An addiction is defined as something a person does not want to do, but is compelled to do in an uncontrolled and compulsive way to avoid physical and psychological suffering. There are various types of addictions to substances, people, places and things. No matter what they compulsively and uncontrollably do, there are people who are involved in non-chemical dependencies, but at the same time are causing problems to their families, to the one using or participating directly, and in general to those around.

Addictions and behavioral disorders are presented jointly in time and space, and often mean the addicts exclusion from most of the scenarios in which human beings go about daily.

This exclusion causes, among other things, feelings of confusion difficult to understand, and a host of mixed emotions that accentuate in situations that seem hard to control. This is coupled; in the case of substances intake, to the ability developed to obtain almost permanently altered states of consciousness.

An addiction, drug or medicines addiction, is a psycho-physical state caused by the interaction of a living organism with a drug, characterized by behavior modification or other reactions, generally because of an uncontrollable urge to use a drug continuously or periodically, this way experimenting its psychic effects and, on occasion, to ease the ailment produced by the drug deprivation, namely the abstinence syndrome.
The feeling of wellness or pleasure that the use of some substances produces is caused by biochemical transformations in the brain, so the absence of use causes the opposite effect: ailment produced by the lack of chemicals that relieve the tension.
The pleasure that causes the substance is short-lived and with time, the pleasure reduces. This progressive desensitization is called tolerance.
If drugs are used as an escape from problems that one does not know how to solve, the probability of addiction is much higher than if they’re used is for recreational reasons. To a greater or lesser extent, though, there is always some kind of risk.

TOBACCO ADDICTION

Tobacco addiction is caused –mainly- by one of its active components, nicotine; in the end, the action of said substance determines the abuse.

Tobacco addiction is a systemic chronic illness belonging to the group of addictions and is catalogued in the Diagnostic and Statistical Manual of Mental Disorders DSM-IV of the American Psychiatric Association. Currently it is considered worldwide as the main cause for a fatal and preventable illness. It is considered a systemic chronic illness with possibility of treatment.

According to the World Health Organization, tobacco is the first cause of illness, disability and premature death worldwide. In Europe, tobacco addiction causes each year 1.2 million deaths. It is directly related to the emergence of 29 illnesses, of which 10 are different types of cancer, and is the principal cause of 95% of lung cancers, of 90% of bronchitis and more than 50% of cardiovascular illnesses. In Spain, 50 thousand people die every year because of tobacco use, even more than traffic accidents and the use of all the illegal drugs put together.

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ALCOHOL ABUSE

The abuse of alcohol consumption –that many people call booze, it was a party, I over drank- no matter if it is beer, whisky, cognac, brandy, etc., nor the quantity, nor the kind of drink consumed, nor the frequency of drinking. It could be one or several drinks –one, two, three times a week, or even daily-. This has lead many people to determine that they are entering a problem zone, being family related, work related, social, emotional, economical, and obviously, they deteriorate heir physical, mental and spiritual health.

We realize that one person is abusing alcohol thanks to information from their family and friends, since the drinker always denies it regardless of the problems he or she is causing to others or themselves.

Alcohol abuse always comes with a host of inappropriate conducts which –left unattended- will cause the person to drink more and his or her problems increase.

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DRUG ABUSE

Drug abuse is a stage of the addictive process; it represents the deterioration process of the personality and a spiritual unbalance. It’s an antecedent to a stage of dependence to one or various drugs, as well as to abrupt and uncontrolled behavioral changes.

The search for pleasure causes the person who abuse of drugs to forget that its effect is transient and in order to feel the effect of the earlier occasions of use, it is necessary to consume a higher quantity more frequently.

Drugs oscillate among the depressive states of some people: their search for identity, the evasion to problems and their resolution, and the absence of life abilities that allow them to endure and overcome anguish states associated to their daily lives.

The life of people who abuse of drugs is systematized, rituals are created and the patterns of consumption are automated. Thus, there are emotional, social, economical, affective and spiritual losses.

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PILL ABUSE

Known to the world as the “silent addiction”, the abuse of pills, tablets and other medicaments originally prescribed by a physician in an appropriate and necessary manner, becomes with time in one of the organic, behavioral and emotional, undercover problems more difficult to treat, either in men or women.

It’s silent because it has generated a culture associated to “have a drugstore at home”, keeping medicines that remain when the recommended period of intake ends.

At the same time, it presents itself at the appearance of symptoms of any illness or ailment, or when persons close to the addict recommend the use of such and such medicine to avoid going to the doctor. This explains clearly the concept of “denial” to the ailment because of self-medication and the idea that “I can control everything”.

The abuse occurs when a person to whom medicines have been prescribed for a given time, continues the intake compulsively and uncontrollably by his or her own decision or self-medicating, and sometimes lying and deceiving doctors to obtain written prescriptions.

Pill abuse, no matter if they are tranquilizers, stimulants, hypnotics, sedatives, painkillers, anesthetics, among others, is a sign of deterioration and emotional unbalance, and in general of all the areas of a person’s life, including his or her body, since all medicines have collateral effects. However, it specially shows deterioration in the spiritual balance of the person.

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CHEMICALS DEPENDENCY

The term chemical dependency refers to a primary illness characterized by the dependency and attachment to a chemical product that alters the state of mind and humor. Chemical dependency includes drug addiction and alcoholism (dependency to alcohol and to drugs).

A person chemically dependent cannot stop drinking or taking a chemical product that alters the state of mind, despite suffering economical, vocational, legal, spiritual, social and health and mind consequences.

It is an illness that exists regardless of age, sex, race, religion or economic status. Is progressive and chronic and if not treated in time, could be fatal.

Denial is a characteristic of chemical dependency, is a defense mechanism that includes a host of psychological maneuvers designed to reduce the impact of the knowledge of the fact that use of alcohol and drugs are the cause of individual problems, more than a solution to those problems.

Typically an alcoholic or an addict is the last person to admit that they can have a problem of use or consumption of drugs.

Denial becomes an important part of the chemical dependency illness process; it’s an important obstacle to the recovery and an associated factor to relapse events.

Denial is astute and baffling, and plays a big part on the chemical dependency, when the addict says he or she does not have a problem.

If an individual who is chemically dependent is “in denial” about his or her alcoholism and dependency, he or she cannot hook on the recovery process.

One cannot work on a problem; unless one can accept it exists.

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BULIMIA

Its main characteristics are present when a person suffers of compulsive eating binges, followed by guilt and the feeling of losing control. It usually alternates with fast or little food intake episodes, but at the same time they suffer from compulsive binges again.

Bulimia or bulimia nervosa. It means excessive hunger or ox-hunger, and is a mental disorder associated with food.

An eating binge is when in less than two hours there is food ingestion much higher than most of the people would eat. Despite the type of food consumed in those binges could be varied; it usually consists on candy and food with a high caloric content (like ice cream, cakes, cookies or chocolate). Individuals who suffer this disorder feel a lot of shame for their behavior and try to hide the symptoms. Eating binges are made secretly or as quietly as possible. Episodes are usually planned and are characterized (although not always) by a quick food intake.

Another property essential to this disorder are inappropriate compensatory conducts in order to avoid weight gaining. Many individuals use different methods to try and compensate eating binges: the most common is self-induced vomiting. This purge method (cyclical patterns of excess food intake and purges) is used by 80-90% of the people who go to clinical centers to get treatment. The immediate effects of vomiting are the immediate disappearance of physical discomfort and the decrease of the fear of gaining weight. Other purge conducts are: the excess use of laxatives and diuretics, enemas, very intense physical exercise and fast.

Diagnosis criteria on bulimia

Both the DSM-IV and the CIE-10 agree that, in order to diagnose bulimia nervosa, eating binges and inappropriate compensatory conducts have to take place at least two times per week for three months.

Direct and secondary effects

• Aspiration (passing of gastric content to the bronchial tree)
  
• Esophageal or gastric rupture
  
• Pneumomediastinum (entrance of air into the thoracic cavity) * Hypokalemia (low levels of potassium in the blood) * Cardiac arrhythmia
  
• Anxiety or eating compulsion
  
• Use of different diets
  
• Dehydration
  
• Menstrual disorders and amenorrhea
  
• Sudden weight increase and decrease
  
• Increase in the frequency of dental cavities
  
• Loss of tooth enamel
  
• Increase in the size of salivary glands, or their infection
  
• Hair loss
  
• Weight destabilizing
  
• Depression
  
• Fainting
  
• Wounds of the oral mucosa
  
• Alterations of tooth enamel
  
• Headaches
  
• Dizziness
  
• Throat aches (after vomiting)
  
• Dry skin
  
• Weakness of the legs

Mortality rate is of about 5%. A study says that 20% of women with bulimia still fight against the disorder after ten years.

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ANOREXIA

The term anorexia comes from the Greek a-/an- (negation) + orego (tend, crave). It is a frequent symptom in a multitude of illnesses and physiological situations that consists of the decrease of appetite, which can lead to a decrease in food intake.

The most common cause of anorexia is the very satiety after food intake. This physiological situation is called postprandial anorexia.

It may appear in general infections, inflammation of intestinal mucosa (Chron’s illness, ulcerative colitis), neoplastic processes, in dementia or psychological disorders like depression or anorexia nervosa, being by itself of little specificity to obtain a diagnose.

The abuse of certain drugs can also trigger the onset of poor appetite, mainly with those stimulants of the central nervous system. It is also a secondary effect of some drugs (antidepressants, Methylphenidate, etc.). The changes caused in the body are:

Clinically important:

• Acute radiation Syndrome
  
• AIDS
  
• Anorexia nervosa
  
• Acute appendicitis joined by symptoms like abdominal pain and vomit
  
• Cancer
  
• Chronic renal failure
  
• Congestive heart failure
  
• Crohn’s Illness
  
• Dementia
  
• Severe depression
  
• Somatizing behavior
  
• Superior mesenteric artery syndrome
  
• Ulcerative colitis

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GAMBLING

Compulsive gambling consists on a progressive behavior alteration by which and individual feels the uncontrollable need to play (gamble), understating any negative consequence. It is an addiction. In some countries, it is cause for divorce.

It’s a disorder recognized by the World Health Organization (WHO) in its International Classification of Diseases en 1992. Nevertheless, this was not the first time that, as a diagnostic category and with the name of pathologic game, was accepted in professional fields. In 1980, it appeared in the Diagnostic and Statistical Manual of Mental Disorders (DSM III). In order to detect cases of pathological game inside the normal population (usually in order to determine the prevalence and incidence of the problem), diverse statistical instruments like the South Oaks Gambling Screen or the Brief Scale of Detection of Pathological Game are used.
The game could become something more important in the life of a gambler than his or her family, job or properties. The dedication to game can be so strong that food, sex or social relations become secondary.

Compulsive gambling is an illness characterized by the uncontrollable urge to play. One might say that someone is a compulsive gambler when he or she not only plays to win, but for the pleasure of playing and is not able to stop, causing emotional, legal, financial and family problems; this addiction is usually joined by others like alcohol and drugs… It’s an illness that, in the end, destroys both the player and the people around him or her. Besides, pathological gamblers lower their social interactions with people not related with gambling, so they only socialize with friends in bars, casinos, etc. Regarding pathological gambling as an illness is discussed by certain professional fields, although given they are a minority, are systematically silenced by a more numerous field, composed primarily by ex gamblers and their families.

The compulsive gambler is managed by an uncontrollable urge to take on risks, which progressively undermines all his or her life. In many occasions, the gambler has to resort to illegal activities or against his or her own nature to obtain the money lost in the game. It also presents a high risk of committing suicide. The deterministic approach to choose as “has to” or “impossible to resist”, assumes that on occasion treatment is more harmful that the disease itself, understanding that for the gambler there is no other option but to offence, so he or she could end up assuming that they are victims of their own urges.

Gamblers can manifest other illnesses of psychosomatic origin. It usually couples with other addictions, like alcoholism and tobacco addiction. Families generally have a characteristic pattern of operation, so the affect by the problem is not always the person that seeks help in professional services and/or self-help associations.

Signs of compulsive gambling:

• Their behavior produces in the family symptoms of depression or desperation.
  
• Threatens the family’s economic resources.
  
• Job unattended.
  
• Illegal activities in order to gamble or pay money to friends, family, financial institutions, etc.

Other warning signs include:

• Choose to gamble instead of being with family, friends and work.
  
• Have blind faith they will get huge winnings.
  
• Think they lost because they didn’t play well.

Even though the DSM system (III, III-R and IV1) and the CIE-102 includes this disorder among the alterations due to low urge control, it is certain that the DSM operative diagnostic criteria have exactly the same design than those of substance addictions, which shows the underlying philosophy for the illness in that system: it is an addictive problem “without substance” included in the wrong division.

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DEPRESSION

Depression (from Latin depressus, which means “despondent”, “down”) is an emotional disorder that in colloquial terms presents itself as a state of despondency and unhappiness that can be transient or permanent. The medical term refers to a syndrome or host of symptoms that affect mainly to the affective sphere: pathological sadness, downheartedness, irritability or mood disorder that could lower performance in the workplace or limit the usual vital activity, regardless of the cause being known or unknown. Although that is the main core of symptoms, depression can also express through conditions of the cognitive, volitive or even somatic type. In most of the cases, the diagnosis is clinical, but must be differentiated from other similar expressions frames, like anxiety disorders. The person suffering from depression could not experiment sadness, but loss of interest and inability to enjoy the usual recreational activities, as well as a less encouraging experience and a slower pass of time. Its origin is multifactorial, but there are triggering factors such as stress and feelings (derived from a disappointment in love, the contemplation or experience of an accident, murder or tragedy, disturbance for bad news, sorrow, and a near-death experience. There are also other origins, like an inappropriate mourning (for the death of a loved one) or even the use of certain substances (alcohol abuse or other toxic substances) and predisposing factors, like genetics or an educative parental conditioning.

Depression can have important social and personal consequences, from the work disability to suicide.

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CODEPENDENCY

Codependency is an emotional illness. It is a pattern of self-destructive conductual interactions inside a dysfunctional relationship or in relationships established with colleagues, family or friends. A codependent person is one that allows the behavior or other people affect him or her, and who is obsessed with controlling the behavior of other people. Codependency determines that a codependent person can feel “shame” or tries to change his or her feelings and most private thoughts, if those conflict with that or other person. It means low self-esteem, seek for approval, not having any limits on their thoughts, feelings or behavior. It is common to please other people, self-denigrating themselves.

Symptoms

Symptoms of codependency include controlling behavior, distrust, perfectionism, avoiding feelings, self-respect problems, excessive worrying, hyper vigilance or physical illnesses associated to stress. It is frequently joined by clinical depression. The codependent person abates before feelings of frustration or sadness, due to his or her inability to handle the situation.

A) Tendency to put the needs of others first, as well as the exclusion of self-recognition. B) Continuous pretentiousness of self-esteem, in order to control other people as oneself. C) Anxiety and distortion of limits associated to intimacy and separation. D) Difficulty to express feelings. E) Excessive worrying about how others will respond to their own feelings. F) Fear to be hurt or rejected by other people. G) Their self-esteem depends on the approval of others. H) Tendency to ignore their own values and trying to own other people’s values.

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MARITAL PROBLEMS

The formation of a couple is a process in which the sharing of thoughts, interests, ideas, values and affection, among other factors, is the goal to achieve.

However, each people are unique, we have our history, values, culture and way to see life and on occasion, due to the low ability we develop to communicate and express our wishes and even our regard to other person, there are conflicts that, paradoxically, are easily solved.

Dependency on other people presents itself in general as one of the main causes that generate conflict in interpersonal relations.

We think about owning the other person, his or her identity, thoughts, ideas, wishes, and we even consider as proper or not some of them, without realizing that in addition to regulate our own life, we irrationally wish to regulate the other person’s life.

Marital relationships get deteriorated when factors like power, dominance and control of the other person, are manifested in daily interactions.
One of the advantages of the marital problems treatment is that there is an intrinsical benefit to all participants. Beginning with a respectful and sane interaction of one another, as well as with the surrounding society, with the lesser possible cost of conflict. And when the conflict becomes unavoidable, to be able to handle conflicts effectively.

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MARITAL PROBLEMS

The formation of a couple is a process in which the sharing of thoughts, interests, ideas, values and affection, among other factors, is the goal to achieve.

However, each people are unique, we have our history, values, culture and way to see life and on occasion, due to the low ability we develop to communicate and express our wishes and even our regard to other person, there are conflicts that, paradoxically, are easily solved.

Dependency on other people presents itself in general as one of the main causes that generate conflict in interpersonal relations.

We think about owning the other person, his or her identity, thoughts, ideas, wishes, and we even consider as proper or not some of them, without realizing that in addition to regulate our own life, we irrationally wish to regulate the other person’s life.

Marital relationships get deteriorated when factors like power, dominance and control of the other person, are manifested in daily interactions.
One of the advantages of the marital problems treatment is that there is an intrinsical benefit to all participants. Beginning with a respectful and sane interaction of one another, as well as with the surrounding society, with the lesser possible cost of conflict. And when the conflict becomes unavoidable, to be able to handle conflicts effectively.

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COUPLE RELATIONSHIPS OR DATING

Dating is a stage in interpersonal relations where in addition to the discovery of our own personality, some different abilities are tested to remain together with that other person. It highlights moments and specific situations in which affection, values, customs, sexuality, culture, emotions, feelings and social abilities of both members of the couple who are dating. These could be manifested as openly as the relationship itself permits it.

However, various negative factors coming from social pressure, customs from different places and even family traditions produce conflict in dating relationships. This causes the couple to go through moments difficult to handle, and on occasion stay with their partner irrationally stationed in adverse situations, unable to solve problems that in most cases are not vital for any of the members of the couple.

Professional intervention for couples and dating problems allow both members to totally get rid of myths and traditions irrationally acquired at home, in their culture and traditions.

Personal autonomy is an indicator of the ability to promote and overcome separation and rejection, as well as to establish deep affective relations, healthy and productive.

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GRIEF FOR THE DEATH OF A LOVED ONE

Grief is a multi-faceted response to loss. Includes an emotional confusion, disbelief, separation, anxiety, sadness, desperation and loneliness, which appear after the loss of someone or something loved and valued.

Besides the conventional focus in affection and emotion, there are also cognitive, physical, behavioral, social –and even in philosophical dimensions- effects.

Death of a loved one is common in human experience. The term loss often refers to something tangible, physical, and grief is the emotional reaction.

Death of a family member, seen as a not resolved grief, may conclude with the separation of that family, loss of jobs, or the search for non-existent culprits.

Professional intervention facilitates the transition along the grief situation, preparing the next necessary step, which is progressively detach from the feeling of sadness and sorrow, preparing ourselves to continue living responsibly.

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SEXUAL TRAUMA AND ADDICTION

Hyper sexuality or sexual addiction is the desire to maintain a level of human sexual behavior high enough to be considered clinically significant.

There is an uncontrollable urge for any kind of sex, from sexual relations with other people to masturbation or use of pornography.

Hyper sexuality is characterized by a frequent genital stimulation that, once achieved, in the long term may not result in an emotional (or sexual) satisfaction. On the other hand, it comes on occasion with feelings of discomfort and guilt. It is believed that this dissatisfaction is the one that encourages the elevated frequency of sexual stimulation, as well as psychological and neurological symptoms.

The concept of hyper sexuality replaces the old concepts of “nymphomania” and “satyriasis”. Nymphomania was considered as a psychological disorder exclusive of women, characterized by a very active libido and an obsession with sex. In men, the disorder was called satyriasis. Currently, the terms “nymphomania” and “satyriasis” are not listed as specific disorders in the DSM-IV, but the remain as part of the CIE-10.

The threshold for what constitutes hyper sexuality is subject to debate, and critics ask if there could be a diagnosis threshold. Sexual desire varies considerably in humans; what one person would consider as normal sexual desire, could be understood by others as excessive or low.

Consensus among those who consider hyper sexuality as a disorder is that the threshold is reached when behavior causes discomfort or impedes social operation. Hypersexual persons could have problems at work, with the family, economic and social. Their sexual desire compels them to frequently visit brothels, to buy pornographic articles, make phone calls to erotic lines and sustain sexual relations with unknown people, making their life revolving around sex.

Hyper sexuality could also be expressed in those with bipolar disorders during manic periods. People who suffer bipolar disorder could continually present enormous oscillations in their libido, depending on their state of mind. Sometimes that psychological need of sexual activity is much higher that they accept as normal, and sometimes it’s really below that.

Hyper sexuality is one of the less known and visible dependencies, because people who suffer from it usually keep it hidden and on the quiet, especially with people who knows them (with whom they even appear as timid). It is estimated that up to 6% of the population suffers from it, and only 2% of them are women. It’s treatable, provided that the person who suffers from it is able to recognize it.

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PSYCHIC TRAUMA

In general, psychic trauma is an event that deeply threatens the wellness (or even the life) of an individual. Other times, it’s the consequence of that event on the mental structure or emotional life of the individual.

In terms of psychiatry a trauma is defined –indirectly- as the “direct personal exposure to an event that involves real threat or death potential or grave damage or any other threats to a person’s physical integrity, or being a witness of an event that involves death, harm or threat to the physical integrity of other person, or find out about the unexpected or violent death, serious damage or death threat or harm experienced by a family member or other close relation (criterion A 1). The person’s response to the event must involve intense fear, feeling of inability to control, or horror (or in children, the reaction must involve agitated or disorganized behavior) (criterion A 2)”. (Post-traumatic stress disorder, in DSM-IV).

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SADNESS

Sadness is one of the basic emotions (not innate) of the human being, along with fear, rage, nausea, joy and surprise. It represents a mood and affective state caused by moral decay and the wish to achieve something.

It comes to human live intermittently, is of short duration and sometimes causes that the people who experience it the ability to generate highly creative ideas, which on execution solve the sadness episode.

It’s the expression of affective aching through tears, sad face, loss of appetite, etc. Often we feel sad when our hopes are not met, when life circumstances are more painful than joyful.

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APATHY

Apathy is the lack of emotion, motivation or enthusiasm. It’s a psychological term for a state of indifference, in which the individual does not respond to aspects of emotional, social and physical life.

Typology

Clinical apathy is considered depression at the most moderate level, and is diagnosed as a dissociative identity disorder at an extreme level. The physical aspect of apathy is associated with physical deterioration, loss of muscle and lack of energy called lethargy, which also has a lot of pathological causes.

The apathy could be specific, towards a person, activity or environment. It’s a common reaction to stress, manifesting as learned helplessness and is commonly related to depression. It can also reflect a non-pathological lack of interest to things not considered important.

It is known that certain drugs cause symptoms associated with or triggering of apathy. It can also be very similar to sloth, of which it could be an extreme form.

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STRESS OR GENERAL ADAPTATION SYNDROME (GAS)

Stress, “fatigue”, is a physiological reaction of the body where various defense mechanisms interact to face a situation that is perceived as threatening or of increased demand.

Stress is a natural and necessary response for survival despite which nowadays it is confused with pathology. This confusion is caused because that defense mechanism could end, under certain circumstances that abound in certain lifestyles, triggering severe health problems.

It’s an emergent work-related pathology that has a particular incidence on the service sector. Being the bigger risk on the tasks that require higher requirements and dedication.

General symptoms of stress

The effect that has the stress answer deep in the body: Dominance of the sympathetic nervous system (peripheral vasoconstriction, mydriasis, tachycardia, tachypnea, slowing down of bowel movement, etc.), release of catecholamine (adrenaline and noradrenaline), of cortisol and encephalin, increase of glucose in blood, coagulation factors, free amino acids, and immunological factors. All those mechanisms are prepared to increase the probability of survival facing a short-term threat, not to be kept indefinitely, as usual.

In the medium term, this sustained alert state wears off the body reserves and could lead to various pathologies (thrombosis anxiety, depression, immunodeficiency, muscle pain, insomnia, attention disorders, etc.).

Triggering conditions of stress

The stressors or stress factors are situations triggering of stress and may be any stimulus, internal or external (physical, chemical, acoustic, or somatic, or even sociocultural) that, directly or indirectly, lead to the destabilization on the dynamic balance of the body (homeostasis).

An important part of the effort made for the study and understanding of stress has been focused in determining and classifying the different triggers of this process. The revision of the principal types of stressors that have been used to study stress give us a first approach to the study of the triggering conditions of stress and show us the existence of eight categories of stressors:

• situation that force a quick information process
  
• environmentally harmful stimuli
  
• threat perceptions
  
• alteration on the physiological functions (illnesses, addictions, etc.)
  
• isolation and confinement
  
• blocks in our interests
  
• group pressure
  
• frustration

However, there is a possibility to carry out different taxonomies on stress triggers:
The sole stressors: refer to cataclysms and dramatic changes on the conditions of the environment, and usually affect a large number of people.
The multiple stressors: affect to only one person or a small group of persons, and correspond to significant changes of vital implications for the persons.
The daily stressors: refer to the host of discomforts, incidentals and alterations on small daily routines.
The biogenic stressors: are physical and chemical mechanisms that directly trigger the stress response without the arbitration of the psychological processes.

These stressors could be present acutely or chronically and, also, could be the result of mental anticipation about what might happen in the future.

Adaptation states

Selye described the general adaptation syndrome in three states:

• reaction alarm, when the body detects an external stimulus;
  
• adaptation, when the body takes defensive contra measures towards the aggressor;
  
• depletion, when the body’s defenses begin to run low.

Stress may contribute, directly or indirectly, to the appearance of general disorders or specific disorders of mind and body.

First, this situation causes the brain to stay on guard. The brain’s reaction is to prepare the body for the defensive action. The nervous system awakens and hormones are released to activate the senses, accelerate the pulse, deepen breathing and tensing the muscles. This response (sometimes called fight or flight response) is important, because it helps us to defend ourselves against threatening situations. The answer is programmed biologically. Every one reacts more or less the same way, both at home or in the workplace.

Short or infrequent stress episodes pose little risk. But when stressing situations happen without resolution, the body stays on constant alert state, which increases the rate of physiological waste leading to fatigue or physical damage, and the body ability to recover and defend itself might be seriously compromised. As a result, the risk of lesion or illness increases.

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NEGATIVE ATTITUDES

An attitude refers to the intentionality in judgment and behavior, of one or several people in respect to situations, persons or specific interactions. In attitudes, there is a mix of values, ideas, judgments, learned answers and semi personal intentionality.

Negative attitudes are the manifestation and the execution of what is planned by one or several persons from their values and judgments, often associated to irrational fears that hide the inability to solve problems and daily life situations.

Negative attitudes affect every aspect of human life, systematically interrupting and hindering the achieving of some human activities.

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DIFFERENT TYPES OF VIOLENCE

Violence is a phenomenon that has accompanied human beings in their evolution, however while human relations have become more complex, the styles of violence have also varied with the pass of time.

There are survivors to different violent scenarios who facing the paralyzing inability to resolve a violent situation become victims and survivors, sometimes unable to forget and overcome the moments and situations of risk and danger at various scales.

A victim is the person who suffers harm or detriment, which is caused by an action, either for someone else’s fault or force majeure.

A victim is who suffers personal harm by a fortuitous event or someone else’s fault. The victimizer is different from the victim because he disguises –consciously or unconsciously- simulating an inexistent aggression or impairment; and/or wrongly putting the blame on the environment or the others.

The term victim is used mainly in three areas: crimes, wars or natural disasters.

Professional intervention produces strategies to face thoughts and ideas that are paralyzing, chaotic or catastrophic. The resolution of the experienced violence is eased with guide and professional support.

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FAMILIY RELATIONS

Family, as any other human organization, is in crisis in certain stages of its development and evolution.

Family growth is caused by the relations among its members and with other members outside the family, in an endless chain of information and feedback.

Each member of the family plays different roles, every so often and on certain circumstances.

Thus, families produce a security niche, but on daily life can also produce insecurity and emotional, economical and even legal risks, among other factors, which could mean serious difficulties for personal and individual development of the members.

In every culture, family sets in its members an independent feeling of identity.

Professional guidance allows the existence of two elements in family members: an identity feeling and a separation feeling.

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WORKPLACE RELATIONS

Workplace harassment

Workplace harassment, known also as moral harassment or very frequently as mobbing, is the action of a harasser or harassers that lead to fear or terror on the affected worker towards his workplace, and is also the effect or the illness produced in the worker. This person or group of persons receive unjustified psychological violence through negative and hostile acts in the workplace by his peers, juniors or superiors, systematically during a long time, for months or even years. Ultimately, the aim of this harassment, intimidation or disturbance is that the victim or victims quit their job.

Swedish scientist Heinz Leymann researched this phenomenon in the 1980s and it was him who first used the term mobbing related to this problem.

Commonly, mobbing or workplaces harassment is confused with burnout syndrome. However, their not the same phenomenon, because literally burnout means “to be burnt” or worn out by very specific circumstances or inherent characteristics of the job, which generates in the worker an intense emotional need. This is quite common among teachers or nurses, for example.
It is also confused with bullying and school harassment, although they’re similar to some extent; the difference is that on the latter there is always physical violence, while in mobbing the strategies used by the harassers or mobbers are always more subtle, rather of a psychological matter, because the intention is to leave no trace of the harassment in order to take notice of the beleaguered or mobbed as incompetent or problematic and, on the way, free them from any guilt because of the difficulty to prove of a psychological aggression.

The term mobbing comes from ethology, a science that studies animal behavior, especially birds, where the defensive conduct of a group of small birds consists on the continued harassment of a bigger enemy, frequently a raptor. This behavior in nature frequently ends with the flight or with the death of the harassed animal.

Mobbing could lead to a professional illness related to the workplace, although both the authorities and the companies are not very keen to admit it as such.

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INEXPLICABLE SITUATIONS

Most of the people reach a stable life with habits, tranquility and even pleasures, because they know where they come from and they may even know where they’re going.

However, an extreme movement begins abruptly in our lives -surprising and rare-, hard to handle and difficult to assimilate. Things happen around us that dizzily change the course of our lives and, of course, also cause abrupt changes inside us, which are unknown and baffling. Our lives have changed from one moment to the other; at the same time we became other people unusually rapid.

Some people name these events as fate; others refer to them as inexplicable situations.

The strategies to face uncertainty, problem solving, decreasing of stress and anguish, become very important factors to re-balance those extreme changes in our lives.

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EATING DISORDERS

Eating disorders are chronic and progressive diseases that, despite manifested through eating behavior, consist in a very complex host of symptoms among which prevails an alteration or distortion of body self-image, a great fear to gain weight and the acquisition of a series of values through a body image. In some cases, publicity has great influence in this. Young people that watch a food or drink ad and feel the urge to eat or drink, makes them do it and takes them back to their bad eating habits.

Factors that cause eating disorders

• Biological factors. There are studies that indicate that abnormal levels of certain chemical components in the brain predispose some people to suffer from anxiety, perfectionism, compulsive thoughts and behavior. These people are more prone to suffer an eating disorder.

•Psychological factors People with eating disorders tend to have non-realistic expectations about themselves and other people. Despite being successful, they feel disabled, inept, defective, etc. They lack a sense of identity. That’s why they try to take control of their lives and most of the time they focus on physical appearance to regain that control.

• Family factors. People with overprotective, inflexible or ineffective families that cannot solve any problem tend to develop these disorders. Very often they do not show their feelings and have great expectations about success. Children learn to hide their feelings, anxieties, doubts, etc., and take control through weight and food.

• Social factors. Mass communication media associate good with physical beauty and bad with physical imperfection. People who are popular, successful, intelligent, admired, are people with the perfect body, or the beautiful. People who are not thin or beautiful are associated with failure.

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OBESITY AND OVERWEIGHT

Obesity is a disease in which the natural energy reserves, stored in the adipose tissue of humans and other mammals, increases to such a point where it’s associated with certain health conditions or an increase on mortality. It is characterized by an increased body mass index or BMI (equal or greater than 30). It’s part of the metabolic syndrome. It is a known risk factor for chronic diseases like: hard disease, diabetes, hypertension, stroke or seizure and some forms of cancer. The evidence suggests that it’s an illness of multifactorial origin: genetic, environmental, and psychological, among others. Or it can be caused by excessive accumulation of body fat, general hypertrophy of adipose tissue.

It is a chronic disease originated by many causes and with numerous complications. Obesity is characterized by the excess fat in the body and is presented when the body mass index on adults is greater than 30kg/m2, according to the WHO (World Health Organization).

Obesity does not discriminate skin color, age, socioeconomic status, sex or location.

In the past, the overweight person was considered as healthy, however nowadays it is known that obesity has multiple negative health consequences. Currently it is accepted that obesity is a cause factor of other illnesses like cardiovascular, dermatological, gastrointestinal, diabetics and osteoarticular ailments, among others.

The first steps to know if there is obesity, is to get the body mass index (BMI), which can be obtained calculating the height divided by the weight of the individual, and then square the result.

Although obesity is an individual clinical condition, it has become a serious public health problem that is on the rise: it has been proven that excessive body weight predispose to various illnesses, especially cardiovascular, diabetes mellitus type 2, sleep apnea and osteoarthritis.

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DIABETES AND ASSOCIATED EMOTIONS

In Medicine, the term diabetes includes two different pathological situations: diabetes mellitus and diabetes insipidus. These disorders do not have any pathological relation among them; for their causes and processes (etiopathogenesis) are different, but share certain clinical manifestations (copious excretion of urine or polyuria, and intense thirst or polydipsia) that have made them share the name.

Usually, the term “diabetes” is used in reference to diabetes mellitus, which is a more frequent and known disorder than diabetes insipidus.

The diabetic, the family, their emotions and diabetes

Once the patient is diagnosed with diabetes, his or her whole family must be included in the guidance process of the treatment. The patient sees this and any other illness as a “loss”, and his or her emotional reaction will be similar to those experienced in any other loss process.

The following symptoms are associated to the knowledge of the diabetic patient and could be from mild to severe. It means they can be taken in a positive way or in a very negative way. Depending on the situation, the family must be well prepared and guided to help the person and his or her emotions.

1. Generalized anxiety
   
2. Mild or severe depression
   
3. Inability feelings (that could be part of clinical depression)
   
4. We must be observant to what the patient thinks, since he or she could develop self-destructive thoughts (usually not following the doctor’s orders, quitting the treatment or actively trying to kill themselves).
   
5. I’ve seen many cases in which these self-destructive thoughts are complicated with alcoholism.
   

You must consider that it will not only affect the patient, but the whole family, which could experiment symptoms. Hence the importance of treating the whole family; it could happen that there is more than one diabetic in the family.

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