Sunday, February 24, 2008

Aggression, continued

I've been thinking more about aggression lately as you may have noticed from the previous blog. For the last several months, I've been facilitating Aggression Control therapeutic groups at the prisons. The curriculum I was given to work with was bare bones at best and while it all makes sense on paper, explaining these concepts to these guys is a real challenge. I add my own material and make it as alive and relevant as possible. Can you imagine walking into a room of about 8 to 10 violent offenders and telling them they have choices? My first group rule is ALWAYS that the therapist (me) stays safe. Then they have to promise not to hurt each other.

I would say that most people I know, in the Free World, are not aggressive types. Yes, they may become verbally aggressive at times but how many of you get in fist fights on a regular basis? But take the population with which I work. Some of these guys were born into aggressive households, been physically (and otherwise abused), been removed and placed into foster care and then continued to be abused or fight back until they were placed in TYC. That's when they really learned to fight just to stay alive.

There is one inmate who had a background similar to this and then killed a man while under the influence of narcotics. He has no recollection of the murder. He was sentenced to 35 years in prison. He was 17 at the time. When he entered TDCJ, at 17, someone tried to rape him. He knew that if he allowed himself to be raped by this one person, he would be the target of many more assaults. So he killed that person, too. And he got more years added on to his sentence. But he was not the victim of any further attempts at sexual assault. When I met this man, who is now in his early 30s about a year ago, he was handcuffed and shackled, being dragged into a solitary cell and about to be gassed for becoming violent with security guard. I've worked with him for about a year now, both individually and in group therapy. I've witnessed the bravado, the fears, and the vulnerability of a man who was never allowed to be a boy. He has come such a long way, he now uses humor instead of threats of aggression. He's learned that not everyone is a physical threat to him. But make no mistake, in prison, these guys never know when the next attack is coming. He "graduated" from group therapy a few weeks ago and credited me with the changes he's made. And when I reminded him that he is the one who did the work, I think he really believed it. But despite all the work he's done, despite the changes in behavior and attitude, this young man will probably still spend at least 15 more years in prison. Think of all he will have missed. High school, dating, the first job, marriage, children, a home of his own, friendships and relationships. He doesn't engage in self-pity and I, for the most part, don't pity him either. But I have to wonder, what are we doing here?

We allow children to be brought up in aggressive homes, they watch aggressive television and movies, play bloody video games, and then when they act aggressively we punish them by putting them into prisons where they must use aggression to stay alive or at least stay unmolested.

Well, I do my little part. I teach the principles of assertiveness rather than aggression. I teach long-term consequences and payoffs. We do role plays and analyze previous situations they've encountered. I tell them the only appropriate time to use aggression is when either they or someone they care about is being threatened. That part they get. I'm not teaching pacifism here.

Sometimes it irritates me when I hear people talking about the inmates as an us/them situation. As if only monsters would behave aggressively; surely civilized people would never do these things. Now don't get me wrong, I always teach choice. Sometimes our choices are rather limited but we do have them. And even being brought up in a terrible home and foster care and everything else does NOT give anyone an excuse to be violent toward another person. And there are plenty of inmates in prison who did have good homes and all advantages and still made terrible choices. I'm just saying, can't we look at these problems as affecting all of us? An aggressive society costs us so much in terms of money spent housing inmates, the legal processes, thefts, injuries to victims, and so on. And it continues to cost one young man who has been in prison for 17 years and has no chance of leaving anytime in the near future.

What are you doing to create a more peaceful world?

Thursday, February 21, 2008

Aggression, Violence & War

I was checking out something on the APA website yesterday and came across an archived statement that was of interest to me. I'm sharing in case anyone else finds it thought-provoking.

First of all, this APA is the American Psychiatric Association and when I read this "Position Statement" I thought it had just been posted. Everything seem so relevant to today's international environment. It wasn't until I was about halfway through that I thought to look at the date - it was written/approved on June 23, 1948. I'll just recreate an excerpt here but I encourage you to check out the entire statement on the website.

"The American Psychiatric Association is seriously concerned about the unusual psychological features which are part of the present international tensions. It believes it has a duty to offer a statement on these matters for the attention of national leaders in all countries and for the general public, whose health and welfare are intimately related to international tensions.

The American Psychiatric Association makes this statement because psychiatrists are expected to understand the psychological causes of difficult and faulty interpersonal relationships, and should be able to offer some advice on their improvement. Such knowledge and advice should be applicable whether the adjustment difficulties are between individuals or groups of individuals, even national groups of individuals.

Basically, antagonisms are due to the activity of the self-preservative tendencies and their accompanyng emotions of fear or greed. The original biologic value of such reactions was to insure progress and development and increasing superiority of the species. The utilization of this primitive behavior, harsh and cruel as it may have appeared to the weaker strains, has led to the evolution of Man.

But if Man is to survive and develop to still higher levels of intellectual and social achievement, should he not now utilize friendly cooperation rather than aggressive antagonisms?

This question is directed to all national leaders because they so largely guide the feeling, thinking and bevahior of the gneral public in their respective nations.

Those who have had the opporutnity of observing the general public in countries other than their own, realize there are only minor differences between the citizens of various countries. The friendly kindness of the common people, their willingness to work for the common good, their love of their children and their homes, their diligence and their self-sacrifice - these virtues and values are shared by nearly all people in all civilizied countries.

But if the common man begins to fear he may lose these necessary values to the good life, either by actual or threatened aggression from without, or by unfair propaganda from within by unprincipled leaders, the masses of the people may easily be induced to take a position of antagonism. They may develop anxiety and fears to and even incorrect beliefs about the common peple in other countries. To overcome these fears, to overcome this sense of insecurity, actual warfare may confidence between leaders of the people in all countries, combined with mutual honesty, mutual forbearance, mutual support - positive healthful attitudes, conveyed from the leaders to their followers - should lead to a higher, better and healthier civilization than any we have known in the past."

Kinda makes you wonder, doesn't it, what the authors of that statement, written 60 years ago, would think of how much "higher" our civilization has evolved.

Tuesday, February 19, 2008

A long night's journey

Baby Luke has been having some health problems. I would say mysterious because no one seems to know exactly what it is but I think that word connotes something pleasant -- and this is not. Can we just say the scary unknown? It started a month ago with him waking in the night, arching his back, and screaming bloody murder. I called the 24-hour UTMB nursing number and waited for a call back. By the time it came, he was calmer and even smiling. So I just considered the episode a fluke.

Forward to a few weeks ago when it happened again. The screaming lasts anywhere from 20 to 40 minutes. Nothing I do helps. I've had suggestions to use massage, foot reflexology, warm baths, you name it. Nothing helps him. All I can do is keep him from hurting himself while he thrashes about.

We went to see his pediatrician but had to see another doc in the practice. She suggested cutting out all dairy in case it was an allergy. So we did. Do you have any idea how difficult it can be to teach daycare workers that dairy can take many forms? "All we gave him was the cheese goldfish. No dairy, see?" Then, even off the dairy and on soymilk, he continues to have the episodes. This doc also said he may be having night terrors. But I look that up in my little ole' DSM-IV to find that he does not meet the criteria for that. It happens in REM sleep, lasts more than the 10 minutes, and he is responsive to stimuli.

Back to the doctor (his, this time). I'm told he may be having Reflux again. Or it could be Intermittent Intususseption (spelling?). If it's reflux, these handy dandy prevacid tablets will work. If not, and it's the long thing, he may need surgery to correct his intestines "telescoping" into one another. If it's not corrected in time, he could lose part of his intestines or get an infection and die. I was voting for the reflux here. So onto the prevacid last Friday. And lo and behold, no painful episodes for Friday, Saturday, or Sunday. I even call his doc and leave a message that the prevacid did the trick!

About 2 hours later, after the doc has closed, we have another episode while he's playing. He suddenly falls to the floor, screaming, tears running down his face, and he's arching his back so far I'm worried about an injury. I decide to take him to the hospital. We go to one of the nearby hospitals and find it is full to the brim with folks. Do you know people actually bring in take-out and have like picnics in there? Yuk! After an hour, with no triage, I asked how much longer. Luke was feeling fine then and hard to keep away from the weird chicken eating people. The receptionist/nurse asked, "what was he here for again?" So I left. I figured I'd be better off at home and how likely was it that he'd have another episode before Tuesday?

Right. I had just put him to bed and took some meds myself. I've been sick all weekend and running about 102 fever. I'm just about to lay down when it starts again. Since someone had suggested I actually film what he looks like doing this, I did. I could not stand seeing him crying and watching me filming him. What a terrible idea. So we jump into clothes and back to a hospital but not the same one. This time I take him to the other local hospital. A better one. You may ask why I didn't take him there to begin with. But then you may not know that my daughter died in that hospital. So I took him there and just did what I had to do. We were triaged in pretty good time there. I think we arrived about 10:30, were triaged by 11:15 and then...well then we waited. We were taken back into the exam room at 2:00 a.m. He had an X-Ray of his tummy. We waited. At about 4:00 a.m., after another episode of pain, we were finally seen. It may have helped our case that I carried his screaming body into the nurses' station asking how much longer. The doc says there is some obstruction and he thinks there may be constipation in spite of the several diarrhea diapers he's had over the past two days. Something about having both? So we got an Rx for pain meds and suppositories. He also said that since their hospital is not really equipped for pediatrics, we'd be better off going into UTMB if we need more tests. And that's what I had been thinking. He also said that UTMB radiologists literally wrote the textbook that pediatric radiologists all over the country use.

So I guess that may be our next step. I have to call the pediatrician and get further instructions.

I kept telling myself last night that since one of my children has died, surely I wouldn't lose another one. And if I were at the same hospital, wouldn't that remind the cosmic forces or something? Except I really don't believe it works like that. All I know is that I have to take the best care of this little guy that I can. Enjoy every minute of his life I get to spend with him. And pray for the best.

Sunday, February 10, 2008

I'm back

I noticed when I logged on that it's been almost a year since my last post. Unbelievable. Of course, the last year has been unbelievable in many ways. My friend Candice is fond of lists so perhaps that's how I can summarize and get back in the stream.

First, the Bad Stuff...

1. Losing Rachel - my lovely daughter died suddenly 5 months ago. My world ended and like so many others who have survived the death of a loved one, it was unbelievable that the world continued to exist. Other people laughed. I was expected to eat, sleep, work, and care for the little ones. I miss Rachel more than words can express. Nothing more on that now. Maybe later. Maybe never.

2. My work life was almost unbearable there for a while. Not the work itself but the supervisor I was dealing with. I had to file a formal complaint and go through all of that process. He has apologized now and there's some comfort in that. Still. He made my life (more) miserable.

3. My health. My back is deteriorating but the pain gets stronger. Weird, huh?

4. I had to put my dog, Chance, to sleep last May. I had him for about 12 years and so of course, I still miss him. I guess I always will.

5. Luke had health problems. He was sick almost all the time. Taking off work, doctor visits, trying everything to get him better. Found out he had allergies so I guess we can put this into the good list -- he's been much healthier since he's been on the Claritin and inhaled steroids.

6. Since the last posting, my other daughter has got clean, relapsed, and then got clean again. Attempted suicide. She's alive and getting healthy. Again, with moving to the good list stuff. That or I'm just an eternal optimist.

Let's go on the good stuff.

1. I moved into an apartment that I love in Friendswood.

2. I still love my work. Yes, I'm still at the prison. I'm facilitating several group therapy topics. Great to see a few folks actually learn stuff.

3. Luke is developing so well. I had concerns about him and know he's not out of the woods yet. There are still some things he has trouble with but overall, he's a dynamite kid!

4. I'm getting to adopt Luke!

5. I get to have my two "big kid" grandchildren almost every weekend.

6. I haven't had to use my cane in months!

7. I have good work friends.

8. I still have good friends from other areas in my life. This is a big GOOD one.

9. I'm taking the exam for my LPC soon.

10. The sun is shining today. We're going out to play now.

So, if anyone still checks in here or will again, just know that I appreciate all of you. Writing about anything was tough for a while. But I'm getting stronger and healing. Okay, wait a minute. What does healing mean? Not hurting so much? Not hurting so often? Finding happy moments again? Yes, maybe that's it. In that case, I'm on my way. I still miss you, though honey. Always will. Until I see you again. I'll always be your mom. Unless, of course, you want to be the mom next time around. Whatever.