Fooling Yourself Into Failing Yourself: The Trap of Anxiety and Avoidance

File:Fear of a blank planet.jpg

“But I just don’t like to do that.”

That is what she told me — the young woman who said she didn’t want to go to a restaurant alone. “Why should I do that? I’d much rather eat with someone and be able to talk at dinner. Eating alone wouldn’t be any fun.”

True. Most of us would prefer a dinner companion. It probably would be more enjoyable to dine with a friend. But there is an important distinction here. It is between being able to do something that you might prefer not to do, and being unable to do the thing because it is uncomfortable for you; maybe even frightening. And, it is between deluding yourself into thinking that the activity might be boring or stupid when the truth is that you are afraid to do it.

Deluding and denying. We do it all the time. “I don’t like to do that. Why would I want to do that? Why do I have to do that?” And so we persuade ourselves that we can live without certain experiences, side-stepping the things we don’t know about or haven’t done — the small and large challenges of life.

But what are we really doing here?

http://upload.wikimedia.org/wikipedia/commons/thumb/4/4a/WeirdTalesv36n1pg068_Shocked_Woman.png/240px-WeirdTalesv36n1pg068_Shocked_Woman.png

For the young woman in question, her repeated need to be accompanied to places — her fear to act alone — caused her to be dependent upon people, especially boyfriends. As a result, she found it difficult to be without a male companion for very long and, when she did find one, discovered that she wanted (and needed) to be with her lover more than he wanted and needed to be with her. Thus, her insecurity about being alone and her avoidance of doing things alone made her dependent upon others.

Eventually, the “clinging” drove her boyfriends away. Then she really was alone. Finding herself abandoned and rejected, she turned her reliance on family or friends; if she had those friends, that is, because she had spent so much time with her boyfriends that she’d neglected making platonic friends, along with the work required to keep them.

Some people who are avoidant don’t realize how anxious they are — how much fear dominates their lives. After all, if you turn down invitations to parties because of underlying social anxiety, you manage to avoid getting nervous as you think about the party, dress for the party, drive to the party, walk in the door, and then try to fit in.

The fact that you don’t feel anxious doesn’t necessarily mean that you don’t have anxiety problems. In fact, sometimes a better way to determine whether you have a life-compromising form of anxiety is to make a list of the things you will not do unless forced to at gun point.

  • Things like giving a public speech, raising your hand in class, traveling to the downtown area of a big city, driving on the expressway, making a phone call, going to a party where you know few people, and eating at a fancy restaurant or any place where you are not familiar with the cuisine.
  • Things like going to a movie, play, lecture, or concert alone; flying, sending a poorly prepared dish back to a restaurant’s kitchen, saying “no,” returning an item at the store, etc.
  • Things like trying some new activity on your own or voicing a strong opinion that just might be criticized by someone else; and not looking for a new job for fear of the interviewing process.

Please notice that I’m not talking about some of the very commonly experienced fears such as spiders, high places, and confined places: the phobias we call arachnophobia, acrophobia, or claustrophobia and the like. Rather, my focus is on the anxieties that make for daily difficulties — that make a life so narrow that it begins to look a little bit like this:

http://upload.wikimedia.org/wikipedia/commons/thumb/f/fa/Toledo_narrow_street.jpg/240px-Toledo_narrow_street.jpg

To the avoidant, anxious person, the narrowly confined life seems safer. It is fraught with fewer frustrations and failures. It demands less. It feels less foreboding.

If you are heavily invested in social media, you can even persuade yourself that your electronic social life of texting, instant messages, blogging, tweeting, role-playing games, and hundreds of Facebook friends is better than the real thing. And what might the real thing be? Dedicated time unmediated and uninterrupted by technology spent with a person who is right in front of you and within the reach of an outstretched hand.

Can you approach social situations without a preliminary drink or joint? Are you certain that the alcohol or marijuana you use to unwind is recreational rather than an effort to self-medicate your anxiety? Yes, we are pretty good at talking ourselves into just about anything rather than seeing ourselves as we really are.

But if we are avoidant, there is a price:

  • The same things done over and over and that can be done only in the same places and in the same way; and sometimes only in the realm of electronically achieved distance and safety.
  • The need to rely on others who provide an emotional security blanket, or substance use upon which one is also reliant.
  • The self-doubt and the worry that accompanies thoughts of leaving our “comfort zone.”
  • Too much time spent looking at a television or a Smart Phone or a computer screen.

Avoidance offers no growth and no “life,” only the illusion of safety and the temporary relief that we all know from our school days when the teacher was sick and the test was postponed. I suppose that you can try to postpone the “tests” that life offers until the end of your days. Believe me, I’ve seen it happen. I’m talking about a life of challenges unmet, mastery unachieved — the narrow life that Thoreau described when he said:

The  mass of men lead lives of quiet desperation. What is called resignation is confirmed desperation.

And, in a companion quote often misattributed to Thoreau:

Alas for those that never sing,
But die with all their music in them.

But he also wrote:

Great God, I ask for no meaner pelf

Than that I may not disappoint myself,

That in my action I may soar as high

As I can now discern with this clear eye.

We live in “The Age of Anxiety” according to W.H. Auden. In any life there is a first time — a clumsy, unsure time — for everyone and every thing. We fear the judgment of others, the embarrassment, and the mortification of taking a chance and stumbling in public. We compare how we feel inside to the apparent (but not always real) serenity, calm, and self-confidence of others as we look at them from the outside. We condemn ourselves for lost time and opportunity, say to ourselves that we are “too late” or “too old” to take on a new challenge, and thereby guarantee that even more time will be lost; perhaps all the time we will ever have.

We tell ourselves that we can’t try a thing until we first feel better, calmer, and more confident; not realizing that “trying” is just what we need to do in order to feel better about the thing; failing to grasp that anxiety is not the biggest part of the problem, but that a failure to act in spite of the anxiety is.

If you are anxious enough or avoidant enough you might well avoid counseling, too. That is a shame, because there are very good treatments available in the realm of Cognitive Behavior Therapy (CBT). For a discussion of therapy for Social Anxiety Disorder, for example, you can look at this: Social Anxiety Disorder and Its Treatment.

Only if you fully realize that your avoidant coping strategies are costing you something of value will you call a therapist. Are you afraid to call? Is it less distressing to email? Did I hear you say, “Maybe tomorrow?” You may not detect the sound, but the clock is ticking.

As Eleanor Roosevelt said, “You must do the thing you think you cannot do.”

Now.

http://upload.wikimedia.org/wikipedia/commons/2/2e/RelojDespertador.jpg

The top image is described as Fear of a blank planet, cover by Lasse Hoile Porcupine Tree Band 2005: http://www.porcupinetree.com/ “OTRS Ticket 2006082110002647.” The Illustration of a Shocked or Frightened Woman has been altered by AdamBMorgan from the original that appeared in Wierd Tales (September 1941, Volume 36, Number 1). The next image is One of the narrow streets in the old part of Toledo, Spain by Allessio Damato. Finally, An old style alarm clock captured by Jorge Barrios. All are sourced from Wikimedia Commons.

Boyhood Heroes and Autograph Stories: Remembering Bill “Moose” Skowron

Moose Skowron

The Brooklyn Dodgers won the 1955 World Series thanks to the MVP performance of an unheralded 23 year-old pitcher named Johnny Podres. That winter I had a chance to meet him. He was scheduled to make a weekend appearance at the Peter Pan restaurant in West Rogers Park, Chicago. I couldn’t wait.

My dad drove me there and I could see the line in the eatery, all eager young boys, some older than my nine years, some younger. And there he was, seated at a table in front of the long line, observable at a distance through the restaurant’s large pane glass window. A genuine baseball player in the flesh. A real World Series hero.

But there was only one problem.

I couldn’t get myself out of the car. I froze. I was intimidated. My dad did his best to persuade me and I certainly had enough time to muster the courage to go in. Podres wasn’t going anywhere fast. But neither was I. I was fastened to the seat at a time before seat belts.

I cannot tell you what exactly I was afraid of. I don’t remember what I was thinking. All I know was that I was terrified, all too shy, and eventually my dad drove me home.

I was reminded of this story recently when a high school friend asked me if I remembered Johnny Podres appearance at the Peter Pan. He had the courage to go in. In fact, I suspect it simply wasn’t in his nature to even to be scared of it.

Within a very few years, however, I became an eager autograph collector, brazenly approaching my heroes (probably only 10 years or so older than I was at the time) as they emerged from their locker room or outside the ball park, usually Wrigley Field. I nearly got trampled trying to get Willie Mays’ signature. He simply bulled his way through the crowd of boys who were hoping to have a less physical kind of contact. But young men like Ernie Banks and Ron Santo would sign and sign and sign until everyone had a turn and a treasured keepsake.

In the summer of 1960, when I was in eighth grade, my Jamieson School friend Joel and I went to Comiskey Park to see the White Sox play the Yankees. My uncle Sam had gotten us great box seat tickets and we were eager to get some autographs before the game.

We noticed several kids bunched on the stadium side of the infield wall, all getting the popular Sox outfielder Minnie Minoso to sign their scorecards. Soon, Joel and I observed that there seemed to be a man in charge — a man who had a camera hanging by a strap around his neck. We joined in the crowd milling about the pale hose star, even getting into a picture that was taken.

The adult leader didn’t take too long before persuading various other Sox players to come over to the same group of boys about our age, making autograph collecting easier than usual. Normally one had to call to a player from the stands, requesting him to take pen in hand and ink that day’s score book. From that point we did our best to blend in with the others, getting as many autographs as we could.

Curious, I asked one of the boys in the group who they were. It turned out that the kids were there on an excursion from South Bend, Indiana. All of them were newspaper boys who had won the Comiskey Park adventure for doing their deliveries and collections reliably and well. That was why, of course, the photographer/chaperone of the group had taken a picture of all of us with Minnie, for eventual publication in the very same daily paper.

Joel and I wondered how we would get a copy of the photo. “We’ll figure it out,” I said. “Just be sure you don’t say anything to that guy,” as I motioned toward the adult overseer.

We were standing a bit apart from the group, not wanting them to hear our plotting, when the same man called to us, “Hey, you two, come over here!”

At first I wondered if he’d figured out that we didn’t belong. But instead he told us he was going to try to get our photo with Mickey Mantle! We watched with heady anticipation as he talked to the Yankee great and future Hall-of-Famer. But Mantle shrugged him off. He seemed more intent on watching the other Yankees take batting practice and waiting for his own turn to hit.

Next he approached Bill “Moose” Skowron, the Yankee’s heavy-hitting first baseman. I’d always thought that “Moose,” a popular Chicago native who would eventually play for the White Sox, was called by that nickname because he was so powerfully built, unusually square-shouldered and intimidating in physique. But, it turns out that his childhood friends called him “Moose” after Benito Mussolini, who Skowron resembled a bit, especially in the 1930s when the young Skowron started to wear his hair in the crew-cut style that made him look even more like the Italian dictator.

Skowron would end his playing career with 211 regular season home runs and a .293 batting average in eight World Series appearances that led to five World Championships. He was also elected to the American League All-Star team on six occasions.

http://upload.wikimedia.org/wikipedia/commons/thumb/b/b2/Comiskey_Park_860817.jpg/240px-Comiskey_Park_860817.jpg

The “Moose” walked with our benefactor behind the home plate batting cage toward the place where we were standing — on the stadium side of the barrier to the field. Skowron smiled and said hello, then turned and sat himself on the flat top of the low brick partition as he faced the gigantic center field “exploding” scoreboard that Bill Veeck, the Sox owner, had installed only that year — the first of its kind.

The photographer stood with his back toward that same scoreboard and motioned us to get on either side of the ball player, as close as we could to “Moose” while remaining in the stands. Then the 29 year-old athlete leaned back a bit, put his arms around us and the photo was taken.

Skowron said goodbye and quickly returned to his pre-game routine. But we were in trouble. Joel couldn’t restrain himself and blurted out the question I had feared, “Say, how do we get to see these pictures?”

As the saying goes, if looks could kill two 13 year-olds would have expired behind home plate at Comiskey Park.

“Aren’t you… don’t you belong… you’re newspaper delivery boys, right?”

“Uh, uh, uh…”

“Oh, s**t, f***k, you little a*s h***s, you sons of b*****s.”

I think there might have been another dozen or so swear words, some of which I never heard before and haven’t heard since. By now it is kind of a blur. And so ended any hope of ever getting our hands on a picture of the two of us with Bill Skowron.

Fortunately, my dad was able to track down the South Bend newspaper and did, in fact, find the group photo with Minnie Minoso in which we can be easily recognized. Only one problem. The caption identifies Joel as Steve Carpenter and me as Claude Fitzgerald. Or something like that.

I wrote the above in May, 2011 and for some reason set it aside. But the story was on my mind, and I told it to a recent acquaintance, a neatly bearded, fine older gentleman named Abe. He’d mentioned that he was a friend of the “Moose,” who apparently continues to live in the Chicago area.

Stories are funny things. Sometimes you think a narrative is finished when in fact it isn’t. Something else happens to someone involved in the tale that adds an important twist to it, changing its meaning. So it was with this story.

To my surprise, a few months after I’d related the yarn to Abe, he said that he told the story to “Moose” and asked him if he would sign a photo of himself in his playing days, inscribed to me. With that Abe handed me the image (below) featuring the young “Moose” and a few words to me in his still steady hand. It was an act of unexpected kindness from both of these men, something that made my day.

Thus, the story did not end with my disappointment at the failed opportunity to get my hands on a photo with a baseball hero, but with me receiving a picture after all; one that, because of the way it happened, means more to me than the half-century old version possibly could have.

I guess it just goes to show that (if you are willing to wait 51 years) you can have just about anything you want in life.


I have reposted this essay as a tribute to Bill “Moose” Skowron, whose death was reported today. He was 81.

—-

The top photo is “Moose” in his days with the Yankees. The second photo is of the scoreboard at Old Comiskey Park by Baseball Bugs sourced from Wikimedia Commons. The final photo is of  Bill “Moose” Skowron at old Comiskey Park in his days with the White Sox.

Boyhood Heroes and Autograph Stories: Remembering Bill “Moose” Skowron

Moose Skowron

The Brooklyn Dodgers won the 1955 World Series thanks to the MVP performance of an unheralded 23 year-old pitcher named Johnny Podres. That winter I had a chance to meet him. He was scheduled to make a weekend appearance at the Peter Pan restaurant in West Rogers Park, Chicago. I couldn’t wait.

My dad drove me there and I could see the line in the eatery, all eager young boys, some older than my nine years, some younger. And there he was, seated at a table in front of the long line, observable at a distance through the restaurant’s large pane glass window. A genuine baseball player in the flesh. A real World Series hero.

But there was only one problem.

I couldn’t get myself out of the car. I froze. I was intimidated. My dad did his best to persuade me and I certainly had enough time to muster the courage to go in. Podres wasn’t going anywhere fast. But neither was I. I was fastened to the seat at a time before seat belts.

I cannot tell you what exactly I was afraid of. I don’t remember what I was thinking. All I know was that I was terrified, all too shy, and eventually my dad drove me home.

I was reminded of this story recently when a high school friend asked me if I remembered Johnny Podres appearance at the Peter Pan. He had the courage to go in. In fact, I suspect it simply wasn’t in his nature to even to be scared of it.

Within a very few years, however, I became an eager autograph collector, brazenly approaching my heroes (probably only 10 years or so older than I was at the time) as they emerged from their locker room or outside the ball park, usually Wrigley Field. I nearly got trampled trying to get Willie Mays’s signature. He simply bulled his way through the crowd of boys who were hoping to have a less physical kind of contact. But young men like Ernie Banks and Ron Santo would sign and sign and sign until everyone had a turn and a treasured keepsake.

In the summer of 1960, when I was in eighth grade, my Jamieson School friend Joel and I went to Comiskey Park to see the White Sox play the Yankees. My uncle Sam had gotten us great box seat tickets and we were eager to get some autographs before the game.

We noticed several kids bunched on the stadium side of the infield wall, all getting the popular Sox outfielder Minnie Minoso to sign their scorecards. Soon, Joel and I observed that there seemed to be a man in charge — a man who had a camera hanging by a strap around his neck. We joined in the crowd milling about the pale hose star, even getting into a picture that was taken.

The adult leader didn’t take too long before persuading various other Sox players to come over to the same group of boys about our age, making autograph collecting easier than usual. Normally one had to call to a player from the stands, requesting him to take pen in hand and ink that day’s score book. From that point we did our best to blend in with the others, getting as many autographs as we could.

Curious, I asked one of the boys in the group who they were. It turned out that the kids were there on an excursion from South Bend, Indiana. All of them were newspaper boys who had won the Comiskey Park adventure for doing their deliveries and collections reliably and well. That was why, of course, the photographer/chaperone of the group had taken a picture of all of us with Minnie, for eventual publication in the very same daily paper.

Joel and I wondered how we would get a copy of the photo. “We’ll figure it out,” I said. “Just be sure you don’t say anything to that guy,” as I motioned toward the adult overseer.

We were standing a bit apart from the group, not wanting them to hear our plotting, when the same man called to us, “Hey, you two, come over here!”

At first I wondered if he’d figured out that we didn’t belong. But instead he told us he was going to try to get our photo with Mickey Mantle! We watched with heady anticipation as he talked to the Yankee great and future Hall-of-Famer. But Mantle shrugged him off. He seemed more intent on watching the other Yankees take batting practice and waiting for his own turn to hit.

Next he approached Bill “Moose” Skowron, the Yankee’s heavy-hitting first baseman. I’d always thought that “Moose,” a popular Chicago native who would eventually play for the White Sox, was called by that nickname because he was so powerfully built, unusually square-shouldered and intimidating in physique. But, it turns out that his childhood friends called him “Moose” after Benito Mussolini, who Skowron resembled a bit, especially in the 1930s when the young Skowron started to wear his hair in the crew-cut style that made him look even more like the Italian dictator.

Skowron would end his playing career with 211 regular season home runs and a .293 batting average in eight World Series appearances that led to five World Championships. He was also elected to the American League All-Star team on six occasions.

http://upload.wikimedia.org/wikipedia/commons/thumb/b/b2/Comiskey_Park_860817.jpg/240px-Comiskey_Park_860817.jpg

The “Moose” walked with our benefactor behind the home plate batting cage toward the place where we were standing — on the stadium side of the barrier to the field. Skowron smiled and said hello, then turned and sat himself on the flat top of the low brick partition as he faced the gigantic center field “exploding” scoreboard that Bill Veeck, the Sox owner, had installed only that year — the first of its kind.

The photographer stood with his back toward that same scoreboard and motioned us to get on either side of the ball player, as close as we could to “Moose” while remaining in the stands. Then the 29 year-old athlete leaned back a bit, put his arms around us and the photo was taken.

Skowron said goodbye and quickly returned to his pre-game routine. But we were in trouble. Joel couldn’t restrain himself and blurted out the question I had feared, “Say, how do we get to see these pictures?”

As the saying goes, if looks could kill two 13 year-olds would have expired behind home plate at Comiskey Park.

“Aren’t you… don’t you belong… you’re newspaper delivery boys, right?”

“Uh, uh, uh…”

“Oh, s**t, f***k, you little a*s h***s, you sons of b*****s.”

I think there might have been another dozen or so swear words, some of which I never heard before and haven’t heard since. By now it is kind of a blur. And so ended any hope of ever getting our hands on a picture of the two of us with Bill Skowron.

Fortunately, my dad was able to track down the South Bend newspaper and did, in fact, find the group photo with Minnie Minoso in which we can be easily recognized. Only one problem. The caption identifies Joel as Steve Carpenter and me as Claude Fitzgerald. Or something like that.

I wrote the above in May, 2011 and for some reason set it aside. But the story was on my mind, and I told it to a recent acquaintance, a neatly bearded, fine older gentleman named Abe. He’d mentioned that he was a friend of the “Moose,” who apparently continues to live in the Chicago area.

Stories are funny things. Sometimes you think a narrative is finished when in fact it isn’t. Something else happens to someone involved in the tale that adds an important twist to it, changing its meaning. So it was with this story.

To my surprise, a few months after I’d related the yarn to Abe, he said that he told the story to “Moose” and asked him if he would sign a photo of himself in his playing days, inscribed to me. With that Abe handed me the image (below) featuring the young “Moose” and a few words to me in his still steady hand. It was an act of unexpected kindness from both of these men, something that made my day.

Thus, the story did not end with my disappointment at the failed opportunity to get my hands on a photo with a baseball hero, but with me receiving a picture after all; one that, because of the way it happened, means more to me than the half-century old version possibly could have.

I guess it just goes to show that (if you are willing to wait 51 years) you can have just about anything you want in life.


I have reposted this essay as a tribute to Bill “Moose” Skowron, whose death was reported today. He was 81.

—-

The top photo is “Moose” in his days with the Yankees. The second photo is of the scoreboard at Old Comiskey Park by Baseball Bugs sourced from Wikimedia Commons. The final photo is of  Bill “Moose” Skowron at old Comiskey Park in his days with the White Sox.

Too Many Balls in the Air: The Frustrated and Frustrating Life of ADHD

http://upload.wikimedia.org/wikipedia/commons/c/c8/Carbon_Cycle-animated_forest.gif

He was dynamic, outgoing, and enormously entertaining.

He was creative, full of ideas, and energetic.

And he was one of the most frustrating people you would ever care to be around.

About whom do I speak? A bright, charming man with Attention Deficit Hyperactivity Disorder.

ADHD is more complicated than you might think. Although there is much written about it, I want to cover a few of the things that can be missed about the condition. But first, let me explain the name and define it.

There are three types of ADHD (Attention Deficit Hyperactivity Disorder):

  • 1. ADHD, Predominantly Inattentive Type. This used to be called ADD, but technically speaking, sufficient inattentiveness is considered a category of ADHD, even though little hyperactivity may be present. These are the folks who seem to be listening, but are lost in space; easily taken away by a tune, a sound, or an idea; the people who miss the details and forget the assignments.
  • 2. ADHD, Predominantly Hyperactive-impulsive Type. This is what most people think of when they hear or read the four letter acronym ADHD. People with this diagnosis are characteristically talkative, active, intrusive; a bundle of unmanaged, impulsive activity.
  • 3. ADHD, Combined Type (meaning it includes the symptoms typical of the first two categories); too many balls in the air, for sure.

What about the man I mentioned at the top; a person who had the “combined type” of ADHD?

He had lots of energy and ideas, so people found him engaging. But it wasn’t a very productive sort of energy. He would begin things, but not complete them. He was disorganized — losing keys and papers, and forgetting appointments. He promised to do things, but couldn’t be relied upon to do them as quickly or as well as expected, if at all.

This man (let’s call him A.T.) went nowhere fast; very fast. A.T. looked liked the “Energizer Bunny,” but mostly traveled in circles.

http://upload.wikimedia.org/wikipedia/commons/5/5f/Tux_Linux_crystal_award_nevit.gif

He tended to over commit himself, taking on more tasks than he could handle effectively, chronically underestimating what he could accomplish in the time available. A.T. was routinely late for appointments, and made decisions quickly, without fully considering the longer term consequences of his actions. Bored easily, distracted more easily, and prone to procrastination, he knew that he wasn’t what others hoped for and expected. Although he was full of promise, his reputation was that of someone who was a thoughtless, irresponsible underachiever — an individual who needed minding.

Employers were disappointed, co-workers were frustrated by A.T., and his spouse was driven just a little crazy, feeling that she couldn’t depend on her partner. She’d married someone who was exciting, only to find that the excitement he produced was more of the “Oh, no!” kind that made her sweat when she discovered he was late to pay a bill or pick up the kids. Not surprisingly, she started to see him as just another one of the kids, as their partnership turned into more of a “disapproving mother/resentful child” relationship than either of them wanted.

http://upload.wikimedia.org/wikipedia/commons/thumb/9/96/Europa-Park_-_getroffen_4_-_von_Mama_ausgeschimpft.jpg/240px-Europa-Park_-_getroffen_4_-_von_Mama_ausgeschimpft.jpg

Before I tell you about A.T.’s treatment, let me say a few things that might not automatically come to mind about the condition and its consequences:

1. Hyperactive/impulsive ADHD individuals can sometimes look like they are world beaters, but mostly beat themselves; indeed, they are often chronic underachievers. If you are planning on forming a working group or partnership with such a person, don’t be fooled by a positive first impression of excitement and energy. You will almost certainly be disappointed down the road.

2. ADHD, even today, is sometimes not detected in schools. There are several reasons:

  • The inattentive form of this condition may well produce school failure, but not misbehavior. Inattentive children are often quiet and relatively well-behaved, unlike their hyperactive-impulsive counterparts.
  • School personnel may incorrectly attribute ADHD-like behavior to laziness or oppositionality. Moreover, school systems, even when they do formal evaluations, are frequently reluctant to identify problems that require additional resources and personnel, which they are hard-pressed to provide given their limited funds.
  • An ADHD child who is bright can compensate (to some extent) for his attentional problems by relying on his excellent intellectual abilities, at least for a while. Eventually, however, many of these children (as they age and school begins to demand more of them) find out that advanced intelligence is no longer sufficient to permit success.
  • There is no single standard measure that reliably identifies ADHD. Evaluators commonly use some combination of paper and pencil tests, clinical judgment, and attentional measurements. Intelligence (IQ) and neuropsychological tests can easily miss some of the most clinically obvious cases of this condition.

3. The fact that ADHD children are able to become “hyperfocused” on things like computer games or other tasks that they find especially interesting, does not invalidate the diagnosis of ADHD. Indeed, this sort of selective attention is seen fairly often.

Some researchers believe that those games provide rewarding stimulation in the form of frequently changing images, sounds, and challenges; as well as the success of achieving points or increasing levels of success, thus “capturing” the attention and imagination of the ADHD youngster. By comparison, the real world school room seems boring. Recommendation? Limit your child’s screen time, even in front of regular TV shows.

http://upload.wikimedia.org/wikipedia/commons/thumb/a/a3/2_men_using_their_computers.jpg/500px-2_men_using_their_computers.jpg

4. Although many people are hesitant to take medication, ADHD is a diagnostic category that is especially responsive to psychotropic medication. Hundreds of studies support the effectiveness of such treatment for about 85% of children with this condition according to Russell Barkley’s authoritative 2006 book Attention-Deficit Hyperactivity Disorder. In a 2007 paper by Elliot and Kelly — “ADHD medications: an overview” published in the journal Attention — the authors state that “No medicine available to psychiatrists produces a more rapid and dramatic effect more safely than the proper dose of a stimulant to a patient with ADHD.”

5. If medication does work, it will likely be needed on a continuing basis, not as a temporary fix. The irony is that stimulant medication, which will cause internal agitation in those who are not suffering from ADHD, actually permits the person with the condition to focus more and become less prone to the hyperactivity/impulsivity that had been a problem.

6. ADHD is correlated with a greater risk of developing a Conduct Disorder, typically characterized by antisocial misbehavior and defiance of authority. Not surprisingly, such individuals often abuse alcohol or drugs (not only as an act of rebellion, but also as a self-medication designed to calm their hyperactive state). Adolescents and adults who have ADHD are thought to make up at least 25% of the population of prisons according to Barkley.

In all these examples, the impulsive, ill-considered behavior that is typical of ADHD takes a fearful toll. Such individuals are easily bored, requiring intense and novel reinforcement (rewards) to motivate them, and are prone to “sensation-seeking” — looking for extreme excitement that their condition seems to make them crave. Indeed, one patient of mine reported driving at speeds approaching 100 MPH on city streets simply for the feeling it produced in him. Nor did he think he was at much risk (or putting others at much risk) in doing so, thus demonstrating the poor judgment characteristic of those with the hyperactive-impulsive form of ADHD, as well as their tendency to disregard rules and authority figures.

7. While many general medical practitioners (GPs) can prescribe medication for ADHD quite well, some are hesitant to do so, sometimes due to lack of training or inexperience with this particular diagnosis. Cautious GPs will prescribe psychotropic medication, but are prone to giving doses that are too small. It is generally best to see a psychiatrist in such cases; that is, someone who specializes in the prescription of medication for psychiatric disorders.

8. The frustration that ADHD produces in school children can make them give up (and eventually drop out), believing that nothing they can do will make any difference in their performance. Some of them will become avoidant of academic or other work tasks because they believe that they will fail, thus producing a self-fulfilling prophecy. Many will get angry at the teachers, bosses, and parents who so often are reminding them of their inadequacies. Thus, ADHD fuels other behaviors that make a good life difficult.

What happened to our friend A.T?

You’d think it was simply a matter of telling him of the benefits of medication, wouldn’t you?

Not so fast.

He was one of those folks who was uncomfortable with the “idea” of having to be reliant on medicine. He told me that he didn’t “believe” in medication, as if it was a matter of religious faith.

A.T. was also quite narcissistic; in denial concerning his own responsibility for the things that went wrong in his life. Similarly, he had no trouble blaming others including bosses and wives. Not to mention that he drank too much and didn’t acknowledge that it was a problem. Indeed, he had only come into treatment at his spouse’s insistence.

One of the challenges of psychotherapy is the fact that few people fit “pure” diagnostic types. Instead, one must be aware of all the complicating factors that can make effective therapy difficult. This man’s narcissism, denial, and alcohol abuse certainly created just such complications.

Had A.T. been more motivated and self-aware, less prone to denying the misery he was creating around him, a cognitive-behavioral (CBT) approach to his ADHD could well have helped, even if he chose not to take medication.

CBT programs include formal guidance in planning and organizational skills, assistance in problem solving and decision-making, help in reducing the number of distractions in the environment, practice in new thinking skills, training in ways to reduce procrastination, and advice to help you cope with failure. Homework is required between sessions.

The program described by Steven Safren and his associates in the work book Mastering Your Adult ADHD, developed by psychologists at Massachusetts General Hospital and Harvard University, was able to produce significant improvement in about 50% of those patients who continued to have clear problems even after being treated with medication.

So, if you have ADHD, medication and CBT provide reasons for optimism that things can get better.

Just don’t drop the ball!

Thumbnail for version as of 15:40, 14 September 2005

The top image is the Carbon Cycle created by the U.S. Government Department of the Interior. The one that follows is the Tux Crystal Linus Award by Nevit Dilmen. The next photo was created by Thomas Pusch and is called Scolded By Mama. The fourth picture is of Two Men Playing a Computer Game by Love Krittaya. Finally, a picture of a Geode  by Whitsoft Development. All are sourced from Wikimedia Commons.

How to Make Yourself and Those You Love Miserable

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It is easy to find on-line guidance to a better life. But the recommendations contained on those self-help web sites (and in books that aim at the same audience) have become almost too commonplace to make any impact.

The remedy? Something that is just the opposite: a list of suggestions on how to make yourself and others miserable. Of course, I’m not wishing that you follow these directions. Rather, I’m hoping that some of you who might yawn at still another list of “things to do” to improve your life, will be struck by the things you already do that make it much worse.

Here goes:

  • Regularly compare your material and financial circumstances to others, especially to those who are doing better than you are.
  • Make a list of all the people who have wronged you over the years and try to remember exactly how awful they made you feel. Think about those who owe you an apology. Forgive no one. Let no slight be too small to dwell on it.
  • Carry on a vendetta. Stay up late at night planning and plotting how you might get back at people. Stay angry. Let all your hatred out in blistering, profane, and cowardly “flames” behind the mask of the Internet.
  • Give your children gifts rather than your time. Set no limits on them. Then wait until they are teenagers and wonder why they are depressed or rebellious.
  • Curse the darkness, the winter, the cold, the rain, the frailty of the human condition, and all the other things that you can’t change.
  • Get impatient with the people who are walking in front of you at a snail’s pace, the couples whose bodies and shopping carts block the entire grocery aisle, and the slow progress of the check-out line at the store.

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  • Make no contribution to the betterment of humanity. Assume an attitude of entitlement. Figure out how to avoid work. Idle away your time. Ask “what your country can do for you,” not “what you can do for your country” in opposition to JFK’s 1960 inaugural address admonition.
  • Forever rationalize your dishonorable or questionable behavior or deny it altogether, even to yourself.
  • Persuade yourself that you need to wait until you feel better before you do the difficult thing that you have been postponing. Keep waiting, even if the time never comes when you believe that you can take action.
  • Do not let conversation with your spouse or children get in the way of watching TV. Keep the TV on most of the time, most importantly at family dinners. If possible have a television in every room.
  • Ignore the beauty of a spring or summer day, the newly fallen snow, and the cheerful laugh of small child. Stay in-doors as much as possible, year round.

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  • Allow yourself to be upset by overpaid, under-performing athletes who doom the home team to continued failure. Yes, Cubs fans, this means you!
  • Treat emotions of sadness, tenderness, and hurt as your enemy. Push them away and thereby alienate yourself from yourself. Curtail grieving and try to deaden your feelings to the point of numbness.
  • Work up as much hatred as possible toward opposition political parties. Listen to every talking head who wants to whip you into a frenzy.
  • Expect justice and fairness in all things.
  • Drink too much, drug too much, and spend every extra minute on the web or playing computer games instead of having direct human contact with someone who is in the same room with you. Further distract yourself from your problems by watching TV and listening to music. Escape reality.

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  • Keep using failed solutions to your problems even though they haven’t worked in years, if ever.
  • Behave in mid-life the way you did as a young person; or, if you are a young person, behave the way you did as a child. Do not reflect on or learn from experience which might teach you something new.
  • Use others instrumentally. That is, value them only in terms of what they can do for you. Lie, cheat, betray, and steal from them if that serves your interests. Then wonder why people mistrust you.
  • Spend as much time as possible worrying about the future and regretting the past, rather than living in the irreplaceable moment.
  • Aim low. Avoid the disappointment that comes with high expectations. When the going gets tough, quit.
  • Train yourself to be a miser. Practice selfishness. Hold on to your money as if you expect to live forever and will need every last cent. Make Scrooge from A Christmas Carol your hero.

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  • Judge others less fortunate than you are by using the phrases “he should have known better,” “he didn’t try hard enough,” and the like. Assume that all people deserve whatever misfortune befalls them. Disdain compassion, but remain puzzled when others call you heartless.
  • Indulge in every available excess: unprotected sex, food, spending, smoking, caffeine, etc. Don’t exercise. Ignore medical advice and, even better, avoid going to your doctor. Treat your body badly and then wonder why it betrays you.
  • Be sarcastic, passive-aggressive, and indirect whenever you are injured rather than looking someone in the eye and expressing your displeasure in a straight-forward fashion.
  • Avoid facing things. Give in to your fears, anxieties, and phobias.

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  • Don’t let anyone know you well. Believe that your vulnerabilities will always be used against you. Keep social interactions on the surface. Eschew intimacy and maintain your distance, thinking that this is the best way to avoid personal injury. Trust no one!
  • Assume that the normal social rules regarding fidelity to friends and lovers don’t apply to you. Hold on to a double-standard that favors you.
  • Insist on having your way. Don’t compromise. Don’t consider others’ needs or wants. Assume a position of moral superiority, self-righteousness, and arrogance in things religious, political, and personal.
  • Do everything others ask of you. Rarely say “no.”
  • Try to control people and events as much as you can. Don’t go with the flow. Micromanage. Hover over others. Repeat complaints to them incessantly. Remind subordinates, friends, spouses, and children of small errors, even if they are ancient history.
  • Make no significant effort to better your life. Depend on others to take care of you and make all significant decisions for you. Be a burden.
  • Raise all your children exactly the same way even though it is obvious that they are not all the same.
  • Imitate vampires (who have no reflection in the mirror and therefore keep their mirrors shrouded) by never really looking hard at your own reflection in the looking-glass. That is, never take a frank inventory of your strengths and weaknesses or the mistakes you’ve made. Be like the evil queen in Snow White, whose only desire was that the mirror would tell her that she was “the fairest of them all.”
  • Whenever you talk with someone, wonder what they really mean, pondering the possibility that they find you boring, stupid or physically unattractive.
  • Feed yourself on gossip more than food. Delight in talking about others behind their backs.
  • Value beauty, appearance, reputation, and material success over integrity, knowledge, kindness, hard work, and love.
  • Try to change others, but do not try to change yourself. Take no responsibility for your life circumstances, instead blaming those who have stymied you.
  • Stay just as you are regardless of changing life conditions. For example, if wearing warm clothes worked for you when you lived in Alaska, continue to wear them when you move to Arizona in July.

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  • Don’t forgive yourself. Maintain the most perfectionistic and demanding moral and performance standard even if you are not a brain surgeon. Stay up at night castigating yourself over every imperfection, no matter how small.
  • Make a list of all the things that are wrong with your life, all the opportunities lost, every heartbreak, and the physical features and bodily changes that you don’t like. Stew in your own juices. Salt your wounds. Pick at your scabs.
  • Take everything personally.
  • Permit friends, family, and co-workers to walk all over you. Do not stand up to them for fear of causing offense and disapproval.
  • Discount your blessings. Concentrate on the dark side of life.
  • Never even consider going into psychotherapy. Assume that this is something only for those who are weak and that anyone who needs to grapple with emotional issues in counseling demonstrates a failure of will power and logic.

With thanks for the inspiration for this essay to Dan Greenberg and Marcia Jacobs, co-authors of a very funny, but ironic book entitled How to Make Yourself Miserable.

The top image is Grief by Edgar Bertram Mackenna. The video frame that follows is from John F. Kennedy’s 1960 inaugural speech. The next image is Sommerblumenstrauss by A. Gundelach. The following photo by Andygoodell is A Jack Rose Cocktail. The fifth picture is of two children in Bangladesh by Nafis Kamal, while the sixth is called Chicklet-Currency courtesy of the U.S. Department of the Treasury. After the image from Disney’s Snow White, is a 1911 photo of Enrico Caruso, the great Italian tenor. All but the Snow White frame are sourced from Wikimedia Commons.

Signs of Insecurity: Behavior That Reveals a Lack of Confidence

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Insecure people often reveal their self-doubt without being aware of it. Indeed, a wise observer can “read” another individual. For example, members of the Chicago Symphony Orchestra have told me they can tell whether a new conductor is competent and talented within 10 minutes of the beginning of their first rehearsal with him. What follows is a short list of behaviors that suggest insecurity:

  • 1. Are you able to give a compliment? Even more important, can you graciously accept one? The latter behavior tends to be difficult for someone who is unsure of himself. He might blush or become flustered. Alternatively, he is prone to dismiss the validity of the praise, instead telling you why it isn’t true. What should one do if complimented? Smile and say “Thank you.” Nothing more.
  • 2. The ability to maintain eye contact is hard for many individuals who lack confidence. They will turn away or look down, but rarely hold the gaze of the other by looking into his or her eyes.
  • 3. The self-doubting person tends to apologize when no apology is necessary. It is as if she expects to be reproached or is afraid to give offense; so, she prophylactically tries to excuse any possible mistake to avoid such a response.
  • 4. Answering a question with an upward inflection of the voice has been done by everyone. The person being questioned doesn’t have certainty about his answer, so he replies with a tone betraying his insecurity. Since I originally wrote this piece, a name has been given to the practice: upspeak.
  • 5. Men and women who are uncomfortable with sharing personal information for fear of being judged will oft-times turn the conversation to a different topic, away from anything that might make them vulnerable or reveal too much. This is also called “changing the subject.”
  • 6. One way of inoculating yourself against criticism is to joke at your own expense. Do this often and others may conclude you believe you are flawed.
  • 7. Do you have trouble making a decision? The comedy team “Cheech and Chong” (I’m not sure which one) said: “Taking responsibility is a lot of responsibility.” If you automatically let others choose the restaurant, movie, and other activity, you are either easy-going and good-natured or don’t want to be held accountable for making the wrong choice.
  • 8. Do you state strong opinions? Those who avoid doing so might maintain the peace — often a good thing — but some fear drawing fire and unwanted attention.

Before I give you nine more signs of insecurity, I’ll say what might cause the condition. Many possibilities. Critical or neglectful parents, poor academic skills, frequent moves making you “the new kid” (especially if you are introverted by nature), learning disabilities and ADHD, being “different” in some fashion (size, shape, color, religion), thinking of yourself as the “poor” kid in a community of the affluent, sensing you are the average child in a school filled with bright youngsters, feeling ashamed of your parents or residence, frequent rejections, getting fired (whether deserved or not), clumsiness, a history of abuse or bullying; physical unattractiveness, deformity, or injury, etc. For a more thorough discussion of these causes, click here: The Causes of Insecurity. Now back to the list of signs of insecurity:

  • 9. Do you laugh nervously in social situations? It is another behavior betraying self-consciousness.
  • 10. People will appraise you harshly if they see you bite your nails or they appear bitten.
  • 11. Are you self-effacing, placing yourself at a disadvantage — letting others go first, speak first — reluctant to raise your hand? Do you hesitate to take your turn? Do you sacrifice your interests as a matter of course? Insecurity can make you wait until the opportunity before you is lost. Excessive deference displays little regard for yourself, even if some amount can be a sign of good breeding and consideration.
  • 12. Are you nervous eating in front of others? Do you fear dropping something, displaying poor table manners, or making a mess? You probably won’t, at least not more than the rest of us.
  • 13. Can you make phone calls without trepidation; especially those in which you need to introduce yourself, correct a problem, or speak to an authority? Too much discomfort in anticipation of these actions can reveal your sense of uncertainty.
  • 14. Might you make too many excuses? Those who are unsure give explanations where none are required. Imagine you order an entrée at an elegant restaurant and the waiter asks whether you want an appetizer to start. You explain why you don’t. Some folks offer multiple excuses for what they do, anticipating criticism. If you must give a reason, limit yourself to one. The more you give, the more uncertain (or dishonest) you sound. For  example, “I can’t come to the party because I have a stomach ache and my car broke and I need to study.” One reason will be more convincing. You needn’t explain yourself as often as you think.
  • 15. Insecurity can be suggested by hesitation to ask for a favor or an inability to say “no.” Anticipation of rejection or disapproval is the motivator for both of these problems with self-assertion. By contrast, a self-assured person will not believe the relationship (or his own value) is dependent upon going along with someone else’s wishes or fulfilling the desires of others as a matter of routine.
  • 16. Do you make frequent requests for reassurance? A few examples: “Does that make sense?” “What do you think?” “What would you do?” “Do you think that is a good idea?” “Do I look OK?” Must you have sex to prove your partner remains interested in you? If you are self-assured, you won’t implore your lover to calm your doubts and remind you, over and over, in words and deeds, of your desirability or intelligence.
  • 17. Last one. Here insecurity takes a different form. This person wants the spotlight at all times, the better to be told “You are the fairest of them all!” She or he pushes for recognition, strutting about the stage we call life; checking to see where he stands and what others think of him. Bragging and display become a full-time job. Perhaps he was the class clown in grade school, but now he drops names to prove his importance and get your attention. His inner emptiness must be filled and refilled, like a bucket with a hole in it. Such people are plagued by narcissism as well as insecurity, a troublesome combination. There is hell to pay for those who expose the pretender’s flaws: lacerating attacks against any critics. If you are this variety of insecure person, I doubt you will admit it even to yourself. If you meet such an individual, run!

I suspect you get the idea. Please add an item if you like. You can use the list in one of two ways: to consider whether you are insecure or evaluate the confidence of those around you. Of course, you are the only one whose self-confidence you can change.

You may find the following related post of interest: Signs of Self Consciousness: When the Mirror Isn’t Your Friend. Also, you might want to read  The Upside of Insecurity or, this very recent post: Insecurity and Our Preoccupation with Appearances/

The image above is Insecurity by Lacey Lewis: http://www.lacey-lewis.com/ With permission.

The African Dip: Thoughts on Passive-Aggressiveness, Powerlessness, and Acceptance

The  Flying Turns

My dad occasionally took me to a legendary Chicago amusement park called Riverview when I was a little boy. I was dazzled by the roller coasters, the “Waterbug” ride, and something called the “Rotor.” The latter required you to enter a circular room which spun on a central axis until the velocity and centrifugal force were sufficient to pin you against the wall, just as the floor dropped away.

But, as small as I was, it is a sideshow called The Dip that I remember most vividly. Today I’d like to use this politically incorrect carnival attraction as a spring-board to a few thoughts on the expression of indirect anger that sometimes is called “passive-aggressive,” as well as a therapeutic approach to setting aside the temporary upsets that are a part of any life.

Black men in cages. That is what “The Dip” involved.

Unbelievable, perhaps, as we think about it in 2010. Each man sat on a stool inside the cage. In front of the cage, off to the side a bit,  stood a small circular metal target that was attached in some fashion to the stool, perhaps electronically, but more likely mechanically.

For less than a dollar, you could purchase three balls to throw at the target, one at a time. If you struck the target solidly, the stool on which the man sat collapsed, and he dropped into a pool of water underneath the cage. You might have seen similar “dunk tanks” at various fund-raising events, often giving students the chance to dunk their teachers.

Harmless fun? Not so in the case of a black man doing the sitting and a white man trying to knock him off his seat.

This sideshow was once reportedly called, “Dunk the N****r,” later “The African Dip,” and finally “The Dip.” It was eventually shut down by a combination of Negro outrage and the increasing disgust of white people to the offensiveness of its implicit racism.

The black men were in a relatively powerless situation — almost literally, “sitting ducks.” But, they did what the situation allowed them to do so as to unsettle, tease, and otherwise disrupt the white pitcher’s aim. The Negroes were careful not to say anything too frankly insulting, lest they stir up the racism (and potential for less veiled violence) that was at the heart of the event.

But they would and could get away with belittling their adversaries athletic skill or throwing ability in a way that was amusing. If their comments distracted the opposition at all — got them to laugh (or the crowd to laugh at them) — or caused a break in the hurler’s concentration, the chance of staying on the seat improved a bit.

According to Chuck Wlodarczyk in his book Riverview: Gone But Not Forgotten, the caged men’s banter could include comments about one’s appearance: “If you were heavy, they’d call you ‘meatball.’ If you were thin, they might have called you ‘toothpick.’ If you were with a girl, they might have said ‘Hey fella, that ain’t the same girl you were with yesterday!'”

You don’t have to be a black man in a cage to have some experience of expressing anger indirectly. We’ve all done it. It takes many forms: talking behind someone’s back and mocking that person, being sarcastic, complaining to a co-worker’s superior rather than to the offender’s face, neglecting tasks you have been assigned unfairly, and procrastinating. These passive-aggressive words or acts are rarely very satisfying. The anger doesn’t dissipate; the grudging discontent usually continues; nothing positive happens.

The sense of powerlessness and lack of control that the passive-aggressive individual experiences can come to dominate that person’s emotional life, rather than allowing him to put effort into changing the power dynamic or to remove himself from a position of weakness.

Unfortunately, for some of those who feel powerless and injured, even a passive-aggressive action seems impossible. Consequently, they take a more uniformly passive role. They defer to others, try to avoid giving offense, act meekly, and position themselves under the radar. All that does, however, is give them second class status, just as it informs bullies that they are easy targets.

Someone in this situation, who repeatedly feels mistreated but isn’t able to take on those who inflict the injuries directly, needs to ask himself a few questions. Why do I put up with it? What am I afraid of? Am I really as powerless as I feel? Am I perhaps overreacting? What would happen if I were more direct? Is there any way to get out of the situation I am in?

Cognitive Behavior Therapy (CBT), which aims to quell and counter irrational thoughts, is often helpful in dealing with a lack of self-assertion and the fear that is usually associated with it. Equally, it gives you practice (sometimes using role-playing within the therapy session) in a gradually ascending hierarchy of challenging situations that require an assertive response.

Some CBT therapists, much like ancient Stoic philosophers, employ an “acceptance-based” psychotherapy and integrate this Zen-like element into their treatment. Why, they might ask you, do you so value the minor indignities of daily life and of opinions and behavior of boorish persons? Is it really a good idea to spend the limited time of your life being upset over rudeness from a tardy repairman or a fender-bender accident you didn’t cause — things that will be of no significance in a week, a month, a year?

Put differently, there will always be injustice, and some of it must simply be accepted as the nature of life and of living. Not every fight is worth fighting about, not every slight is intended. If your skin is so thin that you are regularly being upset by people, perhaps you are valuing the approval and opinions of others too much.

For those who ask “Why me?” those same therapists might say, “Why not you — you are alive, aren’t you, so you are subject to all the same things that can affect any other person.” And, as the Stoic philosophers and Zen practitioners would tell us, if we can accept this vulnerability as part and parcel of living, thereby assigning it less meaning and taking it less personally, our lives will be more satisfying — less fraught with anguish, anger, and hurt.

This is not to say society should have tolerated the indignity and racism of “The Dip.” There are times when the indirect, but pointed wit of the caged men is the best course of action; and, many occasions when the force of your personality must be brought to bear by confronting injustice. But some combination of directness in taking on unfairness and forbearance in accepting things — in allowing oneself not to sweat the small stuff — tends to produce as good a result as life will allow.

Of course, you have to figure out what the small stuff is and what other things really do matter to you.

Meditation is usually a part of the treatment enabling you to stay in the moment, and let go of your attachment to passing feelings and thoughts, worries and regrets, and anticipations and fears. To be preoccupied with just such temporary upsets causes you not to be able to fully experience what is going on in the present and determine what is really of importance in your life.

By encouraging and training you in meditation, the counselor  is attempting to give you a method to achieve a state of psychological enlightenment that (without using words) helps you to distinguish the transitory aggravations, disappointments, worries and anxieties of life from whatever matters the most to you, so you can put your effort into the things of greatest value in your life.

Some final questions:

  1. Do you often find yourself fighting over things others consider to be small?
  2. Do you frequently feel put-upon but are capable only of a passive-aggressive response?
  3. Do you (too easily and too often) assume a fetal position with others (metaphorically speaking), who come to think of you as an easy target and treat you badly (in part) because they know you will not stand up for yourself?

If you have answered any of these questions in the affirmative, you might benefit from asking a couple of other questions:

  1. What does this mode of living cost me?
  2. Am I willing to do the work necessary to change?

If the cost is substantial and you are eager to change, then a therapist can be of assistance. Only then will you be ready to get out of the cage, real or not, in which you find yourself.

The image above is the Flying Turns, a toboggan-style ride that was one of the many attractions that made Riverview Park famous.

Fear of Change: the Therapeutic Implications of Japanese Holdouts

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Things change. The question is, do we change with them? Or, do we instead, continue to operate by the same outdated rules of conduct.

I often said to my patients that they seemed to be behaving as if the conditions of their early life still existed. They had long since fashioned solutions to problems that they faced many years ago, and continued to use the same solutions, even though those methods of living didn’t fit with their current life situation. It is as if one were born in Alaska, learned to wear multiple layers of heavy clothing and then moved to the tropics without a change of attire. The warm clothes were helpful up North, but are a disaster down South.

What does this have to do with the “Japanese Holdouts of World War II? The answer is that these men lived by an outdated set of rules with heartbreaking consequences.

If you recall your history lessons, you will remember that the Japanese soldiers of that period were trained according to the principles of Bushido, a feudal fighting code that derived from the period of Samurai warriors. Above all else, weakness was condemned and surrender was disgraceful. Death by one’s own hand was seen as preferable to permitting oneself to be captured, so as to avoid both personal disgrace and family shame.

The Allied approach to the war against these very soldiers in the Pacific was one that involved “island hopping.” The strategy passed over certain islands, both to save men and ensure that the Allies would be able  to capture those islands that were of the greatest strategic value. When the Japanese surrender came in 1945, numerous Japanese troops found themselves stranded on out-of-the-way Pacific islands, cut-off from their command, and without the capacity for communicating back home. These men neither knew the war was over nor could imagine that any honorable soldier, let alone their entire nation, would surrender. Some were in small groups who gradually died from disease or starvation; others were, at least eventually, alone.

While many never surrendered and died still waiting for reinforcements that never came, it was not uncommon in the late 1940s and 1950s to read news accounts of isolated Japanese combatants giving themselves up. The photo at the top of this page is of Second Lieutenant Hiroo Onada, who finally surrendered in 1974, and would not do so until his former commanding officer, by then a bookseller, personally ordered him to lay down his arms.  At that point, World War II had been over for nearly 30 years.

Thirty years. Yes, 30 years dedicated to a war that was over and a life of desperation that was no longer required.

But how many years, if any, have you given up to a thread-bare, bankrupt strategy of living that has long since outlived its usefulness?. And, more to the point, how many more will you endure? When will you realize that your “solution” has now become the problem?

In my psychotherapy practice I saw numerous variations on this theme. People who were abused or neglected  or criticized as children and who continued to live in terror of disappointing others. Those who found substance abuse the only available way of treating the depression or anxiety they experienced when they were young, and who continued to do so. People who avoided challenges because they were scared of failure, having failed many times in the past. Individuals who wore a chip on their shoulder, forever sensitive to insults and injuries that reminded them of long ago attacks, but now were only injurious in their imagination. And those poor souls who expected rejection because of past rejection. Like the Japanese holdouts, the years pass but the fear doesn’t, and the possibility of satisfying relationships and happiness slips away.

If you still are responding to the present as if it were the past, with solutions that solve little (even if they were once necessary), then it is time to change your life. The barricade of your life’s defenses might be protecting you only from the phantom of an enemy who lives within you, not on the other side of the fortification.

A good therapist is likely to be able to help you develop a new way of living, one more appropriate to the world as it is, not the world as it was; to set aside and heal old wounds.

Is it time?

What is the continuation of your old way of living costing you?

The war, your personal war, might just be over and you don’t know it.

The Power of “No”

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Most people don’t realize how much power they have. Or how easily they give it away.

The key is to be able to say “no.” And to hold to that position without alteration.

I learned how easily I could give it away in graduate school.

A door-to-door salesman rang the bell of my apartment. He had a list of magazines. Did I want to subscribe to any of these?

The simple and direct answer was “no.” Had I said this and held to it steadfastly, his time wouldn’t have been wasted and my money, of which I had very little, would have been saved. Instead, I felt that I had to give him a reason, an excuse. I didn’t of course.

But, I chose to say, “Gee, its too bad you don’t have Sports Illustrated on your list.”

“Oh, but I can get that for you!”

I was sunk. I didn’t really want to buy anything. But I’d given the young man, probably no older than I was, an opening. And now I was committed to purchase a thing I didn’t need.

Well, I suppose I was young, inexperienced, and immature. All true. I allowed myself to be held hostage to my insecurity, a feeling of guilt, a need to explain myself, even though it wasn’t required.

If you must have the approval of others, if you believe that you are duty-bound to give them a reason for your actions, then these situations present you with a problem. So too, if you fear confrontation. If you think someone will only provide approval if you consent to their wishes, then you will leave the interaction as the other’s thrall. In effect, the keys to your life and the certificate of ownership will be the property of someone else.

But if you don’t let them or their opinion of you count for so much — if you can live with their unhappiness and don’t feel the need to convince them of the rightness of your position — you will come out of the interaction still in possession of yourself, as opposed to being the possession of your counterpart.

Remember, in many situations you don’t have to persuade the person across the table of your position. You just have to hold to it.

Short of pulling a weapon on you, there is usually very little that people can do to require you to do something that you don’t want to do.

Unfortunately, there are quite a number of people, especially female, who are able to say “no” in defense of their children, but not as an advocate for themselves; all the more, they are prepared to go on attack if they believe that those same little ones have been ill-served by someone else. And yet, when it comes to defending themselves, these moms have trouble. Put simply, it comes down to the fact that they don’t value themselves very highly and therefore can’t easily assert themselves. But for a person they do value, especially their flesh and blood, they are transformed.

If you can’t yet do it for yourself — say “no,” stand your ground — you’ve got some work to do. Your life will be much more the life that you want it to be, if you prevent others from taking you in their direction against your wishes. Think of all the favors you’ve done that you wanted to avoid, the responsibilities you took on at work that really shouldn’t have been yours to take, and (for some women only) the men whose attention you suffered unnecessarily.

If you can’t prevent these things on your own, psychotherapy can help you to learn to employ the word “no” to great effect. It allows you to examine the reasons for your inability to be assertive and gives you tools (and practice) in how to live in a new way.

The ability to say “no” is extraordinarily empowering.

This is one thing you shouldn’t say “no” to.

The above image is by Fibonacci from Wikimedia Commons.

The Upside of Depression and the Downside of Medication

http://upload.wikimedia.org/wikipedia/commons/thumb/d/dc/Depression.jpg/500px-Depression.jpg

Are there advantages to being depressed? Something good about something we think of as so bad? A recent New York Times Magazine article by Jonah Lehrer makes just that case: Depression’s Upside.

The essence of the argument is that some episodes of depression allow for and encourage a kind of analytic rumination that is productive. Put another way, the tendency in depression to focus on a problem, mulling it over to the exclusion of other thoughts, permits the sad person to find a solution to his difficulty and change his life in a positive way.

The counter-argument, however, is that the ruminative process is both painful and unproductive — that it often creates a kind of self-flagellating preoccupation with one’s trouble rather than a process that leads to something good; that unhappiness and focusing on pain and its concomitants simply feed on themselves to no helpful end.

In my clinical experience, therapy with people who are depressed over loss or injury often breaks down into two phases. The first of these is a grieving process, where the person expresses and processes (or sometimes purges) the feelings of anger, sadness, emptiness, desolation, and hopelessness that come with the loss of something of value — a love, a job, high social status, a capability, a fortune, etc.

The second phase involves learning from one’s painful experience about how to live differently, make different decisions, associate with different people, become more assertive, overcome fear; value things differently in life such as money, material things, status, accomplishment, friendship, and love.

Naturally, neither of these two phases is absolutely discrete — they blend into each other and overlap each other. As a practical example, someone who has had a series of bad relationships will typically need to grieve the unhappy end of the most recent one and, in the process, learn how he happened to choose a person or persons who made him so miserable; then changing whatever needs to be changed internally and externally so that different and more satisfying choices occur in the future.

People who are like the hypothetical individual just cited usually come into therapy in emotional pain and seek relief of that pain as promptly as possible. This desire is entirely reasonable — who wouldn’t want this? Some of them request medication, which is often the fastest way to “feel better.”

But many are leery of psychotropic drugs and see them as artificial, hoping that therapy will produce a more lasting fix without dependency upon a foreign substance. Indeed, while a good therapist will strongly encourage the use of medication for someone who is seriously depressed, i.e. suicidal, unable to work, sleeping away the day away (or almost unable to sleep); that same therapist will also know that medication sometimes serves to “de-motivate” the patient, giving him or her a relatively quick solution that allows that person to tolerate an intolerable situation. In the New York Times Magazine article mentioned above, Dr. Andy Thomson describes this problem eloquently:

I remember one patient who came in and said she needed to reduce her dosage. I asked her if the antidepressants were working, and she said something I’ll never forget. ‘Yes, they’re working great. I feel so much better. But I’m still married to the same alcoholic son of a bitch. It’s just now he’s tolerable.’

Clearly, this woman was aware that she needed to be in some amount of discomfort in her relationship with her husband in order to be motivated to get out of it. The drug made her feel better, but, it also reduced her incentive to change herself and her life. It was, in effect, a kind of band-aid, rather than a real cure. It anesthetized her and, in so doing, robbed her of something that was essential for new learning and behavior change to occur.

Unfortunately, most people who come to therapy are neither as courageous or insightful as the woman just described. Once they feel significantly better, whether due to therapy or medication, it is common for them to be less interested in continuing treatment. They have recovered from the event that precipitated their entry into therapy, but they might not yet have learned enough to avoid making the same mistakes that contributed to the problem in the first place.

Such a person can reason that the cost of therapy (both financially and in terms of time, effort, and the difficulty that comes with changing one self) is now greater than emotional pain from which they might still be suffering. Put another way, at this point, doing therapy “causes” more difficulty and pain than not doing therapy, just the reverse of what seemed true when they started the treatment process.

At this stage, those who continue in therapy have something that an old mentor of mine, Truman Esau, used to call “therapeutic integrity.” What he saw in some of his patients was an almost heroic desire to make themselves better regardless of how much the actual process of doing so was difficult, uncomfortable, or painful.

These patients didn’t shy away from problematic truths about themselves or others. They worked hard to stretch and challenge themselves, knowing that it was crucial to improve. They didn’t simply want a quick fix. Like the woman in Dr. Thomson’s example, they recognized that some pain was essential to being motivated. They knew that there was no such thing as “a free lunch,” and were willing to do whatever it took to repair and better their lives.

If you are in therapy now, it will be important for you to be sensitive to this shift from the often intense distress that brought you into therapy, to the point when the therapy itself might seem distressful. This can mean that the therapist is not skillful or that he is pushing you too much, but it just might also signal that some of the most difficult life changes you need to make are still ahead of you, even if the cost of making those changes seems greater than when you started treatment.

If you leave therapy because it is hard and unpleasant work, the problems you have won’t care. They will simply continue to reside in you, work on you, and trip you up. It is not enough to get over your last disappointment or unhappiness, but to change yourself enough to avoid future problems.

Few things that are worthwhile come to us for free.

The above image titled Depression is the work of Hendrike, sourced from Wikimedia Commons.