Category Archives: Psychological

The Illusion of Invincibility

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safety_pin_crp1When my daughter was little, my husband and I tried to safeguard her against people who might do her harm. “It’s OK to kick and scream,” we told Emma. “You don’t have to be nice if someone tries to hurt you. Not everyone is a good person.”

“Those bad guys better watch out!” Emma replied. “I’m gonna have safety pins with me, and if they try to get me, I’m just gonna take out my pins and stab them!”

I loved my daughter’s confidence in her strength, her ability to quell her fears by standing up to danger. No matter that her plan for protection was childish folly.

We’re now seeing a similar impulse play out on a national scale.

The New York Times reports that in the wake of the latest mass shootings here and in Paris, Americans are rushing to arm themselves. When something frightening happens, people want to feel safe and in control. Their fear of becoming a victim is transformed by the illusion of invincibility.

The gun lobby and its political minions masterfully exploit this psychological dynamic by stoking fear, then offering a reassuring (though false) “solution” like the one promulgated after 20 six-year-olds were gunned down at Sandy Hook three years ago today. “The only thing that stops a bad guy with a gun is a good guy with a gun,” proclaimed NRA spokesman Wayne LaPierre in response to that horrific massacre.

This sentiment has been echoed by the Republican Presidential contenders in response to more recent mass shootings. The day after the San Bernardino massacre, Ted Cruz proclaimed at a gun rights rally, “you don’t stop bad guys by taking away our guns, you stop bad guys by using our guns.” A couple of months before, Ben Carson essentially blamed the victims of a heavily armed gunman at Umpqua Community College by saying, “I would not just stand there and let him shoot me.”

If only it were that easy!

Yet the research—not to mention law enforcement and military personnel–overwhelmingly contradict this simplistic notion. “Good guys” unloading their weapons against an active shooter in a public space would likely result in greater mayhem and casualties. Guns on alcohol-infused campuses are a recipe for disaster.  The risk of gun deaths from homicide, suicide, or accidental shootings is much higher when there’s a gun in the home. And guns, in the heat of the moment, can turn a “good guy” into a killer instantaneously. More guns mean more gun deaths.

Yet reason doesn’t seem to stand a chance against fear and its exploitation. In the three years since Sandy Hook, Congress has done nothing to enact gun-safety legislation. Although some states have tightened restrictions on guns, many more have actually made it easier to purchase and carry guns.

It’s one thing for my young daughter to fantasize about wielding her safety-pins for protection. But it’s quite another to arm ourselves to stay safe from gun violence. As adults, we should know better.

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Had enough? One of the reasons we have failed to enact more common-sense gun-safety laws is that those who support such measures don’t speak out. You can bet gun- rights advocates don’t make that mistake. Contact your representatives. Rally. Sign petitions. Vote your principles. And check out these organizations that are working hard to make a difference:

Everytown for Gun Safety

Moms Demand Action for Gun Sense in America

Newtown Action Alliance

Suicide by Gun

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Means Matter logo

Once again, America is transfixed by a mass shooting. No doubt the list of massacres will grow to encompass other shattered towns and families, evoking fear and horror every time.

Yet almost two-thirds of gun deaths do not make national headlines. These are the more than 21,000 people–many of them teenagers— who every year kill themselves with a gun.

As someone who has worked in the field of suicide prevention for decades, I know that the best way to prevent these tragedies is to restrict access to guns. Current research contradicts the commonly held but false belief that suicidal individuals will just find some other way to kill themselves. In fact, self-destructive feelings are often impulsive and fleeting, dissipating as the crisis passes. Ninety percent of those who survive an attempt never go on to die by suicide. But when guns are involved, the crisis can quickly escalate, precluding safe resolution. Fast and deadly equals no second chances.

According to the Harvard School of Public Health, those states with the highest rate of gun ownership also have the highest rates of suicide. Access to lethal means is a far greater risk factor than mental illness. Although some promote the fallacy that a gun in the home makes you safer, the opposite is true. The risk of suicide is two to five times greater for all household members in gun-owning homes. In one study, 82 percent of children 17 and under who shot themselves to death used a gun belonging to a family member. Homes without guns have the lowest suicide rates, but even in homes where firearms are present, risk decreases if they’re properly stored—unloaded and under lock and key.

When it comes to preventing suicide, means matter. We always ask why people kill themselves. But we’re better off focusing on how so many people die.

It’s the guns. If we really want to save lives, restricting easy access to such lethal means is our best approach.

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The statistics cited here are from these sources, which provide a wealth of additional information:

http://www.nytimes.com/2015/03/10/health/blocking-the-paths-to-suicide.html

http://www.hsph.harvard.edu/means-matter/

http://actionallianceforsuicideprevention.org/sites/actionallianceforsuicideprevention.org/files/Reducing%20a%20Suicidal%20Persons%20Access%20to%20Lethal.pdf

 

 

 

 

Out of the (Gratitude) Closet

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Gratitude closet

I love my colleague Tina for many things, but especially because she drinks her coffee from a mug that announces, “I Don’t Do Perky.” False Positive is the title of an article I wrote for psychotherapists about the downside of positive thinking. And a humorous essay of mine begins, “This gratitude craze bugs the shit out of me.”

So it may come as a surprise that I’ve recently begun keeping a gratitude journal.

Call me a hypocrite. I prefer to think of it as similar to the time I went from being a person who doesn’t much like dogs to owning one. I could really relate to canine-indifferent friends who couldn’t express an enthusiasm they did not feel for such lovable behaviors as tail-wagging and that (not so, to them) endearing doggy lean-in.

Likewise, I understand why someone who is suffering can feel even worse when asked to embrace positive emotions. It’s not that I’m a depressive ingrate by nature (at least not most of the time). But I’m wary of efforts to sanitize thought and speech. Too often, expressions of negativity are met with rebuke instead of empathy, and I’ve seen the damage this causes, personally and professionally.  I thus try to champion all those nasty feelings we feel pressure to squelch: anger, sorrow, bitterness, envy, vengeance. Superimposed gratitude is like a thin coat of whitewash that seals in the toxins.

And yet, stubborn resistance is equally problematic.

So during a hard time this summer, I relinquished my protestations and started a gratitude journal, figuring that it couldn’t hurt.

It’s nothing fancy, just an old 5×7” Reporter’s Notebook covered with my daughter’s grade-school scribbles . Every night I write the date and “I am grateful for/that . . . “ Then I list 3-5 things. I try not to repeat myself (though our latest addiction, the TV series Nashville, has made it into several days, and there’s a sprinkling of entries that say “RAIN! RAIN! RAIN!”).

Here are some of the things I’ve jotted down recently:

(And although this isn’t a current event, I’m grateful to my daughters, whose persistent dog lobbying brought Button into our lives for 15 years.)

Button

Two weeks into my gratitude journal, one of the things I wrote was “Feeling way less depressed.” Though the ritual of giving thanks surely helped, there were other things at play as well: I’d resumed weekly therapy after cutting back; the post-cancer scans that always make me nervous were clear; I finally followed through on my intention to volunteer; my weight finally started heading in the right direction; things started to go better for the Democrats; the summer drought of movies yielded to a fresh crop of Oscar worthies; our actual drought yielded (a little) to rain and the promise of more to come.

There is always more to come.  Assuming El Nino delivers on its promise, I look forward to jotting down my gratitude for SUN! SUN! SUN!

That’s how it goes, the chiaroscuro of darkness and light that makes up life’s full spectrum.

I’m grateful for it all.

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Ever felt (or promoted) the prohibition on negative feelings? How’d it go? What are you grateful for?

Talking Cure

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Conversation

Sherry Turkle, a sociologist and psychologist who studies the impact of technology on relationships, wrote recently about the need for face-to-face conversation in a world increasingly dominated by texting and smartphones. It is through this “talking cure” that we build empathy, intimacy, and self-reflection, coming to know ourselves and others deeply.

Turkle wasn’t talking about Freud, but she was describing the mainstay of psychotherapy.

Soon after Turkle’s essay appeared, new research questioning the efficacy of talk therapy in treating depression made headlines. That same day, I listened to a podcast about Dr. James O’Connell, who has been providing healthcare to Boston’s homeless population since 1985.

O’Connell’s approach is more art than science.  He described having to unlearn the techniques and arrogance he’d perfected as an ER doctor when he took a job at a homeless shelter. The nurses, unimpressed with his skills, advised him to keep quiet about his medical expertise. They instructed O’Connell to spend his first two months doing nothing but soaking the feet of those living on the street.

“Don’t judge, these people have been through hell,” the nurses told him. “You will not gain anyone’s trust without being present.”

O’Connell spoke of the profound isolation and loneliness as well as the tremendous courage and resourcefulness of the men and women he came to know in his decades on the street. He believes the adversity they experienced would have broken him. This knowledge is fundamental to engaging in such hard work:

“We’re all broken in our own way,” O’Connell says. “It’s a connection with that brokenness that actually keeps us going.”

O’Connell’s words took me back to what inspired me to become a therapist: volunteering at a crisis hotline.

I had never before encountered the level of adversity our callers faced—poverty, abuse, addiction, chronic mental illness. Like O’Connell, I was awed by the courage and dignity of those whose lives were unimaginably precarious. The work was hard, but I loved it—the listening, the immediacy of the connection, feeling that my presence made a difference. Nothing much changed in anyone’s life, mine or theirs. Yet everything changed because we mattered to one another.

This is the essence of therapy. Our work is a modest endeavor–a conversation, a space of undivided, unhurried attention and exploration. The talking cure depends on humility and presence. These are the ineffable, unmeasurable things that matter—on the streets, in conversation, and in psychotherapy.

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 How do you preserve conversation in a technology-obsessed world? What is the essence of presence for you?

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(Originally published in Impulse, the electronic newsletter of the Northern California Society for Psychoanalytic Psychology)

The Pull to Be Positive

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happy and sad face“Fake it till you make it.”

I thought of this adage when I took a friend who had never been backpacking into the wilderness years ago. We encountered a stream crossing that involved balancing on a log high above the roiling waters below.  I was terrified, but I never let on. My confidence was key in helping my friend safely across. It also helped me become as light-hearted as I had pretended to be.

Three years ago a cancer diagnosis thrust me again into the territory of needing to go on despite my fear. I wanted to lead everyone who cared about and depended on me, especially my children, through the treacherous waters without raising undue alarm that I’d go under, taking them with me. My darkest feelings were confined to my journal, my therapist, my husband, and a couple of trusted friends. For public consumption, I presented a sunnier side, writing breezy blog posts about wigs and Chinese medicine, stressing my gratitude and good fortune. It wasn’t a stretch: I was tolerating chemotherapy well, and felt truly lucky about early detection, great health insurance, an excellent prognosis, and lots of support.

The plaudits poured in.

“You’re so strong!” I was told all the time. “You’ll be fine because of your positive attitude.”

The implication that it would be my fault if things didn’t turn out fine always brought me up short. But being strong for others helped me be strong. Inspiring others kept their and my own spirits from flagging. I loved and needed the admiration.

I also hated it. For what if my spirits sagged? If I expressed too much doubt and fear, would I be letting down my fan base?

More important, would people desert me?

No one means to withdraw, but it happens: the involuntary recoil, the averted gaze, not knowing what to say, so saying nothing. I couldn’t bear the burden of people’s fear and helplessness. I couldn’t bear my own. So I tried not to add to it. Besides, who doesn’t want to flee the quicksand of negativity? Emphasizing the positive truth, even if it wasn’t the whole truth, was an act of self-preservation.

Only much later, long after treatment had ended and I knew I was fine, could I fully let in the darker side. It reminded me of the time years ago when I tripped and fell carrying my newborn daughter, asleep in her car seat. The seat, with Ally in it, landed hard on the concrete walkway. Fortunately, it remained upright, my baby safe and unperturbed.

“Oh, thank God,” I’d silently gasped, brushing myself off, scooping up Ally in her car seat, and continuing on, barely registering the close call.

It was only later that I could allow in the terror, all the What ifs? Ally is 24 now, and I am still overcome with dread whenever I think back to that moment.

Cancer is never over in a moment. Even when it’s gone, the possibility of its return menaces. Of course I celebrated leaving treatment behind. Yet the more chemotherapy’s protective shield of poison withdrew from my body and faded into the past, the more vulnerable I felt.

As previously disavowed feelings of fear and sadness bubbled up to the surface recently, I happened to tune into a TED Radio Hour about fighting cancer. A hospital chaplain who herself had gone through the ordeal stressed that only well after treatment has ended can survivors even begin to process their cancer experience.

Finally! Someone willing to challenge the platitudes about looking forward, not backward, the claptrap about cancer’s gifts. I listened eagerly as the chaplain described meeting with a woman a year after the latter had been declared cancer-free.

Revealing the suffering and fear she’d repressed during treatment, the woman remarks, “I felt like I was crucified on the cross.”

I waited expectantly for the chaplain to enlighten the TED audience about the isolation of cancer; the need to express what it’s really like; how crucial it is to listen to what’s hard to hear.  Instead, the chaplain recounts what she said to the woman:

“Get down off your cross.”

My worst fears were confirmed: Fake it till you make it, or you may find yourself having to make your way alone.

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What’s your experience with the pull to be positive? Upsides and downsides? What’s your best (or worst) “Fake it till you make it” story?

Joy’s Shadow

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Joy and SadnessIs broccoli an adverse childhood experience? That’s about the biggest upset Riley, the protagonist of Pixar’s new film, Inside Out, encounters until age 11, when her family moves. Even for this securely attached child with loving parents and a sunny disposition, calamity ensues.

Riley’s destabilization is triggered by loss of everything familiar, preoccupied and misattuned parents, and looming adolescence. The biggest threat, however, is that Joy is planted too firmly at the helm, with Sadness practically banished.

Inside Out has been acclaimed for its attention to neuroscience, but there are also strong influences from contemporary psychoanalysis. The movie echoes pediatrician and psychoanalyst D.W. Winnicott’s notion that “there is no baby without a mother and no mother without a baby.” It opens with newborn Riley’s first blurry glimpse of her parents, who exult in their baby. She is truly the gleam in her parents’ eye. Joy is not only a core emotion and an aspect of temperament, but a product of mirroring crucial to personality development.

Those of us who are therapists do not often encounter in our work clients whose earliest relationships result in Joy’s authentic governance. Yet we frequently see people who have long labored under the command of relentless good cheer. This, too, is the life of Riley. No wonder the other emotions are content to go along with the premise that Joy ought to be in charge: She sacrifices aspects of self to protect and please those she depends on.

Luckily, Riley is blessed with good-enough parents and optimal frustration: growth follows de-integration as split-off parts are integrated in an ongoing process of empathic failure and repair. Most important, Riley is allowed to mourn.

Inside Out has been lauded for its depiction of emotion, yet it is also a depiction of mania. And no wonder. Manic defenses ward off feelings of despair through constant activity, the fantasy of omnipotent control, and disavowal of sadness. Mania masquerades as happiness, but underneath lies the inability to feel sadness. This is Joy to a T.

It’s also a big aspect of American culture. Perhaps this explains why Inside Out has garnered such massive acclaim. The importance and integration of all emotions may be a given among therapists, yet the movie has been hailed as Revelation.

This may say more about us than Inside Out purports to say about the brain, emotions, memory, or personality development. But to the extent that the movie reaches a large audience about the role of affect and empathy, and the perils of happiness on command, it’s good to have Pixar at the controls.

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If you saw Inside Out, how did you like it? What aspects did you identify with? Have you experienced the pull to be positive no matter what?

 

Insane

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No gunsMy husband and I were hiking in the Alps with a group of Australians shortly after Dylann Roof murdered nine members of a Bible study group in Charleston, South Carolina. We felt like we were on a different planet trekking all day among towering peaks and wildflowers as at night we kept abreast of the horrific news on our smartphones.

The stark racism behind the Charleston shooting makes it almost beside the point to zero in on guns; a massacre so intertwined with America’s long and sorry history of racial oppression, particularly in the South, has understandably made this the prevailing focus. Nonetheless, although the why of Roof’s violent bigotry is deep-rooted and complex, the how is simple: easily obtained guns and ammunition.

Our Australian hiking companions were incredulous about America’s failure to do anything about gun violence. These were not our usual crowd of Bay Area liberals for whom guns arouse a knee-jerk suspicion. Our fellow trekkers were arrayed across the political spectrum. Several were ranchers; one talked about getting his first rifle as a kid. Yet Australia chose a different path from the United States after its own traumatic experience with a mass shooting.

In 1996, an Australian gunman killed 35 people in what came to be known as the Port Arthur massacre. Instead of sorrowful hand-wringing and inaction, John Howard, the newly elected conservative prime minister immediately passed with bipartisan support strict gun control laws throughout the country.  Private sales were banned, and only a narrow range of reasons were valid for ownership (self-defense, fear, and gun “rights” were not among them). Gun owners had to pass a safety class, could not carry their weapons around, and had to register and store them properly.

Some legislators paid a political price, but almost 90 percent of the population favored the new regulations. As our Australian friend who had grown up with guns explained, there were initial misgivings, but after a couple of years everyone saw that life continued to be fine, and the resistance disappeared.

The new laws were extremely effective. In the next decade, Australian gun homicides declined by 59 percent, the suicide rate by 65 percent. The rate of home invasions also declined. And there have been no mass shootings since Port Arthur.

As we listened to our hiking companions’ stories, they listened to ours:

  • About how even after 20 first-graders were shot to death in Sandy Hook in 2012, Congress could not summon the courage to mandate universal background checks supported by 90 percent of Americans.
  • About how the NRA’s response to gun violence is to advocate arming more people; “The only thing to stop a bad guy with a gun is a good guy with a gun,” an NRA spokesman said after Sandy Hook.
  • About how men armed to the teeth swagger around advocating open-carry laws.
  • About how restrictions on guns have loosened rather than tightened since Sandy Hook.

“You’re kidding! That’s insane,” one of the Australians exclaimed over and over.

Indeed.

We hear a lot about insanity in conjunction with America’s mass shootings, which now occur at the rate of about every other week. The mental instability of the killers is inarguable, as is the need for more effective mental health screening and treatment. Yet scapegoating the mentally ill (who are far more likely to be victims than perpetrators of violence) misses the point of a widespread cultural insanity. It also misses the point of doing something about the delivery system if not the root causes of our national pathology.  As Australian’s John Howard recalled about the Port Arthur massacre in an op-ed he wrote following Sandy Hook,  “The fundamental problem was the ready availability of high-powered weapons, which enabled people to convert their murderous impulses into mass killing. Certainly, shortcomings in treating mental illness and the harmful influence of violent video games and movies may have played a role. But nothing trumps easy access to a gun.”

We left the Alps much rejuvenated by the scenery and much enlightened by our Australian friends. Because we were on vacation, I didn’t write about it at the time. When we returned, we were gripped and heartened by the sea change that finally brought down the Confederate flag from South Carolina’s capitol in the aftermath of  Dylann Roof’s rampage. Guns, again understandably, took a back seat as we celebrated this important if symbolic milestone in tackling racial oppression.

But I knew it wouldn’t be long before gun violence was in the news again. Sure enough, this week Chattanooga and Lafayette were added to the roster of communities shattered by a gunman. More gun deaths will surely follow—those that make headlines and those that don’t. As glad as I am about the Confederate flag’s downfall, I wish we could take a page from the Australians, and see our gun insanity follow suit.

High Style, Size 0

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High Style eta_hentz_ivory_beadsThis week I went to the Legion of Honor to see High Style, an exhibit of 20th century haute couture from the Brooklyn Museum’s Costume Collection.

I could actually care less about fashion. I grow uneasy flipping through women’s glossy magazines, and I hate clothes-shopping. Buying shoes is even worse.

Still, I love fashion exhibits at museums.

First up at High Style were the shoes—sumptuous embroidered leathers that squashed toes into ridiculous points. High style shoeAs someone who seeks out Mary-Janes and who has never teetered on anything higher than a low-heeled pump, I marveled at the tortures women subject themselves to. One atelier boasted of crafting the most expensive shoes in Paris—the equivalent of $10,000 in today’s dollars. This made me feel better about my $150 Arcopedicos, the only shoe besides my Merrell hiking boots I really trust.

Then it was time for the real deal—the clothing. I loved the beading, plunging backs, and tight bodices. Soft, sensuous folds clung so enticingly to the mannequins–mannequins who were faceless, sometimes limbless, disappearing into nothingness. And so slim!

As I drank it all in, I became increasingly uneasy, aware that anorexia was integral to the look I so loved. According to the New York Times, more than 36,000 French women suffer from anorexia. In America, it’s estimated that 0.5 to 3.7 percent of women suffer from the disorder in their lifetime. That’s a lot of women disappearing into nothingness, sometimes fatally so–eating disorders have the highest mortality rates of any mental illness.

The birthplace of haute couture is seeing progress, however. Recently the French Assembly passed amendments that would help combat anorexia promulgated by the fashion industry. As a laudatory editorial in the New York Times points out, “The amendments send a powerful message from the global capital of fashion that severe malnutrition should never be considered fashionable.”

In the same week I saw High Style, my Facebook feed featured an image that originally went viral in 2013–“real women” mannequins in a Swedish department store. They’re a lot different from the alabaster ghosts of High Style:

Real Women mannequins

So go, enjoy the show (it runs through July 19). Then enjoy a nice lunch afterwards. Most important, always enjoy being a real woman.

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How has the fashion industry’s depiction of women affected you?

Y is for You Look Fine

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You Look Fine (El Toro County Park, April 2015)

Recently my husband and I came across this signpost after hauling ourselves up a steep hill in Toro County Park, a vast region of rolling hills, trails, and recreational facilities on the outskirts of Salinas.

Was it social commentary on our fat-shaming and appearance-obsessed culture? Or just the frustrated lament of someone waiting for hiking companions to tidy up their wind-blown and hat-crushed hair for a quick smartphone photo? (More important, would there be another signpost at the end of our long, hot, trek pronouncing, “You Look Like Hell?”)

The message was welcome, if oddly placed, and one that got me thinking (which helped propel me up the many arduous and dusty miles to come, not to mention providing me with a “Y” post that is not a bunch of Yosemite photos or a “Y Am I Doing this Challenge?” lament).

Mostly I think of “You Look Fine” as the bare-minimum response that gets a man out of trouble when asked the world’s most dangerous question: “Does this make me look fat?”

(In case that unforgivably gender-stereotyped sentence makes your blood boil, rest assured that just this morning, my husband, who is red-green color-blind, asked as he was rushing out the door if his jacket looked okay with his pants. “No, it doesn’t,” I said. “You should wear something else.” He looked upset and hurried off as I unconvincingly called after him, “It’s fine. Really.” Later I emailed him the “You Look Fine” photo, amending my early morning candor.)

Wouldn’t it be nice if “You Look Fine” signposts proliferated? Imagine them replacing mirrors, or showing up in mirrors, alongside your reflection! What if they were on street corners, subways, doctors’ offices? Even better, what if we could get away from feeling influenced by any assessment of our appearance, whether positive or negative?

What we really need are signposts that say “You Are Fine.”

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What’s your theory about how the mysterious YLF signpost got there? What signposts would you like to see proliferating in unexpected places?

X is for X-BFF

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X BFFsI’ve been in and out of love with men many times over the decades, but breaking up with my best friend, Sharon, was worse than any failed romantic relationship. It knocked the wind out of me for years, consuming me as I tried to figure out what went wrong. How could someone who was so much a part of me be gone from my life? I felt like a crazy person, unable to move on from my guilty, shameful obsession.

I’m not the only one. Almost every adult woman I’ve talked with has a similar story. The details and personalities differ, but the women I’ve spoken with all feel equally crazy and obsessed by a deep hurt that at best leaves a lot of scar tissue, but often never heals. (I was lucky—Sharon and I eventually reconciled.)

I wonder if the hyper-idealization of friendship between girls and women is part of the problem. Our friends are supposed to be everything to us—super supportive, always there for us, able to finish our sentences, someone who gets us inside and out. In fact, sometimes we seem like the same person, inside and out! That urge to merge is so delicious—and so deadly.

We know how to be close, but difference often feels like an unbearable distance. That’s often when trouble starts. Worse, women seldom know how to deal in a healthy way with all those “not nice” feelings: conflict, aggression, envy, and competition. So we sweep problems under the rug, hoping they’ll go away. Or act out big time. Or exhaust ourselves with endless processing. (No wonder the movie Bridesmaids  always strikes a nerve for me—I’ve seen it four times!)

What makes female friendship so susceptible to ruptures? Can we enjoy tight bonds without cutting off the circulation?

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What do you think? What are your experiences with X-BFFs? Were you ever able to drop the “X” even if regaining “BFF” proved elusive?