Author: Kathy Marshack

A few years ago I heard a well known Dale Carnegie graduate give a talk on how to attract new business. He used as an example, what attracted him to the family physician who had attended to him, his wife and children for years. The good doctor had given a similar talk at a public event and impressed the man with his expertise, solid reputation, and sincerity. For something as personal and life important as the health care of his family, the man wanted such an individual as this dedicated doctor. And for years his initial decision to choose this physician proved to be a good one.

Yet in spite of the importance of choosing the right health care professional, this Carnegie graduate dropped the doctor like a hot potato when managed care rolled into town. Because his company chose a managed care plan that would not allow the doctor to join the panel, the dedicated patient who had so carefully chosen and developed a meaningful relationship with his health care provider, decided to follow the impersonal dictates of the managed care plan.

Closer to my own area of practice, psychology, is another story that is even more disconcerting. A young teenage girl had been treated for depression by a psychologist. In actuality she was not seriously depressed but rather angry at her boyfriend for being somewhat shallow. The girl’s parents called the managed care company and were referred to the psychologist. After a few short sessions with the psychologist, the girl felt she had more control of the situation and would not allow the boyfriend’s manipulation to continue. Two weeks after terminating psychotherapy, the girl and her father had a fight that erupted into yelling and screaming between the two of them. The father in frustration called his managed care plan (an 800 number in southern California) and told them his daughter was suicidal. Without any psychiatric evaluation and without contacting the daughter’s psychotherapist, the clerk at the other end of the 800 number advised the father to take the girl to a psychiatric hospital. Although the girl was not suicidal and didn’t need hospitalization, she did learn to fear her father and to behave lest she be hospitalized again. Not a healthy outcome.

The mistakes made by the Carnegie graduate and the father of the teenager are not uncommon. There is a mystique about managed care. People have come to believe that the 800 number is like a parent, able to solve all of their woes. They believe that they will get the same personal service they received for years by a doctor who knows them. They are puzzled when the service they do receive is not sufficient to resolve the problem. Often they assume that there is nothing more that can be done, since their managed care company has not authorized additional services. It’s as if the managed care company has assumed the paternalistic mystique that the family doctor once held. But now the mystique has no concern about the individual, only cutting medical costs.

So when you are shopping around for a health plan, I hope you consider just what you are buying when it comes to mental health benefits. Do you have ample psychotherapy benefits; at least 26 to 52 visits per year? Do you have the right to choose the most experienced and competent psychologist? Is there true confidentiality guaranteed? Is the treatment plan dictated by actuarial tables or by the unique needs of the situation and the employee? Is the payment to the therapist worth the time of a competent professional, or are you forced to seek out an untrained, inexperienced person who will charge rock bottom prices? Ultimately you are responsible for your own health so make sure that you’re your own health advocate.

If you have a loved one with Asperger Syndrome, it is vital that you learn about “mind blindness” or “lack of empathy.” This is a key feature of what makes your relationship with the Aspie unique. Mind blindness or lack of empathy is the disconnect between emotional and social cognition. A person with Asperger Syndrome has trouble reading nonverbal clues and therefore ignores the bulk of a conversation. The Aspie knows what they think and feel but are often unaware of what their loved ones think or feel. They become so focused on themselves that it may seem like they don’t care or love you, but that is not true. What happens is that they just don’t notice.

Mind blindness can have some especially serious side effects on the partner or spouse of someone with Asperger’s. Even though their behavior is not intended to hurt you, it still does. Then you may reach out to someone else like a friend, but if they do not understand Asperger’s they will most likely not understand what you are going through. Without the right care, low self-esteem, depression, and resentment may settle in deep.

If you find yourself in a relationship that has a lack of empathy, realize you are not alone! Many experience a similar situation. As a psychologist and marriage counselor I recognized that there’s a great need to give guidance to families of adults with Asperger Syndrome. Here are my suggestions for you:

1. Seek out therapy from a professional specializing in Asperger Syndrome. Click here to see my specific therapy recommendations.

2. Join a support group. Click here for tips on how to find one that suits your needs.

3. Educate yourself about Asperger Syndrome. My book, Life with a Partner or Spouse with Asperger Syndrome: Going Over the Edge? was written specifically for those in a relationship with someone with Asperger’s. My upcoming book is entitled, Parenting with a Spouse or Partner with Asperger Syndrome: Out of Sight, Out of Mind. A free sample chapter is available for download. I have also compiled a list of books that I have found especially helpful – Recommended Books Part 1 and Recommended Books Part 2.

These suggestions will help you to see more clearly your own situation and take the necessary steps to live a happier, more full-filled life.

In a previous blog, I spoke about the recent trend in sleep deprivation. Sleep deprivation, also known as insomnia, is of serious concern due to the long-term effects it can have on a person’s physical and emotional health.

A study performed by researchers at the University of Pittsburgh School of Medicine came to an interesting conclusion for those with insomnia. Their conclusion was to spend less time in bed. When someone has insomnia, they begin to associate the disorder with their bed. They lie awake for hours struggling to fall asleep which ends up upping their stress level. The key is if you are not falling asleep, get out of bed and try an activity that will help you relax your body and mind.

Establishing a healthy sleep routine and learning specific relaxation techniques will also be beneficial for those with insomnia. I recommend scheduling an appointment with a mental health care professional. They can help you establish a good routine and teach you the right techniques for your sleep deprivation issues. Most importantly, often times they help you identify the root cause of what’s keeping you awake at night. If you live in the Portland, Oregon or Vancouver, Washington area contact my office for more information.

Depression is a real and very serious disease that affects millions. There are many reasons why someone may suffer from depression, but it is important to note that if you have depression it is not your fault. Many tend to think that it is their fault and because of that they are embarrassed and sometimes even shy away from getting proper help.

I wanted to share with you some of the often underlying reasons why someone may have depression. Here are some factors to consider:

1. Gender. Women, regardless of nationality or socioeconomic level, have higher rates of depression than men. This may be in part due to hormonal changes often experienced during the days before menstruation, the postpartum period after delivering a baby, and around menopause. Women are also affected by the difference in their social status from men.

2. Social and economic considerations. Being in a low socioeconomic group is a major risk factor for depression. However, people of all income levels are likely to be depressed if they have poor health and are socially isolated.

3. Severe or chronic medical conditions. Depression follows or is caused by many medications or serious medical problems.

4. Emotional and personality disorders. Chronic depression is a frequent companion to anxiety disorders. Personality disorders, such as borderline and avoidant personalities, appear to strongly predispose people to depression.

5. Substance abuse and addictions. It is estimated that 25% of people with substance abuse problems also have major depression. Internet addiction is a recent phenomenon that may a pose risk for depression as well.

6. Sleep disorders. A study of male medical students found that young men who experience insomnia are twice as likely to suffer from depression at middle age.

7. Family history. A family history of mental illness, especially mood disorders, appears to predispose a patient to the development of depression. Often a combination of genetic, biologic, and environmental factors are at work. Children of depressed parents are at a higher risk for depression and other emotional disorders.

If you or someone you know has depression, seek help. Depression is a disease that can be treated effectively. Click here for more information and depression and available treatments.

“A little knowledge that acts is worth infinitely more than much knowledge that is idle.” – Khalil Gibran

Dr. Robert A. Scott, Adelphi University President, the host of the television series “Exploring Critical Issues” will soon be discussing the topic, “Autism and Asperger Syndrome.” The purpose of the segment is to discuss the newest autism research and policies with the goal of bring awareness to this fast growing disorder.

Asperger Syndrome (AS) is much more common than previously realized and many adults are undiagnosed. Studies suggest that AS is considerably more common than “classic” Autism. Whereas Autism has traditionally been thought to occur in about 4 out of every 10,000 children, estimates of Asperger Syndrome have ranged as high as 20-25 per 10,000. A study carried out in Sweden , concluded that nearly 0.7% of the children studied had symptoms suggestive of AS to some degree. Time Magazine notes in its May 6, 2002 issue cover story, “ASD is five times as common as Down syndrome and three times as common as juvenile diabetes.” Click here to learn more about Asperger Syndrome.

Along with Dr. Robert Scott is a panel of four autism experts including Dr. Stephen Shore, Assistant Professor of Education at Adelphi University. Dr. Shore wrote the forward to my book, Life with a Partner or Spouse with Asperger Syndrome: Going Over the Edge?. He teaches courses in special education and autism at Adelphi University. In addition to working with children and talking about life on the autism spectrum, Dr. Shore addresses adult issues pertinent to education, relationships, employment, advocacy, and disclosure as discussed in his many books.

This one hour broadcast will air:

Sunday, May 8th

Sunday, May 15th

Tuesday, May 10th

Tuesday, May 17th

Thursday, May 12th

Thursday, May 19th

“Autism and Asperger Syndrome” can be viewed online at www.telecaretv.org.

How do you describe a person who has been traumatized by another person’s trauma? I would describe them as a “survivor of survivors.” Whether it is from PTSD, alcoholism, Asperger Syndrome, or something else, the actions of that person will affect their loved ones, sparking a cycle of re-traumatization. This type of cycle is vicious and harmful to say the least.

It’s hard to explain why a person will feel traumatized by the behavior of another person, but those feelings are very real and should not be minimized. If those feelings are not addressed, depression, anxiety, and low self-esteem will set in.

The key is to try and stop the cycle so no one else turns into a survivor of survivors. For the cycle to stop, both parties must seek professional help. There are a variety of effective therapies now available. In addition to therapy, joining a support group is an excellent way to gain comfort and strength from those in a similar situation.

If you have a family member with Asperger Syndrome and live in the Portland, OR/Vancouver, WA area, I invite you to join Asperger Syndrome: Partners & Family of Adults with ASD. On March 19, 2011, we will be discussing “Are You a Survivor of Survivors?” and exploring this topic in detail.

If your loved one is suffering from another type of trauma or disorder, please contact my office for more information. Do not delay in stopping the cycle!