Me Student! You Professor!

I don’t much like talking to strangers.

Some people are better at it than others, but it’s something I’ve never really been good at or wanted to do much of. Come to think of it, I’m not even that great at talking to the people I know – such is the fate of us introverted internal processors. I have great conversations in my head with myself, but when it comes to vocalizing my brilliant, eloquent thoughts to other people, I often end up garbling the words into something near unintelligible.

I’ll use just about any excuse to get a Far Side cartoon in here and there. I can relate to Tarzan, though – he had such great intentions, but flustered in the pivotal moment. I can also relate to the many students I talk to who are intimidated – to say the least – at the prospect of talking to their professors. Heck, I was one of those students at one point in time. Continue reading

Building Awareness of Self-Awareness

Full Sword in scabbard

Image via Wikipedia

I spoke in my last post about comfort zones, strengths, and growth from within areas that we are already relatively comfortable.  It was a pretty straightforward account of how knowing what are strengths are can help us to build on and expand those strengths into new areas.  The problem, of course, is that this viewpoint presupposes that you actually do know what your strengths are.

Hmm…

There are a few issues worth considering here.  I suppose the first would be a consideration of what a strength actually is.  Some people would distinguish between a strength and a personality characteristic, for example.  In such a scenario, the former may be something more of a skill that can in some quasi-quantifiable way be improved over time (i.e. writing, planning, organizing), while the latter might be more of a stable, enduring quality or trait that is in some sense automatic (i.e. charisma, quick thinking, adaptability). Continue reading

Ask Your Riding’s Candidates About Psychological Services

Aside

We’ve got an election coming up here in Canada, and the fine folks at the Canadian Psychological Association have put together a website on advocating for psychology during the campaigning.  Check it out!

They have a section on the site that lists questions you could ask the candidates in your riding about psychological services.  I’ve borrowed and listed them below:

  1. Does your party platform contain anything related to the psychological health of Canadians?
  2. Do you support parity between resources made available for treatment of psychological and physical health problems?
  3. Do you support the specific inclusion of initiatives related to psychological health and addictions for 2014 when the federal-provincial health accord comes up for renewal?
  4. What will your party do to improve access to psychological services in Canada and in this riding, particularly for middle and low income Canadians?  Less than one-third of persons with mental health problems receive needed services. Psychologists are the country’s largest, regulated group of health professionals who specialize in mental health. With cuts to the budgets to publicly funded service in hospitals and schools, psychologists increasingly work in private practice. Though psychologists in private practice are successfully self-employed, their services are not accessible to many Canadians who need them. They are not accessible because too many Canadians do not have the financial means or extended health insurance to pay for them.
  5. There are significant recruitment and retention issues in government and other sectors when it comes to psychologists (e.g. Department of National Defense, Veterans Affairs, Correctional Services Canada). What will your party do to ensure an adequate supply of Canada’s mental health human resource meets the needs of Canadian who fall under the Federal Governments constitutional authority?
  6. What will your party do to support individuals, families, the workplace and communities when it comes to psychological health and disorders?

Not sure who the candidates in your riding are?  Find out at the Elections Canada website.

What Makes a Psychologically Healthy Workplace?

The headlines are staggering:

workplace bully

via blog.hrinmotion.com

Stress linked to bulk of lost work days in Canada

Mental health leaves cost Canadian economy $51 billion: Study

Workplace bullying runs rampant

Mental health of workers should be a priority

Employee stress level increasing: Survey

And, it only took me about 5 minutes to find the above news items.

*     *     *

Anyone who’s ever had to deal with a mental health issue, be it large or small, acute or chronic, a mild annoyance or a crippling debilitation, knows that there is a huge difference between how physical health issues and mental health issues are perceived and treated by others, including our so-called “universal” health care system here in Canada.

Universal health care? I’m afraid we still have a long way to go. The unfortunate truth is that the accessibility of mental health care has been, and continues to be, woefully non-universal. Why is this, when studies such as those that appear in the news headlines above continue to show the devastating impact that mental health issues are having on the economy? Never mind the impacts on quality of life for those who are suffering.

The optimist in me says that one day, hopefully in my lifetime, with science continuing to show the links between mental and physical health, we’ll wake up as a society and stop thinking of mental health issues as second-class concerns, and our health care system will follow suit.

In the meantime, much of the work that can be done to address mental illness and its impacts is preventative. Intuitively, one of the best places to prevent mental illnesses from developing (leaving aside early childhood for now) is the place that we will all spend the largest chunk of our time: the workplace.

Workplace environments can be staggeringly painful, wonderfully inspiring and comforting, and anything and everything in between. I’ve been fortunate enough to experience probably more positive than negative workplace environments in my employment history, which is something that I’ve discussed in the past. However, I have also had the displeasure of working in environments that made me dread going to work every day.

The verbally abusive boss and coworkers. The bullying. The feeling that you’re stagnating, not growing in any way. The long hours. The feeling of being alone, isolated, with no one you can talk to about your concerns. Myriad other concerns. Simply put, it sucks. And no wonder people crack under the pressure. Some mental health issues, like certain kinds of depression, can be thought of as your body’s signal that something in your life is not working for you the way it should be. That something is missing. It’s your body’s “check engine” light. And just like a car, it’s far easier (and far less expensive) to be doing regular maintenance than to be stalled in an intersection with no other option than to call the towing company.

Fortunately, there are good people out there doing research into just what makes a workplace psychologically healthy. The American Psychological Association, for one, has a Psychologically Healthy Workplace program that has set out a few guidelines for employers on what they can do to help. The diagram below describes the model in nice visual detail.

psychologically healthy workplace

via phwa.org

The examples below are taken directly from the Psychologically Healthy Workplace Program’s website:

Employee Involvement
• Self-managed work teams
• Employee committees or task forces
• Continuous improvement teams
• Participative decision making
• Employee suggestion forums, such as a suggestion box and monthly meetings

Work-Life Balance
• Flexible work arrangements, such as flextime and telecommuting
• Assistance with childcare
• Eldercare benefits
• Resources to help employees manage personal financial issues
• Availability of benefits for family members and domestic partners
• Flexible leave options beyond those required by the Family and Medical Leave Act

Employee Growth and Development
• Continuing education courses
• Tuition reimbursement
• Career development or counseling services
• Skills training provided in-house or through outside training centers
• Opportunities for promotion and internal career advancement
• Coaching, mentoring, and leadership development programs

Health and Safety
• Training and safeguards that address workplace safety and security issues
• Efforts to help employees develop a healthy lifestyle, such as stress management, weight loss and smoking cessation programs
• Adequate health insurance, including mental health coverage
• Health screenings
• Access to health/fitness/recreation facilities
Resources to help employees address life problems, for example, grief counseling, alcohol abuse programs, Employee Assistance Programs (EAPs) and referrals for mental health services

Employee Recognition
• Fair monetary compensation
• Competitive benefits packages
• Acknowledgement of contributions and milestones
• Performance-based bonuses and pay increases
• Employee awards
• Recognition ceremonies

Would you add anything to the above categories?  I can safely say that my current work environment does pretty well in most of the above areas. Can you say the same? How will you know when you are in a psychologically unhealthy workplace, and what will you do to get out of it?

Cross posted at Career Services Informer.

Feeling Pie: The Real Emotional Eating

feeling pie

One of the greatest therapy metaphors I ever heard was from a friend who was seeing a psychologist for a while.  She was trying to explain how she felt worried about how someone in her life would react emotionally if she were to do something, I forget what it was but that’s not really important.  To this, the therapist replied in the form of a metaphor (always a great choice).

Let’s all take a moment to just imagine a little something.  Imagine that everyone is walking around holding a pie.  But these are not normal pies.  No, these are feeling pies.  And everyone only has one.

These are very special pies.  They are all unique because they are all made of different kinds and amounts of ingredients, those being one’s feelings and emotional states.  Some are a bit more savoury – maybe a creamy, spice-laden pumpkin pie whose flavour slowly unfolds and subtly lingers.  Others might be bright, vivacious, tangy fruit pies that scream juicy tartness and explode in a sweet-sour citrus splash of delicious fury.

Regardless, everyone has their own unique pie made up of all of their feelings.  And no one is allowed to give or take pie to or from anyone else.

Now, say we’re sad.  We take a big old piece of pie, the sad part of our pie, and eat away.  Only we can eat the pie because only we can feel our emotions.  Correspondingly, only we can control our emotional response to any given event.  This is the key point in the feeling pie metaphor.

The corollary implication is that, because everyone has their own pie and everyone is in charge of their own pie, we can’t under normal circumstances make someone else eat a certain part of their pie.  Sure, we can create an event to which that person will react emotionally in a certain way, perhaps even predictably.  But that person is ultimately responsible for that feeling.

pumpkin pieSo, why would we worry about feeling guilty for possibly making someone else feel bad?  Their feeling bad is outside of your feeling pie jurisdiction.  That’s their pie and you don’t get any, them’s the rules.

You’re carrying around enough pie already and you don’t want any more anyway.  Besides, you know you have the best tasting pie around – it’s perfectly custom made for you and by you.  Why buy when you already have homemade?

If I feel guilty about how someone might react, I’m prospectively basing the emotion I think I’ll feel on an emotion that someone else might feel.  I’m eating guilt pie because I’m afraid that someone else is going to have to take a bite of anger pie, or sadness pie, or fear pie, etc.  So, I avoid doing that thing that I want to do, because I ultimately see myself as responsible for that other person’s emotions.

And that’s precisely the viewpoint that feeling pie is all about deconstructing.  It’s not about doing whatever you want all the time.  What it is about is acknowledging that you aren’t responsible for other people’s feelings, and no one but you is responsible for yours.

Addict for a Day: Inside AA

One of the final classes of my degree – the long, painful, exceedingly expensive (okay, also purposeful and rewarding) last 2 years of my life – is an introductory course on addictive disorders, their treatment, and the pharmacology of substance use.  While dark, disturbing, and downright depressing, the subject matter is also curiously intriguing and interesting.  Anyone who’s watched an episode of Intervention knows what I’m talking about.

There’s something about addiction that just tears people right apart, along with their career, family, and hope for a future.  Yet, we’re drawn to this suffering, moths to the flame.  Perhaps we wonder on some level how far we ourselves would have to go, how bad things would have to get, before crossing our own line.  Isn’t it our way – as people and as society – to try to get as close as we can to self-destruction without actually doing it?

So, the class is a mixed bag.

One assignment sent me to an alcoholics anonymous meeting.  I had never been to one before.  Plus, I never agreed with their philosophy of recovery, being the stubborn atheist/humanist I am.  I guess the whole concept of surrendering control of yourself to a higher power never sat well with me.  Nonetheless, I looked forward to going and seeing what it was all about.  The assignment was simple enough: attend a meeting, write about it and whether or not you think the program is effective.

Sure.

It was about 2 in the afternoon.  I don’t know why, but I was feeling nervous as I walked up to the building.  Maybe it was fear that I would be “found out.”  That somehow the fact that I didn’t have a problem with alcohol at all would be written all over my face and I would be some kind of outsider.  Maybe it was that I just had no idea what was going to happen in the meeting.  I mean, everyone sees them portrayed on TV or in movies… people sitting in a circle of chairs, taking turns talking about their daily struggles with sobriety, maybe praying, that kind of thing.  But I wasn’t taking anything for granted.  I knew how inaccurately therapy is portrayed in the media, so I was ready to be surprised.

It wasn’t until later that I realized why I was feeling nervous.  It was fear of being judged.  Did other people know what went on in there?  What if they did, and saw me walking in, and thought – god forbid – that I was an alcoholic?

With a sinking feeling, I thought, ‘wow…  what must it be like for someone with a real problem?’

Inside there was nothing to write home about.  A bunch of chairs set up in rows, a podium and mic at the front, flanked by windows covered by large posters emblazoned with the 12 steps and the 12 traditions of AA.  There was a coffee bar.  $1.50 to indulge in an addiction that I actually did have.  I was happy to have something to do as I took a seat in the back row, directly facing the podium.  Sip, sip… don’t mind me…

There were a few people already there, some at tables behind me, some on couches lining the perimeter of the room, a couple seated in the rows of chairs in front of me.  A man was at the podium now, he read some rules and something called a ‘daily reflection,’ not, of course, without introducing himself under his breath with the perfunctory “I’m an alcoholic” statement.  At least the movies got that part right.  There was a murmured greeting from the crowd.  He went on about something to do with honesty and admitting powerlessness, periodically scanning the crowd, who now numbered maybe a couple dozen.

One by one, he called people to the podium.  There was a couple – American – who had just got off a cruise ship that didn’t have any meetings on board.  “Real glad to be at a meeting now,” he said.  About a year sober, trapped on a cruise ship for 2 weeks with no way of avoiding booze.  I believed him.  An older woman was next.  Then a ‘newcomer’ who was clearly in a rough spot in his life.  He talked about treatment centres, relapses, boredom, mental agony trying to decide whether or not to drink on any particular day.  Another guy said that he used to go to a bar, order a beer, and stare at it for half an hour trying to decide whether to take that first sip.  Sounded like torture to me.

Everyone spoke eloquently.  Some very convincingly.  I got the sense these were experienced people.  And then, the inevitable moment came.  Podium guy looked for someone to come up to speak, and sure enough, gestured to me.  Of course, I had thought of what I might do if this situation arose.  Sure, I could pass – not speak, stay in the silent comfort of my seat – but then, this was an educational opportunity.  ‘I’m here, aren’t I?  Might as well get as much of an experience as I can while I’m pretending to be an addict.’

My introvert alarms were sounding as I stepped up to the mic.  ‘I told you not to do it!’

Sshh.

“My name’s David,” I said, without the ‘I’m an alcoholic’ part – I couldn’t make those words come out, like they were cursed or something, or would sound too forced, or any of a million other lame excuses.  I didn’t want to lie to these people, who had shared such painful stories that were, in all seriousness, pretty courageous and inspiring.

“Hi, David!” came the group’s reply.  I couldn’t help smiling.  I felt accepted.  The nervousness started to evaporate.

“I’ll make this quick,” I said instead.  “This is actually my first ever meeting,” I blurted, to cheers from the crowd.  I went on to say that I wasn’t sure where I was in the grand scheme of things, and that I wanted to see what these meetings were all about, which were both technically true.  When I was finished, there was more applause, and several encouraging handshakes on my way back to my chair.  I felt welcomed, but still pretty awkward as I listened to the next few speakers mention what it was like for them when they first started coming to meetings.  Speakers consistently made direct eye contact with me when talking about how important it is to keep coming to meetings.  That nice feeling of being welcomed started to turn into a sense that I was being gently pushed.  A vivacious, attractive younger woman was last to speak.  She was a great speaker, very charismatic, very personable.  She made a convincing case for following all the steps and reading all the AA literature.  I wondered if she was routinely asked to speak at the end the meetings with young newcomers.  Or maybe just at the end of meetings to provide those in attendance some motivation to return.

Finally, everyone formed into a circle, holding hands, and a prayer was spoken (the “serenity prayer“):

God grant us the serenity to accept the things we cannot change,
courage to change the things we can,
and wisdom to know the difference.

It was pretty awkward to be the only one that didn’t know the words.  The meeting ended and I think I was the first person out of the building, as if I had a limited time before my ‘clever guise’ wore off.  I didn’t get out without a short conversation with the young woman who spoke last, she gave me a booklet with meeting times and locations for the whole month.

I did feel like a weight was lifted off my shoulders as I walked away.  I think it was the whole pretending thing, and the mindset that I seemingly adopted to go with that ‘addict’ role.  That feeling that I was being judged by ‘normal’ people.  It was all very automatic, which is kind of frightening.  We do this to people, society.  Great job.

So, is the whole thing effective? From what I saw, it was keeping some people sober.  Maybe their addiction just switched to having to go to meetings, but there’s surely a lot worse out there.  I can tell you that I felt welcomed, supported.  That if I really needed it, these people would help me.  I don’t think that means that it’s going to work for everyone, nor should it.  I still don’t believe in the same things they believe, and I don’t think I ever will.  I think that the power to change, for better and for worse, is fundamentally within one’s control, not outside it.  I believe in responsibility, on a personal and a social level.

Nostalgia, False Memories, and the ‘Other Half’

Memory is a reconstruction.

For a while, the theory on memory was that all of our experiences, perceptions, sensory input, etc. got stored somewhere in our brain as they happened, then sent off to some other part of the brain shortly thereafter for long-term storage.  Like an infinite tape recorder or, perhaps more accurately, a movie of your life, a lifetime’s worth of memories are just sitting there, somewhere in the deep dark recesses of your hippocampus, available for remembering given the right circumstances.

And that’s just not how it really works.

The classic example used to disprove the “tape recorder” theory of memory involves, believe it or not, the implantation of false memories.  Now, false memories and therapy have something of a tempestuous past.  I like to think of it as a bad marriage that stuck together for the kids, only to doom them to a lifetime of going about thinking that normal relationships are supposed to be volatile, dysfunctional, soul-sucking anger magnets…

- wait, did somebody say childhood satanic ritual abuse? -

Yes, there’s been a bad history.  But implanting false memories, as it turns out, is incredibly easy.

Researchers have successfully gotten people to “remember” that they have been to Wendy’s playhouses, met Bugs Bunny at Disneyland, and recite detailed episodes of getting very lost in a mall as a child, all of which never actually happened.  Wendy’s franchises have never had play areas, and Bugs Bunny has nothing to do with Disney.

Yes, it’s more accurate to think of memory as being constantly reconstructed.  The act of remembering often alters the memory, sometimes beyond recognition.  This is a major reason why eyewitness memories are relied upon less in court cases than they used to in the past.  It’s a great example of psychological knowledge influencing public policy.

I think things always seem way better when you remember them.  Much better than even the experience itself.  What I’m speaking of, of course, is nostalgia.  Yes, we all know that sensation of recalling a cherished memory, maybe from childhood, young adolescence, young adulthood… our eyes glaze over as we return in our minds to that time, the emotions, the sensations, the freedoms.  I’ve often wondered, why does the past always seem so much better than the present?  If only I could return to that age of innocence, that night a few years ago, that childhood memory, that time when things were so different, so great….

But we kid ourselves.  Yes, we had an awesome time on the playground, swirling around on those ridiculous merry-go-rounds or steel death-cages called monkey bars, back before everything turned plastic, safe, and sanitary.  But I’m convinced that we magnify this joy in our remembrances.  Childhood becomes idealized.  Everything is colourful, playful, innocent, joyous.  Crippling fear, shyness, embarrassments, and tantrums are conspicuous by their absence.  Maybe there’s just no sense in remembering the bad times.

But are we doing our past and present selves justice?  It seems like, if we’re not looking forward – to the next paycheque, the next purchase, the next holiday, the next weekend – we’re looking backward at how great things used to be.  We don’t really acknowledge the pain (if we’re lucky enough not to have experienced an inordinate amount of it), and in so doing, we are really just reinforcing the false belief that life is supposed to be easy, fun, fair.  After all, there was a time where we remember it as such.

Then, when the shit hits the fan, it just seems that much worse.  The past may be home to the best experiences in our memory, but the present typically houses the worst.

Really, life is full of terrible experiences, ‘negative’ emotions, lows.  What we really fail to get into our heads is that that’s how it’s supposed to be.  This myth that we can be happy all the time is ultimately just leading us on a rabbit chase.  And really, as much can be gained from the lows as the highs.  There is just as much life there, just as much experience.

So I propose we start constructing our memories a bit more accurately.  Like all those times we peed our pants, or got caught stealing candy, or couldn’t go out to play with friends.  How crushed and defeated, how hopeless we felt.  That’s the other half of being human, and while it’s not as fun, it’s just as important.

The Evolution of Cooking Shows, featuring Anxiety

These days, I’m not too big a fan of TV in general.  Growing up, like most self-respecting child-products of the nineties, I watched the Simpsons religiously (5 pm every weekday with new episodes Sundays at 9), and could tell you exactly when the show started to go downhill (I’m sure all the good writers died), as well as give you a first hand account of the craziness that took over the world in the summer of 1995 while we were forced to wait a whole 4 months to find out who shot Mr. Burns.

In recent years I’ve found that I just don’t have the patience for TV.  I should probably specify that by saying that I have not purposefully set aside time for the sole purpose of watching a particular show in a long time.  The commercials, combined with the fact that there is really not much that I find worthwhile to watch, have wholly converted me to the practice of watching TV series on DVD, and I’m certain that the experience is 10 times more pleasurable.

yan can cook

Martin Yan back in his glory days

Having said that, there are a couple of notable exceptions.  Living in a semi-rival city, I don’t often get to watch games featuring my team, so I usually watch the occasional ones that I can.  But the place where I easily spend my most time in TV land is the Food Network.  I don’t know what it is, but I love cooking shows.  I have since I was quite young and used to watch (fantastic) shows like The Urban Peasant and Yan Can Cook.  Back then, there wasn’t a Food Network to speak of.  These shows were running on local TV stations during daytime TV hours.

Despite the basic premise of filming someone cooking food, cooking shows have evolved somewhat.  There are still great shows that follow the basic formula – I’m a big fan of Chef At Home – but by and large, cooking shows have become one of two things: “reality” shows with a competition-based cook-off, or the standard-esque formula delivered towards a niche audience with or without an obvious twist.  Both categories are home to a great many terrible shows and also some that are worth watching.  From the former, I would recommend anything featuring Gordon Ramsey.  The man is a genius.  I’m a fan of a lot of the grill-based shows in the latter category, as well (as long as it’s not Road Grill… the horror…Matt Dunnigan, you are my worst grill-based nightmare).

By this point, you’re no doubt wondering: Dave, it’s great that you think so many fascinating thoughts about cooking shows, but why are you writing about them here, on a psychology-themed blog?

matt dunnigan and gordon ramsay

Matt Dunnigan? No. For the love of God, no. Gordon Ramsay? That's more like it.

Relax, I was getting there.  See, there’s a show that started airing on the Food Network this season that seemed from the name alone that it had just gone too far.  Deviated too far from the mean of what makes a cooking show good, into the realm of the extreme for the sake of being extreme.  I’m talking about a show called Bitchin’ Kitchen.  From what I can gather (gasp! No Wikipedia article!), the show’s humble origins were online before it was picked up by the Food Network.

Anyway, the show is hosted by Nadia G., (or ‘Nads,’ as she self-refers) a young woman with a burly New York-esque Italian (eye-talian) accent, decked out in punk rock gear and brightly coloured make-up.  The show features recipes like “one night stand breakfast,” “pissed penne,” and “get famous frittata.”  Points for originality, sure.  Hey, points for comedy while we’re at it.  Maybe even some points for trying to make cooking shows cool.  But again, something just seems wrong about it all.  Am I too much of an old-school cooking show purist?  What happened to the days of gray-haired, overweight people using a stick of butter per recipe? (you don’t count, Paula Deen… you’re too… Southern.)

bitchin kitchen

Nadia G. rocking a frying pan

Regardless, the particular episode that I watched was called “Anxiety Stricken Chicken,” which is what made me decide to write this post.  The link above is to the web episode, not the Food Network one, so there are some differences.  Read the by-line for the episode for yourself:

Anxiety is the plague of the Net Generation. In this episode Nadia G. teaches us how to cook a chicken soup that will sooth the soul, the way mom used to make it… unless mom was a crack-ho, but that’s another episode.

Crack-hos aside, the episode makes frequent pokes at anxiety and the people that suffer from it.  Nadia G. talks about having her own panic attacks as if they were a psychotic break (“hundreds of skinless creatures crawling all over the room,” which she later cites as the reason for straining the chicken skin from her soup).  There is even a reference to anxious people being nerds.  For most of the episode, Nadia makes references to being obsessed with a lump on her neck.  She lists “cloneezapam” as an ingredient in the soup (“clonazepam” aka klonopin is a widely used and quite potent benzodiazepine, a class of anti-anxiety medication). Towards the end of the episode, she opines,

For the longest time, I was convinced that my panic attacks were due to rocking too hard.  So, I cleaned up my act, and surprise, surprise: life still sucks!

I haven’t made up my mind about whether this is the kind of humour that’s hurting society’s perception of mental illness and more specifically anxiety and anxiety sufferers or if, a la the racially charged comedic stylings of Russell Peters, the ability to make fun of anxiety is actually a crucial step in raising our awareness of it.  Conquering it.  Though Peters is a a minority who makes fun of minorities, so that changes the rules a bit.  Does Nadia G. really suffer crippling panic attacks?  It’s quite possible, but we may never know.

One thing’s for certain.  Whether or not the humour is good-intentioned and whether it raises awareness or it further raises stigmatization, until we see more of a positive presence of mental illness in the media, it doesn’t really matter.

On change

A couple thousand years ago, the Greek philospher Heraclitus said that nothing endures but change.  It is, so to speak, the only constant.

These days, it’s a message that I find myself coming to face with frequently.  I suppose it has to do with the place I am at in life, at the “beginning” of a career, a real life.  It’s felt this way for a while, maybe because the end of my life as a student has seemed so near for so long.  Maybe it’s because the realities of adulthood - a terrifying concept, at best - have started to really stack up, and bills and debts became larger and more frightening, etc., etc… all the while watching others my age who decided not to spend tens of thousands of dollars on school driving new cars, buying houses, getting married, having kids.  Progressing, in some senses of the word.  Settling.

The word ‘transition’ is a bit of a tricky one.  It implies an in-between state, not at the start, not at the end.  In the middle, wherever that may be.  To be in transition is in some sense to assume that one will not always be so.  That there is a graduation, an end to the process of alteration.  We’ll come out on the other end no longer changing, but changed.

Of course, there’s really no end to the change.  Old Heraclitus was bang on, and thousands of years later the frontiers of scientific thought have chimed in agreement to the perplexing tunes of relativity and quantum mechanics.  Nothing is absolute, not even the fundamental particles of matter.

The thing is, we’re creatures of habit.  Change is a really hard thing to have to put up with, as most anyone in the process of moving will tell you.  And more often than not, at least from the perspective of counselling, it’s change rather than stagnancy that takes people from a state of being okay to a state of distress.  It takes us out of our comfort zone.  Makes us put up our radar a bit higher.  We have to pay more attention to what’s going on, and that takes resources.  In extremely unfortunate (but much too frequent) cases, like trauma, these resources are vast, and not easily reallocated to other, more adaptive things.  Major life changes like transitioning into and out of the workplace, starting or breaking up a family, etc. can also take very long periods of time to get used to.  Sometimes people just don’t.

At the same time, no change would be boring.  Knowing things will be the same day in, day out can be extremely depressing, and just as damaging as too much change.  The extreme that comes to mind is solitary confinement.

So, there’s a conundrum here.  We’re quite stretched between wanting things to stay the same and wanting things to change.  In a way, the ‘good life’ is all about finding the right balance between the two.  No one knows exactly how to get it right (and if they profess to, they’re trying to take your money), but we all know when we’ve struck that sweet spot with the right mix of stability and spontaneity, just like we know when things are way out of whack.

The best we can do is adjust as we go.  Like finding the perfect water temperature in the shower – it’s only possible once in a while, and it’s damn frustrating to get there.  Even the smallest adjustments seem to cause unreasonably magnified outcomes.  Then we think we get it right, and the great big hot water tank of life has other plans.  But, in a matter of minutes it’s over.  Time to get on with the day.

Are therapists plumbers in this metaphor?

On Nothingness

photo by Caity

Sleep is just one of “those” things.

It’s tied in to so much of our well being, that to notice how important it is to our daily functioning, all one has to do is go for a brief period where it’s hard to come by.

Besides studying counselling psychology, one of the things I do on the side is work as a casual/on-call staff in community homes around Vancouver for people diagnosed with severe mental illness.  The homes are staffed 24 hours a day, and I seem to be among the small percentage of casuals who don’t mind working overnight, so I often work the graveyard shift.  This is all well and good, and I really don’t mind working nights here and there, but sometimes the ramifications on my sleeping patterns can reverberate all the way through the week (i.e. if I could right now, I would be sleeping such that my 7 hour class starting tomorrow morning would be more bearable, but it’s just not meant to be).

Anyway, I was on a night shift on the weekend and I found myself looking up into the sky at about 3:30, 4:00 am.  It was muggy outside and there was a distinct purplish pink hue to the normally gray overcast clouds.  And there was a moment of beautiful urban silence.  Like time slowed and the rest of the world had truly gone to sleep, leaving me alone standing in a backyard in the middle of a vast sprawling city.  I’m not sure how long it was before the sound of traffic shattered my reverie.  It was probably only moments.

The thing that I kept thinking about as I stood there looking up into the empty purple sky was nothingness.  How immensely vast the atmosphere is, the planet is, solar system, universe.  How there is no way to conceptualize this kind of space and emptiness!  How truly surprising, inspiring, and revolting the things that we’ve accomplished in spite of this crushing unknown.  The vanity of our attempts to reduce or explain it down to a level that is supposedly comforting and relatable… the mythologies, the religions…

But the irony of my experience that night is that the most salient feeling I had was one of comfort.  I’ve felt this before when looking up into the sky on clear nights, contemplating the stars and wondering, after their light has travelled for millions of light years, whether they even still exist.  Knowing that in this perspective, I am less than a speck in space and time.  I could understand how this might be an overwhelming feeling of being lost, without meaning, for some.  But for me it’s always been a comforting experience.  A spiritual experience.  To know that there really is nothingness all around.  To embrace it, without pushing it away or belittling it.  To be lost, and to not care.

It makes what we have in our meagre lives seem a lot more… human.

Now, if only I could get some sleep.

One Word

She glanced up momentarily as her hands relentlessly picked away at a tissue in her lap, eyes moist and reddened, yet unable to mask an inner resolve as hard as steel.  The counsellor across from her shifted in his chair, and casually folded one leg over the other.  When he spoke, it was with a quiet hope that his voice would not waver.

“There’s one last thing I’d like for us to do.  It’s a visualization, of sorts.  Just a way  for you to have something to take away that will help remind you of the work we’ve done here.”

As he spoke, her awareness drifted back to her fingers as they tore nervously at the tissue.  Knowing that it was all coming to an end, she eventually looked back up at him and nodded, a mix of apprehension and curiosity washing over her.  He took a breath and nodded as well.  Her fingers went still.

“I’d like you to reach into this bag and choose one of the small rocks inside.  It’s going to be your rock, so take a moment and pay attention to how you are making your choice,” he said as he passed her a small ziploc bag full of small, smooth stones.  A look of interest flashed across her face and she began to carefully feel several rocks before selecting two, feeling each in the palm of her hand.  After a moment of thoughful examination, she made her choice.  A roundish one, uniform gray in colour.

“Great.  I’d like you just to hold on to that rock in your hand for a minute.  Now, I’d like you just to take a deep breath and make yourself as comfortable as possible in your chair.  Plant your feet firmly on the ground, and close your eyes, if you’re comfortable.  We’re just going to take a few moments to reflect on what coming here has been like…”

As he spoke, calmly and evenly, thoughts and images of the last several months began to race into her mind.  She saw herself in the waiting room, fidgeting nervously and keenly aware of others’ sideways glances.  The long walk down that hallway to his office, trying to make idle conversation.  The familiar, crippling fear she felt when she first decided to come for help that had never completely gone.  The pain, the panic, the frustration.

“…now, as you’re recalling all of these memories and sitting in that experience, just try to let a word come to mind that seems to fit for you.  Just one word, one that wants to come on its own.  Don’t look too hard.”

Several moments passed as the air in the room thickened.  He watched the thoughtful expression on her face twist up for a moment, then suddenly, a single tear shot down her cheek.  She opened her eyes, and let him know that she had found her word.

“Here is a marker.  Now, if you’d like, you can write your word on the rock, and it will be my gift to you.”

She didn’t hesitate as she reached for the pen and carefully drew onto her rock the word that had so clearly come to mind as she remembered the fear, the anxiety, and the many, many tears.  She turned the rock over to show him what she had wrote, and in clear, purposeful lettering, one word was scrawled:

“Strength.”

I’ll see you around

this sad goodbye bear is going goodbye

“You must have the worst job in the world,” a client once told my supervisor.

I would be quite inclined to disagree, obviously.  However, the context in which these words were spoken lend them a strong element of truth.

There are probably lots, but I’m hard pressed at the moment to think of many jobs outside of the helping professions where you habitually build significant relationships with people, who are more often than not in a state of distress, see them change, grow, improve (or worsen),  hear some of their closest secrets, their worst fears, and at the end of the day, without fail, have to say goodbye.

And I’m quickly discovering that this is one element of being a helper that, for lack of a more descriptive word, sucks.  It’s balls.

It’s one of those things that you read in the intro to counselling textbooks and think that you’ve got a handle on, that you’ll know all the right things to say, that you’ll know how to take care of yourself when a client walks out of your office for the last time visibly trying to hold back tears after you’ve stumbled through saying goodbye.

I feel like there have been a lot of those lessons, the ones where all of a sudden what you read or learned about makes sense in a totally different way once you live it.  And you’re left thinking “ahhhhh… that’s what they were talking about!”  Except it’s just not possible to really know what they were talking about before you experience it.  You think you do.  But you don’t.  I’ll have a post of some of these lessons sometime in the future.

But one has to ask: why do we put ourselves through this painful process of saying goodbye, when it goes against every human impulse to remain connected, to just say, “I’m sure I’ll see you again, somewhere, sometime”?

Because there really is every impulse to say something to that effect.  Something about saying “goodbye” is so final, so definitive, such a reminder of our mortality, that to face it head on can be incredibly anxiety provoking.  Endings are uncomfortable, and experiencing one often brings up memories of endings from our past.

One of the most salient such memories for myself is having to say goodbye to my grandfather on his deathbed.  What could I possibly say that would communicate what I feel?  And how?  I’ll always remember how awkward that moment was, and how really, I couldn’t think of the ‘right’ thing to say.  How, more than anything, I felt embarrassed, and then guilty that this was the strongest thing that I felt.

In the situation I’m in now, at the end of an 8 month practicum, saying goodbye after goodbye after goodbye to the very people I had previously been trying to get to know better, to build a strong therapeutic relationship with, it’s hard not to be reminded of all the times I wish I had done a better job saying goodbye to other people in my life.

But I guess that’s just human nature.  It’s easier to avoid the hard feelings.  To ignore the discomfort.  To say, “I’ll see you around sometime” when we know that we damn sure won’t.

It’s time to reclaim goodbye.

1-800-DOCTORB. The B is for Bargain!

It just struck me as rather… juxtaposed… that I’m sitting here right now, doing some research for this post on none other than Dr. Drew of MTV fame while simultaneously listening to one of the best records ever recorded, Abbey Road by the Beatles.

I suppose that one could be doing a lot of silly things while listening to such an album, and the listening experience would still be quite pleasant, if not fantastic.  It was just a thought though.

I tried to find an embarrassingly bad picture of Dr. Drew, but he has proven so striking that not even 3 pages of google images yielded any such results. So I leave you with this "I'm listening thoughtfully and still looking cool" image.

Something about Dr. Drew very much rubs me the wrong way.  I was convinced for so long that there was no way he was an actual doctor.  Sadly, wikipedia proved me wrong.  Anyway, I’ve become quite interested in how therapy is represented in the media (in fact, I realized after it was too late that it would be an interesting thesis topic… oh well).  Dr. Drew seems to be the exact opposite of what used to be therapy’s most popular television icon…

Alternatively, this was THE FIRST result on google images for Dr. Phil. Don't look too closely at the bald spot. It'll burn into your retinas.

Despite the obvious visual improvements and lack of funny accent with Dr. Drew, I can’t help but think that we’ve gone from one extreme of terribleness to the other.  Dr. Phil, as we all know, began his TV career with the help of Oprah, meaning that his target audience was probably middle class females between the ages of… I dunno… 30 to 50.

Dr. Drew, on the other hand, seems the epitome of cool.  Dr. Phil was on Oprah, Dr. Drew is on MTV.  Dr. Phil got a daytime talk show, Dr. Drew got shows on everything from Discovery Health to radio to shows like “Celebrity Rehab with Dr. Drew,” “Sex Rehab with Dr. Drew,” and “Sober House.”  His target audience is clearly young, attractive, upper class yuppies.  I’m pretty sure Dr. Phil had some kind of terrible divorce or something.  Dr. Drew has three kids (triplets), probably a hot younger wife, and apparently he’s some kind of opera singer.  That’s one fail at life for Dr. Phil to at least three wins at life for Dr. Drew.

Irrevocably cooler, yes.  But an improvement?  I’m not so sure.  I mean, I’ve never watched a full episode of any one of Dr. Drew’s shows (I either get too angry or too saddened to watch), but his carefully groomed, perfectly plucked, and youthful image just somehow seems wrong to me.  Does this man look 51 years old?  Does he?  Dammit man, does he!?  It’s not right!

Am I jealous?  Is this some kind of twisted man-crush?  Why… the cruelty!

I started this post with the full intention of making him out to sound like a quack, and look at what’s happened.

Okay – all I ask is that we stop naming these TV “doctors” by their first names.  It’s not right.  Dr. Phil.  Dr. Drew.  We have to stop this pattern before it gets out of hand.

Dr. Dave.  Hmm…

One thing I always say about anxiety

For quite some time, and likely still, the “common cold” of mental health seemed to be depression.  Statistics are hovering around the 1 in 10 mark for experiencing a depressive episode in one’s lifetime, with men being the more likely gender to suffer it.  Keeping in mind, of course, that these are only reported cases in which a diagnosis was given.  If we acknowledge that in a lot of cases a depressive episode will go unreported and undiagnosed, that number goes up a significant amount.  I would guess that it doubles at least.

But this is not a post about depression.

I recently decided to go through the list of people that I’ve seen in the last 8 months and tally up the “presenting concerns.”  The issue at the top of the list, unsurprisingly, was our common cold – depression (incidentally, only a small fraction of these people had a diagnosed ‘disorder’ such major depressive disorder – though many met the criteria).  But coming up at a close second was another issue that has been, in my view, becoming more and more prevalent: anxiety.

It’s not always easy to separate the two.  In fact, in the DSM-V, they are flirting with creating a new diagnostic category called mixed anxiety depression because the two so often play together.

In any case, if I were to count the number of issues of my clients without limiting it to one issue per client, I’m confident that anxiety would be at the top of the list.  It’s just something that accompanies other problems.  And there’s good reason for that, which I’ll get into shortly.

Now, I’m not too big a fan of the manualization of therapy.  I like to think that each individual person that I sit with has a unique life situation and that there are many equally valid ways of resolving whatever distress they are going through, and that we have to work to find out which way is going to be the most productive.  I have a problem with pretending to know exactly what is required to do to ‘fix’ a person before I even know anything about them.

However, when it comes to anxiety (and perhaps more specifically, panic), there’s come to be one thing that I ALWAYS do, and it couldn’t be simpler.  It takes 5 minutes.  It’s so simple that I’m going to do it with you, right now, because I know that you’ve experienced anxiety before and that this might be new information for you.  But that’s all it is: information.  So, without further ado, I present to you…

A Brief Discussion on the Physiological/Evolutionary Nature of Anxiety
with illustration!

At some point in our evolutionary history, the fact that some folks had something that we now call the ‘autonomic nervous system’ became somewhat of a survival advantage.  You see, this nifty gifty had  two sub-systems: one called the sympathetic and one called the parasympathetic nervous system.  The former had this neat function where it got us really pumped up in response to some kind of threat in our environment.  Maybe a poisonous snake crossed your path, maybe some pre-historic douche-canoe was making moves on a certain female member of the species that you wouldn’t mind impregnating.  In any case, a threat is detected.  This is where the sympathetic nervous system decides to step in and do its thing.  Suddenly, more blood starts pumping out to your arm and leg muscles, your heart rate doubles, breathing becomes fast and shallow, and your pupils dilate, and all sorts of chemical changes start happening.  In a split second, you are literally stronger, faster, and more alert.  Now, you have much more capacity with which to either flee the threat or engage it physically.  This is what is more popularly known as the fight/flight response.

This is all well and good.  Obviously this all developed over generations and the process of evolution refined it to be what it is today.  But as with so many traits that allowed us to survive in an ancestral environment, it doesn’t always function with the same level of effectiveness in our lives today.  The simple fact of the matter is that, for the more fortunate of us, we don’t live life surrounded by the possibility of constant threats to our survival.

So, for those of us who don’t have problems with anxiety or panic, this system tends to be well-regulated most of the time.  Every now and then a legitimate threat is perceived and you’ll get that response happening, but most of the time, when faced with normal everyday stimuli, nothing happens.

When we start talking about anxiety, and particularly with panic attacks, what effectively has happened is that the sympathetic nervous system’s threshold has been lowered way down.  It’s been over-sensitized for some reason (which obviously varies depending on one’s history – in the case of trauma there is very good reason for this).  But the point is that there is a natural, physiological process that is happening – one that was well-developed back when our ancestors didn’t have the cognitive abilities that we now possess in order to make logical sense of the the world around us.

So, when someone with social anxiety begins to have a panic attack when forced to interact in a group, we (and they) can easily come to the conclusion that it just doesn’t make any sense for that to happen – nothing bad is going to come out of it and there is no logical reason to become anxious.  But on a deeper level, this system that’s basically been told to go into red alert status starts going off the rails.

So what about this other subsystem of the autonomic nervous system – the parasympathetic one?  This one is actually responsible for the exact opposite function of its sister – it calms us down when a threat is no longer present.  Our blood begins to flow back to our core, heart rate slows, pupils return to normal size, breathing slows, and all sorts of chemical changes happen.  It’s no longer adaptive to be hyper-vigilant and ready to spring at the drop of a pin.  And this is also the system that has to start kicking in when maladaptive anxiety is starting to cause panic.

It’s just not possible for both of these systems to be fired up at the same time.  You can’t be anxious and relaxed simultaneously.  And this is the bottom line of what I say to anxious people.  The beauty of it is that there is an incredibly simple way to kick-start the parasympathetic nervous system’s calming effects – it’s as simple as taking control of your breath.  Slow down your breathing, you slow down your heart rate, and just maybe, that gets some of the other processes going.

I find it to be a hopeful message.  It’s just a starting point, and it’s by no means the ideal, ultimate  solution to anxiety, but it is simple enough that it’s worth saying every time.