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Tuesday, November 26, 2013

Free downloadable Self-injury Solution guides

Given the SBS Insight Discussion on Self-injury tonight I just need to remind people that you can get downloadable free Guides to Seeking Solutions for Self-injury
at 
http://www.suicidepreventionstudies.org/uploads/Seeking%20solutions%20parents%20and%20families%20version%202.pdf
and
http://www.suicidepreventionstudies.org/uploads/A%20Guide%20for%20Young%20People.pdf
and 
http://www.suicidepreventionstudies.org/uploads/Seeking%20solutions%20for%20school%20staff.pdf

Haiku on Down/Even/Fracture

Down

Rain is falling down
World would be a crazy place
If it fell upward

Down the rabbit hole
Alice found bureaucracy
"I'm late for a date"

The end of the week
Crumbs down in the biscuit tin
Will not pay the rent

Even

There is silent calm
Even birds cease their chatter
Just before a storm

You get very odd
Then you start to get even
Makes me feel quite odd

Scattered raindrops fall
Erratic earth dampening
Evens out in time

Fracture

Gaia's womb contracts
Small fracture in the Earth's crust
New island is born

Old scars in the mind
Fractured thoughts and dead feelings
Covered in callus

The fractured nut bar
Giving you crunch in the mouth
Doorway to flavour

Tuesday's free download: Adolescent Suicide: Postvention in a school.

This paper examines the effect of completed suicide by a student on other high school students. The case history of a 16-year-old female student who jumped from an eight-storey car park roof is discussed. The death was followed by an increase in suicide attempts. The postvention strategy in the school is discussed and offered as an example of what may need to be done in the aftermath of the suicide of an adolescent.


Then hit the Resources Tab
Download here: *Adolescent Suicide 2: Postvention in a school.
Martin, G., 1992. Adolescent Suicide 2: Postvention in a school. Youth Studies Australia, 11, 1:24-27.
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Saturday, November 23, 2013

On Transverse Myelitis and Anxiety

I get anxious.
Yes, I know I am a psychiatrist, but (with all my experience and skills) since being lucky enough to score Transverse Myelitis, all sorts of situations make me anxious. Some of it is daily, and some of it is occasional and some of it is related to circumstances.
The daily stuff relates mainly to movement and toileting.
I am still walking, albeit clumsily and a bit erratic. When I first get up, I tend to have difficulty lifting my feet, so I scrape or shuffle on the carpet a bit, or get a moment’s footdrop, and trip (so far no serious falls, and I do seem to have a good balance recovery so far). When I am tired at the end of the day’s work, going back to the car I am tense and on guard, and taking extra care to avoid foot drop. I would look dead stupid tripping and falling in a hospital corridor!
At night when I have to get up to go to the toilet a couple of times, I stand up carefully from my bed, make sure I have my balance with a bit of a wide gait, and then use my iPhone to light my way round the bed and to the bathroom. The variability gets me down – some days I feel my feet, other days my ‘thick socks’ reach up past my knees. Overall, movement leaves me chronically tense, with moments of minor panic.
Toileting is a real problem, because everything is so erratic. I feel I need to clear out, but there is nothing there. Then small tell tales happen (like wind), and I know I need to be in the toilet pronto. I have to plan every journey – making sure I don’t drink too much before leaving, knowing I can usually manage an hour or so of driving before I am under pressure, knowing where loo stops are in case of emergency. I am chronically anxious that I may have to go to the toilet in the middle of a consultation. So far it has not happened. So far I have not dribbled in public and embarrassed myself. There was only one occasion when I passed wind while lecturing, and I was standing behind a lectern so I think my audience would not have noticed (I hope). But the whole thing makes me have to think my day through carefully, and what I am describing sounds a bit like agoraphobia.
I certainly have been enjoying my 6-month sabbatical writing books and professional papers, and only consulting two days a week. Yes, the productivity has been good, but I made clear decisions not to attend conferences, not to fly anywhere, not to speak after hours (after dark), not to do TV and radio interviews I did all that for 35 years; I don’t need to keep on doing it.
Ostensibly my choice was to protect my time for writing, but secretly I know that I don’t want to go to conferences because it is always hard getting up on stage, it is always hard standing for 30 minutes talking with my pins and needles getting worse and worse. It is always hard standing talking to colleagues, when my focus is on whether I need to go to the loo, or plan the next hour or so.
Why not fly? Because it is all such a palaver, and you have to organise sufficient time for everything, and make sure you can manage the distances in airports, and the new systems they keep bringing in, and the crap from all those officious people making sure you are not dangerous, and the toileting.
But secretly, I know I am a bit phobic of crowds. My eyesight is not all that good since five years ago when I got whacked in the eye by some stupid, chronically angry, overhung woman brown belt trying to prove something during a Karate grading. And with balance problems from TM, I need to avoid people. If I was sensible and gave in and used a wheelchair everyone would smile benignly, pat me on the head, and walk around me. But when they don’t know you have been paralysed, they barge into you just like they would anyone else – or at least they play brinkmanship, leaving their swerve till the last minute – all of which makes me anxious.
And then there are all the memories of what I used to be able to do, and the process of coming to terms with becoming totally paralysed from the chest down. OK, I know I have made a reasonably good recovery, and there are others far worse off, but I still have flashbacks, and the occasional nightmare (as if every day is not a chronic nightmare).
So, I have recurrent anxiety, mild panic attacks, symptoms of agoraphobia, and post-traumatic stress disorder. So what have I done to help myself? Come on physician, heal thyself...

Managing My Anxiety
I have not really done very much, but yet I have done a lot. OK I will explain...
I am not the kind of psychiatrist who prescribes much. I do not believe all the crap served up to us by pharmaceutical companies whose only motive is the profit motive. I have seen the complex and sometimes dangerous side effects of so many drugs, and I am very very wary. I am seriously averse to providing multiple drugs – simply because so often the side-effects from a mixture of drugs are not known, or are minimised. I have repeatedly had the experience of ‘curing’ back ward psychiatric patients by taking them off all of their drugs, and helping them back into life, home and society. I have repeatedly cured ‘zombie’ children and adolescents by taking them off multiple drugs prescribed by other psychiatrists, and helping them to understand themselves and their families, as well as develop some self-efficacy and future directions.
Don’t get me wrong. One of the prime reasons for being a physician is to help people with pain, and that can be emotional as much as physical.
 But take drugs myself? OK, yes, about 3 times a week I take a couple of paracetamol when my chronic chest pain is unbearable. But anxiolytics, antidepressants.... No!
So what about the ‘done a lot’? OK. I have been very careful with my diet, as discussed in a couple of other blogs. Why use too much coffee if it makes you ‘wired’, stops you sleeping, and gives you an irritable bladder? Why drink alcohol if it makes your neurological problems in your legs three times worse? I have learned to avoid certain foods because they give me wind. I have been very careful to avoid foods that make me constipated. I have reduced quantities of fat and protein in accordance with the MS diet (in the belief there may be some similarities between MS and TM). I get lots of healing sleep. I do as much regular exercise as I can manage, and always take a recovery rest afterwards. I meditate as often as I can – formally (sitting), and informally (goof my mind off while listening to boring lectures). I have been writing down my experiences (like this blog, and my book ‘Taking Charge; a journey of recovery’) which has been immensely helpful in working through problems. I smile at people lots. I maintain an optimism I do not sometimes feel, but which makes me feel more confident. I have avoided stress, and anyone who causes me stress – I don’t need it or them.
I have practiced and practiced mindfulness – being mindful of what I eat, how my body works, how I sleep, what my dreams might mean, what I say to the love of my life, how I treat my staff, what life means. I write 3 Haiku in 5-7-5 format every single day to help me be mindful of old issues that emerge in response to key words.

I am still more tense than I ever used to be. I still get anxious in certain circumstances. I still have old traumatic memories. I am definitely mildly agoraphobic. Well, I accept all of that... and.... I laugh at myself (not hysterically, you understand. I would not want anyone to think I am mad, or know that I have psychiatric problems). LOL
You can read more about the whole catastrophe by purchasing ‘Taking Charge; a journey of recovery’ from http://www.familyconcernpublishing.com.au in paperback or download pdf form. You can also buy the book from Amazon Kindle. Search for ‘Taking Charge; a journey of recovery’ at http://www.amazon.com 

Tuesday, November 19, 2013

Haiku based on We and Advance/Catch/Behind/

We

We are in trouble
I'm a bit deaf, you mumble
The signs are not good

Oui, I need a wee
I have done for a wee while
Whee, can we stop please

We are attracted
This dear Mother Earth and I
Must be gravity

Advance/Catch/Behind

Just advance three steps
And catch sight of my behind
Not a pretty sight

Advance gingerly
Hide behind that ancient oak
Catch the faerie dance

Behind the silk fan
Her breath catching, heart pounding
Thoughts race in advance

The Tuesday Free Download: Effect on adolescents of the completed suicide of another student.

This paper demonstrates that students in a school from where two suicides had occurred were more likely to know about the suicides, but also more likely to be depressed and suicidal compared with students from two comparison schools of similar social background.
One of our early studies into Youth Suicide, this one suggested the implication that all schools from which a student suicides need careful postvention work to reduce the likelihood of copycat suicide.

Then click the Resources tag

Download here:  *Adolescent Suicide 1: The effect on adolescents of the completed suicide of another student.
Martin, G., Kuller, N. & Hazell, P., 1992. Adolescent Suicide 1: The effect on adolescents of the completed suicide of another student. Youth Studies Australia, 11, 1:21-23.

Wednesday, November 13, 2013

Haiku on Test/ Unite/ Vital

Test

Tester or testee
A power differential
Could tester fail test?

All students tested
End of academic year
You signed on for this

Life is a challenge
Each milestone can test your strengths
And perseverance

Unite

If all world profits
Were pooled and shared equally
Would humans unite?

The oesophagus
At the cardiac sphincter
Unites with stomach

Across all the world
It is grief that comes from loss
That unites humans

After night's losses
Mourning can unite us all
Leaving yesterday

Vital

Having been mothered
A vital ingredient
Caring for a child

To be young again
Living with vitality
No care in the world

Kicked in the vitals
Again I fall to the floor
Poor Karate blocks

Monday, November 11, 2013

Mindfulness training manuals to help you manage mental health problems in young people


       

A Manual for training mental health workers: "Taming the Adolescent Mind". And a workbook for professionals to be able to train other groups of mental health workers....
Learn about the mindfulness groups, and THEN help others to gain the skills, and learn to apply them with young people.

Both of these  are for sale, and can be found at http://www.familyconcernpublishing.com.au
Scroll down on the front page to see the images, click on buy, and follow the prompts.

About the author
Dr. Lucy Tan, whom I have had the privilege to supervise during the years of her PHD, has recently published her work on the use of Mindfulness with adolescents who have mental health problems.

She began her work with a normative study looking at how Mindfulness could be measured, and with what it correlated:
Tan, L. and Martin, G., 2012. Mind Full or Mindful: A report on mindfulness and psychological health in healthy adolescents. International Journal of Adolescence and Youth. Published online (3rd September, 2012). DOI:10.1080/02673843.2012.709174

Then there was a small pilot study to see whether a 5 session Mindfulness group could have some impact on mental health problems and symptoms in adolescents. The results were stunning...
Tan, L. and Martin, G., 2012. Taming the Adolescent Mind: Preliminary report of a mindfulness-based psychological intervention for adolescents with clinical heterogeneous mental health diagnoses. Clinical Child Psychology and Psychiatry. DOI 1359104512455182, 18:2, 300-312.

Armed with confidence, she then completed a randomised controlled study of 100 young people attending a child and youth mental health clinic. This paper is not yet published, but again the results are quite stunning and suggest the utility of the program she devised for her PHD.
Tan, L. and Martin, G. Taming the Adolescent Mind: A randomised controlled trial examining clinical efficacy of an adolescent mindfulness-based group program. Journal of Child Psychology and Psychiatry. Submitted.

Twenty-five free academic papers to download

We have reached an auspicious number of academic papers that can be downloaded free of charge in pdf format - 25! Twenty-five weeks of steady commitment to providing provocative papers around mental health issues…
OK. I know some of them are elderly, but surprisingly they are still goodies; still cogent, and still worth a read...
OK. I know I have spent my life trying to understand adolescent suicide, and that is not everyone's cup of tea. But there are other issues addressed, including books on self-injury, and others on aboriginal social and emotional wellbeing.

Go to http://www.familyconcernpublishing.com.au

Then click on the tab: 'Resources'

Scan down the list and see what might interest you. No rush… We will not be removing them unless the original publisher complains.

Monday Free Download: Continuing medical education in marital and family therapy: a survey of South Australian psychiatrists

The ‘common wisdom’ (i.e. in the gutter press) about psychiatry seems to suggest that psychiatrists diagnose (based on systems like ICD and DSM), and then reach for the prescription pad. This may be a peculiarly American view. In online psychiatry groups elsewhere around the world, there are lively discussions about  how to do various forms of psychotherapy and whether psychoanalytic thinking retains its currency. This 1995 paper seems to suggest that a percentage of psychiatrists had skills in marital and family therapies, and were actively seeking continuing medical education in these fields. Perhaps it is time for a follow-up survey. I wonder whether we would be find anything different?
Then the Resources Tab
Download here: Continuing medical education in marital and family therapy
Allison, S., Powrie, R., Pearce, C. & Martin, G., 1995.  Continuing Medical Education in Marital and Family Therapy.  Australian and New Zealand Journal Of Psychiatry, 29:4, 638-644.

Sunday, November 10, 2013

Sunday Haiku on Part/ Rich&Stay/ Test

Part

I am wholly me
Yet me is a part of us
Who are part of whole

Right, I fixed the bike
Seem to have part left over
What does this chain do?

In relationship
Living out a part could be
Intolerable

Rich and Stay

Life's richness evolves
Crave familiarity
Nothing stays the same

How can we stay rich?
Such a central conundrum
For wealthy people

The rich can stay rich
By building more casinos
To rip off the poor

Test

Tester or testee
A power differential
Could tester fail test?

All students tested
End of academic year
You signed on for this

Life is a challenge
Each milestone can test your strengths
And perseverance

Saturday, November 9, 2013

Haiku on Mood/Number/Our

Mood

From the furrowed brow
Tightly pursed lips, hunched shoulders
You're not in the mood

By definition
Temporary state of mind
Mercurial mood

Her eyes change colour
With every change of mood
Currently jet black

Number

Golden ratio
Nature's numbering system
Fibonacci sum

Please pick a number
Sorry, that number is wrong
You could try again

In numbered houses
On streets in countless cities
There are real people

Our

Can't do this alone
The our is upon us
Must work together

My time plus your time
Not the same thing as our time
Need both us and me

This is not our life
We serve a higher purpose
All parts of the whole

Monday, November 4, 2013

Monday Free Download - Metaphor: Complete or Incomplete

This 1984 paper from the Australian Journal of Family Therapy (now the Australian and New Zealand Journal of Family Therapy) reflects the early struggles of learning the trade of family therapy. As therapists, we use metaphor in all sorts of forms, both overtly and subtly. A theoretical introduction is followed by clinical examples - some of it (in retrospect) a bit fumbling and inexact. But then you have to start somewhere...

Go to http://www.familyconcernpublishing.com.au

Click the Resources Tab

Download here: * Metaphor: Complete or Incomplete

Martin, G., 1984. Metaphor: Complete or Incomplete.  Australian Journal of Family Therapy, Vol. 5 No. 2.

Sunday, November 3, 2013

Haiku reflecting 'Harmony', 'Impression' and 'Lush'

Harmony

The Welsh male voice choir
From the mines to the heavens
Total harmony

The choral marriage
Playing roles in harmony
Metaphor for life

Pianoforte
Black and white keys, loud or soft
Racial harmony

Impression

Girl with red dress on
Sashayed across the dance floor
Quite an impression

Mad as a hatter
Strong clinical impression
Not diagnostic

Life seems much faster
Is that universal truth?
Or my impression

Lush

They're flush with money
Lush silk carpets wall to wall
Very large slush fund

Japanese garden
Carefully tended with love
A lush peacefulness

Mountain road in mist
Lush untouched forest breathing
Palpable silence