I'm back.

I'm starting to write about new things.  The past was prologue.  

I'm putting some test drafts here for the 20 of your to read.  I have not done anything to broaden the readership of this blog, but that may happen.  We'll see.

Something’s Happening Here

1. Realization

Way back In the Spring of 2012 I was sitting across across from  Carrie, an attractive, articulate, sixteen year-old young woman.  She had come to me because she was having panic attacks. These attacks often came when she was studying for exams at school.  She said sometimes she felt as if her head was going to explode, and at other times that she couldn’t breathe.  Carrie spoke in a very animated fashion about how difficult it was for her to maintain her excellent grades and still keep up with the constant influx from her social connections.  As she spoke her voice cracked a little and her dark hair fell in front of her dark eyes that would fill, but not overflow with tears.  Her parents, Sandra and Joyce, were sitting in my waiting room, while her friends, many of them, were wondering where she was and why she was not answering their text messages that were making her phone ping every thirty seconds.

I have been a psychotherapist for over forty years and have been closely involved in thousands of people’s lives, yet that was the memorable moment when it became undeniably obvious to me that I was living in a new world; a world that is not only creating changes in how we all live, it is creating changes in who we all are. Changes that will alter the basic make-up of our species,.

The changes are technological, environmental, genetic, and societal.  The most powerful changes are the result of how all of those factors interact.  This new world will increasingly require  people to learn different skills in order to adapt and succeed.  Many of the ways of thinking and acting that were adaptive and helpful two or three generations ago, are no longer useful; others are now counter-productive. The time and effort that our ancestors needed to learn how to hunt or to grow for food has been replaced by knowing how to talk to Siri or an Amazon Echo.

Our grandparents lived in a world that was very different from the one that their grandparents lived in.  The early twentieth century was a time of change, especially compared to the early nineteenth century. It was a time of significant industrial and mechanical advances. The pace of that change has continued to increase so that now, in the early twenty-first century, we live with constant change.  We expect it to continue. But as we are changing the world, the world is changing us. 

For thousands of years the personalities, beliefs, and behaviors of all people have been shaped by the same basic forces: our genetics, then our families, then our communities, and we are all also limited or enhanced by our general health.

Who we all are, as individuals, begins with our own genetic structure, 99.9% of which we share with every other member of our homo sapiens family. We are all the product of millions of years of evolution. All human babies are born with the genetic scripts that have been passed from generation to generation, with occasional mutations, for two-hundred thousand years. 

Next, we are all plunked into a family grouping, whatever shape  takes:  two parents, a tribe, a refugee camp, a single parent, a mother and a sperm donor, whatever.  This “family” immediately begins to teach us their version of how the world works.  We all quickly begin to understand how we are expected to behave in order to get what we need.. We have to adapt to that specific environment to survive.  Babies are very dependent so we all had to learn fast.

The third powerful influence on our behavior is the community, the subculture in which we find ourselves as we emerge into the world.  This consists of our friends, our school, our church, our neighborhood, our diet, the climate,  and all of the experiences that we find outside of our family, which now, of course, includes all of the Internet and social media.

These three factors interact with each other to shape us all. To this mix of influences we have to add our health.  If we are strong and robust we can partake in much of what we wish.  If we have a major illness or deformity, our lives will be different, not worse necessarily, but different. If we are obviously different in some way it will cause many people to react to us differently. Most people will be kind and helpful, but others will be mean, many will just look away.  We, in turn, will react to their reactions to us. Everything interacts.

Combined, these influences shape what we  believe, and how we think, feel and act.  It has been this way since our ancestors first walked upright and formed groups.

To me, Carrie is the symbol of how these basic, long-standing forces are beginning to change. The pace of these changes will only increase.  Carrie was conceived in a petri dish.  An egg was taken from one of her mothers and fertilized with sperm from an anonymous man who was selected from a profile in a data base.  Her parents were not allowed to be married at the time, but they were living together. As soon as the law was changed they got married. Carrie has a little brother now, and they all live in a happy, caring family.  The community in which Carrie lives accepts her family without question. These are circumstances that her grandparents would not have believed possible.

The visit with Carrie happened in 2012, and already so much from that time seems out of date. This is mainly due to new technologies, and to the new scientific knowledge that these technologies have helped us acquire.  The aspects of Carrie’s life that seemed unusual then are commonplace and well accepted now. In just the past few years there  have been changes in all of the basic powerful forces.  There has been constant scientific advances in our understanding our own genetics., many new variations in the definition of a family; major shifts in demographics and composition of societies around the world, and significant advances in medicine.

All of these changes have affected the expectations of how Carrie will live her life. The skills she is learning, and how she learns them, are changing.   Her life will be vastly different than the life I lived, growing up in the middle of the twentieth century.  All of these things are not only changing how people behave, they are changing our DNA, our bodies and our minds.  Some of it is intentional; most of it is not.  The more we all are aware of what is happening to us, the better prepared we will be to make good use of the changes we feel are beneficial.  We also need to stay vigilant,so that we can avoid the ones we don’t wish to have thrust upon us.

Questions:

1. Do you know anyone who has two mothers or two fathers?

What do think of it?  How old are you?

Are there some kinds of family combinations that would make you uncomfortable?

Polygamy?  Three fathers with six children?

2, Take a look at yourself in a mirror.

Are you White?  Do you realize how that has affected your life?

Are you tall?  Well endowed? Have a symmetrical face?

3, How close are you to the members of your family?

Do you feel you have absorbed their values, or have you explicitly rejected them?

4.  What is your favorite piece of digital equipment?

How long have you had it?

When will you need to replace it?

Did you think you needed it before you learned there was one?

Transition, But First, Going Away

I am pretty sure that I am finished being a hands-on, face to face psychotherapist.  I cleaned out my desk.  The office is being rented to someone else.  I have kissed all of my patients good-bye. 

It was difficult, kind of earth-shattering in a very personal way, but now it’s done.

I did this gradually, over a two year period, so I think it went as well as possible.  It also gave me time to transition to the next phase.  I have worked with so many people who needed to navigate through difficult transitions,  They had many different reasons: job loss, death of loved ones, illness, accidents, divorce, recovery, new job, new move, new partner. I tried to help them develop new skills. Now it’s my turn.

What I seem to be doing, just by having the time now to do so, is to step back and look around. I had been focused on so many individuals who each had to deal with unique situations. Now I want to look up at the sky.  I want to try to put everything in some kind of perspective, to see how everything ties together. The world is changing very rapidly.  It is creating a great deal of excitement and hope, but also disruption and fear.  You can se e that in the politics that are in such turmoil.

I also see so many educated, dedicated, creative, caring people who are doing exciting, transformative, world changing things in so many areas, such as genetics, brains science, communications, space exploration, immunology, business management, sustainable energy, product development, medicine, food science ….. on and on in almost every field, even psychology.

I guess what I’d like to do is help everyone take a moment to step back and see how all of these changes interact with each other, and what kind of a new world we are creating. How do electric cars relate to genetic editing, to transgender marriages, to sustainable energy, to drone warfare, to on-line education, to a mars landing, to guided meditation?

Is all of this taking us where we want to go or is it just keeping everyone busy and making some people very rich?

I have become very aware that everyone’s lives will be very different in just twenty five years.  I have also become very aware that, if I’m here, I will be 96 in twenty five years.(WTF?)

Therefore, before I ask the two hundred basic questions I have been thinking about, and try to generate a discussion about how we should all participate in designing our future, I will be going away.  Far away, to the other side of the world.  Got to do this while we can, ya know.

When I return we will begin the next phase, unless I decide that it’s enough to just play Shoots and Ladders, Pony, trains and ball.

See you in month or so.

Enjoy the summer.

The Day After

Now it’’s Thursday, after the Tuesday which was the last day in my office, except for cleaning out the draws.

Tuesday was much more difficult and complex than I thought. I had a full day of appointments.  It was my last meeting, as a therapist, with all of them.  It was my last day of being a professional, in that capacity, after forty-three years.  

Two days ago I was talking about the frustrations, about how I often felt that my job was a lot like having to redirect a tide that has been coming in, every day, for years, over the same path.  There was just so much I could do to change to constant flow of the water, the moon and the earth.  There is also the realization that those forces continue whether I am in my office or not.

Today, the day after, my feelings are much different than I had expected.  Instead of that frustration mixed with relief, I feel much more a sense of loss, mixed with satisfaction.

Each hour I said good-bye to someone I had been intimately involved with ( in a professional way, of course) for anywhere from six months to twelve years.  Two of them I have actually known for almost twenty-five years, as they have returned to visit me through several life changes.  I know the names of their parents, children, lovers and friends better than I know the names of my aunts and cousins.  We have been together through losses, tragedies, addictions, bad decisions, distorted thinking, and serious illnesses.  We have also been able to achieve marvelous successes, in recovering, in business, in relationships, in finding ways to put their lives back together.

During the past two weeks I have said good-bye to my last ten patients.  It is very gratifying to say that they all are doing well.  Only one of them requested a referral to another therapist, which was fine.  But the other’s, even the two who are completely nuts  

(diagnosis code:WOW) feel ready to take on the world on their own.  And they are.  Three have new, better jobs, two have moved to better places and feel secure, two are in new relationships, one is getting married and one is pregnant.  Marvelous stuff!

Don’t let me mislead you here.  There were dozens of others who I have referred out, or let go over the last two years who will not do as well.  They are part of the frustrations that haunt me.  The ones I stayed with until the end are the ones who I knew were doing a lot to pull things together.  

The point I want to make is that while there are still huge problems in our society, and worse problems in the rest of the world, yesterday really made it clear to me that we, as a species, are social creatures.  We live better, feel better, and do more when we feel connected to other humans.  That makes up a large part of what I did for people: I was there for them.  They knew that. I understood them, as best as I could. I didn’t judge them. I helped explain them to themselves, and I tried to nudge them in a better direction. For many of them I was the only one who ever did this for them.  Many had been pushed around, neglected, demeaned, ignored, abused, pressured, rejected and worse.  

It was their responses to me that kept me doing this for over forty years. I know I received so much for almost everyone I saw.  Most of the people I saw came to trust me.  They were able to tell me things that had happened to them, or just about the thoughts that ran through their minds Things they had never told anyone. I took that as an honor.  It was a great feeling to be granted this special privilege.

I am not a religious person.  I do not expect to experience a great spiritual awakening. I am very comfortable not having complete explanations for things, yet knowing that somewhere there is a cause for every effect, and that someday it may be made clear and understandable.  I don’t believe in uncaused (miraculous, paranormal) causes.

I have listened to the stories of thousands of people.  I have seen the rich and poor, and everyone in between.  I have seen geniuses and some who take a bit longer to understand things.  I have seen people of all races, creeds, national origins, sexual proclivities, and different levels of power. I have seen many people who have very unique beliefs.   

        I have come to some conclusions.  The most important one is that their is no intrinsic way to rank order who is worth more, or who is more important.  Money and material wealth are clearly false goals.  There is no real meritocracy.  Every soul, every spirit, every mind has the same value. We are a species who are both blessed and cursed by being able to wonder why we are here.  We are all here, and despite the many advances in medicine and science, at some point, we will each be gone.  It is up to each of us to find our place in the world, to try to figure out what we feel is right and important. We each have to do what we need to do to stay alive, stay connected, find some pleasure and find some satisfaction.  

Its not an easy task.  It is a life long process of trying to get it right, without having any idea of what “it” is. Usually we find our answers with other people, in mutually caring relationships.  We do this first with people who are very close to us, and then with others, in our communities, in our societies and in our world.

Now, like all of my former patients, I am movin’ on to the next stage, eager to see what kinds of interactions that will bring. Change is difficult, but it can also be exciting.

Last Day Tomorrow!

I wrote this on Monday.
I see that it is a lot like my last post.  Obviously, that's the way that I feel, so I will post this here, now:

This Tuesday will be the last day that I meet with patients in my role as a psychotherapist.  I have been slowly working my way to the end after doing this for over forty years.  I have been closing the practice in slow steps so this ending does not come as a shock or a disappointment.  It is more of a “finally, it’s over.”

I have spent over thirty of those years running my own practice in a mill city in Massachusetts, less than an hour from Boston.  It is a fascinating city with a long history.  It is a city with a constantly changing population of immigrants, who move through a very stable core of long time families.  The city is surrounded by suburban towns which range from working class bedroom communities to towns filled with very wealth families and some large estates.  

During my years here I have seen everybody. I have seen some of everything. It has been a fascinating time.  In many ways I feel that this was what I was meant to do.  From the feedback I received over the years I was reassured that I was good at it, and that the work I did was successful and appreciate.  It has been gratifying that since I have announced that I was not beginning with any new patients I have received many calls from patients I had seen who told me how much I helped them get through difficult times in their lives.  I will certainly miss that.  Of course, there have been many people who I have not heard from.

Another thing I learned through the leaving process was how exhausting and stressful the job was.  I never really felt that when I was in the middle of it.  I remember that for years I would see thirty-five to forty clinical hours a week, and at the end of the week I would be happy to take a break.  But I always felt stimulated by the work.  I always had things to think about, interventions to try, strategies to plan, and puzzles to solve.  I didn’t realize until I had reduced my workload drastically, how totally absorbing and tiring it was.

Some of that of course, is due to my getting older.  But more I think is due to seeing that once I was able to really put the weight of it down, it seemed so much heavier to pick up again.  When I was in stride, and carrying it with me and thinking all the time, it seemed to just flow.

There is still  down-side that I feel more acutely now that I am finishing, and that is the frustration of how difficult the whole process is, and in many ways, how little gets accomplished.  Yes, I was helpful, and many people, over  time, were able to change aspects of their lives to either learn to cope better, change some of their circumstances, or learn many new skills about how to run their lives and make decisions.  But, and it’s a big But, there were so many aspects of a person’ life that I could not touch, change or influence in any way.  So much of mental health difficulties are intertwined with other factors, A person’s genetics, poverty, loss, some kind of victimization, racism, some kind of illness, crazy families, economic pressures, bad jobs, bad bosses, or just some random occurrence in life: luck.   Often it was two three or four of those things happening at once.

And now, I spend more time with friends and family.  I try to spend more time just doing more of the things that are interesting and fun.Still,  I find I can’t get way from that feeling of frustration. I feel that those underlying causes of psychological and emotional distress still surround me.  It’s not just the craziness and tragedies that I see in the news, I see it in my friends who are anxious, in their kids who are struggling, in the city schools that we visit, in the neighborhoods of the city where I worked for so many years, and in almost every city around here.    And what makes it more striking, is that Massachusetts is one of the most prosperous, healthiest, best educated and well governed places on earth. I know how bad it is everywhere else. 

We keep pushing the rock up the mountain, and it keeps rolling back down.

Seeing all this still bothers me, especially with the current craziness going on politically.  In my youth, in the sixties, I felt we were really taking the right path and making a difference.  I do feel that things have moved in the right direction, and that there are a lot of good people who try and who care.  Yet, change always comes with a backlash.  And now change is constant, and change is always hard to accept.  It affects everyone differently. Often, the resistance is powerful.

It’s a shame.  The rock is still there, fifty years later.  The mountain is still there.  I had hoped, especially with all of our new technology and new knowledge, that more of us could agree on some longer lasting solutions.  I had expected that by now we would have broken down the rock and leveled off much of that mountain.  

Sad. I don’t know, Maybe soon.  Not holding my breathe. But still trying. 

"Bringing the Future Forward Faster"

Like Forsythia, i have sent letters to my grandchildren.  I have gotten a few drawings, some with stickers, in return.  The older kids, who are not 5 and 4, are beginning to learn to read, so getting a letter will have a bit more meaning. I don’t know if it’s fun for them because it’s rare, and it seems almost magical to have someone deliver something to your house, or if they really feel that it’s more personal, as it is something tangible that was created just for them.  I don’t think they care about that, especially because they have so much stuff.

My kids have so much stuff that not only beeps at them, or plays music, but talks to them and tries to interact with them.  The two year-old sometimes seems surprised when he gets a toy with a lot of colors and he pushes the spots and nothing happens.  He thinks objects are supposed to talk.  The older ones now get totally absorbed watching their iPads.  Their parents have realized they have to limit the time they spend on those things.  Sometimes it seems as if using an iPad becomes addictive, but at other times, I’ve seen the kids get bored with just sitting there and they go do something more active, like actually play with toys.  If they’re tired they stick with the iPad.  If they are still energetic then they leave it and go.

I don’t know if the iPad is worse than TV. My parents limited my TV time. That is after we got a TV, which wasn’t until I was about six. iPads seem a bit more interactive.  My grandkids prefer it to TV.  They also watch TV programs on the iPad.  They can watch them whenever they want. There are now several new games, robots, and classes designed to teach kids, as young as six, to learn to write computer code so that they can eventually learn to design their own digital entertainment, or the next program to unfold proteins, or track galaxies, or compute algorithms that predict stock market trends, or how to build a social network.

Does all of this make the world better?  I think it does, in some ways, but obviously in other ways it clearly doesn’t matter.  The key word that is being thrown at us all the time now is “Innovation.”  Make something new, Be a creator.  The chip company, Qualcom, now has ads all over the place that read, “When will What’s Next become Now?  Why Wait?” They want to bring the “Future Forward Faster.”

They must have paid some group a lot of money for that. The future is where it’s at.  The present is already passé.

I guess I’d like to know which future we are talking about. The future with rising tides, pollution, more racial tension, and stress; or the other future of fun, equality, and health and prosperity for all. Or maybe it’s the future where the video games are more realistic and the graphics are better because they were programmed by an eight year-old girl.

I’d like to know a bit more about what’s coming before I rush to get there faster. Right now, it’s beautiful day in May, and I’m pretty happy where I am.

The End is Coming!! At least for me

It’s getting near the end for me as a hands-on clinician.  It’s been a long trip.  I feel almost very good about all I’ve done.  I find it interesting that I still feel very haunted by the people who baffled and frustrated me.  I also feel very gratified by the people who have done well and gone on to better lives.  This is especially true for almost all of the final group of people, I’m seeing, especially the ones I saw today.  The are all ending well.

I still hope to be productive.  I still feel there is so much to be done and that the methods most mental health people use, while very helpful, are also very limited and not really up to the task of meeting the needs of our society.

We are beginning to do better with many physical diseases and disabilities, but psychological and emotional problems are so much more complex.  They rarely, if ever, have just one cause.

We are also living during a very strange and stressful time of transition. Yes, the world has always been stressful, and  for the last hundred years there have been major, dramatic changes in the lives of people all over the world, ever since the beginning of the industrial revolution.  But now the pace of change is accelerating, and the rules of life are changing.  The skills people need to do well and prosper are very different than the ones that were required for me to make a living and raise a family.  Things were much more predictable then.

So many of my patents now live with so much stress because of work and finances.  Companies are being bought every day.  Companies that never make the news, but they are bought and most of the people are let go.  New companies start, but most of them don’t make it.  There is a great deal of loyalty to employees in the beginning, but it can disappear with one bad quarter, or if the company does so well that it gets bought, a few people get rich and the rest get unemployment.

I am thankful my kids seem to be stable and skillful, at least for now.  Even they have a different outlook on the world than I did.  They know that things can change, and they would have no control over it.

My grandchildren are beautiful, charming, creative, brilliant and having fun.  The oldest is 5 1/2.  What will ten years do to her?  Will the stress of school, competition, change, college, social networks, constant media in-put, and robots become overwhelming?  Or will our families, societies, governments and business learn to adjust in ways that make life interesting, meaningful  and fun?

I don’t know.  I think that is the uncertainty that is driving so much of this angry, confusing election cycle.

Will we be scared, mistrustful and selfish, just to save ourselves? Or will we finally overcome some of those interpersonal barriers and use all of our new technologies to make things better for all of us?  

I think we will know a little more in a few months, but the change and the chaos still have a few years before more is figured out.  

In many ways it is a relief for me to become more of an observer and commenter, than to have to try to help everyone navigate through all the uncertainties. 

Keep your eyes open.  Think about what’s coming.  Think about what you want to do.  Think about what you should do after that.  It takes an effort to make sure we take the time to reflect and not just react, especially when things seem to be different than they were ten minutes ago.

Trolleys and Genes

Last week was school vacation week.  The family day-care was closed.  I was assigned to entertain my 2 1/2 year-old grandson; a job I welcomed. I decided to make the kid happy.  A day of bliss.

It was a cool spring day and there could be no better time for a boy of his age to ride on the MBTA, the Boston trolley and subways system.  Soon we were at the station and the Green Line Trolley came around the curve. The boy pointed and screamed with joy.  As we boarded we got a big hello from the driver.  We sat in the front seat so we could see down the track.  The doors closed, the bell rang three times and we were rolling.

A huge smile.  His eyes were open wide. And then, what’s that?  Another trolley coming in the other direction!! Trolley!  Trolley! he pointed and yelled.  The whole car shared in his delight.

He is the third of my grandchildren.  Each of my two children have an older girl and a younger boy.  The girls never cared about balls or trains.  This one is entranced by anything with a motor: trains, trucks, planes, fire engines.  The other boy, who is even younger, is all about balls.  He has about fifty of them scattered throughout his house so that wherever h is he can pick one up and throw it. Especially down the stairs.  Ball!  Ball!

On the morning that I was to go on my trolley ride I was reading an article about a molecular biologist at UCLA, T.C. Ngun, who had studied the genetic material of 47 pairs of identical twins.  Using a computerized search algorithm that scanned the genome of male twins, one of whom declared himself to be gay while the other was straight, Ngun and his team were able to find nine areas of difference between the two groups.  However, the differences were not in the gene itself, but in the epigene, the material that the body uses to get a gene to turn on and to create the chain of proteins that it is programmed to create.

What makes this even more interesting, is that the epigene often changes over time.  It responds to the environment it is in.  It could be stress, or diet, or even a close relationship. It could even be something that happens in utero.  But under different conditions will it turn a gene on, or off.  That can partially explain how two sets of genes that are identical, as they are in identical twins, turn out two very different people.

I’ve been a therapist for a long time.  I’ve had many patients who were gay, and many more who weren’t.  I began seeing people at the time when it was still dangerous to be gay.  People were often beaten, beaten by the police, just for being in gay bars.  So, not everyone was comfortable with admitting how they felt at that time, even to themselves. 

I also came to understand that the paths people walked on before they decided they were gay were very varied.  Some people realized by the time they were six that they were different, even if they couldn’t say why.  Others felt the urges much more powerfully some time during adolescence.  Many other men and women either didn’t realize their sexual preference, or covered it over in order to appear more normal, or perhaps, learned that they could feel very differently at different times in their lives. 

That is why I find it fascinating to watch the gyrations this country is going though about how to deal with transgendered people, or people who feel more comfortable thinking of themselves as of a different gender than of how they were born.  During all my time as a therapist, and with the many people I worked with who struggled to be more comfortable with their sexual feelings, I never had anyone tell me that they thought they were members of the opposite sex. But perhaps that was because they didn’t know they could.

I thought about this as I watched my grandson riding the train.  He was enrolled with the experience.  He was wearing a shirt that had airplanes on it.  When we got downtown he wanted to watch the construction machines.  These seemed like very typical boy behaviors.  The girls, who are a few years older, never cared about any of that stuff.  They are just moving out of the princess stage, but are still very aware of colors and clothes.  The girls are also very aware that they can be anything they want, and both often play games of being like their mothers, who go to meetings, run businesses, and work at their laptops.

It seems as if many of our new technologies are leading to new discoveries about who we area as people, and how we get that way.  I have been following a lot of that progress, and most of what we are learning is that things are much more complex that we thought.  As a psychologist I am not at all surpassed that our development is a complex interaction of nature and nurture.  I am a bit surprised that this interaction can take place down at the cellular level, and in our genes.

Of course it makes sense.  But it warns us that dealing with all of these tendencies and behaviors is also much more complex than many people had hoped.  It means that the results of a major life event, such as a trauma, or starvation, or a being infected by a toxin or virus, can create changes in a person’s genes, and that reversing those changes can be very difficult.  It can also mean that just giving a person a drug to change their brain, without changing their environment and social interactions, may not be very helpful.

It opens up so many questions about who is what sexually, who is what socially, what is a family, what is a race or a tribe?

Of course, I think a lot about what the world will be like when this kid grows up.  Will there still be trolleys with bells that go “ding-ding,” or just self-driving robot cars that take people exactly where they want to go.  

I am confident there will be a lot of interesting and beneficial things he will be able todo, especially if he goes into behavioral-genetics. But before I could discuss that prospect with him, he fell asleep, two stops from home.

Do You Know Where You Are?

I have patients who are very nervous about diving.  Some of them get very anxious on highways because the traffic moves so fast. Too much stimulation!!

Others are afraid that some monster truck will jump out of a hidden driveway and eat them up.  For a lot of them the underlying worry is that they will get lost.  For many, it is not a rational fear, and that can be treated. But for others it is true; they don’t know where they are, and they can’t relate where they are to other places they’ve been. There can be reasons for this; sometimes it’s trauma.  Some people just don’t want to go back there again.

There are older studies that show that men and women navigate differently.  It has been shown several times that men rely more of knowing directions, like north and south, and also distances, like three blocks or five miles. Women seem to navigate by landmarks   They go to the school and take a left and then over the hill to the church and take a right. But all that was before there were electronic GPS systems.  Now a GPS is part of almost all of our lives.  It’’s in our phones and usually connected right to the speakers in the car.  I have many friends who won’t go anywhere without asking Siri how to get to the same restaurant that they went to last week. 

My wife and I have taken several long road trips and I am still amazed that the GPS is so accurate, not flawless, but accurate.  And since it is in the phone it is linked to other things in the phone.   I can find a gas station, a hotel or a restaurant near by.  My kids know where we are and I know where they are.  CNN can track me too.  The weather app tells me the local weather.  I get local traffic and local hiking trails.  All amazing stuff.

Of course, there is a price to pay, and it may be the the price is more than we think.  A recent, 2014, Nobel Prize in Physiology or Medicine 2014 was divided, one half awarded to John O'Keefe, the other half jointly to May-Britt Moser and Edvard I. Moser "for their discoveries of cells that constitute a positioning system in the brain”.  They found that our brains seem to draw girds, just like maps, and we use those cells to establish a consistent idea of where we are located. 

Building on that work other researchers have learned that these cells also link their ability to locate in space with an ability to locate in time.  That plays a large role in the way the brain creates and stores memories. It relates to our ability to create, maintain and tell stories.  Stories usually involve telling where people are, and what they do there. It is those links that seem to deteriorate from  Alzheimer’s Disease.  Without those links, people get lost in space, time and memory.

So, when you jump in your car and ask your GPS how to get there, you are letting that part of your brain slip away.  You probably remember the study done on the brains of London cab drivers.  They have to learn all of the convoluted streets of London without a GPS (I don’t know if that is still true).  MRI tests of their brains showed that the hippocampus of their brains had a much thicker cluster of nerve cells and that these brain changes occurred as they were learning the map. Further studies showed that these drivers, who could recall all of the details of the London streets, performed less well than non-drivers on other memory tasks. Later, when they stopped driving a cab, they regained their ability to remember other things.

Knowing all of this a group consisting of a psychologist, a neurologist, a physicist and an oceanographer went off the the Marshall Islands in the South Pacific Ocean to study the wave pilots.  They found one man who had the knowledge of the ancient skill of navigating between the islands by reading and riding the winds and currents.  He was the last of the non-tech navigators and they wanted to be able to learn his unique skills before they were lost forever.  One of researchers had once gotten lost in a fog while kayaking.  He was able to find his way back using his sense of direction and finding some landmarks that he recognized.  He later learned that two others did not have those skills and drowned.  He, and many others, wonder what would happen to any of us if the power goes off?

In just the past fifteen years more and more of us have learned to use machines and electronics to help us get where we want to go, and to do what we need to do.   We do this because it is easy and effective.  I’m not old-school on this.  As I said, these things are amazing and often save hours of aggravation.

But we have to be aware of the effects it could have on us.  If we use the time and effort these tools save us to think about other things, such as focusing on the reasons we are gong, then these electronic aids can be very helpful.  But if we just drift away and let the electronics do it all, we may just forget why we were going there in the first place.  Eventually, we might even forget how to remember. 

Or else, some people may develop an entirely new ways of remembering and of creating stories about what happened. I wonder how different those stories will be?

If all this confuses you, try this:

https://www.youtube.com/watch?v=AKKqLl_ZEEY

My Father Didn't Go to War

(I realize this is kind of rambling, but I wanted to get it posted. I've really been getting swept up with this kind of research into who we all are and what we are becoming)

        The Scientific American has a very brief report this month (April 2016) about how orphaned bugs, earwigs in this case, who were deserted by their parents, grow up to be less attentive parents themselves.  Apparently most earwigs are watchful and devoted to their eggs and nymphs, but those who did not receive such attention did not administer such caring behavior to their offspring.

The report did not say if this was then carried on through future generations, or if these unattended children had a lower rate of survival, and thus were slowly eliminated from the gene pool. In fact it did say that the first generation of unattended children grew bigger and stronger than their peers.  It was not until they became parents that they showed the effects of their lack of maternal care.

Joel Meurnier,  a evolutionary biologist who is at the University of Tours, France, said that these studies could reflect goes on in humans. He noted that these insects represent one of the most primitive forms of family life, which evolved from there. That prompted me to begin to search for studies of humans, and to see if any research has found if some of the effects of the trauma of losing a parent early in life can be genetically transmitted to the next generation.

Searching around the web, which is much easier than going to the library and searching through six hundred journals, which is what I had to do in grad school, revealed that there are  studies that show that there are several ways in which the effects of trauma can be transmitted to the next generation.  One of the ways seems to be directly through the genes of both the mother and the father.

Anyone who has dealt with families has seen that traumatized parents, such as concentration camp survivors, often raised their children in an atmosphere of fear and distrust. Many of their children learned to be constantly vigilant.  Much of this was understandable, given the life experiences of both the parents and children.  So it is possible that  environmental factors could explain much of the behavior of these children. It is difficult to determine if their are biological causes as well.

Then I found an article by Virginia Hughes that was published in Nature in April of 2014.  She cites a study done by Isabelle Mansuy  of the University of Zurich, Switzerland, who found changes in the RNA in the sperm of mice who had been traumatized.  This seemed to be one vehicle by which a tendency towards anxiety and depression was passed down to the next generation.

There are other studies that show that this happens to the genetics of the mother also. There is a growing recognition that the causes of anxiety, depression and other behavior patterns are not just environmental, and not just inherited traits that have been passed through many generations, but are also epigenetic.  That means that environmental events that happen in one generation can be passed on to the next.  For over a century, this kind of thinking was rejected.  Evolution was not supposed to be so directly affected by the life experiences of an individual.  But there is increasing evidence that things are more complex and more interactive.

From these studies I made a huge speculative jump and began to wonder: 

As you may have realized by now I am not good at details, but big picture stuff always floats through my mind.  I was reading and thinking about the 20th Century. It was a time of many awful traumas, most of which were worse than what is going on today.  The wars and the severe economic depressions affected nearly everyone, all over the world.  Entire cities, countries and even continents were devastated.  Many millions of people were killed, many more had their homes destroyed, were turned into refugees.  Millions more, who may not have been directly, physically harmed, were still subjected to constant fear, anger and horror that lasted for years.

The first world war made no sense, especially to those who were fighting it.  There were national rivalries between the leaders of countries, but the people who fought the battles really felt no natural animosity toward each other.  Yet, at the Battle of Verdun, in WWI, men lived in trenches for months, just yards away from each other, killing each other one at a time until 800,000 people had died. The men who survived were never the same, psychologically. They were traumatized , yet that was rarely recognized as such. Although there were descriptions of “battle fatigue” and “shell shock,”  no one knew how to treat it.

WWII was worse in terms of devastation and death.  The weapons were more powerful and came from greater distances, culminating in two nuclear bombs falling on Japan.  There were invasions of The Soviet Union that killed millions.  Japan invaded China with traumatic effects. There were large revolutions and coups in Africa in which hundred of thousands if not millions of people were killed and displaced.

Many of these soldiers were referred to as “The Greatest Generation” and hailed as heroes.  The standard behavior seemed to be that most of them did not talk about the war.  They tried to be stoic and move on, rejoin society and have a life. Was this possible?  I doubt it.

That’s what brings me back to the kind of research that I cited above.  It now seems likely that the effects of trauma can be carried through the sperm of the father, and by cell changes in the blood of the pregnant mother. To state it in the more exact language of one study: “the role of glucocorticoid hormones in signaling and epigenetic mechanisms participating in the effects of stress on gene transcription in hippocampal neurons” can be passed on to the next generation. (Johannes M. H. M. Reul*, Psychiatry, 22 January 2014).

What that means is that trauma affects the RNA of the person who experiences it, and that these genetic changes can be passed on to his or her offspring, and that those offspring are more likely to experience anxiety and depression than children whose parents were not traumatized.  Anxiety runs rampant through my generation, the baby boomers. 

I don’t mean to diminish he suffering of previous generations.  I don’t know if Russian serfs felt traumatized or just accepted life as it was. There have always been wars, plagues, invasions, slaughter and trauma.  I can only imagine that most American slaves, especially those who actually made the crossing, were greatly affected.  Certainly, by today’s standards, most human lives were short and miserable for thousands of years.  But they didn’t have today’s standards; the kind of life we live today was unimaginable.

What was the effect of going to war on the men who returned from battle, in any generation?   Were they more distant emotionally?  How did that affect their marriages?  Their parenting skills?  Their politics?  

There were no studies done about this afterWorld War II, and certainly none done after the Battle of Waterloo or at Hastings.  War was too common then to think that such a study would be necessary.  Now, during America’s prolonged wars in the Middle East there have been many studies.  They show that there are many difficulties of sending a parent off to war,problems with the soldier, the spouse and the children. Psychologists are trying to find ways to minimized the damage.

My generation was the first to really have psychologists and psychotherapy offered to everyone.  Through many technical and social advances we have much higher expectations for the quality of our lives.  We do not expect to suffer, to live in fear, to feel constantly victimized, or to watch our children die.  We were also the first generation, possibly in the history of the world, in which many of its members stood up to the government and refused to go to war. We were more sensitive to social justice, more skeptical of power, and a bit more selfish and spoiled.   

Due to his age and other physical restraints, my father did not go to war.  He was not traumatized, and was a pretty open and accessible father, at least for his generation.  That probably helped shape who I became. Some of the folks who also marched against the war in Vietnam had fathers who had been soldiers  in WWII,with whom many had difficult relationships.

These are things that make me wonder. Is it possible that being in battle not only changed the soldiers emotionally, it changed them genetically?  If that is the case, that would help explain why so many veterans are still suffering, even after years of treatment. The only studies I found of genetics of Vietnam veterans and their children focused on Agent Orange and on major birth defects.  What I would look for would be much more subtle, and probably is too difficult to find after so many years.  

For me the question remains: how much of a tendency toward anxiety, depression and anger has been passed on through both genetics and epigenetics?  If some of the results of a personal trauma can be passed on from one generation to the next, how much does it have ripple effects through our society, or any society that has suffered major disruptions.  Why do some regions, such as the Balkans or the Middle East seem to have such insolvable problems, that go on for generation after generation. Also, how much do epigenetic effects explain some of the families I have seen that have been full of physical and sexual abuse for a few generations?

The follow-up question is even more intriguing: can some of these epigenetic changes be undone in a generation?  Can people learn to trust and be more open and caring.  If so, would these  positive experiences create changes in a father’s sperm, or a mothers cortisol level that would be passed on to the next generation?

It turns out that such research has already begun.  There are studies which show that mindfulness training does produce some of these effects.  Many people who learn to meditate in a meaningful way report feeling calmer and have a more positive outlook.  They also show physiological changes in their genes that affect inflammation and other aspects of body chemistry that affect mood.  It is not yet knows if they changes can be transmitted to the next generation. 

But it would be helpful if we could get the whole world to chill-out for an hour a day, and pass the effects on to the next generation.  I know a woman who is advocating this, an evangelical Buddhist.  Now I understand it more, on a cellular level.  But she’s not getting much traction so far, especially in today’s political climate.  Still, we’ve got to start somewhere, and it certainly can’t hurt.

More complex causes of crazy

In this week's (March 28, 2016) issue of The New Yorker Magazine is an excellent article by Siddhartha Mukherjee about the craziness, schizophrenia and bipolar disorder, that has affected several of the men in his family.  He relates the histories of his uncles and his brothers.

But the article is really about two researchers in Boston, Beth Stevens and Steve McCaroll, who have tracked down a gene that seems to be a major player in what happens in some brains to make them  function differently.  It seems to have to due with  a gene, C4A,  that regulates the proteins that usually prune certain synapses that are used for cognition and planning.

If this turns out to be part of what happens in the brains of the people who then develop the kinds of symptoms that are labelled as psychiatric diseases. One would hope that this knowledge would be a big step toward finding a more successful treatment.  But S. M. does a good job of showing how much more complex all of this is.

Genes  do play a big role in disrupting a person's thoughts and ideas, but these genes do a lot of other things too, so that if we do eventually find ways to change a group of genes -- we can already modify a single gene -- it will still be very difficult to know what those changes that will produce. There is lots of room for unintended consequences here.  How much it will alter how the person thinks, and really, who that person is.?  S.M. makes that very clear at the end of the article. He only knew his brothers the way they were.  Knowing them was knowing them with their moods and struggles.  Would it be possible to separate out just the difficult parts?

Also, it is still not known what the circumstances are necessary to be to get the C4A toast in the way that seems to be detrimental.  It may be just a random mutation and it just happens, or, more likely, it needs some kind of trigger at some specific time to make it happen.  This seems to be true with most gene expressions.  If the circumstances aren't there then little, or nothing happens.  I don't know.  And I don't think there are too many more specific answers yet.

Will we know more?  That I think is pretty certain.  But I don't know if it will just pose new questions and lead to longer hallways that need to be explored.

Life is complex.  Even more than we expected.  That is what we have learned so far.

ReDesigning People -- 1

Hey, where have you been.  I've been working on some new stuff.  It's taken a while but now I'm pretty far along.  Maybe I'll keep posting stuff here.  But I've said that before.

Anyway, here's an

Introduction:

In the Spring of 2012 I was  sitting with Carrie, an attractive, articulate sixteen year-old young woman.  She had come to me because she was having panic attacks.  She said sometimes she thought her head was going to explode, and at times that she couldn’t breathe.  These attacks often came when she was studying for exams at school  Carrie spoke in a very animated fashion about how difficult it was for her to maintain her excellent grades and still keep up with the constant influx from her social connections.  As she spoke her voice cracked a little and her dark hair fell in front of her dark eyes that would fill, but not overflow with tears.  Her parents, Sandra and Carol, were sitting in my waiting room, while her friends, many of them, were wondering where she was and why she was not answering their text messages that were making her phone ping every thirty seconds.

I have been a psychotherapist for over forty years and have been closely involved in thousands of people’s lives, yet that was the moment it became undeniably obvious to me that I was living in a new world; a world that is not only creating changes in how we all live, it is creating changes in who we all are. Changes that will alter the basic make-up of our species,.

The changes are technological, environmental, scientific and societal.  The most powerful changes are the result of how all of those factors interact.  This new world requires  different skills in order to adapt and succeed.  Many of the ways of thinking and acting that were adaptive and helpful two or three generations ago, are no longer useful; others have become counter-productive.

Our grandparents and great grandparents lived in a world that was very different from the one that their great-grandparents lived in.  The early twentieth century was a time of change, especially compared to the early nineteenth century. It was a time of significant industrial and mechanical advances. The pace of that change has continued to increase so that now, in the early twenty-first century, we live with constant change.  We expect it to continue. But as we are changing the world, the world is changing us. 

Until the mid-Twentieth Century our species has been Designing People in basically the same way for a few millennia. There have always been three basic interacting forces that designed who we become.  First there is evolution. The genetic scripts of who we are pass from generation to generation, with occasional mutations, some of which survive. Second, the family grouping, whatever shape that has taken, exerts its influence.  The third powerful designer of our behavior is the community, the subculture in which we find ourselves as we emerge into the world.  Combined, these influences shape what we  believe, and how we think, feel and act.  It has been this way since our ancestors walked upright. 

To me, Carrie is the symbol of how these basic designing influences are changing.  Carrie was conceived in a petri dish.  An egg was taken from one of her mothers and fertilized with sperm from an anonymous man who was selected from a profile in a book.  Her parents were not allowed to be married at the time, but they were living together and as soon as the law was change d they got married. Carrie has a little brother now, and they all live in a happy, caring family.  The community in which Carrie lives accepts her family without question. These are circumstances that her grandparents would not have believed possible.

The visit with Carrie happened in 2012, and since then things have continued to change rapidly in our society. This is mainly due to new technologies, and to the new scientific knowledge that these technologies have helped us acquire.  The aspects of Carrie’s life that seemed unusual then are commonplace and well accepted now. In just the past few years there are even newer methods of creating children, more diverse blending of families, and different variations of societies that are all having a strong influence on everyone’s life. The expectations of how Carrie should behave, the skills she will need to learn, and how she will learn them, are also different.   All of these things are vastly different than what was expected of me, growing up in the middle of the twentieth century.  All of these things are not only changing how people behave, they are changing their bodies and minds.  They are ReDesigning People.

New information about who we are, what we want, how we behave, and how we communicate, comes pouring in in huge waves, every moment of the day. It affects us whether we realize it or not. Many people spend hours a day sitting in front of a screen gathering and dispensing information while things beep and pop up, pictures and videos appear and disappear, quickly replaced by others, with very little time for reflection.

We have devised new ways of mixing stands of DNA in a petri dish to create new people, and now newer, faster, more direct ways of splicing and reconnecting those genes in order to alter who that person will be.  

The evolution of machines  has progressed much faster than the evolution of people.  Many of the daily tasks that for centuries required manual labor are now done by machines, even the task of building those machines.  We also use machines to calculate, and then to find patterns, make predictions, and develop protocols about what we should eat, what medicines we should take, what we will buy, and who we will marry.  These machine generate algorithms which influence many of the decisions we make, mostly without our realizing that it is happening.

The climate we live in, including the air we breathe, the water we drink, the food we eat, the clothes we wear, all contain chemicals, viruses, bacteria, and proteins that have either been locked away in environments that never had contact with people until recently, or have been created in laboratories to either help us stay healthy or make us buy food that will make us fat.

These are changes that will affect the way Carrie lives her life, and they will have a more profound effect on her children. Her generation will also experience a continued growth in how medicine is developed, designed and delivered.  The hope is that people will be able to live longer and healthier lives. However, it may just be that as diseases are treated, other aspects of our lives fall apart. Will our brains last as long as our healthy bodies?  Will earth be covered with centenarians who need their diapers changed?  Will our air become too warm or too polluted for people to breathe easily?

Societies are changing also. To the horror of some and the delight of others, people from every part of the world are moving to every other part of the world. Marriages are occurring, babies are being born and cultures are mixing in ways that has never happened before.  Many of the old institutions that helped people define their values and guided them towards certain behaviors are being questioned or ignored.  This is a disrupting transition that is creating a great deal of conflict between those who feel the old ways are still the best, and those who feel that old traditions and rituals are antiquated and irrelevant.  While it is presently unclear how those arguments will be settled, it is clear that societies are changing dramatically, and people will think and believe differently than they do now.

The effect of all of these changes is that we are ReDesigning People, in part by design, in part due to unintended consequences.   As a psychotherapist I have spent years helping people to redesign their lives.  In many cases I felt successful, but in many others I felt there were too many factors  over which I had no control that were more powerful than anything I could do in my office. I could do little about the person’s genetic make-up, their economic resources, the extent to which they were subjected to racial prejudice or the toxic environments had shaped their lives. 

In many ways Carrie is a very fortunate young woman.  From her background we can assume that her genetic structure is close to flawless.  The egg and the sperm that were used to create her were specifically selected because they came from people who were strong, healthy, smart and attractive.  While she was in utero her DNA was tested and screened for many possible genetic defects. She is being raised by a happy couple, who have financial resources, in an accepting neighborhood with a good school system and a diverse population. Given all of this her prospects for a good life are high.

Sadly, she is suffering for the overarching malady of this new world, anxiety.  Anxiety often is the result of having feelings of little or no control of what will happen.  The feeling of living with constant change, and the uncertainty of what that change will produce has instilled a feeling of anxiety into almost everyone who has electricity, a computer, a cell phone and wi-fi.  There is too much information, too much traffic, too many demands, too little time, and not enough stability.  It is impossible to name any company, any city, any government , any medicine or any institution that won’t be radically different in fifty years.

This creates anxiety.  Anxiety creates stress on our bodies, brains and minds.  It changes our functioning down at the cellular level.  All of these forces, some of them very favorable, but many of them very unpredictable, are changing the nature of who we are.  We are ReDesigning People.

In this series of essay I will describe this process and some of its possible consequences in greater detail.  I certainly welcome any comments.