The causes of the Civil War Essay Example | Topics and Well Written Essays - 750 words

The causes of the Civil War - Essay Example Today the American Civil War represents one of the most important conflicts in the history of the United States. While the war itself only lasted from 1861-1865, the effects have been felt significantly throughout the United States since. In addition to enacting significant death tolls on both the Northern and Southern participants, the political ramifications of the conflict were truly revolutionary as they resulted in the emancipation of slaves throughout the country. While ostensibly the Civil War was a direct result of then President Abraham Lincoln’s Emancipation Proclamation, declaring the abolishment of slavery, upon further inspection it’s clear there are a number of complex causes behind the war. This essay considers the various causes to the Civil War in an attempt to gain a broader understanding of their political implications. Perhaps the primary catalyst behind the Civil War was the economic differences between the Northern and Southern states. While indust rialization had enacted factory production and similar means of economic subsistence in the Northern states, the Southern states had evolved along a different path. Within the Southern regions, where the climate encouraged more agricultural means of production, the economy had become almost entirely reliant on cotton production. Within this spectrum of existence, cheap labor was essential to ensure the economy functioned, so slavery became a key part of Southern existence. In addition to embracing slavery, the Northern modes of city-life encouraged greater means of interaction between the social classes. As a result, it’s argued that Northern regions evolved more progressive views on the social hierarchy, while the Southern regions remained in an antiquated order (Chambers 1999). This would led to conflicting perspectives that would eventually mount, greatly contributing to the opposing regions engaging in warfare. Another pivotal aspect that contributed to the start of the C ivil War was general disagreements on political policy between the Northern and Southern regions. In these regards, one of the primary disagreements was between the belief the Southern belief that states should be primarily responsible for determining legal policy, versus the Northern view that the Federal government should be the primary decision maker in these matters. One of the primary arguments was advanced by politician John C Calhoun and referred to as nullification. This would give states the power to nullify laws that were passed by the Federal Government. As it became clear that such a measure would not be allowed, the Southern states moved toward seceding from the Union (Jones 1999). Ultimately, this would be a primary influence in bringing the Southern states to war. Another primary political issue was the moral disagreement between individuals that supported slavery and those that were vehemently opposed to it. As slavery had become a long-entrenched aspect of the Ameri can economic landscape, even as growing concern over its immoral aspects mounted it became increasingly difficult to break the nation from these past practices. With the Louisiana Purchase, the United States gained a large portion of land in the Western United States. The Federal Government deemed that new states admitted to the Union through this land would be free from slavery, placing increased pressure on the Southern states that embraced slavery to move toward abolishment. In addition to these aspects, tension began to emerge between the Southern and Northern states regarding slave laws. With laws such as the Compromise of 1850, Federal officials in southern and northern regions were forced to arrest fugitive slaves, or else themselves be arrested or fined (Gienapp 2001). Laws such as this caused tension with Northern individuals that believed these laws violated general human rights. In addition, there existed a growing abolitionist movement of political revolutionaries that s ought to end slavery through protesting and sometimes violent means. These

Picasso's Painting A Disheveled Woman Essay Example | Topics and Well Written Essays - 1500 words

Picasso's Painting A Disheveled Woman - Essay Example The essay "Picasso's Painting A Disheveled Woman" gives detailed information about the important artwork of Pablo Picasso, A disheveled woman. Picasso's Painting, ‘A Disheveled Woman’ was a painting created in 1901. Red, orange and brown background colors are mixed in the paintings background such that it is not possible to discern the color of the dress worn by the woman. Therefore, lines become the fundamental artistic elements that are applied to produce this figure of a woman against the background of mixed colors. The painting has applied black lines that are drawn unevenly bold from the woman’s hair and head, but starts to thin out from the arm regions and approaching the dress frills, which are marked by thinner lines compared to the ones used to draw the body frame of the woman. The painting does not apply straight lines to mark the body frame of the disheveled woman, but rather uses crooked and rugged ones. Additionally, the lines marking the dress and it s frills are also warped, curved and discontinued at certain points. Further, the lines drawn to show the woman’s hair are also rough, irregular and clumped together towards the back neck and around the shoulders, while loosened on the woman’s front regions of the head. According to the Visual Grounded Theory, a comprehensive analysis of a visual object must encompass its context of creation, to the product, its contents, and also its stylistic structures, in order to be able to discern the comprehensive message communicated by the visual image .

Current Events and U.S. Diplomacy Research Paper

Current Events and U.S. Diplomacy - Research Paper Example On entering Afghanistan in the first lime, the U.S. troop focused on overthrowing the governing Taliban, which had provided haven for al-Qaeda. Although the U.S. troop took several years before fully taking control, on entering Afghanistan, they took less than three months and defeated the Taliban. In 2009, the war still continued. Researchers believe that the economy of Pakistan has since then been destabilized. On coming into power, President Obama, through his advisors documented that the destabilization would be one of the countries biggest foreign policy challenge (Scott, 2003). Therefore, Obama committed another 17,000 troops to Afghanistan to increase the number to approximately 55,000 troops. Obama’s commitment into the war has since then seen the war change the name from Afghan war to Obama’s war.U.S. focuses on counter attacking terrorism and promote the stability of the country. Obama’s strategy was to disrupt, dismantle, and conquer al-Qaeda based in Afghanistan and Pakistan (Baker, 2009). It is hopeful that this attack will prevent their return back into the country. Vietnam is another country whose relation is similar to that of Afghanistan as discussed below. Vietnam War, according to historians is arguably a war that caused death many innocent people. As documented by Levy, (2004), this war claimed not less than 2 million people who were civilians, over 200,000 South Vietnamese army troops, over a million soldiers from the north, and approximately 58,000 soldiers from America. Although the communist North eventually defeated South Vietnam, U.S. contributed immensely to end this war through their support to South Vietnam. From the communist perspective, U.S. were to blame for ruining the country. The reason why U.S. was highly blamed was due to the use of herbicides. These herbicides like Agent Orange polluted the Vietnam environment contributing to health hazards. SRV, popularly known as Socialist Republic of Vietnam, was fo rmed by the United Vietnam and its capital set at Hanoi. The relationship that existed between America and the formed SRV was unstable, which caused the U.S. army to react. The two countries (U.S and Vietnam) remained connected due to the concern that U.S. showed to its prisoners who were held in Vietnam during the war. In addition, the Water Scandal contributed significantly to the deterioration of the relation. As a result, communist Vietnam lost trust with U.S. Since U.S. proved persistent, the effects brought about by the post-Vietnam War period impacted U.S. development positively leading to a new world formation. By mid 1990s, there existed no established diplomatic relations. The efforts to have the two countries united seemed unrealizable. However, after creation of Ambassador between the two countries, this dreams seemed close to realization. When this association was introduced, other associations came in and successfully moved forward. For instance, a bilateral trade Agre ement was signed in 2000. Further still, Vietnam was included in the World trade Organization at the start of 2006 (Levy, 2004). Other significant association that occurred during these times was the close visits by senior officials. For instance, the then U.S. president Bill Clinton visited Vietnam in 2000, while the Van Khai, the then prime minister visited US in several occasions in 2005. From 2006, it is evident that the U.S. and Vietnam relation has had a positive turn. In 2007, Nguyen Minh, the Vietnam president visited U.S. for the first time ever

Picasso's Painting A Disheveled Woman Essay Example | Topics and Well Written Essays - 1500 words

Picasso's Painting A Disheveled Woman - Essay Example The essay "Picasso's Painting A Disheveled Woman" gives detailed information about the important artwork of Pablo Picasso, A disheveled woman. Picasso's Painting, ‘A Disheveled Woman’ was a painting created in 1901. Red, orange and brown background colors are mixed in the paintings background such that it is not possible to discern the color of the dress worn by the woman. Therefore, lines become the fundamental artistic elements that are applied to produce this figure of a woman against the background of mixed colors. The painting has applied black lines that are drawn unevenly bold from the woman’s hair and head, but starts to thin out from the arm regions and approaching the dress frills, which are marked by thinner lines compared to the ones used to draw the body frame of the woman. The painting does not apply straight lines to mark the body frame of the disheveled woman, but rather uses crooked and rugged ones. Additionally, the lines marking the dress and it s frills are also warped, curved and discontinued at certain points. Further, the lines drawn to show the woman’s hair are also rough, irregular and clumped together towards the back neck and around the shoulders, while loosened on the woman’s front regions of the head. According to the Visual Grounded Theory, a comprehensive analysis of a visual object must encompass its context of creation, to the product, its contents, and also its stylistic structures, in order to be able to discern the comprehensive message communicated by the visual image .

Advanced Gas-cooled Reactor versus Pressurized Water Reactor debate Essay

Advanced Gas-cooled Reactor versus Pressurized Water Reactor debate - Essay Example On the contrary, the Pressurized Water Reactors are cheaper to maintain, environmentally safe and reliable. This prompted the government to commission the Sizewell B project. Future energy generation considerations are likely to favor the use of renewable sources that are cheaper, and environment friendly. Contents 1.0 Introduction From the 1960s, there was a clarion call to develop nuclear energy in UK with Advanced Gas-Cooled Reactors (AGRs) being the preferred choice. The first prototype of the advanced gas-cooled reactor was developed in 1962, but the first commercial AGR became operational in 1976. Complexities in implementation of the prototype delayed completion of the first AGR commercial plants. Other AGR projects were to be commissioned later in the 70s, and the 80s. However, they faced the same challenge (delayed implantation) compounded with a heavy cost implication. This led to an acrimonious debate about the use of AGR technology to generate electricity, when other econ omically viable means were available. The immense pressure forced the UK government to abandon building AGRs anymore and instead focused on the Pressurized Water Reactors (PWRs). This led to the commissioning of Sizewell B in 1987 to 1995. The PWRs were considered to be cheaper, environmentally safer and more reliable than the AGRs. ... The AGR is designed to use carbon dioxide as a coolant and graphite as a moderator. The AGR is a specifically UK breed of reactor developed, from the design for the very first nuclear reactor, to generate electricity for commercial use, a reactor built at Calder Hall in Cumbria, UK (Breeze, 2005, p. 258). Figure 1: Schematic diagram of an AGR Source: World Nuclear Association There are several advanced gas-cooled reactors built in the UK, but they have been found to be costly to operate. Most of the AGR plants cost more at the completion than it was initially anticipated and no further units of the design are planned. Instead, the last nuclear power plant built in the UK employed a United States PWR design (Breeze, 2005, p. 258). Pressurized water reactors (PWRs) are used in light-water reactor power plants. Although, there are different manufacturers in the United States, the fundamental characteristics of the PWRs are the same: the main coolant brings up steam vapor in the heat exc hanger, known as the steam generator and this steam drives the turbines. Figure 2: Schematic diagram of a PWR Source: Tennessee Valley authority By the 1970s, United Kingdom was the only major Western Europe country yet to adopt the use of light water reactors (LWR) technology to develop. This was a result of a protracted debate between the protagonist of the AGR and the LWR. It was argued that the LWR was unsafe, thus the promotion of AGR usage. The Magnox stations in UK had for a long time been faced with the problems of low volumetric power density, low operating temperatures and low pressures. The time had come to look for an alternative, and well improved design. This led to the development of the advanced gas-cooled reactors.

Hot Cross Bun Formulation

Hot Cross Bun Formulation The purpose of this study is to reflect on the package of care offered to a client and to critically evaluate the evidence base for the model which might be considered best practice for a specific client problem, or issue. This entails identifying a particular clients presenting issues while describing the evidence that is available for a suitable therapeutic approach, or model which would promote best practice. The study will reflect on a client who has been diagnosed with post- traumatic stress disorder (PTSD) as a result of a road traffic accident (RTI) and concentrates on the use of imaginal exposure therapy (IET) for the treatment of symptoms. Triggers and maintenance factors contributing to the clients deteriorating well-being will be explained using formulation as well as the protective and predisposing elements that were explored in therapy. Relevant literature will be cited throughout and appropriate research articles that have been critically reviewed will be discussed. Pre sentation, referencing and informed consent are consistent with the School of Health and Social Cares guidance and have been adhered to throughout this assignment. Introduction PTSD is an anxiety disorder that can develop after exposure to one or more terrifying events, in which grave physical harm occurred or was threatened. It is a severe and ongoing emotional reaction to an extreme psychological trauma. The trauma may involve someones actual death or a threat to the individuals or someone elses life. The PTSD sufferer is affected to a degree that usual psychological defenses are incapable of coping. Reports of battle-associated stress appear as early as the 6th century BC. PTSD-like symptoms have been recognised in many combat veterans in many conflicts since. These symptoms have been called shell shock, traumatic war neurosis, and Post-Traumatic Stress Syndrome (PTSS). The modern understanding of PTSD dates from the 1970s, largely as a result of the problems that were still being experienced by Vietnam veterans. The term Post Traumatic Stress Disorder was coined in the mid-1970s. Early in 1978, the term was used in a working group finding presented to the Committee of Reactive Disorders of the American Psychiatric Association. The term was formally recognised in 1980 in the third edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association. Although a controversial diagnosis when first introduced, PTSD has filled an important gap in psychiatric theory and practice. From an historical perspective, the significant change ushered in by the PTSD concept was the stipulation that the etiological agent was outside the individual him or herself (i.e., the traumatic event) rather than an inherent individual weakness (i.e., a traumatic neurosis). The key to understanding the scientific basis and clinical expression of PTSD is the concept of trauma. DSM-IV-TR criteria for PTSD In 2000, the American Psychiatric Association revised the PTSD diagnostic criteria in the fourth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)(1). Diagnostic criteria for PTSD include a history of exposure to a traumatic event meeting two criteria and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms, and hyper-arousal symptoms. A fifth criterion concerns duration of symptoms and a sixth assesses functioning. PTSD is unique among other psychiatric diagnoses because of the great importance placed upon the etiological agent, the traumatic stressor. In fact, one cannot make a PTSD diagnosis unless the patient has actually met the stressor criterion which means that he or she has been exposed to an historical event that is considered traumatic. Clinical experience with the PTSD diagnosis has shown, however, that there are individual differences regarding the capacity to cope with catastrophic stress so that while some people exposed to traumatic events do not develop PTSD, others go on to develop the full-blown syndrome. Such observations have prompted a recognition that trauma, like pain, is not an external phenomenon that can be completely objectified. Like pain, the traumatic experience is filtered through cognitive and emotional processes before it can be appraised as an extreme threat. Because of individual differences in this appraisal process, different people appear to have different trauma thresholds, some more protected and some more vulnerable to developing clinical symptoms after exposure to extremely stressful situations. Although there is a renewed interest in subjective aspects of traumatic exposure, it must be emphasised that exposure to events such as rape, torture, genocide, and severe war zone stress, are experienced as traumatic events by nearly everyone. The National Institute for Clinical Excellence (NICE) has published guidance to help the National Health Service (NHS) recognise and treat people who develop PTSD after traumatic events. Recommendations include psychological treatment in the form of trauma-focussed cognitive behavioural therapy (CBT) and/or a course of anti-depressant medication while receiving therapy. Trauma-focussed CBT focuses on a persons distressing feelings, thoughts (or cognitions) and behaviour and helps to bring about a positive change. In trauma-focused CBT, the treatment concentrates specifically on the memories, thoughts and feelings that a person has about the traumatic event. Imaginal exposure therapy (IET) is a component of trauma-focused CBT and involves revisiting the traumatic memory or memories in a safe and controlled environment so that the intensity of the individuals anxious and fearful reactions (thoughts, emotions, physical sensations and behaviours) is reduced. Clients are exposed to the trauma memory by repeatedly describing the events of the trauma aloud until the anxiety response is reduced. This process is referred to as habituation. The treatment aims to eventually eliminate the fearful responses so that the client can face a feared situation without experiencing anxiety or fear. The goal IET is to process the trauma memories and to reduce distress and avoidant behaviours that the traumatic memory evokes. CBT, as we know it today, is a result of a group of modern related therapies that have empirical psychological support. There have been two main influences to modern CBT and these are behaviour therapy (BT), as developed by Wolpe, Skinner and others in the 1950s and 1960s and cognitive therapy (CT) as developed by Beck and others in the 1960s and 1970s (Westbrook, et al. 2011, p2). Freudian psychoanalysis had dominated the psycho-therapeutic world since the late 1800s, but in the 1950s, Eysneck and others in the psychological community questioned the lack of empirical evidence to support psychoanalysis. As a result, BT developed within the academic and scientific psychology community, basing its methodology on observable events between stimuli and response. Despite the success of BT, there was still some dissatisfaction with what was seen as the limitations of a purely behavioural approach (Westbrook, et al. 2011, p3). Beck and others were developing ideas about CT as early as the 1950s; these ideas focussed on mental processes such as thoughts, beliefs and our interpretation of events, and continued to maintain an empirical approach to validate its theory to the psychological world (Westbrook, et al. 2011, p3). Although Beck was not the first to link faulty behaviour with irrational thought and unhealthy emotions, his work revolutionised the psychology world a nd continues to be used today. Background to the Client Throughout this assignment the client will be referred to as T. Protecting the clients identity complies with the British Association for Counselling and Psychotherapy (BACP) and the British Association of Cognitive and Behavioural Psychotherapies (BABCP) guidelines regarding client anonymity as described in the Ethical Framework for Good Practice and fulfils the requirements of the Universitys School of Health and Social Cares policy on confidentiality. T was seen in a primary care setting with a counselling service that offers short to medium term therapy for clients over the age of 16 years. She was referred to the service by her GP. She is a 25 year old female who is married with two boys aged 7 and 5 years. She is currently unemployed and lives in social housing with her husband who works in a local factory. T was raised and lived in an area where the 2007 Index of Deprivation (ID2007) indicates deprivation is 110.6% higher than the national average. There is a higher proportion of the working age population claiming incapacity benefit than the County average (Area Action Partnership). T first went to her GP shortly after being released from hospital after an RTA. She was a front seat passenger and received injuries to her face, arms and legs which included severe bruising, cuts and a temporal mandibular joint (TMJ) injury. Three months after the accident T continued to experience nightmares and flashbacks. The GPs letter to the service noted the clients deterioration and the original diagnosis of acute stress disorder (ASD) that had been diagnosed in the first month following the accident was amended to PTSD. Several studies have provided convincing evidence that early CBT treatment of ASD reduces the possibility of the development of PTSD (Moulds, et al. 2009, p16). ASD was introduced into the fourth edition of the diagnostic statistical manual (DSM) in 1994. The diagnostic criteria for ASD (Appendix A) are similar to those of PTSD, but differ in two fundamental areas. Firstly, ASD can only be diagnosed in the first month following the traumatic event and secondly, ASD includes a greater emphasis on dissociative symptoms (American Psychiatric Association, 1994). During their consultation, the GP noted that T had become withdrawn and distanced from her family and friends, she reported feeling like she was watching the world from inside a bell jar, this dissociative symptom is described as derealisation, and is common in ASD patients (Simeon and Abugel, 2006, p86). The GP assessed T using the Patient Health Questionnaire (PHQ 9) and the General Anxiety Disorder Assessment (GAD 7) which resulted in scores of 15 and 19 respectively. These scores indicate that T was suffering with moderate to severe anxiety with depression. T was seen over a period of 13 sessions. The duration of each session lasted between 1 hour and 90 minutes. Longer sessions were included to provide sufficient time for sharing the trauma history and allow time for anxiety levels to decrease (Leahy and Holland, 2000, p197). The contract between the counselling service and T was explained. This included informed consent to tape sessions, confidentiality and its limitations and an evaluation of risk. Evaluation of risk is an important part of the therapeutic process and is done throughout therapy. It involves assessing the client, the environment and also the therapists own personal and professional limitations (Mueller, et al. 2010, p 65). CORE OM was used to calculate a risk score and also to assess Ts suitability for therapy. The Cognitive Therapy Rating Scale as developed by Safran and Segal was not available to the therapist during the first session, but subsequent reviewing of the scale indicated that T was a suitable candidate for cognitive behavioural interventions. CORE OM score is shown below in figure 1. Prior to developing a treatment plan, the therapist socialised the client to CBT explaining the evidence that supported using CBT interventions for PTSD. (Bryant, et al. 1999) and (Westbrook, et al. 2011, p81-83). First session therapist notes detailed Ts past history, the development of problems and the protective factors in her life (Appendix B). T was clear about what she wanted from therapy. Her problems fell into three main areas: (1) Nightmares, poor sleep, anxiety around bedtime, which resulted in an increased irritability with others; (2) Avoiding travelling in any form of transport, which resulted in her relying on others to take her children to school and other social or sporting events; (3) Withdrawing from friends and family, which led to her isolating herself socially. She believed that if she avoided all forms of transport and stayed inside, she would reduce the chances of experiencing any flashbacks or getting very panicky which she found extremely distressing and frig htening. T and the therapist created a Problem and Goal form to capture this information (Appendix C) and agreed to discuss the problems and goals again when the treatment plan was formulated. The specific client issue selected is Post Traumatic Stress Disorder (PTSD). PTSD is defined as a common anxiety disorder that develops after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened (DSM-IV-TR: 463). The DSM-IV-TRs criteria are precisely written as: exposure to a traumatic event, persistent re-experience of the event, avoidance of the stimuli, persistent avoidance of increased arousal, duration of disturbance and impairment of social occupational or other important areas of functioning. Within the criteria there are subsets portraying greater detail of the types of symptoms that may be experienced by the client (Appendix A). T was seen over a period of 13 sessions. The duration of each session lasted between 1 hour and 90 minutes. Longer sessions were included to provide sufficient time for sharing the trauma history and allow time for anxiety levels to decrease (Leahy and Holland, 2000, p197). The contract between the counselling service and T was explained. This included informed consent to tape sessions, confidentiality and its limitations and an evaluation of risk. Evaluation of risk is an important part of the therapeutic process and is done throughout therapy. It involves assessing the client, the environment and also the therapists own personal and professional limitations (Mueller, et al. 2010, p 65). CORE OM was used to calculate a risk score and also to assess Ts suitability for therapy. The Cognitive Therapy Rating Scale as developed by Safran and Segal was not available to the therapist during the first session, but subsequent reviewing of the scale indicated that T was a suitable candidate for cognitive behavioural interventions. CORE OM score is shown below in figure 1. Prior to developing a treatment plan, the therapist socialised the client to CBT explaining the evidence that supported using CBT interventions for ASD. (Bryant, et al. 1999) and (Westbrook, et al. 2011, p81-83). First session therapist notes detailed Ts past history, the development of problems and the protective factors in her life (Appendix B). T was clear about what she wanted from therapy. Her problems fell into three main areas: (1) Nightmares, poor sleep, anxiety around bedtime, which resulted in an increased irritability with others; (2) Avoiding travelling in any form of transport, which resulted in her relying on others to take her children to school and other social or sporting events; (3) Withdrawing from friends and family, which led to her isolating herself socially. She believed that if she avoided all forms of transport and stayed inside, she would reduce the chances of experiencing any flashbacks or getting very panicky which she found extremely distressing and frigh tening. T and the therapist created a Problem and Goal form to capture this information (Appendix C) and agreed to discuss the problems and goals again when the treatment plan was formulated. The therapist asked T if she could recall her most recent experience of a flashback (Figure 2a). T reported that the pattern of events leading to feeling panicked or experiencing a flashback were the same. She would make an effort to do a certain activity, but flashbacks and panic were triggered by (in particular) smells or sounds that could not be avoided. The hot cross bun formulation in figure 2a tracks events from leaving the house, hearing cars and smelling petrol, which was the trigger point. On this occasion T reported having a clear memory of being trapped in the car (which was also her recurring nightmare), she could remember smelling petrol and hearing the screeching of brakes. Her brain misinterpreted these signs for an actual threat, creating distorted thinking: Ive got to get home something terrible is going to happen, hostile emotions; fear, anxiety and terror, unpleasant physiological reaction; heart pounding, shaking, feeling nauseous, which led to her avoidant behavi our to reduce her anxiety and escape her perceived fearful situation. Flashbacks are defined in DSM IV as a recurrence of a memory, feeling, or perceptual experience from the past (American Psychiatric Association,1994). Another example of a flashback involved T sitting in her garden when a neighbour was mowing the lawn with a petrol engine lawn mower. T could smell the petrol and this triggered a flashback to the events of the RTA. The therapist encouraged T to follow the formulation and create her own diagram based on her experience in the garden (Figure 2b). T and the therapist were able to look at both diagrams and see that the pattern was similar. A sound or smell was identified as the trigger in both examples. Her thought process, affect and physiology were similar, but crucially, this led again to her avoidant behaviour. Hot Cross Bun Formulation Event/Trigger: Walking to the shop to buy milk, hearing the cars and smelling petrol Flashback of being trapped in the car Thoughts: Im going to die, Ill never see me children again Ive got to get away from here Ive got to get home, something terrible is going to happen Behaviour: Emotions: Escape the situation Fear Tearful Terror Anxiety Physiology: Heart pounding, Nausea, Tense, Sweating, Shaking Based on Hot Cross Bun (Padesky, 1993) Hot Cross Bun Formulation (originally hand drawn by client) Event/Trigger: Sitting outside in the garden, having a cup of tea Hearing neighbour start up his lawn mower Smelling petrol from the lawn mower Flashback of fear of being burned alive Thoughts: Oh God! Its happening again Ive got to get inside the house. Ill be safe there Behaviour: Emotions: Tearful Fear Needing to get inside the house Terror Anxiety Physiology: Heart pounding, Nausea, Tense, Sweating, Shaking, Based on Hot Cross Bun (Padesky, 1993) T and the therapist discussed the process of recording details in this format and agreed that it gave them both a greater understanding of Ts situation. This collaborative approach is characteristic of CBT and was necessary when working towards a treatment plan for factors that needed to be targeted in therapy and homework setting. Padesky and Greenberger (1995, p6) explain the importance of the client and therapist working as a team, particularly as clients may have an expectation that the therapist is going to fix them. Milton (2009, p104) agrees adding that the therapist also plays the role of a trainer, encouraging the client to become an observer of themselves in order to challenge their thoughts, feelings and beliefs. Westbrook et al (2011, p238) cites Kazantzis et al (2002) in providing evidence of greater improvement in those clients who complete homework. T was keen to monitor any anxiety provoking scenarios at home using the hot cross bun model. She was aware that if her se cond goal was to be achieved (Appendix C) she needed to reduce and eventually eliminate her avoidant behaviour (Wells, 1997, p49-50). A treatment plan was discussed and agreed with T based on her problem list and goals for therapy (Appendix C). The treatment plan included the following elements: Pyscho-Education Grounding and Safety Work Imaginal Exposure Therapy Cognitive Restructuring Relapse Management The session on psycho-education gave T the opportunity to learn about her symptoms, and to recognise and anticipate them for effective management. Fisher, (1999) states that psycho-education is an essential element for stabilising a trauma client. Briere and Scott (2006, p87) agree, adding that psycho-education provides the client with accurate information about the nature of their trauma, which gives them a greater understanding of their situation. Psychoeducation involved justification of use of IET, a history of our learning experience and the fight or flight response. Regular reference was made to the clients formulation so that she could understand how and why her threat response had been activated. Once T understood her anxiety response in relation to her experiences, she felt ready to continue onto the next stage of therapy. Grounding and safety work was completed prior to IET. Herman (1997, p155) argues that the central task of the first phase of trauma therapy must be safety. The client needs to feel safe within themselves; learning grounding and safety skills gives the client the opportunity to manage potential uncontrolled flashbacks. This also formed part of Ts relapse management in the later stages of therapy. Once safety and grounding work was completed, the therapeutic process moved onto the trauma itself using IET. Throughout therapy there were opportunities to explore Ts present situation and past events. This information was initially written down in a mind map format and shared with T during the session. As additional information was gathered in subsequent sessions this was written in longitudinal format (Figure 3). From the information gathered, the client recognised how and why she had always been the rescuer in the family. This included an age inappropriate responsibility when her father had left the family home and T had taken on the role of carer to her distraught mother and siblings. She suffered an emotional breakdown at the age of 14, over whelmed by the pressure of doing well at school so that she could get a good job and support the family. T recognised how this belief system developed after her father left and how it was effecting how she saw herself in the present. During therapy T and the therapist discussed the importance of this belief and how it had allowed her to cope during those years growing up. The therapist asked what purpose this belief served in her life now when she was happy with her family and well supported by her husband. She no longer needed to be the rescuer. T and the therapist explored how this belief may be affecting what was happening to her when she was fearful of having a flashback. T concluded that she needed to add I must always cope to her beliefs in Figure 3 and I cant cope to her thought process. T recognised the contradiction between this thought and her rescuer belief. Longitudinal Formulation Early Experiences 5 years old, Dad leaves family home Oldest of four children, Takes on a helping role Later supports mother through depression Breakdown at school aged 14 years due to self- imposed pressure Met future husband aged 16,Pregnant at 17 years and married at 18 years old Beliefs Its my responsibility to take care of everyone and make things right I must always cope Assumptions and Rules I must be perfect and do everything right, otherwise I will let everyone down If something goes wrong it will be my fault Critical Incident Car Accident Activation of Beliefs Its my responsibility to save everyone Automatic Thoughts I should have got B out of the car. I didnt do everything I could have I failed. I cant cope with this Behavioural Emotions: Avoidance Fear Social withdrawal Anxiety Fearful to go outside Guilt Fearful to travel in any transportation Worry Physiology Poor Sleep Tense Heart Pounding Sweating The goal of IET is to expose the client to the memory of the trauma rather than to relive the trauma itself. Ts therapy involved her retelling the story initially in the past tense and then in the present tense. An important part of the healing process was encouraging T to bring those traumatic memories to mind, in a safe and trusting environment, while remaining in the present. The client learns through repetitive description, that the memory of the event is not dangerous and will also allow habituation to take place (Zayfert and Becker, 2008, p127). T decided that she would record the sessions on the voice recorder section of her mobile phone and listen to the recordings at home as part of her homework. Zayfert and Becker (2008, p130) emphasise how critical listening to the tapes at home is as the repetition is vital if the exposure is going to be successful. The therapist explained that T would be asked to close her eyes and describe the events of that day. Leahy and Holland (2000, p 198) suggest breaking the clients story down into smaller parts if there are a series of traumatic events. T was asked to recall the events of that day in terms of chapters; several chapters were listed (Appendix D). Ts experienced anticipatory anxiety at the thought of retelling the story and this was discussed. The therapist reassured her she would be experiencing the memory, that the RTA was not happening right now and that she was safe in the room and could open her eyes at any time. T began at a point in time when she felt safe and ended the narration at a point in time when again she felt out of danger. The therapist explained the Subjective Units of Distress (SUDS) Rating Scale and then T began narrating her story in the past tense and was allowed to do this uninterrupted; the therapist only intervening to check on Ts anxiety. Ts SUDS score was noted for each chapter (Appendix D col A). At the end of each session, T was given time to process her experience before leaving. T gave the therapist feedback on how she felt sessions had gone, and what, if anything she had learned. The next session involved the client narrating the story, but this time in the present tense. T found this difficult at first and often resumed the past tense. T and the therapist had discussed the likelihood of this happening and T agreed that the therapist would prompt her to return to the present tense. SUDS scores were again noted (Appendix D col B). T reported being surprised at the change in scores from the previous week. There were certain sections of the story that T found very difficult to narrate; these sections were narrated without much detail. After discussing this briefly, T and the therapist listened to the recording of the present tense narration. T recorded SUDS levels herself (Appendix D col C) and once complete, the three SUDS scores were examined and discussed. T noted how scores had both increased and decreased from first narration to second narration, but that all scores had reduced on her first listening to the tape. T was then asked to grade the chapters and chose five (the most anxiety provoking) to work on. The five chapters were listed chronologically (figure 4) and then in order of their anxiety rating (figure 5). For the next five sessions each chapter was narrated and listened to repeatedly until Ts SUDS rating had dropped; starting with the least and working towards the most anxiety provoking. The therapist asked questions relating to the clients senses and emotions and physiology so that her memories were fully activated (Leahy and Holland, 2000, p197). To Ts surprise, narrating in the present tense and sensory questioning produced additional memories that T had not remembered in the previous narrations. Figure 4 Chronological Order 1Â  Car flips over upside down smell of petrol 2Â  Wood coming towards the car 3Â  The car door wont open (Ts recurring nightmare) 4Â  B is not moving 5Â  G is screaming at T to get them out of the car Figure 5 Order of Severity Least to Worst 5 4 3 2 1 Wood coming towards the car Car flips over upside down smell of petrol G is screaming at T to get them out of the car The car door wont open (Ts recurring nightmare) B is not moving The therapist noted the five chapters as hot spots (Figure 6) and asked T what her thoughts were when she brought the scene to mind. These were also noted together with the emotion that went with them. The therapist was able to challenge Ts distorted thoughts through cognitive restructuring which included her rescuer belief that she was somehow responsible for getting everyone out of the car that day. Once SUDS levels had been reduced for all five chapters Appendix E), T was able to say out loud her re-evaluation statement for each chapter accepting and believing it. Fig 6 Re-Evaluation of Peak Experiences Hot Spot Thought Belief Emotion Re-Evaluation The car has flipped Ive survived the crash Fear I did not burn to death. Over onto its top; there but now Im going to burn I did not die, I did survive Is a smell of petrol to death the experience and I am safe now. Its over. THIS IS A FACT Wood from a fence is The wood is going to hit Fear The wood did not hit me or anyone else. Flying towards the car me. Ill never see my boys I did survive the experience. I am safe. again. My children are safe. Its over. THIS IS A FACT The car door wont open. Its not going to open, Terror I was not trapped. I did get out of the car. It just wont budge at all Im trapped. I am not trapped now, I am safe now. Its over. THIS IS A FACT B goes limp and his head Oh my God! B is dead Terror B did not die. He did survive the accident Falls forward He is safe now. Its over. THIS IS A FACT Sister G screams to T to I must break the window. Fear We all got out of the car. We did not die. Get them all out of the car I have to get us all out. We are all safe now and its over. If I dont break the window THIS IS A FACT Were all going to die Outcomes and Personal Reflection Ts post therapy CORE score of 31 (figure 7) represents a mean score of 0.912 (9.12) and falls within the healthy range of the Core measure. As there is a mean difference of over 5, this, according to CORE measurement indicates a clinical and reliable change (CORE ims). Fig. 7 Core OM Results Pre and Post therapy Pre Post Well Being 14 06 Functioning 21 05 Risk 02 00 Problems 42 20 Total 79 31 Ts presentation improved in the finals stages of therapy. Her cuts and bruises had healed well and she was no longer suffering with TMJ. T reported healthier sleeping patterns, but still with occasional dreams. She believed that she had spent so much time listening to her chapter on being trapped in the car that she became fed up of listening to it, rather than it provoking any anxiety. She was able to travel as a passenger in a car, and also to drive the car herself, but did not feel ready to drive on her own in the car. As a result understanding her an

Perceptions of Anomalous Cognition :: Biology Essays Research Papers

Why Psi: Perceptions of Anomalous Cognition Why would I risk the ridicule of my peers to explore a topic as controversial and inflammatory as that which is known as "psi" phenomenon? And more importantly how and why is it relevant to the study of neurobiology? Given the nature of the topic, it may not always be easy to discuss such scientifically or diplomatically. It is my contention; however, that serious review of the scientific evidence, legitimate scientific discourse and funding for research has been seriously impeded because of its controversial nature. And, furthermore, that it is as relevant a topic for investigation as are other methods by which information is perceived by humans. There are some valid reasons for the prejudice that surrounds this topic. Often when one thinks of psi phenomenon some strange themes come to mind such as UFO's and Alien Abductions, ESP, crop circles, Astrology, Ghosts, Mediums, Channeling and Angles. Most of these come under the heading of "paranormal" and are decidedly difficult to examine scientifically. The plethora of information on such subjects that floods the internet is more likely to reference mysticism, faith and spiritually than offer scientific theory or experimental outcomes and I will leave such to those realms. I, therefore, in this paper will not be referring to alien astrologers channeling their horoscopes through mediums who have been abducted. Only the concepts that comprise that which is known as "anomalous cognition will be discussed." Its components are telepathy, clairvoyance, and precognition (1). My first exposure to the term "anomalous cognition" came as a result of my research for this paper. I just had always called it "knowing." Ever since I was a little girl, however, I have been repeatedly told that my experiences were "all in my head." That had been exactly my position also. But what my critics, who included my family members, friends and my husband, really meant was that my experiences existed only in my imagination. They argued, as is commonly believed and sometimes verified, that experiences like mine could be caused by selective or faulty memory, wishful thinking or subliminal clues (2). And for many years, I tried to believe that one of those explanations applied to me. My husband the scientist, engineer and amateur magician has been telling me for years what he believed to be the prevailing opinion about psi within much of the scientific community. The picture was not very flattering.