30 Dec 2022

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Health Journal: How to Create a Health Journal

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Journal Entry 1: I am worried about my friend Anna. Anna is a 36-year old African American female, and a mother of two boys aged 11 and 8 years. She was diagnosed with depression as a result of a failed marriage and losing her job. Although she is going through cognitive-based therapy to address her problem, she seems withdrawn and distant from her family. She separated with her long term partner and opted to live alone with the boys. The court granted her an opportunity to stay with the children with the partner being tasked to provide monetary and social support to the children. Nonetheless, Anna’s current state has affected her eating habits. She often prefers buying junk food for herself, and the boys. She has gained much weight in the last two months and she is already bothered about her case. I believe there are ways I can help her cope with the situation. 
Critical Reflection: I clearly understand the importance of good health especially when coping with depression and anxiety. While good health is mainly viewed from an illness point of view, I consider good health to be the overall mental and physical wellbeing. Anna’s treatment for depression was cognitive behavioral therapy (CBT). CBT is a type of psychotherapy. It modifies thought patterns in order to change human behavior. In Anna’s case, CBT is being used to change her moods and ensure that she regains optimism about life. She has lost hope in life especially with the struggle of bringing up two boys in the harsh economic times. CBT blends concepts in behavioral therapy and cognitive therapy. According to Lopez-Lopez et al. (2019) CBT interventions are complex, as they include multiple content components and can be delivered in different ways. The fact is the basis of my view that CBT can be to change Anna’s eating behavior. On top of changing her behavior to remain optimism about life, she should be given a reason to remain healthy by observing a healthy diet together with that of her two children. Driessen & Hollon (2010) argues that CBT is a well-recognized therapeutic approach to manage clinical depression. As a mood disorder, the aim of therapy is to help the client review her activities and behavior to respond to the problem without hurting herself. The efficacy of CBT is high for depression (Lopez & Basco, 2010). Therefore, based on the results, the psychotherapist should integrate the goals to improve her eating habits. Anna’s eating problems are solely attributed to her psychological state. She has been struggling to balance between her responsibility to continue taking care of her boys and the demand to look for a new job to start making a living. Furthermore, she is not over her previous relationship that exposed her both to mental and physical abuse. After making all the considerations, it is easy modifying her therapy sessions and even including her two boys. If she is not in a position to continue taking care of them for the time being, they should be handed to another party. Healthy eating is needed for her to recover from her current state. She needs good health to seek for a new job and remain productive for her sake and that of her children. She should be made to understand that a failed relationship coupled with a lost job is not the end of her life. She should dedicate her efforts to correct the problem and start again from scratch. CBT is a flexible therapeutic approach that can integrate behavioral changes in her eating. A two-week timeline can be dedicated to the new CBT model that not only addresses her problems but also achieves desired results in her eating behavior. 
Journal Entry 2: Growing Up, I was a chubby child. The pressure to lose weight was too much from friends and family. I was forced to carry the double-burden of being overweight in that my immediate social circle was not supportive. I encountered several cases of body-shaming that adversely affected my self-esteem. Since I was just twelve years old, I did not what dieting is. Due to my poor strategy to overcome the challenge, I lost 90 pounds by the time I was thirteen years old. I was caving in to the pressure the society was piling on me to lose weight. I later realized that my case reflected the struggles many adolescents go through as they struggle meeting the expectations of the society on weight. I suffered anorexia and low self-esteem before I overcame. 

Critical Reflection: The prevalence of obesity among adolescents in the United States remains alarmingly high (Rancourt et al., 2018). Obesity has been identified as an emerging epidemic considering the health risks associated with it. I try to understand the paranoia among my friends and cousin when I was overweight. However, overburdening adolescents with the pressure to lose weight only adds to their misery during their identity-development phase of life. During adolescence, the views of the society towards an individual can either break or build a person’s confidence and self-esteem. According to Perrrin et al. (2010) the stigma of overweight has worsened since 1970s. I can analyze my experience during adolescence through the lens of overweight stigma. Overweight stigma is a concept referring to the negative perceptions, beliefs and attitudes that people have towards overweight people. Puhl & Heuer (2010) argues that stigma and discrimination towards overweight and obese persons and pervasive and pose serious physical and psychological consequences on the victim. The type of stigma thrives in societies where being overweight is viewed as a failure on the side of the affected person. Instead of developing practical strategies to cope with weight gain, the society prefers stereotyping overweight persons and breaking their self-esteem. 

Weight stigma is generally ignored as a serious threat to normal growth and development among adolescents (Puhl & Heuer, 2010). There are several strategies that can be used to cope with weight gain during adolescence. Markey (2015) presented the case of a friend, Ann, who tried the Paleo diet and succeeded losing weight. In six weeks, Ann had lost fifteen pounds (Markey, 2015). Her strategy was simple: She stopped eating grains, dairy, refined sugars, and processed foods. Ann was not contented despite losing fifteen pounds in six weeks. She was forced to live a miserable life and miss out on the activities that engaged her life. She could not attend office parties or girls’ night outs. She slid into her old life and immediately gained back the pounds. Markey (2015) proposes a strategy that does not involve dieting. Every dieter has intense cravings on foods they have stopped taking. Furthermore, peoples’ dieting efforts are undermined by their preoccupation with thoughts of food. Obese children are burdened by more than weight (Brubaker, 2014). They have to cope with their internal struggles to manage the weight and the external force of being unwanted in the society. I can place my struggles and experience with weight in its rightful context. I propose that during adolescence, individuals should be granted an opportunity and environment to work on their weight without being stigmatized. Stigmatization adversely affects identity development and spills over to the person’s confidence later in life. The stereotypes associated with overweight people should equally be addressed to prevent recurrence of my case. 

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Journal Entry 3: I was born and brought up to the age of thirteen years in Athens. Moving to Canada at thirteen posed serious challenges during my identity development stage. I could not speak fluent English. I felt excluded as a foreigner. I found it difficult making friends and coping during my initial days in Canada. Later I realized that the best way to overcome the challenges is to work on my brand and prove my worth as an individual without spending time lamenting about the challenges encountered. 

Critical Reflection: Identity formation difficulty among immigrant adolescents is deeply researched topic in psychology, sociology and mental health. According to Streeck-Fischer (2015) adolescence is a period of instability caused by restructuring of personality and various biological changes ushering adulthood. The fragile process if made more difficult among immigrant children as they struggle either to retain their native heritage or adopt the culture of the new country and its society. Harassment, discrimination and stereotyping are common among immigrant youths. As an immigrant at the age of thirteen, I realized that while my age mates were progressing with their education and other major milestones in life, I had stagnated struggling to fit in the new society. Filion et al. (2018) argues that adolescence comes with new found freedom and a new sense of importance in the society. The adolescent uses different avenues to assert their position and dominance in their immediate social circles. In my case, I had very low self-esteem and self-confidence. The few times I tried presenting in class ended up in laughter due to my poor spoken English. I slowly sank into a state of pre-depression and wishing that the whole situation could be avoided. However, my teachers and peers were very supportive. They noted the challenges I was encountering and provided a healing environment. I focused more on my strengths as an avenue to bridge the gap between my drawbacks and the goals I had set. 

I fear failing in life. The pressure from my parents to succeed has been high. I thought the pressure was normal until I encountered scholarly articles exploring the subject. According to Hjeltnes et al. (2015) mindfulness can be used to cope with anxious feelings in academic performance situations. In my case, an intersection of academic performance related anxiety and the challenges of an immigrant youth weighed heavily on my back. I have several insights on coping strategies as an adolescent immigrant. I accepted that stereotyping is common and occasionally I have to meet a person who may utter a disrespectful word towards me. I learned to live with the criticism. The only way I could improve on my state was through self-acceptance. Second, I expanded my worldview through cultural competence. Instead of locking myself in my own world and excluding the new culture in Canada, I engaged in a life-long process of learning. I embrace diversity and its beauty. Today, I have friends across the board. We share our experiences and realize that diversity should not be used as a divisive tool but rather as an icing to social groups especially in college. Cultural competence can be used to improve the experience of immigrant children and youth in Canada. Considering the diverse population, cultural competence should be taught as a distinct subject since it can be applied in all fields. I reflect on my past and realize that life is a long-learning process. Living as an immigrant has shaped my world-view to accommodate more views and approaches to life. I am no longer rigid when facing situations. I also have a solid social network that share similar views on diversity and cultural competence. 

Journal Entry 4: Growing up as a racial minority in the United States is one of the best experiences I had in my life. After moving into the United States at the age of thirteen, I started a new journey to have my voice heard in an environment where I was often pushed down or discouraged by circumstances to talk. For instance, I was not as fluent in English as my peers. Therefore, despite having important ideas and concerns, I often decided to remain silent to avoid being embarrassed after talking. The experience shaped me into the person I am today. I have grown resilient and determined to overcome challenges. I have also learned that racial minorities face serious challenges presenting their grievances in settings where they are often not supported. I have developed a network of friends who have helped me adjust in the new setting. 

Critical Reflection: My experience as a racial minority helped me to view racial differences and diversity as a strength and not as a weakness as presented in various media. Instead of lamenting about my challenges, I decided to speak up and develop friends who helped me cope with my challenges. I am a patient person. Many times, friends take advantage of my personality and end up hurting me. That has not stopped me from making more friends and fitting in the U.S. society. Therefore, in this critical reflection, I shall reflect on my journey integrating in the U.S. society and coping with the challenges as they presented. According to Jimenez (2011) concerns still exist about immigrants’ ability to integrate into the broader society. In my case, I was torn between retaining my Greek heritage or adopting the U.S. heritage. At the end, I realized that the two can easily integrate if tackled from a point of self awareness. 

I noted the differences between the two and worked towards the process of integration. According to Okely, Weiss & Gale (2018) culture can be defined as a shared set of values, beliefs or behaviors that differentiate one society from another. As I have learned living as a racial minority and having a culture that is not common among my peers, most of the challenges racial minorities encounter are due to their own perceptions. There are times when certain people will utter negative words against me. I cannot spend much time responding to such negativities since they will only deprive my energy that should be directed towards important activities. In the process of integration, I started working on a project that would bring together several friends from different cultural backgrounds to showcase our traditional cuisines as a way of embracing diversity. The activity worked wonders. We realized that racial and cultural differences should only be used to explore different approaches to life and not as way of showcasing superiority and subjecting other people to prejudice and stereotyping. I realized that the U.S. culture is quite individualistic. I found it hard coping at first since I have been brought up in a different setting. For instance, in our family, meal time is the time everyone come together to discuss about our experiences and progress in school. Meals are given much attention and so everyone must make sure they eat at the same time with the rest of the family members. If I was to advise a person on the best way to adjust in the U.S. society as an immigrant, I would tell them to first try their local cuisines. I shared a lot with American friends who were welcoming and ready to learn about my culture. Sharing life experiences also helps in the adjustment process. It is also advisable to remain open-minded to try out new things and ideas. 

Journal Entry 5: While visiting a nursing home, I encountered a 62-year old male who once served as a nurse. However, his life was a shamble after quitting the profession for business and ending up poor and miserable. I found out that he was bitter and felt that his life has been a waste. Interacting with older adults in nursing homes is fun. However, I was often irritated by the different views they have about life and until I learned about Erik Erickson’s stages of psychosocial development. When interacting with an older adult, it is a common scenario finding them either feeling happy about their achievements in life or bitter about the failures they had in life. Since I have interacted with older adults in my family, I learned how to apply the stages and understand the challenges each person is going through in their lives. The knowledge fits in this category since it is part of self-awareness and awareness of others. Diversity entails understanding other people and the challenges they are going through to increase our scope of knowledge. 
Critical Reflection: Erik Erickson, a psychoanalyst and psychologist introduced the theory of psychosocial development in the 1950s together with the stages of Psychosocial Development. This reflection will only focus on stage eight, termed as “integrity versus despair”. It is a stage that people should understand when dealing with older adults in their homes to help them face their end of life with dignity and happiness. According to Malone et al. (2016) Erikson’s model of adult psychosocial development outlines the significance of successful involvement within one’s relationships, work, and community for healthy aging. The role of the community and immediate social circle to any individual cannot be ignored. Having interacted with older adults, I noted that the end-of-life crisis occurs in a manner that they try to reflect on their past activities to establish the areas they failed and the ones they succeeded. The best way to ensure that the process does not weigh heavily on them is to ensure that they only reflect on their achievements and stop dwelling on issues they cannot change. I took personal responsibility to change the views and attitudes of an older adult who was bitter because of the opportunities he had missed in his youthful years. He was isolated from the rest of residents at the nursing home. After inquiring, I learned that he had been abandoned by his family, and he was very bitter about it. Using Erikson’s model of psychosocial stages of development, I categorized his stage and realized that he feared he would die without having reconciled with the family. He was in a state of despair. I organized with the management to reach out to his family so that he could engage with them and free his mind. The process was successful and his attitude towards life changed. Perry et al. (2015) argues that older adulthood is a period when repurposing of life skills is needed to avoid sinking into depression due to the challenges experienced earlier in life. I have applied the knowledge learned in that field to other areas. Whenever I meet a new person, I try to understand the challenges they are going through based on their psychosocial developmental stage. After placing them in the right context, I establish best ways to develop a healthy engagement that benefits all the parties involved. Life-long learning is a process. I consider myself a student wherever I go to be open to new information and facilitate the process of learning. Recently I urged my friends to integrate psychological concepts on human behavior in their knowledge in different areas since our service is centered on humans. 

References

Brubaker, M. (2014). Obese children burdened by more than weight. Newsroom. https://health.ucsd.edu/news/releases/pages/2014-11-24-childhood-obesity-and-nafld.aspx 

Driessen, E., & Hollon, S. D. (2010). Cognitive behavioral therapy for mood disorders: efficacy, moderators and mediators. The Psychiatric Clinics of North America , 33 (3), 537–555. https://doi.org/10.1016/j.psc.2010.04.005 

Filion, N., Fenelon, A., & Boudreaux, M. (2018). Immigration, citizenship, and the mental health of adolescents. PloS One , 13 (5), e0196859. https://doi.org/10.1371/journal.pone.0196859 

Hjeltnes, A., Binder, P.-E., Moltu, C., & Dundas, I. (2015). Facing the fear of failure: An explorative qualitative study of client experiences in a mindfulness-based stress reduction program for university students with academic evaluation anxiety. International Journal of Qualitative Studies on Health and Well-Being, 10 (1), 27990. https://doi.org/10.3402/qhw.v10.27990  

Jimenez, T. R. (2011). Immigrants in the United States: How well are they integrating into the society? Migration Policy Institute. https://www.migrationpolicy.org/research/immigrants-united-states-how-well-are-they-integrating-society 

López-López, J. A., Davies, S. R., Caldwell, D. M., Churchill, R., Peters, T. J., Tallon, D., Dawson, S., Wu, Q., Li, J., Taylor, A., Lewis, G., Kessler, D. S., Wiles, N., & Welton, N. J. (2019). The process and delivery of CBT for depression in adults: a systematic review and network meta-analysis. Psychological Medicine , 49 (12), 1937–1947. https://doi.org/10.1017/S003329171900120X 

Lopez, M. A., & Basco, M. A. (2015). Effectiveness of cognitive behavioral therapy in public mental health: comparison to treatment as usual for treatment-resistant depression. Administration and Policy in Mental Health , 42 (1), 87–98. https://doi.org/10.1007/s10488-014-0546-4 

Malone, J. C., Liu, S. R., Vaillant, G. E., Rentz, D. M., & Waldinger, R. J. (2016). Midlife Eriksonian psychosocial development: Setting the stage for late-life cognitive and emotional health. Developmental Psychology , 52 (3), 496–508. https://doi.org/10.1037/a0039875 

Markey, C. N. (2015). Don’t Diet. Scientific American Mind, 46-53.

Perrin, E. M., Boone-Heinonen, J., Field, A. E., Coyne-Beasley, T., & Gordon-Larsen, P. (2010). Perception of overweight and self-esteem during adolescence. The International Journal of Eating Disorders , 43 (5), 447–454. https://doi.org/10.1002/eat.20710 

Perry, T. E., Ruggiano, N., Shtompel, N., & Hassevoort, L. (2015). Applying Erikson's wisdom to self-management practices of older adults: findings from two field studies. Research on Aging , 37 (3), 253–274. https://doi.org/10.1177/0164027514527974 

Puhl, R. M., & Heuer, C. A. (2010). Obesity stigma: important considerations for public health. American Journal of Public Health , 100 (6), 1019–1028. https://doi.org/10.2105/AJPH.2009.159491 

Okely, J. A., Weiss, A., & Gale, C. R. (2018). The interaction between individualism and wellbeing in predicting mortality: Survey of Health Ageing and Retirement in Europe. Journal of Behavioral Medicine , 41 (1), 1–11. https://doi.org/10.1007/s10865-017-9871-x 

Rancourt, D., Jensen, C. D., Duraccio, K. M., Evans, E. W., Wing, R. R., & Jelalian, E. (2018). Successful weight loss initiation and maintenance among adolescents with overweight and obesity: does age matter? Clinical Obesity , 8 (3), 176–183. https://doi.org/10.1111/cob.12242 

Streeck-Fischer, A. (2015). Identity formation difficulties in immigrant adolescents: three cases from Germany. The American Journal of Psychoanalysis, 75 (4), 438–453. https://doi.org/10.1057/ajp.2015.43  

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