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When you are in a confrontational conversation be sure to remember the five golden rules.

1. Iron clad statements and absolutes are not good ideas
   1. “I know“
   2. Always
   3. Never
   4. Won’t
2. Conditional statements are more effective
   1. In my judgement
   2. I think
   3. In my opinion
   4. It is my belief
   5. The rule/policy indicates
3. Avoid the use of slang. Slang indicates a loss of control.
4. Use clear, simple, reasonable directives.
   1. Stop
   2. You
   3. Here
   4. There
      1. Emphasize the directive with a firm gesture.
5. Threats are counter productive
   1. Identify the offensive behavior that needs to stop.
   2. State the penalty
   3. Enforce the penalty no matter what

You may also give some thought to your personal presence. There are some fields of thought which indicate that for every 10 pounds a person is overweight their presence or stature is reduced 10%. So, if two persons were of equal height and one was 40 pounds overweight that person would present a 40% less commanding figure than the leaner of the two.

I’ve been working for many years in the field of behavior disorders and emotional disturbances. The aspect that most captures the attention of most people is confrontational behavior. The odd thing is, I see so much of it that I don’t notice it that much. That is bad. When you lose too much sensitivity to an issue you run the risk of being less effective in teaching better replacement behaviors.

Occasionally, I take time to review the precepts and thus reoriented myself to the key issues. As it is time for my self reflection I am sharing the exercise with you so that you may gain some insight into the issue.

Finally, I must often remind myself that confrontation in and of itself is not a maladaptive behavior.

First, what are the reasons some do not react in a confrontational manner to severe stressors?

• fear of rejection
• fear of consequences
• fear of losing control

Next, what are down fall areas of a lack of confrontation skills.

• uncontrolled outbursts
• emotionally damage
• altered sense of reality
• public failure

Who are those who are successful with the skills of confrontational behavior.

• diplomats
• leaders
• business persons

How can confrontational behaviors be utelized in a positive manner.

Before Confrontation the individual must engage in Introspection.

• why are you upset
• what do you desire
• what is the root

During confrontation the individual must maintain respect for the other party.

• time and place
• one to one
• calm
• mutual purpose
• body language

After confrontation defined actions must be put in place.

• agreement
• follow up

If you have read much of my work you will know I am not a huge Dr. Phil fan. It’s not that I hate the guy or anything. I just don’t feel his “get over it!” philosophy of counseling is the best choice for every situation.

But, I have to admit when it comes to putting a success strategy into words he has some really original ideas (or does he?). When I looked more deeply into the statements they began to ring some familiar bell in my subconscious. I couldn’t really put my finger on it until I was preparing a seminar for some education professionals and I decided to brush up on my Stephen Covey.

Well, you be the judge.

Dr. Phil: Have a vision. Champions get what they want because they know what they want.

Stephen Covey: Begin with the end in mind. Formulate a personal vision statement.

Probably just a coincidence, right?

Dr. Phil: Make a strategy. People who consistently win have a clear and thoughtful strategy.

Stephen Covey: Put first things first. A framework for prioritizing work to achieve long and short term goals.

Well, I mean that one was pretty obvious in the first place.

Dr. Phil: Find a passion.  Be passionately invested in both the journey and the goal.

Stephen Covey: Sharpen the saw. Seek balanced self satisfaction. Remain productive by engaging in related recreational activities.

Uhm… well I’m sure Dr. Phil will have an original thought on this next one.

Dr. Phil: Live the truth. Winners hold themselves to high realistic expectations.

Stephen Covey: Synergize. The whole is greater than the sum of its parts.

Man. Maybe I should just “Get Over It!” and stop obsessing about this thing.

What is the difference between Behavior Consulting and Counseling? It is kind of like looking at the difference between secular and faith based counseling. In fact, there was no differentiation between secular and faith based counseling and behavioral coaching until the 1800’s. Up until that point all three fell into the pervue of the church. The clergy took on the daunting task of bringing hope, counsel and guidance to those who were in need. Medical doctors took on the physical domain and the two didn’t disparage one another.

I. Faith Based Counseling and Secular Counseling.

In the early history of the Church, the Church itself was solely responsible for the counseling of people. As society grew the perception developed that the Christian Community was no longer qualified to counsel its people. As a result, the secular community has all but taken over the responsibility of counseling and behavior modification.

II. Contrasting Faith Based and Secular Counseling

A. Secular Counselor = Agent of the State = Insurance Coverage May Apply

Precepts

1. Everyone has problems; you must learn to live with it. These strategies may help.
2. Human behavior is based on millions of years of evolution. You must continue to evolve emotionally.
3. Self is most important; as long as you do not infringe upon the self of others do what you need to be happy.
4. The problems of self can often be traced to the behaviors of others.

B. Faith Based = Agent of the Church = Fees are often a sliding scale and insurance coverage may not apply.

Precepts

1. Cast off your sins; Christ, the perfect sacrifice has paid the price.

2. God created each of us with a specific temperament. Fighteing your temperament creates disharomony in your sense of well being.

3. God is most important. True happiness is accessible through our proper duty to Him.

4. Face (confess) and accept the consequences (repent) of your actions.

III. Faith based view.

God created us with three areas of need (Inclusion, Control, and Affection) which we may meet through His service.

Inclusion

The need to initiate and maintain surface relationships.

The need to be approached by others for surface relationships.

Control

The need to be in control of relationships with others.

The need for others to control our relationships and behaviors.

Affection

The need to establish love and affection relationships with others.

The need to receive love and affection from others.

IV. The Five Temperament Types. Faith based view.

1. The Melancholy - Forever examining their own shortcomings.

2. The Choleric - Confident and task oriented.

3. The Sanguine - Extremely socially active.

4. The Supine - Quintessential servant ever placing the needs of others first.

5. The Plegmatic - Extremely deliberate perfectionist.

V. So What?

Temperament is an extremely important factor to consider when:

1. Finding compatible career.

2. Finding hobbies that bring the most satisfaction.

3. Making decisions and undertaking responsibilities.

4. Choosing your level of dependence or independence.

5. Charting our spiritual development.

6. Choosing and understanding our mate.

I’m about to share some very personal information with you. While you are reading you may find your self saying, “Careful Reg, your melancholy is showing.”

I will start off by telling you that Hospice has been called in to assist with my mother. If you don’t know about Hospice they are a health care organization that specializes in providing services to patients with “life limiting” illnesses. Hospice concentrates on quality of life rather than quantity. In fact, they have a good website which answers questions about their organization much more completely than I could (Hospice).

I appreciate the organization very much.

That being said, I must wander what series of cultural events lead to a situation when the matriarch of a family with eight children needs outside assistance from an organization like Hospice.

It seems to me that not long ago (was it so long ago?) my family existed in the form of a tribe-like clan. Generations of us lived and died in the Appalachian mountains of West Virginia and wherever there was one in need many were there to provide for that need. I remember aunts and uncles and cousins and nephews and nieces in abundance. In fact, the connections were so interwoven that I could not mis-behave at elementary school without the consequence of receiving less that three scoldings or spankings before I completed my walk home at the end of the day.

And yet, now my mother needs the support of a benevolent organization.

The questions screams out to be asked, “Reg, why don’t you take care of your mother?” And the unsatisfying answer is, I am simply too far away. It is a six hour drive from my home and work to where my mother is. No less than three states must be traversed in order for me to reach her. And, sadly, in America, this seems to be the norm.

There have been profound changes in the way American families structure and maintain themselves - and sometimes deconstruct - and those changes have had a profound effect on how our elders spend their declining years. Few adults have had the luxury or good fortune of being able to find and develop gainful employment in the locality in which they grew up. We have found that as a people in order to better ourselves (or in current economic conditions) maintain our standard of living we must be willing to relocate and with relative frequency.

I will again use my own personal experiences as an example. In the small West Virgina community in which I grew up industry had long since moved on. Farming became the marker of a bygone era and drift mining gave way to less expensive strip mining which required a much smaller workforce. The population there has been in a steady decline for generations. As a result I sought out a teaching position in a community some distance away yet within the same state. After several years it became clear that the population there was ebbing and I sought out another position in Florida. After several years there the economic ebb and flow adjusted and I found myself relocating to North Carolina, and it seems I may be moving yet again very soon.

What has this microcosm of my personal experiences to do with the phenomena? Simply this, you can duplicate my experiences with nearly every professional you know. Poll the local public school to find out how many are native to the area. You will be surprised at the result.

As a result many of our parents are “cast adrift” in their time of need.

Here are my struggles. I hope sharing them may prepare you in case you ever find yourself facing this situation.

I had difficulty accepting my feelings. My mother was once a very quick mind. Alzheimer’s and Dementia have robbed her of this. The realization of this is very heavy.

I had difficulty discussing things with others. I experienced a high reluctance to ask enough questions to have a clear understanding of the situation at hand.

There were some mistakes I did not make. I never did things that would undermine my mother’s independence or sense of self confidence. I didn’t make promises I couldn’t keep.

What are your plans for your aging parent? Or, what plans have you made to face you elder years?

In the rurals of West Virginia someone who was useless for work during the day due to their drinking habits at night was said to be guilty of “consorting with dead soldiers.” Dead soldiers being the common term for a pile of empty beer bottles or cans.

In a community where the economy is marginal and depression surpasses the national norm, this is a more common phenomena than you might imagine.

As a tertiary result one of the most needed strengths for a counselor is in the area of drug and alcohol abuse; and such was a considerable component in my doctoral program.

Unfortunately, many with this self medicating addiction don’t want counseling. They want a cure for their hangover. And, if you want to make headway in getting the trust of these persons, so that you might be able to later actually counsel them, it is a good thing to have some of these “cures” in your repertoire. I don’t guarantee any to work.

Five Cures

1. Eat a banana. It settles the stomach and is almost as smooth coming back up as it was going down.
2. Aspirin and peppermint. Peppermint soothes and protects the stomach while the aspirin works on the headache.
3. Tomato Juice. It contains a lot of simple sugar (fructose I believe) that helps the body metabolize the alcohol.
4. Caffeine free Coke. The bubbles soothe the nausea and the sugar will make you a little more lively. Plus you’ll avoid the caffeine of regular coke which can act as a diuretic, something you really don’t want to deal with at this point.
5. Counter Attack with Toast Soldiers. Toast cut into 2 inch strips is perfect for dipping into a soft boiled egg. This is an excellent and nutritive, restorative for to counteract the previous evenings “dead soldiers.”

But, here is the greatest strategy of all, DON’T DRINK.

Alcoholism is serious, alcoholism is real, alcoholism is dangerous, alcoholism is treatable.
If you know (or are) someone who needs help, try these resources.
AA
Resource center
Hotline

Em Shui © Reg Adkins

It will not come as a surprise to you that temperament counseling which relies understanding the underlying needs for each person and Feng Shui which relies on a understanding of the underlying impact of the arrangement of the physical elements or your life are very complimentary concepts. They both concentrate on concepts of control, inclusion and affection (emotional energy). Here are some points that might help your arrange your most conducive environment.

You most powerful work area is probably on a North West slope with the strength of a fence or better yet, a mountain at your back and your dog at your side. Since this ideal is not easily achieved in our culture, here are a few nudges that will enhance the essential feeling of your office or work space.

Choose the corner that is furthest from your entrance for your desk. You will then be in a position to control your work which enhances your confidence.

Adjust the placement of your seat so that it doesn’t directly face the door. It is always preferable to introduce energies from a slightly oblique angle to allow you time to absorb and process. Placement directly in front of the door is like leaving a forest and abruptly encountering a rock face.

In fact, you should soften any abrupt structural intrusions into your space by adding a muting natural decoration. Consider a hanging plant or an artifact of Native American art.

Place your back to a wall so that you may bolster your own strength with the support it provides. Corner seating allows you to tap the strength of two walls.

If you must choose to sit with your back to a window make sure there is a substantial and tall structure (think mountain) there.

Face in the general direction of the door when conducting business. This symbolism will help you remain open to possibilities.

Make certain to arrange your workspace so that you are not facing exits, stairwells, or closets. These will subconsciously call your mind to leaving and unused resources.

Facing the softer natural light in the North and West will boost your creativity. Facing the more harsh brightness of the South and East will sharpen your mind for figures and logistical concerns.

Be certain to vary the accouterments of your space to display the best of both light and dark colors, soft and hard surfaces and smooth and rough textures. These subtle incorporation’s will nudge your mind away from restlessness and distraction.

Mirrors create distraction and anxiety. They leach away your control of the environment. Keep them away from your work area.

Your documents represent hours of your work and as such much of what you value is contained within them. Keep them orderly and well maintained like your mind.

Clutter on your desk makes you feel confined and restricts the flow of your mind. The tools on your desk should enhance your ability to work and not overpower your workspace. The same holds true for the arrangement of your entire office.

Elemental Value Added Truth:In a 1984 issue of Science, Roger S. Ulrich, PhD, of Texas A&M University reported results from a pivotal study on health care design. He found that patients whose windows looked onto a green landscape had shorter postoperative stays, took fewer pain medications, and received fewer negative medical evaluations…

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Snake oil 

Bad temperament counseling is a branch of bad counseling. It should be easy to identify bad temperament counseling from good counseling but it isn’t. The problem is smooth words can interfere with our ability to discern good information from bad information.

How many charlatans have there been? Over the years many have taken advantage of many more by manipulating the need for good counsel of those who had that need.

Are the following on your list?

• tea leaves
• phrenologists
• astrologers
• tarot readers
• bone throwers

Not even those who are supposedly credentialed providers are above pressing their influence over those in need. What about the famous Dr. Lichtman who bilked insurance companies out of over $3 million in 1996?

There are a few signs to be alert for when consulting a temperament (or any other) counselor.

• promises to find an absolute solution
• treatment plans that last for years rather than weeks
• counselors who begin session without an analysis
• counselors who offer you solutions to some one elses behaviors

What are the signs of a “Good” Temperament counselor?

• Someone who takes a full case history beforebegining counseling
• Someone who conducts a temperament analysis before begining counseling.
• Someone who talks in terms of meeting the following needs in a appropriate manner
  • Affection
  • Control
  • Inclusion
• Someone who speaks to you about help in 10 sessions or less rather than in years of therapy.
• Someone who has a strong faith basis for their practice.

Keep in mind the field of counseling is no more immune to bad apples than those of law, or medicine.

Just a few resources looking at counseling services online. As you can see, even though this is by no means an exhaustive list, it is fairly extensive.

If you would like to contribute to the usefulness of this resource you can do so by reporting any outdated or broken links in the comments section.

I have recently worked through the list down to the Telepsychiatry section. If you want to help, that would be a great place to start.

• ABC’s of Internet Therapy
• International Society for Mental Health Online (ISMHO)
• Psychotechnology Online
• NetPsychology
• University of Notre Dame Counseling Center Outreach and Web proposal (Wendy Settle):
• Risks and Benefits of Online Psychotherapeutic Interventions
• Standards for the Ethical Practice of WebCounseling
• Computer assisted therapy, A Guide
• Services by Telephone, Teleconferencing, and Internet:
• University of Chicago Department of Psychiatry
• Grand Rounds on the Internet
• Student Counseling and Resource Service
• Student Counseling Virtual Pamphlet Collection

Comprehensive

•  
  • Internet Mental Health
  • Mental Health InfoSource
  • Mental Health Net
  • Mental Health Resources, About.com
  • Drugs, Brains & Behavior
  • Merck Manual
  • Behavioral Healthcare Resources on the Web, Myron Pulier
  • Depression Central, Ivan Goldberg
  • Medical Matrix, Gary Malet et al.
  • Neuropsychology Central, Jeff Browndyke
  • Neurosciences on the Internet, Neil Busis
  • Psicoenlaces, José Gutiérrez Maldonado
  • PsychNet-UK
  • Help is at Hand, RCP
  • Publications for Patients and the General Public, NIMH

Focused Content

• Adverse Drug Reactions, FDA
• Algorithms, Harvard
• Antidepressants, SSRI, Preskorn
• Behavior OnLine
• Best Psychiatrists for People with Mood Disorders
• Bipolar Disorder, Pendulum
• Borderline Personality Disorder Sanctuary
• Brainstorms, J of Clinical Psychiatry
• Center for On-Line Addiction
• Child Abuse, Mandatory Reporting
• Cochrane Collaboration
• Depression, Outpatient Management, Preskorn
• Drug Interactions, Flockhart
• Drug Interactions, Grapefruit Juice
• DSM-IV Diagnoses and Criteria
• Ethics, Psychology
• False Memory Syndrome
• Food Composition, USDA
• Freud, Conflict & Culture, Library of Congress
• Freud, Psychopathology of Everyday Life
• Gabapentin and Mood Disorders
• Guidelines, Expert Consensus
• Health Insurance Portability and Accountability Act
• ICD-9-CM
• Illicit Drugs
• Importing Medicine, FDA
• Importing Medicine, Travel, FDA
• Interpretation of Dreams
• C.G. Jung
• Legal, Forensic Psychiatry & Medicine
• Medications, FDA
• Medications, Healthtouch
• Medications, Medline
• Medications, USP via InteliHealth
• Medline, Comparison
• Medline, PubMed
• Mental Health Information Centre
• Message Boards, iVillage
• Message Boards, NetDoktor.com
• News, PsychLinx
• Patient Assistance, NeedyMeds
• Patient Assistance, PhRMA
• Pharmacology Guide, Glaxo Wellcome
• Psyche Matters
• Psychiatry On-Line
• Rating Scales, Queendom
• Schizophrenia, schizophrenia.com
• Secret Shame
• Self Psychology
• Sleep Medicine
• Sleep Well
• Studies ISO Participants, CenterWatch
• Studies ISO Participants, NIMH
• Suicide, Contagion, CDC
• Surgeon General Report
• Temporal Lobe Symptoms
• Transcranial Magnetic Stimulation
• Trauma Information Pages, David Baldwin
• Vietnam Veterans Home Page

Links Verified as active to this point.

• Telepsychiatry
  • Arizona TeleBehavioral Health Network
  • Canadian Society of Telehealth
  • Centre for Online Health, U Queensland
  • DoctorGlobal
  • Electronic Communication, Electronic Patient Centered Communication
  • Health Privacy
  • Robert Wood Johnson Foundation
  • Telemedicine Information Exchange
  • Advisories on the Use of Medical Web Sites, ATA
  • Comparison of Health Information Megasites, Bibliography
  • QuackWatch
  • AMA, Guidelines for Physician-Patient Electronic Communications
  • Woodford, Fighting Phobias in the CAVE, Michigan Today

Organizations

• Adult Children of Alcoholics
• Alzheimer’s Association
• American Association for Marriage and Family Therapy
• American Counseling Association
• American Foundation for Suicide Prevention
• Association for Advancement of Behavior Therapy
• Association for the Advancement of Philosophy and Psychiatry
• Association for the Study of Dreams
• British Healthcare Internet Association
• Food and Drug Administration
• National Alliance for the Mentally Ill
• National Institute of Mental Health
• National Mental Health Association
• Obsessive-Compulsive Foundation
• Substance Abuse and Mental Health Services Administration
• World Health Organization

University Student Counseling

• Student Counseling Virtual Pamphlet Collection
• Dr. Cyberviser, Oberlin
• Go Ask Alice, Columbia

Publications

• Psychiatric Services
• Dr. Valerie
• Psychiatric News

Hardware and Software

• ComputerPsych, Kennedy and Kramer
• Mental Health Connections
• Neuropsychology Central

This is the final installement in the temperament counselling program for Javelina and the Big Bad Wolf. If you would like to read the series in order in its entirety, here are the links to the first seven segments.

Javelina registered for a women’s retreat weekend. She made additional plans to add the subsequent Monday to her retreat in order to have some private time to think through the issues of her marriage with BBW. When she told him of her plans he became very angry. He told her that the arrangements were not convenient. He said that it was unfair of her to leave him to take care of the children for an entire weekend plus a Monday. She finally told him that if he didn’t allow her this time she was filing divorce papers. As this played on one of his deepest fears he backed down.

BBW came to a session while Javelina was away at the retreat. As soon as the session began he initiated a passionate monologue about the unjust way that she took this time away from the family. He did not understand why she needed to go to a retreat with other women to work our THEIR marital issues. He felt put upon in that he was left to care for the children while she was off “having fun with her girlfriends.” This tirade went on for a good quarter hour.

At this point I broke in and stopped him. I helped him explore what the underlying issue of the problem was. We focused, not on the issue, but upon his reaction to it. As I read back his dialogue to him, he gradually became aware that nearly every sentence began with “I” and went on to communicate his needs. In nearly every instance the issues were about him and not about Javelina.

He then confessed that the last time she went away to think, she left him for a year. The issue then became very apparent. His anxiety was not about Javelina attending the women’s marriage retreat is was about his fear of being deserted.

I asked him about this fear directly.

He was quiet for some few minutes.

Finally, he responded “Maybe” and began his huffing puffing stream of words again.

I stopped him and asked again, “Is it fear?”

After another few quiet minutes he replied he’d never thought about it that way but yes, he thought it was. He became very vulnerable and I told him that THIS not the filibustering was the kind of communication Javelina was looking for. It was as if a light went on in his brain. I began to coach him on how to reach this type of communication with Javelina and that he could call her and explain to her that he feared she might not return to him after this time away.

He called her at the retreat and they spoke for nearly an hour. She came home from the retreat beaming. She confided that this was perhaps the first time they had conversation that were exercises in growth rather than demolition.

After this final session BBW underwent a dramatic life change. He began to share with Javelina his true underlying feelings. At first she was stunned. She couldn’t believe his transformation. She began to look forward to being at home again rather than postponing it with work. Their relationship has moved from predatory to symbiotic.

As a supine in inclusion BBW had a great inherent underlying capacity for serving others. Once we were able to overcome his learned perception the serving was unmanly he was able to build tremendous bonds with his wife through this strength.

As a phlegmatic melancholy in control BBW had a need for personal space and clearly defined tasks. Once Javelina understood that spontaneous change and blurred roles were creating situations in which BBW lashed out cruelly in a verbal manner she was able to bring changes to him in a more structured and comfortable manner.

As a phlegmatic sanguine in affection BBW was unable to express himself the overt signs of affection he actually desired to receive. Counseling helped him to understand that in order to receive the affection he wanted he needed to express the affection that Javelina wanted. Which, because she was a phlegmatic supine was not difficult to demonstrate by doing small things for her that she naturally perceived as affection signs.