Saturday, November 19, 2011

Troubled Childhood - The Breeding Ground for Adult Sexual Abuse


The very institutions that are supposed to protect our citizens from harm are now embroiled in conflict as they contend with the secrecy and shame of sexual abuse. The fabric of our culture has been shaken to the core by the perpetration and deception surrounding sexual assault.

What needs to be a healthy sexual instinct and act has become a deadly, destructive weapon when it is used by those who are not conscious of the depth of their inner-darkness. One’s "seedy-side," in need of transformation, remains sublimated rather than redeemed. Twisted thoughts, urges and behaviors get linked to sexual desires that should be wholesome and foster a positive connection with our most intimate, significant others.

We have been down this path before, and yet continue the destruction. Sexual abuse and secrecy have rocked the Catholic Church, and more recently, educational entities and institutions such as Jerry Sandusky and Penn State University, and governmental entities and individuals, such as the alleged activities of presidential contender, Herman Cain.

I believe this sordid mess starts as a family problem. A troubled childhood is the breeding ground for most adult sexual abuse. What doesn’t get processed in the past, gets replayed as a toxic narrative in the here-and-now. The same worn-out scripts or adverse childhood experiences get activated and are linked to inappropriate, stunted sexual development and behavior. Adult perpetrators of sexual abuse are not able to stop their activity, because they have never responsibly addressed the full emotional impact of the abuse directed towards them.

Like a bad video, sexual abuse gets passed down from one generation to the next unless the process is consciously altered. It takes supreme courage for those who have been abused, through parental neglect and aggression, to deal with their own fallout so they don't offend others in adulthood. It is every adult’s responsibility to seek help for their own troubled childhood experiences.

Sexual abusers experience fallout from bad parenting, with characteristics of extreme power and control, emotional unavailability, hostility and aggression, and harsh, critical treatment. Some are exploited sexually, but many are wounded in other ways. With their spirit broken from childhood, these to-be-offenders are primed due to angry, shame-based feelings connected to childhood trauma.

Adults who have experienced abuse during childhood can process the past and learn to release the shame and blame that haunts them. With support, they can learn to reframe their present thinking and behavior and treat themselves and others in a healthy manner.

If our society is to be restored from the vestiges of sexual abuse, we must all be committed to preventive strategies and interventions, and vigilant reporting, to make sure that our citizens, including children are shielded from potential harm of sexual predators.

Thursday, November 17, 2011

Pennsylannia, Penn State: Living in the Land of an Altered Reality


Denial is a powerful thing. It is a reaction to painful, disturbing realities that are seemingly too great to bear. For the short term, it appears more emotionally palatable to live in the land of an altered reality than to confront one's inner demons and courageously process them.

The stakeholders in the state of Pennsylvania and Penn State University appear to be living a lie - a massive fabrication filled with ineptness and endless cover-ups. In typical fashion, the perpetrators of childhood sexual abuse, and those who suppress it, have their power and control protected at the expense of our young people. The innocence and trust of our children continue to be shattered as those in a role of authority find ways to irreparably damage them.

The state of Pennsylvania is in no position to effectively address the Sandusky problem, since their laws and execution of them are at the core of the scandal. It is a kin to asking the Catholic Church to police its own ranks. Only the judicial department of the federal government can sort out this mess and clarify for all of us what happened and how it played out.

The state of Pennsylvania is culpable based upon its ambiguous statutes regarding mandated reporting of abuse. In most state statutes "all individuals" are to take responsibility for reporting suspected child abuse to child protective state agencies and the police. Severe penalties for not reporting eyewitness accounts and alleged information about sexual abuse are a punishable offense. In some states, failures to report suspected sexual abuse is considered a felony. The impotent Pennsylvania law permits reporters an easy excuse by merely requiring that those working in institutional settings pass the alleged information along to immediate superiors. Apparently, this latest version of the Pennsylvania statute was supposedly considered an improvement over the previous child abuse reporting law. This doesn't bode well for the competency and insight of Pennsylvania legislators. The statute is set up for failure. It allows those individuals with powerful information to begin the denial process by using the passing of time and the mechanism of one’s selective memory to spring into action. It was the responsibility of Mike McQueary to immediately call the police and child protective services regarding his eyewitness account of Jerry Sandusky's locker room rape of a young child. The archaic Pennsylvania statute allowed professionals at Penn State University to play "hot potato" with the lives of our children. By the time the information reached the university president, we can only speculate on how deluded the toxic message became.

McQueary now wants us to believe that he contacted the police and tried to stop the sexual abuse as indicated in an email he sent to a friend. Had he merely picked up the phone on day one and called the police or child protective services, they would have asked him a host of questions to get to the bottom of Jerry Sandusky's behavior towards the child in the Penn State locker room. Rather than make the contact, McQueary met with Joe Paterno, whose remarks before the grand jury about Jerry Sandusky's behavior had already been toned down and compromised. It appears clear that through minimization and deception, Penn State University officials, from the top down, felt the need to protect their football culture from a sordid affair perpetrated by a coach who no longer works there.

If anyone has doubts about Jerry Sandusky's culpability in abusing children, one only needs to listen to the interview with Bob Costas of NBC Sports. When Costas asked Sandusky if he had a sexual affinity for young boys, Sandusky repeated the question several times and dodged and weaved through each response. It was an awkward interview, set up by an obvious inept attorney in hopes of doing damage control.

Furthermore, due to a judge with a conflict of interest, Jerry Sandusky is free on $100,000 bond without even meeting the minimal court requirements for alleged sex offenders of an ankle bracelet. Jerry Sandusky appears to have used the power of his volunteer organization dedicated to working with-risk kids, to sexually prey on the neediest of children.

At every level, this tragedy represents a breakdown consisting of denial and deception within Pennsylvania government and the Penn State University institutional setting. To create a sense of civility, responsibility and accountability, all entities dealing with our children must courageously step forward to encourage, support and protect those who have the most to lose - our children. When will we learn to face boldly, the ravages of childhood sexual abuse? When will we stop the denial and deception and quit living in the land of an altered reality?

Wednesday, November 09, 2011

Penn State, Joe Paterno and the Pennsylvania 'Pass the Buck' Law


We live in a culture riddled with secrecy, denial and childhood sexual abuse. The revelations and reality about the pattern of institutional cover-ups at Penn State University underscore the nature of the problem. The voice of children, who are the victims of sexual abuse, are often disregarded and invalidated. The power of denial transcends the painful reality of violating our most valuable, yet vulnerable resource. Often, parents, schools, community caretakers and agencies are more interested in protecting the perpetrators of abuse than in seeing justice rendered. It's unfortunate, but in a litigious society the wheels of justice are more likely to be granted to the most powerful players.

Unfortunately, it is human nature for those who are first-hand witnesses of sexual abuse to deny, minimize, or avoid its impact; this is also true for those who are potential reporters who have been provided with first-hand information regarding suspected sexual abuse, such as the case with Joe Paterno. Rather than standing tall as a mandated reporter (along with assistant Mike McQueary), he decided to follow the letter of Pennsylvania law, absolving himself of responsibility by seeking to pass the information along to "higher authorities."

Most states have mandatory reporting laws that address this problem of potential reporters trying to shirk their responsibility. In Arizona, the key phrase in the mandatory reporting law is "any person” is obligated to report suspected abuse. In other words, most everyone constitutes a mandated reporter and penalties for not reporting are severe.

It appears that in the Pennsylvania mandated reporting law, those individuals who work in institutional settings are provided an "out" by merely mandating that personnel such as educators pass suspected abuse information to their superiors. This distinction in the Pennsylvania reporting law creates a loophole, which is disturbing. At Penn State University, rather than holding first-hand responders responsible for reporting suspected abuse, the Pennsylvania statute let Paterno and McQueary off the hook and gave them the opportunity to dilute the information as they passed it on to their administrative superiors.

I am not suggesting that Penn State administrators, including the university president, are not culpable for what occurred. Rather, I am making a case that Mike McQueary and Joe Paterno had a legal and ethical responsibility to report suspected abuse and were provided a legal escape through Pennsylvania law.

According to Mike McQueary, he witnessed a horrific scene within the locker room at Penn State University. He viewed a child being sodomized by former assistant football coach, Jerry Sandusky. He supposedly found the situation so repulsive, that he fled the locker room. Due to his eyewitness account, McQueary had the most significant role and obligation to report the alleged sexual abuse to the police and child protective services. Joe Paterno received first-hand information about the alleged sexual abuse from McQueary and should have collaborated with him to report it. According to most state’s child protective service protocols, "any person" should be obligated to report suspected child abuse - including Joe Paterno, who had first-hand knowledge relayed to him about the heinous acts of Jerry Sandusky.

Once again, we are witnessing the ugly side of college sports and institutional cover-ups. It is obvious that the NCAA is being tarnished by the behavior of many players and coaches. I find it mystifying and yet understandable, that the Penn State University administrators, including the president, have taken the fall for the legal and ethical cowardice of a coach who plans on leading his team onto the field this Saturday for a game that most people will find repugnant.

Tuesday, October 18, 2011

How to Manage our Hard-Wired Youth


A friend of mine who is a high school English teacher in our local schools has been perplexed by the behavior of some of her current students. She said, "Help me understand why a third of my students can't sit still in their desks? They wiggle, they squirm, they tap their pencils and their feet and are constantly in motion." She is experiencing a dose of today's "hard-wired" youngsters.

Although some of this student behavior is developmentally appropriate, our society has rapidly experienced a metamorphosis that fosters and perpetuates the kind of fidgety behavior that my teacher friend is observing. Our fast-paced, complex culture places stress and strain on all of us. Many times our children feel overwhelmed by the "juggling act" that is performed in trying to keep their lives in balance.

What are some of the factors that create an environment of over-stimulation and hyperactivity among our young people? Some clinicians in the field of behavioral health suggest that Attention Deficit Disorder accounts for most of our restlessness in children. However, many of our hyperactive students do not meet the criteria for ADHD. I believe that children are suffering from agitation, restlessness and hyperactivity due to other situational factors.

What is it about our culture that contributes to the restlessness experienced by our youth?
• Violent lightening fast-paced movies and videos. I believe that students who are consistently immersed in watching movies and videos filled with acts of violence are much more susceptible to restless agitation. Many children are unable to detach themselves from the overstimulation of violent behavior in the media. As they absorb multiple acts of violent sociopathic behavior, they are unable to process and disengage from the material without it affecting their current behavior.
• Excessive involvement with video games and computers. Many children become obsessively connected to electronic gadgetry and it may have a direct link to the quality of their mood, level of concentration, and quality of sleep. Some children use the electronic media as a means for avoiding more meaningful activity such as socialization with age-mates. Electronic stimulation may be referred to as the "companion symptom." Children can carry it around like a friend and the activity takes on a life of its own.
• Extensive use of cell-phones, including text-messaging. Kids lose focus and concentration as they ritualistically use these tools to connect with others.
• Loud, hard-wired music. Have you ever pulled up next to a car that was blasting the radio playing heavy metal or rap music? Did it sound like they were having a peaceful experience? Children are not always aware of the effects that certain styles of music can have on the sympathetic nervous system. These children may complain of irritability, moodiness and agitation as a result of this exposure.
• The problem of over-scheduling activity. Many children are unable to find a balance between creative free time and structured activity. Although karate and dance lessons may be important, children need time to play creatively. This may include artistic activity, hiking, camping, cycling, playing board games or doing nothing. The excessive activity level of many students makes it difficult for them to complete school responsibilities, such as homework, creating unnecessary stress and anxiety. Parents may perpetuate the problem by insisting that their children "stay on the move" at all times. Excessive preoccupation with activity creates overstimulation. How many birthday parties does your child need to attend before you say, "enough is enough?"

Several years ago my wife and I toured the nation of Israel with her family. I recall being in the mountainous village of Safed that is home to an artist colony. I remember a young boy who was using an easel to draw some ancient ruins. He looked serene and content. I asked him if I could take his picture and he agreed. He smiled and I snapped the image. I think it was his innocence and creativity that sparked me to want that image. I mentioned the encounter with our tour guide and he replied by saying, "The entrepreneurs in America have ruined a whole generation of children with their electronic gadgetry." Although his point may be overstated, his premise is accurate.

As parents, it is important to guide your children in setting reasonable limits regarding exposure to the media and activity. This can be accomplished by monitoring your children's level of electronic exposure and degree and quality of structured activity. Parents can help their children develop an awareness and appreciation for the connection between excessive media stimulation and over- involvement in activity and the symptoms of irritability, agitation, and hyperactivity that may develop.

Tuesday, August 16, 2011

Fibromyalgia: It's in your Head but it's not your Fault



Fibromyalgia syndrome (FMS) is the medical terminology used to represent a complex clinical disorder of symptoms characterized by soft tissue pain, stiffness, and altered deep pain threshold with psychological fallout. It can mimic or accompany symptoms of joint injury, but it is not an arthritic or neurological condition. The disorder affects between 3 to 6 million people – or as many as one in 50 Americans. About 80 and 90 percent of those diagnosed with fibromyalgia are women. I am one of the 10 percent of men afflicted with this disease.

There is usually an emotional overlay of depression and anxiety that affects the sufferer. There are numerous reasons why this is true. Many within the medical community have discounted fibromyalgia as a bona fide disease. Patients have been told that they are over-dramatizing their pain and that the stiffness or soreness has been psychologically induced. Others have been told that the condition was fabricated for attention or perceived by health providers as feigned helplessness. These assertions from medical experts make patients with FMS feel ignored, mistrusted, alone and without support. Patients often turn to self-blame, which fuels the pain cycle. A supposedly reputable physician once told me that “I just didn’t have a strong tolerance for pain.” I never saw him again.

The pain and symptoms of fibromyalgia are real and have a definite physical basis.
There is no known cause for fibromyalgia. Some researchers have speculated that physical trauma or viral influences have triggered FMS syndrome in many patients. There are no known abnormalities in the muscle tissue of fibromyalgia patients that would account for the disease.

Current research has focused on regions of the FMS patient’s brain and the susceptibility of certain brain locations to pain sensitivity. The brain receives a pain signal from the muscles and stays in a state of alert. For unknown reasons, the brain fails to let go of the pain signal and sets up a chronic pattern or pain syndrome. The brain stays in a constant feedback loop, consisting of a system of amplified pain signals.

Recent brain scan research studies have shed new light on this disorder. Results published in the May 2008 edition of the Journal of American College of Rheumatology shows that neuroscientists have been able to conduct scanning technology to areas of the brain affected by fibromyalgia. Mild pressure on trigger points of the patient has produced measurable brain response in processing the sensation of pain. The elevated response of pain in FMS patient’s brain scans was significantly different from those in the control group of the study. This is one of several studies that validate the reality of fibromyalgia as a disorder affecting the brain's response to muscular and neuropathic pain. Hopefully, future studies will lead to new treatment options.

Currently, treatment options consist of the use of a multidisciplinary approach. Medication management, physical therapy, meditation, exercise, alternative therapies, and cognitive-behavioral therapy are useful. CBT is a valuable therapeutic treatment option for those suffering from pain syndromes. One of the byproducts of pain can be the escalation of anxiety and depression. Likewise, anxiety and depression can intensify the impact of pain and make it more debilitating. Therapist must be familiar with the diagnosis of fibromyalgia and help patients accept the physical limitations that accompany a chronic pain disorder.

Cognitive-behavioral therapy’s goal is to teach the FMS patient to embrace pain rather than fight it. Cognitive distortions, such as magnification and “catastrophizing” need to be addressed so that patients learn to de-escalate fueling the pain process. How one thinks about his pain affects its impact. One can learn to rationally respond to pain by saying:
• "Although this problem is difficult, I can learn to manage it."
• "What's the use of getting all upset about my pain, it won't help anyway."
• "If I relax and walk into my pain, maybe all this will feel less troublesome."
• "I'm not alone in this. I have the support of my family and friends."
• "I'm not helpless, I have many strategies I can try to minimize the effect of my pain. Just keep moving!"

Therapy can assist the fibromyalgia patient to identify stressful triggers that exacerbate pain. This may involve examining family struggles, exploring inner-conflict, and working with core, self-defeating assumptions that affect thinking and behavior. Teaching the patient mindfulness meditation as a way of relaxing the sympathetic nervous system is beneficial. The goal is not to try to fix the unfixable, but to help patients manage their distress.

A therapist can provide the fibromyalgia patient with structured homework assignments that will help pain sufferers to experiment with new behaviors such as increased involvement and activities. Motivating the client to set realistic goals for everyday functioning can be helpful. Encouraging a multidisciplinary approach involving exercise, physical therapy, rehabilitation and medication management are essential.

Fibromyalgia patients fear that their disorder will cause them to lose the ability to function at work and at home. Teaching patients to focus on what they can do rather than their limitations is important. There is a tendency for fibromyalgia patients to distort reality by focusing on negative perceptions to the exclusion of the positive. Helping the patient and family to accept physical limitations is a necessary component to successful treatment.

Fibromyalgia patients can easily get enmeshed in a cycle of pain and associated emotional symptoms. It is the goal of any approach to assist the patient in coming to terms with his disorder and making plans to manage it. This is accomplished through acceptance and teaching the patient positive ways of thinking about his condition and multiple ways of treating it. As many in the medical community have insisted, fibromyalgia patients are not making it up. It’s a relief to know it’s in their head, but it’s not their fault!



James P. Krehbiel, Ed.S., LPC, CCBT is an educator, writer, licensed professional counselor and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. He specializes in treating anxiety and depression for adults and children. He served as a teacher and guidance counselor for 30 years and has taught graduate-level counselor education courses for Chapman University. In 2005, he self-published Stepping Out of the Bubble: Reflections on the Pilgrimage of Counseling Therapy (Booklocker.com). His latest book, Troubled Childhood, Triumphant Life: Healing from the Battle Scars of Youth (New Horizon Press) is about the impact of adverse childhood experiences on adult functioning. He offers solution-focused strategies to assist adults in overcoming the perils of the past.

Sunday, July 10, 2011

10 Insights to Help Couples Resolve Conflict


Many couples get caught up in arguing over the typical problems that plague relationships. A list of topics that couples encounter is actually quite simple. Couples feud over finances, household tasks, in-laws, parenting issues, lack of trust and so on.

Partners tend to play out a relationship dance as their way of managing the stress associated with the aforementioned themes. They will press the play button and chronically create the same interactional pattern of behavior. The conflict generally takes on a life of its own and leads to a heightened state of reactivity or passivity. One partner may be visibly angry, while the other mate shuts down and distances from the conflict.

It is not unusual for partners to become aggressive or fluctuate to the other extreme by passively pretending that the conflict does not exist. In their denial they may say, "I don't know what our problem is; I don’t see it because we never seemed to argue."

Continuous silence and avoidance are not impressive qualities of a healthy relationship. Learning how to fight appropriately is an integral part of promoting understanding among couples. Assertive, honest communication involves sharing intense feelings that validate a partner’s concerns. Couples must learn to feel safe enough in a relationship to allow for the expression of difficult thoughts and feelings. Here are some insights that may assist couples to fight more constructively and bring healing to their relationships:

• Recognize that some conflict is inevitable, an avoidable by-product of any meaningful relationship.
• Learn to respond rather than react. Reactivity is borne out of stress and anxiety. Promote understanding in the relationship by remaining calm, listening carefully and asking your partner questions for clarification.
• It's perfectly acceptable and understandable to disagree, at times. You don't always have to be right! Accept and respect differences in your partner's opinions.
• Listen carefully to each other without making value judgments. Respect differences in perspective.
• Avoid getting defensive and intent on justifying your point of view.
• Avoid shutting the conversation down unless you sense you're navigating a slippery slope and need a time out. Mutually decide when to resume conflict resolution toward closure.
• Stressors, including unresolved family-of-origin issues, can affect current communications. Recognize the stressors, acknowledge them to your partner and refrain from using them as psychological weapons.
• Avoid manipulating your partner, by bringing up issues involving family history. This pattern only exacerbates reactivity and defensiveness.
• If you get off track in your communications and you feel unsafe, call a truce and resume your discussion later.
• Reinforce one another when you are successful at processing conflict into closure.

Communicating through conflict takes courage, patience and perseverance. Remember, that conflict is inevitable, and that one’s style of relating may affect the outcome. Unfortunately, temporary hurt is often the byproduct of honest, forthright communicating. However, if couples can learn to make their point in a kind, considerate manner, that will help foster successful conflict resolution and heal troublesome emotional scars.

Tuesday, July 05, 2011

Filling the Feeling of Boredom with Meaning


Several decades ago, I was privileged to attend a presentation in the Chicago area held by psychiatrist Victor Frankl, author of Man's Search for Meaning. Frankl's family members were the unfortunate victims of the Holocaust during Nazi Germany's reign in Europe. His family was killed, but he spent years in a concentration camp and survived. Frankl's foundation for therapy was based on his experience and desire to see his patients develop a sense of meaning and purpose for their lives. I recall him saying, "When everything was taken away from me, all I had left was my attitude about was happening; I made a conscious choice not to be bitter."

Often I deal with people who claim they're bored with life. They complain incessantly about their relationships, prior history, level of activity, children and the vacuum that they feel within. There is no sense of direction or structure to their lives. Often, they turn to various forms of self-medicating or chronic activity to fill the void. Also, they may tend to derive their feeble sense of satisfaction from being an extension of other people's lives. They have an exaggerated need to control or "fix others" and idealize about those who appear to have their lives in order. They're fascinated by "heroes" and elevate them at the expense of their own self-identity.

There are little ways for all of us to find meaning and purpose for our life by becoming less self-absorbed. In the process of genuine involvement or sharing, it is important to remember that meaning is derived from what we accomplish, not because others choose to reciprocate. Sometimes the right thing to do is to be compassionate to others, whether they appreciated it or not. Finding meaning and purpose is about our responsibility, not how others react to us.

It is important to do the right thing because it makes us feel grateful, empowered and creates integrity. There are many ways all us can feel connected to the larger global community. Here are some examples:

• Attend worship services and pray for the needs of others.
• Treat people that annoy you with respect.
• Volunteer time and service to community agencies, such as libraries, nursing homes and political organizations.
• Give charitable donations to relief projects.
• Give to the needs of those that are less fortunate.
• Learn to be tolerant of other people's perspectives that vary from your own.
• Donate to breast cancer walks and other promotions for serious illnesses.

It is important to get your thinking in perspective. Look around you and then ask yourself, "How bad do I really have it?" If you're whining or complaining, you may need a dose of reality by connecting with those who are vulnerable and less fortunate. Remember, doing good deeds is about deriving meaning, not focusing on the reactions and responses of others. Those who are involved in helping others and give graciously will find a sense of joy, purpose and satisfaction they never thought possible. All we have left when all is said and done is the content of our character and the quality of the relationships that we leave behind.