Stuttering or Stammering.

Causes (exact cause is unknown) How ever

1. Inherited causes.  Genes play role in development of stuttering. It is thought that people who carry genes for stuttering can develop this disorder some point in life whenever there is circumstances that can lead genes expression like (Stress full life events, mental health issues, anxiety etc.) Pathologically it appears that there is incoordination in the sound producing muscles which interferes with fluency of the longer sentence production. Shorter sentences may be fine like the children at the age between 2-5 years when they learn to make longer sentences like from “Mommy Burger” to “mommy can I have burger too”. Stuttering has associations with low frustration tolerance, (individuals who have this, more often tighten there muscle hence deterioration or worsening of stuttering. Other’s reaction of teasing to stuttering (leading to emotional response like shame, embarrassment, anxiety) which can make it worse.

1. Treatment:  Speech and language therapist teach the persons to control their speech with speaking low and maintain relaxation while talking.  Trying to talk slow and smoothly usually much slower than normal speech.
2. Treatment of underlying mental Health issues like anxiety (Which can make it worse)
3. People who stutter usually are aware of this difficulty. That it takes longer for them to say the sentence. This put them under pressure to say the things rapidly and make it difficult for them to continue speech in smooth way and timely manner. Listeners are usually unsure how to respond to it , this lack of information how to respond, leads listener to do things like they might, look away, or fill in sentences, or interrupt or not to talk to the person at all. They also might get annoyed and become impatient which can make the speech even worse.
4. When talking to people who stutter, it is always advice able to give them time and show them you are relaxed and not bothered by their slow or uneven speech and willing to listen patiently. Not to tell then “slow down a bit” or “take a deep breath” or “Relax” By doing that it only makes it worse.
5. It may not be a bad idea to ask the person who stutters that how would you like me to respond. It will put them at ease and do not talk down or treat them differently. In addition, give them message that listener understands the stuttering and interested to listen.

Disclaimer: All contents on this site are for general information and in no circumstances information be substituted for professional advise from th relevent healthcare professional, Writer does not take responsibilitiy of any damage done by the misuse or use of the information

Depression and addiction: The price some celebrities pay for fame

The death of Robin Williams is another reminder that smiling faces may hide behind serious illnesses. (File photo: Reuters)

When Children should start formal education

1.  It is controversial when Children should start formal education. In 90% of the world countries, it starts between 6-7 years of age, But in Finland formal education starts at age 7 years they have their reasoning behind it. In UK 130 teachers write a letter and educators to the education system advocating to start formal education at age 7 like Finland (Scandinavian countries). Rational behind is it is too soon too much pressure and it can hamper the progress and can create psychological problems in young brain.

However not all children are alike some may be ready earlier than others however individualized assessment and readiness should be taken into consideration. Some nurseries provide paly-based education without formal education until age 6 that seems more reasonable.

Message is :  Too much too early may have negative impact on the developing brain.

1. Parent face dilemma of few months short of admission age. In that case, parent should continue the playgroup approach with young one is having them familiarize the basics of initial year’s education to help them get ready for the formal education.

        2.There are group of educational experts argued in favor of starting the formal education late like in Scandinavian countries. Their reasoning behind is too much too early can influence the growing brain negatively. We do see in the school system not uncommonly the children who are barely making through the initial years develop constant anxiety and  sometime may lead to negative attitude about the school and whole concept of schooling.

A letter written by 130 teachers, academics and authors said the UK should follow the Scandinavian model and put off formal lessons for two years.

Under the UK’s current system, children start full-time schooling at the age of four or five.

Experts say this is causing ‘profound damage’ in a generation which is not encouraged to learn through play.

But the call was last night dismissed by as ‘misguided’ by a spokesman for the Education Secretary Michael Gove.

Children in the UK are obliged by law to be in school aged five, which the lobby group said is creating a ‘too much, too soon’ culture.

The warning singled out recent government proposals which mean five year olds could be formally tested from the beginning of their schooling.

Under the current system, children are first assessed at the age of seven. But under Deputy Prime Minister Nick Clegg’s proposals, a ‘baseline’ test could be introduced in the first year of primary school.

The group of experts warned that monitoring a pupil’s progress from such a young age promotes stress and fear around learning.

http://gulfnews.com/news/world/other-world/special-report-decoding-the-mind-of-a-rapist-1.1124611

“Rape and the Rapist some understandings about the crime.”

1.How can we simplify the psychology of rape? What or how can we define the mind of a rapist?

Answer:     Although Psychology of Rapist is very complex because different mechanisms involve which is poorly understood, however there are two broad views about Rape.

According to psychology theory Rapist has some psychological unresolved conflicts from the child hood ranging from sexual abuse to deprivation and poor relational concept with (female) women, Rapist might have impulse control issue, or sex addictions or having antisocial motives and/or have underlying mental illness.

While according to sociology theory explains the sexual permissiveness in the society is the cause and/or male dominance is somehow expressed through this heinous crime following rejection by a woman. (5% of women and 0.4 % of men experience rape)  (Cross Government Action Plan on Sexual Violence and Abuse www.homeoffice.gov.uk/documents/ Sexual-violence-action-plan)

Often time the Rape victim is to be blamed of not appropriately dressing and making unsafe choices to give the opportunity to the rapist to commit crime ( which is debate able)

2. Could you list tell-tale signs on how to identify a rapist? Do they have a pattern? Can rape be impulsive? Sexual abuse amounting rape in majority of cases is not the strnger.

Answer:      Rapist could be Known (family friend, acquaintances, neighbor and worst case scenario father or brother or strangers could be any one and very difficult to identify).

However commonly Rapist has lots of social problems, full of anger and hattered and may have been victim of sexual abuse during childhood.  Drug addict and sudden angry out bursts put someone at higher risk.

Rapist can have Impulse control issues combined with antisocial element and cannot resist sexual impulses.

Sexual abuse amounting to rape majority of time is by the known person who knows the victim.  Someone might have unresolved psychological conflict relating the female, sexual satisfaction non availability, anger and frustration of being abused at some point in life, revenge feeling toward the society or the victim and family etc.

3. Can rapists be categorized? Are there many kinds of rapists (based on differing degrees of violence or torture involved)?

Answer: It is very hard to categorize the Rapist. Old myth that Rapist will look certain way or will have big scar on the cheek is not true. Rapist can be a person sitting next to you in the class, or Cinema Theater or mopping in the corridor quietly.

Different rape categories are   Date Rape, Marital Rape, Drug Rape, incest rape, rape by pedophile. Rape at isolated places, Rape by serial rapist.

4. Can a common man be triggered to rape? What are the potential triggers? Is being angry at a woman and being unable to express the anger a trigger?

Answer:     As study shows it is very difficult to segregate the rapist from the law abiding citizen. However psychologically disturbed person loner or having few/none friends having under lying mental illness, being sexually abused put someone at higher risk to be the perpetrator. Revenge rapes have been reported in the media but are unpredictable and is usually associated with antisocial behavior.

5. How would you explain the psyche of a man who has no criminal record, is a normal person and has no violent streak and yet rapes a relative?

Answer:  Isolated introverted usually single male who usually fantasize sexual act with the known victim reach to the point where cannot resist the impulses to act on.

6. While a common man/woman may see rape as an act of brutality or sheer terror, how would a rapist see rape?

Rapist are different types as mentioned above they probably view the rape victim as sex object ( as rapist may have been abused by himself and see this an opportunity to reenact his impulses), as weak member of the society who cannot defend themselves, isolated psychologically disturbed men act impulsively to satisfy his sexual frustration in heinous way.

Rape is significantly under reported even in the very open societies. Nobody is immune to it and general safety precautions and helpful hints to avoid this, should be learned and practiced.

Few tips to help avoiding Rape:

Rapist is usually introverted and use isolated places.

Avoid passing through unfamiliar less crowded place at late hours alone, if you happen  to be in the situation wait until crowed of people come and then go through, like empty bus stands, train stations or other public places late hours.

Never answer  the door bell if alone at home and stranger is at the door, don’t be brave call the police.

In case of outside and being trapped in isolated place and feels threatened or intimidated by stranger lock yourself in the car and turn the car alarm, it will bring people’s attention.

In case of date rape or incest Rape kick the perpetrator hard in the groin will give you some time to escape and run to the crowded area for help.

If you are trapped with perpetrator in an isolated place scream as hard as you can to bring some bodies attention for help and frustrate the rapist.

Rape has huge impact on the victims mind and lasting effect. Rape victim can suffer from PTSD ( Post traumatic stress disorder) Panic Disorder and/or other anxiety disorders, Victim can feel every men as rapist or becomes emotionally numb and lose confidence in all important areas of life. If it start interfering with occupational, educational and social or other important areas of life seek Professional help immediately.

It is a condition of dysfunction or structural damage in bodily organs through inappropriate activation of the involuntary (Autonomic) nervous system and glands of internal secretion.

Psychosomatic Illness

A disorder that involves both mind and body is called a psychosomatic illness. In other words, the illness may be emotional or mental in origin but have physical symptoms. Psychosomatic illnesses are not imaginary. They are physical disorders in which both emotions and thought patterns are believed to play a central role, and usually develop when a person’s disease-fighting ability is weakened due to stress. After a particularly stressful event, like the loss of a loved one, for example, an individual might develop high blood pressure shortly afterward or even have a heart attack. In another person, the same situation might lead to a peptic ulcer or a series of asthma attacks. A third individual, equally as grief-stricken, might not get sick at all. For a psychosomatic illness to occur, a person must first be vulnerable in a particular body system. It’s important for these illnesses to be recognized and treated as soon as they occur.

Mental conditions either can cause or can make the physical illness worse.

Psycho- Physiological disorders.

• Skin disorders  ( Eczema, skin pigmentation, etc)
• Musculoskeletal disorders ( Aches and pains, etc)
• Respiratory disorders ( Asthma, Atopy, Etc)
• Cardiovascular disorders (Heart condition, etc)
• Genitourinary disorders ( frequency, urgency, etc)
• Endocrine disorders ( Thyroid, Diabetes, etc)
• Disorders of organ of special sense – Chronic conjunctivitis
• Disorder of other types – Disturbances in the nervous system in which emotional factors play a significant role, such as multiple sclerosis

Hypochondriasis

It is  “Unrealistic preoccupation with a fear or believe (non delusional) of having a serious disease based on the individual interpretation of physical signs or sensations as evidenced by the physical illness. In addition appropriate physical evaluation does not support the diagnosis of any physical disorder which can account for the physical signs or sensations or for the individual’s unrealistic interpretation of them. The fear of having, or belief that one has a disease, persists despite sufficient explanation and medical reassurance.”

It Occurs between age 20-30 and affect both sex equally and Diagnostic Criteria require it should last for  6 months

Somatoform Disorders.

Classification of Somatoform disorder and dissociative disorders

Differentiating points between Somatizations disorder and Physical illness

1-    Involvement of multiple organ systems

2-    Early onset and chronic course without development of physical signs and structural abnormalities.

3-    Absence of Characteristic Laboratory abnormalities of the suggested physical disorder.

• Describe symptoms in dramatic and emotional terms
• Seek care from more than one physician at the same time
• Describe symptoms in vague terms
• Lack signs of defined medical illness
• Have complaints that medical tests fail to support

People with somatization disorder do get diagnosable medical illness too It is very important to  R/O Actual physical disorder.

To measure stress according to the Holmes and Rahe Stress Scale, the number of “Life Change Units” that apply to events in the past year of an individual’s life are added and the final score will give a rough estimate of how stress affects health.

Score of 300+: At risk of illness.

Score of 150-299+: Risk of illness is moderate (reduced by 30% from the above risk).

Score of 150-: Only have a slight risk of illness.

• By Janice Ponce de Leon, Staff Reporter
• Published: 21:09 August 11, 2012
• 

• Image Credit: Ahmed Ramzan/Gulf News
• The child was said to be hyperactive and his school expelled him.

The survey in Sharjah asked 193 Emirati pupils aged 11 and 12 what they thought was their exposure to various types of abuse.

The most significant finding was that more than 40 per cent said that they felt neglected, said the researcher Ahmad Alomosh, professor of applied sociology at the University of Sharjah.

But Dr Muhammad Tahir, the head of psychiatry at Health Call Clinic in Dubai, said it was important to remember that the survey gathered children’s impressions.

To read this complete article, follow this link:

http://www.thenational.ae/news/uae-news/emirati-children-say-they-feel-neglected

During Ramadan a Muslim Holy Month every year brings overhauling of the physical and mantel health systems.

1)      This is month of training to have good habit of generously giving; taking care of people around us and more giving is more taking. As research has shown that giving away gives sense of well being “ In one study mentioned Charity, as giving a feeling of high to a person who do charity”

Medical Health benefits an added benefits to spiritual gains

2)      Fasting produce more endorphin which gives us good feeling.

3)      Fasting cause help burn the cholesterol and have positive effect on physical health.

4)      Spending more time in prayer, (burning extra Calories and shedding extra pounds) self reflection and helps us keep focused on the greater good.

5)      Spending time in night prayers is good physical (Isotonic and isometric exercise which involves almost every muscle of the body) exercise in addition to peace and tranquility brought about by the prayer. (Meditation).

6)      Sujood ( prostration, helps maintain healthy blood flow to brain, facial muscles, eyes, ears etc, and drains out the secretions from sinuses and lungs),

7)      Hunger during fasting gives feeling of rejuvenation and extends life expectancy.(A slower metabolic rate, more efficient protein production, improved immune system, and the increased production of beneficial  hormones contributes to the long-term benefits of fasting)

8)      Early AM eating (Suhoor has added benefit of, lowering lipid level, give rest to the digestive system during fasting and helps weight management)

9)      During Fasting energy is diverted from the digestive system toward metabolic process which helps in healing and improving immune system.

10)  Detoxification process is enhanced during the fasting. In the Liver, Kidney, Colon, Lungs, Lymph glands and Skin the detoxification process is actively precipitated during this time.

11)  During fasting process of autolysis help breakdown body’s own fat to use own energy resources in the absence of incoming food nutrients.

12)  Physiologic effect of fasting includes lowering the blood sugar, lowering the cholesterol and lowering the blood pressure.

13)  Slight dehydration leads to water conservation has shown improving longevity of life in plants.

In 1994 the first International Congress on “Health and Ramadan” held in Casablanca, entered 50 extensive studies on the medical ethics of fasting. While improvement in many medical conditions was noted; however, in no way did fasting worsen any patients’ health or their baseline medical condition. On the other hand, patients who are suffering from severe diseases, whether type I diabetes or coronary artery disease, kidney stones, etc., are exempt from fasting and should not be allowed to fast as such.

Psychological and mental health benefits.

A)    Fasting helps attain mental and emotional well being.

B)    Taking time to contemplate the life events and try to streamline in good way.

C)    Spending more time with family and loved ones (due to short work day) when ordinarily it may not be possible otherwise.

D)    Refraining from useless harmful leisure activities.

E)     Fasting result in many mental health benefits, helping us learn patience and trains us to be more understanding and empathic toward others.

F)     Upbeat sense of giving away, love and affections throughout the month which ends with EID is a bonus factors in terms of bringing social sects together and breed loving and caring society.

G)    Zakat (compulsory Tex on savings to give to the poor member of the society) is organized way of doing Charity, is more likely given during this month further enhance the value of friendship and caring among the members of the society.

H)    Help maintain equilibrium and healthy economic balance.

I)       Days spent in fasting and night in prayer helps us keep focused and learn the skill of patience and being tolerant.

J)       In present day life usually we tend to over eat normally, socially or as in business gatherings, during this month it gives us break and helps us refrain from putting extra pounds hence improve feeling of wellbeing and self esteem.

K)    Usually in present day life we rush for everything and try to do many things in given time and keep our self at the edge which can have negative effect on our body and mind. Like excessive hurry can lead to keep our body in always emergency mode and in this mode body produces excessive Corticosteroids to provide extra energy/benefit to deal with emergency situation, If this become chronic and protracted state, it can lead to many negative effect on body like increased sugar levels in blood, increased blood pressure, and on mind excessive stressful, overwhelming feeling and can even lead to anxiety feelings, etc if prolonged.

L)     Ramadan gives us break from this kind of routine stress by many different ways.

M)   Each year adds on the skills of above training, it can become part of our nature and can help us function one step higher year after year.

N)    During this month generally people avoid indulging in even minor sinful activities, which has positive effect on our conscience and self confidence.

O)    Truth of belief, Patience, Honesty, and helping others is the goal during this time.

P)     It helps attain “Desire, strength and will power”

However things needs to be aware of

1#Healthy eating and keeping balanced diet as well as trying to avoid overeating while breaking the fast is important as well.

(General concept of eating less than full stomach is the key to healthy eating)

2# Drinking water before eating has an enormous value.

3# Avoid excessive dehydration especially in hot weather. Like covering head, staying indoor as much as possible.

4# Exposure to heat leads to excessive loss of water and electrolyte contents in the body by perspiration, sweating and through breathing.

5# which can also takes away salts from the body which can be substituted at breaking the fast with balanced electrolyte drinks. (Like optimum amount, salt lemon drink, diluted milk with salt drink, LABAN, etc)

This is just a brief summary of benefits of fasting (Ramadan), actual benefits are monumental beyond comprehension, some of which have proven by science others still needs to be known.

Given an example of glass being half full or half empty.
Modern day life stress can impact life to varying degrees to the point it can
cloud realistic thinking. When under severe stress people think negatively and feel
anxious about unnecessary worries. But when stress is over this can be replaced
with usual self of realistic optimistic thinking approach. However in certain
vulnerable cases where stress is severe or prolonged with multiple negative life
events this may not happen. It can lead to continuous negative thinking which
can affect emotional well being, affect behavior and can lead to further
deterioration in work performance. Hypothesis is when somebody feels depressed
negative thinking becomes severe and at all the time, like NEGATIVE VIEW OF SELF,
NEGATIVE VIEW OF THE WORLD AND NEGATIVE VIEW OF FUTURE. Cognitive Behavior therapy
is based on this hypothesis of negative thinking process and helps to replace it with
positive thinking and can result in the improvement in feelings, emotions and
performance.

Following exercise may be helpful in this regard. Whenever there
is situation which leads to negative thinking and gives rise to the sadness or
anxious emotions and leads to the automatic negative thoughts (pessimistic
thoughts). If at that time someone try to take a step back and try to think
realistically and with rational approach, the feeling of sadness or anxiety
might decrease and help the person feel better.

Now having knowledge of this is great, but when somebody
fall in negative thinking cycle it is hard to think rationally and
realistically. How ever with practice some one can learn skills to do that
while under severe stress and still can think optimistically and positively.

If still you can not do it yourself ask the help of
therapist who can help learn the skill and be helpful in future situations.

For someone’s New years resolution can be of learning this
skills and make difference in life.

Should you need additional information or would like to make an appointment with Dr. Tahir, ( Child and Adult Psychiatrist)  E-Mail us at stahirmd@yahoo.com.

What Is stigma: When somebody is viewed by others as having deficiencies and is inferior in certain regards, and people has stereotyped view about him. People having mental illness especially chronic and severe form usually notice by verbal and non verbal gestures of others and this seems to be a major hindrance in sharing information and seeking treatment. Which in turn leads to further deterioration in their condition.

Physical illness somehow is viewed differently and gets lots of acceptance and support from family friends and society, however mental illness unfortunately carry prejudice, which is being noticed by the sufferer overtly or covertly and hence develop feelings against sharing such information.

There is a great need to develop awareness about the pschological issues and knowledge that there is affective treatment available which can bring a positive change in life and hence productivity for the family and society at large.

Should you need additional information or would like to make an appointment with Dr. Tahir,E-Mail us at stahirmd@yahoo.com.