TIPS & TOPICS
Volume 5, No.10
February 2008

In this issue
— SAVVY
— SKILLS
— SOUL
— STUMP the SHRINK
— SURVEY FEEDBACK
— Until Next Time

In February, many of you celebrated Valentine’s Day, the traditional day on which lovers express their love for each other. So this edition will take a slight twist away from the purely clinical world. Sigmund Freud talked about the need for a balance of love, work and play to be happy, healthy and content. So this month we’re all about —-love.

Also, a huge votes of thanks to the over 125 people who took the time to provide Feedback on my website (and TIPS and TOPICS, TNT). See at the end who are the three winners of the random drawing.

SAVVY

Gary Chapman wrote a not so recent book “The Five Love Languages – How to Express Heartfelt Commitment to Your Mate”. Everyone wants to give and get love. But often the problem is that “message sent” is not the same as “message received”. While Chapman talks about marriage and expressing love, the principles and process is applicable to all relationships.

• Identify your own “love languages” and those of the people to whom you want to express love.

People “speak” different languages of love; what is meaningful to you may be quite different from another’s love language. People express love and receive it in different ways. Here’s Chapman’s list of the five love languages:

* Words of Affirmation
* Quality Time
* Receiving Gifts
* Acts of Service
* Physical Touch

People generally have a primary love language and then secondary languages in order of preference. Take an inventory of influences on you – temperamental, familial, social, and cultural- that accounts for what “speaks’ to you. It is fun and illuminating to recognize which of these five languages are most compelling for you, and which are most important for those we love.

Here is a brief summary of each love language to get you started:

Words of Affirmation
In any language, there are “dialects”, slightly different ways of expressing the same, basic, main language. The language in this instance happens to be Words of Affirmation.

• Verbal compliments and appreciation e.g., “Wow, you look great!”; “Thanks for getting those jobs done. It’s such a relief to get them off the list.”
• Encouraging words e.g., “I really do think you can do it.”; “I’ll support your decision if you go ahead.”
• Kind words e.g., “I felt disappointed and hurt that you didn’t offer to help me” is gentler and kinder than: “Don’t you care enough to help me out? Am I the slave around here?”
• Humble words – “Love makes requests, not demands.” (Chapman, p.48) e.g., “Are you really busy right now? Could you give me a hand so I can get to bed earlier?” is better than: “Do I have to do everything myself? I’ll be up all night at this rate.”

Quality Time

• Giving someone your undivided attention: Quit the multi-tasking e.g., watching TV while someone is trying to share something important; or checking e-mail or the latest sports scores while you’re talking to your loved one on the phone.
• Togetherness – focused attention: “The activity in which we are both engaged is incidental. What is important emotionally is that we are spending focused time with each other.” (Chapman, p.60).
• Quality conversation – “Sympathetic dialogue where two individuals are sharing their experiences, thoughts, feelings, and desires in a friendly, uninterrupted context.” (Chapman. p.61)
• Self-revelation: About what you are thinking and feeling; intimacy (into-me-you-see).
• Quality activities: Anything in which one or both of you has an interest. The emphasis is not on what you are doing, but on why you are doing it.

Receiving Gifts

A gift is something that says “Look, he was thinking of me,” or “She remembered me.” “You must be thinking of someone to give a gift. The gift itself is a symbol of that thought.” (Chapman, p.74.)

• Gifts are visual symbols of love, which are more important to some people than to others.
• Gift giving and receiving involves attitudes about money. Some have a spending orientation and feel good about themselves when spending money; while others feel good about themselves when they are saving money and investing it wisely (Chapman, p.77)
• The gift of self sometimes speaks more loudly than material gifts. The gift of presence means you are there when your loved one needs you – e.g., You may provide the best education to your child, but cannot “find” the time to be at his/her soccer game or music recital.

Acts of Service

This involves doing things you know your loved one would like you to do. In seeking to please them, you serve them to express your love by doing things for them e.g., a neck and head massage after a tense day; putting the toilet seat down when you’d rather not bother; keeping the car in operating condition; walking the dog.

• Acts of service “require thought, planning, time, effort, and energy. If done with a positive spirit, they are indeed expressions of love.” (Chapman, p.88)
• “Requests give direction to love, but demands stop the flow of love” (Chapman, p.92)
• Learning the love language of acts of service will require some of us to reexamine our stereotypes of the roles of men and women .(Chapman, p.99)

Physical Touch

• Babies who are held, hugged, and kissed develop a healthier emotional life than those who are left for long periods of time without physical contact.
• Physical touch communicates emotional love, in the true sense of “making love.”
• “A slap in the face is detrimental to any child, but it is devastating to a child whose primary love language is touch.” (Chapman, p.106)
• “To touch my body is to touch me. To withdraw from my body is to distance yourself from me emotionally” e.g., if a person refuses to shake hands with another, it speaks to something wrong in the relationship. (Chapman, p.107)

Reference:
Chapman, Gary: “The Five Love Languages – How to Express Heartfelt Commitment to Your Mate”. Northfield Publishing, Chicago, 1992

SKILLS

You now have a sketch of what the five love languages encompass. It is worth identifying your primary love language, and how you rate the other languages.

• Identify your primary love language. List the other four in order of importance.

Chapman (p.124-125) suggests three ways to discover your primary love language:

1. What does your spouse, partner, significant other do (or fail to do) that hurts you most deeply? The opposite of what hurts you most is probably your love language.

2. What have you most requested of your spouse, partner or loved one? The thing or behavior you have most often requested is likely what would make you feel most loved.

3. In what way do you regularly express love to your spouse, partner or significant other? Your method of expressing love may be an indication that this is also what would make you feel loved.

If two languages speak equally as loudly to you, “then perhaps you are bilingual.” (Chapman, p.125). This makes it easier for your loved one to “speak” love to you as they now have two main choices.

• Discover your loved one(s) primary love language and the order of importance of the other four languages.

–> First, write down what you think is your loved one’s primary love language, and the other four in order of importance.
–> Next, sit down with your loved one. Discuss what your guesses or assessment revealed.
–> Then tell each other what you consider to be your own primary love language plus the importance (or not) of the remaining four languages.

–> Then Chapman (p.126) suggests that you play a game called “Tank Check” three times a week for the next three weeks:

The game
When you come home, you ask the other to rate their love tank. The first one asks: “On a scale of zero to ten, how is your love tank tonight?” Zero means empty, and 10 means “I am full of love and can’t handle any more.”
You then offer your reading on your emotional love tank – zero to ten – indicating how full it is. Your spouse/partner/significant other says, “What could I do to help fill it?”
You then suggest what you would like the other to do or say to help you fill your love tank.
Reverse the process so both of you have the opportunity to do a reading on your love tank and to make a suggestion toward filling it.

SOUL

Consultants exist whose sole job is to advise companies on how to reward their employees. They provide a broad array of ideas on the kind of prizes, incentives, free vacations, retreats, gift certificates and parties to keep morale and productivity high. Kudos to managements that want to keep employees happy.

In the context of this month’s theme on love languages, it is worth noting that not every employee will “feel the love” in the same way. For some, it may be much more meaningful to be granted flex hours which allows them to telecommute some days; or keep a four day, ten hour schedule so they can spend (Quality Time) with their children and get to the after- school games; or coach the baseball team. That gift of a free vacation with all your work colleagues may not speak to them.

Or, those free in-office neck and back massages once a week (Physical Touch) may be much more appreciated than the Borders Books gift certificate (Receiving Gifts). Your supervisor’s thoughtful, personalized handwritten note on how you particularly excelled this month (Words of Affirmation) may be heard much more loudly than being awarded the CEO’s close-by, prime parking spot, or some other (Act of Service.)

If you know your own love language, as well as those of loved ones, team-mates or supervisees , this can certainly make the home and workplace better environments to be. I can hear Elton John already- “Can you feel the love tonight?” !!

STUMP the SHRINK

Reader’s 1st Question:
I work in a large treatment system and we have mental health services and substance abuse services that are two separate ‘agencies’ under one ‘umbrella’ organization. The agencies generally work together very well and are integrated at some particular programs, but continue to have a lot of policies and procedures that are separate. We are developing a drug testing policy that covers both agencies. Of course, the substance abuse agency has a long- standing policy and practice for drug testing. The mental health agency does not have any. With all that as background, I have a couple of questions that I would appreciate your feedback:

1) There is a proposal for regular (bi-monthly) drug-testing inservice plans for anyone with a Substance Use Disorder. What do you think of this? The discussion is that there should be caveats that would speak to the clients’ psychiatric state at the moment and whether asking for a test would be appropriate (i.e. psychotic, paranoid, etc)

Shrink’s Response:

This is the analogy. A medical doctor manages hypertension by objective measurement of the blood pressure, not relying just on patient self-report. Similarly, if we take a matter-of-fact approach and manage a person’s addiction recovery with urine drug screens, then drug testing is just part of the treatment plan—not a detective or police job trying to catch people. However, if the urine tests positive, you are presented with an opportunity to re-assess and change the treatment plan for this relapse or poor outcome. It is not an occasion for “consequences”, suspension or discharge. We don’t discharge someone for being symptomatic when their blood pressure goes up. And we don’t suspend a client who becomes psychotic or depressed or manic etc.

Reader’s 2nd Question:

2) Some of the resistance from the mental health staff speaks to the impact drug testing, particularly urine testing, would have on the relationship and trust with the clients. Any other feedback and input you could provide would be appreciated. Thanks, in advance, for your time and attention.

Shrink’s Response:

All effective treatment begins with a good working therapeutic alliance. Take for example a client you are helping move into an apartment he really wants, and he understands that abstinence is required. Knowing that he has lost previous good placements because of substance use problems, he recognizes the importance of demonstrating abstinence. Now the drug testing is in the service of the client’s desired goal. It is not unlike helping a person prevent a stroke by monitoring their blood pressure.

Mental health clinicians often deal with a client’s substance use differently from the ‘relapse’ of a mental health problem- e.g. psychosis, depression, cutting behavior. Drug testing is viewed as a police job, trying to catch clients at lying, and hence clinicians’ worry about hurting the relationship. Drug testing should be framed as a lab test to see how well a person’s recovery is working. If the client is initially objecting to drug testing, then the clinician needs to re-visit the therapeutic alliance; and create more buy-in for drug testing to help him/her reach their desired goal. Continuing the housing example: the clinician re-visits the client’s original goal of their own apartment, and how drug testing fits in.

SURVEY FEEDBACK

Last month we asked for your feedback on my website we are planning to totally revamp. We were most impressed with the comments, valuable input, and are appreciative of the 126 + people who responded. Perhaps the incentive prizes helped too! A big thank- you to all who took the time to respond—many of whom clearly invested considerable energy to provide thoughtful feedback and suggestions.

In the interests of transparency, here’s how the winners were selected. Each response was numbered; all 126 pieces of paper were shuffled, mixed and placed in a bowl. Numbers were drawn randomly. If the drawn response was simply a sentence or two in an e-mail, then that number and response was excluded as being non-substantial and ineligible for the drawing. The winners had ‘substantive’ responses.

A Reminder of the Prizes

Prize 1
—> Hazelden’s Clinical Innovators Series “Applying ASAM Placement Criteria” DVD and 104 page Manual with more detail based on the DVD with Continuing Education test (10 CE hrs), 75 minute DVD David Mee- Lee (DVD) and Kathyleen M. Tomlin (DVD manual) valued at $175.

Prize 2 & Prize 3 Each
–> A DVD in production on “Engaging People in Collaborative Treatment”. Winners will be the first to get this when it is finished.

Congratulations to the Survey Winners:
1. Chandler Davis- Oregon
2. James Recktenwald
3. Nhat Minh Nguyen – Virginia
Thanks to all who responded – sorry you couldn’t all win. In March, I’ll share some specific comments and suggestions, plus a glimpse of our plans to adopt some of what you told us.

Until Next Time

I look forward to seeing you in March.

David