It doesn’t sound as if the Pachamama Alliance has reached them. They should. Do you know about the Alliance? http://www.pachamama.org/

The Kuna are really merry, friendly and simple people. It was a pleasure to mingle with them. I really hope something is done by the Panamanian government to preserve their culture.

So interesting that they want to discuss sex and food first. What do they want to know?

Cordialmente,
Fernando

Thank you for sharing your thoughts
Fernando

best
Fernando

Thanks for the post and the many thoughtful responses.

Dr. Anne Perschel, Psychologist to Leaders and Business Adviser to Psychologists

With regards to the secondary type, as I wrote and in line with your remarks, it can be treated within a short period of time with high effectiveness.

My point is that secondary enuresis is one of many symptoms in a more complex constellation of psychological issues. Granted that enuresis/encopresis can be easily treated, but the underlying reasons for it will still prevail if not addressed.
Symptoms have the characteristic of sliding into other manifestations if a “patch solution” is implemented. We’ll solve the enuresis but something else will show up.
I do not disagree with focused therapies (which I think are great “instant” relievers of psychological suffering) and I also believe that they should be complemented with a more holistic approach.

If the kid lives in a dysfunctional environment (which also complicates commitment with the treatment from the parents/guardians) the causes that triggered that symptomatology will still operate and will continue triggering more problems. That’s why I encourage treating those factors also, instead of just the enuresis/encopresis.

In some cases, digging deep into the family issues or the issues the child is having is something uncomfortable (sometimes inconvenient to talk about) either for families or the children themselves, but that shouldn’t stop us from providing a solution that englobes not just the reason why that kid arrived to your office but the individual and its environment as a whole.

Thanks again for discussing the post
Fernando

Primary enuresis (in which the child has never obtained bladder control during the night) is by far most often a symptom related to a sleep condition in which the child falls into such a deep state of sleep that their sphincters relax and they void their bladder. The two primary medical treatments over the last several decades have been either a low dosage of tofranil, a tri-cyclic antidepressant which appears to interrupt the sleep cycle or DDAVP, an antidiuretic hormone which causes the child to retain fluid during the night. The behavioral treatment which has shown the most effectiveness is a “bell and pad” which uses classical conditioning to train the child to awaken before voiding.

Secondary enuresis, a conditon in which the child has attained bladder control for a period of time and is no longer exercising it. If bladder control is being maintained during the day but not at night, I would consider it to be a psychological symptom of stress and would look for the causes of that stress and address those. If it is an acute onset of daytime enuresis, I would consider it to be a symptom of difficulty resisting distraction, a characteristic of ADHD. In other words, the child is too busy and too distracted to notice his physical cues and waits too long to make it to a toilet in time.

Primary and secondary encopresis are successfully treated the same way. With all medical conditions having been ruled out, the treatment is incredibly simple. At approximately the same time every day, usually dinner, the child is fed a warm meal. The warm food stimulates the bowel. 15 minutes after eating the child is to sit on the toilet for 15 minutes. If they have not had a bowel movement in that time they are given a suppository to produce a bowel movement. They are praised for the bowel movement which ever way it occurs. The next day the same thing happens. Within a week the child will be having regular bowel movements at the same time every day. If they have a regular bowel movement, there will be no leakage or accidental bowel movements. The only difficulty in maintaining the regular bowel movements is for the family to develop enough routine in their lives that the child can have the opportunity to have a bowel movement at the same time every day. As with the diurnal enuretic kids, these encopretic kids most often are highly distractible and do not recognize the cues than they need to attend to their bodily functions and wait until it is too late to manage them appropriately. Some of these kids also have significant psychological issues, many do not. But my experience is that the enuresis and encopresis can be addressed successfully without manufacturing some deep psychological conflict. I have had a higher level of success in treating secondary encopresis than any other problem, 100% success to date. Thanks is due to Logan Wright and Eugene Walker and their 1977 publication “Treatment of the Child with Psychogenic Encopresis”. Clinical Pediatrics, Vol. 16, No. 11.

@George: totally appropriate clarification. Thank you for completing the post :-)

best
Fernando

Spot on – I agree with your comments. I too have observed first hand the failings of assertive CBT, motivational interviewing, and DBT. All too often these approaches are little more than a dollar store band-aid for a client in need of a depth or integrative orientation.

Regards,
Don

Spot on – I couldn’t agree more with your comments. I too have observed first hand the failings of assertive CBT, motivational inteviewing and DBT approaches.

Best regards,
Don

The company is financially sound and even when we had to cut costs the service we provide to our clients and the benefits for our employees have not changed. Moreover, it´s the biggest mental health care provider in the USA, which is a very compelling reason to work there during this economical turmoil. Since the crisis started only a dozen people were laid off and there are no plans of further reducing the workforce. Quite the contrary, the company is constantly hiring. My company hires people not only under a contract, but that contract is not limited in any way. No one’s gonna say, “hey! Come on board for an year and we’ll see”. Quite the opposite, we need people to stay and move up. And that’s why also, we want to hire people that are willing to commit (take again into account the stress factor, which we emphasize a million times during each interview).
The reason you want to ask someone why he or she has been inactive for so long doesn’t necessarily imply a “bad answer”, or that we suspect that you are an undercover couch potato. In fact, if you told me that you were laid off and due to the crisis you haven’t been able to find a job even though you’ve been turning every rock… perfect, then it wasn’t your fault and let’s head on to the next question. Even more, the person could have been doing some other interesting stuff during that time and may even surprise you with the answer. I once interviewed a guy who didn’t have an “official” job for an year. He told me that he’d been in Africa teaching kids to learn english. Why didn’t he put it in his resume? Since the conditions there were very precarious and there was no way for a future employer to check the veracity of the information he felt like leaving it out and if the situation arose (as it did) in an interview he would just tell the story. Another one was studying to become a monk in a monastery. That kind of interesting stuff shows up. It is also what people are sometimes afraid to show on job interviews. The things and traits that make each one of us unique. The idea is to create situations where those stories could flourish.

I’m not an evil robot that stares at you and asks “confess why you haven’t worked for 2 years kid!? Don’t tell me that being five years old is your alibi”.

I make those questions in the middle of a conversation about cars, spaceships or global warming. I make every effort to provide a casual environment. I like people feeling comfortable.
What these kind of questions provoke is a genuine and spontaneous reaction. You are caught off guard and there’s where the real you shows up. They’re not meant to disrespect, toy with or trick people, it’s just a way of allowing people who are interviewing for a job to be themselves and for interviewers to see them, and not a character made for the occasion. A job interview is always a stressing situation both for the applicant (who feels he’s been put at a test) and for the interviewer, sometimes because of the pressure from above to fill a sensitive position, because the person you are interviewing is always a potential workmate or because you are putting your self-esteem at stake… finding the wrong person for the position or the wrong position for that person can be felt as a personal failure. The reason why job interviews are not straightforward is for a simple reason. None of us will be 100% frank in a job interview, frank being “I’m completely open to you and without reservations”. You don’t need to lie, you can always give some make up to your life story and most importantly, you are trying to sell yourself. So straightforward answers lead to a dull interview with lots of prefab and rehearsed answers which ends up being a waste of time for both parties. People like spontaneous people. I’m no exception.

Going back to the crisis, so far it’s mostly a local phenomenon. Even though some countries in Europe are feeling it, the rest of the world hasn’t been shaken that much by it. It’s a matter of thinking bigger and realizing that the world does not end in Mexico’s border.

Anyhow, can you elaborate on why you think the questions are disrespectful? I’d very much appreciate feedback on that (seriously).

Thank you for your thoughtful comments. Even when we don’t seem to agree I value your constructive criticism. And if it helps me change my point of view, way better.

yours,
Fernando

I hope you enjoy your reading.

cheers
Fer

Mary Aloe

I hope to make some quality posts soon but first I have to look around the forum and
familiarize myself with everyone and the forum.

Bye for now. lol

***************************************************

Biggest Loser of All Time

Thanks for sharing!

People, if you are interested in the subject, check out Julie’s blog . She’s posted very insightful on topic articles.

Enjoy, and keep up the good work!

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Thanks for commenting!

In my recently published pre-teen novel, Ian, one of Santa’s Helpers, struggles to understand the difference between managing and leading. He understands that management is based upon processes, order, and controls and that leadership is more about developing the potential in others.
I think that it would be a step in the right direction if we were to teach some of the management and leadership concepts, including Transformational Leadership, to our youth at an early age. Later on in life, they will be more receptive to change which is always happening in the business world, or in our lives, in general.

All the best!
Eric Dana Hansen, Author of “IAN, CEO, North Pole”
http://www.ianceonorthpole.com

nice blog here too… keep up the good work.

=)
smj

Keep up the good work!