America – Addict Nation Pt 2

 

A Call for Help

Shortly after I left my job working in inner city poverty in Baltimore I got a call from a good friend who had been a community organizer in that program. He had become an administrator at what was referred to as a Methadone treatment program. The treatment providers were recovering addicts and social workers. They were under the supervision of psychiatrists. Those supervisory relationships were not working well. I was familiar with that problem because the administrators of the program in Baltimore had been psychiatrists and the rest of us in the treatment delivery teams had to fight them constantly so that we remained focused on the real needs of the community we were serving and how those needs were addressed. What my friend wanted was someone who could address the needs of the incoming clients to the staff in a way that meant something to them. Long term intensive psychotherapy did not. Since I had been on the street with him and other staff I could talk the language of his staff and relate to their perspective. The staff needed a down to earth approach.

A New World of Problems

So I came on board as a clinical consultant. New clients were routed to me for an evaluation. In spite of my time on the street I was surprised at who was coming for help. I had been relating more to community services and the drug world was a different place. I expected to see heroin addicts arriving to take methadone. The people who came had many different problems. Some weren’t even what I would call “physiological” addicts. One nineteen year old had been using hallucinogens for six years. He wasn’t physically addicted to anything but had missed his adolescence.

I won’t go into all the details except to say that it made me aware that drug issues rarely stop at the matter of physiology. There are developmental issues, marital issues, education issues, job issues and on and on. There was absolutely no way to address everyone in the same way. It became a matter of designing approaches and determining needed resources for a broad range of needs.

Treatment Chaos

If we think anything else, we are deluding ourselves. As we begin to look at our opioid crisis there evidently are burgeoning treatment programs but some of them are shady and shabby enterprises. Just recently we learned that Google raked in over $1 billion in ad revenue related to advertising for treatment services. It seems there is insufficient regulation or attention to what needs to be provided and what is provided. We are missing the needs point. There is shouting about the addiction problem, but I’m not hearing a whole lot about a comprehensive plan or even a plan for working on having a plan.

Many Other Needs

One issue alone is illuminating. It is clear that a lot of these opioid drugs have flowed into Appalachia. This is the area where people have labored in coal mines, been injured, and suffer from chronic pain. The coal industry is clearly dying and there is little attention to what needs to be done for the economies of such areas. This alone tells us that we have a lot to study and work to be done. And much of the work needs to start today.

The Bottom Line

In some ways this blog post is nothing other than a warning. We have been diverted by political and ideological infighting. It is time to go to work in a more focused and cooperative way.

I’m going to close this post out now because this subject deserves study, certainly a book, or maybe a library of books. And we are not doing enough that is effective. We have a national scandal at many levels. We need to search and study our world.

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

America – Addict Nation Pt 1

 

A Recent Discovery It Seems

The discovery that we have an opioid addiction problem in the United States is getting considerable news coverage. From the noise and amazement, it would seem it just started up.
Of course a problem of this magnitude didn’t just happen overnight. And, in fact, over 60,000 people died from it and related issues last year. That’s more than the 58,000 people we lost in all of the Vietnam War and more than the 37,461 deaths from car accidents in 2016.

Dealing with Scope and Reality

I couldn’t resist the headline because it is typical of the way major issues are suddenly hyped. Reality is often even more insidious. This is not to suggest that we should dismiss the issue. It is indeed serious, but it deserves a much broader form of coverage.

There Are More Than a Few Questions at Issue

I have a few questions and comments. First some questions.

As a member of the “helping professions” my lead question specifically is “What the H..L were the medical communities doing?” Is it conceivable they really did not see how many prescriptions they were handing out with little understanding of the needs of their patients and what was underlying the requests for medication? There needs to be a major discussion among those professions.

Next question relates to big pharma. What we know already is that there were massive shipments of addictive drugs and that many of those shipments were concentrated in areas such as Appalachia. Are we expected to believe that the pharmaceutical companies had no awareness? The bottom line is that this involves criminal behavior. They need to be held accountable. And that in turn should open the scandal of drug prices in this country and the patent need to regulate the pharmaceutic industry in a much more effective and comprehensive fashion.

Next question relates to Congress. Are the member of Congress living off planet? The silence on so many issues is outrageous. There is not nearly enough attention to this crisis in Congress. We should be overwhelmed by their outrage and efforts to look into it. Or, is this another indication off the corruption of big money in Congress?

What Should We do?

Right after we address the above questions we have to go to work. One of many things which distresses me is that I’m hearing little or no talk about what we actually need to do for the sufferers from these addictions. And yes, it is addictions—plural.

Some action is being taken and some of it is at the community level. We have a scandal of large magnitude on our hands and it is ours as a nation. In my next post on this issue I’m going to go into the matter of some of my history as it relates to this problem. We truly have our work cut out for us and it is not just a matter of addressing addiction. Along with those issues we must attend to the larger dysfunction of our nation. We all need to be distressed about what has happened to our country and make a commitment to do something about it.

To Be Continued.

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

Our Nation in Crisis – An American Vision: Part 5

 

Responding to Problems – Two Examples

An Epidemic of Drug Abuse

We are told we have a national heroin epidemic. Probably not quite. That’s an easy description.

It seems that we have been passing out prescription pain medication a little too easily. I have not heard a clear statement about why this issue is suddenly so prominent. If the issue is pain, then what kind of pain are we dealing with and why is it happening? Is it physical or emotional? Regardless of why, it is an issue and why is it happening?

And then we come to the issue of how we respond. After I left my job in the inner city of Baltimore I got a call from the man who had been our lead community organizer. He had become the administrative head of a drug treatment program generally referred to as a methadone program. He asked me to become a clinical consultant. Most of the staff were social workers and counselors (recovering addicts) and he thought, with my time on the street, I could help the staff especially since they were not meshing well with the psychiatrists. Fine with me.

What I found was not a nest of recovering heroin addicts but a diverse group of all kinds of people wrestling with a myriad of drug problems. It didn’t matter whether it was heroin, opioids, hallucinogens, or any other drug, they all had personal and vocational issues. In short, we had to respond to the human condition and it did not reduce to one form of treatment. People are different and programs need to be flexible.

It seems we have a national problem with one indicator being drug issues. Much of the problem involves factors discussed previously. The question is what we are dealing with and how wisely we respond.
Empowerment or Subjugation of Women

And then there are issues which are basic and may be wholly unrecognized.

One of the things that interests me as a psychologist is the operation of the unconscious mind. Above I mentioned that we are all racists and it is clear racism operates generally as an unconscious attitude. There is another unconscious attitude which appears fairly universal and that is misogyny. It is generally defined as dislike of, contempt for, or ingrained prejudice against women. How can this be so widespread? We are talking about our mothers, our wives, our daughters, our sisters. I don’t have a ready answer about the reason for its existence but it is clearly pervasive. It had an effect in our recent election.

I have some thoughts. Misogyny leads to women being subjugated and dismissed. Often it is said that it is about maintaining control of paternity. That is hardly a sufficient answer because it is so widespread even where paternity is not at issue. More likely is the matter of power and possession. Men do not like to yield power and in relationships it is desirable for them to yield to the creation of a partnership. Sometimes they do in their own relationship but will fight against the rights of women in general. It is a curiously complex phenomenon.

Another area where it is apparent is sexually. Women captivate men emotionally and in the sexual release there is a yielding of power which, while men want it, they may have trouble with the outcome of the experience. No matter how we look at it, women are somehow threatening to men and men often feel women must be controlled.

As we look at our troubled future it is apparent that women can play an important role in building a constructive future. It would help if we could understand that, just as with racism, there is an unconscious need to control women. Men would benefit from understanding why there is this fight within themselves. We can already see that microloans for women are having huge benefits, personally, in their families and in their communities. Recognizing and owning the process underlying misogyny would pay huge benefits.

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 Movement

A New System

There is a new movement concerning how we handle problem issues in our personal lives. That may mean the things we have called mental illness. It’s about time.

As a psychologist I’ve had to wrestle with my profession and the allied profession of psychiatry. Fundamentally I’m not a huge fan of the term mental illness. Obviously no one would be enthusiastic about mental illness. But I’m talking about my reservations about the whole concept and how we respond to problems and crises in our lives.

Long ago we dragged problems assumed to be associated with demonic possession and related issues away from the church and gave it to the medical professions. Not a bad idea but it is long overdue to reformulate our concepts. Time for a redefinition.

Down With Mental Illness!

Certainly there are biochemical issues which can be devastating. I’m thinking of such things as schizophrenia. But there are also a class of problems with varying severity we all have to contend with. Then recently I heard a discussion about new approaches.

The people presenting were fundamentally talking about management. They pointed out, for example, that anxiety is a significant problem for many people and probably all of us from time to time. There are a number of diagnoses associated with anxiety. But there is the suggestion that we need to approach it differently. Certainly it can be a major problem but it is also useful in that it alerts us to danger and problems and pushes us to seek cause and management. Now that it a conceptualization I like.

Life Management

We may have a life coach but we actually need to conceive of ourselves as in the business of life management for ourselves. We tend to do it in our day to day lives when we take time off, go to the gym or give ourselves a treat. But management goes well beyond that.

We have to understand how we are. Introverts manage their tendency to withdraw. They come to understand that they are much more comfortable when they are clear how they should react and manage a situation. I remember Johnny Carson talking about how introverted he was. But night after night he went before an audience as a comedian. He spoke at one point about how well it worked when he was well prepared and knew what he was doing exactly. He knew how to manage it and he looked like an extravert.

Specific Issues

Extraverts have to learn to back off with some people and be engaging but not too engaging. For more serious issues we have PTSD and Autism for example. The new movement is taking a different approach.

PTSD is, in many ways, completely understandable. If you live day to day being forced to kill people or trying not to be killed, it is going to take a toll. A change of perspective rather than seeing oneself as a failure for reacting is helpful. Also there are ways to help a person decondition with exposure to specific stimuli. These examples merely hint at productive approaches.

Then there is autism. When we listen to the issues autistic people deal with, each of us will identify specifics which are at issue for us as well. The difference may be of degree and the number of different issues present. Managing in discrete areas will help.

Stepfamilies pose another set of issues. Often everyone in the family is making a life change adjustment at the same time. It’s very stressful and requires attention to management for adults and children. Is it pathological or a mental illness? Of course not. It requires understanding and management.

The Bottom Line

New thinking is leading us away from the concept of mental illness. Now it seems we are turning to management when we use such things as exposure to stimuli, cognitive behavior management. We can now stop threatening people with stigma and help them manage their lives in new ways. At last!

What are your primary life management issues?

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

Stepfamilies – Struggle and Triumph

 

Do you know what a stepfamily is?

A stepfamily is also known as a blended family or a remarried family. It happens when people who have children from a former marriage marry. If there are no children, it is simply a remarriage.

Years ago people used to hide the fact that they were a stepfamily. Children were adopted or the fact of the nature of the family was a secret. And then in the 1970s a stepfamily movement took shape and people began to discuss their existence and the problems they faced.

A Host of Adjustments

At the time the divorce rate was higher than it is today. People marrying earlier was one problem. But there were many contributing factors. There is an adjustment to a divorce or the death of a spouse which must be dealt with. Too often people moved quickly into another marriage and brought their children wth them. Adjustments weren’t finished and the children had to deal with their own adjustments. They had to adjust to a new family they didn’t want.

Looking Back

My wife and I suffered divorces at the same time and remarried in that period. Together we had custody of our children—in crisis. It was stressful, is one way to state it. And it is a simplistic statement.

Soon we sought understanding and refuge in the stepfamily movement and became national experts in the experience and its adjustment. Now we are here having been married for forty-two years this summer and our children have been on their own for a long time. There are now grandchildren. Survival was not easy.

The Struggles

Families of any kind can be stressful. Careers have to be maintaining and children have needs and grow fitfully. But a stepfamily begins in crisis. Everyone is in crisis and the threat of it tearing itself apart is clear and present. The adjustment period for the adults is between six and eight years in general. And during this period the children are working on their own adjustment.

But there is help and understanding. The adjustment period is long but people need to understand it gets better during the period in fits and starts.

Inspiration

It was clear people needed information and understanding. Many of us wrote books to help others. My wife and I wrote a book which we later revised in another form. It is called Stepfamilies: Professionals and Stepcouples in Partnership. The title is telling. Getting help is important for very many couples. But there is no reason that all the wisdom needs to come from someone else. The adults involved can understand and help construct their own helping and healing system. So, it can become a partnership. Or, of course, the couple may simply find the book sufficient and useful.

We now have an important body of knowledge and don’t have to be alone in a difficult period.

How many stepfamilies do you know? Probably more than you think.

Stepfamilies: Professionals and Stepcouples in Partnership

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

Whatever Happened to Community Mental Health by Roger B. Burt

Is This a Time of Reform?

With Crisis Comes Opportunity

With all the political turmoil the question reform seems odd. It merely seems to be chaos and we have no idea where it will lead. And I’m not hearing a lot of wisdom from the talking heads.

Some things strike me as almost inevitable. Change, consolidation and finding a direction. This kind of turmoil can’t continue forever. All we can hope is that a direction will appear before we end up in an unimaginable crisis.

The point is that world events are hardly linear and neither are their components. Opportunities appear, reform eras come and go and from each of these things we may grasp them and make improvements. Sometimes the time is simply not ripe.

The Reform Era of the 1960s

We built a new country after World War II and then came a major reform era. We began to talk about stewardship of our world in more defined ways, the advent of effective birth control opened a new era for women and our thinking broadened in many ways.

As a psychologist one movement which caught my interest was community mental health. It was time to move away from in depth psychotherapy and psychoanalysis to a broad movement which would bring “mental health” services to the population at large. To do that they we were to apply a public health model.

Seizing an Opportunity

Just as I was finishing my Ph.D. at Duke the movement opened and I was interested. I have to admit I never liked school all that much. I just stuck with it. Too much of it was not particularly engaging for an intuitive personality type. I needed novelty, possibilities and community mental health offered those things. So I came to Baltimore to become engaged in inner city poverty. I did not really know what I was getting into but I loved it. We learned how to give services in diverse poverty communities. And we learned to do battle with the conservative forces in the mental health hierarchy who were not at all interested in groundbreaking and simply wanted the grant money.

What a Learning Experience!

We had to lay aside old ways of thinking. Had to delve deeply in the communities as they were and even keep ourselves safe. We dealt with junkies wanting to con us out of meds, riots when Dr. King was murdered, and sort out our own diversity. It was challenging, dangerous and exciting. Because we came with a new framework we could perceive origins, outcomes and vulnerabilities. In fact, we saw the savage policies which flooded our prisons and the roots of division between the people and the police seeding riots decades later.

For the Record

All such things must come to an end and in time the rambunctious, groundbreaking twenty somethings moved. But I could not resist putting down the experience for the records. The story in all its fascinating details is told in may book Whatever Happened to Community Mental Health.

From Past to Present

And then something happened recently. I came to awareness which had eluded me. The movement had come too soon. Certainly there were problems which would have worked against progress anyway, but in many ways wed lacked the tools to really document and develop what we found and what we did.

When we had gone out onto the streets we were all naive. We had to learn a new approach whether we liked it or not. Insight therapy and medications were not fundamentally useful. The community was in crisis with each community having a different crisis of sorts. And so we had to learn community and life management. But there were no tools to document what we found and ways to construct broadly useful models.

Now Comes Information Technology

The needed tools now exist. With parallel resources putting down what we found and what worked, we could have moved toward a comprehensive, flexible system which would have evolved into a whole new movement. I can only imagine what utility it would have today.

The long and short of it is that it is now time for a community mental health movement. All the prerequisites exist in Whatever Happened to Community Mental Health. We will see if these kinds of potentials will grow out of our present crisis. There are so many flowering buds out there in this age.

What do you see coming?

Roger B. Burt’s Amazon Home Page

Whatever Happened to Community Mental Health by Roger B. Burt

Creating Characters and Plots by Roger B. Burt

Expressiveness in Men and Women

 

How are your feelings manifested?

For most of my writing on the Gaia’s Majesty Trilogy the story and the characters seemed to flow out of my brain. Well, actually I did do an outline first but then the waves of details and change started to flow. For the outline I chose to use the tools found in Inside Story: The Power of the Transformational Arc by Dara Marks. It is actually aimed at creating scene plays but works wonderfully for novels as well.

Even with an outline I often felt on autopilot. Looking back it seems though that my right brain was dominant with a little assist from the left.

I wondered where my characterization of Avery, my lead female protagonist, came from. And I also had to look at how I characterized her guy, Beck. What I saw was that it came directly out of my work with couples in therapy of various kinds.

Recognizing Origins

Avery came out as a bright, dedicated woman but she could seem immature at times particularly when she was under stress. Of yes, having your life suddenly bombed and strafed and finding out you were part of an almost mythological body of humanity is stressful.

Certainly I wanted her to be interesting and to show emotions as she was swept out to sea as it were. But in working with couples I saw a characteristic difference overall between men and women. Women were more expressive of their emotions and the men seemed to be feeling less. Of course, what I learned over time was that they weren’t feeling less, but merely showing it less. And, in fact, there is actually research supporting that observation. When physiological indicators are measured it becomes clear men are feeling just as strongly as women, but contain it, often without tears.

So I was giving Avery free rein to show the emotional states she had to be having and Beck was more studied at least on the surface. The fact that she had a range of feelings, including some which might seem immature, was indicative of strength and not weakness. And the fact that Beck seemed more studied didn’t mean he cared less.

Our Truths Displayed Broadly

What was conveyed was human truth and we see it in places such as corporate or organizational meetings where women may show more depth of expression and, yes, be what we call emotional. When it occurs, the men often take it as a sign of weakness. Got it wrong guys. In fact, their own lack of expressiveness or muted expressiveness may be getting in the way of their homing in on the issue at hand. In some ways, with appropriate structure, laying out what we feel forthrightly helps us assess the matter at hand. Then we can move on to do the focused work needed.

The lesson is that, in writing, we might be less judgmental and more accepting of the flow which occurs. It displays how we are as people and the diversity we bring to our interactions. We can always redirect and hone our work later on. I’m sure Avery and Beck loved each other just that much more because of what they brought to the emotional table.

Where do you stand on the emotional landscape?

Roger B. Burt’s Amazon Page

Creating Characters and Plots by Roger B. Burt

Whatever Happened to Community Mental Health by Roger B. Burt