A Little More on Conformity vs Resistance

Last week I talked a little about how easily we are influenced by our situations, and I wanted to say just a little more about it this week in response to some email questions I got (send questions any time! I love them!). The topic of obedience, conformity, and resistance has been the subject of numerous books, essays, experiments, and articles, so I'm just summarizing a few bits and pieces:

That shock experiment I referred to last week is almost 50 years old! The question is--has our society progressed at all? We're a lot more nonconformist these days, right? We understand the value of human life. We know our rights. We'd tell that experimenter where to shove that shock box.

Well, this experiment has been replicated as recently as 2006 (modified to meet modern ethical requirements). And guess what?

The results were the same. Most of the participants in the study shocked the "learner" until the highest voltage possible, no matter the participants' gender, ethnicity, age, and education. They all showed similar rates of obedience to instructions to shock the learner.

So--was there anything that made a difference? Yes. People who felt more empathy for the learner's pain showed higher rates of refusal. There's also some indication that people who seek more control over situations will resist. But the replications of that old study aren't the only indication that ordinary people sometimes behave in evil ways:



Abu Ghraib is a tragic, real-life example.

 Here are some conditions that make it more likely that people will conform--even when the outcome is evil behavior:

1. When children are taught to obey all authority (and not specifically instructed that it's OK to disobey unjust authority)
2. When human diversity is not respected (easier to abuse someone you think of as less than human)
3. When people feel anonymous and not personally responsible for their actions
4. When it's not acceptable to admit mistakes
5. When we sacrifice personal freedom for promised security
6. When we tolerate bullying and teasing

More on both conformity and resistance here.

I think Schindler's List is a great movie that shows both the power of resistance and of conformity. If you're in the mood for a documentary, Ghosts of Abu Ghraib examines how American soldiers became cruel torturers. Writers are supposed to be astute studies of human behavior--so we need to understand both internal, personal characteristics AS WELL AS how our immediate situation influences us. I'll bet you folks can come up with other suggestions from books, movies, and real life--please share them!

A brief history of anxiety

One of the books on my reading list is A Brief History of Anxiety, by Patricia Pearson, reviewed here. In it, the author explores her own history with anxiety:

Ms. Pearson married and had children. She has a successful writing career. But the woman she describes can barely hold her life together. One night she dreams that she is lying on a cushioned bench admiring the Grand Canyon. Suddenly she realizes that the bench is attached at one end to a cliff face but is otherwise suspended in midair.

“If I moved even an inch in any direction, I would fall for miles,” she writes. “The choking panic that I felt was extraordinary. I felt a perfect — a Platonic — sense of terror.”

That, in a nutshell, is her situation, one that she addresses through therapy, pull-up-your-socks willpower and a blend of religion and the insights of writers like the cultural geographer Yi-Fu Tuan.

In addition, Pearson uses the book to explore the broader cultural history of anxiety:

Her subject is elusive. Unnamed until Freud coined the term “anxiety neurosis,” the uninvited stranger lurks at the margins of history. When King David, in the Bible, says that “fearfulness and trembling are come upon me,” is he suffering an anxiety attack? Ms. Pearson cites an 18th-century English treatise blaming city living for “a class and set of distempers, with atrocious and frightful symptoms, scarce known to our Ancestors,” that is, “nervous disorders” afflicting a third of the population. Could this be it?

Everywhere and nowhere, anxiety, Ms. Pearson writes, is “unbearably vivid yet insanely abstract.” In many cases it is the fear of fear itself, a free-floating, nebulous entity that, like a mutant virus, feeds on any available host. Reason is powerless against it. Ms. Pearson argues, in fact, that rationalism, intended to banish superstition and fear, has instead removed one of the most effective weapons against anxiety, namely religious faith and ritual.

Even worse, the worship of reason and science, by encouraging the notion that human beings can control their environment, has created a terrible fault line in the modern psyche, although not all societies suffer equally. Mexicans have lots to worry about but don’t. The World Mental Health Survey, conducted in 2002, found that only 6.6 percent of Mexicans had ever experienced a major episode of anxiety or depression. Meanwhile, to their north, 28.8 percent of the American population has been afflicted with anxiety, the highest level in the world. Mexicans who move to the United States adapt, becoming more anxious.

I'd never heard anything like the bit about anxiety rates in Americans, Mexicans, and Mexican-Americans. I'm skeptical; I wonder how much of the result is due to cultural difference. I.e. Are Mexicans culturally less likely than Americans and Mexican-Americans to admit to mental health problems? But the idea that American culture skews towards "the worship of reason and science", and that anxiety rates are higher than they might be otherwise as a result, is an interesting one. In any case, this sounds like a book that's both intelligent and entertaining; I'm looking forward to reading it.

Writing Is Like a River Trip

My blogger friend, the ever-inventive and imaginative and wildly funny Greenwoman, has come up with a new challenge. It's called Writing Is Not Like a Box of Chocolates: A Meme.

These are her rules:
"Take the phrase “Writing is like . . .” and finish it. Post it on your blog. Tag three others to do the same. That is all. See how easy that is?"

I know that Greenwoman expects me to say that writing is like dancing with goats wearing spangly pants, or like battling a woodchuck who keeps taunting me with a blank sheet of paper and rude hand gestures, or like wandering into a drainage ditch wearing my best Lilly Pulitzer frock—but finding a crop of diamonds and a chilled martini shaker at the bottom of the ditch.

There, now I've said all those things to please her, because she deserves it. But I'm going to write something else. Something "not silly" and "not funny." (Hold onto your party hats!) I'm used to being funny, so writing something "not funny" feels like I just tossed my pants into the hog pen and am standing here looking wan and dumb, and the scarecrow is giving me the leery eye. (Maybe this happens on Greenwoman's farm?)

Sometimes I don't gotta be funny. Here you go.

Writing is like paddling a canoe through a tract of waterways as vast as the world. Your boat moves through glades and narrow channels, whisking down rapids. You move north, ever north, through a landscape that you made and lost once in a dream.

At times, the river widens and spills you out onto a great body of water, and you are a small thing under a hollow and terrible bowl of sky. The distant shore cannot be seen, although you shade your eyes with your hand. You pull forward all the same. There is the outlet, there is the way home. The river closes around you once again, and the current takes you.

Sometimes you hear laughter and voices over the hedges that line the banks. One morning a dragonfly settles on the gunwale, and stirs its blue wings. You are lost, quite fully lost, and you know it. You can let the canoe drift in lazy, spinning circles, or you can paddle fierce and hard for the far shore.

Either way, you’ll get there. You will be carried. You will carry yourself, when the drought comes and dries up the riverbeds.

You emerge into a bright patch of sunlight and hear the buzz and fall of summer heat. Sometimes your boat slips down dim alleyways of water lined by stately trees. Sometimes it rains on the big lakes, and you pray you’ll make it home alive.

You might look over the edge of your boat one day and see a gift on the bottom of the shallow river, shot through with light. A bag of stones. A letter from a loved one. A ribbon, a coin, a flash of fish scales in the murk, falling down and down. Trivial, lovely.

You pull up your treasure. Your boat drifts, and the dusk falls. Your hands are dripping with discovery. You wonder: Who put this there? Who left this gift? Then you remember: You yourself dropped that bag of memory into the dark waters. You hid it there. Everything beautiful is waiting to be found.

________

Now I'm tagging three people who shall take this meme and run with it. They are:

Mary Frame
Because her excellent and helpful blog posts about the craft of writing lead me to believe her answer to this will be thoughtful and thought-provoking. (No pressure, Mary--if you want to say that writing is like a jar of pickles and not explain why, you go right ahead.)

Kalen O'Donnell
Because he's crazy! And he threatened me for my ARCs! So now I have him dart-gunned, bagged, and tagged. (By the way, his threats have paid out, and ARCs will be given away next week. Stay tuned.)

Tracey Hansen
Because she will do what I should have done and write something lewd, rude, and soaked in wine! I hope. Yes, please?

Climate Change and Severe Mental Illness Deniers Use a Common Strategy

One topic I discuss on this blog is the tactics used by various advocacy groups to make misleading arguments in their efforts to advance their interests.

There is, of course, a large anti-psychiatry contingent that argues that severe and chronic mental illnesses like schizophrenia and (real) bipolar disorder are not real brain diseases.  They also argue that, since their brains are normal, the abilities of affected individuals to think rationally enough to properly take care of themselves are not highly impaired, so that involuntary commitment and treatment are never indicated under any circumstances. Of course, they seem to make a big exception for people who suffer from the brain disease of Alzheimer’s disease, but that’s another issue.

It recently occurred to me that the argument I have been hearing from those who deny that climate change exists, or that people are contributing to it, is very similar to one that is used by the mental illness deniers. They knowingly set a bar for “proving” the nature of these phenomena that is totally unachievable by science, and then use this ridiculously high bar to assert that, since the science is not "proven," then it is invalid.

In complex phenomena like weather or brain structure and function, the number of involved factors contributing to the final result is enormous, and their interactions unpredictable to a significant degree. Schizophrenia, for instance, is clearly not a disease of the gross pathology of the brain, which is what the deniers insist is necessary for “proof,” but is probably a disease of the interconnections between literally billions of nerve cell synapses that connect one neuron to others. We have no way currently to map out these connections in precise detail, and they change constantly over very short periods of time, so we cannot prove that they are pathological. There is, however, an astronomical amount of indirect evidence that they are.

Similarly, climate change deniers use the fact that the various computer models which predict how the process will unfold differ from one another in their predictions about the exact timing and locations of various expected weather events as evidence that the science is completely flawed. What they completely omit to mention, of course, is that no one is arguing that we have or probably ever will have the ability to predict weather patterns with that degree of precision. They also conveniently forget to mention that all the models point in the same direction, and that the patterns are already happening in ways that are consistent with the more general predictions.

Well, there are a lot of things that science cannot predict with absolute certainty, so we have to go with the preponderance of the evidence. In cases in which the consequences of inaction are enormous, we still have to act without this ridiculously high level of “proof.”

I would argue that allowing the mentally ill to languish in jails or in cardboard boxes on the streets of cities like San Francisco is such an instance. So is climate change that can lead to mass population dislocations with resultant wars, severe pollution, starvation, and the spread of tropical diseases that might kill us all.

I do not know if there is a name for this logical fallacy so glibly employed by science deniers. But there should be!

A 17 year olds Christmas

Once you hit 13 years old you don't get excited about Christmas at all. The fairytale's over, you don't want My Little Pony's princess castle plus accessories anymore, the realisation hits that all camera footage taken WILL be shown to everyone in years to come so you try to act cool, and the thought of being around your family including the weird extended bunch for three days straight fills you with dread. It's just another day as far as you're concerned, just with more food.

A few years before you would've gone bonkers at hearing Noddy Holder (who you thought was THE Noddy) for the first time that year, got goosebumps at seeing decorations in Asda, and pricked up your ears at the creaking sound of your dad opening the loft door to reveal a grotto of red and gold tinsel after nagging him since November. The last week of school used to be the BEST with Christmas dinners, raffles, colouring in, wordsearches, decorating the classroom and giving out tons of cards to your classmates whether you've spoken a word to them or not. But at 13, going to sleep on Christmas Eve is no bother at all. The ritual of "Shall we put some milk and mince pies out for Father Christmas?!" gets a barely audible reply of "Gnmangunga." as you slouch up the stairs to perfect a new Myspace profile picture. Flicking through the TV channels and spotting Christmas With The Kranks would cause you to carry on flicking until you found Extreme Makeover: Home Edition. However the worst symptom of CBAC (Can't Be Arsed Christmas) is getting an advent calendar from your Nan...and eating it all in one go, which should be labelled a CRIME.

Something happens at 17 years old. A tiny Mr Scrooge lodging in the depths of your brain is moved on by tiny elves and leaves a pathway leading right back to Christmases 10 years ago. Flashbacks of constant telly watching, chocolate eating, game playing, present shopping, and adrenaline rushing all come flooding back with a consequence of downloading every Christmas song onto your iPod INCLUDING S Club 7's Perfect Christmas. Then you wrap up in woolly jumpers, scarves, hats, coats and gloves, even though they're not needed, and run to the co-op to buy their 3 for £1 yule logs and the Radio Times Christmas edition, circling every movie and TV special when you got home and making a detailed TV plan whist munching on your 4th mince pie. You don't wait  for dad to get into the loft, stuff it, you go up there yourself because you can reach the ladder now. Sliding boxes down the stairs and forcing your little brother (at 12 he's caught the first stages of CBAC) to help you put the tree up takes a  full day, ending with laying the lights out on the living room floor and unscrewing and switching each bulb to see which is the faulty one. Weekends are spent making up quizzes for Christmas Day, ordering presents from Amazon and quoting Elf. Hauling the Asda catalogue onto the sofa and cutting out everything I want, sorry I'd like, for Christmas, and tomorrow is the big day where me and Matt go to Chelmsford and raid Marks & Sparks, Next and HMV for mum's presents, followed by McDonald's. The plan's already made for the big day. Get up at 7am, run into Matt's room, drag him out of bed taking his stocking too, sit on my bed opening our stocking presents and eating whatever food is contained within them, fling open mum and dad's door and shower them in our stocking presents showing each in detail knowing full well that they got them in the first place but SHUSH don't ruin it. The 15 minute wait then begins while mum puts the turkey in the oven and makes sure everything is ready downstairs before filming us walking downstairs, oh so spontaneously, and filling the room with wrapping paper. I'll then spend hours getting ready, donning any new clothes and jewellery whether they go or not, and start playing Kerplunk. Babe, I'm sorted.

I feel 7 years old again. I'm on www.noradsanta.org every day playing the new games and the thought of tracking Santa on that website on Christmas Eve makes me giddy. We haven't got our icicles up outside yet because it's still icy and I'm getting flicking-on-switches-to-produce-pretty-lights withdrawals. I'm rocking as I'm writing this thinking about the Doctor Who Christmas special, all the comedy specials and the huge soap explosions which are coming our way. Mum's handmade Christmas cards are waiting downstairs for me to add some gold swirly handwriting to, as are the place names for Christmas dinner. Poor old Mr Turkey is in the garage (dead) surrounded by pigs in blankets. I want to play Guess Who, Twister, Snap, Bingo and CHASE THE ACE. I want an S Club 7 2011 calendar and the new Steps album. What's happened to me? God forbid I'm growing out of my hormonal moody teenager phase, I was just getting used to it. Alas, I won't complain, I'll embrace all things Christmassy and carry on. It's alright 13-16 year olds! CHRISTMAS WILL COME BACK SOON! *bundles mum, shoves a mince pie in her face and turns up 4music's Top 10 Christmas Hits*

Youve come a long way baby

I just came across a blog post by an MD in the Times Union of Albany: Medical Mystery Monday #80: the case of the chest pain.

A 24 year old woman comes to the Emergency Room with intense chest pain, palpitations, and nausea. She states she has been feeling this way for about 10 minutes, and took a cab straight to the ER after the onset of symptoms. The patient was sitting reading the paper when the symptoms started suddenly. She states the chest pain is located in the middle of her chest, and worse when she takes a deep breath. The patient has experienced a similar episode two months ago, and her family history is unremarkable

Most readers of this blog know the solution to this medical mystery only too well. The chest pain is caused by a panic attack, a fact noted by the majority of the post's commenters.

In the 1980s, when I had my first panic attack, most doctors weren't trained to recognize them, and how like a heart attack they could feel, and would have discharged the patient after tests showed her heart was healthy. Without a word about the possibility of panic. Either because they didn't know better, or hadn't been trained to say something. And so I went to the emergency room the first time I panicked, and then again and again over the years.

For me, the result wasn't sweetness and light. At the behest of cardiologists, ENTs, gastroenterologists, neurologists, and the likes, I took a parade of medical tests, all of which showed me to be in good health. The cognitive dissonance was jarring: Inside, I was dying, each and every time, yet others -- experts -- told me I was the picture of health. By the time I finally figuring out what was happening, neurosis had slipped into the cracks where confidence had lived before panic came into my life. I was skipping many of the activities I used to love. Sometimes, I couldn't even get myself out of the house and to the corner market for the fear.

The approach in many ERs has evolved quite a bit since then. A neighbor recently told me about a friend who'd just had a panic attack. After the appropriate tests, the ER where she'd gone with what she imagined was a heart attack discharged her, but told her she'd quite possibly experienced panic, and referred her to a mental-health clinic. As this anecdote and the Times Union blog post illustrate, the medical profession has come a long way when it comes to recognizing panic.

Book Review High Price by Dr Carl Hart A Life and the Lies in Drug Abuse Research

For a long time I have been critical about conclusions drawn from animal experiments which purported to be models for addictive behavior with drugs in humans. In particular, I got annoyed hearing over and over about how rats and rhesus monkeys would press levers to get cocaine, heroin, or methamphetamine compulsively, even until they died, choosing drugs over even food and water. These experiments were touted  incessantly by so-called experts. As I mentioned in a previous post, the head of the National Institute for Drug Abuse, Dr. Nora Volkov, even had the nerve to say that rats and humans could have the same phenotype!

My usual response to this was that rats and monkeys do not know about the damage the drugs might do to them, but that humans do, and that makes the comparison ridiculous if not completely preposterous. Furthermore, if a monkey experienced the “crash” that followed stopping cocaine or meth, it would not know that the crash was due to the drug, only that the drug stopped the crash.  And scientists even STILL have had no luck in finding rats who hide bottles of alcohol.

As it turns out, these points, while probably valid, are only minor considerations in determining the lessons to be learned from these animal studies. A far bigger issue was that the experiments were not even accurately or honestly described by those touting them. In an outstanding new book called High Price by African-American neurospsychologist Carl Hart, a faculty member at Columbia University, the author points out that descriptions of the environments in which the animals were kept were completely missing from the descripions, but that environmental factors were key in determining animal drug use behavior.

Dr. Carl Hart

The animals in these experiments were essentially kept in solitary confinement, as they had throughout most of their lives, and had nothing else to do but push the lever!  If they were instead placed in an enriched environment with alternatie activities available and other animals with which to socialize, their “drug-seeking” behavior changed drastically.

A series of experiments that the drug warriors don't want you to know about were conducted in the 1970s, and known as Rat Park. Researchers allowed two groups of rats to self-administer morphine. They housed the first group in stark cages, one rat to a cage. They placed the second group in an “enriched environment,” which offered opportunities to burrow, play, and copulate. The isolated rats drank 20 times more morphine-laced sugar water than those enjoying the Rat Park. These results have been reproduced using both cocaine and amphetamine.

Dr. Hart points out that if you were held in solitary confinement with just one movie to watch, you might watch it over and over. That would not prove that the movie itself was addictive!  In people, when they have appealing alternatives, they often do not choose to take drugs in a self-destructive manner.

Add to the mix of misinformation about drug abuse is the unheralded but monumental effect of racism on both drug use and the prevailing ideas about it.  Legal bans on certain drugs (and not others) were legislated after widespread reporting of highly exaggerated horror stories about drug use by a despised minority:  crack cocaine by Blacks, marijuana by Blacks and Mexicans, methamphetamines by toothless "poor white trash" in Appalachia, and opium by Chinese railway workers. No one was immune from these cultural influences and myths, including the minorities themselves. The Black Caucus in the United States Congress was, originally, solidly behind the huge and unfair differences in the length of jail sentences for people convicted of using crack vs. powdered cocaine, the effects of which drugs are physiologically identical.

Some facts:  The problems in the black urban community attributed to crack were already prevalent well before crack was even introduced. The vast majority of illegal drug users do not become addicted or even psychologically dependent on the drug. Among addicts, half are employed full time. Violent convicts in jails are less likely to abuse drugs than other prisoners. The vast majority of homicides do not involved drug use, and alcohol is probably the worst offender among those that do. Dealing crack is only about as profitable as working at McDonalds for low level dealers. Few people who abuse drugs take only one drug, yet there are very few studies of the effects of combinations of drugs. Self reports from addicts who are asked about their cravings for the drugs do not predict whether or not an addict in recovery will relapse.

Adderall and Methamphetamine are nearly identical molecules with identical effects, yet drug manufacturers go out of their way to say that those children treated with stimulants for “ADHD” are no more likely to go on to abuse drugs than anyone else.  Of course, since their drugs are already being legally provided to them by physicians, they have no need to obtain them from illegal sources, which is one of the measures the experts use to measure drug abuse!

This kind of circular reasoning in the literature abounds. In a series of experiments with rhesus monkeys, Dr. Hart reports, “…researchers found that the animals’ choice to use cocaine is reduced to the size of the food reward they are offered as an alternative.” People are now using this data to claim that junk food is as addictive as cocaine, when initially cocaine was claimed to be “…especially addictive because animals preferred  it to food when hungry.” (p.93).

The book by Dr. Hart is especially eye opening because it combines discussions of this sort of pseudoscience with the author’s explorations about his own personal story. As an African-American having grown up in an inner city in which many of his friends and relatives did poorly and got into drugs and crime, he asks himself why he not only escaped this but became an Ivy League professor and an expert. The experiences of this black man in America shines a bright light on the real causes of self destructive behavior. It is not drugs.

The following graphic is not discussed in the book, but, with what we know about the havoc that a felony conviction and hanging out with convicts for months or years can create in the lives of young men, it is clear that far more harm is inflicted on drug users by the laws against drug use than by the drugs themselves.

By the way, do you know how to abuse drugs? You hold them in your hand and scream at them, “You worthless pile of sh*t!  You call that a buzz?? You suck!” You then throw them to the ground and stomp on them. 

Yeah, it’s the self that’s being abused by addicts, not the drugs. 

You owe it yourself to read this highly engrossing and informative book.

A La Cart!

As a longtime observer of shopping carts in the wild, I was intrigued to discover an influx of foreign carts into our neighborhood. Suspecting that these carts were here not to mix and mingle and learn English, but were bent on bad business, I faithfully recorded their secretive plans and movements and had their comments translated (at considerable personal expense). The startling results reveal rich cultural differences between American and foreign carts. No plots were revealed.

Oh, vous délicieux phallique jaune objet. Je suis violant vous maintenant ! Oui, me violer vous pensez-vous ? Je suis un panier d'achat et suis très amoureux. Va-va-va-voom ! N'est-ce pas?

(Oh, you delicious phallic yellow object. I am raping you now! Yes, do you feel me raping you? I am a shopping cart, and am very amorous. Va-va-va-voom! N'est-ce pas?)

Ich bin Vizened und alt, und Sie werden nicht löschen Sie mich aus diesem Pol. Nein! Nehmen Sie die Hände weg meine Gestricken Kleider! Ich habe Stiefeln im Innern von Mein selbst, und Wille verwenden es, um Ze Sheeet von Ihnen!

(I am vizened and old, and you will not remove me from this pole. Nein! Take hands off my crocheted garments! I have jackboot in interior of mein self, and will use it to kick ze sheeet out of you!)

Gehen Sie weg!

(Go avay!)

Soy un tonto baile. Voy a Remolino y Molinete y mostrar mi tren de aterrizaje a los chicos, y voy a vestir un tutú rosado. Me deja en el Salón de baile!

(I am a fool for the dance. I am to whirl, and twirl, and show my undercarriage to the boys, and I will wear a pink tutu. Show me into the hall where the dancing takes place!)

Yo, man. Pass me een rook. Een rook. Ja. Ik had veel te veel Miller Lites. Fuck. Ik ga te kotsen.

(Yo, man. Pass me a smoke. A smoke. Yeah. I had way too many Miller Lites. Fuck. I'm going to puke.)

The best of PANIC! A Buddhist perspective on coping with anxiety

I've decided it's time to occasionally republish the more popular PANIC! posts from the past so that newer visitors to this blog will get a chance to weigh in on them. Following is the first such blast from the past, complete with comments to date (you can view the original post here). Please feel free to join the conversation!:

A Buddhist perspective on coping with anxiety.
The website of the Buddhism Society at Brown University has an article by Venerable Thubten Chodron entitled "Dealing With Anxiety" [note: this article is now available here], which posits that anxiety is caused by our natural inclination towards self-centeredness:

If somebody else's car gets dented we say, "Well, that's too bad," and forget about it. But if our car gets dented, we talk about it and complain about it for a long time. If a colleague is criticized, it doesn't bother us. But if we receive even a tiny bit of negative feedback, we become angry, hurt or depressed.

Why is this? We can see that anxiety is very intricately related to self-centeredness. The bigger this idea that "I am the most important one in the universe and everything that happens to me is so crucial," is, the more anxious we are going to be. My own anxious mind is a very interesting phenomena. Last year, I did a retreat by myself for four weeks, so I had a nice long time to spend with my own anxious mind and know it very well. My guess is that it's similar to yours. My anxious mind picks out something that happened in my life -- it does not make a difference what it is. Then I spin it around in my mind, thinking, "Oh, what if this happens? What if that happens? Why did this person do this to me? How come this happened to me?" and on and on. My mind could spend hours philosophizing, psychologizing and worrying about this one thing. It seemed like nothing else in the world was important but my particular melodrama.

When we are in the middle of worry and anxiety regarding something, that thing appears to us to be incredibly important. It's as if our mind doesn't have a choice -- it has to think about this thing because it's of monumental significance. But I noticed in my retreat that my mind would get anxious about something different every meditation session. Maybe it was just looking for variety! It's too boring to just have one thing to be anxious about! While I was worrying about one thing, it seemed like it was the most important one in the whole world and the other ones weren't as important. That is until the next session arrived, and another anxiety became the most important one and everything else was not so bad. I began to realize it isn't the thing I am worrying about that is the difficulty. It is my own mind that is looking for something to worry about. It doesn't really matter what the problem is. If I'm habituated with anxiety, I'll find a problem to worry about. If I can't find one, then I'll invent one or cause one.

One means to coping with anxiety is to adopt a perspective that goes beyond just yourself:

By meditating on the kindness of others, we will see that we have actually been the recipients of an incredible amount of kindness and love from others. In doing this meditation, first think about the kindness of your friends and relatives, all the different things that they have done for you or given you. Start with the people who took care of you when you were an infant. When you see parents taking care of their kids, think, "Somebody took care of me that way," and "Somebody gave me loving attention and took care of me like that." If nobody had given us that kind of attention and care, we wouldn't be alive today...

...Think about the incredible kindness we received from those who taught us to speak. I visited a friend and her two-year-old child who was learning to speak. I sat there, watching as my friend repeated things over and over again just so her child could learn to speak. To think that other people did that for us! We take our ability to speak for granted, but when we think about it, we see that other people spent a lot of time teaching us how to speak, make sentences, and pronounce words. That is a tremendous amount of kindness we have received from others, isn't it? Where would we be if no one taught us how to talk? We did not learn by ourselves. Other people taught us. Everything we learned throughout childhood and everything we keep learning as adults -- every new thing that comes into our lives and enriches us -- we receive due to the kindness of others. All of our knowledge and each of our talents exist because others taught us and helped us to develop them.

It may or may not help you achieve enlightenment, but this sure seems like worthwhile advice.

Hitting a Nerve

So I had a nerve block done yesterday, and I feel worse than ever!

After the procedure, I woke up my face was on fire, my head felt like it was trapped in a vice and I screamed out with pure agony. I was told not to expect it to work straight away, if it worked at all. I had the nurses shove an oxygen mask on my already throbbing face, which caused electric shocks to bounce around my head. They must have thought I was nuts, but I was in such pain I couldn't speak. 

Sometime later, I calmed down. I suspect I was given something, because my blood pressure was sky high. The tightness in my head lessened a little, and as soon as I could stand, and with the doctor's blessing, I left the hospital. There was no way in hell I was going to stay any longer than necessary. 

During the long drive home I slept a little, the anaesthetic kept knocking me out. I got home and I suspected that the block had failed. On top of my usual nightmarish pain, I felt like I was hit around the head with a crowbar. I could feel some numbness on the top of my head, but this morning it was gone. I am so disappointed, and confused. Why aren't any of the medications or procedures helping me? 

Trigeminal Neuralgia is such a monstrous condition, it's so difficult to treat and there is no cure. I am not giving up though, there HAS to be something the doctors can do! They are the absolute best in their fields and I have faith in them. 

I have been told that there may be a Migraine element to my pain, and until I see that particular specialist (I got an appointment for November,) I won't have any answers. If I suffer from migraine's too, and I really suspect I do, I may finally get some medications that will help both my Atypical Trigeminal Neuralgia and Migraines. 

Fingers crossed, and perhaps the block will take effect after all. All I have got is hope. 

H - Hold 
O - On
P - Pain
E - Ends 

Can a website help you better manage your anxiety and panic

Maybe sometimes you get so scared you think you're going to die. Or maybe your head jitters with anxiety, or wondering whether life is worth living makes it hard to get out of bed.

What do you do? Steps taken by people with panic, anxiety, and/or depression include psychotherapy, cognitive-behavioral therapy, SSRIs, benzodiazepenes, exercise, meditation, and biofeedback -- and that's just the start of the list.

But do any of them actually work?

Typically, at PANIC!, we've addressed questions of treatment efficacy via discussion of information from "official" sources -- published research studies, for instance.

Sites like CureTogether and patientslikeme offer a new and exciting source of information about what ails you, from the type and severity of the symptoms that others report, to the popularity and perceived efficacy and side effects of a wide range of treatments.

By submitting information about yourself (anonymously), you can help strengthen the database of knowledge about health problems -- and maybe learn about a treatment that could work for you.

If nothing else, these sites remind us that we're not alone. (On one of the sites, I actually found an example of someone who's also panicked while meditating!)

A Culture of Compassion

This weekend I have a little break in the Sanctum blog tour, and I want to shift back into my usual blogging habits to post on something a lot of folks are talking about, and with very good reason.

Bullying and harassment.

In this post, I'm speaking specifically about this phenomenon within our writing, reading, reviewing, publishing, blogging, book-celebrating community (because the topic in general is massively broad and can't be addressed in a single post!)

October is Bullying Prevention Awareness Month. It's a chance for all of us to sit down and ponder this phenomenon. It's not new, and no one's arguing that it is. However, the reach and impact of bullying and harassment has clearly been intensified by technology, like so many other aspects of our lives. We're connected to each other 24/7, and we can speak to people who are thousands of miles away as easily as we speak to our neighbors, classmates, colleagues, and family. That brings a lot more people into our worlds, but in a very particular way: none of us have to look each other in the eye.

First, a definition. Bullying is not a synonym for criticism. It's just not. Bullying is an abusive, coercive behavior with the intention to intimidate or control its target. This is a repetitive behavior, not a one-time occurrence. Often there is a power imbalance. When this is happening online and between adults, it's called "cyberharassment" or "cyberstalking". In technical parlance, "cyberbullying" is a term reserved for when the victim is a minor.

There have been many research studies on what makes for effective bullying prevention. You know what I've noticed? One factor seems to be a key determinant in stamping out bullying or harassment within a system, be it a school, a workplace, or any other venue: CULTURE.

If the culture or climate of a place tolerates bullying/harassment or reinforces it, whether through active participation or silent complicity, cruelty will thrive.

In light of that, I have a few suggestions to help promote a culture of compassion while preserving our discourse. And I'm going to assume I'm talking to people who are not actively engaging in bullying or harassment. I also want to specify that I'm speaking not as someone who is above this fray, but as a member of this community. Everything I say below is something I'm working on doing, not something I've got down pat.

BE THE CHANGE YOU WANT TO SEE. Obviously, those aren't my words (they're Gandhi's). But I had to open with that because it's so powerful: We can't stamp out bullying if we don't carefully guard our hearts, mouths, and typing fingers from spewing hatred. And if we start to do this, we can step back from it--we can change our behavior. We can speak to each other with civility and respect while still disagreeing. It's not always easy, especially online where the emotional consequences of our actions are largely invisible to us. This means we also need to support each other to keep things cool. If we fire each other up in hatred, we're not helping--we're hurting. One truly awesome example of someone who uses her power for good is Maureen Johnson. I've become a huge fan of hers as I've watched her deal with people online with constant respect and measured civility, even when she vehemently disagrees with them. It's lovely to watch. It can't always be easy for her, but her online persona is an example of how to extend grace to others while being strong and assertive.

DON'T GO THERE. In the online world, it's clear that pageviews often reinforce bullying/harassing behavior (I've seen harassers say this themselves). The person who is harassing sees how much traffic s/he's getting and takes it as a sign that people are enjoying watching the spectacle. Refusing to give someone an audience, as hard as it is (because outlandish, incendiary stuff is sometimes morbidly entertaining to read, right? I admit my own guilt in this--I might read something and shake my head, but I'm still providing an audience, and I've been trying to stop that recently). Let's help each other resist providing a constant source of attention directly to the behavior we'd like to see go extinct.

SUFFOCATE THE FIRE. Let's not speak directly to online bullies/harassers. Truly.  If you engage the harasser in a flame war, you're not helping. That kind of intense connection often fuels bad behavior and sometimes costs well-intentioned people the moral high ground. We can't fight hate with hate. If you feel yourself getting riled up and wanting to rage, STEP AWAY FROM THE KEYBOARD for at least several minutes. I'm not saying "stay silent." I'm just suggesting we direct our energy elsewhere, in a constructive way that will reduce harassment rather than intensifying it.

REACH OUT. If we witness someone being harassed and intimidated, let's reach out. THAT'S where we can put our energy. Especially to those who are vulnerable and not necessarily shiny, not popular, not established. Let's let them know they are worthy of time and compassion. Let them know they matter. Let them know they are deserving of peace. We shouldn't be shy about telling others that we're happy to be sharing the world with them and that their voices can be heard. In fact, let's not wait until someone gets bullied to do this. Let's get in the habit of doing it now.

SPEAK OUT. If we do see bullying or harassing behavior, let's label it and say that it's unacceptable. Alert authorities if applicable (website administrators, law enforcement under certain circumstances, advocacy groups). And if you are being bullied or harassed, do say so! A powerful example of this is Cassandra Clare's recent post about what she's gone through lately. She explains in detail what's happened to her--but makes it clear that talking directly to these harassers is not the thing to do. She differentiates between criticism of her books (which is not bullying or harassment) and what the people who are cyberharassing/cyberstalking her have done (whipping up outrage against her using false rumors and accusations, revealing personal details about how to find her, and a few other nasty things). She refuses to remain silent, but she channels all her energy into directing people to respond appropriately.

What say you? Shall we follow her example? Shall we openly and explicitly commit to a culture of compassion? Shall we support each other in civility and empathy (including forgiving the occasional slip up when it is accompanied by a commitment to re-engage in a kinder, more appropriate manner)? Shall we reach out to those who are vulnerable, and model treating every member of this community as worthy to share it with us?

So many of you can say this better than I can, and so many of you already do this more than I do. And so I will also say this: thank you for being good examples, and for being brave and speaking out. I am grateful. You inspire me to be better.

My Royal Parks Half 13 1 a comedown

It's been nearly two weeks since I ran a half marathon. My first. 13.1 miles. One of the best known half marathons with the prettiest and most popular route through four of London’s eight Royal parks: Hyde Park, Kensington Gardens, Green Park, and St James’ Park, with a handful of London’s best landmarks in-between. I ran the whole way, I never stopped or even walked, and I finished in 2 hours 48 minutes which shaved 12 minutes off my expected time of 3 hours. I did, you could say, a bloody great job.

So why, then, have I been monumentally grumpy and sad and frustrated in the fortnight since I crossed that finish line after a 400m sprint (just saying)?

When I imagined the time post-race I thought it would mimic my post-Vitality British 10k in July; I’d be full of adrenaline and positivity and pride and determination to do more and more and more. That’s how I signed up for the Royal Parks Half in the first place. I was high on success, tried to open a recipe for an extortionately cheesy and carb-filled pasta dish, but slipped and ended up pledging to Alzheimer’s Society that I’d raise £500 for them by running 13.1 miles. Less than 12 hours after running my first ever 10k.

And sweet Lord, don’t get me wrong, I was bloody chuffed when I crossed that finished line in Hyde Park. I hadn’t put any pressure on myself and I’d done what I set out to do: run a half marathon without stopping. I didn’t push for a time, I didn’t have any competition in my sights, and I didn’t give a merry fuck what I looked like around that course. Red, sweaty, slumped over, angry-looking, and slug-like, if you were wondering.

It hurt though. Obviously. It’s a very long way, 13.1 miles, and I ached in places I didn’t know I would ache… 

…

Ok, my fanny felt bruised. Like someone had punched it. For real. Why didn’t anyone tell me that could happen? Should it happen?! WHO KNOWS. 

But I was fine and very much looking forward to a bath. The aches and cramps and suspicious searing pain in my left foot would dissipate after a LUSH sponsored bubble bath, lots of pasta and a good sleep.

The next day I ended up in A&E.

Of course. 

In hindsight, going to County Hall/The London Eye for a big World Mental Health Day event to talk, one-to-one, with The Duke & Duchess of Cambridge and Prince Harry about my London Marathon plans the day after running my first half marathon was… questionable. 

I ended up in tears as I walked/hobbled from Waterloo Station that Monday morning. My foot was in agony. But I was too proud and too embarrassed to show it so I walked as normally as possible with a big smile on my face until the event was over and Ryan met me to carry me to A&E.

It was ridiculous and I was so angry. I felt like I was wasting the NHS’ time and money, but thankfully I was out within two hours with instructions to rest and work from home for the rest of the week. I could have had a stress fracture but apparently they don’t show on x-rays for 7-10 days after the ‘incident’ so mine was clear. 

Thankfully it’s healed and I haven’t needed to go back for a second x-ray. I still have no idea what happened but it’s definitely not broken, so. Good.

But that fortnight of resting and, more importantly, not running has been the most miserable fortnight I’ve had in a while. Not only have I not been able to run, but I’ve taken the injury as a personal attack on myself. I’ve beaten myself up horrendously as I’ve winced around the flat and watched running friends bask in the glory of the half marathons they’ve completed up and down the country over the last few weeks. This has pretty much been my thought process:

1. They’re fine, why weren’t they injured?
2. Bastards.
3. …
4. They did it in well under two hours.
5. Nearly three it took me. 
6. …
7. Pathetic really.
8. I obviously wasn’t ready.
9. Why did I think I could run a half marathon? 
10. Look at me.
11. …
12. My foot hurts.
13. Ow.
14. Those half marathon photos are horrendous. 
15. Look at my body shape, what even is that.
16. *pokes stomach fat*
17. *punches foot*
18. Ow.
19. …
20. They’ve already been for a 5k run?!
21. IT’S BEEN TWO DAYS, YOU BELL.
22. …
23. My foot hurts.

etc. 

So, I’ve learnt a lot. I’ve learnt that:

• I hate being restricted from doing things, especially running. 
• I’m very good at attacking myself for something that is totally common.
• I’m still incredibly good at flip turning my mood upside down.
• Ditto unncessary spiralling and catastrophising.
• I hate people saying nice, encouraging things to me when I’m feeling so sorry for myself.
• I always put pressure on myself no matter what I consciously think.
• I have bad trainers.
• I’m bad at being sensible and following doctors’ orders (I managed to work from home for one day). 
• My overachiever days as a kid are most certainly not over.

They sound like mostly bad things I’ve learnt, but they’re not. They’re just things. The only rule with classing them as just #things is: I’m allowed to feel sorry for myself but I can’t continue to feel sorry for myself. I still want to mope and feel bitter and jealous, I still want to hate my body and think I’m not good enough for all this running, but I can’t and I won’t. It’s not fair. 

I ran a half marathon. I ran the whole 13.1 miles, did a sprint finish, and crossed the line in under 3 hours. I injured my foot and had to rest for a fortnight but that’s ok, it’s a runner’s right, I’m learning, and I’ve got a full marathon to train for so I’m carrying damn well on.

I’m doing, you could say, a bloody great job.

A tsunami of new hikikomori another lost generation in Japan

According to one recent article, "Given that the earthquake and its aftermath will likely bring pre-existing cases of hikikomori to clinical attention for the first time, and cause brand new cases as well, Japan will face an unprecedented need for psychiatric services, far more than would be expected in similar crises in other countries."

And what's a hikikomori? A 2006 NPR piece describes them as "mostly young men who lock themselves away in their bedrooms, fearful of society's expectations."

Sounds like a different flavor of agoraphobia.

Image source.

When and How Can a Parent Stop Parenting

In her column of 9/13/09, a letter writer asked Dear Abby:  “At what point does a parent stop giving unsolicited advice? It is painful to watch my "child" repeatedly make choices that aren't in her best interest.”  The writer's daughter was 43. 

After describing some self-destructive behavior by her daughter, the writer added, “Although I am trying to keep my mouth shut, she tells me she "feels" my disapproval… Must I duct tape my mouth shut?

The relationship between parents and adult children is by its very nature a bit of a mine field. In order to rear their children properly, parents have to discipline them. Parents have to tell children what to do, what not to do, and how to behave in various social situations. Parents have to find ways to make their children follow these parental directives. Good parents continually set limits with their children.

The difficulty is, when is this supposed to stop?

Does the child suddenly become capable of making his own enlightened choices by virtue of having lived eighteen years? Should parents ignore the wisdom of their added years and never advise their adult children about anything? If the parents do persist in giving counsel, how upset are they going to be if the child chooses not to follow their sage advice? If a parent suggests a course of action over a particular issue, will the adult children feel infantilized?

Even with peers who are not relatives, the issue of when and when not to give advice can get to be problematic.  In Eric Berne’s psychotherapy model, transactional analysis, he shows how asking for and giving advice can become a “game.”  On the surface, two people may seem to be engaged in an “adult to adult” conversation, but the subtext may be entirely different.  One member of the dyad may be acting like, say, a helpless yet petulant child trying to frustrate the other member, who may be acting out the role of an exasperated parent who thinks he or she knows what is best for the other person.

A game people play

When the two parties actually are parent and child, the question of whether or not there is a hidden agenda being acted out becomes that much more complicated.  The parents may claim that they are “just expressing their opinion,” while the adult children feel like they are being told what to do as if they had no valid opinions on the subject themselves.  Is the parent’s advice merely an opinion, or is it a directive (a commandtelling the child how to behave)?

 

Unless parents and adult children are adept at metacommunicating about this issue (talking about the way they talk to one another), tension is bound to develop.

This situation becomes compounded exponentially in those situations where the parents themselves are highly conflicted about the advice they give.  They may be unsure of and unhappy with their own choices in life, but cannot admit that even to themselves - let alone to their adult children.

In such a case, two events frequently transpire: the parents bring up the issue involved rather often — because they are themselves preoccupied with it — and they give out a double message.  The offspring often interpret the advice to mean “Do it because I did,” but almost simultaneously, the way the advice is given may also have elements suggestive of “I hope you don’t have to do what I did and become miserable like me.” Whenever this chain of events takes place, a question about the motivation behind the parental advice giving is invariably created for the child.

The child must choose between two possible presuppositions. As mentioned, either the advice is meant as a directive or is merely the parent's opinion about a controversial issue. The frequency of the advice giving will most usually indicate to the child that how he or she behaves is a matter of grave concern to the parent. Therefore, the younger family member will presuppose that the parent's statements about the issue are directives or instructions.

But which part of the double message should the children heed? In situations where the advice is given ambivalently or is part of a double message, they will then make an effort to determine, using principles of ordering environmental cues that I describe in my book, Deciphering Motivation in Psychotherapy, which side of the double message to follow.

  

Consider the example from that book of a woman I will call Trudy and her mother. Trudy was having all kinds of anxiety symptoms over making a decision to really commit to her boyfriend.  Her mother had said on numerous occasions that "marriage is a mixed blessing: one has to take the bitter with the sweet."

One could interpret this as sage advice on the wisdom of not expecting perfection and retaining one's equanimity in the face of unavoidable adversity. Nothing in the lexical content of the statement indicates that Trudy's mother was commanding her to behave in any particular fashion or make any particular choices regarding marriage or spouse selection. The statement can be viewed as an expression of the mother's opinions about life and as good advice - nothing more.

  

On the other hand, the fact that the mother seemed compelled to drive this point home by repeating it over and over again suggested otherwise. The statement began to sound like a warning: "You'd better watch out! If you get married, you'd better be prepared for all the bitter you're going to get along with any sweet!" Every time the mother would talk about the good points of relationships, she seemed to be throwing in a warning about it.

Not only that, but her frequent repetitions indicated to the daughter that the mother was very concerned about whether the message had been heard loud and clear by Trudy. Perhaps she was worried that Trudy had not understood it the first twenty times it was said.

  

Naturally, Trudy began to worry about the consequences of getting involved with men. She became concerned not only that she might be in for a rough time, but also, for some reason, that her mother might become very upset about it. What Trudy did not realize was that the mother's repetitions indicated that she was trying to convince herself, not Trudy. In any event, the motivation presupposed by the mother's statement was in question, and the patient had been forced to guess what was correct. A good therapist would be alert to the possibility that Trudy may have guessed wrong.