PUP: The Dream is Over

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The Dream is Over is adrenaline pumping guitars and gang vocals of childhood friends screaming until they tear their throats, but come back because they love it too much to quit. The denouement – a sludgy breakdown at the end of “Familiar Patterns” in which you envision large mosh pits of sweaty young men in black T-shirts bashing into each other, sucking air because they’ve been screaming all night too. Up until that point, the album is relentless. Try to keep up and it’s like being in the orange zone. I’ve been pumped all day listening to this thing. It’s going to take a while to fully appreciate the entire album as there are a few songs I get stuck on, listening to on repeat – in particular “sleep in the heat” which is a real banger. It’s got epic “whoa” chants, reminiscent of Irish drinking songs. The album is finely tuned, each instrument coming through clearly and blending appropriately with the others. The rhythm section has you rocking your body and tapping your foot, so you look like a fool or a possessed man to those observing you when you’re driving around town and stopped at the light. The kick and the bassist are tight, the guitars have that sloppy, punk:garage:surfer rock sound, but these guys hardly use power chords – complex rhythms, pin point stops, and smooth transitions. After listening to this on repeat, I feel like I’ve been blasting lines all day and won’t be able to fall asleep until the dreaded hour between 4:00am and 5:00am.

What we call support comes from feeding tubes

Falling rocks broke the sky, your birth was a drive-by

Put that honey in your tea, if all you do is lip and cry

Bright eyes belie the veil that you’re contemplating to exhale

Foaming fermentation swap of black saliva our lips are locked

You’re Dionysus, poised in a crisis

Lissome stem, to hold your head

Our mouths are sewn, lush petals overgrown

Dragging alone, beside your bed

Fervid hearts teased beneath a diaphanous sheet

Awake in a lake of love

ABA Therapy: Conform your Child to a Social Standard

This is a rant about those dogmatic behavior analysts, individuals who must always be in control, have perfect order, change “problematic” behavior, and turning our children into obedient slaves using questionable intervention packages and poorly designed analyses. They don’t have the wherewithal to see the detriments in their poorly constructed analytical tools. Statistical significance has long become the gold standard in comparing treatment to control groups, yet behavior analysts default to visual inspection of questionable graphing data subject to significant observer error variance. They sure make a lot of assumptions about data and of course, human behavior.

The behavior analyst has determined there are only 4 functions of behavior including tangible (behavior to get something, such as a preferred item or activity) escape/avoidance, attention seeking, and automatically reinforcing (self-stimulatory behavior). However, any single behavior can have multiple functions, which may be even be a combination of the four basic functions. The behaviorist has determined that all behavior is maintained by these functions. All human behavior can be broken down into these simple boxes, a laughably superficial proposition. Behavior and human motivation is a bit more complex and this hardly addresses deeper existential questions. As Donnie Darko would say, “Life isn’t that simple, you can’t just lump things into [these] categories.”

Emotions are a Spectrum of Fear and Love

Spend some time with a behavior analyst and you recognize an obsessive personality, a hint of arrogance and snobbery, and a fear of not knowing. You may want to put them onto the anxiety spectrum, if you are into that sort of classification system (300.02 GAD if you must). All behavior can be understood and analyzed through their functional analyses, applying poorly validated self-report questionnaires to tell you exactly why a particular behavior is occurring. Then they speak with such conviction of their “treatment,” because of course, the end goal is to modify behavior to a socially acceptable level through robotic reinforcement and punishment schedules, to train a human being like Caesar Millan in the Dog Whisperer.

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The purpose of ABA is to change individuals into compliant automatons so they may be socially accepted, modifying behavior to a social norm: conformity. The setting is a one-way street in which the therapist is highly directive and controlling the action. The client may be given choices, but those are given by the trainer. Behaviorism is not a collaborative effort. The definition of ABA is “the process of systematically applying interventions based upon the principles of learning theory to improve socially significant behaviors to a meaningful degree”. Who determines “socially significant?” Probably something to do with making life more comfortable for those in the target’s immediate environment.

People trained become mechanical, hard wired to have a specific response to stimuli and no longer thinking for themselves. What are the long term effects of such training? Give a snack for good behavior and put it on repeat. Good job! High five! Here’s a cookie. Place high demands and expect compliance based on our wishes. It does not teach self sufficiency – it trains obedience, a response to reward systems. Clients never learn important lessons on critical thinking or to question “why?”

The thought of an autistic existentialist must be terrifying to the ABA therapist. Children are told they are not normal and should be more like their socially appropriate peers. They are awkward and should be responding differently, in a socially acceptable, appropriate manner. You jump up in the middle of the playground and everyone makes fun of you, but you don’t care. Your ABA therapist, however, gives a social story to teach you shame. This can be socially destructive and destroy the uniqueness of the individual.

An alternative approach is play therapy in which the child initiates the play of the session, a less restrictive and non-directive form of therapy. Carl Rogers says to accept unconditionally rather than force change, and then it will occur naturally. Show them love and caring, prize them as unique individuals, and meet them where they’re at rather than try to bring them to your level. How do you respect autonomy when you incessantly purport to modify behavior, when you direct rather than listen?

And let’s not forget that ABA has its roots in punishment procedures aimed at reducing undesirable behavior with aversive stimulus …

The Lovaas Model

Incarcerating mental illness: Tax dollars poorly spent

There is an increasing number of mentally ill clients in correctional facilities and in the drug courts (Zweben, 2000). A study at Cook County Department of Corrections in Chicago found that 8 percent of participants had a dual diagnosis disorder (Abram, Teplin, & McClelland, 2003). In the female population, 72 percent with a severe mental illness had a co-occurring substance use disorder and 14.9% of inmates with a substance use disorder had a sever mental illness (Abram et. al., 2003). The self-destructive nature of a dual disorder leads many into a system where offenders are cast into a revolving door of arrest and release (Craig, 2004). High-risk women such as prostitutes, the homeless, and drug users are incarcerated for a few days and released to a rejecting community leading to a transient lifestyle (Abram et. al., 2003). The stated intention of corrections should be to provide inmates with rehabilitation services, an opportunity to intervene in their chaotic lives and provide a service to alleviate pressure on the system (Abram et al., 2003). The recurring arrest of the same suspects is wasting tax dollars and the focus needs to shift from incarceration to rehabilitation (Abram et al., 2003). The majority of homeless incidents are from minor infractions such as substance use and disorderly conduct charges (Simpson, 1992). Correctional facilities should work to incorporate homeless offenders into the community as a functioning member of society (Siegel, 1991). At the time of arrest, many officers inherently stigmatize the offender and have no clinical experience to help a client in need of treatment (Belenko, 2000). Offenders will rarely receive any treatment even during probationary periods (Belenko, 2000). There is a visible opportunity to advocate for these individuals but no one seems to be taking it.

References

Abram, K., Teplin, L. A., McClelland, G. M. (2003). Comorbidity of severe psychiatric disorders and substance use disorders among women in jail. The American Journal of Psychiatry, 160(5), 1007.

Belenko, S. (2000). The challenges of integrating drug treatment into the criminal justice process. Albany Law Review, 63(3), 833-872.

Craig, D. (2004). Iowa’s dual diagnosis offender program Corrections Today, 66(2), 96-98.

Siegel, N. (1991). Homelessness: Its origins, civil liberties problems and possible solutions, 36 Vill. L. Rev. 1063-1082.

Simpson, K. (1992) Problems of the Homeless in the Criminal Justic System at 5, Law and the Homeless Seminar paper, University of Maryland School of Law.

Zweben, J. (2000). Severely and persistently mentally ill substance abusers: Clinical and policy issues. Journal of Psychoactive Drugs, 32(4), 383-389.

Evolution of Sleep: The inner turmoil of the Vampire on Eldergrey Lane

… and allow me to describe to you the deceptive nature of my suspended consciousness.

It is a discomforting time …those moments approaching sleep spent lying in a state of delirium and insomnia … the day has ended and I am no closer to my last. I live a provisional existence.

I long for mortality, for my body to absorb my soul. The cure is as temporary as the illness.

Another horrible night denied a peaceful resting place.

My life is trapped in a coffin …

As I recycle the air, it becomes difficult to breath, a sort of asphyxiation. Each breath is shorter, the pace limited by a lack of space. The mind races to a panic.

Breathe in … 

Hold …

The nails splintered from the constant clawing at the casket cover … dried and cracked, the skin peels and bleeds.

This is torture.

The muscles cramp, long dehydrated from a lack of life.

Involuntary spasms

… an existence spent in a chasm.

Breathe out …

I am the living. I am the dead. The eyes are open. The eyes are closed. There is no considerable difference between the two.

I began the night on my back, flipped over to my stomach, then tossed to the side. Following this sequence, with each passing hour

… the cycle moving faster …

.. the pain becomes unbearable with each futile position.

My shoulders are sore, my stomach twisted, my hip bone pierced by pine.

My life of malaise forever unbalanced in perdition …

There is no comfort under such conditions!

Stretch the fingers

Twisted knuckles knurl

I clench them to a fist and raise it in anger punching my depressed ceiling.

I can feel the pang of hunger, the lust for life, the need to feed.

I must awaken

I am living in anxiety, longing for my life of suffering to close with the lid of the coffin. My heart is consumed in misery, a dark curse, the pestilence of a bloodline given to me not by choice. I was broken in 1684, a day when two fractured lives expected to form a beautiful quiescence. Such love and passion, torrid, sucking each other dry, my life entrusted to her mouth. I can still taste the saliva pouring from her pursed lips along my neck to the terminal destination of my collar.

Clenching my eyes, entranced, the ecstasy of the moment tastes of sugar cane.

Now, I cannot even see my reflection

I changed.

Closure is always just on the periphery, but I fold life in the palms of my hands like a locket preserving a distant memory. The lows outweigh the highs. Life is to suffer. Time is an unfortunate characteristic of the universe. Everyone is so distant. I vainly look into the mirror, desperately seeking own gaze, yet I find nothing.

Torturously immortal, I traverse this village, my countenance shrouded in darkness, and interact with it inhabitants under the guise of a hopeless romantic. I extend idolization to the desperate. I have broken hearts. It is almost as if I am spreading some disease. I am sorry…I did not know misery is contagious.

The sun rises, the sun sets. They move with my heart, cycling through days …

…. but I am still.

I feed on agony, watching them come and go, giving up to me, throwing their desperate selves. Each hand desires a little more.

I dream of haunted things …

…. infecting memories, digesting hearts

How much are you willing to give? How many times will you wash your pillow case? Change your sheets? What is left? You fall in love, this unique snowflake of an anecdote, your ultimate drug, the high that moves you beyond the quasars.

Would it be ironic, for death to stalk every loving relationship, the resultant separation and abandonment.

Love is fleeting. The emotion leaves.

Serotonin depleted.

It is desire, the ambition, the lust…

It is torture and grief.

And exhausting.

The worst of my situation is drinking from the cup of pain and suffering, the essence of human malady …

… until I am put to rest.

A life of failure, destined to purgatory, my victims have become a source of entertainment, each a stepping stone on the path of my absurd existence.

And all I wanted was to love and to be loved.

I hold the pencil, the eraser … and chronicle their lives. I have made so many mistakes.

My dear …to love me would be to drive a stake through my heart, to end my misery, but you wear your heart on your sleeve. You are the cliché victim, so hopeless and beautiful. I am so sorry for the unbearable life of suffering I will bring upon your soul. I can only hope you may forgive.

If I died tonight I would only have one regret:

That I was unable to show how much I really love you.