Behavioral Health

[impressive]

Part One: The Rant

As a few of you know, I am again amongst the ranks of the employed (as opposed to the independently contracted -- which I still am/do, too). I left my field of formal study (mathematics/computer science) way back in 1993 to be a stay-at-home-mom. Now, the need for health insurance arising from my divorce has forced me to accept employment.

I've taken a part-time job in a field in which I've been involved for the past 14 years as a volunteer -- first as just an advocate for my own child, then as an advocate for all individuals with disabilities. Over the years, I've developed quite a reputation in my community, my state, and even nationwide in certain circles due to a team on which I served during the last reauthorization of IDEA (the federal special education law). Desperate parents call me for help, bureaucrats fidget when I attend public meetings, the statewide newspaper occasionally asks me to write counterpoint OpEds, and my legislators (and especially their staff people) all know me well.

That being said, I have no formal qualifications for this job. Just some damned intense on-the-job training. I'm quite confident that I can do it and do it well.

However, it alarms me that someone with an unrelated degree can be hired, run through what amounts to a day-long training session, and then be considered "qualified" to assess a child's behavior, develop a behavior plan, and train direct care staff on the implementation of that behavior plan. Seriously. The people filling positions like the one I now hold are considered "experts" -- and they could know JACK SQUAT. They could be perpetuating -- or even instigating -- behavior problems due to complete ignorance, and it's completely legitimate in the sense that all regulatory requirements are being met.

Part Two: The Pondering

The psychology of behavior and motivation, though, is absolutely fascinating. I adore the process of dissecting behavior to ascertain its function using the mantra: all behavior is communication. The lessons learned while working with children who have autism or other behavioral challenges are easily applied to others. It's almost enough to make me want to go back to school and study it formally. Almost.

I've often heard folks refer to the AH as one big psych experiment, and we've certainly seen a case study or six. The recent AH reality TV show threads have only made it more obvious to me that our e-community is a fishbowl for anyone seeking research material.

So ... do you dig digging into behaviors? Do you wonder what motivates people to do the things they do? Why someone chooses to spend a ridiculous amount of time and energy on an activity that has no potential to bear fruit? What need they're attempting to address?

Do you take it a step further, into the realm of experimentation -- or even manipulation? (I mean, what's a "behavior intervention plan" but a formal mind fuck?) Find out what happens when you press this button?

There is plenty of available research on positive versus negative reinforcement, and the prevailing wisdom is that positive is more effective in the long term. Makes sense to me. Still, the prevalence of people who've been conditioned to roll-over-sit-stay-speak to what amounts to emotional assault just boggles my mind.

Oh, well. I'm rambling now. Feel free to share your thoughts on the subject(s).

 

[Recidiva]

People are fascinating in the way that music is fascinating. I know the notes, but I couldn't possibly imagine all the combinations myself.

Listening to my own thoughts, I can spend long times in solitary where I pick out my own themes, my own issues, clarity and order. But there are limitations to what I can do alone. I can't tickle myself. I can't startle myself. And I can't care as much about myself sometimes as I seem to care about other people. If it were just me, alone, I'd probably be happily sitting on a mountaintop. Death's fine. Pain's fine. Karma's cool. Whatever is is fine. But ultimately my mountaintop becomes boring and I trudge down to the village for some connection, some inspiration, and also...a reason to appreciate my mountaintop.

I see it in my kids most clearly. I work harder for them because they're helpless and they don't know the answers, and even if they did, they probably couldn't use that information. But then they figure out stuff in ways I didn't, and I get to see it. Lessons learned and reiterated and enacted in constant variety.

Online I get to see people handle problems well, or handle them badly, but all in all, they're doing things differently than what I do. I get to be dissonant or harmonic to their themes. I become a better musician, with a better ear, and a better appreciation for diversity. Then when I get tired I carry it all back up to the mountaintop and hum what I learned.

 

[Brute_Force]

Your post caught my attention because of the title "Behavioral Health," and though I have no formal training in the field, I have a lot of very personal insights into it because I have studied it in college and also on my own. My fields of specialization are narrow but DEEP. I know a good deal about the history of mental illness and the various treatments and classifications that have evolved over time.

I know nothing about autism or the treatments of it, but I do find it rather disturbing that people can just get classified as experts in the field who hold no formal degrees or certifications that make them such.

For a long time, I have been interested in people's motivations and the kinds of techniques used to motivate them. However, I must say, rather sadly, that at this juncture, I have come to believe that people's motivations are often so sordid and disgusting that I have lost interest in trying to understand them. I have what some have called "compassion fatigue," a state in which a person who has been compassionate and helpful toward others for so long without intrinsic or extrinsic rewards that they just become too exhausted to care anymore.

 

[impressive]

Online I get to see people handle problems well, or handle them badly, but all in all, they're doing things differently than what I do. I get to be dissonant or harmonic to their themes. I become a better musician, with a better ear, and a better appreciation for diversity. Then when I get tired I carry it all back up to the mountaintop and hum what I learned.

Om...

 

[impressive]

I have what some have called "compassion fatigue," a state in which a person who has been compassionate and helpful toward others for so long without intrinsic or extrinsic rewards that they just become too exhausted to care anymore.

Primary source of advocate burn-out. *nods*

 

[Recidiva]

Om...

It's a cyclic thing. I crave total solitary where there's silence, and then I crave the loudest, most dissonant place I can find (hello GB)

As for messing with people, I wouldn't say that I do that. I probe, but I don't dissect.

It's also out of curiosity and not malice. I'm generally trying to help, or understand.

 

[jomar]

Part One: You could be living in my community.

Part Two: Para three - Yes. Para four - No.






Probably more later, have to run.

 

[Recidiva]

Your post caught my attention because of the title "Behavioral Health," and though I have no formal training in the field, I have a lot of very personal insights into it because I have studied it in college and also on my own. My fields of specialization are narrow but DEEP. I know a good deal about the history of mental illness and the various treatments and classifications that have evolved over time.

I know nothing about autism or the treatments of it, but I do find it rather disturbing that people can just get classified as experts in the field who hold no formal degrees or certifications that make them such.

For a long time, I have been interested in people's motivations and the kinds of techniques used to motivate them. However, I must say, rather sadly, that at this juncture, I have come to believe that people's motivations are often so sordid and disgusting that I have lost interest in trying to understand them. I have what some have called "compassion fatigue," a state in which a person who has been compassionate and helpful toward others for so long without intrinsic or extrinsic rewards that they just become too exhausted to care anymore.

I work with medical reports, seeing all this tragedy all day long.

I handle fatigue by trying to channel it, and not standing in the middle of it and despairing. There's no end to it, but I can make a dent in it by having a bucket and a shovel.

I'm good now at taking things in only one shovelful at a time and heaving them out as quickly as possible.

 

[impressive]

It's a cyclic thing. I crave total solitary where there's silence, and then I crave the loudest, most dissonant place I can find (hello GB)

As for messing with people, I wouldn't say that I do that. I probe, but I don't dissect.

It's also out of curiosity and not malice. I'm generally trying to help, or understand.

Well, in general, I'd say most of the people working in behavioral health fields are trying to help/understand. I don't think there's much malice involved. Still, there's a fuckload of ignorance -- which, in terms of the outcome for the poor schmuck receiving services, could be the same as if there was malice aforethought.

 

[mismused]

delete

 

[Recidiva]

Well, in general, I'd say most of the people working in behavioral health fields are trying to help/understand. I don't think there's much malice involved. Still, there's a fuckload of ignorance -- which, in terms of the outcome for the poor schmuck receiving services, could be the same as if there was malice aforethought.

My son's autistic, so I've had to bend my brain around quite a bit of ignorance and stubbornness. I've found that many "normal" people make less sense than autistic people, who will at least be up front about what they're going to do, if not why. All the social nuance of people you think "should know better" is often caused by pre-existing conditions I can't fix any more than I can fix autism. I have to negotiate with insanity constantly.

I know I shouldn't negotiate with terrorists, but there are pre-existing conditions regarding becoming a terrorist that, when understood, also provoke compassion. Also irritation and the urge to kill, but it's all in there as melody and the bass line.

It may look like the pompous blowhard politically driven ass is the cause of the problem. But what caused the pomposity, need to blow or suck, and the political ambition?

I understand it gets difficult to nail down responsibility when everything can regress back to the Big Bang as THE MOMENT of defining everyone's character and motivations.

I tend to see these people simultaneously as obstacles and as victims themselves.

 

[rgraham666]

Oh yes. I'm fascinated by my species and its behaviour.

You're quite right when you say, all behaviour is communication. I wrote a little essay on that a couple of years ago. Information Disease. The people that wrote the book that gave me the idea of information disease were communication specialists.

Exploring human behaviour is one of the main reasons I write. By creating characters I get to explore the motivations and actions of human beings, and learn something about it. My early BDSM works especially. I didn't understand the mind sets of either side of that equation. Writing about it really opened my eyes.

 

[Brute_Force]

I know I shouldn't negotiate with terrorists, but there are pre-existing conditions regarding becoming a terrorist that, when understood, also provoke compassion. Also irritation and the urge to kill, but it's all in there as melody and the bass line.

It may look like the pompous blowhard politically driven ass is the cause of the problem. But what caused the pomposity, need to blow or suck, and the political ambition?

Very well said.

 

[impressive]

I tend to see these people simultaneously as obstacles and as victims themselves.

Agreed, for the most part.



mismused -- I adore your over-inflated opinion of me.

 

[xssve]

See this post in Amicus's thread - human behavior has always been a fascination for me, and I've got most of it puzzled out, though I'm not sure specificlaly what you're getting at in the OP.

If it's the empowerment of unqualified people in your field, I suggest it's a function of basic group theory - i.e., a person with a degree in something is presumed capable of figuring out something else - not necessarily the case, but it is a n assumption that other college educated people are prone to make, i.e., in the early days of institutional medicine, midwives and herbalists, etc., were roundly dismissed and even harrassed, even as they are today, although this is where most of the innovations of modern medicine in fact derive.

It's most simply that we construct paradigms of reality that shape our judgments, ala, R Graham's information disease - we all need a theory of "how the world works", and most people will settle for the first one that doesn't inconvenience them too much.

Thus, people with disabilites are treated differently in different societies, considered to be "touched by god" in some cultures, they are given a kind of respect, and supported by a sort of informal collective charity, given some minor but useful job etc.

Perhaps because of Western cultures obsession with bloodlines and genetics, which are tied to economic and class bias, people with disabilites have more typically been shunned as embarassments, from the crazy aunt locked in the attic, to mass incarceration in sanitariums - Foucaults "Ship of Fools" - his Madness and Civilization is one fairly comprehensive historical analysis of the phenomona.

It's changed some in recent years, but there remains an underlying class bias, as madness is often associated with impoverishment, and indeed, social stresses are often greater, and depression and other psychological maladies are more common among the destitute. As well, the fact that many sufferers from psychological dysfunction have difficulties with the social nuances required to successfully compete economically, and thus, tend to be impoverished, and that people who simply place little value on material accumulation, artists, etc., are often considered mad as well.

Most of our greatest artists, musicians, philosophers, inventors, etc., - free thinkers in short, have been considered mad, not uncommonly homosexuals or sex fiends - once one is beyond the pale already, there is little incentive not to continue to expand and explore "outside the box".

Finally, there is fear - these people are often suspected of simply not sharing in our common paradigms of reality, which is in fact, often the case - thre is always a tug of war between objective consensus reality (empirical) and subjective consensus reality which tends to be tied to group identity - i.e., in order to be a "good" evangelical Christian, one must profess belief in creationism, or whatever other subjective criteria are presented as group "values".

Anyway, if you could be more specific, perhaps I could shed some further light on the subject - essentially people are motivated predominantly by pleasure, the seat of consciousness is now considered to be located in the anterior cingulate gyrus, essentially the paleomammalian cortex or midbrain which recieves pain and pleasure stimuli and generates emotional and/or rational responses, and put simply, people are often more miotivated by fear of group exclusion than they are commited to observing, understanding and adapting to the empirical evidence of objective reality, and in truth, these can be debilitating pressures, particularly if one is not blessed with or has developed a valuable talent, and take enough pleasure in exercising it to compensate for the social censure of the group.

In this case, the absence of pain might be defined as the motivating reward, which is how the punishment principle works, i.e., the desired behavior is displayed in order to avoid the punishment.

 

[mismused]

delete

 

[Jenny_Jackson]

Me nephew is a psychologist. He says you really only need two terms to assess child behavior: "Fuckwad" and "Damned little Shitbird"

 

[impressive]

I've got most of it puzzled out, though I'm not sure specificlaly what you're getting at in the OP.

I'm not really getting at anything. Just trying to provoke discussion & learn what others might have to say on the subject.

Thanks for contributing!

 

[impressive]

Me nephew is a psychologist. He says you really only need two terms to assess child behavior: "Fuckwad" and "Damned little Shitbird"

*makes notation on my reports*


(Wonder how the PWB will take that diagnosis?)

 

[cloudy]

Behavior fascinates me, too. That, and the aforementioned desire to help, is what prompted me to begin my master's in clinical psychology.

I never finished - the classes are done, but the clinical practicums are still to go. Maybe one day I'll have the money and be in proximity to a school where I can finish.

Behavior modification works. I don't do it to mindfuck anyone, but sometimes you have to know which buttons work and which don't to be able to exist peacefully in society with others.

 

[impressive]

Behavior modification works. I don't do it to mindfuck anyone, but sometimes you have to know which buttons work and which don't to be able to exist peacefully in society with others.

Dee Dee.

 

[cloudy]

Dee Dee.

Indeed.

 

[R. Richard]

Me nephew is a psychologist. He says you really only need two terms to assess child behavior: "Fuckwad" and "Damned little Shitbird"

When I was in school, I was examined by a psychiatrist who was employed by the school system to deal with 'difficult children.' The boy had degrees from prestigeous schools and a sterling reputation. However, I insisted upon having an observer present while educated boy probed deep into my child's mind.

Psychaitrist boy was well along a straight path to declaring me a paranoid schizophreniac, he had almost all of the symptoms down and was ready to move on his god-like findings. Suddenly, the observer and I had a very disturbing conversation, based upon some of the data that I had given psychiatrist boy. Psychaitrist boy then asked the observer, "All of those people are then really trying to kill White Boy?" The observer [a man with no degree but some tiny idea of what was going on in the street] told him, "Them and more. However, from time to time, some of the people who want to kill him form temporary alliances with him to protect themselves against others."

I [a mere child] then asked psychitrist boy, "Why don't you take my knife and roam the alleys of South Central tonight. I'll take your car keys and wallet and see if I can survive in your society?"

Psychiatrist boy looked at me, crumpled up his notes and walked out without another word. He had just made the discovery that worse than an insane child was one who was coldly, terrifyingly sane.

 

[rgraham666]

Reading xssve's post bought a lot of thoughts up. Especially the way our society marginalizes the mentally and physically disabled.

I believe the main reason for this is religious. Our religion here in the West is rationality and economics. For things to be 'good' they must be 'rational' and 'economically useful'.

This makes those people that don't have these qualities sinners. And religious societies are never kind to their sinners.

 

[Recidiva]

Psychiatrist boy looked at me, crumpled up his notes and walked out without another word. He had just made the discovery that worse than an insane child was one who was coldly, terrifyingly sane.

I have a bit of a kinship with Hannibal Lecter who likes to fuck with everyone trying to pick his brain apart.

Also Hamlet.

HAMLET:
I do not well understand that. Will you play upon
this pipe?

GUILDENSTERN
My lord, I cannot.

HAMLET
I pray you.

GUILDENSTERN
Believe me, I cannot.

HAMLET
I do beseech you.

GUILDENSTERN
I know no touch of it, my lord.

HAMLET
'Tis as easy as lying: govern these ventages with
your lingers and thumb, give it breath with your
mouth, and it will discourse most eloquent music.
Look you, these are the stops.

GUILDENSTERN
But these cannot I command to any utterance of
harmony; I have not the skill.

HAMLET
Why, look you now, how unworthy a thing you make of
me! You would play upon me; you would seem to know
my stops; you would pluck out the heart of my
mystery; you would sound me from my lowest note to
the top of my compass: and there is much music,
excellent voice, in this little organ; yet cannot
you make it speak. 'Sblood, do you think I am
easier to be played on than a pipe? Call me what
instrument you will, though you can fret me, yet you
cannot play upon me.