Expression of Fear

FEAR

Expression of Fear

            Fear is an emotion, without which we could not survive.  It alerts us to danger either real or imagined.  Sudden exposure to a fearful circumstance triggers the so called “fight or flight” mechanism.  Information about a threat to the organism is transmitted to the brain’s amygdala, which instantly sends signals to the hypothalamus.  It responds by directing the adrenal glands to secrete more epinephrine (adrenalin) which prepares us to take action against the perceived threat.  Our pupils dilate to enhance visual acuity, the heart rate increases to provide more blood to the brain and muscles, breathing quickens and the alveoli of the lungs open wider to absorb more oxygen.  Muscles tense and the famous “cold sweat” appears as a preparation to prevent over heating during the anticipated battle or flight.  Blood sugar levels increase to provide more energy, and there may be involuntary emptying of bowels and bladder (yes, the term “scared shitless” is for real).

            The process is automatic, nearly instantaneous and completed even before a decision can be made as to how to respond to the threat.  It can also be activated by fears for others, and most of us have undoubtedly experienced it when we are faced with a child running out in front of a moving automobile, and can even be provoked by imagined threats as in the case of those with phobias.  Many seem to be born with a hair trigger for initiating the response and for many it erupts without any stimulus at all, which we call Panic Disorder.  It is a common condition, said to account for 12% of Emergency room visits in the U. S.(link to article is here) Panic attacks frequently mimic the chest pain associated with heart attacks.  Panic disorder is amenable to treatment and in my experience a detailed explanation of the mechanism involved is helpful, as most are relieved to find they are not suffering from a life-threatening condition.  

The Physiological Response to Fear Was Key to Survival

            If the threat persists the endocrine system takes over and the amygdala stimulates the pituitary gland to produce adrenocortical hormone (ACTH) which further activates the adrenal glands to produce epinephrine, norepinephrine and cortisol.  This mechanism served Joe Caveman well allowing him to either climb a tree or stick a spear into the saber tooth tiger confronting him, but modern-day Joe can neither kill nor run from a boss who he is convinced is determined to destroy him, leaving today’s Joe chronically stressed.  Even minor stresses such as being stuck in traffic may lead to fears of missing an important appointment or attendance at his kid’s game.  Those hormones so eloquently designed to save the lives of his ancestors were not designed for long term use and their presence at high levels is analogous to keeping an engine revved up for long periods of time while it sits at the curb.  This phenomenon is felt to be a major contributor to a variety of medical problems, especially cardiovascular disease.   

Existential Fears

 Existential fears are not new to our planet.  The threat of natural disasters has always been present and persist to this day, but even though we now have a greater understanding of such phenomena, we are still helpless to deal with them in most cases, and find ourselves seeking divine protection from the big ones like earthquakes, floods, tornadoes, hurricanes, volcanoes, asteroids and the like.  I have vivid memories of fears of World war II during which invasion of the west coast by Japan was felt to be imminent following the bombing of Pearl Harbor.  Even in our small mid-western town there were designated bomb shelters as we were predicted to be next on Hitler’s list for invasion after they conquered England.

 I also recall the tears in my Mother’s eyes as we watched my brother board the train headed for training camp only a little over a month after celebrating his 18th birthday.  A few weeks later we received a call that he was “shipping out”, but he was not allowed to reveal his destination.  Nevertheless, there was some relief since the call came from New Jersey indicating that he was likely headed for the European theater rather than the South Pacific from whence came endless horror stories.  In the following months the fear for the family increased as more gold stars appeared in neighborhood windows, and the appearance of a Western Union messenger in the area would fill families with the worst kind of fear i.e. of reading “we regret to inform you…….”.

Since those early days of my life, in addition to a series of senseless wars, a a string of potentially apocalyptic events have occurred with some regularity with only brief periods in which there was nothing to fear on a grand scale. The development of the atom bomb was unique in that for the first time in history it gave the human race the power to destroy all life, and when Russia developed their version, backyard bomb shelters sprung up all over the place.  The worst of those fears came close to realization with the Cuban Missile Crisis in 1962.  In the 1970s, discovery of depletion of atmospheric ozone also resulted in fear of drastic consequences for mankind.  At the same time, there were also warnings about climate change which went unheeded, but now sow fear in many of us for our children, and their children. 

Fear & Pandemics

Fear is an unpleasant feeling.  It is understandable that we prefer to put it off if the threat is not imminent.  Such is the case of the source of our most recent global fear, i.e. the COVID-19 pandemic.  Viruses were discovered at the end of the 19th century, and 100 years ago a viral pandemic killed an estimated one third of the world’s population.  When I was a kid, polio was endemic, the world recently experienced a frightening Ebola epidemic, and for more than 50 years, scientists had been warning us of another pandemic.  In spite of all that experience and warnings we were woefully unprepared for COVID-19.  Now, more that 2.2 million people have died from it, and only the pandemic deniers are without fear.  As I mentioned in my opening statement, fear is protective, and sadly those who deny put themselves and others at risk. 

For many the fear of contracting the corona virus is superseded by more urgent fears such as: job loss, eviction, homelessness, or hunger.  There is also the sad fact that a primary concern about closing schools means that without the benefit of school breakfast and lunch programs many kids will go hungry.  It is estimated that 13 million kids arrive at school hungry and that 1 in five live with “food insecurity” (I wonder who is in charge of making up these kinds of meaningless terms, but I assume it means they don’t get enough to eat).  Yep, here we are, living in the world’s richest country where we pay farmers not to plant crops, but can’t feed our children.  Go figure!

The Fear Tactic: A Tried and True Motivator

Throughout the ages, leaders of all stripes have stoked fear in order to provoke the fight response as a motivator to followers not unlike the way our ex (thank God) president cranked up his followers on January 6 to storm the Capitol building.  They obeyed their charismatic leader when he told them they must “fight like hell” to save their country [link to video of Trump at Pre-Riot Rally].  During the insurrection they were recorded chanting: “fight for Trump.” The mob was a disparate group.  Among the most bizarre were the Q-Anon followers who were there in support of their leader (Trump), who they were convinced was destined to save the world from a secret cabal of Satan worshippers, who among other things, butchered children in order to drink their blood.  There were also groups of white supremacists, fascists, and anarchists, along with misguided patriots who had been convinced that the election had been stolen and that our democracy was about to be taken over by socialists.  Indeed, in subsequent interviews, some participants were proud of what they had done. 

Regardless of motivation, the mob’s behavior confirms the presence of a great deal of anger.  It raises the question as to from whence it came.  Did it arise from fear?  It does appear that they all were motivated by fear of something usually enhanced by misinformation.   We still don’t understand much about mob behavior, but I suspect that it must be exhilarating to be able to express suppressed anger when in the midst of like-minded people.  Why is it that when angry people congregate, anger tends to escalate, often ends in rage, and draws people into behaviors that they would never consider under ordinary circumstances?  Are they drunk with the mob’s power, or is it the need to belong?   Does group-think allow them to rationalize their behavior, or is it simply the thrill of acting out?   With the crowd shouting “hang Mike Pence’’ and hunting for other members of congress by name, the results of the insurrection could have been disastrous.  Unfortunately, the problem has not been resolved as polls indicate there are millions of citizens who still believe the election was fraudulent, the election was stolen, and vast left-wing conspiracies persist. 

Fear: The Seed of Hatred

Fear leads to anger, but long-term anger results in hatred, undoubtedly the most destructive force of any society.  We now have people in Congress who say they are afraid of suffering physical harm from their colleagues.  Some object to the prohibition against carrying a gun during deliberations.  They act as if it pains them to conform to the traditional decorum of the institution, and negotiation is a dirty word.  We now have large numbers of members of both political parties, each concerned that the other is a threat to our democracy. The Trump followers who invaded the Capitol were determined to destroy democracy in order to save it.  They continue to devour misinformation especially the “big lie” that Trump actually won the election.

In my early years I was also witness to other times in which right-wing political groups wrought havoc.  In the 1950s, Senator Joe McCarthy managed to instill fear into the citizenry with baseless allegations of communist spies having been recruited into important government and military positions.  This was in the early days of TV and his hearings were widely watched.  Many careers were destroyed as his House American Activities commission extended their “investigations” to include anyone of note, especially those in the arts since they were known to generally have liberal political views.  Later the John Birch society, a political group organized by John Welch, produced all manner of big lies mostly consisting of a grand conspiracy to take over the American government, the most outrageous of which was the accusation that Eisenhower, widely hailed as the one most responsible for winning world war II was actually a communist agent.  In both these cases the obvious goal was to create fear, but wiser heads in the Republican party intervened, whereas today’s Republican office holders fear going head-to-head with the exiled king Trump.   

Courage: The Antidote to Fear

Courage occurs when values overcome fear.  On January 6, 2021 small force of Capital Police courageously faced a mob of thousands in attempting to protect the occupants of the capital building.  Two died and multiple others were seriously injured, yet the news of the day was replete with inferences that there may have been some who were complicit in the insurrection.  To this day there has been very little mention of the other four souls known to have died that day as a result of anger gone wild.  Are they not also victims?  And what of those millions of others who have been convinced that the government of which they were once proud is now corrupt, and now fear the consequences? 

Active Listening: The Antidote to Divisiveness

The saber-toothed tiger is long gone and we humans have gained dominion over all our enemies except for those darn viruses – things so small we can’t even see them.  Now that we have destroyed most other critters, we are so secure in our dominance that we now try to save those who are left, and we find that our only enemies are each other.  We talk a great deal about our divisiveness, but do very little to correct it.  Back in the days when I was practicing my craft, I saw many couples who were deeply divided.  In nearly all those cases it was apparent that they did not listen to each other.  Oh yes, they heard each other loud and clear but did not listen.  Listening involves more than words.  To listen one must be attentive, and hear not only the words but the music i.e. the feelings.  To acknowledge those feelings provides validation, a feeling which affirms one’s humanity.  For example, to say to a true believer that he/she is crazy for believing the election was stolen is unlikely to be helpful to either party.  On the other hand if one responds with something like: “I don’t believe it was rigged, but since you do I can understand that you are pissed off”, you might go on to a meaningful discussion.  You might even find that person wanting to know why you were not a believer.  God forbid, but you could even end up respecting or even liking each other.*

Since we all have our fears, I can’t finish this thing without once again mentioning my favorite quote on the subject of courage. 

TO BE LOVED DEEPLY GIVES US STRENGTH, TO LOVE DEEPLY GIVES US COURAGE

P.S. This was a difficult paper to write because I continue to ignore the advice of my high school English teacher Miss Higgins who said that most authors select topics that are too broad in scope, and consequently do not do justice to their topic.  Some of us are just slow learners

*Editor’s Note: I recall an interview with former FBI Director James Comey after the election and prior to the holidays. When asked for any advice regarding the holidays and interactions with those who were upset about the election results or even believed the false accusations that the election was rigged. I thought Comey’s statement was interesting and relevant to eshrink’s blog subject this week. Comey talked about people’s fear of being wrong…their fear of being duped. He talked about the countless cases he had seen where people had been defrauded of their life savings and/or their retirement by unscrupulous “investors” who promised their money was safe. To his shock, many of these victims would not only refuse to testify against the accused shyster, they sometimes would testify on the shyster’s behalf. Oftentimes, the fear of being wrong or the fear of being “taken” trumps everything else. Victims of these crimes had a belief that they could “see through” a fraudster and they had a deep seated belief that the shyster was a good business person. His advice was to understand the person’s thinking from the lens of fear.

Floyd the dog

The Annual Christmas Letter

Editor’s Note: The holidays are typically so busy, I intentionally decided to post Eshrink’s Christmas letter AFTER Christmas. Yes. That’s it! I didn’t forget to post it. I’m not suffering from menopausal A.D.D. or anything like that. I decided Eshrink readers deserved a good laugh to end this crazy year of 2020.

Dear Friends, Family and Christmas letter afficionados,

We are living in another one of those times which “try men’s souls”.  In our case both our souls survive in spite of the isolation imposed by this damnable virus, and we remain in possession of all necessary body parts.   Our efforts to avoid the bug have included cancellation of the annual Smith vacation, and Thanksgiving by Zoom.  It is not looking good for Christmas either.  The kids did conspire to throw a big outdoor family party for the old man’s 90th B-day complete with balloons and posters, but lacking in hugs.  When I am not hobbling around the house with my cane complaining about my aches and pains in fruitless attempts to elicit sympathy, I can usually be found at my desk writing a blog, a stupid Christmas letter, updating my obituary, or dealing with Floyd the devil dog. 

That latter activity has become a full-time job.  Those of you who have visited us have undoubtedly met Floyd whom we rescued from our local dog pound 3 years ago, for he is a very gregarious outgoing mut of undistinguished lineage.  As a matter of fact, his welcomes can be overwhelming at times, as it was for a rather staid elderly widow who after seating herself on our couch was enthusiastically greeted by Floyd via his leaping over the coffee table to land directly in her lap (did I mention he is very athletic?).  His other favored method of greeting a visitor can be even more problematic.  Some who read this may have been conned into helping Floyd exercise his fetish of having his belly rubbed without realizing that when he enters into that state of ecstasy his bladder sphincter also relaxes and the one who rubs will find themselves in the direct line of fire.   

In a previous letter, I believe I mentioned some of Floyd’s past exploits.  I could tolerate his digging up a well-manicured lawn, constant barking, burying our newspapers, and even the embarrassment of his leaping into the mail truck, but those behaviors are minor compared to his more recent attempts to kill me.  He is quite capable of feigning affection while possessing the heart of a cat killer (another story).   He has even attempted to break up my marriage by refusing to allow me to even come into contact with Barb.

Floyd’s bona fides as a devil dog were confirmed by his ability to make Barb and I the neighborhood pariahs.  Although he is in many ways very gregarious and welcoming to other dogs, he has decided that they are not to be allowed to walk on our street, and he routinely stands guard barking at the many dogs that are walked past our front yard.  Until last Memorial Day he was contained by an underground electric fence but on that day which will live in infamy he decided to brave the shock to run through it and launch a vicious attack on a neighbor’s dogs.  Needless to say, our neighbor was not happy.  A week later, in spite of my cranking the fence shock level up to the max, he again attacked the same dogs – this time drawing blood.  I learned that the middle of a dog fight is not a good place to be nevertheless; I managed to pull Floyd away from his victims but ended up flat on my skinney butt holding onto his collar.  I barely had time to get up off the ground when an ambulance arrived followed minutes later by two cop cars and the dog warden.  The ambulance guys seemed disappointed that I was not hurt, the sheriff deputies were amused, the neighbor was only mildly homicidal, and the dog warden gave me a serious lecture and a ticket to appear in county court.  All the players in this little drama were unmasked, by the way. 

Peter, always the good son, insisted on accompanying me to the court appearance even though I assured him I would be allowed a phone call before they locked me up.  The court appearance was an illuminating experience.  The room was packed with fellow criminals, but I decided to play the gimpy  old geezer card and made sure my cane was on full display as I hobbled up to the podium to plead guilty.  I was surprised to learn the judge had a rather comprehensive description of the events leading up to my appearance, and was impressed that I had paid my neighbor’s vet bill ($242.90).  I assured him that we were lo longer depending on the underground fence and were in the process of hiring a dog walker.  He seemed impressed and suspended my sentence and told me I would only pay court costs of $50.00, but when I checked out I was told I owed $98.00.  I didn’t complain out of fear that I might be charged with contempt of court or something equally disgraceful.

Floyd’s absolute favorite activity is riding in a car, and a recent episode in which he attempted to engineer my death explains why.  With the covid thing, Barb and I have spent time exploring some of the less traveled back roads of the county.  Though he feigns ignorance when convenient, Floyd seems to be electronically gifted for he learned some time ago that he could lower the car window by tramping on the button.  On this one particular trip I neglected to set the window lock button, and when I slowed to turn off the road, he was instantly out the window and racing down the middle of a heavily traveled 2 lane country road.   As soon as I could turn around, I succumbed to Barb’s pleas by going after him, but when I caught up, he turned and ran in the opposite direction.  I turned again, and this time he had stopped to investigate something in the middle of the road.  With deep ditches on each side of the road, I was forced to stop in the traffic lane.  Barb got out to retrieve the scoundrel, but found we did not have his leash.  It was obvious that a gimpy old fart like me would be of little help, but as I attempted to extricate myself from the car, I was saved by a guardian angel.  This person was not your stereotypical angel.  He had no wings, but of course you can only know an angel by what he does, not by how he looks.   He stopped his pickup truck in the lane opposite mine, and stepped out – a man mountain with biceps the circumference of my thighs.  Meanwhile, cars were backed up in both directions, but amazingly no one was rear-ended.  I knew this angel must be heaven sent when he got his female boxer dog out of his truck,  Floyd found her irresistible.  When the devil dog approached to check her out, my angel scooped him up, dumped him in my car and drove away before I could even thank him.

The angels who look after my family have also done a good job.  Barb is still a delightful companion (most days) and everyone has escaped the ravages of the covid virus except for Emma whose case was mild.  Caroline’s roommate has contracted the disease and Caroline is in quarantine but so far remains negative.  Everyone is gainfully employed in spite of the pandemic.  Barb and I remain perplexed as to how we managed to end our lives surrounded by such a marvelous group of people, and what I have done to deserve the longevity with which I have been blessed.  We can only assume divine intervention was involved.  Therefore; with love for all and in the spirit of the season Barb and I  WISH FOR YOU THAT YOUR ANGELS WILL KEEP YOU SAFE AND BLESS YOU WITH THE MERRIEST OF CHRISTMASES AND THE HAPPIEST OF NEW YEARS.

How to Survive Loss

Life can be defined as a finite period of time characterized by continual change. Consequently, since nothing is permanent, we all experience losses. Some are trivial, others are devastating. We are now living in a time of great turmoil with millions of people subject to losses beyond their control. Thousands of homes and businesses have been destroyed by the effects of climate change with fires, floods and storms throughout the world. Many more have been displaced by wars and political upheavals with thousands having lost their homes, possessions and way of life, but the most immediate and tangible threats are due to the COVID-19 pandemic where in addition to the loss of over a quarter million lives, several million remain unemployed, and self-imposed isolation has taken a toll on mental health.

According to the CDC, 8 out of 10 deaths from the virus have been in those over age 65, but they noted even those in their 40s and 50s are at higher risk than younger folks. Many studies have documented that widowhood carries with it a mortality rate of well over 30% during the 1st 90 days of bereavement and 15% thereafter, powerful evidence that loss of loved ones has serious consequences for survivors. The pandemic has limited traditional mechanisms of dealing with grief since last goodbyes are often denied due to isolation policies, and funerals, wakes, and life celebrations are limited. Time will tell if their lack will result in an increased prevalence of unresolved grief.

Grief | Loss due to death vs Loss due to breakup

Meanwhile, we are still subjected to the ordinary losses associated with the process of living. Much of my time as a psychiatrist was devoted to helping those afflicted with the pain of losses, as I am sure is true for most clergy, counselors, social workers, psychologists and bartenders, etc., but it is only recently that the Board of directors of the American Psychiatric Association has recommended that unresolved grief be considered a diagnostic category. Although death of a loved one may seem the ultimate loss, in some ways it is easier get over than the termination of a relationship via other means, such as divorce or breakup of an important personal relationship. The finality of death encourages one to move on, but when the object of one’s affections is alive a relationship real or imagined will persist. Thus, Don Jackson, a renowned family therapist said there is no such thing as divorce. Or as I have often said: divorce is like a death in the family, but you can’t bury the corpse.

Our nature requires relationships. Relationships help to define our identity, i.e., who and what we are. For example, I am often introduced as Barb’s husband which provides considerable information about me. Our identities are also shaped by those with whom we associate even the organizations to which we belong or those we choose to lead us. Long term relationships invade one’s personal space to the extent that we often absorb some of the involved person’s personal characteristics to the extent that they become part of who and what we are. Consequently, their loss may result in what I call a psychological amputation. Thus, in the face of such losses, one is left with the feeling that a part of one’s self has been taken away.

As with the loss of a physical body part, a psychological amputation can result in myriad feelings and reactions in addition to sadness. There may be anger, at times even rage, directed to whomever one blames even him/herself. Instances in which rejected suitors have stalked, assaulted, or even murdered, are unfortunately not rare, which naturally leads one to question the nature of such alleged love. There may be feelings of betrayal at the deceased for being abandoned or for behaviors thought to have hastened his/her death. God is often a target for anger, especially in deaths, and in such instances the Biblical quote: “the Lord giveth and the Lord taketh away” rarely provides solace. Although I have found that referral to the patient’s pastor or Rabbi is frequently helpful.

GUILT

Anger may also be self-directed resulting in guilt. In such cases, the patient may spend endless hours ruminating over what he might have done to prevent the loss or even worse how he could have caused it. A close friend of mine, who shall remain nameless, continues to have pangs of guilt over her Grandmother’s death nearly 80 years ago because as a child she had “sassed Grandma” shortly before her sudden death.

There are instances in which survivors may feel guilty for not grieving enough. One case from many years ago, which has stayed in my mind, involved an elderly lady who was referred to me by her family doctor with the complaint that she had lost the strength in her right leg. An extensive workup had not yielded a diagnosis and the referral appeared to be a hail Mary. She walked into the office unassisted. Although using a cane, she appeared to walk quite well. Her story was that her husband of many years had recently died following years of a debilitating illness for which she had been his primary caregiver. She reported that she rarely left the house during all that time, having obviously taken seriously the vow about “in sickness and in health.” Shortly after her husband’s death, she was excited to visit a friend in a neighboring village whom she hadn’t seen since her husband became ill. After starting her car, she was unable to move her leg to the accelerator in order to drive away -a classic case of conversion reaction, resulting from the guilt she felt over enjoying her new found freedom.


The Affect of Death on Children’s Development and Attachment Theory

It has long been noted that children who become orphaned are at risk for significant relationship or mental health problems later in life. (This is a relevant post from Psychology Today). Konrad Lorenz’s studies of imprinting demonstrated the importance of relationships in young animals, and Bowlby, with his Attachment Theory, came to similar conclusions regarding humans. When the process of attachment is interrupted prematurely it may leave the child lacking in skills necessary to develop healthy relationships, and leave them impaired for life.

Much has been written about the stages of grief. However, I have not found that concept particularly helpful, for in my experience people do not always follow a particular pattern of behavior when they have lost something or someone, though I have found that denial is frequently present especially when the loss involves another human life. Although at a conscious level there is realization that a person is gone, a survivor may behave as if expecting them to return. In such cases there are frequent slips in which the deceased person will be described in the present rather than the past tense. There is resistance to disposing of clothing and other personal effects, or to removing the voicemail greeting from the family phone. Frequent trips to the cemetery are common and may involve imaginary conversations with the deceased. The survivor may be said to have “held up” surprisingly well during the burial proceedings.

Perhaps, the most painful loss of all is the death of a child, and in my experience the most likely to result in denial. Although at a conscious level the parent knows their child is dead, they may continue to insist that their room will remain untouched as if they are waiting for him/her to return. Deaths by suicide usually introduce a series of unanswered questions which further complicate the healing process, often leaving survivors blaming themselves.

It goes without saying that it is very difficult to resolve a problem without acknowledgement that it exists, and in my experience, denial following the death of a loved one is quite common. It is usually the first hurdle that must be overcome in order to find resolution of grief. There are numerous exercises which may be ordered to help one achieve acceptance. My favorite is to arrange a visit to the graveyard with a close friend or pastor, simply say goodbye, and have a good cry. For those in denial, there is usually a great deal of resistance to using that word, and the mere suggestion to carry out those instructions is often met with tears.

Loss of Relationship by means other than death can be even more complicated.

The break-up of young lovers, especially first loves, is complicated not only by the level of passion involved, but their lack of experience in dealing with loss. They should be taken seriously as such losses can result in serious suicided attempts especially in teenagers. But for anyone the loss of a love object can be devastating for with it go dreams of an idyllic life with the hope of loving and being loved. It may result in sadness, depression, anger, or even violence.

How to Survive Loss

Hope is invaluable with the loss of things which are replaceable for it inspires one to action. The streets of our big cities are littered with homeless people most of whom have lost hope, while those who have lost their homes in fires or other calamities, although saddened and depressed by the loss of all their possessions, need hope if they are to replace that which has been lost. However, with abandonment by a loved one hope can hinder resolution. It goes without saying that one cannot live in the moment if they are stuck in the past, which happens when we continue to dwell on recovering something which is beyond reach.

Recovery from loss is simple but not easy.

We must “let go” if we are to “move on.”

We let go by grieving. Grieving is the process by which we allow ourselves to grapple with and purge intense disabling emotions following a loss. Grief can be initiated by the loss of anyone or anything to which a person has a personal attachment.

Cultures have developed various traditions which seem designed to promote resolution of grief following deaths. In a previous blog I have written about those I experienced in a rural midwestern village 75 or 80 years ago, but my favorite funeral celebration is the traditional New Orleans jazz funerals in which the funeral procession is led by a brass band to the graveyard while playing a funeral dirge, then following interment the band marches back toward the decedent’s home playing a lively Dixieland tune. The message could not be more evident. There is acknowledgement of the sadness of death followed by the celebration of life, a perfect example of letting go and moving on.

Other Types of Loss

In addition to the loss of loved ones, since the word pandemic entered our lexicon, we have been subjected to losses of some of our most precious possessions. It has been said that you don’t fully appreciate the importance of something until it is gone. Granted, it has been catastrophic for those who have lost jobs, housing, or businesses, but the isolation and cumulative effect of the loss of activities which we previously would have considered mundane have also taken a toll.

On a positive note, if there is one, perhaps we have learned to know the value of some of those things we previously took for granted. There is also hope that constriction of our social activities may result in more family cohesion. Who knows? Maybe kids and parents will even start talking to each other. Losses of all kinds are bound to get our attention, and there is often a lot we can learn from them, especially those we create by our own mistakes for failure is the great educator.


CATHARSIS

Although in rare instances, loss may result in a sense of relief, in nearly all cases, there will be strong feelings elicited as previously mentioned. Such emotions are disabling and must find expression, a process which we call catharsis. It is not a good time to do the strong silent thing when consumed by grief.

As I have mentioned many times, we are herd creatures, which is hardly a new concept having been the subject of John Donne’s poem, “NO MAN IS AN ISLAND” written in 1624. As such, we are dependent upon others whether we like it or not. In the face of intense emotions we can become overwhelmed and confused. In such times more than ever, we need validation, i.e., someone who we trust to listen, be supportive, and reassure us that our feelings are rational. Indeed, the process of attempting to communicate those feelings verbally helps to organize one’s thoughts, and a recent study in the American Journal of Psychiatry, has confirmed what we already knew, which is that confiding in others helps prevent depression. After all, that is how I made a living.

Surviving Loss is a PROCESS

Usually catharsis is not a one-time thing and there will be triggers that will resurrect some of those feelings in milder form from time to time, but most will learn to let go of past traumas by focusing on the road ahead. Hopefully, they will come to understand that to look back over their shoulder will likely cause a stumble, and that they must let go of the past in order to move ahead.

With millions all over the world facing serious losses, we are not only “all in this together,” but we are also very much in need of each other and there has never been a better time for us to be our “brother’s keeper.”

Barb and Darell Smith wedding

Happy Anniversary Dr. and Mrs. Eshrink | 67 YEARS!!!!

Barb and Darell Smith wedding Mom and dad circa 1978

 

Editor’s Note: Hello Eshrinkblog readers! Today is my dad and mom’s wedding anniversary and I’m hijacking his blog to share what I’ve learned from watching mom and dad as a married couple. I learned about loyalty, respect, appreciation, but also about the secret to effective arguments and all the red flags that come from ineffective arguments between couples or even the lack of arguments: resentment, emotional distance, loneliness, etc.

 

But before I share my perspectives, you might check out earlier Eshrink blogs about Marriage and his Valentine (the post “My Valentine” is the winner for the most read blog post on the eshrinkblog.com network)

LESSONS I’VE LEARNED from MY PARENTS’ MARRIAGE

These are just my perspectives from watching an incredible couple grow, change, and adapt throughout their life together as a married couple while taking that “death ’til we part” thing to heart.

 

ARGUING with a PURPOSE

It’s been my experience that I’ve learned more from the bad stuff than the good stuff so I’ll start there. My mom and dad argued. I hated it when they argued, but they didn’t hide it, which I guess made my little kid brain think it was okay or normal. I found out later that my parents’ style of arguing wasn’t the norm. I would hear about double binds, put downs, identifying the source of the hurt feelings, owning your feelings, etc. I didn’t understand half of it, but the arguments were usually at the kitchen table and lasted a long time (at least in little kid time it seemed like they lasted a long time). Somehow, listening to those “discussions” (that’s the term they would use when I would bring them a picture I drew and tell them I didn’t like it when they argued), I learned the “action” or incident that sparked the argument wasn’t about the action at all. Rather, it was about the feelings that action generated (i.e, leaving the dirty socks on the floor isn’t about the socks on the floor it’s about inconsideration…how it can make the other person, the one who is the primary “cleaner in chief” feel like they’re not important or appreciated or their role is undervalued somehow). Mind you, mom and dad never argued about socks on the floor…but you get the gist. The argument has a root cause that is about feelings associated with a particular action.

 

More importantly, I got to see them make up and resolve the argument. Even if a resolution wasn’t total and complete, it seemed the argument was worthwhile in that it was not only an opportunity to share grievances openly and honestly, but it allowed them to reach a renewed understanding or different perspective. It wasn’t about who was right and who was wrong. It seemed their process actually made their bond stronger.

 

RESPECT for the INDIVIDUAL. RESPECT for the UNIT.

As for the good stuff: my mom and dad have always seemed to have a deep respect for each other as individuals and an appreciation of their differences. Mom is an artist at heart. My dad has always been more practical and technical. They were equals who were different. Not equal as in the same, but their interests and differences were equal in importance. While I would say mom and dad had traditional gender roles for the time in most ways, it seemed they supported each other in broader interests; my mom’s belly dancing classes, art classes, bowling league, her decision to start a small business, The Tortoise Shell, etc.

 

And even though I don’t think I ever saw my mom mow the lawn or fix a leaky faucet, I do remember my dad cooking and doing dishes when it needed done…and not in a begrudging way, but just because it needed done…to boost the other half of the unit who needed a respite (since raising four children and keeping a house is more than a full time job). As I discussed in the argument section above, I sensed they had a respect for their choice to be a married couple…respect for the unit…and had decided the whole was greater than the sum of the parts (not sure I have that quote right, but they were better/stronger together as a unit than individually).

.

APPRECIATION

My mom’s appreciation of my dad was always apparent to me. I would hear her brag about him to other people. She would correct people when they called him Mr. Smith instead of Dr. Smith, which would totally embarrass me. However, when she explained to me, “We worked hard for your father to get through medical school and become a doctor. He IS a doctor!” I started to understand why it was so important to her. Note the “we worked”…they shared in each others accomplishments because they did “do it together”… they built a relationship with the space for each to grow and achieve and explore. As for med school, my mom worked full time as a nurse to make sure they could get through and still have food to eat (dad’s always had a big appetite…it’s genetic on the Van Horn side of the family) haha.

 

I remember dad’s appreciation of mom, too, but maybe in more subtle ways (I remember us as being a genuine and authentic family…phony accolades weren’t our thing). I remember sitting at the dinner table with us four kids rolling our eyes and grumbling about the night’s dinner of cubed steak or chipped beef and gravy (shit on a shingle was dad’s name for it). Dad would go out of his way to make sure we heard him thank mom for making dinner or say how great the meal was. He also showed his appreciation for her ability to create beauty all around us…from flower arrangements, to gardens, interior design. He appreciated, not only the talent she has always had for those things, but how she continued to learn more and maximized those talents to bring beauty to everyone she touched. Later in life (back to that growing thing I discussed, dad would tap into his artistic side with the help and encouragement of mom, when he started framing pictures for her shop, The Tortoise Shell).

 

RESILIENCE and ADAPTABILITY

My mom and dad, both as individuals, but as a unit, seem to be resilient no matter what life throws at them. I’m not saying it has been easy or equitable. Sometimes one of them seems more resilient or open to change than the other, but overall I’ve noticed they don’t spend much time looking back…at least not looking back in a “good ole days” way…When I’ve noticed them look back, it seems to be to learn from the past (somehow they taught me…if you learn something about yourself or a situation when you make a mistake, then you nullify the mistake in a sense because the knowledge you gained will serve you in the future). However, there was always the caveat that we didn’t want to “overdo” this particular method to gain knowledge and wisdom 🙂

 

My parents seem to be in a constant change of learning and growing. I used to think people got fixed and rigid as they got older, but I’ve watched my parents continuously learn, grow, and change. New interests. New perspectives. New appreciation.

They take life as it comes and grab the happy when it comes. They celebrate the wins together. They grieve the losses together, but they never give up 🙂

Happy Anniversary Mom and Dad! Thanks for being such great parents (and saddling me with all of this liberal guilt…haha!!).

Love good,

Maggie #4 and Proud Eshrinkblog Editor

P.S LAST BUT NOT LEAST | PDA

I’ll never forget how my mom and dad would show affection for one another. As a little kid, my dad’s flirty grab of my mom’s bottom while she was fixing dinner at the counter would be met with “Smitty!” from my mom. When I was younger, I would giggle during those brief gropes and of course be completely grossed out and embarrassed for them when I was a moody teenager. Hugs were and still are in abundance between my mom and dad, discrete pats, and kisses hello and goodbye and in between have always been the norm. Keep Rockin’ Matrimony M & D!!!

Below is the card I sent them for this year’s anniversary. The perfect card for the perfect couple.

LONELINESS

Many years ago I treated a patient who was suffering from a near fatal case of loneliness.

 

No, I am not exaggerating for this person would later confess that she had come to me in a last-ditch attempt to resolve her problems while promising herself that if I couldn’t help she would hang herself. She was a 20-something attractive and very modestly dressed woman who did indeed look very despondent with the psychomotor retardation and furrowed brow characteristics of clinical depression. When I asked her why she was there to see me, she hung her head, stared at the floor, and tearfully responded that she had been shunned.

 

She went on to tell of how her infraction of the church’s rules (one that most of us would consider a minor infraction) had resulted in her being officially designated as one with whom the entire church should have no contact whatsoever. You may be thinking: “Big deal go find another church.” But her story was more complicated. She had grown up attending this church. It was the center of not only her spiritual, but also her social and family life. Since the church doctrine insisted that only members of their church were true Christians, the members were warned about the dangers of consorting with people outside the church, apparently convinced that sin was contagious. Thus, when alienated from the congregation, which to make matters worse, included her entire family, she found herself totally alone.

 

Such stories are not new as evidenced by Nathaniel Hawthorne’s tear-jerker, THE SCARLET LETTER, but give witness to the importance of relationships and the pain of loneliness. Many religions have used banishment of varying degrees of severity to punish wayward members. The Catholic Church’s policy of excommunication appears to be less stringent and is viewed by the church as a means to save souls whereby one can return to the fold and regain salvation by repenting. Such tools are powerful and their use can have long lasting effects. For example, I recently discovered that my Great, Great, Great Grandfather was shunned and ejected from the Quaker church. It occurred to me that if he had toed the line, I might be a Quaker.

 

AND YOU THOUGHT SMOKING WAS BAD

Solitary confinement has long been used as a means to enhance the discomfort of imprisonment, and is agreed by many to be a form of torture. In a previous blog, WHAT’S LOVE GOT TO DO WITH IT? I contended that our need for relationships is encoded in our DNA, having evolved long ago as a major contributor to the survival of our species. If one were to accept that premise, it would be logical to assume that loneliness could be a major problem for us. Indeed, according to Vivek Murthy, M.D., the former Surgeon General of the U.S., loneliness has become “a growing public health crisis.” He has said that loneliness is a more effective agent in reducing longevity than obesity, and that its toxic effects are worse than smoking 15 cigarettes per day. Recent research into the prevalence and effects of loneliness tends to confirm Murthy’s assessment. Last year Cigna released a report on a study of 20,000 people age 18 and over as measured by the UCLA loneliness scale.

 

Nearly half reported loneliness as a problem, but even more concerning was that 27% felt no one understood them, and 43% admitted they felt their relationships were not meaningful. One in five felt they rarely or never felt close to others or that there was anyone they could talk to. It was also noted that Generation Z (those born after 1996) were the loneliest of all the generations measured.

There have been a number of studies which confirm the effects of loneliness on physical and mental health. It is not surprising that it could result in affective disorders such as depression, and may help explain the increase incidence of suicide as mentioned in my previous blog, but there is also evidence that loneliness can cause or aggravate innumerable maladies including: hypertension, coronary artery disease, dementia, inflammatory diseases such as arthritis, impairment of immune systems, and even some malignancies to name a few.
A study in the Archives of Internal Medicine sponsored by the National Institute of Health followed 1604 people over the age of 60 (average age 70) for 6 years and measured their physical decline and mortality rate. Their stark conclusion was: “Among participants who were older than 60 years, loneliness was a predictor of functional decline and death.” Need I say more about our need to engage with our fellow man?

 

WE ARE NOT THE ONLY LONELY

It turns out that we are not the only nation where loneliness has become a problem, both from a public health and productivity perspective. Great Britain’s parliament has recently appointed a commissioner to investigate remedies for what has been called a silent epidemic after a study showed that 20% of Brits reported they were lonely most or all of the time. It appears there are similar studies in progress in other European countries. It would be helpful to know if loneliness is a worldwide problem or peculiar to our culture.

NOTHING ELSE TO DO

If one accepts the premise that loneliness is a significant problem, the question arises as to how did we get this way and what can we do about it. Prior to the industrial revolution, multi-generational families provided a sense of belonging. Relatives galore, including parents, siblings, cousins, grandparents, aunts, and uncles usually lived in close proximity. With the switch from an agrarian to an industrial society, there had been a migration to cities where houses were built close together, which resulted in the development of neighborhoods usually composed of people with common interests. There was the inevitable clustering of children who interacted with only minimal adult supervision, and stay-at-home moms who could relate to each other in a very personal way. Neighbors were evaluated based on certain standards including friendliness and mutual respect. The lack of air conditioning and television made front porches very popular especially on hot evenings, and provided an opportunity for informal socializing. The only taboo subjects were sex, religion, and politics.

 

BETTER THINGS TO DO?

Soon after World War II ended, front porches began to disappear from neighborhoods, and there was a wild rush to the suburbs where large green lawns were treasured and families had fewer opportunities to be “neighborly.” On hot summer nights, it became more comfortable to be inside the house (with air conditioning) than outside. There were also new-found entertainment devices available – first radio, then TV, movies in the VCR and then DVD Player, video games, and then the internet which gave us social media and streaming. One could go for months or longer without ever having face-to- face contact with one’s neighbors. There was no longer danger of an errant foul tip sending a baseball through someone’s window. Privacy became important, and it was no longer considered a snub to build a fence between houses.  There were no kids playing hopscotch on the sidewalks, as a matter of fact, there often were no sidewalks in these new neighborhoods.

Competing Schedules and Activities

As more mothers joined the workforce and children were exposed to more structured extra-curricular activities, long-held family traditions changed. There was concern about the “latch key children” so named because they would come home to an empty house. The evening meal, often the only time in which the entire family came together, was often disrupted due to conflicting schedules. This led to the so-called crock pot families where the family meal was available to all who passed by…making it easy to just grab a bite and be on your way without any hassle (or conversation).

Forced Socialization in the Pew

Another effective defense against loneliness was the weekly church service. Traditionally, religious institutions encouraged socializing (and in some cases, demanded it). However, attendance at religious institutions has declined in recent years (one study says church membership in the U.S. has declined from 70% in 1999 to 50% in 2018).

 

WHY SO MUCH LONELINESS?

It is ironic that in this digital age when we have vastly improved modes of communication, that we would identify loneliness as a problem. Facebook’s founder, Mark Zuckerberg, insists that he saw his invention as a tool by which relationships could be fostered throughout the world and help dispel feelings of loneliness and dissention, but it appears that it has done more to promote divisiveness and distrust.

 

With the invention of the telephone we gave up non-verbal cues in our conversations, and the trade-off for its convenience seemed like a good deal. Now kids have largely given up talking on their cell phones in favor of texting. Voices from the internet, news media and politicians all conspire to promote divisiveness and paranoia to the point that it is almost impossible to have a rational conversation about many of the issues of the day.

 
Today people are marrying later and living longer. As reflected in the census figures of 2012, 32 million or 27% of Americans lived alone which was up from 17% in 1970. As you might expect, widowhood is likely responsible for many single occupant households, and in another study it was found that 47% of women over the age of 75 lived alone. With aging, comes the inevitable debilities and limitations. The National Institute on Aging reports that nearly half of all people over the age of 75 have hearing loss, which can be a major impediment to any meaningful social interaction resulting in withdrawal from friends and family.

 

It has been said that Americans are losing faith in our institutions, and our political leanings are often shaped by who we hate rather than who we like. Political discourse has hit a new low. Muck raking is no longer good enough, and has been replaced by personal insults a la grade school rants. Respect for contrary opinions has now gone out of fashion. Divide and conquer is the new strategy, and a tactic that seems to have even been adopted by the news media (Matt Taibbi has written an entire book about it, called “Hate Inc.”). We lack heroes. We frequently hear the term “disenfranchised” these days, a synonym for “left out” and to be an outsider is lonely for any herd critter.

ALL IS NOT LOST (stay with me…a little break from “downer” time)

There is some evidence that there may be some efforts underway to deal with the loneliness issue. I was pleased to see a recent article in Psychiatric News suggesting that psychiatrists are focusing more on loneliness as an underlying psychiatric problem (don’t know why it took so long to figure that out). A former president of the American Psychiatric Association has suggested that assessment for loneliness be part of any evaluation or perhaps become a diagnostic category in the DSM 5 (the shrink bible). There is also a growing awareness of a worldwide suicide epidemic which most would agree loneliness all too often plays a part.  Lonely lifestyles also frequently seem to be common with mass murderers.
lonely quote

LONELINESS VS. BEING ALONE

Proximity to other people is not necessarily a solution for loneliness, for it is not unusual to feel lonely in the midst of a crowd. Obviously, some type of emotional engagement is necessary to dispel lonely feelings. Ordinary discourse involves much more than words. Unfortunately, in our digital world many of the nuances of communication are lost. Not only are the tone, rhythm, volume, and timbre involved, but there are multiple non-verbal cues which can modify or even completely change a communication. As a matter of fact, some very significant interactions may occur without any words spoken. In that vein a text hardly measures up to a face to face encounter as a means to communicate feelings.

 

Emotional tone is less relevant, for even an argument can dispel lonely feelings.
Although, until recently, there have been few attempts to measure the extent of loneliness, there is definitely a consensus among sociologists and mental health professionals that there has been a definite increase. Employers have taken note of recent research which has shown that employees are more productive when they are encouraged to interact with each other. As a consequence, in many cases the traditional office cubical arrangement has been scrapped in favor of a more open environment, teamwork is encouraged, and brief chats at the water fountain are less likely to result in a dirty look from the boss. Since most workers spend nearly half of their waking hours in the workplace such changes could be very beneficial for large segments of society.

 

GO TEAM

The needs for engagement with other humans has long been addressed by the formation of millions of organizations that bring groups of people together with myriad goals, but which also provide an opportunity to relate to others. The sense of belonging to a group is a powerful antidote to loneliness. Young people who feel neglected or alienated are more likely to join street gangs (easier to radicalize for terrorism and/or recruit for “religious” cults*). Athletic events and concerts attract millions, most of whom “show their colors” and cheer as one. One of my all-time favorite TV shows was Cheers which identified the locus of the show as the place “where everybody knows your name.” Organizations of all kinds including sports teams, military, and political groups or for that matter any group of people with a common goal make use of the need to belong which at the end of the day is an antidote to loneliness.

THEY NEED EACH OTHER

AARP sponsors a very interesting and apparently successful program called “Experience Corps” in which volunteer over 50 are enrolled in a program where they are trained to help children develop literacy skills. They spend 6 to 15 hours per week working with K-3 students with spectacular results including as much as 60% improvement in reading skills, fewer behavior problems, improved attendance, and increased graduation rates  The AARP foundation at last report had 2,000 volunteers throughout the country serving over 30,000 students. However; it appears the volunteers may be benefiting more than the kids from the program. A University of Michigan study reported a statistical decrease in depressive symptoms and functional limitations among the volunteers after two years involvement in the Experience Corps. There may also be a secondary benefit in that some kids may learn to venerate rather than denigrate us old folks. (Score 1 for the Old Farts!)

 

BE CAREFUL WHAT YOU WISH FOR

None of this should be interpreted as an attempt to diminish the value of solitude. Certainly, this need to relate can be overdone, and in some cases become pathological. In many cases of marital therapy, for example, too much togetherness can be identified as the problem. In testimony before Congress, Prof. Julianne Holt-Lunstad defined loneliness as ” the perceived discrepancy between one’s desired level of social connection and their actual level of social connection.”  She explained that some people who are socially isolated don’t necessarily feel lonely, and some people who are lonely are surrounded by people who make them feel more alienated.

 

One’s work may require so much contact with others that it can become oppressive, and some personalities may cause anal pain of the worst kind!  Nevertheless; before you make plans to spend the rest of your life on a deserted island or join an order of non-verbal monks, be careful what you wish for. Time-alone can be refreshing, relaxing and creative, but as with most things in life, it can be overdone. Alone can be good, but lonely can be very bad. In this time in which we are all mutually dependent, it has become even more necessary to have relationships than we did in those days when we needed help to bring down a woolly mammoth. It is difficult nowadays to survive in this world as a loner. We face enormous problems including an increased global population, competition for resources, and degradation of our environment. It is once again time for us to hang together or hang separately.

WHAT MAKES THEM TICK?

The ability of the human race to relate to each other has allowed us to survive and to thrive.  We need to exercise that talent now more than ever.  As I finished writing this, once again two hate-filled young people described as loners committed horrible atrocities within hours of each other. It goes without saying that we need to take logical steps to limit access to those instruments designed to kill people, but the prevalence of these kinds of behaviors also require us to learn more about the milieu in which they occur.  For example: are there genetic influences involved, does our society in some way generate such hatred, are certain personalities more easily recruited to violent organizations, is shyness a precursor, and finally does the hatred cause the loneliness or vice versa?  We need to understand more about how these people end up the way they are if we are to have any success at solving the problem.

The Way It Was | Part 2

Note from the editor: Click here to read Part 1 of “The Way It Was”

Conversations Overheard

There was a fringe benefit for me from the depression in that I received my first indoctrination into the ways of the world which included comprehensive discussions of politics, economics, world affairs, and morality but with a special focus on means of survival in difficult times.  My education occurred while lying on our living room floor listening to Dad and friends (not to be confused with Fox and Friends) debate all kinds of issues while they focused on possible work sites.  The men were regular visitors to our house where they met and planned strategy to find work.  It is likely that they were attracted to our house as a meeting place by Dad’s famed home brew.  Although he was not a bootlegger per se, he was known to have occasionally traded a bottle or two for some needed commodity.    I was an accomplice in the enterprise as I took great delight in placing a cap on each bottle and watching Dad press it in place. 

There must have been a robust feeling of camaraderie amongst those guys who were all in the same sinking boat.  There was laughter in spite of their dire circumstances, and there were frequently told colorful stories which without benefit of Dad’s home brew would not likely have reached my tender ears.  The coarse language was not lost on me, and was quickly incorporated into my vocabulary, the use of which would often get me in trouble.   One particularly memorable event occurred when Dad took the guys down to our cellar to show them his success of the day.  He had received a feisty old rooster in return for a day’s work, and the rooster was confined to the cellar, a small space with a dirt floor cool enough to render the beer palatable.  Someone stumbled over the pan of water left for the rooster and Dad filled it with beer.  Surprisingly, the old guy imbibed with gusto and was soon stumbling, flapping his wings, and attempting to crow in a falsetto voice.  If he was hung over in the morning it was short-lived as a few hours later he would be on a platter sharing space with some drop dumplings.

Work

In spite of the bravado most of the conversations had to do with work or rather the lack of it.  The meetings were unscheduled and men would drop in at various times during the evening with comments like “I thought I would drop in to shoot the shit.”  There were always rumors of things to come both good and bad… this place was laying off, another was going to be hiring, another business was in trouble and about to go under, etc.   In 1933 the unemployment rate is said to have been 25%, but that number does not tell the whole story.  Many who were said to be employed were actually able to work only part time.  For example, Barb recalls her Father listed as an employee at a local steel mill, but usually actually working only one day a week and sometimes sent home early even for those days.  He avoided eviction by painting houses owned by his landlord. 

One conversation in particular stands out in which one of the men who was employed at a local glass container factory said he had just come from his workplace and had been turned away.  He reported that at every shift change there were huge crowds of employees at the entrance hoping to be chosen to work that day, but few would be chosen.  He loudly and profanely complained that the foremen “suck asses” and relatives were always the first chosen to work.  Some jobs or professions previously considered ordinary were highly prized.  Postal workers, school teachers, and local government jobs were highly prized for their stability.  The lack of available cash led to a great deal of bartering, especially with farmers who had no one to whom to sell their crops.  Conversely, professionals such as doctors and lawyers along with day laborers were often paid with food (e.g. the story of the inebriated rooster).   

Civics (Yesterday’s Term for Politics)

No education is complete without lessons in civics and the down-but-not-outers were not shy about expressing their opinions in such matters which was probably enhanced by the tongue loosening effects of Dad’s beer.  There was considerable disagreement amongst the group with almost everything.  In our home Dad was registered as a Republican and Mom was a lifelong Democrat.  I have the opinion that in those days one usually belonged to the party with which they had grown up much as with they do with religion.  Dad in spite of his upbringing had experienced an epiphany: he blamed Hoover for the depression and lauded FDR’s efforts to restore the economy. 

Those on the negative side of the debate were equally vociferous in their ridicule of FDR’s “make work programs” and “socialist stuff.” There were all kinds of jokes referring to the WPA and their workers having a penchant to be seen leaning on their shovels.  With the establishment of social security in the mid- thirties the idea of government taking money out of his check (if he had one) and giving it to someone just because he got to be 65 years old did not sit well with the naysayers.  A typical analysis might go something like this: “What ever happened to the idea of saving for old age” or “If they can’t take care of themselves, they should go to the poor house” (large forbidding appearing buildings euphemistically referred to as county homes).  Families were expected to care for their elderly or infirm parents consequently; they shared in the disgrace, and were denigrated for forcing their parents to “suck on the public tit.”

The most often discussed and vilified make work program was the WPA (Works Progress Administration).  The average wage was $52 per month yet one of my uncles worked in the program until it was disbanded in the early 1940s.  During that time, he managed to raise two children with the help of his wife who was able to find work cleaning the house of an affluent neighbor.  Although largely removed from most employment opportunities, wives did find ways to contribute.  For example, Barb’s Mother did laundry in her home in spite of a childhood injury that left her crippled.  The WPA worked on infrastructure projects while the CCC (Civilian Conservation Corps) focused on environmental projects.  It was an organization for young men who were housed in barracks throughout the nation and paid even less.  They were best known for planting millions of trees, often in areas where logging had left a desolate landscape.  Roosevelt in announcing its formation said; “forests are the lungs of our nation.”  They also fought forest fires, worked in national parks and landmarks building roads, trails and camping facilities.  Many such projects remain in use to this day.

Philosophy 101

While listening in on those conversations from my vantage point on the living room floor I was also privy to discussions of moral issues some of which have bedeviled philosophers for eons.  For example, one evening one of the guys reported that he knew of a place where it was possible to steal casing head gas.  Although gasoline was 18 cents a gallon, he did not have 18 cents, his car was out of gas, and he couldn’t look for work. (For the unenlightened of my readership: casing head gas is formed by compression of natural gas by functioning oil wells.  It is a very low quality fuel and can cause significant damage to automobile engines.)  Since he was without the means to get there, he was attempting to recruit an accomplice.  This provoked a heated debate.  Not only was his proposal illegal there was that “thou shalt not steal” thing in the Bible for which some thought there were no exceptions.  This brought up oft delivered hypotheticals one of which was very relevant to their situation which was “would you steal food if your children were starving?”   

Keep Walking or Go to Jail

Vagrancy laws made homelessness even a greater problem than it is today for one could go to jail for “having no physical means of support.” When I looked up the origin of such laws, I was surprised to find they were written after the Civil War as as a means to get freed slaves off the street and into the chain gangs which could be rented out, a process some called a new form of slavery.  These laws were found to be useful during The Depression as a means to rid the parks and other public facilities of the homeless.  I had always wondered where all those men I used to see walking along the highways were going.  Later it became obvious that they must stay on the move or go to jail.

These were the same guys who would sometimes appear at my Grandmother’s back door offering to do work for food.  Of course, there was no expectation that work would be done.   Grandma would bring a plate out for them and after a brief repast they were on their way. Since farmers were those who were most likely to have food to spare and cops were scarce these backroads were fertile territory.   I heard stories of farmers who discovered “bums” asleep in their haymows especially during inclement weather.  Depending on the compassion of the farmer they might be awakened by the business end of a pitchfork or sent to the house for something to eat then on their way.

Many of these hoboes or bums as they were called in those days would become so enured to that lifestyle that they would spend the rest of their lives on the move never staying more that a few days in one place.  They became expert at hopping freight trains, knowing their schedules and where they slowed enough to get on them.  They often migrated with the birds following the seasons.  They eventually developed places where they could hide for a few days at a time usually close to a rail depot but far enough away to avoid the railroad police.  It is said they verbally catalogued places that were soft touches for hand-outs.  Thus, a nomadic subculture came into being demonstrating the remarkable change which can be brought about in an industrial society by an economic crisis.

An Early Exit Prevented

At some undetermined time during those preschool years I experienced life threatening incidents one of which would label my Father as an unlikely hero.  In what was probably an effort to provide food and recreation simultaneously, he had decided to take me, my brother and mother fishing probably with the hope of making a meal of our catch.  The site, called Pleasant Valley was a favorite of mine and was next to a small conclave of houses reached via a covered bridge over the Licking river.  Its only reason for existence was a Post Office situated next to a major rail line.  It was a mail distribution facility for a large part of the county, and its fascination for me was to be able to watch the train rush past at what seemed to me to be at least 100 mph, while a metal arm reached out from the mail car, dropping a bag of mail, while snatching a similar bag, and pulling it back into the car without even slowing.

Most likely, on that day I was preoccupied with the hope that the mail train would come by.  The river was high, and I recall staring at the water as it rushed by, then everything was suddenly brown.  Probably that memory remains so vivid due to fact that I would have a recurring dream of that incident for years although; such dreams were not frightening but consisted of the sensation of floating in that brown water.  I am told that Dad saw me fall into the swollen river and immediately jumped in although he could not swim.  I was told that my life was saved by a single button for I was wearing a light jacket with one button fastened and Dad reached out with one hand and was able to grasp the jacket with one hand.  He threw me upon the bank and as he was floating by, managed to grab a root growing out of the river bank and save himself.  Thanks be to God that the button held for had it not you would have been denied the joy of reading these blogs!

Editor’s Note: Stay tuned for Part 3 of The Way It Was! 

Transitions

This title was chosen by my son for reasons which will soon be obvious. His youngest has just left home, this time for good, and he and Sue are now presiding over the proverbial empty nest. It is a frequently quoted truism that if you truly love someone you will let them go when it is in their best interest to leave. I was reminded of this last night as I watched Casablanca…one of my favorite movies in which that theme was paramount. Though it is a noble act to let go of those you love, separation is painful, and usually results in significant changes in our lives.
We experience multiple types of transitions during our lifetimes, but since we are at heart social beings, or to put it more crudely, tribal in nature, changes in our relationships are apt to generate the most intense feelings. It is something of a paradox that as the world gets smaller, we find so many people of whom we care to be geographically farther away. Yes, indeed we are able to communicate with ease yet Facebook is a rather poor substitute for a next-door neighbor, or a relative living in the neighborhood. Prior to the industrial revolution, one’s cadre of friends and relatives was unlikely to change very much, and most people were born and died in the same place, often even in the same house. Now neighborhoods are in a constant state of flux, and there is a lower expectation of lifelong relationships.

STUCK WITH THEM
No wonder our children are among the very most important people of our lives. Since humans require nearly 2 decades to reach maturity and carry our DNA, we tend to form very strong bonds. We are often identified as “Johnny’s” father or mother. We live vicariously through them and share their triumphs, failures, joys, and sorrows. In many ways they are our second chance at life as we attempt to steer them away from repeating our mistakes. As the years go by our intimate involvement in their lives blurs with our own–they become part of us and in doing so shape our identity, i.e. who we are.
GRIEF WITHOUT A CORPSE
With all that in mind, it is not surprising that separation anxiety is a common affliction. When the kids grow up and leave, something more than their presence is missing. It is as if a part of ourselves is gone. Not only is the nest empty, but we feel an emptiness within ourselves, a kind of psychological amputation. In my experience, this emptiness is most profound when the youngest one leaves  for with it comes the realization that nothing will ever be the same. This time they are leaving to build their own nest.
THE FUN TIMES
Life is an ever-changing process. We begin as totally helpless and dependent creatures and experience a myriad of transitions during our lifetime all designed to produce an individual capable of building and presiding over that nest. Some of those changes are more dramatic than others. There are the first steps, the first words, the first solo bicycle ride, the first day of school, the first sleep over and a few thousand other adventures all with a goal of achieving sufficient independence to allow them to face the world on their own.
WHY DID I GET INTO THIS?
But it is not all sweetness and light. There is the messiness, the lack of discipline, the terrible twos, the out of bounds phase, the adolescent rebellion, the sleepless nights, and the continued testing of limits to name a few of the frustrations inherent in the child-rearing business. Those little buggers are also expensive. According to the USDA the average cost of rearing a child in 2016 was over $245,000 which does not include costs for higher education (but for the kids, I could have been a millionaire). Considering all the chaos they generate it is little wonder that we don’t occasionally wish them to be grown up however; one should keep in mind the maxim to “be careful what you wish for.”
BEGINNING AND END
According to the Bureau of Labor Statistics 67.3 % of high school graduates enrolled in college last year (2017). It seems safe to assume that most of these kids would leave home while in school, but retain a close connection to their old familiar environs. In many cases the college transition is a prelude and training for that final fly away. The days when we dumped kids and their gear off to a strange new environment were certainly memorable to Barb and me.
Our first experience with the off to college scenario was painful for all involved. Molly, our firstborn (now deceased), who suffered from serious medical and emotional problems was unable to complete that transition. Next in the line of succession was Peter, who was much too macho to display his feelings, but I was already missing him by the time we pulled away from his dorm. After a four-year hiatus, it was Trudy’s turn. Trudy, the adventurous one, was on the phone almost immediately, tearful and very upset to find beer being consumed at the sorority rush parties that she attended. We had no idea where this came from for temperance had never been emphasized at home. As you probably already suspect. her distress was short lived and as was her habit she soon became involved in everything.
THE LAST ONE STANDING
Of course, those separations were painful, but none so telling as Maggie’s departure for we were now returning to a house inhabited only by Barb, myself and Grover the dog. Maggie was one who had insisted on an out of state school, for she was eager to assert her independent status. She wanted distance from childhood connections. Her reaction to the college transition was a convincing testimonial for that “be careful what you wish for” thing. Permanently engraved in my memory is the sight of that sobbing, skinny little red-haired girl who stood there all alone in that huge empty parking lot making feeble attempts to wave goodbye as we pulled away. Barb wanted to go for one last hug, but I insisted she had already had several last hugs. We were later told that she cried for the next month and lost 20 pounds. [See an earlier blog post about Separation Anxiety + Mental Health}
NOT ALL SWEETNESS AND LIGHT
In case you are thinking this gang of mine is the Partridge family incarnate, think again. It is true that to date we have come through our transitions relatively unscathed, but not without trials and tribulations. In spite of their best efforts some families are overwhelmed by circumstances beyond their control. Barb and I are indeed fortunate that in spite of our screw-ups we have ended up with 2 generations of exceptional people, and the beat goes on.
STILL AT IT
It so happens that this month marks the beginning of significant transitions for every one of my Grandchildren which of course they will undoubtedly handle better than do their parents (or Grandparents for that matter). My three oldest grandchildren are already emancipated and starting new and more challenging jobs. Another is off to her first year in college, and our youngest is entering high school. As mentioned in my opening statement, Carter’s room is empty, and home is now in another city far away. Trudy’s is the only nest still occupied.
LIFE GOES ON
Whatever distress the kids may feel from leaving those years of memories behind is apt to be short lived compared to that of their parents. There is hope for Mom and Dad however. In return for enduring the vicissitudes of child rearing God has rewarded us with grandchildren. Thus, we have an opportunity to get all the goodies and none of the crappy stuff ,which leaves me wondering what it would be like to be a great grandparent. Stay tuned for the answer!

The Power of Belief

WHAT SHOULD I BELIEVE

          A few months ago in a blog about conspiracies (May 2017, Conspiracy Theories) I attempted to find answers to the question of why so many of us seem willing to subscribe to stuff even when it is far from the truth, or in some cases totally illogical.  The question has been of particular interest to me having seen many, many patients through the years with disordered thinking leading to false beliefs.  The extreme example of the phenomenon is seen in the paranoid psychotic person whose perceptions are so distorted that his interpretations of reality are far enough removed from that of the average person that he lacks credibility.  They are often so bizarre as to make others sufficiently uncomfortable that he may be shunned.  As a matter of fact, it is not a stretch to describe paranoia as conspiracy theories on steroids.

ARE WE ALL A LITTLE CRAZY?

We now realize that there are many conditions that can impair brain function resulting in paranoia, yet when comparing the paranoiac to the conspiracist, we see they have much in common, which begs the question as to whether the paranoid’s extreme suspiciousness rather than qualitatively different is merely an aggravation of the basic human condition.  After all, suspiciousness has been adaptive behavior for the human race.  It has contributed to our survival and those without suspicions are called gullible and looked down upon.  On the other hand, the conclusions arrived at by delusional thinking are rigidly held in spite of whatever logic or facts are presented.  In like manner, the political zealot’s ideas seem set in concrete, and he brushes off contradictory information as either irrelevant or untrue.

THAT TRUTH THING AGAIN?

If suspiciousness is not only protective but in search of truth, why do we so often believe stuff when there is no evidence that it is true.  Any good con man will tell you the best way to gain trust is to tell the mark what he wants to hear, and the best lies are those that confirm what he already believes.  As a personal example, there is the case of Donald Trump, who I thought was a jerk long before his TV show.  Granted, that opinion was based on feelings and maybe not even rational for obviously I didn’t really know him.  Nevertheless, I am now even more convinced that he is a jerk and moreover a bad President.  Consequently, I suck up what is said about Trump on MSNBC and reject what Fox News has to say as bullshit.  I find it difficult to understand how some of my friends can listen to the Fox News bullshit, and I am sure they feel the same way about me and MSNBC bullshit.  As a consequence, we rarely discuss politics, but I am sure that they talk politics to friends who are of like mind while I rap only with the anti-Trump contingent.  Perhaps this is not such a bad thing. One study indicated that groups with opposing beliefs actually became more extreme in those beliefs while discussing the issues with those who differed with them.  Thus, there may be wisdom in the maxim that “one should not discuss politics or religion in polite company.”

CATCH 22 AGAIN

Unfortunately, that policy presents us with another one of those unresolvable dilemmas, for if one assumes that it is impossible to resolve differences without discussion and discussion simply reinforces beliefs, compromise is unlikely to occur.  The phenomenon does offer a measure of security to politicians or political parties in that limited exposure of their base to contrary ideas will keep them in the fold.  With that, he can devote more resources to winning the independent vote.

When I was a kid we played a game called Follow the Leader in which participants were to follow the behaviors of the designated leader, and those who failed to mimic the leader were expelled until there were only two players remaining, at which point the one survivor would become the leader and the game would resume with the new leader.  There is ample evidence that similar behaviors are seen in nearly all aspects of human behavior, and that we are indeed herd animals.

SO YOU THINK YOU ARE A THINKER?

There is a famous British study in which a large group of volunteers were asked to walk aimlessly around a large hall without talking to anyone, while a few were secretly given instructions as to where to walk, and to appear confident of their destination.  95% of the crowd followed those who appeared to know where they were going, in much the same manner as would a flock of sheep follow a Judas goat.  This phenomenon, only one example of what has been called herd behavior or herd mentality, has received a great deal of study through the years by philosophers, psychologists, sociologists, economists, theologians, historians and even psychiatrists like Freud and Jung.

The principles of herd behavior, or tribalism, have been found to have great utility in influencing all manner of human behaviors.  Indeed, it is difficult to imagine any aspect of our lives that is not affected in some way by our tribal memberships.  Those of us who fancy ourselves to be independent thinkers have little awareness as to how these and other genetically ingrained behaviors unconsciously affect not only our behaviors, but our thought processes, opinions and beliefs.  To belong, one must conform and conform we do, often with little awareness of why we do so.

HERMITS NEVER MAKE IT

The importance of herd behavior is not lost on the world’s politicians and despots.  They know how to make use of our need to belong to a group or to use a shrink term to be “validated.”  In order to brainwash someone or start a cult, one must begin by isolating the prospective victims in order to deny them validation so they will eventually align themselves with their persecutors.  They make use of the fact that as herd animals, contact with other living things is essential, and they hope that their victims will eventually accept whatever relationship is made available to them.  Similar dynamics undoubtedly play a part in the development of the “Stockholm Syndrome” as in the case of Patty Hearst, who joined the cause of her anarchist kidnappers after having been isolated and abused by them.  As I mentioned in a previous blog, it has been shown in several studies that solitary confinement often results in the development of psychosis, further evidence of the importance of relationships.

JUST ONE OF THE GUYS

It is largely accepted as fact that negative political campaigning is more effective than merely focusing on issues.  In such cases the emphasis is not on issues, but rather on his/her opponent’s character and identity.  The candidate will set out to show that he is like his audience and thus is a member of their tribe while his opponent does not belong.  When addressing a blue-collar audience, he may shed his coat and tie and roll up his sleeves.  The recent election has demonstrated that a baseball cap can generate more votes than a resume in those rallies while more formal attire will be chosen for $1000-a-plate dinners.

HERDS GONE WILD

Nowhere is the herd concept better illustrated than at athletic events.  I have been an Ohio State fan all my life, which by the way is a long time.   Of course, football is the most raucous of all modern sports and one in which tribalism is on full display.  I paid significant sums of money for the privilege of sitting in crowded uncomfortable seats sometimes in rain or snow. Surrounded by 100,000 fellow tribe members all rooting for the enemy to be vanquished, I felt I truly belonged.  Fellow tribe members were readily identified by clothing adorned with the school colors.  We pledged our fidelity by singing the alma mater followed by the school “fight” song.  Seating was arranged so that the opposition fans were separate from us good guys, and the cheerleaders encouraged our totally uncivilized behavior.  The best seats are those on the 50-yard line not only providing a better view of the action but placing the fan in the center of the crowd much as other herd animals jockey for position to be in the center of their herd.  Our loyalties also affect our beliefs, e.g., questionable calls by the refs are bad if they favor the other team, and the boos of one are apt to be taken up by other fans.

In similar manner mob behavior can be initiated, and there have been instances where those officiating games have feared for their lives.  Soccer games seem especially prone to mob behaviors.  Political rallies can be orchestrated to take advantage of that same dynamic.  It is said that Hitler frequently placed plain-clothed SS agents in crowds when delivering his tirades. Their job was to stir up the crowds by cheering his every word thereby stimulating herd behavior, a technique not lost on modern day political organizers.  For example, it is clear that the “lock her up” chants during the last presidential campaign were not entirely spontaneous.

GOOD GUY, BAD GUY

Throughout history leaders have come into power by designating a person or group of people as enemies.  A prospective leader must be able to place blame for whatever widespread complaint exists, and convince his audience that they are under assault by the bad guy or a group of bad guys.  It is helpful if he can induce hatred, for passion increases voter turnout, and the resulting divisiveness is encouraged.  An opponent will feel compelled to respond in kind to the accusations and the campaign becomes a battle of personalities rather than ideas.  Charisma triumphs and meaningful debate never happens.

We are all under a great deal of pressure to believe as are our fellow tribesmen. Consequently, we are strongly influenced to share our beliefs with those who are sympatico, which often leaves us isolated from those who don’t share those beliefs.  In a previous blog, I referenced a study which demonstrated that people are more apt to believe information obtained from a friend than from conventional sources, another indication that belonging is enhanced by sharing beliefs.

IS INDEPENDENT THINKING A LOST CAUSE?

Although many of our beliefs are buttressed by facts, there is also a certain amount of volition involved.  We sometimes reject beliefs that we find objectionable in spite of significant corroboration, and readily adopt those we find appealing despite limited evidence of their validity.  Religions demand professions of belief if one is to enter into the fold, be eligible for an afterlife or in some cases even one’s mortal life.  Early Christians presented their captives with a choice of believing or dying.  Radical Muslims are reported as doing the same even today.

Today, there are powerful pressures brought to bare in efforts to channel our beliefs.  We are drowning in information, much of which is distorted or false.  We are affected by advertising so sophisticated that it is personalized to each of us.  News sources which we trusted to provide truths are under assault.  Then there is that whole internet thing which muddies the waters even more.  Perhaps it is understandable that in our search for a lifeline we should reach out to our tribe to tell us what to believe.

Addendum by eshrink’s offspring (Maggie)

So, what is the answer to this dilemma? Maybe recognition of our need to belong is the first step to evaluate our own ability to think rationally. Instead of convincing or attempting to persuade others, maybe more listening and less talking will lead to greater understanding. No matter our opinions and thoughts, greater understanding and close relationships are what define the human condition.

One of the primary teachings I learned while earning my journalism degree was one of neutrality and learned objective behavior. “A reader should never know what your opinion is. Save that for the editorial page,” a professor preached to our class. To counter the need to disagree, I was taught to ask why. There is always more value in understanding why someone believes something than trying to convince them why their thinking is flawed. To ask the question and learn about their thought process (if there is one) can lead to greater understanding for the person asking the question and sometimes illicit the process of critical thinking in the one whose opinion differs from your own.

At the end of the day, this life is about relationships. Humans connecting with one another. Maybe we can be an example for the pundits and the politicians who want to gain power by dividing rather than unifying. One can only hope.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FAMILIES

FAMILIES

In previous blogs I have discussed the importance of relationships in our lives; however none are more important than our relationships with our family of origin. They will be a powerful influence as to how we view the world and other people.  More importantly, these experiences will be major determinants in the development of our personalities.  Those fortunate enough to grow up in nurturing environments will find it easier to nurture their offspring.   To feel loved is likely to protect one’s self-esteem, and allow one to experience the joy of loving others.  Our values are in many ways shaped by family for even if one is rebellious and rejects what he has been taught, his new found truths often originate from the nature of his family relationships.

Apprenticeship to Adulthood

We humans are unique among mammals in the length of time required for us to reach maturity. Not only is our rate of growth slow, but there is much to learn if we are to survive and thrive in a complex society.  Although much is determined by our genetic make-up, we learn behaviors and perceptions primarily by unconsciously mimicking others.  In that sense, growing up is much like an apprenticeship.

The 21st Century Family

An accurate definition of family is now difficult to pin down. There are no longer traditional roles for family members, such as were the norm in my generation.  Since most parents work, there are fewer stay-at-home moms.   We now see an occasional stay-at-home dad, something unheard of in my time.  Other than widows, single mothers were not nearly as prevalent during my youth as they now are.  Modern mobility has limited the number of nuclear families who can experience the support of extended family members.  Many of our children grow up barely even knowing the names of their cousins.  Blended families composed of his, hers and their children can face special challenges.

The Power of the Family Bond

In spite of these changes, the bonds between family members are among the strongest of all our relationships. This is evidenced by the fact that one of the first phases of recruitment by cultists is to alienate the prospect from family members, usually leaving siblings and parents confused and devastated.  The same tactics are used by those who would attempt to relieve the elderly and infirm of their possessions.  In both cases, they discredit the families of origin and attempt to break the bonds between the victim and the victim’s biological family.  Those in positions of leadership of all stripes realize the strength of familial relationships, and seek to provide an atmosphere in which a surrogate family can develop.  Street gangs likewise are said to provide family like bonds, which have been lacking in the lives of those they recruit.  The search for the type of relationships found in families seems to be a common human need.

“I found it difficult to remain therapeutic while feeling homicidal.”

Although families offer the best environment for rearing children, they can also be the scene of horribly abusive behaviors. I have had little experience dealing with such problems, especially when they involve children.  I generally avoided treating such cases as I found it difficult to remain therapeutic while feeling homicidal.  In like manner I find that the understanding of other cultural practices such as honor killings, genital mutilation and such to be way above my pay grade, and in spite of being paid quite well.  Consequently, I will confine my remarks to treatment of more mundane problems.

Who is the “real” patient?

Most families seeking help are usually concerned about the behavior or mental status of one of their members. They are often coerced into treatment by the identified patient’s therapist.  That term (identified patient) is useful in that one may find that the person in treatment may be the healthiest member of the family, and labeled as sick because he is out of step with the rest of the family (i.e., the identified patient is actually the most emotionally healthy of the group who is reacting to an unhealthy family dynamic).

The importance of family therapy

There are multiple reasons that I believe involvement of family is critical in the treatment process:

  1. Family members may be able to provide valuable information about the patient’s behaviors.
  2. It allows the therapist to view family relationships first hand and thus provide insights as to the stresses in the patient’s environment.
  3. Family members may provide a more complete family history
  4. It allows the therapist to assess the level of support available, and to encourage such support
  5. Perhaps most importantly, it is a mechanism in which the dilemma of providing family with needed information about their loved one’s illness without violating the confidentiality inherent in the doctor-patient relationship. This becomes even more important in those cases where there are paranoid tendencies, or there has been a great deal of conflict.

The Complexity of Family Relationships

Although the average family size has shrunk considerably over the last century, relationships between members can still be complex. It must come as no surprise that there are often conflicts within families.  Since it is difficult to walk away from one’s family, those conflicts are not easily resolved, and over time may escalate.  To be chronically angry can be debilitating and painful, and as such, blaming another for those feelings comes easily.

The Blame Game

As mentioned in previous blogs it is important that the therapist avoid joining in the search to establish who is at fault, for to do so merely perpetuates the problem. He must be able to analyze the problem from the outside looking in, that is, learn how to be a meta-communicator. Hopefully, the members will find it difficult to continue blaming each other if the therapist redefines the problem as blaming rather than defining the problem as identification of who is at fault.

The Power of Brevity

In order for the therapist’s comments to be effective, they must be brief if they are to be remembered. The importance of brevity as with most things in my practice was learned from a former patient during a chance encounter, during which he thanked me for having helped him several years previously.  He credited his recovery to one statement of mine.  He said: “The thing that helped me most was when you said ‘you think too much’ and now whenever I start to worry about all the things which could go wrong those four words come into my head and I am able to move on.”  I cannot take credit for any brilliant insights for I didn’t even remember the incident, but it is an example of how an offhand comment may be more effective than hours of therapy.  The same principle applies to our everyday lives, as the most memorable comments are those expressed in a few words.  The lengthy ones are often forgotten before they are completed.

Obviously there are many reasons for families to seek counseling other than to deal with hostility, but no matter the problem it is helpful to look at it as a communication system gone awry. Imbedded in many different behaviors is a message, and thus can be seen as a form of communication.  For example, what is the message being sent by a teenager who is acting out?  It could be that they are angry about limits set, unrealistic expectations from parents, lack of trust by parents, sibling rivalry, or resentful that not enough limits have been set, or for reasons which have nothing to do with the family.  Of course, the teenager is almost certain to be the last person likely to divulge such information.  Disclosure can many times offer a pathway to an understanding, which may be therapeutic.

Can’t see the forest for the trees

It was not my intent for this paper to be a treatise on family therapy; however I thought it might be useful to see how some of the concepts could be useful in understanding not only our own families, but relationships in general. As I mentioned in a past blog as with marital relationships, it is almost inevitable that one will be so caught up in seeing the trees that he will become oblivious to the forest.  That is, he will not realize what is going on even though he can hear the words.  This was brought home to me several years ago when following a party a colleague said “Smith I can’t believe how you treat your wife.”   I was shocked, could he be talking to me, the couples therapy and family expert?  After all, I had no doubt that I was among the world’s best husbands, but Barb later confirmed that my friend was correct in his assessment.  As has been said, “None are so blind a those who will not see.”

Reframing

For example though all have separate personalities, they also have different roles to play as family members. For example it is common for families to have a star and a black sheep.  Parents may lament that they don’t understand why the black sheep can’t be more like the star, and continue listing all of black sheep’s misdeeds and faults.  In such a case the therapist might address the black sheep kid by saying, “That is such a loving thing, doing all that stuff to make your sibling look good.” No matter the response the system is changed, and this is apt to open up some different dialogue. This is a process therapists call “reframing.”

Scripting

There are many roles that kids and parents may unconsciously adopt. There are the placaters or people pleasers, the mascot or clown, the lost child or withdrawn person, and as mentioned in the previous vignette the hero or achiever, and the black sheep or scapegoat, to mention a few.  Family roles may develop in order to fill a need or may come about by the process of scripting.  I mentioned previously the role families play in the development of our identity, and when they convince us we are a certain type of person, we are apt to follow that script.  Some have gone so far as to say if you can convince someone he is a homicidal rapist, he is apt to become a homicidal rapist.  Obviously, there are many influences other than our families which affect our identity; however, the opinions of our parents and siblings are undoubtedly the most powerful.

Disagreements

In this time of rapidly changing mores, it is not surprising that there will be frequent disagreements between we old folks and the kids. Of course disagreements between siblings seem to be written into their DNA, and disagreements between parents is certainly not unusual.  When family members cannot agree to disagree, an argument is likely to occur, and such arguments often lead to verbal or even physical attacks.  I don’t mean to suggest that disagreements are all bad for as Walter Lippmann famously said, “Where all think alike, no one thinks very much”.  When we tell our kids what to think while telling them we want them to learn to think for themselves it is little wonder they become frustrated for that is a classic double bind, or in today’s vernacular a no win situation.

Systems of Conflict Resolution

If a disagreement reaches the point that one feels threatened or under attack, either verbally or physically, he may respond in a variety of ways.

Attack/Attack system

He may retaliate in kind which is an attack-attack system. This is almost guaranteed to increase the level of anger, as each participant attempts to outdo the other.  These are the types of interaction which can lead to violence.

Attack/Placate system

The attack-placate system is often seen in cases of spouse abuse, when the abused attempts to talk hubby out of his anger by reassuring him and in other ways spreading oil over the troubled waters. This too usually fails as the abuser may feel patronized.

Attack/Divert System

Another type is the attack-divert system which as you might imagine can become rather bizarre. This might be effective in minor skirmishes, but simply changing the subject in the face of overt hostility is weird, and leaves the problem unresolved.

Acknowledge the Affect

For the best method to deal with such emotionally laden situations, I hearken back to my mantra of “acknowledge the affect.” In such cases, the message the attacker is trying to send is that he is feeling some kind of negative affect such as: anger, hurt, envy, jealousy, or fear.  Statements such as “I can see you really feel strongly about that” or “are you angry with me?” will often defuse the situation.  It is not necessary to change your opinion or point of view, but simply to communicate that you understand how he feels.  If your attacker’s affect is not available then one can use his own such as: “I feel …………” The concept has wider application, for in any emotionally charged situation it only makes sense to deal with the emotions rather than to ignore them.

What’s Next?

In my next blog, I plan to focus on child rearing. I am well aware there are probably hundreds of books written by people who are convinced they know better than you how you should raise your kids.  I don’t plan to do that since I have made plenty of mistakes in that department; although my kids all turned out well in spite of my screw-ups.   Rather than directions as to how one can raise perfect little people, I plan to provide helpful hints on how to screw up your kids lives: I call it “How to screw up your kids without even trying.”

Thanks for reading!

DO YOU HEAR ME NOW

Editor’s Note: Image not approved by e-shrink, but I needed some eye candy 🙂

In a previous blog, I promised an encore presentation on the subject of interpersonal communication. Your patience is about to be rewarded for I will now set about to fill these pages with the words of wisdom promised.

Actually if one excludes extrasensory communication and similar spiritual phenomena, there is little mystery about how we communicate with each other, but it is amazing how we can screw it up. It appears that all creatures have some means to communicate. Some plants are said to communicate with each other, and I just read an article in Scientific American presenting evidence that some bacteria send signals to others of like kind.

The Dawn of Communication

It is impossible to know exactly how earliest man communicated, but it can be assumed that job one as they came together as groups and then tribes, was to be able to communicate with each other. They would soon find that gestures and other nonverbal means were not sufficient for them to be successful carrying out joint efforts, like gathering food, providing shelter, and protection. Sound would prove to be the most effective means. Messages could be carried over distances without interrupting the sender’s activities. For example a certain sound may have been agreed upon to sound a warning. Meanwhile, man would be evolving physically with very versatile machinery to produce a variety of complex sounds which we now call words and language was born.

Necessity is the mother of invention

Since our Great, Great, Great, Great………..and so on grandparents, like us, were never satisfied with the latest technology, they would undoubtedly start looking for ways to communicate distances beyond their range of hearing. It would also be nice to save and share messages. Smoke signals and other such signaling procedures would have little useful utility. They solved that problem by devising symbols for each word thus enabling them to not only hear, but also see all those words. Fast forward a few thousand years, and here I sit recording words in this mysterious black box. As you are all aware this is not the end of that story, but more about that later.

Most of us talk better than we listen

Of course humans have developed the most complex system of communication centered on our verbal language skills. As a matter fact, many anthropologists rate our ability to use language as the major factor which allowed man to become the dominant creature on the planet. It is language that allows me to write this paper, and to communicate ideas, opinions, directions, knowledge, feelings, or indeed any thoughts which come into my head to anyone who is inclined to listen, and therein lies the most common flaw in any communications system, i.e., most of us talk better than we listen.
Psychiatrists listen, it is what we do, as a matter of fact sometimes that is all we do. It has always amazed me how therapeutic listening can be. There are many times when patients have left my office saying they felt much better after venting their particular problem, in spite of sparse verbal responsiveness on my part. It makes me sad to think that some people find it necessary to spend money to have someone listen to them. Come to think of it, if we all would be better listeners it might save a lot on shrink bills.

 

I can identify with those people who feel no one listens for I have always envied those guys with deep commanding voices who are able to dominate a discussion. In those situations I am rather soft spoken and sometimes feel excluded. My attempts to change the timbre of my voice have been unsuccessful; consequently; I am usually content to let my wife take the lead in those social situations as she is very good at social repartee.

The Nuts and Bolts of Communication

Everyone knows that in order to have a communication, one must have a transmitter and a receiver. For the sake of brevity (my readers seem to appreciate that quality in these blogs), I will limit my comments to communications between people; although, I realize there are now many machines that communicate, and that animals communicate with each other and with us. It is important to remember that in the presence of other people it is impossible not to communicate, for paradoxically not to communicate sends a message: therefore a communication has taken place. When one ignores another person, it may send a powerful message, but one which can be interpreted in many ways. The message may be clear depending on the situation or context, but can also be confusing.

An outstretched middle finger pointing skyward will rarely be misinterpreted

Verbal conversations are the most versatile and intimate of our means of messaging while written messages are less likely to be misunderstood. Non-verbal messages can also be very precise, for example in our society the presentation of an outstretched middle finger pointing skyward from an otherwise closed fist will rarely be misinterpreted. In spite of such exceptions, words are generally the more precise tool. The superior quality of verbal versus non-verbal communication is evidenced by the difficulty those born without hearing experience as compared to those who are blind. It is well known that a person’s lack of one special sense will result in a compensatory increase in acuity of its opposite. The result for deaf people is that they can become markedly adept at sign language, but to converse with hearing people becomes very difficult. They must either use crude gestures, or depend on written messaging, the first being ineffective and the second inefficient. Lip reading is apt to be fraught with errors and may not even be possible for those born deaf. Blind people however converse with little difficulty and their enhanced hearing may allow them to hear inflections which might go unnoticed by those with normal vision which could help make them superior communicators. The result is that deaf folks often prefer to relate to others who are deaf, while blind people find it easier to assimilate into ordinary society.

The Art and Science of Listening

As I mentioned previously, I believe that failure to hear is usually due to a failure to listen. Listening requires effort. In order to be an effective listener one needs to use all of his faculties, including not only his ears, but also eyes, touch, and sometimes even his sense of smell. It goes without saying that it is essential to be attentive, and to maintain eye contact unless the one talking seems uncomfortable. Observing a person’s posture and movements are all part of the listening process. For example, folding one’s arms across their chest indicates they are not likely to be receptive to your comments. Of course there are many less obvious non-verbal cues which are delivered unconsciously, to which we may respond to without awareness they have occurred.
People who study non-verbal communications can gather amazing amounts of information by simply watching a person. While teaching both individual, couples, and family therapies, we often would show a video tape of a session without sound, and speculate as to what the body language revealed. If the therapist who conducted the session was present he/she would usually be surprised at his/her lack of awareness of some their own non-verbal behaviors. Although a thorough review of the subject is way beyond the scope of this paper, we can learn some things which can be helpful to enhance our abilities to really listen just by watching.

Listen with your eyes

Most cues will be obvious, the breaking of eye contact, leaning forward or backward in a chair etc. One very telling clue as to our engagement is the shifting toward or away from symmetrical positioning e.g. the mirroring of postures. If the person with whom we are conversing mimics our sitting position, it is likely that they are engaged in the conversation, and to change positions will indicate disengagement. We are likely to sense those changes in others more easily than in ourselves. Leaning forward toward the conversant will indicate interest and encourage more talk on the subject while leaning back can be interpreted as: “enough of that subject.” At the same time it may be helpful to remember that if you are bored you probably will look bored, and you will give off the same signals as your bored companion. As mentioned previously, words are still your best shot to receive a clear message, and the non-verbal stuff should be viewed as ancillary.

The Transmission

Now that you know everything there is to know about being a receiver, we can move onto how you may become a talented transmitter. If you are to become a scintillating conversationalist, or a raconteur par excellence you must learn how to deliver a clear and succinct message. This must not be as easy as it sounds for even when listening as hard as I can, I sometimes have no idea what is being said. The KISS acronym (keep it simple, stupid) is still a good rule when it comes to personal conversation. Complexity tends to obscure rather than illuminate. Most contemporary poetry violates this rule in my opinion. My attempts to understand it leaves me with the same feeling I get after spending a half hour working on a rubric’s cube. I confess that I carry a few big words around to use when I want to impress; however long multisyllabic words should be avoided if a little one will do. (You may notice that I have used some of my favorite fancy words in this paragraph, and I trust you are duly impressed).

Direct vs Indirect

Conventional wisdom is that one should always be direct with one’s communications, and “not beat around the bush” as my grandmother would say. In general that is a good rule to follow; however there are times when one might need to deviate from that practice. It brings to mind the solution that my wife Barb found to a vexing problem. It involved a young man who did some office work for her from time to time. The problem was that he had a persistent very strong body odor. She was concerned for him, and suspected the B.O. might well have something to do with his limited social life. Of course, she was reluctant to confront him directly. Although her maternal instincts had kicked in, she did not feel close enough to him to be comfortable discussing his problem directly. After considerable deliberation she resolved her dilemma by giving him a box of deodorant soap for Christmas. Unfortunately, she had no follow up with which to judge the success of her coded message.
There are times however when a direct communication is the best choice in embarrassing situations. One personal example happened while I was giving a lecture to a group of nurses. I noted some snickering among them which was puzzling since grief was the subject of the talk. I later learned that my fly was unzipped. It would have been an act of kindness to have been informed of my zipper problem. To make matters worse, I was forced to endure taunts by colleagues that this was an obvious Freudian slip.

Sending manure and roses in the same box

Although words are of the utmost importance in communicating, we must not forget the music that goes with them. By that I mean the tone, volume, cadence, pitch, and other elements produced by the noise maker in our windpipes. The mechanisms we use to produce sound is remarkable in its versatility and is capable of expressing innumerable emotions which can accompany our words. What we say can be modified, enhanced, diminished or even totally changed in their meaning by our voices. When the words fit the music it can add clarity, but when they don’t it can be confusing. This also applies to visual clues as previously discussed. In those situations in which sound contradicts the words, we have two conflicting messages in one. The purpose of double messages is usually to express hostility, but make it difficult for the recipient to respond as we used to say at the lab: “to send manure and roses in the same box”. In such cases it may be difficult for one to decide which is the more pungent odor.

Sarcasm and the double message

Sarcasm is probably the most recognized form of the double message; however there are some who are masters of the technique. Some women are said to be “catty” in their conversations with other women For example at a dressy social function Miss Catty might say, “What a nice dress, I saw one just like it on the dollar rack at K-mart the other day.”The recipient of this message is apt to remain speechless unless she is quick enough to come up with an equally sarcastic response. In any event the two are unlikely to become friends. There are words and phrases which can be interpreted differently. Some idioms can be confusing and even suggest opposite viewpoints. Since language is never static some may change in their meanings as for example the phrase, “cute as a bug” usually referring to a younger person now seems to be accepted as complimentary; however I don’t believe many people would consider bugs cute.

Anger vs Hostility

Many people find it difficult to deal with anger either of their own or others. This can be limiting in their ability to form lasting and honest relationships for there will always be reasons for anger towards others whether real or imagined. Unexpressed anger will result in either hostile behavior or depression.

In our so called civil society it is often deemed inappropriate to express anger directly, but rest assured it will be communicated by all those non-verbal means we have talked about in spite of our best efforts to conceal it. Contrary to public opinion anger and hostility are not synonymous. Anger is an emotion while hostility is a behavior. Hostility is unlikely to resolve the issues which perpetrated the anger, and furthermore the response to hostility is apt to increase one’s anger.

The efficient and healthy way to express anger

There is a very simple and efficient way to express anger and that is to say “I am angry with you.” This will allow the source of your anger the opportunity to ask about your anger and consider options other than fighting. As I mentioned before, you are the only expert on your emotions so they can’t be refuted by others. If he shows no interest in resolving your differences, you are best off to just dump the sucker.

When you’re on the receiving end of anger

The opposite side of the coin is when you are the recipient of the anger or hostility. If the person is sufficiently enlightened to open the conversation with their feelings of anger, you have a good chance of resolving the issue, but it is more likely that it will be hostility, e.g., name calling, accusations, jealousy, or even physical assault. In the latter case just run unless you have a ball bat handy.

Acknowledge the affect

In other circumstances you may be able to diffuse the hostility by acknowledging the affect. The affect for you non-shrinks is the word we use for feelings. As a matter of fact that phrase: “acknowledge the affect” became my mantra when teaching psychotherapy. Phrases such as, “you must be very angry, or you really look mad,” may lead to a more productive discussion. In some cases it may be more effective to use your own affect especially if there is no response to your acknowledgement of his anger. Whatever you say must be honest, like “I feel sad, this hurts my feelings, or you are scaring me.” Although these strategies do not guarantee success, they are less likely to result in escalation of the conflict. Of course sometimes we would rather fight and in such cases that remains a prerogative; although it is often difficult to determine the winner.

Being assertive without hostility

Many of us have grown up in homes where we were taught to be submissive. This is probably true for women more often than for men. Then we grow up and find that we must be assertive or be ignored. Our childhood experiences of assertiveness was usually linked with anger, but as we grow up we learn that to be accepted into society we must learn civility. The result is that in this competitive world we must assert ourselves or be left in the dust. The problem is that we don’t know how to be assertive without being hostile. This was a problem for many, many of my patients. As women strived for more independence, and learned to work alongside men who were accustomed to being considered the dominant gender their need for assertiveness training increased, and this need is not confined to women. Learning to recognize feelings will help one to compartmentalize them and learn how to communicate without unwanted hostility. In other words acknowledge the affect.

The Awesome Complexity of Communication

The subject of interpersonal communications is obviously much more complicated than what is presented here. It is estimated that our vocabulary includes between 10,000 and 17,000 words depending on age and education level. When the myriad non-verbal modifiers are added coupled with the thousands of ways words can be arranged we become aware of the awesome complexity of this function which we take for granted.

P.S. I am a bit anxious about submitting this for publication as I have a grandson who is about to graduate with a major in communications. I can only hope he will be merciful in his critique.
Next time, I hope to share some thoughts about families.