Health Care Alternatives and Reality – Series – Pt. 5

 

The Myth of Mental Illness

The above is the title of an important book by Thomas Szasz. Mental illness still dominates a significant portion of our health care system and it still has major conceptual problems. Of course, as a clinical psychologist, I was schooled in it. I actually came to love Carl Jung’s work a lot more than Sigmund Freud’s but his work still dominates.

Alternative Realities

And so we again return to where we live on the cusp. Over the decades I found nonphysical problems related to mental and cognitive issues to be far removed from “illness” and often nuanced. And when we move away from the dominant model, we find suitable alternatives. Unfortunately the insurance industry dominates the field and therefore may dictate treatment or at least what it is called. What it is called will often influence what is done. Substantial reform is needed.

Some of the Issues

When my wife and I personally confronted issues for remarried families (aka stepfamilies) we learned important lessons. An important initial lesson was that the process is a matter of adjustment, not psychopathology. Certainly there were some people with substantial disturbance from other causes but we learned to begin with our model of adjustment. The  couple was focused on initially. Too often the mother or stepmother was put in therapy as if they were the problem although they may have shown the greatest distress initially. And we were resistant to putting children in therapy because adjusting to a new family was not pathological in almost all cases. Because of our approach we could structure an information system and found that generally the family could take over adjustment and handle their own future after very few sessions. See our book Stepfamilies: Professionals and Stepcouples in Partnership by Mala S. Burt, M.S.W. and Roger B. Burt, Ph.D.

Another major issue is what is termed post traumatic distress disorder or PTSD. The military is wrestling with removing the word disorder because it proves to be a bar to veterans getting help with their adjustment. Does anyone really believe that someone should go to war and kill people daily or risk being killed daily while suffering stress and not need to cope with management and an enduring reaction. I shared my perception with some friends who were veterans and found them in tears when I suggested they were not “sick” although there were still issues decades after their war experience. 

Enduring and Broad Issues

Those are just two examples of the reality of a world far more nuanced than what is described as mental illness. We can go on between things like personality diversity, numerous personal management needs as we pass through stages of our life. When I first came into the field the predominant viewpoint was that our development was finished in early adulthood. Absurd.

Management of life experience continues throughout life and it would be best if we approached our lives in that fashion. Take an area of life experience and we see that there is change, stress and adaptation. It would help if we defined a type of insurance that was appropriate and took these issues out of the hands of insurance companies focused exclusively on profit.

Life on the Cusp

Yes, here is that cusp again. Each of us is different with a raft of different experiences. We work for stability and commonality and often success. But it would help if we understood the richness of our diversity in the sense that much of the issues are not pathological and that our views from the cusp feed creativity, diversity and innovation. And life can be difficult, even jarring. From time to time we need to seek expertise and guidance but we generally do not need to cast it all into psychopathology. There are problems out there with profound biological origins where the person needs substantive help but very often management and guidance are what is needed.

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

Pie in the Sky

 

How do you think seniors are doing?

We Have Work To Do

Even if the actualization of a thought is distant or unlikely, there are times when some things have to be said.

Here is today’s dream.

The Elder Tsunami

The “advanced” economies of the world are facing the rapid aging of their populations which means a growing burden on the societies as a whole. The birth rate is often low and getting lower which means less familial and societal support for the elderly. Who will take care of them as they age and become frail? Family is often distant or members few in number. 

Time was that we lived in close family groups. No more. Instead we are fragmented. We need a realistic national dialogue about solutions. Perhaps, as the neocon obstruction dissipates we may see improved governmental programs, but it seems no matter what, it will be insufficient or impossibly expensive. And I must add that Paul Mason’s book Postcapitalism, that directs our attention the future, is making my blood run cold. It is a complex and dense book but each area he touches on is being validated by current events. But the true import of the coming changes in the world economic system is not being recognized publicly—yet.

https://www.amazon.com/Postcapitalism-Guide-Future-Paul-Mason-ebook/dp/B011I42XQ0/ref=sr_1_1?s=books&ie=UTF8&qid=1464014949&sr=1-1&keywords=postcapitalism+paul+mason     (get this from Amazon page for WordPress)

Certainly there are ideas out there to mitigate the coming trials. One alternative is social.

Societal Commitment

The Elderly for Each Other

I’m impressed by the progress that Habitat for Humanity has made nationally. There can be other forms of programs with societal support. The most likely source for the elderly is each other. Retirement is reached and then often there are healthy years before the inevitable decline. When I was working on my doctorate at Duke they finished a study which described a two year major decline before death that was common. Prior to that time, before the final decline the recently retired elderly could become more of a formalized volunteer force. It already happens somewhere, sometimes, but could be expanded.

The Elderly for the Young

In later years, having a cause is also useful. One cause I would recommend is making the commitment to support the efforts of a younger generation. The future for the elderly dims but there is reason to support younger generations. I don’t mean to say that these things don’t happen. What is at issue is the societal institutionalization of an ethos where we as elderly focus more strongly on our collective wellbeing whether that is for the elderly or for the ones who will remain. We have not been doing this well.

System Efficiency and Personal Management

And then there is the matter of health. Another thing we must do is to finally create a less expensive and more efficient health care system. Currently we have a very haphazard system which is expensive. Each of us experiences it on a regular basis. And included in these changes for the health care system needs to be a change of viewpoint by the elderly. Many have been trained over the decades to assume that the medical personnel will define what must be done and they adopt a passive stance. It is time to change that societal viewpoint so that we take the highest form of responsibility for our own care informationally and by action.

In Summary

In short, I would like to see a societal change in which the elderly, as they go through the later stages of life, work more closely together for mutual benefit. Secondly we should see to it that there is more organized societal support for the generations coming up. It is clear Millenials have felt overlooked and that needs to change. And the third item is long overdue reform of the health care system.

I know the response in many quarters will be that these goals are unrealistic or are already being undertaken. My response is we have not done enough and can do much more effectively.

I can dream can’t I?  Are you dreaming?

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

Demands Beyond writing – Promotion and Its Complexity

It’s More than Creative Writing

Did you know writing would be this complicated?

In olden days a writer found an agent and the agent found a publisher. Sure that’s a little simplistic, but it was broad stroke for how it was before self publication. When my wife and I wrote our workbook to help stepchildren adjust to their new family a good friend took it into Doubleday and they published it. They sent us on a national tour including an appearance on the Phil Donahue Show. Those days are gone.

How It Is Now

It seems publishers only talk to agents and agents don’t talk to—I don’t know who. In short there is no easy way forward to get a book published, publicized and marketed. It seems it is mostly up to the author. Of course there are predators out there who engage authors and charge incredible fees for doing things which are of little use. I won’t go into that mess. But we experienced it.

And Then There is the Promotion and Author Help Industry

There are books to help us write books, there are books to help us edit books and on and on. Advice pours forth from multiple sources and it is up to us to sort it and make sense of it. I’ve spent some years now reading sorting and in the end came down to trying it out. Some of the advice turns out to be dated, some spot on. 

The Best Advice

One of the best pieces of advice I read was to be patient. I’ve become quite clear that nothing works right away. It is said that there are 3500 books “published” each day. That comes down to a huge crowd and a lot of noise. It takes time to be noticed. The other things I got clear about was that things have to be tried and then we have to adapt.

Having a Thick Skin

Some things we have to listen to are writing related and some general publicity and advertising issues. But there is also reality. When the first of the Gaia’s Majesty Trilogy was published, the very first review on Amazon gave it one star. It was not to the reader’s taste, she thought the vocabulary was “too big” and she couldn’t write an effective sentence. Got that. And there it sat on the Amazon page all alone as I worked to attract other reviews. Who is going to buy a book with one star? It took some time, then the five star ratings showed up and the total climbed. Phew! The world is not an even, supportive place.

Being Fair With Each Other

One of the things I concluded immediately is that we need to be fair with each other. When I pick up a book and don’t resonate I have to be honest that the issue may be me and not the book. We don’t all like the same things. I’m not much of a fan of word heavy literature or that’s what I would term it. I want that book in my hand to be stirring and along with it my imagination and that essential thing in my life “possibilities” must call out to me. I’ll rate books but won’t rate books that are not to my taste. It wouldn’t be fair or reasonable.

Endurance

I guess in the end what I would say is that we have to endure and stay with our projects. Let’s face it, we like the creative writing process and some people accept it as a hobby and don’t expect to sell much and may not even try to promote it. It seems best if we weigh our goals and accept the complex noisy world in which we live. We learn to improve our writing skills and we have to learn what to expect and to accept endurance is essential.

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

A Vision for Appalachia

Where should we apply our resources?

In this political season there is vision coming from some quarters and none from other quarters. One of the saddest things I am seeing is the complete lack of vision in regard to the future of the people of Appalachia and the victims of the coal industry.

Beauty at Our Doorstep

Appalachia is one of the most beautiful areas I have ever visited and its people have been treated terribly. We now have politicians claiming they are going to save the coal industry and the reality is that it cannot be saved. The corporations have found ways to decrease the labor needed and the coal is running out even while it is clear that we have to turn to renewable energy sources.

The Meaning of Help

So what of the people of Appalachia? Are we to do nothing for them, for their future. They have a very high opiate addiction rate partly because of the injuries so many have sustained in the coal mines. Addiction is not a simple matter. One thing that must be done for addicts, as we attempt to help them with the addiction, is to move them toward hope and purpose. We are not doing that.

We hear that their future is dim, that other forms of energy must be used but we hear nothing of how they and their communities may have a new and brighter future.

Other Models

Recently I spoke with someone who also attended Duke University and he had made a visit to the Research Triangle (Raleigh, Chapel Hill and Durham area). He said everywhere he turned he saw thriving startup companies. It made me think of Appalachia.

The mountains and the valleys are lovely, graced with streams and glorious seasons. Each of these little areas can be homes to the right businesses. Of course, there is snow which has a beauty of its own and then there is spring and a brilliant fall. The summers, because of the mountains, are more muted. 

New Possibilities Being Born

We have entered the technological future and are seeing the possibility of something called post capitalism. We no longer are inclined to build huge industrial complexes. Instead we have pocket industries of a wide variety of sorts. Where California is lacking in water, Appalachia has abundant water.

Taking the Challenge 

Because of history, the eastern mountains have many problems and change will not come overnight. But with vision we have an area which has tremendous potential. The beauty of it can help build a future but it will have to be a very different kind. It will take considerable resources, including health resources, patience and offering something to younger generations among many other things. At present I hear nothing of vision for them and their area. 

We have been mired down in obstruction and lack of vision. Maybe I can raise the hope that we can begin to focus on constructive action and many shades of vision. In that we just might be able to develop the potential of Appalachia and to give the people hope and purpose. I can dream can’t I?

What visions are found in your dreams?

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

Health Care Alternatives and Reality – Series – Pt. 4

Our Ailing Health Care System

Where to Begin!

Since this is a post, not the required book, I’ll keep it short. 

We are a nation in crisis currently and not the least of the crises is our health care system. The enduring battle to reduce if not cripple government has taken its toll. We are the only developed country without an advanced health care system for all its citizens. And even what we have is under attack. Our system is inefficient and costly. Even if you are well off and well insured you immediately see problems.

And now that the government is under continuing attack we may see the collapse of small hospitals in rural areas. It would make the system even worse.

Seeing Problems First Hand

A few years ago I began to suffer mysterious and ephemeral problems and began a search for a cause. It turned out that I had Lyme Disease which had been poorly studied and is now epidemic. That was a major indicator of medical shortsightedness in itself. But then the problems became more obvious. I saw three separate physicians and each ordered a blood test (which we now know was virtually useless). When the results came in I found they were all the same tests. What a waste.

In France the public carries a data card and all results go on it. If we had such an efficient system the second physician would have had the results and there would not have been a second or third set of tests.

Floundering Over the Years

I am now considered to be a chronic Lyme Disease sufferer. It has been ten years since I believe I contracted the illness and I’m in my fourth return of the disease. This time my treatment will be more protracted. I can’t fault the medical people who have tried to help but the research has been abysmal and denial has been widespread. The stories of problems are endless.

Each of us has our own stories of problems, failures and inefficiencies. And the mental health field is no different. In a later post I’ll focus on one notable issue I became centrally involved in.

Failure on the Horizon

Many of us are looking at health care systems around us failing or on the verge of failing. As noted above, poorer, rural areas are particularly vulnerable in present circumstances. If those hospitals close, the effects will be devastating and the consequence will echo down the generations.

And currently we see areas which are very vulnerable and I saw a very specific area decades ago and it has not gotten any better. When I went to work in the impoverished area in the inner city of Baltimore our young staff learned quickly that the greater threat to “mental health” was poverty because of the depression and anxiety. But our seniors held fast to their desire for centralized systems rife with long term therapy and medications which served our people in the inner city poorly. I’ll leave it there for now. The sad tales go on and on.

But There Is Hope

Suddenly we are seeing an uprising in America. Our young are proclaiming “Enough Is Enough” and women are proclaiming “Me Too” in regard to sexual harassment and at the same time we are seeing a reenergized civil right movement. Now we can see the distinct possibility of vision and attention to the realities for our future. And health care is an essential part.

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

We The People

 

Have you thought deeply about the basis of recent tragedies?

Thought Needed

In the wake of recent atrocities no doubt the finger pointing and attempts to use the events for partisan political gain will continue. But we continue to need wise illumination and guidance.

An assessment of the basis for these events can fill books but there are a few basic pieces of history to which we need to attend. The words “We the People” are being used as the headline for this post because we need to understand that it is fundamentally the public at large which must face the basis of the problems and what we are to do about them. As of now truly enlightened historical commentary has been limited.

The Human Social Animal

There needs to be two broad areas of concern. One relates to how human beings are at base and how it affects our society. Humans are social animals which is both a strength and a weakness. Being social, we cleave together in groups of “our” people and work together for that common good. There is strength in numbers and it forges not just relationships but the development of productive effort.

Yet, our young staff working in the inner city of Baltimore in the 1960s learned to attend to a fundamental truth. In a very real sense, because we are socially centered beings, there is a dark side of racism and rejection of “the other”. What we learned was that each of us had to own that dark side and discovery and attention could help us contain and overcome the effects. As a society we still have not adequately recognized these realities nor how we can most productively work together.

Misguided Public Policy

At another level there was the matter of public policy. In Baltimore, as I stated in another post, we saw the beginning of a gulf between the police and the public when the police were forced to “arrest” innocent, homeless people. The police did not want that duty but were forced into these arrests which created terrible scenes in the communities. And then came another level when we began the “war on drugs/war on crime”. It was a bipartisan error forged by both major political parties.

And with this new war the police were forced into “stop and frisk”, stopping people on the roads where their cars were searched often resulting in the discovery of small quantities of illegal drugs. Convictions led to long prison sentences which robbed many men (especially minority men) of their future. Their home communities declined and the effect was to not decrease but increase crime. It also led to the scandal of our swollen prison populations. The ramifications are extensive.

The Public and Police as Victims

The people in these communities along with the police all became victims. Divisions and hostility was increased. And recently we have seen terrible tragedies especially within the black communities. Not every police officer is consummately effective in a difficult crisis situation. Errors will be made. Racism may contribute but it may also simply be an error. We cannot blame the police as a whole. And the effects of errant policies may lead the depressed or dysfunctional person to strike out. Depression is a janus and may lead to suicide or murder.

Looking to the Future

Are we to face ourselves and face the fact that it is we the people who have brought us to these tragedies? And we the people deserves emphasis. We must face our own racism. And if the public responds to prejudice and racial manipulation on the part of self serving politicians, then we become responsible for the tragedies as is currently the case. And if we fail to educate ourselves in the election process, then we abdicate our responsibility as citizens. I have often heard people say it does no good to vote. To not vote does harm, to fail to face reality and assess the often self serving political rhetoric does harm. We each have only one vote but we need to exercise it in the interest of our country and our fellow citizens. 

We the people helped create the problems we are facing and we the people can help solve them. That is the hope and the nature of a democracy. We face a swelling set of changes in this country and we had best attend to the process and our mutual interest.

And now, after recent school shootings, our young are rising up. And we are also seeing women rise as they throw off subjugation. These two processes are landmarks we must applaud and support.

What can be your contribution to solving these problems?

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

A New Jobs Portrait

We can Study the Future for Jobs

Furutistic Future Plan Urban Structure Concept

It’s really strange to listen to the non discussion about the future of jobs. We seem to be thinking that the jobs we have now are the only jobs there will be. It reminds me of the head of the copyright office who said in the early twentieth century that we might as well close up the department because everything that can be invented had been invented. It is as if we forget that the industrial revolution was indeed a revolution and we are acting as if the Information Technology revolution isn’t happening. Where is the foresight and the researchers.

Lessons We Can Learn

Making a reference to politics is jarring presently but I have to note that pathetic politicians are telling the people of Appalachia that they will bring back coal jobs and its as if they believe what they are told. I don’t even need to go into why they are not coming back. What is preferable is to look at Appalachia. Have you ever been there? It’s beautiful. Granted the towns need work and investment but those valleys are exquisite and while they aren’t suitable for sprawling industrial complexes or large agricultural operations, they are suitable for many kinds of companies, especially small technologically based companies.

There Is a Paucity of Discussion

Maybe I’m not hearing the discussion or they are done in whispers. A lot of technologically based startup companies can be small or linked because of improved communications systems. I don’t think its up to me to build a copious list but there should be a crowd of researchers at work. Perhaps Appalachia can’t spring to life over night and older residents might not benefit from new types of work but a future could be built for the younger generations. What I know from testing people for vocational opportunities is that you can’t know what there can be as resources until you look. It may take training but above all it has to begin with vision and a willingness to employ it.

Looking Around the World

Germany is legendary in the way it created apprenticeship programs. For some reason they thought that not everyone could or might want an advanced education as in universities. So they set up apprenticeships programs for existing industries. We can do such things for the industries and systems which are coming of age just now. Many tech industries are hungering for new workers and we need to research what the needs are and then go looking for the suitable skill patterns.

Opening Our Minds

I’ve noted this before when I mentioned what I saw as I tested the intelligence of people in preparation for retraining. Intelligence tests as they are constructed are not the be all and end all of ways to assess abilities. The ones we’ve used for a long time such as the Wechsler Adult Intelligence Scale were divided into Verbal and Performance. The Verbal was thought of as being most closely related to educational needs and the Performance section related to skills used by what we call blue collar people. Well, guess what. I saw that the Performance skills also related to information technology. Many people with lower Verbal skills were thought of as learning disabled. In fact they had higher Performance skills which was their area of talent.

It Comes Down To This

Can we do some research please and open our minds? We need to assess the jobs which will be needed and look at our pool of talent. New training or retraining may be needed but if we look I  believe we can open our future.

What do you see ahead?

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt