Memory Making

            Many of us rely on our memories to do much of what we do on a day to day basis.  It’s something we all have that we often take it for granted.  Without our memories, we would not be able to function in our world.  We would just forget everything as they come and go, and live the next moment as if the past did not just happen.  There will be much confusion and frustration if we did not have our memories. 

            Scientists believe that we essentially have two kinds of memory—short-term memory and long-term memory.  Short-term memory is a resource with limited space, and can only take in so much information.  Some researchers have estimated that we can probably store about 5-9 items in this short-term memory storage system.  In order to retain this information, we need to keep on repeating the information to ourselves, just like we do when we are trying to remember a string of numbers being recited to us.  Once we remember something without having to rehearse it over and over again, the memory is said to have already been transferred to our long-term memory.  Scientists really do not know how long we can retain information stored here.  There is a general belief that long-term memory is forever, unless our brains get damaged for some reason or another. 

            Information rehearsed in short-term memory gets moved to long-term memory fairly easily.  When we make sense of something and put meaning into it, then we are better able to remember that bit of information.  For example, if we are remembering a string of numbers that is the telephone number of an acquaintance, we might use our previous knowledge to remember it.  If the number is, say, 4212469, which is PsychConsult’s number, we might think that 421 is somewhat counting backwards and 2469 is somewhat counting forwards in two’s.  This now becomes our key in remembering this set of numbers, which makes it easier to recall. 

            So, putting meaning into the new bit of information and making sense of it, even though it is something personal, is a way of making bits of information stick to our long-term memories.  This process that entails embedding new sets of information into what we already know is called the process of “consolidation.”  This happens more quickly when we consciously and purposively make sense of the information we are being presented.  The more connections we make between the new information and the wealth of knowledge we already have, the easier that memory gets recalled later on. 

            Usually, the more organized our thoughts are, the easier they are stored in our memories.  When needed, organized information is also easier to retrieve.  And so, this is yet another way that we can make sure we remember a complex set of information.  We need to organize them in a way that is sensible to us.   

            As adults, we are able to think about how we remember things.  We are able to analyze the ways that we think and remember.  This is helpful if we want to improve the way we remember things.  Next week, I will write about some ways to enhance our memories. 

Using Diagnoses and Labels in Mental Health

            Lisa was referred to my office, and I had the chance to see her.  After a few sessions, her teacher contacted me and asked me what diagnosis I had of her condition.  I then asked myself: “What would a diagnosis do to help this young lady?”  I was not sure.  I also thought:  “What would a diagnosis do to help the teacher?”  I then thought that maybe this would help her have a handle as to what might be going on with this student.  It is a succinct way of labeling the various behaviors they have been noticing with the student.  It is true that for many of us, having a name for a condition help us put into context what a person might be going through.  In a way, the diagnosis has become an explanation for all the behaviors we cannot seem to make sense. 

            This is particularly true of many medical issues.  When I am suffering from a particular skin disorder, for instance, having a specialist identify what this skin disorder is—having a name for it—can actually result to the necessary actions to take in order to know how to treat it.  In fact, this is the true purpose of having a diagnosis.  When we know what the medical issue is, given its symptoms and presentation, medical professionals have a clear idea of its usual presentation, its course, the recommended treatment, and the prognosis of the outcome. 

            Using diagnostic labels is also a convenient way for medical and allied professionals to communicate.  It enables these practitioners to speak to each other and assume a common basic  knowledge, or lack thereof, about the specific and relevant diagnostic label. 

            In the specialization of mental health, there is no laboratory test, no blood test or brain scan, can actually be used to diagnose any disorder.  The current measures of the symptoms are essentially behavioral, meaning that actual observations and reports from people who know that person well are used as a basis of making a diagnostic decision.  And so, some level of subjectivity happens. 

            I must admit that having a diagnosis of a particular set of behaviors can be quite helpful.  When a person suffers from a Major Depressive Disorder, this can signal the need for some kind of intervention.  Similarly, when a person is becoming Dependent on certain substances, having a label can push that person to seek relevant help. 

            Despite the benefits of using diagnostic labels, there are some drawbacks in relying on it too much.  One is the effect that the stigma of mental illness can bring about.  Being diagnosed can stigmatize a person, and may have effects in future employment and limiting other opportunities.  Another is the tendency of diagnostic label being used to identify a person, rather than just an aspect of that person.  The person can be called “Autistic,” instead of a person with Autism, which connotes that first and foremost the person is of this sort, rather than being an individual first before having such a condition.  Yet another concern is the blurring of an individual’s personal circumstances when a diagnosis is used.  The person then just conforms to the diagnostic criteria, rather than the criteria fitting the presentation of the individual.  In many specific instances, individual nuances further define the presentation of symptoms and there are often no two cases that are exactly alike. 

            As a practicing clinical psychologist, I struggle with being able to identify and declare a diagnostic label, and seeing each person as an individual with their unique nuances.  I want to maximize the benefits of both, and not short changing my clients.   This is a tough scenario to balance with no single answer for all the clients.  In the end, I make my judgment in the best interest of each individual client.  With that foremost in my mind, I know I cannot go wrong. 

            In the case of Lisa, I provided a diagnostic label.  Afterwards, I qualified what behaviors were explained by this label, and which ones were not part of the disorder.  More importantly, I made recommendations of how teachers and staff members can best interact with Lisa so that she is provided the help that will assist her in her special needs. 

Your Online Identity

            A few weeks ago, an unprecedented event in any mass communication medium occurred.  Five hundred million people logged on to Facebook within a single day.  More and more, the internet is becoming a formidable force in our day to day lives.  For the majority of internet users, it is a source of information and a quick and convenient way of getting in touch with friends and relatives.  For many of these people, it is also an extension of oneself, a kind of an online life.  In fact, I set up this blog as an extension of my professional identity. 

            For those of us who have signed in to any free internet service, creating an online identity is a must.  Whenever this happens, what many do not fully understand is that we have consequently (whether you like it or not) become a source of information for those who own these websites.  Website owners and hosts now own the information of whatever we do online , which include the sites we visit and other related information.  That is the business that they are in. 

            The phenomenon of Facebook brings this data gathering method to a whole new level.  When we connect with friends on this site, liking or disliking posts made by these connections; in fact, all our activities within this site are all data.  Now, they are mainly used for targeted advertising.  The ads we see on our screen are not random; they are the services and products in which the demographic we represent are likely to be interested.  Simply put, they use the information we give to them so they can try to sell something to us. 

            Another concern is protecting our privacy.  When we create an account with any free internet service, we are signing terms that might compromise your privacy.  For instance, unless we meticulously specify through our settings that we want to keep our privacy, any picture posted on Facebook becomes public property and anybody can download them and use them for any purpose they so please.  And so, many of my techie friends actually advise me to read the terms of agreement first before signing in to any web service.  And yet, many of us do not care to go through these long documents more carefully. 

            I felt the need to write this entry because all too often we are not so mindful about what we post online, whether that is an innocuous comment or a frivolous picture we took.  Just like in our daily lives, we do need to be prudent about what we put out there for all to see.  Ultimately, the data we upload is stored in a hard drive likely to be halfway across the world.  We have no control over it, and deleting information may not automatically erase it.  The written word is said to be powerful because of its staying power.  After all, all data from any website are presumably regularly backed up for security purposes. 

            In the end, we need to remember that the internet is a form of mass communication.  In fact, it has democratized the power of the written word.  It is a wonderful tool that we should all use.  In fact, that is what I harness when I put out a blog like this.  But at the same time, we need to be judicious in its use as well.  I invite all of us to think of it as appearing on television or being interviewed on the radio.  What would you be willing to say in these more traditional broadcast media?  I think we should think similarly about the internet. 

When OFW’s Reunite with their Children (2)

     Last week, I outlined the difficulties that both parents and children go through when they reunite after many years of living in different places.  In many instances, this reunification happens in a country outside the Philippines, where parents have stayed for a number of years and are often more familiar with the local environment and culture than are children who just joined them.  Many times, children have been living with relatives in the Philippines and are not even emotionally close to their parents. 

     This week, I would like to focus on what these families might want to do in order to effectively deal with the stresses that are inherent in this happy event of reunification. 

     I believe that the two most important elements that need to be present in these situations are open and honest communication, and a supportive environment.  Parents need to begin by creating a norm of being honest and open about their thoughts and feelings.  In modeling this behavior, they can also encourage their children to fearlessly speak their hearts and minds without fear of being misinterpreted or even scolded.  At the same time, they need to be sensitive to how their children might feel and to always remind their children that they will be there for them through their difficulties.  When I say this, I do not mean to spoil the children and give them everything we think they want.  Rather, what I mean here is to establish clear and constant routines each day, complete with realistic expectations for each child.  Parents can foster these through the following: 

- Creating a daily routine for each one to follow (yes, schedules work very well for young people);

- Assigning reasonable and age-appropriate chores for each individual, which are open for negotiations;

- Clearly stating expectations from each child (e.g., curfew, school-related behaviors and results, making friends with others, etc.);

- Having regular meals together and using these occasions to talk about each other’s days;

- Spending alone time with each child, doing something that that child likes to do on a fairly regular basis (e.g., once a week or once every 2 weeks);

- Listening to one another and genuinely understanding what the other person might mean when they say something;

- Paying attention not only to what is being said but also to the more subtle the emotional content (or what is not being said but is being communicated);

- Refraining from scolding children when they say something apparently disrespectful, but to help them find ways to say what they want to say in a more acceptable way;

- Negotiating any rule or expectation that might be deemed unrealistic or too difficult for a particular child; and

- Making sure that there is time for fun and enjoyment with the whole family. 

     In cases when children moved from the Philippines to a new country, parents need to understand that the uprooting of their children will be difficult.  They probably need to mourn over this drastic change, and find ways to be able to nurture the relationships they left back home.  And so, children may need to be given ample opportunities to communicate with their friends and relatives back in the Philippines.  At the same time, parents also need to orient their children to the life in their environment.  They might like to talk about their own struggles in adjusting to the life in the host country, and what helped them deal with these difficulties. 

     If you find that you are having significant difficulties managing the situation of your family when you are in a situation as I have described here, you might want to consider seeking the help of friend or extended family who are accessible.  In the absence of such natural social support, professional help might also be considered.  Ideally, face-to-face consultations with a psychologist or counselor might be indicated.  However, you might also consider the online help provided by the Department of Psychology at the Ateneo de Manila University.  Free online counseling services for OFW’s and their families can be accessed through the following website http://ofwonline.net.