When an employee of the Federal Government such as a Postal Worker, IRS Worker, or Military Support Services becomes injured they are immediately flung into an arena which is dark and confusing.  Most injured workers are not aware of how complex and how diversified the system is.  Most practitioners do not accept or work within the parameters of the Department of Labor, Federal Workers’ Compensation Program, (OWCP).  An injured worker is assigned a case worker who is marginally aware of their medical condition.  The injured worker is trying to interpret the regulations as are federally mandated. 

 When an individual has a severe physical injury, it is medically probable that they will also have a psychological trauma such as depression, anxiety, chronic, pain and insomnia.  All of which will decrease a person’s self-esteem.  These issues are in need of psychological treatment.  The first course of treatment should be Cognitive Behavior Therapy.  Treatment helps an individual understand their symptoms and the causes.  If in addition to therapy severe sleep disorders and clinical issues exists this raises the possibility of psychopharmacology being a supplemental treatment. 

 An injured worker must search out individuals to treat them so that they can remain functional in their families and eventually return to some gainful employment.  This is the role of a treating psychologist. Our function is to help an injured worker understand their limitations, disabilities, and learn to cope with those limitations.  It is necessary to provide substantial support while maneuvering through the complex medical/legal system.

 A Cognitive Behavior Therapist is a fundamental necessity in helping to manage pain.  The other alternative is to use pharmaceuticals which are marginally effective and most often have to be increased in dosage.  It is necessary for an injured worker to understand that in the Federal Workers’ Compensation System, chronic pain management is not considered a disability.  Psychological factors such as depression, anxiety, insomnia, and low self-esteem are compensable and approved for treatment.

There are many more calls and referrals regarding children with Attention Deficit Hyperactivity Disorder, which is a form of Obsessive Compulsive behavior of children.  In April 2010 a study appeared in Health Day News of 304 youths found to have ADHD symptoms.  The finding was that these symptoms are more common in children and teens with high or low activity levels of the neurotransmitter serotonin.  The children blamed themselves for conflict between their parents.  This study would indicate that there is an interaction of genetics and psychology which may be the root cause of Attention-Deficit Hyperactivity Disorder (ADHD).

 In this study it states “To date, studies have mostly focused on the effects of genetic and environmental influences on ADHD separately,” wrote Molly Nikolas of Michigan State University.  She states, “Our work examines interaction between the specific gene variant and a family environmental risk factor in order to determine the roles in the development of ADHD via behavioral and emotional disregulation in children.”  The genetic region examined by the researchers is the 5 HTTLPR, which is responsible for the regulation of the production of the protein that transports serotonin.  Previous studies have linked this area to a number of personality traits and neuropsychiatric disorder.  Again, “Overall, these results complement growing evidence suggesting that 5 HTTLPR variants confer a liability for ADHD that is activated in particular environments, rather than conferring risks for ADHD directly.”  This study was published on April 15, 2010 in the Journal of Behavioral and Brain Functions. 

 This finding indicates that simply medicating children for the sake of controlling their behavior may not be the best way to treat them for this disorder.

Currently a new evaluation has been made available by Western Psychological Services, which is intended to measure children and adolescent’s problems by incorporating a self-report of moods and anxiety disorder, including problems associated with OCD related behaviors.  Studies have shown that children tend to report higher levels of Obsessive Compulsive Disorder related symptoms than their parents. Children especially report symptoms of Obsessive Compulsive Disorders, especially mental symptoms such as obsessive thinking, and compulsive tendencies.  This test is a valuable aide both in confirming and ruling out the presence of obsessions and compulsions, and in understanding the child’s experience of his or her symptoms.  This evaluation is a useful tool in assessing many apparent disorders that children are currently suffering.

Dr. Frank Lucchetti is pleased to announce the availability of the Millon Behavioral Medicine Diagnostic Inventory to assess psychological factors that can influence the course of treatment of medically ill patients.

 Sir William Osler, the imminent nineteenth century clinician, said, “The good physician will treat the disease, but the great physician will treat the whole patient.”  The MBMD ™ (the Millon Behavioral Medicine Diagnostic) Inventory is designed to provide the critical psychological information doctors need to treat the whole patient.  We must understand that psychological and behavioral factors play a potential role in the presentation or treatment of almost general medical condition.  The use of this diagnostic tool is reserved for those situations in which the psychological factors have a clinically significant effect on the course or outcome of the general medical condition, or place the individual at a significantly higher risk of an adverse outcome.

 Psychological and behavioral factors may affect the course of almost every major category of disease, including cardiovascular conditions, dermatological conditions, endocrinological conditions, gastrointestinal conditions, neoplastic conditions, neurological conditions, pulmonary conditions, renal conditions, and rheumatological conditions.

 The MBMD is a tool which can be useful in the integrative treatment of individuals who had substantial medical conditions, chronic pain, and are deciding on major surgical procedures.  This tool, along with appropriate psychological intervention can be a cost effective and useful treatment in recovery, and the management of physical disabilities.  This tool is now an integral part of treatment in my psychotherapy practice.

A definition of rudeness is where one individual imposes their wishes and needs on another individual without consideration. It has become a symptom of our society today that everyone is busy and everyone has no time. The end result is that there is an epidemic of rudeness in our society. Recently, in an article by Robert Cenek in the Cenek Report wrote, “Rude work places are all the rage”. In this article Mr. Cenek states that he’s not optimistic for much change in the future. It’s a malaise that’s symptomatic of a similar trend in our society. I would say that I experience on an average of five to ten acts of random rudeness with other members of our great land on a weekly basis. We are raising an entire generation to function without simple “Thank You’s” and “Excuse Me’s”.

This would not only translate to a work setting but certainly in our social functioning in retail. Do you remember the old days when the customer was always right? And that the emphasis by the retailer was always to keep the customers as number one and to provide the best service for them. This is certainly the good old days because corporate America today rather functions on the bottom line or the corporate profit. In fact, I am aware of one corporate philosophy which is “It doesn’t matter how we treat our employee. There are plenty of others to take their place if they don’t like it.” This type of mentality is the epitome of rudeness and, of course, what else would a customer expect other than rudeness from this type of a work environment. There is an old fashioned concept at one time that we may all remember. That was “Three’s a crowd”. When this occurred immediate action would be taken to assist the customer. Today’s concept is “let them wait they’re getting a good deal and if they don’t like it they can go some place else.” This mentality translates further to where if you ask for help they point you in a direction. “Over there and help yourself, I don’t have time to assist you.”

Certainly, this kind of behavior translates to people being frustrated and acting rudely. It would seem that we as consumers and individuals on this planet are being told to accept it as is and this is done in a non-caring environment. As such, it is quite easy to see why others who are exposed to such mentality become rude. No one should tolerate rudeness and disrespect at work. If tolerated, the enterprise will face a high cost in lower moral and productivity among the staff. Christine Porath, a professor of management at the Martial School of Business (USC), does research on the impact of rude behavior in the work place. Over 90% of the nearly three thousand employees that Porath has surveyed claim experiencing incivility on the job. Of these, 50% lost work time worrying about the incident, 50% contemplated changing jobs to avoid a reoccurrence, and 25% cut back on their efforts on the job. If rude behavior is allowed to flourish at an enterprise, talented people who have self-respect will start heading for the door. Professor Porath found that one in eight workers who were rudely treated by a co-worker left their job shortly there after. The only workers who stay in a rude work place are people who rage.

Rudeness can easily be transformed into something that has been label “Road Rage”. This is an inherent rudeness while operating a motor vehicle. Again because of pressures in our society people tend to be busy, rushed and “have no time”. It’s perfectly acceptable to cut off another motorist or to “speed” or to deny others’ rights such as those of right of ways because of need for time. Many motor vehicle laws are broken consistently and daily as a result of rudeness. I am not sure if we are going to be able to return to a kinder gentler society, but certainly that is going to be necessary if the quality of our lives is ever going to improve.

Certainly, the most difficult issues for modern couples is the ability to commit ones’ self to a personal relationship as well as to a career or demanding work. In an article recently in Style Magazine; Actress Julian Moore in the March issue was quoted as saying “At the end of the day, the
thing that gives me meaning is my family. But work is a huge expression of who I am, what my interests are in the world. It would be hard not to have both things. There is no career vs. family- its’ both. It’s life.”
In my years of practice in the field of psychology, I have encountered the issue of personal self-worth and achievement as well as maintaining a
functional, healthy relationship. It is especially difficult for a woman in today’s society to have a career which is highly competitive and demanding
as well the demands of being mother and wife. It is my opinion that the most difficult job that any of us have is that of parenting. It is especially true
for a woman who has to bare the child, feed the child, and nurture the child.
This is true for the first years of the child’s life. Certainly, a fathers’ involvement is important but a mothers’ consistent involvement and time is not just important but vital to survival. I am not a believer that there is such a thing as quality time. This concept existed 20 years ago when women were introduced into the work force and worked long hours away from family settings. In order to cope with a woman’s guilt and stress of not being their for her children and spouse, the concept of quality time was invented that it was primarily the if a women spent half hour concentrated effort, no distraction with her child, that this was equal to half a day that a mother might spend in activities with her child. It is my opinion that there is no such thing as quality time that all there really is time.
The more time a parent invests with their children, the more benefits that will result in a child’s’ growth. Unfortunately, there is no substitute for mothering. A mother is the most important person in any of our lives and is the person who we often look too for nurturance and guidance. A healthy relationships with our mothers in our societies seem to benefit and have an easier time of adjustment in society than those who have had dysfunctional relationships with their mother.
In psychology, it is quite interesting that many of the diagnoses in the DSM IV relate to the relationship that one has with their mothers and
approximately 70% of all mental disorders have a connection to the initial relationship with our mothers. This puts a great burden on the responsibility of being a parent and especial that of motherhood. It is certainly a lot easier for males in our society to be a father since the traditional role of father is to be a provider and not so much a nurturer. If both parents choose to work to meet their life goals then it is necessary that the father be a nurturer in order to provide for the needs of the children. Now it is also possible in our society to be a family and not have children.
That is a new definition of a family. An adult committed relationship without children is now considered a family. This type of family is confronted with the commitment of both people to the relationship. Relationships are like living entities and need to be continuously addressed. The most difficult part of life for most human beings seems to be having a functional relationship. When one looks at an individuals career vs. relationship a person can have highly successful career, eg. note: Movie Stars and Public Officials but not have a successful relationship. This again points to how difficult it is to have a successful relationship.

Every human being needs to touch and be touched. Each of us have thoughts and feelings so deep and personal that words will simply not bear their weight. And yet, we long to communicate them, to share them with another. Our most intense joy is amplified and given permanence by being shared. Our deepest feats and anxieties are made endurable and manageable by being shared. But they can only be truly shared in their full depth and significance when they are shared in the totality of who we are. They cry out for touch. We need to touch. Perhaps in our artificial technologized culture we need the closeness and intimacy of touch more than ever. Our western culture has achieved such a level of cerebration, of the worship of intellect and intellectualizing, that we are terrified of touch. We have so hidden from ourselves those deep feelings about which we cannot intellectualize that their sheer pressure inside of us terrifies us. We are taught almost from birth that man’s glory is his intellect and his emotions are fetters from which he needs to be freed. Emotions are to be risen above, avoided, denied, escaped. One of the greatest unlearned lessons of history is that emotional and intellectual freedom is to be found not in freedom from feelings, but in being freed for them. Indeed, I have come to the conclusion that what differentiates man from the beasts is not his mental skill, for all his superiority in that. What sets man apart most profoundly is the depth and complexity of his capacity for emotion.
We need to share ourselves with each other as surely as we need to breathe. But just as surely, that sharing cannot be accomplished on a merely
verbal level. What we need to communicate is more primal, more basic, than language. You have perhaps heard of the nursery babies who die without the human touch, who need only to be played with, handled and cuddled to survive. Recent experiments with baby monkeys, even, indicate that without the physical intimacy of mothering they do not develop properly. Those completely starved of touch, die. Research in the teaching of reading indicates that not only is verbal facility — the ability to use words — not our primary mode of communication, but children who do not crawl, and touch, and handle things, almost invariably have difficulty with language. The thought and word are not our primary mode of communication. We are primarily animals who touch! Our deepest thoughts and feelings can only be communicated by touch . . . by physical intimacy.
When your child comes to you, frightened and hurt, TELL him you care, TELL him you love him, TELL him you are sorry. Then TOUCH him. Take him in your arms and cuddle him. Then he will believe you. Then he will know you care. But to whom can you go when you are frightened or hurt? With whom can you share those deepest feelings, which can, only be shared by touching? We adults have limited touch to three areas. We allow the handshake and such similar symbolic, but safe, gestures. We may touch in sexual intercourse. And we may touch in hostility, where one feeling — anger –protects us from others that might burst out. That is just about it! So far as a language of touch is concerned, we have condemned ourselves to a sort of pig latin where, when we touch at all, our meaning must always be veiled.
Let as examine there three areas of touch open to us. A handshake. Why this symbol? I am told that this ritual derives from the days when men wore swords. They held out their unarmored hand as a gesture of peace and trust. But why is it still with us if it fills not need in our arsenal of communication. The handshake is a ritualized caress. It is a symbolic reestablishment of communication. As a gesture of friendship, no symbol could be as powerful as that of touch. For there is power in touch. it demands and communicates a dimension of commitment and trust unlike any other form of communication. I may talk to you and remain hidden from you. But, if we touch, I am vulnerable. I may reveal more of myself to you than I can trust you with. There is a feeling of control in verbal discourse that is absent with physical intimacy. Sham and pretense is much more difficult.
This is precisely why we are wary of touching. It is a terribly risk-filled form of human relatedness. The more so because we need it so much and
are starved for it. We are well aware that if the power of touch is loosed, those feelings that we keep carefully bottled up inside may come spilling out.
Touch has the power to burst the floodgates of our dammed up emotional lives.

And we are right! Touch is dangerous. Is is not by accident that we use the same word . . . feeling . . . to refer to emotion and to touching. They are
closely related. So, when we meet after a period of separation, we shake hands. We need to reestablish contact, to be together again. But touch is dangerous. So we keep it off, out there. The handshake becomes at the same time a caress and a fending off, a contact and a buffer. We need to touch, but we are afraid of its power and the trust it demands.
The second area of touch we allow ourselves . . . sexual .intimacy . . . is really our only area of open intimacy. In bed, preferably with a member of
the opposite sex and properly only one who is a legal mate, we finally allow ourselves to touch. There we may speak, as only touch can, of who we are
and how we feel.
That the courtship-intercourse-situation is virtually our only allowable intimacy. And so we fill that one allowable intimacy with all of our needs to
touch. We thrust all sorts of totally inappropriate feelings into that relationship. That one act must bear the weight of all our needs to communicate what cannot be said! Is it any wonder our culture is obsessed with sex, and yet plagued with problems and frustrations about it?
Is it any wonder our teenagers, like their parents, are hung up on sex? The only vocabulary of feeling we have given them is that of seduction. in
any given parked car with young people necking, there is involved FAR LESS sex than the need to be close to another — to speak in touch the anxiety,
the joy, the affirmation and the uncertainty of being alive; to give and to receive the comfort and security of being together that CANNOT be said.
There is, in back of our so-called sexual revolution, more than simply new attitudes towards sex. There is rather a groping for a now vocabulary of
feeling. The major problem in that revolution is not the threat of sexual license. The major problem is our culturally inherited inability to distinguish
the need for an expression of sex, from the rest of our deepest feelings . . .the inability to distinguish physical intimacy from seduction.
The final area where we allow ourselves to touch is that of overt hostility. It is seen in contact sports; both those in which we engage and
those we watch, touching vicariously. It is seen in the discipline of children. It is seen in the various outbursts of physical violence, even in
much antisocial behavior.

The need to touch can he expressed in hostility while minimizing the risk of the floodgates bursting. The expression of strong hostility keeps the other feelings from being revealed. There is more love present but hidden, in most of our acts of anger than we are often aware. And, tragically, many a child is only able to get physical intimacy from his parent by misbehaving. The consequent emotional confusion, misunderstanding, and
apparent irrationality that clutter our lives are quite understandable in light of our starvation for touch. This unfortunate state of affairs even infects that one intimacy we allow ourselves. Misplaced and misused hostility is often responsible for our hang ups in our sexual adjustment.

To whom Can YOU go when YOU are frightened, or hurt, or just need to be WITH someone? To whom can you go for the human touch?
To a handshake? To a fight? Or, to bed? We are alone with our deepest feelings, and we long to share them. But we have cut ourselves off from this most profound means of communication We have invested too much stock in talk and we are in danger of bankruptcy. No one is hung up for lack of an argument . . . philosophical, theological or scientific. NO ONE! if we would administer to the terrors and hurts of the world; if we- would care, the only way caring can be heard; if we would be whole again, and bring wholeness to those we love; we must, perhaps, become as little children, and learn again the human touch.
”To pass among them or touch any one, or rest my arm over so lightly around his or her neck for a moment, what is this then? I do not ask any more delight, I swim in it as in a sea. There is something in staying close to men and women and looking on then, and in the contact and odor of them, that
pleases the soul well, All things please the soul, but these please the soul well.” from “I Sing The Body Electric,” LEAVES OF GRASS
By Walt Whitman

Recently, I was contacted by KGO Radio Station to give a response to this interesting question. The audience and callers were specifically interested
knowing if there is psychological data which supports an appropriate age for a young person to begin a sexual activity. It is my opinion that there is no such standard which currently applies.
If we look at anthropological and sociological history we find that our ancestors were in fact beginning the mating ritual at a much earlier age and
primarily this was driven by the need to survive. Our ancestors did not survive as long we currently able too, and as such began reproduction earlier
in there lives. Still today there are parts of our world were young women are married at the age of fifteen and sixteen and begin to deliver children
immediately due to non-use of birth control. Certainly, in a developed country such as the United States and most of Europe the knowledge and use
of birth control is greater and young couples if they are choosing to be married are choosing not to have children until later in life. However, the
trend seems to be in the United States that people are marrying or committing themselves at least to a relationship much later in life and
therefore are postponing starting families.
This does not however indicate that young Americans are postponing sexual activities. It is not uncommon for seniors in high school to be sexually
active. It is my belief that the current politically correct drive to postpone sex until marriage is just that, political in nature, that still the human sexual drive and human need exists as it always has. Young people are choosing to express this in their personal way. It is my opinion that it is important for an individual to know the consequences of a sexual relationship. The possibility that not only pregnancy may be possible but that there is also an inherent risk regards to contracting sexually transmitted diseases. When a young person is able to understand these factors and is able to discuss this openly with there partner, then it is my opinion that they may be mature enough and capable to enter a sexual relationship. If a young couple is not able to discuss these openly with each other significant adults in their lives, they are not prepared to deal with the consequences that involve an intimate relationship. They may be considered to young to be sexually active. Sexual activities between two human beings should not be measured by guilt or negative feels.
It is necessary that the individual’s religious and personal beliefs are consistent with their behavior. In doing so, there will be no guilt or loss of
self-esteem. If this indeed can be done then, their behavior should be considered as being responsible and appropriate. Certainly, those two
standards need to apply not only to sexual activities but to all types of human behavior.

Most of us believe that we need to make changes and certain choices which are better for us such as save more money, reduce gas consumption, eat healthier, or exercise more but we do not carry out these choices. This is a common psychological stressor which causes a “want-should” conflict. It is easier for us to consider all necessary changes and improvements in the context of tomorrow or in the future. The concept of implementing it in the present and making the change now is terrifying and debilitating. When making decisions we often think that we can make certain choices but do not want to make them right now.

Psychological experiments have shown that people are more likely to choose what they believe they should choose when the choice will be implemented in the future rather than implemented immediately; a tendency which is referred in the literature as “future lock-in.” Future implemented choices are construed at a higher level than immediately implemented choices, and this difference mediates the increased support for the should choice resulting in future implementation. All of us feel that in our future we will behave more virtuously and be better. Even though we are doing nothing actively to reach that level we all tend to think that we all are going to feel and do better in our future.

This type of thinking is consistent with our form of government in which we are living now at the expense of our future. Everyone realizes that we are spending and doing things that we do not have money for. However, the belief is that in our future we will be much more prosperous and, therefore, will be able to pay for our current needs. This type of mentality is interpreted on the personal level as well. People end up over charging and spending because their opinion is that they need it now and want the gratification now with the belief that in the future there will be some kind of prosperity or answers to help them meet their needs.

This type of future-lock can only temporarily sooth us and help us because there is no doubt that the burden which we create for ourselves either financially or personally will always be noted and be constant, and as such trying to be happy is an impossibility. You must learn to live for the moment. All we can effectively do is deal with the present. The past can no longer be changed and the future is not under our control. What is under our control is our daily actions and our daily living. It is better for us to shorten our future to an 8 hour span, or possibly 12, and no further. On a daily basis it is best for us to set goals that we can accomplish within that day versus setting goals that will be accomplished years in the future. This is not to say that a person should not have dreams or aspirations. However, it is clear that in order to meet those dreams and aspirations there must be some active pursuance and diligence on a daily basis. If one does not act in that manner there is no future gratification as well.

Being responsible and attentive to our daily needs and those of our loved ones is the primary focus of how to achieve future success. Making the difficult choices and the difficult changes on a daily basis is the only way that there will be a healthy and happy future.

During the course of the 20th century companies and governments around the world have developed a new perception of the role of women in the workplace and in positions of power. Little by little women have risen to higher positions in academia, politics, and the professions. These women have shown that they can be as confident and as effective as men. As Nuria Chinchilla, a professor of business in Madrid, Spain, stated at a recent women’s conference, “Feminine genius and energy will transform society and modern companies during the 21st century.” According to Professor Chinchilla, “Every woman must directly deal with difficult obstacles in order to achieve the ambition of a good life that fulfills professional goals and roles of a mother, wife, and citizen. To achieve total integration and harmony, they must move toward a new concept of success that involves freedom and flexibility in their corporate cultures as well as social conditions.”
Government plays a helpful role by instituting policies that assist and promote participation by women in all aspects of life including politics, business, and the family. Professor Chinchilla, who conducts conferences of modern-day women, says that women in general have a much higher ambition level than men although, to achieve success, both genders must work together. As Chinchilla offers, “No two people are alike. So why not talk about diversity instead of equality.” She asserts that fraternity is a term that can refer to either maternity or paternity and, as such, emphasizes the need for all people to be accepted equally. In their broadest sense, success in life and respect for the individual are fundamental in all cultures. Women are well adapted to working without reward or remuneration. An example of this is the many hours women labor to care for children and life partners. Many women believe, however, that they must give up their career ambitions to care for their families because it seems impossible to
pursue both their personal and professional goals. As a result, many talented people are lost along the way. Within the discussion of whether a woman should be president is the necessary and fundamental question of whether, as the main goal of modern civilization, we can achieve a healthy balance between work and family. It certainly would seem that if we expect our human species to continue and for us to realize the full advantage of the creativity and expertise of women, then retaining women with talent in the workplace and allowing them to fulfill both their personal and professional needs will save a great deal of money and contribute a great deal of value to both government and the private sector.
As a poet once said, we live in interesting times. If a woman is going to be president it will certainly necessitate a major shift in individual attitudes to one that is based on acceptance of diversity and equality. We will need to strive for the inclusion of all people in our society at every level. When this happens our future will be brighter and our focus on basic human needs will be stronger.
# # #