Author Archives: Susan

SB 38 Proposed by Counselors and MFTs to Remove Wording Requiring Consult for Medical Board Professionals and Rx


Senator J.P. Morrell has proposed a measure that will remove language requiring that counselors and marriage and family therapists consult and collaborate with physicians, psychiatrists, medical psychologists, advanced practice registered psychiatric nurses, when treating or assessing individuals with “serious mental illness.”
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Governor Edwards outlined another bleak picture of Louisiana’s finances, telling legislators on Friday that he and his team have to deal with more shortfalls even before they are finished 2016 problems. “I’m asking the Legislature to approve the use of $119.5 out of the Rainy Day Fund, toward the shortfall,” Governor Edwards told the joint meeting on the budget.

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John Wick Chapter 2

This film, a sequel to John Wick, is remarkable. The first film tells of a retired hit man who is lured back into practice with the promise of compensation that will permit him to retire and to marry. He lives up to his reputation and then some. He is not so much an assassin as a murder machine, cementing the regard accorded him.

In retirement, Wick marries, only to lose his wife to disease. After the funeral, he receives a gift that his wife had sent him—a puppy. The note says that she has made her peace with
impending death, and wants John to find peace as well.

Later, John, accompanied by his pet, takes his classic Mustang for a drive, in the course of which the son of a big time mobster admires the car and asks to buy it. John refuses the offer and returns home.

That night the son and his henchmen invade John’s home, beating him, breaking the puppy’s neck and stealing the car. The mobster chief, realizing that his son has awakened a sleeping
dragon, sends a team to proactively kill John Wick, all of whom Wick bloodily dispatches along with additional assassins sent by the boss.

The boss finally captures Wick, who manages to escape and to track down and kill the boss’s son.

The sequel, Chapter 2, begins with Wick’s recovery of his beloved Mustang from a chop shop owned by the boss’s brother. Wick deals lethally with the hornet’s nest of mobsters in and
around the chop shop, then finds its owner but proposes “peace,” echoing his dead wife’s wish and hoping to resume his retirement.

They agree, but Wick’s peace is intruded on by the arrival of an Italian mobster to whom Wick had, much earlier, made an unbreakable blood oath to assist. This mobster wants Wick to
kill the mobster’s sister because he envies the sister’s place at “The High Table,” the governing council of the gangdom universe. Trapped by the obligation, Wick prepares for his mission by visiting The Continental, a hotel catering to gangdom, which boasts an unbreakable rule: no killing on the premises. There he transacts for weapons with a sommelier of arms and a tailor of bespoke suits equipped with bulletproof interlining and accommodations for weaponry.

He journeys to Rome and kills the sister, requiring a murderous exchange with her guardians. After breaking arms and necks, strangling, stabbing and shooting, and disposing of almost all of them, he finds himself having to deal with the brother who had commissioned the murder, who wants to tidy up by killing Wick. After more mayhem, Wick finds the brother in the bar of The Continental and shoots him. His violation of the no murder mandate results in a High Table order for Wick’s assassination. Wick is given an hour’s grace and leaves, promising to kill
anyone who comes after him.

The popularity of this film and its predecessor is evidence of the audience appeal of violence, an appeal also demonstrated by the long-running, apparently endless Bourne series. It
demonstrates the validity of the Freudian view that aggression, like sex, is a primal drive. John Wick is especially artful in facilitating a guilt-free gratification of that need.

Standards of art and fashion, and I would argue, morality, are parodied by their exaggerated display. Think of drag queens and Liberace. The term “camp” was first employed as a
description of some forms of homosexuality. The etymology of that term is uncertain, but some suggest it derives from the French le camper, to pose or display. The audience laughter
during the blood-spattered episodes of John Wick, the film’s notion of immorality decorated with unbreakable rules and of standards of fashion in the tools of killing, suggest that there
can be campy aggression, posed and exaggerated to the point of provoking laughter rather than disgust, shame, pity or fear.

Can a Single Stressful Event Cause Long-term Effects in the Brain?

Dr. Daniela Kaufer and her colleagues at the University of California, Berkeley, have found that Chronic stress triggers long-term changes in brain structure and function. (Molecular Psychiatry 2014) Kaufer’s research proposes a mechanism that could explain some changes in the brains of people with PTSD. She found that PTSD patients develop a stronger connectivity between the hippocampus and the amygdala (the seat of the brain’s fight or flight response). And, they develop a lower connectivity between the hippocampus and the prefrontal cortex, which moderates our responses. For the most part, it has been generally accepted that brain changes as a function of stress are based on repeated or chronic stress.

Recently, however, a research group at the University of Milan working with animal models found that even a single stressful event may cause long-term consequences in the brain. Dr. Maurizio Popoli and his colleagues (Molecular Psychiatry, 2016) found that a 40-minute protocol of stress enhances the release of glutamate, which is the major excitatory transmitter in the prefrontal cortex (PFC). New findings show that the enhanced glutamate release is sustained for at least 24 hours after the short stress protocol. AND, they found significant atrophy of apical dendrites after the 24 hours. Previous findings had suggested that dendrite atrophy is only seen after weeks of chronic stress.

These results may completely change the traditional distinction between chronic and acute stress. The University of Milan findings indicate that a single exposure to stress may cause a release of glutamate that lasts for at least 24 hours. And, the consequences are that the dendrite atrophy begins after only 24 hours and can last up to 2 weeks after the single stress protocol of 40 minutes. The authors relate these stress-related brain changes to PTSD and other stress-related disorders.

Dr. Kaufer and her colleagues also found that chronic stress generates more myelin-producing cells and fewer neurons than normal. This results in an excess of myelin – white matter – in some brain areas. The excess of white matter with fewer neurons disrupts the balance and timing of the internal communication within the brain.

Just how chronic and now acute stress creates these long-lasting changes in brain structure is still a mystery. The findings of brain-related changes secondary to acute and chronic stress hold the hope of finding new therapies that can reduce the risk of developing mental illness after stressful events.

Mind Over Matter: A Review of Split

The theme of several personalities fighting for control of the body they share has a long history in imaginative fiction as well as in psychological theory. In October 1919, The Journal of  Abnormal Psychology carried reports by Morton Prince and Charles Corey of cases of multiple personality. It is worth noting that Robert Louis Stevenson had published The Strange Case of Dr. Jekyll and Mr. Hyde some twenty-five years earlier, a work of fiction that has taken the form of novels, plays and movies in the ensuing years. M. Night Shyamalan, writer/director of the current movie Split, centers his film on this intriguing theme.

Both cases in the scientific journal are those of women and  are presented in the context of Freud’s early writings; Stevenson’s story is that of a man whose contesting selves emerge as a result of drug use. The quasi-clinical account of The Three Faces of Eve in 1957 was followed by a spate of similar accounts of women with multiple personalities, with steadily increasing numbers of contesting selves. The literary multiplication was matched by increasing attention in the therapeutic community, eventuating in official recognition by the American Psychiatric Association of Dissociative Identity Disorder. Clinical accounts continue to be almost exclusively of women, and are most often seen as the result of earlier child abuse.

Shyamalan’s movie reflects some of these trends and bucks others. Kevin Crumb is a young man with twenty-three personalities, the result of abuse by his mother. He is in treatment with Dr. Karen Fletcher, and the therapist believes that Kevin’s individual minds produce dramatic physical changes in the body that they share. She takes this to be a new frontier in the understanding of body/mind relationships justifying ground breaking, controversial presentations to the scientific community.

In the course of her treatment Kevin appears to become more stable, but Dr. Fletcher learns that Barry, the personality that determines which of the twenty-three controls the body at any
one time, is losing control. He is under attack by another self, Dennis, who is violent and likes to watch naked girls dance.

Dennis seizes control—it is called being in the light—and kidnaps three teen-aged girls. Held hostage, the terrified girls meet other personalities and learn about a twenty-fourth personality, The Beast, who will kill them. The movie portrays the girl’s struggles with the various selves and their panicked attempts to escape.

The doctor uncovers Dennis’s displacement of Barry and the kidnapping, but becomes herself his victim. The Beast emerges, superhuman in strength and totally vicious. His mission is to rid the world of those who are impure because they lack the experience of being abused. The Beast kills the doctor and two of the girls, devouring parts of them, but he spares the third girl, Casey, when he learns that she was the victim of sexual abuse by her guardian uncle.

The police arrive on the scene, but The Beast and his hoard escape and Casey is rescued. The tale seems to wind down as Casey is told she is free to return to her uncle, news she receives with a long cryptic stare.
There is an addendum. It takes the form of a diner scene. Customers are listening to the news about the kidnapping and killings. One of them remarks that it reminds them of a case years ago of a madman murderer in a wheelchair. As the group leaves another person at the counter reminds them that the maniac’s name was Glass. That person is Bruce Willis, reprising his role as David Dunn in The Unbreakable, in which he bested the mad killer.

Can we look forward to The Horde vs. The Unbreakable?

For many of us the Holidays can be a time of Major Stress. Some dread that time with family that brings back all those childhood issues. Some stress over having to spend so much money that they do not have for the children or for gifts they feel obligated to buy. For others, it is the tug-a-war between obligations and in-laws. Or, should we say, in-laws and out-laws? And, for still others, it is too much eating and drinking. And, too much to do.

How much stress you allow to touch you has everything to do with how conscious you are or can be about what is in your mind. How aware are you of what pushes your buttons? How much can you prepare for avoiding being stressed by in-laws and sis’ jealousy and mom’s critical attitude? Do you have a plan? If you have a plan, will you follow it? Too often we think we can just play it off the cuff. But, when we try to do that, we are often overwhelmed by a concert of things going Not Quite as You Wanted or Expected.

If you are truly aware and conscious, you will be monitoring your mental pulse all the time. What will you do if something gets under your skin? Will you be able to quietly slip out and find a quiet place to regroup, meditate and do some mindful breathing. If you are the Cook or Host and things are not going according to schedule, what can you do to regain mental control? Self-talk about how the season is about love and joy and not how spectacular the turkey is could help.

Even the AARP put out a list of things to do to Reduce Holiday Stress. So, I guess no matter how old you get, little things can still upset you and frazzle you during the holidays.
AARP suggests you
1. Create a Game Plan,
2. Make a budget and stick to it,
3. Accept the reality of guests arriving late and your mother
getting on your nerves,
4. Beware of unhealthy stress relievers, such as drinking or
eating too much,
5. Create new traditions,
6. Make time for your own health by keeping your sleep
schedule and getting regular exercise,
7. Give yourself a break in the midst of doing things for
others; listen to calming music, do some deep breathing or
just sit,
8. Be proactive and think about h
ow to do things differently so
you won’t be so stressed out, and
9. Enjoy! Remember to savor the time with people you love.

Technology to the Rescue

It’s about Time! Instead of technology increasing our stress, new apps are coming out that aim at helping us stay healthy and combat stress. In the last operating system upgrade (iOS 10) for MAC iPhones and iWatches, there is attention paid to reminders and apps that remind you to breathe or spend a few minutes of Mindfulness time. Continue reading

Are you one of those people who routinely over commits yourself?

If you are one of us who says “Yes” every time someone asks if you want to do something, then you are your own worst enemy. A primary cause of stress is feeling the pressure of time. The more we try to cram into a day, the more we become aware of how time can fly by or how much longer it takes to do something than we thought it would. Continue reading

Stress Linked to Increased Risk of Dementia

Chronic stress has become not only a #1 health risk , but also a major way of life for too many of us. If you are honest with yourself, the risk of dementia is more frightening than a heart attack. We can survive a heart attack but once dementia sets in, there is no escape – to date. The important link for all us neuroscientists is how anxiety, fear, and stress affect the brain. Continue reading