Friday, October 26, 2007

Calling a therapist

People mostly call psychologists (or any shrink, for that matter) when they're in trouble. It's because they have made a mess, or because someone intimately involved in their life has made a mess. What do they think we're supposed to do?

A few months ago a new patient is overwhelmed by grief in my office because she has just found out her husband has had an affair. "Lady, I can't fix that!" I want to say, but she already knows that. She just wants someone to bear witness to her unhappiness, to have someone say to her "That's a shame. I'm sorry you're hurting." Hearing that won't fix anything, but somehow she will feel validated in her misery.

Where are the friends and family that should be standing witness to this sort of event? We've become so fragmented that we seem to have lost our natural support systems, and we're reduced to hiring a sympathetic ear to make real what has happened to us. Maybe the young people with their cell phones and instant messages have the right instinct. Maybe out of the deep human need to escape isolation they are re-creating their own tribes.

My job as a psychotherapist is to help people change. The absolute worst time to try to make a considered and thoughtful change is in the midst of a catastrophe. Granted, a catastrophe, especially one that you create yourself, establishes a dramatic context for the necessity of change, but nobody can think clearly while overwhelmed with misery, desperation or grief. To know what you want to change requires that you know who you are. You have to start from where you are, not from where you want or ought to be. That requires clear thinking, not desperate emotionality. "The court told me I have to see a psychologist" is possibly the worst possible starting point for anything useful.

Monday, October 15, 2007

The function of truth in therapy: Comments on Kaiser

Helmuth Kaiser's theory was that therapy occurred when at least two people were together and at least one of them said what s/he meant and meant what s/he said. He believed that people pretended to understand one another rather than accept the total separateness and isolation of their lives.

While I believe there is some validity in the first statement, I'm not at all sure about the second. Suppose, for instance, that there is a therapist (I'll use male references) and a patient. When the therapist "says what he means and means what he says", who changes? One? Both? Imagine now that the therapist spends the entire hour talking "truthfully" about himself. How could that possibly be effective treatment for the patient? On the other hand, how can the therapist induce the patient to say what he means and mean what he says?

Instead let's look at the issue from a standpoint I have proposed in previous notes. When the therapist gives a truthful response instead of following the social rules, s/he destabilizes the situation. That is, by breaking out of the social role and responding authentically to the patient, s/he makes it possible, or even necessary, for something new to take place. Now the patient can think and say something new, something that is not a social cliche or a comfortable lie. Of course the patient can invent new lies, but that takes a great deal of creativity and is hard to sustain in an ongoing interaction.

So I think the therapist moves the therapy along by speaking the truth, however uncomfortable, by saying what he means and meaning what he says, and thus makes it possible for the patient to think of himself in a new way, one that is more honest. This can be an uncomfortable process, certainly an anxiety-provoking one. (There are many examples in the "Dishonesty Dialogues.) When I pay attention to my interactions with other people, it is astonishing to me how much of the time I hide behind socially acceptable lies. If I tell the truth in social situations, however, no matter how tactfully and kindly, it doesn't take long for the room to empty and for people to find more comfortable and less challenging conversations. But the few that stick around or come back for more are worth getting to know. When I tell the truth in a therapy session, the patient is freed to change, think, get more in touch with himself, make his meanings and words fit together.

Friday, September 21, 2007

Breaking the rules

It's interesting how many times (a day) I hear people excusing their breaking the rules with the excuse that their rule-breaking was justified by strong feelings. "I just got so mad I flipped him off" or "I was so upset I didn't know what I was saying" or "She/he/it made me so angry I couldn't control myself" or.....

It's as if they think they have some free pass to violate the rules of the domain or system they're in because of strong feelings, like a "Get Out of Jail Free" card. The rules apply, UNLESS the person feels very strongly. Of course strong feelings make impulse control more of an issue, but do they excuse behavior? Do people think they should be allowed to break the law on the basis of poor impulse control? Is it ok to say "I killed him because I just got so mad I couldn't help myself"?

And of course it seems that we do allow this to some degree. Judges and juries are more lenient to crimes committed in the "heat of passion" than they are to "cold-blooded" or calculated crimes, although there is little difference to the victim. The issue seems to be whether we can always be expected to be responsible for our actions, under all emotional conditions. Do we believe that people can feel strongly enough that they are no longer accountable for their actions, or do we believe that people are always responsible for and accountable for their behaviors?

Years ago I had to evaluate the mental state of an elderly farmer who was accused (and who admitted to) killing his wife impulsively. He told me she had come up behind him quietly and "goosed" him, and that, startled, he spun around and slapped her, resulting in her falling, hitting her head and dying. After telling me this quietly, he thought for a minute, and said the following: "You know, I've been a good man all my life. Raised my kids, went to church regular, worked hard and made my own way. Now, one killing and all of a sudden I'm a murderer".

Monday, September 17, 2007

Aspiring downwards

When I was a young man (don't laugh, it happened) most of my group wanted to be sophisticated, elegant, educated, well-dressed, charming and polite, because we wanted to be adults, and we thought that adults were like that. We hoped that smelling good, being clean and neat would also help us be accepted (especially by girls). We thought (fools that we may have been) that this combination would be attractive to young women, and indeed to every adult with any pretensions to "class". You might say that we (mostly us lower middle-class) aspired to the manners and behaviors of the upper socio-economic classes.

Now I find myself increasingly puzzled over the apparent desire of young people who are themselves middle or upper class, moneyed, educated and sophisticated, who seem to aspire toward the manners and behaviors of the lowest socio-economic classes: the population of the ghettos, the criminals, the terribly poor (who, by the way, don't see themselves as people to be emulated). Why aspire downwards? I see well-to-do young people wearing clothes that are deliberately damaged so as to appear worn and battered. They clearly enjoy looking scruffy, the males unshaven, both sexes ill-dressed. I hear them talking gutter talk, using argot of the tenements and the ghettos, listening to and singing the primitive and crudely vulgar music of the poorest, least-educated people. Do they do this because they no longer see the "upper classes" as worthy of emulation? Have they lost any admiration for education, "class", manners, good dress? Is it a form of rebellion against an adult society, a society run by the middle and upper classes? I wonder if the constant exposure by television and newspaper/tabloid news of everything corrupt and dishonest has made young people believe that there is no longer any integrity, no morals or honor among their seniors. Now that I’m one, I don't admire us much either. On the other hand, there isn’t much news value in honesty or integrity.

Sunday, September 16, 2007

In psychotherapy, what is a "cure"?

There is a conflict among psychotherapists about what constitutes a "cure". One group says that the patient is the final authority. Another group says that there is no such thing as a cure. A third group say that when symptoms of depression and/or anxiety have gone, the patient is cured. A fourth group says that until the underlying character defect that causes the patient to have symptoms is corrected, the symptoms will return under the pressures of life.

The problem with all these points of view is that they don't define clearly what the "illness" we psychotherapists treat actually is. When the patient complains of symptoms of various kinds to a physician, the physician doesn't just apply medications to relieve the symptoms. Instead, the physician looks for the cause of the symptoms, and attempts to address that. Are the symptoms of depression and anxiety like that? Do we need to look for some underlying cause to correct, lest the symptoms return?

I think reasoning by analogy is very risky business. We don't know what causes pathological anxiety or depression. We can make up plausible, but ultimately untestable fictions that account for the symptoms, but plausibility is not a sufficient foundation for any structure. The problem is, we don't know what causes anxiety or depression. We have no therapies that address "causes". However, when depression is treated as a symptom, and when the treatment is effective, as it is in 70% of the cases, the depression does NOT return. The same results apply to the effective treatments of anxiety. The patient doesn't feel bad any more. Is that not enough?

By the way, the two therapies that have currently demonstrated consistent effectiveness at symptom reduction are cognitive-behavioral therapy and interpersonal therapy. No other therapy has been demonstrated scientifically to be as effective for the reduction of symptoms. But people have problems that do not manifest themselves as clear-cut symptoms, and symptom-reduction therapies are ineffective for them.

Friday, September 14, 2007

Religous arguments II

It occurs to me, after reading the comment made to the preceding blog, that part of the problem with the science vs. religion argument is the usual boundary issue: whose domain rules should be used to evaluate the issue?

Members of the religious domain want to use their rules and standards to evaluate the validity of the scientific domain; members of the scientific domain assert that their domain rules should be used to evaluate the religious domain. From the standpoint of each domain, the other domain is sorely lacking. In fact, we all tend to judge the domains of others by our own domain standards. They do the same to us. The issue that arises over and over again throughout human history is how to deal with domains whose rules and behaviors are abhorrent to us.

I'm certainly not saying that we have to evaluate each domain from within its own rule structure. It would be impossible to have law and government if each group could only be judged by its own rules. The problem is how to establish the validity of an over-arching set of domain rules. Governments do that by simple establishment of an entire nation as a domain with its own rules, or "laws", and further asserting that such laws have priority over the rules of all domains under them or subordinate to them.

In order to evaluate government domains and their rule systems, we then have to establish some further system that includes all the government domains within a new rule system that is asserted to have priority over all subordinate domains, such as governments. Few governments are willing to surrender their own rule systems to such a system (like the UN or the League of Nations). But without subordinating their own rules, they cannot be in a position to judge the appropriateness or acceptability of the rules of other governmental/national domains. So they dance back and forth across the boundary, trying to assert their right to judge without surrendering to the judgment of others. An interesting if insoluble problem.

Tuesday, September 11, 2007

Religious arguments

I just received a brochure from a major group of skeptics offering to teach me how to win arguments with religious believers. I concede that I am a skeptic, addicted to the scientific method, demanding evidence and consistent theory. However, I don't see the point in attempting to argue against the validity of any religious position.

In the first place, it's not ever going to be possible to convince a religious believer with a rigorously logical argument. Not only do religious people not require (or even recognize) the rules for logical discourse, their belief by definition is not based on logical reasoning or irrefutable evidence. It is based on emotion, "faith", the appeal of various aspects of the religion, family belief systems, and so on. Faith, by definition, doesn't depend on replicable evidence.

In the second place, what is the point? Who gains by weakening someone's religious beliefs, no matter how absurd they are? People who are fervent religious believers can be rational and skeptical in other areas, so they don't appear to be "weakened" by their belief system. I dislike their tiresome self-righteous tendency to treat deviance from their particular point of view as ignorant or stupid or even evil. But I don't see how, as a skeptic, I should be as intolerant and arrogant as they are.

I observe that religious beliefs give a certain comfort to people in pain and in trouble. I imagine that believing in life after death takes away some of the sting of loss and grief. Believing in some system that makes life appear to be more fair is very appealing, even though religions that attempt to do this (in spite of the evidence) have to reach pretty far to try this. We want to believe in the punishment of the wicked and the reward of the innocent, and clearly that doesn't happen in this world.

So to you religious people out there who may by chance have read this far: I'm glad you find comfort in your beliefs. I hope they sustain you in your darker hours. I only hope you don't find it necessary to punish me for not believing in your religion.

Boundary crossing

An additional thought to append to the preceding note: "Crossing a boundary" means to take the rules from one domain into another domain. Bringing gang rules into a school is an example. Sexual advances from an employee to an employer (or vice versa) is another. The issue is not so much whether we like or approve the rules but that they break or conflict with the rules of the new domain.

To "fit in", we must comply with the rules for the domain we are in. It isn't an absolute necessity that we fit in; it's just a choice we can make. If we don't like the rules in a domain, we don't have to enter that domain unless the choice is forced on us. We don't care so much, for instance, if rival gang members shoot each other. We object to their behavior breaking our domain rules when their violence spills into the public sector.

In recent years, we have begun asserting the priority of an overall set of domain rules, which we call "human rights". We assert them to have priority over all local domain rules, which justifies our entering into other domains, by force, if necessary, to impose our higher priority rule set. This comment is not intended to criticise such action, but to point out that wars break out in order to assert the priority of one or another set of domain rules as "universal". Religions, in particular, generally assert their domain rules as superior and that all conflicting domain rules be changed. The assertion of human rights as a pre-eminent set of domain rules is no different than any other assertion, religious or otherwise.

Sunday, September 09, 2007

Boundaries

There's a lot of psychobabble about "boundaries" and the problems that result from "crossing them". Amidst all the smoke it's hard to find what kind of fire is burning. I've spent a lot of hours listening to people talk about the problems that were caused by other people "crossing the boundaries", and out of that I've begun to understand what they mean.

A boundary is an imaginary line that separates one domain from another. "Moving" in this sense can be physical or mental. When we move into a different domain, the rules that govern how we are expected to act change. Each domain is defined by the rules that govern residence in the domain. Examples are generally both easy and obvious. How we act in church is governed by different rules than when we are in our homes or in a bar. How we act at a party is different than how we behave at a funeral. Our behavior in an organization is governed by the rules of the organization, which can cover any aspect of human behavior. When you join the Army, you dress, act and behave differently than you are being a member of a sorority or fraternity.

So what does it mean when we speak of "crossing boundaries"? By the above definition, boundary crossing occurs when someone entering a different domain does not adhere to the rules of the new domain. Showing up at a funeral in a bikini would be an example, but examples are so numerous they become trivial. What we experience when someone moves into "our" domain and does not follow "our" domain's rules is rudeness, at the least. How serious the boundary violation is depends on how important is the rule that is being broken. Domains vary a great deal in the rigidity and vigor with which rules are enforced, some domains (like informal social groups) being relatively lenient, while others (like religious organizations) being relatively rigorous.

We see the boundary crosser as behaving disrespectfully (at least) toward us and all who are in the domain with us. We see it as a violation of our "rights" to set the rules in our domain and have them respected by others. Yet the "right" is a social custom, not some divine necessity or basic aspect of human nature.

We typically respond to anyone who "breaks the rules", who "shouldn't act that way", with anger. The public display and demonstration of our anger is expected to discourage people from not following the local rules, or even to force them into compliance. We have every reason to be uncomfortable with people who "cross boundaries', who are unwilling or unable to follow the "rules" that govern our lives, manners, dress, behavior and so on. We can't predict what they will or will not do. Our "rules" don't seem to control them or govern their behavior.

At the same time, it's important for all of us to recognize that the "rules" of a domain are essentially arbitrary and man-made. We can choose to comply with them, and that makes our social existence smoother. But compliance with these rules is a choice, not a necessity. If we choose in a particular instance not to comply, we should expect conflict and disagreeable responses, perhaps even assault.

Saturday, September 08, 2007

Unhappiness, grief and depression

In an earlier post I suggested some differences between unhappiness and depression. I now think that I confused the terms "unhappiness" and "grief" by compounding them. At the time it seemed important to me to avoid confusing depression with grief/unhappiness. People generally confuse depression and unhappiness, not realizing that depression is a treatable (and curable) illness.

Grief is not a part of unhappiness, I believe. Grief is a natural healing process that provides relief from losses occurring in all of our lives. It is possible to have a happy and satisfying life even though it is visited by grief at times. Unhappiness is a different emotion, resembling depression more than grief in that it is generally not time-limited, as grief normally is. However, depression is an illness that is characterized by anger or hopelessness directed at the self, while unhappiness is the result of life problems and circumstances that are not suitable for the individual experiencing them.

We can understand grief and depression fairly easily. Unhappiness, however, can result from either circumstances beyond our control (life in a concentration camp, for instance) or from circumstances that could be changed but at a price the person believes may be too high. When our lives are unsuitable for us, we become unhappy, and the unhappiness can endure as long as conditions remain the same. However, I am also aware that many individuals have achieved a happy life in spite of terribly unsuitable and difficult life situations, and that most of us have experienced periods of happiness even during difficult times. Obviously the condition of unhappiness is not solely conditioned by external circumstances.

Unhappiness, then, is composed at the least of our awareness that our life situation is not what we need it to be. One patient described his chronic unhappiness very well: "It's like wearing your shoes on the wrong feet. You can do it, you can even walk in them, but nothing feels right and everything seems to hurt."

Sometimes it seems to me that people choose to remain in unhappy circumstances rather than face the uncertainty and risk of change. This is especially true with those who have never really been happy. When we know no other way to survive than through an unhappy life-style, we tend to avoid chance-taking. For example, I think of the many abused spouses who elect to remain in their marriage rather than risk the uncertainty of trying to survive alone, or to risk the moral judgment of one's religion, or whatever. People get "stuck" in bad jobs and bad relationships, unwilling to risk alternatives or change. Sometimes they even get stuck in lifestyles that they believe are "right" but which result in chronic dissatisfaction and unhappiness.

People can (and should) get treatment for depression. While they sometimes ask for treatment for grief, little beyond support (or supportive treatment) is necessary. In fact, psychotherapeutic intervention for grief may even be harmful in that it treats a normal human response to loss as if it were some sort of pathology.

What about unhappiness? Should we treat that in psychotherapy? In general, I believe it is useful to use psychotherapy as a tool in treating someone who is unhappy over a longer period of time. The therapeutic issue that immediately arises is whether the situation and circumstances that give rise to the unhappiness are chosen by the patient or imposed on the patient. To what degree does the person consent to the circumstances of their life? Can they find their current situation livable if they change their attitude and values? Sometimes the answer is yes. Sometimes, however, the answer is no, and the patient must decide to live with their unhappiness or to change their circumstances. The latter choice is rarely welcomed by partners and family members.

Frequently, if not invariably, the unhappy person has to examine their values and the choices arising from those values. Changing values and associated behaviors is not an easy task, but then neither is living with unhappiness.

Sunday, August 26, 2007

Deification trivializes the message.

When we turn teachers or leaders into Gods, we trivialize their messages and their work. As example, consider Siddhartha Gautama, who was later called the Buddha, or Enlightened One. He was an ordinary man, a minor son of a regional kinglet, much like a mayor in a modern city, who left the life his parents arranged for him and pursued enlightenment. He found it, after years of thought and meditation, and then taught the method of attaining enlightenment to all those who would listen.

Later followers elevated him to some sort of Godhood. By glorifying and deifying their teacher, they raised their own status and authority. They made legends of miracles attending his birth and death. He became The Buddha, as if he were the only person who had attained enlightenment. What a farce. The followers, seeking their own self-aggrandizement, missed the entire point, which is (of course) that absolutely anyone can attain enlightenment. Buddha-hood is for every person that is willing to achieve it, not for divinities or deities. There are undoubtedly many Buddhas in this world now, but real Buddhas do not seek power, position, recognition or authority. Why should they? Becoming enlightened is hard work and it is not achieved overnight. It can't be granted to others or handed out as a reward. Everyone has to search diligently for their own enlightenment, and there is no shortcut.

But the point is that enlightenment is for everyone, not special people or godlets. Christianity shows the same pattern as Buddhism. The followers elevate their leader to the status of a god, and then worship, as if that were what the religion is about. They miss the point. Christ (another title, not a name) taught behaviors and attitudes that lead to enlightenment. The heart of Christianity is compassion, as it is in Buddhism. That heart does not lie in rituals or titles or churches. Ridding oneself of the selfishness that allows us to see others as different is hard work. Literally treating the other as if the other were our self is a hard task. Everything else is worthless posturing.

Monday, August 20, 2007

Gratitude

It seems clear to me that it takes a pure heart indeed to do good deeds without resentment. Many people I talk to have tried to be "good people" by doing "unselfishly" for family or friends. But we all have built in a sense of fairness or balance, and sometimes without realizing it we are building up a sense of expectation of payback, payback in the form of friendship or love or gratitude. When it doesn't materialize, we get gradually more resentful and cynical. "No good deed goes unpunished", we say.

In fact it seems to me that the more we do for someone, the more likely they are to resent us and avoid us, perhaps out of a sense that they owe us something. They don't like feeling obligated, some tell me. They find themselves even mildly distrustful of the person who has done them a series of services. "What are they after from me?" they ask. And many times they are right. The good-deed-doer does expect something back, and they are waiting for the person they helped to show a sense of obligation and gratitude.

Not gonna happen. That road is how you become a doormat and permanently disappointed. If you can't do a good deed just for the internal satisfaction of doing something nice, you can expect to feel short-changed. "Do unto others" is good advice, but don't expect gratitude.

Sunday, August 12, 2007

Roads, bridges, gasoline

We have low gasoline taxes, high road use, heavy gas-guzzler cars, driving 3 or 4 blocks to get something, no real bicycle/motor-scooter traffic. In Italy and Switzerland (and probably in other EC countries too) the roads and bridges are maintained through a gasoline tax. They have been paying $4 to $6 per gallon for a number of years, while we were paying $1.50 (those days are gone forever). Our roads were paid for with allocations from other taxes.

What if a tax were placed on our gasoline, the funds earmarked for the roads and bridges? If the tax were high enough, say $6 per gallon or even higher, several things would happen which need to happen. 1) We'd drive the gas-guzzlers a lot less. That means lighter cars, more efficient engines with lower horsepower. Like we need 300 hp to drive to the supermarket. 2) We'd use the roads a lot less, with a lot less weight so there would be much less damage and wear to the roads. 3) We'd start using motorscooters and bicycles, and we'd make it safer for such vehicles to go places. In my town riding to work on a bicycle makes you a target for jerky teen-agers (of all ages) with their pickup trucks and huge tires. People would learn to start treating scooters and bicyclists with courtesy. 4) The roads would last longer and take less maintenance, and the bridges could be upgraded without a lot of additional tax money. 5) There would be a real incentive to develop alternative fuel sources, electrical cars, and so on. 6) There would be a real incentive to develop a mass transit system and train system that really works. 7) The air pollution and dependency on foreign oil would decrease, and we might actually find ourselves NOT going to war in oil-rich countries (undoubtedly a coincidence, given the prevalence of WMD). 8) If the gasoline tax were truly earmarked and restricted, our beloved politicians would have less opportunity to spend it inappropriately.

What we have now is laughable, especially in comparison with what is available in other countries. In Oklahoma City, for instance, there IS NO TRAIN GOING NORTH to cities like Wichita or Kansas City. The train that runs the 160 mile trip to Dallas (from Oklahoma City) takes over 5 hours to get there, because it stops and waits at every town. The trains are no good because there is no incentive to use them; because they are inconvenient and poorly managed there is no incentive to improve them.

Am I missing something, or is this a good idea that other countries already thought of?

Sunday, August 05, 2007

Rich churches

Religions are among the most wealthy organizations in the world. They are exempt from income taxes because they are (in theory) charitable organizations. They were originally exempted in the US because we did not want to give government the power to tax a church or churches out of existence. The exemption has gone well past this mark.

I pass a local church with a building that will seat several thousand people. The "minister" has an expensive new car (a Lincoln Town Car), and lives in a small mansion. Don't misunderstand: I don't begrudge him/her making a high salary because the minister is obviously a talented speaker and is valued highly by his "flock". I begrudge him/her being paid out of tax-exempt funding, essentially at the expense of those of us who do pay taxes.

I have a modest proposal. How about churches pay income tax on 1) everything they EARN as a church, through investments, land sales and the like; and 2) everything they take in that is in excess of legitimate expenses and building funds. They should be donating excess funds to the poor, or to charitable institutions, or providing medical assistance. They should NOT be allowed to invest excess funds in the stock market or real estate market or whatever. They are NOT businesses, but they act like them, so let them pay taxes like other businesses.

That would be a lot of money.

Tuesday, July 17, 2007

Lies of omission in relationships

In psychotherapy telling the truth is important, since only in the unstable relationship that results from telling the truth can growth occur. To say what you mean and mean what you say, as suggested by Helmuth Kaiser, is a difficult task but ultimately allows people to grow and change.

A patient (ostensibly faithful) asked if he should admit to his wife that three years previously he had had a brief affair, which he described as "meaningless". By that he explained he meant that there had been no emotional involvement with the other person either before or after the sexual event. He states, "I want to be honest with her". (I am for the purpose of this note ignoring the possibility of STD and his responsibility of protecting her against the consequences of his act). He states as justification that if the situation were reversed (which he doesn't believe is true) he would want her to tell him.

What he really means is that he thinks that by confessing his affair he can reduce his feelings of guilt. Of course this would probably work; he would feel some relief and less defensive with his wife. However, she would undoubtedly feel worse, and the relationship would certainly become less stable and more unpredictable. He is willing to feel better at her expense under the guise of "honesty".

On the other hand, if he doesn't tell her (a lie of omission), the relationship goes on as it has in recent months. It remains relatively stable and predictable. However, he would have to go on living with his guilt and defensiveness, recognizing the increase in distance between them (which she may ultimately sense), and limiting any possible growth and change for the better (or worse) in their relationship. She will certainly know him less well than she thinks; he will not discover what changes he needs to make in their relationship to make it better. Over time the relationship may become more stagnant.

He has left himself (and her) no really good alternatives. Each choice will be accompanied by a price, as every choice always is. Each choice results in damage to the relationship. The confession results in acute pain and damage, but the potential for healthy (but not necessarily pleasant) change. The lie of omission results in a slow and chronic pattern of distance, rigidity and loss of intimacy. He simply has to choose which kind of pain he prefers.

I seem to be making the assumption that good relationships must grow, and that therefore honesty is required. I'm not sure this is true, however, One can make the case that there may be times when relationships should be static, where no important changes occur, where individuals in the realtionship may remain consistent and predictable. Acttually, relationships go through periods of stasis as well as of growth. We seem to need both; I don't think many people would like constant change and unpredictability in their personal life.

So you pay your money and make your choice.

Anger as magic II

We can observe anger and rage in infants. It is an expression of frustration, frustration that the world is not doing what we need. Infants rage when they are hungry, cold, wet, too hot. Their expression of their anger is communicative; its goal is to goad caretakers/authorities into taking action to make things right. The baby shouts at the world; the world recognizes the problem and does something to fix it.

We are angry for the same reasons that we expressed our anger as infants. We express anger or rage when the universe and/or other people don't do what they should do. Every expression of anger is aimed at causing the object of our anger to change. It is a primitive expression of demand. The other objects in our world should behave differently, and we will rage at them until they do. We get angry at everything that gets in our way, as if the universe were a sentient creature out to thwart us.

It is our primitive and barely conscious belief that anger is somehow effective in getting what we want from others and the universe out there that is incorrect. If I stub my toe on a rock, walking in the dark, I may curse the stone or the dark, or just "it". I rage at "it" just as if I expected it to attend to my needs like parents when I was an infant. On some level we (and I) have a belief that anger is magic, that it alone creates change in the world.

At the same time, rationality tells us that we are more likely to get cooperation from others when we are not angry. We observe that our anger is more than likely to engender defensiveness in others rather than rational thought. We can observe that attempting to solve our own problems reasonably is more effective than attempting to coerce others (or the universe) with our anger. We know the rock on which we stub our toe can't be forced to stay out of our way through raging at it, but we do it anyway.

Sometimes we prefer our anger to its opposite, fear. The same bodily reactions occur in fear and anger: the rapid breath and heartbeat, the adrenaline flow, muscle tension and the like. However, in fear the direction of our movement is away, to flee, while anger moves us toward forcing the other to change. The question is, however, do we have to be angry to confront something that we need to change? Can we get better results with or without the anger? What would our personal lives be like if we didn't get angry? Could we survive?

Sunday, July 15, 2007

The function of religion

Quite apart from the issue of whether a (or any) religion is valid, i.e. describes some aspect of reality, it seems to serve several important functions. It provides a "pre-history" which describes the beginning of the world. In societies in which there is little control of conditions or where food is scarce or requires skill to obtain, religion offers magical and ritual methods of attempting to exert control. Whether through invocation of game animals or placating gods supposed to be in charge of a particular aspect of life, such as weather, war, and so on, this aspect of early religions offers members a way of feeling they have control over important parts of their life that are really chance.

When the rituals don't work and the god(s) don't perform up to specifications, we develop a system to account for the failures of the magic: we imagine trickster gods or bad gods who oppose good gods. If the good god magic doesn't work, there must be another god who sabotaged it. Every culture of which I am aware has developed in this direction.

Since life is so manifestly unfair and since we so badly want it to be fair, we incorporate in our religions conditions that reconcile the unfairness. The more unfair and out of control things become in our lives, the more we seek a religious justification and rationale. I wonder if, as things get more erratic and unjust in our "democracy", we might not expect to see a surge of interest in the more extreme aspects of religion? Clearly we need better and more powerful magic; clearly we need to make more fairness, no matter who we have to go to war with.

Friday, July 13, 2007

Anger as a mental illness

We don't hesitate to classify chronic sadness as an illness. Depression is a serious disorder, resulting in many deaths and what is almost as bad, lives with all the joy emptied out. Chronic anxiety is also an illness. Anxiety shortens lives and makes most events fear-producing (not that there are not genuine reasons for anxiety at times). Chronic anger, however, has never been classified as a "mental illness", though it probably costs more lives than the first two together. It has broken many marriages and families, stressed people to the maximum and ruined their health. Why don't we see this as an illness deserving serious study and treatment?

It occurs to me that we as a nation (USA) see anger generally as a "good thing". We live in denial as to its toxic qualities and life-damaging effects. We love movies in which the good guy, having been suitably mistreated in the early part of the film, rises in righteous indignation and smites the bad guys in bloody and exciting ways. Consider the "Die Hard" movies, the movies starring Charles Bronson or Arnold Schwarzenegger or... there are really too many to enumerate. I like them too. When Dirty Harry lets 'em have it, I feel the same rush of satisfaction that the rest of the audience does. Our TV shows are full of it (anger, I mean), and we all watch them.

It's a way of life for us. We seem to need the thrill of knowing we are absolutely RIGHT and justified in whatever we do to take vengeance on the wicked. I find the same reaction in myself much of the time. In real life (whatever that may be) I'm rarely certain that I'm right. I'm possessed by the nagging feeling that perhaps the other person(s) may be right, that maybe I've missed something or misunderstood something. So when the time comes that I KNOW they are wrong and I'm RIGHT, I love the rush of adrenaline that spikes my righteous wrath. There's a thrill to "letting it go", even though I know it's bad for me and bad for relationships.

Maybe I don't want to see chronic anger as an illness. Where would we be without it? Would we still belong to Great Britain? Would we be able to stand up for ourselves and fight back without it? We as a nation were founded on rebellion and righteous wrath. Many of us espouse Christianity or Buddhism, which certainly do not encourage revenge or anger, but that doesn't even slow us down; in some cases it may make us worse because it makes us RIGHTER.

So I'm wondering if the reason we don't recognize chronic anger as the sickness it is, is because we like it too much.

Friday, July 06, 2007

Thought Experiment II

Suppose we were able to design a computer that can pass the Turing test, and let us further suppose that it has awareness of self, although we really can't define it. At keast it reports that it has self-awareness, awareness of itself in time and space. Now let us suppose that at any given moment we can turn it off, "freezing" all the circuits as they are at that moment, and then at some later moment turn it back on.

When it is on again, it reports that there is no lapse of awareness, just a lapse in time. In other words, it experienced restarting as a simple continuation of its previous functioning. This experience and report is essentially identical to what we humans experience when we are anaesthetized. We "go to sleep", and when we recover consciousness, we don't experience a lapse of personal awareness, just a lapse in time. We become unconscious at 1 pm and recover our consciousness, little the worse for wear, at 5 pm. We are the same person we were when we became unconscious.

Now reconsider with me the previous "thought experiment". In it we considered the plight of a person who could (through some advanced technology) be completely deconstructed and destroyed, then rebuilt at another place and time exactly as it was when deconstructed. It was possible to conclude that there would be literally no way, even in theory, to reconstruct the experience of the person who was deconstructed. The replica or reconstruction would experience exactly what the person or computer in the first example might experience. It "went to sleep" and then "woke up" at a later time with no experience of lapse of selfhood. But the original, the one who was destroyed, might have experienced total and irrevocable death, and as a result there would be no way to recapture its experience of termination.

The problem seems to arise from the way in which we think of consciousness. We tend to think of it as a unique phenomenon, unique to each one of us, and not in itself replicable. However, we also know that every person (and probably some animals) experience their identical awareness as unique. So, is the reawakened or reconstituted computer or person experiencing the "same" or a "different" consciousness? When we think of the computer, replaced atom for atom, reporting in its reconstructed state that it is "the same" as it was before destruction, does that mean that somehow identity has been passed along with the sense of consciousness?

I think it begins to seem that we make a mistake when we equate consciousness with self-awareness. We think of self-awareness as unique to each of us, but consciousness is simply a kind of functioning that animals and people can have without requiring that self-awareness be part of that consciousness. In the original thought experiment, it was posited that the process of destruction of the original could fail, and as a result both the original and the reconstructed person/computer would be identical and in effect be the same person. This now appears to me to be a difficult concept only because we equate self-awareness with consciousness. Both the original and the replication would be conscious. Both would have whatever self-awareness that accompanies consciousness on that level. To consider which is the original person now becomes meaningless. They are both the original. They both are conscious. They both have self-awareness. Each awareness is immediately different from the other because each now has different input, so off goes their consciousness marching to a different tune.

I'm still thinking about it.

Saturday, June 23, 2007

Identity and self I

Most of who we think we are is tied up with what groups we belong to. In this essay I'm going to consider what that means, how it limits us, and how we can let go of some of our self-imposed limits and be more directly in charge of our lives.

Humans are tribal animals. We belong together in groups, like all primates. From our first group, our family, to our last, we belong to groups. Groups include your friends (rarely more than 29, because that's the size of the basic primate tribe), your profession or job, your gang, your hobby group, your country, your religion, your garage band, and so on. We each belong to a number of groups, but at any given moment we are primarily in just one.

What does it mean to be "in" a group? Groups have boundaries which separate the "ins" from the "outs". It is usually required by the group members that prospective members demonstrate their willingness to belong by jumping through a hoop of some kind. These hurdles are called "initiation rituals". Groups may require you to pass an examination, carry out a series of difficult tasks, or tolerate pain or embarrassment to "prove" your right to be a member. The difficulty of the initiation helps establish how important it is for you to be a member and reassures the current members that their group is worth the effort of joining. Leaving a group usually results in considerable resentment from the group members or punishment for the person leaving.

When we're functioning as a member of a group, we have to follow the prescribed rules for behavior, dress, language and other related choices. Even though you may belong to other groups with different rules, you are expected to follow the rules for the group you are currently in. The rules have already been established by the group, and may be ethical rules, behavioral rules, dietary rules, moral choices... the list is lengthy but the penalty for breaking the rules may be punishment or even expulsion from the group. Essentially we incorporate the values (repeated behavioral choices) of the group as our own. As a result some part of how we identify who we are is our group identity. That's frequently what we answer when someone asks us who we are. Many of us identify first with our occupational group: I'm a policeman (or whatever). For others the occupational group is less important, and we identify ourselves with another group, such as family or club.

But we are more than our group identity. We have our names, our historical sense of being the focus and center of all the experiences that were focused in our brains. We have our physical point of view, which is unique to us; nobody else can look out of our eyes or hear with our ears. We identify our self as that person who thinks the thoughts that pass through our brain, who remembers the experiences of the past in the first person.

Of course all these latter issues are largely fictional. Everyone without exception who is conscious and aware shares identically the same experience of uniqueness. Our experience of personal uniqueness is really the one thing we all absolutely have in common. (If that be irony, make the most of it.) Everything described in the preceding paragraph is temporary and removable. We can lose our point of view with losing our eyesight or hearing. We can lose our personal memories in a heartbeat, the instant of a ruptured blood vessel in the brain, or slowly through some deteriorative process like Alzheimer's. Our thoughts change from second to second, like a fountain flowing, without constancy and largely without coherence. Every night we surrender control of our thinking process to sleep. Who are we then? When we're asleep or unconscious who are we?

Not every culture celebrates individual value and personality like the West. Not every individual regards their personality as unique, valuable, important. As I get older I find myself wondering if the self I regard as essentially constant really even has any existence at all. Perhaps the "I" is just a comfortable illusion.

Identity

Current physical models of the universe specify that there is no "center", that there is no uniquely privileged place which we can call a "zero point" from which to measure distances or locations. All positions are purely relative to one another. Yet we each experience the universe from a single and genuinely unique location, in our brain and through our senses. From our standpoint, each of us is at the unique center of the universe; our experience of being individual and unique is one which is shared by every other sentient creature. In fact, it is the ONLY thing we all absolutely have in common: our experience of a unique awareness located in a particular place and time.

Buddhist thought points out that the experience of personal identity or uniqueness is illusory, in that we share our experience of uniqueness with everyone who has ever lived. Yet the illusion is inescapable. Here we are, looking out through our own eyes and thinking our own thoughts, separately from the experience of everyone else who has ever lived. We find ourselves thinking, "why is my experience of myself right here, right now, behind these particular eyes, and not some other place or time or self?" What places "me" here and now? Even recognizing that the self is as illusory as the uniqueness of a candle flame doesn't escape the fact that I experience myself here and now. Even those who are able to transcend the illusion of selfhood are still located in time and space, here and now.

It's easy to see that the "self" is illusory. It is apparently stable, yet it is obvious that it changes from second to second. Most of us would hardly recognize the self we were 20 years ago, or the one we may become in another 20. Awareness drifts from moment to moment like smoke. Our awareness begins in childhood, suspends every night in sleep, and ends in death, and that's all the universe we can ever experience. In fact, it is our awareness of being located in time and space, here and now, that gives strength to the illusion of a constant identity. We look out through our own eyes, not someone elses; we think our own thoughts and have our own memories, not someone else's. Because of that apparent unique location, we identify the one who looks and is aware as a constant "self", an identity.

The conflict between experience and reality cannot end. We feel unique; we know we are not. We think others are different from us; we know they are not. We pretend our experience is unique; we know it is not. We experience ourselves as at the center of the universe, the zero point; we know we are not and it is not. But the question remains: what is it that is at the center of our awareness and behind our eyes? It looks and feels unique but it isn't. What is it?

Sunday, June 17, 2007

Fairness

Fairness is such a peculiar concept. Most of us (maybe all) have strong feelings about the importance of fairness. When we're children "being fair" means that the same rules apply to all players, that there is no "privileged position". Sometimes being fair means that we should all share equally. When children argue about being fair, they always mean that someone else is getting more than they are. They NEVER protest that they are getting too much. Of course, we do much the same today. If the goods were "fairly" (i.e. "equally") distributed among all the world's population, most of the middle and upper socioeconomic classes would have a good deal less than they now do. So when we talk about wanting things to be fair, we don't really want an equitable distribution of the world's goods and services.

The other way in which we use the concept of "fairness" is in regard to the way in which "good behavior" is rewarded. In all cultures this issue has been a struggle. It is obvious that there is no relationship between moral values and rewards or punishments. Good guys have bad things happen; bad guys have good things happen; both are essentially random. We do not wish the world to operate that way. We insist that there is a logic in what happens to us.

To account for the unpredictability and irrationality of events, we invent arbitrary gods who war with one another and with men. Then we invent ceremonies to placate the gods in order to induce them to be more fair, or at least to give us more while punishing our enemies. When we give up hope for fairness, we imagine the god(s) are simply abusers of power or even worse are simply uninterested in the affairs of men, and we resign ourselves to endure unfairness.

In Buddhism (Theravada Buddhism) and some other related religions the arbitrary and unfair nature of the world is accounted for by "karma", which, by assuming that we have a cosmic account from other past lives, imposes a sort of fairness on the present. If something really bad happens to me that doesn't seem fair, then it is because I did something bad in an earlier life for which I am being punished, and the universe is fair after all.

In the Old Testament we observe a god who punishes unbelievers and rewards according to whim. In Christianity we are offered a life in another world after death in which the good are rewarded and the evil punished. Somehow the idea that there is a god who is a perfect accountant and balancer of the scales has endured across the ages and cultures. But the knowledge that this world isn't fair is unavoidable. We won't accept that, so we invent systems which are (at the least) pretty unlikely in order to make things seem more acceptable.

None of us seem to like the idea that the Universe simply grinds on according to its laws and with no regard for important us. Doesn't everything really have a meaning?

Saturday, June 16, 2007

A thought experiment

In 1984 the philosopher Derek Parfit suggested a thought experiment dealing with the nature of individual consciousness. According to my admittedly imperfect memory he imagines a teleportation machine that works by "scanning" an object. As it scans the object atom by atom, it destroys the atom by turning it into energy. It sends the energy to a receiver which uses the energy to create an identical atom in a different location.

The item is thus destroyed at the original location to be rebuilt a distance away. So far, so good. The item is re-assembled, atom by atom, to form an identical replica of the original item. Since the replica is in every sense identical, can one say that the replica IS the original item? One assumes that an operating machine would be disassembled and reassembled, still working, at the different location.

Now, thinking of the human as an extremely complex machine, we suppose the device "sends" a particular person through the intervening space to the receiver where the person steps out of the receiver. Whatever thoughts the person was thinking at the time of the transmission would continue to be thought when the person was reassembled. Is it the same or a different person? Parfit then suggests a problem: suppose that due to a malfunction, the original is NOT destroyed. Which of the absolutely identical copies can be said to be the original?

Of course the issue of identity and how it can be defined is the concern here. But I want to suggest an interesting variant: suppose the "original" is destroyed as is posited in the original concept. From the standpoint of the person who steps out of the receiver, his thought processes seem consistent and continuous from his birth to the present instant. He would certainly experience in his awareness that he was the actual person who stepped into the transmitter. But now imagine the experience of the original. He steps into the transmitter, and there he ceases to exist. His awareness stops, no matter that an identical awareness starts elsewhere. So while the person stepping from the receiver would experience a continuous and harmless process, the original consciousness would have ceased to exist because its atoms were destroyed.

What are we to make of this in defining individual consciousness and identity? The process is not symmetrical. From the standpoint of the person at the receiver, there has been no interruption. But from the standpoint of the sender, the process was discontinuous and terminal. We can of course never know this experience directly, since while the receiver person reports "No problem" or the equivalent, the person at the sending end has nothing to report and nothing to report with. In fact, this outcome cannot apparently be resolved by experiment since there can be no report of the sender's experience! What we have just considered here is the only evidence we are ever going to have.

Monday, June 11, 2007

Outside The Box

Sometimes when the universe presents us with new data it's "inside the box", by which I mean that it is not widely disparate from other data. We can see where it might fit in. We can expand current theories to include the occurrence of the new data.

Sometimes the data is "outside the box", but not so far from other data points that we can't see how to develop a new theory to expand the box and all the possibilities therein. The data may be strange, but it relates to other data, perhaps in unexpected ways. A recent example of that is "dark matter" and "dark energy". While the theories that include "dark matter/energy" are somewhat cloudy, the expansion of the theories about the universe now includes a number of other data points not previously easily included. Clearly such new theories are less certain and will require additional proof and even new theoretical constructs. However, we can imagine in general terms how such constructs might appear and how they will fit in with current theories.

But sometimes the data is very far outside the box. It's so far that it cannot fit in with other theories. They are contradictory to other data points or massive groups of data points. There is no easy theoretical construct that can include them without rebuilding the entire box. When someone "sees a ghost", that data point is so far away from all the others that to include it we need an entirely different view of the universe. The very meaning of the phrase "supernatural" is equivalent to "completely outside the box". Most of the current fads in "new world" thinking fit in this category.

This is not to say that we shouldn't consider rebuilding the entire box. All advancement in science has come from this direction. "Germs" were outside-the-box thinking, and to include them we had to completely reconsider our theories about how bodies worked. Other "outlier" data points could be seen to fit into the new construction, which could then be further expanded.

For data points so far outside the box that we have to rebuild our view of the universe, we should require a higher level of proof. The data points can be mistaken; the "ghost" was a trick of the light or a flare in the lens. Occam's Razor recommends that we find the construct that requires the least change in our view of the universe, that we rebuild the box minimally, if at all. We should see if the data points are truly "out there" or only appear to be out there. We shouldn't accept a change in world view on the basis of a single event. We have to see how the rebuilding of our world view fits with other known data points and theories.

Whatever reconstruction of the universe we may come up with, it must include all the old data points as well, and explain them as well or better than the earlier theories. Many people seem to be comfortable with holding two or more mutually inconsistent approaches. On the one hand, they demand intellectual rigor and theoretical integrity and consistency. On the other they hold absurd and contradictory world-views, based on feeling or “faith”. “Faith” seems to be a poorly-defined word which is used to justify the acceptance as fact of unverifiable and absurd items, as if accepting something unproved and unprovable is some sort of virtue. When people can’t even be consistent with themselves, how can we expect them to be consistent with one another?

I have an acquaintance with a Ph.D., who adheres to scientific rigor in her area of expertise, but at the same time is able to believe in homeopathy, “meridian lines” on the body and extrasensory perception. She is even astonished that I'm unwilling to accept her personal experience as sufficient proof, because personal experience trumps science. Amazing, isn’t it?

Monday, May 28, 2007

Dishonesty Dialogues VI

Pt: (Looks down, then back up) I don't know what's the matter with me. (Long pause) I guess I'm sorta... I don't know. Depressed. I guess.
Ther: But you're not sure?
Pt: Yeah, I'm... I guess... I'm depressed all right.
Ther: Did you know that when you came in, or did you just then figure that out?
Pt: I guess I knew it when I came in. Sorta, anyway.
Ther: But you said you didn't know. I'm puzzled.
Pt: Well, I guess I kinda knew, but.... (long pause). My wife and I had this big argument last night, and...
Ther: (Interrupting) Is this about your depression?
Pt: Yeah! See...
Ther: (Interrupting) We can come back to your argument in a few minutes. I'm feeling unfinished about what we started with.
Pt: (Puzzled) What?
Ther: When you said you didn't know what was the matter with you, but then later you said you did know. I said I was puzzled by that.
Pt: I don't know what you mean. (half smile, looks down and back up)
[Therapist thinks 'I now have to make a choice, to stay with the earlier confusion or to move on to this second instance, because he certainly does know what I mean. The pattern is that he professes to be confused when he really for some reason doesn't want to specifically address the issue. However, the second instance is just another version of the same issue, so...']Ther: Why do you say you 'don't know what I mean' when in fact you do know what I mean? Seems to be almost habitual.
Pt: Gives me time to think, I guess. Yeah, I guess that's it.
[Therapist thinks "He never says things straight out, but always with the 'I guess' or 'sorta'. I wonder if that's part of the same mechanism."]Ther: Does it seem to you that you're under some time pressure to answer me quickly? (Before patient can reply, therapist continues:) Take all the time you want.
Pt: (looks very uncomfortable) Yeah, I guess I...
Ther: (Interrupts again) No, take all the time you want.
Pt: What? Oh. I'm... I guess I... I don't know why I do that.
Ther: I don't agree with you. You do that so consistently, in such an organized way, that I'm convinced there is a specific purpose behind your behavior, even if it's not easy to put into words.
Pt: I guess I've always done that.
[Therapist thinks, "At least a step in the right direction"]

Dishonesty Dialogues V

The following dialogue is with a patient who has always been the family "ugly duckling", stupid, unloveable and in every way unable to compete with her sister, who is considered "perfect".Pt: ... so I.. we went to the fair, and I had some extra money because I got my check. And C mentioned she hadn't gone because she didn't have the money to spend on it. I asked her if she wanted to borrow $10 and could pay me back whenever. I said "It doesn't make any difference to me". And you know what I said? I said "I have all the money I need." Now why did I say that?
Ther: Why do you think?
Pt: I guess to impress her. A stupid thing! I never did that before in my life, and I thought, "Why am I trying to impress her?" I guess.
Ther: You wanted to impress her?
Pt: I guess. I don't know why I said that. I couldn't believe I said that, afterwards. I never, it never dawned on me what I said right then. Ther: Did you want her to be able to take the money and feel okay about it?
Pt: Probably part of it. Because I did want her to take it. I mean, I'm not rich, but I do have enough money to give her $10.
Ther: So why was it "stupid" to try and make her more comfortable? Is there something else you said that I'm missing?
Pt: No, but I shouldn't have said that! I don't have all the money in the world!
Ther: But your lie was intended to do what? Impress her that you're rich?
Pt: No. I knew she already knew I didn't have a lot of money.
Ther: Did you want to impress her with what a giving and nice person you are?
Pt: Not that either.... I hardly know her and I don't even much like her.
Ther: So... the lie was for what purpose, then?
Pt: To make her feel OK about it.
Ther: What's the matter with that? Is that a bad thing to do?
Pt: No, I'm just saying it was a stupid thing to do.
Ther: How, "stupid"?
Pt: Well, maybe "clumsy" would be a better word.
Ther: So it was clumsy, awkward. But it was well meant, it was an attempt to make someone else feel better. You don't like people to feel bad.
Pt: No, I don't want them to feel bad. That hurts.
Ther: So you embarrassed yourself to make someone else feel better. Your intentions were good.
Pt: Intentions. You know you can't go by intentions.
Ther: Not entirely, but they do count too, you know. Maybe you were awkward and you exaggerated in order to me her feel more comfortable. What's the worst part about it?
Pt: That I lied, and I did it so easily.
Ther: So you've found a way to think of something you did that was actually nice, and you change it around so that you can think badly of yourself.
Pt: No!
Ther: Yes! Are you going to try and tell me there was nothing good about what you did?
Pt: (Long pause) No. I guess...
Ther: Why is it so important that you think badly about yourself?
Pt: (Long pause) It's safer that way. If I'm no good, then... it scares me to feel like I'm good. It scares me to think someone might like me. So I have to drive them away.
Ther: Loneliness is better than.... what?
Pt: Being hurt.
Ther: You believe that?
Pt: Absolutely!
Ther: Another half-truth.
Pt: What do you mean?
Ther: Well, let's look at what you said you believe. Your only choices in relationships are what?
Pt: Being safe by myself, and lonely. And on the other hand, caring and getting hurt and rejected.
Ther: That's the downside of both. What's the up side?
Pt: Well, being with someone, being loved, caring about someone, having a friend. And on the other side of that is if you care about them and they leave you, the hurt is unbearable.
Ther: So you balance on one side feeling loved and lovable, companionship, closeness plus the certainty of getting hurt, sooner or later; on the other side is safety, the assurance of NOT being rejected, plus the steady ache of loneliness.
Pt: That's it.
Ther: Just don't lose sight of the pluses as well as the minuses.


The careful reader might note that the exaggerations made by the patient ("unbearable hurt") are for the sake of justifying a choice she has already made. The whole thrust of the earlier part of the section is to demonstrate that she is "stupid" and can't do anything right. This proves her parents right about her and reinforces her unconscious wish to take the blame so that she can maintain the fantasy of perfect parents who will someday love her if she can just stop being "stupid".

Monday, May 21, 2007

Dishonesty dialogues IV

Pt: I really don't know why I tried to kill myself...in fact, I don't really remember it real well. I had been drinking, which isn't something I usually do... and... I don't know.
Ther: (Looking at BDI score) You score on this depression evaluation is low. It suggests that you are just barely depressed, at least according to your answers. That puzzles me.
Pt: What does?
Ther: That according to you and what you've told me, you aren't depressed clinically. But on the other hand, I have the records of your suicide attempt, and it was a pretty serious one. How am I to make sense of this?
Pt: (laughs) I don't know.
Ther: Another puzzle. You seem to be quite comfortable with what appears to be a very serious problem. How do you know you won't do it again, when you can't make sense out of it happening the first time? And you're laughing! What in the world is funny here?
Pt: I guess it's easier to laugh than to cry.
Ther: Does that mean you felt like crying but you made yourself laugh instead?
Pt: No.... uh...
Ther: Then we have still another puzzle. What happened?
Pt: It just struck me as bizarre that I would try to kill myself and have no idea why I did that. And I'd rather laugh because it's more comfortable.
Ther: (Has lots of questions) You'd rather laugh than what?
Pt: Rather laugh than be scared.
Ther: I'm uncomfortable with you trying to hide your perfectly legitimate anxiety about killing yourself by laughing it off. I don't take near-death lightly, and I don't believe you normally do. So how am I to understand this? (Thinking of Freud's paper on Gallows Humor and TA theory about the same topic). I'm thinking that sometimes people laugh about horrible or unavoidable misery by making a joke about it, like when somebody about to be electrocuted makes a joke about electricity.
Pt: Yeah... I can imagine doing that.
Ther: So it's possible that you could laugh about your suicide attempt the same way?
Pt: Sure.
Ther: Does that mean it's unavoidable and so you might as well try to lighten it up?
Pt: (long pause) Well, the fact is... (long pause) Look, I'm 53 years old. My kids are moved out, my job really sucks now, at least for the last couple of years. I broke up with the guy I was in love with because it was clear to me that he wasn't gonna leave his wife, and I can't tolerate being "the other woman" like I thought I could. My mother has moved away, and she was my best friend. All this happened in the last couple years. So I'm thinking, what's the point in going further with this? I'm really not that depressed.... but I really am unhappy with my life. There's just nothing in it that I care about anymore, and I don't have any religious beliefs that would stop me from dying.
Ther: So it seems likely that sometime in the next weeks or months I'm gonna read in the paper about you dying.
Pt: God damn it, you just want to cut to the bottom line.
Ther: Well, you're not psychotic, so I can't hospitalize you. Clearly you have a right to make the decision to die, and as long as it's not be reason of mental illness I don't have a legal right to stop you. I understand now what you are talking about.
Pt: My life has just gotten emptier and emptier, and it doesn't look better down the road, what with ill health and old age and all the rest of what's coming. So, I think, why should I hang around until I get old, drooly, helpless, incontinent.... all that stuff.
Ther: What bothers me about what you're saying is that while all that "stuff" is true, it's only half true, so I think there's something more here.
Pt: Why do you say "half true"?
Ther: Well, you paint a very bleak picture. How come your life is so bleak? Or do you think all of us oldsters should just pack it in before the going gets any rougher?
Pt: A lot of shit has happened to me...
Ther: Oh, I see. Just you, then.
Pt: I guess you could say that.
Ther: And your belief that life is bleak and then bleaker is predicated on your belief that nothing can change and make it better, is that right? You're making a joke about electrical services?
Pt: (laughs) Yeah, I guess so.
Ther: I have a thought experiment I'd like to suggest, if you're interested.
Pt: Sure.
Ther: You're capable of keeping a decision you make, aren't you? I mean by that, if you really meant it, you'd keep your word?
Pt: Yes. I would never break my word.
Ther: Once I had a patient who was locked into a miserable marriage of many years duration. She told me "the only thing that keeps me going is knowing I can always kill myself". I guess that seemed a better or more acceptable decision than moving awy and changing her name to "Smith". Anyway, I suggested she consider making a permanent, life-long, no-suicide decision, which she did eventually. A couple years later she filed for divorce. She told me "I could stand anything if I thought I could always check out any time. But when you look at your spouse and think 'I'm gonna be around maybe another 30 or 40 years, and you think, Not like this!' So I had to get a divorce."
Pt: (Is silent for a while, looks thoughtful)
Ther: Making a decision like that is really a major undertaking. It has the power to force you to change your life. So I certainly wouldn't suggest you rush into anything like that. The homework assignment, should you choose to accept it, is to imagine you had made such a permanent decision. And for the next week to consider what you'd have to change if you were stuck in being alive for another 40 years.

There are a number of places in this conversation where the evasions and dishonesties could have been usefully focused. For instance, early in the exchange the patient laughs and responds "I don't know" to the question as to why she might be suicidal, yet it's clear that she does in fact know quite well and has thought about it a great deal. In another exchange about her laughing inappropriately she first gave as a reason that she was laughing "instead of crying", but 2 sentences later she said she would "rather laugh than be scared". Clearly she wants to think of herself as naive (in the first instance) and in the second instance as sad instead of frightened. Many other issues are worth attention, such as her underlying passivity and expectation that life will somehow reward her for being good, and clearly it hasn't; her suppressed resentment is a feature that later in her therapy became an important issue.

Dishonesty Dialogue II.

B. Suicide attempt
The patient was seen as an inpatient following a serious suicidal attempt.
Pt: I just want to die… (sobs)
Ther: So why aren’t you dead? (thinking, “I hope this gets her attention”)
Pt: What? (stops crying and looks at the therapist for the first time)
Ther: You heard me. If you just wanted to be dead, you’d be dead. (Thinking, “she uses the word ‘what?’ to buy time”)
Pt: I just don’t have the nerve.
Ther: What do you mean by that?
Pt: I mean I’m afraid of the pain, and of the… of dying.
Ther: OK, now I understand you better. You want to die, but not all that much… at least, the pain and the dying seem worse than living at the moment, but not by very much, huh?
Pt: That’s right. (some relief in the voice)
Ther: Why did you only tell me part of it?
Pt: Well, that’s the part I wanted you to know about. I mean, about how bad I feel.
Ther: You wanted me to take your unhappiness seriously… not think it isn’t as bad as it really is?
Pt: That’s it.
Ther: I guess you must expect that people won’t take your unhappiness seriously.
Pt: Nobody does, I think. They just tell me that things will get better, and shit like that.
Ther: So if you had trusted me to listen better, what might you have said?
Pt: I guess…. I coulda said that I’m so unhappy that I want to die, but I’m still too afraid of death and pain, and that… I’m afraid you won’t believe how bad I feel, because… nobody else does.
Ther: Now do you think I would believe you?
Pt: (pause, some surprise in voice) Yeah, matter of fact, I think I do.

Dishonesty Dialogues III

Pt: Dr. B, you look like you lost some weight.
Ther: (Pleased) I've been working out a little.
Pt: Good.... I was worried that something might be wrong.... your health.
Ther: Yeah?
Pt: I don't want you to get sick and die... I worry about your health at your age.
Ther: Somehow, when you say it like that, I don't feel that there's any personal concern. (grins)
Pt: Sure there is!
Ther: What concern?
Pt: (long pause) Well, all the work we've done together... I don't... (pause)
Ther: Out with it.
Pt: I don't know if I could start over again with another therapist. So don't die. (laughs)
Ther: I understand now. I'll do my best to stay alive... not on your account, of course. (laughs)
Pt: (laughs with relief)

Sunday, May 20, 2007

Dishonesty dialogues I

I have provided these slightly edited dialogues is for the purpose of illustrating how people constantly provide partial truths, outright lies, and simple or complex distortions in order to present themselves as they want to be seen. The lies of commission and omission stabilize a partial or distorted self-concept, even though it is understood that the focus of therapy is about making changes in oneself. For the most part, the lies are so habitual and practiced that the patient has limited awareness of his/her behavior. The rules of polite, social conversation usually preclude probing questions, because such questions make us uncomfortable and move us too close to unpredictability in casual relationships. The social lies are the “grease” that make polite conversation as shallow and deceptive as we need it to be, and even in the therapy situation people rarely understand that the rules of discourse are different.
So here you will see the usual lies we all tell, and hopefully we can see what the patient is trying to “sell”. Usually what the patient is trying to present is the person s/he wants to be, not the person s/he fears s/he is. It seems to me, however, that changing our self starts with who we are, not who we ought to be or want to be. This follows from the previous discussion of the effects of lying or truth-telling on outcomes in relationships.
There are many ways of handling dishonesty. Every competent therapist, consciously and deliberately or not, has learned how to detect and deal with such lies. It’s my belief that this approach, that of confronting dishonesty, lies at the heart of every effective therapy. I would like to direct your attention to the patient’s style of dishonesty, rather than the therapist’s style of confrontation, which is probably not as important and is certainly idiosyncratic.
Much of the following material was originally presented at the International Society for the Study of Personality Disorders, in Vienna, 1995.
A. Smoking
Pt: I really want to stop smoking (looking directly and sincerely at the therapist).
Ther: (After a pause) And?
Pt: What? What do you want me to say?
Ther: I’m not understanding. There must be more to it than that.
Pt: What do you mean?
Ther: If wanting to stop smoking were all there is to it, you’d have already stopped.
Pt: (long pause) OK, I really want to stop smoking, but I guess I want to keep on smoking more.
Ther: You “guess”?
Pt: (irritated) All right, all right! I want to smoke more than I want to quit.
Ther: I understand you now. So when we started this conversation, what did you have in mind when you told me only part of the truth?
Pt: Well, I guess that’s what I should say… I mean, it’s what I ought to do.
Ther: You didn’t want to say the part about wanting to keep on smoking?
Pt: No.
Ther: Because…
Pt: Well, that makes it look like I don’t want to stop.. or that I don’t want to try to stop, and I do.
Ther: So… if you were going to say the whole thing in one sentence, how would you say it?
Pt: I’d come in and say… “I want you to know I really want to stop smoking, and I don’t want to say that I really also want to keep on smoking, because I think you wouldn’t like that… that’s not the sort of person I want…. Ought to be.
Ther: OK, that makes sense.
Pt: So. Now what?
Ther: I’m sorry. What are you asking?
Pt: How is that supposed to help me?
Ther: I’m not sure. But I do know that dishonesty hasn’t and can’t help you, and if you intend to change something it’s going to start with where you are and who you are, not where or who you ought to be.
I hope the dialogue begins to clarify the patient’s struggle to have a more positive if less honest self presentation. I might add the patient was unusually cooperative and intelligent.

Friday, May 18, 2007

Anger as a form of dishonesty

I don't mean all anger. Some anger is purely and simply the result of frustration. The world, the traffic, our boss... something isn't done as it should be. Something gets in our way, and we lash out at it.

But some anger derives from fear, which it conceals. A friend gets angry at me and I respond by getting angry back. What really happened was that his anger made me anxious, frightened me with the thought of losing a friend or simply of being disliked/rejected. So I covered it with anger, which is a more comfortable part of my self-image than that of being afraid. Sometimes I get angry because I'm afraid that if I let it go on or show fear, the other person will "bully" me. Sometimes I get angry because I don't want people to think of me as afraid. Maybe I simply don't want to think of myself as fearful. Maybe it's easier to think "I'm a little anxious" than "I'm a little afraid".

Angry behavior stabilizes and verifies my self-image as "I'm ready to stand up for myself". It also locks me into behavior that is frequently unhelpful and generally ineffective. If I want to change that behavior, I have to tell myself and others the truth so that I can begin to move on.

Saturday, May 12, 2007

Honesty and dishonesty

In an earlier post I discussed the pros and cons of lying and truth-telling. Briefly, lies serve the purpose of momentarily stabilizing interpersonal relationships as well as our image of ourselves. Lies create more controllable and predictable outcomes; the truth leads to unpredictability and the potential for more change.

The task of psychotherapy is to promote change. Consequently it is important to tell the truth in order for change to occur. Why does it seem so difficult to tell the truth, even to a therapist? My experience is that people grow accustomed to comfortable self-deceptions and outright lies because they are better able to pretend to be the person they want to be. We “put our best foot forward”. We “clean up our act”. We “try to make a good impression”, not realizing that all these dishonesties keep us trapped in our distorted view of ourselves. While we may not know what the “truth” about us actually is, we usually know when we are not telling it.
It seems to me much easier to define “lies” than to define “truth”. What are lies? Lies can be in two forms, lies of commission and lies of omission. The former is fairly easy to define: to lie is to make a statement of fact that you know to be untrue. Examples are abundant. The lie of omission is a little more difficult to define, as any attorney can tell you. Leaving out all or part of the truth is harder to define. When our former President said "I did not have sex with that woman" he was. at the least, telling a lie of omission. But even if you allow him the liberty of defining words any way he wants, his intent was clear: it was that of lying to conceal the truth. Leaving out a part of the truth that would materially affect the person(s) with whom we are communicating is an important lie.

So the intent to deceive is part of the definition of lying. Clinton lied because he wanted to control and stabilize the outcome of the interpersonal transaction with the public. He expected (rightly) that the truth would result in unpredictable outcomes. You will note that this definition is not a "moral" one, but simply a functional description of how deceitful or honest communications work. A moral description would include our judgment of Clinton as a person; a functional description would simply note the intended outcome and effect and judge its efficacy. A lie can be judged to be effective to the degree it works to stabilize any relationship.

The rightness or wrongness of lying is a moral issue. The effectiveness of a lie has to be judged within its context. Stabilization of a relationship is not a bad or wicked thing to do. However, lying minimizes the likelihood of change at that time, which can be either a good or bad thing, depending on what the relationship is judged to need. Change is not always a good thing or a practical thing at a given time; its value depends on the situation and context.

Helmuth Kaiser, in his book Effective Psychotherapy, concluded that therapy occurs when one of two (or more) people in a room is saying what he/she means and meaning what he/she says. In my opinion, this is the most profound and powerful statement about human relationships ever made. I have been thinking about this idea for more than 40 years, and its value has been proven to me time and time again.

"Saying what you mean and meaning what you say" is a good definition of telling the truth and avoiding even lies of omission. When truth-telling occurs in a relationship of ANY kind, change can happen. The situation/relationship becomes inherently unpredictable because it is open to change at that time. In a marriage change is growth, which itself may be either useful or harmful to the stability of the relationship at that time. Marriages and friendships can grow and improve or grow and end when the whole truth is told.

In a psychotherapeutic relationship this kind of truth-telling, ‘saying what you mean and meaning what you say’ promotes change. However, the contract between therapist and client precludes (or hopes to preclude) abandonment of the relationship when such change occurs. So both parties agree to remain in a truthful relationship with one another and to deal with change and instability that results in some kind of positive way. This procedure makes change inevitable in a therapeutic relationship.

When the topic of conversation is about facts, the definitions of truth and lies given above is fairly clear-cut. I can say where I have been and what I have been doing. I can say where the money was spent and what I had for lunch. I can even talk about what I thought about last night or whether I like your new shirt. When the topic of conversation is about the relationship itself, the definitions are more difficult. What is the "truth" about a relationship? How would one go about telling a lie, either of omission or commission, in a relationship? While I don’t have a general answer to this latter question, I can suggest some specific ones: I can lie about how I feel or how I react to something that happens. I can lie about what I meant when I said something. I can lie by not telling you what I really thought or felt at a given time.

As we talk in a therapeutic relationship, sometimes the topic of the conversation may be about ourselves, our values, or our history. There is something different about this sort of talk. I have noticed many times that when I try to think about my values and beliefs by myself, I have no way of determining whether I'm telling the truth or lying. There is no one to listen, and that makes all the difference.

These same statements made in the presence of another person sound differently; telling lies makes me uncomfortable when someone is listening in a way lying does not when I'm alone. Suppose, for example, I'm trying to explain to myself some behavior that seems to express a different value than I might want. I recall as a child taking a toy from the counter of a store. I knew that this was a bad thing, but I told myself that the store had a lot of toys and they wouldn't miss one. Within a few minutes I had myself convinced this explanation was the "truth". However, later my father asked me where I had gotten the toy, and the explanation I had prepared was unconvincing and clearly false, and I knew that it was false the moment I began the explanation. It wasn't whether my father could tell I was lying. At that moment I could tell that I was lying, and that was a surprise.

I don't know how to account for this peculiar quality of perception, the fact that we hear things with different ears when someone is listening. However, this factor is one of the things that helps a close relationship (therapeutic or not) grow and change. When you're talking about important issues for you, you can tell whether you are lying. Forcing yourself to be ever more truthful opens the possibility of destabilizing an unhealthy adaptation and beginning the change process.

Lying about myself serves a number of purposes. As in all lies, when I lie about myself I stabilize my perceptions about myself. As a young therapist I was required by a supervisor to write verbatim the contents of a therapy session with an individual client, and I was to do so immediately after the session. As you might expect, this was a time-consuming task, usually taking several hours. When the task was completed, the supervisor would sit with me and the transcript, and listen to the tape made of the session. Of course the transcript was neater and more compact, without all the stammering and fragmented thoughts characteristic of a normal conversation. But beyond this "normal" editing, there were major changes, rephrasing of comments, omissions of entire topics, misstatements and alterations. And all of them served the purpose of making the therapy look better, making the therapist look better, and fitting what was said more neatly into the theories I had been taught. Nothing I ever did so convinced me of the nearly infinite capacity for self-deception we all have, and how difficult it is even under the best of conditions to tell the entire truth.

A competent and truthful therapist (or friend or mate) can frequently hear the evasions and discomfort associated with telling a lie, and bringing the lie to the attention of the speaker makes it easier for the speaker to tell the truth. In the next blog I intend to post some dialogues between me and clients in which the dishonesty of the client was fairly easy to spot, but at the least illustrates the point.

Sunday, May 06, 2007

Values clarification

When people are unhappy with their lives they can either live with their unhappiness or do something about it. When they decide to do something about they may thrash about almost randomly, making poorly considered decisions. The "mid-life crisis" and the cliche red sports car are examples. So is the "geographical cure" or the "vocational cure" in which the person hopes that moving or changing jobs will cure the unhappiness. It rarely does, though we have probably all tried it or considered it. Those "cures", like marriage, only change problems; they don't solve them. Desperation doesn't lend itself to making good decisions.

Most psychotherapists spend much of their professional lives dealing with people who are unhappy in this way. Such people are not "mentally ill" but their unhappiness arises from psychological causes. They may be repeating patterns from their past (see the section on Injunctions) or they may simply be suffering from values conflicts which have not even been considered, much less resolved. They think they want a particular thing or to reach a particular goal; they don't realize that this aspiration is incompatible with other goals, either present or in the near future. They may not even want to consider the conflict of present wants and future goals, because they might (or certainly would) get frustrated.

Consider the young married person who desperately wants to succeed at his/her demanding job, but whose marriage is failing because of lack of attention, and child-raising is essentially abandoned to others or hired help. Imagine that same person at age 50, divorced, with family distant or uninterested, with lots of money but nothing special to spend it on but him/herself, wondering what went wrong. Yet that same person, back at the start of the disaster that his/her life has become, could have told you what his/her long-range values were. The person might well have said he wanted a loving marriage, children who grow up healthy and happy, and to have some time for fun. They didn't want to think that what they saw as an "interim period of sacrifice" was actually becoming their life. They didn't recognize that the values they were living by were inconsistent with one another, and that the outcome was in many ways predictable.

The therapist working with such people spends a lot of time getting the client to listen to themselves. The therapist makes the client listen to their inconsistencies, their self-deceptions, the incompatibility of current behaviors with future goals. The therapist makes the client start to pay attention to what the client's actual future goals may be. A very wise therapist once said "The hardest question of all is 'What do you want?'"

I call this sort of therapy "values clarification". It is not based on exploring your past, except insofar as it clarifies present choices. It is based on honesty with self and others. The therapist struggles to say what he means and mean what he says, and he encourages the client to do the same. Dealing with dishonesty of all kinds is at the center of the therapy. Self-deception is easy and ubiquitous. Omitting the truth is considered acceptable, and in public it is acceptable, but it is not in psychotherapy, which is not bound by social rules and "tact", though it is bound by the importance of kindness.

I see my task as a therapist as fairly active and confrontational when I detect inconsistencies and conflicts among people's values. Sometimes the client is uncomfortable enough with their conflicts to conceal them or avoid them; sometimes the client simply has never thought about where their choices are inevitably taking them. In some ways this particular job is a more difficult task for a young therapist than an older one, and in human history this task is most often undertaken by the "elders" of the human tribe. I suspect that in our abandonment of grandparents as advisors we have lost the natural source for this sort of wisdom, and are reduced to having to pay for it.