Therapeutic Credulity

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Commenting on this article which is as hilarious as it is infuriating.

http://theness.com/neurologicablog/index.php/a-psychiatrist-falls-for-exorcism/

 

I don’t even know where to begin with this article, so I’m just going to dive right in.

This quote: Gallagher could benefit immensely from even a basic understanding of cold reading and mentalism (not part of psychiatry training).

While I’m no psychiatrist, these concepts actually are covered quite extensively in psychological/therapist training, and I’m pretty sure that psychiatrists tend to do undergrad work in psychology, but I could be wrong. I’m sure some med students decide later on to specialize in psychiatry, which I think is pretty ridiculous for very many reasons, most of which because I think psychiatrists should have a very good understanding of therapy before learning the “magic” of psychopharmacology.
The article also mentions: let’s not forget, these are mentally ill patients.
How insulting and misguided! There isn’t a line that divides crazy from not crazy, but there are many markers by which we can determine the level of a person’s functionality, and plenty of highly functional people could still benefit from therapy, including psychopharmacological therapy, and the days when general practitioners play psychiatrist and hand out psych meds just to ease the patient’s fear of being crazy SHOULD be far behind us. But comments such as “these are mentally ill patients” as if that just explains everything about them in a seriously negative fashion are exactly why people are still so concerned about seeing the proper specialist to treat their symptoms.

The author concludes by saying that if we play into a person’s delusion we’re doing them a disservice by reinforcing the delusion. Wrong!
Trust is extremely important in the client/therapist relationship, and a person who believes that they’re being watched by the gov’t, spied on by neighbors, abducted by aliens, possessed etc, are SO used to being placated and condescended to, but ultimately disbelieved. They do not trust mental health practitioners because they’re tired of being treated like a “crazy” person and to them their experiences are (most often) absolutely real. They desperately need someone to believe them. Additionally, I’m a huge proponent of the “whatever works” brand of therapy. If not, what’s to stop me from telling highly religious clients that prayer doesn’t work, and that going to church is just making things worse? I don’t believe in their god, so maybe I think these things are counterproductive, but I have to work within the framework that I’m given. What about 12 step? We know that shit does not statistically work. We have a huge body of studies to draw from, but unfortunately the medical and psych communities in many places still haven’t caught up and believe that some guy and his friend in the early 20th century were qualified to write a manual to treat addiction. Additionally, we all have had clients and people we know who did exceptionally well with 12 step, so it perpetuates the myth that it’s effective as treatment despite evidence to the contrary. So if my client has tried and failed at 12 step for years, but they love it and sometimes it works for a while, do I print out dozens of research studies to try to convince them that the shit isn’t helping and likely making them worse? Absolutely not! This falls under the Ways to Quickly Alienate Your Client and Forever Destroy Client/Therapist Relationships heading. It’s not a good idea to tell people that the things they believe to be true are not true, and that the things they hold dear are dreadfully unhealthy. There is an extremely apt, oft used but grammatically jarring phrase: Meet the client where they’re at. You start by building trust, then work within the framework presented and see where it can be taken. If a person believes that they’re possessed and that they need to have an exorcism, I’m certainly not going to refer them out to some nutjob religious fanatic, but I’ll help them to be sure that the method they choose is safe, and if they get their exorcism and it works, great! But more than likely it won’t work, or if it does it likely won’t last, and I can be there to help them through that, and to help them seek out other options to wellness. In addition, therapy is really all about helping a person to come to conclusions on their own. We’re there to guide them, to ask questions that help them to think critically about their situation and to examine their choices and beliefs in a healthy manner. If I could just tell people, Drugs aren’t healthy, or Your relationship is likely to literally kill you, or You’re just delusional those things aren’t real, and suddenly everything changes for them, well then I’d be out of a job (er, I already am, but not for this reason, heh) and there’d be little need for psychiatrists either. Most importantly with this issue, actual delusions are most likely biological, and irrational thinking, for lack of better or more succinct phrasing, is habit. If the meds work, delusion gone, but the irrational thinking is still there and even if the person doesn’t feel possessed anymore they may still believe that they were or are but that for whatever reason the demon is not active or biding its time or whatever, and they’ll still need assistance to deal with this. Plus, if a person believes they’re possessed they may refuse meds because they’ll say they aren’t crazy they’re friggin possessed, so how do we get them to give meds a try? Hint: Telling them that they aren’t actually possessed but just crazy doesn’t work.

No, I don’t believe everything a person tells me, but I’m not just humoring them either. I understand that what they’re experiencing is frightening and debilitating, and it’s all too real to them. Our perceptions are just as flawed as our memories. A person who is colorblind will see grey where I see pink. That doesn’t mean that they aren’t seeing grey. We perceive things in vastly different ways, sometimes in a very literal sense because of physiology, other times because our experiences, societal norms, family values and upbringing, have colored our perceptions. I can’t impose my values on someone no matter how much I may believe that theirs are wrong or unhealthy. But I can hope that trust, proper counseling, and application of effective therapies (which definitely does include pharmacological therapies) may help that person to recognize which values and beliefs are healthy, which are benign, and which are decidedly unhealthy.

All that said, I’m definitely never going to write a paper explaining that my clients are definitely being haunted and possessed. That’s taking therapeutic credulity a bit too far. :p

Grace

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I’ve known for quite a while now that the worst thing about having MS and various other illnesses, it’s not the pain, not the losing of mobility, not the falling down, the slurred words, the fatigue, lack of job and income or the inability to care for myself. No, it’s the losing of my memory. That’s definitely the worst thing. I tried explaining to someone today what it’s like. Supposing someone broke into your house and took one thing. You probably wouldn’t notice, especially if it was something small like a book or DVD, and the only way you could notice that it was gone is if you went looking for that thing, and you might look other places for it because you know you own it but no matter where you look it’s just gone. Now imagine that things start going missing a few at a time, and you don’t really notice at first but then you start realizing that many things that you’ve wanted to retrieve just hadn’t been there lately and you wonder what’s going on, but there’s no explanation for it. Eventually you realize that your shelves and closets and drawers and cupboards are noticeably more bare than they were, that so many things have gone missing now that you can’t even keep track of what you’ve lost. You know it’s all missing, you can see the bare shelves, but there’s no easy way to take stock or inventory of what’s gone. Sometimes maybe you decide to retrieve a book or DVD, but maybe you only recognize it by sight so you rummage through all of your belongings, and best case scenario is that you find it right away, worst case you may search and search and tear your house apart but you just can’t find it anywhere, leaving you frustrated and exhausted, and angry and confused because where the hell is everything?! Now, add another layer, you’ve got a friend over and you decide you want to show them something, but it’s very difficult to describe, so you tell them excitedly that it’s around here somewhere and go on your usual search around the house, telling them you’ll find it, you know it’s there, you’ll definitely find the damn thing, and you start to get frustrated because you JUST saw it so you know it’s there, so your friend awkwardly tries searching for it with you, but since you can’t describe it they’re not sure what they’re looking for and all they do is get in the way, and you both become embarrassed by the whole situation and you finally just decide to drop it but the awkward embarrassment stays for a bit, because your friend reeally doesn’t understand what you’ve been going through as all of your belongings are somehow slipping away a bit at a time.

So now, imagine that your “house” and “belongings” in this situation are your mind and all the memories and contents therein. Imagine having a conversation with someone and visualizing something with a very self explanatory name, like toaster oven or weedeater, and despite the fact that you can see that object clearly and know exactly what it does, you can’t seem to find the name, and so any words associated with the description are also shrouded. If you could describe it in the simplest terms, “makes toast, small oven”, then you’ve found your object’s name or an approximation like “toast oven”. But no, you can’t find either of those words, you frantically try to think of words to describe this thing but when you’re on the spot with a faulty memory retrieval system, it’s that much more difficult to accomplish, and all the while your friend tries to help you by throwing out words, but all that does is confuse you. And it’s not just names of items, it’s names of bands, authors, books, places, names of people you know and people you don’t know but should know their damn names, like your best friend growing up, your favorite actor or musician, or even the friggin president. But it’s not just names, it’s life events, things you’ve done, things you’ve experienced, it’s all slipping away. Some of it may just be a bit hazy, but some of it is just GONE. 

I can see all of these things happen to me. I used to have an impeccable memory. I have memories back to at least age 3 and until recently, there were very few gaps. I used to remember almost anything I’ve ever read, anything I’ve researched, anything that was told to me. The only things I was ever very hazy about was math, which has never been my strong suit, and names of people I’ve met but don’t know well. Otherwise I was always the person people came to when they needed information about all manner of trivia, life events, names of actors, matching a song to a band, and in the work setting I was the go-to person for pretty much everything pertaining to our particular work setting. Nowadays, it’s rare to have a conversation without faltering at some point or another because I can’t think of the proper word for something, the name of a person, place or thing, an adjective, an event. Sometimes it’s so difficult to retrieve words that I stammer and stutter just trying to formulate my thoughts into a sentence.

I’ve always prided myself of being able to learn from my experience and knowledge, to apply that information to my life and my actions and use my wealth of knowledge to shape me into a better person. What are we but the sum total of our experiences and knowledge, and how we choose to reflect on those things? As my memory becomes more faulty, I feel as if bits and pieces of me are slowly leaking away, and I can’t help but wonder what will be left. Pain and anger? Frustration? Confusion? Will I be the old (or maybe not so old) lady in the care home who fights her caregivers every step of the way because deep down inside I know that I should be able to do this on my own, because I know that I used to be independent, smart and capable, and now that’s gone and it’s killing me inside.

As these things are happening, as my body deteriorates, my world crumbles all around me and each day is filled with pain, some days I can feel myself screaming inside, like a person trapped, a person lost. Outwardly, and whenever possible inwardly, I try to weather these changes with grace. Even on days when I just want to scream and throw things about the room, I maintain my composure. I’m not trying to stifle my feelings, I process them as they come, but I feel that if I can’t or won’t handle my lot in life gracefully, I’ll lose myself, and really will be nothing but pain and anger, resentment and confusion. I don’t want that for myself and my loved ones.

I’d always told my clients in my counseling days, there are very few things that you can control in your life. You can control what you say and do, and you can control your reactions to things that happen to you. That’s it. So decide who you want to be and control your actions and reactions accordingly. I’m going to follow my own advice for a change. I have to try. I’m 36 years old, and I’m losing my memory, my mobility and my sight, and I do not want these things to change who I am as a person, I must try to take control of those things that I can control for as long as I’m able, because those are my choices. I can deal with this situation to the best of my ability, or I can let my emotions drive my actions, in which case I will likely lose myself completely.

The Should Be Death of Chiropracty

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I began watching a documentary today called Doctored. The description states “An investigation into the ‘monopoly’ of the medical industrial complex and how Americans are viewed as patients.” I think to myself, this sounds interesting. I’ve seen many studies regarding how patients are viewed with regards to invisible illnesses (particularly pain) and especially the discrimination toward patients with mental health diagnoses. I have experienced some of these issues firsthand, as I’ve mentioned here in my blog many times, and it’s definitely a big problem. Doctors believe that psychology and psychiatry are simple sciences at best and they have no issue diagnosing and treating psychological issues despite the fact that they have little to no training in the matter. They view counselors as nothing more than a sympathetic ear, a shoulder to cry on, and that they have no time or patience to be that person so they’ll send them off to a counselor or therapist and the patient will have their cry out, or as in the movies they’ll suddenly have this huge cathartic breakthrough and they’re all better. Before that happens, however, they’re treated as a crazy lunatic who can’t tell the difference between pain in their body and pain in their mind, so unless they go have that breakthrough moment and can get off the psych meds (that possibly the doctor has prescribed themselves) then the person is viewed as unreliable, the doctor can’t take any of their self reports at face value, because this is probably just the crazy talking.

So, I start watching this documentary thinking, I may have something to learn here. It begins with scenes from a taped interview in the 80’s of some doctors angrily arguing with some chiropractors about the veracity of their claims to treat illness using chiropractic theory and methods. Sadly, the documentary does not go on to denounce chiropracty for the sham it is, but vilifies all those terrible, haughty doctors who denounced chiropracty for some many years. The documentary tries to say that doctors and the AMA created a smear campaign against these poor chiropractors who were trying so hard to just help people.

I’ve heard time and again that there’s no scientific evidence to support the effectiveness of chiropracty, and I’ve had my own personal negative experiences with chiropractors and chiropractic treatments that I was ready to believe it. But I realized, I’ve never actually done any research into the topic, I’ve mostly used my personal experiences to bolster my belief in this theory. So, as I’m often wont to do, I began doing some research, and amongst the slew of interesting articles that I read, I found one that was particularly interesting. It is a discussion regarding an article that was posted in a journal of chiropractic medicine by a group of chiropractors and doctors stating in no uncertain terms that there is absolutely no proof, nor veracity to the claims, that chiropractic medicine is a viable treatment option. https://www.sciencebasedmedicine.org/the-end-of-chiropractic/

So then I wonder, just as the author of the article wonders, where is the outrage? Where are the multiple exposés denouncing chiropracty for the fraud it’s always been?

This documentary is trying to say that medical professionals tried to suppress the miraculous healing that chiropracty had to offer because they wanted to monopolize the trade of healing and healthcare. In reality, doctors happily send people off the chiropractors who will do little more testing or analysis than xrays, if they’re lucky, and xrays are a terrible way to diagnose soft tissue issues such as disk swelling and annular tears. In fact, if a spinal issue were severe enough to be seen on an xray, a doctor would likely be very involved in the person’s treatment. Scoliosis can appear on an xray, and if it becomes severe enough it requires much medical intervention. But the reason that chiropractors are still so heavily used, the reason so many people are referred to them, is because compared to the cost of definitive medical testing, namely MRIs and the follow up treatment that may need to be required for such health conditions that may be diagnosed as the result, chiropractors are cheap. Insurance companies go to great lengths to insist that people attempt to cure what ails them through inexpensive (to the insurance company) chiropracty before ordering any further tests. This documentary’s opening complaint is that the doctors are trying to force out the chiropractors because they’re elitest and money hungry and can’t fathom the idea of a person being cured elsewhere before they extract their pound of flesh from them. (Well, not literally. Or maybe so, if they’re a surgeon. I dunno.) In any case, the reality is that chiropractors have a huge lobby, and have wormed their way into the healthcare community via the government and insurance companies. I won’t argue that doctors are often very elitest, with an attitude that, if you don’t have a medical degree then you shouldn’t have an opinion, and that definitely has to change, patients should, even MUST, drive their own healthcare, and doctors must let them, and help them. They could start by asking the patient to do their own research, and if patients made the effort they’d soon discover the sham that is chiropracty.

I will conclude by giving my own personal experiences with chiropractors. When my back pain first became so severe that I often found myself crawling on the floor, I finally had an angry discussion with my GP that something must be done. I was informed that I first must see a chiropractor. The chiropractor insisted that within 3 months I would be cured, that it may get worse before it gets better, but it will get better. I saw him twice a week, he applied much pressure in various ways to the area of my back that ached the most. It was excruciatingly painful, leaving me shaking and crying after each “treatment”. The chiropractor told me that I had a low pain tolerance, and that it was probably the biggest reason that I found myself unable to stand up when my back hurt. So in essence, he blamed my severe pain on my inability to tolerate severe pain. Three months went by and my back was worse, but he assured me that another 6 weeks should do the job, and he continued to quote the 6 week mark until I’d been seeing him for 9 months and my back was worse than ever before. Finally my GP was ready to refer me to a pain specialist, who immediately ordered MRIs. It turns out that my previous diagnosis of minor scoliosis (via xray) was actually much more debilitating than initially assumed. My spine had rubbed a bald spot on a disk in my lower back. Every time the chiropractor pressed that area the disk would rupture, and that’s why I was in such excruciating pain and that’s why I got worse with every visit. Still, for some reason I decided to see another chiropractor some years later. He came highly recommended by my brother, who was then a massage therapist in the chiropractor’s office. I met with the chiropractor who assured me that he could cure my scoliosis, if I met with him twice a week for 3 months. I had no intention of living through another nightmare of pain and empty promises. Both chiropractors were also involved in extremely shady practices. One of them did not accept my insurance, instead he told them that I paid exorbitant amounts of money out of pocket, then they decided how much they wanted to reimburse me for those costs and would send me a check, at which time I would sign over the checks to my chiropractor. I’m still not entirely certain whether this was legal. The second chiropractor employed massage therapists who were not yet out of school and therefore not licensed, which is 100% illegal. But it worked out great for him in that none of his therapists could rat him out for any of his shady practices because they’d never become licensed.

I have no doubt that there are honest chiropractors out there, who aren’t shady, who believe they’re helping people, who would report their client’s lack of progress immediately to their GP and insist on further testing, but in my experience, they are just as happy to continue doing what they’re doing in order to continue receiving the paycheck of twice weekly visits from someone who is never going to get better.

For further reading on discrimination perpetuated by the medical community: http://mobile.nytimes.com/2013/08/11/opinion/sunday/when-doctors-discriminate.html?referrer=

And: http://www.usatoday.com/story/news/nation/2014/06/25/stigma-of-mental-illness/9875351/

Grief and Chronic Illness

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Loss is a terrible thing. In life, we will have moments of loss that are often viewed as normal, many sometimes even so unavoidable they are expected and inevitable, but they still shake us so to our core we’re sometimes little able to function afterward. In our culture we don’t prepare for losses, particularly deaths, but wait for them to come, take us by surprise and knock the wind out of us.
Grief creates a very tangible, visceral pain. It literally hurts in our bodies. A study done recently showed that pain medication eases the psychological pain of social rejection.* Social rejection causes one to grieve immensely, and on a long-term, or chronic, scale. It seems that our grief for painful occurrences in life are just as painfully tangible as an upset stomach, a headache, and the malaise that many people feel while grieving.
There are two types of grief experienced in life. The acute, an occurrence that prevails with suddenness and quickly changes the topography of our lives, such as the loss of a job, the ending of a relationship, the death of a beloved pet, the sudden death of a beloved person, etc. These things occur swiftly, change our lives, but the primary event is over when it’s over and given time, we may adjust to our new lives with this change in it. We grieve strongly and terribly, mourn what or who we’ve lost, then we pick up the pieces and move on.
The second type of grief is chronic grief, and occurs when our losses are continual issues in our lives, when the things that we grieve are long-term, and ever changing, such as a chronic illness, the death of a loved one for which we cannot (or will not let ourselves) heal, chronic illness of a loved one, or news of the impending death of a loved one or beloved pet for which there is no definite time constraint (maybe a month, a year, or 10 years, we don’t know, but they’ve definitely got a terminal illness such as cancer that is incurable and will eventually kill them). Chronic grief is a terrible thing. Acute grief is expected, and accepted. One is supposed to hurt when they’ve suffered a loss. But people have difficulty identifying with the long-term pain associated with the chronic, of any sort. Chronic physical pain is beyond comprehension for many people. How can any person hurt all day every day? It must be something made up, exaggerated, stated excessively, because such a life cannot be feasible. Chronic psychological pain is just as difficult to grasp. How does one continually not deal with an issue or problem? How does one continue to hurt?
Truly, people can only suffer so much. Chronic pain of any sort tends to numb us. People with chronic physical pain often have very high pain tolerances. But also, they can have very low pain tolerances, as if their capacity for experiencing pain has been used up, and one more thing added to the list is enough to bring them to tears. Terrible psychological pain can cause the same effects. Maybe a person is just holding it together dealing with their various chronic and/or acute griefs, and that one more thing, like dropping a pizza cooked fresh out of the oven, and they burst into tears like their whole world has come unraveled.
Many of us with chronic illnesses deal with both chronic physical pain and chronic grief. We mourn the many things we’ve lost in our lives due to the illnesses that we struggle with every day. Imagine waking up one day and learning that not only are you going to suffer every day for the rest of your life, but you’re slowly going to lose your career, independence, self-sufficiency, hobbies, friends, mobility, the respect of those around you, perhaps your memory, and each day will be more difficult, more of a struggle to hold onto those few things you still have, and each day it’s possible that you’ll wake to find that you’ve lost something else, and you still hurt, everything still hurts.
I’m tired of being treated like a child when I become frustrated for the things I’ve lost. I’m tired of being told that it’s simply depression that causing me to grieve the things I’ve lost when it’s FAR more complicated than that. I’m tired of being looked at with pity, as if my mind is gone, when it’s really not me who has the problem understanding the situation. I’m tired of trying to justify my emotions to others.
Every person has a right, and even a need, to grieve their losses. If or when that grief becomes out of proportion to the loss there may be need for intervention. I had worked with people who continued to mourn the loss of a child so strongly that it was a disruptive force in every aspect of their lives 20 years after the fact. This is no longer healthy grieving, but obsession. I understand full well how grief can be destructive rather than palliative, but when each day presents a fresh wound, are we not entitled to our time to let it heal? 

* http://www.sciencedaily.com/releases/2009/12/091222154742.htm

Multiple Sclerosis: A Quick Summary of Symptomology

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Multiple Sclerosis is an autoimmune disorder that causes the body to attack myelin, which protects nerve fibers in the central nervous system, which causes scarring known as lesions in the brain and spine. As the myelin deteriorates it is akin to having wiring without insulation. Signals get crossed and confused, causing all manner of incorrect information to be transmitted to the rest of the body which manifests in many different ways. It can cause neuralgia (extreme pain in the nerve pathways), paresthesia (feelings of tingling, skin crawling, painful stinging like multiple bug bites, or pins and needles like a limb has fallen asleep), allodynia (pain or discomfort to touch that is non-noxious or not harmful such as clothing rubbing against the skin), muscle spasms, muscle spasticity (hard, painful contractions of the muscles that will not relax or release), as well as other debilitating symptoms such as optic neuritis (swelling of the optic nerves which can be extremely painful, and can cause vision changes such as double vision, cloudy vision, light sensitivity, color changes, and even temporary or permanent blindness), and temporary or permanent loss of motor control or muscle function anywhere in the body. This includes the heart and vascular system, and diaphragm, lungs and respiratory system. In addition, MS flares ups, or “exacerbations” cause inflammation in the brain which, over time, lead to structural brain changes, the most common of which is shrinkage. The brain literally shrinks, and many of the parts of the brain that are responsible for regulating such actions as sleep, appetite and mood no longer function at full capacity, if at all. Many people with MS suffer from mood disorders and sleep disorders that are not easily treated by traditional medications.
The most common symptoms of MS are fatigue (and this is not just how you feel tired after working a 10 hour shift, it’s being so tired even after sleeping 10 hours that you can barely stay awake, barely get out of bed to get food or use the bathroom, and no matter how much you nap throughout the day the fatigue persists), loss of balance and vertigo (which also tends to cause nausea and a lot of stumbling and falling down), and what is known as “brain fog” or “cog fog”, which is a cognitive disruption, an inability to think clearly and is often accompanied by confusion, dissociation, slow reaction times (both physically and mentally) and disorientation. Often the combination of these common symptoms, the fatigue, loss of balance and brain fog, tend to cause one to appear drunk, which is very frustrating for many people with MS. People are also often accused of laziness due to their fatigue, are treated as if they’re mentally challenged, and many physicians will insist that these symptoms, especially changes in mood, fatigue and sleep disturbance, have a psychological root cause, rather than a physical one, and will continue to refer them back to a psych prescriber. These issues are both barriers to treatment, and barriers to understanding by the person’s friends and family.
What must be understood is that every person’s MS manifests differently and at different rates, and there a 4 types of MS, some types generally more debilitating than others.
So if you’ve ever seen or heard of someone with MS who is perhaps very high functioning, then you encounter another person with MS who is less so, please do not compare them, or tell the one person that the other person you know can still work or exercise or go out dancing or etc and that if they only TRIED they’d feel better, because one person may be able to do these things while another cannot.
Educate yourself. MS is sadly a very common, and very debilitating disease, but it’s also very poorly understood. Learn about each new person’s struggles and support them in whatever way help THEM, not by comparing them to others, but by learning what the individual can and cannot do, and assisting them in whatever way might benefit their situation the most, even if all you’re doing is providing a sympathetic ear.
None of us asked for this disease, and if given the choice, we all would trade to get back our old lives in a heartbeat. We’re not lazy, we’re not moping around, we’re not hamming it up, we’re sick. Imagine how you would feel if you had lesions in your brain that caused even one of these symptoms to occur all day every day, and decide what your response to that situation might be before passing judgement on anyone else. All we’re asking is a little understanding and empathy.

Selfies…the Greatest Menace to Modern Society! Just Ask These Mental Health Professionals!

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Recently an article was posted to my Facebook feed that I wish I hadn’t seen. Unfortunately, once seen, things cannot be unseen, and although I strongly expressed my opinion with regards to this little nugget at the time and location of its post, I find myself ruminating on the matter and felt that it required somewhat more formal redress. The article that was posted was actually quite short and poorly written, so I won’t bother to post that particular link, but therein was cited a source with more comprehensive, and sadly more disturbing information. http://guardianlv.com/2014/04/selfies-cause-narcissism-mental-illness-addiction-and-suicide/
Basically, as the URL states, a handful of so-called experts are claiming that the taking of selfies can cause, or are indicative of, a host of mental illnesses. If you’re behind the times, a “selfie” is a photo that a person takes of themselves or possibly two or more people (if they can fit more) by holding the camera away pointed at themselves, or by taking a photo of themselves in a mirror. This article is expounding on the dangers of taking selfies, and of online media in general, stating that selfies cause or are indicative of narcissism, low self-esteem, attention seeking behavior, self indulgence, actual addiction to taking selfies and in this extreme case they cite, a suicide attempt.
Now, I’m sure many of you have that one friend or acquaintance on a social media site who is constantly posting selfies and waiting for the compliments to roll in, so these declarations may not seem all that far from the mark, but first, let’s take a look at this article and get some facts straight.
The case that is cited in this article is about a man with Body Dysmorphic Disorder who is taking hundreds of selfies a day in the attempt to get the perfect one, which he is of course unable to do, because he has Body Dysmorphic Disorder! Whatever flaw he believes himself to have will always show up in his pictures, so he could take them for hours and hours and never take one that he found acceptable, which is exactly what he did. His parents, who are cited as “mental health professionals”, deemed his constant picture taking an addiction. Mental health professionals could mean anything. Are they case managers, counselors, aides at a hospital? Do they know how to diagnose and/or treat a mental illness? My guess is probably not on the latter if they believe his excessive selfie habit is an addiction. The term addiction is used rather loosely amongst laymen to mean any general activity or behavior done to excess, but let’s make one thing clear here. Something done to excess does not necessarily an addiction make. Addictions are all about reward responses. A person is rewarded, either biochemically, psychologically, or both, to continue to engage in a particular behavior. Yeah, over time they often come to hate their addiction because it pretty much takes over their whole lives and ruins their health, livelihood and relationships, but they didn’t start engaging in that particular behavior because they hated it, they did so because they enjoyed it and continued because they couldn’t stop. A person with Body Dysmorphic Disorder who has an issue with their physical appearance would not enjoy looking at pictures of themselves. It would be extremely disheartening, frustrating, and likely to cause, or deepen preexisting, depression. Each photo amplifying for them the terrible flaw they cannot hide no matter how hard they try. For this particular person, he wanted so badly to take just one image of himself that he could feel was acceptable, and the most comfortable way to do this would be to take the photos himself, (how are you going to enlist a friend or hire a photographer to take over 200 pictures of you a day, and of course only you can look over them because you wouldn’t want anyone to see the bad ones, right?, then tell that person that none of them were any good, let’s do it again tomorrow), but because of his preexisting mental illness, the Body Dysmorphic Disorder, there was really no way he’d ever take an acceptable photo. So with each new photo he becomes more frustrated, more depressed, more upset, until finally he becomes hopeless and attempts suicide. A very sad story, but not an addiction. Addiction to activities, such as video games or sex, or in a case of taking selfies, have a very specific pattern. That activity becomes the focal point of one’s life because that person wants to engage in that activity, even when they don’t want to, because on some level they gain some manner of satisfaction from it. A person doesn’t skip work because they stayed up all night playing video games, or neglect their child because they’re too immersed in their game world, because they hate playing them. They may hate the fact that they can’t stop playing them, that they’ve become such a destructive and disruptive force in their lives, but they keep playing them because they enjoy it and when they’re not playing them that’s all they think about doing. This poor guy didn’t take hundreds of selfies a day because he loved it, he didn’t attempt suicide over an addiction, he did this because he had a delusion regarding the image of his body that was not going to go away.
Now, moving on to some of the other points of the article. “Taking of selfies is indicative of narcissism, attention seeking behavior, self indulgence and low self-esteem.” I love how the article constantly lumps narcissism and low self-esteem together. Which is it? You can’t really be both at the same time. However, both narcissistic people and people with low self-esteem may be prone to attention seeking behavior for very different reasons, and what better way to gain attention than to snap a flattering photo of yourself and post it on your social network of choice, right? Well, what if one of these people happened to be out on the town with friends and handed a camera to one of them to take their picture with everyone so they could post it. Is that any different? What if they were on vacation? “Take a picture of me in front of the Eiffel Tower!” Narcissist. Attention seeker. What if they just got a new haircut and wanted to show their friends but there was no photographer handy? Or…what if there was? How are these two scenarios any different? To me this seems like a lot of scaremongering. People don’t know what to make of the changing landscape of technology and social media. It’s certainly a LOT easier to take and distribute images of oneself now than it ever has been, and people don’t know whether this is a good or bad thing, so they’re nervous about it. I can say that I have “selfies” of myself and a friend in Disneyland when I was 19 taken with a regular film camera. We eventually found someone to take our picture in front of the Disney castle, but prior to that we just put our heads together, held the camera at arm’s length in a very familiar pose that is seen often nowadays and took the picture. The only difference was that we had to go develop the film before we could see it.
So, let’s try looking at this from a different perspective. They seem to want to mention those with low self-esteem, and the attention seeking behavior, as a bad thing. But has anyone stopped to think that perhaps this method of self expression is healthy? Liberating, even? Imagine this person with very low self-esteem who has always hated to be photographed and never posted pictures of themselves online or sent pictures of themselves out with their Christmas cards or whatever the case may be. Now it’s the digital age. They can take as many photos of themselves as they desire in the privacy of their own home. Examine the photos at length, find angles that are flattering, see things about themselves that they never realized that were positive attributes, and eventually they manage to take a photo that they not only find acceptable, but can actually be proud of! They post it on their site, and all their friends tell them how good they look. What a major accomplishment! This person, who previously believed that their appearance was of little consequence, to say the least, suddenly is able to safely and comfortably choose a photo on their own terms and actually receive praise. It’d be a great boost to their self-esteem, and give them more confidence in themselves and their appearance.
As with many things in mental health, context is everything. I find it just appalling that people who call themselves mental health professionals would make such blanketed statements about an activity that’s mostly innocuous, at worst may fuel the flames of a narcissistic person’s ego and at best could be a very healthy and empowering activity. The particular case cited in this article is obviously not the norm, otherwise they would have cited multiple instances of “addiction” and suicide attempts linked to this activity. For all you psych types out there, remember your stats and research methods classes? We’d call cases such as these “outliers”. They do not fit the regular pattern or curve.
It’s taking pictures of yourself. That’s all. It’s not really indicative of anything concrete other than the indisputable fact that a person desired to have a photo taken and considered themselves to be their own best photographer. There’s no reason for anyone to believe this to be anything more than it actually is.

Teenagers and Sociopathy

Standard

The word of the day today, sent straight to my email inbox from dictionary.com was “columbine”, meaning “dove-like”, among other things. It stated that the columbine flower was named such for its strong resemblance to a group of doves. I thought that that sounded interesting, and didn’t believe I’d actually seen columbine flowers, so I Googled “columbine” without really thinking about what would pop up in the search, (flowers?), and I was greeted by dozens of flashy article headlines related to the Columbine HS shooting. I was in college when the shooting occurred, barely out of my teen years myself, and remember quite clearly all of the hype and speculation related to this event. I remember feeling empathy for both the victims and the shooters, which of course I could never say aloud in mixed company. High school and my teen years were a special kind of hell, as is true for many people, and for those people who had happy childhoods, never wanted for anything and went to a nice, suburban, upstanding school, it’s something they have a difficult time understanding.
My first reaction upon being greeted by the page full of Columbine HS articles was straight up disgust. I hated all of the guesswork that occurred in the aftermath. Was it the music they listened to? Were they bullied? Were their parents to blame? Was the school to blame? Whom can we blame?! Obviously someone or something has to take the fall for this, and adults country wide were wracking their brains trying to figure out what thing, things, or people should take the brunt of responsibility for turning two obviously upstanding boys into murderous maniacs. It’s got to be the music… But for me, being still very close to my teenage self and mentality, I knew they’d not find any answers, because there would BE no answers. I knew in my gut, or my heart, or my subconscious, or wherever it is that these instinctual feelings and reactions are stored, exactly how those two boys felt, and it was nothing so simple as bullies or not getting laid or listening to heart pumping music with angry lyrics. It was pure and simple rage, and it was contempt, and it was this feeling that you could not quite identify that something, everything, was not right with the world, and this urge to correct it that ran so deep that violence didn’t really seem all that excessive. It seemed, in fact, the most apt solution. Nothing can fix this but wiping the slate clean. And yes, I know I sound like I was a crazy person, but teenagers are most certainly “crazy”, and I’ll explain why momentarily.
Just as I was about to narrow my search to columbine flowers, one headline stood out. It claimed to know the REAL reason why they did it, and it was a Slate article. Being one of my more favored sources of news and information, I decided to have a look at this article from 2004: http://www.slate.com/articles/news_and_politics/assessment/2004/04/the_depressive_and_the_psychopath.single.html The headline was particularly interesting. “The Depressive and the Psychopath”. As stated in my previous post, it was made clear how I feel about calling people by their mental health diagnoses, but in this case I was willing to let it slide. It appeared that they were just trying to make a point, and it certainly did its job, it piqued my curiosity.
The article describes one of the Columbine shooters as being inwardly tortured, extremely depressed and prone to fits of destructive rage, the other outwardly calm and polite, but inwardly contemptuous of both peers and authority figures, having a major superiority complex in some instances, a practiced liar who enjoyed getting away with it, and the article describes them as being a “depressive” and a “psychopath”, otherwise known as a sociopath. Had these two NOT been known as the notorious Columbine shooters, had they not been under such microscopic scrutiny and someone were to view their case histories individually, what would most people believe of their behavior? Typical teenagers! It is so very common for teenagers to exhibit signs of depression, labile mood, acting out behavior, poor judgement and poor impulse control. It is also very common for teenagers to lack empathy, to lie, be contemptuous of peers and ESPECIALLY authority figures. Particularly if those teenagers have suffered any kind of perceived injustice, mistreatment (perceived or actual), if they are different in any way from their peers which includes being of superior intellect, having different style of dress, listening to different music from what is popular, or anything that may set them apart from the crowd, because even as teenagers yearn to be unique and find their individuality, they also yearn not to stand out.
All teenagers are “crazy”. Not necessarily mentally ill, but crazy in the sense that they don’t tend to think or act rationally or consistently, and their emotions and behavior tend to be unpredictable, to say the least. Teenagers have a very difficult time understanding cause and effect. They have very poor ability to think their actions through to a logical and inevitable conclusion.
There are a few reasons for this, some biological, some social. The teenage brain is pretty bizarre. It’s going through a period where it’s almost literally rewiring itself. New connections are being formed all over the place and old connections are being rerouted. This is why parents often stare at their 14 or 15 year old, baffled, wondering where their child went and who this alien creature is living in their house. When just a year before they may have had a smart, logical, even tempered, maybe even bubbly tween or young teen, now they have a moody, pensive teen whose behaviors are beyond comprehension. Suddenly their well planned and effective system of rewards and consequences no longer works. The parent tells the teen they’re grounded, the teen says they don’t care. The teen no longer does their chores despite the fact that this means they’ll no longer receive their weekly allowance, then they balk when they aren’t given money at the end of the week. However, if they’re offered to do a side job, such as mowing the lawn, to receive pay that day, they’re often amenable, even though the side job is much more difficult than their assigned weekly chores. This is due to that inability to correlate long term cause and effect. Instant gratification, a reward for something done right now, is very easy to grasp. Shirking duties throughout the week doesn’t necessarily correlate to the loss of money at the end of the week. It’s not that they don’t know that they won’t get paid, it’s that they’re hard pressed to illicit an emotional response right now for something that will happen so far from right now, so they decide they’ll deal with it when the time comes. Then when the time comes…so does the explosive emotional response. Often parents will ask their teen, after they’ve done something particularly incomprehensible, “What were you thinking?!”, and the teen will respond in all earnestness, “I don’t know!”, because they really do not know. They weren’t thinking things through. They only thought that at that moment they wanted to do something, so they did, consequences be damned.
So what makes the two boys at Columbine HS different from other teens? It certainly wasn’t their aspirations. I can’t even count how many times my friends and I discussed vandalizing or blowing up the school. The school was generally our focal point because it was A) the place we spent most of our time, and B) the place that generated most of our daily stressors. We couldn’t conceivably blow up the whole city, or the whole country, but the school was doable. But we never intended on following through. I honestly think the biggest difference between those two boys and other teens with similar aspirations was merely means (they had access to guns, and I hate to say that because I don’t feel that there’s anything wrong with responsible gun ownership. Then again, giving your children easy access to your gun cabinet/safe isn’t really all that responsible), and that their two personalities fed off each other in such a way that their grand dreams of blowing up the school didn’t end in chuckles and a trip to the mall to get a slice of pizza. They egged each other on to continue planning and to follow through when other kids would not have. So the Slate article is correct in discussing the toxic mingling of their relationship with each other. However, I seriously dislike the portrayal of the boys’ futures had they not followed through. Eventually the teen brain matures. Many teens reconcile their anger, disdain and contempt as this occurs. They develop the capacity for empathy as they lose their haughty sense of self (which is often a mask for insecurity), and as they stop taking things so seriously, stop brooding over all the things that anger them to their core, such as the website with the ill written list of things that one of the boys hated, they start to be more appreciative of the differences of others, more accepting of their flaws, more insightful of their own flaws, their own strengths, the insecurities that drove them to be so angry. They grow up. I don’t believe that either of these boys would have been predestined to a life of crime. It’s so easy, in hindsight, to pore over their writings and scrutinize their activities and say THERE is the mind of a killer, that is the WHERE and the WHEN that the crazy started, and it never would have stopped.
It concerns me that people might read or have read articles such as this and will overreact to teenagers’ behavior and move to stifle them, when really teenagers should be given more opportunities for self-sufficiency, not less. They should not be treated as children until the moment they turn 18, then turned loose into the world, proclaimed magically gone from child to adult in a day, with no life skills, no critical thinking skills, never having had an opportunity to explore their own boundaries. Teenagers should be treated with respect, to give them a sense of self worth and a reason to respect, not disdain, their elders. They will be adults before you know it, and they have a lot of learning to do in a short amount of time, all while their brains are throwing them into chaos, so no matter how easy or difficult their lives may be, the life of a teenager is still hard.
And by the way…the columbine flower looks nothing like a flock of doves. :p