Just yesterday evenig the famous T.V personality had been talking on his feet about political figures and their apparent shortcomings. It was then my turn to be interviewed. He asked about the recent press conference on the College of Physicians policy on management of perople with substance disorders.
I decided it was time to introduce Recupero Seguro to the public. I told how this 60 year old man with a diagnosis of bipolar disorder and many psychiatric hospitalizations had become dependent on drugs, both cocaine and heroin during a long hyperactive period in his life. But how he is now off drugs for months and in the way to recover.
I also suggested that news media look for more examples of people achieving sobriety and control over their mental disorders or addictions.
Many of us are immersed in a plan to contribute to the new Recovery paradigm in the mental health community of patients, their families and caregivers. This blog represents part of that enthusiasm.
Friday, October 30, 2009
Sunday, July 12, 2009
Pura y Recupero: dos personalidades
Pura es persistente, empatica, llena de confianza en la vida y en los demas.
Recupero es depresivo a veces, suspicaz la mayor parte del tiempo, erratico en sus metas.
La siguientes notas son citas directas de un libro que trata sobre el desarrollo de la personalidad.
-------------------------------------------------------------------
Puras is persistent, empathetic, trusting person. Recupero is depressive but mostly suspicious and erratic in his goals for life.
The following direct quotations on the topic of personality development may be of interest to you.
-----------------------------------------------------------------------
Notes from Paths to Successful Development: Personality in the Life Course
Book by Lea Pulkkinene, Avshalom Caspi, Cambridge University Press, 2002, 422, pgs.
"Development is defined as “selective age-related
change in adaptive capacity” (Baltes, Staudinger, and Lindenberger,
1999) and special attention is given to the developing person's con
tribution to the creation of his or her own development (Brandtstädter,
1998). Individuals steer their physical, cognitive, social, and personality
development by constructing strategies for coping with various develop
mental challenges, by setting goals, and by making choices. According
to Brandtstädter (this volume), such intentional self development over
the life span is geared to the realization and maintenance of normative
representations that individuals construct of themselves and their future".
..........................................
"The function and significance of goals and choices in successful deve
lopment is especially apparent beyond childhood, and several chapters in
this volume are explicitly concerned with these topics in their efforts to
study successful development. Pulkkinen, Nurmi, and Kokko (this vol
ume) discuss how individuals steer their development by setting goals
and making choices as responses to developmental challenges. On the
one hand, personal goals reflect major age-graded transitions and nor
mative demands. On the other hand, individual differences in personal
goals reflect motivational orientations, such as security seeking or aim
ing at personal growth, which result in intraindividual coherence in goal
patterns. With data from the Jyväskylä Longitudinal Study of Personality
and Social Development, Pulkkinen and her colleagues show that some
personal goals are so pervasive that they operate as unifying life themes
that define long-term successful and unsuccessful development".
.......................................
"Bouchard (1995) correctly argued that a purely sociocultural perspec
tive on the life course “ignores the fact that life-histories themselves are
complex evolved adaptations, ” and suggests that an evolutionary perspec
tive may complement the sociocultural perspective by exploring how per
sonality variation is related to those adaptively-important problems with
which human beings have had to repeatedly contend".
.......................................
"An agentic conception of human nature is also central in Heckhausen's
work on control. Heckhausen (this volume) proposes that humans strive
to maximize primary control of their environment throughout life. How
ever, control capacities undergo radical changes and losses and indivi
duals have to disengage from unattainable goals and manage their own
emotional responses to such loss experiences. This type of control that
is directed at the internal world of the individual is referred to as sec
ondary control. Heckhausen shows how the age-normative structure of
life-course transitions allows individuals to anticipate decremental
changes in the opportunities to attain developmental goals. For example,
an individual can increase primary control striving when approaching
“developmental deadlines” (e.g., union formation, health-maintenance
in old age) and use secondary control to compensate for potential neg
ative affect and self-evaluation associated with failure to meet or resolve
developmental deadlines successfully."
Que cree usted?
What do you think?
Thursday, March 26, 2009
elevator speech Pura et al
Hi there. What's your floor?
15th...thanks.
Hey, don't I know you from somewhere?
Yes, now I remember. We met last year in the training on recovery from emotional problems. You were in the company of a gentleman who said he was in treatment for many years.
Oh. yes. I am Pura. He is Recupero. He is not doing to well lately.....
You must the the social worker that told us about the consumer council and how patients have discovered how assertive they can be in their own care.
Yes. How are you doing?
Ok. Here is my floor. Can I speak to you some more?
Sure. let's sit by the window.
So...I tell you...has been a long time for me to get used to this movement that began in late 2006. There are hundreds of coordinators in healthcare systems that have become experts and other people are consulting them.
Right Pura. Actually I am a coordinator too but I have a lot to learn. I just completed this 3 day training and was impressed with the harmonious relationships and the mutual support of all the coordinators.
I heard about that and came here although I am only a volunteer in the hospital. I enjoy helping these patients and am now also meeting with staff and families of these patients. They suffer as much.
I have to go now to see this family in room 15A. Hope to see you soon again.
...........and thanks for the conversation.
15th...thanks.
Hey, don't I know you from somewhere?
Yes, now I remember. We met last year in the training on recovery from emotional problems. You were in the company of a gentleman who said he was in treatment for many years.
Oh. yes. I am Pura. He is Recupero. He is not doing to well lately.....
You must the the social worker that told us about the consumer council and how patients have discovered how assertive they can be in their own care.
Yes. How are you doing?
Ok. Here is my floor. Can I speak to you some more?
Sure. let's sit by the window.
So...I tell you...has been a long time for me to get used to this movement that began in late 2006. There are hundreds of coordinators in healthcare systems that have become experts and other people are consulting them.
Right Pura. Actually I am a coordinator too but I have a lot to learn. I just completed this 3 day training and was impressed with the harmonious relationships and the mutual support of all the coordinators.
I heard about that and came here although I am only a volunteer in the hospital. I enjoy helping these patients and am now also meeting with staff and families of these patients. They suffer as much.
I have to go now to see this family in room 15A. Hope to see you soon again.
...........and thanks for the conversation.
Wednesday, February 11, 2009
El manejo de una enfermedad mental
Información para Personas que Han Experimentado Síntomas Psiquiátricos
¿Qué es el Programa del Manejo de las Enfermedades Mentales y la Recuperación?
http://mentalhealth.samhsa.gov/cmhs/CommunitySupport/toolkits/illness/espanol2.asp
El programa del Manejo de las Enfermedades Mentales y la Recuperación consiste en una serie de sesiones semanales en las cuales profesionales de la salud mental, especialmente entrenados, ayudan a las personas que han experimentado síntomas psiquiátricos a desarrollar estrategias personales para enfrentarse con la enfermedad mental y salir adelante con sus vidas. El programa se puede proveer de una manera individual o en grupo, y generalmente dura de 3 a 6 meses.
¿Cuáles son algunos de los beneficios del Programa del Manejo de las Enfermedades Mentales y la Recuperación para las personas que han experimentado síntomas psiquiátricos?
Aprendizaje sobre la enfermedad mental y las estrategias para el tratamiento
Disminución de los síntomas
Reducción de las recaídas y las rehospitalizaciones
Progreso hacia las metas personales y hacia la recuperación
¿Qué es lo que se va a enseñar en el Programa del Manejo de las Enfermedades Mentales y la Recuperación?
Los siguientes temas son cubiertos en las hojas educativas:
Estrategias para la Recuperación
Hechos Prácticos sobre la Enfermedad Mental
El Modelo sobre la Vulnerabilidad al Estrés y Estrategias para el Tratamiento
Creando Apoyo Social
Reduciendo las Recaídas
Usando las Medicinas Eficazmente
Enfrentándose al Estrés
Enfrentándose a los Problemas y a los Síntomas
Consiguiendo que sus Necesidades sean Satisfechas en el Sistema de la Salud Mental.
¿Cómo pueden ayudar los miembros de la familia y otros grupos de apoyo?
Con el permiso de la persona que ha experimentado los síntomas psiquiátricos, usted puede ayudar de la siguiente manera:
Leyendo las hojas educativas usadas en el programa
Asistiendo a algunas sesiones con los profesionales de la medicina y la persona que ha experimentado los síntomas psiquiátricos
Revisando las hojas educativas con la persona que ha experimentado los síntomas psiquiátricos
Ayudando a la persona a desarrollar e implementar planes para enfrentarse a los síntomas, reduciendo las recaídas, y buscando metas hacia la recuperación.
¿Cómo puede uno aprender más de como participar en el programa?
Visite nuestro sitio en la red del internet: www.mentalhealthpractices.org
Póngase en contacto con su centro comunitario local de salud mental
Este documento es parte del equipo de los recursos de implementación de la práctica basada en la evidencia desarollado por medio de un contrato (núm. 280-00-8049) de la Administración de los Servicios de la Salud Mental y Abuso de Substancias (SAMHSA)(siglas en inglés), el Centro para los Servicios de la Salud Mental (CMHS) (siglas en inglés) y una subvención de la Fundación de Robert Wood Johnson (RWJF)(siglas en inglés). Estos materiales están en forma de borrador para ser usados en un estudio piloto. Nadie puede reproducir, copiar, o distribuir esta publicación con fines lucrativos sin la autorización específica del SAMHSA (siglas en inglés).
Back to Illness Management and Recovery
¿Qué es el Programa del Manejo de las Enfermedades Mentales y la Recuperación?
http://mentalhealth.samhsa.gov/cmhs/CommunitySupport/toolkits/illness/espanol2.asp
El programa del Manejo de las Enfermedades Mentales y la Recuperación consiste en una serie de sesiones semanales en las cuales profesionales de la salud mental, especialmente entrenados, ayudan a las personas que han experimentado síntomas psiquiátricos a desarrollar estrategias personales para enfrentarse con la enfermedad mental y salir adelante con sus vidas. El programa se puede proveer de una manera individual o en grupo, y generalmente dura de 3 a 6 meses.
¿Cuáles son algunos de los beneficios del Programa del Manejo de las Enfermedades Mentales y la Recuperación para las personas que han experimentado síntomas psiquiátricos?
Aprendizaje sobre la enfermedad mental y las estrategias para el tratamiento
Disminución de los síntomas
Reducción de las recaídas y las rehospitalizaciones
Progreso hacia las metas personales y hacia la recuperación
¿Qué es lo que se va a enseñar en el Programa del Manejo de las Enfermedades Mentales y la Recuperación?
Los siguientes temas son cubiertos en las hojas educativas:
Estrategias para la Recuperación
Hechos Prácticos sobre la Enfermedad Mental
El Modelo sobre la Vulnerabilidad al Estrés y Estrategias para el Tratamiento
Creando Apoyo Social
Reduciendo las Recaídas
Usando las Medicinas Eficazmente
Enfrentándose al Estrés
Enfrentándose a los Problemas y a los Síntomas
Consiguiendo que sus Necesidades sean Satisfechas en el Sistema de la Salud Mental.
¿Cómo pueden ayudar los miembros de la familia y otros grupos de apoyo?
Con el permiso de la persona que ha experimentado los síntomas psiquiátricos, usted puede ayudar de la siguiente manera:
Leyendo las hojas educativas usadas en el programa
Asistiendo a algunas sesiones con los profesionales de la medicina y la persona que ha experimentado los síntomas psiquiátricos
Revisando las hojas educativas con la persona que ha experimentado los síntomas psiquiátricos
Ayudando a la persona a desarrollar e implementar planes para enfrentarse a los síntomas, reduciendo las recaídas, y buscando metas hacia la recuperación.
¿Cómo puede uno aprender más de como participar en el programa?
Visite nuestro sitio en la red del internet: www.mentalhealthpractices.org
Póngase en contacto con su centro comunitario local de salud mental
Este documento es parte del equipo de los recursos de implementación de la práctica basada en la evidencia desarollado por medio de un contrato (núm. 280-00-8049) de la Administración de los Servicios de la Salud Mental y Abuso de Substancias (SAMHSA)(siglas en inglés), el Centro para los Servicios de la Salud Mental (CMHS) (siglas en inglés) y una subvención de la Fundación de Robert Wood Johnson (RWJF)(siglas en inglés). Estos materiales están en forma de borrador para ser usados en un estudio piloto. Nadie puede reproducir, copiar, o distribuir esta publicación con fines lucrativos sin la autorización específica del SAMHSA (siglas en inglés).
Back to Illness Management and Recovery
Thursday, August 21, 2008
Pura and Recupero again
She sat quietly in the back of the room. She was enthused about what she had never seen before and was in front of her eyes now. The well-lighted room was missing only one thing. It had no window to the ocean. She could imagine the blue sky outside with some cotton-like clouds, perhaps a jet booming away. If she closed her eyes she could hear the waves.
But she was sitting right there for the longest time. The group of about 30 people had arrived in two waves, the larger one about 30 minutes into the meeting. The had been listening to this guy in white gown showe good humor and give interesting information about what they were about to do for the first time ever.
One person came in and left inmediately noticing she was in the wrong meeting. She hesitated to leave, though perhaps impressed by the speaker or maybe by the quiet, attentive audience.
Pura saw Recupero come in, wave her "Hi" and sit in front.
Then, one by one they read different articles of what the speaker called a model Mission Statement of a Patient Council. They had questions about some of the terms in the document but seemed to agree with the main purpose of the document. They were being asked if they had interest in establishing a group of patients that could formally advise the mental health care system! Amazing but not unheard of.
Well...they even nominated an executive committte or board, voted on four candidates. they chose them apparently to satisfaction. No body complained. The original speaker sat down and became part of the audience as the newly-elected President of the Council took over and gave his own pep talk.
The Council members decided to have the second meeting within one month and to include what they called rules of behavior for Council members in the agenda.
Within two hours they had organized another valuable source of information and feedback for caregivers and administrators of the mental health system.
Pura was sorry that Recupero did not get nominated for any position. (In private he told Pura he thought there were very few people from the clinic that he attends. He wished it had been different).
Pura said: "Well.. this is only the first meeting. Watch and see this organization grow".
But she was sitting right there for the longest time. The group of about 30 people had arrived in two waves, the larger one about 30 minutes into the meeting. The had been listening to this guy in white gown showe good humor and give interesting information about what they were about to do for the first time ever.
One person came in and left inmediately noticing she was in the wrong meeting. She hesitated to leave, though perhaps impressed by the speaker or maybe by the quiet, attentive audience.
Pura saw Recupero come in, wave her "Hi" and sit in front.
Then, one by one they read different articles of what the speaker called a model Mission Statement of a Patient Council. They had questions about some of the terms in the document but seemed to agree with the main purpose of the document. They were being asked if they had interest in establishing a group of patients that could formally advise the mental health care system! Amazing but not unheard of.
Well...they even nominated an executive committte or board, voted on four candidates. they chose them apparently to satisfaction. No body complained. The original speaker sat down and became part of the audience as the newly-elected President of the Council took over and gave his own pep talk.
The Council members decided to have the second meeting within one month and to include what they called rules of behavior for Council members in the agenda.
Within two hours they had organized another valuable source of information and feedback for caregivers and administrators of the mental health system.
Pura was sorry that Recupero did not get nominated for any position. (In private he told Pura he thought there were very few people from the clinic that he attends. He wished it had been different).
Pura said: "Well.. this is only the first meeting. Watch and see this organization grow".
Tuesday, March 25, 2008
Albergar y expresar la esperanza contribuye a la prevencion del suicidio
parte noticioso parcial tomado de El Nuevo Dia
24 de marzo del 2008
Joven se lanza de octavo piso
El nuevo caso de suicidio se reportó anoche en un condominio de San Juan.
Por ELNUEVODIA.COM
Un joven de 19 años se quitó la vida anoche lanzándose desde el balcón de su apartamento, en un octavo piso, en San Juan.
Opinion de un lector de esta noticia en la versiòn internet del periòdico.
¨La depresión es una enfermedad tan dolorosa, es una tristeza constante, un dolor en el pecho frecuente inexplicable. No sólo los siquiatras están para medicar, deben orientar, dar seguimiento a sus pacientes. Pero, lamentablemente muchos siquiatras y especialistas están totalmente comercializados y un paciente es un número más $$$$$. La Depresión es una enfermedad progresiva, que sino se atiende adecuadamente, puede complicarse y covertirse en algo más serio. Mucha gente tiene información de esta enfermedad, que si es falta de la sustancia serotonina en el cerebro, que si por herencia, vulnerabilidad, STRESS etc. etc. Pero nadie puede entenderla si no la vive en carne propia.La familia del paciemte es un apoyo vital para su recuperación, los medicamentos, psicoterapias, visitas al siquitra. Si es que tienes la suerte de encontrar uno que "EN VEZ DE HONRAR EL JURAMENTO DE HIPOCRATES" " HIZO EL JURAMENTO DE HIPOCRITA" y de hacerse millonario a costa deldolor ajeno. Lamentablemente he conocido muchos "HIPOCRITAS" o DIZQUE MEDICOS y en Puerto Rico están choretos. OJO AL PILLO
¨Mi opinion en el periodico
"Una golondrina no hace verano.
Yo conozco muchas personas que han padecido de depresiòn intensa y ha recibido ayuda efectiva de sacerdotes, de pastores, de psiquiatras o de psicologos y consejeros o de trabajadores sociales y profesionales de enfermeria. Esas personas afectadas emocionalmente dan testimonio de la ayuda que recibieron y de como una pizca de esperanza para recuperarse fue la clave para levantarse de su depresion.
Mis condolencias a la familia de este joven que muriò.
Mi abrazo fraternal a Golita porque sì hay esperanza de superar una depresiòn y que hay muchas personas ayudando a los que sufren. Invito a las personas que estan en el proceso de recuperarse a dar su testimonio positivo. Eso va a ayudar a muchas otras personas. "
24 de marzo del 2008
Joven se lanza de octavo piso
El nuevo caso de suicidio se reportó anoche en un condominio de San Juan.
Por ELNUEVODIA.COM
Un joven de 19 años se quitó la vida anoche lanzándose desde el balcón de su apartamento, en un octavo piso, en San Juan.
Opinion de un lector de esta noticia en la versiòn internet del periòdico.
¨La depresión es una enfermedad tan dolorosa, es una tristeza constante, un dolor en el pecho frecuente inexplicable. No sólo los siquiatras están para medicar, deben orientar, dar seguimiento a sus pacientes. Pero, lamentablemente muchos siquiatras y especialistas están totalmente comercializados y un paciente es un número más $$$$$. La Depresión es una enfermedad progresiva, que sino se atiende adecuadamente, puede complicarse y covertirse en algo más serio. Mucha gente tiene información de esta enfermedad, que si es falta de la sustancia serotonina en el cerebro, que si por herencia, vulnerabilidad, STRESS etc. etc. Pero nadie puede entenderla si no la vive en carne propia.La familia del paciemte es un apoyo vital para su recuperación, los medicamentos, psicoterapias, visitas al siquitra. Si es que tienes la suerte de encontrar uno que "EN VEZ DE HONRAR EL JURAMENTO DE HIPOCRATES" " HIZO EL JURAMENTO DE HIPOCRITA" y de hacerse millonario a costa deldolor ajeno. Lamentablemente he conocido muchos "HIPOCRITAS" o DIZQUE MEDICOS y en Puerto Rico están choretos. OJO AL PILLO
¨Mi opinion en el periodico
"Una golondrina no hace verano.
Yo conozco muchas personas que han padecido de depresiòn intensa y ha recibido ayuda efectiva de sacerdotes, de pastores, de psiquiatras o de psicologos y consejeros o de trabajadores sociales y profesionales de enfermeria. Esas personas afectadas emocionalmente dan testimonio de la ayuda que recibieron y de como una pizca de esperanza para recuperarse fue la clave para levantarse de su depresion.
Mis condolencias a la familia de este joven que muriò.
Mi abrazo fraternal a Golita porque sì hay esperanza de superar una depresiòn y que hay muchas personas ayudando a los que sufren. Invito a las personas que estan en el proceso de recuperarse a dar su testimonio positivo. Eso va a ayudar a muchas otras personas. "
Friday, December 14, 2007
The American Psychiatric Association and Recovery from Mental Illness
from the
AMERICAN PSYCHIATRIC ASSOCIATION ANNUAL MEETING
MAY 19-24, 2007 - San Diego, Calif.
The William C. Menninger Memorial Convocation LectureNobel laureate John Nash Jr., Ph.D., at the age of 30, descended into the debilitating blackness of severe paranoid schizophrenia. Despite the odds, however, his perseverance and genius eventually led to his winning the 1994 Nobel Prize for Economics for landmark work he had begun in the 1950s on the mathematics of game theory. Yet, this is no fairytale ending; it provides powerful support for the growing movement within psychiatry to help patients with severe mental illness focus on recovery, not pathology.
Lecture given by Professor John F. Nash, Jr.
----------------------------------------------------------------------------
From a 1998 PSYCHIATRIC NEWS
"The philosopher Henry James once said that three things in human life are important: "The first is to be kind, the second is to be kind, and the third is to be kind,"Joel Feiner, M.D., in a lecture on the evolution of community psychiatry at APA's 1998 Institute for Psychiatric Services last month in Los Angeles.
Feiner's belief that proper attachments in rehabilitation are critical to recovery from psychiatric illness.
The therapist's positive view of the patient allows the patient to feel valued. "When a person feels valued, he is willing to risk new things and try new behaviors," Feiner said.
The interaction between case manager and patient is critical, but high turnover means that case managers often leave, severing the patient's link to the psychiatric clinic. It is therefore risky to let patients invest a great deal emotionally in their relationship with the case manager, he added.
The relationship between the clinician and the patient should take precedence over the relationship between the caseworker and the patient, since in most cases, the clinician is far more likely to remain accessible than is the caseworker, observed Feiner. When a good relationship between clinician and patient is not established, compliance is undermined. Mental Health Connections has a high level of compliance, although noncompliance in most mental health programs is a huge problem, said Feiner.
About half the patients in most other programs are medication noncompliant in the first year after discharge, he observed. Noncompliance is costly in both human and economic terms, resulting in unnecessary hospitalization, lost productivity, additional treatment, and death, Feiner noted. Another cost of noncompliance is "compassion fatigue," sometimes called "burnout," among overworked psychiatrists".
AMERICAN PSYCHIATRIC ASSOCIATION ANNUAL MEETING
MAY 19-24, 2007 - San Diego, Calif.
The William C. Menninger Memorial Convocation LectureNobel laureate John Nash Jr., Ph.D., at the age of 30, descended into the debilitating blackness of severe paranoid schizophrenia. Despite the odds, however, his perseverance and genius eventually led to his winning the 1994 Nobel Prize for Economics for landmark work he had begun in the 1950s on the mathematics of game theory. Yet, this is no fairytale ending; it provides powerful support for the growing movement within psychiatry to help patients with severe mental illness focus on recovery, not pathology.
Lecture given by Professor John F. Nash, Jr.
----------------------------------------------------------------------------
From a 1998 PSYCHIATRIC NEWS
"The philosopher Henry James once said that three things in human life are important: "The first is to be kind, the second is to be kind, and the third is to be kind,"Joel Feiner, M.D., in a lecture on the evolution of community psychiatry at APA's 1998 Institute for Psychiatric Services last month in Los Angeles.
Feiner's belief that proper attachments in rehabilitation are critical to recovery from psychiatric illness.
The therapist's positive view of the patient allows the patient to feel valued. "When a person feels valued, he is willing to risk new things and try new behaviors," Feiner said.
The interaction between case manager and patient is critical, but high turnover means that case managers often leave, severing the patient's link to the psychiatric clinic. It is therefore risky to let patients invest a great deal emotionally in their relationship with the case manager, he added.
The relationship between the clinician and the patient should take precedence over the relationship between the caseworker and the patient, since in most cases, the clinician is far more likely to remain accessible than is the caseworker, observed Feiner. When a good relationship between clinician and patient is not established, compliance is undermined. Mental Health Connections has a high level of compliance, although noncompliance in most mental health programs is a huge problem, said Feiner.
About half the patients in most other programs are medication noncompliant in the first year after discharge, he observed. Noncompliance is costly in both human and economic terms, resulting in unnecessary hospitalization, lost productivity, additional treatment, and death, Feiner noted. Another cost of noncompliance is "compassion fatigue," sometimes called "burnout," among overworked psychiatrists".
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