07.25.09
Posted in Personality, Contributors, CBT, Stress, Anxiety, Depression, Uncategorized at 2:41 am by admin
THOUGHTS FROM AFAR
I know almost noting about he American health system. But I am an Israeli, UK educated physician working in management dealing with mental health care reform.
So here is my twopenneth of thoughts.
I do know that no one buys a pig in the poke. Today’s medicine is expensive, incoherent and economically unsound. These conditions make a ‘tax led’ expansion nigh on impossible.
I think that we should consider what can be done and how?
The driving force for change may be political. But change has to encompass both delivery and payment.
I will develop a theme that states basically that costs and delivery can and must be altered before payment can be tackled.
Payment is pivotal in the making of universality.
REFORM:
There is no such thing as reform in medicine. There are far too many vested interests, preconceived ideas and established practices.
To make life easy lets call the involved parties shareholders.
Shareholders must want change. The change has to be as a constructive evolution and not a threatening revolution.
There can only be small, graduated and, hopefully coordinated incremental changes.
All reform has to have both a strategy and tactics.
Each change must be seen as being beneficial to most and detrimental to none.
In other words every shareholder must see some befit before he will take some risk. The benefit must be tangible and the risk less than such. It cannot be the opposite.
DESIRES:
What do we want to do?
Most encouragingly all the shareholders agree about what they want and do not want.
They want comprehensive, coherent professional care.
They do not want to have their economic status threatened. The user does want affordable health care. The industry member wants to maintain their income level.
So far so good.
So let’s take the first step that is accepted by all.
Lets just save money.
FISCAL PRUUDENCE:
We’ll examine but two issues.
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Litigation:
The cost of insurance coverage is enormous.
We could offer an alternative coverage. The choice would be of the individual but the premium would be affected accordingly.
We would need to set up a State Quality Monitoring Board[SQMB]. The SQMB initially would have the following powers:
- Arbitrate in all litigation concerning mal-praxis.
- Set maximum sums to be paid according to misdemeanor.
- Set and monitor accepted practices in utilization of ancillary medical diagnostic services.
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Reduced expenses:
On signing to being in a program that is under the aegis’s of the SQMB the premium could be reduced if the patient also agrees to:
- Wherever possible, as the treatment of choice, use generic medications.
- That all laboratory services would be done in accordance with absolute, medical needs. Put bluntly, not because I may get sued or it would be nice to have the tests but because I need this test to do good medicine.
If we get this far, and we can, we will see savings.
So we can move to the next step.
EFFICIENCY:
Medicine is a system of services. More often than not the patient is not doing what he should. Quite often he is doing what he should not be doing, or could be doing it somewhere else cheaper.
As a rule of thumb the patient:
- Should know what he is to do.
- Be followed up to ensure that he is doing, as he should.
This means evolving a system of care that has a case manager.
This involves profound conceptually and structural changes in the delivery of medicine.
As the patient is liable to have many needs his medical needs are holistic and should be dealt with at the community or primary care level.
The care manager should know:
- What is needed?
- Where is it best done?
- Has it indeed been done?
This means several things:
- We resort to the idea of the centrality of the Family Doctor.
- A nurse does the case working.
- Case management is a ‘medically based decision’. It is not fiscal. It is an essential part of an efficient delivery.
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Cases are managed at the level of the family Doctor.
- Referrals and recommendations are from and to him alone.
- The ‘specialist’ is redesignated as a ‘consultant’.
For this stage to work effectively the Family Doctor Practice should be reasonably large so that it can negotiate with experts and providers in the field. THE FAMILY DOCTOR IS THE TEAM LEADER .
The enlarged family practice should subscribe to the SQMB.
The setting up of the family practices would be the corner stone of health reform
I would consider favorably:
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That subscription to a practice would be:
- Per annum at a fixed fee with a basic health basket [Number of visits, hospitalization days, lab costs] per family.
- FFS above the basic basket. This aspect would be monitored and authorized by the SQMB.
- That the SQMB would offer assistance in negotiating between the Family Practices and between both insurers and other health providers [hospitals, labs and etc.]
IN THE FULLNESS OF TIME THE ENLARGED FAMILY PRACTICE WOULD BECOME THE CORDINATING BODY IN CHARGE OF THE PATIENTS COMPRHENSIVE NEEDS.
In other words we now have three well-delineated bodies:
- The professional hub – based firmly on the Enlarged Family Practice
- The administrative hub- based firmly on the state based SQMB.
- Payments – Private and non-private insurers.
UNIVERSALITY:
Only when medicine has been rationalized can it become universal. We cannot expect the State to foot the bill when the medicine is neither rational nor cheap. Medicine has to become professionally and fiscally rational. Only then can further decisions be made.
This decision is UNVERSALITY OF SERVICE.
The decision is twofold:
- Political.
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Fiscal:
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What is the State paying for?
By my proposals the Sate would know what are the expenses involved.
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How does the State pay?
This decision is purely fiscal. Medicine, as such, has no part in this discussion.
-
How will the State know that I got what it paid for?
By setting up and developing the SQMB we have the basis for an answer.
Universality has a temporal dimension. The SQMB should also be placed in charge of evaluating, developing and training professional man power so that future needs will be met.
In summary:
I suggest series of changes none of which threaten any one. A clear distinction should be made between means of payment and means of service. Limiting expenses in medicines, procedures and insurance coverage should initially reduce costs. Service should be rationalized by developing in tandem the ‘Enlarged Family Practice’ and the ‘State Quality Monitoring Board’ [SQMB].
When costs and services have become coherent and rationalized the cost of universality of care and the political implications can begin.
Permalink
02.07.09
Posted in CBT, Personality, Stress, Depression, General, Anxiety, Uncategorized at 4:39 am by admin
ASHDOD UNDER FIRE:
In retrospect:
A child of the ‘60’s has a curse and blessing. We have musical ADHD. We think in terms of either song or film titles. Or at least that is my excuse.
Let me encompass my recollection my way. They are mine to encompass. They are personal. So, selfishly, I will present them to assuming that you too have my presentational preferences.
MOON RIVER: A song about a man and his river.
“Two drifters off to see the world. There is such a lot of world to see….
… But we are after the same, Rainbows end — it’s waiting round the bend —
Moon River and me”
Like a river we flow with our experiences.. Rocks like experiences become part of that river. We flow with it. Sometimes our river is placid. Sometimes it is a surging torrent casting all before it. Sometimes it breaks its banks. Experiences are forever entering the river. The river carries them along. Sometimes it does so with ease. Sometimes they cause eddies and turbulence. Sometimes the experience dams the stream. The dam causes flooding mud and devastation. Afterwards the stream is reduced in its vigour and richness.
But all in all the quality and richness of our river is the sum of our experiences and how we flow with them.
As we navigate the river of our life we are aware that we may hit a rock. That brings me to my next point of departure:
A ROSE BY ANY OTHER NAME: A Shakespearean quote used as a book and film title. It means so many things. But the bottom line concerns conceptualisation and reality.
At time of extreme stress we tend to a few things to cope.
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In acute danger we survive. We do so by either running, freezing so as to avoid attention or crying for help. They are highly efficient mechanism. We survived the jungle with these gambits. They do not need changing. They are certainly not a cause of remorse, shame or self-rebuke. When your life is at threat that is what you do. We secrete massive amounts of adrenalin. The adrenalin turns off everything that is superfluous. This includes thinking. At this moment we react. Adrenalin turns on everything that we need. I speeds our heart, it cools us with sweat, and it prepares our muscles to run. It causes us to cry, literally for help. Crying is a highly efficient way of gaining attention and help. Screaming is even more so. Most important it changes our sense of time. Past and future al virtually erased. The present is as if slowed down.
At that moment our stream has stopped.. This stage is called fear. It is a distinct, well-coordinated reaction to a highly defined cause. Our life is in real danger.
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Immediately after the danger there is a stage of recuperation. The danger has passed. The adrenalin is still highly active. Time is still slowed down. It is still hard to think in our usual logical way. We are still in a state of arousal. It takes adrenalin a good few hours to burn off. Afterwards there is a feeling similar to a hangover or ‘crash’. We feel tired and listless. We may feel sad. It is the adrenalin. That is all. Our appreciation of time is still not as it was. We can drift back to the event. But now it is a memory. We remember the event as a memory. The memory can be vivid. The memory of our pain and fear can be almost as if they were re-happening. But they are not. The sadness and pain diminish slowly but surely. We all remember when we lost someone dear. Maybe through death. Maybe someone you loved very much loved you less. But we have all experienced the first day. As if there will never be another day. But there is. This is a real pain. The sense of sadness and tiredness is real.
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The recuperation becomes in the days to come a memory. It is an unpleasant memory. You have learned the hard way that your experience could have ended your life. A lesson learned the very hard way. You will be reluctant to remember. But you will be equally reluctant to endanger yourself in ant similar way. This is how we have not only coped but learned how to avoid danger.
Now what has this to do with “A rose by any other name”? Because these stages are blandly called ‘anxiety’, ‘depression’ or ‘adjustment disorders’. They most certainly are not. They are normal healthy reactions.
So what is anxiety? Anxiety is the fear of something unknown. Now I will say something that may seem odd. Please be patient with me. It is not the event that is the fear but the inability to know the likelihood of it happening. Anxiety is not merely the fear of something unknown. Anxiety is caused by the inability ascertain the likelihood of the event happening.
Let me give you an example. We all know that we will die. We are anxious obout death only when we are not certain that it is not imminent. Generally but always the sufferer can point to the cause of his anxiety. When he cannot as he has so many the same principles applies. The anxiety is the inability to say what the likeliness is.
We not only flow with our river of experiences. We navigate our river too. In our river here are rocks. We know that. They are only important when we do not know at what depth they are. If they are near the surface then the navigator is alert. He is anxious. If the rocks are defined then he suffers from ‘specific anxiety’. If he feels that there are undefined rocks but he cannot ascertain if they are not immediately imminent then the navigator suffers from ‘General Anxiety’. The shallower the river, the more it is blocked ‘upstream’ the closer the rocks are to the surface.
So what is depression? Depression is a sense of loss accompanied by grief and often anger. After, any event for better or worse, the river of your experience continues to flow. If you have left something behind that you wanted with you, there is a sense of loss. Your river of life has lost its richness and quality. This is true depression.
So you see life’s quality is about the depth and quality of our own river of experiences. How we flow with them. How we deal with events is called coping. Coping is a mixture of ability, expectation and complexity of the problem.
At critical moments when a bomb falls we can do but a few important things.
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Expectation: By carefully explaining what is happening to the traumatized person one can efficiently and effectively change expectations. In the early stages[ hours to days] it is generally more than enough to simply explain to the person what is happening to him as it happens. In other words to minimize his criticism of himself. Avoid the ‘name of the rose’ mistakes. Avoid labeling.
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Strengthen and enrich his ‘river of experiences’. Help him identify with the events, to feel actively involved in a struggle that he identifies himself with. To use examples in his past where pain passed.
If you can get into his river, help him enable the flow to restart then you have helped. To survive remember to get out of his river and back into your own.
Permalink
06.20.08
Posted in Stress, Depression, General, Uncategorized at 1:52 am by admin
I was sat watching Rambo.
Now what the hell has Rambo got to do with you?
Because Rambo really happened. I want to tell as many people as I can about the ‘accidental’ Rambo I met.
I met Adi in October 1974. A tall almost emaciated Yeminite soldier. He was admitted into our Shell Shock Unit. He had been in a general Psychiatric hospital –where he had thrown the director into a decorative pool. To the directors credit he got out and threw Adi in the pool. Then he sent this misfit to our unit of complete misfits.
The shell Shock Unit.|
Adi was almost mute. All he would say was incomprehensible.
We could follow nothing.
So I gave him Pentothal. Until Adi we could always trace the cause of the trauma and recycle in a way that somehow made it ‘psyche-digestible’. But Adi just went berserk. In those awful long nights I was obsessed not by the mayhem that we were seeing. why was it not working? An injection then complete mayhem. Till then it had been the opposite.
I had to get Adi back…. and I could not.. Then one night I reasoned like this:-
Adi under Pentothal is virtually Psychotic. So why not give him an injection of antiPsychotic intra venously?
At midnight I phoned up my boss and asked permission. Tomorrow I would inject both Pentothal and an anti-Psychotic.
At eight in the morning we started. In went the Pentothal and we lost Adi again to his demons. In went the anti-Psychotc and Adi stated repeatedly : ‘Carol, how big he is. So small he is.’.That was it.
Nothing more. But something.
Like all successful Pentothals Adi woke up. But this time I was at a loss as to what had happened. I asked him what ” How big he was –How small he is.” meant? Who is Carol?
Adi simply looked amazed. “How do you know?” “Did I say that?” .
As in a very few other Pentothals we had gone to the wrong place in time. The ‘wrong trauma’.
With Ephraim we had blundered into Auschwitz.
With Mike, a hysterical blind victim we had found ourselves in a tank battle in 1971.
With Shalom we were in a Moroccan prison.
Adi had gone back to 1967— the six day war. …….
Adi had a son called Shai. Shai, his only son had died before the 6 day war started. In the 6 day war Adi was a non combatant. He was a driver of the Burial Corps. He was present when the Clergy tried to piece enough body parts to bury. Some times there was not enough. What there was they put in ammunition caskets and nailed that in the coffin and filled the rest was earth to make up the weight. Carol was Adi neighbour. There was barely enough of Carol, a very tall guy to put in the ammunition box. Adi sat by his neighbour, Carol’s, coffin all night. He asked Carol to look out for his dead son Shai when they met. He muttered to himself — well you know what….After all Carol was very tall and now there was not enough to fill the ammunition box.
Adi and all his unit had sworn to keep the secret of what happened when preparing the dead that week. The Chief Military Rabbi then asked them made them swear an oath never to tell. Honour the dead and their memory. But Adi had told. Under Pentothal. Six years had passed. Inadvertently he had told us. This in his eyes was unforgivable.
I want to jump forward a month.
We worked a lot in Adi and made real progress. The Chief Military Rabbi in the Yom Kippur War visited us. It was a warm spring afternoon. We sat on thee grass and the Rabbi answered questions.
Adi asked if what he had done was excusable? Adi was well known and respected. So there was a very heavy silence. The Rabbi turned to his two assistance.
“I now declare this a Rabbinical Court and we are now in session. Adi Chatuka cover your head.” The rabbi then placed his hand on on Adi’s head. ” This court absolves you from all your oaths that you took in 1967. This court absolves you from all guilt”
Adi said. ” Rabbi, these guys have fought hard for me , to help me, but no injection helped like this”.
We were all in tears.
But I have still to explain why Rambo?
What happened in 1973?
First a bit of history and a brief explanation.
The Egyptian were helped by the Sudanese commando brigade as they crossed the Canal. In accordance with Soviet doctrine they were doped to their eyeballs with Ritalin. The Sudanese were the bane of our soldiers existence . They were big, fearless with bulging ferocious eyes. They were unstoppable. Well almost unstoppable. Adi stopped one. But at what a price
Here’s how. ….
Adi was a tank driver. They were trying to stop the Egyptian advance. They were surrounded by Sudanese. The Sudanese were unstoppable. They were like a swarm of locusts. They were everywhere.
Adi’s tank commander was a greenhorn. This irritated Adi who felt he had a liability and responsibility. Adi wanted to get everyone home safely. He drove over Sudanese. He mowed them down. Adi was doing well. He was getting out of the mess. Then it went awfully wrong.
The tank commander was sat half out of the tank. A Sudani killed him. Adi went after the Sudani. Adi got out of the tank and fired a machine gun at the Sudani. The Sudani kept coming . Adi was screaming at him “Die — you are already dead.” More rounds and still the Sudani is running. So with one long burst Adi cut the Sudani into two. But still the legs of the Sudani kept running. Adi past out and was mute.
Months went by.The treatment was working.
Adi then did something that no other soldier of mine did. He went back into reserve duty. My mistake maybe but also fate played a hand.
Adi was posted to almost the exact spot where he had fought his Sudani. Then it was the demarcation line between the Israelis and Egyptians.
Adi dissociated. He saw the Sudani and Adi attacked. Adi was running , weaving and firing as he advance on the now docile Egyptians. There was only one way to stop him. We ran Adi over with a command car. In the turmoil Adi was shot in the leg.
There was an enquiry. There always is. This one was fair. The investigators told me that Adi was a few yards from starting the war all over again. There was grudging admiration for Adi’s soldiers craftmanship. My mistake was generously overlooked. The authorities let it pass.
I went to see Adi in hospital. The Orthopedic Surgeon asked me if this was another faked malingerers suicide. I told him that it was not.
No this was a real genuine fucking hero.
Adi almost started another war. But his own never ended. The Sudani never left him. He drifted. Adi was in and out of trouble. Often they wanted to put Adi in a closed ward. I stopped them. But it was getting harder. Adi’s wife and neighbours were all suffering outbursts and wild behaviour. Then one day the Police phoned. It was three in the morning. They were laughing at this lunatic that admitted to a murder.
“Did he murder someone?” I asked, a bit nervously. The reply was negative ” Only some Sudani” .Accompanied by more laughter. I said OK — tomorrow we’ll put him into the closed ward and I put the phone down.
Then it hit me. So I phoned back to the Police. ” Are you sure that he said a Sudani?”—” Yes very sure” was the answer.
At three thirty in the morning I got Adi out of the holding cells. ” You realise that the Sudani is dead — no more night mares”. I took him home. Nothing sensational. We were both very tired –of everything.
Things got reasonably manageable but never any where like normal. Adi made a living as a Taxi driver. Very rarely I saw him.
One day a journalist came to my clinic. She asked if what she had heard was true? —- A taxi driver had told her his story without identifying himself. He had picked her up as a fare by the clinic. How did she find me? Adi had said that whenever he felt bad he would drive by the clinic. He knew if things got really bad he always go in. That was enough for him.
Adi’ s wife died of cancer. So did Adi. They are all together with Shai, Carol and the two Rabbis.
Wars are fought and payed for by heroes. But heroes who did not ask to be heroes. Adi was an accidental hero and a great guy.
I don’t know what this did to you. If you think on Adi for a minute — that is good.
I sent this to people I know well, people I don’t know well, people that will understand and people that will not. If anyone is offended — well I am sorry.
I simply wanted to share and honour Adi. I hope that you do too.
Permalink
08.10.07
Posted in CBT, Stress at 6:21 am by admin
I was playing with Harry. He is my five month old grandson. We were playing ‘ Peepo’.
Peepo is a game where I repeatedly move my head and say ‘peepo’.
At first Harry was baffled.
I moved my head behind and in front of the pram. It took him a few turns to start anticipating where I was going to be.
He got it right and was extremely proud of himself.
So we made the game more complex.
I added the right and left positions as added possibilities.
Harry got those under his belt even faster.
Now what had happened?
Let me make small detour. I’ll tell you when we get back to the point.
I met a very clever guy a few days a go. He described clearly what had being creeping in the shadows of my mind for a long time.
Very simply he said that thinking was a Darwin evolutionary like process.
He meant that the brain produces a lot of thoughts. They are in ‘competition’.
The best thought wins. The best thought is maintained till a new one comes along and beats it.
But how is this done?
He spoke and I pictured a picture. Here is my picture.
Picture the brain as a dynamic tree. Picture an ever growing tree.
Imagine this tree growing filmed in a delayed frame film.
You can see the tree growing can’t you?
Look at just one of the twigs. A bud develops. A series of buds develop. But one becomes stronger and healthier. It grows faster. It becomes a twig. New buds may grow from it. It may become a branch itself. From it develop myriads of new buds. New twigs are formed and so on.
But how is the bud chosen? Which bud wins? How is the twig developed? When does a twig become a branch?
In other words ‘OK I accept competition’ but what are the rewards? Survival of the fittest thought is acceptable. But what is the fittest thought?
Why we are thinking at all?
Thinking is more or less predicting. Some may say that we are predicting what will give pleasure and what will cause pain.
It is our way of seeing into the future.
In Harry’s case he was predicting where I might be.
If buds have no predictive power they are low in the evolutionary order. The higher or more relevant the predictions are the more likely is a twig or branch likely to occur.
Let’s go back to Harry.
Harry did two things. And he got two things. More precisely he got the same thing twice. Harry got to predict where I was. He was happy that he had found me. He was happy that he had got it right. I then moved my head to new places. Then Harry used his experience at predicting when faced with a new situation. He got that right faster than previously. So he was again pleased twice. He was pleased that it was me. He was pleased that he had worked it out.
Harry built a bud. Then he built a twig. Then a new twig branching off from the one he had just built. Harry’s twigs have two elements. The elements are deduction and pleasure. It may have been deduction and avoiding fear.
So far so good.
But I am a Psychiatrist. Unfortunately I look at the process to see where it can and does go wrong. We all know that it does go wrong.
Often we develop buds that are simply on the wrong twig. Twigs are convenient. They give us a quick start. Look how they helped Harry. They make us more efficient. We tackle things almost in ‘automatic pilot’. But we do not always have the ability to see if the bud is on the right twig. Often it is an inappropriate place. It might even be on the wrong branch. But we are not aware.
We are doing ‘as if’. But in reality it is ‘as if something else’. This leads to frustration. This new unexpected experience ‘grows buds’ of its own.
Relocation of twigs and branches is really called Psychotherapy. The original Psychotherapies discovered why and how the twig and branch got to their present position.
Latter day Psychotherapy is based on how to discover where the twig is and relocate buds in a more appropriate place. This is one explanation of CBT [Cognitive Behavioural Therapy]
Computerised CBT enables you to discover traits as you are presented with repeated similar ‘inappropriate placements’.
You can learn more about the theory of theories by reading Piaget. Winnicott is an excellent reference for the role of parenting. This link will explain how CCBT works.
If you want to learn more about Harry, simply drop me a line.
Dr. Michael Benjamin
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07.21.07
Posted in Personality, CBT, Stress, Depression, Anxiety at 2:19 am by admin
Cope better.
But how can you?
Make your coping styles more effective.
But how?
The answer is free Online Self-Help CBT.
Let me explain why. My name is Dr. Michael Benjamin. For 38 years I have studied how people cope. As a Psychiatrist I learned how central coping styles are. Let me share what I have learned:
Coping styles are a mixture of experience and personality. By personality I mean the way that we think, feel and behave in given situations.
Are you getting a little edgy? How do I change my personality? Don’t worry you will not.
There is a dyad that we all accept as true. Feelings and thoughts, they interact and effect each other. Feelings and thoughts are the reaction to an event. Very often we have thoughts or basic assumptions which are completely wrong. The assumptions are unchallenged. They generate feelings. These feelings generate thoughts. Vicious circles are in the offing. A reaction to an event becomes prolonged. The reaction outlasts the event. The thought feeling dyad has led you into a mood. The mood makes it harder for you to cope.
Some people are very bad with their basic assumptions. They exaggerate. But by their very nature basic assumptions are unchallenged.
Cognitive Behavioural Therapy [CBT] is the way to challenge and change theses assumptions. Online Self-Help CBT is a very effective, easy tool to use. Almost immediately you feel a sense of mastery. You start to cope better. You will rapidly observe traits. Similar, wrong assumptions crop up regularly. You change them individually. Then you will soon see and change traits.
Maybe you wish to exchange experiences. A burden shared is a burden lessened. Online Self-Help CBT allows you to participate on a e-Group designed to do just that.
Dr. Michael Benjamin.
Psychiatrist
myRay: http://www.myRay.com Free Online Self-Help CBT
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07.20.07
Posted in CBT, Stress, Depression, Anxiety at 8:31 am by admin
We know that thoughts and feelings interact. But how do they do so? Why is it important that we know?
We are thinking all the time in two ways. The first is the obvious one. It is the headlight attention thought. It focuses on the subject that we are paying attention to.
But we are always aware of our surroundings. We have a sort of scan or radar scanning what is going on. It may be something in our vicinity. But it may be a relevant subject. Say we are nearing an exam.
This scanning process defines the importance of the subject that it is scanning. It has three levels of grading. The first is to tell us that the subject is of no significance. It is virtually telling the headlight attention ‘there is no need to refocus.’
The next level is ‘Well I am not too sure ‘. ‘You can stay focused but I am putting you on standby’. This is object or event is labeled. But how is this done? By marking it with an emotion. So we have one subject in our ‘headlight’ but a feeling can occur. We are unaware of why we are feeling it. Obviously the event in the ‘headlight’ too can evoke an emotion. The event in the ‘headlight’ can evoke subjects associated with it to appear in the ‘scan’.
We are subject to a range of emotions. Many of which we are completely unaware of the source.
Now some people do this labeling process badly. They tend to over emphasize the possibility of something happening. Events are given emotions where they need not be.
We know this person. He is the worrier, the over conscientious, ever ready guy we all know. He is permanently tense. Happiness for him is not being unhappy. Relaxation is the absence of tension. Eventually he may well develop depression or anxiety.
Now we know the problem can we find a solution?
CBT – Cognitive Behavioural Therapy – is that solution. CBT allows us to examine easily the thoughts that were previously ‘hidden’. On doing so they are automatically corrected. More so we can see that very often the same thought and emotion occur. People can rapidly discover traits. They can readily correct theses traits.
Online Self-Help was designed to specifically help correct erroneous traits.
Dr Michael Benjamin
Psychiatrist
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07.14.07
Posted in CBT, Stress at 3:34 am by admin
You want to loose weight.
You feel that handling stress will help.
You are correct.
You can do this simply and effectively. Use myRay the Online Self-Help site http://www.myRay.com.
Within no time you will gain a sense of mastery and control.
At this point you must be wondering who is this guy?
My Name is Dr. Michael Benjamin. I am a Psychiatrist. I have learned that coping style is a mixture of of personality and experience.
I know that we can easily change coping styles.
We do this by the changing the relationship between your thoughts and feelings.
You can discover why this important. But mostly you will want to utilise the fact.I have designed free online site to do this.
The site myRay, http://www.myRay.com will help you improve your coping styles
You can readily regain a sense of mastery bu using http://www.myRay.com
You can readily improve your quality of life by using http://www.myRay.com
myRay http://www.myRay.com is a free Online CBT site.
Use http://myRay.com as often as you wish.
With kindest regards.
Dr. Michael Benjamin
Psychiatrist
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Posted in CBT, Stress, Depression, Anxiety at 3:02 am by admin
I learn from my patients. As we push the myRay, the online CBT site to its maiden voyage I have gained two valuable insights from them.
As good as any explanation can be it must be plausible. It has to be very firmly supported by the trusted Family Doctor. I will deal with the second point in a later blog.
I have described the relationship between Appraisal of an event, (Automatic Thinking), Feelings & Mood. I explained the interaction between Mood, Personality & Automatic Thinking. On using this information we can easily, rapidly and efficiently choose the correct therapeutic intervention.
The concept Automatic Thinking needs clarifying. We notice every event that occurs. The “noticed event “ is categorized according to its importance and significance. We react emotionally to the results of this categorization.
Very often we are completely unaware of this process. This process allows us to both react appropriately and yet not be easily distracted.
We often are only aware that we have a feeling but not why.
This categorization process is profoundly influenced by Mood & Personality.
What does this mean? It means that what emotions are not irrational. They are formed and driven by a “submerged “ thought process.
But what if the categorization process is incorrect? We can feel erroneous feelings and react to them without really knowing why. Even worse these feelings will eventually and persistently fuel our mood. In turn mood modifies the categorization process. We can get into a vicious erroneous cycle without knowing why or how to correct it. To compound the problem we are not aware of the error. We act as if the information we are being fed is always correct.
The pure simplicity and beauty of CBT is its ability to examine and find a fast remedy for this process. CBT enables us to raise the process above the water line. It makes it observable. We can review it systematically. Correction then becomes easy.
The free online CBT site myRay offers an added value. By using web technology we can rapidly observe and correct trends. Why is this extremely important? Personality and mood influence the process. One definition of personality is the collection of trends in the way a person acts feels and thinks. Need I say more?
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07.13.07
Posted in CBT, Stress, Depression, Anxiety at 3:26 am by admin
I have spent my 38 years in Psychiatry trying to organize terms that seem obvious. Unfortunately they are not.
There is an ABC of Psychology and Psychiatry. The A is affect or the way that we feel. B is behaviour. C is cognition, the way that we think.
The way that they think and feel determines the way we will behave. The way that we think, feel and behave is called our coping style. Our coping style is an admixture of our personality and life experience.
Let’s discuss thoughts and feelings. Thoughts and feelings are the reaction to an event. The dyad should be limited in time. If the dyad continues after the event has ceased to exist it is now called a mood.
It is common knowledge that thoughts and feeling interact. Nice feelings good thoughts. Bad feelings bad thoughts. We can see the possibility of a vicious circle. In fact this will help us define depression. The circle may become so tight that we do not respond as before to any situation. Our mood has worsened. We are now depressed, anxious or in stress.
Let us make one final distinction. Are we talking about poor quality life? Is there a limitation in functioning? This is important. If we are merely discussing you should be offered Cognitive Behavioural Therapy (CBT). In my effort to make CBT readily available I built the free Online Sef-Help CBT site myRay [http://www/myRay.com] to do just that this.
Is there a limitation of functioning? Are you no longer behaving as before? If so then you should be offered medications.
In my next article I will explain how feelings and thoughts interact. This explanation explains why and how CBT works.
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07.08.07
Posted in Personality, CBT, Stress at 11:00 pm by admin
Real leadership is about the ability to lead.
You need to know where you want to go and make sure that you are being followed.
One important parameter is forgotten. A leader has to be aware of his team’s ability to follow.Can all your team members do this? Can they follow you?
Leadership is not only about your ability to lead.
It is also about your ability to identify those who can follow.
More importantly to identify those who cannot.
Can all his members cope? Can they function under pressure?
20% of the population is going to develop anxiety or depressive states. This does not happen overnight. Members of this population exhibit ‘poor coping styles’. They are driven, rigid and not happy. They may seem to be conscientious and even an asset. But if you could do something, don’t you think that you should?
What can you do?
I have built a free, non-commercial Online Self-Help site. myRay [http://www.myRay.com] is easy effective and improves quality of life and coping styles. myRay [http://www.myRay.com] is designed for people who are prone to depression and anxiety and yet are still functioning relatively well.
myRay [http://www.myRay.com ]
can be recommended with discretion and without fear of insulting anyone.
I hope that this is food for thought.
I want to stress that myRay [http://www.myRay.com ]
is free. The user is free to use it as often and for as long as he wishes.
With kindest regards
Dr. Michael Benjamin
Psychiatrist
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06.23.07
Posted in CBT, Stress, Depression, Anxiety at 2:25 am by admin
myRay is a modern development of a proven form of psychological treatment called Cognitive Behavioral Therapy (CBT). CBT has been widely used by psychologists and psychiatrists for many years and has been shown to be particularly helpful in the treatment of anxiety, depression, panic, stress and anger.
Traditionally, CBT has been given on a “one to one” basis between the therapist and the patient but, with the advent of the widespread use of computers, it has been possible for the patient to use a computer program to learn and practice the required techniques.
myRay uniquely takes this one step further and uses an Internet-based suite of modules that teach relaxation techniques, time management and stress reduction.
It invests heavily in teaching the patient the principles and techniques of CBT in an interactive environment. myRay has extended CBT; the program not only deals with the ways in which we appreciate an event, but also the ways in which we tend to behave and experience it too. Its main advantage is that the program monitors your responses and gives you feedback on your progress and responses.As long as you have Internet access you can use the program in any location at any time, to suit your needs and schedule.
The program contains: a glossary of terms, explanation of concepts, video tutorials, feedback scores and charts, breathing and relaxation exercises, instruction in time management and the opportunity to join a confidential e-Group where you can share your experiences and advice with other users. The e-Group, in particular, is a very exciting concept in up to date, Internet-based group therapy.
The key concept of the program is based on your working with real personal experiences to understand how you have traditionally reacted to them, how to modify your reactions, using the techniques learned in the program, so that you will become less troubled, anxious, stressed and depressed about challenging experiences in the future.
myRay has been devised by a Consultant Psychiatrist with over thirty years experience in clinical practice and a team of information technology experts. It has been thoroughly tested. The basic concept has been evaluated and published in internationally renowned professional journals where it has been shown to be very effective.
Enrolment is easy; simply take our 28 question assessment test. If your results indicate that you could benefit, then you will be offered the chance to subscribe
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