Category Archives: Psychological

V is for Vaccination Village

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herd immunityI live in Marin County, California—ground zero of the vaccination wars that erupted after this winter’s measles outbreak in Disneyland. Marin County is one of the most affluent, best-educated, and progressive enclaves in America. It also has some of the highest rates of personal belief exemptions for standard childhood vaccinations. Left-wing parents here who do not want to vaccinate their children cry “Freedom!” just as loudly as their right-wing counterparts. Some have quipped that Marin County is the place where the Tea Party and the Green Tea Party come together.

I support SB277, a bill currently making its way through California’s Senate that would eliminate all but medical exemptions for vaccinations for school-aged children whose parents wish to enroll them in public schools.

Yet I hesitate to wade into the battleground, knowing how firmly held beliefs become even more entrenched when disputed, even in the face of scientific evidence. Although a false claim linking autism to vaccines has been thoroughly debunked, fear persists. I do not know how to approach parents who fervently defend their right to choose what is best for their children when I know it is not best—for their kids, or for anyone else’s. Maybe if my friend Mark Paul’s essay, “My Polio, My Mother’s Choice,” were required reading, it would be more persuasive than my impatient incredulity.

These days, though, I fear that perhaps we’re suffering from something even worse than the easily preventable outbreak of disease. The vaccination wars speak to deeper problems in our country: distrust in the government, both earned and unearned; too many who turn away from science; and, most gravely, the abandonment of the village. The near-universal practice of vaccination confers herd immunity, protecting those who are too young, too old, or too immuno-compromised to be vaccinated. But if enough people seek “freedom”—freedom from their responsibility to the herd–where does that leave us? We are too much in it for ourselves now, no longer interested in contributing to the common good. This worrisome trend affects many issues beyond vaccination

It does, indeed, takes a village. But what if people want only the rights, and not the responsibilities, of being a villager?

 

U is for Undercommit, Overachieve

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 undercommit, overachieve

“Undercommit, overachieve.”

It’s not exactly what we’re used to hearing in our hyper-striving culture, but it’s advice I treasure from a writing teacher.

Every week when we went around the room to commit to what we’d do before the next writing class, our teacher would encourage realism: “How much time are you spending writing now? None? OK, how about one hour once instead of several hours every day in the next week?”

My Weight Watchers leader does the same: “If you’re not exercising at all currently, will you really go to the gym on a daily basis?”

One small commitment can grow into so much more.  A massive overhaul, though? That’s just a set-up for failure. If you don’t believe me, just ponder what happens with all those New Year’s resolutions!

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 “Give it your all!” or “Undercommit, overachieve” —

Which speaks more loudly to you?

K is for Kitchen Table

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tableMy youngest daughter, Ally, who had our old kitchen table at college, wanted to sell it before studying abroad for a year. I, however, insisted on storing the table during her absence, certain she would need it upon her return.

But it was really my need: for Ally to still want to keep a part of home, and for her to remain with us, “in storage,” during the temporary absence that foreshadowed the permanent separation of growing up. Although the table would be cumbersome to move and store, I wasn’t ready to let go.

After all, it was so much more than a table. I remembered how my future husband set it with yellow roses and homemade spaghetti soon after we met, and the subsequent family dinners once we had kids. I recalled the homework, the crafts, the cookie decorating, how the table contained the overflow of books, mail, and all the stuff of family life throughout the years. I had held on to the table to forestall feeling the loss of these cherished times, the ache of the empty nest.

Transitional objects are not just the loved-to-bits blankies and stuffed animals of childhood; they help us cope throughout life. We hang on to them until we do the work of integrating and grieving what they signify, and can relinquish them once they become just the thing itelf.

So after remembering, and mourning, I called Ally and said, “Sell the table.” It had become just a piece of furniture to me, and a ratty one at that. I could bear its loss, and even look forward to what might open up in letting go.

In the end Ally decided to keep the table. Perhaps she still needed a token of home while growing up. Or just a place to eat dinner and throw her books.

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What have you hung on to, and what has helped you relinquish it?

H is for Hero Worship

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little engine that could

The Little Engine That Could is a favorite children’s story that teaches the value of determination, hard work, and an optimistic attitude. Fueled by the mantra, “I think I can, I think I can,” the tiny train surmounts incredible obstacles. Cue the ecstatic acclaim.

I’ve  thought about this quintessentially American fable ever since James Robertson came to national attention earlier this year. When his car died 10 years ago, Robertson, a 56-year-old Detroit resident, walked 21 miles a day to and from work for a decade. There was no reliable public transportation, and Robertson could not afford a new car on his factory wage of $10.55 an hour. So he kept on going through all kinds of weather and unsafe areas, never missing a day of work, and never complaining.

Robertson’s been lauded as an American hero. As one letter writer in my local paper enthused,

Mr. Robertson is what America is supposed to be all about; he reflects the values that made this country great. . . . America loves those who are willing to work hard and fend for themselves . . .

We sure do. We’re a can-do country, born and bred on The Little Engine that Could. People so loved Mr. Robertson’s story that through crowd-funding, they raised enough to give him $360,000 in cash and a new car.

Those who overcome adversity certainly deserve our admiration. But there is a dark side to our adulation of such against-all-odds triumphs. Just look at what else the aforementioned letter writer has to say (I repeat his admiration of Mr. Robertson as a springboard to his further point):

America loves those who are willing to work hard and fend for themselves rather than trying to game the system and depend on government assistance when it is not really needed.

Wouldn’t it be great if there were more people like James Robertson willing to do what it takes to get and keep a job and be productive members of our society, and fewer individuals who are able to work but choose to take advantage of the government’s willingness to give away our tax dollars?

I have no quarrel with Mr. Robertson, but there’s plenty wrong with a society that idealizes high levels of adversity as an acceptable test of character. Should it take 21 miles of walking through all kinds of weather to keep a job? If this is the expectation, then we don’t have to look at a system of wages in which a full-time worker can’t afford a new car. We can ignore the lack of public transportation, childcare, decent wages. It’s an implicit acceptance that society owes nothing to the individual.

Such thinking lets us off the hook. It allows us to believe that those who cannot make it are to blame. The letter writer may have been inartful in his words, but his sentiment is not unique—in fact, it’s what fuels our most monumental political debates and is arguably a fair summary of the Republican Party’s platform.

It also substitutes favored-cause crowd-funding for sensible and humane public policy.

This swap, not surprisingly, doesn’t turn out so well—not only for those whose inspring stories are not trumpeted in the national media, but even for Mr. Robertson: His ex-girlfriend went after his money, and he had to move out of his neighborhood because he felt threatened by those have-nots who remained .

Sure, there would still be jerks even in a more equitable society that embraced collective good and not just individual triumph. But I can’t help but wonder how things might be if more people could be deemed worthy of support without having to be stand-alone (or walk-alone) heroes.

Because, after all: What if the Little Engine can’t?

G is for Gratitude

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Gratitude

This gratitude craze bugs the shit out of me.

Yeah, yeah, I’ve read the research, too. I know that counting your blessings lowers your blood pressure and elevates your mood. Plus, unless you’re so insufferable that you’ve driven everyone away, a grateful attitude usually means having lots of loved ones who can actually stand to be around you.

The fact that it works infuriates me even more.

Apparently, I’m not alone.

 “’Dear Amy,’” writes Needs a Hug. “. . . I realize that in the grand scheme of things, I have a very good life. Still, . . . I get a little blue. . . Many people seem to feel . . . I will perk up if reminded how much better off I am than others. . . . I feel as if I have no right to feel tired, sad or overtaxed. If I hear one more, ‘Well, at least’ statement, I could fall apart.’”

Tell it like it is, Needs a Hug. Maybe your happy-talk friends just need a knuckle sandwich.

Speaking of sandwiches, remember Café Gratitude, that venerable landmark in the corporatization of self-esteem?  In its heyday you could indulge in “I Am Cheerful” veggie burgers or “I am Fabulous” lasagna, washed down with an “I Am Eternally Blessed” milkshake.

Forgive me, but I am nauseated, and it’s not because of an overabundance of goddess-kissed food.

Call me old-fashioned, but I am suspicious of any feeling that has a menu item named after it. Perhaps I’m being unfair, though. After all, Café Gratitude is merely the logical outcome as the Positive Food and Positive Psychology movements join forces. Merging “You Are What You Eat” with “You Are What You Think” perfectly embodies the trend toward self-esteem as commodity.

This instills in me not so much a feeling of gratitude as the desire to launch a competitive franchise. Maybe I’ll call it Café Curmudgeon. How delicious to imagine the chains battling it out on rival street corners, like Starbucks and Peet’s!

Now don’t get me wrong. Through nature and nurture, I am a cheerful and optimistic person. But just as Heaven is flat and boring compared to the juicy degradations of Hell, life without cynicism and darkness is depressing. What would Peanuts be without Lucy, serene in her crabbiness? Besides, maybe she wouldn’t be so cranky if her sanctimonious little brother, Linus, would just stop radiating goodness all the time. Can’t he give it a rest?

Where would the world be without the temperamentally morose? The evolutionary advantages of depression are clear: after all the more outgoing people have killed one another off, those emerging sluggishly from the cave to take a piss can repopulate the planet.

But once outside the cave, do we really want to live in a lobotomized world? The Stepford Wives depicts a society of happy, grateful people. There’s just a slight catch–harmony is achieved by killing off real women and replacing them with zombies. This seems a bit much, even for the suburbs.

Gratitude, positive thinking, relentless cheerfulness—maybe it’s all part of the same Stepford conspiracy to sanitize authentic emotion. As my friend Avvy says about our horror of dark feelings, “Wash out all aggression. Rinse and repeat.” But woe to those who are not so fastidious about their laundry.

At a Brownie meeting when my daughter was five, I took exception to the part of the oath that demands “A Girl Scout is always cheerful.”  Heedless of my daughter’s social standing, I told the other moms that, in my experience as a therapist, many of my clients’ problems stemmed from exhortations to be cheerful no matter what. There was dead silence for a few beats before one of the mothers said, “Maybe Girl Scouts isn’t for you.”

My therapy clients, too, have been banished by families who do not welcome their lack of good cheer in response to difficult childhoods. They hear, “You’re so sensitive. It’s water under the bridge. Can’t you just let it go?” Well, no, actually. My clients fear that letting go lets derelict people off the hook. It’s not that they want to feel angry and unhappy, but premature gratitude is like a thin coat of whitewash that seals in the toxins.

My clients have read the research, too, though. We know the hazards of lingering in the muck. Shouldn’t we at least try to put on a happy face? Fake it ‘til we make it? If only it were that easy. Now my clients not only feel miserable, but also guilty for making themselves sick, trapped by their inability to choose gratitude.

Yet there’s hope for ingrates and curmudgeons alike, if the annals of restaurateuring are any indication. Café Gratitude’s vast empire has shrunk dramatically ever since disgruntled employees sued them for questionable labor practices. In a letter announcing the closure of most of their restaurants, the owners explained:

 A series of aggressive lawsuits has brought us to this unfortunate choice. . . . We were happy to . . .  sustain ourselves on the transformation and personal growth of our people, while providing local organic vegan food to our community in an atmosphere of unconditional love. That commitment is under attack and we are not able to weather this storm.

 

Now that’s delicious!

Groundhog Day: The Quintessential Holiday

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GroundhogGroundhog Day . . .  is a day celebrated on February 2. According to folklore, if it is cloudy when a groundhog emerges from its burrow on this day, then spring will come early; if it is sunny, the groundhog will supposedly see its shadow and retreat back into its burrow, and the winter weather will persist for six more weeks.

–Wikipedia

We have made it through the holidays—relatives endured, credit cards maxed out, waistlines larded with latkes, and other wonders of the season.  We have turned the page on the old year, ushering in the new with high hope and resolve.

But now that we’ve paid that first installment on Visa and skipped a session or two at the gym (seriously, setting the alarm a half hour early–what were we thinking?), it’s time to get real.

That’s why I propose elevating Groundhog Day, which best represents who we are as a people, to the holiday status it deserves. Sure, the Fourth of July honors our penchant for blowing things up. And Thanksgiving is a strong contender with its non-denominational emphasis on food. But that gratitude thing can be a deal breaker for some.

Groundhog Day, on the other hand, is for everyone—those who are pulled kicking and screaming into the sunlight only to go back to bed, and those who find a silver lining in a cloudy day.

And that’s just the tradition built around a reluctant rodent prognosticator! The other reason why February 2 should be our national holiday is captured by the 1993 film, Groundhog Day, in which Bill Murray hits the alarm each morning only to find he is trapped in the same dreary day as before.

Sound familiar?

Yet Groundhog Day goes on to transform the Myth of Sisyphus into an embodiment of that all-American saying, “If at first you don’t succeed, try, try again.” (Freudians, those jaded Old Worlders, call it repetition compulsion.)

The definition of insanity may be repeating the same thing over and over again and expecting different results. But these do-overs also give us a chance to get it right. Bill Murray, by dint of repetition and infinitesimal change, emerges from the winter of his discontent into the sunny skies of Andie MacDowell’s favor. Surely that is a model worth celebrating.

I forget what happens to the groundhog. Probably it bites somebody and goes back to sleep. Which is another holiday tradition we can all embrace.

 

 

On Not Climbing Half Dome

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Half Dome June 2014

As two free-climbers inched their way into the history books and up El Capitan’s Dawn Wall this week, I recalled a trip my husband and I made to Yosemite last June. Unlike the intrepid duo’s, our feet remained firmly on the ground. We enjoyed glorious hikes at Glacier Point and Sentinel Dome.  Surveying the panorama of granite and sky, though, it suddenly hit me: I am never going to climb Half Dome. This brought a slight pang; I always envisioned hauling myself up those metal cables someday. Mostly, though, I felt relieved.

A hiking blog fully endorsed taking the easy way out:

Sentinel Dome gets top marks for the summit views. You get almost everything that Half Dome provides, without the clenching and near-death experience. Geezers can do this hike from a nearby parking lot.

I don’t think of myself as a geezer. This decision was driven much more by choice than by creaky knees and wheezy lungs.  Still, in giving up the hard work that would no doubt reward me with a huge sense of accomplishment as well as stupendous views, was I settling into a twilight of resignation?

But there’s a difference between giving up and letting go. We certainly can be stymied by inertia and self-doubt. Yet maybe we’ve just lost interest or ability, shifted priorities, or never really wanted to climb Half Dome all that much in the first place.

Reality is to dreams as glaciers are to granite. It grinds you down, yet also sculpts and liberates something new: Self-knowledge. Acceptance. Knowing what you want and don’t want. Now that’s a Dawn Wall whose conquest is a monumental achievement.

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What are your Half Domes you’ll never climb, your Dawn Walls you still hope to?

 

Subjunctive/Indicative

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what-if (1)

Phuc Tran, who as a child barely escaped death in the last days before Saigon fell, speaks in a TED talk about how grammar and culture shape one another and create different worldviews. English, he notes, employs the subjunctive tense–the could haves, would haves, and should haves. It communicates hope, imagination, and possibility, but also regret and longing.

Vietnamese, on the other hand, offers no such grammar. Lacking the subjunctive, it traffics in the indicative–how things are rather than how things might be or could have been. Tran credits to this foible of grammar his parents’ resiliency in tackling the survival needs of their transplanted family: “There was no psychic energy drained to focus on what could have been.”

Tran, however, thinking primarily in the English of his adopted country, often imagined the What ifs? of past, present, and future, musings his elders saw as pointless. The subjunctive tense allowed him to dream but also proved a quagmire when life didn’t pan out as he wished it would. “Accepting things for what they are, their indicativeness,” says Tran, “was my first step away from depression and anxiety.”

Tran’s talk led me to reflect upon how often we use the subjunctive in therapeutic dialogue: “What would it be like if you could let yourself ­­­____.” “What could you have done instead?” “How should your mother have responded?” “If you could feel, what might it be?”  The subjunctive softens defenses and helps gain access to feelings, fantasies, and memories, allowing the patient’s experience to emerge without too much interference. Most importantly, it fosters the expansive space in which possibility and creativity thrive.

Yet “the dark side of the subjunctive,” as Tran calls it, can lead to fixation on an unchangeable past. We see the dilemma play out between what we might call the more indicative approaches, like CBT, and the more subjunctive, analytic therapies that plumb the darker recesses of thwarted possibility. Who among depth psychotherapists and their patients has not wondered where the balance lies between past and present, what might have been versus what is? There is wisdom, as well as limitation, in Tran’s father’s outlook.

Mourning what has been lost or never was–and dreaming about what might be–is fundamental. So is acceptance of reality. The psyche, like language, is enriched by both the subjunctive and the indicative.
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Where has the subjunctive led you?
(Originally published in the December 2014 issue of Impulse, an electronic publication of the Northern California Society for Psychoanalytic Psychotherapy)

The Vote for Independence

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UK and Scottish flags

I was alarmed when I learned that 16- and 17-year-olds were allowed to vote in Scotland’s bid for independence. What might happen if complicated economic and social issues were fanned with the flames of developmental yearnings? Extending the franchise to such young people seemed as dubious as introducing Ayn Rand to resentful teenage boys. After all, what adolescent chafing for freedom doesn’t want to be the self-determining hero who defies the influence of the state?

It might be unwise to superimpose youthful reading follies or one’s own household experience onto geopolitical affairs. The Scottish independence movement rests on an uneasy history and understandable grievances about economic and social policies that favor the rich and southern countries at the expense of the North.

Still, I couldn’t help but think of my own children’s strivings for independence over the years: The two-year-old who insisted on negotiating a steep flight of stairs by herself, chanting, “Self! Self!” with every step. Perpetual refrains of, “You’re not the boss of me!” Then the heavy artillery of adolescence: “Stop treating me like a kid!” “It’s so unfair!” “I can’t wait to get out of here!”

Is it really that far from my house to the blended Houses of Stuart and Hanover? Let’s drop in on a typical family meeting as it might have been unfolding recently at Balmoral Castle. We join parents David and Elizabeth (aka Queenie) as they sit down for a serious talk with their teenager, Scot:

David: Scotty, your mother and I want to talk with you about this petition for emancipation you’ve filed.

Scot: Stop calling me Scotty. I’ve told you a million times I prefer Scot. Besides, what’s there to talk about? I’ve had it with you, and I’m leaving.

Queenie: Is this about our taking all those pound notes from your billfold without asking?

Scot: It’s so unfair.  You treat me like a serf. I’m outta here.”

David: Don’t be ridiculous! You can’t possibly make it on your own!

Scot: Sure I can! In fact, I’ll be better off without you.

Queenie (crying a little): How could you do this to us after all we’ve done for you? I’m tired of you blaming us for everything!

David (shouting as Scot gets up from the table): We’ll cut off your allowance! If you walk through that door, there’s no coming back!

Scot slams out of the room.

David (turning to console his weeping wife): There, there, dear. It’s just a bluff. Scotty will calm down and be back in time for dinner.

In the ensuing weeks, Scot is more resolute than ever. He hangs out with friends, eliciting sympathy and offers of supper and a spare bed from their mothers, who have never much liked those imperious snobs, David and Elizabeth.

We rejoin Scot’s parents as they argue over whether to double down on tough love, or reach out to their wayward child. 

Queenie: Perhaps we’ve been too harsh . . .

David: Nonsense! We can’t give in to these antics!

Elizabeth: Maybe we could grant a little bit more independence . . . a later curfew, more control over his money . . . I don’t want to lose him.

David (sighing as he reaches for the phone): Scotty, er . . . Scot . . . It’s me, Dad. Listen, your mother and I want you to know we miss you. We love you very much and wish you’d come back. Can we talk?

A few hours later, Scot strolls through the front door.

Scot: Now that I’ve got your attention . . .

Or something like that . . .

Now the ballots have been counted. Scotland, despite the youth vote, has decided to stick with the parental unit. Perhaps the realities of going it alone registered; perhaps gaining concessions, more autonomy, and a later curfew were sufficient. With high-fives for democracy all around, the UK and Scotland are still one big, happy, dysfunctional family.

Which may be about as good as it gets for reasonable households and countries everywhere.

Buying Time

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Golden-Gate-Bridge-from-Chrissy-Field-March-1-2014.jpg

One day several years ago, a 14-year-old boy got off the bus and walked to the railing of the Golden Gate Bridge. Some things were troubling him, and he put his leg up over the railing, preparing to jump. Then he took his leg down, caught the bus home, and told his mother, who sought help immediately. He’s fine now.

Without that pause to reconsider, this boy’s life may have ended in a tragedy that has claimed the lives of more than 1,600 people known to have jumped to their deaths from the iconic but deadly landmark.

There’s long been talk of a suicide barrier on the Golden Gate Bridge. At last there is action: Earlier this summer, the bridge district directors committed the final $76 million needed for safety nets to deter jumpers. The barrier will be operational in three years.

It’s been a long time coming. The most potent opposition has rested on a widespread misconception: many wrongly believe that people stopped from jumping will just go on to find another way to kill themselves.

Nothing could be further from the truth. Although some who are intent on suicide will find a way to die no matter what, fewer than 10 percent of those pulled from the bridge later take their own lives.

Ninety percent go on living—that’s a phenomenal success rate.

The most lethal means of suicide—death by firearms and jumping—are often chosen not by those who have carefully planned their own demise, but by those acting impulsively in a moment of upset. Young people are particularly susceptible to impulsivity; teens account for more than 10 percent of those who make the fatal plunge.

It only takes a moment—to go over the edge of the alluringly low railing, or to pull back from it. A moment that means life or death.

Buying time is the essence of suicide prevention. Time allows impulses to pass, moods to shift, circumstances to improve. Would-be jumpers who are thwarted by a barrier gain precious time to change their mind.

That’s time those who go over the railing probably wish they had. Kevin Hines is one of the very few who made the leap and lived to tell about it. Here’s what he said in an interview with a New York Times reporter: “I’ll tell you what I can’t get out of my head. It’s watching my hands come off that railing and thinking to myself, My God, what have I just done? Because I know that almost everyone else who’s gone off that bridge, they had that exact same thought at that moment. All of a sudden, they didn’t want to die, but it was too late.”

As the saying goes, suicide is a permanent solution to a temporary problem. With the Golden Gate Bridge barrier in place, we will have a much better permanent solution to the temporary problem of suicidal impulses.

It’s about time.

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For further information:

“The Urge to End it All,” by Scott Anderson. New York Times Magazine, July 6, 2008.

The Final Leap, by John Bateson (publication date 2015).

Myths about Suicide, by Thomas Joiner (2011).

Bridge Rail Foundation: http://www.bridgerail.org/

24/7 National Suicide Prevention Lifeline: 1-800-273-8255