We’ve got to stop meating up like this

I’ve been a vegetarian (meat – no, eggs and cheese – yes) for over 35 years, for well thought out moral, environmental, and health reasons. I very rarely talk about it. I basically do not proselytize on this subject. That changes, now, and here. I’m going to talk about it, and I want you to think about it. Suddenly, it matters, as you’ll see.

EATING AS A MENTAL HEALTH ISSUE?

A long time ago, someone who’d been born into luxury and comfort and safety discovered that no one can really escape the fact that life hurts. All of us come to sickness, pain, loss, and death. Or, as it is said that he put it: All of us come to unavoidable suffering. (This person, of course, was Siddhārtha Gautama, more commonly known as “the Buddha“, this being an honorific term translating approximately as “sage”, “wise one”, “enlightened one”.

One of the more interesting things about the Buddhist moral tradition is its concern for the suffering of all beings. In our own time, formal mental health intervention is one of the ways we deal with human suffering, along with medical/surgical interventions, etc. At various times, the tide of human suffering has advanced and retreated. It’s about to advance, again, it appears, and what we eat has something to do with this, as you’ll see.

CLIMATE CHANGE AND STRESS

The fast-approaching climate change crisis has already begun affecting people in the lowlands of Bangladesh and some of the island nations of Polynesia, due to threatened and actual rises in sea levels, and increased frequency of typhoons (we call them hurricanes in the USA).

Imagine the impact on your life if rising water chased you permanently from your home, without hope of return in your lifetime or that of your children. You’ll become a climate change refugee. Where will you go? What will happen to your way of life, to the hopes you had for your children?

At the purely human level, this is about exorbitant levels of stress. In sociology, it is well known that in stress-impacted families domestic violence rates go up, sexual abuse rates go up, divorce rates go up, mental illness rates go up. and so on. That’s quite an impact for something that can be traced to small changes in the percentages of certain gases in our planet’s atmosphere.

Now imagine that this mental health challenge is quite significantly related to what you eat, daily. As it turns out, this is true. It’s highly likely that the oceans will rise around four feet in the next century. That will impact coastlines all over the world, because it’s on coastlines where most of the world’s population lives. The impact of storms will be very much increased.

In the USA, large areas of Florida may become to dangerous to live in. New Orleans, Washington DC, New York City, and other major population centers will become at high risk for catastrophic storm damage. Many parts of the world, including in our own country, will have to deal with millions of climate change refugees.

A one meter rise (four feet) in ocean level is estimated to probably create 20 MILLION climate change refugees in Bangladesh. Where will they go?

THE RELATIONSHIP BETWEEN WHAT WE EAT AND CLIMATE CHANGE

Now, let’s talk about what we eat. To put it plainly, what you choose to eat can have a huge impact on the mental health of others (as well as your own health), through the mediating factor of climate change. I want you to understand the relationship better.

Here is an article in which a British Lord, a well-informed, well-placed fellow, says some things to say about the relation between industrial meat production and climate change, something about which we’re going to be hearing much more in the near future.

• ‘‘People should give up eating meat to halt climate change“

The point he makes is that among the lifestyle changes we need to seriously consider are some that have nothing directly to do with fossil fuel consumption. With industrial meat and milk production, methane gas is the problem, not carbon dioxide. (This is more generally known as “natural gas” – yeah, the stuff people can cook and heat with.)

This aspect of the climate change crisis – the methane produced by the meat/dairy industry – is not well known…yet. I’ve know about it for about a year.

METHANE IS NOT YOUR FRIEND!

Here are some basic facts you should know about methane as it relates to climate change, with some quality documentation:

• Methane is lighter than air, and is naturally produced in a variety of ways, including the decay of organic matter in low- or no-oxygen environments. One of those environments is the digestive tracts of rumiant animals (cattle, etc.) Such animals produce “16% of the world’s annual methane emissions to the atmosphere”, [1]
• “The livestock sector in general (primarily cattle, chickens, and pigs) produces 37% of all human-induced methane”. [2] (quoted in [1])
• “Methane is a relatively potent greenhouse gas with a high global warming potential… Methane in the atmosphere is eventually oxidized, producing carbon dioxide and water. As a result, methane in the atmosphere has a half life of seven years.” [1] (The core reference used here is [3])

OTHERS DIE SO THAT YOU CAN EAT AS YOU LIKE

An additional aspect of this mess, which is worth mentioning, is that to produce one pound of edible protein from a cow, that cow must consume 22 to 26 pounds of vegetable matter. Feed that matter (or similar crops more suitable for human consumption) directly to people, and you can feed roughly 20 people instead of one. [4] Now you know one of the two reasons I stopped eating meat over 30 years ago.

This doesn’t matter, of course, if you think that the death of a little brown/black kid from nutritional inadequacy (it sounds so benign, yes?) doesn’t matter as much as the death of a little white child. Most people don’t have to think about this, of course, thanks to the blessings of the “out of sight, out of mind” phenomenon.

But…I’m asking you to think about it. At some point the relationship will become unavoidably obvious. Imagine the impact on your mental health if you have someday to realize that you could have done something about this problem, personally, but just walked on past the opportunity, as if it didn’t matter.

START SMALL…KEEP GOING

A final thought: It doesn’t have to be either/or. Simply reducing the amount of meat you eat will be helpful. You can walk slowly toward omitting it entirely from your diet. And you should know this: the concern expressed in Lappe’s book [4] for correct mixing of vegetable proteins to simulate meat protein turns out to be unnecessary. I gave that up a long time ago, and just eat a variety of vegetarian protein sources. My health is,  and has been, excellent. Dr. Andrew Weil confirms the legitimacy of this more relaxed view of the protein sufficiency of vegetarian diets. [5]

It’s easier than you think to do the right thing – for the health of your body, for your eventual mental health, and for the mental health of large numbers of people you’ll never meet. You can do this simple think yourself, and tell others about it. You might even send them here to read this.

References

[1] “Methane” (Wikipedia article). Downloaded 2009.10.26 from http://en.wikipedia.org/w/index.php?title=Methane&oldid=322309918 – mostly a chemistry article, but with some good summaries and references relevant to the industrial meat/methane issue.

[2] Livestock’s long shadow: environmental issues and options. Food and Agriculture Oorganization of the United Nations
Rome, 2006. Downloaded 2009.10.26 from http://www.fao.org/docrep/010/a0701e/a0701e00.HTM A PDF download version of this is available here: ftp://ftp.fao.org/docrep/fao/010/a0701e/A0701E.pdf (for broadband use only – it’s a large file).

[3] Chapter 2 of: Climate Change 2007: The Physical Science Basis. Contribution of Working Group I to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change. This is a section of the most recent publication of the Intergovernmental Panel on Climate Change of the United Nations Environment Program (UNEP) and the World Meteorological Organization (WMO). This group of 500+ scientists of international stature was established “… to provide the world with a clear scientific view on the current state of climate change and its potential environmental and socio-economic consequences.” (http://www.ipcc.ch/organization/organization.htm)

[4] Frances Moore Lappe. (1991). Diet for a Small Planet. New York: Ballentine. This is the book, originally published in 1971, which turned me into a vegetarian. I bought a copy on the way out of town, leaving the University of Colorado with a fellow graduate student to go deer hunting in Montana. I went along as a  “participant-observer”. I helped skin and dress 5 deer. The amount of sheer wastage we produced was staggering to me. I had no idea meat production involved such waste, and this was only in the butchering part of the process. It was an incandescent experience. The book gave me the rationale for my diet-change, but this experience gave me a good part of the motivation. I’ve never looked back, in 35+ years. What’s to miss?

[5] Weil, Andrew. (2001). Eating Well For Optimum Health: The Essential Guide to Bringing Health and Pleasure Back to Eating. New York: Harper.

Frances Moore Lappe (Author)

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:: Leaving therapy – and it’s not your choice?

(This post was written at the suggestion of two people who commented on . Leaving therapy – so what’s the problem?)

Sometimes therapy ends, and it’s not your (the client’s) idea at all. I have no statistics on how often this happens, and I don’t know how this happens, when it does.  I do know that sometimes therapists move to another  location, or financial support for the therapy ends, or maybe a spouse moves, taking you to another location for reasons not deriving from anything you planned.

While I cannot address all situations, perhaps I can address some of them.

THERAPIST TERMINATES YOU

This can happen if they come to believe that they are not the one to be providing services, or if they don’t think you are getting enough out of it, or are in therapy for reasons other than that you are wanting, and able, to do meaningful work. In any case, it not at all a common event. I’ve never done it. I don’t think I have much to say that might be useful, in this case, except that the best thing to do, if you want to continue, is find another therapist – and to learn as much as you can about the reasons for the termination, so you can make use of the information, if possible.

FUNDING ENDS

The involvement of “managed care” brings in 3rd party service utilization reviewers, whose job it is to minimize spending of money for treatment. This makes sense if one seeks to maximize profits, or maximize service coverage to a population under conditions of limited funding. In terms of meeting the clients need, it is less likely to make sense.

Regrettably, sometimes utilization reviewers do not really understand the situation they are reviewing, or do not accept the therapists assessment of it, or have an evaluation process they must follow which drives their decision for them. The result, in all cases, is that you’re leaving before you want to.

This is a difficult situation – certainly for you and likely for your therapist too.  There are a number of ways in which you can try make the best of it. If it were me, I’d seek out books that seems to address my problems, and I’d journal a lot – talking to yourself on paper is a proven method for self-therapy, as is “bibleotherapy”. Several studies have shown these methods, if well done and conscientiously applied, to be just as effective as traditional therapy. That’s right – just as effective.

The problem is that you have to manage yourself. There’s no one to lead you through the process. A major key to susccess here is motivation. People can do incredible things when motivated. So, seize the opportunity, and simply declare to yourself that you will NOT be defeated by circumstances. Then start reading, and writing, and WORK at it. Act like your life depends on it. It does, yes?

THE PROBLEM OF SITUATIONAL INJUSTICE

Being, in effect, kicked out of therapy against your will is probably hardest for those who have a real sense of not having been treated fairly by life, and many people have good reasons for thinking that this is their lot.

OK. Life isn’t fair. Almost everyone I can think of, including me, has reason for complaint. But, the problem is that if y9u get stuck in the complaint, nothing really happens. You have to get to the next stage: converting your protest into self-supportive action. What that might be is well beyond anything I can address here, but the general idea is the real point I want to stress: You stop being a victim of circumstances the day you decide to. You do this by changing your response to circumstances over which you have no control.

If the world isn’t giving you what you need, find a way to get it for yourself, or at least to get something for yourself. Consider Beethoven, the great German Classical/Romantic composer. He wrote 9 symphonies, and by his third, he was obviously going deaf. It’s essentially a worst-case scenario. What did he do? He did what he could to get treatment, and it didn’t work. He also continued writing music, for years and years, hearing it only in his head. He got something for himself, and in so doing gave us all much more. He did the best he could with what he had. What else was there to do? You must do the same, if you hope to achieve a sense of happiness.

SELF-SUPPORT

You got into therapy to get something for yourself – an act of self-support. If therapy is no longer available to you, you simply continue this action, with what IS available to you, and there’s always something.

I recall a wonderful story I heard once about a meditation student. He was becoming discouraged. He worked hard but didn’t think he getting where he wanted to go with his meditation practice. He consulted his teacher, and was simply told that what he needed to do was go out into the area where he lived, find discouraged people,  and encourage them!

This sounds a bit absurd, initially, but it’s actually very clever. It’s often easier to do something for others than for yourself, but in this case, encouraging others is likely to give the student ideas about how he might encourage himself. But there’s more: by being helpful to others, he’s giving sustenance to his own sense of self worth.

DO WHAT YOU CAN DO, NOT WHAT YOU CANNOT

You cannot change the national health system, or how your insurance company operates, or the fact of your having to live with a limited budget. So, don’t throw yourself against a rock – an immovable object. If you want to advocate for systems change, do it! But be realistic. And while you’re working to change the world, work also promote your own health in every way you can think of. THAT you CAN do.

In doing this, you give yourself PRIMARY SELF RESPECT, something I’m much in favor of. You must be the first person who offers you support and encouragement. If it’s hard, do it anyway. Persist, and it’ll become easier, like anything else you practice.

One way you can work to improve your situation is to join a self-help group. Some can be found  on the Internet, and other will be advertising localling in your region – or you might start one. The challenge with these groups is to be wary of advice from people who really don’t understand your problem. So, even if you work with a group, you should be reading and writing (journaling) on your own, to help you “keep your own counsel”.

DO NOT DEFEAT YOURSELF

Life itself is struggle. Your struggle to advance your own mental health is just a part of that. In challenging circumstances, the first rule is not to defeat yourself, which is what you do if you give up. It takes maturity, and courage, to continue working when the world is not supporting your effort very much. If your mental health is at stake, the matter is serious, and it likely that your continued effort is justified. People who struggle usually make progress, though it may not at all be linear progress.

So, remember: there’s always something you can be doing to help yourself. Identify it, and go to work. Be resolved to be defeated only by that which you cannot control, not by your failure to engage with that which you do control.

http://sleightmind.wordpress.com/2009/01/15/leaving-therapy-so-whats-the-problem/#comment-217

:: Early detection of Alzheimer’s disease: New TYM self-administered screening test – research report

A new brief screening test for early detection of Alzheimer’s disease has been developed. Good information on this research, and the test, is available on the Internet as of this week. The test has excellent sensitivity (ability to detect the disease when actually present) and selectivity (ability to exclude from detection those who do NOT have the disease.

LIMITATIONS

This is a screening test, not a diagnostic assessment tool. At this point in its development, it also lacks sufficient validity research to be used in a clinical setting. At best, it should be considered as possibly indicative of the status of any individual who takes it. That status, if of real interest, should be confirmed by other means.

KEY LINKS

Quick Alzheimer’s Test Highly Accurate – A brief but thorough summary report on the new research, written for health care professionals. Read this first.

Self administered cognitive screening test (TYM) for detection of Alzheimer’s disease: cross sectional study – The full test of the research report published in the British Medical Journal on 2009.06.09. This is technically demanding text, but rich in detail, with plenty of content useful to the non-technical reader as well.

Diagnosis of dementia – Editorial in the British Medical Journal, 2009.06.09, related to “Self-administered…” article in the same edition. Valuable additional information on the topic.

TYM (Test Your Memory) test – A PDF version of the test card used in the research. PLEASE NOTE that this test is designed for patients of British origin. I believe one can make some obvious cultural adjustments to the test text  without compromising validity.

TYM Scoring instructions – From the authors of BMJ research report.

:: Prerequisites to Pride – why VISIBLE diversity in achievement is so important

I wrote recently (A unique and shining moment…) of observing something very encouraging and informative – the positive effect on persons of color of the election of Barack Obama to the Presidency of the United States. Of course it’s had a positive effect of many of the rest of us as well, and I honestly believe that this effect will grow, over time. This is a man who exemplifies what can be accomplished when one marries vision, persistence, focus, and intelligence. This is a life from which we can all learn.

But how is that? How is that the life of another person can teach US something? In psychology, there has been considerable research and writing on something called Social Learning Theory. The research has largely supported the theory, and it all reduces to this: We learn from observing the actions of other people, and this effect is increased to the degree that we can see ourselves in them.

So, when a child, adolescent, or adult sees a human being with whom they can identify do something remarkable, it becomes easy to fantasize (the beginning of belief) that they also could do something remarkable.

Put differently, when we have models of functional normalacy, it becomes significantly easier for US to become functionally normal. Life really isn’t about the remarkable. Most of us will never be “remarkable”, and we don’t really need to be. We just need to have enough, do enough, be enough. This is hard to do when the most visible people in your culture clearly are NOT like you. There are many minority groups in our country who are negatively impacted by this problem. It injures them, and to that degree injures all of us.

I’m absolutely amazed and thrilled to observe, at this very moment, CNN reporters interviewing very ordinary kids walking on the Capital Mall today, the day before the Presidential Inauguaral, kids who are simply glowing with pride. I truly believe that for many of them it has never been easier to feel good about themselves, about their possibilities, and about the world in general. This is a very very good thing.

We all need vision, in our lives, and our minds. Some of us can provide vision for others of us, by what we do, especially in the public arena. Such role models most include ALL the people who comprise our remarkable nation, and world. President-Elect Obama’s remarkable achievement has given ALL of us a great gift, and its value is only beginning to manifest.

When I was eleven years old, I can recall seeing an article in the Reader’s Digest – a lead article at that – which went to great lengths to attempt to tie Martin Luther King and his associates to the International Communist movement. This was an idea actively promoted by the long term despotic Director of the US Federal Bureau of Investigation, Herbert Hoover, as has since been well documented.

My own parents, both raised in Texas, had always taken a clear position that persons of color (not the term in common use at that time) were as good as anyone else. They certainly didn’t see themselves as part of any movement, however, and nothing was said about that absurd article in the Reader’s Digest. And I can vividly recall going to Texas as a child and seeing “Black only” water fountains out in back of the service stations. It just looked strange. Still does, in  my mind’s eye – strange and frightening.

But today, and tomorrow, all of us – ALL of us – who wish to, can feel proud about how far we’ve come. And we need to remember that there are still very significant groups of people in our country who have great difficulty feeling proud about who they are. They need all the encouragement, and positive, affirmative, action, we can produce in our society. I’m thinking particularly at this moment of Native Americans and people in minority sexual/gender identities. But there are many other groups about whom we should be equally concerned. This is a social health issue, and most certainly a mental health issue.

Diversity is one fundamental aspect of humanity. People whose only distinction is that they are “different” are a fundamental asset for us all, and we need to cherish them, and help them to cherish themselves, so that they can achieve and maintain the essential pride which is the birthright of us all.

:: Leaving therapy – so what’s the problem?

By at least a ten to one margin, the most read and commented-upon post to this blog is my August 1, 2007 End times: Coming to the end of psychotherapy. I had not expected this, when I published the piece.

Originally written to help one of my clients sort out their thinking as they came to the end of their time working with me, I had posted it because I did think others might find it useful. It appears, now, that it addresses a real and persistent problem. Well, such problems are what we deal with in psychotherapy, and sometimes in our blogs as well.

So, “what’s the problem”? There appear to be two of them: psychotherapy clients, and their therapists. That’s simply what the data appear to support. Let me address each, in light of the continuing comments to the blog entry, and in relation to one in particular (which was withdrawn by its author, so you cannot find it there).

THERAPY CLIENTS AND THEIR ISSUES

Clients appear to have trouble with leaving for several reasons, among which are:

• They cannot decide if it’s time or not. They don’t know how to arrive at  a decision they can feel comfortable with.
• They have to leave, and don’t want to, and it’s disturbing them.
• They’re ready to leave therapy, but don’t want to lose contact with their therapist.
• They want to leave therapy, but their therapist is objecting, or advising against it.

I think you’ll agree that that covers a lot of ground.

THERAPISTS AND THEIR ISSUES

From the report of people writing comments to my blog entry, it appears that therapists also have trouble with therapy termination for a variety of reasons, among which are:

• They think their client is making a poor decision, and really isn’t ready to leave.
• They think their client is being “resistant” to therapy, and is basically “fleeing” therapy.
• They appear committed to a long term relationship with their client, for reasons which (to me) appear suspicious, and object to a client’s attempts to break free.

I want in this post to comment about therapists and their problems, mostly, since the clients’ side of the picture has been commented upon by me extensively in my original post, and in my responses to readers’ comments.

When therapists think their client is making a poor decision, and really isn’t ready to leave. In a hospital, if the doctor treating you isn’t ready to discharge you and you leave anyway, which is certainly your right, unless you’re being held there under court order, you’re advised that it will be noted in your chart that you’re leaving “AMA” – again medical advice.

In other words, it is customary to tell you that we think (I used to work in a mental hospital) that you’re making an ill-advised decision. Partly this is to protect ourselves legally, but it’s also a last chance to ask you to think things over. Warning you about an “AMA” discharge seems good practice for both parties, and it’s usual and customary practice.

Such circumstances certainly occur in outpatient practice as well, and the same justifications for voicing and recording objections of the treating professional to the departure of the client hold weight in this context. In other words, we are almost certainly remiss if we DO NOT give this warning.

So, clients, you do well to consider the larger picture when you find that your therapist does not support your leaving. The disagreement likely has in it an element of real concern for your welfare.

Yet some clients come to therapy with the expectation (which can escalate to a demand) that their therapists “support” them, period. This is both unreasonable AND reasonable, in the following senses:

• Reasonable: Our first obligation to you is to support the promotion of your health. It’s the oldest admonition in the healing arts. This means that we need to be able to offer you an informed opinion about your condition, AND that we actually make you that offer. But…
• Unreasonable: There’s no guarantee that you’ll like what you hear  when we offer you this kind of support. Making you immediately happy is not the purpose of such support. Assisting you to be healthy in the long run IS.
• Reasonable: “Support” is a favorite word women use in talking about their close social relationships, and with good reason (men seem not to talk about this). It’s a high value for most women, and by “support” they mean what I would call the offering of emotional congruence. That kind of support is appropriate in therapy as long as it supports (in the other sense!) your health. Such support can very meaningfully help a client learn to value their own feelings and viewpoints, for example. But…
• Unreasonable: Do not expect us to support you emotionally while you make what appears to us to be a bad decision. That’s like praising you for staying on road while driving, as you drive across a washed out bridge.

So, can we do both at the same time? Can we support your “personhood” while disagreeing with your decision to leave? Of course, and I think we must.

I think that at all points in the therapy relationship we need to support our clients’ thinking for themselves. This, fundamentally, is about self respect. But, we also need to MODEL this behavior, which is what I do when I disagree with a client’s decision to leave. How can I advise you to respect your own thinking if I do not respect my own? Therapists are in many ways like parents: they cannot be, or act like, “friends” or “buddies”. We are coaches,  sources of expert opinion and intervention, and most definitely models. Any other understanding is almost always ill-informed and ill-advised.

Basically, our being both supportive and unsupportive of a client, when we find that that is our true position,  is asking a client to be an adult. We’re saying “It’s important that you make your own decision, and do what you think best. Nothing else will really work for you, howsoever scary it may be at the moment.” And then we may also say “And I do not agree with your decision to leave therapy at this time. I think it’s ill advised.” And then, finally we say (at least I say this, because I think it’s very important): “Now you have to make a lonely decision. I’ve given you my best thought, and the most important part of it is that it’s up to you to decide, just as it’s your fate to meet up with the consequences of your decision. This is the way life really is, and I’m here to help you with this little piece of it.”

Some clients have trouble with this, in large part, I think, because we therapists don’t work hard enough making clear what our purpose is: not to make life easy, but to make it better. Often, that means “no pain, no gain”. Some clients really kick and scream about this. I consider that a normal part of their life development. We’ve all done it at one time or another, believe me! And we therapists must remain adult, hold our ground, and hold out for the overall improvement of our clients. We, too, have a lonely decision to make: just as you have to do what you think best, and no one can really take over for you, so do we. It’s part of our ethical commitment to you.

(I’m laughing to myself right now…recalling how many times I know of parents who truthfully told their kids “You’ll thank me for this some day.” What a day of true joy THAT is – ha!)

When therapists think their client is being “resistant” to therapy, and is basically “fleeing” therapy. Well, some clients ARE resistant, and they do flee. The “resistance” is typically based either on a failure to understand what therapy is actually about (“What? I have to walk TOWARD my pain? Are you NUTS?”), or on fear, or both. The “fear” is more serious, more complex, and more difficult to deal with.

Just to give one example: a client I had once basically had never, as a child, had an emotionally supportive, protective relationship with an adult she could trust. I was probably the first person who’d ever invited her to trust herself (AND me) as we looked back at the painfulness of that childhood. She’d thought that therapy would be like a magic pill, and that we’d quickly and permanently anesthetize large parts of her memory.

When I advised her that that wasn’t quite accurate, she simply couldn’t trust that I knew what I was talking about. I think that she also couldn’t trust that she could survive contact with her feelings. She ran, against my advice and in spite of my best efforts to calm and reassure her. I believe her departure was due both to her mis-perceptions about how therapy works and her fear of herself and all other adults. A tough story, for both of us.

On the other hand, some therapists call any client who want to leave before the therapists deems them ready “resistant”. I strongly object to this. First, I don’t think it’s helpful in any way. Second, I think it a poor characterization of what’s actually happening.

Resistance can be a very good thing. I will resist your picking my pocket, for example. But it also can be a completely wrong word. If I resist having a perfectly good meal with you, because if I do so I’ll miss my train, “resisting” your invitation is simply rational. So is it rational if my client evaluates her situation, listens to me and anyone else she cares to listen to, then decides that what she want to do is leave? In that case, her leaving is the only sane, rational thing to do, and I would strongly support her leaving for that reason.

I have in fact most certainly told clients who I thought were leaving therapy prematurely (I do get a few!) that I thought all in all they simply had to go, that not to go would be wrong because it would be an act of self-disrespect. And I said this after telling them that I was convinced that therapy would be good for them, and  thought they needed it.

Again I say: I know this isn’t simple. But it IS true, and telling the truth is my first interest and first obligation. The challenge of understanding this truth is a completely separate issue.

WORKING TOGETHER TO MAKE THIS EASIER

From the moment I began addressing this topic, over a year ago, I knew that often it’s a difficult one for all concerned. I have, at all points, felt most concerned about the difficulties clients have with ending therapy. They are the more vulnerable, less informed, less experienced of the two individuals involved. I think we therapists need to help them with this issue just as we do with others.

Therapists get in trouble with this issue just as do their clients, sometimes for the same reasons! Sometimes their troubles are of their own making, and sometimes they are due simply to the nature of the problem. A fundamental objective of my writing on this topic is to raise awareness by both therapy clients and therapists both of the pervasive existence of this problem and of its nature.

We need to talk more with each other about this matter, preferably from an informed point of view. We certainly also need to respect each others difficulties in dealing with therapy termination. All in all, this problem isn’t going to go away, and isn’t likely to get much easier over time. It will just be there, waiting for us.

When therapy termination time comes, we need to do with this what we do with other problems in psychotherapy, turn toward it, look it in the eye, see its parts, feel our feelings, talk to each other, and, while as fully alive and functional as we can be, simply walk through the fire. It’s what we do, and it’s what we’re good at – or trying to get good at! It’s just another part of a life which isn’t always easy but which IS manageable.

:: A unique and shining moment – and a caution

Tuesday, election day for us in the USA, I was barely able to get productive work accomplished. It wasn’t just a matter of being concerned that “my” candidate for President might lose. It was a mixture of many things, including:

• the sense that our country stands at a unique moment – we either embrace the serious challenges facing us, or fall farther behind other countries who already are assuming a leadership position in the world relative to matters such as universal health care, a rational national energy policy, and an active commitment to economic, cultural, and social justice for all its citizens;
• the sense that this long election campaign so much needed to end, for all our sakes, coupled by amazement at the apparently limitless energy of all four of the major national candidates, right until the final hour;
• indescribable amazement at the fact that someone who was a state senator a mere four years ago appeared about to win the Presidency, someone whose intelligence, emotional balance, and capacity to organize his campaign in a manner never before seen has been commented upon by virtually everyone who wasn’t actually running against him (and at times even by them).
• amazement every time I saw the Obama family on a public stage; when I was a child, and even a young adult, this family could simply not have been in such a position, running for a national office. Could we really have come this far?

And now that it’s all over, a new surprise: it seems that virtually everyone is celebrating. It appears nearly universal – that we recognize that as a nation we have turned a corner. This is a national Affirmative Action moment.

I say that because I can see the effect Obama’s election is already having on African Americans – there is an apparent sense of personal validation. THIS, for those who just don’t get it, is why we need people of all “flavors” in leadership positions. “Equal” mean equal access, and not just in theory. In actuality. Equality simply needs to be a visible reality, so that our children can see it. Now, in a sense that has never before been true, for African Americans, it is.

BUT…the caution: We still have a long way to go. The trans-generational effects of slavery, and of Jim Crow racism, are with us still, and will be for quite a while yet. The solution isn’t to make black people white, but to make our society brown – a mixture, at all levels. It simply has to be acceptable to appear, sound, and (even!) act black, at all levels. I can say this, as a Caucasian: too many white people simply don’t yet get this. And it isn’t just true for black people – tolerance for diversity remains one of our most central social challenges.

Now….to stay on topic – does any rational person doubt that social inequality has mental health consequences? It isn’t enough to have “equal access”. Only equal achievement will do the trick, and we have yet to achieve this, on so many fronts.

Social intolerance, and inequality of achievement affects everyone. What hurts one hurts us all. We cannot fail to care about our neighbors. We may well disagree about how to turn our caring into social policy, but about the goal there cannot rationally be disagreement. When one of us is injured by life, by social circumstance, by accident of birth, we all are injured.

This is a rare and shining moment we are having this week. We are not likely to pass this way again any time soon. I savor this moment, and seek to draw energy from it. There is a great deal of work to be done, by us all.

We really do need all hands on deck. I’d like to think that this week, “the crew” increased very meaningfully. I’m grateful to Obama, for who he is and what he has done, but I’m probably more grateful to my fellow citizens. As he said, we did this. It is our moment more than anything else – and no ones more than those folks who voted for the other candidate but still feel good about this moment. The last time we came together like this – and world drew close to us – we had just suffered a national terrorist attack. This time feels very much better, and will surely have more far-reaching consequences.

As we look at the challenges the whole world faces, in this and the next generation, we all need to believe “Yes, we can”. Then, we need to act on our belief.

:: New entries – from the past

I am moving to this blog a number of entries from a blog I’ve kept for three years at my professional website. Partly this is to simplify that site, but also it is to have all my blog entries in one place, and possibly more available to the public. In addition, comment isn’t possible at my professional website, but is here.

As they appear here, all new entries (each of which will be dated prior to this entry) will appear in the appropriate archive, and will be sorted into the category list.

:: For a busy time of year: Five ways to keep your balance

Here we go again. “The holidays…” We’ve been down this road before, haven’t we?

Maybe, just maybe, this time. we could dance rather than run. How about it? Interested?

OK, then let’s consider what a dancer must do:

• They must know the steps of the dance, in advance, at least to some degree. Pure improvisation is only for the very skilled!
• They must not lose their balance. This requires that they have a decent sense of where they are, at all times. Self-awareness will keep them on their feet.
• They need to be able to feel the natural rhythm of the music to which they are dancing.
• They need to be able to navigate on the dance floor, in the midst of other dancers, possibly some musicians, and the architecture and furniture of the room in which they are dancing.

So, translating that, I come up with this:

• A little planning for the days ahead seems wise. We should sketch out the steps. We would do well to do only a little that is unfamiliar, else we’ll probably not have much fun, and won’t do all that well. This isn’t a rehearsal, but rather a performance.
• In the midst of all the rush, we need not to lose ourselves. So, do a little “check-in”: Are we feeling sufficiently in-balance? Reasonably optimistic? Reasonably rested? (They’re often related.)
• We need to stay in touch with the larger things around us – the people we live with, the people we care about, priorities we have which are larger than the concerns of the season. It’s about awareness and balance and grace.
• Life is often about adequate management of details, as a team. Consider making a few lists, and checking in frequently with people you’re “traveling” with. See any obstacles coming at you? Are you making best use of your potential for adaptive response to challenge, and of the people who can help you with this adaptive response?

All in all, it should be fun – and hopefully also entertaining, thought provoking, nourishing, and gratifying. But start with the fun. Lots of people don’t even get that far.

Plan with humility. Talk with others. Sleep. Eat sustaining food. Exercise. Relax with awareness. Avoid over-reaching. Be grateful for what you already have.

Enjoy the dance.

:: When “negative thinking” seizes your mind, make something good of it!

We therapists tend to favor positive thinking and especially positive self-concept, for good reason. Generally, positive thought, as opposed to the other kind, leads more often to good feelings. One reason for this is that in many situations a positive outlook about oneself produces behavior that simply works better. (It is generally important, of course, that such positive thought have at least a modest relationship to reality!)

I could say a lot more about positive thought, but that’s not really my subject. Negative thought has a place in our lives, too. I want to promote the virtues of negative thoughts, here – both their direct virtues and those we can derive, if we know how.

Let’s look in a little more detail at the two kinds of virtue that may be found in association with negative thinking:

• Inherent virtue: Negative thought is sometimes right. This is CORRECT negative thought. It tells us that such things as “Do not proceed straight across this valley, for there’s a swamp ahead, and you’ll get into it but you won’t get out, ‘cause you can’t swim!” This is obviously helpful thinking, though it’s hardly positive in nature.
• Derived virtue: All other negative thought is incorrect. While that isn’t helpful, we can still convert this problem into a good outcome. How to do that will be explained below.

When we notice that we’re not feeling good, and then find that we’re in the grip of negative thinking, especially about ourselves, we should suspect that we may be under the spell of an INCORRECT negative belief. We may well not know, initially, the exact nature of that belief, but once we become aware of it, our goal should be to reduce or eliminate its effect.

Sometimes we must get help to accomplish this – with the more complex and serious negative beliefs. The rest of the time we can often do the job ourselves.

I have written a new article at my professional website which deals in detail with this subject – Building emotional resilience: Finding and calming negative self-beliefs to decrease personal distress and become stronger. Sooner or later, we’re all affected by negative self-beliefs which well may be wrong, and we do well to work to correct them. In this piece, I offer a couple of ways to do this.

For years, I have used myself these methods, and I know they can work very well. I rely upon them, in fact. When I find myself getting in my own way because of negative self-belief, these are the methods I most often use for self-rescue.

Interested? You should be. I hope you check it out.

:: Discussion list management – just say no to autocracy

I have today resolved to remove myself as contributor to all Internet discussion lists which have moderators who screen all posts before allowing them to display (or not – and of course that’s why they screen them). I can no longer tolerate autocratic* discussion list moderators. (Please see my Note, below, re: “autocratic”.)

HAVING TO ASK PERMISSION TO SPEAK – NO LONGER OK

I began the first draft of this post a few days ago, in a state of outrage. The problem was that in one 24-hour period I had received TWO queries as to the appropriateness of proposed posts to an Internet discussion list I set up a few years ago. Both individuals contacting me had advanced degrees in psychotherapy-related fields, plus years of experience in their fields. Their maturity and good judgment may be assumed. Why, therefore, are they asking permission of me to express themselves on this discussion list? For one thing, I have made it clear, in other contexts, that this List does not have an autocratic moderator. Still, they ask permission.

This is reminiscent of the behavior that been observed in the USA of recent immigrants from the former Soviet Union. They get in trouble at some point, and ought to call for help. They are asked – “So why didn’t you call the police?” One person put it plainly: “Where I come from, police don’t resolve trouble. They make trouble.” While this might be very easily understood for, say, an African-American from south-side Chicago, or Louisiana, or a great many other places (sadly), for many of the rest of us it is not.

WHERE THERE’S POWER THERE MUST BE CHECKS AND BALANCES

The problem is power distribution. The moment someone has inordinate power – a lot more power than someone else, without adequate checks and balances, the stage is set for abuse. How the abuse comes about can be surprisingly subtle, and that’s a good part of the problem. Altruistic people, possessed of good intelligence and values, nevertheless simply cannot make certain decisions for other people. When they think they can, and there’s no recourse to those of us on the outside of the process, trouble seems to me to be inevitable.

True autocrats are not controlled by those they serve. They are self-determining. This is the very definition of a “dictator” -someone who says in effect “I will tell you what you will do, and that will be the end of it.” This is unacceptable, in every context which comes to my mind.

POORLY MANAGED POWER IS A PROBLEM IN TOO MANY PSYCHOTHERAPY DISCUSSION LISTS

In truth, there are a number of psychology and psychotherapy-related Internet Discussion lists run by moderators who frankly say “You may speak here only about the topics that I’m interested in, else I’ll prevent you from speaking on the list.” Or, worse yet: “You may express only certain points of view, else I’ll prevent you from speaking here…” The idea of constructing an area where only certain activities are allowed isn’t problematic. The problem is that when one person, or even a minority of a group, controls the behavior of the group as a whole the free flow and interaction of ideas is constricted in ways which do not maximally benefit the welfare of the group.

LESSONS OF HISTORY? WHAT LESSONS?

If the intellectual history of western Europe, or anywhere else, for that matter, teaches us one thing, it is that only when there is a free marketplace of ideas does the best of which we are capable emerge. That it will emerge is not at all guaranteed by such a marketplace, but when the people as a whole are not actually running the market, the likelihood of such an emergence is always reduced. One of things I find most regrettable is that there are too many people, including some in positions of power, who have no apparent knowledge of this history lesson.

WHY THEY KEEP ASKING

Returning to the Internet discussion list problem – this is not the first time I have been asked whether I, as a list moderator, would inflict some kind of punishment upon someone should they post some particular expression to the list. I have, in fact, been contacted repeatedly over the years by people concerned about this matter.

I assume that the anxiety motivating these people to contact me derives from bad real-world experiences on other discussion lists, in part because I have myself had conflicts with Internet discussion list autocrats.

“MAJORITY RULE” ISN’T ENOUGH; WE MUST CARE FOR ALL

Free speech is a core value of my national culture. It is a cornerstone of freedom, we are told, growing up, in our schools and families. At the same time, actual behavior in these schools and families have on occasion denied this principle. Ideology and behavior are tto often at odds, that that in effect we are sometimes told “You have free speech, and if you know what’s good for you you’ll use it in the following way…”

Well, that doesn’t look like free speech, does it?

This actually a more complex problem than it might seem. If autocratic restrictions are a bad thing, how about restrictions deriving from the expressed will of the majority of a group? Well, this certainly is less oppressive, but isn’t necessarily acceptable. Under such a structure, for example slavery might well flourish – and historically has.

A good solution appears to be obtainable when one considers the subtle notions embodied in the conclusion of John Donne’s famous Meditation 17. I find this so powerful that I feel compelled to quote the entire fragment here:

…No man is an island, entire of itself…any man’s death diminishes me, because I am involved in mankind; and therefore never send to know for whom the bell tolls; it tolls for thee.

Where one man, woman, or child lives in oppression of any kind, there lives a threat to us all. THAT is why autocratic management of anything which might provide benefit to the people in general is so unacceptable.

Democracy – the rule of the people by the people for the people – is historically a rather rare and precious thing. It seem to require conscious fostering and advocacy, and even defense, at times, for its survival.

DRAW A LINE – TAKE A STAND

So, I will take this stand, from now on: I will make no further contributions to any Internet discussion list which is run by a moderator whose actions are those of an autocrat (as opposed, say, to those of an administrator).

I urge you to do the same, and to do it conspicuously.

The free marketplace of ideas is worth fighting for.

NOTE

* I want to be careful about my use of the word “autocrat”. Am I name-calling, by using it here? I hope not. I certainly am labeling, which is a legitimate kind of intellectual shorthand. The reason why I don’t have trouble with the word is that it has a long and distinct history in the political philosophy and political science. It is not really an imprecise term.

The virtues of autocracy have been debated at least since the time of the Athenian democracy. Implicit in that debate is a fairly clear idea of what’s being debated:

…the control of the many by the few (or the one) without regard to the opinion of the many.

This should be added: whether or not that “regard” is present is to be determined by the many, not by the few. THAT is the critical factor which keeps things from reeling out of control. Someone in a position of power who pays satisfactory attention to the opinion of the many is not an autocrat but an administrator.