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Is there any guideline on how a layman giving support for another layman on their psychological problems?

Is there any guideline on how a layman giving support for another layman on their psychological problems?


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I am being contacted by a stranger for having some understandings about a psychological disorder (in this case, BPD). I will help them what I know, in my ability, but I want to avoid the assumption that I know the best, or any unintended harm on their therapy. I think the form of this support has been around for a long time, and basically we can rely on common sense to operate. However, is there a complete guideline for kind of situation?


This Article Contains:

Client-Centered Therapy, also known as Client-Centered Counseling or Person-Centered Therapy, was developed in the 1940s and 50s as a response to the less personal, more “clinical” therapy that dominated the field.

It is a non-directive form of talk therapy, meaning that it allows the client to lead the conversation and does not attempt to steer the client in any way. This approach rests on one vital quality: unconditional positive regard. This means that the therapist refrains from judging the client for any reason, providing a source of complete acceptance and support (Cherry, 2017).

There are three key qualities that make for a good client-centered therapist:

    Unconditional Positive Regard: as mentioned above, unconditional positive regard is an important practice for the client-centered therapist. The therapist needs to accept the client for who they are and provide support and care no matter what they are going through.

Another notable characteristic of person- or client-centered therapy is the use of the term “client” rather than “patient.” Therapists who practice this type of approach see the client and therapist as a team of equal partners rather than an expert and a patient (McLeod, 2015).


What Is Vicarious Trauma?

It doesn't take a lot of words to give a complete vicarious trauma definition. Vicarious trauma is an intense reaction to being exposed to someone else's trauma story or being exposed to the details of the traumatic event. The only thing missing is who this happens to most.

Who Is Affected by Vicarious Trauma?

People in the helping professions are the ones that typically experience vicarious trauma. The term 'vicarious trauma' was originally coined to describe the reaction a psychologist or counselor has after hearing the stories of traumatized clients. Later, other helpers who deal with traumatized people were added. It also makes sense that people, especially children, who have witnessed these threats or violence may experience vicarious trauma as well however, this last bit has not been added to most definitions yet.

The list of people who experience vicarious trauma may include:

  • Psychologists and counselors
  • First responders
  • Clergy
  • Doctors, nurses, and others in the medical professions
  • Social workers
  • Justice system professionals
  • Humanitarian workers
  • Journalists
  • Anyone who witnesses or hears the details of a traumatic event happening to a loved one.

The Deeper Meaning of Vicarious Trauma

If you're a helper by trade, experiencing vicarious trauma means you have connected deeply with one or more clients or people you're helping. Countertransference is a relevant psychological term for this. It refers to the 'emotional reaction of the analyst to the subject's contribution,' according to Google Dictionary.

Countertransference can be extremely helpful as you go about helping someone. It enables you to understand how they're thinking and feeling so you can help them more effectively. In short, people who experience vicarious trauma have succeeded in establishing that connection. The only problem is that they've failed to create a boundary that keeps the feelings of the person they're helping separate from their own.

If you have vicarious trauma, it means you care what happens to the person who's experienced the trauma. It says you do 'feel their pain.' Most of all, it means that you're a loving, caring human who looks beyond self to see the suffering of others just so that you can help them.


Is there any guideline on how a layman giving support for another layman on their psychological problems? - Psychology

The length of stay in the hospital will vary depending on the individual donor's rate of recovery and the type of procedure performed (traditional vs laparoscopic kidney removal) although the usual stay is 4 to 6 days. Since the rate of recovery varies greatly among individuals, be sure to ask the transplant center for their estimate of your particular recovery time.

After leaving the hospital, the donor will typically feel tenderness, itching and some pain as the incision continues to heal. Generally, heavy lifting is not recommended for about six weeks following surgery. It is also recommended that donors avoid contact sports where the remaining kidney could be injured. It is important for the donor to speak with the transplant staff about the best ways to return as quickly as possible to being physically fit.

How does living donation affect the donor?

People can live normal lives with only one kidney. As long as the donor is evaluated thoroughly and cleared for donation, he or she can lead a normal life after the surgery. When the kidney is removed, the single normal kidney will increase in size to compensate for the loss of the donated kidney.

Physical exercise is healthy and good for you. However, it's important for someone with only one kidney to be careful and protect it from injury. Some doctors think it is best to avoid contact sports like football, boxing, hockey, soccer, martial arts, or wrestling. Wearing protective gear such as padded vests under clothing can help protect the kidney from injury during sports. This can help lessen the risk, but it won't take away the risk. Talk to your healthcare provider if you want to join in contact sports.

Donors are encouraged to have good long-term medical follow-up with their primary care doctors. A urine test, a blood pressure check and a blood test for kidney function (GFR) should be done every year.

Does living donation affect life expectancy?

Living donation does not change life expectancy, and does not appear to increase the risk of kidney failure. In general, most people with a single normal kidney have few or no problems however, you should always talk to your transplant team about the risks involved in donation. Some studies report that living donors may have a greater chance of developing high blood pressure. It is recommended that potential donors consult with their doctor about the risks of living donation.

What can I expect emotionally after donating a kidney?

After donation, living donors often report a wide range of mixed emotions, from joy and relief to anxiety to depression. The process of getting through the evaluation and surgery can be so time-consuming that donors do not always have time to process everything they are feeling. It is normal for these emotions to come to the forefront after the donation and transplant take place.

Living donors generally rate their experience as positive. Different studies indicate that between 80-97% of donors say that in retrospect, they would have still have made the decision to donate.

However, concerns about the recipient's outcome (as well as the donor's recovery) can contribute to feelings of anxiety, and may donors report a feeling of "let down" afterwards. Feelings of depression among living donors are not uncommon, even when both donor and recipient are doing well.

While extensive data on these issues is lacking, some studies have reported the following psychological outcomes:

  • Less than 1% regretted the decision
  • 3 to 10% reported depression
  • 10% reported "family conflicts"
  • 7% reported anxiety disorders
  • 16% concerned about negative financial consequences of donation
  • 3 to 15% concerned about a negative impact on their health

Living donors who are struggling with these issues are encouraged to:

  1. Talk to the transplant hospital's Transplant Social Worker for advice
  2. Seek professional counseling or other outside help to manage difficult emotions, and
  3. Talk with other living donors who can be particularly supportive if they have experienced the same feelings.
  • Let your transplant team know how you are feeling both physically and emotionally during your follow-up visits.
  • Talk to the transplant hospital’s social worker for support and guidance.
  • Seek professional counseling or other outside help to manage difficult emotions.
  • Talk with other living donors who can be particularly supportive if they have experienced the same feelings.

What are the long-term risks of donation?

You will also have a scar from the donor operation- the size and location of the scar will depend on the type of operation you have.

Some donors have reported long-term problems with pain, nerve damage, hernia or intestinal obstruction. These risks seem to be rare, but there are currently no national statistics on the frequency of these problems.

In addition, people with one kidney may be at a greater risk of:

You should discuss these risks with your transplant team, and ask for center-specific statistics related to these problems.

Are there any dietary restrictions after donation?

After donation you should be able to go back to a regular, healthy lifestyle. If you are in good health, there will probably not be any specific dietary restrictions. Talk with your transplant team about your specific dietary needs.

Will I be able to obtain insurance coverage after donation?

Your health insurance should not be affected by donation. The Affordable Care Act has made it illegal for health insurance companies to refuse to cover you or charge you more because you have a pre-existing condition.

However, some living donors have reported either having difficulty getting life insurance or facing higher premiums for life insurance. In such cases, it may be necessary for transplant centers to inform the insurance carrier of existing data that report that the patient is not at increased risk of death because of donation.

If you already have insurance, check your insurance contracts carefully to see if living donation would affect your current policies. You might also want to consult with a lawyer who is knowledgeable about insurance law.

What if I donate, and need a kidney later?

This is something potential donors should discuss with the transplant team. Talk to your transplant team about any pre-existing condition or other factors that may put you at a higher risk of developing kidney disease, and consider this carefully before making a decision about donation.

There have been some cases in which living donors needed a kidney later - not necessarily due to the donation itself. It is considered a potential risk of donation. UNOS policy give priority on the waiting list to living donors.

Can I become pregnant after I've donated kidney?

Pregnancy after donation is possible but is usually not recommended for at least six months after the donation surgery. Living donors should talk to their ob/gyn and transplant team before getting pregnant about pregnancy and make sure that they have good pre-natal care.

Generally, living kidney donors do well with pregnancy after their donation. However, some studies have shown small increases in some risks like gestational diabetes, pregnancy-induced hypertension, protein in the urine and pre-eclampsia. Living donors should inform their ob/gyn about their donation to allow monitoring for these potential complications.


Editorial Reviews

Review

"A Layman's Guide to Managing Fear" is a great self-help book.I have been a Counselor for many years now and I use some of the samesuggestions and tactics in my practice and you didn't have to pay $55.00 ormore an hour to hear them!"
--Mark Myers

"OnePowerful Book That Can Change Your Life!!Within this book are the answers that so many people so desperately needto hear. There is hope and freedom in the pages of this small life saver"
--Trisha Bleau

"Stan has hit the nail onthe head with his recommendations of a three tiered approach to dealing withfear. Very well put together and accessible to all ages."
-- Gordon R. Estes, Jr.

"The book has cognitivetherapy and christianity woven together in a way that does not feel overwhelmingor intrusive. Worth the read."
-- Ron Jon

"Popovich has writtenabout three distinct methods of dealing with fear. As a licensed counselorintern, I have incorporated many of thetechniques mentioned in this book Believers and non-believers alike couldbenefit from reading this."
-- Satchel Pierce Stillwell

"I like that Stan combinesvarious methods and even tells us how we can combine the methods for acomprehensive list of suggestions."
-- Anne Cuthbert

"I'm always looking forhelp for my clients that is written in terms that they can understand. Thisbook does just that. Take it with you to your therapist & discuss it withthem as basis for moving forward."
-- Hilary MacKenzie

"As a therapist, I havefound that client's like to have a simplified explanation, one without all thepsyco-babble. This book provides just that."
-- Don

From the Author

"I have used Stan'stechniques with my clients. I wouldrecommend this book for counselors, individuals, pastors or anyone in thehelping profession."
-- Bonnie Roberts

"Very easy to readwith practical suggestions. The clear and concise way it is written makesit a good book to which therapists can refer their patients."
--Brenda Dolan-Pascoe

"A great laymen's guide to anxiety bolstered by a variety of approachesincluding both spiritual and psychological. Full of practical tips for helpingunderstand and reduce anxiety. A fast and interesting read that I would highlyrecommend."
--Sara Nannen

"I enjoyed reading this book because it provides many helpful remindersand techniques to use when struggling with fear and anxiety. The book isorganized thoughtfully, and the concrete examples help the reader understandhow the tools work."
--Patricia Allison

"Very easy to read with practical suggestions. The clear and concise way it is written makes it a good book to which therapists can refer their patients."
--Brenda Dolan-Pascoe

"A great laymen's guide to anxiety bolstered by a variety of approaches including both spiritual and psychological. Full of practical tips for helping understand and reduce anxiety. A fast and interesting read that I would highly recommend."
--Sara Nannen

"I enjoyed reading this book because it provides many helpful reminders and techniques to use when struggling with fear and anxiety. The book is organized thoughtfully, and the concrete examples help the reader understand how the tools work."
--Patricia Allison

"The book is divided into sections that address different approaches from general counseling techniques, asking God's help (Spirituality), as well as non-resistant methods that are very helpful. As a therapist I would recommend this book to my clients who are experience anxiety."
--BJ Buchanan

"I can see how this book could be used in a small group setting as it offers practical methods to move through fear that could be role played in a safe environment"
--Vickey Gibbs

"This small guide on overcoming fear makes several salient and powerful points. Popovich offers cognitive strategies - how to think one's way out of fear - in straightforward terms. He brings clarity and simplicity to interventions that often take full books to describe."
--Sarah Chana Radcliffe


"Kudos! A refreshing perspective that combines christian beliefs and the structure of cognitive behavior therapy that are integrated to create a method to effectively manage fears. Well thought out and written."
--W.R. Drinkwater


"Stanley Popvich's book is an easy read that will benefit both professional and nonprofessional individuals. It is thoughtful, reflective and captures the subject matter well. Everyone has experienced fear at one time or another in their lives. Stanley's specificity in style of writing allows the reader to relate to the subject matter."
--Lucille M. Force


"This book is an excellent read covering counseling, psychology and an element of spirituality. This book is concise, punchy and exciting. I fully recommend anybody purchasing this book as it gives people an insight and awareness of the power of ' fear ' and conquering it. An absolutely brilliant book!"
--James Ward

"As a Licensed Professional I highly recommend this book to people who are experiencing issues with Fear. This book is faith based and offers unique insight into battling fear in one's life. Although, it is a Layman's Guide. It has very useful strategies to help one overcome the challenges and struggles of fear."
--Darleena Anderson

From the Inside Flap

From the Back Cover

About the Author

Stan Popovich is the nationally known author of "A Layman's Guide to Managing Fear Using Psychology, Christianity and Non Resistant Methods": an easy-to-read book that's helped thousands of people to confidently manage their persistent fears and anxieties.

This life-changing book was inspired by his own 20+ year struggle with anxiety and fear, and his journey to discover the keys to freedom and emotional health.

In the Guide, Stanley shares his deeply relatable experiences, as well as the expertise of several professionals in the fields of self-growth and mental health.

He's been featured on many TV and radio programs around the U.S., including ABC Radio Network and Fox News Radio, and he's shared his wisdom in various national publications around the world.

His book has accumulated over 400 positive reviews, many from professional counselors who use the Guide to help their clients, and his warmth and expertise have brought him thousands of fans on Facebook, Twitter, and Linkedin.


Collaboration in the Classroom

Although planning for data projection and network access is an important part of today's classroom design process, information technology is likely to have an even greater indirect effect on how fixed-site classrooms are used in the future. The migration to the Web of the content traditionally delivered by instructors in lecture format is helping shift the function served by brick-and-mortar classrooms from information delivery to collaboration and discussion. Collaborative learning refers to a wide variety of "educational activities in which human relationships are the key to welfare, achievement, and mastery," wherein faculty "help students learn by working together on substantive issues." 13 Surveys indicate that lecture is still the most common instructional method used by college educators in the United States. 14 Nonetheless, the transition from lecture to collaboration is well under way.

What impact does this have on classroom design? This fundamental change will challenge designers to create environments that facilitate collaborative activities. Instead of theaters where students watch instructors perform, classrooms must be flexible meeting places. Bruffee 15 described the ideal classroom for collaborative learning:

This description implies a maximum class size of 50 students. The question of classroom density is an important one: Researchers have explored the psychological and educational effects of classroom density, both spatial (the size of the room) and social (the number of students). In their meta-analysis of 77 different studies on this issue, Glass and Smith 16 concluded that higher social density results in lower student achievement. When designing collaborative classrooms, a good social density benchmark is three to five groups of 6 to 12 students each. Spatial density should be such that both students and instructors have enough room to move easily from group to group (specifically, 4 to 7 feet between groups). Designers should also pay careful attention to the degree to which students feel crowded in a classroom. The experience of crowding in educational settings appears related to personal space violation. 17 Research suggests that groups of students can be expected to work together most effectively at personal distances of 2 to 4 feet without feeling crowded.

Although class size is a limiting factor when implementing certain collaborative learning activities comfortably, small group collaboration and discussion are easier to manage in large classes than many instructors realize. Informal small group techniques like think-pair-share, 18 wherein students think briefly about a question posed by the instructor, discuss their thoughts with a student sitting next to them, and then share their joint thoughts with the class, are feasible in large classes 19 and can be facilitated by technology. More formal activities such as jigsaw groups and structured controversy can also engage students in large classes. 20

Classroom response systems or "clickers" are used by a growing number of instructors to gather student feedback and stimulate in-class discussion. In classes that allow group network access, a wide variety of groupware tools can support collaboration in groups of all sizes. DyKnow Vision allows students to view and annotate instructor whiteboard activity in real time. Instructors can then invite students to the virtual whiteboard, displaying their work to the entire class. GroupSystems is a suite of tools for supporting idea generation, organization, and evaluation in face-to-face and distributed groups.


5 Strategies to Use When People Do Not Understand Mental Illness

You recently went to see a counselor to get help for your mental health, and you were diagnosed with a mental health condition. You then decide to tell your relatives and closest friends about your diagnosis. Unfortunately, some of them do not understand what you are going through. They try to &ldquosolve&rdquo your mental health challenges by giving their opinions or tell you that your condition isn&rsquot real&mdashthat &ldquoit&rsquos all in your head.&rdquo

This is a very tough situation to be in. While you don&rsquot want to isolate yourself from the people you care about, you also don&rsquot want to let your relationships impede your recovery.

With that in mind, here are five ways to deal with this situation.

1. Focus on Getting Better. Don&rsquot waste your energy arguing with your friends or relatives who are giving you a difficult time. If you want, you can respectfully let them know where you stand, and how you feel about what they said. However, do not engage if it&rsquos upsetting you or triggering your symptoms. This isn&rsquot a public relations event where you need to gain everyone&rsquos approval. This is your life and you&rsquore the one struggling. Your energy and focus should be for you to get better.

2. Listen to the Professionals. Your friends and family may mean well, but when it comes down to it, they do not have the answers to your medical condition. So, do not go to them for advice on how to manage your symptoms or accept their advice if they give it voluntarily. When you have questions about your mental health, consult with your doctor, counselor or another mental health professional who is trained to help you manage your condition.

3. Tell Them to Learn about Your Condition. Tell your friends and relatives that the best way for them to help you is for them to try to understand your condition. They could talk to a counselor or go to family therapy, they could read some helpful books or join you at a support group. They won&rsquot know exactly what you are going through, but this will help them learn how to support you.

4. Distance Yourself from People Who Give you a Hard Time. This may seem cruel, but if some of your friends or relatives are hindering your recovery progress, then you may need to distance yourself. Especially, if you have asked them to learn about your condition, and they have refused. As much as you can, surround yourself with positive and supportive people.

5. Take Advantage of the Help That is Available Around you.If possible, talk to a professional about how to manage any difficult relationships. If you have problems or issues with a particular person, you can always ask your counselor for advice on what to do or how to talk to them. In the long run, this can help you learn valuable skills on what to do when a person doesn&rsquot understand your condition.

Your mental illness is a medical condition. When a person has a medical condition, they typically go see a doctor to help treat it. The same thing applies to your mental health. Go see a professional and focus on getting better. Not everyone will understand what you&rsquore going through, and that&rsquos okay. You are the priority, not their approval.

Stan Popovich is the author of &ldquoA Layman&rsquos Guide to Managing Fear Using Psychology, Christianity and Non-Resistant Methods.&rdquo Stan&rsquos managing fear book has become popular with over 400 positive book reviews and counting. Please visit Stan&rsquos website at www.managingfear.com.


We&rsquore always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices.


Illness, pathophysiology and the “self’’

To understand the justification of equating mental and medical disorders, a comparison often made between type 2 diabetes and mental disorders, especially schizophrenia, other psychoses and depression, is worth examining in some detail. Diabetes, although very complex, is understood as the result of dysfunctional glucose metabolism related to absolute or relative insufficiency of insulin signalling. This dysfunctional metabolism is the consequence of endogenous predispositions, such as hereditary diathesis, and environmental factors, including personal choices, such as poor diet and sedentary life style. Therefore, by improving glucose metabolism, either through medication, insulin replacement or changes in lifestyle, positive health outcomes can be expected. Diabetes is diagnosed by confirming high levels of fasting glucose and other related biochemical markers of glucose metabolism. Further, the cascade of its effects on other systems (e.g., cardiovascular, central nervous system) are, or could be, well explained on the basis of physiologic mechanisms. They can also be prevented/treated by better and early control of diabetes. All through this, however, the patient is aware of the nature of his or her problems, including personal choices, and diabetes generally does not affect his or her day-today thinking, behaviour or perception. Except for mental health complications due to neurologic illnesses (e.g., delirium in the context of severe metabolic complications, depression as a consequence of awareness of the life and death implication of the disorder, abnormal perceptions in the case of some neurologic conditions), it can be stated that somatic illnesses, such as diabetes do not usually alter the core self of a person substantially. More importantly, the model of attribution presented to the patient is congruent with the scientific �ts,” thereby making it easier for the person as well as society to accept the condition.

Mental disorders, on the other hand, affect the very core of one’s being through a range of experiences and phenomena of varying severity that alter the individual’s thinking, perception and consciousness about the self, others and the world. This is seen to an extreme degree with more serious mental disorders, such as psychoses and bipolar disorders, but to a lesser albeit significant degree with anxiety, mood, eating and other psychiatric disorders. Emotion, perception, thought and action are the essence of human identity and the concept of “self,” and these are the prime domains altered in mental disorders. The precise definition of what constitutes the self and whether the location of a state of self is a material reality in the brain, its form and the brain-related factors that influence it are deeply philosophical issues, 6 , 7 but not the subject of this editorial. Suffice it to say that factors involved in increasing the risk for mental disorders are endogenous (genetics is recognized as a major contributor to most mental disorders) as well as environmental, much like most medical disorders. Psychological deprivation and trauma, social defeat and isolation, poverty and poor family environment are but some of the environmental factors that have been reported to increase the risk for mental disorders. In addition to changes at the physiologic level, common to somatic and mental disorders the latter encompass changes in one’s definition of “self,” and are not situated outside the “self.” It can even be argued that in the absence of any substantiated biological marker for mental disorders (only 1 has been included in the recent DSM-5: orexin change in narcolepsy), 8 the hallmark defining features of mental disorders, at least for now, remain the changes in how the patients feel, think and act and how these changes affect their relation to themselves and to others.

As a first corollary of this definition, contrary to medical conditions where restoring dysfunctional physiologic mechanisms is the main target of therapeutic interventions, this is only 1 part of the therapeutic interventions for mental disorders. The primary focus of therapeutic interventions in mental disorders is helping the patient to feel better and interact more adaptively with his or her social and physical environments. Although there is little doubt that all medical conditions require psychological attention, mental health interventions focus primarily on achieving a positive change in feeling, self-esteem, mood, perceptions, thoughts and action — all changes in the “self” that are not primarily targeted in the treatment of medical conditions. Different models of psychological and social interventions are the main ingredients for these desired changes in the self.

A second corollary of this definition is the fact that mental health is very laden with values, not because scientific factors are lacking, but because values become of the utmost importance — more so than for medical disorders — when we deal with the self and its restoration. While somatic illnesses such as diabetes are primarily defined and shaped by biologically discernible facts, values do play a certain role but do not define the disorder. Societal and personal values are important in the treatment of most medical disorders, but acquire paramount importance in the case of mental disorders. Societal and cultural values even define variations in diagnoses over time and across geographic locations. Compulsory treatments, a particularity in the mental health field, are a strong testimony of how mental health can interfere with the self and how the personal values of the patient can clash with the societal values, thus necessitating legal, value-laden mitigation.


Having Taken the First Step

What does it feel like when one has fairly recently embarked on a course of Buddhism? The answers will vary a great deal, no doubt, but there ought to be some general characteristics and some problems common to the majority of "newborn" Buddhists in the West. Let us assume that you are a person who has quite recently, or within the last year or so, begun to take Buddhism seriously as a personal way of life. You may by now be just looking round a bit in your new mental surroundings and trying to take stock of what has happened, now that the first novelty of the situation has worn off. You have, I sincerely hope, tried to do a bit of meditation, though it would not surprise me in the least to hear that you have found this difficult and disappointing. If so, I would like to tell you straight away that you should not be discouraged. This is quite the normal thing. Meditation may seem disappointing and even almost useless for quite a long time, but if you persevere in it, results are bound to come. But these results may not be at all the sort of thing you expect. And you may not even be the person who first becomes aware of them. So press on regardless, and don't look for results. If you can see the point of this piece of advice you have already in fact made useful progress. Insights often come very subtly.

People's motives for taking up Buddhism may vary a great deal on the surface. But fundamentally you have probably come to it because, in one way or another, it seems to promise you security. If you haven't realized before that this was a good part of your motive, you might usefully use your next meditation period trying to find out whether I was right or not. If you have realized this, then you may agree that you find the formula "I go to the Buddha, the Dhamma, and the Sangha for refuge" strangely comforting. And so it should be in one way, even though fundamentally you have to learn to be "a refuge unto yourself." This is perhaps the first of the many paradoxes you will encounter attempting to tread the Buddhist path.

Now if we consider this problem of security a little further, we soon find that we do indeed crave for it. The obvious reason is that we feel life frankly unnerving, in fact, because insecure. Here, then, we find straight away two of the three "Marks of Existence": all things are marked by impermanence and suffering. Because they &mdash and we &mdash are impermanent, they are frustrating and cause us all kinds of anguish. Buddhism offers a way out of this situation by treading the Noble Eightfold Path. I am assuming that, having "taken the first step," you are now familiar with the Four Noble Truths and the steps of this Path. So I just want to mention a few points which may arise at this stage. The first step of the path is known as Right Understanding or Right View. This is seeing things as they are. There are large areas of experience which we would much rather know nothing about. This is the origin of repression, to use a Freudian term which is misleadingly translated. The German for "repression" in the psychoanalytical sense is Verdrangung, "thrusting away." It is really successful self-deception. Getting rid of our repressions is therefore not doing what we like, as seems to be popularly imagined, but ceasing to deceive ourselves.

Fundamentally, Buddhism is just a technique of self-undeception. This is not easy, though sometimes it may be fun. It needs some study of theory as well as practice. It is perfectly true that you never gain enlightenment by intellectual knowledge alone, but if you haven't studied the theory to some extent you will almost certainly never be able to start properly on the practice. Before you can develop your intuition you must know what it is &mdash or at least what it isn't &mdash and self-deception in this respect seems to come terribly easy to many people. Intuition, or as I much prefer to call it, insight, is not an emotion, but the best way to develop it is by getting to know one's emotions as thoroughly as possible. When these emotions have been really seen for what are, they no longer stand in the light. Now the biggest emotional blockage we have is that which surrounds the ego-idea. Since it is to the ultimate elimination of this idea that the whole Buddhist training is directed, it may be as well to have a good look at it. In so doing we may get a shock.

By the ego (or self) in Buddhism we mean of course the concept of "I am," though this is much more a feeling than a purely intellectual concept &mdash which is the very reason why it is so much more difficult to uproot. From the psychological point of view we must take it to include not only what in Freudian terms is called the ego, but also the id and even the super-ego. Though not wholly adequate, the Freudian conception goes a good way toward giving us the basic idea. This ego of ours is a complex and dynamic set of functions which are not by any means all conscious or under any form of normal conscious control. Its nature is in fact blind ignorance and it fights desperately to maintain that ignorance. It is most important for us to realize from the outset that this is the case, because this is the root-cause of all our troubles. The three unhealthy roots of human nature are greed, hatred, and ignorance, and all our suffering is due to these three. Ignorance is the most fundamental, and greed and hate spring from it.

Now the power of ignorance is broken by knowledge, which is seeing correctly. So all we have to do is to learn to see. A-VID-YA "unwitting" or not seeing is no mere passive principle &mdash it is an active force which opposes discovery of the truth at every turn. No need to look for an external devil: the Father of Lies is within every one of us. We all know the story of the Emperor's new clothes. In Buddhism the precise opposite of this situation occurs: the clothes go walking in the procession, but there's no emperor inside them. The whole show is laid on for the honor and glory of a character who doesn't really exist. Here, then, is our second paradox, and it is certainly no less startling than the first one: the ego is the most ruthlessly gluttonous all-devouring monster there is, and yet really all the time there's no such thing! All its activities without exception are simply "a tale told by an idiot, full of sound and fury, signifying nothing." How can we solve this riddle? How can we ever come to grasp the nature of this peculiar monster that "has no mouth and no belly, yet gobbles up the entire world" (as some old Chinese monk might have said, but probably didn't)?

Clearly there must be a sense in which the self exists and another sense in which it doesn't. Let us first of all have a frank look at it in the sense of something existing. It is not a pretty sight. Underneath all our lofty ideals, our pious thoughts and holy aspirations, we are all alike. Our little personal petty self is the really important thing to us. It is out to grab all it can get, whether in the way of affection and admiration and sympathy or of more apparently tangible satisfactions in the way of sex, money, power, nice things to eat and drink and smell and touch and hear &mdash all sorts of things and it doesn't care in the very least how it gets them. We don't all want &mdash at least consciously &mdash all of these things perhaps, but we usually want a lot of credit for not wanting some of them or at least doing without them, even if by necessity rather than choice. All these are aspects of greed including the last, which is of course conceit. They are the things the ego fattens on. Equally impressive and perhaps even more horrifying is the list of items under the heading of hate we are all capable in our minds of murderous rage, sadism, treachery, and disloyalty of every conceivable kind. Until we have found and identified the seeds of all these things in our own hearts, we cannot claim to have made much progress in self-knowledge.

Of course most of us will never yield to such impulses, which may only be very faint but until a higher stage of development has been reached they will not be totally eliminated as tendencies. The most likely way in which they may find some outward expression will be, perhaps, in the form of over-emotive indignation at the acts of hate committed by somebody else.

What can we do about this situation? First, face it. Second, penetrate to its roots. Buddhism is not something airy-fairy or romantic, it is practical. It is first and last something to do. To penetrate to the roots of greed, hatred, and delusion is not very easy and it requires certain methods or techniques. But the great thing is to keep going at and not be diverted by irrelevancies, interesting by-paths, plausible excuses or pseudo-mystical fantasies born of conceit and ignorance. A certain discipline is required, in fact. This can be summed up in one word &mdash restraint. Restraint is not repression. In its simplest form it can be something as apparently "easy" as sitting still. It is just not automatically yielding to every impulse that arises while not, on the other hand, pretending that that impulse does not exist. A good part of Buddhism, in modern terms, is "sales-resistance": cultivating at least a degree of immunity to the appeals of the outside world which are today constantly attempting, quite deliberately and purposefully, to arouse new desires within us. It is being deaf to the blandishments of the hidden persuaders whether from within or without, or better perhaps, hearing them without reacting. Who is the rich man who, like the camel, cannot pass through the eye of the needle? He is not only the millionaire, the expense-account johnnie, the take-over charlie: he is anybody who has too many mental encumbrances, too many wants.

Here then is an exercise: sit down with a straight back for ten minutes resolved not to make a single voluntary bodily movement during that time, and just observe what happens. You may get some surprises, but whatever happens you are bound to learn something. If you find, as will probably be the case, that a lot of thoughts and mental images arise, try to discover where they come from, to catch them at the very moment of arising. You won't succeed easily, but you will begin to see something of the mechanism of desires and emotions, and this is immensely valuable. Perhaps the most widespread meditational practice in all schools of Buddhism is anapanasati or mindfulness of breathing. Just watch the ebb and flow of your breath without interfering and, as far as you can manage, with undivided attention. This is the surest way to achieve calm, concentration, self-knowledge, and insight.

There is no Buddhism worthy of the name without practice, but study is also required. This is especially so in the West, where we have not the background of Buddhist thought which exists in Eastern countries. We have to learn as adults what Eastern people have absorbed from childhood. The study of Buddhist theory should therefore not be neglected. Those who deny its necessity do so usually out of conceit, laziness, or ignorance &mdash or a combination of all three.

The obvious problem which arises here is: "Where shall I start?" There are many schools of Buddhism and their scriptures, even those readily available in English, are voluminous. There is Theravada and Mahayana, in the form of Zen, Tibetan Buddhism and several other varieties. There are numerous books about most of them. Unguided and indiscriminate reading will only lead to mental indigestion. The obvious thing is to get down to basics. If we ask where these basic principles are set out, the answer is in the Pali Canon of the Theravada school. In fact, the seeds of all later, so-called Mahayana developments are there in this basic Buddhism.

The only reason why some people find Theravada Buddhism apparently unsatisfying is its seemingly negative approach. In the Mahayana schools there is greater explicit stress on two things: compassion and the higher wisdom. But we need not worry. Compassion grows inevitably as one trains oneself in Buddhism, and the higher wisdom cannot be gained until the lower wisdom has been developed. It is to this task that the basic training is directed. Before we can begin to grasp the nature of Reality, which is transcendental, we must first grasp the nature of the mundane, the phenomenal world as our senses present it to us. This basically means knowing ourselves. Knowing ourselves means facing our own insecurity. Recognizing the equal insecurity of others is compassion.

Why do we feel so insecure? If we can answer this question, we are on the right track. It is due to our recognition that all things are transient. We seek to achieve a stability in the world which, by the very nature of things, cannot be. But Buddhism teaches us more than this: all things are not only transient, they are "empty." This applies to our precious selves as much as to anything else. Man, said the Buddha, is a mere compound of five things, the five khandhas or aggregates. He has a physical body, feelings, perceptions, emotional reactions, and consciousness. None of these constitutes any sort of a "self" which is permanent and unchanging, nor is there any such thing outside of them. His consciousness is just a series of states of awareness, conditioned by the other factors, reaching back into a limitless past. All we are actually aware of is the present moment, or rather consciousness is just that awareness. There is no separate entity behind it which is aware. In the jargon of some modern philosophers, everything about man is contingent or adjectival, not substantival. The further implications of this must be left for study and meditation, but this is a fundamental principle of all Buddhism. The search for a "self" behind all this is futile. If you don't believe this you can try to take up the Buddha's challenge and find it.

There may well be a strong feeling of resistance to the acceptance of this point. If so, this feeling itself should be very carefully examined. It is the basis of our habitual ego-reactions. We want so badly to have a "self" and we expend a vast amount of energy in trying to build one up and support it in every way we can think of. That, fundamentally, is why we feel insecure in the world. One could usefully devote a good deal of time meditating on this point alone.

The most notable contribution made to psychology by Alfred Adler was his analysis of the inferiority complex. People who, for one reason or another, feel inferior, says Adler, tend to over-compensate and present an appearance of conceit and aggressiveness. Since Adler's psychology is very much one of social adaptation at not, perhaps, a very profound level, he did not pursue this idea as far as he might have done. But as far as it goes it is quite good Buddhism, though we might prefer to rename his complex the "insecurity complex." We might even go so far as to say that for the Buddhist everybody's ego practically consists of an inferiority or insecurity complex, for such an assumption certainly explains a great deal. Every form of ostentation we may indulge in is a way of bolstering up the ego, whether in cruder or subtle form. The large car which seems designed as wide as possible is as much an example of ego-boosting as the padded shoulders worn by the tough: indeed the resemblance is sometimes striking. Of course the compensation for insecurity may take a reverse form of exaggerated modesty and simpering sweetness, or of unnecessary and slightly ostentatious self-sacrifice. This latter is a form of compensation we may choose when all else fails, and it has the advantage of making us feel very holy. Martyrdom is in fact the last consolation of a disappointed ego. And the hallmark of a person who has really gone far in the conquest of self is genuine unobtrusiveness.

The formula of Dependent Origination shows by selecting twelve prominent factors how it is that we go round and round the weary circle of rebirths, and how karma operates. It is not a simple formula of "causation" but rather of conditioning. Ignorance (avijja) is a necessary condition for our being here &mdash hence if we were not ignorant we would not have been reborn. And birth is a necessary condition for death &mdash if we had never been born we could not die. Thus, too, feeling based on sense-impression is a necessary condition for the arising of craving: if there were no such feeling there would be no craving. But we can stop the craving from arising or at least prevent its developing into grasping. This is the point at which karma comes into play. Karma is volitional activity born of desire, and as such produces pleasant or unpleasant results in the future. Whatever condition of body and mind we happen to be in now is due to our past karma it is vipaka or karma-resultant. In accordance with the vipaka we are liable to act in the future, but if we have understanding we can control our future actions, and thus their future effects.

The aim of Buddhist training, of whatever school, is to break away from the cycle of becoming. This means somehow attaining the Transcendental Reality which is not karma-bound and therefore permanent, secure, and free from suffering. We do not, as unenlightened individuals, know what this is: at best we have a vague intuition of something wholly other. Its true nature is hidden from us by the veils of our ignorance. The state of enlightenment is called Nirvana (Nibbana in Pali), which is, be it noted, selfless (anatta). This means that we cannot grasp it as long as the self-concept (or feeling) is operative. It is beyond the realm of duality, which is that of subject and object, or self and other-than-self.

Probably most people have at times had a feeling while in the normal sense "wide awake" as if really they were dreaming and would soon wake up. This is actually quite true as far as the first part is concerned. Life as we know it is in one sense a dream. The Buddha was the Awakened One, and our normal state is perhaps somewhere about half-way between ordinary sleep and true enlightenment, or wakefulness. We can therefore usefully regard the Buddhist training, if we like, as a way of making ourselves wake up. Sometimes in sleep we become aware of being asleep and want to wake up. Eventually we succeed, but it is often a struggle. The struggle to wake up to enlightenment is far greater than this, because the resistance is stronger. The resistance is stronger for a very simple reason: to the ego it seems like death. This is fair enough, since in fact it is the death of ego. And since we have no real experience of the egoless state, it is unimaginable and therefore we are skeptical about it, but this skepticism too really springs from fear. We should have to give up all our attachments to attain it, and that is too high a price to pay. We are like the rich young man to whom Christ said "Sell all that thou hast and give it to the poor." He went sorrowfully away.

What then must we do, now that we have taken the first step and embarked on the course of Buddhism? We need to have a chart and compass to help us on our way. But first we have to know where we are supposed to be going. The goal of Buddhism is Enlightenment or Awakening or Nirvana, the Deathless State which is the end of all suffering and frustration, the one permanent and supremely desirable thing. Buddhism claims to be a way of attaining this. There are five factors to be developed which, if they are predominant in our minds, will tend increasingly to bring us to the goal. They are Faith, Energy, Mindfulness, Concentration, and Wisdom. The first of these may come as a surprise to some people. "I thought," they may say, "you didn't have to have faith in Buddhism." In fact faith is an important factor to develop. We can call it confidence or trust if we prefer it. But unless we have some confidence that there is such a goal as Nirvana, we shall not even start taking Buddhism seriously at all, and we need also to trust the Buddha as the teacher who has shown the way to reach that goal. At the very least we need to be free from the sort of nihilistic skepticism which is so common today and which prevents us from believing wholeheartedly in anything worthwhile. When we say "I take refuge in the Buddha, the Dhamma, and the Sangha" we are expressing faith in the Teaching and the Order of monks who have preserved it and handed it on.

If we have faith we next need to put forth effort, so we need energy. Right Effort is a step of the Eightfold Path. It means getting rid of wrong states of mind and developing right ones. Clearly a certain amount of vigor is required to do this, and faith will strengthen our will to persevere. Clearing up our mental muddle calls for increased self-knowledge, and this is gained by Mindfulness. Mindfulness is being aware of one's own nature and observing one's own reactions, being fully cognizant of what one is about all the time. It is developed by training, such exercises as mindfulness on breathing and on walking being especially beneficial. With full mindfulness, self-deception becomes impossible. It is the way of uncovering the subterfuges of the ego. The Buddha described it as "the one and only way" to the liberation of beings. It is an absolutely indispensable factor in all Buddhist training. Being mindful one is, too, in some degree automatically concentrated, but the practice of mental concentration can be carried further, to samadhi, which is mental one-pointedness. By a combination of these two factors, the mind can be sharpened to an instrument capable of cutting through the veils of ego-created illusion. The last of the five factors is Wisdom. Wisdom in this connection means discernment. It includes investigation of all mental phenomena to their essence, which is voidness. When this lower, still mundane wisdom has been sufficiently developed, a basis has been created for the arising of the higher Insight-Wisdom, the perfection of which is Enlightenment. When this has been attained, the job is done.

But these factors must be developed in such a manner that they are properly balanced. Faith must be balanced with Wisdom, and Energy with Concentration. Faith without Wisdom can overreach itself and turn into that kind of blind faith which Buddhism does not encourage. On the other hand, Wisdom without Faith is sterile. Energy unaccompanied by Concentration can easily lead to restlessness, while Concentration without sufficient Energy leads to sloth. It is the function of Mindfulness, by watching over the other factors, to see that the proper balance between them is maintained. These five factors are called indriyas or "ruling factors." This means that they can and should dominate the mind and give it direction. They are the five guides to keep us on the way. Having taken the first step, and with these as guides, but especially under the leadership of Mindfulness, let us walk on.


How to Improve Your Teaching With the Course Syllabus

Did you ever have a student misunderstand an assignment, express surprise that you had considered attendance important, or want an explanation of how you grade after the final exam has been scored and the semester is over? If, like most teachers, you receive a few such remarks every semester, you already appreciate the need for clarity in your communication with students.

One of the best ways to clarify such communication is through your course syllabus. As a teacher, you have probably distributed thousands of them and no doubt have written a score or more, yet often the syllabus is given little serious attention. But as Rubin (1985) has pointed out, “We keep forgetting that what we know—about our disciplines, about our goals, about our teaching—is not known (or agreed upon) by everyone. We seem to assume that our colleagues and our students will intuitively be able to reconstruct that creature we see in our mind’s eye from the few bones we give them in the syllabus” (p. 56). A poorly written and incomplete syllabus can frustrate both students and teachers and disrupt the whole learning process.

One of the easiest ways to improve your teaching is to increase the communication effectiveness of your syllabi. To do this, you need to understand the purposes of a course syllabus and its essential elements.

The Purpose of a Course Syllabus

The course syllabus serves at least seven basic purposes (Rubin, 1985). Some of these directly serve your students and are readily apparent to them. But as you will see, the syllabus should serve some of your needs as well. In summary, a syllabus:

Helps Plan and Clarify Your Course

The very process of writing a well-constructed syllabus forces you to crystallize, articulate, organize, and communicate your thoughts about a course. This thought and writing produces what Gabbanesch (1992) calls the enriched syllabus, which compels you to publicly reveal your previously well concealed assumptions. In other words, it makes explicit that which was implicit, and it is the implicit that often confuses and frustrates students.

Try inviting a person who has no expertise in your academic area to critique your syllabus. You will be surprised by the number of vagaries and gaps the naive reader will identify. Teachers can easily overlook important matters or be unclear about them in their syllabi, even after they have taught the course for years.

Introduces You to Students

Your syllabus allows you to share your pedagogical philosophy. Students may not perceive it in quite this way, but that is one of the things you achieve through the syllabus. A syllabus tells your students whether you view learning as an active or passive process and whether you emphasize knowledge enhancement, skill building, or a combination of both.

The syllabus reveals how your course is structured (e.g. simple to complex or chronologically) and should include the purpose of the organization. Syllabi tell your students if the parts of the course are mutually exclusive or whether success in its later stages depends upon skills mastered earlier. The syllabus also reveals your teaching style. Are you organized or disorganized, flexible or rigid, rigorous or lax?

The tone of your syllabus can indicate how approachable you are, and students often form an immediate impression of whether they will like you— and your course—from reading the syllabus. Needless to say, it is better if the impression is positive.

Explains Why Students Should Take Your Course

After students read your syllabus, they should know how your course satisfies departmental or institutional requirements, how it fits into their major, or why it is a valuable elective. Is the course a prerequisite for more advanced courses? How would you define the course (e.g. introductory, intermediate, or capstone level)? You may want to indicate who can benefit from the knowledge and skills acquired during this course. Faculty know the answers to these questions—or at least they should—but it is a mistake to assume that students do. If you do not clearly state the purpose and value of your course, your students may believe the main purpose of taking it is simply to fulfill a poorly understood curricular requirement.

Explains the Various Aspects of Your Course

Your syllabus should be explicit about assignments and methods of evaluation. Tell your students how your assignments will enable them to accomplish course objectives. Specify elements such as criteria for excellence in assignments, the number and nature of tests, and the weighting of assignments in determining the final grade.

Do not forget to communicate the level of participation required. Will your students listen passively as you lecture or should they expect to participate in challenging discussions requiring advance preparation? Similarly, will the emphasis be on primary or secondary materials and why? You might also want to explain the difference between primary and secondary sources.

A syllabus should also specify prerequisites, both in terms of courses and prerequisite skills or experiences your students will need to do well. If you expect students to perform certain skills, will you teach these skills during the course or will you assume your students already possess them when they enter the course?

Explains How Students Will Develop by Successfully Completing Your Course

Students should understand what content they will learn, what skills they will develop, and what attitudes, values, and feelings may change as a result of taking the course. Including such information will help you develop some well considered course objectives, if you have not already done so.

Communicates the Course’s Nature and Content to Faculty/Administrators

In addition to informing your students, a good syllabus provides a record of your course for colleagues who may teach it later. It can also aid departmental and institutional curriculum planning, and assist outside agencies in assessing your program’s goals and effectiveness.

Provides a Documented Record of Your Teaching Career

Your course syllabi are an important teaching legacy. They often provide the only permanent record of your teaching philosophy, commitment to teaching, and pedagogical innovations. If you keep old copies of your course syllabi and read several years’ worth at one sitting, you can easily see how you have developed as a teacher. This growth and development is often striking.

When job hunting, syllabi are also integral components of the application portfolio. They can also serve as salary, promotion, and tenure documents that evaluation committee’s request when assessing teaching ability. A good syllabus can be as important to you as to your students—unless, of course, you are an independently wealthy tenured professor.

The Essential Components of the Course Syllabus

Once you know the purpose of the syllabus, its basic elements are easily defined. The following may serve as a simple checklist as you review syllabus content.

Basic Identifying Information

Include the name of your institution, the semester, year, course title and identifying code, location and time of class meetings, and the credits earned for successfully completing the course.

Instructor’s Personal Information

Include your name and title, office location, office telephone number, office hours, and email address if students can communicate with you via that medium. Some instructors include their home telephone numbers, but may specify restrictions in calls to their homes (e.g., no calls between 10PM and 8AM).

Texts and Other Materials

Specify the titles, authors, and editions of your texts, differentiating between required and recommended status. It is wise to specify locations for obtaining course materials (e.g., bookstore, library, your office, or computer lab), the conditions for obtaining them (e.g. whether they must be purchased, are on two-day reserve, or are cleared for photocopying), and the number of copies available (e.g., for reserved materials).

Course Description

This usually comes directly from your institution’s catalog and should include a brief description of the following items: the major topics covered the knowledge, skills and attitudes acquired prerequisites and any special opportunities (e.g., field trips).

Course Objectives

This section is of particular importance because of the current emphasis on the assessment of student learning outcomes. Clearly state your objectives. I recommend Gronland’s 1991 publication, How to Write and Use Instructional Objectives, if you are unsure of how to write objectives in this manner. Objectives can be cognitive (e.g., understands the nature-nurture controversy), affective (e.g., appreciates the role of psychology in everyday life), or behavioral (e.g., can administer an IQ test). A clear set of instructional objectives provides direction for instructional methods, yields guidelines for testing, and communicates instructional intent to students.

Course Requirements

Explain exactly what a student is expected to do in your course including a clear description of the tests administered, the papers written, and the oral presentations made.

Course Calendar

Your calendar contains the dates of specific lecture topics, reading assignments, exams, and deadlines for papers and other projects. Any changes to your calendar should be supplied to students in writing.

Grading Procedures and Scales

Make explicit your procedures and criteria for evaluating students’ performance and assigning grades. Clear policies regarding extra credit, make-up tests, deadlines, and penalties for post-deadline work are necessary. Include an academic honesty policy with definitions of academically dishonest behaviors (e.g., plagiarism and cheating) and sanctions for their occurrence if your school does not emphasis this concept in its literature (i.e. catalog).

A syllabus is written contract between you and your students. End each syllabus with a caveat, such as the following, to protect yourself, your department, and your institution if changes in the syllabus must be made once your course is underway: “The above schedule and procedures in this course are subject to change in the event of extenuating circumstances” (Altman, 1989).

It is imperative that all teachers adhere faithfully to the policies and requirements set forth in their syllabi. Do not forget the reciprocal nature of this contract. By requiring students to abide by the rules and procedures spelled out in your syllabus, you are also agreeing to do the same. A well written syllabus will make these expectations clear to all concerned. You should plan to discuss the syllabus in detail during the first class meeting. This brings up the need for prompt distribution of syllabi. They should be available on the first day of class, not a week or a month into the semester. After all, if you expect students to meet deadlines for examinations and other course requirements, you should also meet your own teaching deadlines, and distributing the course syllabus during the first class meeting is one such deadline you should not miss.

Good syllabi fulfill specific purposes, possess essential components, and answer crucial questions. However, few syllabi perform all these functions equally well. My advice is this: try to write syllabi that are as brief and focused as possible, but that communicate the nature of your course to students in a clear and understandable manner. The better your students understand the purposes and procedures of your course, the more likely they are to enter enthusiastically into the learning partnership you offer them.


CHALLENGES FACED BY THE NOVICE THERAPIST

Whether one is a young student, or a seasoned individual therapist, dealing with families can be intimidating at times but also very rewarding if one knows how to deal with them. We have outlined certain challenges that one faces while dealing with families, especially when one is beginning.

Being overeager to help

This can happen with beginner therapists as they are overeager and keen to help and offer suggestions straight away. If the therapist starts dominating the interaction by talking, advising, suggesting, commenting, questioning, and interpreting at the beginning itself, the family falls silent. It is advisable to probe with open-ended questions initially to understand the family.

Poor leadership

It is advisable for the therapist to have control over the sessions. Sometimes, there may be other individuals/family members who maybe authoritative and take control. Especially in crisis situations, when the family fails to function as a unit, the therapist should take control of the session and set certain conditions which in his professional judgment, maximize the chances for success.

Not immersing or engaging/fear or involving

A common problem for the beginning therapist is to become overly involved with the family. However, he may realize this and try to panic and withdraw when he can become distant and cold. Rather, one should gently try to join in with the family earning their true respect and trust before heading to build rapport.

Focusing only on index patient

Many families believe that their problem is because of the index patient, whereas it may seem a tactical error to focus on this person initially. In doing so, it may essentially agree to the family's hypothesis that their problem is arising out of this person. It is preferable, at the outset to inform the family that the problem may lie with the family (especially when referrals are made for family therapies involving multiple members), and not necessarily with any one individual.

Not including all members for sessions

Many therapeutic efforts fail because important family members are not included in the sessions. It is advisable to find out initially who are the key members involved and who should be attending the sessions. Sometimes, involving all members initially and then advising them to return to therapy as and when the need arises is recommended.

Not involving members during sessions

Even though one has involved all members of the family in the sessions, not all of them may be engaged during the sessions. Sometimes, the therapist's own transference may hold back a member of the family in the sessions. Rather, it is recommended that the therapist makes it clear that he/she is open to their presence and interactions, either verbally or nonverbally.

Taking sides with any member of the family

It may be easy to fall into the trap of taking one member's side during sessions leaving the other party doubting the fairness and judgment of the therapist. For example, after meeting one marital partner for a few sessions, the therapist, when entering the couple, discussions may be heavily biased in his views due to his/her prior interaction. Therapists should be aware of this effect and try to be neutral as possible yet take into confidence each member attending the sessions. Therapist's countertransference can easily influence him/her to take sides, especially in families that are overtly blaming from the start, or with one member who may be aggressive in the sessions, or very submissive during the sessions can influence the therapist's sides and one needs to be aware of this early in the sessions.

Guarded families

Some families put on a guarded fa󧫞 and refuse to challenge each other in the session. By being neutral and nonjudgmental, sometimes, the therapist can perpetuate this guarded fa󧫞 put forth by families. Hence, therapists must be able to read this and try to challenge them, listen to microchallenges within the family, must be ready to move in and out from one family member to another, without fixing to one member.

Communicating with the therapist outside sessions

Many families attempt to reduce tension by communicating with therapist outside the session, and beginning therapist are particularly susceptible for such ploys. The family or a member/s may want to meet the therapist outside the sessions by trying to influence the therapist to their views and opinions. Therapists must refrain from such encounters and suggest discussing these issues openly during the sessions. Of course, rarely, there may be sensitive or very personal information that one may want to discuss in person that may be permissible.

Ignoring previous work done by other therapists

It is easy for family therapists to ignore previous therapists. The family therapist's ignorance of the effects of previous therapy can serious hamper the work. By discussing the previous therapist helps the new therapist to understand the problem easily and could save time also.

Getting sucked to the family's affective state/mood

If transference involves the therapist in family structure, the therapist's dependency can overinvolved him in the family's style and tone of interaction. A depressed family causes both: Therapist to relate seriously and sadly. A hostile family may cause the therapist to relate in an attacking manner. The most serious problem can occur when a family is in a state of anxiety, induces the therapist to become anxious and make his/her comments to seem accusatory and blaming. It is very difficult for the beginning therapist to �l” where the family is affectively, to be empathic, yet to be able to relate at times on a different affective level-to respond according to situations. It is important to be aware of the affective state/mood of the family but slips in and out of that state [ Table 2 ].

Table 2

Guidelines for conducting interventions with families

Timings for appointments to be followed for smooth conduct of sessions
Arriving late may reduce actual session time by the same margin
Any cancellation or postponement of sessions to be informed in advance by both parties
Session location would be intimated in advance
An approximate total number of expected family sessions to be informed in the beginning including frequency of the sessions
Inform clients about the reason why the family is being seen together
Advise clients that changes may occur gradually after assessments and immediate solutions may not be provided as far as possible
The duration of the sessions would be informed in the beginning itself (45 min to an hour)
Any other matters arising, in the end, can brought up during subsequent sessions
During sessions, clients to refrain from interrupting when someone else is talking
Family members to wait for turns to talk as everyone would be given the opportunity
Clients to avoid verbal arguments or fights during the sessions
Inform clients about the confidentiality of the contents of the sessions and record-keeping practices
Clients to avoid any discussions outside of therapy sessions with the therapist
Clients to discuss relevant matters as far as possible in the sessions even though some matters may be conflicting in nature
Make a formal contract with the family about roles of therapist and the family members
In families with violence, a no-violence contract is preferable during the entire process of family therapy

Illness, pathophysiology and the “self’’

To understand the justification of equating mental and medical disorders, a comparison often made between type 2 diabetes and mental disorders, especially schizophrenia, other psychoses and depression, is worth examining in some detail. Diabetes, although very complex, is understood as the result of dysfunctional glucose metabolism related to absolute or relative insufficiency of insulin signalling. This dysfunctional metabolism is the consequence of endogenous predispositions, such as hereditary diathesis, and environmental factors, including personal choices, such as poor diet and sedentary life style. Therefore, by improving glucose metabolism, either through medication, insulin replacement or changes in lifestyle, positive health outcomes can be expected. Diabetes is diagnosed by confirming high levels of fasting glucose and other related biochemical markers of glucose metabolism. Further, the cascade of its effects on other systems (e.g., cardiovascular, central nervous system) are, or could be, well explained on the basis of physiologic mechanisms. They can also be prevented/treated by better and early control of diabetes. All through this, however, the patient is aware of the nature of his or her problems, including personal choices, and diabetes generally does not affect his or her day-today thinking, behaviour or perception. Except for mental health complications due to neurologic illnesses (e.g., delirium in the context of severe metabolic complications, depression as a consequence of awareness of the life and death implication of the disorder, abnormal perceptions in the case of some neurologic conditions), it can be stated that somatic illnesses, such as diabetes do not usually alter the core self of a person substantially. More importantly, the model of attribution presented to the patient is congruent with the scientific �ts,” thereby making it easier for the person as well as society to accept the condition.

Mental disorders, on the other hand, affect the very core of one’s being through a range of experiences and phenomena of varying severity that alter the individual’s thinking, perception and consciousness about the self, others and the world. This is seen to an extreme degree with more serious mental disorders, such as psychoses and bipolar disorders, but to a lesser albeit significant degree with anxiety, mood, eating and other psychiatric disorders. Emotion, perception, thought and action are the essence of human identity and the concept of “self,” and these are the prime domains altered in mental disorders. The precise definition of what constitutes the self and whether the location of a state of self is a material reality in the brain, its form and the brain-related factors that influence it are deeply philosophical issues, 6 , 7 but not the subject of this editorial. Suffice it to say that factors involved in increasing the risk for mental disorders are endogenous (genetics is recognized as a major contributor to most mental disorders) as well as environmental, much like most medical disorders. Psychological deprivation and trauma, social defeat and isolation, poverty and poor family environment are but some of the environmental factors that have been reported to increase the risk for mental disorders. In addition to changes at the physiologic level, common to somatic and mental disorders the latter encompass changes in one’s definition of “self,” and are not situated outside the “self.” It can even be argued that in the absence of any substantiated biological marker for mental disorders (only 1 has been included in the recent DSM-5: orexin change in narcolepsy), 8 the hallmark defining features of mental disorders, at least for now, remain the changes in how the patients feel, think and act and how these changes affect their relation to themselves and to others.

As a first corollary of this definition, contrary to medical conditions where restoring dysfunctional physiologic mechanisms is the main target of therapeutic interventions, this is only 1 part of the therapeutic interventions for mental disorders. The primary focus of therapeutic interventions in mental disorders is helping the patient to feel better and interact more adaptively with his or her social and physical environments. Although there is little doubt that all medical conditions require psychological attention, mental health interventions focus primarily on achieving a positive change in feeling, self-esteem, mood, perceptions, thoughts and action — all changes in the “self” that are not primarily targeted in the treatment of medical conditions. Different models of psychological and social interventions are the main ingredients for these desired changes in the self.

A second corollary of this definition is the fact that mental health is very laden with values, not because scientific factors are lacking, but because values become of the utmost importance — more so than for medical disorders — when we deal with the self and its restoration. While somatic illnesses such as diabetes are primarily defined and shaped by biologically discernible facts, values do play a certain role but do not define the disorder. Societal and personal values are important in the treatment of most medical disorders, but acquire paramount importance in the case of mental disorders. Societal and cultural values even define variations in diagnoses over time and across geographic locations. Compulsory treatments, a particularity in the mental health field, are a strong testimony of how mental health can interfere with the self and how the personal values of the patient can clash with the societal values, thus necessitating legal, value-laden mitigation.


CHALLENGES FACED BY THE NOVICE THERAPIST

Whether one is a young student, or a seasoned individual therapist, dealing with families can be intimidating at times but also very rewarding if one knows how to deal with them. We have outlined certain challenges that one faces while dealing with families, especially when one is beginning.

Being overeager to help

This can happen with beginner therapists as they are overeager and keen to help and offer suggestions straight away. If the therapist starts dominating the interaction by talking, advising, suggesting, commenting, questioning, and interpreting at the beginning itself, the family falls silent. It is advisable to probe with open-ended questions initially to understand the family.

Poor leadership

It is advisable for the therapist to have control over the sessions. Sometimes, there may be other individuals/family members who maybe authoritative and take control. Especially in crisis situations, when the family fails to function as a unit, the therapist should take control of the session and set certain conditions which in his professional judgment, maximize the chances for success.

Not immersing or engaging/fear or involving

A common problem for the beginning therapist is to become overly involved with the family. However, he may realize this and try to panic and withdraw when he can become distant and cold. Rather, one should gently try to join in with the family earning their true respect and trust before heading to build rapport.

Focusing only on index patient

Many families believe that their problem is because of the index patient, whereas it may seem a tactical error to focus on this person initially. In doing so, it may essentially agree to the family's hypothesis that their problem is arising out of this person. It is preferable, at the outset to inform the family that the problem may lie with the family (especially when referrals are made for family therapies involving multiple members), and not necessarily with any one individual.

Not including all members for sessions

Many therapeutic efforts fail because important family members are not included in the sessions. It is advisable to find out initially who are the key members involved and who should be attending the sessions. Sometimes, involving all members initially and then advising them to return to therapy as and when the need arises is recommended.

Not involving members during sessions

Even though one has involved all members of the family in the sessions, not all of them may be engaged during the sessions. Sometimes, the therapist's own transference may hold back a member of the family in the sessions. Rather, it is recommended that the therapist makes it clear that he/she is open to their presence and interactions, either verbally or nonverbally.

Taking sides with any member of the family

It may be easy to fall into the trap of taking one member's side during sessions leaving the other party doubting the fairness and judgment of the therapist. For example, after meeting one marital partner for a few sessions, the therapist, when entering the couple, discussions may be heavily biased in his views due to his/her prior interaction. Therapists should be aware of this effect and try to be neutral as possible yet take into confidence each member attending the sessions. Therapist's countertransference can easily influence him/her to take sides, especially in families that are overtly blaming from the start, or with one member who may be aggressive in the sessions, or very submissive during the sessions can influence the therapist's sides and one needs to be aware of this early in the sessions.

Guarded families

Some families put on a guarded fa󧫞 and refuse to challenge each other in the session. By being neutral and nonjudgmental, sometimes, the therapist can perpetuate this guarded fa󧫞 put forth by families. Hence, therapists must be able to read this and try to challenge them, listen to microchallenges within the family, must be ready to move in and out from one family member to another, without fixing to one member.

Communicating with the therapist outside sessions

Many families attempt to reduce tension by communicating with therapist outside the session, and beginning therapist are particularly susceptible for such ploys. The family or a member/s may want to meet the therapist outside the sessions by trying to influence the therapist to their views and opinions. Therapists must refrain from such encounters and suggest discussing these issues openly during the sessions. Of course, rarely, there may be sensitive or very personal information that one may want to discuss in person that may be permissible.

Ignoring previous work done by other therapists

It is easy for family therapists to ignore previous therapists. The family therapist's ignorance of the effects of previous therapy can serious hamper the work. By discussing the previous therapist helps the new therapist to understand the problem easily and could save time also.

Getting sucked to the family's affective state/mood

If transference involves the therapist in family structure, the therapist's dependency can overinvolved him in the family's style and tone of interaction. A depressed family causes both: Therapist to relate seriously and sadly. A hostile family may cause the therapist to relate in an attacking manner. The most serious problem can occur when a family is in a state of anxiety, induces the therapist to become anxious and make his/her comments to seem accusatory and blaming. It is very difficult for the beginning therapist to �l” where the family is affectively, to be empathic, yet to be able to relate at times on a different affective level-to respond according to situations. It is important to be aware of the affective state/mood of the family but slips in and out of that state [ Table 2 ].

Table 2

Guidelines for conducting interventions with families

Timings for appointments to be followed for smooth conduct of sessions
Arriving late may reduce actual session time by the same margin
Any cancellation or postponement of sessions to be informed in advance by both parties
Session location would be intimated in advance
An approximate total number of expected family sessions to be informed in the beginning including frequency of the sessions
Inform clients about the reason why the family is being seen together
Advise clients that changes may occur gradually after assessments and immediate solutions may not be provided as far as possible
The duration of the sessions would be informed in the beginning itself (45 min to an hour)
Any other matters arising, in the end, can brought up during subsequent sessions
During sessions, clients to refrain from interrupting when someone else is talking
Family members to wait for turns to talk as everyone would be given the opportunity
Clients to avoid verbal arguments or fights during the sessions
Inform clients about the confidentiality of the contents of the sessions and record-keeping practices
Clients to avoid any discussions outside of therapy sessions with the therapist
Clients to discuss relevant matters as far as possible in the sessions even though some matters may be conflicting in nature
Make a formal contract with the family about roles of therapist and the family members
In families with violence, a no-violence contract is preferable during the entire process of family therapy

Is there any guideline on how a layman giving support for another layman on their psychological problems? - Psychology

The length of stay in the hospital will vary depending on the individual donor's rate of recovery and the type of procedure performed (traditional vs laparoscopic kidney removal) although the usual stay is 4 to 6 days. Since the rate of recovery varies greatly among individuals, be sure to ask the transplant center for their estimate of your particular recovery time.

After leaving the hospital, the donor will typically feel tenderness, itching and some pain as the incision continues to heal. Generally, heavy lifting is not recommended for about six weeks following surgery. It is also recommended that donors avoid contact sports where the remaining kidney could be injured. It is important for the donor to speak with the transplant staff about the best ways to return as quickly as possible to being physically fit.

How does living donation affect the donor?

People can live normal lives with only one kidney. As long as the donor is evaluated thoroughly and cleared for donation, he or she can lead a normal life after the surgery. When the kidney is removed, the single normal kidney will increase in size to compensate for the loss of the donated kidney.

Physical exercise is healthy and good for you. However, it's important for someone with only one kidney to be careful and protect it from injury. Some doctors think it is best to avoid contact sports like football, boxing, hockey, soccer, martial arts, or wrestling. Wearing protective gear such as padded vests under clothing can help protect the kidney from injury during sports. This can help lessen the risk, but it won't take away the risk. Talk to your healthcare provider if you want to join in contact sports.

Donors are encouraged to have good long-term medical follow-up with their primary care doctors. A urine test, a blood pressure check and a blood test for kidney function (GFR) should be done every year.

Does living donation affect life expectancy?

Living donation does not change life expectancy, and does not appear to increase the risk of kidney failure. In general, most people with a single normal kidney have few or no problems however, you should always talk to your transplant team about the risks involved in donation. Some studies report that living donors may have a greater chance of developing high blood pressure. It is recommended that potential donors consult with their doctor about the risks of living donation.

What can I expect emotionally after donating a kidney?

After donation, living donors often report a wide range of mixed emotions, from joy and relief to anxiety to depression. The process of getting through the evaluation and surgery can be so time-consuming that donors do not always have time to process everything they are feeling. It is normal for these emotions to come to the forefront after the donation and transplant take place.

Living donors generally rate their experience as positive. Different studies indicate that between 80-97% of donors say that in retrospect, they would have still have made the decision to donate.

However, concerns about the recipient's outcome (as well as the donor's recovery) can contribute to feelings of anxiety, and may donors report a feeling of "let down" afterwards. Feelings of depression among living donors are not uncommon, even when both donor and recipient are doing well.

While extensive data on these issues is lacking, some studies have reported the following psychological outcomes:

  • Less than 1% regretted the decision
  • 3 to 10% reported depression
  • 10% reported "family conflicts"
  • 7% reported anxiety disorders
  • 16% concerned about negative financial consequences of donation
  • 3 to 15% concerned about a negative impact on their health

Living donors who are struggling with these issues are encouraged to:

  1. Talk to the transplant hospital's Transplant Social Worker for advice
  2. Seek professional counseling or other outside help to manage difficult emotions, and
  3. Talk with other living donors who can be particularly supportive if they have experienced the same feelings.
  • Let your transplant team know how you are feeling both physically and emotionally during your follow-up visits.
  • Talk to the transplant hospital’s social worker for support and guidance.
  • Seek professional counseling or other outside help to manage difficult emotions.
  • Talk with other living donors who can be particularly supportive if they have experienced the same feelings.

What are the long-term risks of donation?

You will also have a scar from the donor operation- the size and location of the scar will depend on the type of operation you have.

Some donors have reported long-term problems with pain, nerve damage, hernia or intestinal obstruction. These risks seem to be rare, but there are currently no national statistics on the frequency of these problems.

In addition, people with one kidney may be at a greater risk of:

You should discuss these risks with your transplant team, and ask for center-specific statistics related to these problems.

Are there any dietary restrictions after donation?

After donation you should be able to go back to a regular, healthy lifestyle. If you are in good health, there will probably not be any specific dietary restrictions. Talk with your transplant team about your specific dietary needs.

Will I be able to obtain insurance coverage after donation?

Your health insurance should not be affected by donation. The Affordable Care Act has made it illegal for health insurance companies to refuse to cover you or charge you more because you have a pre-existing condition.

However, some living donors have reported either having difficulty getting life insurance or facing higher premiums for life insurance. In such cases, it may be necessary for transplant centers to inform the insurance carrier of existing data that report that the patient is not at increased risk of death because of donation.

If you already have insurance, check your insurance contracts carefully to see if living donation would affect your current policies. You might also want to consult with a lawyer who is knowledgeable about insurance law.

What if I donate, and need a kidney later?

This is something potential donors should discuss with the transplant team. Talk to your transplant team about any pre-existing condition or other factors that may put you at a higher risk of developing kidney disease, and consider this carefully before making a decision about donation.

There have been some cases in which living donors needed a kidney later - not necessarily due to the donation itself. It is considered a potential risk of donation. UNOS policy give priority on the waiting list to living donors.

Can I become pregnant after I've donated kidney?

Pregnancy after donation is possible but is usually not recommended for at least six months after the donation surgery. Living donors should talk to their ob/gyn and transplant team before getting pregnant about pregnancy and make sure that they have good pre-natal care.

Generally, living kidney donors do well with pregnancy after their donation. However, some studies have shown small increases in some risks like gestational diabetes, pregnancy-induced hypertension, protein in the urine and pre-eclampsia. Living donors should inform their ob/gyn about their donation to allow monitoring for these potential complications.


How to Improve Your Teaching With the Course Syllabus

Did you ever have a student misunderstand an assignment, express surprise that you had considered attendance important, or want an explanation of how you grade after the final exam has been scored and the semester is over? If, like most teachers, you receive a few such remarks every semester, you already appreciate the need for clarity in your communication with students.

One of the best ways to clarify such communication is through your course syllabus. As a teacher, you have probably distributed thousands of them and no doubt have written a score or more, yet often the syllabus is given little serious attention. But as Rubin (1985) has pointed out, “We keep forgetting that what we know—about our disciplines, about our goals, about our teaching—is not known (or agreed upon) by everyone. We seem to assume that our colleagues and our students will intuitively be able to reconstruct that creature we see in our mind’s eye from the few bones we give them in the syllabus” (p. 56). A poorly written and incomplete syllabus can frustrate both students and teachers and disrupt the whole learning process.

One of the easiest ways to improve your teaching is to increase the communication effectiveness of your syllabi. To do this, you need to understand the purposes of a course syllabus and its essential elements.

The Purpose of a Course Syllabus

The course syllabus serves at least seven basic purposes (Rubin, 1985). Some of these directly serve your students and are readily apparent to them. But as you will see, the syllabus should serve some of your needs as well. In summary, a syllabus:

Helps Plan and Clarify Your Course

The very process of writing a well-constructed syllabus forces you to crystallize, articulate, organize, and communicate your thoughts about a course. This thought and writing produces what Gabbanesch (1992) calls the enriched syllabus, which compels you to publicly reveal your previously well concealed assumptions. In other words, it makes explicit that which was implicit, and it is the implicit that often confuses and frustrates students.

Try inviting a person who has no expertise in your academic area to critique your syllabus. You will be surprised by the number of vagaries and gaps the naive reader will identify. Teachers can easily overlook important matters or be unclear about them in their syllabi, even after they have taught the course for years.

Introduces You to Students

Your syllabus allows you to share your pedagogical philosophy. Students may not perceive it in quite this way, but that is one of the things you achieve through the syllabus. A syllabus tells your students whether you view learning as an active or passive process and whether you emphasize knowledge enhancement, skill building, or a combination of both.

The syllabus reveals how your course is structured (e.g. simple to complex or chronologically) and should include the purpose of the organization. Syllabi tell your students if the parts of the course are mutually exclusive or whether success in its later stages depends upon skills mastered earlier. The syllabus also reveals your teaching style. Are you organized or disorganized, flexible or rigid, rigorous or lax?

The tone of your syllabus can indicate how approachable you are, and students often form an immediate impression of whether they will like you— and your course—from reading the syllabus. Needless to say, it is better if the impression is positive.

Explains Why Students Should Take Your Course

After students read your syllabus, they should know how your course satisfies departmental or institutional requirements, how it fits into their major, or why it is a valuable elective. Is the course a prerequisite for more advanced courses? How would you define the course (e.g. introductory, intermediate, or capstone level)? You may want to indicate who can benefit from the knowledge and skills acquired during this course. Faculty know the answers to these questions—or at least they should—but it is a mistake to assume that students do. If you do not clearly state the purpose and value of your course, your students may believe the main purpose of taking it is simply to fulfill a poorly understood curricular requirement.

Explains the Various Aspects of Your Course

Your syllabus should be explicit about assignments and methods of evaluation. Tell your students how your assignments will enable them to accomplish course objectives. Specify elements such as criteria for excellence in assignments, the number and nature of tests, and the weighting of assignments in determining the final grade.

Do not forget to communicate the level of participation required. Will your students listen passively as you lecture or should they expect to participate in challenging discussions requiring advance preparation? Similarly, will the emphasis be on primary or secondary materials and why? You might also want to explain the difference between primary and secondary sources.

A syllabus should also specify prerequisites, both in terms of courses and prerequisite skills or experiences your students will need to do well. If you expect students to perform certain skills, will you teach these skills during the course or will you assume your students already possess them when they enter the course?

Explains How Students Will Develop by Successfully Completing Your Course

Students should understand what content they will learn, what skills they will develop, and what attitudes, values, and feelings may change as a result of taking the course. Including such information will help you develop some well considered course objectives, if you have not already done so.

Communicates the Course’s Nature and Content to Faculty/Administrators

In addition to informing your students, a good syllabus provides a record of your course for colleagues who may teach it later. It can also aid departmental and institutional curriculum planning, and assist outside agencies in assessing your program’s goals and effectiveness.

Provides a Documented Record of Your Teaching Career

Your course syllabi are an important teaching legacy. They often provide the only permanent record of your teaching philosophy, commitment to teaching, and pedagogical innovations. If you keep old copies of your course syllabi and read several years’ worth at one sitting, you can easily see how you have developed as a teacher. This growth and development is often striking.

When job hunting, syllabi are also integral components of the application portfolio. They can also serve as salary, promotion, and tenure documents that evaluation committee’s request when assessing teaching ability. A good syllabus can be as important to you as to your students—unless, of course, you are an independently wealthy tenured professor.

The Essential Components of the Course Syllabus

Once you know the purpose of the syllabus, its basic elements are easily defined. The following may serve as a simple checklist as you review syllabus content.

Basic Identifying Information

Include the name of your institution, the semester, year, course title and identifying code, location and time of class meetings, and the credits earned for successfully completing the course.

Instructor’s Personal Information

Include your name and title, office location, office telephone number, office hours, and email address if students can communicate with you via that medium. Some instructors include their home telephone numbers, but may specify restrictions in calls to their homes (e.g., no calls between 10PM and 8AM).

Texts and Other Materials

Specify the titles, authors, and editions of your texts, differentiating between required and recommended status. It is wise to specify locations for obtaining course materials (e.g., bookstore, library, your office, or computer lab), the conditions for obtaining them (e.g. whether they must be purchased, are on two-day reserve, or are cleared for photocopying), and the number of copies available (e.g., for reserved materials).

Course Description

This usually comes directly from your institution’s catalog and should include a brief description of the following items: the major topics covered the knowledge, skills and attitudes acquired prerequisites and any special opportunities (e.g., field trips).

Course Objectives

This section is of particular importance because of the current emphasis on the assessment of student learning outcomes. Clearly state your objectives. I recommend Gronland’s 1991 publication, How to Write and Use Instructional Objectives, if you are unsure of how to write objectives in this manner. Objectives can be cognitive (e.g., understands the nature-nurture controversy), affective (e.g., appreciates the role of psychology in everyday life), or behavioral (e.g., can administer an IQ test). A clear set of instructional objectives provides direction for instructional methods, yields guidelines for testing, and communicates instructional intent to students.

Course Requirements

Explain exactly what a student is expected to do in your course including a clear description of the tests administered, the papers written, and the oral presentations made.

Course Calendar

Your calendar contains the dates of specific lecture topics, reading assignments, exams, and deadlines for papers and other projects. Any changes to your calendar should be supplied to students in writing.

Grading Procedures and Scales

Make explicit your procedures and criteria for evaluating students’ performance and assigning grades. Clear policies regarding extra credit, make-up tests, deadlines, and penalties for post-deadline work are necessary. Include an academic honesty policy with definitions of academically dishonest behaviors (e.g., plagiarism and cheating) and sanctions for their occurrence if your school does not emphasis this concept in its literature (i.e. catalog).

A syllabus is written contract between you and your students. End each syllabus with a caveat, such as the following, to protect yourself, your department, and your institution if changes in the syllabus must be made once your course is underway: “The above schedule and procedures in this course are subject to change in the event of extenuating circumstances” (Altman, 1989).

It is imperative that all teachers adhere faithfully to the policies and requirements set forth in their syllabi. Do not forget the reciprocal nature of this contract. By requiring students to abide by the rules and procedures spelled out in your syllabus, you are also agreeing to do the same. A well written syllabus will make these expectations clear to all concerned. You should plan to discuss the syllabus in detail during the first class meeting. This brings up the need for prompt distribution of syllabi. They should be available on the first day of class, not a week or a month into the semester. After all, if you expect students to meet deadlines for examinations and other course requirements, you should also meet your own teaching deadlines, and distributing the course syllabus during the first class meeting is one such deadline you should not miss.

Good syllabi fulfill specific purposes, possess essential components, and answer crucial questions. However, few syllabi perform all these functions equally well. My advice is this: try to write syllabi that are as brief and focused as possible, but that communicate the nature of your course to students in a clear and understandable manner. The better your students understand the purposes and procedures of your course, the more likely they are to enter enthusiastically into the learning partnership you offer them.


5 Strategies to Use When People Do Not Understand Mental Illness

You recently went to see a counselor to get help for your mental health, and you were diagnosed with a mental health condition. You then decide to tell your relatives and closest friends about your diagnosis. Unfortunately, some of them do not understand what you are going through. They try to &ldquosolve&rdquo your mental health challenges by giving their opinions or tell you that your condition isn&rsquot real&mdashthat &ldquoit&rsquos all in your head.&rdquo

This is a very tough situation to be in. While you don&rsquot want to isolate yourself from the people you care about, you also don&rsquot want to let your relationships impede your recovery.

With that in mind, here are five ways to deal with this situation.

1. Focus on Getting Better. Don&rsquot waste your energy arguing with your friends or relatives who are giving you a difficult time. If you want, you can respectfully let them know where you stand, and how you feel about what they said. However, do not engage if it&rsquos upsetting you or triggering your symptoms. This isn&rsquot a public relations event where you need to gain everyone&rsquos approval. This is your life and you&rsquore the one struggling. Your energy and focus should be for you to get better.

2. Listen to the Professionals. Your friends and family may mean well, but when it comes down to it, they do not have the answers to your medical condition. So, do not go to them for advice on how to manage your symptoms or accept their advice if they give it voluntarily. When you have questions about your mental health, consult with your doctor, counselor or another mental health professional who is trained to help you manage your condition.

3. Tell Them to Learn about Your Condition. Tell your friends and relatives that the best way for them to help you is for them to try to understand your condition. They could talk to a counselor or go to family therapy, they could read some helpful books or join you at a support group. They won&rsquot know exactly what you are going through, but this will help them learn how to support you.

4. Distance Yourself from People Who Give you a Hard Time. This may seem cruel, but if some of your friends or relatives are hindering your recovery progress, then you may need to distance yourself. Especially, if you have asked them to learn about your condition, and they have refused. As much as you can, surround yourself with positive and supportive people.

5. Take Advantage of the Help That is Available Around you.If possible, talk to a professional about how to manage any difficult relationships. If you have problems or issues with a particular person, you can always ask your counselor for advice on what to do or how to talk to them. In the long run, this can help you learn valuable skills on what to do when a person doesn&rsquot understand your condition.

Your mental illness is a medical condition. When a person has a medical condition, they typically go see a doctor to help treat it. The same thing applies to your mental health. Go see a professional and focus on getting better. Not everyone will understand what you&rsquore going through, and that&rsquos okay. You are the priority, not their approval.

Stan Popovich is the author of &ldquoA Layman&rsquos Guide to Managing Fear Using Psychology, Christianity and Non-Resistant Methods.&rdquo Stan&rsquos managing fear book has become popular with over 400 positive book reviews and counting. Please visit Stan&rsquos website at www.managingfear.com.


We&rsquore always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices.


Collaboration in the Classroom

Although planning for data projection and network access is an important part of today's classroom design process, information technology is likely to have an even greater indirect effect on how fixed-site classrooms are used in the future. The migration to the Web of the content traditionally delivered by instructors in lecture format is helping shift the function served by brick-and-mortar classrooms from information delivery to collaboration and discussion. Collaborative learning refers to a wide variety of "educational activities in which human relationships are the key to welfare, achievement, and mastery," wherein faculty "help students learn by working together on substantive issues." 13 Surveys indicate that lecture is still the most common instructional method used by college educators in the United States. 14 Nonetheless, the transition from lecture to collaboration is well under way.

What impact does this have on classroom design? This fundamental change will challenge designers to create environments that facilitate collaborative activities. Instead of theaters where students watch instructors perform, classrooms must be flexible meeting places. Bruffee 15 described the ideal classroom for collaborative learning:

This description implies a maximum class size of 50 students. The question of classroom density is an important one: Researchers have explored the psychological and educational effects of classroom density, both spatial (the size of the room) and social (the number of students). In their meta-analysis of 77 different studies on this issue, Glass and Smith 16 concluded that higher social density results in lower student achievement. When designing collaborative classrooms, a good social density benchmark is three to five groups of 6 to 12 students each. Spatial density should be such that both students and instructors have enough room to move easily from group to group (specifically, 4 to 7 feet between groups). Designers should also pay careful attention to the degree to which students feel crowded in a classroom. The experience of crowding in educational settings appears related to personal space violation. 17 Research suggests that groups of students can be expected to work together most effectively at personal distances of 2 to 4 feet without feeling crowded.

Although class size is a limiting factor when implementing certain collaborative learning activities comfortably, small group collaboration and discussion are easier to manage in large classes than many instructors realize. Informal small group techniques like think-pair-share, 18 wherein students think briefly about a question posed by the instructor, discuss their thoughts with a student sitting next to them, and then share their joint thoughts with the class, are feasible in large classes 19 and can be facilitated by technology. More formal activities such as jigsaw groups and structured controversy can also engage students in large classes. 20

Classroom response systems or "clickers" are used by a growing number of instructors to gather student feedback and stimulate in-class discussion. In classes that allow group network access, a wide variety of groupware tools can support collaboration in groups of all sizes. DyKnow Vision allows students to view and annotate instructor whiteboard activity in real time. Instructors can then invite students to the virtual whiteboard, displaying their work to the entire class. GroupSystems is a suite of tools for supporting idea generation, organization, and evaluation in face-to-face and distributed groups.


Editorial Reviews

Review

"A Layman's Guide to Managing Fear" is a great self-help book.I have been a Counselor for many years now and I use some of the samesuggestions and tactics in my practice and you didn't have to pay $55.00 ormore an hour to hear them!"
--Mark Myers

"OnePowerful Book That Can Change Your Life!!Within this book are the answers that so many people so desperately needto hear. There is hope and freedom in the pages of this small life saver"
--Trisha Bleau

"Stan has hit the nail onthe head with his recommendations of a three tiered approach to dealing withfear. Very well put together and accessible to all ages."
-- Gordon R. Estes, Jr.

"The book has cognitivetherapy and christianity woven together in a way that does not feel overwhelmingor intrusive. Worth the read."
-- Ron Jon

"Popovich has writtenabout three distinct methods of dealing with fear. As a licensed counselorintern, I have incorporated many of thetechniques mentioned in this book Believers and non-believers alike couldbenefit from reading this."
-- Satchel Pierce Stillwell

"I like that Stan combinesvarious methods and even tells us how we can combine the methods for acomprehensive list of suggestions."
-- Anne Cuthbert

"I'm always looking forhelp for my clients that is written in terms that they can understand. Thisbook does just that. Take it with you to your therapist & discuss it withthem as basis for moving forward."
-- Hilary MacKenzie

"As a therapist, I havefound that client's like to have a simplified explanation, one without all thepsyco-babble. This book provides just that."
-- Don

From the Author

"I have used Stan'stechniques with my clients. I wouldrecommend this book for counselors, individuals, pastors or anyone in thehelping profession."
-- Bonnie Roberts

"Very easy to readwith practical suggestions. The clear and concise way it is written makesit a good book to which therapists can refer their patients."
--Brenda Dolan-Pascoe

"A great laymen's guide to anxiety bolstered by a variety of approachesincluding both spiritual and psychological. Full of practical tips for helpingunderstand and reduce anxiety. A fast and interesting read that I would highlyrecommend."
--Sara Nannen

"I enjoyed reading this book because it provides many helpful remindersand techniques to use when struggling with fear and anxiety. The book isorganized thoughtfully, and the concrete examples help the reader understandhow the tools work."
--Patricia Allison

"Very easy to read with practical suggestions. The clear and concise way it is written makes it a good book to which therapists can refer their patients."
--Brenda Dolan-Pascoe

"A great laymen's guide to anxiety bolstered by a variety of approaches including both spiritual and psychological. Full of practical tips for helping understand and reduce anxiety. A fast and interesting read that I would highly recommend."
--Sara Nannen

"I enjoyed reading this book because it provides many helpful reminders and techniques to use when struggling with fear and anxiety. The book is organized thoughtfully, and the concrete examples help the reader understand how the tools work."
--Patricia Allison

"The book is divided into sections that address different approaches from general counseling techniques, asking God's help (Spirituality), as well as non-resistant methods that are very helpful. As a therapist I would recommend this book to my clients who are experience anxiety."
--BJ Buchanan

"I can see how this book could be used in a small group setting as it offers practical methods to move through fear that could be role played in a safe environment"
--Vickey Gibbs

"This small guide on overcoming fear makes several salient and powerful points. Popovich offers cognitive strategies - how to think one's way out of fear - in straightforward terms. He brings clarity and simplicity to interventions that often take full books to describe."
--Sarah Chana Radcliffe


"Kudos! A refreshing perspective that combines christian beliefs and the structure of cognitive behavior therapy that are integrated to create a method to effectively manage fears. Well thought out and written."
--W.R. Drinkwater


"Stanley Popvich's book is an easy read that will benefit both professional and nonprofessional individuals. It is thoughtful, reflective and captures the subject matter well. Everyone has experienced fear at one time or another in their lives. Stanley's specificity in style of writing allows the reader to relate to the subject matter."
--Lucille M. Force


"This book is an excellent read covering counseling, psychology and an element of spirituality. This book is concise, punchy and exciting. I fully recommend anybody purchasing this book as it gives people an insight and awareness of the power of ' fear ' and conquering it. An absolutely brilliant book!"
--James Ward

"As a Licensed Professional I highly recommend this book to people who are experiencing issues with Fear. This book is faith based and offers unique insight into battling fear in one's life. Although, it is a Layman's Guide. It has very useful strategies to help one overcome the challenges and struggles of fear."
--Darleena Anderson

From the Inside Flap

From the Back Cover

About the Author

Stan Popovich is the nationally known author of "A Layman's Guide to Managing Fear Using Psychology, Christianity and Non Resistant Methods": an easy-to-read book that's helped thousands of people to confidently manage their persistent fears and anxieties.

This life-changing book was inspired by his own 20+ year struggle with anxiety and fear, and his journey to discover the keys to freedom and emotional health.

In the Guide, Stanley shares his deeply relatable experiences, as well as the expertise of several professionals in the fields of self-growth and mental health.

He's been featured on many TV and radio programs around the U.S., including ABC Radio Network and Fox News Radio, and he's shared his wisdom in various national publications around the world.

His book has accumulated over 400 positive reviews, many from professional counselors who use the Guide to help their clients, and his warmth and expertise have brought him thousands of fans on Facebook, Twitter, and Linkedin.


What Is Vicarious Trauma?

It doesn't take a lot of words to give a complete vicarious trauma definition. Vicarious trauma is an intense reaction to being exposed to someone else's trauma story or being exposed to the details of the traumatic event. The only thing missing is who this happens to most.

Who Is Affected by Vicarious Trauma?

People in the helping professions are the ones that typically experience vicarious trauma. The term 'vicarious trauma' was originally coined to describe the reaction a psychologist or counselor has after hearing the stories of traumatized clients. Later, other helpers who deal with traumatized people were added. It also makes sense that people, especially children, who have witnessed these threats or violence may experience vicarious trauma as well however, this last bit has not been added to most definitions yet.

The list of people who experience vicarious trauma may include:

  • Psychologists and counselors
  • First responders
  • Clergy
  • Doctors, nurses, and others in the medical professions
  • Social workers
  • Justice system professionals
  • Humanitarian workers
  • Journalists
  • Anyone who witnesses or hears the details of a traumatic event happening to a loved one.

The Deeper Meaning of Vicarious Trauma

If you're a helper by trade, experiencing vicarious trauma means you have connected deeply with one or more clients or people you're helping. Countertransference is a relevant psychological term for this. It refers to the 'emotional reaction of the analyst to the subject's contribution,' according to Google Dictionary.

Countertransference can be extremely helpful as you go about helping someone. It enables you to understand how they're thinking and feeling so you can help them more effectively. In short, people who experience vicarious trauma have succeeded in establishing that connection. The only problem is that they've failed to create a boundary that keeps the feelings of the person they're helping separate from their own.

If you have vicarious trauma, it means you care what happens to the person who's experienced the trauma. It says you do 'feel their pain.' Most of all, it means that you're a loving, caring human who looks beyond self to see the suffering of others just so that you can help them.


This Article Contains:

Client-Centered Therapy, also known as Client-Centered Counseling or Person-Centered Therapy, was developed in the 1940s and 50s as a response to the less personal, more “clinical” therapy that dominated the field.

It is a non-directive form of talk therapy, meaning that it allows the client to lead the conversation and does not attempt to steer the client in any way. This approach rests on one vital quality: unconditional positive regard. This means that the therapist refrains from judging the client for any reason, providing a source of complete acceptance and support (Cherry, 2017).

There are three key qualities that make for a good client-centered therapist:

    Unconditional Positive Regard: as mentioned above, unconditional positive regard is an important practice for the client-centered therapist. The therapist needs to accept the client for who they are and provide support and care no matter what they are going through.

Another notable characteristic of person- or client-centered therapy is the use of the term “client” rather than “patient.” Therapists who practice this type of approach see the client and therapist as a team of equal partners rather than an expert and a patient (McLeod, 2015).


Having Taken the First Step

What does it feel like when one has fairly recently embarked on a course of Buddhism? The answers will vary a great deal, no doubt, but there ought to be some general characteristics and some problems common to the majority of "newborn" Buddhists in the West. Let us assume that you are a person who has quite recently, or within the last year or so, begun to take Buddhism seriously as a personal way of life. You may by now be just looking round a bit in your new mental surroundings and trying to take stock of what has happened, now that the first novelty of the situation has worn off. You have, I sincerely hope, tried to do a bit of meditation, though it would not surprise me in the least to hear that you have found this difficult and disappointing. If so, I would like to tell you straight away that you should not be discouraged. This is quite the normal thing. Meditation may seem disappointing and even almost useless for quite a long time, but if you persevere in it, results are bound to come. But these results may not be at all the sort of thing you expect. And you may not even be the person who first becomes aware of them. So press on regardless, and don't look for results. If you can see the point of this piece of advice you have already in fact made useful progress. Insights often come very subtly.

People's motives for taking up Buddhism may vary a great deal on the surface. But fundamentally you have probably come to it because, in one way or another, it seems to promise you security. If you haven't realized before that this was a good part of your motive, you might usefully use your next meditation period trying to find out whether I was right or not. If you have realized this, then you may agree that you find the formula "I go to the Buddha, the Dhamma, and the Sangha for refuge" strangely comforting. And so it should be in one way, even though fundamentally you have to learn to be "a refuge unto yourself." This is perhaps the first of the many paradoxes you will encounter attempting to tread the Buddhist path.

Now if we consider this problem of security a little further, we soon find that we do indeed crave for it. The obvious reason is that we feel life frankly unnerving, in fact, because insecure. Here, then, we find straight away two of the three "Marks of Existence": all things are marked by impermanence and suffering. Because they &mdash and we &mdash are impermanent, they are frustrating and cause us all kinds of anguish. Buddhism offers a way out of this situation by treading the Noble Eightfold Path. I am assuming that, having "taken the first step," you are now familiar with the Four Noble Truths and the steps of this Path. So I just want to mention a few points which may arise at this stage. The first step of the path is known as Right Understanding or Right View. This is seeing things as they are. There are large areas of experience which we would much rather know nothing about. This is the origin of repression, to use a Freudian term which is misleadingly translated. The German for "repression" in the psychoanalytical sense is Verdrangung, "thrusting away." It is really successful self-deception. Getting rid of our repressions is therefore not doing what we like, as seems to be popularly imagined, but ceasing to deceive ourselves.

Fundamentally, Buddhism is just a technique of self-undeception. This is not easy, though sometimes it may be fun. It needs some study of theory as well as practice. It is perfectly true that you never gain enlightenment by intellectual knowledge alone, but if you haven't studied the theory to some extent you will almost certainly never be able to start properly on the practice. Before you can develop your intuition you must know what it is &mdash or at least what it isn't &mdash and self-deception in this respect seems to come terribly easy to many people. Intuition, or as I much prefer to call it, insight, is not an emotion, but the best way to develop it is by getting to know one's emotions as thoroughly as possible. When these emotions have been really seen for what are, they no longer stand in the light. Now the biggest emotional blockage we have is that which surrounds the ego-idea. Since it is to the ultimate elimination of this idea that the whole Buddhist training is directed, it may be as well to have a good look at it. In so doing we may get a shock.

By the ego (or self) in Buddhism we mean of course the concept of "I am," though this is much more a feeling than a purely intellectual concept &mdash which is the very reason why it is so much more difficult to uproot. From the psychological point of view we must take it to include not only what in Freudian terms is called the ego, but also the id and even the super-ego. Though not wholly adequate, the Freudian conception goes a good way toward giving us the basic idea. This ego of ours is a complex and dynamic set of functions which are not by any means all conscious or under any form of normal conscious control. Its nature is in fact blind ignorance and it fights desperately to maintain that ignorance. It is most important for us to realize from the outset that this is the case, because this is the root-cause of all our troubles. The three unhealthy roots of human nature are greed, hatred, and ignorance, and all our suffering is due to these three. Ignorance is the most fundamental, and greed and hate spring from it.

Now the power of ignorance is broken by knowledge, which is seeing correctly. So all we have to do is to learn to see. A-VID-YA "unwitting" or not seeing is no mere passive principle &mdash it is an active force which opposes discovery of the truth at every turn. No need to look for an external devil: the Father of Lies is within every one of us. We all know the story of the Emperor's new clothes. In Buddhism the precise opposite of this situation occurs: the clothes go walking in the procession, but there's no emperor inside them. The whole show is laid on for the honor and glory of a character who doesn't really exist. Here, then, is our second paradox, and it is certainly no less startling than the first one: the ego is the most ruthlessly gluttonous all-devouring monster there is, and yet really all the time there's no such thing! All its activities without exception are simply "a tale told by an idiot, full of sound and fury, signifying nothing." How can we solve this riddle? How can we ever come to grasp the nature of this peculiar monster that "has no mouth and no belly, yet gobbles up the entire world" (as some old Chinese monk might have said, but probably didn't)?

Clearly there must be a sense in which the self exists and another sense in which it doesn't. Let us first of all have a frank look at it in the sense of something existing. It is not a pretty sight. Underneath all our lofty ideals, our pious thoughts and holy aspirations, we are all alike. Our little personal petty self is the really important thing to us. It is out to grab all it can get, whether in the way of affection and admiration and sympathy or of more apparently tangible satisfactions in the way of sex, money, power, nice things to eat and drink and smell and touch and hear &mdash all sorts of things and it doesn't care in the very least how it gets them. We don't all want &mdash at least consciously &mdash all of these things perhaps, but we usually want a lot of credit for not wanting some of them or at least doing without them, even if by necessity rather than choice. All these are aspects of greed including the last, which is of course conceit. They are the things the ego fattens on. Equally impressive and perhaps even more horrifying is the list of items under the heading of hate we are all capable in our minds of murderous rage, sadism, treachery, and disloyalty of every conceivable kind. Until we have found and identified the seeds of all these things in our own hearts, we cannot claim to have made much progress in self-knowledge.

Of course most of us will never yield to such impulses, which may only be very faint but until a higher stage of development has been reached they will not be totally eliminated as tendencies. The most likely way in which they may find some outward expression will be, perhaps, in the form of over-emotive indignation at the acts of hate committed by somebody else.

What can we do about this situation? First, face it. Second, penetrate to its roots. Buddhism is not something airy-fairy or romantic, it is practical. It is first and last something to do. To penetrate to the roots of greed, hatred, and delusion is not very easy and it requires certain methods or techniques. But the great thing is to keep going at and not be diverted by irrelevancies, interesting by-paths, plausible excuses or pseudo-mystical fantasies born of conceit and ignorance. A certain discipline is required, in fact. This can be summed up in one word &mdash restraint. Restraint is not repression. In its simplest form it can be something as apparently "easy" as sitting still. It is just not automatically yielding to every impulse that arises while not, on the other hand, pretending that that impulse does not exist. A good part of Buddhism, in modern terms, is "sales-resistance": cultivating at least a degree of immunity to the appeals of the outside world which are today constantly attempting, quite deliberately and purposefully, to arouse new desires within us. It is being deaf to the blandishments of the hidden persuaders whether from within or without, or better perhaps, hearing them without reacting. Who is the rich man who, like the camel, cannot pass through the eye of the needle? He is not only the millionaire, the expense-account johnnie, the take-over charlie: he is anybody who has too many mental encumbrances, too many wants.

Here then is an exercise: sit down with a straight back for ten minutes resolved not to make a single voluntary bodily movement during that time, and just observe what happens. You may get some surprises, but whatever happens you are bound to learn something. If you find, as will probably be the case, that a lot of thoughts and mental images arise, try to discover where they come from, to catch them at the very moment of arising. You won't succeed easily, but you will begin to see something of the mechanism of desires and emotions, and this is immensely valuable. Perhaps the most widespread meditational practice in all schools of Buddhism is anapanasati or mindfulness of breathing. Just watch the ebb and flow of your breath without interfering and, as far as you can manage, with undivided attention. This is the surest way to achieve calm, concentration, self-knowledge, and insight.

There is no Buddhism worthy of the name without practice, but study is also required. This is especially so in the West, where we have not the background of Buddhist thought which exists in Eastern countries. We have to learn as adults what Eastern people have absorbed from childhood. The study of Buddhist theory should therefore not be neglected. Those who deny its necessity do so usually out of conceit, laziness, or ignorance &mdash or a combination of all three.

The obvious problem which arises here is: "Where shall I start?" There are many schools of Buddhism and their scriptures, even those readily available in English, are voluminous. There is Theravada and Mahayana, in the form of Zen, Tibetan Buddhism and several other varieties. There are numerous books about most of them. Unguided and indiscriminate reading will only lead to mental indigestion. The obvious thing is to get down to basics. If we ask where these basic principles are set out, the answer is in the Pali Canon of the Theravada school. In fact, the seeds of all later, so-called Mahayana developments are there in this basic Buddhism.

The only reason why some people find Theravada Buddhism apparently unsatisfying is its seemingly negative approach. In the Mahayana schools there is greater explicit stress on two things: compassion and the higher wisdom. But we need not worry. Compassion grows inevitably as one trains oneself in Buddhism, and the higher wisdom cannot be gained until the lower wisdom has been developed. It is to this task that the basic training is directed. Before we can begin to grasp the nature of Reality, which is transcendental, we must first grasp the nature of the mundane, the phenomenal world as our senses present it to us. This basically means knowing ourselves. Knowing ourselves means facing our own insecurity. Recognizing the equal insecurity of others is compassion.

Why do we feel so insecure? If we can answer this question, we are on the right track. It is due to our recognition that all things are transient. We seek to achieve a stability in the world which, by the very nature of things, cannot be. But Buddhism teaches us more than this: all things are not only transient, they are "empty." This applies to our precious selves as much as to anything else. Man, said the Buddha, is a mere compound of five things, the five khandhas or aggregates. He has a physical body, feelings, perceptions, emotional reactions, and consciousness. None of these constitutes any sort of a "self" which is permanent and unchanging, nor is there any such thing outside of them. His consciousness is just a series of states of awareness, conditioned by the other factors, reaching back into a limitless past. All we are actually aware of is the present moment, or rather consciousness is just that awareness. There is no separate entity behind it which is aware. In the jargon of some modern philosophers, everything about man is contingent or adjectival, not substantival. The further implications of this must be left for study and meditation, but this is a fundamental principle of all Buddhism. The search for a "self" behind all this is futile. If you don't believe this you can try to take up the Buddha's challenge and find it.

There may well be a strong feeling of resistance to the acceptance of this point. If so, this feeling itself should be very carefully examined. It is the basis of our habitual ego-reactions. We want so badly to have a "self" and we expend a vast amount of energy in trying to build one up and support it in every way we can think of. That, fundamentally, is why we feel insecure in the world. One could usefully devote a good deal of time meditating on this point alone.

The most notable contribution made to psychology by Alfred Adler was his analysis of the inferiority complex. People who, for one reason or another, feel inferior, says Adler, tend to over-compensate and present an appearance of conceit and aggressiveness. Since Adler's psychology is very much one of social adaptation at not, perhaps, a very profound level, he did not pursue this idea as far as he might have done. But as far as it goes it is quite good Buddhism, though we might prefer to rename his complex the "insecurity complex." We might even go so far as to say that for the Buddhist everybody's ego practically consists of an inferiority or insecurity complex, for such an assumption certainly explains a great deal. Every form of ostentation we may indulge in is a way of bolstering up the ego, whether in cruder or subtle form. The large car which seems designed as wide as possible is as much an example of ego-boosting as the padded shoulders worn by the tough: indeed the resemblance is sometimes striking. Of course the compensation for insecurity may take a reverse form of exaggerated modesty and simpering sweetness, or of unnecessary and slightly ostentatious self-sacrifice. This latter is a form of compensation we may choose when all else fails, and it has the advantage of making us feel very holy. Martyrdom is in fact the last consolation of a disappointed ego. And the hallmark of a person who has really gone far in the conquest of self is genuine unobtrusiveness.

The formula of Dependent Origination shows by selecting twelve prominent factors how it is that we go round and round the weary circle of rebirths, and how karma operates. It is not a simple formula of "causation" but rather of conditioning. Ignorance (avijja) is a necessary condition for our being here &mdash hence if we were not ignorant we would not have been reborn. And birth is a necessary condition for death &mdash if we had never been born we could not die. Thus, too, feeling based on sense-impression is a necessary condition for the arising of craving: if there were no such feeling there would be no craving. But we can stop the craving from arising or at least prevent its developing into grasping. This is the point at which karma comes into play. Karma is volitional activity born of desire, and as such produces pleasant or unpleasant results in the future. Whatever condition of body and mind we happen to be in now is due to our past karma it is vipaka or karma-resultant. In accordance with the vipaka we are liable to act in the future, but if we have understanding we can control our future actions, and thus their future effects.

The aim of Buddhist training, of whatever school, is to break away from the cycle of becoming. This means somehow attaining the Transcendental Reality which is not karma-bound and therefore permanent, secure, and free from suffering. We do not, as unenlightened individuals, know what this is: at best we have a vague intuition of something wholly other. Its true nature is hidden from us by the veils of our ignorance. The state of enlightenment is called Nirvana (Nibbana in Pali), which is, be it noted, selfless (anatta). This means that we cannot grasp it as long as the self-concept (or feeling) is operative. It is beyond the realm of duality, which is that of subject and object, or self and other-than-self.

Probably most people have at times had a feeling while in the normal sense "wide awake" as if really they were dreaming and would soon wake up. This is actually quite true as far as the first part is concerned. Life as we know it is in one sense a dream. The Buddha was the Awakened One, and our normal state is perhaps somewhere about half-way between ordinary sleep and true enlightenment, or wakefulness. We can therefore usefully regard the Buddhist training, if we like, as a way of making ourselves wake up. Sometimes in sleep we become aware of being asleep and want to wake up. Eventually we succeed, but it is often a struggle. The struggle to wake up to enlightenment is far greater than this, because the resistance is stronger. The resistance is stronger for a very simple reason: to the ego it seems like death. This is fair enough, since in fact it is the death of ego. And since we have no real experience of the egoless state, it is unimaginable and therefore we are skeptical about it, but this skepticism too really springs from fear. We should have to give up all our attachments to attain it, and that is too high a price to pay. We are like the rich young man to whom Christ said "Sell all that thou hast and give it to the poor." He went sorrowfully away.

What then must we do, now that we have taken the first step and embarked on the course of Buddhism? We need to have a chart and compass to help us on our way. But first we have to know where we are supposed to be going. The goal of Buddhism is Enlightenment or Awakening or Nirvana, the Deathless State which is the end of all suffering and frustration, the one permanent and supremely desirable thing. Buddhism claims to be a way of attaining this. There are five factors to be developed which, if they are predominant in our minds, will tend increasingly to bring us to the goal. They are Faith, Energy, Mindfulness, Concentration, and Wisdom. The first of these may come as a surprise to some people. "I thought," they may say, "you didn't have to have faith in Buddhism." In fact faith is an important factor to develop. We can call it confidence or trust if we prefer it. But unless we have some confidence that there is such a goal as Nirvana, we shall not even start taking Buddhism seriously at all, and we need also to trust the Buddha as the teacher who has shown the way to reach that goal. At the very least we need to be free from the sort of nihilistic skepticism which is so common today and which prevents us from believing wholeheartedly in anything worthwhile. When we say "I take refuge in the Buddha, the Dhamma, and the Sangha" we are expressing faith in the Teaching and the Order of monks who have preserved it and handed it on.

If we have faith we next need to put forth effort, so we need energy. Right Effort is a step of the Eightfold Path. It means getting rid of wrong states of mind and developing right ones. Clearly a certain amount of vigor is required to do this, and faith will strengthen our will to persevere. Clearing up our mental muddle calls for increased self-knowledge, and this is gained by Mindfulness. Mindfulness is being aware of one's own nature and observing one's own reactions, being fully cognizant of what one is about all the time. It is developed by training, such exercises as mindfulness on breathing and on walking being especially beneficial. With full mindfulness, self-deception becomes impossible. It is the way of uncovering the subterfuges of the ego. The Buddha described it as "the one and only way" to the liberation of beings. It is an absolutely indispensable factor in all Buddhist training. Being mindful one is, too, in some degree automatically concentrated, but the practice of mental concentration can be carried further, to samadhi, which is mental one-pointedness. By a combination of these two factors, the mind can be sharpened to an instrument capable of cutting through the veils of ego-created illusion. The last of the five factors is Wisdom. Wisdom in this connection means discernment. It includes investigation of all mental phenomena to their essence, which is voidness. When this lower, still mundane wisdom has been sufficiently developed, a basis has been created for the arising of the higher Insight-Wisdom, the perfection of which is Enlightenment. When this has been attained, the job is done.

But these factors must be developed in such a manner that they are properly balanced. Faith must be balanced with Wisdom, and Energy with Concentration. Faith without Wisdom can overreach itself and turn into that kind of blind faith which Buddhism does not encourage. On the other hand, Wisdom without Faith is sterile. Energy unaccompanied by Concentration can easily lead to restlessness, while Concentration without sufficient Energy leads to sloth. It is the function of Mindfulness, by watching over the other factors, to see that the proper balance between them is maintained. These five factors are called indriyas or "ruling factors." This means that they can and should dominate the mind and give it direction. They are the five guides to keep us on the way. Having taken the first step, and with these as guides, but especially under the leadership of Mindfulness, let us walk on.



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