Some - perhaps many - Americans like to think that our nation has entered a "post-racial" era, where racial prejudice and discrimination is just a thing of the past. After all, people of diverse racial and ethnic backgrounds have risen to positions of prominence in government (up to and including the presidency), business, the medical and legal fields, and just about any other position of status you could think of. But does that make us "post-racial?"
Three news stories of the past week raise the question of exactly how far we have actually come since the civil rights movement. Fifty years is a long time, but is it enough time to erase the preceding centuries of prejudice and discrimination? Is it enough time to truly level the playing field of "White privilege?"
It seems unlikely, and each of our lived experience is likely enough to tell us that, although we do tend to consider people of varied races and ethnicities "equal" - equally intelligent, equally able, equally moral, equally "human" - we also judge each other according to negative stereotypes. These judgments don't just go in one direction - everyone seems to have them toward racial/ethnic groups other than their own.
Some folks would like to sweep these judgments under the rug - claim that signs of equality (such as people of color who hold positions of power) represent the absence of prejudice. These folks see this week's Supreme Court decision on the Voting Rights Bill as further evidence that racial injustice is a thing of the past. However, others, including the ACLU and NAACP, warn that the Court's decision poses a risk precisely because of the continued existence of prejudice.
So, what exactly did the Court say? The Voting Rights Bill was first passed in 1965, and renewed in 2006. This bill required specific States, counties, and municipalities to have any changes to voting policy, including districting, approved by the Justice Department ahead of time. The Supreme Court threw out the list of places required to obtain this "preclearance," not because targeting certain places is in itself unconstitutional, but because the list was based on evidence gathered in the 1960s. In other words, the Court did NOT say that such oversight is no longer needed. Instead, they said that Congress needs to determine WHERE such oversight is needed on the basis of current evidence, rather than 50-year-old data. The clear implication is that current evidence would indeed show some places in our country where the racial climate warrants judicial oversight to ensure voter rights.
The Supreme Court is one of the three news stories I mentioned earlier. What about the other two?
The first illustrates our attempt to repudiate our racial past. Paula Deen, a famous cook, tv personality, and author, lost the vast majority of her contracts (for tv, books, and product endorsements) after admitting in a deposition that she has used the "n-word" in the past. Now, Paula Deen was born in Georgia, in 1947. In other words, she grew up in the deep South prior to the Civil Rights movement. I would have been shocked if she HADN'T even used the "n-word." It is ludicrous to judge her so harshly for being a part of the culture of that time and place. It certainly should not be taken as evidence that her current beliefs and behavior are racist. My psychodynamic side wonders whether we, as a society, are attacking in her what we are trying to deny about ourselves and our own societal history.
The last of this week's news stories is an illustration of how racial prejudices continue to shape our collective psyche. George Zimmerman, a Florida man who is half-White and half-Latino, has gone on trial for shooting an African American teenager named Trayvon Martin. As a member of the neighborhood watch, George Zimmerman is reported to have followed Trayvon Martin, while calling the police to report a "suspicious" person, before a confrontation during which Zimmerman ended up shooting and killing Martin. While the defense is claiming self-defense, the prosecution claims that Zimmerman racially-profiled Martin, assuming he was a criminal because of his race and gender.
The outcomes of all three of these news stories are yet to be determined. However, what they demonstrate (at least from my perspective) is that our society is desperate to distance ourselves from any hints of racism, at the same time these hints belie the myth that America is "post-racial." We're just not there, yet; and it's going to be pretty hard to get there if we can't acknowledge and talk about it!
A collection of reflections for those learning and practicing psychotherapy, and clinical social work more generally
Showing posts with label Culture. Show all posts
Showing posts with label Culture. Show all posts
Sunday, June 30, 2013
Monday, December 31, 2012
Over the "Cliff" - the Power of Language
The latest word out of Washington is that the Congress will not agree on any kind of legislation by tonight's deadline that would avert the spending cuts and tax increases set to take effect tomorrow. There are any number of things I could write about this situation - perhaps about the importance of compromise, the implications for social services, or the class inequality which will mean the poor shoulder a heavier burden. All of these issues are important. However, from a psychological perspective, what has stood out to me throughout conversations on this topic is how the language we use to talk about it influences its emotional impact.
Notice in my first sentence that I referenced "spending cuts and tax increases," rather than the more common phrases that are being used to describe the situation. In contrast, media and politicians speak of the "financial crisis" as "the fiscal cliff." Words like "crisis" and "cliff" imply threat and danger. These words are chosen to incite anxiety among the public, and therefore to further stir up an already tense political climate.
Post-modern schools of practice such as Narrative Therapy, and Acceptance and Commitment Therapy are based on the premise that our perceptions of "reality" are based on language rather than fact. They build on Social Constructionism's stance that all "truths" are constructed through social processes. What all this means is that we use language to construct reality, and the reality we end up with is more a function of the language we choose than "facts."
In therapy, we work with clients to alter their perceptions of reality by changing the way they think about things. We may call it reframing, or cognitive restructuring, or reauthoring, or interpretation, but the desired result is that people will find more flexible and less negative ways of making meaning out of their experiences.
The same process might apply to the so-called fiscal cliff. Because talk of "going over the cliff" calls up a vivid image of...well, falling off a cliff...the natural response is to want to dig in our heels and cling to something for safety. That reaction does not inspire balanced and flexible ways of thinking about our economy!
Unfortunately, "tax increases" and "spending cuts" have also become layered with socially-constructed meaning. These seemingly-neutral descriptions have become rallying cries for partisan politics - the words elicit a negative, defensive response from conservatives and liberals, respectively. Unfortunately, this effect of language has paralyzed our entire political system, preventing any of our politicians from taking a balanced, flexible approach - an important ingredient in any meaningful compromise.
I don't have an answer or solution here. It is more of an observation, and an encouragement to be aware of the impact of language - the language you choose, and the language you hear - and consider whether that language is the only, or most helpful, way of thinking and speaking.
Notice in my first sentence that I referenced "spending cuts and tax increases," rather than the more common phrases that are being used to describe the situation. In contrast, media and politicians speak of the "financial crisis" as "the fiscal cliff." Words like "crisis" and "cliff" imply threat and danger. These words are chosen to incite anxiety among the public, and therefore to further stir up an already tense political climate.
Post-modern schools of practice such as Narrative Therapy, and Acceptance and Commitment Therapy are based on the premise that our perceptions of "reality" are based on language rather than fact. They build on Social Constructionism's stance that all "truths" are constructed through social processes. What all this means is that we use language to construct reality, and the reality we end up with is more a function of the language we choose than "facts."
In therapy, we work with clients to alter their perceptions of reality by changing the way they think about things. We may call it reframing, or cognitive restructuring, or reauthoring, or interpretation, but the desired result is that people will find more flexible and less negative ways of making meaning out of their experiences.
The same process might apply to the so-called fiscal cliff. Because talk of "going over the cliff" calls up a vivid image of...well, falling off a cliff...the natural response is to want to dig in our heels and cling to something for safety. That reaction does not inspire balanced and flexible ways of thinking about our economy!Unfortunately, "tax increases" and "spending cuts" have also become layered with socially-constructed meaning. These seemingly-neutral descriptions have become rallying cries for partisan politics - the words elicit a negative, defensive response from conservatives and liberals, respectively. Unfortunately, this effect of language has paralyzed our entire political system, preventing any of our politicians from taking a balanced, flexible approach - an important ingredient in any meaningful compromise.
I don't have an answer or solution here. It is more of an observation, and an encouragement to be aware of the impact of language - the language you choose, and the language you hear - and consider whether that language is the only, or most helpful, way of thinking and speaking.
Saturday, September 22, 2012
The Next New Thing
Did you get the iPhone 5? If you did, you're certainly not alone: they've sold millions already, and many customers have to wait 3-4 more weeks for the phones they've ordered. In fact, the rumor was that Apple's stock of preorder phones available on the launch date sold out within 1 hour (even though the hour was 3am Eastern time)! And, as with every new device Apple produces, crowds camped out over night - sometimes for multiple nights - waiting in line to get their hands on the new product.
This craze sparks my curiosity...not about what makes the most recent new thing so much better technologically, but about the social psychology that makes people feel so much urgency to lay their hands on it. Why do people who already have fancy smartphones that work quite well wake up at 3am - or camp out for multiple nights - to get a better one?
Four explanations come to mind:
1) Boredom - Having relatively short attention spans, and being used to instant gratification (thanks, in part, to technology), we may become bored with our current gadgets even before the new one comes out (and before our 2 year contract ends!)
2) Jealousy - When someone else has better or fancier things, it detracts from our opinion of whatever we have. Something we may have liked suddenly loses its value to us, and we want to upgrade.
3) Competition - We may feel like we will be at a competitive disadvantage if we don't have the most advanced technology. We might get anxious and upgrade just to be on the safe side.
4) Insecurity: Those of us who feel like we are already at a disadvantage in life may try to compensate for it, or "prove" our value and place in the world, by acquiring the latest status symbols.
What do you think? What makes a new phone worth losing sleep and braving the elements to get?
This craze sparks my curiosity...not about what makes the most recent new thing so much better technologically, but about the social psychology that makes people feel so much urgency to lay their hands on it. Why do people who already have fancy smartphones that work quite well wake up at 3am - or camp out for multiple nights - to get a better one?Four explanations come to mind:
1) Boredom - Having relatively short attention spans, and being used to instant gratification (thanks, in part, to technology), we may become bored with our current gadgets even before the new one comes out (and before our 2 year contract ends!)
2) Jealousy - When someone else has better or fancier things, it detracts from our opinion of whatever we have. Something we may have liked suddenly loses its value to us, and we want to upgrade.
3) Competition - We may feel like we will be at a competitive disadvantage if we don't have the most advanced technology. We might get anxious and upgrade just to be on the safe side.
4) Insecurity: Those of us who feel like we are already at a disadvantage in life may try to compensate for it, or "prove" our value and place in the world, by acquiring the latest status symbols.
What do you think? What makes a new phone worth losing sleep and braving the elements to get?
Sunday, July 22, 2012
(Im)perfection
Much media attention in the past few weeks has been focused on the findings of an independent investigation of how Penn State officials handled suspicions of child sexual abuse by former defensive coordinator Jerry Sandusky. As you have no doubt heard, these findings (the so-called Freeh Report) detailed how head coach Joe Paterno, and a number of other Penn State officials, concealed allegations against Sandusky in order to protect the reputation of the football program and university.
In the aftermath of this report, the school has been under increasing pressure to remove tangible signs of Paterno's legacy from the campus. The first thing they did was to paint over a halo that appeared above his head in a mural. Then, today, they removed a bronze statue of him from in front of the football stadium, moving in to "storage." They have said, however, that they do not plan to rename the library building that is named after him.
In the aftermath of this report, the school has been under increasing pressure to remove tangible signs of Paterno's legacy from the campus. The first thing they did was to paint over a halo that appeared above his head in a mural. Then, today, they removed a bronze statue of him from in front of the football stadium, moving in to "storage." They have said, however, that they do not plan to rename the library building that is named after him.
These actions, and the social pressures driving them, bring up an important topic (besides the obvious point that hiding a crime, especially one as depraved as child sexual abuse, is both morally reprehensible, and makes one complicit in the crime). While I do not want to diminish the significance of the latter point, what I find even more striking in all of this is the extent to which popular opinion of Paterno has been...extreme.
First, the degree to which he was idolized and idealized prior to the Sandusky scandal. I mean, there was a halo over his head in a mural! I don't care who you are - none of us is a saint or angel. We're all human. We're all flawed. We do everyone a disservice when we try to turn men into demigods. We do it all the time, with athletes, coaches, movie stars, musicians...and it isn't fair to them or us. It's not fair to them because we end up holding them to unrealistic standards, and respond with undeserved anger when they (inevitably) let us down. It's not fair to us because it establishes an unrealistic ideal, against which we always fall short, thereby contributing to lowering our self-worth.
I am reminded of a useful metaphor used in AA. It draws on religious imagery, but I think the idea applies to all of us. AA's founders advised members to pray "on their knees" as a reminder that we are neither angels or gods to stand before God, nor beasts or demons to prostrate ourselves. We are in between - we are neither all good, nor all bad, but an imperfect mixture.
I think it's important for all of us to accept imperfection in ourselves - and in each other. I'm glad they painted over Paterno's halo, because I don't think any human should be set on that kind of pedestal. However, I'm not sure I agree with removing his statue. Yes, what he did - or failed to do - is bad, and contributed to ongoing victimization of children. However, his faults do not negate or erase his achievements: he was also, indisputably, a brilliant coach, devoted to Penn State. I hope that no one ever decides that any good things I am or do no longer matter because of my failings and flaws!
How can we move toward embracing our own, and each others' imperfections?
Thursday, June 28, 2012
Weight-y Stereotypes
I spend a lot of time telling clients that "people, as a species, are terrible at mind-reading." And, in general, I really do believe that we are notoriously inaccurate when it comes to reading minds.
Typically, I say this kind of thing when a client is assuming that someone is judging them negatively. Now, I work primarily with eating disorders, and people with eating disorders spend a lot of time comparing themselves to other people - but, almost exclusively, compare what they see as negative about themselves to what they see as positive about others. They also tend to assume other people are making similar comparisons, and recognize their inferiority. Because my clients spend so much time thinking that others share their negative view of themselves, I end up talking about mind reading quite often.
However, it turns out that my clients' mind-reading may not be as inaccurate as I have chosen to believe.
There was a segment on the Today Show this week on "the secret ways women judge each other." It presented some disturbing findings about the assumptions we make about each other's character, based solely on weight and appearance. With only their appearance to go on, women were much more likely to describe heavy women as lazy, sloppy, undisciplined, and slow, while describing thin women as conceited, superficial, vain, self-centered, mean, and controlling. AND, women used these descriptions regardless of their own weight - so heavy women still described other heavy women as lazy, sloppy, etc, and thin women described other thin women as conceited, superficial, etc.
This kind of internalized stereotype has a negative effect on our relationships with each other, and contributes to negative self-image and negative body-image. And, as we know from various types of discrimination, widely held negative stereotypes often do leak into our behavior. When it comes to weight, heavier women face very real discrimination, especially in employment, where they are less likely to be hired, and make on average $6,000 (yep) less a year, controlling for all other variables. Think about it: the stereotypes for heavy women don't suggest professional excellence.
Of course, when it comes to clients with eating disorders, mind reading is still inaccurate, since they are not viewing their bodies accurately, and therefore make inaccurate assumptions about how others see them. However, I have a new understanding of where this mind reading comes from: if we're all making so many unfounded judgments about each other, it's really no wonder people get a little paranoid about how they're being judged!
I still think mind-reading is dangerous - assuming we know what anyone else is thinking can contribute to negative mood states, and misjudged actions. However, a real solution needs to address the underlying problem - our tendency to judge and make comparisons rather than showing compassion. That's what we, as a society, should really be focused on changing!
Labels:
Cognitive Distortions,
Culture,
Social Justice
Monday, June 25, 2012
The Role of Group Dynamics in Bullying
There has been a lot of news coverage this week about a viral video of a group of middle school boys verbally harassing their bus monitor, including cruel comments about her weight, age, and the fact she shed tears in reaction to their comments.
Reactions from the public have been split between vilifying the boys, and collecting donations for the bus monitor. In fact, the boys have reportedly received their share of cruel comments in return, including death threats. One of their fathers appeared on the news, stating that he had not raised his son that way, and planned to take the child to therapy to figure out whether there was something more serious going on with him. A clinician who had not met the boys also got on the news talking about sociopathy.
However, before we pathologize these boys (and possibly create a self-fulfilling prophecy), I'd like to encourage everyone to slow down a bit, and not rush to judgment. Yes, the boys certainly did something wrong, and certainly should have known better. However, their behavior needn't be attributed to sociopathy. In fact, it seems much more likely that the boys were demonstrating a perfectly normal, albeit negative in this case, function of a social group.
Please don't mistake this for condoning their behavior, but let's use it as a learning opportunity for all of us - after all, the public exhibited a similar group dynamic against the boys in retaliation! Here is how I understand it:
In social groups, people are motivated to conform to the group's behavior - in other words, each individual adapts his or her behavior to more closely match that of other group members. We all do this, for a variety of reasons: we want to fit in, be liked, or at least not actively disliked; we want to be right (and assume the rest of the group is right); we want to belong - experience ourselves and be experienced by others as part of the group. The pressure to conform is quite powerful. For example, in one research study, Dr. Asch put one participant into a group of confederates (i.e., people helping the researcher, but unidentified to participants as such). Then he showed the group a line, and asked which of three other lines was the same length. It wasn't one of those optical illusions - it was supposed to be obvious which answer was correct, but the confederates intentionally gave an incorrect answer. 76% of participants agreed with the wrong answer at least once, and on average participants conformed with the group about a third of the time. And this was with adults - the pressure to conform, as we know, is much greater for young adolescents!
Sometimes this (natural) conformity leads us in positive directions, and sometimes it leads us in negative directions. What would cause it to be negative (such as group bullying)? There are various theories on what may contribute. In an earlier post on hazing, I described some possible influences, such as groupthink, and social roles. Other factors include group contagion (one person has a negative idea/impulse, which s/he may or may not consider acceptable individually, and others in the group go along with it, which validates it as acceptable to everyone), and deindividuation (people lose their sense of separate from the group, and therefore their independent evaluation of group behavior).
Add to this the boys' developmental stage, which often includes challenging the authority of adults, and I imagine the scenario thus: Somebody says something disrespectful, but not all-out mean. The bus monitor does not respond (perhaps trying to avoid reinforcing the behavior through a response). When the first boy "gets away with " being disrespectful, some other boy wants to look cool/conform, and says something a little more disrespectful. Peers reinforce the behavior by laughing, gasping, whatever - and so it continues to escalate. Each of them probably had at least one moment of thinking "this is wrong," but it was likely followed by thinking "everyone else is doing it, so maybe it's not wrong," or "if I don't at least laugh along, they're going to think I'm a loser; maybe they'll even do the same thing to me!"
I bet most of us have been in situations that felt like this - gone along with something we suspected was a bad idea. So, let's have a little compassion. Let's not use groupthink and anonymity to lash out against these children. Let's teach them, and others, that you don't always have to "go along to get along."That you can't check your moral compass at the door when you enter a group. And that we (as a group) should respect courage rather than conformity...but sometimes we don't.
Reactions from the public have been split between vilifying the boys, and collecting donations for the bus monitor. In fact, the boys have reportedly received their share of cruel comments in return, including death threats. One of their fathers appeared on the news, stating that he had not raised his son that way, and planned to take the child to therapy to figure out whether there was something more serious going on with him. A clinician who had not met the boys also got on the news talking about sociopathy.
However, before we pathologize these boys (and possibly create a self-fulfilling prophecy), I'd like to encourage everyone to slow down a bit, and not rush to judgment. Yes, the boys certainly did something wrong, and certainly should have known better. However, their behavior needn't be attributed to sociopathy. In fact, it seems much more likely that the boys were demonstrating a perfectly normal, albeit negative in this case, function of a social group.
Please don't mistake this for condoning their behavior, but let's use it as a learning opportunity for all of us - after all, the public exhibited a similar group dynamic against the boys in retaliation! Here is how I understand it:
In social groups, people are motivated to conform to the group's behavior - in other words, each individual adapts his or her behavior to more closely match that of other group members. We all do this, for a variety of reasons: we want to fit in, be liked, or at least not actively disliked; we want to be right (and assume the rest of the group is right); we want to belong - experience ourselves and be experienced by others as part of the group. The pressure to conform is quite powerful. For example, in one research study, Dr. Asch put one participant into a group of confederates (i.e., people helping the researcher, but unidentified to participants as such). Then he showed the group a line, and asked which of three other lines was the same length. It wasn't one of those optical illusions - it was supposed to be obvious which answer was correct, but the confederates intentionally gave an incorrect answer. 76% of participants agreed with the wrong answer at least once, and on average participants conformed with the group about a third of the time. And this was with adults - the pressure to conform, as we know, is much greater for young adolescents!
Sometimes this (natural) conformity leads us in positive directions, and sometimes it leads us in negative directions. What would cause it to be negative (such as group bullying)? There are various theories on what may contribute. In an earlier post on hazing, I described some possible influences, such as groupthink, and social roles. Other factors include group contagion (one person has a negative idea/impulse, which s/he may or may not consider acceptable individually, and others in the group go along with it, which validates it as acceptable to everyone), and deindividuation (people lose their sense of separate from the group, and therefore their independent evaluation of group behavior).
Add to this the boys' developmental stage, which often includes challenging the authority of adults, and I imagine the scenario thus: Somebody says something disrespectful, but not all-out mean. The bus monitor does not respond (perhaps trying to avoid reinforcing the behavior through a response). When the first boy "gets away with " being disrespectful, some other boy wants to look cool/conform, and says something a little more disrespectful. Peers reinforce the behavior by laughing, gasping, whatever - and so it continues to escalate. Each of them probably had at least one moment of thinking "this is wrong," but it was likely followed by thinking "everyone else is doing it, so maybe it's not wrong," or "if I don't at least laugh along, they're going to think I'm a loser; maybe they'll even do the same thing to me!"
I bet most of us have been in situations that felt like this - gone along with something we suspected was a bad idea. So, let's have a little compassion. Let's not use groupthink and anonymity to lash out against these children. Let's teach them, and others, that you don't always have to "go along to get along."That you can't check your moral compass at the door when you enter a group. And that we (as a group) should respect courage rather than conformity...but sometimes we don't.
Sunday, May 20, 2012
Hazing Is Not Child's Play
In order to make any significant changes in hazing, I think we have to begin by asking how and why it occurs. Hazing is ostensibly a form of initiation - a way of inculcating the group identity into new members. It is most often associated with fraternities, sororities, athletic teams, and marching bands. However, it may be most commonly performed with military recruits (I know I'm making a controversial claim, here, but what else can we call boot camp, where recruits are subject to physical and mental assault to "break them down?").
That explains the why. What about the how? How do normal kids, with sound moral character and prosocial behavior in most areas of their lives, end up hurting each other in the name of group cohesion? We know that social groups can develop "groupthink" - groups already composed of people with some similarity develop shared faulty reasoning that evolves from pressure for uniformity, and suppression of contradictory opinions. Groups also tend to make riskier choices than individuals, and normal individuals have been induced to behave violently toward others as a result of obedience to authority (as in the Milgram experiment), and as a result of social role and distinction between social groups (as in the Stanford Prison Study).
Other factors that may contribute to willingness to participate in hazing parallel domestic violence. Those who have experienced hazing as part of their own initiation into the group may "identify with the aggressor" - in this case, that means adopting the group identity, and ultimately wanting to be like the people who haze them. They may also harbor some anger, however, and express it through the hazing of the next generation of group initiates, perpetuating the "cycle of violence."
So, knowing that group membership is an important source of identity and esteem for humans in general, and that rites of passage may be particularly meaningful during the transition to adulthood, it behooves us to find other ways for young adults to establish group identities and mark transitions without harming each other. Planned team-building activities provide one avenue, but have not proven sufficient to stop hazing.
Changing the mentality of the whole group is a bigger challenge. The only way I can think of to approach it that has the slimmest chance of working is having adults involved with each group facilitate ongoing, frequent discussion of how the group wants to identify itself, its norms and culture, and its traditions, including initiation. The whole group needs to get to a point of endorsing a violence-free process.
It would go a long way toward this end if we as a culture also work to end institutionalized and sanctioned forms of hazing, such as those employed by the military. We need to shift our collective understanding of group identity to preclude and prevent violence.
For more information, see Cornell's hazing website.
Monday, May 7, 2012
Face Time? Reflecting on Cell Phone Use in Treatment
We have interesting relationships with our phones these days. They keep us continuously connected to one another, least of all by phone calls, and more and more via text, email, social media, and even sometimes "facetime" (like a phone call with video). We live in a world where we expect instant access, instand information, to be constantly reachable, and to reach others constantly. It's almost an addiction.
Given the significance of the phone in our culture, what is its significance for treatment? Here, I'm setting aside the complex question of telephone calls between therapist and client, and simply thinking of the client's phone and what it represents.
There are layers to this question, as there seem to be layers to so many things in therapy. One interesting dynamic has to do with the role of phones in substance abuse treatment. If you've worked with this population, you know that they cannot have their own phones in treatment programs. The reason is that their phones represent a connection to the drug world. Not only do they most likely have contact information for deals and people they used with stored in the phone, but those people most likely also have the client's information, and may call to offer drugs, invite the person to "hang out" (and get high), or to ask the client to get drugs for them.
However, amputating people's phones doesn't really solve the problem. Not only can they still get drugs if they really want to, they also can't get in touch with supports for recovery. They can't call their sponsor, or other people from 12-step meetings, arrange rides to meetings, reach or be reached by their providers. It's always a frustration to me when I work with clients who are in a program and have no phone, because inevitably there is some occasion when they or I have to miss a session, and rescheduling is practically impossible.
Phones can also influence other kinds of treatment, particularly at any level of care other than standard outpatient individual therapy. People on inpatient units typically cannot keep their phones with them, and don't have phones in their rooms, with public payphones the only option. I understand the rationale. In medical facilities cell phones can disrupt certain medical devices, and in psychiatric facilities, there's always the risk that interacting with people from outside could be a stressor and lead to decompensation, or even aggression. However, as with substance abuse treatment, removing phones also isolates people from supports that could help the person stabilize and feel more hopeful about life outside the hospital. And more selfishly on my part, I'd like to be able to reach clients in the hospital, since all too often I'm not even notified if a client of mine is admitted.
In group treatment, phones take on a different role. Since most phones have cameras on them these days, phones represent a potential breach of confidentiality if people take any pictures during treatment. Texting and web access also open the possibility of breaking confidentiality, or even "subgrouping" - contacting other people in the group during or after group to talk about what is going on. However, in psychoeducational groups, phones with web access could be a way to check or gather related information. On the whole, however, phones seem to be at best a distraction, and at worst a way of derailing group process. However, with a large group it may be hard to always know if someone is texting, or just looking at their labs...particularly if the group is sitting around a table.
How do you see cell phones playing into treatment dynamics? Are there particular populations or settings where they seem most positive or negative to treatment?
An like an addiction, we may go through withdrawal if we have to be away from our phones and out of contact. I know that I, for one, get anxious and start to imagine what I might be missing. And I don't even use my phone that much (since it's web applications are too slow!).
Given the significance of the phone in our culture, what is its significance for treatment? Here, I'm setting aside the complex question of telephone calls between therapist and client, and simply thinking of the client's phone and what it represents.
There are layers to this question, as there seem to be layers to so many things in therapy. One interesting dynamic has to do with the role of phones in substance abuse treatment. If you've worked with this population, you know that they cannot have their own phones in treatment programs. The reason is that their phones represent a connection to the drug world. Not only do they most likely have contact information for deals and people they used with stored in the phone, but those people most likely also have the client's information, and may call to offer drugs, invite the person to "hang out" (and get high), or to ask the client to get drugs for them.
However, amputating people's phones doesn't really solve the problem. Not only can they still get drugs if they really want to, they also can't get in touch with supports for recovery. They can't call their sponsor, or other people from 12-step meetings, arrange rides to meetings, reach or be reached by their providers. It's always a frustration to me when I work with clients who are in a program and have no phone, because inevitably there is some occasion when they or I have to miss a session, and rescheduling is practically impossible.
Phones can also influence other kinds of treatment, particularly at any level of care other than standard outpatient individual therapy. People on inpatient units typically cannot keep their phones with them, and don't have phones in their rooms, with public payphones the only option. I understand the rationale. In medical facilities cell phones can disrupt certain medical devices, and in psychiatric facilities, there's always the risk that interacting with people from outside could be a stressor and lead to decompensation, or even aggression. However, as with substance abuse treatment, removing phones also isolates people from supports that could help the person stabilize and feel more hopeful about life outside the hospital. And more selfishly on my part, I'd like to be able to reach clients in the hospital, since all too often I'm not even notified if a client of mine is admitted.
In group treatment, phones take on a different role. Since most phones have cameras on them these days, phones represent a potential breach of confidentiality if people take any pictures during treatment. Texting and web access also open the possibility of breaking confidentiality, or even "subgrouping" - contacting other people in the group during or after group to talk about what is going on. However, in psychoeducational groups, phones with web access could be a way to check or gather related information. On the whole, however, phones seem to be at best a distraction, and at worst a way of derailing group process. However, with a large group it may be hard to always know if someone is texting, or just looking at their labs...particularly if the group is sitting around a table.
How do you see cell phones playing into treatment dynamics? Are there particular populations or settings where they seem most positive or negative to treatment?
Friday, April 20, 2012
Marking Milestones
It seems to be practically instinctive, the marking of milestones. From birth, our parents note our first step, first tooth, first word, first day of school. We learn to do the same, remembering our first kiss, first car, first day of a new job...etc. It's not just "firsts," though. Sometimes milestones are best (or worst) performances, such as athletes' "personal bests." Milestones can also be momentous occasions or achievements, such as graduations, weddings, baptisms and bar mitzvahs, among other events. Finally, milestones can be "lasts" - for example, the last day of school, the last time/place we saw someone, or the last time we did something we've now given up (like one's last drink in AA).
We mark milestones in all sorts of ways. This topic came to me as I followed news coverage of a milestone in my native Red Sox Nation: today is the 100th anniversary of the very first game ever played in Fenway Park. Now, that may or may not be of any interest to you whatsoever. However, it is interesting to note how that milestone has been celebrated. The two teams who played 100 years ago are playing again today...dressed in reproduction 1912 uniforms no less. Everyone alive who's ever been part of the Red Sox organization has been invited back to the park to participate in festivities, and some of the favorites are throwing out ceremonial first pitches. A special fanfare was commissioned to be composed, and is being performed by the Boston Pops. And of course, everyone is telling all of their most memorable Fenway stories.
I think we mark our own milestones in ways that are less sensational, but none-the-less similar. We remember the stories on anniversaries. We use objects as tangible reminders or symbols. Maybe we even try to recreate the experience. All of these acts serve the psychological purpose of meaning making - they help us make sense of our lives, and life in general. They help us see how far we've come, to keep us motivated to keep going. They connect us with one another through time and space.
Similarly, marking milestones can be useful in therapy. Celebrations of important achievements, symbols of where clients have been or where they're going, and markers of baby steps along the way - like chips in AA to mark 24 hours, 30 days, 90 days, 1 year sober - create a trajectory of growth and development that clients can look back on. In doing so, they can better recognize progress that may otherwise be hidden by the tumult of the path, and they continue to "re-author preferred narratives" of their lives.
How do you mark milestones in your own life? How do you incorporate awareness of milestones into therapy?
We mark milestones in all sorts of ways. This topic came to me as I followed news coverage of a milestone in my native Red Sox Nation: today is the 100th anniversary of the very first game ever played in Fenway Park. Now, that may or may not be of any interest to you whatsoever. However, it is interesting to note how that milestone has been celebrated. The two teams who played 100 years ago are playing again today...dressed in reproduction 1912 uniforms no less. Everyone alive who's ever been part of the Red Sox organization has been invited back to the park to participate in festivities, and some of the favorites are throwing out ceremonial first pitches. A special fanfare was commissioned to be composed, and is being performed by the Boston Pops. And of course, everyone is telling all of their most memorable Fenway stories.
I think we mark our own milestones in ways that are less sensational, but none-the-less similar. We remember the stories on anniversaries. We use objects as tangible reminders or symbols. Maybe we even try to recreate the experience. All of these acts serve the psychological purpose of meaning making - they help us make sense of our lives, and life in general. They help us see how far we've come, to keep us motivated to keep going. They connect us with one another through time and space.
Similarly, marking milestones can be useful in therapy. Celebrations of important achievements, symbols of where clients have been or where they're going, and markers of baby steps along the way - like chips in AA to mark 24 hours, 30 days, 90 days, 1 year sober - create a trajectory of growth and development that clients can look back on. In doing so, they can better recognize progress that may otherwise be hidden by the tumult of the path, and they continue to "re-author preferred narratives" of their lives.
How do you mark milestones in your own life? How do you incorporate awareness of milestones into therapy?
Wednesday, March 7, 2012
When Did "Religious" Become a Bad Word?
Yesterday, in the context of a conversation about the Republican primaries, a colleague expressed distrust for "religion." I think she (mostly) meant the religious beliefs on the Presidential candidates, and how these beliefs may influence their politics, but it was worded as a blanket statement about religion in general. I wanted to say, "You know I'm religious, right?" but I bit my tongue.
It never ceases to surprise me how negatively mental health professionals seem to view religion. Because I also have a graduate degree in theology, potential employers have asked me questions based on a range of insulting assumptions: that I will proselytize clients, discriminate against LGBTQ individuals, discourage birth control and/or abortion, or otherwise advance the agenda of the so-called "Religious Right." Now, I went to a Boston school noted for its liberal theology, and (in the same conversation with my colleage) have described myself as left of Democrat. I don't ascribe to any of the social principles of the Religious Right, and it makes me angry that they give everyone who's religious a bad name. However, it also makes me angry that open prejudice against religion is demonstrated - and accepted - in a field that is supposedly open-minded and respectful of diversity. When did "religious" become a bad word?
The profession of social work was begun by religious women - women who were committed to social justice because of their religious beliefs. The staunchest advocates for justice - all kinds of justice - that I've ever met have been people of deep faith. The vast majority of religious people are also respectful of other faith traditions, and do not try to impose their beliefs on others. With that combination - respecting a diversity of beliefs, and working for justice - how can religion be a bad thing?
Thinking about the current Republican candidates: much has been written about Mitt Romney's Mormanism, with a generally negative tenor. However, from what I've seen of his campaign, and through his time as governor, he hasn't based his political decisions on his religious beliefs. In contrast, Rick Santorum is unapologetic about basing his political platform on religious beliefs - with little apparent concern that much of the population does not share his ideology. That is a bigger concern for me. I think it's laudable for people, including politicians, to have faith...but not to impose that faith on others.
I think similarly about the relationship between my own faith and work. I am motivated by my religious beliefs, and related values of justice and service, to do this work, and I came to the work through a sense of calling or vocation. But that's about me - what makes it meaningful for me, and gets me out of bed every morning. It's not about my clients, whom I do not expect to share my beliefs, and to whom I rarely reveal anything about my faith background. In my work, I'm much more interested in what matters to them - what gets them out of bed in the morning.
So, please don't make assumptions about my faith based on the "Religious Right," and don't insult me by suggesting my agenda is conversion rather than service. Let's respect faith as an asset, and not fear it, or write it off as a liability.
It never ceases to surprise me how negatively mental health professionals seem to view religion. Because I also have a graduate degree in theology, potential employers have asked me questions based on a range of insulting assumptions: that I will proselytize clients, discriminate against LGBTQ individuals, discourage birth control and/or abortion, or otherwise advance the agenda of the so-called "Religious Right." Now, I went to a Boston school noted for its liberal theology, and (in the same conversation with my colleage) have described myself as left of Democrat. I don't ascribe to any of the social principles of the Religious Right, and it makes me angry that they give everyone who's religious a bad name. However, it also makes me angry that open prejudice against religion is demonstrated - and accepted - in a field that is supposedly open-minded and respectful of diversity. When did "religious" become a bad word?
The profession of social work was begun by religious women - women who were committed to social justice because of their religious beliefs. The staunchest advocates for justice - all kinds of justice - that I've ever met have been people of deep faith. The vast majority of religious people are also respectful of other faith traditions, and do not try to impose their beliefs on others. With that combination - respecting a diversity of beliefs, and working for justice - how can religion be a bad thing?
Thinking about the current Republican candidates: much has been written about Mitt Romney's Mormanism, with a generally negative tenor. However, from what I've seen of his campaign, and through his time as governor, he hasn't based his political decisions on his religious beliefs. In contrast, Rick Santorum is unapologetic about basing his political platform on religious beliefs - with little apparent concern that much of the population does not share his ideology. That is a bigger concern for me. I think it's laudable for people, including politicians, to have faith...but not to impose that faith on others.
I think similarly about the relationship between my own faith and work. I am motivated by my religious beliefs, and related values of justice and service, to do this work, and I came to the work through a sense of calling or vocation. But that's about me - what makes it meaningful for me, and gets me out of bed every morning. It's not about my clients, whom I do not expect to share my beliefs, and to whom I rarely reveal anything about my faith background. In my work, I'm much more interested in what matters to them - what gets them out of bed in the morning.
So, please don't make assumptions about my faith based on the "Religious Right," and don't insult me by suggesting my agenda is conversion rather than service. Let's respect faith as an asset, and not fear it, or write it off as a liability.
Sunday, February 26, 2012
The Grass is Always Greener...
How many people are spending the evening watching the Academy Awards? (For those of you who live under rocks, that's the Academy of Motion Picture Arts and Sciences annual awards for the film industry, also known as the Oscars). Films, and the people involved in them, are nominated for various awards, ranging from best picture, to best actor and actress, to behind-the-scenes participants like screenwriters and soundtrack. Then, everyone who is nominated gets glammed up and attends the awards ceremony to find out who won.
I think it has a lot to do with a lingering dissatisfaction so many people have with their own lives. A song from Disney's Pinocchio captures the phenomenon:
Much of the media focus is on the "red carpet," which serves as an opportunity to scrutinize the biggest names in the film industry (in other words, "movie stars") as they enter the venue. Tomorrow morning's "news" will tell us who was wearing whom (as in, what designer), who looked great and who...didn't, who was poised and who made a gaff of one sort or another. Hair, makeup, teeth, shoes, handbags, significant others...nothing seems to be off-limits.
Why are we so fascinated with the film industry's "celebrities?"
The grass is always greener in the other fellow's yard
No matter what your life may be, you think your life is hard
If we could pick and choose, and nature wasn't a factor
Here's a bit of news: I'd pick the life of an actor
We look at the wealth, luxury, "fame and fortune" that come with success in the film industry and, well, we get jealous. Particularly in this economic climate, when so many people have problems related (directly or indirectly) to cash-flow, it's easy to envy the rich and famous. How much easier would life be if we didn't have to worry about student loans, or car payments, or mortgage payments, or foreclosure, or health care costs...etc?
Actually, from my outsider's perspective, it usually doesn't seem like the rich and famous are any happier or more satisfied with life than the rest of us. In fact, sometimes it seems like they are often less so. If we think about the number of famous cases of addiction (drugs, sex, gambling - all kinds of addiction), eating disorders, self-harm, domestic violence, divorce, arrests, and untimely deaths...it all points to a remarkable discontent among our so-called "celebrities."
Why might the rich and famous not be enjoying their riches and fame? Beyond the cliched answer that money doesn't buy happiness, it probably has something to do with the pressures of being under constant scrutiny, with strangers passing judgment on everything about them, along with a sense of entitlement (they think they should be happier than is realistic, perhaps), easy access to vices, and a celebrity culture that sanctions unhealthy behavior.
In turn, average people see the glitz and glamour and think that, if they had all that money, fame, and power, all their problems would be easy to resolve. We don't stop and ask ourselves what we would do after solving our current problems - what new problems we would create for ourselves if we found ourselves rich and famous.
Instead, maybe the answer is to practice contentment, not in spite of our problems, but in the midst of them. To accept that a certain amount of discomfort and even pain are part of life...and are actually ok, that we can be happy anyway. To value what we have and find meaning in what we do now, instead of creating an image of someone else's "perfect" life, against which we'll always fall short. Let's give up on having green grass, stop comparing, and start connecting to one another. That's where life's value comes from.
Thursday, February 16, 2012
I'm Skeptical
This is probably one of the most frequent phrases i find myself saying: "I'm skeptical." It's true - I take just about everything with a grain...or sometimes a shaker...of salt.
I haven't always been this way. In fact, I was exceptionally gullible as a child (and was frequently tricked by my father, perhaps contributing to my eventual skepticism). I attribute the majority of my skepticism to two other sources, however.
The first is endemic to the information age. We have almost limitless information at our disposal, some of it from legitimate sources, and some of it...not. It's much easier for anyone to get their ideas out there (take this blog, for instance!). As a result, my first year curriculum at college emphasized making us "critical consumers of information." Where it was enough for our parents to try to find relevant sources for research projects, we were up to our eyeballs in sources and needed to know how to scrutinize the quality of available information.
We're also connected to one another in new ways, through digital access points that also introduce new security issues: cell phones, email, social networking, etc. We have therefore had to learn to be cautious about how we're presenting - and protecting - ourselves, while also paying attention to how we're connecting and with whom. In the last week, news stories have reported teens having pictures taken from the facebook pages and posted on a porn site, as well as an extortion attempt against another teen based on information revealed online. In the same period, I've gotten multiple emails "pretending" to be from a friend, and Paypal, both of wanted me to click a link to enter information. I've also gotten phone calls telling me I've won a prize and just need to enter information. Skepticism is both a natural outcome of, and much-needed defense from, this kind of environment.
The second reason I'm as skeptical as I am is because of the work I do. Yep, I said it. Call me jaded, if you will, but being a therapist has rid me of whatever naivete I had left. I have learned not to equate what someone says with "the truth," both because everyone sees the world through their own (often distorted) lens, and because sometimes people don't tell the truth, even (especially?) to therapists! Defense mechanisms, transference, addiction, delusion, shame, anger, fear, etc., can all lead a client to say things that are distorted, or downright lies. We sometimes euphemistically say that the worst offenders are "poor historians." But, to recognize when things aren't adding up, we have to have our antennae up. We have to be skeptical to be effective. Gullibility can interfere with effective treatment.
That's been my experience at least. As a result, I'm almost always at least a little skeptical. Do you agree? Disagree? How do we strike the right balance of respecting our clients, while also respecting their treatment enough to be...skeptical?
Sunday, January 29, 2012
Embodiment
This culture has a very strange attitude toward the human body. We're simultaneously obsessed with the illusion of health, and the fulfillment (or denial) of physical desires. A vivid illustration of this mass of contradictions is the simultaneous existence of 1) television ads for almost-magical diet and "health" products...juxtaposed with ads for junk foods, alcohol, and of course, the omnipresent "sex appeal;" 2) the high prevalence of obesity...alongside eating disorders.
While the last few decades may have marked a new depth of dysfunction in our relationships with our bodies, the origins of the dysfunction go way, way back - actually, as far back as Ancient Greece. There, we find the first attempts to divorce body from mind and spirit - the first expositions on the ideal of a mind unencumbered by the body's inconvenient needs. I suspect that ideal may have contributed to something else we find in Ancient Greece - hedonism, the excessive pursuit of desires for food, drink, and sex.
(Wait, we're starting to sound a lot like those Ancient Greeks, just with more fancy gizmos, and less respect for philosophy)
It turns out that it's really no coincidence that the ideal of physical denial occurs alongside diametrically opposite behavior. Scientists have studied the impact of various degrees of denial (e.g., dieting) on animals and humans, and have found that denial produces a biological impulse to binge on whatever has been denied. It's like the body says, "wait, I'm not sure when I'm going to get this again, so I better take as much as I can get right now!" And, here's the kicker - the body continues to want to overcompensate for past denial for significantly longer than the denial itself lasted.
That's where dieting often fails - asking your body to function on significantly fewer calories than it needs prompts a biological impulse to binge.
So, what's the answer? What's the message here? Well, we all - clients and therapists alike - need to recognize that, at least for as long as we're here on earth, we are embodied. There's nothing we can do about that. Instead of shooting ourselves in the (metaphorical) foot by trying to outsmart our bodies' basic needs, what if we try listening to our bodies, and giving them what they need? Our bodies are a lot smarter than we are, and tend to tell us when we need to rest, when we need more protein, iron, or vegetables, when we need more exercise. But we have to be listening - we have to be mindfully aware of our bodies to hear the signals they're sending us. And that takes some practice, and courage.
It's worth it, though. Take a leap of faith, and embrace embodiment.
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