FOR SOCIAL WORKERS, TEACHERS, EMPLOYERS AND MEMBERS OF THE HELPING PROFESSIONS: HELPING THE DRUG-USING ADDICT OR THE DRINKING ALCOHOLIC-TREATING UNDERLYING PSYCHOLOGICAL PROBLEMS
COMING OFF DRUGS: FOR SOCIAL WORKERS, TEACHERS, EMPLOYERS AND MEMBERS OF THE HELPING PROFESSIONS-HELPING THE DRUG-USING ADDICT OR THE DRINKING ALCOHOLIC
GENERAL BEHAVIOURAL PROBLEMS: FEARS AND PHOBIAS
All children go through phases where they have fears. This is a perfectly normal part of development. Fears and phobias are most common during the toddler and preschool years, and are usually transient. As the child becomes older the fears become more realistic and appropriate.
Fears and phobias seem to peak at about 3 years of age. Children of this age may exhibit fears about a whole range of things. The most common are fear of the dark, of insects, of monsters, animals and so on. As a child’s cognitive ability and imagination expand, so do his fears, so older children may be afraid of ghosts, or of going to sleep in case they do not wake up.
Sometimes fears and phobias may be grounded in an actual situation. For example, the child may have been frightened by a dog, or a friend or relative may have been sick or died, or a television program or movie may cause ongoing anxieties in the child who is unable to differentiate reality from fantasy.
Occasionally a child’s fears may be evidence of deeper underlying fears and anxieties, or of emotional problems that need specific attention, especially where the fears are significantly interfering with the child’s everyday life. These children represent a small minority, and it is important for parents not to overreact.
In most children, these fears and phobias are transient, disappearing as the child gets older or else becoming relatively trivial so as not to interfere with the child’s activities. For example, many adults have phobias such as a morbid fear of spiders or snakes.
You can reduce the impact of these fears by recognising that they are a normal part of development, by not overreacting, and by handling them in a sensitive and reassuring manner. A night light is often helpful for children who are afraid of the dark. Allowing the child to play with a young puppy or with a friendly and gentle older dog may reduce his fear of dogs. Reassurance about the child’s safety is always important. Avoid ridiculing or dismissing the child’s fears, which are very real. In reassuring him, be careful that you do not unwittingly reinforce the child’s fears: for example, by agreeing that the dog is aggressive and scary. There is a fine line between making the child feel better and making the fears even more real in his mind.
It is rarely necessary to seek medical advice for the normal fears and phobias of childhood, unless they are having a negative impact on other aspects of the child’s aay to uay lire, or unless it is reit mat tney are manitestations ot deeper psychological problems.
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ANXIETY DISORDERS/WORKING THROUGH THE RECOVERY: MAKING DECISIONS
There are certain situations where we may be under stress, but feel we cannot do anything about them. We can spend days and nights worrying. As hard as the situation may be, we need to understand how it is affecting us. If we have done everything we can do and the situation remains unchanged, we need to let go of the worry. Sometimes these situations may revolve around other family members or friends and may be extremely serious. It comes back to making a decision to let go of the worry. We are only losing valuable energy worrying or trying to change a situation we can’t.
Sometimes there are very difficult decisions to be made. Once we make a decision we need to let it rest. Many people use their energy continually reviewing the decision. It doesn’t matter whether our decision is ultimately right or wrong. Worrying about a decision is putting our recovery on hold. Our recovery must be our number one priority.
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ÑHILDREN’S SLEEP PROBLEMS/BUILDING THE BASICS: EXERCISE FOR DETERMINING YOUR CHILD’S SLEEP ASSOCIATIONS
Describe your usual bedtime routine:
What events precede bedtime? (Examples: give bath, put on pajamas, quiet play, put baby into bed, sing lullaby, turn down lights, say goodnight, leave the room.)
Describe the sleep environment. (Examples: lights low, child in own bed, stuffed bear, blanket in bed.)
Who takes the active parts? (Examples: Dad does quiet play, Mom puts child in bed.)
Describe your middle of the night response:
What happens when the child wakes up? (Examples: he cries, he comes to our room.)
What is the child needing from you? What do you do in response? (Examples: feed him, give her the pacifier, scold her, etc.)
Who takes the active parts? (Examples: Dad calls back to her, Mom nurses, etc.)
Assess your child’s sleep associations:
From your answers above, summarize the set of circumstances that your child seems to need and expect to get to sleep -the things that signal to her that all is okay and it’s time to go to sleep.
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COUCH – MEDICINES
There are medicines to help dry up phlegm. They can have the disadvantage of making it stickier so that it is harder to cough it up. They will also give you a dry mouth and nose. Chemical names of some of these are pseudoephedrine HC1, phenylephrine HC1, atropine sulphate and hyoscine hydrobromide. The first two make some people feel unpleasantly agitated and restless, so ask what is in your cough medicine and whether you can have a different one if you have this symptom.
If your cough is dry, it is safe to take medicines to try to stop it. Chemical names of some are pholcodine, hydrocodone tartrate, codeine phosphate, dextromethorphan hydrobromide and nor-methodone. These are closely related to painkillers, in fact some of them are quite good painkillers as well. They can cause similar side effects, especially constipation, nausea, and drowsiness. For the first of these it is best to take preventive steps as described on pages 130-31. The other two tend to wear off, so persevere for a few days before deciding that these medicines don’t suit you.
Quite a lot of cough mixtures contain antihistamines, which are not of much help for cough from any of the causes listed above. Antihistamines may make you either drowsy or overactive and restless. Ask whether one is in your cough medicine if you get these symptoms, and if so, ask to have a different cough mixture that does not contain an antihistamine.
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HEADACHE — TENSION – CONCLUSION
Those who habitually clench their teeth during the night may awake with severe facial pain. Tension headaches may occur in those who also suffer migraine and sometimes it is difficult to tell them apart.
During situations of stress the sufferer may have recurrent migraine interspersed with tension headache. In treating this common disorder it is important to try to teach the patient to relax.
A variety of eastern and western relaxation methods can be learned. Physical activity can provide an outlet for inner aggression and help relaxation and reduce the frequency of headaches.
The pain of a tension headache will usually respond to simple analgesics. Stronger pain-relieving drugs may be necessary.
Diazepam, a commonly used tranquilliser, has the advantage of not only relieving nervous tension but also muscle spasm. This may be used to treat an acute attack, or for prevention.
Some patients are depressed and their headaches improve if they are given anti-depressant drugs. Manipulation of the neck can relieve the spasm and pain of an acute headache and may reduce their frequency.
The drug pizotifen which is used in the prevention of migraine and cluster headaches may also reduce the frequency of tension headache.
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MENSTRUATION – MENSTRUAL FLOW
The thick layer of cells is broken up and shed. Blood vessels are opened up and so bleeding occurs.
This is the period, or menstrual flow.
And then the cycle begins over again.
The usual pattern is for a cycle of about 28 days. Ovulation happens about 14 days before the period starts.
This is fairly constant, and may vary only from 13 to IS days.
While this time of ovulation to period is constant, what does vary is the time from period to ovulation.
Sometimes a period may be missed altogether, and many women are concerned that “bad\blood is being retained and can cause all sorts of problems.
This is not so.
When the periods are “heavy”, it means that an excess amount of endometrium is built up and then got rid of.
Conversely, when the period is light, it means that only a small amount of tissue has been built up.
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THE G.I. FACTOR: PREVENTING TYPE 2 DIABETES
Most people who develop type 2 diabetes have a tendency to be unable to produce enough insulin to control their blood sugar levels. Remember, high G.I. foods increase the amount of insulin the body needs, so, for those people susceptible to diabetes, eating carbohydrate with a high G.I. factor will only increase the demand on their already struggling pancreas.
Who is likely to be at risk? People who are over the age of 50, have a family history of diabetes, are overweight, have high blood pressure or have had diabetes during pregnancy (gestational diabetes) are at risk of developing type 2 diabetes. A reduction of the G.I. factor of their diet, reduces the demand on their pancreas to produce more insulin, perhaps prolonging its function and delaying the development of diabetes.
If you fit into one of these categories, you can reduce your chances of getting diabetes by controlling your weight, exercising more and eating more foods with a low G.I. factor.
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FAT LOSS – BEHAVIOURAL INFLUENCES: IMPLICATIONS
1. The purpose of counselling is to empower clients so that they can develop an awareness of their habits, prioritise those things to work on and be selective about those techniques most appropriate for the task.
2. Fat loss leaders need to develop a close liaison with professional psychologists for referring complex cases.
3. In dealing with habits, the first stage is to develop an awareness of the components of the habit.
4. There is a range of techniques for changing behavioural habit patterns including interrupting stimulus-response connections, changing the stimulus, reinforcement and self-monitoring. Not all techniques work for all people.
5. Negative thinking habits can be worked on using standard psychological techniques such as rational emotive therapy, positive thinking, etc.
6. Behaviour modification and cognitive therapy techniques need to be maintained over the long term and not just used in the initial stages of fat loss. This takes longer than most people anticipate and a realistic expectation is important.
7. It should be assumed that the majority, if not all, overfat problems require at least a modicum of change in habit patterns. The degree to which this is so and the types of approaches used to combat these will depend on the individual and the circumstances.
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