N- 1

NO PLACE

To

HIDE

what's on the outside
is every bit as important
as what's on the inside.

from page 14

Dr. Bar-Levav
holding his
granddaughter,
Leah Fogel, with
grandchildren,
from left, Rina
Edelson, Ariel Fogel,
Amir Fogel and
Daniel Edelson.

are in a situation where violence could
be acted on. We don't want to face it,"
he said. "So we deny that there's a
danger and we don't look out for ways
\ -.7to protect ourselves. It's an uncon-
scious pattern.
Dr. Kenneth Israel from Franklin, a
psychiatrist for 43 years, said he never
took a course that addressed safety
issues, but was taught to be aware of a
patient's sensitivity.
"During all of my training there was
a sensitivity that you were dealing with
2 . quite disturbed people — to be tactful
and not encroach on anyone's privacy
in an aggressive way," he said. "If you
knew of a patient's history of threaten-
ing or violent behavior, you would
have to pay special attention to that."
He said that in an out-patient situ-
ation, predicting behavior is "a fool's
errand. Nobody's good at it."
Dr. Mark Silverman, a Birmingham
>psychiatrist for 10 years, said that
accurately predicting dangerousness is
only good for the short term.
"Literature and experience show
that we are very good at predicting
imminent danger in the very near
future, and we are very less accurate
when attempting to predict dangerous-
ness beyond 24 hours," he said. Then
the prediction falls on past behavior.
Although they didn't want to make
a sweeping generalization, the psychia-
trists interviewed said that those diag-
nosed as paranoid would be among
the mentally ill patients most predis-
posed to violence.
"A paranoid is more likely, especial-
ly if they hear voices," said Weckstein.
"The more unrealistic people are in
/Their life, the more likely they will
react to their anger."
Forman said those patients with
acute delirium, substance abuse and
withdrawal problems, or those who
are acutely psychotic, are also more
likely to do violent acts.
Israel said he would be most con-
cerned, not only about people with

strong paranoid trends in their think-
ing, but other diagnostic groups —
"the impulsive, short-tempered, explo-
sive-type personalities who are not
paranoid, but who might get offended
or resentful."
Silverman said studies of chronically
mentally ill people consistently have
shown that, as a population, they are
less violent than the general population.
"For the most part, chronically
mentally ill people shy away from con-
tact from the population, and do not
pose a threat," he said.
Dr. Richard Ruzumna, president of
the Michigan Psychoanalytic Institute
in Farmington Hills, said that there
are no specific courses at his psychoan-
alytical training facility on recognizing
the dangerous patient, but many semi-
nars explaining how to recognize signs
that a patient is regressing.
"If a patient were developing a
delusional or psychotic transference,
and beginning to develop feelings that
are out of touch with reality about us,
we would be very alarmed," said
Ruzumna.
The Michigan Psychoanalytic
Institute also offers treatment clinics
to provide low-fee psychoanalysis and
psychotherapy and outreach, includ-
ing to Kadima, a non-profit mental
health agency.
Kadima Executive Director Janette
Shallal, a social worker for 27 years,
said Brooks needed medication.
"When someone is actively psychot-
ic, give him medication to find out the
psychosis," she said. "If an out-patient
client is not taking the medication reg-
ularly we know about it, by the way he
interacts with us, and we get on the
phone with their psychiatrist.
When you're not medicated you
don't know what the voices are say-
ing," she continued. "It's not unusu-
al for a patient to stop taking the
medication, then they de-compen-
sate within weeks and go back to
Square I." Li

FOOD FOR A MIND BAGELING WORLDI"

Call 1-800 - Bagel - 1-1e for a location near you
www.einsteinbros.com

t e yachtsman

OUT DOOR

APPARE FOR LAKE & AND

Active Summer Phun Apparel From

111111111111111111M

morn.,
111,'

1111111

Patagonia

FR A /

\A/ A 1=1

The Ultimate Clothing to See the World in.'

MoonStone

Hours:
10-7 M-F
10-5 Sat.

1105 S. Adams - Birmingham - 723-9838
We are located on the N.E. corner of Adams & Lincoln

For your best price,
selection and
persozzezh.zeel service

CINDY

SCHLUSSEIL

sHuman

motor sales, inc.

woirad

month

6/18
1999

Icakta, nni

61E9— 2011 0

Detroit Jewish News

17

