The milestones of sexual development model

Introduction

The men and women who come to us for help are profoundly vulnerable. They feel broken, unable to enjoy the basic human pleasure of being sexual. Clinically, cases which first appear to be simple dysfunction may later reveal extensive defects in sexual development. The focus of this article is on deeply troubled men and women with intrapsychic obstacles to intimacy stemming from family-of-origin issues.

Some of our most blocked patients experienced sexual abuse, and appropriately staged treatment for them is well defined (Maltz, 2001). However, perhaps two thirds of them were not sexually abused, yet standard behavioral exercises are too advanced and inappropriate for them. How can we identify and help these clients, whose sexuality never developed normally or whose sexual identity never evolved?

Read the rest here.

Stressed mothers 'transmit stress patterns to offspring'

New research suggests that infants born to mothers who have been through stressful life events may experience changes at birth that impact their emotional behavior well into adulthood. This is according to a study published in the journal Biological Psychiatry.

Researchers from the University of Haifa in Israel say that previous research conducted in both humans and animals has shown that females who are exposed to stress even before they conceive can have have an impact on offspring.

The 5 stages of loss and grief

By JULIE AXELROD @ http://psychcentral.com/

The stages of mourning and grief are universal and are experienced by people from all walks of life. Mourning occurs in response to an individual’s own terminal illness or to the death of a valued being, human or animal. There are five stages of normal grief that were first proposed by Elisabeth Kübler-Ross in her 1969 book “On Death and Dying.”

In our bereavement, we spend different lengths of time working through each step and express each stage more or less intensely. The five stages do not necessarily occur in order. We often move between stages before achieving a more peaceful acceptance of death. Many of us are not afforded the luxury of time required to achieve this final stage of grief.

The death of your loved one might inspire you to evaluate your own feelings of mortality. Throughout each stage, a common thread of hope emerges: As long as there is life, there is hope. As long as there is hope, there is life.

Many people do not experience the stages in the order listed below, which is okay. The key to understanding the stages is not to feel like you must go through every one of them, in precise order. Instead, it’s more helpful to look at them as guides in the grieving process — it helps you understand and put into context where you are.

1. Denial and Isolation

The first reaction to learning of terminal illness or death of a cherished loved one is to deny the reality of the situation. It is a normal reaction to rationalize overwhelming emotions. It is a defense mechanism that buffers the immediate shock. We block out the words and hide from the facts. This is a temporary response that carries us through the first wave of pain.

2. Anger

As the masking effects of denial and isolation begin to wear, reality and its pain re-emerge. We are not ready. The intense emotion is deflected from our vulnerable core, redirected and expressed instead as anger. The anger may be aimed at inanimate objects, complete strangers, friends or family. Anger may be directed at our dying or deceased loved one. Rationally, we know the person is not to be blamed. Emotionally, however, we may resent the person for causing us pain or for leaving us. We feel guilty for being angry, and this makes us more angry.

Remember, grieving is a personal process that has no time limit, nor one “right” way to do it.

The doctor who diagnosed the illness and was unable to cure the disease might become a convenient target. Health professionals deal with death and dying every day. That does not make them immune to the suffering of their patients or to those who grieve for them.

Do not hesitate to ask your doctor to give you extra time or to explain just once more the details of your loved one’s illness. Arrange a special appointment or ask that he telephone you at the end of his day. Ask for clear answers to your questions regarding medical diagnosis and treatment. Understand the options available to you. Take your time.

3. Bargaining

The normal reaction to feelings of helplessness and vulnerability is often a need to regain control:

If only we had sought medical attention sooner…

If only we got a second opinion from another doctor…

If only we had tried to be a better person toward them…

Secretly, we may make a deal with God or our higher power in an attempt to postpone the inevitable. This is a weaker line of defense to protect us from the painful reality.

4. Depression

Two types of depression are associated with mourning. The first one is a reaction to practical implications relating to the loss. Sadness and regret predominate this type of depression. We worry about the costs and burial. We worry that, in our grief, we have spent less time with others that depend on us. This phase may be eased by simple clarification and reassurance. We may need a bit of helpful cooperation and a few kind words. The second type of depression is more subtle and, in a sense, perhaps more private. It is our quiet preparation to separate and to bid our loved one farewell. Sometimes all we really need is a hug.

5. Acceptance

Reaching this stage of mourning is a gift not afforded to everyone. Death may be sudden and unexpected or we may never see beyond our anger or denial. It is not necessarily a mark of bravery to resist the inevitable and to deny ourselves the opportunity to make our peace. This phase is marked by withdrawal and calm. This is not a period of happiness and must be distinguished from depression.

Loved ones that are terminally ill or aging appear to go through a final period of withdrawal. This is by no means a suggestion that they are aware of their own impending death or such, only that physical decline may be sufficient to produce a similar response. Their behavior implies that it is natural to reach a stage at which social interaction is limited. The dignity and grace shown by our dying loved ones may well be their last gift to us.

Coping with loss is a ultimately a deeply personal and singular experience — nobody can help you go through it more easily or understand all the emotions that you’re going through. But others can be there for you and help comfort you through this process. The best thing you can do is to allow yourself to feel the grief as it comes over you. Resisting it only will prolong the natural process of healing.

Clinical guidelines for delirium

Delirium (sometimes called 'acute confusional state') is a common clinical syndrome characterised by disturbed consciousness, cognitive function or perception, which has an acute onset and fluctuating course. It usually develops over 1–2 days. It is a serious condition that is associated with poor outcomes. However, it can be prevented and treated if dealt with urgently. A person may already have delirium when they present to hospital or long-term care or it may develop during a hospital admission or residential stay in long-term care. Delirium can be hypoactive or hyperactive but some people show signs of both (mixed). People with hyperactive delirium have heightened arousal and can be restless, agitated and aggressive. People with hypoactive delirium become withdrawn, quiet and sleepy. Hypoactive and mixed delirium can be more difficult to recognise.

Guidelines for diagnosis, prevention and management of delirium here.

Acceptance & Commitment Therapy (ACT)

source: the Association for Contextual Behavioral Science (ACBS)

Psychological Inflexibility: An ACT View of Suffering

The core conception of ACT is that psychological suffering is usually caused by the interface between human language and cognition, and the control of human behavior by direct experience. Psychological inflexibility is argued to emerge from experiential avoidance, cognitive entanglement, attachment of a conceptualized self, loss of contact with the present, and the resulting failure to take needed behavioral steps in accord with core values. Buttressed by an extensive basic research program on a associated theory of language and cognition, Relational Frame Theory (RFT), ACT takes the view that trying to change difficult thoughts and feelings as a means of coping can be counter productive, but new, powerful alternatives are available, including acceptance, mindfulness, cognitive diffusion, values, and committed action.

The ACT Model

ACT is an orientation to psychotherapy that is based on functional contextualism as a philosophy and RFT as a theory. As such, it is not a specific set of techniques. ACT protocols target the processes of language that are hypothesized to be involved in psychopathology and its amelioration, such as:

• cognitive fusion -- the domination of stimulus functions based on literal language even when that process is harmful,
• experiential avoidance -- the phenomenon that occurs when a person is unwilling to remain in contact with particular private experiences and takes steps to alter the form or frequency of these events and the contexts that occasion them, even when doing so causes psychological harm
• the domination of a conceptualized self over the "self as context" that emerges from perspective taking and deictic relational frames
• lack of values, confusion of goals with values, and other values problems that can underly the failure to build broad and flexible repertoires
• inability to build larger unit of behavior through commitment to behavior that moves in the direction of chosen values

and other such processes. Technologically, ACT uses both traditional behavior therapy techniques (defined broadly to include everything from cognitive therapy to behavior analysis), as well as others that are more recent or that have largely emerged from outside the behavior tradition, such as cognitive defusion, acceptance, mindfulness, values, and commitment methods.

ACT for Physical Therapists

ACT can be very useful for patients suffering from chronic pain. For many of these patients the persisting pain starts to interfere with life. Most often the response to this situation is that patients stop doing the things they want to do at work and in their private life. For many of these patients avoiding pain and struggling with it becomes the focus of their life.

In challenging the patients to notice the pain and notice all the things the mind tells you about it (whether they are true or not).

This training in noticing of awareness is a mindfulness therapy. ACT does not aim to eliminate pain but tries to turn the focus back to what the patients want their lives to be about.

Pain is not the same as pain behavior  Pain behavior is what we do in response to pain and pain behavior is subject to all the usual influences on behavior and can be reinforced just like other behaviors.

Three critical elements sustain motivation

Motivating a patient is one of the major parts of the job of a Physical Therapists. So, it is important for him/her to identify the forces that motivate human behavior.

This is a very nice article I recently read in Scientific American:

When it comes to cultivating genius, talent matters, but motivation may matter more.

(By Daisy Yuhas)

Got motivation? Without it, the long, difficult hours of practice that elevate some people above the rest are excruciating. But where does such stamina come from, and can we have some, too? Psychologists have identified three critical elements that support motivation, all of which you can tweak to your benefit.

Autonomy

Whether you pursue an activity for its own sake or because external forces compel you, psychologists Edward L. Deci and Richard M. Ryan of the University of Rochester argue that you gain motivation when you feel in charge. In evaluations of students, athletes and employees, the researchers have found that the perception of autonomy predicts the energy with which individuals pursue a goal.

In 2006 Deci and Ryan, with psychologist Arlen C. Moller, designed several experiments to evaluate the effects of feeling controlled versus self-directed. They found that subjects given the opportunity to select a course of action based on their own opinions (for example, giving a speech for or against teaching psychology in high school) persisted longer in a subsequent puzzle-solving activity than participants who were either given no choice or pressured to select one side over another. Deci and Ryan posit that acting under duress is taxing, whereas pursuing a task you endorse is energizing.

Value

Motivation also blossoms when you stay true to your beliefs and values. Assigning value to an activity can restore one's sense of autonomy, a finding of great interest to educators. In a 2010 review article, University of Maryland psychologists Allan Wigfield and Jenna Cambria noted that several studies have found a positive correlation between valuing a subject in school and a student's willingness to investigate a question independently.

The good news is that value can be modified. In 2009 University of Virginia psychologist Christopher S. Hulleman described a semester-long intervention in which one group of high school students wrote about how science related to their lives and another group simply summarized what they had learned in science class. The most striking results came from students with low expectations of their performance. Those who described the importance of science in their lives improved their grades more and reported greater interest than similar students in the summary-writing group. In short, reflecting on why an activity is meaningful could make you more invested in it.

Competence

As you devote more time to an activity, you notice your skills improve, and you gain a sense of competence. In 2006 psychologists at the Democritus University of Thrace and the University of Thessaly in Greece surveyed 882 students on their attitudes and engagement with athletics during a two-year period. They found a strong link between a student's sense of prowess and his or her desire to pursue sports. The connection worked in both directions—practice made students more likely to consider themselves competent, and a sense of competence strongly predicted that they would engage in athletic activity. Similar studies in music and academics bolster these findings.

Carol S. Dweck, a psychologist at Stanford University, has shown that competence comes from recognizing the basis of accomplishment. In numerous studies, she has found that those who credit innate talents rather than hard work give up more easily when facing a novel challenge because they assume it exceeds their ability. Believing that effort fosters excellence can inspire you to keep learning.

The next time you struggle to lace up your sneakers or park yourself at the piano bench, ask yourself what is missing. Often the answer lies in one of these three areas—feeling forced, finding an activity pointless or doubting your capabilities. Tackling such sources of resistance can strengthen your resolve. The choice, of course, is yours.

Changing faces with a smile - Operation Smile

Not directly related to Physical Therapy, but it certainly worths watching this video and realise how it feels when you can make someone smile through your personal work..!

Operation Smile provides free surgeries to repair cleft lip, cleft palate and other facial deformities for children around the globe.

An amazing little girl who had her cleft lip surgery.People ask me why I volunteer overseas so much.. It takes my eyes off me and allows me to remember what life is all about. When we use what we have been given (whatever that might be) to make a positive change for our world, that's when life make sense.... In a time when the world seems to be imploding with greed, there are certain things that will always remain invaluable..like the smile on this girls face when she realizes her life will be changed forever.

How to live to be 100+

Watch this video and you will be amazed about how simple life can be..!

How to live to be 100+?

1. Move naturally - you do not need any exercise session if your lifestyle is natural and you use your body to do your job instead of buttons and remote controls.

2. Right outlook - wait for a while, relax, focus in the present and concentrate on the joy of the life right here, right now.

3. Eat wisely - you do not need any kind of diet if you eat what your body asks for naturally - a lot of vegetables, fruits, pulses, water, little bit of pure wine if you wish, small quantities and till you reach 80% of your fullness.

4. Connect - be with your love ones, make friends, communicate, share, love - all these are naturally into you.

Everything said in a beautiful video in TED.

We are going to be health professionals affecting others' people life. First, we have to learn to enjoy our own life.