Sunday, November 29, 2015

Bang, Bang....Again

Bang, bang.  another white man fires an assault weapon into a crowd of unsuspecting people. He is not a Muslim. He was hardly on anyone’s list of really dangerous people.  It’s just another shooting that will make the headlines for a day, or maybe two, and then, like all the others, just fade away onto the long list of pissed-off, white men shooting people they don’t know. That is, unless the bullet went through your husband, sister or child. There have been about one school shooting a week, just at schools, since the massacre at Sandy Hook.
Already, it is clear that the explanation for this man’s behavior, as with all of them, is that he has”mental health difficulties.” This is a concern of mine since I am a mental health professional.
But this one at Planned Parenthood, in November, 2015, has upset me, perhaps even more than the others. This one appears to be much more of an American Terrorist who has been motivated and encouraged by the current level of political antipathy.  But I doubt that Carly Fiorina, or Fox News feels that they have any blood on their hands.
I followed the messages on Twitter that were responding to the shooting as the man was being surrounded by the police.  So many of them were supportive of his invasion into Planned Parenthood.  I realize that it was Twitter, and that is the place to say as many outrageous and inflammatory things as possible, but so many people, many of whom seemed to base their comments on religion, felt that the shooting was somehow justified.
What frightened me was how these messages were full of the same kind of certainty, and the same kind of blind religious fervor that makes everyone fear ISIS.  But that is a part of the freedom that America offers — the freedom to believe anything you want, and to turn in into a public truth.
None of these thoughts are completely new or wildly insightful.  It just becomes increasingly upsetting for me, as I age, to see that even though so many aspects of our lives have changed, evolved and improved, these improvements are always followed by a strong paranoia about change. At some level there must be a genetic predisposition to fear differences.  Changes in the way we live makes things feel different. People fear change. Fear is a more powerful and protective emotion than curiosity.  We have to feel safe, and somewhat secure within ourselves to be curious. Fear takes that away.
Fear distorts our judgment about how dangerous a threat really is. The fears people have can be mollified by classifying the dangerous person as an outlier.  We always say that the person who frightens us has mental health problems.  He is not one of us, just like the foreigners, the Muslims and, very often, African-Americans.  Politicians know that fear is very powerful, and they often inflate it, to distract everyone from calm, rational, reasoning; from finding a response that may be beneficial, that could lead to a solution beyond just placing blame.  Stoking fear has always been a very successful strategy. 
Any American is much more likely to be harmed by a disturbed white man with a rapid-fire weapon than by a band of ISIL jihadists. But I guess we accept that danger as part of the great American tradition of freedom of expression mixed with the right to bear arms. 

That’s what frightens me.

Friday, November 27, 2015

A Holiday Hint, from me and Rosanne

        I would like to begin by wishing everyone a happy, and healthy holiday season, whatever your holiday may be,  I realize that for many the holidays are full of stress and expectations.  There are already many excellent pieces of advice and guidance posted all over the Internet.  They range from how to deal with your crazy uncle to how to deal with your turkey trauma, and how to come out to your family on the holiday. Read them carefully, and take from them what you can.

I have been a psychotherapist for over forty years. I believe I have seen or heard about almost every aspect of the human condition by now.  I still get surprised from time to time, but I don’t think there is anything that one human could do to another that would shock me.  My view of interpersonal behavior is that it is often distressing and depressing, but just as often it can be uplifting and inspiring. 
Over the years I have gained a great appreciation of how complex human behavior really is.  All of our thoughts, feelings and behaviors are shaped by so many factors, both within us and around us. And all of these influences are interacting with each other all of the time. Nothing stays static, there is never a break, life continues.  It is usually almost impossible for us to really understand why we are acting or reacting the way we are at any certain moment.
I often quote one of my favorite philosophers on that subject, many of you may remember her, the great, and unfortunately late, Rosanne Roseannadanna.  In almost all of her short philosophical statements she would say:

“It goes to show you, it’s always something.  If it isn’t one thing, it’s another.”
To that I would add that it is often more than one thing; it can be many, all at once.   You get demands, ideas, expectations and affection  from your parents, your spouse, and your kids.   This happens at the same time that good and bad things are going on with your job or at school.  The immediate state of your health can make things dramatically better or worse.  Other things, such as your friends, your house, the weather, and your finances also are playing a part.
This is especially true during the holiday season. This is a time full of a constant stream of emotions,both positive and negative, which are more intense than usual. There may be feelings of inclusion and feelings of exclusion.  You may experience feelings of great joy, but they can also be mixed with strong feelings of sadness and loss.

The only advice I would like to give is very general: take good care of yourself.  You can do this by being more aware of what is going on around you, and who is doing what to whom.  Try to anticipate what will come next and prepare a way to deal with it.  And, once you are feeling mostly okay, then take good care of those around you.  That’s really what all these holidays are about.

Wednesday, November 18, 2015

Good Bye "Rita"

I went to work again today.  I am doing clinical work on an almost weekly basis.  I am trying to help a limited number of patients get where they want to be, and still carrying a few others who will never get there.  Today I said good bye to one of those who fit into the later category.

"Rita", ( all the details have been changed) I will call her, is even older than I am, and she is in much worse shape physically. I first saw her over thirty years ago for a brief period of time.  I saw her five years after that, and ten years after that, and finally, three years ago she really came to see me on a regular basis.  Last year I saw her only four times as she was physically unable to get to my office.  She was brought to this last appointment by her son, and she hobbled in on a cane.

Rita first came to see me on the insistence of her doctor who told her he would commit her if she didn't keep her appointment.  In those days it was much easier to send someone, especially a woman, into the hospital, and they would often stay there for months.  She was one of those women who was well known around the community.  Some thought she was volatile, others just called her nuts.

She always dressed very provocatively, which made it difficult for people to realize how smart she really was. She ran her own insurance agency and she knew her business well, and ran it honestly.  But she was ultra-sensitive to personal slights, and was overly suspicious of people's motives.

Over the years she came to trust me, mostly because I helped her stay out of the hospital.  She finally let me know about many of the thoughts she had about who was plotting against her, and how people took advantage of her.  I came to understand that the lines between what was real and what was distortions were very slight.  She wanted attention; she wanted affection, many people took advantage of that.  Because to that her fears and suspicions became exaggerated over the years. The more distrustful she became the nastier she was to people, which, of course made them pull away from her and avoid her.  She knew they were talking about her, and they were.

Now she lives in the back room of her son's house.  She hides from her son's wife.  Her only consistent contact comes when she talks to her former husband on the phone.  She pushed him away years ago.  He didn't want to leave, but now he is down south and won't come back.

The last few times she came in, including this final one, she retold some of the earlier stories of what had happened to her, how people mistreated her, and how she had responded.  It is fascinating to see how those stories have changed over the years.  In this last retelling she now recalls events as having much less conflict than in her earlier accounts.  She also has a much more positive memory of how she acted in many situations.   She now remembers herself as avoiding trouble when before she had been the victor in epic battles.

This may be because she no longer feels the power of the anger she used to have, or she just as mellowed and wants everyone to remember her as quiet and sweet.

We had a comforting last session.  We reviewed a lot of what we had been through together, but now we can leave it all in a more comfortable context.

Her children, who battled with her for years, and whose lives she certainly made very difficult, will all be with her for the holidays.  For her that it is Shakespearean: All's Well That Ends Well.

Saturday, November 14, 2015

Terror, Violence, Instability...Crazy?

Another shocking act of terror, this time, again, in Paris.

The purpose is to be shocking, the purpose is to terrorize. Twenty years ago I remember reading a prediction that this would be what the world would be like.  After the disintegration of the Soviet Union, the idea of a lot of "asymmetrical" battles would occur against fanatics.  They would not represent countries, or anything or anyone that a nation could clearly go to war against, just random acts of terror like this, designed to make everyone feel vulnerable, anywhere, any time.

I gave my little talk last week at the Psychological Convention.  My talk was premised on the idea that emotional and psychological problems are very complex, and that their causes are not just psychological, or biological, or familial, or environmental, but all of those things -- all of those things interacting, all the time.

One of the questions I posed to the group was, " Are all suicide bombers crazy?"  No one answered that question and we moved on to the Big Data part of the discussion.

But clearly now, that is a relevant question.  What does it take for someone to decide that it is a viable option to go and kill as many people who have done nothing to him, with the knowledge that he will almost certainly die himself while doing that?

I guess, at some level, they have to feel their cause is that important.  Do they also think their lives have no future, or do they believe that they will be given a greater future in some kind of after-life?
Or do they feel that the resulting infamy and media coverage is enough to have made their lives worth it?

What kind of group pressure, family pressure, religious fervor, does it take?

This kind of behavior is not new.  Countries, empires, city states, have all been able to convince energetic, healthy young men to go charging into battle for centuries, often at the cost of their lives. All for the greater glory of....what?

Even now the U.S.  has its soldiers all over the world, and now we will certainly have more of them, going into battle against these forces of terror.  Battle, often to the death, has been the way of humans for as long as their have been different groups that can oppose each other.  Religiously, it began right at the beginning with Cain and Able.

But now, the world is much more interconnected.  More and more people are beginning to feel that a person living in China or New Zealand, is very similar and just as worthy a soul, as a person living in Ferguson, MO, London, Moscow or Mogadishu.  We read the same internet news, look at the same pictures of kittens, trade with each other, lend each other vast sums of money, and visit each other's countries in numbers that were unheard of fifty years ago.

But, there are still many, probably a majority of people, who feel that their culture, religion, race, subculture, family, is better, and more important than any other.  They feel that anyone, or any slight difference is a threat to their survival, and therefore needs to be destroyed.

It is the struggle between these two world views that is going on now, internationally, and nationally here in the U.S.  It seems to describe the differences between our two major political parties.

In some ways, both of these views are correct.  The world will not be safe until we all learn to understand each other and resolve our differences peacefully.  We now have the knowledge and technology to be able to do that.

But until that is done, there are people who will fight that goal, and insist on destroying it, and "we" need to be protected from "them."

Tuesday, November 03, 2015

Presentation 2

My presentation will be this Saturday at one of the big convention hotels half an hour away.  I will give my talk in the middle of the afternoon, when most people will be tired and sick of being there. But they have to stay to the end to get their CEUs.

I'd better be entertaining.

The point of my talk is to try to get Psychologists to realize that it is time they moved into the 21st Century.  A great deal of marvelous and exciting scientific work has been done since the turn of the century.  A lot of it is very relevant to Psychology, but not in Psychology.  It has been done in the fields of genetics, brains science, cognitive science, neurology, and even anthropology and architecture.  In addition there have been great leaps forward in computer technology, the collecting of Big Data and using it to find patterns.

This is already being done by companies such as Ginger io and Lyra, among others.

In preparation for my talk I've been bringing up these developments to many of the therapists I know.  They look at me kind of stunned.

What about confidentiality?
What about the centrality of the patient/therapist relationship? They wonder.

To which I answer :

What about the school shootings?  What about the rising suicide rate?  What about bullying?  What about domestic violence?  What about the rise in opioid use and over-doses?

How are mental health professionals really helping to solve these major problems?

What if a lot of these things could be found and prevented with the use of Big Data and computer discovered algorithms?

What's wrong with that?

Can Big Brother really be like a good Big Brother, and be helpful?
What if it is your doctor's office and not the government?


Too late.  It's already here.