Anti Depressants-Sleeping Aid

December 19, 2010 5:14 am

In contemplating group work with alcoholics, the leader will need to consider several basic issues. What is the purpose of the group? What are the goals for the individual members? Where will the group meet? How often? What will the rules be? The first question is the key. The purpose of the group should be clear in the leader’s mind. There are many possible legitimate purposes. Experience shows that not all can be met simultaneously. It is far better to have different types of groups available, with members participating in several, than to lump everything into one group and accomplish nothing.

Some of the major group focuses include education, self-awareness of alcohol use, support for treatment, problem solving, and activity/resocialization.

Educational groups attempt to impart factual information about alcohol, its effects, and alcoholism. There is a complex relationship between knowledge, feelings, and behavior. Correct facts and information do not stop alcoholic drinking, but they can be important in breaking down denial, which protects the alcoholic drinking. Besides battering denial, educational efforts assist the already motivated person. Information provides an invaluable framework for understanding what has happened and what treatment is about. Alcoholics acquire some cognitive tools to better participate in their own treatment. Educational groups generally include a lecture, film, or presentation by a specialist in the alcohol field, followed by a group discussion.

Another kind of educational activity developed by Leona M. Kent in California, is the AA Training Group. In a series of ten sessions, the clients are introduced to the structure, philosophy, and jargon of AA. The intent is to help the referral process to AA of persons in treatment programs. Many of these clients are resistive, or confused, and apprehensive about AA. Normally, in AA this kind of information is shared informally between a sponsor and a newcomer. Without an introduction, some clients would never get close enough to understand how the AA program works.

Self-awareness and support groups are intended to assist the members to grapple honestly with the role of alcohol in their lives. The group function is to support sobriety, to identify the characteristic ways in which people sabotage themselves. In these groups, the emphasis is on the here and now. The participants are expected to deal with feelings as well as facts. The goal is not intellectual understanding of why things have, or are, occurring. Rather, the hope is to have members discover how they feel and learn how feelings are translated into behavior. They then choose how they would prefer to behave, and try it on for size.

A problem-solving group is directed at tackling specific problem or stress areas in the group members’ lives. Either discussion, role play, or a combination may be used. For example, how to say no to an offer to have a beer or how to handle an upcoming job interview could be appropriate topics. The goal is to develop an awareness of potential stress situations, to identify the old response pattern and how it created problems, and then to try new behaviors. These sessions thus provide practice for more effective coping behaviors.

Activity groups are least likely to resemble the stereotype of group therapy. In these groups an activity or project is undertaken, such as a ward or client government meeting or a planning session for a picnic. The emphasis is on more than the apparent task. The task is also a sample of real life; thus it provides a practice arena for the clients to identify areas of strength and weakness in interpersonal relationships. Here, too, the people have a safe place to practice new behaviors.

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WHY YOU CAN’T STAY AWAKE: OTHER TYPES OF DOES

If you experience a period of excessive sleepiness, you may find that it, like other sleep disorders, is a response to a transient life situation, such as conflict, loss, grief, or stress. If so, your problem will usually resolve itself within a short time. The need for additional sleep may even be therapeutic to some extent, serving to gently remove you from conscious awareness of your problem and perhaps allowing you the opportunity for further restorative sleep. However, if you find that the sleepiness persists for longer than two or three weeks, or if it begins to interfere with your daytime functioning, you should seek the advice of a physician.

If no evidence of sleep apnea or narcolepsy can be found, then some other cause for excessive daytime sleepiness must be identified. Although seen relatively infrequently, any of the following types of DOES may be the source of difficulty in staying awake and functioning fully during the day.

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WHY YOU CAN’T STAY AWAKE: OTHER TYPES OF DOESIf you experience a period of excessive sleepiness, you may find that it, like other sleep disorders, is a response to a transient life situation, such as conflict, loss, grief, or stress. If so, your problem will usually resolve itself within a short time. The need for additional sleep may even be therapeutic to some extent, serving to gently remove you from conscious awareness of your problem and perhaps allowing you the opportunity for further restorative sleep. However, if you find that the sleepiness persists for longer than two or three weeks, or if it begins to interfere with your daytime functioning, you should seek the advice of a physician.If no evidence of sleep apnea or narcolepsy can be found, then some other cause for excessive daytime sleepiness must be identified. Although seen relatively infrequently, any of the following types of DOES may be the source of difficulty in staying awake and functioning fully during the day.*155\226\8*

April 29, 2009 4:34 am

EXERCISES IN PAIN FOR THE SELF-MANAGEMENT OF PAIN: EXPERIENCING PAIN IN PURE FORM

We are now in a better position to discuss this idea. We can relax and stick a pin into our skin without feeling discomfort, and we can touch our skin with the burning string as it glows red hot without any real feeling of hurt. In both instances we feel something, as we have not made our arm numb by dissociation. I find it very hard to describe what we do actually feel. There do not seem to be the right words to describe it. This is so because it is a feeling which we do not ordinarily experience. It is not just the feeling of touch because there is more in it than that. It is not pain as we ordinarily know it because it does not hurt. It is in fact the feeling of pure pain.

As we learn to do our exercises with less and less regression, we become more fully aware of this new sensation. It is not a nice sensation, neither is it nasty. There is no pleasure in it as in the masochistic embellishment of pain. We can feel pleased in a natural way with our newly learned ability to experience pain in this fashion, but this is a reality-based pleasure and quite distinct from the perverted pleasure of masochism.

As with the other aspects of this system, of self-management of anxiety and pain, we integrate this principle into our ordinary way of life. When by chance we are exposed to pain, we recollect the sensation of pure pain which we experienced during our exercises, and as we relax, the present pain merges into this new sensation. We must practise this in all the incidents of trivial pain which befall us. In the past we could have borne these minor incidents just as best we could; but now we use them to practise our new-found ability.

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April 23, 2009 2:36 am

STRESS: LOSS IN THE QUALITY OF LIFE

The poetry of it

“It seems strange to say it. But when things have been going well there has seemed a kind of poetry in life. Yes, I think ‘poetry’ is the right word. There has been something beyond the level of bed and breakfast, and getting the kids off to school. There has been something about it all that I felt within myself. A quiet knowing, an understanding, between my husband and I, and joy. And now it has all gone. The joy has gone, and the understanding has gone, and our marriage is on the way to going too.

‘Everything has changed. No, it has not all changed. Only one tiny bit of it; it’s me; and I know it.

‘What is the change? Simply that I am on edge. On edge, and the joy has slipped down the other side, along with the understanding I felt I had of things. And my husband and I are slipping apart, too.

‘Our quality of life, the things that are worthwhile, have all gone. And now a nothingness comes to my life; a nothingness in that which was so full.”

It is just that the nervous tension of stress inhibits what we might call the ‘poetry of life’.

Stress and love

“Oh, how I have loved! It has fulfilled my life, fulfilled my being. And it flowed on. It overflowed into the world around me; to the animate and the inanimate; to the heavens above me, and the earth which provides.

‘Now, something of it has gone from me. The joy, and the blessedness that I felt in the one whom I love, has gone from me. It’s running out of everything around me; it’s gone.

‘There’s loss in death; but this is more, it’s loss of life, life as it could be, and has been.

‘What caused this loss? Not him. Not me. Perhaps it was me? Perhaps it was my reaction to the problem? But how can I love when I feel so stressed?”

Quality of life varies from individual to individual. Not all of us will attain that degree of quality which is indicated in the example. However, what degree we do attain, whether great or small, is easily eroded by the tension arising from stress.

Suspicion and jealousy

“As a child I pulled the blanket over my head as a protection against the fears of the night. I feared the devils of the dark might set upon me.

‘Childhood fantasies are left behind with the years, but now I am beset by a new generation of devils – more vicious than those of the past – Suspicion and his son, the little devil called Jealousy. Suspicion and Jealousy. Mean qualities of little people. I can see that I have them both.”

Who are the suspicious and jealous? They are the insecure. The effect of stress, and the disordered action of nerve cells, is to make us uncertain of ourselves. Insecurity is the ground in which suspicion and jealousy grows.

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2:34 am

INFERIOR PSYCHOLOGICAL REACTIONS TO ESCAPE STRESS: RATIONALIZATION

Rationalization is the unconscious process by which we give socially acceptable reasons for things that we do from lesser motives. It is the unconscious excuses which our mind makes for us, without us being aware as to what is going on.

The businessman is coming under stress from worry about his tax return which he knows was not the complete truth. He rationalizes, ‘The accountant passed it. That’s his affair. It’s not my responsibility.’ Of course it is his responsibility. But by rationalizing in this way he saves himself stress from the problem.

A young man is feeling the effects of stress from his guilt about a sexual encounter in which he really seduced the girl. So he rationalizes, ‘She went along. She did not resist. Said “No”. That’s just at first. Just part of the game. A few tears to make it seem she meant it. She didn’t resist. What in hell am I worrying about?’

A girl laughed at her new lover’s impotence. ‘I shouldn’t have done it. He’s so sensitive. So very sensitive. Wish I hadn’t. Then what of me! My feelings! He shouldn’t have tried if he did not know he was all right.’ In this way she rationalizes her guilt and reduces the feelings of stress.

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2:25 am

WARNING SYMPTOMS OF STRESS: DREAMS AND HEADACHE

Anxiety dreams

«I never used to dream very much. When I did, I was usually spared those worrying, frightening dreams which people speak about. Now it has all changed. Horrible. Terrifying. Wake in a sweat. Heart pounding. Often don’t know what it was all about. Just awful. Just the feeling of it being awful. »

These are known as ‘anxiety dreams’. They are the product of anxiety resulting from stress.

An interesting point arises here. I have seen a number of patients who complain like this. But when I have shown them how to let their mind run easy in meditation, so that their coping ability was increased and their stress relieved, the nature of their dreams has changed. Their dreams have lost their horrible, terrifying quality, and have come to concern matters of common experience without any great emotion at all. This change in the nature of their dreams is, in fact, a common occurrence in patients as their anxiety is relieved.

Nervous headache

«Headache. Headache on and off all the time. I know what causes it. Just the worry of this damn problem. It won’t go away. »

We all know that stress is a frequent cause of headache. But we do not know with any certainty the actual physiological mechanism which produces the pain of headache. It is easy to think of the over-active nerve cells causing the headache. The trouble is that brain tissue itself is insensitive. It can be cut or cauterized in the conscious patient without producing pain. So it seems likely that the pain of headache is mediated through stimulation of pain receptor nerve cells in the blood vessels of the brain.

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