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	<title>Marin County Psychological Association (MCPA)</title>
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		<title>Deconstructing Lust</title>
		<link>http://www.smblogsites.com/marincountypsych/?p=190</link>
		<comments>http://www.smblogsites.com/marincountypsych/?p=190#comments</comments>
		<pubDate>Thu, 25 Apr 2013 06:16:48 +0000</pubDate>
		<dc:creator>DrNemerovski</dc:creator>
				<category><![CDATA[relationships]]></category>
		<category><![CDATA[sexuality]]></category>
		<category><![CDATA[Emotions and Feelings]]></category>
		<category><![CDATA[Emotions! Making Sense of Your Feelings]]></category>
		<category><![CDATA[guilt and shame]]></category>
		<category><![CDATA[limbic systemt]]></category>
		<category><![CDATA[Mary Lamia]]></category>

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		<description><![CDATA[Deconstructing Lust by Mary Lamia, Ph.D. Lust may be experienced as intense desire, ardent enthusiasm, or unbridled sexual longing. This passionate craving is attention directing and a motivational force as is the experience of any emotion. When untethered, lust can &#8230; <a class="more-link" href="http://www.smblogsites.com/marincountypsych/?p=190">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
				<content:encoded><![CDATA[<p><strong>Deconstructing Lust</strong></p>
<p>by Mary Lamia, Ph.D.</p>
<p>Lust may be experienced as intense desire, ardent enthusiasm, or unbridled sexual longing. This passionate craving is attention directing and a motivational force as is the experience of any emotion. When untethered, lust can lead to actions that may appear irrational.  Even so, it can be regarded as a manifestation of unconscious emotional memories.</p>
<p>Like love, technically lust is not considered to be an emotion, but involves emotions such as bliss, excitement, joy, and interest, as well as the erotic anticipation of sensory pleasure. People who are in the throes of lust may lose their sensibilities, since lust seems unable to recognize the reality of a situation or motivates one to neglect it. Lust is an octane for the relentless pursuit of another person in spite of intellectual reason and sometimes regardless of emotional barriers such as guilt or shame.</p>
<p>At times lust is unbridled sexual attraction that seeks expression, where the physical appearance and attributes of one person ignite emotions of intense interest and excitement in another.  Yet whatever is triggered in your psyche regarding the lustful qualities of another person is something specific to your own history.  As a result, a friend might confess to you that he lusts after a certain person, and you may be baffled by his interest in someone who seems unattractive to you. Additionally, lust can lead you to fill-in unknown information about the object of your desire, assigning them perfection in your fantasies.  This is because such passion is a construct of implicit memory that becomes enhanced by conscious imagination.</p>
<p>Implicit memory plays a primary role in the process of falling in lust and can be considered akin to what resides in you unconsciously—emotional memories concerning early attachment and love that direct your behavior, goals, passions, and interests in the present. Phenomena regarding implicit memory have been reported as early as Decartes’ 1649 work regarding <em>The Passions of the Soul</em> where he observed that childhood experiences remain imprinted on the brain (cited by Schacter, 1987). Since that time, numerous philosophers and psychological researchers have found that people are affected by early impressions that are not consciously remembered. In <em>A General Theory of Love</em> contemporary theorists, Lewis, Amini, and Lannon (2001) describe the limbic connection that occurs in intense human relationships and how we are driven by our implicit memories. Such unconscious emotional connections that are based on attractors—patterns imprinted on the limbic system— can serve to regulate human physiology and emotional health. So limbic resonance, even in the form of reciprocated lust, serves an evolutionary purpose. Psychologist Lynn O’Connor (2002) contends that limbic resonance (unrelated to lust), such as in friendships or the relationship between a therapist and patient, results in physiological regulation.</p>
<p>However, early limbic connections that are less than optimal also tend to be repeated throughout life (Lewis, Amini, Lannon, 2000). Therefore, lust and the implicit memories that determine its object can be the result of either healthy or unhealthy early relationships.  It is possible that the nature and outcome of a relationship can illustrate whether a passionate interest is based on implicit memories that resulted from healthy attachments or pathologic ones.  However, the fact that relationships involve at least two individuals, each with unique implicit memory, distorts the picture and adds great complexity to deconstructing lust.</p>
<p>The ineffable quality of lust may be the result of another person matching the template within your implicit memory and the emotions associated with it. Lust provides a rare window through which you can view your vulnerabilities as you are swept away by your imagination.  And if you are able to face and endure the shame and disappointment that are often the outcome of such attraction and subsequent disconnection, you will have ample opportunity to learn about yourself.</p>
<p>For information about my current book for young adults<em>, <strong>Emotions! Making Sense of Your Feelings </strong>(American Psychological Association Magination Press, August 2012</em>), see my website: <a title="http://www.marylamia.com" href="http://www.marylamia.com" target="_blank">http://www.marylamia.com</a></p>
<p><strong>References</strong></p>
<p>Lewis, Thomas L.; Amini, Fari; Lannon, Richard (2000). <em>A general theory of love</em>. New York: Random House.</p>
<p>O’Connor, L. E. (2002). Review of <em>A General Theory of Love</em> by Thomas Lewis, Fari Amini, and Richard Lannon. <em>Human Nature Review</em>. 2: 89-91.</p>
<p>Schacter, D. (1987). Implicit memory: History and current status. Journal of Experimental Psychology: Learning, Memory, and Cognition, 13(3),  501-518.</p>
<p># # #</p>
<p>Please visit <a href="http://www.marincountypsych.org" target="_blank">http://www.marincountypsych.org</a> for more information about our association and membership benefits or to locate a licensed clinical psychologist in Marin County.</p>
<p># # #</p>
<p>Blog Disclaimer:</p>
<p>The opinions expressed by the authors are their own and do not reflect the opinions of the Marin County Psychological Association. The information posted on this blog is not intended as, and is not, a substitute for professional mental health services.</p>
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		<title>Parenting After Separation or Divorce</title>
		<link>http://www.smblogsites.com/marincountypsych/?p=186</link>
		<comments>http://www.smblogsites.com/marincountypsych/?p=186#comments</comments>
		<pubDate>Fri, 15 Feb 2013 06:11:22 +0000</pubDate>
		<dc:creator>DrNemerovski</dc:creator>
				<category><![CDATA[divorce]]></category>
		<category><![CDATA[family therapy]]></category>
		<category><![CDATA[parenting]]></category>
		<category><![CDATA[relationships]]></category>
		<category><![CDATA[Uncategorized]]></category>
		<category><![CDATA[Annette Holloway]]></category>
		<category><![CDATA[APPLE Family Works]]></category>
		<category><![CDATA[children and divorce]]></category>
		<category><![CDATA[Family Service Agency of Marin (FSA)]]></category>
		<category><![CDATA[Isolina Ricci]]></category>
		<category><![CDATA[Marital and Family Therapy]]></category>
		<category><![CDATA[PARENTING AFTER SEPARATION OR DIVORCE]]></category>
		<category><![CDATA[Philip M. Stahl]]></category>

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		<description><![CDATA[PARENTING AFTER SEPARATION OR DIVORCE By Annette Holloway, PsyD Many families are faced with questions about how to best raise children when the adults don’t live together any more. This is particularly difficult when you are feeling angry, hurt or &#8230; <a class="more-link" href="http://www.smblogsites.com/marincountypsych/?p=186">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
				<content:encoded><![CDATA[<p><strong>PARENTING AFTER SEPARATION OR DIVORCE</strong></p>
<p><strong></strong>By Annette Holloway, PsyD</p>
<p>Many families are faced with questions about how to best raise children when the adults don’t live together any more. This is particularly difficult when you are feeling angry, hurt or betrayed by the other parent.</p>
<p>You might know in your mind that it’s best for the children if the parents can cooperate about parenting issues, but how do you actually do that when the littlest thing the other person says sets your teeth on edge? And what do you do if you feel that the other parent isn’t treating your child well?</p>
<p>Here are some general guidelines and helpful resources to get you started, if you feel this applies to you.</p>
<p><strong>What you can do</strong></p>
<p><em>Keep the children out of the middle.</em></p>
<p>This basic principle covers many situations and can also be a touchstone to consider whenever you are about to do something that involves the kids and the other parent. Keeping kids out of the middle means not using them to carry messages of any kind to the other parent, not bad mouthing the other parent in front of the kids and not using them to find out what the other parent is up to in his or her private life. It’s important to remember that a person can be a good parent even if he or she wasn’t so great at being a spouse. By keeping the kids out of the middle, you avoid asking them to choose between two parents whom they love. Children want to be loyal to each parent; they are in a very painful position if being loyal to one means being disloyal to the other.</p>
<p><em>Take care of your needs with the help of people other than your children.</em></p>
<p>You do need to vent about what the other parent said or did, to de-stress after juggling your complicated schedule and to take care of your finances. You need to learn (or add to your) good self-care techniques, and develop a support network or strengthen the one you already have.</p>
<p>But you need to do these activities and learn these skills without leaning on your children for help. They need you to <em>help</em> <em>them</em> manage the changes that are happening in their lives, and over which they have no control.</p>
<p>Children of divorce whose parents can be neutral with each other and who maintain households with totally separate routines and rules usually do just as well as children whose divorced parents cooperate well and interact easily. You don’t need to co-parent by meeting frequently face to face, creating similar schedules and meal routines, and doing things together; some couples can manage to do this but many can’t.</p>
<p>The good news is that co-parenting separately, with different styles and conventions in a “parallel play” style can create just as good outcomes for the children as being more coordinated.</p>
<p><strong>How you can do it</strong></p>
<p><strong></strong><em>Talk with people </em>who can empathize with you – understanding, nonjudgmental friends, a therapist, a spiritual or religious leader – or write in a journal. Find ways to lower your stress level: exercise, seek beauty, look at interesting things, be in nature, pet an animal, or do something nice for someone else.</p>
<p><em>Inform yourself</em> about co-parenting by reading a book (“Mom’s House, Dad’s House” by Isolina Ricci or “Parenting after Divorce” by Philip M. Stahl) or taking a class. Two local groups that offer classes specifically about co-parenting are Family Service Agency of Marin (FSA) and APPLE Family Works (492-0720), both in San Rafael.</p>
<p>At FSA, Parenting Apart is a 6-class series that helps parents better understand their children&#8217;s experience of divorce, learn skills that promote the healthy development of their children and help manage conflict with the other parent. The class focuses on positive actions parents can take for the benefit of their children (for more information call 491-5723).</p>
<p><em>Talk to your children</em> about what is happening and <em>ask</em> how they feel about it. Children need to be told explicitly that the separation or divorce did not occur because of anything that they said or did. They also need an age-appropriate explanation about why their parents don’t live together (“We tried to make things work but we couldn’t be happy together, so we separated, but we both still love you” might be appropriate for a preschooler.) These kind of discussions need to occur on an ongoing basis, as their understanding of the world and of people grows.</p>
<p>As a parent, you know your child better than anyone. If you feel like they need extra support to help them adjust to belonging to two households, find appropriate help. Clinics like FSA and APPLE Family Works offer a variety of services at a sliding scale if your insurance doesn’t cover what you need.</p>
<p>Whether you and your child are going through a high-conflict or low-conflict divorce, there are steps you can take to help them do well in the long-term. Your sense of confidence about being a “good enough” parent and your intent to help them negotiate the new status quo will help both of you get through a difficult time more easily.</p>
<p><em>To contact Dr. Annette Holloway (PSY 25056) call 415/843-1453, or email </em><em><a href="mailto:Annette@FamilyTherapySF.com">Annette@FamilyTherapySF.com</a>.</em></p>
<p>References:</p>
<p>Lamb, M. E., &amp; Kelly, J. B. (2009). Improving the quality of parent-child contact in separating families with infants and young children: Empirical research foundations. In R. M. Galazter-Levy, J. Kraus, &amp; J. Galatzer-Levy (Eds.), <em>The scientific basis of child custody decisions </em>(2nd ed.). Hoboken, NJ: Wiley.</p>
<p>Pruett, M., &amp; Barker, R. (2010). Effectively intervening with divorcing parents and their children: What works and how it works. In M. S. Schulz, M. Pruett, P. K. Kerig, R. D. Parke (Eds.), <em>Strengthening couple relationships for optimal child development: Lessons from research and intervention</em>. Washington, DC: American Psychological Association.</p>
<p>Ricci, I. (1997).  <em>Mom’s house, Dad’s house: A complete guide for parents who are separated, divorced, or remarried</em> (rev. ed.)<em>.</em> New York: Fireside for Simon &amp; Schuster.</p>
<p>Stahl, P. M. (2007). <em>Parenting after divorce: Resolving conflicts and meeting your children’s needs</em> (2nd ed.). Atascadero, CA: Impact.</p>
<p>Whiteside, M. F. (1998), The parental alliance following divorce: An overview<em>. Journal of Marital and Family Therapy</em>,<em> 24</em>, 3–24.</p>
<p># # #</p>
<p>Please visit <a href="http://www.marincountypsych.org" target="_blank">http://www.marincountypsych.org</a> for more information about our association and membership benefits or to locate a licensed clinical psychologist in Marin County.</p>
<p># # #</p>
<p>Blog Disclaimer:</p>
<p>The opinions expressed by the authors are their own and do not reflect the opinions of the Marin County Psychological Association. The information posted on this blog is not intended as, and is not, a substitute for professional mental health services.</p>
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		<title>The MCPA Birding Adventure 2012</title>
		<link>http://www.smblogsites.com/marincountypsych/?p=179</link>
		<comments>http://www.smblogsites.com/marincountypsych/?p=179#comments</comments>
		<pubDate>Fri, 11 Jan 2013 06:14:22 +0000</pubDate>
		<dc:creator>DrNemerovski</dc:creator>
				<category><![CDATA[Uncategorized]]></category>

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		<description><![CDATA[The MCPA Birding Adventure by Jeffrey Martin, Ph.D. Snowy Egret Our day was very successful with curious eyes magically transforming duck ponds into diverse wildlife habitats. The sun was shining bright as were the bright colors and designs on species &#8230; <a class="more-link" href="http://www.smblogsites.com/marincountypsych/?p=179">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
				<content:encoded><![CDATA[<p><strong>The MCPA Birding Adventure</strong></p>
<p>by Jeffrey Martin, Ph.D.</p>
<p style="text-align: center;"><strong><a href="http://www.smblogsites.com/marincountypsych/wp-content/uploads/2013/01/Snowy-Egret-1.jpg"><img class="aligncenter size-medium wp-image-180" title="Snowy Egret-1" src="http://www.smblogsites.com/marincountypsych/wp-content/uploads/2013/01/Snowy-Egret-1-300x200.jpg" alt="" width="300" height="200" /></a></strong><em style="text-align: center;">Snowy Egret</em></p>
<p><strong>Our day was very successful with curious eyes magically transforming duck ponds into diverse wildlife habitats. The sun was shining bright as were the bright colors and designs on species such as the Green-winged Teal</strong><strong> </strong><strong>and the Ruby-crowned Kinglet that provided a rare flash</strong><strong> </strong><strong>of a widely spread ruby crest. </strong><strong> </strong><strong>We spotted, in less than 2 hours together at the marsh, at least 35 different species of North American birds. A special surprise was several dozen Cackling Geese.  These look like &#8220;miniature&#8221; Canada Geese.&#8221;  They often hang out with Canada Geese, but are much smaller (perhaps one third the size) and are a separate species (keep your eyes out in the winter for them).  They are only here in the winter, and only a few.</strong></p>
<p style="text-align: center;"><a href="http://www.smblogsites.com/marincountypsych/wp-content/uploads/2013/01/Northern-Pintail-1.jpg"><img class="aligncenter size-medium wp-image-181" title="Northern Pintail-1" src="http://www.smblogsites.com/marincountypsych/wp-content/uploads/2013/01/Northern-Pintail-1-300x179.jpg" alt="" width="300" height="179" /></a><em style="text-align: center;"> Northern Pintail</em></p>
<p><strong>Birds of prey were plentiful, as two Northern Harriers demonstrated their low flying agility in territorial combat with White-tailed Kite and Red-shouldered Hawk. A couple dozen Black-crowned Night Herons spent their daytime dotting the trees nearby. It was also a stress-free day and fun to hang out with colleagues, just for fun, and it was great to meet families.  And the two fruit salads were a great complement to lox and bagels we shared afterwards.  Special thanks to Dan, a birding friend of Jeff&#8217;s who brought a 60 power spotting scope, and a crate for the kids to stand on for a good look! </strong></p>
<p><strong>Cackling Goose (several dozen)</strong></p>
<p><strong>Canada Goose</strong></p>
<p><strong>Gadwall</strong></p>
<p><strong>American Wigeon</strong></p>
<p><strong>Mallard</strong></p>
<p><strong>Northern Shoveler</strong></p>
<p><strong>Northern Pintail</strong></p>
<p><strong>Green-winged Teal</strong></p>
<p><strong>Canvasback</strong></p>
<p><strong>Ring-necked Duck</strong></p>
<p><strong>Bufflehead</strong></p>
<p><strong>Ruddy Duck</strong></p>
<p><strong>Horned Grebe</strong></p>
<p><strong>Eared Grebe</strong></p>
<p><strong>Western Grebe</strong></p>
<p><strong>Great Egret</strong></p>
<p><strong>Snowy Egret</strong></p>
<p><strong>Black-crowned Night Heron</strong></p>
<p><strong>White-tailed Kite</strong></p>
<p><strong>Northern Harrier</strong></p>
<p><strong>Red-shouldered Hawk</strong></p>
<p><strong>American Coot</strong></p>
<p><strong>Black-necked Stilt</strong></p>
<p><strong>Mew </strong><strong>G</strong><strong>ull</strong></p>
<p><strong>Anna&#8217;s Hummingbird</strong></p>
<p><strong>Black Phoebe</strong></p>
<p><strong>Say&#8217;s Phoebe</strong></p>
<p><strong>American Crow</strong></p>
<p><strong>Marsh Wren (heard)</strong></p>
<p><strong>Ruby-crowned Kinglet &#8212; rare display of fanned out ruby crown</strong></p>
<p><strong>Yellow-rumped Warbler</strong></p>
<p><strong>Song Sparrow</strong></p>
<p><strong>Red-winged Blackbird</strong></p>
<p><strong>Western Meadowlark</strong></p>
<p><strong>House Finch</strong></p>
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		<title>Get Involved, we need you in MCPA and CPA</title>
		<link>http://www.smblogsites.com/marincountypsych/?p=176</link>
		<comments>http://www.smblogsites.com/marincountypsych/?p=176#comments</comments>
		<pubDate>Wed, 28 Nov 2012 07:31:42 +0000</pubDate>
		<dc:creator>DrNemerovski</dc:creator>
				<category><![CDATA[Uncategorized]]></category>

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		<description><![CDATA[Get Involved, we need you in MCPA and CPA Thoughts from Beth Cooper Tabakin, Ph.D. Have you ever wondered how to increase your professional wellness? One of the answers may be as simple as joining and participating in one of &#8230; <a class="more-link" href="http://www.smblogsites.com/marincountypsych/?p=176">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
				<content:encoded><![CDATA[<p><strong>Get Involved</strong>, we need you in MCPA and CPA</p>
<p>Thoughts from Beth Cooper Tabakin, Ph.D.</p>
<p>Have you ever wondered how to increase your professional wellness? One of the answers may be as simple as joining and participating in one of the many offerings of professional activities available to you. Please join me and attend this year&#8217;s Leadership and Advocacy Day in Sacramento. Meet other psychologist leaders and learn to advocate and educate legislators about issues of our concern.</p>
<p>A secret to success may be as simple as joining your colleagues in MCPA or CPA.</p>
<p>What is the difference between illness and wellness? &#8216;LLNESS&#8217; is the same in each word, the difference is illness starts with an &#8216;I&#8217; and wellness starts with a &#8216;WE&#8217;. Hmmmmm I and we&#8230;&#8230;&#8230;.</p>
<p>I encourage people who have not participated in their local professional associations to do so. The California Psychological Association acts as the voice of psychology in California.</p>
<p>We need you and you need us. Join your colleagues in one of the many MCPA activities such at a social meet and greet, a CEU activity, hike, committee or list serve to name just a few.</p>
<p>This year, I am nominating Dr. Frederick Luskin to receive  the DISTINGUISHED CONTRIBUTION TO PSYCHOLOGY award from CPA which, if he is chosen, will be awarded at this year&#8217;s convention in Newport Beach. The Distinguished Contribution to Psychology award honors a psychologist or non-psychologist who has improved the image of psychology by increasing the public’s understanding of the discipline and/or the profession of psychology. This award is open to all Californians and is intended to promote good will and broader understanding of the field. The person nominated might be a writer (both print and electronic), teacher, manager/administrator, health professional, mental health advocate or the like. The important factor is that the public’s understanding and awareness of psychology is increased in some significant way by the nominee’s contribution. If anyone would like to help me write the proposal, please email me at <a href="mailto:lifeafterbreakfast@gmail.com">lifeafterbreakfast@gmail.com</a> or call (415)2258683.  The proposal is due by December 10<sup>th</sup> and I would love to have collaborative input (I to WE).</p>
<p>May you be healthy and happy and enjoy this life we are given.</p>
<p>All my best,</p>
<p>Beth Cooper Tabakin, Ph.D.</p>
<p>PSY13580</p>
<p>Individual, Couple, and Family Psychologist</p>
<p>412 Red Hill Avenue Suite #6</p>
<p>San Anselmo, California 94960</p>
<p>(415) 459-7707</p>
<p># # #</p>
<p>Please visit <a href="http://www.marincountypsych.org" target="_blank">http://www.marincountypsych.org</a> for more information about our association and membership benefits or to locate a licensed clinical psychologist in Marin County.</p>
<p># # #</p>
<p>Blog Disclaimer:</p>
<p>The opinions expressed by the authors are their own and do not reflect the opinions of the Marin County Psychological Association. The information posted on this blog is not intended as, and is not, a substitute for professional mental health services.</p>
<p>&nbsp;</p>
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		<title>Snapshot: Older Adults, Pain and Pain Medications</title>
		<link>http://www.smblogsites.com/marincountypsych/?p=173</link>
		<comments>http://www.smblogsites.com/marincountypsych/?p=173#comments</comments>
		<pubDate>Tue, 16 Oct 2012 05:51:24 +0000</pubDate>
		<dc:creator>DrNemerovski</dc:creator>
				<category><![CDATA[Uncategorized]]></category>

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		<description><![CDATA[Snapshot: Older Adults, Pain and Pain Medications by Deborah K. Nelson, M.A. Chronic pain in older adults is considered an individual, social, medical and economic crisis.  It has often been described as epidemic as the percentage of older individuals in our &#8230; <a class="more-link" href="http://www.smblogsites.com/marincountypsych/?p=173">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
				<content:encoded><![CDATA[<p style="text-align: left;" align="center"><strong>Snapshot: Older Adults, Pain and Pain Medications</strong></p>
<p style="text-align: left;" align="center"><strong></strong>by Deborah K. Nelson, M.A.</p>
<p style="text-align: left;">Chronic pain in older adults is considered an individual, social, medical and economic crisis.  It has often been described as epidemic as the percentage of older individuals in our population continues to grow.  Research has shown that half of the elder adults who live independently and three-fourths who live in a care facility suffer from persistent pain (National Pain Foundation, Seniors and Pain, 2010).</p>
<p style="text-align: left;">Compounding the problem is the fact that physicians are often hesitant to prescribe pain medications for the elderly.  Concurrent illnesses and multiple health problems make pain evaluation in older adults difficult (American Geriatrics Society, 2009) as pain is experienced across physiological, psychological and social domains.  Thus, discriminating which factors are most important for the purpose of treatment can be very challenging.  Furthermore, there are many age-associated differences in drug effectiveness, sensitivity and toxicity as older patients are generally at a higher risk of adverse drug reactions (American Geriatrics Society, 2009).</p>
<p style="text-align: left;">Physicians, nurses, caregivers and family members have long known that older adults’ pain-related attitudes, experiences and management needs are unique from younger members of society.  Many elderly patients are less willing or less able to vocalize their pain symptoms, often because they have learned to accept pain as part of aging (Martinez, 2010).  Even when they’ve been prescribed pain medications, many older adults are often reluctant to utilize pain medications.</p>
<p style="text-align: left;">Despite recognition of these complex issues, this topic has been (until just recently), presented as anecdotal information in the chronic pain literature. From my experience working with older adults, and witnessing first hand the significant impact untreated pain had on the lives of seniors, I sought to better understand this phenomenon.  Using my dissertation as the research tool, my goal was to better understand how older adults view their pain medications – in particular, the emotional heuristics older adults use when deciding whether to take their pain medications.</p>
<p style="text-align: left;">Participants in my study were an ethnically and socioeconomically diverse sample of eleven community-dwelling older adults (ages 63 – 86), all under a physician’s care for moderate to severe persistent pain.  They participated in semi-structured video interviews that focused on their daily pain management strategy, including perceptions and use of their pain medications and use of non-medication approaches.  I used qualitative data analysis to identify key heuristics and created a 30-minute DVD of participants that highlighted major emergent themes.</p>
<p style="text-align: left;">Results showed that regardless of physician recommendations for how and when to use pain medication, participants crafted highly individual processes for their pain management and use of pain medication.  Emotional heuristics were very much in use, with a chief concern being fear of addiction.  Other key concerns included: side effects and the total pill load consumed each day.  Regardless of their trust in their physician, most participants actively sought out their own information and were consumers of written, broadcast or internet information.  A key determinant of pain management strategy was socioeconomic status, which determined the kinds of complementary interventions that were possible and utilized.</p>
<p style="text-align: left;">Another significant and confounding issue is that pain and depression are: often comorbid, are prevalent in the older adult population, and they mutually influence each other.  The results of this are profound.  A study of pain among older adults reported that the odds of poor physical functioning were 11.2 times greater among those with comorbid chronic pain and depression than among those experiencing chronic pain alone (Mossey &amp; Gallagher, 2004).</p>
<p style="text-align: left;">Psychologists have long worked collaboratively with physicians and pain management specialists to help those experiencing pain improve their quality of life. For those interested in working with older adults who are experiencing pain, the key is to evaluate their full day-to-day experience, understand their life goals and create a custom pain management plan.</p>
<p style="text-align: left;">For further information, please contact Deb Nelson at <a href="mailto:debnelsonpsyd@gmail.com">debnelsonpsyd@gmail.com</a>.</p>
<p style="text-align: left;">References:</p>
<p style="text-align: left;">American Geriatrics Society, AGS Panel on the Pharmacological Management of Persistent Pain in Older Persons. (2009).  Pharmacological management of persistent pain in older persons.  <em>Journal of the American Geriatrics Society, 57, </em>1331-1346.</p>
<p style="text-align: left;">Martinez, E. (2010). Pain and age: The older adult.  <em>National Pain Foundation. </em>Retrieved from http://www.nationalpainfoundation.org/articles/161/pain-and-age-the-older-adult.</p>
<p style="text-align: left;">Mossey, J.M., &amp; Gallagher, R.M. (2004). The longitudinal occurrence and impact of comorbid chronic pain and chronic depression over two years in continuing care retirement community residents. <em>Pain Medicine</em>, <em>5</em>(4), 335-348.</p>
<p style="text-align: left;">National Pain Foundation. (2010).  Seniors and pain.  Retrieved from <a href="http://www.nationalpainfoundation.org/articles/244/seniors-and-pain">http://www.nationalpainfoundation.org/articles/244/seniors-and-pain</a>.</p>
<p style="text-align: left;"># # #</p>
<p style="text-align: left;">Please visit <a href="http://www.marincountypsych.org" target="_blank">http://www.marincountypsych.org</a> for more information about our association and membership benefits or to locate a licensed clinical psychologist in Marin County.</p>
<p style="text-align: left;"># # #</p>
<p style="text-align: left;">Blog Disclaimer:</p>
<p style="text-align: left;">The opinions expressed by the authors are their own and do not reflect the opinions of the Marin County Psychological Association. The information posted on this blog is not intended as, and is not, a substitute for professional mental health services.</p>
<p style="text-align: left;">
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		<title>Reforming the Nail Biter:  On Loving the “Ten Friends”</title>
		<link>http://www.smblogsites.com/marincountypsych/?p=170</link>
		<comments>http://www.smblogsites.com/marincountypsych/?p=170#comments</comments>
		<pubDate>Wed, 18 Jul 2012 16:48:52 +0000</pubDate>
		<dc:creator>DrNemerovski</dc:creator>
				<category><![CDATA[Uncategorized]]></category>

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		<description><![CDATA[Reforming the Nail Biter:  On Loving the “Ten Friends” by Mary Lamia, Ph.D. (Originally published at PsychologyToday.com) You would likely have no difficulty believing me if I told you that a relationship can be healing. However, it may seem strange &#8230; <a class="more-link" href="http://www.smblogsites.com/marincountypsych/?p=170">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
				<content:encoded><![CDATA[<p><strong>Reforming the Nail Biter:  On Loving the “Ten Friends”</strong></p>
<p>by Mary Lamia, Ph.D.</p>
<p>(Originally published at PsychologyToday.com)</p>
<p>You would likely have no difficulty believing me if I told you that a relationship can be healing. However, it may seem strange if I claim that a specific interaction and connection with another person can help children and adults stop biting their nails.</p>
<p>Nail biting, technically known as onychophagia, is quite fascinating, yet there is a striking lack of research on the subject. And some of the research on the subject that does exist is so absurd that it may make you consider biting your nails. Early research on nail-biting behavior characterized it as possibly due to an impaired mother-child relationship (Oguchi &amp; Miura, 1977), as a self-mutilation behavior (Laxenaire, Millet, &amp; Westphal, 1984), or a sign of inward turned hostility (Ellerbroek, 1978). Most commonly, nail biting has been characterized as neurotic symptom of anxiety or a nervous habit (Abe &amp; Masui, 1981; Klatte &amp; Deardorff, 1981; Miltenberger &amp; Fuqua, 1985; Pathak &amp; Mishra, 1985). In an attempt to determine the function of nail biting, a recent study found that, in young adults, nail biting occurred under conditions of working on difficult problems or boredom, which may reflect a particular emotional state (Williams, Rose, &amp; Chisholm, 2007).</p>
<p>Likely there are a plethora of reasons why people bite their nails, and if you have first hand experience as a biter you likely are aware of what it’s all about for you. Regardless of etiology, nail biting is generally regarded as a common habit that should be broken. But therein lies the problem: habits that bring momentary comfort are difficult to relinquish.</p>
<p>If the relational intervention I will be proposing here can help reform a nail biter, it would likely be a more welcome intervention than some of the atrocious procedures nail biters have endured to stop their habit. If you are a nail biter you are likely familiar with any number of aversive techniques. Most common are horrible tasting substances to paint on your nails. However, like a dog that is willing to endure the shock of an electric fence in order to chase a rabbit, the nail biter usually chews right through any evil-tasting stuff. Dreadful as it may sound, pharmaceuticals such as clomipramine and desipramine (tricyclic antidepressants) have been used in the treatment of severe nail biting although using medications was not shown to be efficacious in most cases (Leonard, H.; Lenane, M.; Swedo, S.; &amp; Rettew, D., 1991).</p>
<p>Some studies of procedures that were designed to reduce nail-biting have focused on increasing the biters awareness of the behavior. Non-removable reminders, such as wristbands designated to be a constant cue to the nail biter of his resolve to quit, have been used to control nail-biting but, unfortunately, they were found to be no more effective than aversive techniques (Koritzky, G. &amp; Yechiam, E., 2011).  In another study, participants kept self-monitored records of biting responses and for six weeks they were each seen individually by someone who measured their nail lengths (Adesso, V.; Vargas, J.; &amp; Siddall, J., 1979). The researchers found that self-monitoring along with regularly scheduled nail measurements was effective in increasing awareness for control of nail-biting. The psychological impact of having another person regularly measuring one’s nail length was not implicated in the study as a remedial factor, however, I suspect that it accounted for the result.  A relationship with another person who is attentive and caring, even when they are simply measuring your nail length and your progress can raise awareness. If this person happens to be someone who loves you, his or her concern may also be comforting. And this is the essence of the procedure I propose to reform the nail-biter.</p>
<p>Now for the procedure: The example I will use is with a child who bites her nails, although some of my graduate students have effectively employed the same technique with adult nail-biting partners. Every evening for a minimum of 30-days, look at each of the child’s fingernails to determine whether or not she had been “good” to them—personifying each of her little fingers as a “friend.” As each fingernail is examined, talk to it using statements where applicable such as, “Oh, I am so sorry that she chewed on you today,” or “I’m so happy that she was nice to you today!” and give each of them a kiss in turn. These are her 10 “friends” and your relationship with them will seemingly be separate from the one you have with your child. Your relationship with the ten “friends” will be remembered when she is tempted to bite her nails, as will the relationship she has with her own fingers that have now been personified. Additionally, the comfort that you provide will help to relieve anxiety or stress that may lead her to bite her nails in the first place.</p>
<p>If you are a nail-biting adult who doesn’t have the option of engaging a partner to help you establish a new relationship with your ten “friends,” then, at the very least, you should talk to them every evening yourself. And give each of them a kiss goodnight.</p>
<p>###</p>
<p>For information regarding my books about emotions: http://www.marylamia.com</p>
<p><em>This blog is in no way intended as a substitute for medical or psychological counseling. If expert assistance or counseling is needed, the services of a competent professional should be sought.</em></p>
<p><strong>References</strong></p>
<p>Adesso, V.; Vargas, J.; &amp; Siddall, J. (1979). The role of awareness in reducing nail-biting behavior. Behavior Therapy, 10(1), 148-154.</p>
<p>Klatte, K. M., &amp; Deardorff, P. A. (1981). Nail-biting and manifest anxiety of adults. Psychological Reports, 48(1), 82.</p>
<p>Koritzky, G. &amp; Yechiam, E., (2011). On the value of nonremovable reminders for behavior modification: An application to nail-biting (Onychophagia). Behavior Modification, 35(6), 511-530.</p>
<p>Leonard, H.; Lenane, M.; Swedo, S. &amp; Rettew, D. (1991).  A double-blind comparison of clomipramine and desipramine treatment of severe onychophagia (nail biting). Archives of General Psychiatry, 48(9), 821-827.</p>
<p>Williams, T.; Rose, R.; Chisholm, S. (2007). What is the function of nail biting: An analog assessment study. Behaviour Research and Therapy. 45(5), 989-995.</p>
<p># # #</p>
<p>Please visit <a href="http://www.marincountypsych.org" target="_blank">http://www.marincountypsych.org</a> for more information about our association and membership benefits or to locate a licensed clinical psychologist in Marin County.</p>
<p># # #</p>
<p>Blog Disclaimer:</p>
<p>The opinions expressed by the authors are their own and do not reflect the opinions of the Marin County Psychological Association. The information posted on this blog is not intended as, and is not, a substitute for professional mental health services.</p>
<p>&nbsp;</p>
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		<title>President&#8217;s Note &#8211; May, 2012</title>
		<link>http://www.smblogsites.com/marincountypsych/?p=164</link>
		<comments>http://www.smblogsites.com/marincountypsych/?p=164#comments</comments>
		<pubDate>Wed, 23 May 2012 05:47:56 +0000</pubDate>
		<dc:creator>DrNemerovski</dc:creator>
				<category><![CDATA[Uncategorized]]></category>

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		<description><![CDATA[MCPA President&#8217;s Note by Barbara Nova, Ph.D. Hello, MCPA Members! Whew! It has been a whirlwind start to the year in terms of “behind-the scenes” activities! As far as our more public presence:  Thanks to all who attended both our &#8230; <a class="more-link" href="http://www.smblogsites.com/marincountypsych/?p=164">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
				<content:encoded><![CDATA[<p><strong>MCPA President&#8217;s Note</strong></p>
<p><strong></strong>by Barbara Nova, Ph.D.</p>
<p>Hello, MCPA Members! Whew! It has been a whirlwind start to the year in terms of “behind-the scenes” activities! As far as our more public presence:  Thanks to all who attended both our Annual Meeting in February and the Meet &amp; Greet at Wipeout Grill in March! I very much appreciate all the  feedback – both positive and negative &#8211; from all of you and will continue to try and be responsive to your requests.</p>
<p>A special thanks to those who attended CPA Leadership &amp; Advocacy (L&amp;A) in Sacramento – Mark Kamena, Meghan Harris, Beth Tabakin. This was my second time and I really feel inspired to be more active in government affairs in general. More specifically, I want to urge all of you to voice your opinions via letters to our local legislators about the issue of sunsetting the Board of Psychology. We learned at L&amp;A that without this Board, we licensed psychologists would no longer be able to practice in CA, no longer be able to obtain malpractice insurance (having lost our licensure), and no longer be able to care for or make recommendations for care to our clients and patients. While some seasoned practitioners may see this as an opportunity for early-ish retirement (ha-ha), those of us who are recently licensed or soon-to-be licensed may be in a state of shock &amp; awe that our years of study and training stand the chance of being dismissed (not to mention all those unpaid student loans!!).</p>
<p>Another important issue is fondly referred to as “parity.” The parity bills will make CA law equivalent with Federal law, so that our clients’ access to mental health treatment is more equitable and is not limited to certain specific diagnoses.  Our GAC representative, Beth Tabakin, will be emailing requests to send letters and we are studiously looking for ways to make it easier to complete this task – stay tuned to your emails for updates!! If any of you would like more information about these very important issues, please do not hesitate to contact me!</p>
<p>Several of our board members recently attended CPA’s annual conference in Monterey. In addition to the beautiful setting and weather, we had ample opportunities to connect with old friends and colleagues and have some fun, as well as earn a lot of CE hours in very well-planned and presented seminars! Congratulations and thanks to our very own Mark Kamena who coordinated CPA this year – it was a huge success.</p>
<p>The rest of our year is shaping up with a few changes. Dates for the Marin Baroque Concert &amp; CE event and Dr. Lonnie Barbach’s presentation on “Sex After 60” have been changed to the Fall – check the website and future emails for specifics. We welcomed a presentation on parenting young adults by Dr. Kenneth Perlmutter – thank you, Kenneth! Next up we have our own Dr. Keith Sutton with a much-needed update on diagnosis &amp; treatment issues of ADHD. Hope to see you there (Mind Therapy Clinic) on Saturday, June 2 from 10-12. Thanks for liking us on Facebook!!</p>
<p>-Barbara Nova, Ph.D., MCPA President</p>
<p># # #</p>
<p>Please visit <a href="http://www.marincountypsych.org" target="_blank">http://www.marincountypsych.org</a> for more information about our association and membership benefits or to locate a licensed clinical psychologist in Marin County.</p>
<p># # #</p>
<p>Blog Disclaimer:</p>
<p>The opinions expressed by the authors are their own and do not reflect the opinions of the Marin County Psychological Association. The information posted on this blog is not intended as, and is not, a substitute for professional mental health services.</p>
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		<title>Has Your Aging Parent Told You to “Mind Your Own Business”?</title>
		<link>http://www.smblogsites.com/marincountypsych/?p=159</link>
		<comments>http://www.smblogsites.com/marincountypsych/?p=159#comments</comments>
		<pubDate>Tue, 15 May 2012 23:00:00 +0000</pubDate>
		<dc:creator>DrNemerovski</dc:creator>
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		<description><![CDATA[Has Your Aging Parent Told You to “Mind Your Own Business”? by Mikol Davis, Ed.D. and Carolyn Rosenblatt Getting rebuffed hurts. Have you ever tried to talk to your aging parent about finances and been told to take a hike? “Just &#8230; <a class="more-link" href="http://www.smblogsites.com/marincountypsych/?p=159">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
				<content:encoded><![CDATA[<p><strong>Has Your Aging Parent Told You to “Mind Your Own Business”?</strong></p>
<p><strong><a href="http://www.smblogsites.com/marincountypsych/wp-content/uploads/2012/05/angry_old_woman.jpg"><img class="size-full wp-image-160 alignleft" title="angry_old_woman" src="http://www.smblogsites.com/marincountypsych/wp-content/uploads/2012/05/angry_old_woman.jpg" alt="" width="227" height="272" /></a></strong>by Mikol Davis, Ed.D. and Carolyn Rosenblatt</p>
<p>Getting rebuffed hurts.</p>
<p>Have you ever tried to talk to your aging parent about finances and been told to take a hike? “Just mind your own business. I’ll be fine”.</p>
<p>Or has your aging parent ever said, “Let’s talk about that some other time” when you bring up the subject of money and the future? Of course the some other time never comes.</p>
<p>Some parents clam up, change the subject and otherwise put off having a conversation when their adult kids raise it.</p>
<p>What are they afraid of?</p>
<p>According to what I’ve learned at <a href="http://AgingParents.com/">AgingParents.com</a> from asking directly is that some aging parents are afraid of losing their independence and control. They are afraid of being put in a home if they lose control over their money. It is frightening to bring up something that they believe may lead to loss. They are Depression era survivors. If you talk about money you could lose everything.</p>
<p>Their thinking seems to be that if they can avoid talking about it, they can avoid the things they fear.</p>
<p>When visiting my 89 year old mother in law Alice, recently, my husband, Mikol and I talked to her and her friends about why people won’t discuss finances. Alice is very open and wants Mikol’s help in managing her finances. But many of her friends are not so open. We went out to dinner with some of them and asked them their thoughts on the secrecy around money in their age group.</p>
<p>Here’s what they said are the top reasons why elders don’t want to disclose what they have and don’t want to talk about it with their adult kids.<br />
“If the parents have a lot of assets, they are afraid that their kids will lose motivation to work if they know about how much their parents are worth.”</p>
<p>“If their kids know how much they have, some parents are afraid their kids will pressure them to give the kids money as gifts, or more than they want to give as gifts and it will be unpleasant or confrontational.”</p>
<p>They are afraid that “if their kids know what they’ve got that the kids will take advantage of their parents, or try to get control over the money as the parents get older” and less able to fend for themselves.</p>
<p>Are aging parents’ fears realistic as described here? Perhaps. There is no doubt that in some families we see at <a href="http://AgingParents.com/">AgingParents.com</a>, the “vulture syndrome” does exist. Some ruthless adult kids are circling, relatively speaking, waiting for a parent to pass so they can inherit. Fortunately, I don’t observe that to be a majority of adult children I see.</p>
<p>Perhaps in some families, kids will pressure their parents for money or try to take advantage of them. After all, financial elder abuse is a $3.2 billion dollar a year problem. Most abuse is committed by families. However, these risks are not a good reason to avoid discussion of finances.</p>
<p>If you are a responsible adult child with parents who are getting older and less capable than they once were, it is definitely time to get past their resistance about the subject of money and the future. There’s one good reason for this. If you don’t do it, you may have it all come down on your head when a crisis hits.</p>
<p>Imagine your parent with a stroke, unable to speak. Or your parent falls and is unconscious for a time. If you don’t even know what bank Mom uses, or where the accounts are, how useful are you going to be? Someone still has to pay the bills when your parent is incapacitated. If they bank online and you don’t have the passwords, you won’t be able to do much.</p>
<p>So, the tips for the day are:</p>
<p>1. Insist that your parent speak with you about finances because it’s for your sake. They would be putting a huge burden on you if anything went wrong with their health and you had no information.</p>
<p>2. Find out what they have, where it is, how to get to it, and what it would take to manage finances for them in the event of an emergency.</p>
<p>3. Find out if they have done any planning for long term care in the event that they could not manage without help at home. If they have done no planning, this is a good reason to seek an appointment with their financial adviser post haste.</p>
<p>4. If you have siblings or other relatives who are involved with your parents, call a family meeting. Think it through and talk it through about what you’ll do if a parent suddenly loses independence. It can happen to anyone.</p>
<p>It’s a bit like disaster preparedness: we are all likely to fare better if we have a plan about how to take care of ourselves.</p>
<p>If this hits home for you, consider a date for you to take the first step and get it on your calendar. If you feel lost and confused, help is available to everyone, no matter where you are. Your Area Agency on Aging is a place to locate sources of help.</p>
<p>Until next time,<br />
Dr. Mikol Davis &amp; Carolyn Rosenblatt<br />
<a href="http://agingparents.com/">AgingParents.com</a></p>
<p># # #</p>
<p>Please visit <a href="http://www.marincountypsych.org" target="_blank">http://www.marincountypsych.org</a> for more information about our association and membership benefits or to locate a licensed clinical psychologist in Marin County.</p>
<p># # #</p>
<p>Blog Disclaimer:</p>
<p>The opinions expressed by the authors are their own and do not reflect the opinions of the Marin County Psychological Association. The information posted on this blog is not intended as, and is not, a substitute for professional mental health services.</p>
<p>&nbsp;</p>
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		<title>Marin Baroque &amp; MCPA</title>
		<link>http://www.smblogsites.com/marincountypsych/?p=155</link>
		<comments>http://www.smblogsites.com/marincountypsych/?p=155#comments</comments>
		<pubDate>Tue, 08 May 2012 04:39:26 +0000</pubDate>
		<dc:creator>DrNemerovski</dc:creator>
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		<description><![CDATA[by Betsy Levine-Proctor, Ph.D. CPA Chapter &#38; Division 1 Mark your calendars! The date is June 16, 2012, the time 8:00 P.M.  The event is the debut concert of Marin Baroque, a professional level Chamber Choir and period instrument Orchestra &#8230; <a class="more-link" href="http://www.smblogsites.com/marincountypsych/?p=155">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
				<content:encoded><![CDATA[<p><strong>by Betsy Levine-Proctor, Ph.D.</strong><br />
CPA Chapter &amp; Division 1</p>
<p>Mark your calendars! The date is June 16, 2012, the time 8:00 P.M.  The event is the debut concert of Marin Baroque, a professional level Chamber Choir and period instrument Orchestra co-founded by Daniel Canosa, Music Director, and Betsy Levine-Proctor, San Rafael Psychologist.  The program includes: Bach’s Cantata 106, Actus Tragicus, Vivaldi’s double-choir Beatus Vir, and selected Hebrew Baroque works by Rossi.  Highly acclaimed instrumentalist Shira Kammen will be featured.  Tickets are available at <a href="http://www.Brownpapertickets.com" target="_blank">Brownpapertickets.com</a> and at the door.  The concert will be held in the beautiful sanctuary of First Presbyterian Church of San Rafael, 1510 Fifth Avenue (corner of E Street), San Rafael with a reception immediately following.</p>
<p>In October, 2011, Dr. Levine-Proctor and Mr. Canosa began discussing the idea of developing a music organization which would include a small, professional level singing ensemble and a period instrument orchestra with a primary focus on Baroque music.  Such organizations are quite active in San Francisco, Sonoma County, Berkeley, and Carmel.  However, there is nothing quite like this in Marin County, and a number of individuals, both singers and audience members, have expressed the desire to be involved in one “…without having to cross a bridge to get to it.”</p>
<p>Auditions began in November; rehearsals began in February; and a strategic planning meeting was held in March, facilitated by Dr. Jo Linder-Crow, wearing her non-Executive Director of CPA, Facilitator hat.</p>
<p>Several MCPA Psychologists expressed an interest in Marin Baroque and attended the strategic planning meeting in March.  Drs. Meghan Harris, Past-President, Claudia Perez, Past-past-President, and Laura Dunning, Past-Newsletter Editor and List Serve Coordinator, were all there along with 21 other singers and supporters.  Since then, these three Psychologists have been providing invaluable assistance with publicity and setting up a really useful list serve for the Choir. If you attend the concert and purchase your ticket at the door, Dr. Nancy Hoffman will sell it to you.  Either Dr. Harris or Dr. Dunning will be your gracious wine pourer at the reception, and you will see a number of your colleagues among the audience.</p>
<p>MCPA and Marin Baroque have a surprise collaboration in store for you next concert season which begins in late fall.  Stay tuned.</p>
<p># # #</p>
<p>Please visit <a href="http://www.marincountypsych.org" target="_blank">http://www.marincountypsych.org</a> for more information about our association and membership benefits or to locate a licensed clinical psychologist in Marin County.</p>
<p># # #</p>
<p>Blog Disclaimer:</p>
<p>The opinions expressed by the authors are their own and do not reflect the opinions of the Marin County Psychological Association. The information posted on this blog is not intended as, and is not, a substitute for professional mental health services.</p>
<p>&nbsp;</p>
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		<title>The Invention and Rediscovery of Shame</title>
		<link>http://www.smblogsites.com/marincountypsych/?p=152</link>
		<comments>http://www.smblogsites.com/marincountypsych/?p=152#comments</comments>
		<pubDate>Tue, 17 Apr 2012 06:08:13 +0000</pubDate>
		<dc:creator>DrNemerovski</dc:creator>
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		<guid isPermaLink="false">http://www.smblogsites.com/marincountypsych/?p=152</guid>
		<description><![CDATA[The Invention and Rediscovery of Shame by Mark Zaslav, Ph.D. A genius, superhuman scientist creates two naked, intelligent, robot-beings in his laboratory.  For his first experiment, he instructs them to eat any food in the well-stocked refrigerator, except for a &#8230; <a class="more-link" href="http://www.smblogsites.com/marincountypsych/?p=152">Continue reading <span class="meta-nav">&#8594;</span></a>]]></description>
				<content:encoded><![CDATA[<p>The Invention and Rediscovery of Shame</p>
<p>by Mark Zaslav, Ph.D.</p>
<p>A genius, superhuman scientist creates two naked, intelligent, robot-beings in his laboratory.  For his first experiment, he instructs them to eat any food in the well-stocked refrigerator, except for a substance labeled “Awareness of What is Wrong.”  The scientist leaves the lab, and upon returning notes that his robot-beings are hiding from him.  He asks them why they are hiding and they tell him it feels wrong to be naked in front of him.  Concerned, the scientist asks if they have eaten of the banned substance.  Admitting their transgression, the male robot-being blames the female, and the female blames a snake-like creature.</p>
<p>The beings are banned from the lab and the female gives birth to two sons called A and C.  Both sons present offerings to the scientist-creator.  The scientist expresses appreciation only for the gift of son A.  Son C, in a state of envy and self-righteous rage at finding his gift unappreciated, murders his brother.</p>
<p>This is the story that greeted me when, ten years ago, as a life-long atheist and long-time clinical psychologist, I began to read the Bible.  In the story of Genesis, after the creation of the universe, earth and man, this Garden of Eden “experiment” is the first, and apparently most important demonstration about human nature conducted by God.  At the time of reading this, I was interested in the emerging scholarly literature about the “self-conscious” emotions of shame and guilt.  I was surprised and intrigued by the importance attributed in the Biblical story to the instillation and demonstration of shame.  Certainly, ancient authors were aware of the unique human capacities for tool making and language and they undoubtedly noticed that people had larger brains than other animals, but they chose to begin their story with an allegory about the human capacity for self-conscious moral evaluation.</p>
<p>While guilt and shame are usually mentioned together (and their meanings blurred), modern cognitive and social psychologists view them as different emotions.  Guilt is an emotion we feel when an act causes real or imagined suffering to another person.  Guilt is associated with a sense of regret as well as a motivation to make amends or apologize.  Research on people prone to experience guilt shows that they are more likely to accept responsibility for their behavior, show more empathy, have more durable self-esteem and be less likely to abuse substances than people prone to shame.  In short, proneness to healthy, “shame-free” guilt is associated with positive psychological functioning.</p>
<p>Shame, on the other hand, is associated with a global sense of being bad, deficient or inadequate.  In the parlance of current psychological theory, guilt is about “doing” and shame is about “being.”  We all experience a sense of shame when we fail to meet expectations, behave badly, or are reminded of our shortcomings.  Like guilt, the capacity to experience a sense of sense of shame presumably evolved because it was helpful for our species.  Evolutionary psychologists surmise that shame “handcuffs us to the social contract.”  The capacity for shame promotes social conformity and cohesion, and helps motivate accomplishment or achievement.  Without the healthy capacity to make and respond to moral judgments about the self, a civilization based on honor, propriety, cooperation, hierarchy, obligation and order would be impossible.</p>
<p>For people very vulnerable to a miscalibrated sense of shame however, almost any human encounter, mistake, misfortune, errant thought, or disturbing memory can give rise to an implosion of self-esteem including fantasies of not existing or not even deserving to exist.  Narcissistic personalities, associated with off-putting grandiose and entitled behavior, seem to function primarily to protect against a debilitating sense of shame.  Shameful states are not only painful, but they tend to be private and wordless.  For example, while guilt is often a convenient topic in psychotherapy, shame tends to be avoided unless tactfully brought into focus by a skilled therapist.</p>
<p>The first few pages of the Old Testament effectively summarize the characteristic human responses to shame: hiding, blaming, envy and rage.  Unlike guilt, which tends to motivate affiliative social behavior, excessive shame fuels social avoidance and victimized, angry self-absorption.  For the chronically shame-prone,  there may be a simmering sense of grievance easily triggered by feeling unappreciated or wronged.  Angry, even violent behavior may accompany these states.</p>
<p>In the modern world, famous but damaged people seek the limelight while simultaneously trying to hide in plain sight.  Recent deaths like those of Heath Ledger, Michael Jackson, Amy Winehouse and now Whitney Houston reveal that despite talent, accomplishment and wide adoration, celebrities often feel they can escape secret states of shameful self-loathing only through alcohol and drug intoxication.   Addiction is both shame selecting and shame fueling.  A history of abuse, trauma or neglect predisposes to experimentation with drugs, and the long descent into addiction provides more shameful material from which to hide.  In addictive disorders, hiding literally becomes all consuming.</p>
<p>The prevailing ethos in our enlightened age is that it is “wrong” to be excessively judgmental.  The irony, of course, is that even this admonition to open-mindedness is couched as a moral injunction.  It seems that try as we might as a culture to shift the object of our disapproval to judgment itself, it is impossible for our species to disengage the process of disapproving.  Research suggests that the human brain constantly and automatically makes moral judgments about virtually every aspect of life.  Even when we invoke reason or argument to justify these judgments, it appears that unconscious emotions really determine the verdict we defend.  For instance, Adam and Eve rationalized and cast blame when confronted, not in a genuine attempt at introspection, but merely to dissipate their shameful sense of self-disapproval.</p>
<p>Whether one believes it divinely inspired or not, the Genesis story continues to shine a light on a fundamental truth about being human.  We are the only animals that have evolved a moral sense, and the emotional capacity for shameful self-judgment is the basic building block of conscience.  The Biblical argument seems to be that without moral free will, anchored in the ability to experience shame, we are reduced to robot-beings living a meaningless existence.  In turn, undue vulnerability to shame and its vicissitudes leads directly to the most troublesome aspects of human nature, including deceit, malignant envy, rage and irrational violence.</p>
<p>In the end, the scientist has done his work.</p>
<p># # #</p>
<p>For more about Mark Zaslav, contact him at:</p>
<p><a href="mailto:markzaslav@gmail.com">markzaslav@gmail.com</a></p>
<p># # #</p>
<p>Please visit <a href="http://www.marincountypsych.org" target="_blank">http://www.marincountypsych.org</a> for more information about our association and membership benefits or to locate a licensed clinical psychologist in Marin County.</p>
<p># # #</p>
<p>Blog Disclaimer:</p>
<p>The opinions expressed by the authors are their own and do not reflect the opinions of the Marin County Psychological Association. The information posted on this blog is not intended as, and is not, a substitute for professional mental health services.</p>
<p>&nbsp;</p>
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