decision making

June 3, 2010

The Limits of Reason: How to Think about Your Date, Your Boss, Your Mom, etc.

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As a therapist, I hear a lot of concerns from my patients about parents, bosses, romantic partners, and so forth. The thoughts often take the form of “Why did he do that?” or “What was he thinking?”

Some of this is worth questioning. In life it is useful to take the role of the other person, to look at things from his or her perspective, to try to “understand” that individual’s motivations and reasoning process.

But, there are limits. Here are just a few that make understanding difficult:

1. People don’t always carefully weigh their decisions before making them. We humans frequently think and act impulsively or emotionally. It can be a bit harder to fathom an ill-considered act than one that is carefully reasoned.

2. The person whose mind you wish to enter may not know himself well at all. When you recall what he says are the reasons for his actions, you need to be aware that he may be fooling himself. Alternatively, he might be dishonest with you, giving you less than a full set of data, trying to prevent himself from looking bad in your eyes, or attempting to protect you from being hurt by the truth.

3. We all act in self-serving ways much of the time. The same person who says that he hates it when someone ends a relationship without explaining why — not even making contact or returning phone calls — might well avoid the discomfort of a final farewell or confrontation himself when he decides that a relationship should end, thereby doing the very thing that has been done to him.

4. Most people, in or out of therapy, are often indirect in expressing their unhappiness with you or their disappointments about your behavior. (Marital conflicts and parents talking to children can be noteworthy exceptions to this general rule). But, in the absence of direct communication, it is difficult to be a good mind reader. Indeed, crystal balls are in short supply whenever I go shopping.

5. When trying to understand others, we look for some form of logic. To seek something that is often missing within the person is a pretty big misunderstanding of how people think and act.

6. You may not have enough history and background information to make an accurate analysis of what drives this individual to do what he does.

7. Do you really know the person well “under the skin?” There is often a mismatch between what is happening on the inside and what is occurring on the outside. Put differently, the contradiction between surface appearances and internal truth often affirms the old saying, “Don’t judge a book by its cover.”

Too much time trying to figure out another person is unproductive. For this reason and those cited above, I encourage my patients to set some limits on the amount of time they spend attempting to get into someone else’s head. At bottom, I think, what most of us are looking for is the understanding that will allow us to return to the relationship and put it right, now that we have found the “answer” to what transpired. Or, something that will console us or produce the closure that we are hoping for at the relationship’s end. By attempting to “understand,” we are frequently seeking a sense of intellectual control, partially to acquire information that will prevent future disappointments, but also to compensate us for our loss and to silence the nagging internal voice that asks “What happened?” and “Did I do something wrong?”

It is better, beyond a certain point, to consider several things about oneself:

a. Why did I choose that person to be with? (Obviously this doesn’t apply to your parents; nor does it always apply to bosses or co-workers).

b. How did it happen that I missed the early warning signs of trouble? Oh, I know that you might think that such signs didn’t exist, but it could be that you ignored them, minimized them, or had a blind-spot for them.

c. Why didn’t I set some limits on the relationship in order to prevent the other person from injuring me? And, if I tried, why did my efforts fail?

d. Why didn’t I leave the relationship earlier?

e. What, if anything, did I contribute to the problems that occurred between my friend/partner/lover/boss and myself?

f. Have I grieved the loss or disappointment fully (including attention to both my sadness and my anger)?

g. What do I have to do differently in order to minimize or avoid problems like this in the future?

Instead of addressing the situation in these ways, with these questions, most of us spend no small amount of time ruminating, and then looking for something we can say to the other person to get them to behave as we wish. With some individuals that is possible, but not with everyone.

Jackie Robinson’s breaking of the baseball color-line is instructive in this regard. As you might know, Robinson and his boss, Branch Rickey, agreed that he would not respond to the abuse from fans, players, and coaches that both expected he would receive when he became the first black man in the 20th century to play in the Major Leagues. But, despite two years of taking every racially demeaning insult known to mid-century white males, he succeeded in playing well. Moreover, by this time there were other blacks in the Major Leagues and a great experiment in civil rights had succeeded.

If the story I’ve heard is true, Robinson and Branch Rickey had a conversation at the beginning of Spring Training at the start of Robinson’s third year with the Brooklyn Dodgers. They agreed that Robinson could now be himself, and fight back with words or fists, if necessary. Soon after, the Dodgers played the Philadelphia Phillies, who did not know that Robinson was no longer on a leash. The middle-aged man from the deep south who coached third base therefore once again began the verbal onslaught that he had performed with impunity for the two previous seasons. Robinson called time and walked over to the third base coaching box.

Remember that Robinson had lettered in four sports at UCLA, including football (as a running back). More than most, he radiated intensity, strength, courage, and intelligence. So it was that Robinson moved within inches of the bigot, looked straight into his eyes, and said: “If you ever say anything to me like that again, I’ll kill you.”

Now, I bring this up not to recommend death threats, but rather to point out that Robinson knew exactly who he was dealing with. He knew this man was not going to be persuaded to behave himself by high-flown verbal eloquence; he knew that spending much time thinking about this man’s character was a waste. What Robinson knew for certain was that there was only one thing he needed to understand about his nemesis (his intolerance) and only one approach that would work:

  • I’m bigger and stronger than you are, so if you don’t stop, I will beat the crap out of you.

Everything changed that day as others quickly realized that Jackie Robinson was not a man who could be insulted any more.

Of course, we all need to spend some time thinking about others and why they do what they do. But, endless rumination on the subject rarely is enlightening or successful in making us feel better.

Some people are like boulders. They are big, hard, insensate, obdurate, and potentially damaging objects. It is essential to see their potential to injure and realize that when you are downhill from such a human bolder, you are in danger.

If you understand how gravity works and get out-of-the-way, that is all you need to know and do — all you can do.

A shame, but true.

—

The image above is The Thinker by Auguste Rodin.

March 4, 2010

The Upside of Depression and the Downside of Medication

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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.

December 19, 2009

Who are You to Judge?

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Judgment is problematic. We need it, but not too much of it. Sort of like food.

While I will say more of a secular nature, the most famous comment on judgment comes from the New Testament — the Christian Bible — and is attributed to Jesus:

Do not judge, or you too will be judged. For in the same way you judge others, you will be judged, and with the measure you use, it will be measured to you. Why do you look at the speck of sawdust in your brother’s eye and pay no attention to the plank in your own eye? How can you say to your brother, ‘Let me take the speck out of your eye,’ when all the time there is a plank in your own eye? You hypocrite, first take the plank out of your own eye, and then you will see clearly to remove the speck from your brother’s eye.

The point here is about the potential hypocrisy: for us to judge others by a standard that is harsher than the one that we apply to ourselves. It is akin to the famous late addition to the Christian Bible about Jesus turning away the men who were about to stone a woman who had committed adultery, with the comment “Let him who is without sin among you be the first to throw a stone at her.” He later advises her to go and “sin no more.”

We judge lots of things. We need to judge the accused in the court room, lest wrong-doers do wrong with impunity. We judge ourselves and, one hopes that it improves our future behavior and helps us make good decisions.

We judge for self-protection, too; to comfort ourselves with the belief that the misfortune of others is due to their bad decision-making. By implication, if we make better decisions — display better judgment than they did — fate will be kinder to us. If we are careful, thoughtful, smart, do our homework, live by the Golden Rule, and so forth, good things will happen to us and we will avoid bad things.

This view seems to look at misfortune as some sort of anomaly, something that is outside of the normal course of events when, of course, it is not. All sorts of bad things happen to the innocent or unlucky. This is a troubling thought and our negative judgment of others — our attempt to make sense of their troubled lives or bad luck — makes it easier to sleep at night.

I’m not trying to justify all poor decisions here, many of which surely lead to disaster. Rather, it’s simply that not every bad thing is the result of some fatal flaw in the nature or conduct of a man or woman. Sometimes you can do everything right and have a bad result. Sometimes things just happen.

Judgment serves, too, as an attempt to guarantee immortality. Since most people see death as the worst possible outcome in any life, it shouldn’t be surprising that harsh judgment is often characteristic of religious fundamentalism. For the “by-the-book” parishioner, following all the rules of his or her particular religion guarantees a heavenly reward. And, for those who violate the doctrine, the faithful believe that there will usually be a trip to a darker place.

Judgment in this instance provides some comfort that death is not final; and perhaps the self-satisfaction of believing that in visiting judgment on the unfaithful, one is only trying to move them onto a path that will lead to heaven. For some of the religious fundamentalists I’m sure that it is; for others, however, it might only be a justification for venting angry condemnation of those who are different and who do not believe what the self-righteous might wish they did believe.

Judgment is often made by those who have no experience of the situation or circumstance in which the “judged” behavior occurred. To take a current example, consider Tiger Woods (or some other celebrity) reported to be unfaithful to his spouse. I am certainly not here to apologize for, or attempt to excuse Tiger Woods’ behavior. But I would say this: I suspect that non-celebrities have no idea of the temptation available to a man or woman in Woods’ position nearly every day of his life. And, as Oscar Wilde famously said, “I can resist anything but temptation.”

But, let us move away from the always controversial area of sex to give this idea a different look. I once asked the great Italian symphony conductor Carlo Maria Giulini about his judgment of the behavior of the German conductor Wilhelm Furtwängler. Furtwängler chose to stay in Germany during the period of the Third Reich, although he was not a Nazi. While he was helpful to some Jewish musicians, he also was used (and allowed himself to be used) as a propaganda tool by the Nazis.

Giulini , who began his career as an orchestral violist, had played under Furtwängler in Italy before the war. Moreover, during World War II, Giulini, never a fascist, had defected from the Italian army into which he had been conscripted and went into hiding for nine months, during which time he was a “wanted” man. But when I asked him about the controversy surrounding Furtwängler’s decision to stay in Germany and to allow himself to be a representative of a corrupt regime, Giulini was hesitant to judge:

It’s very, very difficult to judge the position of a man. It’s difficult for you in America to understand the problems we had in Europe. It’s difficult to put yourself in a position, in a special moment (in history), that is absolutely impossible to imagine if you didn’t live in that time. That last thing I should do is to express my opinion on this point. I had my personal political opinion, I took my position — very precise. I was not a fascist (laughs), and at the moment that I had to make a strong decision, I took it. But I am not in a position to do any criticism of another person.

We judge ourselves and others, to the extent that we do it, with the perfection of 20/20 vision that only comes in looking back, in hindsight, at what was done. We sometimes say “he should have known better than to” (make that business deal, marry that person, visit that neighborhood, smoke, drink — take your pick). Well, it is sometimes true. And, after all, I’m in the business of trying to help people to make better judgments. But mostly, that experience tells me that all people make mistakes and, assuming that they don’t mean to injure others, they mostly pay for those mistakes with their own blood, tears, and sweat.

As much as I recognize that judgment has its place, as a therapist, I try to meet people on their own terms, not coming from “on high” as a stern taskmaster or a fundamentalist-style religious figure “laying down the law.”

No, if you want that, you shouldn’t consult me. I am not here to condemn, although I don’t shy away from identifying right from wrong when it can be clearly seen.

Instead, I am here to help, to understand, to provide a bit of solace, to be a guide to a better way, if I can.

—

The gavel at the top of this essay is the work of Glentamara and sourced from Wikimedia Commons.