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Anti Depressants-Sleeping Aid

ADOLESCENT ALCOHOLISM TREATMENT: ALCOHOL/DRUG ASSESSMENT

Once the issue of confidentiality has been cleared up, it is important to take a family history. Ask about alcohol or drug problems, prescription or nonprescription. Include the grandparents, uncles, aunts, brothers and sisters, and cousins, as well as the parents. Other important parts of the history include asking the adolescent how he spends his time. Ask him to describe a typical day. Ask what he and his friends do Saturday night. Ask about his peer group, about their age, activities, drug and alcohol use. Ask how they are seen and described by other groups in the high school, and then ask about his own use of drugs and alcohol. Ask about parental relationships. Ask about sleep, appetite, depression.The fact that adolescent alcohol abuse can go on for as long as 6 years without being diagnosed is a tribute to the ability of these adolescents to hide their problems, to the ability of parents to avoid recognizing problems in their children, and to the ability of school systems to ignore or expel problem children. It is not unusual for parents to be actively protecting, rescuing, and taking care of a substance-abusing adolescent without realizing that this supports and prolongs the abuse. They make good on forged checks. They hire lawyers or pay to have legal charges dropped. They go to bat for them at school or blame school authorities for the problems. In our experience, parents must stop protecting these children and seek help for them instead.When asking about drug and alcohol use begin by asking about the first time he or she was drunk, how much they drink now, how often, if they have ever tried to stop or cut down. Ask about blackouts, legal problems, and school problems. Finally, don’t assume that an adolescent is providing a wholly accurate history about drug and alcohol use. Denial is a central characteristic of adolescent alcohol or drug abuse. It is important to get information from parents and teachers whenever you are concerned about adolescent alcohol or drug problems.*151\331\2*

DREAMS—PSYCHOLOGICAL FILTER

We are now going to explore the use of dreams from another angle. But first let us recapture some of the facts about dreams and REM sleep. When a person is sleeping in the sleep laboratory, if he is awoken immediately after the REM sleep he will nearly always be able to recall his dreams vividly. But if he is awoken five minutes after the cessation of REM sleep, he will have only a vague recollection of the dream. If he is awoken ten minutes after the REM sleep, he will have difficulty in remembering any dream. It is quite normal to forget our dreams, and some people can never remember their dreams and believe that they never dream at all. Most of us wake from our dreams in the morning and still have our dreams fresh in the mind. However, when activities of the real world set in, the dream details disappear. As the day continues, you normally cease to think of your dreams—your mind is occupied with real tasks and real problems. Hence forgetting our dreams is normal and healthy.

Once, on waking in the morning, my wife Patricia tried to tell me about an interesting dream. However, by the time we were having breakfast and discussing the day’s work ahead of us, she had totally forgotten the contents of the dream. Patricia manages my clinic and is also a registered nursing sister. Unless we make a conscious effort to remember a dream, such as writing it down, it vanishes from memory. Just stop for a moment and think. Can you remember the dream you had the night before?

While we are dreaming we act out and experience some of our unconscious wishes and desires. Some of these desires may be very wicked and sometimes even immoral, and some of these desires may be too ambitious or even against the law and can never be fulfilled in real life. The dreams seem to satisfy our wishes and desires and let us experience them as if they are real and as if our dreams have come true.

Once these desires are satisfied, they are meant to be forgotten, so that the mind will no longer be disturbed by these desires and we can get on with our normal daily lives. In this theory about dreams, we are not encouraged to remember dreams or to analyze them. Dreams are perhaps a psychological filter and are used to dispose of our accumulated unconscious desires that may disturb our normal daily activities. After all, nature has designed dreams in such a way that most dreams are forgotten the next morning. Dreams are used to balance out our inner psychic life.

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THE MENTAL EXERCISES ARE EFFECTIVE IRRESPECTIVE OF THE CAUSE OF ANXIETY

It is clear that this approach is not directly related to the actual cause of the tension. This is an important point. At present there is a popular vogue that the only really satisfactory way to treat nervous illness is to unearth the cause. A little thought shows us that this is simply not true. Many people recover from nervous illness when they are given appropriate drugs, and we must not forget that religious experience, meditation, and philosophical practices have brought peace of mind to many who were disturbed. Furthermore, every psychiatrist knows that many patients can be brought to a full knowledge of the previously unconscious conflicts which caused their condition, but their symptoms will remain. Our own brief review of the causes of anxiety has shown that tension often results from a multitude of minor personal stresses of which the patient may be quite aware.

Our present approach to the relief of anxiety and tension by relaxing mental exercises works by aiding the natural processes of the body. It is effective irrespective of the cause of the anxiety; and above all else it is essentially a natural process.

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