Catcher in the Rye Essay: Powerless Holden :: Catcher Rye Essays

Powerless Holden In The Catcher in the Rye, Holden views the world as an evil and corrupt place where there is no peace.   This perception of the world does not change significantly through the novel.   However, as the novel progresses, Holden gradually comes to the realization that he is powerless to change this.   Ã‚  Ã‚  Ã‚   During the short period of Holden's life covered in this book, "Holden does succeed in making us perceive that the world is crazy†1.   Shortly after Holden leaves Pencey Prep, he checks in to the Edmont Hotel.   This is where Holden's turmoil begins.   Holden spends the following evening in this hotel which was "full of perverts and morons.   [There were] screwballs all over the place."2.   His situation only deteriorates from this point, as the more he looks around the world, the more depressing life seems.   Ã‚  Ã‚  Ã‚   Around every corner Holden sees evil.   He looks out on a world which appears completely immoral and unscrupulous.   The three days that the novel covers place a distressed Holden in the vicinity of Manhattan.   The city is decked with decorations and holiday splendor, yet, much to Holden's despair "seldom yields any occasions of peace, charity or even genuine merriment."3.   Holden is surrounded by what he views as drunks, perverts, morons and screwballs.   These convictions that Holden hold waver very momentarily during one particular scene in the book.   The scene is with Mr. Antolini.   After Mr. Antolini patted Holden on the head while he was sleeping, Holden jumped up and ran out thinking that Mr. Antolini was a pervert as well.   This is the only time during the novel where Holden thinks twice about considering someone a pervert.   After reviewing Mr. Antolini, Holden finally concludes that maybe he was not making a "flitty&quo t; pass at him. He wonders if he just like patting guys heads as they sleep.   This is the only time in the novel where Holden actually considers a positive side to something.   However, this event does not constitute a significant change.   As Holden himself says, "It's not too bad when the sun's out, but the sun only comes out when it feels like coming out."4. The sun, of course, is a reference to decency through the common association of light and goodness.  Ã‚   His perception of the world remains the same.   Ã‚  Ã‚  Ã‚   The one conviction that does change during the novel is Holden's belief that he can change the world.

The Crucilbe: Theater Project. Includes Directorial, Set, Sound, And C

I chose Arthur Miller’s The Crucible because of the plot’s dark history and suspense. Also because of the play’s reflection of McCarthyism. The so called â€Å"witch-hunts† for communist brought on by Senator Joseph.   Ã‚  Ã‚  Ã‚  Ã‚  The play is set in Salem, Massachusetts, 1692, where suspicions of witchcraft were floating around the town air. Act 1 starts out in early spring and ends in Act 4 when it is late fall. The play opens with Betty Parris sick in bed, and Reverend Parris tending to her, and wondering what made her so sick. Soon Abigail Williams saunters in, and through much probing, Reverend Parris eventually finds out that she, Tituba, Susanna Walcott and Betty were all involved together in a secret practicing of witchcraft. Abigail tells of a dance around a cauldron in the woods, and says that was all that happened. But, when Reverend Parris reveals how he was in the woods at that particular time, and saw the dances, Abigail gradually explains what went on, while leaving herself out as the main practitioner. She says she was forced into it all by the other girls and Tituba. Now the stage is set for a variety of unexpected accusations, scandals and tribulations.   Ã‚  Ã‚  Ã‚  Ã‚  The main characters are Abigial Williams, the â€Å"trouble maker† of the play, is the niece of Reverend Parris. Though only 13 years old she manages to get the whole village in an uproar. With the help of the other girls in the village, she fools the Salem council into thinking that the devil has inhabited certain citizens. Reverend Parris is the minister for Salem. He is a paranoid, power hungry man. He is more concerned about his reputation than his daughter and niece's souls when the first rumors of witchcraft get under way. However, he quickly learns to take advantage of the witch craze for his own personal gain.   Ã‚  Ã‚  Ã‚  Ã‚  John Proctor had an affair with Abigail when she was his household servant. He hates hypocrisy, and his hidden sin causes him a great deal of moral anguish. He hesitates to expose Abigail as a fraud because he knows his own conscience is unclean. He does not try to expose her as a liar until it is too late. He is accused of witchcraft and convicted. He suffers a moral dilemma over the decision to confess or not to confess to witchcraft. He confessed his affair before Danforth and Hathorne because he refuses to a... ...o show that she was a servant and wasn’t clothed in the same clothes as her masters.   Ã‚  Ã‚  Ã‚  Ã‚  Last is sound. This play didn’t have any chances for back ground music except for the end of each act. The ending song for Act 1 is called â€Å"Pulse† which is performed by The Kroumata Percussion Ensamble located on the C.D. â€Å"The 2nd Construction†. It contains light xylophone, snare drum, timpani and bells. Act 2 opens with the living room and Elizabeth singing in the back ground. It also had a fire place so I wanted the sound of the fire crackling randomly through the scene. Then we hear the neighing of a horse and John proctor arrives.   Ã‚  Ã‚  Ã‚  Ã‚  Act 3 ends with the uproar from John proctor and I chose another piece from The Kroumata Percussion Ensamble entitled â€Å"Soldier’s Song† which is a series of drum rolls, base drum crashes and timpani rolls. Act 4 leads us to the jail cell where the fall moon is shining through the window and the sounds of frogs and crickets can be heard. The scene ends with John being taken away to the hallows. For this scene I wanted a constant percussion ensemble of sounds and to get increasingly louder as the curtain falls.

The Threat of Nihilism: New Educational Opportunities? :: Education Philosophy Philosophical Essays

The Threat of Nihilism: New Educational Opportunities? ABSTRACT: If the educator is characterized by a willingness to stand for something and simultaneously willing to care for someone, then the philosophy of authenticity should help the educator out of the problems that the Enlightenment project and some of its critics have created. While our integrative authenticity should rescue us from despair, it should also correct the possible immobilism occasioned by the interpretation of some postmodernist authors. Here, what we take as somehow fulfilling us, to a certain extent also conceived in a naturalistic way, binds us to the ways of structuring our concerns so that others can participate in a common framework. But such a philosophical perspective is confronted with two objections. First, one asks whether it is still ethics given the importance it gives to the empirical level. Second, it is questioned whether there really is a place for the other, whether it in fact transcends subjectivism. This paper deals with some of Nietzsche's central ideas and argues that the reproach of extreme relativism and scepticism is not justified. It concludes that one may find on the contrary an interesting way of dealing with the necessarily individualistic nature of education as well for the educator as for the educandus. If education can be conceived as an answer from one individual person to another, particularity, care, integrity and trust are of the utmost importance, and so is what "being authentic" means. Of course, an agent cannot articulate a project concerning who she wants to be without a context of intersubjectivity. Such a project must constitute a particularly illuminating example of what can be done in a certain social predicament. Furthermore, authentic identity presupposes a moment of recognition on the part of another. Authentic identity can thus mean pursuing a project in which a willed uniqueness is expressed and the wish for others to recognize this unique person whom we want to become. If the educator is characterized by her willingness to stand for something and simultaneously willing to care for someone, then the philosophy of authenticity, thus conceived, should help the educator out of the problems that the Enlightenment project and of some of its critics have pressed on her. While her integrative authenticity should rescue her from despair, it should also correct the possible immobilism occasioned by the interpretation of some postmodernist authors. Here, what we take as somehow fulfilling us, to a certain extent also conceived in a naturalistic way, binds us to the ways of structuring our concerns so that others can participate in a common framework.

Cultural Problems in International Business

Martinez Construction Company in Germany – Cultural Problems 2. 2. 1 PROBLEMS Cultural barriers to integration The considerable differences between the Spanish and German business practices could have been diminished through a sound pre-assesment made by Martinez Co. Since this understanding process was not pursued, a cultural conflict occured which may significantly hinder the processes of strategic and operational management of the two companies as a whole. The most important barriers of cultural dimension include: Barriers to cultural integration| Suggestion for limiting the impact| 1. Cultural shock’ as a consequence ofstrong cultural diversity of companiesconstituting a holding group;| Cultural transformation, respectingcultural values and customs of a targetcountry. | 2. ‘Cultural maladjustment’ of boardmembers delegated by a parent company;| Management through values, systems formonitoring social feelings of the targetcompany. | 4. Management style d ifferencesbetween companies. | Management through goals as a basisfor work appraisal of the managementpersonnel and employees| Financial issues Martinez Co. ’s representatives are involved in a process of Merger and Acquisition which they discover gradually.This means that they have allowed themselves to be unaware of the exact risks and implications, especially from the financial point of view, from the moment they accepted a contract that did not contain enough information related to this topic. Now they are facing unpredicted expenses, and the possibility of new ones to occur cannot be excluded. Ensuring that an acquisition is a good fit, not only on paper, but as an integrated business, calls for going beyond traditional financial assessments, to detailed value analysis, especially within an international business context. As Treuhandanstalt rushed the process and Martinez Co. imply went with the flow, requirements that should have been included in the contract are now th reatening the Spanish company’s financial capacities. 3. 2 Causes of the problems The problem regarding cultural contradiction became difficult to cross due to the following errors: -Martinez representatives’ did not make an appropriate due diligence as no research regarding business practices in Germany had been made. Juan Martinez was sent to conduct negotiation just because he was genuine and had a practical thinking, but his lack of information proved to have a great negative impact on the deal obtained. Their reasoning to expand in Germany is poor. Diego Martinez took into account only the fact that Germans enjoy Spanish atmosphere and often choose Spain as a target market for business. On the other hand, they did not take into account that differences in leadership approach and culture in general can affect their interest. It is very important to be aware that if companies from a specific country conduct successful affairs in your country, it does not necessarily mean that you will benefit from the same success there. The financial problem occurred mainly because some of the steps within negotiating the merger were skipped.Firstly, Martinez accepted to sign a contract without enough details about Konstrukt’s financial position. They requested, indeed, a Phase Contract which made Germans unclear and, moreover, gave them little perspective about future financial risks. In fact they bought a company without knowing exactly what they are getting. The second main contribution to the synergy’s financial issues was brought by Treuhandanstalt. Although THA must have focused on evaluating the firms, especially their financial soundness and the cost for the buyer, it had, in this case, as main concern the speed of transaction.Therefore, they pressured Martinez during this process, without focusing on future risks and arrangements for upgrade. 3. 3 Negative effects that occur If problems will not be solved The cultural dissonance will ha ve the following consequences: * Management will face severe problems in providing incentives for employees, therefore their productivity will go downwards; * Employees will become confused about their role in the company so their lack of initiative and responsibility will worsen.In addition, this synergy attempt will face challenges caused by financial problems: * The plans of stability and progress will be severely hampered in the case of Martinez Co. ; if they fail now, they will find it extremely hard to expand even on another foreign market (a financial fiasco would make Martinez unconfident and the idea of international expansion would definitely be seen as a peril). * Company might become insolvent if the new expenses emerged are not handled at time and properly. 3. SOLUTIONSCultural barriers – a first solution would be to map out the chain of command (employees must understand their exact role in the company and must be informed about the participative leadership appr oach specific to the Spanish company) –communication based * Strategic focus – agree on the goal (â€Å"enrichment†) and find the right cultural approach to achieve it ( certainty needed, more like Germans) * Mix useful elements from both cultures in such manner that leadership and employees can move together towards their goal ( keep the† all about work policy† but make them involve in decision making through incentives) Financial issues Cash injection , as expense on regulations is compensated by the opportunities offered on this new market ( raw materials at hand, low wages required and brown field investment advantages) *Assess the co’ future growth rate and profitability in order to understand if the acquisition is a good option * Require a renegotiation of the contract, which should imply these extra- expenses. 4. CHOOSING the OPTIMAL SOLUTION . Culture – Mix useful elements from both cultures in such manner that leadership and em ployees can move together towards their goal ( keep the† all about work policy† but make them involve in decision making through incentives) * b. Financial – Assess the co’ future growth rate and profitability in order to understand if the acquisition is a good option ( discuss with third parties and experts) . IMPLEMENTING the OPTIMAL SOLUTION a. Communication: employees must be informed about policies adopted, about their role exactly. This way, they will be less inclined to reject the new management and their approach. b. Studies of the market ( it has potential since raw materials are available an also is labor) , discussion with experts and third parties.

Martin Luther King Memorial in Yerba Buena Gardens Essay

Situated on the corner of 4th St. and Mission St., in downtown San Francisco is Yerba Buena Gardens. Sounds from the hustle and bustle of cars driving and people walking permeate Yerba Buena Gardens, except in one particular location. In one corner of the gardens stands a Martin Luther King Jr. memorial. The memorial is breathtakingly beautiful with a fifty foot high and twenty foot wide waterfall that falls over Sierra granite. In the Memorial’s hallway, visitors read quotes from Dr. King himself that are engraved on glass panels and set in granite. The physical beauty of the memorial is undeniable, however many people are not aware of the symbolism lying beneath the memorial’s surface. The memorial’s waterfall symbolizes the realization of Dr. King’s dreams the realization of Dr. King’s dream, the tears shed by millions and of the voices of African Americas The memorial also reminds us of the oppressed African Americans whose voices were drowned out ignored; yet, it is apparent that society was pushed backwards in the race to equality with the mandatory evacuation of thousands of people due to the development of the Yerba Buena Gardens. King Jr. dreamt that all human beings, regardless of skin color, will one day be able to live in a completely free, just, and non-discriminatory society. It was his dream of an equal society that pushed Martin Luther King Jr. to become an advocate for universal suffrage. Even though the United States already had universal suffrage, unfair literacy tests and poll taxes plagued the voting process and disqualified nearly all impoverished African Americans from voting 1. King wanted a colorblind society; a society where all human beings are treated equally and respectfully and given the same personal liberties and political freedom. Martin Luther King argued, in his â€Å"I Have a Dream† speech, that â€Å"we are not satisfied until justice rolls down like water and righteousness like a mighty stream† 2. This quote from Dr. King’s speech is inscribed on the right end wall of the memorial. After reading the final inscribed quote, it is apparent that the purpose of the waterfall is to signify the realization of Martin Luther King’s dream of a just society. Justice , The United States Martin Luther King’s dream of justice in today’s society; a monumental victory of justice over prejudice. It is so easy to forget about what it took for America to become a truly free and nondiscriminatory nation. The mists are a necessary reminder for people in today’s society that personal liberty and political freedom should never be taken for granted. Though Yerba Buena Gardens is situated in downtown San Francisco, a busy city filled with loud noises, the memorial itself is peculiarly quiet and calm. The memorial’s serenity is due to the overpowering, yet surprisingly tranquil sound of the rushing water from the waterfall. The power of the waterfall to drown out all exterior noise is phenomenal. It is impossible to even hear what someone is saying when they are right next to you. Visitors try to overcome the sound of the rushing water by screaming or whistling, but are unsuccessful. Independent from life’s distractions, visitors are given the opportunity to absorb all that the memorial and Dr. King’s words have to offer. Visitors can take this time to self-reflect and to appreciate the efforts of earlier generations fighting for equality during our nation’s infancy. The undeniable strength of the waterfall’s sound to obscure all external noise makes Being incapable of expressing feelings or thou ghts leaves an unfamiliar and dreadful sensation. People living in today’s society are usually ignorant to this unfamiliar, almost claustrophobic feeling of screaming at the top of your lungs without a single person acknowledging your frustrations. During our nation’s history, however, nearly all African Americans struggled with this same frustration. Helpless against the white minority, blacks throughout history struggled to get their concerns addressed and their votes counted. The visitor’s inability to communicate vocally is short-lived and fortunately, only lasts as long as it takes for the person to walk through the memorial. African Americans, however, were plagued with powerlessness for hundreds of years. Martin Luther King Jr. felt obliged to provide a voice for all African Americans stripped of the right to do so on their own. Due to the hard work of Martin Luther King, civil rights leaders and activists, and President Johnson, on August 6, 1965 the Voting Rights Act was signed into law, which banned the use of literacy tests and also required stricter monitoring of the use of poll taxes in state and local elections† 3. Finally, the time had come when African Americans could voice their opinions and have them be heard, and vote for the political constituent whom carried similar beliefs and morals. The development of the Yerba Buena Gardens, as part of the â€Å"Urban Renewal Project† was not always considered to be something positive and beneficial. During the 1950’s, city planners forced thousands of people living in the South of Market area out of their homes, arguing that the area was â€Å"dangerous ‘Skid Row’ ripe for redevelopment, populated by â€Å"bums† and â€Å"transients† whose fate mattered little† 4. City planners left out the important fact that many people who lived in this area were elderly and poor and had â€Å"little defense against the federal bulldozer† 5. The city did try and relocate as many people as possible, but only had 276 units of new housing to replace thousands of demolished units. Thousands were left homeless and kicked out of possibly the only home they have ever known and will ever know, due to lack of job skills needed to find employment. The irony of placing a Martin Luther King Jr. memorial, a man who advocated for equality and justice until his assassination, on land where thousands of impoverished people were evicted just a couple years earli er, is almost too horrific to comprehend. The hypocrisy in the decision to place this memorial at the Yerba Buena Gardens is undeniable and unforgiveable. The memorial’s waterfall is a reminder of the relentless adversity that plagued millions of blacks for thousands of years and the tears they shed. The waterfall also symbolizes the realization of Dr. King’s dream. The eviction methods used during the Urban Renewal period to obtain the land where the memorial sits were ethically questionable, however it is still important to visit this monument from time to time. The memorial stands there in the middle of Yerba Buena Gardens, in the middle of downtown San Francisco, as a silent, yet constant reminder to never take anything for granted and to always remember the blood, sweat, and tears shed by millions in order for people today to enjoy and exercise the complete personal liberty and political freedom that we are so fortunately blessed with.

Behavioral therapy

Behavioral therapy is also known as behavioral modification. It is a psychological method based on the principle that one can change the badly adjusted, maladaptive, observable, specific and self destructive behavior, through learning new and more suitable behaviors (Skinner, p 194). The origin of this theory can be traced back to the school of behaviorism which indicates that one can scientifically study psychological matters through observation of overt behavior without necessarily involving interior psychological states.Skinners theory of behaviorism accepted and supported that internal state could be part of a certain kind of behavior without necessarily being the main cause; however, he declared that through environmental manipulation, one could improve on them. The behavioral theorists include Hans Eysenck, Joseph Wolpe, Harry Solomon, Ogden Lindsley and B. F Skinner and they all had different ways of looking at behavioral problems. Eysenck’s perspective saw behavioral p roblem as connection between one’s behavior, the environment and personality characteristics. For the sake of this study, I will focus on B.F skinner’s behavioral theory (Skinner, p 198). Origin of behavioral therapy Edward Thorndike did experiments to discover the ability of dogs and cats to solve problems. He constructed wooden crates and he would cage the animals each in their own crate. The animals would escape from the crates. Though initially he just wanted to show that dogs and cats’ achievement could be controlled, he realized that he could measure the intelligence of these animals using his tools (Lindsley, p 34). He would set the animals for the same kind of task and observe how long it took to complete the given task.He learnt that there was no difference in performance between the animals that started an assignment and the ones that first observed the others performing (Skinner, p 89). He also learnt that when an animal did something that made it to successfully get out of the box; the animal was likely to repeat that action when faced by the same kind of problem. He concluded that reward reinforces the relationship between stimulus and action. He later formalized it to be called the law of effect (Skinner, p 199). Classical conditioning theory then came to explain that there is an association between reflex and the neutral stimulus.Watson used rats in his experiments to improve on the law of effect and apply it in behaviorism. He made a maze which the rats were supposed to follow. Once they had mastered the routes, he started putting blocks at different points of the maze (Skinner, p 94). If a route was blocked, the rats would then follow another route indicating that they had memory. Once the second route was blocked they would follow the other available route. He observed that when the reward for an action done was less, then the rats performed the task more slowly (Lindsley, p76). B.F Skinner came to improve on Thorndike an d Watson’s work by studying objectively behavior sequences over a prolonged period of time. He came up with the concept of operant conditioning which related the operant response and the reinforcement. This theory is based on the proposal that learning could help in change of overt behavior. People change their behavior as a result response to the occurrences in their surroundings. A given response leads to a certain outcome. When one reinforces a certain pattern of Stimulus-Response, a person’s response becomes conditioned (Skinner, p 97).The key element in this theory is reinforcement; this is anything that supports the response that is desired. Reinforcement could be positive or negative. Positive reinforcement makes one be encouraged to do more of the action that led to positive results. It includes attaining satisfaction after doing something, being recognized, being praised for work well done among others. Negative reinforcement on the other hand involves the act ions that make one increase the frequency of responses once a certain stimulus is withdrawn. Aversive stimulus results to the reduction of responses (Skinner, p 200). Behavioral Therapy This is a report about Paula a client who was referred to therapy by the general practitioner of the hospital. Following a thorough physical checkup performed on Paula the GP feels that Paula’s heart is sound enough and her condition is psychological. (Getzfeld, 2004). Paula’s case is not an isolated case of psychological dysfunction and in fact a sizeable number of people suffer these attacks in silence. (Beck, Rush, Shaw, & Emery, 1979). This is perhaps due to the feelings of embarrassment and stupidity that they feel they might be accused of.Additionally, panic attacks are not well known to many and hence the stigma. Nonetheless, panic attacks are not insignificant and can have a crippling effect in someone’s life. They are a symptom of underlying stressing and traumatic events in the patient’s life. (Feather & Ronan, 2006). This report gives a diagnosis of Paula’s case. It gives a comprehensive analysis of what is the onset of Paula’s con dition, the triggers and the effects of her attack. At the end of the report it will give the findings and recommendations on the way forward for Paula in getting treatment for her condition.Diagnosis Paula has been experiencing an array of symptoms that occur frequently at the workplace and outside home. These symptoms include dizzy spells, shortness of breath, dizziness and lightheadedness as well as chest pains and fast heartbeats. Paula feels that there is cause for alarm because these symptoms may be an indication of a heart attack. For this reason she has sought medical help from her general practitioners, and she has even visited a cardiologist for a sonogram and echocardiogram. Both these tests showed no defects or indication of heart attack.Nothing is wrong with Paula’s heart and apparently the symptoms may be a psychological related. The doctors at the company clinic where Paula works suggested that she try to relax more and steer away from caffeine, nonetheless the attacks still persevere despite Paula’s attempts to relax. She sought a second opinion from another physician who also gave similar diagnosis i. e. her attacks are a psychological problem hence she needs to sign up for therapy. With that Paula came to the clinic. Brief history of PaulaIn order to clearly diagnose Paula’s condition information from her life experiences both in the present and from the past had to be sought. Paula is 27 years old, single and lives at home with her parents. She has a good job at a securities and bond trading company which she has worked for loyally since she graduated from university with a BA in economics seemingly her life was be smooth and no developmental milestones have been experienced on her part. Prior to her recently persistent attacks she was ready to enroll for MBA.Her father died soon after she graduated from University after a brave fight with cancer, emphysema and the killer heart attack. Her mother has some health problems although nothing too serious. Her grandparents died of cancer; her grandma of breast cancer and her grandpa of colon cancer, she feels that cancer runs in the family and is afraid of it too. This is the reason why she stopped smoking and does not drink alcohol. She says matter of factly â€Å"I have enough bad seeds in me†. Paula is the only child not by plan but out of natural misfortune.She had a little brother who died at the age of three out of heart defects that developed with age. He also had other birth defects that Paula was unwilling to disclose. This memory made her teary. Obviously, the death of the little boy had deep-seated effects in all the family members. (Feather & Ronan, 2006). According to Paula, her parents did not try to get pregnant again and the option of adoption was too devastating to consider. Paula’s mother and friend at work feel greatly concerned over her condition and Paula feels that as well. Paula feels that it is time she had greater c ontrol over her problem.The medication she has been taking i. e. Xanax and Contac zonk her out and she refers to herself as a ‘walking dead’ when she is on this medications. The persistent attacks seem to be triggered by anything major to Paula and given the nature of her job she reports frequent dizzy spells, faints and attacks at work. She remembers a case whereby a client fell through and all the blame was pinned on her. At the same time a coworker at the workplace had shown particular interest on Paula as a woman. All these major events occurring concurrently in her somewhat laid back lifestyle triggered an attack.In the moment of it all, the other workers got wind of her weak point and she is afraid that they might think of her as ‘chicken’ or incompetent of handling such a demanding job. Frequency of attacks Paula’s attacks have been with her for a long while. She points out that ever since she entered university she started experiencing them. The stress levels were high what with the huge load of work, pressure from men in campus and the need to fit in since the university was small and everyone knew everyone else. In her high school it was easy to be an invisible wall paper and stay unnoticed when necessary.Unfortunately in university this was not the case and she lacked the necessary support systems or good outlets to channel the stress she was feeling. She also recalls her father’s death which affected her greatly. It was overwhelming for her although she had suspected it would happen soon. This reminded her of her brother’s death. For this reason Paula feels ‘life is very unfair’. The death of loved ones caused her to withdraw from life completely. At school she would get sweaty and the dizzy spells prior to presentation and even before she lost her virginity she had a panic attack.Paula’s case now involves her mothers, her co-workers the doctors and now psychiatrist. Before, it was her personal problem and she felt she could deal with it. Now her life is significantly affected and people around her are worried. Doctors feel that it is time she saw a therapist to uncover the real cause of the problem. Her mother feels strongly about the same as also the people at work. Assessment and investigation plan It seems that Paula is suffering from severe depression which manifests itself in panic attacks.(Alpert & Fava, 2004) She has not developed the expression skills and seems to bottle up feelings of anxiety, frustration, hurt and stress. She has managed to deactivate her social life and is highly dependant on her mother for comfort although she does not disclose her inner feelings to her mother as well. Notably, at 27 and with a good job she is still unattached to anyone and does not go out with friends. Throughout the sessions she makes no mention of significant persons other than her mother. Even at university she frequently went home to be babied.Her family back ground is a troubled one with a history of heart diseases and cancers. Her loved ones seem to be consumed by these diseases and she feels afraid of being the next. Panic attacks manifest either as ‘a way of getting through tough situations’ as she puts it or as a reaction to overpowering feelings of loss, excitement or expectations. After reviewing Paula’s case in detail it is recommended she have behavioral therapy as a start treatment program since it is the best therapy linked to activating the client from depression, a condition that is the underlying cause of Paula’s panic attacks.BATD (Behavioral Activation treatment for Depression) overview, foundation and Assumptions. This treatment option bases its foundations from cognitive therapy. It basically involves activating the client from depression by encouraging them to make connection between powerful experiences both in the present and in the past with the symptoms that they may be having. In Paulaâ €™s case it is panic attacks. The basic assumption of this therapy is that depression and subsequent symptoms of depression arise from life expenses of the patient and not the genetic predisposition. (Cooper, Smith & Upton, 1994).Vulnerability is severed by traumatic life events. This therapy encompasses assessment and treatment of cognitive, emotional and behavioral aspects of the clients. This means that its efforts are channeled toward sharpening social skills of the client through training and reinforcements, imparting relaxation techniques as well as therapy to help relax the client, increasing pleasurable activities in the clients life say situations with more laughter and easiness, training clients on assertness and emotional expressions and restructurings the clients patterns of thoughts and cognitive perceptions.(Gortner & Jacobson, 2000, Martell, Addis & Jacobson, 2001) These areas are greatly emphasized because they alter the client’s beliefs of the world aroun d them and eventually how they choose to resolve their inner problems or conflicts which are evident in behaviour. According to Beck, Rush, Shaw and Emery (1979 p. 118) mentioned in Jacobson, Mortell and Dimidjian 2007, p. 257 ‘the aim of this therapy to bring about change in the clients negative outlook in life’. The beliefs and expectations of a person indecent in his cognitive make up ultimately affect behaviour.The behavioral activation therapy recognizes that some depressions and subsequently panic attack may be or a result of genetic predisposition, it greatly emphases environmental factors as a great a preventative measure for depression maintenance. Course of treatment Paula’s treatment will commence with the establishment of therapeutic rapport with the therapist while they discuss the objectives and goals for the therapy and the sessions. This will be achieved by encouraging Paula to ask questions and be as comfortable as possible during the sessions.Pa ula and the therapist will explore the implications that her depression has had on Paula’s life for instance she lacks a social life, she cannot do her daily tasks any more, she will lose her job and so on. Under this treatment the therapist will be performing some functional analysis on Paula to gauge how well Paula is responding to treatment. For example, she should be able to start driving her car to work and performing her duties at work. The use of home works will be helpful to both Paula and the therapist in finding areas that the therapy should concentrate on.The therapy sessions will also explore the strategies that Paula should use to avoid a relapse. Paula intervention plan The first step in her treatment plan is to get her to talk more about her unpleasant life experiences. So far she has registered commendable progress into talking about her father and her young brother. When she first came in she was fidgety and kept checking her pulse over her neck. She had a pa nic stricken look but now she has relaxed a little.It is impossible to accurately state the duration that Paula might take to show full recovery since depression can be hard to overcome with the lack of proper support systems and the troubling environment at her workplace. Nonetheless, Paula sounds really determined to get over this problem and regain full control of her life. A two hour session with the psychiatrist thrice a week for a month and once a week for the following two months is recommended. This will be flexible enough for Paula to manage work and treatment. The significant people in Paula life i. e.family and coworkers need to give Paula all the support she needs to overcome this milestone. This is because her depression is not just an inner problem but the environment also triggers her attacks. The boss could encourage Paula to take some early days off and maybe some days be allowed to work from home until she is ready to work full time. The mother needs to continue be ing there for her daughter but on the other hand encourage her to be more independent. This will ensure that she is strong enough to handle life situations on her own and avoid a relapse in case she dies.The coworkers may be a bit more supportive when she experiences panic attacks and let her know it is nothing to be ashamed of. Again, Paula should expand her social networks and support system and this will a particular area where she will be trained during therapy sessions. Paula seems to over think her situations and the events in her life. A case in point is where she is quick to say that her coworkers will recommend she be transferred to the mail room because of the panic attacks. She feels that she should ‘never’ have an attack at the office again.She says ‘everyone will laugh and say look at the retard at it again. ’ She also seems to have planned out her suicide and thought of the consequences i. e. she would go to hell, it would be painless if she o verdosed on Aspirin, she would play some sad music, the suicide letter and other details fully planned. This seems to be Paula’s pattern of thinking and it is detrimental. In therapy, I will be interested in activating Paula’s spontaneity and her ability to accept her vulnerabilities and limitations towards having a fuller life. Measuring progressIn order to gauge progress on Paula’s treatment the therapist should be able to find improvements in Paula’s frequency of panic attacks. Ideally, they should reduce in the first month of treatment significantly. Additionally, her patterns of avoidance will be evaluated to see how well she is able to confront her fears. (Carr, 2001). For example, she avoids getting close to any man who might show interest in her hence stays away from social scenes like movies theatres and social gatherings. She also marks all the exit points to a place just incase she suffers another panic attack.Driving is also a problem to her a nd she has to be driven by her mother. She also avoids going out doors and stays in mostly where treatment will be effective, Paula should be able to take on her daily activities and develop healthy relationships with new people. The therapist will also make use of homework whereby Paula can try to engage in a task she feels prohibitive or unable to handle and see how well or not she manages the situation. This homework will allow her to self monitor her own progress and in therapy session discuss the feelings of accomplishment and pleasure derived from engaging in that activity.Results of the actions So far Paula has impressively shed light on her life. She has made the first big step towards treatment and that is the resolution to seek professional help. The diagnosis is that Paula is suffering from panic disorder which overlaps severe depression. She has had traumatic life experiences and suppressed them sufficiently. However she has reached a point where the emotions and negativ e psychological beliefs can no longer be bottled up hence the frequent panic attacks.The panic attacks have greatly eroded her self-esteem to a point that she planned a suicide although did not execute it. After evaluating her case I recommend psychiatric assessment just to ascertain this diagnosis so that the next level of therapy i. e. relaxation therapy and psychoanalysis can commerce. Although Paula is not actively keen on attempting another suicide, the risk is inherent and she needs close monitoring by her family and friends before and during therapy until she is strong enough to stand on her own.Paula should enroll in an activity that will enable her to think outside herself and her problems as well as boost her self-esteem. Yoga and social gatherings will particularly do her a lot of good. (Gortner & Jacobson, 2000). Lastly but importantly, Paula’s GP and cardiologist input would also be necessary in affirming this diagnosis so that Paula is well convinced that her pa nic attacks are purely psychological and not heart attack related. This will encourage her to continue the treatment. ConclusionPanic attacks are surmountable behavior activation therapy is a good way of assisting clients who suffer these attacks. The collaborative relationship between the client and the therapist should be useful in uncovering the depression in clients who suffer depression. The patterns of avoidance that Paula has developed such as avoiding relationships and friendships with others, avoiding social places staying away from work among others are crippling to Paula’s life and need to be confronted. Paula has to find a way of dealing with her problems in healthy ways. Behavioral therapy Behavioral therapy is also known as behavioral modification. It is a psychological method based on the principle that one can change the badly adjusted, maladaptive, observable, specific and self destructive behavior, through learning new and more suitable behaviors (Skinner, p 194). The origin of this theory can be traced back to the school of behaviorism which indicates that one can scientifically study psychological matters through observation of overt behavior without necessarily involving interior psychological states.Skinners theory of behaviorism accepted and supported that internal state could be part of a certain kind of behavior without necessarily being the main cause; however, he declared that through environmental manipulation, one could improve on them. The behavioral theorists include Hans Eysenck, Joseph Wolpe, Harry Solomon, Ogden Lindsley and B. F Skinner and they all had different ways of looking at behavioral problems. Eysenck’s perspective saw behavioral p roblem as connection between one’s behavior, the environment and personality characteristics. For the sake of this study, I will focus on B.F skinner’s behavioral theory (Skinner, p 198). Origin of behavioral therapy Edward Thorndike did experiments to discover the ability of dogs and cats to solve problems. He constructed wooden crates and he would cage the animals each in their own crate. The animals would escape from the crates. Though initially he just wanted to show that dogs and cats’ achievement could be controlled, he realized that he could measure the intelligence of these animals using his tools (Lindsley, p 34). He would set the animals for the same kind of task and observe how long it took to complete the given task.He learnt that there was no difference in performance between the animals that started an assignment and the ones that first observed the others performing (Skinner, p 89). He also learnt that when an animal did something that made it to successfully get out of the box; the animal was likely to repeat that action when faced by the same kind of problem. He concluded that reward reinforces the relationship between stimulus and action. He later formalized it to be called the law of effect (Skinner, p 199). Classical conditioning theory then came to explain that there is an association between reflex and the neutral stimulus.Watson used rats in his experiments to improve on the law of effect and apply it in behaviorism. He made a maze which the rats were supposed to follow. Once they had mastered the routes, he started putting blocks at different points of the maze (Skinner, p 94). If a route was blocked, the rats would then follow another route indicating that they had memory. Once the second route was blocked they would follow the other available route. He observed that when the reward for an action done was less, then the rats performed the task more slowly (Lindsley, p76). B.F Skinner came to improve on Thorndike an d Watson’s work by studying objectively behavior sequences over a prolonged period of time. He came up with the concept of operant conditioning which related the operant response and the reinforcement. This theory is based on the proposal that learning could help in change of overt behavior. People change their behavior as a result response to the occurrences in their surroundings. A given response leads to a certain outcome. When one reinforces a certain pattern of Stimulus-Response, a person’s response becomes conditioned (Skinner, p 97).The key element in this theory is reinforcement; this is anything that supports the response that is desired. Reinforcement could be positive or negative. Positive reinforcement makes one be encouraged to do more of the action that led to positive results. It includes attaining satisfaction after doing something, being recognized, being praised for work well done among others. Negative reinforcement on the other hand involves the act ions that make one increase the frequency of responses once a certain stimulus is withdrawn. Aversive stimulus results to the reduction of responses (Skinner, p 200).When considering this theory, schedules of reinforcement are considered to be very important. Principles under this theory are that positively reinforced behavior is very likely to reoccur. Shaping is also a principle that states that in order to reinforce behavior, information should be provided in small amounts. Stimulus generalization principles talks of reinforcement being generalized across stimuli that are similar to the original one (Lindsley, p 56). Behavior modification using B. F Skinner’s theory Behavior modification refers to a straight forward therapy technique that bases its arguments on skinner’s theory.It indicates that one can extinguish the unwanted behavior through the removal of the reiforcer and at the same time, behavior that is desired can be obtained and maintained via reinforcement . This argument has been used in solving many psychological problems. It is the preferred method when dealing with children. Other disorders which can be corrected using this therapy are anxiety disorders, phobias, eating disorders, anger management, aggressive behavior and substance use. All these are eliminated through changing the activities and behavior that may have contributed to such disorders (Skinner, p 96).Token economy is a derivative of behavior modification and it is used in institutions like prisons, juveniles, and psychiatric hospitals. This involves giving tokens to these people whenever they behave in a certain required way. When they revert to poor habits, the tokens are withdrawn. This is one way of behavior modifications that these institutions have used in order to keep order within the institutions. At times, Behavioral therapy methods are brought together with additional psychological involvements like medication (Skinner, p 197).This technique uses the follow ing approaches when using behavioral therapy to change a negative behavior to a positive one; systematic desensitization, flooding, behavior modification, prevention of exposure and response, operant conditioning, observational learning, contingency management, matching law, habit reversal training and covert conditioning (Lindsley, p72). Best fit patients for behavior therapy Behavioral therapy can be used as a tool to treat various problems like mental illnesses and their symptoms especially those that have maladaptive behavior.These conditions include phobias, eating disorders, anger management, aggressive behavior and substance use. Organic disorders like insomnia and incontinence could also be handled using the behavioral techniques (Skinner, p 205). This technique works very well in the treatment process of obesity. This process starts with the analysis of the activity and eating patterns in addition to other habits like dieting methods. After all this information is collected , the therapist uses it to come up with positive methods that can be used to promote weight loss, a positive self image and get healthier eating practices.The therapist does an analysis to the behavioral cause of stress in a patient. An appropriate method of treatment is then established. Cognitive therapy This therapy focuses in altering the bad behavior through changing the patterns of thinking behind them. It involves the emotions and the thoughts of the individual and the way they can be changed so that this person starts behaving more appropriately. This therapy can be used to correct many disorders like schizophrenia, autism, shyness, neurosis, stress disorders, attention deficit disorders, social phobias, mental disorders and addictions (McCullough, Para 24).It involves helping patients to triumph over difficult situations and modifying dysfunctional emotional, behavior and thinking responses. Treatment is all about bringing together the beliefs of the client and those of the therapist and testing them. It may also include testing the kind of assumptions an individual makes in life and also identifying the extent of distortion of thoughts that renders them unhelpful and unrealistic (Kohlenberg, p 234). Once the therapist challenges the way an individual thinks about something, that person is likely to change the way of thinking.Initially, this therapy was used to treat people suffering from depression. Beck came up with a list which contained ‘errors’ in thinking. He suggested that the errors maintained depression. They included selective abstraction, minimizing positives and magnifying negatives, over generalization and arbitrary inference (Kohlenberg, p 234). Historical development of cognitive therapy The theory of cognitive therapy came to be more than 50 years ago and it suggested that thoughts act as a go-between to stimuli like emotions and external events.A stimulus brings out a thought which can be a weighed up judgement of a kind and this further leads to a certain emotion. People’s evaluation of thought about a certain stimulus is what results to an emotional response and not necessarily the stimulus itself. Beck also came up with the etiological theory of depression under cognitive therapy. The theory indicated that people think negatively because their thinking is inclined to negative interpretations. People suffering from depression acquire negative schemas which are important ways through which information about the future; the world and the self are processed.These schemas are adopted early in life maybe during childhood or puberty as a result of going through stressful events in life. When such people come across situations that are similar to the ones in which the negative schemata was established, it becomes activated in the current situation (Kohlenberg, p 235). Beck also explained about the negative cognitive triad which constitutes negative biases and negative schemata. He proposed that pe ople who are depressed are very likely to make unconstructive evaluations of their future, world and selves.Depressed people are impossibility thinkers according to Beck. The cognitive triad indicates that a negative schema results to cognitive bias which fuels negative schema (Kohlenberg, p 237). Researchers suggested that depression could occur as a result of responding to perceived or imaginary loss. It could also be caused by self critical characteristics of the ego. Many psychologists wrote about cognitive features of depression trying to identify the cognitive components that caused depression. They also tried to develop many cognitive intercessions that could be used to treat depression.Since then, there have been many successful cases of patients suffering from depression getting well through cognitive therapy. His theory was opposed by behaviorists who claimed that mental causes of problem was unmeaningful and non scientific. With time, it was merged with the behavioral the rapy so as to deal with the problems that it could not have dealt with on its own (Kohlenberg, p 240). Strategies under cognitive therapy Cognitive therapy uses two strategies i. e. emotional focused and problem focused strategies.The problem focused strategy aim at directing the client in the process of identifying the problem. The therapist then helps the client to identify the responses that are utilized in the process of reducing distress in a situation. They are also evaluated to check how effective they are. The therapist and the client then develop and examine alternative responses to see how beneficial they can be to a client. When faced with a stressful situation, the client feels empowered to make mindful alternatives and chose among them the best way in which to respond.This gives the patient a kind of control over situations as they try different methods of getting out of distressful situations (McCullough, Para 32). Emotional focused strategies also aim to get the same outcomes as the other strategy. This perspective aims to alter the perception of the client on the distressing event. It therefore helps in changing the level of perceived suffering. The client is helped to redefine the problem which aids in the transformation of a disaster into a challenge or even an opportunity.The process of restructuring the event can be achieved through various ways like selective attention, distancing, minimization, and looking for constructive value from any given bad situation. When all these happen, the patients get the feeling that he is in control of the situation and this contributes to reduce the levels of stress (Kohlenberg, p 245). Best fit patients for cognitive therapy Since this technique was discovered, the most common condition that it has treated is depression.Patients who have depression are allowed to undergo self evaluation to check whether they act, say and do things the way they are supposed to do and how the patient views all these. Skills deficits are also established so that the therapist can know the source of the problem. Life experiences in terms of how satisfied the patient has been by the kind of life that he has lived (McCullough, p 24). The expectations of the patient are also evaluated in order to know how realistic they are. The therapist checks on the kind of self talk that the patient usually has.If it is negative, then it could be a source of depression since the patient seems not to believe in his capabilities and this could lead to negative repercussions like being fired (Kohlenberg, p 254). The process goes on to evaluate the kind of automatic thought that the patient has. In most cases, there is consistency in that a person who usually has positive automatic thought is likely to have them, in most situations and the same case applies to negative automatic thoughts. Irrationality or rationality of ideas is evaluated because irrational ideas could cause depression.Depressed patients tend to generalize in most cases. The therapist works to find out the extent of generalization in his depressed patients. Cognitive distortion is also checked so that the therapist can be in a position to tell the extent of depression. Optimism versus pessimism is evaluated given different situations. All these are ways through which therapists can know the causes of depression and get ways of tackling it (McCullough, p 25). Comparison and contrast between behavioral and cognitive therapyBehavioral therapy focuses on how one can change from bad behavior through strategies like reinforcement. On the other hand, cognitive therapy focuses on how there can be a change of behavior due to a change in how a person thinks about a certain situation. While cognitive therapies deal with emotions and thoughts that direct a person towards behaving in a particular way, behavioral therapy on the pother hand focuses on how to change and eliminate the bad behavior (Kohlenberg, p 263). While behavioral therapy deals w ith observation of behavior, cognitive therapy deals with the cognitive elements.

Answers Pressure Ulcer

There are two main layers which make up the anatomy of the skin, the epidermis and the dermis. When pressure is applied to the skin the blood supply is cut off and the tissue becomes damaged. 2. There are three main types of force that cause damage to the skin through pressure. These are: . Direct Pressure 2. Shear or shearing force Friction or friction force 3. 3. How long does it take for pressure ulcers to start forming? It is different for each person, some are more susceptible than others.Previously people thought that pressure ulcers started forming after two hours, but this is now known to be inaccurate. 4. What risk factors make service users more susceptible to pressure ulcers? Give 4 examples. 1 . Age 2. Being under or overweight Moisture on the skin 4. Reduced mobility 5. Circulatory problems Lack of sensation 6. 7. Previous history of pressure damage 5. What areas on the body are common sites for pressure ulcer development? Give 5 examples. 1. Scalp 2. Shoulder blades 3. Elbows 4. Sacrum 5. Heels 6. Ears 7. Hips 8. An keels Answers (6-10) 6.Describe the method you would use to check skin for pressure damage. First look at all the areas which are common sites for pressure ulcer development for redness. If you find redness on the skin, feel the area with your hands to check for heat and press the area with your fingers to check for damage of the blood vessels. 7. How would you tell the difference between simple reddening of the skin and actual pressure damage? When you press the reddened areas, healthy skin will go white under your fingers and then return to its normal color, but damaged skin will stay red, which shows that the blood vessels are damaged. . In some cases people have had to have amputations and even died as a consequence of their pressure ulcer. True or false? True 9. What can you do to help prevent pressure ulcer development in service users? Give 3 examples.