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Clinical psychologist recommends:

Befriending psycho-therapy for the tsunami affected

Priyanjali de Zoysa MA (Lecturer and Clinical Psychologist, Colombo Medical Faculty) has recommended befriending psychotherapy for the tsunami affected.

In a symposium recently conducted by the Sri Lanka Medical Association (SLMA) on the tsunami affected and the role of the doctor, Priyanjali de Zoysa speaking on the psycho-social support for the tsunami survivors has said "With most survivors of the tsunami disaster, what is needed at present is not in-depth counselling, psychotherapy or medication, but befriending."

Speaking further on the subject she stated:

What is needed at present

Most humans are resilient. All of us who have undergone various forms of loss and grief ourselves, have eventually come out of it. we may not have needed counselling, psychotherapy or medication in order to do so.

Similarly, with most survivors of the tsunami, what is needed at present is not in-depth counselling, psychotherapy or medication. Instead, what is needed is befriending.

Befriending is a process of active listening and giving an empathic ear to the person who is recounting his troubles. It is not offering psychological interpretations for the person's story, but just being compassionately 'present' with him.

Tread carefully breaking the ice

Tread carefully, break the ice - Rather than talk directly of the experiences the person had undergone, what is generally appropriate is to initiate the conversation with regards to that person's immediate needs.

For instance, food, clothing, getting identity cards and tracing missing family members. So, be informed of the procedures in a given area on how to address these immediate needs of a survivor.

Therefore, if a person asks you a practical question, you will have the needed information. From that point on, the conversation may take a natural turn towards his experiences with the tsunami.

So, don't plunge straight into the person's experience with the tsunami. Talk of more general immediate needs first, and slowly work yourself to the more emotional issues.

Don't pass judgement

Non-judgemental attitude - Do not pass judgement on the person. For instance don't say, "you have lost only your daughter, but look at that lady, she has lost her whole family(!)".

Or don't say, "this is an act of god. So there is a higher meaning to what you went through" or, "this is all because of your Karma". Just listen and be there. Do not offer interpretations of the person's experiences. If the person starts crying, don't stop him. Just be there with him while he cries. If he start shouting at you for not understanding his plight, just be there, don't try to make him understand your viewpoint.

Keep the personal space

Keep the personal space - Some people that have undergone life-threatening situations need to keep more than the usual physical space between himself and the befriender. Be sensitive to that. Don't get too close to the person you are befriending. Respect that person's need for personal space.

Non verbal gestures

Non-verbal gestures - Our non-verbal gestures accounts for 80 per cent of our communication. So, be aware of what you are doing with your hands, eyes and head while you are befriending.

For instance, be aware not to continuously scratch your head while talking as this might give the impression of disinterest or nervousness. Or, be aware not to cross your arms at the chest, this may indicate that you are defensive and not totally open.

For many befriending is enough

Befriending can be all that is needed for many of the tsunami survivors. It's therapeutic experience when a person is able to ventilate his thoughts and emotions to an empathic and compassionate listener (such as a competent befriender).

A few survivors however, may go on to develop psychological problems as a consequence of their experiences. Those persons could be identified later on and they could be offered counselling, psychotherapy or medication, depending on the manifestation of their unique problem.

Service providers too at risk

As service providers for the survivors of the tsunami, it is essential that you look after yourselves too. It is very common that those who have worked with persons that have undergone a traumatic situation also showing symptoms of trauma.

In the case of the tsunami, seeing the enormity of the devastation, hearing the stories of the survivors, seeing the immense task of rebuilding lives may make you feel hopeless, sad, disoriented, guilty, burnt-out or even angry. These are very natural emotions doctors, health workers and service providers experience.

Fortify yourselves first

So, it is important that you fortify yourselves when you work for the survivors. Take a personal momento with you - something that reminds you of stability and hope - when you go out to work with the survivors. This momento will help you anchor yourself when you feel overwhelmed.

Don't try to be heroes

Always work in a team. Do not isolate yourself and do not try to be a hero. If you feel that you can't do any more, that you feel to burnt-out, just stop. You need to be in optimal physical and psychological health if you are to help others. So, don't push yourself if you can't proceed. Take a break. Remember its OK to do so.

(Dr. Anna Eliatamby has helped in the preparation of material used in this talk - Priyanjali)

Your family health pedigree the latest in diagnostic tools

It won't be too long, before you will be asked by your doctor to bring your - family health pedigree record, besides other reports when you go to him for a consultation over a health issue.

According to American Family Physicians 2004 Report, this is already happening in some of the States and the usefulness of it has been highlighted by Dr. Francis Collins MD at the 17th World Conference of Family Doctors held in October last year in Orlando Florida.

Speaking on Human Genomics at this congress Dr. Francis has said "All diseases have a genetic component. Having knowledge of family history will change the management of diseases in future".

And he has gone to detail it out this way "The Importance of knowing one's family health portrait has become one of the outcomes of the human genome project. A web site has been developed for this where patients can enter three generations of their family medical history a paper pedigree which they can take to the doctor".

He has presented this scenario to the gathering - "Peter D. Age 52 goes to a doctor complaining of fatigue, arthralgia and loss of libido".

Many physicians would think it is 'bipola' and treat accordingly. But his family pedigree record reveals of a brother with congenetive heart failure, liver disease and diabetes.

The clinical work-up shows transaminases mildly elevated, lab evidence of borderline anterior pituitary dysfunction and transferring situation of 52 per cent. Hemochromatosis is diagnosed. Brother Peter and his brother are homozygous for the crazy mutation in the HFE gene.

Daily glass of red wine may cut risk of developing Prostate Cancer

Drinking a glass of red wine a day may cut a man's risk of prostate cancer in half, and the protective effect appears to be strongest against the most aggressive forms of the disease, according to a new study led by investigators at Fred Hutchinson Cancer Research Centre.

The findings by Janet L. Stanford, Ph.D., and colleagues in Fred Hutchinson's Public Health Sciences Division, appear online in The International Journal of Cancer.

"We found that men who consumed four or more glasses of red wine per week reduced their risk of prostate cancer by 50 per cent," Stanford said.

"Among men who consumed four or more 4-ounce glasses of red wine per week, we saw about a 60 per cent lower incidence of the more aggressive types of prostate cancer," said Stanford, senior author of the study.

"The more clinically aggressive prostate cancer is where the strongest reduction in risk was observed." Stanford and colleagues found no significant effects - positive nor negative - associated with the consumption of beer or hard liquor and no consistent risk reduction with white wine, which suggests that there must be a beneficial compound in red wine that other types of alcohol lack.

That compound, Stanford and colleagues believe, may be an antioxidant called reseveratrol, which is abundant in the skins of red grapes but much less so in the skins of white grapes.

The compound is also found in peanuts and raspberries and is available as a dietary supplement, which has been suggested to protect against cardiovascular disease. Laboratory studies indicate that resveratrol influences a variety of biological path ways that are important in cancer development.

For example: As an antioxidant, it helps sweep dangerous, cancer-causing free radicals from the body. As a potent anti-inflammatory agent, it blocks certain enzymes that promote tumour development.

The compound also reduces cell proliferation, curtaining the number of cell divisions that could lead to cancer or the continued growth of cancer cells.

It also enhances apotheosis, or programed cell death, which helps rid the body of cancerous cells. It may act as an estrogen, reducing levels of circulating male hormones such as testosterone that fuel the growth of prostate cancer.

While the researchers found that the risk of prostate cancer decreased 6 per cent for every glass of red wine consumed per week, Stanford is quick to point out that research shows the law of diminishing returns come into play when consumption increases beyond moderation.

"From a public-health standpoint, it's difficult to recommend any alcohol consumption given the risks associated with heavy consumption, from increased overall cancer risk to accidental injury and social problems.

But for men who already are consuming alcohol, I think the results of this study suggest that modest consumption of red wine - four to eight 4-ounce drinks per week - is the level at which you might receive benefits.

Clearly other studies show that more than that may have adverse effects on health." For the study, the researchers interviewed 753 newly diagnosed Seattle-area prostate-cancer patients as well as 703 healthy controls who served as a comparison group.,

Detailed information about tumour aggressiveness (such as tumour grade and disease stage) was obtained through the National Cancer Institute's Seattle-Puget Sound Surveillance, Epidemiology and End Results cancer registry.

"Even though this study is based on relatively small numbers, the results are very intriguing and suggest that the potential beneficial effect of red wine and resveratrol - if indeed resveratrol is the active chemopreventive agent involved - would be very important, because it's the more aggressive forms of prostate cancer than are most important to prevent," she said.

A particular strength of the study, Stanford said, is that the participants were relatively young, ranging in age from 40 to 64, and the majority were under 60.

"By focusing on men under age 65, whose incidence of prostate cancer is much lower than that of older men, we can tease out the effect of a particular environmental exposure on cancer risk, such as wine consumption, more easily than if we were looking at men across the entire age range," she said.

This is particularly true when studying complex diseases such as prostate cancer in which numerous genetic and environmental factors are thought to play a role over an individual's lifetime. (Source: Fred Hutchinson Cancer Research Centre)

Sent by Dr. Desmond Fernando

Blood and milk

Why you should drink fresh milk for good health is seen here, when you compare the composition of blood plasma and milk, which shows how close fresh milk is to blood. (Sent to us by the Milk Board) Composition of blood plasma and milk

Blood Plasma			Milk
ConstituentsPercentageConstituents		Percentage
Water		91.0	Water		87.0
Glucose		0.05	Lactose		4.8
Serum albumin	3.20	Lactalbumin	0.52
Serum globulin	4.40	Globulin		0.05
Amino Acids	0.003	Casein		2.9
Neutral Fats	0.09	Neutral Fats	3.8
Phospholipids	0.20	Phospholipids	0.04
Cholesterol ester	0.17	Cholesterol ester 	Traces
Calcium		0.009	Calcium 		0.12
Phosphorus		0.011	Phosphorus		0.10
Sodium		0.34	Sodium		0.15
Potassium		0.03	Potassium		0.15
Chlorine		0.35	Chlorine		0.11
Citric Acid	Traces
Citric Acid		0.20

      
    

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