psychology

The DSM and Helping

Reading the DSM-V on oppositional defiant disorder, I am again convinced that any kind of therapy, helping others, counseling, or changemaking is as much art as science.

I have not worked with an ODD child. I’ve seen depictions on TV shows, but I know full well to mistrust those as at best sensationalized. So, as I read the symptoms of the disorder, I had no experiential antecedents. No one I knew was like that.

I would not have the confidence in a diagnosis that I would make from such an analysis. And I wouldn’t trust anyone else who had just graduated to make that diagnosis either.

But depression? Rape trauma? PTSD? DID? Oh, I can recognize those in a heartbeat.

And for those conditions, there is a world of experience, a host of little details, that don’t easily fit into a diagnostic manual or even a scholarly study.

You can’t put into a book what it’s like to wake up with someone screaming because they just had a flashback.

You can’t put into a book what it’s like to have to constantly be guessing if the person you are talking to isn’t in fact a dissociated personality, an alter, pretending to be the person you know.

I’m not sure what the solution to that is. I mistrust already the idea of putting these utterly individual and totally unique phenomena, each individual human mind, into categories. It’s already an abstraction.

Last night, I was thinking about sex addiction. I don’t want to dismiss the work that’s been done on the topic, but the problem with talking about “sex addiction” is that “addiction” is a paradigm to define the world. You can talk about “sex addiction” from a psychological perspective, or “lust” from a religious perspective, or “moral failing” or “selfishness” from an ethical one.

The reason why we talk about addiction in the context of physical addiction is that there we can see directly how there’s a multi-faceted compulsion that drives behavior.

But “sex addiction”, one can argue, is like “breathing addiction” or “food addiction” or “water addiction”: It’s at most a pathological relationship regarding a human need that’s already pretty compulsory. People do some pretty messed up, self-destructive, and bizarre shit for sex, love, lust and attention. Where’s the dividing line there between an addictive compulsion and just “being a human being”?

I don’t know the solution to these problems. To some extent, maybe they aren’t problems. Maybe for the foreseeable future those who want to help others have to be trained more through apprenticeship than a scholarly paradigm.

In any instance, I am going to continue to advocate for a model of mental health that puts everyone in every community as being part of making people happier, more motivated, more at ease, less ashamed and humiliated, and more functional.

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psychology

Kohlberg and Convention

One of my favorite psychologists is Lawrence Kohlberg. Kohlberg presented a concept of morality where people tended to operate from within three levels (which he further sub-divided into three stages): A preconventional level that’s basically egoistic and focused on avoiding punishment or maximizing gain, a conventional level where people follow the rules but don’t think beyond them, and a postconventional level where people are able to think beyond the rules and even work on changing them. A lot of work on moral reasoning has challenged much of Kohlberg’s edifice. For example: It’s not like everyone operates at a conventional or post-conventional level a lot of the time. We all know that many people who are capable of thinking with deep morality and challenging authority in some instances can have serious character flaws that show preconventional or conventional thinking in other instances. We all know we can’t escape our zeitgeist: We can’t fully think beyond the limitations of our society. We literally and figuratively don’t have the language for it.
Still, Kohlberg’s theory affirms that in a real sense we’re not a fully developed person until we can think for ourselves. We can’t claim our full inheritance as thinking people until we’re able to look inwards and outwards with a critical eye.

I was just reading Joseph Heath’s fascinating (if sometimes dry) book, Following the Rules. Heath argues that there’s in fact a lot of rationality to following the rules. He points out that,
“[P]ostconventional morality in fact depends on conventional morality for its authority”.

This is an idea I’ve struggled with for some time. In fact, every moral thinker and person of conscience has to look at the fact that the rules of every society include many ideas that are clearly unfair and unjust but wonder how to replace those rules without throwing the baby out with the bathwater.

As I’ve learned and grown, I’ve become more and more convinced that Socrates was both misunderstood and totally right. When we do something that is truly wrong, whether it be hurtful or selfish or just self-destructive, our soul shrinks. I believe there is a world of infinity beyond our senses but that we can experience, and that world dims and fades away from our grasp when we act with avaricious grasping or short-sighted cruelty.
I’ve heard of people who brutalized and assaulted a lover only to then bemoan their lover leaving them. I’ve met people who gave a pretense of deep morality while owing others thousands of dollars and making no effort to stand by the content of their word. We see these contradictions in people’s behavior which cease to be contradictions when we realize one thing: We do damage to ourselves by hurting each other.

Morality isn’t about rules. It’s about love.

And that helps us understand a host of other paradoxes. How can some children be given corporal punishment and turn out violent as a result, while others can be given that same punishment and be wonderful people? Simple: It’s not about the rules or the punishment, it’s about the love. When a child does bad things to get attention, they don’t really want punishment. They want love, and they’re grasping for the nearest thing they can get.

It’s important that each of us discover what we believe in for ourselves. But I notice a trend amongst many intellectual people who have yet to find that love inside themselves toward rejecting all of conventional morality. They offer Kohlberg’s idea as proof that we can just reject everything society says.

One of the things that Socrates said that resonated with me the most was as he faced death. He was asked why he didn’t try to escape. Socrates replied that if he ignored the punishment of the society that he had lived in his whole life, he would effectively be breaking a social contract that had given him benefits when it was inconvenient for him. This was despite the fact that Socrates was clearly a postconventional and deeply original thinker.

It’s why Thoreau, Gandhi and Dr. King all knew that civil disobedience and protest had to be done with a willingness to accept consequences. And even Noam Chomsky, arch-anarchist, has stated that the reason for civil disobedience is to resist the breaking of higher laws by the state.

I think there’s a deeper point to be made.

We make goodness today, with our actions. It’s not out there waiting to be found, granted by a celestial father figure. Goodness doesn’t exist except where we see it and make it.
It took millennia of hard intellectual and social work and development to get us further.

So when we look at the barbarities of the past, we have to recognize that they were building too. While there have always been some people in all times able to look beyond where they were and challenge racism, sexism, homophobia, or other forms of injustice in their society, we have to forgive those in the past and the present who can’t get there. And for those who are still alive, we have to help them learn a better way of thinking.
In some ways, it’s as cruel to criticize those, in the past and the present, who behave barbarically, as it is to criticize people for living in huts. Huts were all people had, and for much of our history, barbarism was the only way people knew how to live.

I hope that those reading quell the desire we all have to sometimes imagine others as sheep. I hope that we’re able to recognize that there are good reasons why rules exist and why people have lived the way they have. If we believe in something better, and we absolutely should, then it’s up to us to find it and make it real. Once we have something that is truly better, people will embrace it if we let them.

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happiness, hope, psychology

A New Metric for Happiness

The ways we measure success and happiness are fundamentally broken.

We measure individual success by looking at someone’s salary or the number of books they’ve written and speeches they’ve given, not days with their family and smiles they brought to the people they cared about. We measure collective economic success by looking at missiles and guns produced, not by seeing if every year people are seeing less stress and experiencing more prosperity. We measure the success of our police departments by how much they reduce crime, not how much they make people feel safe or how much they are getting at the root problems of violence and dissatisfaction that cause crime to begin with.

It’s time that we as a society measure not the amount of stuff we can produce (that ends up in landfills) but start measuring happiness. We need to start thinking about happiness as a metric, as an output that we want to measure in a more granular way. Our national goal should be to see people fulfilled, satisfied, happy, and healthy.

So far, nothing I’m saying is really that controversial conceptually. In practice, though, it’s really hard to measure happiness.

How do you measure how satisfied someone’s soul is? Do you use an MRI and see how their brain reacts? Do you ask them to fill out a survey and trust them not to lie? Do you look at their smiles, the way that they are eager and happy?

When you start measuring productivity, you realize that some people produce a lot more than others.

As a professional writer, I can do projects in an hour with no difficulty that others would stress about completing within a day. In other words, I’m at least twenty-four times as efficient as some other people, people who may in fact be perfectly talented and intelligent. But if I were to try to fix my car, I’d probably find that if I could even do it I’d take ten times as long as a professional mechanic and would end up cursing quite a lot more. Nor am I alone in this regard. From the software industry to visual arts, the best people have quantifiable output that’s just faster than everyone else’s by a huge margin.

I used to think that happiness was different. Sure, some people were depressed or had serious psychological issues. But I thought most people reacted to the world the way that I did: Waking up most days eager to face the day, eager to explore and create and share.

I have since found that I was utterly wrong.

So, let me introduce what I call the Abd-ar Rahman Metric. Named after Abd-ar Rahman the III, Emir and Caliph of Cordoba who was a king at the same age that I was still bumbling through college, this metric asks you, “How many days of pure and genuine happiness have you had?”

Really think about that question for a second.

Abd-ar Rahman the III was one of the most powerful people in the world. During his life, he became one of the heads of a major world religion, Islam. He ruled a whole nation for more than thirty years, from 929 to 961 CE. Many people dream of having a fraction of the kind of power and influence that this man had.

But at the end of his life, this is what he had to say:

“I have now reigned above fifty years in victory or peace…. Riches and honours, power and pleasure, have waited on my call… I have diligently numbered the days of pure and genuine happiness which have fallen to my lot: they amount to Fourteen: – O man! place not thy confidence in this present world!”

His number on the Abd-ar Rahman the III Metric is fourteen. In his entire life, he had fourteen days where he felt pure and genuine happiness.

I’m twenty-eight years old as I write this article. Even removing years in my childhood that my memory is incomplete for and being quite conservative, my score on this metric is in the thousands. Let’s say that my score 3650, roughly every other day of the twenty years I can recall being blessed with pure and genuine happiness.

I can’t speak for any of you reading this, but I suspect most of you have had more than fourteen days of genuine happiness. One friend of mine, a person who has had an extremely difficult life in many respects, reported that she at least had a day of pure and genuine happiness on every Christmas, putting her score at least at 25.

My average month contains more days of pure and genuine happiness than the entire life of a man whose worldly power and wealth beggars mine.

I may have to worry about making rent sometimes or dealing with student loans, but I will experience days where the beauty in the world makes me weep for joy. I love the world so much, I want to holler it from the mountaintops.

The secret to my happiness is my belief. I have convictions. I believe this world matters, I believe action in it matters. I believe heroic struggles to improve our world are in and of themselves noble, no matter if they fail or succeed.

I do have some advantages Abd-ar Rahman the III didn’t have. Even with all of his money and power, I have a car while he had horses. I have better medical care. I have better entertainment: Movies, video games, television shows, and music on demand. I have the ability to communicate with people across the globe instantly. Many, maybe even most, people today enjoy a level of material safety and prosperity that no one in Abd-ar Rahman’s time could imagine.

So it is possible that some of the advantages that you and I have over this king have been because we’ve seen a thousand years of technological, social and economic development. Even people who are struggling to get by in the industrialized world still have marvels that kings couldn’t own a century ago, because those marvels didn’t exist.

But I think we can all see that the difference between you, me and Rahman cannot be just a matter of the fact that we can watch Arrow on Blu-Ray and he couldn’t.

The Buddha and Socrates, two men from massively different cultures, both came at the same realization: The way to happiness, to what Socrates called eudaemonia and what the Buddha called nirvana, is the cultivation of the spirit.

Every single person’s path toward that cultivation is different. In my opinion, that path can include the usage of modern techniques such as psychotropic medication.

I think that the secret is invulnerable belief. Invulnerable belief is my artistic calling card.

Maybe I’m wrong. Maybe even Socrates and the Buddha were wrong about the specific mechanisms for happiness.

But what’s clear is that Abd-ar Rahman the III did have wisdom when he told us to not look for happiness in the things of this world.

Cars, houses, fame, the approbation of millions, occupying a high position in society, the respect of peers… these don’t lead to days of pure and genuine happiness.

We as a society have to start figuring out what does.

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hope, psychology

Frankl and Me: Suffering and Meaning

There are definitely times where my work, even as it currently is, is incredibly rewarding. I am able to research a host of topics and learn all sorts of new pieces of information.

One of the best events that will occur to me is when I see someone who vindicates and at the same time rounds out my approach.

To wit:

In my manifesto, “Invulnerable Belief”, I stated,

“No one resents pain that they endured for their family or their country. We don’t look back on those moments where we suffered for the people we love and think, ‘What a waste’. Maybe those pains will haunt us, but put in the same situation, we’d do it again.”

Frankl, a psychologist who survived the Holocaust, searched for meaning and answers as a result of the apocalyptic visions he saw. He concluded the following in his seminal Man’s Search For Meaning:

“In some way, suffering ceases to be suffering at the moment it finds meaning, such as the meaning of a
sacrifice”.

In the New Year, I hope eagerly that more people find the meaning that will liberate them from suffering.

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helping, psychology

Rule One to Save A Life: Love

If you want to help someone, there’s one trick above all (that will undoubtedly get at least one chapter in Skillful Means):

Just love them.

In my life, I’ve never been able to hold onto anger, or sadness. Even if I try to, even if I try to hold a grudge so that I will not be taken advantage of again, it slips from my fingers.

I’ve come to realize that it’s love that does that. The last few weeks have reminded me that enough love, skillfully and patiently expressed, can purge our systems of the negative.

This may sound like some hippy-dippy bullshit, but it’s the teaching of almost every world faith. It’s the secret and unifying factor that united Jesus, the Buddha, Mohammed and Socrates.

Love is too big to let anything else fit. Anger, sadness, jealousy… When our hearts are joyful and filled with love, the bad can’t hold on.

And the magic of it is that, when we let others experience it, when we share it without censorship and without struggle, they can have their own problems rise to the surface too. Their own anger, their own self-loathing, their own fears, can be reflected.

The Omega principle of Rejara Contante’s Principium Cavalliero Errante in Steam Saint is, “When in doubt, discard all rules and simply love”.

It can be so difficult to tell people, whether it be privately or publicly, that we care about them. It’s especially difficult for men. That’s one of the reasons I try to encourage men to embrace the alternate (and classical) masculinities of knighthood, of superheroes, of the white hat cowboy: All those archetypes include the ability to not only love but to express it. The theme song from Rawhide states, “My heart’s calculatin’ / My true love will be waitin’ / Be waitin’ at the end of my ride”.

But it’s exactly in those awkward moments that it is the most important to say it.

So, if you’re worried about how someone else is doing, find a way of showing them how much you appreciate them. You’d be amazed at what chunk of samsara you can knock loose.

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psychology

Alcoholism, Psychology and “Cures”

Yesterday, I came across a statement that ran through my head like someone in a particularly ostentatious 70s track suit all day.

It was this: “There’s no cure for alcohol addiction”.

Umm… Yeah… Wait, maybe… No… Huh?

This statement seems innocuous enough. But it’s actually worth discussing in depth. In fact, I may put on my Wittgenstein hat for a second and say that maybe the statement says a lot more about how crappy our definition of “cure” is (and our idea of “health” is) than any actual information about alcohol addiction or dependency.

It’s true that there’s no magic pill that will make it so someone will never want a drink again. This isn’t Tintin. Alcohol addiction isn’t a bacterium: It can’t be killed.

There is treatment for alcohol withdrawal, of course. The treatments, near as I can tell, are not particularly great, and this research basically suggests that withdrawal symptoms only be treated when they emerge, not on any kind of preventative schedule. But that’s not what we’re talking about.

Yes, alcohol addiction can be a life battle. That’s also true for any other kind of substance abuse or dependency, depression, schizophrenia, PTSD, rape trauma, DID, bipolar disorder, borderline disorder, autism-spectrum disorders… Basically, anything that hits our neurochemistry is something we can grapple with forever.

But let’s be very careful here for a second.

A lot of people conclude from the fact that there’s always the risk of relapse with the vast majority of psychiatric conditions that there’s no real change to our personalities or who we are. We’re just destined to play out the same tragedies and comedies over and over again, like characters in a Greek play.

But developmentally, nothing could be further from the truth. People are always changing. They’re gaining new habits and losing old ones. Their values change, their political affiliations change, their interests change.

Recently, I’ve been finding that I’ve barely been playing any of the old AAA games that I’d sink hours into. I don’t do any online play-by-post roleplaying. And that’s not just because of professional obligations. I find that, even if I have some time, I may want to watch a show, do a roleplaying session in person, or even take a walk more.

That’s staggeringly common. I don’t know if I could be called a workaholic (though I have had many people express concern about how much I work and the standard I hold myself to). But I don’t spend as much time with leisure as I used to.

Now, why is that the case? Because I decided that I really should try to embody the values that I held dear for as long as anyone’s known me. I decided that there wasn’t going to be a magical time where I’d have my calling handed to me. I had to push it and step onto my own path.

So the same personality traits and values are there, but I’m expressing them differently and valuing them over competing values more highly. Is that “change” or not?

Let’s say I get strep throat once. I take the medication to treat it. It goes away entirely: Only trace amounts of the streptococcal infection remain. Then I get strep throat again. Was I “cured” the first time?

Okay. Let’s say I get strep throat once. I take the medication, but I skip some rounds. It lays dormant, then a new bacterial load hits me. Was I “cured”?

Let’s say that the strep throat cost me an organ system. The bacteria are dead but that body part will never come back. Was I “cured” by the medication?

The point is that the idea of a “cure” is actually sort of arbitrary. Even more importantly, we can get affected by the same disease several times and have each of those times be separate incidents.

So, now we can go back to alcoholism. Can it be cured?

The fact is, people can develop better habits to manage and cope with any kind of psychiatric problem. They can learn how to combine medication, support groups, healthy routines, the use of support networks, and sometimes the use of a professional or mentor (like an AA sponsor or a religious figure).

So is a mental illness more like an infection, in that we can get the same kind of illness multiple times from different proximate causes, or is it more like diabetes, in that it’s something that’s in the background and can flare up at any time?

The answer is actually sort of, “Both, sometimes more one than the other”. It’s also sort of, “Neither, because the ideas of ‘cures’, ‘treatment’, ‘management’ and so forth are all totally different when it comes to the mind”.

I say all this because people, when facing something like the soul-crushing fear and hurt from repeated sexual trauma or the agonizing intellectual despair of facing the fact that their steps away from depression may be temporary, begin to worry about each new day.

The wisdom of AA, that you take it a day at a time, is a good starting place. But it condemns the person with that kind of problem to a life where they are pulled by every ebb, flow, eddy and current of life. It makes their life reactive, not proactive.

Yes, someone with alcohol addiction problems may struggle for a very long time to find a set of new habits that will eliminate the temptation to turn back. Yes, many may always find that temptation to be there, not least because of the way that memory can tend to distort the bad and the good. Yes, events in our lives can sometimes permanently impact us and stick with us, haunting us.

But our losses, hardships and traumas don’t need to take something away. They can become assets and sources of strength. Our struggles with temptation can make us more compassionate and more aware of the value of life, and how rapidly we can see it slip away from us.

I firmly believe that most mental conditions can be conquered. I think we move from a stage where we battle every day, to a period where we are beginning to get good habits but there is a risk of relapse, to a stage where we have mastered the problem. The problem may come back, of course, but it could be in a new form. What drives a 20 year old in college into the bottle may not be the same as what drives a fifty-year old with a mortgage and a bridge club.

I have found that each of my crises in life, while related, have been distinct. I learned different lessons from each one. It’s too simplistic to point to one single problem that defines anyone. Just as a bacterium mutates and just as every organism is distinct, so too is “depression” or “alcoholism” an abstraction that we put onto a complicated phenomenon that is different each and every time.

When I work with people, I do often find myself having to warn them that what may seem like a temporary success is just a plateau, one they can slip off of. But if they keep doing the work, they are not likely to ever go back down to their original nadir. And even when they do, they will have the sangfroid to climb back up faster.

In any instance, combating and managing our bad habits, even when it may be a lifelong struggle, is a lifelong struggle worth doing. Every day, we will fight our weaknesses, our limitations, our hurts, and our ability to turn a blind eye to the others in our lives. We will fight to make sure that it is our love, hope and compassion that define us instead of anger and fear.

After all, why do people turn to drugs? There’s a lot of reasons, of course, and a lot of motivations, but it tends to boil down to, “I can’t handle something in my life without this drug”. Alcoholism is just a specific version of being unable to handle life, find joy and happiness or even some degree of entertainment to hold onto existence with, without some kind of external aid. People fill voids with all sorts of unhealthy habits: Biting their fingernails, abusing prescription medication, sex, even exercise. In fact, almost every victim of sexual trauma I’ve ever worked with literally finds themselves running for miles a day or exhausting themselves in the gym. It’s a combination of being able to run away from something, feel stronger and physically in control, feel free, and also get that endorphin high.

So when we “relapse”, what that often means is that life hit us in some new way we weren’t prepared for. It can’t be thought of as just the same problem in a new disguise: It’s actually a new problem, being dealt with in an old way. The problem isn’t just the addiction: That’s just a symptom. The problem is our inability to respond to the stress.

Life will always dish out a certain amount of suck, as I found myself saying yesterday. We will always face challenges and unpleasant situations. But they don’t have to control us or make us anything that we don’t want to be. We don’t have to resent those challenges or resent being alive through them. And we can learn how to face them without falling into destructive patterns.

Maybe thinking about it in terms of a “cure”, then, is just not helpful. Maybe we should think about it as a battle.

Can the battle against pain be won?

Yes.

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psychology

Truth, Christian Counseling, and Personal Commitment

It’s always surprising when and where you’ll find common ground.

One of my struggles, one that’s common amongst anyone who tries to help others in any capacity, is between my commitment to the truth and the need to protect others’ confidences. When you are told of a crime or an injustice, it is difficult to remain silent.

Christian counselors routinely emphasize the importance of truth in their work as well. While it often comes from a place of “God’s truth”, the main commitment to the idea of truth in word and deeds remains the same. As I read their analysis, I find it fascinating to see how they balance that commitment to truth with professional and personal obligations.

One thing I’ve repeatedly seen is that the only way through to recovery is truth. Acknowledging every ugly aspect of life is a vital step to be able to see the truly beautiful. Oftentimes, people who speak what they see as the truth are viewed as negative. But there’s nothing inherently pessimistic or cynical about honesty. In fact, it is fundamentally cynical to pretend that truth and honesty trade off. It says, “The world in matter of fact actually sucks, so the only way to be optimistic and positive is to lie”.

When we pretend that every claim is just as true as any other, we are denying the ability to face and identify injustice and to allow people to recover. The mind needs to be able to hold onto truths and to work against them. When a victim of a trauma or a person struggling with depression can think that it’s all “just a matter of perspective” that they’re hurting, it’s not just their own pain they are whisking away by rhetorical and philosophical magic, but everyone’s.

So, how can we stand up for truth while respecting the rights of others to choose to remain silent?

First of all, when someone tells me a secret, I will tell them if I am comfortable holding it. More importantly, I will tell them that I will never change my mind on my advice for them to say it. It’s their choice to be honest and truthful to their experience, but it’s my choice to advocate for it.

Second, I can stand up for the broader social issues that led to their pain. If I hear a victim tell me their suffering, I can stand up against rape. If I hear about depression, I can raise awareness.

Truth can be immensely positive. If we speak the beautiful truths, that can be a light that will lead someone forward.

I will undoubtedly repeatedly navigate this issue of confidences as I expand the circle of what I do. Being a secretkeeper is an important duty, and one I take seriously. But when it comes to me, my life, and my truth, I won’t compromise, and I believe that anyone who seeks to help others and be positive has to feel the same way.

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