Friday, February 22, 2013

Narrative Therapy


Narrative therapy was originally developed by Michael White and David Epston in the 1970s in Australia. It became popular in America in the 1990s. The therapy’s name is derived from its primary foundation, storytelling.  Narrative therapy is focused on the stories of people’s lives, the meanings that the client attaches to these stories and the differences that can be found in the telling and retelling of these stories (Dulwich Centre Publications [DCP], n.d.).  It involves collaboration between client and helping professional to re-author these stories to include their history and the broader context that affects lives, such as society, economy and other people (DCP, n.d.). It is a way to organize information from a person’s life and make sense of new experiences within this context (Sween, 1998). It also involves the client’s discovering of who they are and what is most important to them (Sween, 1998).

                The following definition of narrative therapy sums up the important points of the perspective: “Narrative therapy involves exploring the shaping moments of a person’s life, the turning-points, the key relationships, and those particular memories not dimmed by time. Focus is drawn to the intentions, dreams and values that have guided a person’s life, despite the set-backs. Oftentimes, the process brings back stories that have been overlooked – surprising stories that speak of forgotten competence and heroism (Sween, 1998, p. 4).”
 
 
Although White and Epston were both influential in the creation of the therapy, White is credited as the Father of Narrative Therapy. White created the Dulwich Center in Australia, which is where he first came in contact with Epston. White’s specialization was in family therapy, but he also worked with children and people suffering from anorexia, bulimia, and schizophrenia (GoodTherapy, 2007). The creation of narrative therapy was a result of his work with these patients and his other work with trauma victims (GoodTherapy, 2007). One of his victories with narrative therapy was helping communities in Canada settle years of land disputes. Another accomplishment was the founding of the Adelaide Narrative Therapy Center in Canada in 2008 (GoodTherapy, 2007).
Narrative therapy draws upon the strengths perspective in that it looks at the client as the expert of their own life, not the counselor or other helping professional (DCP, n.d.). Narrative therapists also believe that all people have competencies, values and commitments that will help them overcome the problems that they face in life (DCP, n.d.).
Narrative therapy was originally created to be used by family therapists, but today a variety of helping professionals use narrative therapy as a tool, including therapists, community workers, teachers, school counselors, and community cultural development workers (DCP, n.d.). Although addiction therapy was not specifically mentioned in the research, it would be very helpful in that situation. Narrative therapy was first developed and used with people who had no choice but to attend therapy or with people who were at first unwilling to talk to a therapist (DCP, n.d). Therefore, it would work well for addiction clients who may be commanded to attend counseling as part of their treatment or who may at first be unwilling to admit that they have a problem.
Below is the picture from our notes depicting the addiction cycle:
 
 
Narrative therapy can help addicted clients break this cycle. Clients would be able to look at their reconstructed stories to find another way to deal with their shame, guilt, anger and depression. These are also options for the negative feelings section. They can also look at the integrated pieces of their life to see where the cause of their addiction lies. When negative consequences arise, clients would be able to re-evaluate these things and make them apart of their story so that they know how these things negatively impact their lives. The strengths perspective component of narrative therapy will also help clients identify their capabilities and use these in overcoming their addictions.
 
One aspect of narrative therapy that would be helpful to clients suffering from addictions is this slogan: “The person is never the problem; the problem is the problem (Sween, 1998).” This takes the blame away from the client. It will also help the client find the outside triggers of their addictions, such as stress, jobs and the economy. The narrative therapy will help the clients identify relationships that will be useful for support and also their own competencies that they can depend upon.  
 
 
References:
 
Dulwich Centre Publications (DCP). (n.d.). Commonly asked questions about narrative therapy. Dulwich Centre Publications. www.dulwichcentre.com.au. Accessed February 20, 2013.
 
Good Therapy. (2007). Michael White Biography. GoodTherapy.org. Copyright 2007-2013. http://www.goodtherapy.org/famous-psychologists/michael-white.html. Accessed February 20, 2013.
 
Sween, E. (1998). The one-minute question: What is narrative therapy? Some working answers. Gecko: Vol. 2. Dulwich Centre Publications. www.dulwichcentre.com.au. Accessed February 20, 2013.

 
 

 
 
 

Friday, February 8, 2013

Bulimia Nervosa

The addiction and disease Bulimia Nervosa, commonly known as bulimia, is described as a cycle of binge eating (overeating) and then some type of behavior that compensates for that amount of eating, such as purging, fasting or excessive exercising (ANAD, 2013). The definition of binge eating is important when explaining this addiction. It involves eating larger amounts of food than one usually does in a very short period of time, usually 2 hours or less (ANAD, 2013). The overeating and purging process must occur more than 2 times a week for at least 3 months to be considered an addiction, rather than a bad habit (ANAD, 2013). The cause of bulimia is unknown, but is probably the result of a combination of factors, including genetic, psychological, family and societal factors (PUB MED, 2011).

Other symptoms of bulimia include preoccupation with food, abuse of laxatives or diet pills, induced vomiting, possibly through laxatives, denial of hunger, swollen salivary glands as a result of excessive purging, and broken blood vessels in the eyes (ANAD, 2013). This disease is also characterized by a lack of control over one’s eating and physical and emotional distress (ANAD, 2013). It is also important to remember that bulimic people are not necessarily underweight. People who suffer from bulimia nervosa can be overweight or a normal weight, which makes bulimia harder to identify than anorexia (ANAD, 2013). Bulimic people share the characteristic of believing that they are overweight. Warning signs of bulimia include consistently going to the bathroom right after meals and buying large amounts of food that disappear too quickly (PUB MED, 2011).

The first step in treatment for bulimia is counseling, usually cognitive-behavioral therapy (WEB MD, n.d.). Hopefully, this will help patients change their mindset so they do not feel the need to practice bulimic behavior. This involves changing the patient’s perspective about their body, reducing the negative triggers that result in overeating and purging, coming to a better understanding about the patient’s emotions and relationships, and developing a plan and coping skills to avert future relapses (WEB MD, n.d.). Therapy also focuses on nutrition, planning a strict diet, usually three meals a day, including two snacks, and avoiding unhealthy food.

Treatment options also include taking medication. This usually means antidepressants, such as Prozac (WEB MD, n.d.). This can help reduce the bulimia cycle of binge-eating and purging and help with depression that can often coincide with bulimia. Another option for bulimics is attending a support group, such as Overeaters Anonymous (PUB MED, 2011). Other things that may coincide with bulimia are substance abuse, especially substances that will help with purging, dehydration, and other health problems that are the result of the unhealthy diet (WEB MD, n.d.). Some of these conditions may need to be treated before dealing with bulimia. Treatment may not involve staying in the hospital, but this is dependent upon how long a patient has been bulimic and other conditions they may be suffering from (WEB MD, n.d.). Treatment for bulimia is long term, meaning that it may take weeks, months, or even up to a year, to see any results or improvement.


The next set of statistics comes from the National Institute of Mental Health (Simmers, 1980). Approximately 7 million women and 1 million men in the United States suffer from some type of eating disorder. 1.1%-4.2% of females living in the United States will suffer from bulimia at some point in their lives. Bulimia is not commonly reported by men, but it has been found that 0.4% of men have suffered from this addiction. Many people who struggle with bulimia first started experiencing it during high-school or college. 33% of bulimic people report the onset of the disease between the ages of 11 and 15, and 43% of bulimic people report their experience began between the ages of 16 and 20. Even though bulimia is a very serious problem that may take years to treat, there is hope. With treatment, 60% of people suffering from this illness will recover and another 20% of people can make partial recoveries (Simmers, 1980.

References

Anad.org (2013) Bulimia Nervosa « « National Association of Anorexia Nervosa and Associated Disorders. [online] Available at: http://www.anad.org/get-information/bulimia-nervosa/ [Accessed: 9 Feb 2013].

pmhdev (2011) Bulimia - PubMed Health. [online] Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001381/ [Accessed: 9 Feb 2013].

Simmers, M. (1980) Eating Disorder Statistics - Facts About Eating Disorders. [online] Available at: http://www.bulimia.com/client/client_pages/eatingdisorderstats.cfm [Accessed: 9 Feb 2013].

Webmd.com (n.d.) Bulimia Nervosa-Treatment Overview. [online] Available at: http://www.webmd.com/mental-health/bulimia-nervosa/bulimia-nervosa-treatment-overview [Accessed: 9 Feb 2013].


Friday, February 1, 2013

Morphine


Morphine is a naturally occurring substance that is procured from opium, the juice obtained from poppy seeds (Kestin, 1993). This means that it is classified as an opioid. Morphine mainly acts on the mu receptors of nervous tissue (Kestin, 1993). Morphine is used to alleviate severe pain (Drugfree, 2013), and is often used for pain that no other analgesics can control (Administrator, 1898). The drug can work within the brain to relieve pain, but it can also act upon the spinal cord to keep it from sending pain signals to the brain (Kestin 1993). It can produce a calming effect and even euphoria on those who use it.
 
                      

 

The physiologist Francois Magendie was prominent in advancing morphine in the medicine world in the 1800s (Administrator, 1898). The Civil War was also a factor in increasing the popularity of morphine for medicinal reasons. It was used during the war to treat and reduce the pain of the soldiers (Administrator, 1898). It was called “God’s own medicine” (Administrator, 1898). However, it was the first time that people became addicted to the drug. In 1898, morphine’s popularity and credibility began to decline because of how easily people became addicted to it. The 2008 National Survey on Drug Use and Health found that nearly 12 million Americans had abused prescription pain relievers, which is a category that includes morphine (Treatment Solutions, 2012).

                Morphine has many side effects besides pain relief. It can cause slow or shallow breathing (Administrator, 1898), nausea, vomiting, cough suppression, delayed emptying of the stomach, constipation, urinary retention, itching and flushing of the skin (Kestin, 1993). It causes changes in the circulatory system and slowing of the digestive tract (Administrator, 1898). Large doses of morphine can lead to severe respiratory depression, coma or death (Drugfree, 2013).

                Morphine is one of the easiest drugs to become addicted to. Studies completed at Brown University show that a single dose of the drug could lead to addictive qualities in a patient (Administrator, 1898). Signs of addiction to morphine include compulsive use, using the drug even though it causes bad consequences and a fixation with getting and using more morphine (Administrator, 1898). Withdrawal symptoms include anxiety, agitation, insomnia, sweating, nausea, vomiting, watery eyes, runny nose, drooling and chills (Administrator, 1898). It is commonly sold on the streets and goes by names such as duramorph, M, Miss Emma, monkey and roxanel (Drugfree, 2013).

 

The following video contains more information about the drug morphine, including proper use of the drug and additional warnings about using the drug.

 

References

Administrator (1898). What is Morphine. [online] Retrieved from: http://drug-effects.us/what-is-morphine [Accessed: 2 Feb 2013].

Drugfree.org (2013). Morphine | The Partnership at Drugfree.org. [online] Retrieved from: http://www.drugfree.org/drug-guide/morphine [Accessed: 2 Feb 2013].

Nda.ox.ac.uk (n.d.). Morphine. [online] Retrieved from: http://www.nda.ox.ac.uk/wfsa/html/u03/u03_016.htm [Accessed: 2 Feb 2013].

Treatment Solutions (2012). Morphine Addiction Treatment. [online] Retrieved from: http://www.treatmentsolutions.com/morphine-addiction-treatment/ [Accessed: 2 Feb 2013].