Digital Parenting

It is often expressed by the parents that handling a child in a digital era is very difficult. Education, entertainment, social connections and even shopping is dependent on digital devices. We cannot deny that the use of internet has indeed made our lives easy but at the same time excessive use of it is showing its side effects as well. Most of us found that our kids on smartphones, tabs, laptops, are using some screen time to engage themselves. You might feel that your child is just physically present with you but he is preoccupied with sharing, watching something, posting on social media and/or taking selfie. Eye contact while conversing with you, mindfulness while eating, and emotional involvement with the celebrations has now become  rare to find. It is a very scary thought for a parent to not have any control over what information is influencing their child's mind, what kind of people he is engaging with on social media, how productive are these long chats with friends and finally what is the child watching on internet. Many parents report that they feel helpless, anxious and even irritable about this. Let’s understand this dynamic concept in detail.

Who is a Digital Parent?

One who either uses one or multiple digital platforms with their child as a parent can be classified as a digital parent. It can be giving instructions via WhatsApp or monitoring their child by video call, or following their child on social media sites. These are all the forms that allow parents to connect, engage, monitor and finally shape their kids as parents. It is important for us to learn the new ways of parenting in digital era. We can appropriately call it as digital parenting.

Significance of Digital parenting.

At young age our kids are making many decisions about devices, games, apps they use and so on. Today there are many apps different purposes like for potty training and study skills videos, subject learning and study, cooking and day to day needs. As a result, we as parent and every child is being attracted to use it often.

Even before reaching to pre-schools kids are able to access the videos and songs. Schools these days use the electronic educational aids, today blackboard is missing and the projector has taken its place. Even homework and instructions are being circulated by using the internet. Most of the parents do not attend parent teacher meet or the cultural activities of their children as they prefer to wave hand by accessing the video call and cheer the kid by sitting in their AC offices. The kids are growing seeing the parents giving more importance to smartphones than them.

And just when you’ve mastered all that, the teen years come along with the onslaught of prominent social media and social networking sites and other anonymous apps. Problematic issues arise that range from sexting and cyberbullying to identifying theft and simply spending too much time online. 

Why is this dangerous:

A)   Smartphones & internet use killing productive Time: Child can learn & enjoy something productive instead of just scrolling the screen for hours. Children & adults don’t even realise that the productive working hours are being wasting time on daily basis. Time management has become so difficult because of excessive use of internet.

B)    Cyber Bullying: Social media has become a new platform for bullying. Comments on posts, making fun of their photos, criticism on social media handle is bothering the kids. Parents may not be aware of what the child is actually facing.

C)   Sexting & Watching Porn: Many teenagers, Adults start interacting with people by chatting and eventually they land up sexting each other. Sometimes these children through general research may accidentally click on some pop ups and advertises which may lead them to adult sites. Smartphones and internet availability has also increased viewership of porn videos by 134% in the last one year.

D)   Online Gambling & availability of illegal substances: Shopping online is very comfortable as it provides the door step service but few of us are getting hooked with the dealers who are selling illegal drugs & some are also experimenting with gambling which is extremely addictive and can cause bankruptcy along with psychological stress, job loss, family dysfunction etc.

What can a parent to do?

At Suasth One Step Clinic, we tried to distil many years of work in this constantly changing space to seven simple, but challenging steps to become a good digital parent.  It is definitely a journey, like parenting itself.  And there is no such thing as perfection.

Family Online Safety institute has suggested the 7 Step prog as below:  

1.  Talk with your kids 

It sounds simple, but the number one indicator of good digital parenting is keeping an open line of communication going with your kids.  Talk early and often.  It is not like the birds and the bee’s discussion.  It is more like an ongoing dialogue that will move and shift as your child works his/her way through several key developmental stages.  Stay calm.  Be open and direct.  But keep talking. 

2.  Educate yourself

This is probably the first technology in human history where the children are leading the adults.  It is very humbling to have a seven year old explain how to upload a video.  Or your teen rolling his eyes once again as you try to master Pandora.  But there is a wealth of tips, videos, explanations and guides out there.  If in doubt, simply type in your question or concern in your favourite search engine and there will be more than enough information available to you.

3.  Use parental controls

It goes without saying that there is content on the Internet you don’t want your kids stumbling upon.  All of the major operating systems, search engines, cell phone providers and gaming platforms provide either free or inexpensive parental controls to help you manage your kids online experience.  And, as your kids get older, move from controls to monitoring tools, particularly around time limits to discourage texting in class or vamping late at night. 

4.  Set ground rules & apply sanctions 

Many parents don’t know where to start in creating rules of the road for their children’s digital use.  But there are many online safety contracts to choose from as well as simple house rules such as NO DEVICES at dinner and handing in their phones at night.  Once you’ve set the rules, enforce them.  Let your kids know that they will lose online privileges if they break the rules and be clear and consistent about what those sanctions will be.

5.  Friend and follow, but don’t stalk

When your teen opens her social media account at 13, ensure you’re his/her first friend.  Follow your kids on their social handle and other social media and social networking platforms.  Don’t overdo it and leave daily comments, but don’t under do it either.  It’s a good idea to stay close as your teen makes his/ her first foray into the world of social media.  But don’t be tempted to spy on your kids, either.  Talking instead than stalking is what builds trust.  Give your teen some space to experiment, to take (healthy) risks and to build resiliency. 

6.  Explore, share and celebrate!

With the rules and tools in place, don’t forget to just go online with your kids.  Play games, watch videos, share photos and generally hang out with your children online.  Learn from them and have fun.   Share your favourite sites and download their apps.  See the world through their eyes.  And let them know your values and beliefs as you guide them on their way. 

7.  Be a good digital role model 

Be the change you want to see in your kids.  Resist the temptation to pull out your phone to check your email over dinner or send a quick text while driving.  Keep an eye on your own digital habits and compulsions and model good digital behaviour and balance.  Your kids will pay far more attention to what you do, than to what you say – both online and offline.  

मॉडर्न कोण ?

अलीकडेच अनेक नव्या रुग्णमित्रांशी चर्चा करताना मला अस वाटल की आपण सगळ्यांनी नव्यानी मॉडर्न म्हणजे काय याचा थोड़ थांबून नव्याने 

विचार करायला हवा. असा विचार येण्यामागिल एक घटना खलीलप्रमाणे:

 एका मध्यमवर्गीय कुटुंबातील सदस्य आपल्याच जवळच्या एका नातेवाईक कुटुंबास जेवायला बोलवतात। त्या कुंटुबात एक १५ वर्षाचा मुलगा आणि दोन १२ वर्षाच्या मुली आहेत . दोन्ही पुरुष जेवणापूर्वी ड्रिंक्स (दारू हा मागसलेला शब्द नको) पिण्याचा बेत आखतात। आपण आपल्या घरातील महिलांना सामान वागणूक देतो हे एकमेकांना दाखवण्यासाठी खास महिलांसाठी अशी 'रेड वाइन' मागवाली जाते। आता प्रश्न राहिला मुलांचा ? त्यांनी काय म्हणून पार्टीला मुकाव? मग त्यांना काहीतरी सॉफ्ट ड्रिंक मगावल गेल.

 वयात आलेला मुलगा मित्रासारखा वगवावा म्हणुन त्या बापान प्रमाणिकपणे मुलाला सांगितल की 'आज बुवा आमची पार्टी आहे'. मुलगा गालातल्या गालत हसला। बापला खुष पाहून पोरग आईकडे वळल. आई जीन्स आणि कुर्ता अशा वेशात मेकअप करता करता आरश्यात बुडून गेलेली। पोरानी आईला विचारल,'आई नवीन म्यूजिक ट्रैक आहे माझ्याकडे घेवू का ?' आई बोलली,            'हु हु पण पेनड्राईव विसरायच नाही बर?'

जय्यद आणि चोख तयारी निशी दोन्ही कुटुंबीय एकत्र येतात। दोघे मॉडर्न आई बाप सह कुटुंब ड्रिंक्स घेवू लागतात। पोर आपला दिवस कधी  येईल? या दिवास्वप्नात एकमेकांशी चर्चा करतात। त्यांना ऐकिवत असलेली दारुची जादू एकमेकांशी शेयर करू लागतात। इतक्यात १५ वर्षाच्या मुलाला त्याचा बाप म्हणतो,        'काय रे चव बघतो का? माझ्याबरोबरच बसून पी पाहिला पेग..... हअ हा हा ' 

मुलाच नशीब उजाडल (कोल्हापुरी भाषेत सांगायच तर नशीब फळफळल ) आणि आपले मॉम- डैड मॉडर्न असल्याचा त्याला आत्यंतिक आनंद झाला।  

विचार करायला लावणारे प्रश्न :
१. खरच का मॉडर्न होण आरोग्यदाई सवई पेक्षा अधिक महत्वाच आहे?
२.   आपण आपल्या मुलांना मद्यपान आणि सोसियल होण हे अविभाज्य आहे अस का बिंबवणार आहोत?
३. कुठल्यातरी आमुक वयात मद्यपान सुरु होण खरच अनिवार्य आहे का?

What is a role of therapy in addiction treatment ?

The most difficult part in addiction treatment is to make the patients open & ready for therapeutic activities.

when patients enter into the de-addiction & rehabilitation centre for long-term treatment most of them reported the hopelessness, self-pity, anger at self and others, blaming etc.
The only way to help the patients is to make them participate in various therapeutic activities.  Some of the famous therapeutic activities are as below.

1. Motivational counselling: As a therapist that at one point of time an addict also feels that he has to stop using the substance, but fear of withdrawals, lack of information about treatment, unable to ask help stops him from taking action. Motivational counselling can help people to make the decision about the treatment.  It brings hope for recovery. Motivational counselling puts the light on the present painful conditions of an addict and makes him aware that there is a way out.

2. Developing Insight: once the patient got motivated then the next challenge is adherence to treatment.  The craving, confusion, peer pressure rules the addict, Most of them quit the treatment after detoxification. focused individual assignments & counselling sessions often help people to get the insight about their severity of addiction & the impact of it.

3. Expressive therapy: An addict needs a supportive empathetic atmosphere to express his feeling. He needs assistance to express his opinions, experiences, perceptions. Expressive therapy provides an opportunity to express the deep-rooted feelings either in a direct way or in an indirect way. It consists psychodrama, poster making, games,  group discussion, art and music therapy.

4. Challenging the old beliefs & thoughts: This is the core part of therapy. The patient learns to challenge his old beliefs. Introspection of thoughts helps him to learn new coping skills to lead the productive life. changing the thoughts and beliefs improves the healthy decision-making.

5. Family & Marital Counselling: After the discharge, the family becomes a supportive network. If family counselling aims to deal with old perceptions, hurts & negative thoughts, helps family members to be a part of support system. Addict also needs to realise how the family is suffering because of his addiction. at the end, the role of family members in recovery, learning about the disease of addiction, communication styles in the family also needs to be addressed.

Sheetal

Self deception part 1: Denial

When it comes to addiction treatment; therapists, clients, and families they defiantly discuss denial as an important aspect. There is a lot of literature available on Denial.

Here we will try and understand denial as a self-deception tenancy. My post on deadly D's has an explanation on self-deception. In short, self-deception is something which prohibits the recognition and acceptance of the disease and the negative consequences. Denial is the first part of self-deception which always help the addict to be in illusion that nothing to worry..... I can stop using anytime....... or I can control my using...... I know there is nothing wrong if I drink or use....etc.

Eventually, addicts come across the negative consequences but their denial never allows them to see the reality. E.g. few addicts justify drinking saying that limited amount of drinking is good for the heart, good for xyz....etc but they fail to understand that when liver report clearly indicates the dysfunction due to the excessive, harmful use of a substance. They still stick to the selective information which supports the using. 

DENIAL IS REFUSING TO ACKNOWLEDGE THE HARMFUL CONSEQUENCES OF ALCOHOL OR DRUG USE.

What I observed during my practice so far is we can make few categories according to the responses of various addicts which shows the patterns of denial.

1. Denial by defining the problem
2. Denial by blaming or by creating problems with external factors.
3. Denial by minimization.

Let me explain all three points elaborately.

1. DENIAL by defining the problem: addicts feel that if they can give strong reason to use no one will blame them. The other type is kept on proving people that they are functional and able to achieve something.

Like this kind of people, they say that 'look! I have a good job I am earning then how can I be an alcoholic or addict?'
My doctor only prescribed me those pills.... so I am using them.... how can I be an addict then.

But the reality is they fail to see the whole picture. They overlook the other evidence such as the withdrawals, preoccupation, cravings, family conflicts due to use, accidents under influence, fail to cut down or stop using.

2. DENIAL by Blaming or by creating problems with external factors: Most of the addicts throw the blame on external factors. they mention rather justifies that how other people and their behavior is only causing the problem. This kind of addicts may mention job pressures as the reason for alcohol/drug use. they may mention that they drink because of critical wife, physical pain, someone is trying to corner etc. 

They look at the substance as a remedial part but they fail to understand that abusing alcohol or substance is putting them again into a problem rather aggravating the problem instead of solving them. Eventually, they create new problems for them. E.g; if one keep on blaming that wife is a reason for drinking; in turn, he makes his relationship more stressful with a wife. He never puts any efforts to talk about how is he getting affected by his wife's behavior or never makes an effort to openly talk to her. after some period he faces separation. then he again starts drinking more saying that his wife left him. 

3. DENIAL by minimizing: To avoid the confrontation many times addicts stops defending themselves but in such situations, they opt for minimizing the amount they use and also minimizing the harmful consequences they face so far. 

this kind of people they say ...... yes! I drink.... BUTTTT no as much as you think... Just 2 pegs... 

No...believe me! my accidents were not under influence. I do drink but its not as bad as XYZ. 

Eventually, addicts get confronted with harmful consequences. that point they are unable to deny the use &/or negative consequences of addiction. However, the story doesn't end here. 

Unknowingly, once denial stops working they go to the next level of self-deception. 

To know more read my next article.... 

SHEETAL BIDKAR

Slogans of Strength

I feel that people need to search some or the other tool for self-motivation during the recovery. In early abstinence people face a lot of challenges, the risk of losing the zeal of hopeful life is high in this period. I found old timers in AA always use the slogans. here I am sharing the few which I use to motivate my clients who want to walk the path of recovery. I must honestly confess at these slogans have given me a positive energy during the difficult times of my life. 

Note: All the slogans are from the AA literature. I use till and found them very useful so I am sharing them with all of you.

1. easy does it
2. first things first
3. live and let live
4. think......think.......think
5. one day at a time
6. let go and let God
7.  kiss---keep it simple stupid
8. this too shall pass
9. "Be nice to sponsees they might be your sponsor some day"
10. expect miracles
11.  stick with the winners
12. sobriety is a journey ..........not a destination
13.  poor me.....poor me............pour me another drink
14.  live in the NOW
15.  turn it over
16. aa=altered attitudes
17. be part of the solution, not the problem
18.  no pain.........no gain
19. go for it
20. do it sober
21.  let it begin with me
22.  just for today
23. pass it on
24. don't quit 5 minutes before the miracle happens
25.  practice an attitude of gratitude
26.  god is never late
27.   90 meetings in 90 days.........90/90
28. you are not alone
29. use the 24-hour plan
30. stay sober for yourself
31. First drink does the damage
32. when all else fails, follow directions
33. change is a process, not an event
34.  call your sponsor before, not after, you take the first drink
35.  sick and tired of being sick and tired
36.  it's the first drink that gets you drunk
37. what if........
38.  help is only a phone call away
39. around AA or in AA?
40.   K.C.B. --- keep coming back
41. courage to change
42. easy does it, but do it
43. if I think, I won't drink. if I drink, I can't think
44. get it ---give it---grow in it
45.   principles before personalities
46. to be forgiven we must forgive 

Sheetal 

काय झाले?

काय झाले?

मागच्या एका वर्षभरात १७ ते २५ वयोगटातले अनेक व्यसनी रुग्णांशी संपर्क आला. त्यासर्वांमधे एक समाइक असा बेफिकीरपणा दिसला, त्यांनी त्याचे आयुष्यातील गंभीर अडचणी किती क्षुद्र असल्यासारख्या मांडल्या आहेत; यावरूनच त्यांचा जीवनकडे पाहण्याचा दृष्टिकोन दिसून येतो। हे सगळे खरच मनाला सुन्न करणार आहे.


मी जरा फिरलो कॉलेजच्या बाहेर
तर कल्ला करायला काय  झाले ?
मी जरा गेलो पार्टीला तिकडे
तर बिघडला म्हणायला काय झाले ?


अरे बाबा! सगळेच जातात गोव्याला प्यायला
तुम्हाला लगेच चिडायला के झाले ?
राहिला बैक लॉक इंजीनियरिंगला
तर वाया गेलो म्हणायला काय  झाले?


जरा कुठे मनेवर टट्टो काढला
तर गंजेड़ी म्हणायला काय झाले?
बसलो जरा मैत्रिणीच्या कड़े  डिनरला
तर  बायको म्हणायला काय  झाले?

बुडले पाच-एक हजार पैज लावून
तर कर्जबाजारी म्हणायला काय झाले?
मागितले मित्राला लाखभर रुपये
तर कर्ज केले म्हणायला के झाल?

हो हो येतोच कंटाळा घरी राहायचा
दोन दिवस न सांगता गेलो फिरायला
तर शेफारला म्हणायला काय झाल?

अहो होतोय ना त्रास माझ्यामुळे
मग सोडून द्या मला एकट
नाक कापल म्हणून हिनवायला  काय  झाल?

जमत नाही ना माझ तुमच्याशी???(अगदी उद्धट स्वरात )
मग करू वाटा वेगवेगळ्या
तुझ्या काळजीन जीव चालला म्हणायला काय झाल?

आयुष्य खुप सोप्प आहे
फायद्याच्या गणितच फळ आहे.
मर्जीच राजकारण खेळातच जवानी जगण आहे
नाहीतर.... नको नकोस ओझ आहे
नाहीतर.... नको नकोस ओझ आहे

वेदना

विवाह समुपदेशन हा व्यसनमुक्ती उपचाराचा एक अत्यंत महत्वाचा भाग आहे. अशाच एक सत्रात एका रुग्णमित्राच्या भावना कशा बदलत गेल्या त्याची ही कथा. आधी तो आला आणि तिचा अंदाज घेण्याचा प्रयत्न केला, मग थोड़ा राग आणि तिरस्कार दाखवला आणि सरतेशेवटी तो पुरता अंतर्मुख झाला।

वेदना

ती डोळ्यात आशांची आसवे घेवून बसली होती 

न रहवून माझ्या चांगुल पणाची कड घेतच होती 

भला होतो म्हणे मी लग्नाच्या वेळी 

मोडित काढला संसार म्हणे मी तिचा याच दारूपाई। …… 

खरच। ……… का हे खर आहे?

आजार मला आणि वेदना तिला आहे 

मला वाटायच। …  मीच ना पितो?

मग त्रास तिला का बर होतो ?

आज ती खर बोलली 

तिची वेदना डोळ्यातून वाहीली 

कितीदातरी मी  तिला मारल

संसार वाचवायचा म्हणुन 

हरबार तिन कटु बाजूला सारल 

मला कळलच नाही तिन कित्येकदा असच सावरल 

माझ्या चुकांचे चटके सहन करून 

माझी काळजी कारण कस तिन पेलल?

माझी काळजी कारण कस तिन पेलल?

शीतल बिड़कर 

Breaking the behavioural CYCLE

We are responsible for our behavior. It is true that social, psychological & environmental pressures may influenced ones drinking/using behavior. In order to make a change one need to categorized these pressures.
i. Pressures come form others
ii. Pressures come from within ourselves.
iii. Pressures come from environment

People in addiction complains that they want to change but other people & environmental things pulled them back to substance abuse. As I mentioned earlier we will discuss the above mention pressures  one by one.

I. Pressures come from others: in many communities takings alcohol in social gatherings is very common.  This gathering is an external factor which can pull the individual in a risky situation. Social acceptance may influence how much we drink, what we drink, it may also effect the place and time one may opt for drinking. Social pressures also influence the attitude and perception towards alcohol use.

I I. Pressures comes from within ourselves: alcohol, drugs alter our mood one may use it as a coping mechanism. The unhealthy coping mechanism eventually doesn't work and people get confronted with the real harsh consequences of their choices.  Fears, insecurities, resentments and other negative feelings aggregate the intensity of the discomfort and people feels that substance may help them to handle these discomforts.  Our pattern of conditioning our behavior and beliefs definitely influences the acceptance of substances.

III. Pressures come from the environment: availability of substance, peer influence, weather conditions are examples of environmental factors which may influence the decision of substance use.


In order to break the behaviour cycle one needed to use new behaviours for dealing with social and psychological pressures.  Some suggestions are as below.

1. An aviod situation which you feel you may not be able to handle.
2. Plan your reactions to handling peer pressure.
3. Learning new coping mechanisms.
4. If the stress or tension is chronic then seek professional advice.
5. Know your triggers and plan for healthy precautions.
6. Find the positive, healthy alternative activities.
7. Socialisation with self help group members will be very useful.
8. Taking efforts to understand the exact nature of the disease will help us to set some do's and don'ts for ourselves.

Practicing new behaviours will lead to develop healthy behaviour cycle.


Sheetal

थांबून रहाणे : व्यसनमुक्तीमधील आव्हान

जगभरामधे व्यसनमुक्ती उपचारापुढील सर्वात मोठे आव्हान म्हणजे रुग्णांनी उपचारानंतर  पुन्हा व्यसनाकडे न वळणे। नशा करणे थांबवणे या ही पेक्षा अधिक नशा न करता थांबून रहाणे हे खुप मोठे आव्हान आहे. अनेकदा रुग्णमित्र सांगतात की मला वाटल की मी थांबवू शकतो, दारू बंद करणे हा काही खूप कठीण विषय नाही। पण गंमत अशी की थांबवलेली दारू पुन्हा दबक्या पाउलाने कधी पूर्णतः परत गुरफटून टाकते हे मात्र कधीच कळत नाही।

अशावेळी अस वाटत की व्यसनमुक्ती साठी 'थांबून रहाणे ' हेच धेय ठेवले पाहिजे। व्यसनाचा रोग हा पुन्हा पुन्हा उलटणारा रोग आहे, रुग्ण काही काळ व्यसनाशिवाय राहतो आणि पुन्हा पूर्वी प्रमाणेच व्यसन करू लागतो। थांबून राहण्यामधे काही खालील अडथळे येतात।

१. व्यसनमुक्तीची प्रेरणा टिकून न रहाणे: नशा बंद करणे का ठरवले? यामागची प्रेरणा सातत्याने टिकून राहत नाही। शारिरिक परिस्थितीत सुधार होताच पूर्णतः व्यसनमुक्त  होण्याची गरज जणू नष्ट होते। आपण आजारी आहोत या गोष्टीचा स्वीकार करणे कठीण होऊ लागते। काहीवेळा नुकसानाची तीव्रता कमी होते जसे:  कामावरून कमी केल्यानंतर नवीन ठिकाणी काम मिळते, भांडून गेलेली बायको परत येते वगैरे मग अशावेळी रुग्णमित्राला असे वाटू लागते की व्यसनाचे दुष्परिणाम तो हाताळू शकतो। तो या दुश्परिणामांना आळा घालण्याचा प्रयत्न करतो। 

२. रोगमुक्तीच्या काळातील मानसिक तणाव: काही वेळा व्यसनादरम्यान झालेल्या नुकसानाचे पडसाद पुढे अधिक काळपर्यंत दिसून येतो। जसे स्वतःस माफ न करता येणे, झालेल्या नुकसानासाठी स्वतःस दोषी ठरवणे, पूर्वी व्यसनाच्या काळातील गुन्ह्यासाठी न्यायालयीन चौकशीस सामोरे जाणे, अनेक वर्ष बेरोजगार राहिल्यामुळे चांगली नोकरी मिळण्यामधे अडचण येणे असे काही ताणतणाव सातत्याने समोर येतात। व्यसनमुक्तीचा काळ देखील आव्हानात्मक भासु लागतो।

३. आपलेसे करण्यामधे विलंब: नशेच्या काळात सातत्याने विश्वास भंगल्याने नशा सोडल्यानंतर नातेवाईक रुग्णावर लगेच विश्वास ठेवत नाहीत याचाही कहीवेळा रुग्णांना त्रास होतो। या काळात असे वाटू लागते की, 'मी आता नशेपासून दूर आहे तरीही कोणी माझ्यावर विश्वास ठेवत नाही मग मी कशासाठी हा त्रास सहन करू ?' अशा वेळी इतरांना वेळ देणे आवश्यक आहे. आज मी जी मेहनत स्वतःला व्यसनमुक्त ठेवण्यासाठी घेतली आहे तीच मला भविष्यामधे फायदेशीर ठरणार आहे याचा मनात विश्वास धारावा।  

शीतल बिडकर 

Why is Self regulation A Key of recovery.

Self-Regulation

The recovery rate among addicts is very poor all over the world. Various treatment models, different facilities during the treatment, culture-specific models of  treatment are facing the challenge of poor recovery rate. The disease of addiction is known for it's cunning, baffling, progressive nature. One of the reasons for the poor recovery rate is a lack of continuity or consistent motivation during recovery.  Here are some steps for self-Regulation.  Self-Regulation will help people to maintain a long-term abstinence period. The self-Regulation is a key of recovery. Regulating our own thoughts and behaviour will definitely increase the self-esteem and self-respect too. Recovery is a process so one need clarity about why they are seeking the way out from their addictive life? What are the desirable changes they are looking for? What are the motivating factors                                                                                     for recovery?

If you want to take charge of your recovery then here are few steps for you:

1. Self-determined goals: people most of the time start working with the ambiguous mind. The experimenting approach of people makes them less committed. Back of the mind, the thought of escaping from hard work make them feel secure.  If this doesn't work I will do XYZ .... before thinking about recovery one should confront own self to understand the significance of the decision. one of the most common motivation factors for abstinence is fear of death. Such people are only looking for detoxification and a safe place for some time. Once they feel they got the physical energy back then they don't mind discontinuing the treatment.  On the other hand, people who are in an early recovery phase don't mind using the half way home facilities provided by various rehabilitation centers.

2. Self-monitoring: patients they honestly start reporting their craving levels, mood swings, and other difficulties during the early abstinence period.  They also become more vigilant towards their self-talk and their thoughts etc. They ask for help if they observe any new or abnormal though or behaviour occurs.  Self-monitoring minimises the risk of relapse. People understands their triggers, high-risk situations etc.

3. Self-instructions: patients give selves instructions either loud or quietly to help guide actions. They appreciate themselves for taking right decisions or practicing relaxation methods or for avoiding arguments, reacting assertively etc. Self-instructions help the individual to achieve the desirable goals without getting distracted. It also works as a self-reward technique.

4. Self-evaluation: people judge the quality of their performance.  They are willing to analyse their behaviour objectively.  This the one of the most difficult phase in self-Regulation.  One need to work on own biases and need to improve the open mindedness in this phase. Self-evaluation makes people rational about their choices.

Thus, these four steps help patients to regularise their recovery.

Sheetal Bidkar

DEVIANT SEXUAL BEHAVIORS AMONG ADDICTS

This is my research paper got published in news & views.

30th National conference on Sexology, India 

Copy right material 

DEVIANT SEXUAL BEHAVIORS AMONG ADDICTS

Author: Sheetal Bidkar

Background:Most of the addicts are engaged in deviant sexual behaviour. Chronic and persistent substance use can induce the deviant sexual behaviours, which leads to marked distress, interpersonal relationships, & high risk sexual practices.

Aim: to assess the deviant sexual behaviour among addicts & to understand the contributory factors of such behaviour.

Materials & methods: Semi structured interview of an addicttaking in-house treatment in de-addiction & rehabilitation centre at Hyderabad & case history verification with the regular partner of the same. Diagnosticcriteria according to ICD-10Mental and behavioural disorders due to psychoactive substance usefromF-10 to F-19 is been used as inclusion criteria to select the sample.

Result:Deviant sexual behaviour is common among the addicts. Most common is multiple sexual partners according to present study. Heavy substance use increases the risk of unhealthy sexual practices. There is a relationship between varied sexual behaviour &addiction. Addiction, stressful relationships, ill effects of addiction, sexual, social, economic deprivation, moral conflict, negative emotions, apathetic behaviour leads to deviant sexual behaviours like forced abstinence, Multi partner relationship, participation & watching pornography, lack of desire, obsessive self-gratification, exhibitionism. Age, sex, education, socio economic status, marital status, parenting issues, parents mental illness, increased mobility, peer interactions, lack of knowledge about disease of addiction, rigid attitudes, internet use, increased exposure, physical & psychological ill effects of addiction, strained relationships, financial difficulties, increased emotional imbalance are the major contributing factors for deviant sexual behaviours. In the present study, female subjects mostly in forced abstinence, self-gratification& watching pornography. Male subjects mostly in exhibitionism, Multi partner relationships, watching & participating in pornography. All the subjects are from 20 to 45 years age group. All the subjects are either married or having a regular sex partner. Sexual orientation of the subjects is bisexual &/or heterosexual. The severity of addiction appeared to be most significant predictor of developing deviant sexual behaviours.  

Conclusion:Clinicians need to assess the deviant sexual behaviour among addicts & psycho education about the high risk sexual practices should be a part of rehabilitation programs. The study indicates the need for careful assessment of personality in these individuals and emphasizes the need for further studies on larger sample.

Key Words:  deviant sexual behaviour, Substance Abuse, Alcohol dependence, Drug dependence. 

Sheetal Bidkar

५ कानगोष्टी व्यसनींच्या पत्नी साठी

५ कानगोष्टी व्यसनींच्या पत्नी साठी

व्यसनाचा आजार व्यसनी इतकाच त्याच्या पत्नीलाही आजारपणाचा अनुभव देतो। व्यसनी व्यसनाच्यामगे धावतो आणि पत्नी व्यसनी पतीच्या मागे धावताना दिसते। तो नशा करण्यासाठी अनेक तर्क लढवतो आणि ती त्याला वाचवण्यासाठी अनेक खटटोपी करते। तो दारू पिल्यावर धिंगाणा घालतो ही त्याने पिल्यावर किंवा पिऊ नये म्हणून धिंगाणा घालते। तो दारुचे पैसे जमावण्यासाठी खोटे बोलतो ही त्याला वाचवण्यासाठी खोटे बोलते। अश्या कित्येक पती -पत्नींना पाहून मला तर प्रश्नच पडतो, याच्यामधे आजारी कोण आहे ? कोणाचा आजार अधिक बळावलेला आहे ? एका बाजूला जीवापाड़ प्रेम करणारी हीच पत्नी अनेकदा पती पिवून आला म्हणुन त्याला मारते, चिड़ते, आरडाओरडा करते, आतल्या आत रोज त्याला असंख्य शाप देते। 

अशा द्रुष्टचक्रात अडकलेल्या माझ्या मैत्रिणींना या काही कान गोष्टी 

१. आजारी कोण? : व्यसन हा आजार आहे, त्याच स्वरुप समजावून घेवून आपण विचार केला पाहीजे की,  आजारी कोण आहे? मग माझ वागण सामान्य राहील आहे का? माझ्या आणि त्याच्या वागण्यात काही साधर्म्य आहे का? असेल तर पितो तो आणि नशा चढल्यासारखी बेभान मी तर होत नहीं ना? 

२. दोष कुणाचा? : सातत्याने इतरांना, नशीबाला किंवा स्वतःला दोष देण्याच पूर्णतः थांबवल पाहिजे। एक मिनिटभर विचार करा की तुमच्या नवऱ्याला ताप आला किंवा शारीरिक आजरानी तो त्रस्त झाला तर तुम्ही स्वतःला दोषी मानता का? नाही ना? मग या व्यसनाच्या आजारासाठी तुम्ही स्वतःला किंवा त्या रोगीला कसेबर दोषी मानू शकता? दोष कुणाचा हे कळल्याने आजार थोडीच बरा होणार आहे? आजार तर उपचाराने ठीक होईल मग त्याबाबत अधिक विचार झाला पाहीजे। 

३. मी बिचारी: अनेकदा स्त्रिया आपल्या नशिबाला दोष देताना दिसतात आणि स्वतःस असहाय्य समजतात। व्यसनी माणसाबरोबर जणू काही याही स्वतःची निर्णय शक्ती गमावतात, आता मात्र प्रत्येकीन विचारी होणे गरजेचे आहे. स्वतःच स्वतःची मदत करण्याचा प्रयत्न केला पाहिजे। 

४. लपवू नका: आपल्या पतीच्या व्यसनी वर्तनाबद्दल काही पत्नी लपवू पाहतात तसे करणे म्हणजे अप्रत्यक्ष पणे व्यसनाला हातभार लावण्यासारखेच आहे. त्यामुळे तुम्हाला आणि मुलांना त्रास वाढणारच आहे, व्यसनाचे परिणाम लपून राहणार नाहीत मात्र तुम्ही लपवण्याची धडपड करीत रहाल तर त्यादरम्यान ज्या गतीने आजाराची तीव्रता वाढणार आहे ती वाढतच राहील। 

५. खरा उपाय: कही वेळा शास्त्रशुद्ध उपचाराऐवजी काहीतरी अंधश्रद्धापूर्वक उपाय केले जातात, रुग्णाला विश्वासात न घेता त्याला काही औषधे दिली जातात आणि त्यामुळे अगदी जीवावर बेतण्याचा धोका तयार होतो। पुनर्वसन केंद्रामधेच उपाय झाला पाहीजे। व्यसनमुक्ति साठी काय सुविधा असाव्यात ते जाणल पाहीजे। 



शीतल बिडकर 

अधोगती: तुम्ही दारू पिता की दारू तुम्हाला पिते आहे?

अधोगती: तुम्ही दारू पिता की दारू तुम्हाला पिते आहे?

मला अनेकदा माझे रुग्ण मित्र विचारतात, आम्ही पीतो मग काय होतेय? झाला त्रास तर आम्हालाच ना होईल, बाकी कुणाला तक्रार करण्याच काय कारण? आम्ही आमच्या पैशाची पितो वगैरे , यावर मला एकच गोष्ट सांगते ती अशी..

कुणी किती अधोगती करुन घ्यावी हे प्रत्येकान स्वतःसाठी ठरवाव, पण त्याआधी आपण अधोगती कशाला म्हणतो याबाबतचाच विचार करणे अपरिहार्य आहे, अशाच काही अनोख्या केसेस इथे सांगत आहे.


१) नेहमी टाप टीप टिप राहणारा मोहन कधीही स्वछतेच्या बाबतीत तडजोड करीत नसे, त्याने एके दिवशी घरात कोणी नाही हे हेरून दारु पिण्याचा बेत आखला, रात्री उशीरा घरी येतनाच तो दारू, खाण्यासाठी काही घेऊन आला. तयारी अगदी खास केली आणि तो ठरल्याप्रमाणे पीऊ लागला। खाता -खाता त्याच्या हातून एक घास खाली ट्रे मधे पडला, त्याने तो घास फेकून देण्याचे ठरवले व पुन्हा पीऊ लागला, शेवटचा पेग भरण्यासाठी त्याने ग्लास ट्रे मधे ठेवला आणि बाटलीतील रहिलेली दारू तो ग्लास मधे ओतू लागला। झाल अस की दारू ग्लास ऐवजी ट्रे मधे सांडली। एका क्षणाचाही विलंब न करता त्याने ट्रे उचलला आणि तो पुन्हा ट्रे मधे सांडलेली दारू ग्लास मधे पिण्यासाठी ओतू लागला। आधी खाताना  ट्रे मधे पडलेल्या घासाची त्याला आता मुळीच कीळस आली नाही, त्या ग्लास मधे तो खाद्यपदार्थाचा तुकडा तरंगू लागला, त्याने ग्लास घेतला आणि पिणार इतक्यात मनात आल, 'छी छी हे काय? ट्रे मधे पडलेला घास मी कीळसून फेकणार होतो पण दारू मात्र ट्रे मधून परत ग्लास मधे मी आनंदाने पीटो आहे ?' नक्कीच मी दारू पितो नाही तर दारू मला पीत आहे.

मोहन आणखी घाबरला स्वतःवरच थोडा चिडला आणि तात्काळ दारू सोडण्याचा निश्चय त्याने केला आणि अगदी आठवडाभर तो समुपदेशानासाठी येवू लागला, त्याला दारू सोडण्यासाठी इतकीच अधोगति पुरेशी होती।

पण सगळेच मद्यपी स्वतःची अधोगति ओळखू शकत नाहीत, काही नोकरी घालवतात, कहींचि बायको निघून जाते, काही कायमचे अपंग होतात, काही रोडवर पडतात, काही नल्यामधे तर काही तुरुंगात जातात, काही पूर्ण वेडे होतात तरीही स्वतःची अधोगति ओळखता आणि मान्य करताना अपूरे पडतात। व्यसनाची हीच खरी शोकांतिका आहे.


शीतल बिडकर

भेट

भेट

व्यसनमुक्तीच्या प्रवासामधे अनेकदा लोक स्वतःचे आत्मनिरीक्षण करतात, भावना, विचार, कृती याचा जणू  सखोल अभ्यास करतात। प्रत्येक दिवशी ते स्वतःलाच नव्याने भेटतात। अशाच एका भेटीची ही कहाणी।


अशाच एक कातरवेळी, मनात आली गोष्ट वेगळी,
धावलो आरश्याकडे अगदीच अवेळी,

पाहिले मी मज नव्याने त्यावेळी ,जागली नवी उमेद कोवळी,
मला मी नहाळयत होतो, नवी ओळख करीत होतो

भटकलो जरी काही काळ, जीवनाला नव्याने घालितो आळ,
येईल पुन्हा सुखाची सकाळ, बुडेल व्यसनाची संध्याकाळ,

गटचर्चा आणि लिखाण, सत्रात शोध सुरु झाला तात्काळ,
सखे, सोबती आणि मदत गट दविति व्यसनमुक्तीचा सुकाळ,

विचार आणि आचार बदल जाणवू लागला तात्काळ,
आप्तांचा विचार झाला अधिक सबळ,

भावली मला माझी अनोखी भेट.....
भावली मला माझी अनोखी भेट.....

शीतल बिडकर

Sending your loved one's for addiction treatment

Addiction is a family disease. Most of the time family kills lot of  time in taking decision about long term in-house treatment. Unlike other countries in India family can take decision  to admit addicts & mentally ill people by the help of law. If the patients can not take rational & helpful decisions for themselves family can take decision for them with the help of law. So if you are sending your loved once to rehab you should be aware about following things:

1. The stay in rehab will not be comfortable for both the patient & his family.

2. Patient may try some tricks to come out of rehab by giving false reasons like: food or hygiene etc. It is always good to see the place & discuss the facilities, treatment plan with the people in the centre.

3. Have trust: You need to have a trust on people who are there in rehabilitation centre, You must take regular feedback from people over there about patient.

4. Understand the process of treatment: If there is a family meetings or open sessions put more efforts to understand that how this can help your loved once.

5. Give all the possible information: Legal cases, health complications, behavioural abnormalities etc all information give in detail.

6. Do not send things like extra medications, gold chains etc. because patient may misuse them.

7. Stop enabling: Do not become obsessive or over anxious about the client even if he is not cooperating for therapy he is at least maintaining the abstinence.

8. discuss all the do's & don'ts with counsellor before discharge

9. Discuss the post discharge plan with therapists & take dates for follow up.

10. have a back up plan: Patient may relapse after the treatment also be aware about the fact & set a realistic back up plan. i.e. what you should do if he/she goes back to addiction. etc.

Remember Big Journey starts with small steps ............

Sheetal Bidkar

अनोळखी

आम्ही आठवड्याच्या शेवटी अशा सत्रांची आखणी करतो ज्यामधे रुग्ण मित्र काहीतरी नव्याने व्यक्त करतील, अशाच एका सत्रातील ही कविता जी एका रुग्ण मित्राने लिहिली आहे

मला व्यसनमुक्ति केंद्रामधे आधार देणारे माझे समुपदेशक कसे होते त्याची ही कविता


पाठमोरा एकटा खिडकीशी बसुन मी
मुसमुसन बोलत होतो  ……।
शब्द नव्हे तर यातना म्हणा
डोळ्यातून टपकत होत्या,

उमगली जणू मजला
स्वतःची सद्यस्थिती,
अवघडलो  , बावरलो मी
 तुटला  आतून  परी

असंख्य चूका अन असंख्य शाप
समोर केवळ  भकास सकाळ,
व्यसनात बुडलेले, कललेले प्राण
जगण्यालाही ना उरला त्राण

कोणी अचानक पाठीवरी देवून थाप
बोलला स्वतःची कहाणी कित्येक तास
भोगुन, जगून माझेच हाल
मदतीचा का देवू पाहतो हात?
म्हणे मला ………

  मित्र वा बंधू समज
शांत ऐकणारा सोबती समज
मरगळ सारी बोलून टाक
चैतन्याला देउनि हाक

म्हणे तो मी ही होतो व्यसनी,
दोघे मिळून तोडू व्यसनाची साखळी
असलो जरी अनोळखी

दोघे मिळून तोडू व्यसनाची साखळी
असलो जरी अनोळखी
असलो जरी अनोळखी

अनामिक मद्यपी

Interviewing Relapsed patient

Treating a relapsed patient takes lots of efforts. They have fixed view towards treatment, Counsellors & therapy structure. Many of them carry a belief that they know the program & that is not helping them.  They feel that relapse is a outcome of treatment failure. Almost all the de-addiction rehabilitation centres introduced 12 step program & relapse patients they feel there is nothing new I am learning in repeated admissions. Here are some important things therapist can keep in mind before interviewing relapse patients.

1.       Understanding his perception towards treatment: Mostly the structure, timetable & sometimes therapeutic program may have similarities with the previous treatment experience for the client, so allowing him to talk about the past good & bad experiences with the treatment centre or self help group is very important. Though sometimes it sounds irrational but gives the clear idea about his beliefs.     

2.       Allow catharsis: Patients has their own analysis of relapse, what triggered them or why they refused help etc, one need to understand that because that is the reality for the patient. Immediate confrontation with the patient may push him to the shell; He will not feel comfortable to talk anything after that. Giving them a chance of catharsis strength the rapport with him.

3.       Making a partnership: Motivating a client to participate in individual & group therapies is very important. It gives them a message that they are responsible for their recovery. Sometimes they feel that doctors will take care of my disease, I need not do anything about it. After detoxification therapist should clearly mention patient’s role & therapist’s role in his recovery. Making a partnership will motivate them to cooperate with treatment.

4.       Tailor-made Program:  Each client has unique & has different issues, one has to address the client’s needs. Same assignments & treatment may not be effective with everyone. 

Why In-patient Treatment for addicts?

Nobody likes the confinement, we all love freedom. Addicts compare jails with in- patient treatment. However family also sometimes feels that outpatient treatment will be a better option but it eventually gets fail. An addict is pre-occupied with the thought of using substance it is difficult for him to participate in individual counselling sessions with this mind set, There are high chances of addict to use substances as a result of uncontrollable cravings. He may feel ashamed or guilty to go to therapist after drinking or using substance. An addict always gives first preference to his substance so adherence to outpatient treatment becomes challenging.  There are few rational for suggesting a in-house treatment for an addict; the reasons are as below:

1.     No access to substance: In a natural environment addict has open access to substances or alcohol. In-patient treatment automatically turns in to compulsive abstinence as rehabilitation caters doesn’t allow the patients to use any chemicals once they are admitted.  
  

2.     Structured routine: after detoxification, patients are supposed to follow the structured timetable in the rehab. It includes fixed timings for food, exercise, sleep etc. An active addict doesn’t have a structured day in natural environment. He sleeps whenever he wants or he don’t mind skipping food for days together which may worsen his health condition. 

  

3.     Peer help: In the rehabilitation units he gets the peer group like him who is also fighting with the addiction, the peer educators works as role model & he can get motivated.   

4.     Less deviation: patient is able to avoid the unnecessary deviations like meeting the using friends or responding somebody on phone or mails by being in the in-house treatment.

5.     Focus on self: Less deviation, good positive peer support, in puts by therapists allow the patients to focus on themselves and change their thoughts, attitudes towards substances. They will be able to put conscious efforts for bringing the desirable changes. 
  

6.     Under observation: While taking the in-patient treatments there counsellors, therapists, doctors are supposed to give a feedback, that means the patient will be under observation & he will get the right suggestions during the treatment. It saves lot of time & patient gets good directions to mould his behaviour.

7.     Helps to introspect: The suggestions, psycho education, peer feedback, etc helps the individual to introspect his behaviour & learn from the past mistakes.

8.     Managing cravings & triggers without substance: During the treatment patients learn that they can overcome the craving & stress & negative emotions without the substance; they learn the new coping mechanisms & become confident.  
    


     Sheetal Bidkar

चांगल्या व्यसनमुक्ती केंद्राचे काही निकष

मागच्या कही वर्षात महाराष्ट्रात नव्हे तर पूर्ण भारतातच जणु व्यसनमुक्ती केंद्रांचा सुळसुळाट झाला। मी पुण्यात मुक्तांगण नावाच्या एका प्रशिक्षण केंद्रात काम करात होेते आणि सुदैवाने मला पाच राज्यामधील व्यसनमुक्ती केंद्रांची पहाणी करण्याची संधि मिळाली। महाराष्ट्र, गोवा, मध्यप्रदेश , गुजरात आणि छत्तीसगढ़ या राज्यमधील जवळपास ९२ केंद्रांशी माझा संपर्क होता।

त्यानंतर मी २०११ पासून आंध्र प्रदेशमधे काम करीत आहे, सर्व अनुभव एकत्रित करता मला अस वाटत की चांगल्या व्यसनमुक्ती केंद्राचे काही निकष आपण ठरवले पाहिजेत, त्यामधे खालील मुद्यांचा समावेश असावा।


१. व्यसनमुक्ती केंद्रामधे शारिरिक आणि मानसिक आरोग्याची काळजी घेणारे लोक असावेत जसे फिजिशियन, साइकोलोजिस्ट, साइकेट्रिस्ट, कौंसिलर, असावेत

२. व्यसनापासून दूर राहणारे (रेकवरिंग अलकोहॉलिक्स ) लोकच अनेकदा केंद्र चालवत असल्याचे आढळते, पण प्रत्यक्षात त्याचा खास फायदा होत नाही। पिअर एज्युकेटर म्हणुन त्यांची भूमिका नक्कीच महत्वपूर्ण आहे पण उपचारामधे आणखीही घटक असणे योग्य ठरेल

३. कुटुंबीयांसाठीही मानसोपचार होणे आवश्यक आहे.

४. स्व मदत गटाची ओळख व्यसनमुक्ती केंद्राद्वारे होणे गरजेचे आहे.

५. अनेकदा व्यसनमुक्ती केंद्रांमधे मानसिक आजारांच्या रुग्णांचाही समावेश असतो, अशा केंद्रामधे व्यसनमुक्ती साठी लागणारे उपचार वेगळे असल्याची खात्री करावी

६. व्यसनमुक्ति केंद्रांमधे शारीरिक मारहाण तसेच अपमानास्पद वागणूक असू नये.

७. व्यसनमुक्ति केंद्रांमधे पालकांना भेटीची परवानगी असावी।

८. उपचारानंतरही रुग्णानी काय  करावे काय करू नये याच्या सुचना स्पष्ट असाव्यात।

९. उपचारादरम्यान रुग्णमित्राना मोकळेपणाने त्यांचे विचार आणि भावना व्यक्त करण्याची मुभा असावी।

१०. नोकरी, व्यवसाय याबाबतच्या देखील सूचना असाव्यात।

तुमच्या शंका जरूर विचारा 
email: sheetal.bidkar@gmail.com


शीतल बिड़कर 

दुधारी आजार

व्यसनामुळे जे मानसिक आजार होतात, त्याची ही कहाणी


नको नको ते मनात येते
अगतिक मजला करुनि जाते,

भयंकराची भीति आणिक शंकेची गति
अपसूक वाढत रहते अस्वस्थतेची स्तिथि ,

जाणीव जणू मरुनि पडते
कधी जणू मन निपचित होते,

कधी अनावर क्रोध माझा
माझ्या वारी स्वारी करी,

बेभान उद्रेक मज
लाजवी अनेक समयी,

खरे तर मी असा नव्हतो
बुरा परी मी राक्षस नव्हतो,

आता कळेना माझे मला,
वेडा म्हणू की व्यसनी स्वतःला …..
वेडा म्हणू की व्यसनी स्वतःला .......