By R. Angar. Samford University.

Personal and demographic factors did not have a statistically significant relationship to psychological intimacy during recent years (i purchase myambutol 400mg visa. The gender of participants was not related significantly to psychological intimacy discount myambutol 400 mg mastercard, neither was the age of participants (categories = 40s purchase 400mg myambutol with visa, 50s, 60s and 70s). The number of years together (15-19, 20-29, 30-39, and 40 or more) was not significant. Indices of socioeconomic status were not significant: gross family income (5 categories, from [less than]$25,000 to [greater than]$100,000), and level of education (less than college, and college graduate graduate or more). Other social factors that were not significantly related to psychological intimacy in recent years included religious backgrounds (Protestant, Catholic and Jewish), race (white and non-white), and whether couples had children. Table I shows the relational variables that were related significantly to psychological intimacy in recent years (p [less than]. More than 9 out of 10 participants described their relationships as psychologically intimate in recent years if they had also reported positive sexual relations and physical affection. Table II shows the phi coefficients of a correlation analysis between the dependent variable and each of the independent variables. A substantial correlation was found between psychological intimacy and the quality of communication ([phi] =. Based on this analysis, communication was not included as an independent variable in the theoretical model tested with logistic regression. These variables were included in the two theoretical models: the first model contained the sexual orientation of couples, along with the other relational variables; the second model substituted gender of the participants for sexual orientation. Table III shows the results of a logistic regression analysis--this includes variables from Table I, which had also been found in previous research to be related significantly to psychological intimacy. Included in the model was the sexual orientation of couples. Variables in the model that were not related significantly to psychological intimacy included decision-making, the quality of sexual relations, and the importance of sexual relations to relationships. Factors that were predictive of psychological intimacy during recent years were physical affection between partners (B = 1. On the factor of the sexual orientation of couples, lesbian couples differed from heterosexual couples (B = 1. Compared to the gay males and heterosexuals, lesbians were more likely to report that their relationships were psychologically intimate in recent years: 90% of lesbian, 75% of gay male, 72% of heterosexual participants; ([X. To clarify whether the differences between lesbians and the other two groups was a matter of sexual orientation or gender, a second model was constructed and tested with logistic regression. Gender was substituted for sexual orientation of couples in that model. Factors that contributed to understanding psychological intimacy in the first regression analysis continued to have a similar effect in this modified model. The gender of participants had a moderate effect on the reported psychological intimacy in recent years (B =. Sexual Orientation, Gender, and Psychological Intimacy To examine the interacting effects of gender and sexual orientation on psychological intimacy, we returned to the original qualitative data. The four elements in the theoretical model for this study discussed earlier in this paper (proximity, openness, reciprocity and interdependence) were useful in this task. Subtle differences were found in how these elements were weighed by participants, as they talked about the meaning of psychological intimacy in their relationships. Themes of proximity and interdependence were evident among males, as illustrated in the responses of a gay male:Emotionally, things are really good now... We both place a really great importance on togetherness. We make sure that we have dinner together every night and we have our weekend activities that we make sure we do together... The importance of proximity in the connection to his partner became evident as this individual responded to our inquiry about psychological intimacy. At the same time, he noted the value that he placed on separateness from his partner. By implication, he was also talking about the element of interdependence as he expressed the joy of "growing old" with his partner in spite of the differences in their individual psychological makeups. He emphasized proximity along with interpersonal differentiation as he discussed the relationship in recent years. The responses of many women tended to reflect themes of openness and mutuality, along with differentiation in the psychologically intimate connection with their partners. A lesbian participant spoke of those elements in her relationship:What has been good is the ongoing caring and respect and the sense that there is somebody there who really cares, who has your best interest, who loves you, who knows you better than anybody, and still likes you... Variations by gender may have reflected how individuals perceived and valued different elements of psychological intimacy within themselves and in their partners. Because of the gender differences between partners in heterosexual relationships, these variations on the theme of psychological intimacy were manifested in a different way. The following observations of a heterosexual male illustrated those variations; he viewed his wife asvery unselfish, and she would sacrifice so that I could go out and do my thing. One thing that we have always done, always, is talk constantly to each other.

The best example was the Vietnam experience purchase 400mg myambutol otc, where soldiers took narcotics but largely desisted at home -- in other words buy 800 mg myambutol visa, they used drugs as a way of adapting to an uncomfortable experience buy cheap myambutol 800mg line, but they rectified that in other circumstances. Peele: Yes, and they often shift in their reliance on drugs, alcohol, et al. One of the things most wrong -- and wrongheaded -- about disease theories of addiction is that they predict a one-way trip downhill. In fact, all data shows that the majority of people reverse addictions over time, even without treatment. David: What are your thoughts about treatment for addictions? We allow virtually only one type of treatment -- 12 step treatment -- which has been shown to be highly limited in its applicability. That is, we face this great contradiction -- people claim we have an unmatched and successful way of coping with addiction -- only, despite its popularity and imposition on so many people, we have increasing levels of addiction and alcoholism. David: And what do you feel is wrong about the 12-step approach? Peele: Other than this clear evidence that it has a limited positive impact on our society, I personally feel its model of human behavior is limited for most people ( especially the young) in its emphasis on powerlessness and self-sacrifice. I feel that for most people in most situations -- a belief in self and emphasis on enhanced skills and opportunity are the best keys to positive outcomes. David: So for someone who is addicted to alcohol or cocaine, for instance, what would you suggest to them to help them overcome their addiction? People are struggling to improve their lives and to combat addiction all the time. I seek to help them develop the resources with which they may succeed. You know, people try to quit addictions -- like smoking -- for years. David: So are you essentially saying: "if you have an addiction problem, figure out what works best for you and do it? Of course, people seek help from me and others when they are discouraged, or we see recalcitrant individuals. In these cases, my job is like an interior explorer, to help examine their motivations, skills, opportunities, and deficiencies with them in order to develop a path out of the thicket. Again, I am a helper -- people escape their own addictions. But I have seen how people summon their resources to do so, and I have some idea of which resources and ways of coping -- with stress, for example -- often accompany remission. In one colossal survey by the government of 45,000 people who had ever been alcohol dependent, and three quarters of whom had never sought treatment or AA (Alcoholics Anonymous), about two thirds of the untreated were no longer dependent. Obviously, many people do seek treatment, and of course many might not escape addiction without formal help. But when I perform such assistance, I see it as aiding the natural curative process, which is in itself so strong. The latest research emphasizes treating both the substance problem and the mental health issue simultaneously. I also know that, in all emotional-behavioral disorders, people with added difficulties, one on the other, face greater difficulties in remission. I say this not to be pessimistic, but to express sympathy for the depth of the problem. At the same time, I am not at all discouraged that these individuals will be able to improve their lives as well. One other thing wrong with our treatment is our insistence that remission means being perfectly good all of the time. A more incremental approach, embodied in harm reduction, will benefit more human beings. What about the 45 million Americans who quit smoking? I do think that facilitative environments -- involving human support of one form or another, among other things, enable more people to succeed, but formal therapy is not a necessity. Xgrouper: I still have a lot of anger about treatment. If I had known the first time, I would have never gone in due to the nature of the 12 step treatment they used. I went back a second time under pressure from my work and family, but was miserable. If they would have told me upfront that there was a religious aspect to that program, I never would have gone in. I do not trust the recovery movement one little bit. I have a lot of anger towards addictions treatment centers and the 12 step community. Peele: Well, now you are in my pipeline (I just published a book, " Resisting 12-Step Coercion.

David: There are many people out there who are looking for the "right way" to share their disorder with someone they care about buy generic myambutol 800mg. Jean discount 600 mg myambutol visa, you can answer this question first purchase myambutol 600mg line, then David can respond. Jean Y: I think that you need to express the aloneness of this disorder and how very hard it is to maintain a semblance of being a part of the world without their help. David W: Expressing how you feel is important, as Jean said. I would add that I understand that talking to your family and explaining these feelings and moods is difficult. Sometimes when you start talking to them, you lose track of what you are trying to say and go off on different areas as the conversation goes on. Or if they are not reacting like you expected, it can throw you too. You might try sitting down one day when you can think fairly well and write out exactly how you feel and what you want them to know. You can then give the letter to the family member that you are most comfortable with, and write down at the end that you would like to discuss it with them once they have read what you wrote. It may be difficult for them to understand at first. It may be helpful to copy some things off the internet or give them a pamphlet or a book on the subject. Tell the person exactly how you feel and what, if anything, you want from them, because many times, after someone tells their story, the other person is left wondering "well, what can I do. Now that I am going to school, everything is fine, but when I am hospitalized it has been viewed as if I have failed, and the suffering and isolation that I am feeling is totally discounted. I have realized that they have some problems in their own lives though. My sister thought I was fixed after I came out of the hospital, and I would never have an episode again. I lean on my husband and leave them out of it because it, frankly, would take too much effort for me to bother to bring it to the fore. My children take enough out of the family - you know? Thank you, David and Jean, for being our guests tonight and for sharing this information with us. And to those in the audience, thank you for coming and participating. We have a very large and active community here at HealthyPlace. Mary Ellen Copeland experienced episodes of severe mania and depression for most of her life. She interviewed numerous people to find out how people who experience psychiatric symptoms relieve these symptoms and get on with their lives. Our topic tonight is "Living Without Depression and Manic Depression: A Guide To Maintaining Mood Stability". Our guest is author and researcher, Mary Ellen Copeland. Besides writing about it, Mary Ellen experienced episodes of severe mania and depression for most of her life. Good Evening, Mary Ellen, and welcome to HealthyPlace. Before we get into some of the self-help methods, I mentioned that you tried psychiatric medications, antidepressants, along with the hospitalizations and therapy. I think the therapies that were suggested by the doctors were not helpful because my life was so chaotic. David: How many years have you suffered with mania and depression? I remember being very depressed for long periods of time when I was a child. Mary Ellen Copeland: I thought I could control it myself. But now I know a lot of ways to help myself feel better, so the moods no longer overwhelm me and my life. I still have symptoms, but they are much milder and of shorter duration.

Like many chronic illnesses order 600 mg myambutol with mastercard, bipolar disorder afflicts one but affects many in the family proven myambutol 800mg. Where mood swings are mild myambutol 600mg fast delivery, the family will experience many forms of distress but, over time, may adapt well enough to the demands of the illness. They may experience anger if they see the individual as malingering or manipulative. Anger can also be directed at the "helping" professionals who are unsuccessful in curing the illness "once and for all". Anger may be directed at other family members, friends or God. Typically, these same family members experience feelings of extreme guilt (read Bipolar Guilt ) after the individual has been diagnosed. They are concerned about having had angry or hateful thoughts and may wonder whether they somehow caused the illness by being unsupportive or short-tempered (read about causes of bipolar disorder ). Moreover, much literature and other media of the past few decades have largely supported (erroneously) a common notion that parents are somehow always responsible for producing mental illness in children. And so, parents and to a lesser degree, other family members may find that feelings of guilt and the wish to compensate for any wrongdoings prevent them from effectively setting limits and developing realistic expectations. Equally painful is the sense of loss that is associated with the growing awareness that, in severe cases of recurrent manic-depressive illness, an individual may never be quite the same person the family knew before the illness. The mourning process is usually marked with periods of resignation and acceptance and intermittent periods of renewed grief stimulated perhaps, by the accomplishment of a peer, a family celebration or some other seemingly minor event. Eventually, as with any other loss, whether the end of a marriage, the death of a loved one, or the loss of ability through illness or accident, what is needed is a careful re-evaluation of goals and an adjustment of expectations. Related here, may be some feelings of shame associated with unfulfilled expectations and with the stigma of mental illness. It may be interesting for family members to realize that one of the reasons that mental illness carries with it such a stigma is that mental illness is often associated with decreased productivity. The value of productivity and the notion of "the bigger the better," have long formed a mainstay of North American culture. The family may have to grapple with whether they want to place such emphasis on these values. Shifting emphasis on to values related to family, spirituality or other focus may help to diminish any unnecessary suffering due to feelings of shame. Finally, anxiety may be ever present as family members grow to continually anticipate a change of mood, a return of bipolar symptoms. Families may find planning events fraught with worries of whether the ill relative will present any problems at the event. There may be fear that unprovoked conflicts will arise at any time, that other family members may suffer. Children may fear that they will inherit the illness, they fear that they may have to manage the care of their ill relative as well as manage their own lives when the primary caretakers can no longer do the job. To cope with such consuming anxiety, some family members learn to distance themselves (both physically and emotionally) from the family, while others may put their personal goals on hold in anticipation of the next crisis. In any event, families need support to learn to manage anxiety and to lead as fulfilling lives as possible. Attending bipolar family support groups can help to relieve the pressure experienced by families caught in their stressful situations. In severe cases of manic-depressive illness, families typically find that their social network starts shrinking in size for several reasons. The family is often embarrassed by the varied symptoms of an ill relative whether these symptoms have to do with poor self-care skills or belligerent behavior. Visitors may feel awkward about what to say or how to help the family. Usually they say nothing at all and soon both family and friends find themselves participating in a conspiracy of silence. Going to a bipolar disorder support group is one way to help reduce the sense of isolation a family often faces. Through the practice of self-disclosure and the development of a vocabulary to use and the self-confidence to use it, a family can gradually learn how to communicate with extended family members and friends. Family members often feel exhausted because of the time and energy spent on issues related to the illness. There is little energy left to invest in other potentially satisfying relationships or rewarding activities. Increased tension leads to risk of marital dissolution and stress-related physical symptoms. To deal with feelings of resentment and guilt, siblings spend more time away from the family. When the ill member is a parent who cannot meet the emotional needs of his or her spouse, a child may assume the role of confidante with the well parent and may sacrifice some of his or her own personal development as an independent individual.