High Price by Carl Hart PhD

I just finished the new book, High Price by Carl Hart PhD.  Dr. Hart had made the rounds on several talk shows and he sparked my interest talking about his research in drug use behavior and decision making.  I thought the book would be an explanation of his research and how it applies to current drug counselling and treatment.  What I found was an autobiography that was quite compelling.  Dr. Hart views himself as profoundly lucky to end up where he did, and he compares himself to many of his childhood peers who ended up in a life of drugs, poverty and crime in Miami.  Dr. Hart grew up in a rather abusive broken home, raised by extended family.  His own family and friends struggled with addiction, violence, and poverty. Somehow, he avoided the path of many of his cohort.  Hart demystifies the addicts behavior and explains it more in terms of a response to poverty and hopelessness.  He stands opposed to the common view of drug addiction as an unstoppable brain illness.  He removes the typical heirarchy of addictive substances and views all intoxicants on a fairly level playing field. His research shows that given sufficient positive rewards even hard core drug addicts are capable of rational decisions.  He criticizes the efforts of the government to respond to drug use behavior with law-enforcement answers and he illustrates how incarceration of addicts results in continuation of the poverty that was the original problem.  

I took away some great advice for teens struggling with substance abuse. Much like a parent might insist on use of birth control and condoms for a teen they know is sexually active, Hart gives similar advice for teens that you know are using drugs:
1.  Combining multiple drug types is the most common reason for an overdose especially alcohol with another CNS depressant.
2.  Do not model your drug behavior off that of more experienced users because they have much higher tolerance.
3.  Drugs off the street are not always pure and can be adulterated with all kinds of poisons that are more dangerous than the drug itself.
4.  Drugs are highly illegal and you are allowing your future to be controlled by lots of other people other than your parents if you are charged with a drug crime.
5.  Adequate sleep is the foundation of mental health.  Any behavior that results in sleep loss will undoubtedly result in emotional and physical deterioration.

Separation anxiety and school refusal

It's week 3 of school on Arkansas and separation anxiety is on my mind.  This time of year usually creates a dramatic increase in anxiety for kids.  Many children will refuse to go to school or will come down with some mysterious medical symptoms that might be explained as anxiety.  The most common complaints are gastrointestinal and fatigue, but they could include headaches, dizziness, and other neurological symptoms.  Sunday nights and Monday mornings tend to be the most common times when those symptoms are coming from anxiety, so if you notice this pattern you may want to consider anxiety as the culprit. The solution?  Well it may sound old-school but a little bit of "tough-it-out" will really help.  The child must go to school for this problem to get better.  Often the pattern develops and is given too much sympathy, then starts to build into days and before you know it a kid has missed two weeks of school.  I often advise a plan to ride with another family or a grandparent to break the pattern of an overly-sympathetic parent caving to the child.  The child will often remain more composed for someone who is not the parent.  In extreme cases, I will recommend a shortened school day, but I generally recommend trying to start the day at the beginning of the school day.  If your family is suffering from this problem, there are many local mental health professionals that can help including psychologists, social workers, and licensed counselors.  In severe cases medication may be helpful.  Pediatricians are usually the first contact when the medical symptoms are prominent.

Connecticut Shooting

The recent tragedy in Connecticut and other previous school shootings highlight the shortcomings of the mental health system in treating adolescents and young adults.  First people will blame the guns, then demonize shooter and his family. Undoubtedly, the shooter will be revealed as having a serious mental illness.  And undoubtedly, there will be revealed a number of tipping points that could have stopped this from happening going all the way back to his early childhood.  This was a human being at some point in his life who had a mother who cared for him, was intelligent, and had his own dreams and aspirations.  Somewhere these dreams were crushed and this is the terrifying result.  Some small acts of kindness formed together over time might have stemmed the tide of rage and anger that overtook him in these horrific acts.

What I am telling my children is to always remember that even the quietest, strangest kid in your class needs a friend.  Even the meanest bully has a heart somewhere.  I am telling my kids to never forget to say I love you to those you are the closest.  Don't pass up the opportunity to do something nice for another person.  Despite the media attention to this horrible tragedy, we live in the safest times that have ever existed.  It is because of our collective small acts of kindness and fostering empathy even to the least of these, that there is much more good in the world than evil.  As a community, we have to help those we know are at risk of these types of acts.  Working together we can help more.

Why I Love Crossfit

This weekend I participated in a gathering of over 500 athletes from around the region for a team Crossfit competition called Heart of America 4.  If you are unfamiliar with Crossfit, it is a fitness movement that focuses on not specializing in any particular aspect of athletic performance.  A Crossfitter strives to be a complete athlete.  Crossfitters work on endurance, stamina, strength, speed, power, agility, coordination, accuracy, balance, flexibility, and sometimes all of these at once.  Team and individual competitions are starting up all over the country, the most esteemed of which is the annual Crossfit Games popularized by replays on ESPN in the past 2 years.

The Heart of America 4 competition included 5 workouts over 3 days that were unknown to the competitors beforehand.  Each team was comprised of 3 men and 3 women.  When we arrived, the first workout was announced.  All six athletes on each team had 5 minutes to do as many rounds of the following exercises: 5 overhead squats, 10 kettebell swings, and 15 double-under jump ropes.  This may sound pretty hard or complicated, but to the average Crossfitter, these were perfectly reasonable requests.  We had trained on these exercises and felt pretty confident we could do it.  The rest of the weekend included lots of other difficult tasks, but we did it all and came away with a great sense of community, accomplishment and team work.  It was really hard, but really fun.  We had some successes and some failures.  The most touching moments came when our female athletes struggled with new movements and weights they had never done before, but kept going and going until the clock stopped.  Even though we struggled, these were our biggest bonding moments of the weekend as we hugged each other and shed a few tears for the disappointment all the while congratulating our athletes for the effort.

One thing I really love about Crossfit, is that there is no defined body type of a crossfitter yet everyone has to do the same workout.  I'm a bit stocky at 5'9" and 180lbs, but two of the guys on our team were well over 6 feet tall.  One of our female athletes is barely 5 feet tall and 100lbs.  Some of the women on other teams were nearly 6 feet tall and stronger than many of the men.  But through our experience of Crossfit, we all approached every workout with the same attitude: "OK, I can try this."  Certain body types do play to certain strengths and weaknesses, but the goal of Crossfit is to be well-rounded and capable no matter what you are asked to do.  I think this translates well into mental health and life in general.  Our lives are unpredictable.  You never know what surprise, joy, or tragedy is coming around the next corner.  Every human has their own strengths and weakness, personality types, and experiences.  If you have never tried something, you are going to be afraid of it.  If you have never allowed yourself to experience failure, you become mentally stuck and sell yourself short of your true potential.  But if you approach life with the attitude of a Crossfitter, things can be very different.  What am I afraid of? Let's go do it. What is my weakness? Let's work on that.  What have I accomplished so far?  Maybe I can do even more.  Crossfit helps the individual become more prepared for the unknown and the unknowable.  It helps you become confident that you can get through adversity.

I also love the social aspect of Crossfit.  As human primates, we all need to feel that we belong to a tribe.  Society is way too large to manage from a psychological standpoint.   Mentally, it comforts us when we break our massive population into manageable factions and groups.  That's why some of us enjoy being on a team, working in our businesses, being part of a church, joining a book club, attending a support group, affiliating with a political party, and hanging with our family. Psychologists and archeologists think our brains are only capable of maintaining about 150 social relationships at one time.  The people who are the closest are those who have been there when we have laughed or cried together. To belong to something bigger than yourself is really important, and it's also important to feel like you are a contributing member of that group.  Not belonging to anything leads to depression, and social isolation is one of the most miserable of human conditions.  Crossfit is a great outlet for the basic human need of belonging.  It fulfills the individual need for praise and it is very nurturing.  As Crossfitters, we enjoy looking to our coaches to help us reach the next goal, working at full intensity with our friends, and passing on our own knowledge to the newer athlete.  I am so thankful for my experiences this past weekend.  Below are some links:

crossfit.com
crossfit540.com
library.crossfit.com/free/pdf/CFJ_Trial_04_2012.pdf
heartofamericacrossfitthrowdown.blogspot.com

Physician, Heal thyself

In my quest to help kids and families, I committed a cardinal sin- I ate red dye number 40!..  And OMG I paid for it.  I was aware of a sensitivity that I have had to red-colored food in the past.  I've had a few minor reactions to red and blue sports drinks containing red 40 in the past.  Yesterday, I ate a huge red pop-ice at my daughter's summer camp.  I have never had such a severe food reaction.  Literally ever fiber of my body paid for it.  Within about 10 minutes, I felt weird and weak.  Later, I felt dizzy, nauseated, and had a continuous migraine that did not remit until about 24 hours later.  I had migrating joint pains for several hours and became incredibly sleepy within about two hours of ingestion.  This was a big wake up call that even a single exposure to red 40 can be incapacitating.  Interestingly, my daughter had an orange pop-ice, also containing red 40, and she had a similar reaction that happened much quicker and was over with sooner.

Artificial food dyes are in a ton of our food supply.  Several have been shown to increase growth of tumors in mice.  Elimination of artificial food dyes has been shown to improve symptoms of hyperactivity in ADHD children.  Many children with behavioral reactions to artificial food dyes would also benefit from elimination of other foods such as soy, wheat, and dairy.  Children with preexisting environmental allergies may benefit the most from elimination diets.

Finding Emo

I walked into Barnes and Noble dumfounded by a new section in the bookstore, Teen Paranormal Fiction.  The popularity of vampire love has skyrocketed in the last few years.  I'm having trouble grasping the appeal.  I know a little about Twilight and sparkly vampires.  Vladamir Tod seems to be the teen vamp heartthrob.  The kids I see liking this stuff are already having some issues.  They tend to be the kids on the fringe of the social hierarchy.  I'm just not convinced that reading about fantasy characters falling in love is very helpful if this is the only thing you are reading.  It seems to cause an unhealthy fascination with being very different.

I'm all for individuality but sometimes it is taken too far with all black clothes, excessive makeup, hair dye, piercings, tattoos.  And scariest of all, these seem to be the kids most likely to cut themselves.  It gets me wondering if all the blood and gore in these paranormal books and shows is doing some type of desensitizing to self-inflicted violence.  Does it encourage strangeness by supporting the idea that even the evil have some redeeming qualities?

Teaching kids to conform a little can really help them fit in.  I think individuality is a bit overrated.  In the end, your kid needs to finish as much school as possible and eventually get a job.  Don't tie one hand behind their back allowing them to be ostracized for the sake of self-expression.  Don't allow permanent changes to hair, skin, and earlobes.  While they're under your roof, require a little conformity, monitor who they are hanging with, and by all means monitor the media and books that they are downloading into their developing little hard drives.  I believe you are what you eat, and to some extent, you fantasize about what you watch, read and hear.  Keep your appetite healthy and varied.

Entitled Teens

I've seen a number of teenagers lately who are surprisingly demanding and entitled in Northwest Arkansas.   I detect a deterioration in the level of gratitude in teens among the middle class.  I think this is perpetuated by the complete absence of a basic sense of real stress and struggle.  Teens are living much of their life in an artificial bubble protected from the reality.  They are too busy rushing to the next practice, ball game, recital, dress rehearsal, extra credit session to even notice that there are other people to be concerned about.  Then they are glued to their phone, plugged into their iPod, checking who liked their status update, or killing Nazi zombies with all their cyber friends online. I've seen 8 year olds with iPhones in my office playing who-knows which version of Angry Birds.  I've seen working class families with 4 kids who each have a Nintendo 3DS.  What is going on?  Do these kids not know how to take turns, to wait for Santa, to not answer that text right now.

How can we increase the gratitude and reduce the entitlement?
Some ideas:
1.  Decreased screen time.  Demand boundaries for video games, handhelds, phones, texting.   Have family time where no one (that means you dad) is texting, checking emails.  Turn that off!
2.  Play boring old board games, yard darts, badminton
3.  Help someone less fortunate, volunteer with your kids at the animal shelter, homeless shelter
4.  Model gratitude for your kids.
5.  Underschedule.  It's good to be bored.  It's good to think without distraction.  It's good to lay in a hammock, under a tree, climb a tree, chop a tree, build a fire, roast marshmallows, tell ghost stories.
Millions of years of human evolution occurred with fire as our only light.  We had only voices, ears, eye contact and body language as our primary communication.  Relying on the hardware that nature created might help us be less addicted to the human technology that seems to be eroding families.