Peninsular Clinical & Forensic Psychology

the decline of violence

2012-01-26T20:07:00.000-08:00

I have just begun reading a fascinating book with a bit of crappy (or at least obscure) title. it is "The better angels of our nature" by a Harvard Cognitive Psychologist, Steven Pinker. This book examines the (for many people) surprising observation that from a historical perspective violence has seriously and dramatically declined in our society.

This book is particularly relevant for the anxious amongst us who argue till they are blue that we live in a violent and frightening world and if it wasn't for their excessive hypervigilence we would all be murdered or raped and our children stolen.

Anyway... Professor Pinker provides considerable information to demonstrate that we in the early 21st century in western countries live extremely peaceful lives by historical standards. We are dramatically less likely to die early fro violence than in any other period of our history. he reviews the kind of violence experinced in prehistory, ancient greece and rome, in the early christian era, in the middle ages and also in early europe and america. All these times of history are demonstrated to be considerably more dangerous than today. People were very easily murdered raped and totured in these periods without much of a fuss at all. it was considered commonplace.

He spends considerable time on the "the civilising process" that he considers an important part of the change in people that have lead to the decrease in violence. He proposed that over around five hundred years from the middle ages European people learned to manage their impulses, look to long term consequences and thought about other people's thoughts and feelings. This civilising began in the aristocrats but eventually became a part of the whole society. According to Pinker the civilising process occurred because government got its act together over this time, smaller fiefdoms and baronies combined into nations that could support and organise police and military. It also occurred because commerce developed so that work was rewarded over theft and violence.

so far..so interesting... much much more to come!!

Parenting Back to Basics

2012-01-16T01:06:00.000-08:00

Recently I've confronted by how difficult it is to work with children with behavior problems without simultaneously dealing with parenting. Many parents send us their children to "fix." Their child might have shown signs of aggressive, violence, defiance or refusing to contribute. parents will make the phone call to us and ask, "is there something wrong with him/her." Often (but not always) parenting is the first place to start.

I recently reviewed some of the basic principles of parenting that should be checked with any family with a "child with a behavior problem." Any one reading this stuff that wonders about how to implement it or needs help with their kids please contact us for some assistance.

Basic ideas that should be assessed:

Parents model behaviour.
Parents need teach their kids how to relate to others by their speech tone, the words they use, the pitch and their use of language. They need to get very clearly that their children parrot their own behaviour. If they hit, their children will understand that it is OK to hit, if they yell so will their kids, if they swear so will their kids, if they scream and throw tantrums so will they. Parents need to look closely and honestly at their own communication patterns and honestly appraise them - and then change them.

Find the good behaviour to reward.
Parents need to identify even the slightest good behaviour, or even an approximation of good behavior and verbally encourage it. Parent often feel this is a weird strategy and that it feels false or forced. They sometimes need to have someone demonstrate what it means because many have had so little contact with encouragement themselves in their own childhood that they couldn’t even imagine what that might sound like until it is demonstrated. So, for example, if they child (for the first time) puts one toy away, they need to be praised for the one toy before being helped to put away the rest.

More tangible rewards need to be explicitly planned.
Finding the reward is often the creative challenge. Use charts if this is appropriate. They are fairly easy to construct and many are available commercially. I draw up some fairly crappy ones in session, i don't think they need to be sophisticated, just interesting. They need to be changed regularly and need to be easily completed. The behaviours need to be easily achieved, almost “a give away” for the kid, at least to start with. Start with a star in the balloon for putting one toy away, or a day speaking nicely.

Tangible rewards only work ‘tho if the child’s life is not flooded by indiscriminate treats.
Check that the child is not given treats “to keep them quiet,” “for peace,” or because it is just easier to say yes than to say no. Every treat should be connected to behaviour. The children need to be taught the principle that life is better if they make the right choice and so they learn to make the choices themselves.

phew.... more next time.

can we "profile" bushfire firelighters?

2011-12-08T01:52:00.000-08:00

In a recent edition of "Psychiatry, Psychology and Law" researchers looked at whether fire lighters are psychologically different from non fire lighters. They wanted to know if it is possible to identify characteristics of a fire lighter that can predict if they will re-offend.

There has been research previously published categorising fire setters in a urban setting in other countries but there does not seem to be any clear previously published look at Australian bush fire lighters. In urban setting there has been a few categories identified. There are the people who light fires for financial gain or to cover a another crime. There are people who light fires because they are angry with the world and want the world to know. There are a disproportionate number of fire setters who are mentally ill or disordered. They might have schizophrenia or have alcohol or drug problems. There are a small number who are known as pyromaniacs, those people who are unable to resist the urge for fire setting and have increased tension before the act.

when risk factors for fire setting is looked at a list of characteristics are roughly agreed on. The offenders tend to be young males with interpersonal difficulties and alcohol or drug addictions, show evidence of unstable childhoods and some form of mental health problems. In other words they are pretty much the same as all offenders.

So far, then, the research says that fire lighters are just like all other offenders and that fire lighting is to some degree just another criminal activity. Mmmmm.......

why the Myers-Briggs is crap

2011-12-07T01:08:00.000-08:00

i was reminded today of why i get so angry about the Myers-Briggs "type indicator." The Myers; Briggs is a pseudo psychological test often used in work places to help individuals discover their strengths and their personality "type." Wikipaedia reports it was first developed around the second world war to help newly employed women identify their strengths and interests. It was first published to be used publicly in the 60's, so despite over fifty years of psychological development it has no changed.

The main idea of the test (from what i remember from uni) is that personalities can be measured on four different qualities of personality. These qualities are assumed to be dichotomies; that is individuals are assumed to be either introverted or extroverted, sensing or intuitive, thinking or feeling, judging or perceptive.

These are opposite qualities, at either end of a continuum. Now here is the problem. The scoring. If an individual scores (say) fourteen on one of the qualities. they fall into one end of the quality but if they score (say) sixteen they fall into the other. so for example, if someone scores fourteen they are introverted, but if sixteen they are extroverted. that might only be a difference of two questions and yet the test identifies the individual as completely different, actually opposite. I know that is complicated but hang in there with me.

So to the example i was reminded of. a young man who i had been treated went to a "consultant" for career advice. She gave him the MBTI. He dutifully filled it out and brought me the results. The report he was given identified him as perceptive along with other categories. The other three were reasonably accurate but the "perceptive" was clearly at odds with his personality. I asked him about this because it was directing him to a whole raft of jobs that just would have driven him mad. he explained that he answered a few of the questions the way he thought he should have answered him rather than how he truly felt. We changed two questions and he then moved into the "judging" category. Remember they are opposite categories with only a single score between them. When he changed two answers the outcome was totally different.

The upshot is that psychologists understand that qualities are not two opposite categories. People are, for example more or less introverted with a million shades between totally introverted to totally extroverted. in fact most people are somewhere in the middle. so splitting people down the middle where one side is extroverted and the other is introverted is totally simplistic and frankly highly inaccurate. But people still pay lots of money for the privilege.

flying phobia: treatment in process

2011-11-28T02:08:00.000-08:00

today i had a session with a client who was referred after a very frightening flying experience. She had previously been a very confident international flyer, having flown many many times. after a particulalry turbulant flight with screaming crying and hand holding she has developed a phobic fear of flying.

Some twelve months after the flight she found herself crying and panic just thinking about flying again. Seeing a plan sent her into a panic, imagining flying made her cry and talking about the incident she ended up sobbing.

So we launched into a fairly standard CBT-type program for trauma based avoidance. we began by developing some strong anxiety management skills. She trained herself in relaxation techniques for a few weeks. we talked through the incident every session but then put those techniques into practice.Each week has "homework" that involves taking on a carefully graded challenge.

Well today we past the six session mark and she has made great progress. She has sat for a long day at the international terminal and can easily speak through the incident without tears. We planned a trip to melbourne early next year and she will be scanning the net for bargains. only a few months again she couldn't read about flying without tears.

a bit of good news.

when does an friendship become an affair?

2011-11-23T18:43:00.000-08:00

so you have a huge amount in common. you like the same books, tv shows, conversations...you laugh at the same things. You send links, poetry and clips. you write every day but you still only know each other online. you make each other smile and type about the way things might have been, if only....

You never type about sex, never even muse about anything physical. You don't play act or "get out the web cam'" Your relationship is purely an intellectual, non-physical one.

But you look forward to the inbox. You smile when you think of how much you are alike. When your mind wonders during the day it wonders to your online "friend."

when is it "an affair?" When does it "cross the line?" At what point has too much transpired to tell your partner about it? Do you know that line when you see it and cross it?

Does it hurt just as much when it ends?

why does a twelve year old run away from home?

2011-11-14T21:09:00.000-08:00

i worry that this blog sees too much of the dark "underbelly" of life, that i report on the failures and mistakes a little to often. I make a pledge that after this one i will resist the urge to write about the trauma and abuse I have way to much to do with.

let me paint a picture: a loving family has migrated from Europe. The parents already have two boys but are yearning for a baby girl. They got the opportunity to adopt a beautiful baby girl when their own boys were around nine and ten years old. The next thing we know our beautiful baby girl has become "uncontrollable." She is angry and anxious and keeps running away. Her parents who love her dearly cannot fathom her behavior. They cannot make sense of this distress when they and the boys love the little girl and care for her. Eventually she was made a ward of the state and sent to a "training" centre for uncontrollable juveniles. Once it was suggested she return home, but she screamed ran away and became so violent she never was returned. No one could figure out why this had happened.

The cause is almost comical it is so obvious in hindsight. No one questioned why a seventeen year old boy would wish to shower his sister. No-one noticed that the door was locked. No one else knew that bath toys were used to "loosen her up" until she was seven when full sexual intercourse took place.

That was the start of a life easy to imagine. Drug abuse, parenting problems, ongoing conflict and only recently a criminal offence related to violence. Hopefully she will be forced to seek treatment and hopefully things will improve.

I wonder if this could possibly happen in 2011. Do we know enough now to ask why? Do we not assume that our beautiful loved boy could do something horrible if not watched? These days do we watch a little closer and ask a bit more? My God I hope so.

is this the most common parenting mistake?

2011-10-24T23:59:00.000-07:00

today i wondered into a well known department store and made my way to the line for the cash registers. i stood staring into space when i became aware of a three year old tantrum happening in the line next to me. the little girl was screaming and crying and demanding the lollies so thoughtfully placed near the queue. her parents were responding with "stop it," "you are embarrassing" and "you'll get nothing if you keep this up." this persisted for as long as it took to process through five or so people and the kid kept going and so did the parents. i looked away because the parents were obviously becoming very embarrassed. next time i looked, surprise surprise, the kid had a lollie in her mouth and was- "suddenly"- not crying.

why oh why? how did they think it was a good thing to do? why couldn't they just cop the embarrassment of a crying kid and tough it out?

they broke two of the most important rules of parenting little kids: never never give in to a tantrum. it only teaches the kid to persist a little longer each time, because the kid figures out that eventually they, that is; the parent's will break. And, never threaten a punishment you have no intention of handing out. The "you'll get nothing..." line was never going to happen and that was obvious to everyone, even the kid. all that taught was that the kid doesn't have to take her parent's seriously, and she obviously doesn't.

i want to get this message to every parent:

NEVER MAKE THREATS YOU DON'T MEAN TO CARRY OUT, AND NEVER REWARD TANTRUMS WITH TREATS. NEVER, EVER EVER. (if i sound a little frustrated it is because i am)

another win!

2011-10-23T22:55:00.000-07:00

just a short one today - i've been away for two weeks and i just don't have a work head on yet.

anyway i got news today of a a great win. i was referred a lovely woman for treatment about twelve months ago. She was a mother of two and had been "a house wife" for well over twelve years. She was depressed, socially anxious, isolated and overweight. She was a bright woman who had never reached her educational expecations. she left the work force to have children with no real qualifications. by the time she had reached me she had absolutely no confidence and struggled with communication and assertion.

we began to addressing the symptoms; the anxiety, the low energy levels, lack of structure. by Christmas i was then able to give her work experience on an important administrative project that had sat undone for years in the practice. she flew. she then organised her own retraining and completed a TAFE course. low and behold i walked back into the office today to the news she has successfully applied for a full time job in admistration. what a joy it is!!

self harm: unfathomable?

2011-09-13T19:38:00.000-07:00

why do people self harm? it is a question that many people ask and that the majority of us have no idea about. i am asked by friends and family of those who self harm and many clinicians also ask because there are not many training manuals around on how to approach it.

For me the interesting thing about self harm is that it is a behavior (like many) that has many different causes. Even though self harm looks the same from person to person their motivations are varied. Saying that though, there are some common themes. people self harm when they are in great distress, there is no doubt, but the function of the self harm can change.

one of the most common reasons people self harm is that they want their outsides to look like their insides. they want the world to see how distressed they are. by inflicting injury on themselves their internal pain becomes obvious to the world. this is often the function when stress is unendurable. When families are in conflict, when abuse is occurring, when the person feels absolutely powerless to do anything else to illustrate the level of distress they are feeling.

Another reason that people self harm is that while they are hurting their bodies they are distracting themselves from their emotional pain. Kind of like drinking alcohol, drugs or pokies. For some exquisite minutes they are not thinking about rejection, fear, guilt or self loathing. They are consumed mentally by something else.

Then there are the people who just want to feel anything. These people, perhaps because of a life of distress, have turned off their feelings. They might have learnt to mentally disappear as a child to avoid the bad things going on in their lives but then find it hard to feel. Self harm reminds them that they can feel, even if it is just pain.

I also occasionally come across the individual who self harms because it is punishment. This seems to be about self loathing for some apparently unforgivable sin, perhaps carried out in childhood. They last client I had who self harmed to self punish had shared her own sexual abuse with her little brother and she just couldn't forgive herself for that.

Because they all feel similar and look similar there is a tendency to wonder how to treat self harming. I think the first step is to look hard for the of the function the self harm. Without knowing what purpose it serves it is very hard to change it.

Then the slow process really begins....

Anxiety Skills revisited.

2011-09-02T00:00:00.001-07:00

this topic might be an oldy but a goody. i know it is one i revisit repeatedly in therapy but I'm not sure if i have already banged on about it on-line. it is the topic of half done treatment for basic disorders such as panic disorder. i have in the past been referred (one way or another) clients of other therapists, counsellors, psychologists, GPs who have had "counselling" for panic disorder but have shown no improvement, or at least not enough. they arrive saying that they have "had everything already" or "tried everything already." Despite this early statement when i systematically review the skills they have acquired over the weeks/months/years of treatment, there is often some gaps that make all the difference.

There are some fundamental skills that if done properly will make very significant differences to managing panic. Most folk are refereed with some notion that panic has to do with breathing. they are told variously to breath deeply, breath slowly, breath (at all

) or breath into a paper bag. All these ideas are half right or a bit right. however if they are not done well they can cause more harm that good. Imagine the effect of "breathing slowly" only everytime you have a panic attack, remembering the last time you "breathed slowly" was when you were having the last panic attack. "Breathing slowly" then becomes a reminder of the previous panic attack and causes more panic. You see the point? A skill or a strategy can end up being associated with more panic, and increase the panic rather than reducing it. If well meaning helping people don't understand the science of psychology and apply techniques haphazardly they end up with (at best) no improvement and at worst a big deterioration with a considerable cynicism about psychological methods.

I was prompted to write this post by a lady i saw recently who needed a bit of a review of her skills. this post is only partially related to her. She reminded me of the many people I have met who report similar stories. Sometimes therapy is about timing, sometimes that skills need to wait until the client is well enough or desperate enough to hear them. If she is reading this Blog, I hope she realises the post applies to many.

is the world really a dark place?

2011-09-01T02:29:00.000-07:00

this past week i have come across a couple of different examples of how what we look at, read, watch and listen to have a huge impact on the way we view the world. I met with a lovely lady during the week who has struggled for a long time with anxiety (along with a few other things). She had a childhood of abuse and violence. She spoke about her fascination with murder mysteries, cop dramas and American forensic science TV shows. She watches CSI when ever she can and reads serial killer novels.

She was completely surprised when i explained that when we experience anxiety we have a tendency to seek out and orient toward anxiety and threat related stimuli. We look toward, look for, remember all threatening words and images. when we orient toward those anxiety related stimuli our anxiety increases and so in turn we look toward further anxiety stimuli and our anxiety increases again.

She was also surprised when i explained that violence in 2011 is significantly lower than in previous decades. That serial killers are incredibly rare (even in America) and that by far most murders are committed by loved ones or ex loved ones. She had herself convinced from watching CSI that serial killers are quite common and they happen as regularly as they seem to on television.

my advice to her was to avoid flooding herself in violence. There is nothing good to come from blood and gore in the name of some false scientification of a cop show. In fact i explained to her that to maintain the longevity of my career i have to consciously re-orient my attention to safe pictures, to caring stories, to warmth and home life. I consciously chose shows on television about cooking and gardening if the option is violence. if i didn't chose safeness i would also start to see the world as a very dark place indeed.

a new life

2011-08-02T01:15:00.000-07:00

its been too long between good news stories. So i am glad to be able to provide one.

i have been seeing andy for a few months now. he is a lovely gentle man who just couldn't fell any joy in life. At least a big part of his sadness came from how had spent his working life. he was a trained graphic artist and looked for beauty everywhere. over the years family commitments and and a sense of responsibility meant that he slipped professionally further away from art and close and close to corporate life. he was excellent in sales but it made him feel wrong. by the time i got him there was just no way he could return to a life of selling stuff or managing other people to sell stuff better.

so we have worked on Andy's new business as a photography. Depression says "don't bother andy, it wont work anyway," taking all the energy from the project. so a bit of a push in the right direction really helps. my energy takes over when andy's lags.

Last week Andy brought into the practice a beautiful display of his magnificent work. In less than a week he sold three gorgeous photgraphs, two of them framed. what a wonderful start to a life more real! he is planning a trip to nepal to take photos and watch the wonder of the world. It is a beautiful thing when it works! now that is why i do my job.

the cognitions of violent offenders

2011-07-29T00:44:00.000-07:00

i have just read a very interesting article indeed. I know it makes me a bit of a geek but reading the science of psychology give me a bit of a thrill, especially if makes clinical sense as well. The article is called, social cognitive processing in violent male offenders and you ll find in a recent issue of psychiatry, psychology and law.

The basic idea is that violent offenders are different to other offenders because of their cognitions, their thoughts. In other words we can begin to understand why some people are violent and others not by understanding how they think. The study found that violent offenders and non violent offenders do differ a bit on how generally angry they are; their trait anger. violent men are more generally angry than non violent men. However, What makes the most difference between them is their ...wait for it...."hostile attribution bias." What this means is that the violent men believe that others are acting with hostility toward them even if the communication is relatively benign or neutral. You know the scenario at the pub: "what are you looking at?" when the look was innocent.

This is so very important to the clinician treating offenders. If we can identify offenders who believe that others are intending to hurt then when they have no intention then we can (hopefully) change those beliefs.

"malicious mother syndrome:" a tought diagnosis to make.

2011-07-10T03:03:00.000-07:00

i have recently come hard up against one of those interesting issues in psychology that has both a very real practical implication and a theoretical academic one. This "malicious mother's syndrome" has been recently thrown at one of my counselling clients by a very well known and extremely well paid psychiatrist writing for the family court.

The background: she was referred to me after leaving her husband with her children. She was (she reported) assisted to leave by the brighter futures folk associated with DoCS because of the desperate nature of the the violence and control by her husband. she told me that he made was very intimidating, withheld money as a form of control, took the car keys and forced her and the children to walk many km;s to school and the shops, frightened the children was unpredictable and unstable. She never presented as crazy over the many weeks of sessions.

she and the family were sent for an independent assessment that cost them over ten thousand dollars. oh yes...i am so in the wrong profession.

the psychiatrist assessed my client (call her julie) as inflicting this syndrome on her children. that is she systematically tries to turn the children against their father. she manipulates them subtly by saying things to them about their bad daddy, by manipulating them to be upset at handover, by brainwashing them to believe their father is scary when he really is not.

the husband convinced the psychiatrist that he was trying very hard to get on with the three girls but their reluctance is because of his ex wife not him. mmmm.... the court decided that because of this report the girls needed to spend more time with their father not less.

now for me their is a big problem. The diagnosis of MMS relies on evidence that the violence, scaryness, intimidation, control was actually not happening. it relies on it being a safe happy place with dad and mum being the manipulator. it relies on their being no abuse by the father. no abuse by the father is a necessary condition for a assessment of MMS to be logical. how can the psychiatrist possible know that?

i am not arguing for a minute that the syndrome doesn't exist, but i have concerns about how it cam be assessed accurately in our family court system where psychiatrist (and other more poorly paid clinicians) only read/see/ hear what is put in front of them in the shortest possible time and then report to the court. there just seems to be a bit weak spot in the logic of the assessment.

i am not sure i would ever be confident to make that assessment that has a very real impact on the lives of children.

canberra punks and beyond

2011-06-07T01:40:00.000-07:00

i recently stumbled on a website called @canberra punks and beyond.@ I'm kind of ashamed to admit it but i was a very young "hanger on" of the scene. I'm not embarrassed because it is uncool, I'm embarrassed that i was so universally ignored (so it now appears) that i dont feature in any of the photos of the time. i was the quintessential "somebodies girlfriend." definatley not cool enough to be remembered. The embarrassement of youth just comes flooding back. It also confirms for me that despite all attempts at being oh so alternative the "scene" was increadably conventional. It was certianly criminal and violent and almost completley ignored the chicks at the pool tables. The cringes just keep coming, and i just keep looking. its a bit of a scabby wound i need to keep poking at. yicck!

with one hand they give with the other they take away...

2011-05-15T23:36:00.000-07:00

"oh so you all think we are funding mental health, do you?" cackles the witch of the fickle wind. Well she got us good that time. It turns out that the lovely slab of money that was allocated for mental health treatment came in part from...wait for it....other mental health treatment !!! Oh the wisdom, the cleverness of it all.

It turns out that Medicare funding is now being slashed to pay. As of November we will no longer be able to see people with anxiety disorders, depression, post traumatic stress disorder, etc for any more than six sessions (ten under special circumstances). Huh! I'm good? Yeah, but not that good.

Its a slight of hand, an illusion and we all are about to suffer.

The elder's story

2011-05-05T01:36:00.000-07:00

I have been referred a member of the stolen generation for a victim's compensation report. fascinating. She is smart and sharp and identifies proudly as a Aboriginal Elder "born under a tree."

Her story is almost the stuff the movies. She was too light skinned to stay with her full blood dark skinned aboriginal mother. Her mother had been raped by the local white landowner. The baby (lets call her Dora) was fostered to a local related whit(ish) family where she was fondled and eventually attacked by her "uncle." He didn't quite penetrate her but he gave it a good go. After running away (she was smart) she was reforstered but then sent to Parramatta girls school. The girls there were systematically sold for sex by the doctor in charge. A small group removed at night to be abused by old men. Dora told me she worked out that if she put a pillow in her bed and hid in the cupboard the doctor would move onto the next girl instead. the cupboard became her favourite place.

She trained as a domestic but soon became pregnant (is anyone surprised at this point?) we will uncover the rest of her life next time.

Imagine what this kind of abuse does to a whole community. As i see daily abuse like this stays with families for generations. The children often suffer their mother's trauma and they in turn pass on alcohol abuse. mental illness and its effects. What happens when this pattern belongs to whole towns? when every one around has a ma or grandma who can tell the same story? how long will it take to reconstruct whole communities? that is what we all said sorry for and what we all struggle to try to heal.

She is truly an elder. she is kind and wise and strong. i hope i get to learn from her while i write her story.

oops i've done it again.

2011-04-14T03:04:00.000-07:00

I found this post this arvo under "drafts." not sure why it didn't get published back in May but I figured it can send it off into the world now. Better late than never...

hi world, its been such a long time I'm not sure anyone is out there anymore. i figured it was time to produce some more observations about the practice, my practice and experiences with therapy.

so i was caught again. i had spent a lot of time with a man who was referred to me for "anger management." he presented well. he was reasonable and calm and seeking help for his alcohol dependent wife. over a couple of sessions he brought in text messages and hand written notes produced by his wife. all were out of control shrieking, screaming, and swearing. we worked for many months on how to manage the family. the children were at risk because of violence and mum's drinking. amazingly neither parent was prepared to move out to keep the children away from the violence. unsurprisingly the situation just deteriorated. the father brought in (to show me) injectable pethadine prescribed by a local doctor for his wife. one of the children began to self harm. things just got further and further out of control.

as had happened in the past things just "settled down." the dad claimed he had learned to better manage his wayward wife and didn't need to leave after all. he eventually stopped counselling having learned as much as he needed to manage his family and avoid any further violence.

well! what a surprise when mum referred the oldest, self harming daughter. She had been given a completely wrong diagnosis (but I'll leave that for another post) but shed a lot of different light on the family. she painted a picture where dad really is violent, takes drugs, and keeps the arguments going when every one else has given up.

again i am struck by the way that two different people can provide two totally different pictures of the same family. also by how two different likable, reasonable people can tell such a different story without any hint of not telling the truth. neither seem to be telling lies but probably just not entirely the truth. it is after all almost always somewhere in between. i just need to be reminded of this age old pattern of therapy every now and again.

The "self bag."

2010-12-09T21:32:00.000-08:00

a common and recurring theme i come across in therapy is when people identify themselves as having a poor sense of "self," not knowing who they are and being very open to the slings and arrows of other's opinions. This poorly developed self seems to often be a consequence of some trauma in adolescence. it seems to happen especially when so much unhappiness and distress occurs in a Young person's life that they are unable to spend the emotional time on developing a strong "picture" or "idea" of their inner selves. Adolescence should be spent developing ideas about what we like, who we like, what our values are, what ideas we have, what we prefer. Do we value creativity over organisation, independence over support, equality over success. Do we like loud extroverts or introverts, in fact are we introverts or extroverts? do we feel more comfortable in the bush or a city... you get the picture.

anyway, many people come to therapy without that well developed. They were so busy struggling with sexual abuse or violence at thirteen, fourteen, fifteen and the consequences until eighteen that they just never got to examine their inner workings. Any criticism is an attack on the very sense of themselves. any crisis can knock them completely off course and off their agenda.

so i started to work on an idea for healing this wound, or for developing the bits that went undeveloped. I called it a "bag of self." It came from a strategy I had for myself when I needed a much stronger self. I travelled the world alone, with a backpack for eighteen months. This was "a journey" in every sense of the word. I had a day pack that contained items essential to my "self" survival. These were not things like a Swiss army knife. they were instead a diary (my written word), a camera (my visual record), a novel, some paints, pencils and paper. I had with me all i needed to survive any social situation. I waited for a bus for eight hours and had enough of "me" to keep me emotionally safe. The essentials of me went every where with me. They helped me (without me knowing it) to develop a Strong sense of what I am, what i like, my values. I could "sit" with myself knowing I was OK, knowing I could comfort myself and that no-one could penetrate my emotional force field.

I proposed this idea to clients this week and had a fantastic response. My clients "got it" and have begun their own "me bag."

when children abuse

2010-11-17T22:42:00.000-08:00

I have been once again confronted with the spectre of sibling sexual abuse. typically an older brother sexually abusing a younger sister. I interviewed a woman who was sexually abused for many years by her two year older brother. he demanded she do it, she did it. He invited his best mate to join in. the abuse occurred about two to three times per week for about five years. it occurred when mum and dad were at work in the afternoon after school. it began when she was eleven and he was about thirteen-fourteen. it was, from the start, full intercourse. she disclosed to her mother. she was told she was a liar. the abuse continued until she left home. needless to say she has been severely damaged by the experience.

The issue raises for me so many questions. Does it happen in all families? is it a consequence of opportunity, will all boys do it if given the opportunity? does it only not happen because of something about the girl? does it require a particular dysfunction?

families seem to need to be somehow disconnected, but i fear it is not just occurring at the very dysfunctional end of the spectrum. i worry that this might happen in nice middle class families if opportunity is given.

i wonder also when does sexual play constitute abuse? dose she have to say "no" for it to be abusive? if she pulls down her pants, is never threatened or hurt is it play not abuse? is it ever play or is someone always in charge? is a child aware enough to know the difference? that is the offender as well as the victim? is the family always the system at fault?

so many questions, a feel a phd coming on!

Myths of Crime III

2010-11-01T23:35:00.001-07:00

I had a response! I had a legitimate non-spam response! It just takes a bit of encouragement and I'll write forever. So off I go again.

One of the most pervasive myths I deal with is that rape is perpetrated by strangers. Many women I speak with fear walking alone at night, fear being at home alone, fear waiting at a bus stop. They are all afraid of being attacked by a dark stranger.

Going back to the article in the Good Weekend by Mark Daipan and my own clinical experience we know that rape is perpetrated most often by men we know. Most occur by family members. In Mark's article he quoted that in 2008 78% of rapes were perpetrated by family members or known men.

I spend a great deal of my clinical time with the now adults of childhood rape. These children were raped, not by strangers, but by big brother, uncle Jo or Dad's mate. They were also taught to be frightened of "strangers." Ironic isn't it that strangers may have been the people who could have saved these children if they hadn't been so afraid? Ironic that women are now living lives of fear of the "outside" where so often the violence is at home.

myth of australian crime II

2010-10-18T22:59:00.000-07:00

i know i am just probably living under a rock, but i was kind of surprised that i didn't hear a deafening howl from Australian parents after the visit from that new york mother whose kid rode the subway by himself. I heard her speak a few times, once well on 702 radio and again on a morning show and then again on Q&A. She was, in my opinion, pretty convincing. May be she convinced others as well because the uproar I expected was not obvious in my world. Like I said, the rock I live under does not include talk back radio apart from the ABC (go on call me elitist), so I might have missed the hysteria, but I didn't hear it. The woman was sane, firm, a little shrew and sounding a little harsh I admit, but on the whole not a nutter. she did something the rest of us would not do unless forced by circumstance.

She spoke sensibly about the statistics of crime. She detailed the extreme unlikeliness of crime against our children. She spoke about how the prevalence of violent crime is completely exaggerated by global news broadcasts. How Maddy McCann looms large in our consciousness when she is only a single very tragic incident amongst a huge billion people population.

Her interviews made me relax a little, yes it is Ok to let the eleven year old stay in his house with his eight year sister for an hour alone. No, I don't have to justify it. They can walk to school without me watching them the whole way and they should be able to go into a shop by themselves to look at stuff while i do something else. They also should be able to sit in movies without me. They should also be able to explore some bushland near our house and stay in "coo-ee" distance. I don't need to feel guilty about that either. Isn't parenting hard?

elite sport:normal?

2010-10-14T23:21:00.000-07:00

i was made to ponder the meaning of "normal" when I began work with an elite triathlete. She is wonderful. She has been focused and dedicated and extreme in the extreme. She trained three times each day and thought of triathlon as a career. Until she came unstuck. She has began to wonder if she really wants to keep going. She struggles with the messages of loved ones who encourage her to reach her potential. But, Maybe she has reached her potential, if potential includes a factor called "interest." Maybe many, many of us (myself not included) could reach much higher levels of sporting achievement if we dedicated huge amounts of time. Maybe success is attributable in large part to dedication as much as "talent." May be many talented people never "make it" because they can't sustain the interest necessary for the very top.

The other question of course is what price the dedication? Does it leave any elite athlete "normal?" What happens when it comes to an end? how do they adjust and not struggle with finding normal again? Is focus that is that intense, that narrow and that driven a good thing?

Poverty of Childhood II

2010-09-14T02:45:00.000-07:00

Another observation about the real the poverty of childhood. This time the poverty of childhood came from a strange unhappy family. She was the youngest girl and became a shadow. She was her father's sexual partner and her mother's long term carer. After the early death of her father, Her mother lived a very reclusive life and became the eccentric "cat lady" of her neighbourhood. The two of them lived together for years wit very little contact with the out side world. What contact they had was hostile and untrusting. While alive her mother poisoned her with an attitude that the world @outside@ was not to be trusted. They were out to get you, they would get you if they could.

I met a sixty year old lady who waited impatiently for her mother to die. When she was finally free she expected to have friends, go to party's, have boyfriends. Sadly no one every taught her to have a conversation, to meet people or to be a friend. She has no understanding of how to sound happy, let alone be happy. When approached by a person for conversation she sees it as an opportunity to speak about how bad it all is. Funny thing, no-one persists past a few minutes.

My job has been to help her learn the skills she is missing. to help her hear what a conversation should be - giving and taking, asking and listening. It has been a complete revelation that she needs to ask about other people and actually be interested in their answer. It has been wonderfully enlightening for me to bring down to absolute basics how friendship begins and how people communicate, also how again how childhood needs to teach.

Myths of Australian Crime

2010-08-22T03:18:00.000-07:00

Mark Dapin recently wrote a wonderful piece in the Sydney Morning Herald. It looked at many of the myths that plague my clients about the overwhelming dangers they live with every day. It looked at the myths that we seem to believe about the extremely high levels of violence we have in Australia.

Many people come to me paralysed by the fear they feel about their safety and that of their children. They are convinced they live in a very dangerous place. They are waiting to be assaulted, raped, or home invaded. they look and listen for evidence of the danger they are in.

Mark examined data from the Australian Institute of Criminology and outlined ten myths of about Australian crime. The first myth he addresses is that the murder rate is rising. He wrote that rather than the murder rate increasing, it is the rate of reporting the murder that is rising. In fact murder rates are dropping. In 2008 with a population of 21 and a half million people, only 260 Australians were murdered. the rates have dropped significantly since the 70's. Did any one notice? has it been reported? not a chance! no great story in that.

When bad things have good consequences

2010-07-07T03:35:00.001-07:00

I had a lovely young woman come in to tell a story of violence. She was claiming compensation for a specific event of violence. The premise of compensation is that society pays for an injury that results from the violence. Life or "functioning" in psychological speak has got to have got worse as a result of the violence to claim compensation.

She had a miserable life. She lived in our very anglo-celtic town and was from a mixed heritage background. She suffered what we all dread for our children - merciless bullying. She was called ugly to her face because she had obvious racial characteristics thought unattractive by simple, basic, culturally poor children. I felt ashamed to be anglo.

Her mother and father separated and her mother brought her up in way thought abusive in our culture, possibly just "traditional" in her own. Regardless the girl felt unloved and completely alone. She began self-harming with enthusiasm and began acting-out at home. The bullying continued well into high school and she had sex at thirteen to try to fit in. She had sex and just kept going, doing anything to find acceptance.

At a party some eight months ago she was assaulted. bashed by three girls no less. She suffered bruising and swelling around the face and a bleeding nose. Most importantly perhaps she was deserted by every one else at the party. She walked around town for half an hour looking for someone to help. she was taken to hospital by ambulance.

So the outcome was she changed schools and is now popular. She fits in. she has found God and has found her sexual integrity. She was just congratulated for excellent academic success at her new school. what a wonderful outcome!

How to unextreme an extremist

2010-06-27T04:20:00.000-07:00

How do people move away from their extremist beliefs? When an individual leaves a terrorist organisation do they change their attitudes and beliefs or do they just stop acting on them? How often do individuals leave one extremist organisation and replace those beliefs with other extreme beliefs? Do they hold similar values and just moderate them a bit? If governments around the world address disenfranchisement and bring the extremists "into the tent" does that deradicalise them?

What a fantastically interesting area to pursue for a Phd. My lovely friend Kate has the untold luxury and burden of trying to answer these questions for the next two years. She is already one year in and these days we only have a strict three year time frame for each Phd. She has the privilege of interviewing the fair dinkum extremists who have walked away. She gets to get to know why they no longer belong to the groups that throw the bombs. Did they change, or have they just changed how they do it? fascinating

help with technology

2010-06-14T23:46:00.000-07:00

i need some help with the technology I struggle with. if anyone out there reads this stuff you might notice i dont respond to comments. the problem is all the comments i receive are written in japanese script! no matter who posts the comments! i am missing a whole lost of interesting comments and i'd love to respond or at least see if people think i write crap. If you have any suggestions for how to fix the problem please e-mail me to make a suggestion: katman2@dodo.com.au

racism at my table

2010-06-06T02:30:00.000-07:00

racism is always confronting. it is especially difficult when it comes out of the mouth of a family member. Someone who will always at your diner table at family functions but with atrocious values. My brother in law began the tirade about the migrants who are violent criminals. He argued that Sydney is going down the toilet because of these migrant gangs. He sees them "everywhere" and they are responsible for violence and crime.

Psychology can explain racism. it can explain that we have a tendency to attend to the bits of information that confirms our attitudes but we ignore the bits that don't. So my brother in law only sees and only remembers the examples of the migrant violence but conveniently ignores the violence caused by anglo celtic aussies.

The other bit of psychology is much more personal ( in a way). Any forensic psychologist can tell you that people behaving badly are every where. They come from all backgrounds, all races. They are more likely to be uneducated, illiterate, not very smart. They are often traumatised and have been exposed to violence, they are dispossessed and without resources. Forensic psychologists can tell you that shit is not race specific.

Unfortunately bigoted and uneducated racist men don't often want to listen to the wisdom of university educated women. ah...pass the bottle of wine.

sex offender making restitution

2010-05-27T21:24:00.000-07:00

so we have a convicted child porn watcher. he is fairly true to type. He is middle aged, unmarried, lonely. He is ineffectual and unable to maintain normal romantic attachments. Not because he is particularly repulsive, just because he hasn't quite sharpened the skills necessary. He developed a bit of an OCD quality to his computer and internet use. At one stage making sure he had every image or page of a particular topic "covered" and then another topic. One month it was Australian warships, the next it was organic gardening. I'm not kidding.

SO then it was pornography. This time it was "the worst possible thing" he could look at. In some ways he continued to look at it to make sure he was still horrified by it. A bit like poking a tooth decay hole to make sure it still hurts. He handed over his credit car details and purchased images.

Needless to say he was eventually tracked down and sent to me for treatment. We needed to deal the sexual interest of course, with social isolation, with alcohol abuse. We also needed to deal with the guilt he felt. He was completely wracked by it because his activity was , by definition, "the worst possible thing" he could look at. That why he did it. Weird concept to get your head around, I know.

One very important part of treatment was identifying the guilt and doing something about it. As it was it was just contributing to self loathing and more drinking. we looked at the idea of making restitution. Of "balancing out the universe" and doing something good for others that no one else knows about. He loved the idea. He felt some relief. We settled on anonymous blood giving to the blood bank. He could do something good that no-one need know anything about, to balance the anonymous bad stuff that no-one should have known anything about. Kind of neat solution?

domestic violence dilema

2010-05-17T04:30:00.000-07:00

I know this has taken a while. Things have been very busy at Peninsular Psychology. We have moved into a new sunny little house with polished floor boards and lots of room. We are all in love with it - our clients especially.

So back to work.

I was confronted only recently with the dilemmas of leaving a violent marriage. She put up with his controlling violence for years. Ended up sleeping with the kids in one room with a chair against the door. He gave her no money and no access to the car. They lived on a country property and he cut off the phone. Eventually she was discovered by a community service. The women who came to her rescue assisted her to leave with her kids. The settled her in a new house - happy days.

So the interesting twist is that she has no more access to anything in her previous home. her ex changed the locks and it has now become "a civil matter" so of no interest to police. She and the kids had to leave with nothing. They are safe but destitute. he of course pays no child support and she has to deliver the kids to him once a week, despite their tears.

I'm left thinking, there has got to be a better way. They must be a way to remove the offender and leave the family in the home. There must be a way to do this immediately through he criminal justice system without relying on the often two year process of family law. There must be a way to avoid this mess.

Our Mental Health "service"

2010-04-15T16:19:00.000-07:00

I would like to post a letter I have written to our brilliant public mental health service. I think it is fairly self explanatory. Needless to say I myself was purple with rage after the incident. Writing a letter and then posting it to the public is very therapeutic indeed.

Dear Director of Mental Health Services,

I am writing to express some serious concerns I have arising from my recent contact with mental health services.

On Monday I had a session with a client and developed very serious concerns about his mental health. he had expressed non specific but clear threats to kill himself and to kill others. He left the session early and left in a fury.

As soon as the client left my rooms I telephoned his parents. they explained that the client had had previous contact with police and mental health services. In June of last year his parents had called police because of his violence and they attended. he taken to A&E but left there police. Unsurprisingly he walked out. he returned to his parent's home and became more violent. His parents were again unsurprisingly not keen to access the services of the police or mental health again.

Following this conversation I telephoned police because of concerns about his safety. I wanted to pass information to the police so that if his parents needed to contact them they would respond appropriately. I wanted police to ensure if he was transported to hospital he would not be released without adequate assessment and supervision. They accepted the information gratefully.

I then telephoned the mental health assessment team with the same intention. My training tells me that I should provide information to those who might come in contact with my client. My training tells me that people might have been in danger both within and without the mental health service. I was particularly worried that my client might have been released prematurely. I was providing a service to both my client, his parents and mental health staff.

However, I was very clearly told that no information would be taken from me by the assessment tea. I was informed that I must provide all information through central intake. I was told that there was nothing that could be done with the information I was trying to provide. I was put through to the central intake line and left a message. By seven pm no-one had returned my call, I left work for the night. As I write I am not sure how the situation ended. I can only hope the client was never taken to either Mandala or A&E. I sincerely hope there was no violent outcome.

Regardless, I am horrified about the lack of regard, or adequate process provided our clients on this occasion and the blatant professional disregard I experienced. I am a very experienced mental health clinician and was treated with absolutely no respect. I can only wonder how our mutual clients are treated. I can also only wonder about the reaction of the public and of the Area health Service if this situation did indeed go terribly wrong.

regards,

Renee Napier
Clinical and Forensic Psychologist

What do I do when I am attracted to a client?

2010-04-08T18:23:00.000-07:00

Its enough to put the wind up any well meaning but faintly disorganised and ill-disciplined psychologist. I recently recieved some information from the psychologists registration board about a deregistered psychologist. It prompted me to look at a facinating web site that gives a huge amount of detail about decisions made with regards to deregistration. It gives great detail about the kind of accusations, the evidence provided and the situation that has arisen. The web site is found by googling NSW Psychologist Registration Board Decisions. It has one case where a women psychologist fell in love with her Muslim client in a prison, and another where a male psychologist was treating his fellow christian clients with prayer after their satanic ritual abuse. very interesting stuff.

Anyway, one case caught my eye for lots of reasons. A male psychologist ended up being "reprimanded" for his poor treatment of a woman who he treated in a community mental health centre. She was a sexual abuse survivor and had been diagnosed with "Borderline personality Disorder." She had a history of intense and unstable relationships.

The upshot of the story is that they also developed an intense relationship. The psychologist saw her more regularly than normal and for longer. They had physical contact that included hugs, cheek kisses and caresses. They spoke aobut their intense physical attraction and they spoke about sex. The psychologist disclosed too much information about his sex life and history. He used "inappropriate" language. They became too close. But they did not have any sexual contact.

He argued that she complained because he would not have sex with her. Only after she was rejected did she get angry and "traumatised."

For me this is a master lesson in managing clients who "push buttons." Clients with sexual abuse histories often function on a very sexual level all the time. They operate on their sexuality. They prolong eye contact, they idealise verbally (eg, you are the only one who understands), they lightly touch, they stand closer, they attend carefully, they use familiar language. They (often) unknowingly invite us into a close, personal relationship. We sometimes fall for the subtle interplay between ourselves and our clients.

The repremanded psychologist did just that. He fell for his client and fought against his sexual response. He did not manage the situation well. He did not seek help from colleagues, or manage to hand her over. He did not recognise the warning signs early enough to change his manner. In fact he "went along with it" for too long. Very dangerous indeed.

Abuse of the AVo System II

2010-04-06T03:19:00.000-07:00

Back in December of 09 I posted about a woman who was abusing the AVO system originally designed to protect victims of violence. In the original post I wrote about a woman (Michelle) who moved to a new town after a separation from her partner. Her hapless partner managed to continue breach his AVO when she travelled two hours back to where he was living and was "threatened" or "abused" by him. Police continued to charge him with these breaches even though she was in his town and was following him to his work sites. How does this happen? Police continued to charge him with breaches and arrest him after she travelled two hours, sat int he back of his truck and then she called the police at the local station.

Since December the story only got better. She got just a little crazier. My hapless client found himself a girl. She was older and wiser and a single mum. Michelle discovered the woman and tracked her down. Michelle is a very smart, very bitter and very persistent woman. Michelle first just vandalised the girlfriend's property. Then she sent a letter to every real estate agent in the area detailing a false history of unpaid rent and damage. Michelle pretended to be her ex land lord. The girlfriend's land lord believed the story and kicked her and her children out.

Michelle (somehow) showed up at my client's many different and changing building sites. She called WorkCover and insurance companies. At least one building site was closed as a result of her phone calls. When all the workers scattered with the arrival of the inspectors Mr Hapless was specifically called back to the site. WorkCover identified my client as the reason for the fuss. Oh dear! His life was quickly unravelling. Needless to say his business was grinding to a halt.

Lucky for Mr Hapless she started to brag about her behavior to a "new best friend." Lucy, the new best friend was adopted as a confident and udnerstanding ear. Lucy began to feel very uncomfortable with what Michelle was bragging about. She detailed the vendetta she was waging against Mr Hapless and his new girlfriend. Something was worrying enough to trigger contact with the police. Lucy went to the police and made a statement. A long a detailed statement. Thankfully Lucy had never met Mr Hapless and so police took the story seriously.

In this statement Lucy explained so much mystery. She reported to police that Michelle had tracked Mr Hapless with a tracking device under his car. One that was available from the internet (who would have thought!) Police have finally believed Mr Hapless. In fact they even delivered him a Christmas hamper and have charged Michelle with many many offences. Now we are waiting for DNA evidence.

No doubt there is more to come.

Divorce brings out personal values

2010-03-30T18:51:00.000-07:00

A lovely woman in the midst of a divorce, lets call her "Felicity." She raised two children and managed a household over the twenty years of her marriage. He was a very strong man. He worked hard and developed a business both in Australia and overseas. The family did very well financially.

She is one of the warmest women I have ever met. More friends than anyone else I know, very involved in the community, giving and enthusiastic. A bit scatty at times, definitely a party girl. She just loves to entertain.

He on the other hand (second hand info', I know) is serious, controlling and ambitious - in other words strong. He sound impressive. He now has a girlfriend the same age as his daughter. I think that speaks volumes about the kind of relationship he values.

So, there are many observations to make about this family. One that arose today, however, concerns the family court and financial settlement. Felicity's husband is arguing (along with his solicitors) that he should receive fare more of the family funds because he earned the money. He has argued with her that she "just kept a neat house." How many (ex)husbands out there hold the same belief? Quite a few I fear.

How to prove a rape?

2010-03-21T19:00:00.000-07:00

How do you prove rape? The other day I met a lovely woman who was claiming victim's compensation for a sexual assault. She arrived with her long term girlfriend with whom she lives in Gosford. The assault occurred when she was walking home between the station and her house in Gosford. She was followed from the station. Her clothes were torn off her - no buttons left on her pants. She was bruised and torn internally from the force. CCTV footage clearly showed him following her with alcohol in his hand. She has not had heterosexual sex for many, many years.

He was found not guilty. How can that be? Is there some information I don't know? ON the face of it, it seems UNBELIEVABLE. On what grounds was he not guilty? Too drunk? Not too drunk for an erection. Consensual? A lesbian consenting to sex on the ground in an alley way in Gosford, not likely. It didn't happen at all? DNA, CCTV footage. No chance of that defence.

Would any report sexual assault? what are the chances of a conviction? miserable.

The role of Fathers II

2010-03-07T19:34:00.000-08:00

So sometimes therapy is about timing. I posted about the role of father's in girls lives and the value they have to developing self esteem and expectations about romantic relationships. The post was based on a wonderful young woman and her absent father. It was based on the story she told of how she tolerated crap relationships from men because there was no role model in her life for what she should be able to expect.

An hour later I was able to reflect on that client and use her story for another. A man in his thirties walked in accompanied by his partner and father. He explained that he had spent many years recovering. he had been a poly drug user, using anything that came his way including a nasty heroin addiction. He developed a drug induced psychosis and has been traumatised for life. He stopped trusting himself after recovering from searching the roof for the cameras "they" had placed in there. He has used methadone to manage his addictions for years.

For some time now (we are talking years) he has been employed and has managed to provide for a family. The family includes an eight year old daughter, a partner and step children. He has become "respectable." He has become a traditional bread winner. Until the GFC came around and he lost his job. Suddenly he has lost his role, feels useless and worthless and has become suicidal. Really seriously suicidal.

I was able to describe in details the girl who had left only an hour before. I could describe her father's role and how important he was - regardless of how much he earned or where he worked. She just wanted him with her to love her. To teach her how to be loved as an adult and what she should expect from men who claim to love her.

Together, they both brought me to tears (again).

How dad's make a difference

2010-03-04T18:06:00.000-08:00

I was wondering what doom and gloom to include in today's blog when I was inspired by the most wonderful client. "Georgia" has been a variously achieving twenty something young woman with wondering direction and some body issues. She is smart but underachieving, very attractive but dresses to cover herself. She hooked up with a skater from the northern beaches, who thought he was tougher than he really was. He showed little interest in her, made her call him, controlled what she wore and who she saw. She had to acquiesce to his values, his friends, his social status or else she would lose him. Funny thing...she came to us speaking of depression.

A lot of the story revolves around Georgia's Dad. He has been her "best friend." The problem is he travels and works overseas. He is posted for months at a time. The family separated (functionally) when she was eleven. She found herself putting up with the skater because there was no alternative. She didn't have to give up time with Dad to be with skater because Dad wasn't around. She didn't have Dad's level of attention to compare with the skater because there was no attention from Dad. Skater was all the male she had. So she made do.

The great news is that skater and Georgia broke up. That triggered a first visit here. Since that first visit she has made a huge decision. She has decided to join her father in a dangerous African country to volunteer. She wants to apply her love for art and her skills in fabric and textiles in this war torn, highly traumatised country. She has already sent off e-mails and has an ticket booked. Funny thing...she isn't depressed anymore.

poverty of childhood

2010-02-22T23:32:00.000-08:00

So much joy and satisfaction in adulthood is learned in childhood. We must learn to love knitting, to value art, to enjoy cooking to appreciate travel to wonder at a sunset, to value fitness. It all comes from what we learn. We use these skills and enjoyment and activities when happy but also when we need to sooth hurts. When sad we need to reach for activities that make us feel better. We have a bath, walk on the beach, go fishing, replace a brake lining, listen to music or write in a journal.

What happens when we spend the first fifteen years of our lives spending weekends in the car park of the local pub? What happens when we spend weekend after weekend watching mum and dad get drunk and then fight? They are busy with their own lives not even looking at the children they are raising. When no one teaches us to knit, to fish, to listen to music to cook? When we have no time for learning the skills and tasks that give meaning to life.

Our practice is filled with adults who never learned these meaningful activities. Their lives, as children. were barren. They spent their days following their parents from car park to car park, from club to club. When asked what they love to do, what they do when they need self care, they are unable to offer anything beyond substances and maybe a PlayStation. No one ever stood with them and spoke of the joy of a sunset, or taught them how to plant a tree, to write down worries or to sing a song. There are people, plenty of them, who cant do the basics. People who cant identify anything they do that gives them pleasure. They cant identify goals or pleasures because they dont know, they have never experienced them. They can't make themselves feel better, they resort to drugs and alcohol, they are very often depressed. Now that is real poverty.

women and vioence - an update

2010-02-16T00:41:00.000-08:00

my friendly blog reader and advisor asked for more detail. He likes the stories but wants to now "the dirt." I explained that I struggle to provide enough detail to be interesting without giving away too much. This is after all a very small town. So i debated with him and decided to provide, at times, an update on clients and situations to make up for any dearth in the gruesome details at each post.

So an update on my violent mum and the family stuck with no change (from earlier this month). We have had one important movement forward. A police advisor confirmed that police are supposed to intervene when children are involved even if the offender is a woman. The police should have escorted the mother out of the house to keep the girls safe. The police in this case definitely failed the family. Sounds like they were acting on pretty strong ideas about women and violence to the detriment of two young women who need help. Since this incident both young women have been found cutting themselves as a desperate stress reaction.

Part of the solution looks like being legal. Looks like they will end up applying for an AVO to protect them. Hopefully it will require sobriety and hopefully it will add a little strength to dad who needs a bit of support. what is interesting to me about that solution is how avos can be useful as well as being abused (as i detailed in a previous post). goes to show that things are not black or white, that there is no blanket right or wrong, and that you always need to know the circumstances to apply a principle.

why sometimes twelve sessions is just not enough

2010-02-13T21:39:00.000-08:00

eHe was sent for "anger management." A father of two teenage girls and husband of a wife with (at least) drinking problems, he has been a client for many months. We have had little success with either moving forward or moving back. Change in any direction just didn't seem to want to happen. Part the way to separation and she suddenly became nice again, or part the way the drug and alcohol counselling, the conflict escalated until it was unbearable. Yet the family continued with violence and with occasion police intervention. The girls were struggling in a very big way. I sat with him wondering why. why could nothing be changed and why did he continue to sleep in the lounge room rather than just doing something- anything decisive.

The answer became clearer when he confronted me over a conflict. I wasn't able to help when he expected me to. The situation had escalated again and I asked him to wait an hour for an appointment. He left my office in a temper. I hadn't fulfilled his expectations and he felt very abandoned. He was willing to walk out and desert the change process; to give up, to chuck every thing in. I was willing to walk out and not change a thing. A pattern, I suspect, oft repeated at home. Again I had the privilege of seeing people as they really are, not just how they'd like to look. Again I had the privilege of not reacting like his wife; of not becoming angry myself; of just sitting and waiting for his return. What a wonderful moment when he came back and learned about himself; about how that pattern has failed him in the past and needs to change. Aahh...long term therapy can indeed be a important thing.

when women are violent

2010-02-02T00:30:00.000-08:00

As far as I know she is the one who is violent. The kids confirm that mum is a drunk and a prescription drug addict. She looses the plot when drunk and she has physically damaged her husband. Recently she was carted off to the local psychiatric ward by police after breaking his nose. The kids didn't want her home and her husband didn't want her home. This was not the first time.

So what to do? She wanted to come home to her house, she owned it after all.

He was advised to visit local police. he returned saying that the police said they could do nothing. Clearly they can do something. They in fact have an obligation to do something if children under sixteen are involved. They can escort her from the house if they understand that the children are frightened and feel threatened.

Hopefully we can try again.

The power of delusional thinking

2010-01-13T23:38:00.000-08:00

He has been married for over forty years. The last five have been dominated by a belief that his wife was unfaithful. He has become angry and irritable. He thinks about it all day, every day. He replays the imagined scenario over and over and over. She denies anything happened. The only evidence he has is a middle of the night door opening and closing, seeing his best friend walk past a door way and then his wife returning to bed. The "evidence" is sketchy at best. He has not left her but he wont believe her either. He looks for evidence of her crime at every opportunity. He sees it in the fact that doesn't talk to her "other man" and that she does. He sees it in her distress and in her lack of distress. She describes herself as anxious and he figures that "must be" because she really did do it. He punishes her at every opportunity for her disloyalty by cranky, snappy and irritable.

The interesting thing is that it is only a small step to other paranoid thinking. Paranoid people find evidence where there is none, they look for the tiniest confirmation of their belief, they see patterns where there is only randomness. They find a conspiracy of secrets and lies when other people see innocence. they see signs and symbols of the "truth."

In this case it is interesting that his daughter has been diagnosed with paranoid psychosis.

no comments?

2009-12-06T18:24:00.000-08:00

and here was i thinking that no one had ever read my posts. i figured no comments must mean no readers. well actually people do read and try to post comments. problem is they have to be "members" to have the comment recorded. folk who read my bloggs are not keen to join anything or to provide information to anyone. They are a very anonymous bunch. so i guess I'll just keep writing.

Therapy sacking

2009-11-26T22:00:00.000-08:00

I think of it as ball you never saw coming. The comment in therapy that is simple, unemotional and without much meaning but which changes the course of the theapeutic relationship. Today I experienced this which (thankfully) happens rarely these days. I have a long term relationship with a client which is fruitful, dynamic and meaningful . I have comforted her, challenged her and helped her understand problematic relationships over many months. One session, one comment, suddenly she was offended and embarrassed. Suddenly I went from being "wonderful" to sacked. I had no notion that the comment would mean anything at all let alone that it was somehow loaded with negative meaning for her at that moment. Like I said, I just never saw it coming.

I guess that relationships in general are fraught with moments where one person comments and the other takes offence, while the first hasn't got any idea why. I hope that somewhere down the track the client will see that what happened to me in therapy may have happened to others in her life and may explain some of the strains in relationships. Hopefully she'll see that others are also probalby as mystified as me. There should be a word or a phrase to describe the process of comment, offence, no idea why. Any ideas?

cross examination - what a joy!

2009-11-23T16:59:00.000-08:00

Oh what joy! A request to attend Commonwealth Family Court to be cross examined on a report written some weeks ago. The whole wigs and gowns thing. For all aspiring psychologists who will be asked to court some observations...

Here was I thinking that I would be invited in for a respectful chat about my opinions. What a shock! Not a chance. Does the phrase: "hauled over the coals" ring any bells? Its amazing how the word "madam" can be turned into an insult - as in: "Do you expect us to believe, Madam that..." or "In hind-sight, Madam, do you think you should have asked..."

The Barister criticised me for not keeping detailed enough notes, not asking the relevent questions, not seeking corroborating opinions, not knowing the details of my billing system, not having received a directive letter from the solicitor, believing that psychological testing was objective, in short every step of the assessment process was inadequate, unsubstanciated and obviously biased. I left the box sweating but not crying - so it was not a complete disaster.

The moral of this story is not, however, what you'd expect. After I left and the judge began to sum up the cases the Barrister was humilated and reprimanded for his treatment of me. The court did not stop his barrage at the time, he was allowed to "run with it." But it did nothing to impress the man making the decision. I guess the moral is to tough it out, say no when you mean no, say "I can't know that" when you can't. Don't be afraid to be right even when confronted by a man in a wig. If he is wrong it is OK to say so. If he is asking something unreasonable it is OK to tell him so. He is only playing a part in the end.

Also if he says "diagnosis" when he meant to say "prognosis" make sure you let him know he doesn't know everything.

When OCD turns a little scary

2009-11-06T20:07:00.000-08:00

A young man was sent to me recently by Probation and Parole for treatment of his OCD. He was on Parole. That is, he had committed a serious enough crime to have been given a jail sentence and had since been paroled for it. An interesting combination I thought - OCD and the criminal system. the connection between the two was not completely obvious and no all that usual.

He had been convicted of crimes that involved obsessing about a woman. He had pursued her and then eventually hated her because she rejected him. He turned his attention to revenge on her. Not a comfortable development at all. He did not succeed in hurting her physically but relentlessly discredited and humiliated her publically and professionally. A prison sentence may well have been the circuit breaker that stopped a more unhappy outcome.

More interesting, perhaps, is the thought patterns beneath his very still surface. He does look unusual. He has very direct eye contact, no intonation in his speech and no emotion. He speaks as little as possible and never has physical contact. His condition at the moment manifests with compulsive washing of his feet. Many, many times per day. He is very bright.

He writes rather than speaks a lot in session. He writes about the hatred he harbours for the "Christians" that bullied him at school. He writes about the "eutherial slime" that he washes off. He washes off the contamination of people who are hateful and who have hated him in the past. It isn't germs in the conventional sense he is anxious about, it is the germs of the soul that he wants to avoid at all costs.

Abuse of the AVO system

2009-10-29T02:11:00.000-07:00

In the past twelve months I have come across a number of people who have become victims of a system that was set up with the best of intentions but which has in some cases gone horribly wrong. Imagine a woman who seeks and gets an AVO (perhaps for good reason) but then travels from Sydney to the Central Coast to harrass her husband into breaking it. She sits in the back of his truck, takes his tools out of the truck and steals his work mobile phone. He cannot touch her or restrain her. He can do nothing but stand and watch because she has an AVO against him. If he touches her he is looking at prison. What is the alternative? This story is one of many that are similar. The AVO used as a weapon. Women absolutely need the protection of the legal system but I wonder if it needs a bit a re-vamp to get it working properly again?

The "Hey Hey" skit

2009-10-09T02:09:00.000-07:00

It has been the topic for my clients all day - no matter who they are or why they see me. Over and over I've been asked what I thought of the embarrassing "Hey Hey" moment. No easy or simple answer from me on this one! There is so many principles involved.

Firstly, it was of course stupidly insensitive. It was of course racist and just plain dumb. But as most people have pointed out, we australians do not have the same history of "black face" singers. We see it just as an impression, not as a cultural statement. We haven't had years of struggle against that particular stereo type. We are racist in that we aren't aware of the implications.

We also are much better at being irreverent than other groups of people. Give us a sacred cow and we love to have a go at it. An important national characteristic.

Thirdly, Australians should not have to conform to American sensitivities - God knows they have no cultural sensitivity of their own. They plunder the world with out care about the cultures they stand on. But we would be very offended if an american show had a skit with white americans dressed up as Aboriginal Australians, complete with paint and a stupid dance. We need to think about how that would feel and how insensed we would be.

There endeth opinion

DNA has a long history

2009-10-09T01:42:00.000-07:00

I've been seeing a client for a long time. He came to me from probation and parole after many years as a career criminal. He has (of course) a history of very serious sexual abuse at the hands of priests while in care. He took drugs for years, did break and enters and ocaisionally armed robberies. Over the past ten months he has attended counselling, often riding a push bike for many kilometers. He has started to find himself, attending TAFE, making "straight" friends, and looking for God. He found a part time job and started to walk on the beach.

Then a week ago police called. They informed him they needed to talk about DNA found at an old break and enter recently matched to him. His response? A serious and very near fatal suicide attempt. He called me from ICU.

I dont know what will happen to him. I dont know if the law will pursue him. I hope that with a little support, a bit of flexibility he'll get through and continue with the therapy that seems to be helping... even just a little.

The effects of Christian Fundamentalism

2009-09-28T16:27:00.000-07:00

Sexual abuse is not the only effect of an isolated, insular family. I met a beautiful woman who told a story of isolation, rejection and terror. She was raised in a very unhealthy isolated family defined by its fundamentalist Christian beliefs that rejected mainstream church members, as "churchies" and others as "non-believers." The only contact permitted was within the extended family, and then only those who conformed. The bible was read with a stick (literaly), females were only barely educated, people were brought into the fold to marry. She was raised to be terrified of the outside world and terrified that the outside world would discover her shame. They were the "white trash" family (her words) that the world (including high school kids) scorned, bullied and taunted.

She is going to make it. Sometimes therapy is truly inspiring. She smiles now, loves a man and swears as a sign of freedom.

Foster Care: Definately not a perfect solution

2009-09-24T20:02:00.001-07:00

What do we do with a little kid who is neglected? Who has to call the ambulance to revive his mum after another overdose? Who has to clean his baby sister because she has no nappies and the dog died of starvation the backyard? A terrible case of neglect. A young man came into the practice yesterday and told his story.

What makes the story unbearable is that foster care was, if possible, even worse. He was punched, kicked and wipped with chords. He was lifted by his ears until they bled. The perpetrator was his foster father. His very traditional foster father parented him in the same way as he was parented, according to his cultural background.

What should we have done with him? What are the alternatives? How could we have known in advance that violence was likely? How important is cultural placements, if they risk exposure to abuse?

Foster Care:

2009-09-24T00:22:00.000-07:00

OCD and inspiration

2009-09-16T21:42:00.000-07:00

And now to my client of many years who inspired this new form of communication for an e-illiterate like me. She struggles with unnamed and all pervasive fears. She is bright and highly sensitive and a little socially uncomfortable. She has a few diognoses that include at least OCD. She has absorbed her mother's fears so completely it is hard for her to see them as seperate from herself. They have become a part of her as they were a part of her mother. She continues the crazy and irrational rituals that a part of her beleives keep her safe.

She will find a place where it is OK to be and her fears will fade. Until then she continues to inspire me.

internet child porn offenders

2009-09-16T21:13:00.000-07:00

Yesterday i saw a convicted child porn offender. I have been wondering about the the way interest in internet pornography has been developing. This man is middle aged and desperate for a relationship. He had contact with a "child" on an adult (over 18 only) chat sight and behaved badly and stupidly. He stopped the contact. Many months after the contact stopped he was arrested. He had been out of contact for so long he had no idea what the charges were about. His life has been changed forever. On the sex offender register for many years to come.

On the same day we hear that another father has bee found to have raped his daughter for thirty years. He fathered four children with her. This time in australia. this time the authorities had been notified.

Ioften wonder if the problem is not so much the stanger on the internet but the isolated and insular family that lives around the corner.

An unstable child, a mum learning

2009-09-15T21:57:00.000-07:00

Today i met with a wonderful mum who is learnng to live with her daughter. Her daughter has all the markers of a diagnosis of Borderline Personality Disorder; she is hugely unstable emotionally, switches from "loving to hating" in a moment, has intense and often negative romantic emotions and has a history of harming herself. This mum is learning to respond with simplicity, with acceptance and with kindness. She is learning to not "react" to statements or behaviors designed to inflame the situation. She is learning to hold her daughter's emotions "lightly" without becoming emotionally involved with them. She is also learning to protect herself from the hurtful words that come her way. She is learning boundaries. A bit like counselling really...

A phd?

2009-09-13T20:07:00.000-07:00

thinking about investigating the possibility of a Phd with bullying at the centre of it. I've noticed that in our area bullying is a very significant problem. Our local high school seems to be powerless to stop it. It spills over into inter-family conflict: mum, dad, siblings and even grandma all involved! I wonder if the programs get implemented at all? I also wonder if so much is already known about bullying but it still exists because what is known is not implemented? So what gets in the way of the implementing? i would be interested if any one out there could suggest some recent research.

An amazing win

2009-09-09T21:22:00.000-07:00

yesterday i experienced one of those moments that therapist live for - a young man who has turned his life around. He came to me with a ten year intravenous drug and alcohol problem. He lived on the streeets intermitently and lived a violent life to get by. He was used a guinea pig for dealers to try out their drugs on before selling them. Not surprisingly he found his way to me via probation and parole. Twelve months on and he is going great guns. More insights than you could ever expect. working on his "hours" for his P's, parenting his children with commitment. Yesterday he made me smile.

Ah technology

2009-09-06T21:13:00.000-07:00

My first blogg post. Thought I'd spend some time reflecting on the people who cross my path. My clients provide constant insights. They always have some wisdom to share.