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CHAPTER TEN: Memory processes and mind-brain change

W.M. Bernstein Karnac Books ePub

Mr. C is a fourty five year-old man with a PhD in a scientific discipline. He is working productively in his chosen sub-specialty. He loves his work. He has been married to his current wife for ten years and they have three children aged from five to nine. He comes in with a DSM-IV diagnosis of Obsessive Compulsive Disorder. He counts silently to himself, dwells on fears, and often feels very anxious. He has no other medical diagnoses. He had one short course of Cognitive Therapy eight years ago. He sought treatment at the time for anxiety about finding a suitable job. He reports that the therapy was somewhat helpful. He is a normal appearing, slender man. He talks rather easily and has a good sense of humour.

He reports that his obsessional symptoms appeared first when he was in graduate school. He is already receiving medications for his obsessional habit from a local psychiatrist. He was started six years ago on 200 mg of Fluvoxamine two times a day. This is an SSRI often used for OCD. The Fluvoxamine alone reduced his symptoms by fifty percent. Two years ago he had convinced his psychiatrist to add Dronabinol to his psychopharmacological regime. Dronabinol is Tetrahyrdocannabinol (THC), the active psychotropic agent in marijuana. Compared to using the SSRI alone, the patient had found that smoking marijuana along with using the SSRI reduced his obsessional thinking markedly. He uses 10 mg taken three times a day and it is as effective as the smoked Cannabis Sativa plant. He has also been using 1.0 mg of Clonazepam most nights to aid sleeping.

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Two Approaches to Managing Separation Anxiety

Denenberg, S. CABI PDF

Two Approaches to Managing

Separation Anxiety

Kersti Seksel*

Sydney Animal Behaviour Service, Seaforth, New South Wales, Australia

Conflict of interest: The author declares no conflict of interest.

Keywords: dog, separation anxiety

Introduction

Separation anxiety is the term used to describe the condition exhibited by dogs that are unable to cope without human company, often family members. These pets become extremely anxious and show distress behaviours such as vocalisation, destruction, house-soiling, inappetence, inactivity and even vomiting or diarrhoea in the total or virtual separation from people. The longer that these conditions are unrecognised and untreated, the more complex they appear to become and, therefore, potentially the harder to treat.

Diagnosis

Diagnosis is based on a complete behavioural history and thorough physical examination. It may involve complete blood work, dermatological and neurological work up as well as radiography to rule out contributing or concurrent medical factors.

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3 Laying the Foundation for a Successful Search

Lisa Mauri Thomas Sigma Theta Tau International ePub

The voyage of discovery is not in looking for new landscapes, but in looking with new eyes.

Anonymous

You did a lot of work in the last chapter to identify and leverage your strengths, allow your weaknesses to fade into the background, and appreciate how everyone you work with also has a set of strengths to contribute to the cause. In job searching, a big piece to landing your next role has as much to do with your likeability as your nursing knowledge. This chapter shows you specific ways to apply what you learned in the last chapter for success in networking, interviewing, and more. In other words, you have strengthened the ongoing dialogue you have with yourself. Put that self-awareness to work with the people who can help you meet your job search goals. So, smile and jump in!

Now that you have taken the time to discover the professional YOU, turn your attention to your skills. Nursing skills fall into two categories: technical and universal. Technical nursing skills include taking vitals, charting, working with electronic health records, using medical equipment, and interpreting medical information such as physicians’ orders. Universal nursing skills include effective communication on the floor, organization and time management needed for timely patient care, and the critical thinking needed not only to spot errors but to note what is missing or not happening as it should.

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8. Some reflections on the individual therapy: themes and interventions

Gillian Miles Karnac Books ePub

Maria Rhode

The three chapters by Jane Cassidy, Agathe Gretton, and Jackie Hall focus on work with the individual child. While Gretton stresses the overwhelming challenge that the developmental tasks of adolescence represent for depressed children, Cassidy’s main emphasis is on “working through in the counter-transference” (Brenman Pick, 1985), and Hall concentrates on the technical problem of phrasing interventions in a way most likely to support the child’s sense of autonomy. Each of the young people we hear about comes over very much as an individual. What greater contrast could there be than that between Gretton’s patients Sarah and Samantha—the one vividly present, larger than life; the other elusively always on the point of vanishing, both physically and emotionally? Add to these individual differences the cultural differences that emerged between treatment centres, as well as the inevitable differences in emphasis between treatment modalities and even between supervisors within a given treatment modality, and any attempt at generalizing from the clinical work in the Childhood Depression Project begins to look like a daunting task. And yet, common features do emerge, both from the therapists’ accounts and from Project discussions, both within and across Centres. In what follows, I shall concentrate on three main aspects of the work: some recurrent themes emerging in the course of treatment; technical adaptations made by the therapists in response to the young people’s state of mind; and the impact on both therapists and supervisors of working within a research project. In conclusion, I shall offer some speculations on the type of depression encountered in this study, and on the surprising degree of improvement achieved by these very troubled children and young people after a relatively short intervention.

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CHAPTER ONE: The dynamic brain in a dynamic environment: an epigenetic understanding

Susan Hart Karnac Books ePub

Just as everything about our minds is caused by our brains, everything about our brains is ultimately caused by our evolutionary history. For human beings, nurture is our nature. The capacity for culture is part of our biology, and the drive to learn is our most important and central instinct

(Gopnik, Meltzoff, & Kuhl, 1999, p. 8)

From the moment of conception there is a dynamic interaction between our genetic and hereditary properties and our environment. From birth, infants are predisposed to establish attachment and to engage in interactions with their care-givers. They initiate and control interactive situations and have an intuitive basis for sharing other people’s feelings and grasping their intentions. Three-week-old infants are able to imitate other people’s facial expressions, and two-day-old infants are able to reliably imitate a face that smiles, frowns, or looks surprised (Field, Woodson, Greenberg, & Cohen, 1982; Meltzoff & Moore, 1977; Stern, 1985).

The discussion of nature vs. nurture seems never-ending and is, in many respects, meaningless, since nature and nurture can be only expressed through intimate interaction. Nature and nurture are expressed at the moment of conception, throughout gestation, during childhood and youth, and in adulthood. A mother, father, or other primary care-giver affects the development of the infant’s affect-regulating system, which is neurally conditioned, and which later helps regulate other attachment functions. John Bowlby viewed attachment as the part of human biology through which social bonds are enacted. The attachment process enables the development of complex mental functions through complex actions from the primary care-giver. Many of these mental functions are uniquely human (Fonagy Gergely Jurist, & Target, 2002).

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