Susan Cain, a corporate lawyer, has just published a book Quiet: The Power of Introverts in a World That Won't Stop Talking. She writes:

"Imagine a two-year-old who greets you with a huge smile, offering a toy. Now here's another child who regards you gravely and hides behind his parent's leg. How do you feel about these two children? If you are like most people, you think of the first child as social and the second as reserved or, as everyone tends to interpret, 'shy.' From a very young age, we categorize children as one or the other, and we usually privilege the social designation. But this misses what's really going on with standoffish kids. Many were born with a careful, sensitive temperament that predisposes them to look before they leap. And this can pay off handsomely as they grow, in the form of strong academics, enhanced creativity and even a unique brand of leadership and empathy."

For more, read the article in Time magazine, or learn more about Highly Sensitive People (HSP).

Elaine Aron pioneered new ground over a decade ago when she wrote the trade book The Highly Sensitive Person; this was followed up by a workbook, a book on parenting children who are highly sensitive, and even a primer for therapists. Highly Sensitive Persons (HSP), in her view (which incorporates findings from important developmental psychologists such as Chess and Thomas), often show traits of what Carl Jung called Intraversion: they find grounding in thinking, nature, or reading, they rejuvenate themselves through rest and down time, and they may find themselves at odds with the teamwork and outgoing culture of business or Dale Carnegie aficionados.

Of the twenty-one films referenced in this blog, Don Juan DeMarco is the first I will discuss.

Psychiatrist Jack Mickler (Marlon Brando) dissuades a would-be suicide—a 21-year-old, costumed like Zorro claiming he is Don Juan (Johnny Depp)—is held for a ten-day review in a mental institution. Mickler, who is about to retire, insists on doing the evaluation and conducts it without medicating the youth. "Don Juan" tells his story—born in Mexico, the death of his father, a year in a harem, and finding true love (and being rejected) on a remote island. Listening enlivens Mickler's relationship with his own wife, Marilyn (Faye Dunaway). As the ten days tick down and pressure mounts on Mickler to support the youth's indefinite confinement, finding reality within the romantic imagination becomes Jack's last professional challenge.

Such, is the Wikipedia description of the plot.

Finally Hollywood has discovered a good man with the right stuff to play the part of an incredibly loving father who happens to be a graduate of the Bronx High School of Science, loves baseball, and who has just a enough of Asperger's syndrome qualities (a mere scent) to bond closely with his nine-year-old, a boy so riddled with fears that when he sees the swing set in Central Park he immediately sees in his mind an awful swing crash catastrophe. Dad finds unlimited fun ways to engage his intellectually gifted and timid boy, through fantasy trips and excavations of all kind, topped by the search for the Sixth Borough of New York, which floated away from the city one day and never returned.

Many remember Curt Schilling for his postseason successes with the Boston Red Sox, including one in which he pitched while in pain and with a bloodied sock. Schilling recently announced that he has formed his own video-game company, which will be releasing a fantasy-oriented game for gamers. The story behind the story here is that Schilling acknowledges that he has ADHD and that video games have had a positive role in his life in dealing with his ADHD.

Like many with ADHD, Schilling said he has always had a need to be immersed in interesting activities in order to remain focused. He said that during his teenage years, he "must have read The Lord of the Rings 20 times" and early in life he found that video games could help keep him interested in doing something constructive. He found that baseball-video games were too simple to hold his interest, and he became an avid gamer of fantasy games.

In the recent yearly "Reports of the Association" issue of the American Psychologist (December 2011), the American Psychological Association announced "Practice Guidelines Regarding Psychologists' Involvement in Pharmacological Issues." This report notes several factors that will make psychologists more involved in medication-management issues. One survey noted that the number of Americans using antidepressants increased from 6.7 percent in 1990 to 15.1 percent in 1998. Another study indicates that psychologists reported that 43 percent of their patients were using psychotropic medications. In two states, Louisiana and New Mexico, as well as the US Military, psychologists who have been "appropriately trained" are able to prescribe medications.

The task force that came up with this report noted that there is a continuum among psychologists concerning how involved each is with regard to psychopharmacological issues. This article notes three particular points on the continuum for psychologist involvement in psychopharmacology. First, the group of psychologists with actual prescriptive authority (a small, but growing group). Second, psychologists who actively participate in medication decision-making, such as by offering a consultative recommendation about a class of medicines or even a particular medicine to someone (physician, nurse practitioner), retain the legal responsibility for prescribing. Third, psychologists who provide information that may be relevant to pharmacotherapy decision makers, such as referring someone for a medication evaluation or discussing with patients how to address medication concerns with their prescriber. Following are some of the ideas the Task Force came up with.

From the Poughkeepsie Journal, January 12, 2012:

"ALBANY. A federal report finds the Cuomo administration and previous administrations ran a system to care for the developmentally disabled that not only failed patients and had an alarming number of unexplained deaths, but also excluded public review and ideas that could have protected patients better.

Ann Carrns, writing in the January 11, 2012, New York Times, notes a new financial tool, one geared for families with individuals who have special needs:

"Families with children who have special needs or disabilities face even bigger hurdles than most people when it comes to planning for their financial futures. Merrill Lynch Wealth Management has introduced a free online special needs calculator to help parents and guardians get started in evaluating their situation."

The calculator is available here.

One of the respondents to the Times article made an interesting comment:

"Even if you're not using the calculator for your own needs, it's a powerful tool to review. Though only a monetary view, it clearly illustrates one of the many complexities facing families dealing with special needs. You can't run through it without developing a deeper sense of compassion. If enough people are exposed to this tool, it hopefully will yield greater societal understanding."

"Though you may not 'need' this calculator, I encourage everyone to take a close look at this and see if it doesn't expand your own awareness. It did mine. Thank you."

In addition to the seventeen films related to psychiatry posted on this blog, I have been reminded of four others (though technically, one of the four is a series):

Crime Doctor (1943; series 1940s)

Angel at My Table (1990)

Girl, Interrupted (1999)

The Bell Jar (scheduled 2012)

In future postings, we will examine each of the twenty-one movies recommended.

William,

Like you I am getting ready to ring in the new year with family and friends.

For me that means a night with my heroes: my sister Jessie who lives with Bipolar Disorder and my wonderful nephew Calen who lives with Schizoaffective Disorder.

They have become fearless advocates for people living with mental illness, and they remind me daily why our mission to erase the kind of stigma they've come face to face with is so important.

That's why I'm asking you to make a tax-deductible donation to Bring Change 2 Mind before the clock strikes midnight tonight.

Year End Pledge

Jessie and Calen are not alone. We have learned that there are countless heroes out there working hard to change people's attitudes about mental illness.

But there are also many who struggle daily to find their voice, to speak freely about their illness and to seek help for it. That’s why we must continue the momentum our organization has gained this year into 2012 and beyond.

We're all connected, and everyone counts. Working together, I know we can change people's minds. Support Bring Change 2 Mind in 2012 by making a tax-deductible donation today:

Year End Pledge

Thank you and happy new year!

Glenn

Glenn Close
Chairman of the Board
Bring Change 2 Mind

Alcohol, cocaine, hallucinogens, marijuana, and opiates have had a varied and ambiguous legal and political history prior to the 21st century, and these substances will continue to need study, examination, policy, and law-making into the 21st century and beyond. Dwight Vick and Elizabeth Rhoades have written Drugs and Alcohol in the 21st Century: Theory, Behavior, and Policy (ebook) Rochelle Cade offers a review of the book in Counseling Today.

During the past two weeks heart-wrenching tragedies have occurred. One was the killing of a policeman on duty in New York City. His death left four daughters behind. Another was a fire that killed five people on tony Shippan Point in Stamford, Connecticut. In the first case, over 20,000 police officers attended the funeral and the readers of the New York Post contributed over $1.6 million for the Peter Figoski Scholarship Fund college fund for the four young women. In the second situation, the family struggles to plan a funeral for three little girls and their grandparents. AMHF offers condolences to all who are touched by these extremely sad events.

Your hospital beeper summons you to the emergency room to assess the condition of an assaultive patient. Are you safe as you enter the room? In your private practice office, you are assessing a patient with a known history of organic impairment and impulsiveness. Have you thought to ensure your own safety? You are about to apprehend the suspect. Are you at risk for a sudden eruption of violence? You are making a home visit to a family known for domestic violence. Are you safe or at risk when you ring the doorbell? You are a community reach outworker. Are you surveying the scene as you walk the streets?

Recent years have seen an unacceptable increase in violence and police, health care, and human services providers have not been immune from this violence. In fact, these helpers are often asked to provide services to these violent or potentially violent patients, clients, or suspects. How to provide these services safely in a way that reduces the risk of violence is the subject of this essay. It provides six general guidelines or risk management strategies for safety: four for specific and commonly encountered risk situations, and two for self-care. Responding to violent or potentially violent behavioral emergencies is very stressful and this essay can provide only a rudimentary overview of safety practices that are covered in depth elsewhere (1). This essay assumes that you have been well-trained in the basic standards of practice for the services that you provide to patients, clients, or suspects and that you will obtain any further needed training raised by the risk management strategies outlined here. If you work with a partner(s), be sure that you are all in agreement about how you will implement any of the risk management strategies noted herein.

The December 22, 2011, edition of the New York Times brings out another article on the problems and abuses in New York State public groups homes where developmentally disabled persons reside. It is important to note that the focus of the NYT articles has been on "public" rather than private group homes. Many of the private agencies offer good to outstanding care.

Although it notes very troubling, even abusive practices, the Times article may not represent psychiatric medical practice in places other than public New York State group homes, and it brings to mind how medicines and behavior therapies have become the standard treatment for those with psychiatric problems and developmental disabilities. Short-term cognitive therapies may be used, but are limited due to the intellectual limitations of these persons.

My own background has emphasized using long-term therapies with a relationship component. I suspect that this kind of therapy continues to hold great promise for those with developmental disabilities. Sometimes psychological testing can depict the rich internal lives of developmentally disabled persons who struggle with psychiatric problems. Here is one example* of a person whose psychological testing suggested she might be a good candidate for supportive therapy.

Pope Benedict VI decries the increasing commercialization of Christmas. Indeed, readers of this blog remember that among the films with a strong psychological component, listed in a recent posting, is Miracle on 34th Street. This 1947 classic, though "AMHF-blog worthy" being about the workings of a therapist and a HRD "personality tester," primarily takes up themes of the realities of the modern world and the idealism of a handful of individuals that confronts them.

The mission of The American Mental Health Foundation, a research organization about to celebrate 88 years of philanthropic activity, is to help people with emotional problems. Such wording comes straight from its mission statement. In future, AMHF will more directly address the unique emotional needs of the developmentally disabled and elders. The present program does three things: (1) Supports the good works of other foundations working in its spirit, such as Astor Services and Suicide Prevention International (which is preserved in this video); (2) Publishes works of its research like Dr. de Schill's magnum opus Crucial Choices, Crucial Changes as well as books on PTSD by Dr. Raymond B. Flannery Jr., on the psychoanalytic in society by Erich Fromm, and forthcoming on formation of personality by Dr. Henry Kellerman as well as the psychological issues facing women in the workplace by Drs. Joanne Gavin, James Campbell Quick, and David Gavin; and (3) Organizes and funds educational seminars and workshops like the ultra-successful "Small Family Business, Big Family Stress" presentation in the Hudson Valley in April 2011, with a follow-up at the FDR Estate in Hyde Park, this March 31, 2012, on "The Healthy Organization."

The directors of The American Mental Health Foundation look forward to a Miracle on Second Place in Brooklyn (where our foundation offices are located, in Carroll Gardens), and wish our supporters, and everyone, a Happy Holiday, a peaceful and joyous 2012.

Here is a letter I received from Jesse Close:

Dear William:

Share your story with Bring Change 2 Mind. I was 47 by the time I was properly diagnosed with bipolar disorder. For most of my life, my illness went undiagnosed and untreated.

Life is much better now. A proper diagnosis and treatment helped tremendously, and so did having an outlet to share my experiences and my stories with others.

That outlet is Bring Change 2 Mind Stories, a section of our website where you can read about people's experiences with mental illness and share your own. Take a look, and consider sharing yours today.

Share your experiences with mental illness, your own or your loved one's, with Bring Change 2 Mind.

Sharing my story on the Stories page was incredibly uplifting. I gained courage and strength from the support of the Bring Change 2 Mind community, many of whom I did not know before joining. I felt empowered, finally able to talk openly and freely about my illness.

More importantly, after sharing my story and reading other submissions, I saw that I was not alone in what I went through before recovery began. I was an alcoholic but found AA and am now ten years sober. I would become so frightened that I would hide in my closet. But, worst of all, I became suicidal during my bouts with depression.

Sharing your stories and experiences, whether you are living with a mental illness yourself or are close to someone who is, can give you the same strength and empowerment that it gave me. You may also give someone you've never met the strength to speak out.

If you're ready to find your voice, share your story with Bring Change 2 Mind today.

Glenn has said it before: There is strength in numbers and shared experiences. I hope you will lend your voice to our growing community.

Thank you,

Jessie Close
Co-founder, Bring Change 2 Mind

The following is based on interviews with Alexandra Styron.

I first met Alexandra Styron at a reading of her new book, Reading My Father: A Memoir (Scribner, 2011). She was appearing at the Quogue Public Library on Long Island. It was one of those beautiful midsummer afternoons that remind one so much of Henry James's The Portrait of a Lady: "Under certain circumstances there are few hours in life more agreeable than the hour dedicated to the ceremony known as afternoon tea." Mind you, we were not having tea, but the genteel setting on the green sward of library lawns, with the sun's rays dipping and making shadows, brought James to mind: "the flood of summer light had begun to ebb, the air had grown mellow, the shadows were long upon the smooth, dense turf."

Despite the sense of pleasure at seeing the great William Styron's daughter, the "shadows on the perfect lawn" adumbrated, as in James, "the shadows of an old man" having his tea as the day lengthened. Something about the coming darkness in the midst of summer sun becomes a leitmotif for father and daughter.

Among the millions of Facebook responses generated each day, some are posted by persons who display varying degrees of suicide potential and risk. In an attempt to deal with this constructively, Facebook (according to an article in the December 10, 2001, Boston Globe) will begin a service in which Facebook users can let Facebook know if a message suggests suicide risk:

"A program launching Tuesday enables users to instantly connect with a crisis counselor from the National Suicide Prevention Lifeline through Facebook's 'chat' messaging system.

"If a friend spots a suicidal thought on someone's page, he can report it to Facebook by clicking a link next to the comment. Facebook then sends an email to the person who posted the comment encouraging that user to call the hotline or click a link for a confidential chat."

It will be interesting to see how this new service will work out.

In most cases psychiatric drugs are not valuable commodities on the street: antipsychotics and antidepressants with names such as Thorazine, Haldol, Resperidal, Tofranil, SSRIs, Wellbutrin, Abilify, Lithium, and others generally must build up a therapeutic dosage in the bloodstream to become effective. There is no immediate "rush" or feeling of euphoria. In acute-psychiatric illness, a person may be admitted to the hospital where higher initial dosages can be given under supervision. Huge amounts of these substances crisscross the country each day in the U.S. Mail, with 90-day supplies being sent from big box pharmacies to patients.

There are exceptions. In the 1960s and 1970s, the anti-anxiety drugs Valium and Librium were too frequently prescribed or not watched closely enough. They have "a street value" because of the euphoria or sense of calmness rapidly induced. They are seriously addictive. Ritalin and its derivative amphetamine substances, prescribed for Attention Deficit Hyperactivity Disorder, also maintains solid street-value, frequently sought after by college students studying for finals or high-stakes exams like the LSAT, GRE, or MCAT.

I came across this memoir (with its compelling title, somewhat reminiscent of the work of Clarice Lispector) upon learning its author, Carol Hebald, had been awarded (six years before) the same fellowship I had been given as an undergraduate. The foreword is by iconoclast Thomas Stephen Szasz, known for his anti-traditional "anti-views" of psychotherapy. In The Heart Too Long Suppressed, (2001), Hebald writes of a chilling pattern of childhood abuse among several individuals close to her; about her dissociation from reality; and about her self-willed, up-by-the-bootstraps recovery. Here is a controversial book. In this connection, it is worth noting that The Bell Jar, by "Victoria Lucas" (who, of course, is Sylvia Plath) is scheduled for reinterpretation on the silver screen in 2012.