Part 1: Pressure vs Pain

Pressure versus pain can be somewhat difficult to intuit. Think about any time you hit your funny bone, or bump your knee on your desk. What do you do? As humans, and as predators, we generally grab the part or our body that got hurt. "Ow! I could have done without that!"

And we press on or hold the part that got hurt. This is actually a good thing at times, since if you have a cut you should apply pressure... but I digress. The point is, we move into pain. We quickly close in on pain. On the other hand, if someone is aiming at you with a water balloon, you tend to move away. We move away from pressure. 

An example of pressure and pain could be a hard rubber ball at the end of a string, and your best friend, who is a bit of a trixter, swinging it. At first, you would move away from pressure, since you know your friend will probably bonk you on the head. However, when that friend finally nails you with the ball on your head, you will grab your head with your hand. You will move into the pain. Of course, if you are quicker, you will probably grab the ball... but that ruins my example.

The first thing you can look at when someone reacts to you, is whether or not YOUR behavior was interpreted as pressure or pain. In the picture below, my horse is not moving away, but is allowing me to pet him. This seems like a neutral position. 

Neutral - touching without pressure nor pain

If I pinch my horse, what will he do? Well, I'd prefer not to experiment, but ultimately, it depends on how he interprets the feeling. When a horse feels the pinch of a girth being tightened, sometimes he turn to bite. This sounds like moving into pain. Other times, a horse may start to move away from a saddle when someone approaches. This sounds like moving away from pressure. This doesn't mean that when your horse calmly walks over to you he views you as pain!

An example of horses in a more natural environment would be when a horse pokes at his belly when he starts to colic. Moving into pain. When a horse walks away from another horse that has her ears pinned, that is moving away from pressure. In fact, that would be an example of emotional pressure, since there is no physical touch.

So, from this we learn that clients who move toward their treatment goals are moving because they or their therapist is providing them with pressure. When they leave or give up, they may have been pushed to the point of feeling pain, or too much pain.

When dealing with others, think about whether what you are doing elicits pain or pressure, and modify what you are doing to attain a more desirable result.

Feeling stuck? An introduction to getting un-stuck.

There are times in therapy when clients get stuck. As a client, this can be very frustrating, and can even lead some to seek out a new therapist, or a new type of treatment. Worse, some clients may give up on the process of healing all together, because they start to believe that there is no hope. Clearly, being stuck is something to avoid. 

It seems that it should be easy to keep people interested in treatment when they get to interact with horses, but getting stuck still happens. As a therapist, one may decide it is the clients falt. For example, the client must be doing something wrong such as not sharing, being defensive, or using defense mechanisms, or is just not invested in treatment. This may be true, but may also be an excuse so the therapist does not feel like a failure! If you are a treatment professional, ask yourself if there is something more going on. Remember, "it's never about what it's about", meaning, it is often not what is being talked about, rather, it is something deeper. If you are the person who is stuck, ask the same question! There are three areas that can be reviewed to determine how to get things moving again, and this article will, therefore, be divided into three parts:

1. Pain vs Pressure
2.  Ball vs Chair
3. Approach vs Retreat

The first, Pain versus Pressure, is something I learned about through EAGALA, and the last two, are Parelli Natural Horsemanship concepts that I have found very helpful with myself and my clients.

Prey Animals Frustrate Predators

I've been working on my Parelli Level 2, which is the natural horsemanship I'm learning with their home-based curriculum. You can check out their curriculum at: http://www.parellinaturalhorsetraining.com/ Right now they have a sale....

Anyway, Linda Parelli said something I thought was quite brilliant: horses and other prey animals frustrate predators to stay alive. If the predator gets frustrated enough, they will give up, and that horse gets to go on living another day. 

Wow

That really changes how I understand a lot of interactions. I mean, if a horse is often losing confidence and exhibiting behaviors as a result of fear, then I'm bound to get frustrated. That is the whole point of their behavior. So what should I do? Well, I would take note of the behavior and my reaction to it, and if I feel frustrated, stressed or otherwise irritated, I can remember the purpose of this feeling from the point of a prey animal, relax, and retreat. That's the hard part - noticing the feeling withing yourself.

Next, I can take time to think about what I did, or what was in the environment, or frankly, what part of the horse's individuality, elicited the behavior. This is the fun/creative part. There are innumerable possibilities, so sort them out in a hierarchy, and pick one to try. Then try it! Remember to go through this process again until communication improves.

I bring all of this up because it seems very relevant for individuals and families as we deal with one another. So as not to offend, let's take children for example. They can be very frustrating at times. They won't eat, they hate bedtime, won't take a nap, won't pick up their things, they cry, get tired, and are downright frustrating at times. But we love them so. We have a choice here, and important one at that: we can become frustrated and ESCALATE or TAKE NOTE of how we feel. Say to yourself, "Hm, interesting. I feel frustrated."

If you are able to notice where in your body you feel frustration, that can be helpful, too. Next, remain calm. You need your frontal lobes right now, and they start to turn off the more adrenaline you make (horses are the same way). I should note, that it is usually MUCH easier to think about these things when it is NOT happening. You should plan for uncomfortable or not-pleasurable things that happen before they happen, so you can elicit a change in the moment.

Here is a helpful process from High-Fidelity Wraparound, and it is called a Functional Assessment:

1. Clearly describe the potential crisis behavior, fequency, duration and intensity:
2. What happens before the behavior occurs (triggers)? are there times/situations where the behavior does not occur? Why?
3. What happens during the behavior? Does something make it worse?
4. What happens after the behavior occurs? Is there a time when the behavior doesn't occur:
5. Best guess about whey the behavior occurs? (what's the function of the behavior). What has been successfully tried in teh past?
6. Select a positive replacement behavior.

 This is very formal, but as you practice it, it becomes second nature, and you are able to do it on the fly. Next time, I will go through the process with an example to show you how it works. If you wish, please submit a question.

Turning our heads at violence and abuse

It probably happens a lot of places, but it definitely is happening here in Helena, Montana. Residents enjoy little crime, and the ability to do things like leave cars and homes unlocked. We have a low population, and enjoy the right to bear arms. Past that, folks don't seem to want to talk about the existence of violent crime and abuses of all kinds, including domestic violence, physical and emotional abuse, and especially sexual abuse. This needs to change.

The people that are involved in anti-stigma campaigning (mental health) are already on board. This is similar to our volunteer pool. We have a great group of people who really care about others and want to help others, and recognize the need for mental health services. How do we get new people that don't think about mental health as being a part of the overall good of the community?

Perhaps we start with discussing what is important about it. What's in it for me?

Let's talk about your pocketbook. Does it bother you that people steal from you? How about when they steal from local stores, and prices are higher to adjust for the theft. Do you enjoy paying for brick and mortar to house more criminals every year? They get food, clothing, and shelter at your expense. Had you thought about it? Is it worth it just to get these people off the streets, or would it be better for them to be PRODUCTIVE members of society, caring for themselves and their family members. Their work could potentially contribute to the local economy in a powerful way.

According to Dr. Grohol of PsychCentral.com*, over half (55%) of males in state prison have mental health issues. For women, it is even higher, 73%! There is generally very little treatment available. In Minnesota, things got better with a mental health court in place, as evidenced by a 20-25% improvement in offender outcomes.

I'm not suggesting that criminals not serve time for their crimes. I'm just saying that if people are LOOKING for problems within their coworkers and friends, and being open about talking about mental health issues, then folks would be more likely to seek out treatment before they get involved in illegal activities that violate your rights and mine. Sweeping it all under the rug just makes it worse and more costly in the long run.

For example, I recently sat in on a hearing for youth offenders. First on the docket was a youth who has been sexually molesting girls 10 years younger than he. The judge altered the order of the cases so that no one would have to hear the molestation case. Why not? Who was there that would be so offended? Also, did you know that sex offender (SO) treatment is ONLY available at youth prison such as Pine Hills? I believe it is the same for adults. These people are not going to be locked up and have their keys lost. They get released, and no treatment is available, without private pay (they have to pay for it outright). 

Montana Sexual Offender Treatment Association

Fresh Steps EAP is actively participating in High-Fidelity Wraparound through Montana's PRTF Waiver. This program looks at children between the ages of 6 and 18 for risk of being placed in residential treatment. If they are at risk, they enter the program and receive High-Fidelity Wraparound services that have been shown to reduce negative behaviors to include crime. The reason it works is because professional and non-professional team members alike, both collaborate and integrate their services. Agencies standing alone cannot create the powerful outcomes simply because they are not connected to the community. Why? This is where we live, and everyone needs to be 'plugged in' to the community for needed resources. This means that eventually families will learn to be independent and no need professional services. 

If it costs $100K per year to treat a youth in a residential treatment facility, then it may cost over $1M to treat this child over the course of over 10 years. Why not spend the money up front, and get the family and youth back in the community? Much cheaper. Much better for everyone. 

For more information about High-Fidelity Wraparound, please visit:

Vroon VanDenBerg


National Wraparound Initiative

and for more about 

Montana's PRTF Waiver


 

*http://psychcentral.com/blog/archives/2009/07/18/imprisoning-people-with-mental-illness/