Showing posts with label development. Show all posts
Showing posts with label development. Show all posts

Monday, December 07, 2015

BEYOND STAGE THEORY



Developmental sequences like the ones I posted yesterday have some drawbacks.  They are so simplified that they leave out much information that might be important, flattening everything into one dimension.  They leave you to figure out what their one-word titles mean.  Most seriously, they imply in these maturation time-lines that one thing happens, then another thing happens, but there is no sense of how one comes out of the other or what the continuing relationship between them is.  Time’s arrow is assumed to go one way -- to the future.

In truth, human beings in their brain evolution and maturation are recursive and depend upon synergy, concatenation, and entrainment among anatomies and processes.  When a second ability or dimension is added to the first, both may gain or lose, but will certainly change.  Then a third capacity comes from the interaction of the two or the new addition may lie dormant until some happening activates it.  This is true even in the sense of the individual’s development.  

We think in terms of organs, neglecting that the molecular soup in our blood and lymph also evolves and that a molecule can change pretty quickly, if not in kind then in amount.  The visceral nervous system, controlled by the vagus nerve directly from the brain and full of molecular contributions from other tissues, is constantly responding to pathways and cascades of chemicals based on things like dopamine or serotonin or oxcytocin.  They work in a key/lock manner, the molecules only accepted by the cells according to little docks on the cell wall.  For instance, there are two kinds of diabetes.  The kind that is produced when there is no insulin in the blood stream and the kind caused when the cells themselves reject the insulin.  Some environmental forces can affect both through the epigenome.



This is what simply ingesting or injecting powerful chemicals can derange.  Even small changes, even the trace contributions of gut bio-entities like e.coli can disturb mood and thinking processes in the brain.  The molecular loops that work the brain neurons are the same ones that control the intestinal walls.  Sometimes the effect can be seen on the skin, which uses the same loops.  Brain, gut, skin.  Basics.

But they are all meant to be self-contained as much as possible.  They simply can’t evade nutrition, trauma, poor sanitation, and exposure, let alone the things we like to ignore like support, cherishment, and security.   All those visceral things that too many people ignore and suppress.  Their lack will cause suffering in the short term and death in time.  Just about every culture will have ameliorations that will help briefly, but maybe do long time damage, esp. when concentrated, like the current craze for khat, which is sort of like smoking except by chewing the leaves instead of burning them.  Concentrations will make you into a zombie.

Visceral issues like the above cannot be healed by a college education or a course in philosophy, but these can help a person to think through what’s happening -- if they’re conscious enough and have information -- or a person or community can see what’s wrong and show a pathway out of the trap.  A whole culture can make sure that nutrition, sanitation, freedom from violence, and protection from weather are off the table by simply providing them.  Not even as a matter of compassion, but so as to keep them from forming what amounts to autoimmune response, attacking the whole in an effort to protect themselves.


This is a very cold, distanced way to think about issues of destruction and anguish.  There is no one way that will resolve everything and put us back on the path.  But surely it’s simply practical to start with boys out on the edge who can make such major contributions once their basic needs are met, because they need so little.

Still, it’s not a matter of new clothes, a haircut, and learning to read that will redeem them.  What electrochemical pathways of horror and abuse have distorted their thinking, what the broken loops in the systems of head and gut?  The advantage of stage theory is that the natural processes at each interval are well-enough known to suggest strategies of reconciliation and regrowth.  The main thing we know is that human bodies, those skin-enclosed communities of one-celled sub-creatures, fight to live and have a lot of resources, many of them unconscious.  So do the out-skin environmental entities, like cultures and institutions, have ways of supplying help if they can get focused.

I’m amazed when people tell me about the years they were hooked on drugs or the ghastly childhood conditions they survived.  On casual acquaintance a person would never know.  They might be a little more tolerant than most, but they have good jobs and even fancy degrees.  They might occupy every place on the continuum of sexuality from extreme male to extreme female to don’t-bother-me-I’m-busy.  In fifty years (out of 76) I’ve seen people go into deep trouble, even prison, and gradually work their way back out while they still had happy years left.  All these “tendencies” and statistics about what might happen are irrelevant to the individual.  But survivors do seem to converge as people who accept themselves and therefore others.  You know -- “unconditional positive regard.”

There was once a time when it was assumed that beatings were good for boys, because it made them virtuous (translation: obedient), clean and nicely spoken, those markers for "respectable" and prosperous that cause us to vote for politicians who turn out to be devoted to other deficiencies, like greed and vengeance.

So now let's look at the last two stages of human development I named earlier:

6.  Maturity within the culture 
7.  Abstract and meta-concepts, beyond culture


These are likely to be embedded in the culture via the written materials of academia, professions, and literature, including fiction.  Without resolution and comfort in the viscera, it will be hard to calmly look at these ideas.  Whatever value might be in books, it means nothing without acting it out in life.

But there is another force that isn’t a stage -- it recurs in every stage.  It is the question of whether to go on living.  Most of us won’t be concerned enough to worry about it, but even a child living in misery can wish for oblivion without getting specific about how to achieve that state.  Cultures that make their participants wish for escape are evil, but they persist too long and too effectively, because those of us outside the bondage don't help.  

William Langewiesche

I just read a story by the excellent and intrepid William Langewiesche:  
It is not just a description of humans reduced to profit-objects, but also includes the description of individuals and organizations, some of them religious, who dedicate themselves to push-back and salvation.  Why watch “Game of Thrones” when the real world offers far more violent story lines that we could actually address?  Is it the lack of dragons?  Surely not, since our flame-throwing flying machines kill as many innocents as enemies -- SO effective. 

My conviction is that we have played out the limits of the Cartesian approach, all that bloodless pyrex and stainless steel, and cannot go forward without adding feelings.  It might be no more complex than enjoyment of daily life: sun through the window, something good to eat, the embrace of someone who is loving, riding a skateboard fast, sleeping with purring cats or snoring dogs.  Participating in the universe.

Thursday, February 05, 2015

"TRAINING FOR AWARENESS, RESILIENCE AND ACTION": A Handbook for Depressed Kids

(This is a bit of a side-bar for the five Domain discussion I've been pursuing.)



TARA is the acronym for addressing problems of adolescence based on the RDoC approach of brain pathways rather than labeling and sorting using the Diagnostic labels.  That is, reconciling assumptions about clinical issues with what is known about the brain from neurology research. These thoughts (TARA's are the ones in italics) are meant for all kids, but esp. for troubled kids.  Is there such a thing as an untroubled kid?  Anyway, the goal is a handbook which should be published soon.

Training for Awareness, Resilience and Action


“Major depressive disorder (MDD) is one of the current leading causes of disability worldwide. Adolescence is a vulnerable period for the onset of depression, with MDD affecting 8–20% of all youth. Traditional treatment methods have not been sufficiently effective to slow the increasing prevalence of adolescent depression. We therefore propose a new model for the treatment of adolescent depression – Training for Awareness, Resilience, and Action (TARA) – that is based on current understanding of developmental and depression neurobiology. The TARA model is aligned with the Research Domain Criteria (RDoC) of the National Institute of Mental Health. . .

“Approximately 13–20% of the children living in the United States experience a psychiatric disorder often including depressive disorders, with suicide being the second leading cause of death among US children aged 12–17 years in 2010 (Perou et al., 2013)”

Studying brain systems is complicated by development, which is the main characteristic of adolescents, and offers many chances for something to not-get-done/do-too-much/go-entirely-missing.  Three special considerations are understanding the causes, predicting what will happen, and figuring out what to do about it.

Brain systems often evolve from the pre-existing substrate “animal” or limbic impulses by imposing new restraints rather adding something novel.  Maturation can mean "wait now!"  The internal restraints that are not yet in place for adolescents may include those on impulsivity, risk-taking, novelty-seeking, increased emotional intensity and reactivity.  These impulses are naturally present in most mammals and are vital to the exploration of behavior that expands cultures.  A young animal that will not risk doesn't learn to hunt or find a new range.  It stays in place, dependent on adults for food.  In other words, it's "domesticated," an aberration good for the people who "own" them.  It's close to depression IMHO.



The benefit of risk goes to the survival of the culture rather than that of the individual, since a percentage of individuals (8–20% ?) can be sacrificed without destroying  the larger group.  The reality is that in every population, human or not, some individuals are going to be lost.  The culture wants it to be the children of the Other, not them.  

These are the principles of the Minotaur in the Labyrinth.  Thus, high school students work hard to be excellent football players so they will earn scholarships to good schools where they will destroy each other's brains by bashing into each other.  But many of the players will be ghetto kids who will flunk out anyway, after making a lot of money for the institution of higher learning.  Pencil-necked mild kids will make it all the way to post-grad and earn the big salaries the ghetto kids only imagined.  They are domesticated and will donate generously to their Alma Maters. They are likely to struggle with depression IMHO.

Since human mental restraints are located in the prefrontal cortex, damage to the forehead and other frontal areas may delay or eliminate some of the regulatory capacity.  This is the age of reconciliation between the need to belong to a peer-group, and also the need for autonomy.  Many little neurological structures that control emotion, ruminating (going obsessively over and over one’s experience), and other processes that can become depression vortexes, are just maturing and settling their internal interaction with each other.  Raw cognition is not so much a problem as figuring out how to put it together.  The specifics of this stuff is well or at least thoroughly described in the document linked at the beginning.

Survivor.

The other side of the equation is that developing youngsters are still plastic enough to compensate in major ways, if they have enough of what they need and some shelter.

The concept of anhedonia comes up often and seems to be less about inability to accept pleasure -- the origin of the term -- than about emptiness which doesn’t come from boredom so much as from feeling hopeless, pathologically lonely, and isolated.  “There’s nothing to do, this place hates me, I can’t wait to escape.”  They may refuse all awards, honors and praise as attempts to control or as just lies.  I see this around here, both on the rez and off, and it is also clear in the “Bridgend” movie.  This is where S-R breaks down for adolescents.

Here is a list of red flags for depression:

1. Sustained threat with symptoms of anxious arousal, increased conflict detection, attentional bias to threat and emotion-laden stimuli, helplessness behavior, punishment sensitivity and avoidance.

2. Arousal and wakefulness including limbic and autonomic hyperarousal with manifestations such as insomnia and secondary sleep dependent behavioral dysfunctions.

3. Loss, including feelings of sadness, guilt, shame, low self-esteem, worry, rumination, increased self-focus, and withdrawal.

4. Attention and cognitive control with concentration difficulties, distractibility, and low impulse control.

5. Approach motivation, mechanisms of reward learning and social processes such as social communication, perception and understanding self and others and self knowledge are valuable salutogenic life skills which should be addressed in treatment of adolescent depression.  [WTF is "salutogenic"?  Does it mean you're the Salutatorian?"]

These are the children of prostitutes in India who were taught by a female photographer to use cameras which made them all very happy and positive.  Not all of them were able to leave the brothel community.  A few won prizes and traveled.

This is a list of functions to address.  

They’re mostly “mindfulness” learning.  “Mindfulness” is a range of techniques for “being here now,” for increasing awareness of one’s own internal life in the normally unconscious part of the brain and responding body.  The team working on TARA likes yoga, but there are “disciplines” (the restrictive sound of the word is unfortunate) in every culture that respond to this approach from “walking meditation,” to retreats, but the Asian traditions (Buddhist, Hindu, Taoist) have honored them the most.

1. Improve autonomic regulation and decreased hyper-arousal and limbic hyper-reactivity (with hypothesized secondary effects on sleep disturbances).  Unconscious stuff, but habits can be built consciously.

2. Practice attention and interoceptive (internal signals) awareness to enhance dynamic switching away from self-evaluative processing and rumination.  Suffering, danger, hunger, forced labor, abuse and unwanted sex are all imposed experience that destroy this awareness as a way of protecting the self.  It will take assurance of safety to do this.  

When I've been in groups that were intense, the counselor would sometimes say to someone:  "What are you feeling right now?"  Sometimes they didn't know.  Sometimes they realized something surprising, not what they had thought.

3. Promote emotion recognition by training interoceptive awareness (emotion) and enhance prefrontal cortical regulation of affect by practicing labeling and communication of emotions.  It can be a shock and confusion to begin “feeling” without ways to think about feeling.

4. Train top-down cognitive control over affective responses such as negatively biased states of attention, processing, thinking, memory, rumination, and dysfunctional attitudes.  These are dashboard skills: seeing the speedometer needle go up and being able to take one’s foot off the gas.  (Simply braking may not be the answer.)

5. Identify intrinsic values to drive pro-social behavior and increase motivation for committed behavioral activation.  This moves the attention out of the person and into the culture, but in a supported way.

To repeat in slightly different language:

1.  Calm down and create a sense of safety.  Learn how to match detection of danger to reality.  To respond too little is to be vulnerable, but to respond too much is damaging.

2.  Attend to and care about inner experience.   Build your emotional dashboard.

3.  Recognize, regulate and communicate emotions.  Calm the limbic, clarify the pre-frontal thoughts.  

4.  Core values, goal setting and committed action -- connecting the cortico-limbic with the thoughtful pre-frontal processes.


COMMENTS:

I hardly qualify to reflect personally on this material myself since I’ve handled my unconscious mostly by stuffing it down and putting my effort into the rational, often by writing, which many kids do online now.  One risks others reading what was tentative and exploratory, and freaking out -- trying to take over and impose order or THEIR answers.  

Here is a metaphor.  The only way to learn how to drive on ice -- short of a skid-pad -- is to find a safely frozen pond or parking lot (shallow enough to keep from drowning if you break through) and cut cookies, slam brakes, etc.  In actual practice on real ice you are risking a roll-over.  Good to have someone standing by, even when exploring one’s own guts.  As the Brits say, “Take advice.”  

If early versions of humans had evolved as naturally rational beings, with onset of sexuality delayed until full maturity, we would not have an overpopulation problem.  They might be always waiting for just the right moment to fall in love, which means risking children without the skid-pad of marriage.  See how dangerous metaphors are?  

Anyway, it’s inaccurate to think that sexual feelings are only present in teens.  It’s like saying that eating is only important at one stage of life.  The survival basics are always present.  The problem is not eliminating them, but managing them in an authentic way.


Thursday, March 13, 2014

GETTING RE-ORGANIZATED

Okay, so these are muskoxen.  The principle is the same.

The natural instinct of people under pressure is to circle the wagons (protect their stuff), or if they’re more inclined to be buffalos, to circle their own selves, hopefully with their heads pointed outwards.  This is so they can see what’s coming, whether it’s a predator or the future.  Because so many of the threats seem to affect us all, some resourceful people have dug in to help with ideas and practices.  One newly available on the Blackfeet rez was developed by the Native Nations Institute for Leadership, Management and Policy (NNI) at the University of Arizona.  If it had been developed in Blackfeet country, they could have spelled that NINA.  (Jokes.  It means “chief” or “grandfather.”  Chief Mountain is Nina-istuki.  Istuki meaning mountain.)  It’s a series of courses offered through Blackfeet Community College.  Contact Jim Kipp.

Jim Kipp

NNI has a sister organization:  the Harvard Project on American Indian Economic Development.  Several Blackfeet have been Harvard grads, including Darrell Kipp and Terry Whitwright.  Probably others I don’t know about.  Following are NNI’s basic considerations: 

Sovereignty Matters. When Native nations make their own decisions about what development approaches to take, they consistently out-perform external decision makers on matters as diverse as governmental form, natural resource management, economic development, health care, and social service provision.
Institutions Matter. For development to take hold, assertions of sovereignty must be backed by capable institutions of governance. Nations do this as they adopt stable decision rules, establish fair and independent mechanisms for dispute resolution, and separate politics from day-to-day business and program management.
Culture Matters. Successful economies stand on the shoulders of legitimate, culturally grounded institutions of self-government. Indigenous societies are diverse; each nation must equip itself with a governing structure, economic system, policies, and procedures that fit its own contemporary culture.
Leadership Matters. Nation building requires leaders who introduce new knowledge and experiences, challenge assumptions, and propose change. Such leaders, whether elected, community, or spiritual, convince people that things can be different and inspire them to take action.
Early Siyeh Board

That’s all good stuff and from what I know, absolutely true and effective.  They provide examples that they admire.  For the Blackfeet, it’s Siyeh Corporation, which NNI describes as follows:
“For years the Blackfeet Nation struggled to create sustainable tribal enterprises that could produce revenue for the Nation and meet the needs of its citizens for jobs and services. Many of these efforts did not succeed because of conflicts within the tribal government. In 1999, the Nation tried a new strategy. It established a federally chartered, tribally owned corporation designed to manage businesses on behalf of the government and protect those businesses from inappropriate political influence. Named after a great Blackfeet warrior known for his fearless leadership, the Siyeh Corporation today runs multiple businesses and promotes economic growth and stability while preserving Blackfeet cultural and traditional values. Siyeh is changing the economic landscape of an impoverished reservation, increasing the Blackfeet Nation's revenues and enhancing Blackfeet self-government.”

A program called “Honoring Nations” identifies these programs as finalists for an award and examples of successful  tribal programs:

Chickasaw Monument
  • Chickasaw Nation School-to-Work Program from the Chickasaw Nation, Ada, OK 
  • Comanche Nation Funeral Home from the Comanche Nation, Lawton, OK 
  • Hualapai Juvenile Detention and Rehabilitation Center from the Hualapai Tribe, Peach Springs, AZ 
  • Lummi Wetland and Habitat Mitigation Bank from the Lummi Nation, Bellingham, WA 
  • Lummi Youth Academy from the Lummi Nation, Bellingham, WA 
  • Oneida Life Insurance Plan Plus from the Oneida Tribe of Indians of Wisconsin, Oneida, WI 
  • Owe'neh Bupingeh Rehabilitation Project from Ohkay Owingeh, Ohkay Owingeh, NM 
  • Pemaytv Emahakv K-8 Charter School from the Brighton Seminole Indian Reservation, Okeechobee, FL 
  • Port Gamble S'Klallam Tribe Child Welfare Program from the Port Gamble S'Klallam Tribe, Kingston, WA 
  • Potawatomi Leadership Program from the Citizen Potawatomi Nation, Shawnee, OK 
  • Prairie Management Program from the Cheyenne River Sioux Tribe, Eagle Butte, SD  
  • San Manuel Fire Department Outreach from the San Manuel Band of Mission Indians, Highland, CA 
  • Scott County Association for Leadership and Efficiency (SCALE) from the Shakopee Mdewakanton Sioux Community, Prior Lake, MN 
  • Swinomish Climate Change Initiative from the Swinomish Indian Tribal Community, LaConner, WA 
  • Standing Rock Sioux Tribe Elderly Protection from the Standing Rock Sioux Tribe, Fort Yates, ND 
  • Tribal Ventures 10-year Poverty Reduction Plan from the Cheyenne River Sioux Tribe, Eagle Butte, SD 
  • Tribal-State Intergovernmental Law Enforcement Agreement from the Crow Creek Sioux Tribe, Fort Thompson, SD 
  • White Mountain Apache Suicide Surveillance System from the White Mountain Apache Tribe, Whiteriver, AZ 
A friend from back East sends me a link to the day’s cover story in the Washington Post.

There are two schools of thought when it comes to capturing public support (and money).  One is to make the situation seem as awful as possible, and the other is to demonstrate that heroic, ingenious and effective things are happening.  Since I am a Bibfeldtian “both/and” person, I endorse both.  But it’s not enough to design programs.  They must be put into action and when the inevitable bumps come (“Bumps,” hell !! Outrage and accusations!) there has to be enough grit to stick with it.  

Three of the most successful programs on the rez have been the Catholic parochial school, Piegan Institute (which includes a Blackfeet immersion school), and Blackfeet Community College which has not just been a place to earn a degree, but a focus for serious thought and development.

Through Blackfeet Community College the classes from NNI, partly on video, are running weekly.  Let’s be real:  these classes are on FRIDAY and it’s SPRING and this winter was enough to daunt a buffalo.  It’s gonna take grit to get there and sit there and actually think.  But there will be people who can and will do it.  It’s an investment.

People made fun of BCC in the beginning.  They thought no one could teach on a muddy campus, no teacher would stick, no students would actually do the work.  They were universally wrong and BCC has managed to outlast scandal and mutiny to become a viable and credentialed community college. 

I would be very interested to see a formal autopsy of the Po’ka program, why it seemed so valid at first, then wasn’t working, and finally collapsed in legal prosecution for embezzlement sorts of accusations.  Liz Sherman and Dorothy Still Smoking were students of mine long ago and it’s hard for me to think of them as criminal or even negligent.  Their basic characters are hard-working and maybe a little too idealistic.  They were po'ka (special) themselves.  I’d like to see the structure of the organizational design, quite apart from the goals.  Corruption is too easy an accusation.

Darrell Kipp always felt that getting involved in government funding was a mistake, and I thought Dorothy -- a co-founder of Piegan Institute -- was of the same mind.  At the other extreme, getting too dependent on the personality and network contacts of one person is always dangerous, particularly if that person is not on-scene.  My personal prejudice is that many academic assumptions are self-serving, if not toxic.  I know the natural instinct will be to push Po’ka out of consciousness, but I think too many similar learning opportunities have been wasted by lack of scrutiny, fear of blame, need for secrecy. 

The Warbonnet Motel opened just in time for the winter of 1972 when the Browning teachers were trapped in their classrooms and kept sleeping bags under their desks.  Now it's only a slab.

The rez and the tribe are not the only ones to be led astray by technological bedazzlement, jargon intimidation, and lack of access to the real facts, but a good example on the rez is today’s Great Falls Tribune story mentioning “Radiance Technologies” which not only failed but left behind potentially explosive debris in a building that could have been used for classrooms.  The tribe and Montana towns might think about an equivalent to the federal GAO that evaluates deals and cost effectiveness.  It would help either restore credibility to the next miracle offer or else shoot it down before it gets started.

Live and learn!  Fridays!  Call Jim Kipp!