Friday, January 13, 2012

Carl Rogers

Eventually I am going to briefly explain the important parts of these chapters because I need to take up some room and I am not quite sure about what to write. So here is a little description of what, like it or not, this paper is going to contain. I’ll start of with my thoughts and feelings about the structure and uniqueness of The Clinical Treatment of the Problem Child, then get into the actual body of the book and talk about what I thought was interesting and what I think is still used today. Of course using my petite knowledge about the psychology of today and modern-day institutions and therapy. After that I am going to delve into Way of Life and do the same thing. The Way of Life section will probably be considerably shorter because of my limited interested in the book and my blatant laziness. Plus we had to have two sources and I decided to pick the two books that he wrote near the beginning of his career and near the end.
There were a few stylistic things about the book that impressed me enough to include them into this paper. First off, it was written in 1939 when the study of psychology was in its infancy. At the end of every chapter or section throughout the book there is a bibliography showing every source that was cited. I think this is a very clever way to let people know that there is a science behind psychology and it is not all blind conjecture. I think that was very insightful and very much a slap in the face to everyone that didn’t believe in psychology (of course if they put no stock in psychology they would not have read the book, but hey he tried).
Preface
“The primary purpose of this volume is to describe and discuss the variety of treatment skills actually used in clinical work. These ‘ways of practice,’ which have been evolving over a score of years, are set forth in organized fashion, in hope that their presentation will lead to a better understanding of treatment techniques and a more critical consideration of their use.” This guy seems to genuinely want to establish psychology as a science and I think it is neat how easily he can simultaneously write to an audience of professionals in their field to someone like me with absolutely no background in psychology.
Factors that Influence Behavior
He mentions the Hereditary Factor, the Organic Influences, the Family, the Cultural and Social Influences, the Needs of the Organism, and the Interaction of Factors. May of the above mentioned Factors we have already discussed in class, which leads to to believe that Carl Rogers was either extremely ahead of his time, or that psychology has not advanced a great deal over the last fifty years. Probably a little bit of both, because Mr. Rogers states several times that he in no way claims to have all of the answers. “This is not to say, of course, that such qualities for any individual can be predicted by measurements of the parents, since the complex process of genes contributed by the parents insures variability as well as similarity” (pg.5). Being humble is always a bonus, especially if you went to college for ten years and know everything.
The Foster Home as a Means of Treatment
I can’t tell if the author is criticizing the use of Foster Homes or if he is criticizing the reasons children are placed into these dwellings but there is definitely some sarcasm in the way he speaks of the Foster Home. He says “Even the psychiatrist, who more than most is apt to depend on processes that are internal rather than external, falls back with surprising frequency on gross changes of environment to accomplish his purpose” (pg. 63). I personally think that the only reason a child should be put in a foster home is if the parents are deemed unable or unworthy to raise the child. There are much better places for juvenile delinquents than a foster home, like a boot camp or jail.
Types of Institutional Treatment
This is one area that I think has changed greatly in the past fifty years and yet stayed the same . The goal of the institution is a “confused one”. “Punishment is looked upon as almost inevitably a part of the goal, treatment of the child’s behavior being in many cases a secondary aim” (pg. 109). Treatment in an Institution is a joke; there is no such thing. The only reason that patients seem to improve, or tell the doctor that they have been rehabilitated is so they can get out of the institution. That is my opinion of 1999 and good old Carl said, “All to often the two aims (punishment, treatment) are mingled so that the moralistic punishments are meted out with the thought that they will in some miraculous fashion improve the behavior of the child, in utter disregard if everything that we have come to know regarding the causation and treatment of behavior” (pg 109). That stuff is all the same, but today the use of Institutions and what is required to be admitted to them is radically different, possibly due to modifications of the penal system or wider range of illegal activities. Most Institutions now deal almost exclusively with drugs and alcohol. But there are other problems dealt with as well such as homicidal threats, aggression problems, run-a-ways, and suicide. The book doesn’t really say why they institutionalized people in that period of time, but I took the Institutions of this time period to be like jails for children. I wrote way too much on this one. I do think that Institutions have changed very radically but are probably no better off.


Means of Changing Parental Attitudes
There are some interesting situations outlined in this chapter but instead of copying them verbatim I a simply going to summarize the cool ones and tell how they are a means to change parental attitudes. Direct Education was the one that struck me as the most simple and most logical is the one with “extreme limitations”. The situation is as follows, a mother requests the help of a psychologist for her unmanageable child who has never been to school (she is 11). The physician realizes at little more than a glance that the child is a “Mongolian” and her mental development is that of a three year-old. Even after the mother was told that there was no cure and the child would never develop past this point the mother insisted that the child could read and write. While the mother was saying this, her child was making unintelligible noises, drooling, and other things that three year olds do. She blames the child’s state on the fact that she has never been allowed to attend school, but reluctantly admits that four other psychologists have diagnosed her daughter with the same condition. That is more or less the situation and later Rogers says, “The fact that parents may be able easily to absorb training for a job, or to educate themselves in regard to current events, or to learn a new system of contract bridge, does not mean that they can learn even simply factual data when this goes contrary to their emotional needs”(pg. 186).” This man is a genius, he just summed my parents up in one sentence. They will not accept the fact that I don’t wear diapers anymore and constantly talk about the good old days when I was normal, I am getting older and I think this is “contrary to their emotional needs” so they don’t accept it.
The next ones are Interpretive and Relationship therapy but how can those top the beautifully written section on Direct Education. I skimmed over them and I’m sure you know what they are anyways.
On to the next “source”, the Way of Being by Carl Rogers. This book has an interesting introduction where the author makes himself look good by talking about all of the things that have happened in his lifetime and about how he was an instrumental part of it all thorough his books on counseling and psychotherapy. I think he was just getting old and needed something to keep him from getting senile and to leave a farewell book that summed up his entire life’s work. He says, “This book encompasses the changes that have taken place during the past decade – roughly, the seventies. It brings together diverse material which I have written in recent years (pg. Vii).” Blah, Blah, Blah…
There are four main parts to this book and if I had the time or the energy I would not mind reading it all. Part One deals with Personal Experiences and Perspectives of the author, his “Experiences in Communication” and his “Philosophy of Interpersonal Relationships and How they Grow” garbage like that. The next section, “Aspects of a Person-Centered Approach” I thought was neat and described a technique that I had never heard of and never seem used. “The first element could be called genuineness, realness, or congruence. The more the therapist is himself or herself in the relationship, putting up no professional front or personal façade, the greater is the likelihood that the client will change and grow in a constructive manner” (pg. 114). This sounds cool, but in reality if therapists did this the career of a therapist would be drastically shortened, because I don’t think there is any way a therapist without defenses could handle everyone else’s problems all day every day. So they would have to make a trade-off between being a career mediocre therapist or a really good therapist for about five years before they become postal workers.
Sections three and four were stupid so I’ll just leave it at that.
In conclusion, Mr. Rogers did really fit the mold of the hug-me psychiatrist that I thought he would. I don’t really see why he is a humanist or maybe it’s the fact that I still really don’t know what a humanist is. Either way, I think he is a pretty sensible person who does not make up facts and figures and who has apparently been in the game for a long time. You have to respect that, but I bet he never had kids of his own.

Bulimia Nervosa

Bulimia nervosa is defined as two or more episodes of binge eating (rapid consumption of a large amount of food, up to 5,000 calories) every week for at least three months.  The binges are sometimes followed by vomiting or purging and may alternate with compulsive exercise and fasting.  The symptoms can develop at any age from early adolescence to 40, but usually become clinically serious in late adolescence.
Bulimia is not as dangerous to health as anorexia, but it has many unpleasant physical effects, including fatigue, weakness, constipation, fluid retention, swollen salivary glands, erosion of dental enamel, sore throat from vomiting, and scars on the hand from inducing vomiting.  Overuse of laxatives can cause stomach upset and other digestive troubles.  Other dangers are dehydration, loss of potassium, and tearing of the esophagus.  These eating disorders also occur in men and older women, but much less frequently.  Women with diabetes, who have a high rate of bulimia, often lose weight after an eating binge by reducing their dose of insulin.  According to recent research, this practice damages eye tissue and raises the risk of diabetic retinopathy, which can lead to blindness.
Many anorectic women also indulge in occasional eating binges, and half of them make the transition to bulimia.  About 40% of the most severely bulimic patients have a history of anorexia.  It is not clear whether the combination of anorexia with bingeing and purging is more debilitating, physically or emotionally, than anorexia alone.  According to some research, anorectic women who binge and purge are less stable emotionally and more likely to commit suicide.  But one recent study suggests that, on the contrary, they are more likely to recover.
The exact cause of the disorder is unknown, but a variety of psychological, social, cultural, familial and biochemical theories are being investigated.  Bulimia has been recognized for a much shorter time than anorexia, and there is less research on its origins.  One theory is that bulimic women lack all the parental affection and involvement they need and soothe them with food as compensation.  The overeating subdues feelings of which they are barely conscious, at the price of later shame and self-hatred.  One recent study found that bulimic women differed from depressed and anxious women in several ways.  They were more likely to be overweight, to have overweight parents, and to have begun menstruating early.  They were also more likely to say that their parents had high expectations for them but limited contact with them.  The parents themselves were not interviewed.

According to the American Journal of Psychiatry, surprisingly, the risk for bulimia was not related to social class, income, education, occupation, the occupation of parents, or even an outgoing or introverted personality.  A woman's childhood relationship with her mother, as she reported it, was not associated with bulimia, but neglect by her father was.  Women with bulimia had lower self-esteem and more neurotic symptoms, and they were more likely to say they were not in control of their lives.  They also had a slimmer ideal body image, and they dieted and exercised more.  The risk factors for narrowly and broadly defined bulimia were similar (Kendler, 1991).
Women with broadly defined bulimia had high rates of phobias, alcoholism, anxiety disorders, anorexia nervosa, and panic attacks.  Their lifetime rate of major depression was also high (50 percent), but bulimia had no special association with that common disorder.  All other things being equal, a woman with a history of major depression was 2.2 times more likely to have suffered from bulimia as well.  The corresponding odds ratio for phobias was 2.4, for alcoholism 3.2, and for anorexia nervosa 8.2.  In most studies of patients treated for both bulimia and depression, bulimia is found to precede depression, but in this group of largely untreated people the depression had usually come first (Roth, 1996).
In some families of women with bulimia, the problem may be more serious than rigidity, over protectiveness, or inadequate nurturing.  Child sexual abuse, an increasingly common explanation for psychiatric symptoms in women, has naturally been proposed as a cause of eating disorders.  The connection has not been confirmed, and some recent studies raise serious doubts about it.  Women with bulimia do not report more sexual abuse than an anxious and depressed woman in general.
The problem of bulimia is closely related to the problem of obesity, since almost all bulimic women either are or think they are overweight.  According to a widely accepted theory, each person's body weight has a biological set point that is strongly influenced by heredity and difficult to change.  Studies in several countries have found that mothers and their biological daughters have a similar weight-height ratio, while the correlation between adoptive parents and adoptive children is low.  According to the set point theory, metabolism during a diet shows to counteract the effect of reduced intake until it settles at a lower level consistent with the new weight.  A person who continues the same diet will eventually regain weight until the set point is reached.
Many individuals with bulimia do not seek help until they reach their thirties or forties when their eating behavior is deeply ingrained and more difficult to change.
Bulimia is often treated more successfully than anorexia, partly because bulimic patients usually want to be treated.  Most antidepressant drugs relieve the symptoms, usually more quickly than they relieve depression.  Selective serotonin reuptake inhibitors (SSRIs) are probably most useful, because they have relatively few side effects and tend to cause weight loss rather than weight gain.  In 1997, fluoxetine became the first drug specifically approved by the Food and Drug Administration (FDA) as a treatment for bulimia.

References
Roth, W.T., & Insel P.M.  (1996).  Core Concepts in Health.  Toronto: Mayfield.
Kendler, K.S.  (1991).  The genetic epidemiology of bulimia nervosa.  American Journal of Psychiatry, 148:1627-1637.
Mitchell, J.E.  (1996).  Bulimia Nervosa.  West Virginia Health Page.
http://www.wvhealth.wvu.edu/clinical/mentalhealth/edbulim.htm

Brian Tracy Psychology of Achievement

YOU BECOME WHAT YOU THINK ABOUT!

A MAN BECOMES WHAT HE THINKS ABOUT ALL DAY LONG.
-- RALPH EMERSON.

YOU ARE NOT WHAT YOU THINK YOU ARE,
BUT WHAT YOU THINK...YOU ARE.




THE LAW OF EXPECTATIONS

WHATEVER WE EXPECT WITH CONFIDENCE BECOMES OUR OWN SELF-FULLFILLING PROPHECY. …WE ARE OUR OWN FORTUNE TELLERS.
WE MANUFACTURE OUR OWN SELF-FULLFILLING PROPHECY.

EXPECTATIONS HAVE A POWERFUL IMPACT ON OUR RELATIONSHIPS WITH OTHERS, AND WHAT WE BECOME.

ALWAYS EXPECT TO GROW, TO GET BETTER -- EXPECT THE BEST.
THROW OFF PAST MISTAKES OR FAILINGS.

MAKE A HABIT OF ALWAYS EXPECTING THE BEST IN WHAT YOU DO.

MANUFACTURE POSITIVE EXPECTATIONS.






THE LAW OF ATTRACTION

EACH HUMAN BEING IS A LIVING MAGNET. THINK CONTINUALLY OF THE PEOPLE AND CIRCUMSTANCES YOU ALLOW IN YOUR LIFE.




SELF ESTEEM

THIS IS THE CORE OF SELF CONCEPT.

HOW MUCH YOU LIKE YOURSELF DETERMINES HOW WELL YOU PERFORM. THE MORE YOU LIKE YOURSELF THE BETTER YOU PERFORM.



“I LIKE MYSELF ... I LIKE MYSELF ... I LIKE MYSELF…”
SAY IT OVER AND OVER AND OVER.

PICTURE YOUSELF AS AN ATTRACTIVE HIGH-PERFORMING HUMAN BEING. RELEASE YOUR SUBCONSCIOUS BRAKES. ACCEPT FULL RESPONSIBILTY FOR YOUR LIFE.



WE ARE 100% IN CHARGE OF WHAT HAPPENS TO OURSELVES. WE CONTROL OUR DESTINY. DISCARD NEGATIVE EMOTIONS.



ACCEPT TOTAL RESPONSIBILITY FOR YOUR OWN HEALTH.



KEEP YOUR CONSCIOUS MIND ON THE THINGS YOU DESIRE, RATHER THAN THE THINGS YOU FEAR.

brian tracy psy of selling the psychology of selling

The Psychology of Selling
(Six audio cassettes or CDs plus workbook)

Session 1: The Psychology of Selling
The “winning edge” theory. The “inner game” of selling. Self-concept as a regulator. A simple way to increase your earnings. The six phases of selling. The single most significant indicator of your success. The best time to make a sale. Obstacles.

Session 2: Developing a Powerful Sales Personality
Characteristics of superior salespeople. Gaining ten extra years of income. Achieving wealth. Which products are right for you? Creating the profile for success and living up to it. Your invisible helper. What is happening when everything is going right? Becoming unstoppable.

Session 3: Why People Buy
The foundation for all professional selling. The key to business-to-business selling. The six sure-fire ways to uncover needs. Identifying basic and secondary needs. The “spotlight” technique. Phrasing for success.

Session 4: Creative Selling
How strategic selling works. A step-by-step process to determine your greatest opportunities. The crucial question you must ask yourself. Timing sales for success. Great ways to get testimonials. The “20-Idea” method. Selling to “non-customers.”

Session 5: Approaching the Prospect
If it works for Corning Glass… Getting undivided attention. Planting the right questions in the customer’s mind. Answering them. The selling temptation you must avoid. Building expectancy. Correctly using the powerful “suggested influences.” Five personality types.



Session 6: The Sales Process
An opening question that both qualifies the buyer and intrigues him. The purpose of the presentation. Building your case. Stalling all price concerns until you’re ready for them. Five keys to effective listening. A three-step presentation method.

Session 7: The Psychology of Closing
Planning your close in detail. Its major requirements. A new look at buying signals. The role of fear. Five errors to avoid. What not to do. Primary obstacles to closing. The only form of pressure you should ever use. Avoiding the biggest sales killer. Tag-team selling.

Session 8: When Objections Get In the Way
The basic rule about objections. Turning them around. The law of six applied to objections. Analyzing conditions. Nine common objections and how to demolish them. Show-off objections. Subjective objections. The last-ditch objection. The just suppose…sharp angle…instant reverse…and change places closes.

Session 9: Winning Closing Techniques – I
The ascending close. The law of six. Kindling desire. The invitational close. Overcoming price resistance. The law of the excluded alternative. Seven ways to handle price objections. A way to smoke out the real objection. The sudden death close. Finalizing a sale that was going nowhere.

Session 10: Winning Closing Techniques – II
The alternative close. The assumption close. The take away…summary…order sheet…relevant story…walk away…today only…go ahead…and doorknob closes. Questions to ask yourself after every sales call. A billionaire reveals the two requirements for success.

Session 11: Managing Your Time Effectively
The basics of managing time. A simple formula that puts things in perspective. Major time wasters. How to quit spinning your wheels. The essence of selling. Tips to increase effectiveness. How to start your day. When to end it. How to find six new weeks a year.

Session 12: Ten Keys to Success in Selling
What adversity shows you. The incompetent person of tomorrow. Selecting the right reference group. Shakespeare’s advice. Why you’re a genius. Tapping your enormous creativity reserves. The Universal Maximum. A key to success by Baron de Rothschild. A lesson from the airstrip.

Birth Order

Does birth order have an
effect on personality? Does being first born make people more responsible?
If someone is the middle born child, are they going to be more rebellious?
If people are last born are they more likely to be on television? Are first
born children inconsiderate and selfish or reliable and highly motivated?
These, and many other questions are being thoroughly studied by psychologists
(Harrigan, 1992). In 1923, the renowned psychiatrist Dr. Alfred Adler, wrote
that a person's position in the family leaves an undeniable "stamp" on his
or her "style of life" (Marzollo, 1990). Research has shown that birth order
does indeed affect a child; however, it does not automatically shape personality.
If it did, life would be much more predictable and a great deal less interesting
(Marzollo, 1990). Yogi Bera, a famous baseball player, said "Every now and
then a reporter who thinks he is Freud asks me if being the youngest is why
I made it (playing professional baseball). I almost alw
ays say yes, but
I don't think it had anything to do with it" (Harrigan, 1992).
Birth order
doesn't explain everything about human behavior. Personality is affected by
many different factors, such as heredity, family size, the spacing and sex
of siblings, education, and upbringing. However, there is an awful lot of
research and plain old "law of averages" supporting the affect of birth order
on personality (Leman, 1985). There are four basic classifications of birth
order: the oldest, the only, the middle, and the youngest. Each has its own
set of advantages, as well as its own set of disadvantages. While the birth
order factor isn't always exact, it does give many clues about why people are
the way they are (Leman, 1985).
If there is one word that describes first
born children it would be "perfectionist" (Harrigan, 1992). First born children
tend to be high achievers in whatever they do. Some traits customarily used
to label first born children include reliable, conscientious, list maker, well
organized, critical, serious, scholarly (Leman, 1985), self-assured, good leadership
ability, eager to please, and nurturing (Brazelton, 1994). Also, first born
children seem to have a heightened sense of right and wrong. It is common
in most books about birth order that first born children get more press than
only, middle, and youngest children. This can be explained by the fact that
the first born child is typically the success story in the family. They are
the ones that are extremely driven to succeed in "high achievement" fields
such as science, medicine, or law (Leman, 1985). For example, of the first
twenty-three astronauts sent into outer space, twenty-one were first born or
their close cousin, the only child, which we w
ill discuss later on. In fact,
all seven astronauts in the original Mercury program were first born children
(Leman, 1985). Also, first born children tend to choose careers that involve
leadership. For example, fifty-two percent of all U.S. presidents were first-borns
(Lanning, 1991). Researchers say that, in general, first born children tend
to have higher IQs than younger siblings. This is not because they start off
more intelligent, but because of the amount of attention new parents give to
their first child (Marzollo, 1990). Experts claim that a first born's will
to succeed begins in infancy (Lanning, 1991). The extraordinary love affair
that many new parents have with their first child leads to the kind of intensity
that can probably never be repeated with a younger child. In the first few
weeks, a new parent imitates the baby's gestures in a playful game. A rhythm
is established by mimicry of vocalizations, motions, and smiles. Think what
this cycle of action-reaction might mean to an infant:
"I'm pretty powerful,
aren't I? Everything I do is copied by someone who cares about me ." After
a couple of weeks of game playing the infant develops a sense of "I recognize
you!" (Brazelton, 1994). This special parent-child interaction helps to instill
a deep sense of self-worth in first born children. In short, the parents put
their first born child on a pedestal or throne. Also, new parents are convinced
that their child is the cleverest child in the world when he or she rolls over
or says "Mama" or "Dada" (Jabs, 1987). Even though the child is a baby it
can still sense the profound sense of enthusiasm. So, first borns want to
maintain their parents' attention and approval (Lanning, 1991). This is when
the arrival of a second child is often a crisis for the first child. They
are knocked off their pedestal by the baby (Leman, 1989). They are no longer
the center of mom and dad's attention. This often causes them to become resentful
toward their younger sibling.
To reclaim the position at the center of their
parents' attention, he or she will try imitating the baby. When the first
child realizes that his or her parents frown upon a two-year-old who wants
a bottle or a three-year-old who needs a diaper, he or she decides to aid
his or her parents in caring for the younger child (Jabs, 1987). Parents usually
tend to reinforce the older child's decision to be more adult by expecting
him or her to set a good example for the younger child. These experiences
help to make the first born a natural leader. However, first borns are sometimes
so preoccupied with being good and doing things right that they forget how
to enjoy life and be a kid (Jabs, 1987).
Along with being the first child
comes pressure. Each achievement becomes a miracle in a new parent's eyes.
However, when a mistake occurs it is viewed as an enormous failure in the
child's eyes because their parents weren't ecstatic, and so the child goes
to enormous lengths to make his or her parents happy with their performance.
Some parents may also burden the child with their own unfulfilled dreams and
with setting the standard for the younger children (Brazelton, 1994). Norval
D. Glenn, Ph. D., professor of sociology at the University of Texas at Austin,
explains that firstborns often suffer from pseudomaturity. They may act grown-up
throughout childhood, but because their role models are grown-ups rather than
older siblings, they may tend to reject the role of leader in early adulthood
(Marzollo, 1990). Also, a firstborn is not always "the most gracious receiver
of criticism". An adult's constant criticism of his or her performance may
cause the child to become a worried perfectionist. They m
ay come to fear
making mistakes before eyes that he or she feels are always watching them.
First born children may also come to hate any kind of criticism because it
emphasizes the faults that he or she is trying to overcome (Marzollo, 1990).

The first born child does not have unlimited time to view himself as the
child in the relationship with parents. When a sibling arrives, he or she
tends to eliminate the view of himself or herself as a child and he or she
struggles to be "parental" (Forer, 1969). In short, the first born child will
do anything to make everything perfect.
In addition to the labels mentioned
before, first born children also tend to be goal-oriented, self-sacrificing,
people-pleasers, conservative, supporters of law and order, believer in authority
and ritual, legalistic, loyal, and self-reliant. They are often achievers,
the ones who are driven toward success and stardom in their given fields (Leman,
1985). First born children can be found in great numbers in positions like
accountants, bookkeepers, executive secretaries, engineers, and, in recent
years, people whose jobs involve computers. First borns typically choose a
career that involves precision and requires a strong power of concentration
(Leman, 1985). Some first borns that have gone on to become famous leaders,
actors, scientists, novelists, astronauts, etc. include Mikhail Gorbachev (Russian
leader), Jimmy Carter (president), Henry Kissinger (diplomat), Albert Einstein
(scientist), Sally Ride (astronaut), Bill Cosby (actor), John Glenn (astronaut,
senator), Steven Spielberg (producer), Joan Colli
ns (actress), Clint Eastwood
(actor), Peter Jennings (TV journalist), and Bruce Springsteen (singer) (Jabs,


1987; Lanning, 1991; Marzollo, 1990).
In many ways, the only child is like
the first born child. An only child is a first born child who never loses
his or her parents' undivided attention. He or she benefits greatly from his
or her parents' enthusiastic attention, as long as it isn't too critical.
The only child also tends to have the first child's heightened sense of right
and wrong (Jabs, 1987). Leman's "perfect" description of the "Lonely Only"
include all the labels that were included with the first born child. However,
preceding each word would be the prefix super (Leman, 1985). Where the first
born child is organized, the only child is superorganized. Where the first
born child is a perfectionist, the only child is a superperfectionist. Labels
that are often applied to only children include spoiled, selfish, lazy, and
a bit conceited. These labels tend to be applied because only children don't
have to share with other siblings like the first, middle, or youngest children.
Dr. Alfred Adler, a famous psychologist, said that "The
Only Child has difficulties
with every independent activity and sooner or later they become useless in
life." However, most birth order experts, as well as myself, being an only
child, disagree with Dr. Adler and the labels given to an only child. (Leman,
1989). Far from being people who are used to having things handed to them
all their lives, only children are among the top achievers in every area of
profession. For example some of the more famous only children include Franklin
D. Roosevelt (president), Leonardo da Vinci (artist), Charles Lindbergh (pilot),
Ted Koppel (TV journalist), Brooke Shields (model, actress), Nancy Reagan (first-lady),
Frank Sinatra (singer), Danielle Steel (novelist), and John Updike (novelist)
(Jabs, 1987; Leman, 1989).
A problem that only children tend to have is when
eager parents interfere with their child's development. For example, new
parents tend to jump in too early to help the child with everything he or she
tries. They can't sit back and let the child struggle. What they don't realize
is that frustration is a powerful learning tool. When a child fights to master
a task and succeeds on his or her own, their face lights up with pride. "I
did it myself." If a parent tends to jump in to help at every little problem,
then the child could lose his or her will to try to do things by their self.
Only
children seem to be very on top of things, articulate, and mature. They appear
to have it all together. Yet, often there is an internal struggle going on.
Their standards have always been set by adults and are often high, sometimes
too high. Only children regularly have a hard time enjoying their achievements.
They feel as if they can never do anything good enough. Even if they succeed,
they often feel as though they didn't succeed by enough. This is usually the
start of what experts call the "discouraged perfectionist" (Leman, 1985).
Also, many other special problems may develop with only children. These problems
are often classified as only children, who are "problem children." For example,
the "special jewel" or "receiver" child often has a problem with the heliocentric
theory that states that our solar system revolves around the sun. The special
jewel or receiver child believes that the entire universe revolves around him
or her. This type of child generally develops when the parents gi
ve in to
their child's every wish. It is important for this child's parents to say
no. If the child says, "Mom, I want that !", her mother should respond by
saying, "No, I will not buy that for you, but you may purchase it with money
you have earned yourself." Once these children realize that they are dealing
with someone who won't cave in to their every demand they become quite pleasant
(Leman, 1989). Another "problem child" is the "friend-snatcher". The child
who never learns to share his or her toys, will also have a problem with sharing
friends as well. They become agitated when their friend tries to include other
people into the pair's activities. They may try to bribe their "friend" by
offering them toys, food, and maybe even money. For this problem, experts
suggest confronting the child by proposing, that mabye, the reason he or she
is not having very good relationships with his or her friends is because he
or she is not willing to share friends with anyone. Suggest that they need
to try doin
g activities with more than two people and that they need to stop
being so posessive (Leman, 1989).
Next is the "target" child. This child
also has a problem with the heliocentric theory. This child magnifies his
or her importance in every situation and beleives he or she is the one being
singled out for unfair treatment. When life is unfair, as it often is, he
can sink into deep depression and bitterness. For example, if a teacher gives
them an "F" on a world history test, it's because the teacher doesn't like
them and not because they didn't do a good job (Leman, 1989). These are often
problems of an only children who has been sheltered from society by their overprotective
parents. Those who are well adjusted know from an early age that life is a
mixture of good and bad (Leman, 1989).
Middle children are the hardest to
classify because they are so dependant different variables, including the personalities
of their older and younger siblings and the number of years between them (Marzollo,
1990). "What happens to middle children depends on the total family dynamics,"
says Dr. Jeannie Kidwell, family therapist and research scholar (Jabs, 1987).
Middle children can be shy or outgoing, reckless or responsible, uptight or
laid back (Lanning, 1991). Any number of life-styles can appear, but they
all play off the first born (Leman, 1985). He or she may try to imitate the
first-born's behavior. If they feel that they can't match up, they may go
off in another direction, looking for their identity, often in the exact opposite
of that taken by his or her older sibling. The general conclusion of all research
studies done on birth order is that second borns will probably be somewhat
the opposite of first born children (Leman, 1985). In general, middle born
children suffer from an identity cris
is. They are always striving to be
different from their older and younger siblings. Middle children feel that
they are born too late to get the privileges and special treatment that firstborns
seem to inherit by right and born too early to enjoy the relaxing of the disciplinary
reins, which is sometimes translated as "getting away with murder" (Marzollo,
1990). Neither the achiever nor the baby, the middle child may feel that he
or she has no particular role in the family. They may look outside the family
to define themselves. This is why friends become very important to middle
children (Marzollo, 1990).
Middle children search to find their own identity
and define their personality. Because middle children have to fight for their
parents' attention, they become highly competitive. This generally makes middle
children more successful in sports. Lacking the benefit of the exceptions
parents make for their first borns and last borns, middle children may learn
to negotiate, to compromise, and to give and take, valuable skills that will
help them succeed (Marzollo, 1990). They can become effective managers and
leaders because they are good listeners and can cope with varying points of
view. Also, experts have found that because middle children have had to struggle
for more things than their siblings they are better prepared for real life.
One big plus for middle children is a well developed sense of empathy because
they know what it's like to be younger and older. However, all the competing
and negotiating may cause middle children to have an overall low self esteem
and a self-deprecating attitude (Marzoll
o, 1990).
Nevertheless, middle children
have many advantages. They can learn from the older sibling but can also regress
to be like the younger one, doubling their learning opportunities. Yet, they
may also have many mood swings between grown-up and baby-like behavior, especially
during the teen age years (Brazelton, 1994). Leman (1989) says to "Remember,
the average teenager has only two emotional outbursts per year. The problem
is they last about six months each."
Because slightly more than one third
of American families today have only two children, many parents find themselves
thinking in terms of the first born and second born. Middle and second born
children share many of the same characteristics. Like the middle child, the
second-born is likely to search for ways to be different from the first-born
child (Marzollo, 1990). Dr. Kidwell says, "Problems arise when a family has
very rigid expectations." If the only thing that matters is straight A's and
the first kid is doing that, the middle kid has a profound dilemma. He or
she needs something else to be known for (Jabs, 1987, p.29). Some famous middle
and second children who have found their own identity include Bea Arthur (actress),
Glenn Close (actress), Matt Dillon (actor), Linda Evans (actress), Jessica
Lange (actress), Cyndi Lauper (singer), Tom Selleck (actor), Mary Decker Slaney
(runner), Richard Nixon (president), Princess Diana (British royalty), George
Burns (comedian), Bob Hope (comedian) (Jabs, 1
987; Marzollo, 1990).
If
a group of psychologists randomly picked out ten youngest born children, chances
are that nine of them would have these characteristics: manipulative, charming,
blames others, shows off, people person, good salesperson, precocious, engaging,
and sometimes spoiled (Leman, 1985). By the time the youngest child is born,
his or her parents have become veterans in the field of child care (Lanning,
1991). They are more experienced and confident in their parenting practices,
and so they often decide to let the last born enjoy childhood as long as they
can (Marzollo, 1990). This is why youngest children tend to be more pampered
than older siblings. The youngest or "baby" of the family is often given an
extra dose of affection and attention, as well as an occasional exception from
the rules (Marzollo, 1990). This extremely positive upbringing helps to contribute
to the youngest child's fun-loving, affectionate, and persuasive behavior (Marzollo,
1990). The youngest child can grow up to feel the most tre
asured, and the
most nurtured of all (Brazelton, 1994). Also, without the pressure of a younger
sibling gaining from behind, the youngest may grow up easy going and carefree
(Jabs, 1987). However, life isn't all fun and games for the family baby.
The endless praise of last born children may leave them feeling that their
families do not take them seriously (Marzollo, 1990). For instance, a common
youngest child remark would be, "If I get upset or try to state my opinion,
nobody takes me seriously. To them, I'm the baby. They think I don't know
a whole lot," (Lanning, 1991). Youngest children often have feelings of insecurity
or long periods of self-doubt (Lanning, 1991). For example, a youngest child
grows up being coddled one minute as a darling little baby, but the next minute
she's compared unfavorably with an older sibling. He or she is often unfairly
compared with older and stronger siblings.
According to Beverly Hills-based
psychiatrist Carole Lieberman, M.D., the self-image of the youngest child may
become confused (Lanning, 1991). As a result of conflicting experiences,
youngest children can be extremely self-confident in someways and insecure
in others (Leman, 1985). For the most part, youngest children learn to cope
with the problems of self-doubt. In fact, youngest children often go on to
become quite successful, thanks in part to their originality and determination
to prove themselves to the world (Lanning, 1991). Often, they express their
unique view of the world through the visual or literary arts. People-pleasing
fields, such as art, comedy, entertainment and sales are full of youngest children
(Lanning, 1991). Some examples of famous youngest children include Ronald
Reagan (president, actor), Eddie Murphy (comedian), Paul Newman (actor), Mary
Lou Retton (gymnast), Billy Crystal (comedian), Yogi Bera (baseball player),
Ted Kennedy (politician), and Kevin Leman (psychologist)

Bipolar Disorder

Bipolar Disorder
The phenomenon of bipolar affective disorder has been a mystery since
the 16th century. History has shown that this affliction can appear in
almost anyone. Even the great painter Vincent Van Gogh is believed to
have had bipolar disorder. It is clear that in our society many people
live with bipolar disorder; however, despite the abundance of people
suffering from the it, we are still waiting for definite explanations
for the causes and cure. The one fact of which we are painfully aware
is that bipolar disorder severely undermines its’ victims ability to
obtain and maintain social and occupational success. Because bipolar
disorder has such debilitating symptoms, it is imperative that we remain
vigilant in the quest for explanations of its causes and treatment.
Affective disorders are characterized by a smorgasbord of symptoms
that can be broken into manic and depressive episodes. The depressive
episodes are characterized by intense feelings of sadness and despair
that can become feelings of hopelessness and helplessness. Some of the
symptoms of a depressive episode include anhedonia, disturbances in
sleep and appetite, psycomoter retardation, loss of energy, feelings of
worthlessness, guilt, difficulty thinking, indecision, and recurrent
thoughts of death and suicide (Hollandsworth, Jr. 1990 ). The manic
episodes are characterized by elevated or irritable mood, increased
energy, decreased need for sleep, poor judgment and insight, and often
reckless or irresponsible behavior (Hollandsworth, Jr. 1990 ). Bipolar
affective disorder affects approximately one percent of the population
(approximately three million people) in the United States. It is
presented by both males and females. Bipolar disorder involves episodes
of mania and depression. These episodes may alternate with profound
depressions characterized by a pervasive sadness, almost inability to
move, hopelessness, and disturbances in appetite, sleep, in
concentrations and driving.
Bipolar disorder is diagnosed if an episode of mania occurs whether
depression has been diagnosed or not (Goodwin, Guze, 1989, p 11). Most
commonly, individuals with manic episodes experience a period of
depression. Symptoms include elated, expansive, or irritable mood,
hyperactivity, pressure of speech, flight of ideas, inflated self
esteem, decreased need for sleep, distractibility, and excessive
involvement in reckless activities (Hollandsworth, Jr. 1990 ). Rarest
symptoms were periods of loss of all interest and retardation or
agitation (Weisman, 1991).
As the National Depressive and Manic Depressive Association (MDMDA)
has demonstrated, bipolar disorder can create substantial developmental
delays, marital and family disruptions, occupational setbacks, and
financial disasters. This devastating disease causes disruptions of
families, loss of jobs and millions of dollars in cost to society. Many
times bipolar patients report that the depressions are longer and
increase in frequency as the individual ages. Many times bipolar states
and psychotic states are misdiagnosed as schizophrenia. Speech patterns
help distinguish between the two disorders (Lish, 1994).
The onset of Bipolar disorder usually occurs between the ages of 20
and 30 years of age, with a second peak in the mid-forties for women. A
typical bipolar patient may experience eight to ten episodes in their
lifetime. However, those who have rapid cycling may experience more
episodes of mania and depression that succeed each other without a
period of remission (DSM III-R).
The three stages of mania begin with hypomania, in which patients
report that they are energetic, extroverted and assertive (Hirschfeld,
1995). The hypomania state has led observers to feel that bipolar
patients are "addicted" to their mania. Hypomania progresses into mania
and the transition is marked by loss of judgment (Hirschfeld, 1995).
Often, euphoric grandiose characteristics are displayed, and paranoid or
irritable characteristics begin to manifest. The third stage of mania
is evident when the patient experiences delusions with often paranoid
themes. Speech is generally rapid and hyperactive behavior manifests
sometimes associated with violence (Hirschfeld, 1995).
When both manic and depressive symptoms occur at the same time it
is called a mixed episode. Those afflicted are a special risk because
there is a combination of hopelessness, agitation, and anxiety that
makes them feel like they "could jump out of their skin"(Hirschfeld,
1995). Up to 50% of all patients with mania have a mixture of depressed
moods. Patients report feeling dysphoric, depressed, and unhappy; yet,
they exhibit the energy associated with mania. Rapid cycling mania is
another presentation of bipolar disorder. Mania may be present with
four or more distinct episodes within a 12 month period. There is now
evidence to suggest that sometimes rapid cycling may be a transient
manifestation of the bipolar disorder. This form of the disease
exhibits more episodes of mania and depression than bipolar.
Lithium has been the primary treatment of bipolar disorder since
its introduction in the 1960's. It is main function is to stabilize the
cycling characteristic of bipolar disorder. In four controlled studies
by F. K. Goodwin and K. R. Jamison, the overall response rate for
bipolar subjects treated with Lithium was 78% (1990). Lithium is also
the primary drug used for long- term maintenance of bipolar disorder.
In a majority of bipolar patients, it lessens the duration, frequency,


and severity of the episodes of both mania and depression.
Unfortunately, as many as 40% of bipolar patients are either
unresponsive to lithium or can not tolerate the side effects. Some of
the side effects include thirst, weight gain, nausea, diarrhea, and
edema. Patients who are unresponsive to lithium treatment are often
those who experience dysphoric mania, mixed states, or rapid cycling
bipolar disorder.
One of the problems associated with lithium is the fact the
long-term lithium treatment has been associated with decreased thyroid
functioning in patients with bipolar disorder. Preliminary evidence
also suggest that hypothyroidism may actually lead to rapid-cycling
(Bauer et al., 1990). Another problem associated with the use of
lithium is experienced by pregnant women. Its use during pregnancy has
been associated with birth defects, particularly Ebstein's anomaly.
Based on current data, the risk of a child with Ebstein's anomaly being
born to a mother who took lithium during her first trimester of
pregnancy is approximately 1 in 8,000, or 2.5 times that of the general
population (Jacobson et al., 1992).
There are other effective treatments for bipolar disorder that are
used in cases where the patients cannot tolerate lithium or have been
unresponsive to it in the past. The American Psychiatric Association's
guidelines suggest the next line of treatment to be Anticonvulsant
drugs such as valproate and carbamazepine. These drugs are useful as
antimanic agents, especially in those patients with mixed states. Both
of these medications can be used in combination with lithium or in
combination with each other. Valproate is especially helpful for
patients who are lithium noncompliant, experience rapid-cycling, or have
comorbid alcohol or drug abuse.
Neuroleptics such as haloperidol or chlorpromazine have also been
used to help stabilize manic patients who are highly agitated or
psychotic. Use of these drugs is often necessary because the response
to them are rapid, but there are risks involved in their use. Because
of the often severe side effects, Benzodiazepines are often used in
their place. Benzodiazepines can achieve the same results as
Neuroleptics for most patients in terms of rapid control of agitation
and excitement, without the severe side effects.
Antidepressants such as the selective serotonin reuptake inhibitors
(SSRI’s) fluovamine and amitriptyline have also been used by some
doctors as treatment for bipolar disorder. A double-blind study by M.
Gasperini, F. Gatti, L. Bellini, R.Anniverno, and E. Smeraldi showed
that fluvoxamine and amitriptyline are highly effective treatments for
bipolar patients experiencing depressive episodes (1992). This study is
controversial however, because conflicting research shows that SSRI’s
and other antidepressants can actually precipitate manic episodes. Most
doctors can see the usefulness of antidepressants when used in
conjunction with mood stabilizing medications such as lithium.
In addition to the mentioned medical treatments of bipolar
disorder, there are several other options available to bipolar patients,
most of which are used in conjunction with medicine. One such treatment
is light therapy. One study compared the response to light therapy of
bipolar patients with that of unipolar patients. Patients were free of
psychotropic and hypnotic medications for at least one month before
treatment. Bipolar patients in this study showed an average of 90.3%
improvement in their depressive symptoms, with no incidence of mania or
hypomania. They all continued to use light therapy, and all showed a
sustained positive response at a three month follow-up (Hopkins and
Gelenberg, 1994). Another study involved a four week treatment of
bright morning light treatment for patients with seasonal affective
disorder and bipolar patients. This study found a statistically
significant decrement in depressive symptoms, with the maximum
antidepressant effect of light not being reached until week four (Baur,
Kurtz, Rubin, and Markus, 1994). Hypomanic symptoms were experienced by
36% of bipolar patients in this study. Predominant hypomanic symptoms
included racing thoughts, deceased sleep and irritability.
Surprisingly, one-third of controls also developed symptoms such as
those mentioned above. Regardless of the explanation of the emergence
of hypomanic symptoms in undiagnosed controls, it is evident from this
study that light treatment may be associated with the observed
symptoms. Based on the results, careful professional monitoring during
light treatment is necessary, even for those without a history of major
mood disorders.
Another popular treatment for bipolar disorder is
electro-convulsive shock therapy. ECT is the preferred treatment for
severely manic pregnant patients and patients who are homicidal,
psychotic, catatonic, medically compromised, or severely suicidal. In
one study, researchers found marked improvement in 78% of patients
treated with ECT, compared to 62% of patients treated only with lithium
and 37% of patients who received neither, ECT or lithium (Black et al.,
1987).
A final type of therapy that I found is outpatient group
psychotherapy. According to Dr. John Graves, spokesperson for The
National Depressive and Manic Depressive Association has called
attention to the value of support groups, and challenged mental health
professionals to take a more serious look at group therapy for the
bipolar population.
Research shows that group participation may help increase lithium
compliance, decrease denial regarding the illness, and increase
awareness of both external and internal stress factors leading to manic
and depressive episodes. Group therapy for patients with bipolar
disorders responds to the need for support and reinforcement of
medication management, and the need for education and support for the
interpersonal difficulties that arise during the course of the disorder.









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