Going Home

Of the original psychoanalytic triumvirate of Freud, Adler, and Jung, perhaps the most forgotten was Alfred Adler. Adler was best known for the creation of the term “inferiority complex”, but perhaps his greatest contributions were his founding of the child guidance movement, community mental health centers, and his humanistic approach to psychopathology in general.
Adler died suddenly and unexpectedly, most likely of a heart attack, while on a speaking tour in Scotland. He was cremated there, but oddly, his ashes disappeared, perhaps in the chaotic runup to the Second World War. The ashes were just recently found on a shelf just a few hundred yards from the crematorium in Edinburgh, and are being returned to Vienna to be buried in an honored place in the central cemetery.
I am writing these words in a hotel in New York, not far from the hospital where I was born almost six decades ago. Yesterday a cab driver took me down Park Avenue, to a writer’s bar in Greenwich Village I wanted to see. As you travel south from midtown, you drive through a tunnel carved not out of a mountain, but under a building—the Metropolitan Life building (now the Helmsley building). It is an interesting way to build something, and the road itself takes a sharp carve just after you go through the building.
I have not lived in New York for more than half a century, so the experience seemed new to me. But tonight, as I let the thick air of Manhattan surround me as I walked, I remembered it. As a child I would often perch myself on the ledge behind the back seat that most cars had then. I could stare straight up at the world through the back window. That odd sensation of driving down a central street in Manhattan, entering the mouth of a big building, the sky disappearing, and then quickly entering a curve, like a horizontal roller coaster, just came back to me. I remember the strangeness of it, the slight dizziness, not unlike I felt last night in the taxi.
I am not terribly nostalgic about coming home. Life was not good when I lived here. In fact, it was mostly horrible. But it is a touchstone, something that makes one remember who one is. Of course, it is a silly cliché that we all end up going home eventually; we start as ashes and dust and end as ashes and dust.
But there is still something compelling about going back to that original nest, the comfort and safety of the womb, or at least the illusion of that safety.
I left New York and moved to California in high school. Neil Diamond, who went to my high school in New York and had the same music teacher, wrote “L.A.’s fine but it ain’t home, New York’s home but it ain’t mine no more.” What then, is it?
“Home” becomes a touchstone, that which we touch to remind us that we are still alive. It is an anchor, of sorts, a mooring whenever the seas get rough.
Pacific Child began as a dream of independence from the mental health clinics where I had worked previously. Yet it has been my home for 23 years now. As my connection to the heartbeat of PCFA moves closer and more distant, it is my touchstone, my home, my illusion of safety, yet still just a stopover somewhere between ashes and ashes.

Welcome to our New Clinical Director

I am thrilled to announce the hiring of our new agency-wide clinical director, Michael Cameron, Ph.D., BCBA-D. Dr. Cameron has been serving in his new post since March 1st, and has already made a great impression on all those with whom he has come in contact. Dr. Cameron's hiring followed an extensive, nationwide search. Prior to joining PCFA, Dr. Cameron was associate professor and founding chair of the Department of Behavior Analysis at Simmons College in Boston. Dr. Cameron brings a breadth of knowledge and experience to PCFA. His fields of expertise include assessing and treating people with autism spectrum disorder, the evaluation of public and private school-based programs for children and adults with ASD, staff traininhg, and direct supervision of evidence-based behavior analytic services. He also has special interests in health and behavioral medicine. He serves on the editorial boards of the Behavior Analyst Today and the Journal of Speech-language Pathology and Applied Behavior Analysis. He has held positions as clinical director, and vice-president of research and development with behavior analysis agencies in Massachusetts, as well as maintaining a private clinical practice. Dr. Cameron chose to join PCFA because he shares our core values: the client always comes first, and our commitment to providing scientifically validated services built on a solid foundation of respect for those we serve. As agency clinical director, Dr. Cameron is responsible for ensuring the quality, viability and expansion of services of PCFA's offices. He also oversees training and the overall clinical direction of the agency. You can reach Dr. Cameron via our toll-free number: 888-805-0759. His direct extension is 204.

Congrats in Order

Congratulations to our newest BCBAs! Holly Park from our Los Angeles office and Kim Altic from the Redwood Coast office successfully crossed the finish line after completing their marathon requirements toward receiving their board certification. Needless to say, I am so proud of their accomplishments. Both are extraordinarily talented people deeply committed to the work they are doing. We are blessed to have them on our team.

Waiting

I don’t read much fiction, a fact of which I am not proud, but a few years ago I read a book that haunts me. The book was a best-seller by the Chinese author Ha Jin, called “Waiting,” in which a Chinese physician was caught in an arranged marriage and, because divorce was not legal, spent 18 years of his life waiting to marry a nurse with whom he fell in love.

In these modern times and in this western world, we are used to things happening quickly. It is difficult to wait for anything. We want our fast food, our fast cars, and, well…. And as I recognize the person staring back at me in the mirror less and less, waiting seems even more difficult. Time is a limited commodity, and there is simply less of it left in the bottle to drink.

But time is only experience; it is nothing more. And “waiting” is nothing more than wishing or imagining we were somewhere other than where we are now. So, we suffer from our imagination. We suffer from wishing our hands were doing something else, our eyes were feasting on a different sight.

So let us breathe in patience, and appreciate each moment to the extent our neuroses allow. In the Midwest there is a saying: if wishes were horses, beggars would ride. So, let’s let wishes be horses, and let’s let them ride off into the sunset with empty saddles.

Just a Little Bit Better

Ten years after Braulio Montalvo succeeded Salvador Minuchin at the reins of the Philadelphia Child Guidance Clinic, an interviewer asked him what the biggest difference was in his impressions of family therapy from the early days. He stated that he learned to expect less, that families didn't change as radically as what was hoped for when family therapy was nascent. Yet, what became clear to me after practicing family therapy for two decades, was that small changes in families were often perceived by family members as big.

As a couples and family therapist, I learned to ask a simple question. What is the smallest change that needs to happen in order for you to know that things are getting better?

When people were able to focus on making small changes, they felt better. Change did not have to be daunting, and they could see their accomplishments and feel good about their success.

As behavior analysts, we know this well. We are taught to shape behavior by breaking down complex behavior chains into their smallest parts, and we teach "successive approximations" until the complex behavior becomes seamless.

Can we apply our own methods to ourselves? What if we told ourselves, "what is the smallest change I can make in order to know things are getting better?" Would we choose not to focus on losing 20 pounds, but instead on 2? Would we choose to finally pick up the musical instrument that sits dormant, and practice for just five minutes a day? Would we choose to write one page of our dissertation or that article we have been intending to tackle, instead of focusing on completing the entire project?

I am a sixties (that's 1960's, not 1860's) musical fanatic. I can't help but think of Peter Noone singing the chorus of one of Herman's Hermits great songs: Now ain't that just a little bit better?

Happy Kaizen New Year!

Those of you who have recently been meandering around the hallowed halls of Pacific Child and Family Associates have heard me muttering the word "kaizen" repeatedly under my breath. This is my new mantra. I have been trying to implement this American-born and Japanese-bred management style at Pacific Child, in true kaizen style, little by little over the last couple of months. Things are going great here, and I do believe this approach is a very cozy bedfellow for those of us who call ourselves behavior analysts. It is a method that encourages personal initiative. It is interactive and flexible, creating cycles of creative progress which ultimately lead onward and upward.

So, in the next few blogs, I intend to clue you in on the principles of kaizen and how they apply to what we do.

There are several facets of the kaizen approach, some big ones and some not so big ones. One key element is the focus on making small, measurable change, as opposed to large, radical shifts. Sounds like ABA, yes? We take our baseline, assess the problem, make a plan, measure the outcome, and memorialize the results if they are positive. It is the classic A-B design.

But in this entry, I want to focus on another piece of kaizen philosophy. That is the piece having to do with the importance of taking care of oneself. It is about working hard at what we do, but not so hard that we allow ourselves to get burned out.
In this holiday season let’s pause and consider how self-care gives us more energy to care for others as well. Self care doesn’t mean self-indulgence, or being self-centered. And it’s much more than finally taking that long, slow bath or treating yourself to a massage. Nurturing oneself can also mean embracing the kaizen principle of ‘personal discipline’ as a daily practice. That type of self-care helps us reduce from our lives those things which waste time, energy, space and resources. We find we have more time and more energy.
It’s not about expecting more from oneself than is reasonable. Rather, recognizing that the kaizen elements of effort and quality and can be applied to our own lives as well as our work. Underlying it all is the willingness to change.

Research has shown that the majority of New Year’s resolutions are broken very quickly. The one-shot, sudden approach, no matter how well-intentioned, can fail us. I’m going to look toward 2011 as the beginning of a fresh personal philosophy, inspired by the kaizen method of sustained change which is aimed at gradual improvement in a humane, people-oriented way. I hope to take better care of myself and in so doing take better care of our employees and our clients. Happy New Year.

Rising Stars

Just some words of congratulations on some of Pacific Child's rising stars. Marta Marquez and Hilary Zeller are our newest BCBAs! Congratulations on leaping the final hurdle. Also, I want to congratulate LaDonna Haltom, one of our senior therapists in the Southern California office, for being promoted to a supervisor position. Also, I want to welcome aboard two new supervisors. A warm welcome goes to Laura Simpson, our newest supervisor in the East Bay office, and Andria Hernandez, our newest supervisor in the Inland Empire office. We welcome your commitment and passion and your dedication to providing the highest quality ABA services to our clients. Congratulations to you all, and welcome aboard.