Divorce

Divorce is one of the most stressful things that a human being can go through. The loss of a mate is a devastating blow to the psyche. In death a spouse can grieve the permanent loss and someday recover. in a divorce, especially one with children involved, there is an open bond to this person forever.
Some sociologists study monogamy and evolution. They sometimes report that monogamy has passed down through the ages; sometimes they report that either males or females at one time were not monogamous for the betterment of the species at home. I think it depends on whether the scientist was cheating on his wife or not. One of my favorite discoveries was that females can store sperm and that sperm from competing males can compete in the cervix for impregnation. That supports a female with multiple partner non-monogamy.
However I do think that the human being requires some sort of partnership. A truly trustworthy and dependable partnership in order to be successful. People need love and affection to survive. Despite the solo Indians living in the rain forests of Argentina, people are a social animal. Many studies show better health and long life amongst those that have a stable long term relationship. We are able to nest, raise children and survive into old age with a true partner.
So divorce is a rending asunder of the bond, a destroying of the trust and an amputation of the soul. Then there comes an upheaval. Someone or both have to move from the family home. The confidant is no longer. One partner may have emotionally prepared and gathered resources of friends and family. Unfortunately if the other partner was not aware of the impending breakup, they may be completely unprepared and alone.
Now for the long drawn out legal battle. The only winner in divorce is the lawyer. Now the breadwinner has to pay not only for room and board in two locations, but must buy the mechanism of his own demise. The resources are quickly depleted and what was once a comfortable future with a nice nest egg built has become an uncertain time of transition and regression.
See why this is called the most stressful thing a person can go through? Despite the popularity of divorce and lack of negative social stigma, there is still an embarrassment or humiliation involved as each friend relives the bad experience when they finally find out. Thanks to social networking sites like Facebook, one can let a whole crowd of friends in on the secret all at once. John Doe is Single.
So what is a person to do? the usual, and more so. Diet, exercise, interactions, work, fun. Meditation and prayer if you are so inclined. Continue to do the things that fight the stress that you will carry along. Do not rehash, reminisce, bargain, stalk, or badger. Put the pictures in a box to be looked through later. visit with your children and make sure they know that only mom and dad are getting the divorce.
Stay strong, this too shall pass.

relationships

In putting my shingle out there I tried to go with what I felt my strengths were. i have dealt with substance abuse for over 8 years now, and was trained in facilitating Domestic violence groups, specifically dealing with the perpetrator. But what I have found is that people have been coming to me with relational issues. I guess that no one seeks out a therapist because of problems, only symptoms.

What I mean by this is that the root of relational issues may stem from the abuse of drugs or alcohol. Problems certainly may arise because of violence or anger in the home. However, the end result is a pain from a fear of loss, not from a self awareness. "I don't have a drinking problem, she just has a problem with my drinking."

What this tells me is that I have to change not my scope of practice, but rather my advertising. I have to look at the problems that motivate people to get into therapy in the first place.

Have you gone into therapy? why? In my own life there were two things that motivated me to go into therapy: Relational problems, and job problems. It seems that I was having a problem at work because of depression. Funny, being suicidal is not motivation enough for change but the treat of a loss of a job was.

Aluminum

Friday I was scanning a patient's file. He is on Dialysis, and has failed kidneys. Kidneys do a lot more for our bodies than just filter the blood and make urine. Kidneys also have a glandular function that helps create red blood cells. The liver takes out the old RBCs and uses them to create bile, which helps keep the bowels moving (and brown, I know TMI). So people with distressed kidneys also suffer from Anemia and require a booster hormone. But that creates danger of too thick blood which can cause heart attacks and strokes.
How does this relate to mental health? well, beyond the obvious stresses involved in dealing with a potentially fatal illness and a treatment regimen that requires 3 visits a week to a clinic for a 4 hour treatment with two giant needles stuck in the arm, there is the issue of Aluminum.
If you have gone to a stainless steel (spelling intentional) scam cookware presentation, you have heard about the dangers of aluminum. Aluminum has been linked to Alzheimer's Dementia, that much is true. However what the scare tactic using sales men don't tell you is that kidneys remove aluminum from the bloodstream. Well, normally functioning kidneys. That is a danger for dialysis patients, so the aluminum levels are monitored. This is how I cam across this information.
From Agriculture and Agri-Food Canada

www.agr.gc.ca

What are common sources of aluminum?
The American Waste Water Association
(AWWA) has estimated that drinking water (including treated water) provides
about 5% of overall aluminum in human diets. Most aluminum consumed by
humans
comes from food and beverages other than plain water. This list
includes:

•inhalation, especially in certain industrial settings
•soil
clinging to unwashed fruits and vegetables
•processed foods
•baked goods
(aluminum is used to stabilize baking powder and flour)
•brewed drinks
•over-the-counter antacid preparations
•anti-perspirants
•cooking
utensils, containers and foil (Journal of
the AWWA, May 1995).
What are the
health risks?
Unlike iron,
aluminum is not known to have any direct,
positive health effects on humans.
Adverse effects of aluminum are currently
known to be far more chronic
(occurring over the long term) than acute
(occurring in the short term).
Aluminum has been shown to be a neurotoxic
compound if it is allowed to
enter the bloodstream. Long-term exposure of
patients to dialysis water high
in aluminum may cause encephalopathy (defect of
the brain) and/or bone
mineralization disorders.

Aluminum has also been
suggested as a
cause of Alzheimer's disease, Lou Gehrig's disease and other forms
of senile
dementia. It is still unclear if aluminum leads to these diseases or
if it
is that the diseases cause brain tissues to retain aluminum secondarily.

It has not been shown clearly that normal eating or drinking in a
healthy individual will cause elevated aluminum levels in the blood. This is
true even if all cooking is done with aluminum pots and utensils.

Aluminum is likely to be in a dissolved form in the stomach since
aluminum compounds remain in solution at extremely low pH levels. Uptake in
the
stomach might be a risk if the stomach lining has been damaged from
stress or
overuse of ethanol or aspirin. However, almost all absorption
normally occurs in
the intestines, which have a much higher pH. At
intestinal pH levels, most
aluminum will precipitate to a solid and be
excreted.

Concern has been
raised about the ability of some
dissolved forms of aluminum to be absorbed by
the small intestine
(bioavailability). This may be of importance to the elderly
and people with
weakened immune systems. In a literature review completed by
Health Canada,
some researchers suggest that the uptake of aluminum can be
enhanced by
citric and other related acids. However, uptake may be limited by
the
presence of other things in the water that aluminum would rather bind to,
like phosphates. More research is needed on this aspect.

OK, now the point. some of the symptoms of Aluminum Toxicity include: Neurotoxicity, Bone Toxicity, and Anemia.

from Dr. Pepi:

It is particularly poisonous to the nervous system with a range of symptoms that can include disturbed sleep, nervousness, emotional instability, memory loss, headaches, and impaired intellect.
It can stop the body's ability to digest and make use of calcium, phosphorus and fluoride. This prevents bone growth and reduces bone density. Aluminum can also cause conditions which actually force calcium out of the bones. Either of these situations can bring on weakness and deformation in the bone structure with crippling effects.
Toxicity can also result in aching muscles, speech problems, anemia, digestive problems, lowered liver function, colic and impaired kidney function.

I have also come across references to Aluminum Toxicity causing irritability and anger outbursts.

None of this can be diagnosed without a test for the levels of aluminum in the body. But it sounds like aluminum is not good for you. So, what do we do?

eat foods high in sulphur. Sulphur is a long standing folk remedy for a lot of ailments, most likely metal poisoning. Imagine the lead and mercury exposure of people living in industrial areas in the late 1800 and early 1900s. There is a section of Tampa called Sulphur Springs, which was a huge tourist area prior to the mouse. It was the site of the first Mall. The springs served a medical purpose. Don't believe me? try an Epsom bath and see for yourself. Foods high in sulphur include Cabbage, eggs, and foods containing Vitamin B like broccoli. The sulphur helps the body bind the aluminum and remove it from the body.

Limit your aluminum intake. Warnings about using aluminum foil and cans are probably overrated, as are warnings about pans. Unless you are talking about acidic foods, like tomato sauce or citric fruits. Water is a large source of calcium as many sources are treated with Alum to precipitate contaminants. Also some antacids and other foods are high in aluminum. Baking powder (not baking soda) is aluminum based.

I think that aluminum based deodorants are an area of concern as well. But my coworkers are glad that I have not stopped using them yet. I do drink water filtered through Revers Osmosis (not deionized however).

So if you find yourself disoriented, irritable, or angry, why not sit down to a nice bowl of cole slaw or some stuffed cabbage?

Borderline Personality

Some therapists will not work with a Borderline (ooh that's bad we are not supposed to do that), I mean someone suffering from a Borderline Personality Disorder (BPD). However, I love it. They can be the nicest, most reaffirming clients out there. However, if you challenge them or say the wrong thing, they will turn on you in a second. As long as you realize that when they say they hate you, they just mean that you are not pleasing them, right now, you will get along fine. Although, some therapists can have great difficulty with a person with BPD because they have their authority challenged and boundaries trampled.

From Wikipedia, the world's most foremost guide to everything (sarcasm in italics), "As a result, people with BPD often evoke intense emotions in those around them. Pejorative terms such as “difficult,” “treatment resistant,” “manipulative,” “demanding” and “attention seeking" are often used, and may become a self-fulfilling prophecy as the clinician's negative response triggers further self-destructive behaviour.[107] In psychoanalytic theory, this stigmatization may be thought to reflect counter-transference (when a therapist projects their own feelings on to a client), as people with BPD are prone to use defense mechanisms such as splitting and projective identification."

What does this mean? A therapist that does not have a good ego can get his or her feelings hurt by a BPD patient. I would call the technical term counter-transference, but the lay name would be butt-hurt. When the client that shows up late, doesn't pay, stays late, calls the therapist at all hours, doesn't do their homework, and wants to only discuss their latest "crisis," all of a sudden reveals that they hate you and no longer want to come to therapy, it can be hard for a therapist to take. Of course one only has to realize that the patient will most likely show up next week and think you are the greatest therapist in the world to have a little patience and empathy for the client and understand that you are heading in the right direction. And expect the unexpected, and keep on your toes. I like to keep scrupulous notes so that I can keep up some days.

The DSM-IV-TR requires that at least five of the following criteria (or symptoms) be present in an individual for a diagnosis of borderline disorder:

• frantic efforts to avoid real or perceived abandonment
• pattern of unstable and intense interpersonal relationships, characterized by alternating between idealization and devaluation ("love-hate" relationships)
• extreme,persistently unstable self-image and sense of self
• impulsive behavior in at least two areas (such as spending, sex, substance abuse, reckless driving, binge eating)
• recurrent suicidal behavior, gestures, or threats, or recurring acts of self-mutilation (such as cutting or burning oneself)
• unstable mood caused by brief but intense episodes of depression, irritability, or anxiety
• chronic feelings of emptiness
• inappropriate and intense anger, or difficulty controlling anger displayed through temper outbursts, physical fights, and/or sarcasm
• stress-related paranoia that passes fairly quickly and/or severe dissociative symptoms— feeling disconnected from one's self, as if one is an observer of one's own actions

If you see any 5 of these symptoms in yourself please call a therapist and make an appointment.

First Post

Welcome. My name is Shaw Eberhardt and I am a clinical therapist. I would like to share each week on something that I learned in relation a client or a specific question. Please feel free to comment, to add your experience, or ask a question.

For this week I would like to start out with meditation. Many people have difficulty staying in the moment and that can lead to anxiety in the short run, and depression in the long run. Some patients awfulize, meaning that they can tell that the worst is going to happen in the future because of something going on today. What is the worst that can happen? Is it really going to happen?

There are as many forms of meditation as there are leaves in a tree. Find one that works for you. One of the easiest mindfulness meditations is to be aware of your breath. Whenever you think of it take three deep breaths, feeling the air move in and out of your lungs. Try not to hold on to any stray thoughts that pass through. If one thought dominates, take another breath.

Another form of meditation is a guided mediation, that involves listening to a recording of a meditation led by someone else. I have some CDs and MP3s of guided meditations, and there are plenty of scripts on the web. I use a digital recorder to read and replay to myself.

Finally, one of my favorite forms comes after strenuous exercise. You may have done this if you train in Karate or Yoga. In karate we would sit in seiza and in yoga one would do the dead man's pose. After a hard workout there is nothing like sinking into the ground and letting the mind slow. You may have felt the same peace and calmness after a long run or a good game, and getting a drink of cold water.

That is of course the purpose of meditation, the peace, calmness, centeredness, and one-ness with the universe. Or simply a knowledge that at this time, right here, right now, everything is OK. This allows us a safe haven, a launching point. If we can have a centered post we can explore. Much like we used our mother's leg as a home base to return to, when we were exploring the world. If you can feel it once, you can feel it again. With some practice, you can return to that feeling of centeredness even when the world around you is whirling out of control.

See you next week.