907 - 1990), a British psychoanalyst who was attempting to understand the intense distress experienced by infants who had been separated from their parents. Bowlby believed that the earliest bonds formed by children with their caregivers have a tremendous impact that continues throughout life. He suggested attachment also serves to keep the infant close to the mother, thus improving the child's chances of survival.  (          )

The central theme of attachment theory is that humans grow and evolve through forming attachments at an early age. Infants need to develop a relationship with at least one primary caregiver for the child’s successful social and emotional development, and in particular for learning how to effectively regulate their feelings. Primary caregivers who are available and responsive to an infant's needs allow the child to develop a sense of security. The infant knows that the caregiver is dependable, which creates a secure base for the child to then explore the world. If the caregiver is unstable and unreliable, this creates an insecure attachment, which causes severe anxiety and depression. (    )

The assumptions of the origin of the problem are due to faulty socialization, insecure attachment and the development of an insecure working model (theory matrix). Attachment theory is not a developmental theory as there are no stages one must go through in order to achieve health. There is a critical attachment period that occurs between 0-3 years of age.  If bonding doesn’t occur from 0-3 a secure attachment becomes more difficult to attain (Theory Matrix).  Another assumption in attachment theory is that the same motivational system that gives rise to the close emotional bond between parents and their children is responsible for the bond that develops between adults in emotionally intimate relationships.  The later assumption was formulated by later researchers who further developed the theory, one of which is Mary Ainsworth.

Expanding greatly upon Bowlby’s work, a psychologist by the name of Mary Ainsworth performed a study titled "Strange Situation" (1970’s) that revealed the profound effects of attachment on behavior. Ainsworth found that children will have different patterns of attachment depending primarily on how they experienced their early caregiving environment. Early patterns of attachment, in turn, shape – but do not determine - the individual's expectations in later relationships.

In the study, researchers observed children between the ages of 12 and 18 months as they responded to a situation in which they were briefly left alone and then reunited with their mothers. Based upon the responses the researchers observed, Ainsworth described three major styles of attachment: secure attachment, ambivalent-insecure attachment, and avoidant-insecure attachment. Later, researchers Main and Solomon (1986) added a fourth attachment style called disorganized-insecure attachment based upon their own research.

Attachment styles also have an impact on behaviors later in life.  For example, Children diagnosed with oppositional-defiant disorder (ODD),conduct disorder (CD) or post-traumatic stress disorder (PTSD) frequently display attachment problems, possibly due to early abuse, neglect or trauma. Clinicians suggest that children adopted after the age of six months have a higher risk of attachment problems. (      ).  On the other hand, those who are securely attached in childhood tend to have good self-esteem, strong romantic relationships and the ability to self-disclose to others. As adults, they tend to have healthy, happy and lasting relationships.

The therapists “use of self” is an integral part of helping the client to move towards more health and integration.  For attachment theory, the “use of self” is similar to Interpersonal Neurobiology.  The therapist acts as a reparative secure attachment figure and provides a safe container that allows the client to regress to the ruptured attachment. The therapist responds with attunement and repairs attachment ruptures.  Through the practice of empathetic listening, facial expression, eye contact, tone of voice, tempo, breathing, the therapist creates a kind of wordless but dense and charged felt presence, which permeates the being of both therapist and client.   At some point in the therapeutic process, the client internalizes and “earned secure attachment” and will hopefully generalize it to other relationships.

This paper identified some major concepts and assumptions in Attachment Theory and Interpersonal Neurobiology.  It also clarified several ways in which the therapist uses themselves as a reparative object for healing trauma’s and insecure attachments.  Both theoretical perspective draw from similar roots, but are different in their approach.   What is fascinating to me is how they are completely transforming the way in which therapy is done and what is occurring in the brain of both the therapist and client during the therapeutic process.  Interpersonal Neurobiology is taking Psychotherapy to a whole new level by scientifically proving things that have always been doubted by pragmatic Behaviorists.  For example, Wylie and Turner’s article The Attuned Therapist, explains the “seemingly immense divide between psychological and biological sciences and how Interpersonal Neurobiology has been a new “integrative bridge” which includes the whole human system—mind, brain, body and relationship. 

According to Wyle and Turner, “Psychology was dominated by a behavioral model during the ‘60’s and ‘70s, then by cognitive models in the ‘80s and ‘90s, and now affect and psychobiological processes are taking center stage” (2011, 48).  

For many years there was little knowledge about the biology of emotion and feeling—what they were, where they were in the brain, what caused them, how they influenced behavior.  However, according to Wyle and Turner, for the past 15 years, neuropsychological scientist and therapists claim that we are in the throes of an “emotional revolution,” that is more integrative and validating of the power of the emotions and interpersonal relations to change the physical structuring of the brain (2011).   

After decades of cognitive and behavioral therapists purposely seeking to put emotions out of sight and out of mind, they’re being forced to relearn the ancient emotional systems have a power that is quite independent of neocortical processes.  She writes, “In our increasingly technological world, therapy seems to be directing our attention to the very core of our primeval being, the ancient emotional systems that are the source of love, hatred, rage, desire, compassion, of our unquenchable need for connection with others of our own species.” (      49).   I am particularly fascinated by the cutting edge work of Nancy Chodorow who wrote book called The Power of Feelings.  Not only is this work challenging dominant paradigms in Sociology and Psychology, but it is changing and improving the way in which we do therapy.

 References:

Badenoch, Bonnie. (2008). Being a Brain-Wise Therapist: A Practical Guide to Interpersonal Neurobiology. W.W Norton & Company, New York, NY.

Bettmann, Joanna and Jasperson, Rachael. (2010). Anxiety in Adolescence: The Integration of Attachment and Neurobiological Research into Clinical Practice. Clinical Social Work Journal, 38:98-106.

Wylie, Mary Sykes & Turner, Lynn. (2011). The Attuned Therapist. Psychotherapy Networker, March/April.

Dan Siegel’s Website. (2014). Retrieved from: http://www.drdansiegel.com/about/interpersonal_neurobiology/website

La Clinica Website. (2013). Retrieved from http://www.laclinicahealth.org/

Personal Interview with Valerie Barnum. (2013). Client at La Clinica School Based Health Center, Phoenix Elementary School.

WHAT NOT TO SAY TO TRAUMATIZED PEOPLE

Beloved community…..we all very hypersensitive right now and are having to hold space for a lot of difficult negative emotions. And because we are trying to communicate via Facebook, there is a lot of miscommunication and false assumptions being made about people.

Someone asked me if I would write a short tidbit about “What Not to Say To A Traumatized Person,” This is what I came up with which comes from my own personal experiences and professional experiences working with some of the most traumatize individuals in the rogue valley.

1) Why can’t you talk about the incident with me?

Trauma informed therapy is intended to “Go to where the person is at” emotionally. It also doesn’t delve into one’s past history as that could potentially trigger someone into past trauma’s. The goal is to help people set up small and realistic solutions, not overwhelm them. They might be totally disconnected from themselves and their bodies due to dissociation. There is a period of disbelief that occurs and that can last for a period of time before one is ready to move into anger, grief, and finally acceptance. This process of grief and loss will be processed differently by each individual.

Some people aren’t VERBAL processors of their emotions, thus, inquire about their unique way of processing. We often unconsciously project our own biases, values and beliefs on to others. We also project our own sensitivity on to them too, particularly if one is a highly sensitive person, or, empath.

Don’t overwhelm them with too much talking or information. They might be hypersensitive to noise and chaos, as well.

2) Don’t you think this is an opportunity for you to practice your spiritual practice of nonattachment?

The Buddhist spiritual practice of non-attachment is a spiritual law that exists in micro earth-based spirituality and in universal principles. We all know that we can’t take our personal possession with us; however, as humans we get attached to our material possessions, our animals, our gardens, and other humans. The concept of non-attachment can feel very cold, much like one is being asked to turn their emotions on-and-off like a faucet.

We are multidimensional beings—we form deep emotional bonds and attachments. Furthermore, our bodies require a certain balance of equilibrium that has completely been disrupted as a result of loosing one’s home. In Maslow’s “Hierarchy of Needs” the first level of basic survival has been disrupted, which will disrupt one’s ability to feel balanced and have the privilege of experiencing spiritual illumination which is at the top of the pyramid.

3) Everything happens for a reason. Can you see the silver lining in this?

The fire was a random chance phenomenon and we are victims of such occurrences in our lives. One doesn’t need to be told when they are emotionally traumatized that this phenomenon was a part of their “life contract,” and thus, they should consult with their higher self about that. Furthermore, they did not create their own reality either via negative thought patterns. Nor should they be told that this is some karma they are burning off. Most people don’t know how to grapple with the stressors in their own life, much less, karmic patterns from other lives. It can take years for someone to see the silver lining in a traumatic event, and they may never come to this point of resolution.

4) I have experienced a trauma in my life; thus, I know what you are going through.

It is really important to hold an empathetic space for traumatized individuals. It is important to ask someone if they are open to receiving a story about your personal experience. It not only has to be relevant to the person’s life, they need to be in a space to receive it. More often than not too much information is hard due to inability to focus, retain information, fatigue, and memory loss. What I say to my clients is “This is my experience, you may or may not resonate with it, and I am not attached that.”

5) Why can’t you have a sense of humor about this? While humor can help to free up some intense energy, one can be easily offended due to hypersensitivity. I generally don’t use humor until I have built up a rapport with someone. IF they are sleep deprived, they most likely are not even going to be able to grasp the humor anyway.

Tune yourself in to the person emotionally. Don’t shame them for being spacey, unorganized, brittle, or emotionally intense.

PRACTICE RADICAL FORGIVENESS OF YOURSELF AND OTHERS RIGHT NOW.

SOME TRAUMA ADVICE FOR THE COMMUNITY

It is endearing to see so many people offering support to those who have lost their homes, material possessions, and animals.  We are all directly experience various levels of trauma just by living in Oregon right now, as it has been declared a state of emergency by Kate Brown.  However, some of experiencing more extreme levels of trauma, particularly those who have histories of trauma due to sexism, racism, and economic poverty.

 We are all feeling the survival urge to respond, which is normal and needed. We all need to rise and offer what we can to help.  However, it is important to be humble about your training, particularly when working with traumatized people.  While empathy, gentleness, and generosity are welcomed, please don’t attempt to offer trauma therapy to your friends. Emotional support is one thing, but trauma therapy is something that requires training and professional experience in a clinical setting.

 There are numerous qualified therapists in the rogue valley who are now offering their services pro-bono, or, at reduced rates.  I am currently offering free 30-minute social work consultations, a trauma informed support group at the Elks lodge, crisis support, and therapy via zoom. Please contact me via my website, Victoria Christensen, M.A., MSW: www.guanyinhealingarts.com

 As a trauma informed clinical social worker who has been working on the frontlines all over Southern Oregon with a team of integral medical professionals, I wanted to offer some professional advice to our beloved community, as I know there are many stellar humans who have really good intentions. 

 However, I have had several trauma victims contact me expressing frustrations about friends who are trying to step into the role of therapist when they really shouldn’t be.  While friends can be a source of emotional support, assistance with basic caregiving, and material donations, they really can do more damage to a traumatized individual if they aren’t properly trained.

 There are books written on these subjects and therapists spend months in intensive training and clinical internships. Not all therapists have trauma training or expertise, but they may have a general understanding of how to looks for trauma symptoms and effective ways to approach traumatized individuals.

 The first thing to understand is what is happening in someone’s brain when they have been through a traumatic event.  This is called the neuroscience of trauma. The hallmarks of extreme traumatization are often considered to be PTSD, which is categorized as a trauma or stress related disorder.

 Some individuals might have histories of trauma (which they are private about), and the new traumatic event (a fire) can trigger the individual’s past traumatic memories, particularly if they have not worked with a trauma informed therapist who helped them to desensitize the traumatic event.  However, not everyone has to motivation or financial resources to do so. More often than not they use medication and not therapy, which is typical in our dysfunction health care model. 

 When someone experiences a stressful event, the amygdala, an area of the brain that contributes to emotional processing, sends a distress signal to the hypothalamus. This area of the brain functions like a command center, communicating with the rest of the body through the nervous system so that the person has the energy to fight or flee.

The hypothalamus is a bit like a command center. This area of the brain communicates with the rest of the body through the autonomic nervous system, which controls such involuntary body functions as breathing, blood pressure, heartbeat, and the dilation or constriction of key blood vessels and small airways in the lungs called bronchioles. The autonomic nervous system has two components, the sympathetic nervous system and the parasympathetic nervous system.

The sympathetic nervous system functions like a gas pedal in a car. It triggers the fight-or-flight response, providing the body with a burst of energy so that it can respond to perceived dangers. The parasympathetic nervous system acts like a brake. It promotes the "rest and digest" response that calms the body down after the danger has passed.

After the amygdala sends a distress signal, the hypothalamus activates the sympathetic nervous system by sending signals through the autonomic nerves to the adrenal glands. These glands respond by pumping the hormone epinephrine (also known as adrenaline) into the bloodstream. As epinephrine circulates through the body, it brings on a number of physiological changes. The heart beats faster than normal, pushing blood to the muscles, heart, and other vital organs. Pulse rate and blood pressure go up.

The person undergoing these changes also starts to breathe more rapidly. Small airways in the lungs open wide. This way, the lungs can take in as much oxygen as possible with each breath. Extra oxygen is sent to the brain, increasing alertness. Sight, hearing, and other senses become sharper. Meanwhile, epinephrine triggers the release of blood sugar (glucose) and fats from temporary storage sites in the body. These nutrients flood into the bloodstream, supplying energy to all parts of the body.

All of these changes happen so quickly that people aren't aware of them. In fact, the wiring is so efficient that the amygdala and hypothalamus start this cascade even before the brain's visual centers have had a chance to fully process what is happening. That's why people are able to jump out of the path of an oncoming car even before they think about what they are doing.

People are going to be exhibiting and assortment of trauma related responses, which I have outlined here:

 Types of Post-traumatic responses:

 Complicated or traumatic Grief:  Grief is a normal response to loss and often can resolves naturally over time. However, when the loss involves a sudden, traumatic, and violent death or disruption of an individual’s life, however, this response may become more complicated and may be associated with lasting health and mental health problems.

 Major Depression:  grief associated with a traumatic loss also may lead to major depression. Some symptoms of depression (insomnia, loss of interest in formerly enjoyable events, and a decreased ability to concentrate) overlap with symptoms of PTSD. 

 Anxiety: because trauma involves the experience of danger and vulnerability, post-traumatic outcomes often involves symptoms of anxiety (generalize anxiety, panic attacks, and post-traumatic phobias.

 Stress Disorders:  the hallmarks of extreme traumatization are often considered to be PTSD or ASD, watch of which is categorized as a trauma and stress related disorder.

 Symptoms of PTSD:  Post-traumatic stress disorder is the best-known trauma specific diagnosis in DSM-5.

 Symptoms of PTSD are divided into four clusters:

 a)     Re-experiencing the traumatic event: flashbacks and intrusive thoughts and/or memories of the trauma.

b)    Avoidance of trauma relevant stimuli: avoiding or suppressing upsetting thoughts, feelings, or memories. Efforts to avoid external reminders.

 c)     Numbing, negative cognition and mood:  emotional and cognitive numbing, also diminished interest, detachment, and amnesia, persistent negative beliefs and emotional states.  

a.     Dissociative symptoms: Persistent experiences of feeling detached from one’s mental processes, or, body. Feeling as though one were in a dream: feeling a sense of unreality of self or body or of time moving slowly.

d)    Hyperarousal and hyperactivity:  Keyed up nervous system, insomnia, “jumpiness”, hypervigilance, hypersensitivity to noise, stimulus, etc. irritability, sleep disturbance, self-destructive behavior, or attention/ concentration difficulties. Reexperiencing symptoms of PTSD are often the first to fade over time, whereas hyperarousal symptoms typically are more enduring.

If you see some of these symptoms in recent victims, please be humble.  If you are not a therapist with a master’s degree, step up to plate and help set up apt. for them with a trained therapist, particularly who has training in trauma and professional clinical experience.

Be safe, be kind, and be humble.  We have a massive job ahead of us.

FIVE TIPS FOR TRAUMA

With the recent Alemeda fire in Oregon, several expressed advice about how to handle trauma symptoms in themselves and others. Here are five tips that might be helpful:

1)     Lower expectations of yourself:  it will be difficult to function cognitively due to short term memory loss, insomnia, difficulty organizing and planning, inability to retain information, and a keyed-up nervous system.

2)    Take things one step at a time, one day at a time, and one breath at a time:  traumatized individuals get easily overwhelmed by information, or, become stressed about all the things they need to do. It will be difficult for them to do small tasks; thus, please let others help and ask for help when you need it.

 3)    Let go of needing to control:  Individuals who have lost everything will experience a sense of chaos in their lives—both psychologically and in their external world. In order to counterbalance the chaos in their external world, they will be hyper-obsessed about control and needing to keep things organized in their lives. It is difficult for really competent people to experience trauma symptoms and will feel like they are on the edge, they need to be reassured that they will heal in time. They need to be reassured that they will have a support system; thus, friends, family and extended community needs to show up for these people for extended periods of time.

4)    Sitting with negative emotions, but knowing how to identify unhealthy downward spirals of negative thinking that leads to unhealthy isolation, suicidal ideation, and severe depression.   Depression and anxiety are symptoms of PTSD and every one deals with their emotions differently.  However, if you have a tendency to isolate when you are in crisis, reach out to someone for help (a trauma informed therapist is ideal), or, get into a grief and loss support group.

 5)    Set up a self-care plan and limit your exposure to stress.  It is ok to focus on yourself and give yourself the time you need to heal.  Everyone’s path of healing is unique; thus, routinely schedule healthy coping skills such as exercise, meditation, yoga, journaling, reading, listening to music, doing art, moving your body, and eating healthy meals.

Exploring The Death With Dignity Act

 Exploring The Death With Dignity Act

Victoria Christensen

Physician-assisted suicide has become increasingly controversial over the past two decades.  Only eight states, have legalized the practice, despite hard-fought campaigns in several other states to legalize it as well.  In 1994, Oregon voters approved the Death With Dignity Act (Ballot Measure 16) by a vote of 51% to 49%.  It became effective in 1998, surviving court challenges and a repeal effort, to make Oregon the first state in the country to legalize physician-assisted suicide.   The Oregon Death With Dignity Act allows an adult who is an Oregon resident and is suffering from a terminal disease that will cause death within six months, to terminate his or her life through the use of medication.  To do so, the person must express voluntarily his or her wish to die, must make a written request for the medication, and be found by the person’s attending physician and consulting physician to be suffering from a terminal disease.  The Death With Dignity Act is important for social work, particularly medical social work, because it directly affects an individual’s right to die, which in many ways contradicts the medical communities oath to keep people living as long as possible.  The DWDA enables qualified patients to avoid unnecessary suffering, to die with dignity, and to respect those patients’ right to autonomy or self-determination.  While there is no way I can address the complexity of this issue in this article, I will describe the social problems being addressed by the policy, discuss the history of the Act, provide a thorough description of the goals of the Policy and discuss the current status of the policy in Oregon.  

The Death With Dignity Act addresses the crucial social problem of allowing dying patients the right to control their own end of life care.   It is common knowledge that the aging population is increasing globally.   As a result, there is a pressing need for physician-assisted suicide across the globe; however, the notion of suicide stirs up a number of ethical issues about the choices people should or should not have with regard to death.  There are conflicting opinions by multiple groups; such as religious organizations, the medical community, and consumer groups.  Marjorie Zucker’s book The Right To Die Debate: A Documentary History (1999) examines the many voices in the debate and explores the controversy in depth.  In the introduction, she lays the foundation for the debate and explains why the ethical social problem has emerged in response to the way death in America has changed in conjunction with the progress of medical technology.

While modern medicine has made great technological strides in the Twentieth century to save and improve lives, physicians can and frequently use this technology to prolong the dying process.  She writes, “As physicians became increasingly adept at using developing technology and justifiably dependent upon it, they began to be uncomfortable with the notion that some patients ultimately could not be saved.  Medical professionals received a great deal of positive reinforcement for refusing to ‘give up,’ and many looked upon the death of a patient as a failure of their own” (Zucker, 1999, xxvi).  In response to the way death in America has changed, many health care professionals, lawyers, educators and members of the public began raising ethical and public policy questions; such as, when does the use of technology become overuse or abuse? When in the course of an individual’s illness should technology be focused on providing comfort rather than prolonging dying?

When is enough enough?   These questions have led to considerable controversy and a national conversation known as the right-to-die debate (Zucker, 1999).

The arguments in favor of a legal right to physician-assisted suicide are strong and varied.  The debate is often portrayed as a battle between social or religious conservatives who oppose the practice and liberals or progressives who support it. Those who support the Death With Dignity Act argue that death can be dreadful with high-tech medicine.  Patients who endure intolerable suffering ought to be able to end his/her life before her human capacities are irreparably damaged.  Furthermore, there ought to be a legal right to physician-assisted suicide in order to respect the patient’s moral right to autonomy and self determination.

There is research that has documented the most common reasons why someone might want to hasten their life. According to a report about DWDA by the Legislative Committee Services (June, 2010) “Physicians and families reported that patients have several reasons for requesting lethal medication.  These include concerns about losing autonomy, losing control of bodily functions, a decreasing ability to participate in activities that make life enjoyable, and physical suffering.  Also, many family members added that patients wanted to control the manner and time of their death” (p. 2).  

Assisted-suicide advocates often base their arguments on the moral conviction that each individual has an inherent right to determine his or her own destiny.  Thus, the right to life includes the right to end life, and it is as wrong to deny that right as it is to deprive a person of any other liberty.  They say that suicide is already legal in all states; only assistance in carrying it out is at issue (Zucker, 1999).  It is for these reasons and more that the terminally ill wish for a dignified death, and for these reasons that supporters of PAS wish to enable caregivers to provide it.

Death with Dignity is not only a legal issue, but a cultural and spiritual issue, too. Some faith traditions have embraced Death with Dignity as an ultimate act of compassion, and others reject it is as morally bankrupt practice.  Some opponents of legalizing physician-assisted suicide believe that intentionally causing the death of someone, even one who is dying, is morally unacceptable.  Sylvia Engdahl writes that “Most religions have traditionally held that all human life is sacred and that suicide is therefore immoral.  Christians believe that life is a gift from God so only God should determine when it should end; some of them believe that they would be punished in an afterlife for taking their own lives” (2009, pg. 65).

The main objection to the legalization of assisted suicide, apart from religious grounds, is that is may be a “slippery slope” issue.  In other words, one thing might lead to another—once a small concession is granted, the door is opened to larger ones. Opponents believe that such laws might extend to people who suffer from chronic illnesses or disabilities that are not terminal, but are costly and life debilitating—perhaps eventually even to the mentally ill.  Another argument is that if assisted suicide is legalized, sick people may be pressured into requesting it if they cannot afford medical care to relieve their suffering. Adrienne Asch, a noted bioethicist and authority on the rights of the disabled writes “Disability-rights activists fear that availability of assisted suicide will sway the public Into thinking that some people’s lives are not worth living, and that the ill and disabled may be led to feel that they have a duty to die rather than burden society with their care” (2005, p. 31). In other words, there is a fear that individuals disabled by a terminal illness would be discriminated against because Oregon law would no longer protect their lives in the same way it protects the lives of healthy Oregonians.

Opponents also argue that it is difficult to determine whether or not the patient has six months or less to live. In addition, there is a concern about the psycho-social condition of the dying patient. Daniel Callahan, M.D says that “the most common hazard of legalizing assisted suicide is the possibility that the patient is suffering from a clinical depression in the face of his or her illness and anticipated death.  Since depression is potentially treatable, a physician contemplating assisting in suicide must be very much aware of this possibility (1997, 71).  In other words, it is common for terminally ill patients to have some degree of depression, and that it is often difficult for some health care providers to detect as they don’t specialize in mental health issues.

            Prior to the Death With Dignity Act, there were no previous social policies that addressed assisted-suicide at the end of life.  However, prior to the 1950’s there was the beginnings of a Euthenasia Movement.  During the 1940’s the Euthanasia Society was formed with the intention to spread it’s message as widely as possible in speeches, on the radio, and in articles for magazines.   The society also wanted to promote legislation permitting voluntary euthanasia. Marjorie Zucker thoroughly documents the Euthenasia movement in her book The Right to Die Debate. She documents the impact of changes in medical care on end of life issues. The increased ability to maintain the life of mortally ill patients created a dilemma for physicians:  When, if ever, should they stop treatment?  While Euthanasia was highly controversial, medical professionals and educators realized the need for continued education.  Marjorie writes:

During the period 1953-65, the Euthanasia Society of America functioned as an educational organization, providing speakers to organizational meetings and on the radio.  No further attempts were made to pass legislation in this field.  However, the increased ability to maintain life in mortally ill patients provided a new impetus to the discussion of euthanasia.  Two influential books published in the mid-1950’s contained chapters on euthanasia.  One of these books was entitled Morals and Medicine, by Joseph Fletcher, professor of pastoral theology and Christian ethics at the Episcopal Theological School in Cambridge, Massachusettes, who was in favor of voluntary euthanasia (1999, pg. 64).

            As medicine became more advanced and increased peoples’ life spans, most were living to a reasonably healthy and comfortable age.  But for some, life became miserable, and for patients who were unconscious, it became meaningless.  As a result, the wish to control one’s fate, especially when one could no longer speak for oneself, led to the development of living wills or advance directives, or, documents that leave instructions for one’s treatment.  A man by the name of Luis Kutner, a Chicago human rights lawyer who promoted his strong beliefs in human rights in several ways, conceived the “living will,” a term that he coined.  A living will is a document that states one’s wishes about medical treatment at the end of life if one is unable to communicate them directly. Supposedly Kutner spoke at a meeting organized by the Euthanasia Society of America in 1967 and they drew up a living will in response to his proposal and distributed a quarter of a million copies to various medical professionals (Zucker, 1999). 

The Act began as a citizen initiative petition in 1994.  Ballot Measure 16 was approved by voters by a 51 to 49 percent margin in 1994. Despite the measures passage, implementation was tied up in the courts for several years. A legal injunction delayed initial implementation of the Act until October 27, 1997, when the Ninth Circuit Court of Appeals lifted the injunction. The 1995 Legislative Assembly referred Ballot Measure 51 (authorized by House Bill 2954) to voters on the November 1997 ballot, which would have repealed the Death with Dignity Act. Oregon voters chose to retain the Act by a margin of 60 percent to 40 percent. (Oregon Legislative Policy and Research Office, 1997)

Oregon and Washington are the only two states in the union that allow physician-assisted suicide. However, there is a long term goal to assist other states with the implementation of the policy. According to the Death With Dignity National Center Website, there has been a growing support of the Movement:

 With the 14 years of data showing Oregon's Death with Dignity law is safe and utilized the way it was intended with no evidence of a slippery slope for vulnerable Oregonians and since our win in Washington in 2008, bills which seek to improve end-of-life care have been introduced in state legislatures around the country.

State legislators have the Oregon and Washington laws to use as a guide. While many bills are drafted each year, the majority fail. Some consider it a failure that most bills do not end up becoming law, but we view these bills as a testament to the growing support of the Death with Dignity movement, the will of the public, and the strength of Oregon's and Washington's model legislation.

 Measure 16 is regarded as one of the most controversial ballot measures in Oregon’s history. As a result, various agencies are required to do long term research studies that document the progress and issues that arise.  The Oregon Health Division is required to annually review a sample of medical records of patients who requested a life-ending prescription.  In addition, they generate and make available to the public an annual statistical report of information collected under the Act.

The status of the policy in Oregon is good.  Oregon Public Health Division released it’s annual report for 2011, which reflects statistics from the 14th year of implementation, and encompasses data from January 7, 2011- February 29, 2012.  Peg Sandeen, MSW and policy advocate of the Death With Dignity National Center provides a concise summary of the report:

Consistent with information from prior years, the data show Death with Dignity is a rarely used option for a small number of terminally ill Oregonians. The report indicates the process was implemented, in every instance, under the strict guidelines written into Oregon law and the established medical standard of care that has evolved since implementation.

During the 13 months covered by the report, 114 qualified patients received a prescription under the provisions of the law. Approximately 62%, or 71 terminally ill individuals, died as a result of ingesting medication prescribed under the Oregon Death with Dignity Act. Sixty-two different physicians wrote prescriptions under the law. According to the Health Division's report, in the 14 year history of implementation, 935 prescriptions have been written and 596 individuals have ingested medication and died using the standards spelled out in Oregon law.

Similar to prior years, most of the qualified patients who used the medication to hasten death were over 65, had a terminal diagnosis of cancer, and received palliative care service through hospice. Additionally, participants tended to be well-educated (48% with a four year degree or more), had access to some form of insurance (96% with public or private insurance), and died at home (94%). The most commonly reported end-of-life concerns were: less able to engage in activities making life enjoyable (90%), losing autonomy (88.7%), and loss of dignity (74.6%) (2012).

It is important to note that the use of the term “Assisted Suicide” has been called into question by the American Public Health Association as it has negative connotations.

While “physician-assisted suicide” is an accurate and descriptive term, it should be replaced with the advocacy-phrase “aid in dying.”   Activists needed to make an attempt to redefine the crime of assisted suicide as a legitimate “medical treatment.”  Rita L Marker, an attorney and executive director of the International Task Force on Euthenasia and Assisted Suicide revealed that the term has negatively affected the Assisted Suicide Movement.  She writes, “In the more than ten years since the passage of the Oregon law, state after state has considered legalizing assisted suicide.  Each time, there was early support for the measure.  Yet, in each instance, when the official vote was taken, support had evaporated and the proposal went down in defeat” (2009, p. 121). 

As a result, assisted suicide proponents, particularly Compassion and Choices, searched for some way to improve their position.  Thus, they commissioned research and polling.  They found that people have a negative impression of the term “assisted suicide,” but, if euphemistic slogans like “death with dignity” or “end of life choices” were used to describe the same action, response was relatively positive. They embarked on a mission to replace it with kinder, gentler language.   In addition, they wrote press releases to the media, the state of Oregon and major public-policy organizations claiming that use of the term “assisted suicide” demonstrated insensitivity to dying patients and to the physicians who assisted them (Marker, 2007).

 References:

Zucker, Marjorie. (1999).  The Right To Die Debate:  A Documentary History. Greenwood Press: London, pg. xxvi.

Taylor, Bill. (2010).  Oregon Death With Dignity Act, Legislative Committee Services Report, Salem, Oregon, June 2010, pg 2.

Engdahl, Sylvia. (2009).  Assisted Suicide: Current Contraversies, Greenhaven Press: MI, pg. 65.

Asch, Adrienne. (2005).  “Recognizing Death While Affirming Life,” Hastings Center Special Report, November-December, p. 31.

Callahan, Daniel. (1997).  “Self-Extinction: The Morality of the Helping Hand,” Chapter 3, in Robert F. Weir, ed., Physician-assisted Suicide, Bloomington: Indiana University Press, 71.

Long, Lori. (1997). Basics on Ballot Measure 51, Oregon Legislative Policy and Research Office Report, Salem, Oregon.

Sandeen, Peg. (2012). Oregon Death with Dignity 2011 Report. Death With Dignity National Center.  Retrieved from: http://www.deathwithdignity.org/2012/03/07/oregon-death-dignity-2011-report

Marker, Rita. (2007). “When Killing Yourself Isn’t Suicide,” National Review, March 5, 2007,pg. 121.

Loss and Love: Heart Wisdom on Grief

Welcome all of you tattered and exquisitely beautiful souls. Thanks for receiving this offering and showing up for one another in our deepest grief and existential despair. It takes courage to show up in your vulnerability and rawness, so I commend and honor you.

 We are all experiencing the collective trauma of the environment crisis, but also rampant social problems, and the narcissistic injury that president Trump inflicted on us since his election. It has been an endless and horrifying barrage of abuse and while I know the human spirit is strong, our flames are weak.

 We gather here today to honor our individual and collective grief.  And the need for our community to come together and support one another in our collective trauma.

The intention is to cultivate more reverence for the sacred process of grieving.  Our deep grief is not something to simply “get over.” On the contrary,  it is something to learn to appreciate and value as a necessary part of life.  We need to have just at much reverence for loss as we do for love.

Another intention is to get out of mind and into our hearts—our emotions, our bodies, and our soul.  In the west there is an overemphasis on “rationality” and “rational modes of knowing.”  We see a championing of the mind over the emotions— and are literally taught to live in our minds and devalue the wisdom of our emotions, bodies, and spirits.

It is also our intention to offer a safe, nonjudgemental, healing ground to release any deep grief you have been suppressing and any further support you might need in the future.

 We truly are all in the same boat and things are very dark and bleak right now.  We will most likely be experiencing this darkness for awhile now. However, we must find a way to unite in our love for the earth, in our love for the diversity of species on this gorgeous planet, and in our love for one another.

 With all the loss and collective trauma in the world today, we need to offer support to one another as so many are feeling silenced, marginalized, isolated, alone, and wounded.  I want to honor all of the people who are so paralyzed in their pain that they can’t leave the house. I work with a lot of these people in my job as a home health social worker. You would not believe how many vulnerable people are feeling isolated and terrified right now.

 I have felt the depths of despair myself, particularly when I first learned of the environmental crisis in 2015. I was just finishing graduate school and I just released the first edition of my book Feminine Mysticism in Art. I reached out to Andrew Harvey for an endorsement, which he obliged.   And on his website I saw some interviews that he posted. I listened to an interview he did with Guy McPherson and Carolyn Baker—they had just released a book called “Extinction Dialogues: How to live with Death in Mind.” Guy is a climate scientist and Carolyn Baker is a phenomenal psychotherapist and author of multiple books on the decline of global capitalism. I immediate purchased the book and was forever changed.

It looks me six months to read it.  I felt terribly alone and isolated. At the time, I was finishing graduate school and there were only a few people in this community that knew about the devastating reality of global warming. I reached out to these people and continued to seek guidance from personal mentors. I had many sleepless nights—panic attacks in the middle of the night, despair, low grade depression, spaciness, inability to focus, memory impairment.  

 It is common to isolate when one is experiencing deep depression and despair.  However, I don’t recommend isolating for long periods of time as it can lead to a downward spiral to suicidal ideation and even suicide.

We all know the pain and wounds are deep. WE have all been terribly wounded by capitalism—particularly those who have been horribly discriminated against due to race/class/gender/and not to mention LGBTQ concerns.The system of social inequality is continuing to get worse, and we are more divided now than we have ever been due to social inequality, fierce competition, and hyper individualism (every man for himself).

 However, there is also another larger social trend happening at the same time.  We are evolving at a rapid pace, which feels like the quickening. The veils are being lifted and there is a massive tidal wave of awakening occurring.The new paradigm has been emerging for awhile now, but it has been stifled by corruption of the power elite and the corporatocracy that our political system has sadly become

We are witnessing the merging of science and mysticism, new humanitarian social systems, and regenerative agriculture. We are also witnessing the reclaiming of indigenous wisdoms and a renewed connection to the earth. We all have a direct access to the spirit world and literally possess a universe in our own minds.

I truly believe that the indigenous peoples hold the deep wisdoms for our individual and collective healing. The purification times are here, as they have prophecised.

And while the scientific facts are undeniably daunting and fatalistic, no one really knows what is going to happen.  We all know on a soul level, that the apocalypse is and archetype deeply embedded in the collective unconscious and it is emerging now. The meaning of apocalypse is “A Lifting of the Veils.” As Karl Jung purports, the universal occurs in the collective unconscious and we all have access to it.  

 The human mind has always been ignorant, and limited in its ability to conceptualize the brilliance of the Infinite Universe.

 It is our greatest hope, that in going thru the dark night of the soul, there will be the possibility of new life, redemption, and possibly a new golden era on earth.We also need stay open to the upleveling of humanity, which is equally possible if we can unite in one common goal, which is the survival of the species and living in harmony with the Earth.

 It is possible to experience rapid changes during the quickening. We are seeing this change happen now all over the world. It is my hope and prayer that this continues to escalate, as our time is short.

 I would also like to say that the environmental grief that we are experiencing is totally different than personal grief as it involves the potential death of human species and most species on planet earth.

We have experienced problems in the past, but not at the epidemic levels we are experiencing now. We are all suffering from some kind of modern day neurosis—anxiety, depression, ADD, fragmentation of the psyche.  This neurosis is NOT something to pathologize…it is normal to be experiencing an unraveling of the psyche in a time of chaos and social unrest.

 This global dark night of the soul will inevitably stretch all of us beyond our comfort zone and will continue to do so in the near future.  It will trigger a full range of negative emotions, such as utter rage, deep despair, shame, confusion, and apathy.  

 We are being called to surrender to the dark void of transition—to be the mystery at the crossroads. 

It will be incredibly difficult for us to befriend our individual and collective pain as it feels totally overwhelming, doesn’t it? When you love with all of your heart, you loose with all of your heart. And this loss, as many of you know, is a painful death of the ego and even hope. Having the courage to grieve is sitting with the most horrific shadow and allowing it to utterly transform you.

 We all must be committed to our own personal grief work and the many layers of grief that will unfold in the future. We most likely will be grieving for many years, particularly if we are indeed in a hospicing phase of humanity.  Hospice therapist and author, Elizabeth Kuebler Roth, worked with hundreds of people who experienced profound grief and loss at the end of their lives. Her research on grief revealed stages that all people go through in the grieving process (Stages of grief—denial, anger, grief, acceptance).  

 Most are still in the denial and anger phase, which is normal. One can’t force something through the process, nor can one force someone to grieve. We don’t have to do it all at once. It will occur in layers and stages.  And I personally think that we can regress to previous stages.  For example,  after three years of coming to terms with the reality of the ecological crisis, I have moved to a place of more acceptance.  However, I find that I can cycle back through to the anger and grief phases at times.

 Another thing I want to say about grief is that we all grieve in our own unique way. One is not better than the other. There is no pressure to cry if that is not want comes for you. Some may feel the need to make sounds or moans, which is welcomed. You might also choose silence.

For those of you who have been through your own dark night of the soul, you know there are gifts that come in the void of uncertainty. What do you think some of these gifts might be?

 1)   It challenges us to be in the present moment—to get in touch with our intuition and direct access to spirit.

2)   It challenges us to surrender to the Great Mystery. To learn how to sit with the void of the unknown and be OK with not having a plan of action.

3)   There is wisdom that comes in the complete shattering of the ego—radical humility and equality with everything.

4)   Challenges us to re-evaluate our values, beliefs and priorities. (family, friends, earth)

5)   Challenges us to practice non-attachment and letting go

6)   Asks us to practice radical forgiveness of self and others, reaching out to the community for support.

Doing this deep work is a practice of reverence for the death process.  Nature is such a profound teacher of the cycles of life and death, love and loss.   Humans have a lot of attachments, don’t we? Grief is also an honoring of our deep love for the good in humanity, as it is ultimately LOVE that will heal our jaded, broken hearts.  Love is the light that seeps into the cracks of the dark underworld.

 We know the power of this love and we must NOT forget the promise of INFINITE LOVE and GRACE on the earth plan and in the spirit world.  Our connection to the spirit world will literally be our life line and meditation will be a way for us to stay grounded and sane during the great turning. So will cultivating community and finding your own medicine offering for healing.

 There is no doubt it is difficult for humans to stay in a place of hopelessness.  We need to move into inspired action and find the motivation to do what we can in our own personal lives, but also in service to positive social change. It is incredibly healing to get out of your own suffering and assist people who are incredibly vulnerable, whose suffering is much greater than yours.

 There is a tremendous amount of redemption that comes when we start serving others.  There is much work to be done, my friends. And honoring our grief is a necessary part of the humbling and healing process. So pat yourselves on the back because you are stepping up to do some of the most important work of our time.

The RISING TIDE OF POVERTY IN AMERICA: ITS TIME TO ADJUST THE POVERTY LINE

 Calculating who is poor is a tricky and complicated affair, despite the good intentions among policymakers to want to improve the well-being of deprived people. The official government data published by the United States Census Bureau shows that, “In 2012, the official poverty rate was 15.0 percent, or just over 46.5 million people. The poverty rate is the share of people below the official poverty line. The poverty line was $22,314 for a family of four, $22,113 for a family of four with two children, and $11,344 for a single individual under age 65” (2012: 14).  However, there is a lot of controversy about the accuracy of these numbers, as they are based on an outdated poverty measure that doesn’t include alternative data. Policy efforts to reduce economic poverty may overlook important aspects of what is means to be poor. As Robert Havemen proclaims “these numbers ignore many non-economic considerations that may affect individual well-being, such as living in unsafe surroundings, being socially isolated, or experiencing adverse health or living arrangements not remediable by spending money (2009: 81).

            The current official poverty measure was developed in the early 1960s by Mollie Orshansky, and only a few minor changes have been implemented since it was first adopted in 1965 (us census). In the early 1960’s when she developed her poverty plan, President Johnson had declared a War on Poverty, and the nation needed a statistical representation of the poor. Her economy food plan was a bare minimum food plan designed for temporary use during economically challenging times. It was developed by taking the least expensive food plan developed by the Department of Agriculture and multiplying it by 3.

 According to Kathleen Short of the US Census Bureau “At the time it was developed, the official poverty thresholds represented the cost of a minimum diet multiplied by three (to allow for expenditures on other goods and services). Family resources were defined for this measure as before-tax money income.”

The Income based poverty line is an absolute measure that is adjusted each year only for changes in prices, not for changes in the standard of living.  The benefits to defining poverty in this way is that it keeps the poverty line fixed over a long period of time, which inevitably effects social policy and federal tax policy.  It also keeps the numbers relatively low, which looks good for the politicians in office. However, the absolute income poverty measure excludes a large number of people from receiving social services that they need, particularly women, minorities and children.  In keeping this outdated poverty line, the wealthy are the one’s who gain because they don’t have to pay higher taxes for social services and the poor people loose necessary services they need as a result of structural oppression.

Interestingly enough, the relatively low tax rate of the United States largely accounts for the nation’s skewed income distribution.   And despite the mammoth size of the federal budget of the United States, it is predicated on a tax base that is minimal compared to those of other industrialized nations.  “A tenant of the welfare state has been the progressive taxation of income and its redistribution to the poor through social programs; thus, the question of income distribution has become integral to the discussion of tax policy” (Karger and Stoesz, 2010: 244).  Unfortunately, research has revealed that tax policy has always contained provisions that benefit special interests. “Bending the tax code in response to lobbying is a long-standing practice in the United States, though today it is often associated with corporate influence or corporate welfare”(Karger and Stoesz, 2010: 243).  The Neo Conservatives have made it very clear that they want to completely do away with any kind of social welfare.  And keeping the poverty line lower than it should be keeps the tax rates low in the United States.  

Some attempts have been made to improve the nation’s official poverty measure.  According to Robert Havemen “In 1995, the National Research Council of the National Academy of Sciences reported the results of a comprehensive study of the strengths and weaknesses of the official measure, and proposed a major revision designed to correct many of the criticisms that have been levied against it” (2009:82). Since that report, the Census Bureau has developed a variety of improved poverty measures reflecting the recommendations of the 1995 report.  In November 2011 and November 2012, the Census Bureau released the first sets of estimates for the Supplemental Poverty Measure. However, none of these alternatives has been adopted to replace the existing official poverty measure (Census Bureau, 2012).

I would personally modify the absolute income poverty line by using a relative measure of poverty, which increases along with the general standard of living. I would also inculcate a multidimensional approach to poverty that includes hardships that people experience in many dimensions—education, housing, food, social contacts, security, and environmental amenities.  Aside from just measuring income, another measure of affluence that I would include is assets, insofar as they are an indication of real wealth.  Consisting of savings, real estate, stocks and bonds, and related property, assets not only can be liquidated during periods of adversity, thus offering the owner a buffer against poverty. According to Karger and Stoesz “The distribution of assets is even more skewed than income distribution, with the highest quintile owning more than 80 percent. By contrast, the wealth of the lowest quintile is negative, indicative of debt” (2010: 245).

In alignment with the 1995 study by the National Academy of Sciences, I would include all the items the reform proposed, which are so clearly delineated by Robert Haveman’s article “What Does it mean to be poor in a rich society?”:

The reform proposal would involve a new threshold based on budget studies of food, clothing, shelter, and amounts that would allow for other needs to be met, such as household supplies, personal care, and non-work-related transportation.  It would also reflect geographical differences in housing costs.  The income measure would also be reworked to include the value of near-money benefits that are available to buy goods and services (for example, food stamps), and would subtract from income required expenses that cannot be used to buy goods and services (for example, income and payroll taxes, child care and other work-related expenses, child support payments to another household, and out-of-pocket medical care costs, including health insurance premiums) (2009:82).

With the implementation of the new poverty threshold, the national statistics of poverty would go up and more people would qualify for social services. However, the corruption in tax policy favoring special interest groups or corporate welfare has to change.  People are so disillusioned by the corruption of democracy and for good reason.  How are we going to incorporate social change when corporate interests rule the roost?   Furthermore, people are highly disillusioned by the way taxes are used, such as funding wars (supposedly fifty cents out of every dollar goes to military costs. If that much went into social welfare we wouldn't be having the problems that we do).

Year after year, the funding for social services dwindles.  This is perhaps the most inhumane thing we could do to the very people that are the backbone of the capitalistic system.  The system is set up for people to be poor, yet the conservative power elite wants to cut the social services for these people—this is absolutely insane! An assortment of research reveals that although there have been some governmental efforts made to reduce poverty; they are superficial efforts that don’t target the root of the problem, which is unregulated capitalism and corporate greed.  In addition, there are a number of social trends that have changed the landscape of the U.S economy, such as globalization, the middle class slide, increasing populations and the diminishing of natural resources. All of these long-term trends drastically affect the U.S. economy and the global economy as well. 

More importantly, the new poverty threshold would assist more women, minorities and children who represent the majority of the poor. The "feminization of poverty" is currently a phenomenon of great concern to social scientists and social workers.  In the United States, the fastest growing type of family structure is that of female-headed households and, because of the high rate of poverty among these households, their increase is mirrored in the growing number of women and children who are poor; almost half of all the poor in the U.S. today live in families headed by women.  Women have higher poverty rates than do men for two reasons.  First, their economic resources are often less than those of men.  Second, they are more likely to be single parents during their working lives and to be unmarried and living alone in their later years. Minority women are highly represented among the poor because of their minority status and a higher risk of single parenthood (Devine, Plunkett, and Wright, 1992). Furthermore, the poverty of women is reflected in the poverty of children.  “There are almost 13 million poor children in the U.S.: 52 percent of them live in families headed by women and the poverty rate for white, black, and Spanish-origin children living in female-headed households is 46 percent, 66 percent, and 71 percent respectively” (Rodger, 1986: 32). 

With the growing number of poor people and dwindling of social welfare, we are headed for a major social crisis, and that doesn’t include the environmental crisis looming over our heads as a result of global capitalism. Chris Farrell wrote an excellent article titled “War on Poverty: From the Great Society to the Great Recession” (American Radio Works, 2014). He discusses some of these social trends and social policies that have contributed to the rising tide of poor people, such as global competition, the decline of private sector unions, rapid technological change and the deregulation of finance, the working poor, and low minimum wages for less educated, low- skilled workers.  His article is realistic and bleak, but it is right on target.  He ends with a quote that describes our current economic, social and environmental crisis in a nut shell:

There are public policies that would improve the job prospects for poor people. But there’s little appetite to initiate or expand anti-poverty programs and probably won’t be anytime soon.  American politics is likely to be defined in the new term by rising alarm over the increasing federal deficit and mammoth government debt. Meanwhile, state and local governments are slashing their support for the poor.  If the government can’t help, the economy will end up doing the heavy lifting by default. But so far the economy is generating little job and income growth, and even when it does come back, low-skilled workers are likely to be left behind. The risk is that the tragic combination of joblessness and poverty will lead to diminished dream and social isolation which in turn, will feed a cycle of unemployment and destructive behavior.  It’s morally and economically wrong.

The war on poverty will never be a war if people are fed a bunch of faulty statistics, which cause them to believe that poverty isn’t a macro, social epidemic.   It is clear that band-aid solutions simply aren’t working anymore, particularly in a time of global crisis. The costs of social welfare are far less than the price paid for globalization in the name of corporate greed.  Unfortunately, the karmic fall out as a result of “profits over people” is causing a massive global dark night of the soul that will inevitably cause even more suffering. The wisdom that will emerge from this death is more equality, cooperation, compassion and tolerance of diversity. 

We need a massive radical humanitarian movement—a new structural social work that transforms society from the inside out.  It is not going to come from any politicians. On the contrary, it will come from the people waking up to the lies that they have been fed by policy makers and greedy capitalists. According to one of my social work heroes, Bob Mullaly, social work ideology has much more in common with the socialist paradigms than it does with the capitalist paradigms (2007). Mullaly writes “If social workers truly believe in the values and ideas they espouse, then they cannot subscribe to and try to maintain a social order that contradicts and violates these same values and ideals (2007: 206).  The time is now for social workers to unite for change.  We simply can’t sit on our laurels anymore; we must do everything that we can to speak out for social change. 

References:

Carmen DeNavas-Walt, Bernadette D. Proctor, Jessica C. Smith. (2013). Income, Poverty and Health Insurance in the United States. United States Census Bureau, Department of Commerce.

Devine, J.A., Plunkett, M., & Wright, J.D. (1992). The Chronocity of Poverty: Evidence from the PSID, 1966-1987. Social Forces, 70, 787-812.

Farrell, Chris (2014). "War on Poverty: From the Great Society to the Great Recession." American Radio Works, Public Radio: http://americanradioworks.publicradio.org/feaatures/poverty/rising_tide.html

Haveman, Robert. (2009). "What Does it Mean to be Poor in a Rich Society?" Focus, Vol.26, No.2, Fall.

Karger, Howard, Stoesz, David. (2010). American Social Welfare Policy: A Pluralist Approach. Allyn and Bacon, Boston, MA.

Mishel Lawrence, Bivens Josh, Gould Elise, Shierholz Heidi. (2012). The State Of Working America, 12th Edition. Cornell University Press, New York.

Mullaly, Bob. (2007). The New Structural Social Work.  Oxford University Press, Ontario,    Canada.

Short, Kathleen. (2011). The Supplemental Poverty Measure: Examining the Incidence and Depth of Poverty in the U.S. Taking Account of Taxes and Transfers in 2011. The United States Census Bureau, Housing and Household Economic Statistics Division, Washington, D.C.

Rodgers Jr., Harrell R. (1986). Poor Women, Poor Families.  New York: M.E. Sharp.

Coping with Life Changes Caused by COVID-19

The pandemic has changed life for virtually everyone, whether it’s dealing with losing a job, adapting to stay-home orders, or learning to cook for yourself. Some major changes are by choice—choosing to adhere to travel restrictions and cancelling vacations, for example—while others are by force, such as being laid off. Regardless of the change, there are both challenges and benefits that come with transitions.

 Adapting to changes:

As the threat of COVID-19 transmission became clear, people were forced to abandon or postpone weddings, travel plans, and events. While difficult, these changes have been necessary to slow the spread of the virus. Many people experience a sense of grief through sudden changes, so it’s important to focus on self-care as you deal with the disappointment. And if you need extra support, Guan Yin Healing Arts specializes in affordable therapy and can teach you mindfulness practices to ease feelings of stress or depression.

 However, there have been some creative adaptations in lieu of events and travel, as people find ways to celebrate together via video chats, drive-by parades instead of birthday parties, and live-streamed “living room concerts” by musical artists who had to forego their touring plans.

 If you’ve been laid off as a result of the pandemic, it may be difficult to adapt to being home all the time with no work to keep you busy. This can be a great time to reassess your career path and think about whether it may be time to change your focus. As you spend time at home, do some research into fields that interest you, and see if you can find free online courses that may help you get more insight into different industries.

 For those who were considering getting a pet, the pandemic provides the perfect opportunity because you’ll be home more often to help train your new dog or cat. And if you live alone, your new companion will ease feelings of isolation. However, be sure to think about the long-term effects of having a pet before you adopt. If you have a job that will require you to eventually spend long hours at the office, you may want to consider how to care for your pet when you go back to work. If you’re feeling idle at home and looking for ways to stay busy, consider planting a garden to get some exercise and fresh air.

 Another challenge is learning how to battle the pandemic shag; depending on how long you’ve been isolating, your hair is likely in need of a cut. With many barbershops and salons still closed or open for reduced hours, it’s becoming more common that people take their haircuts into their own hands. Before you start hacking away at your locks with a pair of kitchen scissors, research tips and invest in tools, such as hair clippers, so you can make the most of your COVID cut.

 Plans you can’t change:

While many life plans can be changed, there are a few things that can’t wait. For example, if you have to buy a new car, there are ways to do it safely right now, with many car dealerships offering special services such as car deliveries and no-contact showings. Call around to local dealerships to see if you can test-drive a vehicle, but be sure to ask them about their cleaning protocol.

 Pregnant women can’t press pause on their pregnancy and will have to deal with challenges of giving birth during a pandemic. Families expecting a baby can mitigate the risk of contracting COVID-19 by shifting to a midwife clinic instead of a hospital.

 For those who need to buy a house during the pandemic, be sure to take advantage of technology and inquire about virtual tours and 3D walkthroughs. Many real estate agents have precautions in place for the pandemic, so find a touring option that limits your exposure to germs.

 The pandemic has forced everyone to adapt to life changes, from being laid off to cancelling travel plans. While the disappointment may be hard to handle, there are things you can do to mitigate the stress such as planting a garden, taking online courses, and adopting a new pet for companionship. Some things can’t change despite the pandemic, so if you have to buy a new car or a house, research ways to do it safely and reduce the spread of the virus.

 Article written by:

Jennifer Scott

 For more information about Jennifter, visit her blog at spiritfinder.org.

First Impressions, Beauty, and Oppression

As a white woman, I've had numerous people make false assumptions about me, or, false first impressions. I was able to really get a deeper understanding why this was happening when I taught a course in Race and Ethnic Relations at a community college.

In fact, it happened so much that I decided to purposely do a social experiment. As a Sociologist I've read a lot of social research and there is one piece of research in particular that was done on first impressions and how far OFF peoples impressions can be of someone (see research links on the Psychology of First Impressions below).

Misjudging people based on what they look like, their skin color, their dress, their body language--happens all the time. And while most people are unconscious of it, it is a human phenomena that occurs with some of the most educated folks, as well.

People also tend to "judge a book by its cover, despite being a gem. And even when that book is a gem, people are still resistant to reading it.

Upon teaching a Race and Ethic relations class I implemented a social experiment on the first day of class where I asked the students to write on a piece of paper their first impression of me.

Upon reading the responses, it became clear to me why I felt discriminated against based on what I looked like,
which is white, european, blue eyes, blonde hair, tall, athletic.

And while we all have to acknowledge the ways in which we have been priveleged and discriminated against (or oppressed) I found that while I had received some priveleges for being beautiful in the "american definition," I surely had experienced a lot of social oppression as a woman, as well.

However, I am totally cognizant of the fact that my standpoint as a lower middle class white woman, is quite different from an African American woman, a hispanic woman, an asian woman, native american woman, and middle eastern woman (particularly single mothers).

I have been fortunate to be enlightened by some of the most brilliant Black Feminist Sociologists,  such as Patricia Hill Collins, Angela Davies, Bell Hooks, Paula Gunn Allen,  and so many more...etc.

Your social oppression as a white woman is valid but it becomes small when you truly listen to the voices of minorities (both male and female) and have the humility to really educate yourself about their particular intersection of race/class/gender issues.

Most Americans are aware of Racism and talk all PC about it, but they fail to really do the deep dive into the micro and macro systems of social oppression.

I am happy to see so many people take this current George Floyd riots of police brutality as an opportunity to further educate themselves about the subtle and blatant forms of discrimination in the United States and globally.

It is quite humbling, to say the least, when you devote massive amounts of finances and time  into a sociological education, only to be falsely dismissed for being unqualified to teach the class on the first day because of your "looks."

People fail to realize how often white women are discriminated against, particularly in education and politics.

In fact, even though I dressed professional, my looks were a deterrent for some people.

Some of the false assumption made were that I was:

1) Priveleged (despite growing up in poverty)

2) That I was unintelligent (despite being a 4.0 student)

3) How could I be teaching a race and ethnicity class as a white, priveleged woman?

SEXISM IN MEDICAL:

I have since devoted five years of my life working in the trenches of Southern Oregon doing medical social work for severely marginalized people--those with physical and mental disabilities, minorities, the elderly, and single mothers.

Working in the field, I still come up against discrimination in the medical field and even with patients who have a lot of pride, wounded egos, defense mechanisms, and distrust of authority figures.

People make the false assumption that because I work in the medical field, that I am not to be trusted because I am apart of the "system", which means I must support big Pharma and all that "evil shit."  As a bridger of allopathic and alternative health, I am trying to heal the gap as I witness a lack of understanding from pragmatic scientists and extreme health advocates. 

I can't believe how many people, outside of the medical system, make so many grand generalizations that the medical system is totally corrupted by big pharma (which is partially true) but fails to see all the enlightened light workers in the system who get it and are proposing solutions for change.

There are a lot of problems in medical systems, but there are systems that are working too. 

I have also observed that people are really triggered by beauty and I totally understand why.

Not only has beauty been used and exploited by the commercial industry to sell products, it has been used by the fashion and cosmetic industry to instill and reinforce homogenized images of beauty that most women with fuller figures don't fall in to.

A Sociologist and author by the name of Naomi Wolf documents how the The Beauty Myth has been incredibly damaging for women's self esteem.
( For more information read The Beauty Myth: How Images of Beauty Are Used Against Women)

People are socially conditioned that beauty is power. If I have beauty perhaps I can have more opportunities in life.

If I am beautiful perhaps I will be noticed and accepted.

And while beautiful people can tend to get some opportunities that other people wouldn't, they are discriminated against more than people realize.

I am grateful for the opportunities I manifested with my job to dampen my physical beauty and really shine my light from within.

I don't wear make-up and I dress casual when I work with under-priveleged people.

I have found that it helps people to feel more safe with me and build rapport quicker. If I lead with my heart and not my looks, it really helps.

And I never introduce myself by telling someone how many degrees I have. People have been very wounded by power relations, particularly if they are socially oppressed.

Some of the best personal growth has occurred for me by getting out of my comfort zone and humbling myself
to meet people as an equal , totally in my heart and present. 

For more information about the Beauty Myth, read Naomi's book:

https://www.amazon.com/Beauty-Myth-Images-Agai…/…/0060512180

Social Research on first impressions:

https://www.psychologytoday.com/…/the-psychology-first-impr…

And here are some personal blog entries about poverty/racism/sexism
on a micro and macro level:

Researchers identify four facial features that drive our early judgments.

Copy of Effective Treatments for Alcoholism and Addiction

For most people, alcohol is accepted in our culture as a pleasurable accompaniment to social activities. However, a substantial number of people have serious trouble with their drinking. Alcoholism, which is also known as "alcohol dependence syndrome," is a disease that is characterized by the following elements: craving, loss of control, physical dependence, and increased tolerance. According to recent statistics from the National Institute on Alcohol Abuse and Alcoholism, "Nearly 14 million Americans--1 in every 13 adults--abuse alcohol or are alcoholic. Several million more adults engage in risky drinking patterns that could lead to alcohol problems. In addition, approximately 53 percent of men and women in the United States report that one or more of their close relatives have a drinking problem"(http://alcoholism.about.com/library/niaaa01.htm).

In addition, not only does alcohol abuse increase a variety of health risks, it also increases the risk of death from automobile crashes, recreational accidents, and on-the-job accidents. It is estimated that alcohol-use problems cost society approximately $100 billion per year (NIAAA website, 2013). The purpose of this article is to gain a greater understanding about alcoholics and the most effective strategies for treating alcoholism.

There is a plethora of research that is enhancing the practice among involuntary clients, or in this case, alcoholics. Scientists at Medical centers and universities throughout the country are studying alcoholism and have cutting edge information about it. Today, NIAAA funds approximately 90 percent of all alcoholism research in the United States. According to their website, “NIAAA is sponsoring promising research in vital areas, such as fetal alcohol syndrome, alcohol’s effects on the brain and other organs, aspects of drinkers’ environments that may contribute to alcohol abuse and alcoholism, strategies to reduce alcohol-related problems, and new treatment techniques” (NIAAA website, 2013). The goal of this qualitative research interview is to further understand effective ways of treating and preventing alcohol problems.

First and foremost, Alcoholism is a complex issue that involves a multitude of factors; such as biological, psychological and social. “Alcoholism is due to many interconnected factors, including genetics, how you were raised, your social environment, and your emotional health. Some racial groups, such as American Indians and Native Alaskans, are more at risk than other of developing alcohol addiction. People who have a family history of alcoholism or who associate closely with heavy drinkers are more likely to develop drinking problems. In addition, those who suffer from a mental health problem such as anxiety, depression, or bipolar disorder are also particularly at risk, because alcohol may be used to self-medicate.”

Recent research supported by NIAAA has demonstrated that for many people, a vulnerability to alcoholism is inherited. These findings show that children of alcoholics are about four times more likely than the general population to develop alcohol problems. Children of alcoholics also have a higher risk for many other behavioral and emotional problems. But alcoholism is not determined only by the genes your inherit from your parents. It is important to recognize that aspects of a person’s environment, such as peer influences and the availability of alcohol, also are significant influences.

The Addiction Recovery Center in Medford employs the use of several evidence based theoretical frameworks that have shown positive results. She introduced me to the American Society of Addiction Medicine (ASAM), “a professional society representing over 3,000 physicians and associated professionals dedicated to increasing access and improving the quality of addiction treatment; educating physicians, other medical professionals and the public; supporting research and prevention; and promoting the appropriate role of physicians in the care of patients with addictions” (ASAM website, 2013). When a client applies for substance abuse services at the ARC, they are screened and assessed with the ASAM criterion, which evaluates a multitude of factors; such as physiological effects of drug withdrawl, psychological impact, physical complications, readiness to change and history of relapse. (http://www.asam.org/research-treatment/screening-and-assessment)

There are a number of theoretical models that the ARC approves in their treatment program. Depending on the severity of the addiction, the ARC recommends individual counseling, family counseling, group counseling and residential treatment housing. However, due to lack of time, she was only able to talk about a few; such as Motivational Enhancement Programs, Cognitive-Behavioral Therapy, and 12-Step Facilitation Therapy. According to Noel “Treatment varies depending on the type of drug and the characteristics of the patient. The best programs provide a combination of therapies and other services. These models are designed to raise drinkers’ awareness of the impact alcohol has on their lives, as well as the lives of family, co-workers and society. They are encouraged to accept responsibility for past actions and make a commitment to change future behavior. Substance abuse therapists help alcoholic patients understand and accept the benefits of abstinence, review treatment options, and design a treatment plan to which they will commit” (Chaney, 2013).

The National Institute on Drug Abuse released a publication (2012) titled “Principles of Drug Addiction Treatment: A Research-Based Guide” that highlights several evidence based treatment models that are working in treating alcoholism and other addictions. Each approach is designed to address certain aspects of drug addiction and its consequences for the individual, family, and society. Some of the approaches are intended to supplement or enhance existing treatment programs, and others are fairly comprehensive in and of themselves. The two approaches they mention are: Pharmacotherapies and Behavioral Therapies. The Pharmacotherapies consist of an assortment of medications that can be used in conjunction with individual, group and family therapies; such as Naltrexone, Acamprosate, Disulfiram and Topiramate. When used in combination with counseling, these prescription drugs lessen the craving for alcohol in many people and helps prevent a return to heavy drinking.

According to the National Institute of Drug Abuse, “Behavioral approaches help engage people in drug abuse treatment, provide incentives for them to remain abstinent, modify their attitudes and behaviors related to drug abuse, and increase their life skills to handle stressful circumstances and environmental cures that may trigger intense craving for drugs and prompt a relapse” (NIDA, 2013, 34). They identify a number of behavioral therapies shown to be effective in addressing substance abuse; such as Cognitive-Behavioral Therapy, Contingency Management Interventions/Motivational Incentives, Community Reinforcement Approach, Motivational Enhancement Therapy, The Matrix Model and 12 Step Facilitation Therapy.

While I can’t discuss all of these theoretical models, I will discuss Motivational Enhancement Therapy and 12-Step Facilitation Therapy. Using a nonjudgmental approach, Motivational Enhancement Therapy (MET) employs Motivational Interviewing (MI) to analyze feedback gained from client sessions. The goal of MET is to aid the client in clarifying his or her own perceptions and beliefs in order to direct him or her in a decisive way. According to GoodTherapy.Org: http://www.goodtherapy.org/motivational-enhancement-therapy.html

MET is administered in a receptive atmosphere that allows a client to receive feedback from the therapist for the purpose of fortifying the client’s resolve for transformation and to empower the client with a feeling of self-control. Rather than engaging the client’s defense mechanisms through confrontational discourse, the therapist works with the client to create positive affirmations and a sense of inner willingness to facilitate change. Once that is achieved, the client becomes receptive to the healing process and progresses toward wellness (2013, 23).

Motivational interviewing principles are used to strengthen motivation in the client and build a plan for change. Coping strategies are suggested and discussed with the patient and the therapist continues to encourage commitment to change or sustained abstinence.

Another effective treatment model is 12-Step Facilitation Therapy. This peer-support approach encourages people to become involved with a 12-step program that complements professionally supervised therapy. Programs like Alcoholics Anonymous, Smart Recovery and Women for Sobriety are typically recommended with all forms of alcoholism therapy because they provide alcohol-dependant Individuals with an encouraging, supportive environment. These support group meetings focus on abstinence and fosters each individual's physical, mental, emotional and spiritual health.

While there is a lot of cutting edge research on alcoholism and methods of effective treatment, there is always room for further investigation. Not only is there a need for more genetic research, there is a need for alternative treatment approaches and effective medications that can be used in conjunction with therapy. In addition, addiction recovery treatment programs aren’t able to meet the needs of everyone; therefore, there is a need for research on alternatives methods for the treatment of alcoholism. Supposedly NIAAA has sponsored a study called project MATCH, which tested whether treatment outcome could be improved by matching patients to three types of treatment based on particular individual characteristics. This study found that all three types of treatment reduced drinking markedly in the year following treatment.

References:

La Clinica Website. (2013). Retrieved from http://www.laclinicahealth.org/

Travertini, Elise. (2013). Personal Interview about Agency.

Absence of Women from Developmental Theory:

'There will be narratives of female lives only when women

no longer live their lives isolated in the houses and stories of men."

---Carolyn Heilbrun, 1995

 Unfortunately, it wasn't until the feminist movement that real concern for women’s development began to interest scholars, which partly explains why there is a lack of research that specifically addresses women artists and issues of identity. In addition, beginning with Freud, theories of human development have traditionally been conceived in terms of male development, with female development either ignored or treated as an afterthought. Consequently, until very recently we knew little about female development, in that much of the theory of development has been written to describe male phenomena (Adelson and Doehrman, 1980; Gilligan 1979)

 Carol Gilligan (1979) has revealed that women were missing even as research subjects at the formative stages of social psychological theories. Therefore, the potential for bias on the part of male investigators was heightened by the tendency to select predominately or exclusively male samples for research. In addition, Belenky and Clinchy have revealed that:

This omission of women from scientific studies is almost universally ignored when scientists draw conclusions from their findings and generalize what they have learned from the study of men to lives of women. If and when scientists turn to the study of women, they typically look for ways in which women conform to or diverge from patterns found in the study of men. With the Western tradition of dividing human nature into dual but parallel streams, attributes traditionally associated with the masculine are valued, studied, and articulated, while those associated with the feminine tend to be ignored (1979: 6).

 Thus, we have learned a great deal about the development of autonomy and independence, abstract critical thought, and the unfolding of a morality of rights and justice in both men and women. We have learned less about the development of interdependence, intimacy, and contextual thought (Bakan 1966; Chodorow 1978; Gilligan 1977, 1979, 1982; McMillan 1982).  Developmental theory has traditionally established men's experience and competence as a baseline against which both men's and women's development is evaluated, which has led to the misreading of women's experiences.

Various researchers have complained that concepts of autonomy, independence, and abstract achievement do not describe the focal issues of growing up female. For example, Gilligan's (1982) influential study of moral development showed that women conceptualize and experience the world "in a different voice," a voice that is more person centered and empathic, more emotionally connected and less abstract than the male voice. Men and women, concludes Gilligan, operate with different internal modes.

Where a dominant image for men is that of hierarchy, competition and autonomy, women respond to their lives through the images of the web, or concerns about connectedness or relationships to others. As a result of these fundamental differences, experiences such as achievement and affiliation are different for men and women, even though behavioral manifestations may look the same. In addition, Miller and her research group (Miller, 1984; Kaplan,1982; Klein, 1984) have posited the existence of a "relational self' in women that is central to their growth. "Development according to the male model overlooks the fact that women's development is proceeding but on another basis...women's sense of self becomes very much organized around being able to make and then to maintain affiliations and relationships" (Milter, 1976: 3).

Nancy Chodorow (1978), a feminist sociologist and practicing psychoanalyst has used object relations theory to explain how socially constructed gender roles have shaped the development of a woman's identity. She argues that women, because they are mothered by someone of the same sex, form a different inner patterning of relationships that prevents them from ever becoming as separate and autonomous as men.  She writes:

From the retention of preodipal attachments to their mother, growing girls come to define and experience themselves as continuous with other; their experience of self contains more flexibility or permeable ego boundaries. Boys come to define themselves as more separate and distinct, with a greater sense of rigid ego boundaries and differentiation. The basic sense of self is connected to the world; the basic masculine sense of self is separate (1978: p. 169).

 All of these researchers share a growing recognition of the importance of relatedness to women and the necessity of finding some social psychological constructs to describe women's personal experiences of identity formation as distinct from mens.

Women Artists and Identity Formation: Summary of the Findings

This qualitative research project examines the processes by which various woman have come to assume identities as artists as well as the transformations in self perceptions that occur upon having adopted an artistic identity.  Prior  research on women artists and identity formation has tended to take either a strictly "externalist" approach (social constructionist or structuralist) or an "internalist" approach (psychological or biological), assuming that identity transformation is determined by either socio-cultural factors, or,  internal  psychodynamic mechanisms.   Some theorist suffice it is a more complex process.  Yet, by examining the conditions by which women artists' formulate identities, my research reflects the complex interplay of both internal and external factors responsible for the birthing of their artistic identities. Therefore, the formation of an artistic identity is both a subjective, internal process as well as objective, social phenomena. It is both self created and socially constructed.

The data in this research resulted in the construction of a transformational model of artistic identity. It explains the movement from a "pre­ artistic identity" or "naive" identity to a "neophyte" identity, which marks the point of conscious realization or internalization of an artistic identity. The quest for identity by naive artist is best conceptualized as an incubation period which includes an individuals self perceptions prior to the conscious realization of identity and the changes in self perceptions that occur as a result of the internalization of an artistic identity. Therefore, during the incubation period, the process of identity formation is mostly an unconscious orienting process and doesn't start to come into consciousness until an individual becomes sensitized to both internal and external cues about one's self.

The naive identity consists of four sequential phases that lead up to the neophyte identity: encounter, polarization, individuation, and integration. Each phase represents a small snap-shot within a larger transformational process. In addition, the movement from one phase to the next is dependent on two identity catalysts: internal cues and external cues. The catalysts are necessary ingredients that provide stimulation and information to an individual about herself which both aid as well as constrain the formation of an artistic identity.

In the encounter phase one is engaging in various creative expressions, which stimulates the flow of information (identity cues) from both internal and external sources.    In other words, knowledge of self is impossible without the experience of oneself as an artist.   However, in the beginning stage, one's orientation tends to be more "other -directed"-meaning there is a tendency to rely more on external cues as the main source of self-knowledge. At some point, the internalized messages about oneself from external influences come to be "polarized" or internally inconsistent, resulting in sharp dichotomies in self-perceptions, internal conflict and feelings of anxiety, which marks the polarization phase.

In order to resolve one's internal conflict, one has no choice but to differentiate herself or "individuate" from external influences--both familial and societal-- in order to create a sense of autonomy from others. This marks the beginning of the individuation phase. During this phase, there is shift in orientation from "other-directed" to "inner-directed" and a tendency to rely more on internal cues as a source of self knowledge, which aid in one's ability to become conscious of her desires. Once one is confirmed in her desires, she is then able to become aware of internalized beliefs and values that aren't in alignment with her desires and resocialize herself by consciously choosing her own values with which to identify.

During the integration phase, one is able to resolve her internal conflict through her ability to internally create meaning out of information she has received from internal and external sources.   By bridging her submerged world of emotions, intent and desire with her intellectual, objective, social world she isable to consecrate her internal polarities, which brings about the conscious realization and internalization of an artistic identity. This triggers a radical transformation in self perceptions, a heightened sense of awareness and clarity of vision. She is now ready to abandon her old identity as a naive artist and replace it with her new identity as a neophyte.

Intuition in the Formation of Identity and the Scientific Questioning of Intuitive Knowing.

 “…because we live in a culture that doesn’t respect intuition, and has a very narrow definition of knowledge, we can get caught into the trap of that narrowness. Intuition is another kind of knowledge—deeply embodied. It is knowing just as much as intellectual knowing.”

Judy Luce, 1989

There is no doubt that the formation of identity is a creative process in which intuition plays a major role, although the question of how much one can rely on intuition underlies and fuels much of the concern regarding its functions as a valid source of self knowledge. Traditionally, western science has tended to stress the importance of empirical data and objective reality (sensation) on the one hand, and a systematic, impersonal method (thinking) on the other hand. As a result, feelings and intuition have been under-emphasized as a valid source of knowledge because they have been perceived as antithetical to the notion of science since they are vague, inherent, subjective qualities of thinking (Krieger, 1991; Jaggar, 1997; Shepherd, 1993).

In fact, “some extreme materialists see intuition as the foe of reason, or as a kind of quackery, and eschew as superstition anything they cannot measure with the five senses” (Shepherd, 1993: 221). This belief holds that “there is an authentic division between intuition and intelligence, where intellect wears the white hat and intuition the black hat, or no hat at all” (Laughlin, 1997:23).

Although there is no doubt that intuition occurs in all of us all of the time and is fundamental to the formation of identity, the experience of intuition is private, which makes it an unverifiable or ineffable kind of knowledge that can’t always be quantified and tested over time. The unpredictable, spontaneous, and subjective nature of intuition, coming as sudden flashes, can’t always be broken down into its component parts to be studied. In addition, just as an excessive reliance on too much rationalism can misconstrue reality, so can an excessive reliance on too much intuition. Like any quality carried to an extreme, intuition has a tendency to distort reality.

Carl Jung stressed that we must never passively accept the revelations of our intuition as absolute truth, but rather we must interact with them, raise questions, and present objections (Jung 1958). In other words, both reason and intuition have the tendency to distort reality when they are in isolated positions. Linda Shepherd writes, “neither sensation nor intuition are relational or evaluative functions. Sensation gives us information about the world and intuition reveals possibilities and provides insight about the nature of things. But neither can be isolated or substituted for the other because they work together as a whole” (1993: 213).

There is now evidence that modern society is moving beyond a purely either/or perspective on the issue of valid knowledge (Boucouvalas 1997). Researchers have asserted the indispensable unity between reason and intuition in all creative acts (Koestler 1959; Bastick 1982; Jung 1971). Some have even argued that science itself, with all its supervaluation of left brained deductive reasoning, could never have proceeded without the creativity of intuition (Bastick 1982; Jung 1971; Vaughan 1979). Carl Jung acknowledged the important functioning of intuition in the creative process as well as in the development of self. He maintained that:

It is almost absurd prejudice to suppose that existence can only be physical. As a matter of fact, the only form of existence of which we have immediate knowledge is the psychic. We might well say, on the contrary, that physical existence is mere inference, since we know matter in so far as we perceive psychic images mediated by the senses (Jung, 1958: 12).

Various feminist scholars have also acknowledged the value of intuition in the creative process, particularly its ability to provide a connected and holistic understanding of ourselves and the world around us (Chodorow, 2000; Luce, 1989; Kreiger, 1991). For example, Linda Shepherd writes, “the acceptance of intuition can give us greater access to information, augment the limited perspective of the five senses, and prompt us to transcend our linear view of time and space. Intuition can help bridge the boundaries that seem to separate us from others and from nature” (1993:223). In other words, when we deny the validity and importance of intuition, we are essentially denying our sense of relatedness to others, to nature, and to our inner selves.

In our age of diversity, it seems essential to transcend the either/or way of thinking that previously juxtaposed in an antithetical manner the rational and intuitive modes of knowing. Perhaps now with all the current research on intuition, outer knowing, with no need to further prove itself, can take its rightful place as a partner alongside inner knowing. Still, a total acceptance of the validity of psychic phenomena by the scientific community has yet to be established and will most likely require us to redefine and expand our current understanding of physics and psychology. The study of intuitive phenomena calls for a different approach to research that has yet to be determined. New methods need to be found that handle reports of subjective experiences to cope with the difficulty of replicating psychic phenomena and to deal with the uniqueness of individual experiences.

Exerpt from Thesis Research: Women Artists: The Transformation of Identity as Self Created and Socially Contructed, 2001.

A Gift from the Bodhissatvas of Compassion

Every heart is connected to the Great One Heart. It is from this heart of hearts that we are un- conditionally loved, nourished, healed and re- deemed. The Hebrew word for “compassion” is derived from the word for “womb.” God is the primal matrix, the Great One from which all beings are born and all love streams forth. We experience on a very tangible level this immense love pulsating through our veins.

This heart connection to source is our lifeline or umbilical cord.

While it is difficult for humans to fully grasp the immense love of the Great One Heart, we are all intimately connected to it and can learn to cultivate a deeper and richer understanding of this love if we so desire. Not all humans acknowledge Great Spirit as the ground of their being, but this does not stop the unwavering flow of love from source. We may choose to intellectually deny the Creator, but we continue to partake of divine love in each breath we take, for God/Goddess resides in every cell of our bodies and nourishes our souls on spiritual and physical levels.

If we decide to cultivate and understand on a deeper level the compassion of the Great One Heart, we must first open our heart to receive Spirit’s love, which requires a certain degree of reverence, surrender or transformation of the ego, for it is only when we surrender to the Beloved in our brokenness and pain that the Great One Heart can then fill our cups with unconditional love and forgiveness. This is what it means to claim our divine gift as the beloved. It is because of Great Spirit’s compassion for us that we can then love ourselves and extend compassion to others.

When we know, deep in our hearts, that we are a re- flection of God’s awesome love, we are exhibiting authentic self-love. We have claimed wholeheartedly the gift of our belovedness which, as Jesus teaches, is avail- able to all those who have the eyes to see and the ears to hear. The tendency to deny or reject one’s self or elevate self above others usually stems from an insecure ego that has fallen prey to the illusion that its self-worth comes from worldly definitions as opposed to a direct connection to Source. Self-rejection is the greatest enemy of the spiritual life because it contradicts the sacred voice that calls us the Beloved. Our belovedness is the core truth of who we are. Every time we listen with great attentiveness to the voice that calls us Beloved, we will discover within ourselves a desire to hear that voice longer and more deeply. It is like discovering a well in the

Once you have touched wet ground, you want to dig deeper.

When we have been transformed and melted like butter by the love of the great heart, we can then choose to become a vessel of this love and commit our lives to assisting those who are still suffering. We might choose to become what Christians call stewards of God’s love or what Buddhists call a Bodhisattva of compassion, a being (satva) committed to liberation (bodhi). This kin- ship with the suffering of others is the discovery of our soft spot, the discovery of Bodhicitta or Mercy. It is said to be present in all beings. If this is the case, everything that exists in creation does so because of the Great Mother’s compassion.

This love is so great that it moves us to explore what it means to live a compassionate life and seek enlightenment

A Bodhisattva of compassion is one who has empathy for the distress of others, coupled with a desire to alleviate suffering in the world. The word compassion is derived from the Latin words parti and cum, which together mean “to suffer with.” Compassion asks us to go where it hurts, to enter into places of pain, to share in brokenness, fear, confusion, and anguish. It challenges us to cry out with those in misery, to mourn with those who are lonely. Compassion requires us to feel weak with the weak, vulnerable with the vulnerable and powerless with the powerless.

Compassion requires us to withhold judgment and practice empathy. It also requires us to set healthy boundaries that honor our highest good as op- posed to falling prey to a codependency that enables dysfunction. Compassion requires that we value the wisdom of grief and solitude. It also requires us to be humble and forgive those who have trespassed against us, so that even though we can feel the suffering of others, we also maintain the witnessing part of ourselves that allows us to see the bigger picture simultaneously.

We have much to learn from Buddha’s and Christ’s messages of compassion, for they are some of the deepest sources of strength and validation of the arduous path of the bodhisattva or faithful steward. Both Masters understood that life is filled with suffering and that we must learn to live in ways that reduce the suffering of those around us. We, too, must learn to find ways to alleviate our own suffering and transform it into well-being and peace.

We need to look deeply into the nature of suffering to see the causes of suffering and to find the way out. This requires every one of us to focus on our own healing, as it is the only thing we can really control. We can’t alleviate war and suffering in the world until we have first alleviated the war within ourselves.

We all have the capacity to feel compassion, but not all of us desire or choose to cultivate and implement it in our daily lives. For most humans, the practice of compassion is easier said than done since it goes against the grain of the ego, which is self-serving and competitive by nature. In Sanskrit, bodhi means “awakened” and chitta means “mind” or “heart.” Bodhichitta -- “awakened heart-mind” -- is the compassionate wish to realize enlightenment for all beings, not just for one’s self.

Through bodhichitta, the desire to attain enlightenment transcends the narrow interests of the individual self. Bodhichitta is an essential part of Mahayana Buddhism. Without bodhichitta, the path to enlightenment is mired in selfishness. However hard we work, we are still wrapped up in our own heads, our own pain, our own wants. The path to awakening opens when we become aware of others as well as our- selves. One of my favorite Tibetan Buddhist teachers, Pema Chodron, explains the cultivation of bodhichitta in more detail:

Those who train wholeheartedly in awakening unconditional and relative bodhichitta are called bodhisattvas or warriors—not warriors who kill and harm but warriors of nonaggression who hear the cries of the world. These are men and women who are willing to train in the middle of the fire. Training in the middle of the fire can mean that warrior-bodhisattvas enter challenging situations in order to alleviate suffering. It also refers to their willing- ness to cut through personal reactivity and self-deception, to their dedication to uncovering the basic undistorted energy of bodhichitta.

We have many examples of master warriors—people like Mother Teresa and Martin Luther King—who recognized that the greatest harm comes (198) from our own aggressive minds. They devoted their lives to helping others understand this truth. There are also many ordinary people who spend their lives training in opening their hearts and minds in order to help others do the same. Like them, we could learn to relate to ourselves and our world as warriors. We could train in awakening our courage and love.

In our legalistic societies, we have been conditioned to believe that there is little incentive in the human world to cultivate compassion because it might make us too soft, and therefore, more likely to be eaten alive by those who have chosen to shut their hearts down. We have been taught to view suffering as something to be avoided at all costs. Hence the call to compassion is a call that goes against the grain and requires a total conversion of heart and mind. Why would we want to open our hearts when the world will just break them over and over again?

In the midst of so much human suffering, we might assume that it would be easier to shut our hearts down and not have any expectations of hope for the future at all. Yet, in our heart of hearts we all know that a world without compassion would be a living hell, a human wasteland, and therefore the choice to uphold God’s grace amidst great suffering and despair can be seen as a choice for a better world for all. We do this for one reason and one reason only, because it is at the very core of who we are as humans; it is the greatest blessing any of us could ever ask for. In embracing human suffering and healing our hearts, compassion breaks down walls and unites all of humanity in the Great One Heart. It is the gateway to our spiritual evolution as a human race. It is the true utopia that we all seek.

Those who choose to cultivate compassion in their lives soon come to learn of the spiritual riches in the Great One Heart, which makes the false riches of the socially constructed, egoistic material world look like plastic, disposable toys. When we come from a place of compassion, we are holding up an ancient light of truth that has been revered throughout history and can never be destroyed. It is the truth that we are One in the Great Matrix of Consciousness. It is the truth that each one of us is a reflection of the Ultimate Reality. This is the core message of the Bodhisattva and the central message of Jesus’ teachings as well as many other teachers of compassion. Their teachings are designed to awaken each person to his or her Divine Self and to cultivate a direct connection to Source.

The path of the bodhisattva is indeed a radical call, a call that goes to the roots of our being. Those who choose to implement compassion in their lives are the weavers and the menders, the bridge builders, the integrators, the diplomats and the nurturers. They work in the trenches of our communities in an assortment of vocations. They have embraced their grief and experienced the redemptive power of God’s unconditional love. They are the salt of the earth, the lighthouses in the storm that guide us back to our Divine Self. They are the true educators of spirit, the wounded healers, totally perfect in their imperfection because they have been touched by the healing powers of Grace. Their one wish is to awaken all souls to the power within themselves.

It is because of the Great One Heart that the Bodhisattvas of compassion come as humble admirers of the Beloved in others, grateful and joyous, for they know that Love is the only true power. They remind humanity that we have a lot to look forward to. However, we have an immense amount of healing work to be done, for the illusion is much like a weed that wants to strangle out the truth. Bodhisattvas are quite aware of the social in- justices in the world and the human ignorance that produces those injustices. They are deeply pained by them all, just as God is pained by it all. However, rather than run from the places of poverty and despair, which most people tend to do, they go directly to these places where “angels fear to tread.”

Most of them choose to serve without recognition, blue ribbons and purple hearts. They have chosen the difficult task of opening and healing their hearts so that they can then assist in healing what is broken on larger levels. They don’t expect recognition because they know that those who are still suffering are experiencing a spiritual void—a starvation of the soul-- and therefore aren’t coming from a place of gratitude. Most of them work in humble servitude and know their human limitations. They don’t expect to save the world; this is too heavy of a burden for one person to carry. They do, however, wish to assist in the raising of human consciousness, even if it means working with just a few individuals in their lifetime, for awakening others to their Divine Self is the most powerful source of social change. In this sense, they are radical agents of social change. And while they are the very glue of humanity, most bodhisattvas will never be featured on the cover of a magazine for their humanitarian deeds. In keeping their eyes on God, they know where their true source of recognition comes from.

Some people say that it could take many lifetimes of practicing compassion before one can become an authentic, realized Bodhisattva. Therefore, one must be patient with one’s self and practice forgiveness over and over, embracing imperfection and humbly asking for redemption. We can create struggle in our spiritual lives when

we compare the images we hold of ourselves with those of enlightened teachers, of figures like Buddha, Jesus, Gandhi, or Mother Theresa. Our heart naturally longs for wholeness, beauty, and perfection. This can be very discouraging, for most of us are not yet masters. Spiritual evolution is a process that will inevitably reveal all of our faults, but this is meant to make us stronger, more humble and teachable.

While it is difficult for us to understand and make judgments about the nature of spiritual evolution, there are a number of paths of service and rites of initiation that one can experience in order to cultivate the Bodhisattva’s state of consciousness. Some of the more obvious character traits of the Bodhisattva are humility, joy, empathy, kindness, patience, forgiveness, faith, surrender, gratitude and a commitment to service. Most Bodhisattvas have experienced a dark night of the soul, which is an experience of complete darkness, separation and despair, sometimes involving ego death and rebirth. It is a time of utter pain and disillusionment, where one’s sense of self is shattered. However, it is in these places of dark- ness that the greatest healing can take place; that is, if one is able to see the compassion that lies underneath the pain.

It can take many dark nights before one is able to truly see the luminous wisdom that exists in the dark- ness. Some of us may never embrace the wounded parts of ourselves that exist in the shadows, but if we seek the path of liberation from suffering, healing the wounds of the heart, mind, body and emotions is an essential focus to bring about real internal healing.

Bodhisattva’s don’t feel the need to draw attention to themselves, because they don’t need any validation from others in order to be whole. Fully awakened to their complete and utter dependence on God, their cups are overflowing with love and ecstasy, yet they are intimately connected with experiences of pain and suffering as well as the suffering of others. They understand the weakness of the human spirit and are completely dependent on the Great One Heart.

They pray a lot and ask that God will keep their hearts free from the illusion of competition and ego. More importantly, they know that the human race has been forgiven for its ignorance and that God has bestowed the ultimate gift of grace on us. Human suffering and pain are therefore inevitable manifestations of the human drama. Pain can either take us down a road of self-destruction or it can be used as a catalyst for redemption. More often than not, pain is used by God to wake us up so that we can be drawn closer to the central heart or the inner integrity, which is our true destiny.

Another important trait of the Bodhisattva is humility. Bodhisattvas generally avoid self-aggrandizement, a sign of spiritual weakness. They also stay away from self- deprecation, since feelings of both superiority and inferiority are signs of ego imbalance. They have great compassion for those who struggle with low self-esteem because they have experienced the psychological torture that it brings. They also know that it is extremely difficult to see through the illusion of fame and ego, because there are so many incentives on a day to day basis to worship the maya of the world.

Even the most enlightened humans fall prey to the ways of an insecure ego at times, but they know that going back to source, to self-reflection, prayer and humility will return them to balance. This is the Goddess’s promise to all of us; that if we respect and honor the compassionate boundaries that are set for us by our inner spiritual guides, we will not be thrown off- base by the demands of the world.

Awakening the Heart through Art

The world over, art has been used as a compassionate tool to raise consciousness and alleviate suffering. Musicians, writers and artists of all kinds have used their gifts to support the evolution of consciousness, whether by raising money for the poor or as a therapeutic modality to resolve conflicts, heal toxic emotions and bridge gaps in communities. All of the artists and writers in this book have in one way or another devoted their lives to a path of service through art and/or other healing modalities.

If we look at history, we see that most of the great visionaries and prophets were marginalized, particularly women and minorities. While all of the artists in this book have chosen a difficult path, they are also committed to their own spiritual and personal growth. Furthermore, they see the gifts that all of God’s children bring to the healing of the planet, and therefore have made a conscious attempt to avoid competition or spiritual elitism.

Most of them are doing their own shadow work and understand that awakening doesn’t necessarily hap- pen overnight. However, they also understand that the process of awakening involves cultivating a humble heart and what Buddhists refer to as “beginner’s mind,” which means that they are open to learning from all walks of life. We are all teachers and students in this life. It might take many lifetimes to reach enlightenment, and there- fore we can come to accept learning experiences with gratitude. We can greet conflict with open arms and value the life lessons in all relationships. As a result of our ignorance, we need others to help us see our denials or our denied shadows. We simply can’t evolve alone.

Blessings on your easter day, from the deep wells of compassion and grace!

Written by: Victoria Christian

Excerpt from : Feminine Mysticism in Art: Artists Envisioning the Divine

www.mysticspiritart.com

Five Issues Facing The Elderly

Today, people are living much longer than ever before, leading us into uncharted waters. From 1946 through 1960, the United States experienced the Baby Boom years. Today, the earlier Baby Boomers are entering into retirement age. As a result, there will be an increase in the aging population, which will not only bring more job opportunities in the Gerontology field, but will also require massive changes to the Health Care Industry. With professional experience as a medical social worker and geriatric care manager, I am interested in learning more about the various needs of the elderly population, particularly the baby boom generation. My work experiences and observational study of senior citizens have sensitized me to several issues and challenges the elderly population faces; such as declining physical and mental health, financial vulnerability, housing, loneliness, and abuse.

Physical and mental health decline are major concerns that seniors have to contend with as they age. The human body is a system that wears out with long and repetitive use and the capacity to think, act, relate, and learn starts to falter and deteriorate.  Aging breeds illnesses such as memory loss, immobility, and organ failure, hearing loss and poor vision. Susan Levy, M.D. (2010) says “The Most widespread condition affecting those 65 and older is coronary heart disease, followed by stroke, cancer, pneumonia and the flu.  Accidents, especially falls that result in hip fractures, are also common in the elderly” (p. 1).

In my observational study of elders at an assisted living facility, there was a general tendency for the elders to be impatient, irritable and non-communicative.  This was most likely the result of physical pain or neurological and psychiatric problems, ranging from depression and anxiety disorders to Alzheimer’s disease and other debilitating forms of dementia. Shekhar Saxena, (2010) head of the mental health department at the World Health Organization reports that “Within the next 18 years, the number of people, worldwide, suffering from dementia will likely double to 65.7 million and triple by 2050, due to people living longer.  The organization has determined that there are around 35.6 million sufferers today, costing over $600 billion a year for care and treatment” (p. 1).

Another issue facing senior citizens is financial vulnerability and the rising cost of medical care.  The financial dilemma is common among seniors who are no longer able to work.   However, a lack of financial capacity creates a stressful life and invites the entry of problems other than physical and mental health issues. While I will never know the financial status of the elderly people I observed, I do know that they are the lucky few who are able to afford assisted living, which can be quite expensive. It appears that my grandmother’s generation, or the elders I observed, are doing pretty well economically; however, the current health care system will not be able to handle the financial and medical needs of the baby boomer generation.  There will be a rise in health care needs as well as an increase in financial vulnerability with the baby boomer generation.

Housing is a major concern for the elderly. Most seniors would like to stay in their homes for as long as they can.  Reluctance to move is particularly true for those who own their own home. Some have the financial ability to afford caregivers, but others don’t.  Due to failing health and cognitive decline, elders may have to move in with a relative or consider an assisted living facility or nursing home.  However, the housing options don’t look very promising for a growing aging population.

As the overall population ages, the numbers of the most vulnerable will grow as well.  A new report from the Center for Housing Policy, Housing an Aging Population—Are we Prepared? claims that “By 2050 the 65+ population is expected to grow from 40 million today to more than 88 million; put another way, one in every five Americans will be 65+.”  Demand for housing will more than triple over the same period to 19 million” (2012: 3).   The report also found that older adults are more likely than younger adults to have housing affordability challenges.    As a result, the aging of the population is likely to increase the overall proportion of the country with severe housing cost burdens.  The report also finds that many older adults lack access to affordable services that could help them age in place.   Older adults with low and moderate incomes often lack access to various housing choices, such as an assisted living facility.

 Perhaps no other age group feels the sting of loneliness more than the elderly.  I have personally witnessed this in my profession and feel strongly that it leads to depression.  I think it is natural for elders to want to retreat as they age, but they also need encouragement to be socially engaged as much as they are able.  While individuals living alone tend to experience the most isolation, several activity directors have informed me that assisted living facilities have a difficult time getting the residents to be involved in various activities.  There is a natural tendency to isolate as a result of failing health, but there is still a need for one on one interaction with a human.

According to a new study by UCSF researchers (June, 2012), loneliness can cause suffering to people at any age, but it can be especially debilitating to older adults and many predict serious health problems and even death.  One of the more surprising findings of the teams analysis is that loneliness does not necessarily correlate with living alone. The UCSF study also found that people 60-years-old and older who reported feeling lonely saw a 45 percent increase in their risk for death. Isolated elders also had a 59 percent greater risk of mental and physical decline than their more social counterparts.

As the population of older Americans grows, so does the hidden problem of elder abuse, exploitation and neglect.   Elder abuse is the infliction of physical, emotional, or psychological harm on an older adult.  Elder abuse can also take the form of financial exploitation or neglect of an older adult by the caregiver.  In a report by The National Elder Abuse Incidence Study (1998), “Every year an estimated 2.1 million older Americans are victims of physical, psychological, or other forms of abuse and neglect. Those statistics may not tell the whole story.  For every case of elder abuse and neglect that is reported to authorities, experts estimate that there may be as many as five cases that have not been reported” (p. 1).

Some older people are repeatedly abused, but even one incident of abuse can be traumatizing to the elderly person according to authors Carmel Bitondo Dyer, Marie-Therese Connolly, and Patricia McFeeley in Elder Mistreatment: Abuse Neglect and Exploitation in an Aging America.   The author’s say that even one incident of victimization can be potentially harmful and even fatal for an older person:

A single act of victimization can “tip-over” an otherwise productive, self-sufficient older person’s life.  In other words, because older victims usually have fewer support systems and reserves—physical, psychological, and economic—the impact of abuse and neglect is magnified, and a single incident of mistreatment is more likely to trigger a downward spiral leading to loss of independence, serious complicating illness, and even death (p. 339).

 An additional issue is that often older people who have been

abused or neglected do not wish to testify against their family members who have abused them, out of a misguided sense of loyalty, or of love. Fortunately, each state in the United States has an office of adult protective services to investigate the abuse or neglect of adults.  Interventions provided by Adult Protective Services include receiving reports of adult abuse, exploitation or neglect, investigating these reports, case planning, monitoring and evaluation.

References:

Susan, Levey, M.D. (JUNE, 2008).  What Are the Most Common

         Issues of Aging? Retrieved from: http://www.agingcare.com/article.

Shekhar, Saxena. (2010).  Latest Dementia Statistics from the World              Health Organization. Retrieved from: http://careforyou.us/latest-dementia-statistics-from-the-world-health-organization/

Barbara Lipman, Jeffrey Lubell, Emily Salomon. (2012).  Housing an Aging Population: Are We Prepared?  Center For Housing Policy, Washington, DC. Retrieved from: http://www.nhc.org/publications/index.html

Leland, Kim. (June, 2012). Loneliness Linked to Serious Health Problems and Death Among Elderly.  University of California, San Francisco.  Retrieved from: http://www.ucsf.edu/news/2012/06/12184/loneliness-linked-serious-health-problems-and-death-among-elderly

The National Elder Abuse Incidence Study. (1998). U.S. Department of Health and Human Services, Administration on Aging.  Retrieved from: http://www.aoa.gov/AoARoot/AoA_Programs/Elder_Rights/Elder_Abuse/Index.aspx.

Carmel Bitondo Dyer, Marie-Therese Connolly, and Patricia McFeeley. (2003).  “The Clinical and Medical Forensics of Elder Abuse and Neglect.” In Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, D.C., National Academies Press, 339.

Interpersonal Neurobiology, Attachment Theory, and the Use of Self in Psychotherapy

There have been a number of psychological theories that have influenced the Social Work and Counseling Professions.  However, I will only discuss some of the primary concepts of Interpersonal Neurobiology and Attachment Theory.  In addition, I will explain my “use of self” as the therapist in each theory, which relinquishes the social worker as an “expert” and replaces it with a more collaborative approach that involves using one’s self as a reparative object. Being able to be present therapeutically on behalf of another person requires a range of skills and abilities, including the intentional and disciplined use by the counselor of his or her experience, relational skills, and knowledge/wisdom in the benefit of the client. 

Interpersonal Neurobiology:

Interpersonal Neurobiology is an interdisciplinary field which brings together many disciplines in science including but not limited to anthropology, biology, linguistics, mathematics, physics and psychology to determine common findings about the human experience from different perspectives. Daniel J. Siegel, M.D. is a pioneer in the field called Interpersonal Neurobiology, which seeks the similar patterns that arise from separate approaches to knowledge.  Aside from Siegel, some of founding theorists are Stephan Porges, Edward Tronick and several more.

One of the primary concepts of interpersonal neurobiology approach is “Integration,” which ultimately promotes a flexible and adaptive way of being that is harmonious as opposed to chaotic. The brain is always in a process of working towards integration. According to Dr. Siegel, integration is viewed as the core mechanism in the cultivation of well-being and healing.  He writes:

In an individual’s mind, integration involves the linkage of separate aspects of mental processes to each other, such as thought with feeling, bodily sensation with logic. For the brain, integration means that separated areas with their unique functions, in the skull and throughout the body, become linked to each other through synaptic connections. These integrated linkages enable more intricate functions to emerge—such as insight, empathy, intuition, and morality. A result of integration is kindness, resilience, and health. Terms for these three forms of integration are a coherent mind, empathic relationships, and an integrated brain (Siegel’s website, 2014).

Another major concept in the emerging field of Interpersonal Neurobiology is the concept of “neuroplasticity,” which entails the rewiring of the brain through the use of mindfulness practices, or, what Dr. Dan Siegel refers to as “Mindsight.”   At its core, interpersonal neurobiology holds that we are ultimately who we are because of our relationships. We simply can’t grow and evolve without intimate relationships (Seigel’s website, 2014).  

Some of the assumptions of the nature of the problem are similar to attachment theory, such that the lack of early childhood attachment with a caregiver leads to an insecure attachment, which inevitably causes neural disintegration—a chaotic or fragmented sense of self and mind.  According to IPNB, the nature of the problem is both biological and social. An individual is born into the world with a genetic imprint (DNA); however, in the process of human development one can either experience secure attachments with very little trauma’s, or, insecure attachments with several stressors and trauma’s in early life and throughout one’s life span.  If the later occurs, an individual’s brain has a greater risk of becoming wired in a way that is unintegrated and may hold dissociated traumas, losses, and chemical loads that are toxic to the growing brain.

According to IPNB, our relationships have the potential to literally change the brain, particularly the most intimate ones, for example, with our primary care givers or romantic partners. While it was once thought that our early experiences defined who we are (social constructionism), interpersonal neurobiology holds that our brains are constantly being reshaped by new relationships.  This offers tremendous hope to all trauma survivors, psychotherapists, psychiatrists and their patients. Thus, positive relationships produce positive changes, which yields healing for those who have suffered from trauma (Badenoch, 2010).

Integration requires the implementation of a practice referred to as “mindsight,” another major concept of IPNB.  According to Dr. Siegel’s website, “Mindsight describes our human capacity to perceive the mind of the self and others. It is a powerful lens through which we can understand our inner lives with more clarity, integrate the brain, and enhance our relationships with others. Mindsight is a kind of focused attention that allows us to see the internal workings of our own minds” (Siegel, Website). What is particularly fascinating is that when an individual develops the skill of mindsight, they actually change the physical structure of the brain.  And we can grow these new connections throughout our lives, not just in childhood.

The emerging field of neurobiology is also changing the way in which therapist think about therapy, what they think happens during therapy, and how they think they should engage in the joint project together.  Bonnie Badenoch’s book Being a Brain-Wise Therapist, brings IPNB into the counseling room, weaving the concepts of neurobiology into the ever-changing flow of therapy.   She uses examples from her own therapeutic practice, which involves inculcating mindfulness practices into therapy.   Implementing the use of mindfulness practice aids in the building of neural intregration and mental health.

In the book she clarifies her “use of self” as a reparative secure attachment in the therapeutic process with clients.  According to Bonnie, one of the unfolding processes in therapy is the reactivation of the attachment system, often accompanied by anxiety and vigilance, since for most patients, the initial attachment process did not go well.  

In the therapeutic process, attachment seeking behaviors are activated.  As the longing for attachment dawns, therapist have the “precious opportunity to help their patients mend/rewire even the earliest relational fears, adding the new information of compassion, care, safety, stability, and warmth that is our contribution to the interpersonal system. ” (Badenoch, 2010: 54).   Supposedly, human’s neurologically regulate each other right brain to right brain. The Therapist acts as the central nervous system regulator, which allows for the healing to take place.

Bonnie further explains that “The very heart of secure attachment is contingent communication, which involves receiving people’s signals (nonverbal more than verbal) and responding in a way the lets them “feel felt” (Badenoch , 2010: 57). It is important to commit deeply to going into a patients world, no matter how painful. Being able to provide a sense of safety for patients is central to providing regulatory experiences.  Bonnie writes “When this wish to comfort is accompanied by streams of accurate empathy, the stage is set for profound healing. This kind of connection is at the heart of helping our patients develop balance through dyadic regulation (which leads to the capacity for self regulation” (Badenoch , 2010: 92).

Through repeated experience, the client will internalize a warm, caring presence that can comfort them when the therapist is not physically available.  This builds confidence and self-reliance in the client. According to Bonnie there is an increased neural integration as a result of the comfort, empathy and bonding in the therapeutic alliance. Overtime, the patient moves from insecurity to an earned secure attachment (Badenoch, 2010).

Attachment Theory:

Attachment Theory is focused on the relationships and bonds between people, particularly long-term relationships including those between a parent and child and between romantic partners. According to attachment theory, “the presence of a principal attachment figure as a source of emotional security significantly affects human development.  During infancy, the caregiver’s role is to provide a secure base from which the child can explore his/her surroundings. The caregiver’s response to this need will affect the child’s attachment behaviors” (Bettman & Jasperson, 2010: 98).   

The theory of attachment was originally developed by John Bowlby (1907 - 1990), a British psychoanalyst who was attempting to understand the intense distress experienced by infants who had been separated from their parents. Bowlby believed that the earliest bonds formed by children with their caregivers have a tremendous impact that continues throughout life. He suggested attachment also serves to keep the infant close to the mother, thus improving the child's chances of survival.  (          )

The central theme of attachment theory is that humans grow and evolve through forming attachments at an early age. Infants need to develop a relationship with at least one primary caregiver for the child’s successful social and emotional development, and in particular for learning how to effectively regulate their feelings. Primary caregivers who are available and responsive to an infant's needs allow the child to develop a sense of security. The infant knows that the caregiver is dependable, which creates a secure base for the child to then explore the world. If the caregiver is unstable and unreliable, this creates an insecure attachment, which causes severe anxiety and depression. (    )

The assumptions of the origin of the problem are due to faulty socialization, insecure attachment and the development of an insecure working model (theory matrix). Attachment theory is not a developmental theory as there are no stages one must go through in order to achieve health. There is a critical attachment period that occurs between 0-3 years of age.  If bonding doesn’t occur from 0-3 a secure attachment becomes more difficult to attain (Theory Matrix).  Another assumption in attachment theory is that the same motivational system that gives rise to the close emotional bond between parents and their children is responsible for the bond that develops between adults in emotionally intimate relationships.  The later assumption was formulated by later researchers who further developed the theory, one of which is Mary Ainsworth.

Expanding greatly upon Bowlby’s work, a psychologist by the name of Mary Ainsworth performed a study titled "Strange Situation" (1970’s) that revealed the profound effects of attachment on behavior. Ainsworth found that children will have different patterns of attachment depending primarily on how they experienced their early caregiving environment. Early patterns of attachment, in turn, shape – but do not determine - the individual's expectations in later relationships.

In the study, researchers observed children between the ages of 12 and 18 months as they responded to a situation in which they were briefly left alone and then reunited with their mothers. Based upon the responses the researchers observed, Ainsworth described three major styles of attachment: secure attachment, ambivalent-insecure attachment, and avoidant-insecure attachment. Later, researchers Main and Solomon (1986) added a fourth attachment style called disorganized-insecure attachment based upon their own research.

Attachment styles also have an impact on behaviors later in life.  For example, Children diagnosed with oppositional-defiant disorder (ODD),conduct disorder (CD) or post-traumatic stress disorder (PTSD) frequently display attachment problems, possibly due to early abuse, neglect or trauma. Clinicians suggest that children adopted after the age of six months have a higher risk of attachment problems. (      ).  On the other hand, those who are securely attached in childhood tend to have good self-esteem, strong romantic relationships and the ability to self-disclose to others. As adults, they tend to have healthy, happy and lasting relationships.

The therapists “use of self” is an integral part of helping the client to move towards more health and integration.  For attachment theory, the “use of self” is similar to Interpersonal Neurobiology.  The therapist acts as a reparative secure attachment figure and provides a safe container that allows the client to regress to the ruptured attachment. The therapist responds with attunement and repairs attachment ruptures.  Through the practice of empathetic listening, facial expression, eye contact, tone of voice, tempo, breathing, the therapist creates a kind of wordless but dense and charged felt presence, which permeates the being of both therapist and client.   At some point in the therapeutic process, the client internalizes and “earned secure attachment” and will hopefully generalize it to other relationships.

This paper identified some major concepts and assumptions in Attachment Theory and Interpersonal Neurobiology.  It also clarified several ways in which the therapist uses themselves as a reparative object for healing trauma’s and insecure attachments.  Both theoretical perspective draw from similar roots, but are different in their approach.   What is fascinating to me is how they are completely transforming the way in which therapy is done and what is occurring in the brain of both the therapist and client during the therapeutic process.  Interpersonal Neurobiology is taking Psychotherapy to a whole new level by scientifically proving things that have always been doubted by pragmatic Behaviorists.  For example, Wylie and Turner’s article The Attuned Therapist, explains the “seemingly immense divide between psychological and biological sciences and how Interpersonal Neurobiology has been a new “integrative bridge” which includes the whole human system—mind, brain, body and relationship. 

According to Wyle and Turner, “Psychology was dominated by a behavioral model during the ‘60’s and ‘70s, then by cognitive models in the ‘80s and ‘90s, and now affect and psychobiological processes are taking center stage” (2011, 48).  

For many years there was little knowledge about the biology of emotion and feeling—what they were, where they were in the brain, what caused them, how they influenced behavior.  However, according to Wyle and Turner, for the past 15 years, neuropsychological scientist and therapists claim that we are in the throes of an “emotional revolution,” that is more integrative and validating of the power of the emotions and interpersonal relations to change the physical structuring of the brain (2011).   

After decades of cognitive and behavioral therapists purposely seeking to put emotions out of sight and out of mind, they’re being forced to relearn the ancient emotional systems have a power that is quite independent of neocortical processes.  She writes, “In our increasingly technological world, therapy seems to be directing our attention to the very core of our primeval being, the ancient emotional systems that are the source of love, hatred, rage, desire, compassion, of our unquenchable need for connection with others of our own species.” (      49).   I am particularly fascinated by the cutting edge work of Nancy Chodorow who wrote book called The Power of Feelings.  Not only is this work challenging dominant paradigms in Sociology and Psychology, but it is changing and improving the way in which we do therapy.

 References:

Badenoch, Bonnie. (2008). Being a Brain-Wise Therapist: A Practical Guide to Interpersonal Neurobiology. W.W Norton & Company, New York, NY.

Bettmann, Joanna and Jasperson, Rachael. (2010). Anxiety in Adolescence: The Integration of Attachment and Neurobiological Research into Clinical Practice. Clinical Social Work Journal, 38:98-106.

Wylie, Mary Sykes & Turner, Lynn. (2011). The Attuned Therapist. Psychotherapy Networker, March/April.

Dan Siegel’s Website. (2014). Retrieved from: http://www.drdansiegel.com/about/interpersonal_neurobiology/website

La Clinica Website. (2013). Retrieved from http://www.laclinicahealth.org/

Personal Interview with Valerie Barnum. (2013). Client at La Clinica School Based Health Center, Phoenix Elementary School.

Copy of Effective Treatments for Alcoholism and Addiction

For most people, alcohol is accepted in our culture as a pleasurable accompaniment to social activities. However, a substantial number of people have serious trouble with their drinking. Alcoholism, which is also known as "alcohol dependence syndrome," is a disease that is characterized by the following elements: craving, loss of control, physical dependence, and increased tolerance. According to recent statistics from the National Institute on Alcohol Abuse and Alcoholism, "Nearly 14 million Americans--1 in every 13 adults--abuse alcohol or are alcoholic. Several million more adults engage in risky drinking patterns that could lead to alcohol problems. In addition, approximately 53 percent of men and women in the United States report that one or more of their close relatives have a drinking problem"(http://alcoholism.about.com/library/niaaa01.htm).

In addition, not only does alcohol abuse increase a variety of health risks, it also increases the risk of death from automobile crashes, recreational accidents, and on-the-job accidents. It is estimated that alcohol-use problems cost society approximately $100 billion per year (NIAAA website, 2013). The purpose of this article is to gain a greater understanding about alcoholics and the most effective strategies for treating alcoholism.

There is a plethora of research that is enhancing the practice among involuntary clients, or in this case, alcoholics. Scientists at Medical centers and universities throughout the country are studying alcoholism and have cutting edge information about it. Today, NIAAA funds approximately 90 percent of all alcoholism research in the United States. According to their website, “NIAAA is sponsoring promising research in vital areas, such as fetal alcohol syndrome, alcohol’s effects on the brain and other organs, aspects of drinkers’ environments that may contribute to alcohol abuse and alcoholism, strategies to reduce alcohol-related problems, and new treatment techniques” (NIAAA website, 2013). The goal of this qualitative research interview is to further understand effective ways of treating and preventing alcohol problems.

First and foremost, Alcoholism is a complex issue that involves a multitude of factors; such as biological, psychological and social. “Alcoholism is due to many interconnected factors, including genetics, how you were raised, your social environment, and your emotional health. Some racial groups, such as American Indians and Native Alaskans, are more at risk than other of developing alcohol addiction. People who have a family history of alcoholism or who associate closely with heavy drinkers are more likely to develop drinking problems. In addition, those who suffer from a mental health problem such as anxiety, depression, or bipolar disorder are also particularly at risk, because alcohol may be used to self-medicate.”

Recent research supported by NIAAA has demonstrated that for many people, a vulnerability to alcoholism is inherited. These findings show that children of alcoholics are about four times more likely than the general population to develop alcohol problems. Children of alcoholics also have a higher risk for many other behavioral and emotional problems. But alcoholism is not determined only by the genes your inherit from your parents. It is important to recognize that aspects of a person’s environment, such as peer influences and the availability of alcohol, also are significant influences.

The Addiction Recovery Center in Medford employs the use of several evidence based theoretical frameworks that have shown positive results. She introduced me to the American Society of Addiction Medicine (ASAM), “a professional society representing over 3,000 physicians and associated professionals dedicated to increasing access and improving the quality of addiction treatment; educating physicians, other medical professionals and the public; supporting research and prevention; and promoting the appropriate role of physicians in the care of patients with addictions” (ASAM website, 2013). When a client applies for substance abuse services at the ARC, they are screened and assessed with the ASAM criterion, which evaluates a multitude of factors; such as physiological effects of drug withdrawl, psychological impact, physical complications, readiness to change and history of relapse. (http://www.asam.org/research-treatment/screening-and-assessment)

There are a number of theoretical models that the ARC approves in their treatment program. Depending on the severity of the addiction, the ARC recommends individual counseling, family counseling, group counseling and residential treatment housing. However, due to lack of time, she was only able to talk about a few; such as Motivational Enhancement Programs, Cognitive-Behavioral Therapy, and 12-Step Facilitation Therapy. According to Noel “Treatment varies depending on the type of drug and the characteristics of the patient. The best programs provide a combination of therapies and other services. These models are designed to raise drinkers’ awareness of the impact alcohol has on their lives, as well as the lives of family, co-workers and society. They are encouraged to accept responsibility for past actions and make a commitment to change future behavior. Substance abuse therapists help alcoholic patients understand and accept the benefits of abstinence, review treatment options, and design a treatment plan to which they will commit” (Chaney, 2013).

The National Institute on Drug Abuse released a publication (2012) titled “Principles of Drug Addiction Treatment: A Research-Based Guide” that highlights several evidence based treatment models that are working in treating alcoholism and other addictions. Each approach is designed to address certain aspects of drug addiction and its consequences for the individual, family, and society. Some of the approaches are intended to supplement or enhance existing treatment programs, and others are fairly comprehensive in and of themselves. The two approaches they mention are: Pharmacotherapies and Behavioral Therapies. The Pharmacotherapies consist of an assortment of medications that can be used in conjunction with individual, group and family therapies; such as Naltrexone, Acamprosate, Disulfiram and Topiramate. When used in combination with counseling, these prescription drugs lessen the craving for alcohol in many people and helps prevent a return to heavy drinking.

According to the National Institute of Drug Abuse, “Behavioral approaches help engage people in drug abuse treatment, provide incentives for them to remain abstinent, modify their attitudes and behaviors related to drug abuse, and increase their life skills to handle stressful circumstances and environmental cures that may trigger intense craving for drugs and prompt a relapse” (NIDA, 2013, 34). They identify a number of behavioral therapies shown to be effective in addressing substance abuse; such as Cognitive-Behavioral Therapy, Contingency Management Interventions/Motivational Incentives, Community Reinforcement Approach, Motivational Enhancement Therapy, The Matrix Model and 12 Step Facilitation Therapy.

While I can’t discuss all of these theoretical models, I will discuss Motivational Enhancement Therapy and 12-Step Facilitation Therapy. Using a nonjudgmental approach, Motivational Enhancement Therapy (MET) employs Motivational Interviewing (MI) to analyze feedback gained from client sessions. The goal of MET is to aid the client in clarifying his or her own perceptions and beliefs in order to direct him or her in a decisive way. According to GoodTherapy.Org: http://www.goodtherapy.org/motivational-enhancement-therapy.html

MET is administered in a receptive atmosphere that allows a client to receive feedback from the therapist for the purpose of fortifying the client’s resolve for transformation and to empower the client with a feeling of self-control. Rather than engaging the client’s defense mechanisms through confrontational discourse, the therapist works with the client to create positive affirmations and a sense of inner willingness to facilitate change. Once that is achieved, the client becomes receptive to the healing process and progresses toward wellness (2013, 23).

Motivational interviewing principles are used to strengthen motivation in the client and build a plan for change. Coping strategies are suggested and discussed with the patient and the therapist continues to encourage commitment to change or sustained abstinence.

Another effective treatment model is 12-Step Facilitation Therapy. This peer-support approach encourages people to become involved with a 12-step program that complements professionally supervised therapy. Programs like Alcoholics Anonymous, Smart Recovery and Women for Sobriety are typically recommended with all forms of alcoholism therapy because they provide alcohol-dependant Individuals with an encouraging, supportive environment. These support group meetings focus on abstinence and fosters each individual's physical, mental, emotional and spiritual health.

While there is a lot of cutting edge research on alcoholism and methods of effective treatment, there is always room for further investigation. Not only is there a need for more genetic research, there is a need for alternative treatment approaches and effective medications that can be used in conjunction with therapy. In addition, addiction recovery treatment programs aren’t able to meet the needs of everyone; therefore, there is a need for research on alternatives methods for the treatment of alcoholism. Supposedly NIAAA has sponsored a study called project MATCH, which tested whether treatment outcome could be improved by matching patients to three types of treatment based on particular individual characteristics. This study found that all three types of treatment reduced drinking markedly in the year following treatment.

References:

La Clinica Website. (2013). Retrieved from http://www.laclinicahealth.org/

Travertini, Elise. (2013). Personal Interview about Agency.

Loss and Love: Heart Wisdom on Grief

Welcome all of you tattered and exquisitely beautiful souls. Thanks for receiving our offering and showing up for one another in our deepest grief and existential despair. It takes courage to show up in your vulnerability and rawness, so I commend and honor you.

 We are all experiencing the collective trauma of the environment crisis, but also rampant social problems, and the narcissistic injury that our president has inflicted on us since his election. It has been an endless and horrifying barrage of abuse and while I know the human spirit is strong, our flames are weak.

 We gather here today to honor our individual and collective grief.  And the need for our community to come together and support one another in our collective trauma.

The intention for this ritual is to also cultivate more reverence for the sacred process of grieving.  Our deep grief is not something to simply “get over.” On the contrary,  it is something to learn to appreciate and value as a necessary part of life.  We need to have just at much reverence for loss as we do for love.

Another intention is to get out of mind and into our hearts—our emotions, our bodies, and our soul.  In the west there is an overemphasis on “rationality” and “rational modes of knowing.”  We see a championing of the mind over the emotions— and are literally taught to live in our minds and devalue the wisdom of our emotions, bodies, and spirits.

It is also our intention to offer a safe, nonjudgemental, healing ground to release any deep grief you have been suppressing and any further support you might need in the future.

 We truly are all in the same boat and things are very dark and bleak right now.  We will most likely be experiencing this darkness for awhile now. However, we must find a way to unite in our love for the earth, in our love for the diversity of species on this gorgeous planet, and in our love for one another.

 With all the loss and collective trauma in the world today, we need to offer support to one another as so many are feeling silenced, marginalized, isolated, alone, and wounded.  I want to honor all of the people who are so paralyzed in their pain that they can’t leave the house. I work with a lot of these people in my job as a home health social worker. You would not believe how many vulnerable people are feeling isolated and terrified right now.

 I have felt the depths of despair myself, particularly when I first learned of the environmental crisis in 2015. I was just finishing graduate school and I just released the first edition of my book Feminine Mysticism in Art. I reached out to Andrew Harvey for an endorsement, which he obliged.   And on his website I saw some interviews that he posted. I listened to an interview he did with Guy McPherson and Carolyn Baker—they had just released a book called “Extinction Dialogues: How to live with Death in Mind.” Guy is a climate scientist and Carolyn Baker is a phenomenal psychotherapist and author of multiple books on the decline of global capitalism. I immediate purchased the book and was forever changed.

It looks me six months to read it.  I felt terribly alone and isolated. At the time, I was finishing graduate school and there were only a few people in this community that knew about the devastating reality of global warming. I reached out to these people and continued to seek guidance from personal mentors. I had many sleepless nights—panic attacks in the middle of the night, despair, low grade depression, spaciness, inability to focus, memory impairment.  

 It is common to isolate when one is experiencing deep depression and despair.  However, I don’t recommend isolating for long periods of time as it can lead to a downward spiral to suicidal ideation and even suicide.

We all know the pain and wounds are deep. WE have all been terribly wounded by capitalism—particularly those who have been horribly discriminated against due to race/class/gender/and not to mention LGBTQ concerns.The system of social inequality is continuing to get worse, and we are more divided now than we have ever been due to social inequality, fierce competition, and hyper individualism (every man for himself).

 However, there is also another larger social trend happening at the same time.  We are evolving at a rapid pace, which feels like the quickening. The veils are being lifted and there is a massive tidal wave of awakening occurring.The new paradigm has been emerging for awhile now, but it has been stifled by corruption of the power elite and the corporatocracy that our political system has sadly become

We are witnessing the merging of science and mysticism, new humanitarian social systems, and regenerative agriculture. We are also witnessing the reclaiming of indigenous wisdoms and a renewed connection to the earth. We all have a direct access to the spirit world, and literally possess a universe in our own minds.

I truly believe that the indigenous peoples hold the deep wisdoms for our individual and collective healing. The purification times are here, as they have prophecised.

And while the scientific facts are undeniably daunting and fatalistic, no one really knows what is going to happen.  We all know on a soul level, that the apocalypse is and archetype deeply embedded in the collective unconscious and it is emerging now. The meaning of apocalypse is “A Lifting of the Veils.” As Karl Jung purports, the universal occurs in the collective unconscious and we all have access to it.  

 The human mind has always been ignorant, and limited in its ability to conceptualize the brilliance of the Infinite Universe.

 It is our greatest hope, that in going thru the dark night of the soul, there will be the possibility of new life, redemption, and the new golden age on earth. Some visionaries profess that what lies ahead, after the famine, is 1,00o years of peace and harmony. It is the bridging of heaven and earth—the return to the garden of eden. Wouldn’t that be nice?

 It is possible to experience rapid changes during the quickening. We are seeing this change happen now all over the world. It is my hope and prayer that this continues to escalate, as our time is short.

 I would also like to say that the environmental grief that we are experiencing is totally different than personal grief as it involves the potential death of human species and most species on planet earth.

We have experienced problems in the past, but not at the epidemic levels we are experiencing now. We are all suffering from some kind of modern day neurosis—anxiety, depression, ADD, fragmentation of the psyche.  This neurosis is NOT something to pathologize…it is normal to be experiencing an unraveling of the psyche in a time of chaos and social unrest.

 This global dark night of the soul will inevitably stretch all of us beyond our comfort zone and will continue to do so in the near future.  It will trigger a full range of negative emotions, such as utter rage, deep despair, shame, confusion, and apathy.  

 We are being called to surrender to the dark void of transition—to be the mystery at the crossroads. 

It will be incredibly difficult for us to befriend our individual and collective pain as it feels totally overwhelming, doesn’t it? When you love with all of your heart, you loose with all of your heart. And this loss, as many of you know, is a painful death of the ego and even hope. Having the courage to grieve is sitting with the most horrific shadow and allowing it to utterly transform you.

 We all must be committed to our own personal grief work and the many layers of grief that will unfold in the future. We most likely will be grieving for many years, particularly if we are indeed in a hospicing phase of humanity.  Hospice therapist and author, Elizabeth Kuebler Roth, worked with hundreds of people who experienced profound grief and loss at the end of their lives. Her research on grief revealed stages that all people go through in the grieving process (Stages of grief—denial, anger, grief, acceptance).  

 Most are still in the denial and anger phase, which is normal. One can’t force something through the process, nor can one force someone to grieve. We don’t have to do it all at once. It will occur in layers and stages.  And I personally think that we can regress to previous stages.  For example,  after three years of coming to terms with the reality of the ecological crisis, I have moved to a place of more acceptance.  However, I find that I can cycle back through to the anger and grief phases at times.

 Another thing I want to say about grief is that we all grieve in our own unique way. One is not better than the other. There is no pressure to cry if that is not want comes for you. Some may feel the need to make sounds or moans, which is welcomed. You might also choose silence.

For those of you who have been through your own dark night of the soul, you know there are gifts that come in the void of uncertainty. What do you think some of these gifts might be?

 1)   It challenges us to be in the present moment—to get in touch with our intuition and direct access to spirit.

2)   It challenges us to surrender to the Great Mystery. To learn how to sit with the void of the unknown and be OK with not having a plan of action.

3)   There is wisdom that comes in the complete shattering of the ego—radical humility and equality with everything.

4)   Challenges us to re-evaluate our values, beliefs and priorities. (family, friends, earth)

5)   Challenges us to practice non-attachment and letting go

6)   Asks us to practice radical forgiveness of self and others, reaching out to the community for support.

Doing this deep work is a practice of reverence for the death process.  Nature is such a profound teacher of the cycles of life and death, love and loss.   Humans have a lot of attachments, don’t we? Grief is also an honoring of our deep love for the good in humanity, as it is ultimately LOVE that will heal our jaded, broken hearts.  Love is the light that seeps into the cracks of the dark underworld.

 We know the power of this love and we must NOT forget the promise of INFINITE LOVE and GRACE on the earth plan and in the spirit world.  Our connection to the spirit world will literally be our life line and meditation will be a way for us to stay grounded and sane during the great turning. So will cultivating community and finding your own medicine offering for healing.

 There is no doubt it is difficult for humans to stay in a place of hopelessness.  We need to move into inspired action and find the motivation to do what we can in our own personal lives, but also in service to positive social change. It is incredibly healing to get out of your own suffering and assist people who are incredibly vulnerable, whose suffering is much greater than yours.

 There is a tremendous amount of redemption that comes when we start serving others.  There is much work to be done, my friends. And honoring our grief is a necessary part of the humbling and healing process. So pat yourselves on the back because you are stepping up to do some of the most important work of our time.

Thoughts on The Global Dark Night of the Soul

Oh my …..these times are dark!  I have been through many layers of grief regarding numerous social problems and environmental crisis.  It is clear that this crisis--this dark night of the soul-- is creating a massive awakening on a global scale.   While we see neoconservative and corporate agendas stifling the growth to healthier systems, we are also witnesses major positive shifts globally--in social democracy, environmental protection, human rights, and protections to the earth and all living beings on this planet. It has been inspiring to see how effective the youth climate strike has been; however, they also know they are up against centuries of exploitation of the earth and  people under the  unregulated corporate capitalistic system. 

There has been a lot of debate around how much time we truly have to make global changes and if it is even possible. All of this will be known in the near future. It is my hope that we can all unite for change, but I have a healthy skepticism as a social scientist. When we have continually marginalized visionary sociologists for centuries, it doesn't make me very hopeful.  We have now passed the tipping point, which is what Al Gore spent his entire life educating various countries about.  I am appalled that his book An Inconvenient Truth, was not made mandatory reading by all global citizens. 

We have to be utterly realistic about the facts, but also try to find some hope to keep us motivated each day. We are being forced to surrender to the unknown right now, which makes people uncomfortable as we have to sit with all the difficult emotions of facing our individual and collective shadows. The damage done to the earth is unprecedented and some think it is impossible to restore the damage done to our home (Gaia).  There is a lot that is NOT being said by our politicians.  It think they know that in order to rally for change, we need to accept the sobering facts, but also lead with fierce radical humanitarian and ecological values.  As a social research, I embrace evidence based research, but also deeply understand how political spirituality is.  The new paradigm is a harmonious relationship and mutual respect of science and mysticism; however, so many are oblivious to the shadow of old paradigm science. 

As a therapist that works with vulnerable and traumatize people, resilience and full recovery is not always possible. And we are all very confused about how long we have on this planet as GAIA is already showing signs of massive imbalance in equalibrium.  People need some inkling of hope that we can unite for the Earth and our ability to live on this beautiful planet. It is great to see so many minority women in congress, but particularly advocating for underprivaleged populations and indigenous peoples having more clout in environmental policy.  

It is also inspiring to see how many change makers in various disciplines are debating and envisioning The New Systems Shift on a global scale.  I have been doing a lot of research myself in regenerative cultures, which have been theorized by numerous social ecologists, environmentalists, sociologists, and economists for centuries now. However, we are now in a postmodern era with complex social problems and never before have we been up against the possible reality of a mass extinction.  While many of the problems have been occurring for awhile now, there has been a lot of complacency, anomie, and ignorance. 

However, everything is being radically exposed now--we are finally seeing that our democracy has been corrupted and is one of the first things that needs to be repaired.  It is amazing how long it takes for social systems to change, particularly when it is benefitting a corporate power elite who doesn't want change to occur and they own all the vital natural resources. We have given our power away for too long now and we are in a global crisis in every way. This reality has created a multiple of dark night of the soul symptoms which includes higher rates of depression, anxiety, mental illness, addiction, trauma, and suicide. 

Working in the trenches of our communities, I see the suffering that people are experiencing up close and personal. The band aid solutions to larger structural change clearly aren't working and we all know radical changes need to be made.  So many people are falling through the cracks in our social system, particularly vulnerable people such as mentally ill, disabled folks, and senior citizens.  I won't go in to all of these social problems now as most of us have been inundated with them--one crisis after the next.

More reflections to come….