The Importance of Self-Awareness for People Who Want to Change the World

I gave this talk at Sunday Assembly NYC last weekend. A bunch of people have asked to see my notes and slides, so here they are! That’s why this isn’t really in blog-post format. Here are the slides.

[At the beginning, I asked how many people in the audience volunteer their time to a cause they care about, and/or donate money to a nonprofit organization. Not surprisingly, it was most people in the room.]

Why do people engage in altruistic acts like volunteering time or donating money? Here’s a partial list of reasons:

  • Community building: for instance, we might donate or volunteer when there’s an emergency in our community, or when someone in our social network is doing a crowdfunding campaign.
  • Social pressure: for instance, we might donate when a canvasser asks us to and we feel bad about saying no.
  • Religious or moral obligation: maybe not applicable to most people in this room, but some people do altruistic acts because they believe their religion obligates them to.
  • Social rewards: when we volunteer for reasons like resume building or making friends, those are social rewards
  • And, finally: because it feels good! This is the one I’ll mostly be talking about here.

Some people claim that altruism stems entirely from one’s values and ethics, and that emotions have nothing to do with it. They may also claim that doing good things because it makes you feel good makes those things less good, which makes it unpopular to admit that you like how it makes you feel when you act altruistically.

This view is more about the sacrifice made by the individual doing the altruistic act, and less about the actual positive consequences that that act has. It comes from the belief that anything that feels good is inherently suspicious, possibly morally bad, and a barrier to being a good person–a belief I’d associate more with religion (specifically, Christianity) than anything else.

But there’s nothing inherently bad about doing things because they feel good. In fact, we can harness this feature of human nature and use it to do more good! But in order to do that, we have to learn to be aware of our motivations, whether we like them or not.

Before I get into that, I also want to note a practical aspect to this: if we allow activism or charity work to make us feel bad rather than good, we’ll burn out, lose hope, and stop trying. It might be prudent to encourage each other and ourselves to feel good about altruistic acts. Of course, self-care is really important anyway, even when it means taking a break from activism or quitting it altogether. But that’s a topic for another talk.

Let’s look at some research on altruistic behavior. Keep in mind that these are just a few examples of a vast number of different studies and methods; studying altruism scientifically has become very popular.

Empathy, which is the ability to see things from someone else’s perspective and imagine how they might feel, is a predictor of altruistic behavior. However, as we always say in the social sciences, correlation is not causation. The fact that it’s a predictor doesn’t necessarily mean it causes it; maybe engaging in altruistic behavior also enhances our ability to empathize, or something else is impacting both variables. But it does seem that the two are related.

Relatedly, brief compassion training in a lab can increase altruistic behavior. Compassion training is basically just practicing feeling compassionate towards various targets, including people you know and people you don’t. Even after a short session of this, people were more likely to do altruistic things.

People who perform extraordinary acts of altruism, such as donating a kidney to a stranger that you’ll never see again, may have more activity in their amygdala, which is a brain region that (among other things) responds to fearful facial expressions. It’s difficult to say for sure what this means, but it could mean that altruism is driven in part by automatic neural responses to someone else’s fear.

People who volunteer for “selfish” reasons, such as improving their own self-esteem, tend to keep volunteering for the same organization for a longer period of time than those who say they volunteer more for purely ethical reasons. Keep in mind, though, that this doesn’t necessarily mean that the “selfish” volunteers volunteer more overall. It’s possible that the ethics-driven volunteers have less of a motivation to stay with the same organization–after all, many people and causes need help.

Unsurprisingly, spending money on others makes people feel happier, and the happier they feel as a result, the more likely they are to do it again, creating a feedback loop.

It works similarly with donations to charities, even when they involve a simple money transfer without much of a human element. Donating to charity activates brain regions linked to reward processing (usually associated more with getting money than giving it away!), and in turn predicts future giving.

What does all that mean?

Basically, seeing people suffer may make us more likely to engage in altruistic acts to try to help them. Seeing people suffer is painful for most people, and helping them is a way to ease those negative emotions. Doing nice things for people can make us happy, which can make us even more likely to do nice things for people again. The implication of brain structures such as the amygdala suggests that it’s not all about higher-order values and beliefs, but also basic, automatic brain processes that we can’t necessarily control. But of course, our values and beliefs can in turn influence our brain processes!

If we do altruism for “selfish” reasons, like having a sense of belonging or feeling good about ourselves, we may choose things that feel best rather than the ones that do the most good.

One example is voluntourism–when people travel for the purpose of volunteering to build houses, for instance. I have no doubt that many of these programs do a lot of good, but they have also been criticized, including by the communities they’re trying to help. For example, sometimes houses built by college students who have never done a day of manual labor in their lives aren’t necessarily very well-built. And often, these programs don’t actually empower the target communities to thrive on their own, leaving them dependent on charity. But these programs feel very rewarding to the volunteers: they’re intense, they build strong social bonds, they involve traveling to a cool place, and they make people work hard physically and get stronger. No wonder so many people love them.

Another example is in-kind donations. Again, sometimes very helpful, but often not. Organizations that do disaster relief often ask for money instead of goods, because then they can use it for whatever’s most urgently needed. They may desperately need medicine, but keep getting t-shirts instead. Giving them money rather than clothes allows them to buy what they need. Donated goods may also not be practical for the area in question–for instance, TOMS shoes, which is where you buy a pair of shoes and another gets sent to an impoverished child overseas, may not actually be very practical in communities where people walk miles each day over unpaved roads. While they’re very cute and comfortable, they may not last long. But, of course, organizing a clothing drive or buying a pair of shoes probably feels a lot more rewarding than sending a boring check.

Here’s one more study to help illustrate how this plays out. In this experiment, researchers showed one group of participants a story about a starving girl and asked them to donate to help her. Meanwhile, another group of participants saw the exact same story, but this time with accompanying statistics about the broader implications of starvation and how many human lives it takes. You might think that the latter group would give more money–after all, they have even more of a reason to donate.

Instead, they donated much less.

Why? From the NPR article:

The volunteers in his study wanted to help the little girl because it would make them feel good and give them a warm glow. But when you mix in the statistics, volunteers might think that there are so many millions starving, “nothing I can do will make a big difference.”

The participants in the second group, the ones who saw those dismal statistics, felt bad. They felt so bad that they no longer wanted to give money.

And likewise, we may choose forms of giving that feel best, which means “sexy” causes, issue affecting people emotionally or geographically close to us, and causes our friends are doing. We may not even realize that’s how we’re choosing. A little self-awareness can go a long way.

It’s difficult to hear criticism of one’s activism or charity work. It’s especially difficult when our motivations include social acceptance and self-esteem. This is especially important in social justice activism, where you may be working with or on behalf of people who are directly impacted by things you’re not.

I often get angry responses when I try to constructively criticize men who are involved in women’s rights activism. They’ll say things like, “How dare you tell me I’m being sexist, I’m totally an ally!” Their need to feel accepted makes it impossible for them to hear even kind, constructive criticism.

There are other, smaller-scale ways in which we help people all the time–listening to a friend who’s going through a hard time, giving advice, or, if you’re a counselor or therapist like me, doing actual counseling.

Sometimes, people–even therapists–do these things because they want to “fix” people. Seeing people in pain is hard and we want to make their pain go away–not just for their sake, but maybe for our own, too.

But if that’s our motivation and we’re not aware of it, we may give up in frustration when people don’t get “fixed” quickly enough. We may even get angry at them because it feels like they’re refusing to get fixed out of spite. As someone who’s struggled with depression for a long time, I’ve lost friends and partners this way.

As I mentioned, I’m also a therapist. Most therapists, especially at the beginning of their careers, have a supervisor. A supervisor isn’t just a boss or a manager–it’s a mentor we meet with regularly to process the feelings we’re having as we do our work, and to make sure that our motivations and automatic emotional responses don’t get in the way of that work.

Most of you aren’t therapists, but you can still learn from this practice. Supervision is therapy’s version of checking yourself before you wreck yourself. If you’re supporting someone through a difficult time, it might be helpful to talk through your own feelings with someone else.

[Here we did a small group exercise, though I also made sure to give people the option of just thinking about it by themselves if they don’t like discussing things with strangers. The exercise was to think/talk about these three prompts:

  • Think about a time when you volunteered, donated money, or did some other altruistic act, and found it very rewarding. What made it feel that way?
  • Think about another time when you did an altruistic act and didn’t find it very rewarding at all. Why not?
  • Think about a time when you were trying to do something altruistic, but your own emotions or personal issues got in the way. What was that like?

Afterwards, I asked for audience members to share their experiences with the larger group and we talked about how all of those experiences relate to the themes I’ve been talking about.]

In conclusion: Selfish motivations can inspire a lot of good actions. There’s nothing wrong with that! However, being aware of those motivations rather than denying their existence can help you avoid their potential pitfalls.

If we truly care about helping others, we should try to do so in the most effective and ethical way possible, and that means being willing to ask the tough questions about what we do and why.

~~~

Here’s the blog post this was partially inspired by.

[guest post] A Purpose-Driven Life – Is God Required?

My friend Gleb Tsipursky wrote this guest post about a secular approach to finding a sense of purpose in life.

We need God for a sense of purpose in life, at least according to the vast majority of mainstream perspectives in American society. Moreover, research confirms that people with a strong religious belief generally have a stronger sense of meaning and purpose than those who do not. But is it really necessary to believe in God to have a purpose-driven life? Based on my research on meaning and purpose, and my experience in helping people find life purpose in my role as President of Intentional Insights, I will illustrate some science-based strategies that we as reason-oriented people can use to find a deep sense of life meaning without a God.

Image 1

(Graphic created by Cerina Gillilan)

 

In a way, the American mainstream opinion is not surprising – after all, religious dogma generally gives clear answers to the question of life’s purpose. Moreover, it provides the main venue for exploring questions of meaning and purpose in life. According to faith-based perspectives, the meaning and purpose of life is to be found only in God. An example of a prominent recent religious thinker is Karl Barth, one of the most important Protestant thinkers of modern times. In his The Epistle to the Romans (1933), he calls modern people’s attention to God in Christ, where the true meaning and purpose of life must be found. Another example is The Purpose Driven Life (2002), a popular book written by Rick Warren, a Christian mega church leader.

But some thinkers disagree with the notion that religion is the only way to find meaning and purpose in life. Jean-Paul Sartre, in his Existentialism and Human Emotions, advances the notions of “existentialism,” the philosophical perspective that all meaning and purpose originates from the individual. The challenge for modern individuals, according to Sartre, is to face all the consequences of the discovery of the absence of God. He argues that people must learn to create for themselves meaning and purpose.

Another prominent thinker is Greg Epstein. In his Good Without God: What a Billion Nonreligious People Do Believe, he advocates striving for dignity as a means of finding “meaning to life beyond God.” According to Epstein, “we are not wicked, debased, helpless creatures waiting for a heavenly king or queen to bless us with strength, wisdom, and love. We have the potential for strength, wisdom, and love inside ourselves. But by ourselves we are not enough. We need to reach out beyond ourselves – to the world that surrounds us and sustains us, and most especially to other people. This is dignity” (93).

Likewise, Sam Harris, in his book, Waking Up: A Guide to Spirituality Without Religion (2014), states that “Separating spirituality from religion is a perfectly reasonable thing to do. It is to assert two important truths simultaneously: Our world is riven by dangerous religious doctrines that all educated people should condemn, and yet there is more to understanding the human condition than science and secular culture generally admit” (6).

Are they correct? Can we have meaning and purpose, which fall within the sphere that Harris refers to as spirituality and Epstein terms dignity, without belonging to a faith-based community?

In fact, research shows that we can gain a sense of meaning and purpose in life from a variety of sources. The classic research on meaning and purpose comes from Victor Frankl, an Austrian psychiatrist who lived through the concentration camps of the Holocaust. He described how those who had a sense of meaning and purpose in their lives were most likely to survive and thrive in the camps. He conducted research demonstrating this both during and after his concentration camp experience. His research suggests the crucial thing for individuals surviving and thriving is to develop a personal sense of individual purpose and confidence in a collective purpose for society itself, what he terms the “will-to-meaning and purpose.” Frankl himself worked to help people find meaning and purpose in their lives. He did so by helping prisoners in concentration camps, and later patients in his private practice as a psychiatrist, to remember their joys, sorrows, sacrifices, and blessings, thereby bringing to mind the meaning and purposefulness of their lives as already lived. According to Frankl, meaning and purpose can be found in any situation within which people find themselves. He emphasizes the existential meaning and purposefulness of suffering and tragedy in life as testimonies to human courage and dignity, as exemplified both in the concentration camps and beyond. Frankl argues that not only is life charged with meaning and purpose, but this meaning and purpose implies responsibility, namely the responsibility upon oneself to discover meaning and purpose, both as an individual and as a member of a larger social collective (Frankl).

Image 2

(Graphic created by Cerina Gillilan) 

Frankl’s approach to psychotherapy came to be called logotherapy, and forms part of a broader therapeutic practice known as existential psychotherapy. This philosophically-informed therapy stems from the notion that internal tensions and conflicts stem from one’s confrontation with the challenges of the nature of life itself, and relate back to the notions brought up by Sartre and other existentialist philosophers. These challenges, according to Irvin Yalom in his Existential Psychotherapy, include: facing the reality and the responsibility of our freedom; dealing with the inevitability of death; the stress of individual isolation; finally, the difficulty of finding meaning in life (Yalom). These four issues correlate to what existential therapy holds as the four key dimensions of human existence, the physical, social, personal and spiritual realms, based on extensive psychological research and therapy practice (Cooper; Mathers).

So where does this leave us? Religion is only one among many ways of developing a personal sense of life meaning. One intentional approach to gaining life meaning and purpose involves occasionally stopping and thinking about our lives and experiences: we can find an individual sense of life purpose and meaning through the lives we already lead. A great way to do so is through journaling, which has a variety of benefits beyond helping us gain a richer sense of life purpose – it can also help us deal with stress, process sorrows, experience personal growth, learn more effectively, and gain positive emotions through expressing gratitude.

Here are some specific prompts to use in journaling about meaning and purpose in life, as informed by Frankl’s research and logotherapy practice:

  1. What were important recent events in your life?
  2. Which of them involved stresses and adversity, and how can you reframe them to have a better perspective on these events?
  3. What did you learn from these events?
  4. What are you grateful for in your life recently?
  5. What was your experience of life meaning and purpose recently?

Try journaling about these topics for a week, and see what kind of benefit you get, what kind of challenges you run into, and what you learned about how this journaling can be adopted to your own particular preferences and needs.

There are a wide variety of additional strategies to gain meaning and purpose in life without belief in a deity. To help you learn and practice additional strategies, I developed and videotaped a workshop freely available online. I also created a free online course, which combines an engaging narrative style, academic research, and stories from people’s everyday lives with exercises to help you discover your own sense of life purpose and meaning from a science-based, humanist-informed perspective. I am also writing a workbook on this topic These are part of our broader offerings at Intentional Insights, which aims to help us as reason-oriented people use scientific evidence to live better lives and achieve our goals. I hope you can find our offerings helpful for your life, and am eager to hear any feedback you have to share about your experience!

Gleb Tsipursky, PhD, Co-Founder and President at Intentional Insights. Intentional Insights is a new nonprofit that provides research-based content for reason-oriented people to help us improve our thinking, feeling, and behavior patterns and reach our goals. Get in touch with him to learn more: gleb[at]intentionalinsights.org

The Importance of Self-Awareness for Men in Feminism

As I wrote recently, an inevitable consequence of certain communities or movements becoming more accepted and popular is that people will join them in order to feel accepted and popular. Having a sense of belonging is probably a primary motivation for joining all sorts of groups, and it makes sense that whenever someone is feeling lonely, we often advise them to join some sort of group that fits their interests.

Of course, most groups have goals other than “make people feel a sense of belonging.” Those goals may be “discuss books,” “put on a play,” “practice dance,” “critique each other’s writing,” “organize board game nights,” and so on. Even if someone is very invested in that explicit goal, their main motivation to join may still be that implicit goal of having a community.

Feminism–both as “a movement” and as individual organizations and friend groups–is no different. It has certain political goals (which vary from group to group) and it can also be a source of social/emotional support for its members. It can be a source of pride, too.

But feminism (and other progressive movements) differs from other types of groups in that its explicitly stated goals are sometimes in conflict with the goal of making its members feel welcome and accepted. Challenging injustice requires taking a long, critical look not just at society, but at yourself. Sometimes that means that others will be looking at us critically, too.

Self-criticism is never easy or pleasant, but what complicates matters is that people are not always aware of their motivations for doing things. I do believe that the vast majority of people involved somehow in [insert progressive movement here] are involved primarily because they believe in the cause and want to help make it happen. But for many of them, there’s a secondary motivation lurking in the background–they want to have friends. They want to feel liked and respected. They want a sense of purpose. They want community.

These are all normal and okay things to want; most of us want them. I wouldn’t even say that it’s wrong to seek those things from political groups and movements.

But you have to be aware that you’re doing that. If you’re not aware you’re doing it, you won’t be able to accurately interpret the negative emotions you might experience as an unavoidable part of this sort of work.

And that, I believe, is a big part of the difficulties we often have with male feminists and other types of “allies.”

I came across a piece by Mychal Denzel Smith about male feminists recently. In it, he wrote:

If you’re not going to challenge yourself to do better, why claim feminism? 

In part, it’s because there’s a seductive aspect to identifying as a male feminist. Kiese Laymon touched on this in an essay for Gawker last year. Remembering an encounter he had with a colleague, he wrote: “It feels so good to walk away from this woman, believing not only that she thinks I’m slightly dope, but that she also thinks I’m unlike all those other men when it comes to spitting game.” That you’re just out to get laid is one of the most common accusations lobbed at men who identify as feminists, and while I don’t think that’s true for all or even most, it’s definitely true for some. Enough so that my homegirl calls it predatory. That’s a scary thought. And even if you’re not out here attempting to use feminist politics to spit game and get laid, there’s this tendency to feel such pride about wearing that Scarlet F on your chest that you completely miss the ways you’re reinforcing the same oppressive dynamics you claim to stand against. You like the attention being considered “different” affords, but you’re not always up to the task of living those differences.

This resonates a lot with my experiences with men in feminism. While I doubt that most straight cis men join feminist communities primarily to find sex partners, I do think that most of them are hoping for some sort of approval and acceptance. Their opinions and values may make it difficult to fit in not only with other men, but with women who have more traditional views on gender. They may also be facing a lot of cultural pressure telling them that they’re not “real men” and nobody will ever want them. I don’t think it’s necessary or helpful to compare this with the isolation felt by women, queer people, and gender-nonconforming people. It exists.

When you feel like you don’t fit in anywhere because you’re too progressive, and you finally find a social group that shares your values, and suddenly they’re telling you that you’re still not Progressive Enough, it can be very painful. It can feel like rejection. And if you don’t have a conscious awareness of your motivations–of the fact that you feel rejected because you were really searching for belonging–you may interpret these negative feelings as resulting from other people’s behavior, not from your own (legitimate) unmet needs. You may be tempted, then, to lash out and accuse the person of being “mean” or “angry,” to warn them that they’re “just pushing loyal allies away,” to assert to them that you’re “a feminist” and couldn’t possibly have done what they said you’ve done or meant what they feel you meant, and so on.

Meanwhile, the person who called you out gets really confused. They thought you were here because you wanted to learn, to improve as a person, and to get shit done. And here you’re telling them that merely being asked to reconsider your opinions or behavior is enough for you to want to quit the whole thing. It would be like showing up at the hair salon and then getting furious when the stylist assumes you’d like to change your hairstyle.

No wonder many of us assume that many male feminists aren’t really that interested in feminism.

(While this dynamic seems much more pronounced for male feminists for a number of reasons I won’t derail with here, it definitely happens around issues like race, ability, etc as well.)

This isn’t even touching on blatantly abusive behavior, which men sometimes deny or excuse with claims of being feminists. Some male feminists do seem to hope that merely self-identifying that way, or make the cursory pro-equality gestures, will be enough to earn them the social acceptance they’re looking for. Sometimes it is.

But just like feminists are not obligated (and, in fact, are not qualified) to serve as therapists to men with serious issues pertaining to women, feminist spaces are not obligated to prioritize making everyone feel comfortable and included over doing the work that they were set up to do. Activist communities do have many overlapping (and, at times, conflicting) goals, but it’s not unreasonable for groups that were not set up to help men to prioritize people other than men.

(I would love for there to be more male-oriented feminist groups, but from what I have seen, they tend to dissolve into lots of mutual back-patting and not much personal change or action.)

I would like to see more male feminists move away from using the feminist label as a way to seek social acceptance and towards creating some separation between their politics and their search for belonging. It’s not that political affiliations can’t provide that–it’s that it’s dangerous to rely on them for it. It means you can never really question yourself and your beliefs, and you’ll have a lot of trouble accepting criticism (no matter how constructive) from others.

More broadly, I would like for male feminists to get more comfortable with becoming aware of their motivations, needs, and feelings. I would like for them to consciously notice that pleasant rush they feel when women “like” their Facebook posts about feminism, and to appreciate that feeling for what it is without prioritizing that feeling over everything else. I would like for them to recognize the unmet needs for community and acceptance that they have, and to be cognizant of the extent to which they ask (or simply expect) others to satisfy those needs for them. I would like for them to learn to notice these things without immediately rushing to judge them and shame themselves for them, because that’s not the way forward.

As for me personally, I no longer feel any increased trust or warmth towards men who declare themselves feminists. It does almost nothing for me. I need to see actual evidence that they are able to respect my boundaries, accept feedback from me, and generally act in accordance with their stated values. Many of the men I’m closest to have never explicitly identified themselves as feminists to me, but their every interaction with me exemplifies the traits that I look for in people.

By all means, call yourselves feminists to other men–it can open up useful conversations and upend established norms–or in order to filter people out of your life that you know you don’t want in it. But don’t expect a word to speak louder than your actions.

~~~

Caveats:

1. A lot of what I wrote here applies quite a lot to just about everyone, including feminist women. I know this. I focused on feminist men because this issue is particularly pronounced with them.

2. #NotAllFeministMen have such legitimate and good intentions as the ones I’m writing about. But I specifically wanted to write about the ones with the legitimate and good intentions.

For another example of how being aware of your own needs and motivations can make you a better, more effective person, see my previous post.

A Case for Strengths-Based Diagnosis

[Obligatory disclaimer that I am not (yet) a licensed therapist and that the following is my personal opinion, informed by practice and academic study.]

Recently in a class on adult psychopathology, my professor was discussing the strengths and weaknesses of the DSM (Diagnostic and Statistical Manual of Mental Disorders), the text used to diagnose mental illnesses and categorize them for the purposes such as research, insurance billing, and sharing information among professionals.

One of the weaknesses he mentioned was one I’d actually never heard before: that the way the DSM diagnosis is written and shared does not include any space for also “diagnosing” the client’s strengths.

At first, this seemed irrelevant to me, not in the sense that thinking about your client’s strengths is not important, but in the sense that I didn’t see how it matters for a diagnosis. It almost seemed a little patronizing: “Yes, you have major depressive disorder and social phobia, but hey, at least you seem like you’re pretty resourceful and good at expressing yourself!”

But then I rethought that.

Here’s an example of a DSM-V diagnosis:

296.35 (F33.41) Major depressive disorder, early onset, recurrent episode, in partial remission, with atypical features

300.4 (F34.1) Persistent depressive disorder, early onset, with atypical features, with intermittent major depressive episodes, without current episode, moderate

V62.89 (Z60.0) Phase of life problem

It’s honestly difficult for me to imagine looking at this information with anything other than relief. For me, diagnosis has always meant one thing first and foremost: You’re not a terrible person; you just have an illness.

But to other people, seeing something like this can communicate a whole lot else. You’re sick. You’re fucked up. There is nothing redeeming about you. You can’t do something as simple as not being so sad. This is especially true when someone is already predisposed to interpret information about themselves in a negative light, because, well, that’s what mental illness always does.

In that moment, it can be really helpful to have confirmation–not just from a friend or loved one, but from a professional whose job it is to assess you–that you do have strengths and positive qualities.

So, here are some reasons incorporating strengths into diagnoses might be a really good thing.

  1. Giving hope and affirmation to the client.

Just like it can be nice to go get a dental checkup and hear, “You’ve been doing a great job at preventing cavities, but you need to floss more consistently in order to keep your gums from getting irritated,” it can be nice to hear, “Based on what you’ve told me, I believe that you’ve had a major depressive episode for the past few months. However, you’ve clearly been very good at reaching out to friends and family for support, and it sounds like you have a lot of people rooting for you to get better.”

Therapists and psychiatrists say “nice” things like this all the time, but writing it down as part of a diagnosis might be symbolically meaningful. To the client, that communicates the fact that their strengths are just as important as their diagnosis–important enough to be written on the form or in the chart. It shows that their mental healthcare provider, whom they might feel shy around or even judged by, does see them as a whole human being with strengths as well as a diagnosable illness.

  1. Providing possible avenues for treatment.

A psychiatrist may diagnose a client and then refer them to a therapist (therapy combined with medication tends to be more effective than either in isolation). Now what? The therapist can look at the diagnosis, or ask the client what it is, and proceed from there.

What if the diagnosis included something like, “Client reports that volunteer work helps them distract themselves from symptoms, and that writing in a journal has occasionally been helpful”? The therapist now has some potential ways to help the client. Or the diagnosis might include, “Despite severe symptoms, client shows a high level of insight about the possible origins of their depression.” The therapist now knows that lack of self-awareness isn’t the problem–symptom management might be.

I continue to be amazed that none of my therapists ever asked me if there’s any way I could incorporate writing into my depression recovery, or if there are any ways I’ve been incorporating it already. Writing is my life. Usually I’ve either said as much in therapy, or I haven’t because nobody ever asked me what I like to do or what makes me feel good. Why not?

  1. Reducing negative bias from providers.

I can’t make definitive statements without more research, but based on what I understand about bias, I can imagine that consistently viewing a client as “major depressive disorder with atypical features and moderate persistent depressive disorder” does things to one’s perception of that person. Not positive things.

It is difficult (if not impossible) to effectively help someone you view as deficient or weak. First of all, your likely pessimism about the person’s recovery will almost certainly be perceived (and possibly internalized) by them. Second, any roadblocks that come up in treatment will likely be interpreted as “resistance” or “not really wanting to get better” or “not being ready to do the work of therapy.” In fact, maybe it’s that your approach isn’t actually helpful to them. Third, without a conscious awareness of the person’s strengths and assets, what exactly are you using to help them recover? Therapy isn’t about “healing” people so much as helping them discover their own resources and help themselves. If you don’t even know what those might be, how could you possibly help the client see them?

Many therapists try to think of their clients’ positive traits in addition to their “negative” ones. However, formalizing and structuring this process as part of a diagnosis might make it sink in better, and become more embedded in one’s general impression of a person. The questions we generally have to ask while diagnosing someone are fairly negatively oriented–”Do you ever have trouble falling asleep? How often? To what extent does this impact your daily life?”. What if we also asked, “What helps you sleep better? How do you cope with being tired after a night of insomnia?” Maybe that can help shift a therapist’s perspective of this person from “insomniac” to “person with difficulty sleeping, who has reached out to friends for help with daily tasks.”

  1. Preventing provider burnout.

I dislike talking about my work because people are consistently amazed at it in a way that annoys me. “How could you deal with hearing these awful things?” they ask. “Isn’t it really depressing to work with all these people?” It isn’t, because thanks to my training, I’ve internalized a strengths-based perspective. When I think about the people I’ve worked with, I don’t see poor suffering depressives and trauma victims. I see resilient, determined individuals who are working to overcome their challenges in the best ways they can.

I think that some people in this field burn out because they can only see the suffering and the oppression and the unfairness of it. I also see those things, obviously, because they’re sort of a big deal. But if that’s all you see when you sit with a client, not only will that be reflected in your treatment of them, but it’ll also impact your own ability to persevere.

If every time a therapist made a diagnosis, they had to intentionally remind themselves of the client’s strengths, that might go a far way in helping them remember that there is hope and everything is not absolutely bad.

As I’ve mentioned, plenty of mental health professionals already incorporate a strengths-based perspective into their work. But this is more common in areas like social work, where diagnosis is rarely used and actually often criticized, anyway. I certainly don’t remember any of my psychiatrists or PhD-level therapists spending any time asking me about my strengths or coping strategies. They gave me my diagnosis, and that was mainly it as far as assessment goes.

One might argue that strengths assessment has no place in the DSM because it needs to be standardized and reliable. However, reliability may be a problem for the DSM regardless, meaning that different professionals assessing the same client may disagree in their DSM-based diagnosis.

One might also argue that the DSM is “about” mental disorders, not “about” a client’s overall set of traits or strengths. I’ll grant that. Regardless, I think that formally incorporating individual strengths into clinical assessments in therapy and psychiatry may be helpful. May be.

Feminist Bloggers Cannot Be Your Therapists

[Content note: mentions of sexual assault and suicide]

I’ve been thinking more about Scott Aaronson. Specifically, I’ve been thinking about what he struggled with during adolescence, and about the (in my opinion, misguided) notion that feminism could have possibly been of any help to him.

The battle cry I’ve heard from men since Aaronson’s now-infamous Comment 171 was published is that feminist writers and activists need to be more mindful of situations like Aaronson’s when we choose our language and strategies. There seems to be a collective yearning for acknowledgement that the usual feminist rhetoric is not only unhelpful for people in the teenage Aaronson’s frame of mind, but actively harmful to them. There is one piece of this that I fully agree with, that I will get to later. But for the most part, I continue to feel a sort of frustration and exhaustion, and I think I’ve finally figured out why.

I wrote in my previous post on the subject that I feel that we (women) are being given all these male traumas and struggles and feelings to soothe and fix, as we always are. But now I understand why exactly I feel like we’re such an inadequate receptacle for these things.

Let’s look at some of the most salient parts of Comment 171:

I spent my formative years—basically, from the age of 12 until my mid-20s—feeling not “entitled,” not “privileged,” but terrified. I was terrified that one of my female classmates would somehow find out that I sexually desired her, and that the instant she did, I would be scorned, laughed at, called a creep and a weirdo, maybe even expelled from school or sent to prison. And furthermore, that the people who did these things to me would somehow be morally right to do them—even if I couldn’t understand how.

You can call that my personal psychological problem if you want, but it was strongly reinforced by everything I picked up from my environment: to take one example, the sexual-assault prevention workshops we had to attend regularly as undergrads, with their endless lists of all the forms of human interaction that “might be” sexual harassment or assault, and their refusal, ever, to specify anything that definitely wouldn’t be sexual harassment or assault. I left each of those workshops with enough fresh paranoia and self-hatred to last me through another year.

[…] Of course, I was smart enough to realize that maybe this was silly, maybe I was overanalyzing things. So I scoured the feminist literature for any statement to the effect that my fearswere as silly as I hoped they were. But I didn’t find any. On the contrary: I found reams of text about how even the most ordinary male/female interactions are filled with “microaggressions,” and how even the most “enlightened” males—especially the most “enlightened” males, in fact—are filled with hidden entitlement and privilege and a propensity to sexual violence that could burst forth at any moment.

Because of my fears—my fears of being “outed” as a nerdy heterosexual male, and therefore as a potential creep or sex criminal—I had constant suicidal thoughts. As Bertrand Russell wrote of his own adolescence: “I was put off from suicide only by the desire to learn more mathematics.”

At one point, I actually begged a psychiatrist to prescribe drugs that would chemically castrate me (I had researched which ones), because a life of mathematical asceticism was the only future that I could imagine for myself. The psychiatrist refused to prescribe them, but he also couldn’t suggest any alternative: my case genuinely stumped him. As well it might—for in some sense, there was nothing “wrong” with me.

[…]And no, I’m not even suggesting to equate the ~15 years of crippling, life-destroying anxiety I went through with the trauma of a sexual assault victim. The two are incomparable; they’re horrible in different ways. But let me draw your attention to one difference: the number of academics who study problems like the one I had is approximately zero. There are no task forces devoted to it, no campus rallies in support of the sufferers, no therapists or activists to tell you that you’re not alone or it isn’t your fault. There are only therapists and activists to deliver the opposite message: that you are alone and it is your privileged, entitled, male fault.

It’s worth reading the entire thing, and reading it carefully. (Aaronson’s defenders are correct that some people have been making accusations of Aaronson that are directly refuted by things that he said in the very same comment. Let’s not do that.)

Here’s what I thought. If someone came to me and said that he earnestly believes that he will be “expelled from school or sent to prison” if a woman finds out that he finds her attractive, and that he has “constant suicidal thoughts,” and that his daily existence is characterized by “crippling, life-destroying anxiety,” I would not recommend that he read Andrea Dworkin or attend a sexual assault prevention workshop. I would recommend, gently and tactfully, that he go see a therapist.

I would do that because these are very serious issues. They are serious enough that, when a client tells me that they have “constant suicidal thoughts,” there is an entire protocol I’m required to follow in order to ensure that they are safe and receive appropriate care if they accept it.

I will not speculate about what mental illness Aaronson could have theoretically been diagnosed with in his adolescence; I oppose such speculation and it’s actually irrelevant. I don’t need to diagnose him to say that he had serious issues and could have really benefited from treatment. (However, I may reference some diagnoses in what follows, not to suggest that Aaronson had them but to show how mental illness can interact with other life circumstances.)

Maybe Aaronson didn’t think to seek therapy as an adolescent, because therapy and mental illness are still quite stigmatized and would have been even more so when he was younger. Maybe nobody close to him noticed or cared what was going on, and therefore did not encourage him to seek therapy. Maybe the psychiatrist he asked to prescribe castration drugs did not pause to consider that a teenager seeking castration is a red flag, and that maybe he should refer him to a colleague who practices therapy. Maybe, maybe, maybe.

But why aren’t we talking about it now? Why are people blaming feminism–the feminism of the 1970s or 80s, no less–for failing to cure what appeared to be a serious psychological issue? Why are people claiming that the solution now is simply for feminist writers and activists to be more compassionate and considerate towards male nerds like Aaronson, as though any compassion or consideration could have magically fixed such a deeply layered set of deeply irrational beliefs?

This troubles me. If I ever start claiming that, for instance, I’m a terrible person and deserve to literally die because I’m queer, or that I cannot be in the same room with a man without literally having a panic attack, I sincerely hope that people advise me to seek mental healthcare, not to read feminist literature.

Lots of helpful things can harm a small subset of people because of that subset’s individual traits. For instance, there are a lot of PSAs about washing your hands to prevent the spread of disease and things like that. But some people have OCD and wash their hands compulsively, to the point that they’re hurting themselves physically and having trouble accomplishing daily life tasks because they have to wash their hands so much. I can imagine these PSAs being extraordinarily unhelpful to them.

We also often hear about the importance of donating to charity. Most people could probably donate more to charity if they wanted to. However, some people compulsively donate so much to charity that they harm themselves or their families. I can imagine this being exacerbated by someone telling them how important it is to donate to charity. Perhaps they feel they are never good enough.

I can see how feminist literature might have functioned in a similar way for Aaronson. The truth is that most men are about as far away from his mindset as you can get. Some are even the opposite extreme. Most men spend very little time thinking about how their behavior impacts women. Most men need to spend more time thinking about it. But how could he have known that these feminist books were not for him? If they were to put on the cover, “If you’re a great guy who does not hurt women, you don’t need to read this,” well, no man would ever read it. They all think they’re great guys who do not hurt women, even though some of them rape women.

Neurodiversity is an axis of privilege/oppression. People who suffer from mental illness or whose brains are set up differently from what is considered the “norm” (such as people with autism) lack privilege along this axis. They have difficulties because our society is not made to accommodate them. However, if these people are white, or male, or straight, or cisgender, or so on, they still benefit from the privileges afforded to people in those categories.

For instance, despite all his other fears and anxieties, Aaronson did not have to live in constant fear of being sexually assaulted, because he is male. He did not have to live with a significant risk of being harassed or brutalized by the police, because he is white. He did not have to deal with having people constantly refuse to identify him as the gender he identifies as, because he is cisgender. He did not have to struggle to physically access places he needs or wants to go, because he is able-bodied. Of course, he still faces some risk (in some cases fairly negligible) of all of these things, because having privilege doesn’t shield you from everything.

However, as a person who was (apparently) neuroatypical, Aaronson did have to live with “crippling, life-destroying anxiety.” He did not appear to have access (even if it’s just because he didn’t know to ask for it) to mental healthcare that could have helped him. He was forced to spend years feeling horrible. If he told people how they felt, they may have blamed him for it, because victim-blaming is a key component of our society’s oppression of neuroatypical people. Had he lacked some of the other privileges that he had, such as race and class, he may not have been able to access the apparently-useless psychiatrist that he did access.

Aaronson claims that he did not have “male privilege” because he did not feel that he had it. I’ve addressed arguments like these before. He presumably did not feel privileged because on one very salient and relevant axis, he certainly was not.

But otherwise, having or not having privilege isn’t actually dependent at all on how you feel. You have it or not. Men on the street hurl sexual obscenities at you or they do not. Cops stop you and slam you to the ground for no reason or they do not. You are allowed to marry someone of the gender(s) you’re attracted to or you are not.

Aaronson might be interested (or not) to know that many feminists are busy fighting to ensure access to mental healthcare for everyone, and an end to the stigma that prevents people from seeking help. But maybe that’s irrelevant now.

As I mentioned earlier, I am taking one piece of Aaronson’s (and the many others who have echoed him) criticism to heart. Namely, feminist materials need to be better at specifying what to do rather than just what not to do. Now is a good time for a reminder that I offer a workshop on this exactly, with a light-hearted tone and lots of audience participation and definitely no yelling at men that they are horrible awful creeps no matter what they do. I am far from the only person who offers such materials, but it would be cool if there were more. That said, anyone claiming that feminism does not offer this at all has quite clearly not done their research. Andrea Dworkin and some random shitty college sexual harassment training are not the only resources feminism has to offer.

(Some things that I have read along these lines [“these lines” meaning, roughly, “affirmative resources that help men and others conduct their sexual/romantic lives ethically without shaming them]: Charlie Glickman, Doctor Nerdlove, Yes Means Yes (the book and the associated blog by Thomas Macaulay Millar), Pervocracy, Franklin Veaux. If you don’t like any of these, create your own!)

But even then, your average casual feminist blogger or columnist cannot take responsibility for fixing the problems of someone who apparently sincerely believes that speaking to a woman will get him sent to prison. Or someone who is literally unable to talk to a woman because they have so much social anxiety. These are issues for professionals to deal with. Professionals can affirm. They are there to hold your feelings and make you feel comfortable and supported. They can teach social skills. They can help you examine maladaptive and irrational thoughts. They can help you learn how to cope with anxiety. That is what therapists are for. They are imperfect, but they are trained for this. I worry about placing this responsibility on every feminist with a blog.

Aaronson claims in his comment that “there are only therapists and activists to deliver the opposite message: that you are alone and it is your privileged, entitled, male fault.” I’m not sure if this comes from experience or is purely the creation of his mind with the biases that it had at the time. If Aaronson went to see a therapist and that therapist shamed him, then that therapist is wrong and does not deserve the title. (I’m not trying to do a No True Therapist fallacy here; I’m just pointing out that shaming people is against our ethics and if you cannot not shame people then you should not be a therapist.)

If Aaronson did not see a therapist, perhaps because he was afraid that they would shame him, then that’s unfortunate. And I don’t blame him. But I still think that we should be encouraging people with such pronounced irrational beliefs to seek therapy, not feminist literature.

No wonder I was so frustrated when I wrote that earlier post. I felt like feminist writers are being asked to do the job of a mental healthcare professional.

~~~

A few relevant points that I did not have time to expand on here, but may in the future:

  • Part of the reason that a lot of what Aaronson read/watched was so shaming towards men was probably because it was shaming towards sex and sexuality in general. Especially those college sexual harassment trainings, some of which are woefully retrograde. It’s important to remember that stigma/shaming around sex is something that is so entrenched in our culture that it’s bound to show up all over the place, even, yes, in feminist literature.
  • Aaronson claims that all the feminist literature he read confirmed his belief that straight men are awful and violent. While this may be so–I haven’t read Dworkin and don’t intend to–I have also personally watched men respond to materials that were not at all whatsoever shaming of men by claiming that they were being shamed by those materials. This seems to be a very common bias. They expect to be shamed by feminist materials, so they feel shamed by them.
  • I have seen dreadfully few discussions about how everyone–especially non-/anti-feminist men and women–perpetuate toxic ideals about masculinity. It’s usually not feminist teenage girls slamming shy nerdy boys into lockers and publicly humiliating them, is it? We should talk more about that. Unfortunately, most men dislike talking about toxic masculinity, because they think that “masculinity” is synonymous with “men,” and perhaps also because they have bought extensively into this ideal and appreciate the privileges it affords them.
  • There needs to be a space where we can say, “Wow, that is really awful, I’m sorry you felt that way and had to live with that, but I need to point out that your interpretation of things was inaccurate.” Because right now, it’s looking to me like anyone who includes the latter part of that sentence is accused of hating men or lacking compassion. If I read a Richard Dawkins book, came away with the idea that Dawkins believes that all religious people should be put to death, and therefore started to fear for the lives of my religious relatives, I would want someone to try to explain to me that I had misinterpreted the book. It would not be compassionate at all to allow me to continue believing that Dawkins was calling for my relatives’ deaths. It is not compassionate to allow Aaronson to believe that feminists want him to never, ever so much as kiss a girl. (A moot point now, but it wouldn’t have been earlier.)
  • It is also entirely possible that all the feminist literature that Aaronson read was woefully inadequate. (I disagree, and wish he had picked up bell hooks, but let’s grant it.) Feminism is, like every other field of study, constantly advancing and finding new ways to analyze and advocate. The feminist literature of the past decade or so focuses a lot more on helping men than the feminist literature of the 1970s and 80s. But feminist activism still consists mostly of women, and when men join in, they often try to speak to us about our own issues than to other men about men’s issues. And women, naturally, will focus first on issues we primarily face, some of which are life-threatening. Men, please, don’t stand around and lament the fact that feminists are not addressing your problems. Familiarize yourself with feminist principles and join in.

How Rolling Stone Failed Rape Survivors

[Content note: sexual assault]

My new Daily Dot piece discusses the Rolling Stone mess.

Last month’s groundbreaking Rolling Stone piece about sexual assault at the University of Virginia recently came under scrutiny from reporters at Slate and the Washington Post, leading Rolling Stone to retract the piece on Friday.

Unfortunately, many are taking this to mean that “Jackie,” the college student who described her brutal gang rape in the original piece, was lying about her ordeal. Based on everything I have read about this story, however, I find that exceedingly unlikely.

One major criticism of the original Rolling Stone piece has centered on the fact that the reporter, Sabrina Rubin Erdely, did not reach out to the students Jackie accused of rape or to the fraternity where she claimed the assault happened. In the retraction piece, the editors wrote, “Because of the sensitive nature of Jackie’s story, we decided to honor her request not to contact the man who she claimed orchestrated the attack on her nor any of the men who she claimed participated in the attack for fear of retaliation against her.”

I understand this decision, and I understand how difficult it must’ve been for Erdely to try to keep Jackie comfortable enough to speak publicly about such a traumatic experience. But this goes against journalistic ethics and leaves the journalist, the publication, the readers, and the subject of the piece—Jackie—vulnerable. Since Jackie was already going on the record with her accusation, refusing to try to interview the men she accused would not have helped prevent retribution against her. Unfortunately, that is a risk any time a rape survivor goes public—in fact, any time anyone publicly accuses anybody of anything.

Reporting the story ethically and rigorously doesn’t have to mean disbelieving Jackie or treating her insensitively. There’s a difference between a reporter who says, “I’m going to interview whoever I want regardless of what you want” and a reporter who says, “I understand your concerns, but in order for this story to be as powerful as we want it to be, I need to reach out to the people you’re accusing.” If Jackie refused to speak given these terms, perhaps this was not the right time to try to write this piece. As Audrey White writes at Autostraddle:

Erdely’s job as a reporter required she create a bulletproof story to protect Jackie, avoid libel against the alleged assailants, and achieve her ostensible goal of revealing a culture at UVA and in Greek life that promotes and protects sexual assault. … If respecting Jackie’s wishes meant the reporter couldn’t contact anyone else related to the assault, even to confirm basic details like a person’s membership in the frat or the date of an event, she should have found a different source or approached the narrative from a different angle. As it stands, she put the integrity of her story and of Jackie’s search for resolution at risk.

Indeed, it’s now unclear how willing Jackie was to be a part of this story at all. The Washington Post reports: “Overwhelmed by sitting through interviews with the writer, Jackie said she asked Erdely to be taken out of the article. She said Erdely refused, and Jackie was told that the article would go forward regardless.”

While Jackie doesn’t specify exactly how or why she was overwhelmed by this process, the fact that there appear to be “inconsistencies” in her recollection of her gang rape gives a possible clue.

Read the rest here.

Why Dudes Don’t Greet Dudes

My newest Daily Dot piece is about #DudesGreetingDudes.

After that NYC catcalling video went viral online, some men (not all men!) were upset, not because they were trying to defend their right to shout “nice tits” at a random woman, but because even non-sexual comments were being defined as harassment. For instance, Michael Che, co-host of Saturday Night Live’s Weekend Update, wrote on Facebook, “I want to apologize to all the women I’ve harassed with statements like ‘hi’ or ‘have a nice day.’”

In response to comments like these, This Week in Blackness CEO Elon James White created a hashtag called #DudesGreetingDudes:

The #DudesGreetingDudes tweets are hilarious because they’re ridiculous. After all, everyone knows men would never actually talk to each other like that.

But why wouldn’t they?

The common explanation is that street harassment—yes, including the “nice,” non-explicitly sexual kind—is ultimately about asserting male dominance over women, forcing them to give men their time and attention. It wouldn’t make sense for a man to infringe on another man’s mental and physical space in that way.

But I think there’s also a little more going on here, and it has to do with the ways in which men are socialized to view women not only as sexual objects, but as their sole outlet for companionship, support, and affirmation. They’re socialized to view women as caretakers and entertainers, too.

Read the rest here.

Therapists Can Be Wrong

Therapists, like many professionals who work directly with clients, need to present themselves confidently in order to be effective, even when they’re not feeling very confident. It can be difficult for therapists to admit that they have or could be wrong, or that they don’t know everything. Like doctors and teachers and others, therapists worry that acknowledging their own limitations will erode their credibility and trustworthiness. When your livelihood depends on people finding you credible and trustworthy, that adds to the aversion of being wrong and admitting mistakes that virtually all of us already experience.

Yet we have to learn how to admit and accept that we are sometimes wrong–not only because it’s a foundation of accountability and ethical practice, but also because clients can often see through that facade, and they won’t like what they see. It’s difficult to trust someone who will never–can never–admit that they’re wrong.

This was going through my mind as I read one of my required texts for school, Psychiatric Interviewing: The Art of Understanding“Psychiatric interviewing” is really just a term for the process of therapists asking their clients questions, so the book covers a lot of very important ground. While I’ve found it useful so far, a few things irk me about it.

For instance, the author has a strange preoccupation with labeling clients using the article “the” in a way that implies uniformity. The text is laden with references to what “the paranoid patient” may do or how “the guarded patient” may behave in an interview. This type of language is not only dangerously vague (who qualifies as “the paranoid patient” as opposed to “a person who has some paranoid thoughts”? Who gets to make that determination, and using which measure(s)?), but stigmatizing to therapy clients and a potential source of bias for therapists. If you’re a young therapist who reads this book and gets all these ideas about what “the paranoid patient” may do, you may project these assumptions onto every client you work with who struggles with paranoia or expresses thoughts that seem paranoid to you. Assumptions are not necessarily a bad thing–and may even be useful in some cases–but you need to be aware of them as you work. Thus far in my reading of this book, it has not provided any cautionary notes about making assumptions. Even in my classes, in which we are often told not to make assumptions, provide little if any guidance on learning to actually notice these assumptions in practice.

Shea also recommends a few other techniques that I find excessively presumptuous. Take this example dialogue from the book:

Pt.: After my wife left, it was like a star exploded inward, everything seemed so empty…she seemed like a memory and my life began to fall apart. Very shortly afterwards I began feeling very depressed and very tearful.

Clin.: It sounds terribly frightening to lose her so suddenly, so similar to the pain you felt when your mother died.

Pt.: No…no, that’s not right at all. My mother did not purposely abandon me. That’s simply not true.

Clin.: I did not mean that your mother purposely abandoned you, but rather that both people were unexpected loses.

Pt.: I suppose…but they were very different. I never was afraid of my mother…they’re really very different.

A lot of therapists, especially those in the psychodynamic tradition, are understandably attracted to the idea of making this sort of “insight.” As Shea points out, when you get it right, it can build a lot of trust because the client feels understood in a very special way. It feels good to feel “smart” and insightful, to be able to read people like that. It can remind us that there really is something special we can do as therapists that others cannot. It probably doesn’t hurt that this, the therapy-via-Sudden-Brilliant-Insight, is usually the only kind we see represented in the media.

But a lot of the time, there really isn’t enough information to reach this conclusion. Therapists may make these leaps based on hunches, but that doesn’t mean there’s data to back it up. Sometimes the client will tell you so, but I think that a lot of the time, they will say, “Hm, I suppose you might be right,” because you are an authority figure and they want to believe you have the answers.

From the information given, you can’t reasonably jump to the conclusion that the client felt similarly when their wife left them and when their mother died. Those are very different types of loss, and even similar types of loss–two breakups, two deaths in the family–can feel very different.

Certainly there can be conceptual similarities between losing a spouse to divorce and losing a parent to death. It might even be worthwhile to explore them, but the therapist need not assume they felt “so similar.” If I were the client, I would’ve liked the therapist to say something like:

Between this and your mother passing away, it sounds like you’ve been dealing with a lot of loss. I’m wondering if losing your wife is bringing up any memories of losing your mother.

This resonates with me; it might not with other clients. That’s why sometimes the more important thing as a therapist isn’t what you say, but how you respond once you realize you’ve said or done something that strains the connection between you and your client. In this case, a responsive therapist might say something like:

I’m sorry, I didn’t mean to make assumptions about how you’re feeling. Can you say a bit more about how this loss feels different for you?

The client is the expert on their experience.

But instance, in the dialogue, the therapist doubled down on the (mis)interpretation, attempting to justify their response to the client’s disclosure. This leads the client to double down as well, justifying to the therapist why the losses feel different. They shouldn’t have to justify themselves that way.

Here is the thought I had, as both a provider and a consumer of mental health services, when I read Shea’s example dialogue above:

The failure mode of Brilliantly Insightful Therapist is Arrogant, Presumptuous Therapist.

Now, I don’t know if Shea is arrogant or presumptuous; I don’t know him but I would hope he isn’t. I do know that refusing to acknowledge missteps and misunderstandings can lead one to across that way, though. And that’s exactly what Shea refuses to do both in the dialogue itself and when he analyzes the dialogue for the reader:

Needless to say, this attempt at empathic connection leaves something to be desired. The patient’s attention to detail and fear of misunderstanding have obliterated the intended empathic message, leaving the clinician with a frustrating need to mollify a patient who has successfully twisted an empathic statement into an insult of sorts.

This probably infuriated me more than anything else in this text. Here, the failure of the interaction has been blamed entirely on the client. Shea has assumed that the client has taken his statement as an “insult” when there is no evidence of this; the client is merely correcting the therapist’s misinterpretation. It reminds me of how, often when I tell people they’ve made inaccurate assumptions about me, they respond by shrieking about how “upset” I am and how I take everything as an “insult.” Correcting someone is not the same thing as being “insulted.”

If this situation is “frustrating” for the clinician, then, I can only imagine how much more so it must be for the client.

There is no room, in this approach, for any acknowledgment that the therapist’s interpretations might simply be wrong. No room for the possibility that it’s not the client’s personal characteristics (“paranoid,” “guarded,” “histrionic”) that made this interaction fall flat, but the therapist’s presumptions and subsequent refusal to step back from them.

I discussed this particular example because it’s what came up in my reading, but it’s hardly the most egregious thing of this type that happens. Therapists who cannot conceive of the possibility that they’re wrong not only fail to help their clients, but can actually hurt them.

Since there are probably a lot more therapy clients (or prospective therapy clients) reading this than there are therapists, I want to be clear about why I wrote this. It’s not to discourage people from seeking therapy, but to arm them with the knowledge and language to advocate for what they need from their therapists, and to find therapists that suit their needs.

That last part is important. Some people may want a therapist who makes bold interpretations and takes that authoritative, explanatory sort of role. Personally, I think conducting therapy in this sort of way opens practitioners up to all sorts of bias and errors, which is one reason I want to avoid it both as a client and as a therapist. But if that’s the approach that resonates with you, then it’s likely to work a little better for you, because the most important factor is the client-therapist relationship.

Aside from that, the reason I write about problems in mental healthcare is the same reason I write about problems in feminism or atheism–to hold my own communities accountable. Anecdotally, I know that this sort of thing makes it difficult for some people to benefit from therapy, or even to want to access it to begin with. I’m not the only person who dislikes having an authority figure tell me things about my life without bothering to find out if their assumptions are even accurate.

I trust people more when they admit their mistakes.

 

[guest post] Debunking Some Skeptic Myths About Sexual Assault

[Content note: sexual assault]

This guest post was written by my friend HJ Hornbeck and discusses a talk on sexual assault given by social psychologist Carol Tavris at The Amazing Meeting (TAM) this past July. 

Introduction

Carol Tavris’ talk came at the worst time for me, as well as the best. I’m too busy at the moment to give it a proper fisk, because I’m preparing a lecture on sexual assault. I’ll see if I can aim for two birds, but for now her talk deserves at least a point-form response with minimal proof-reading.

Some background first, though. If I can crib from her TAM 2014 bio,

Carol Tavris is a social psychologist and author whose work focuses on critical thinking and the criticism of pseudoscience in psychology, among other topics. Her articles, book reviews and op-eds have appeared in the New York Times, the Los Angeles Times, the Wall Street Journal, and the Times Literary Supplement, among other publications. Many of these essays and reviews are available in Psychobabble and Biobunk: Using psychological science to think critically about popular psychology. Dr. Tavris is coauthor, with Elliot Aronson, of Mistakes Were Made (But Not By Me): Why we justify foolish beliefs, bad decisions, and hurtful acts–a book that has become something of a bible, dare we say, of the skeptical movement.

So she’s a pretty cool, smart skeptic. The title of her talk did raise a few eyebrows, though–why was a conference notorious for havingsexual assault problem hosting “Who’s Lying, Who’s Self-Justifying? Origins of the He Said/She Said Gap in Sexual Allegations”? Still it didn’t attract much attention…

until the live-Tweets arrived.

They’re terrible, by and large, but most of them come from people who are already terrible on this topic. This was a talk given at a conference where the management has historically taken out extra liability insurance to deal with the risk posed by one of its keynote speakers. There’s a certain motivation for the attendees to pull out every dismissive, permissive, victim-blaming message possible from a talk on rape. The tribalism in the tweets is not subtle. I could give a talk on rape myths in front of that audience, and the Twitter feed would still be terrible.

So I’ll wait to see whether the talk is released to a general audience.

I had much the same opinion as Stephanie Zvan; critiquing something you only have a fragmentary record of would only lead to disaster, so it was better to wait and see.

Well, I waited. I saw. And my goodness, what a disaster.

[Read more…]

Open Thread: How Do You Practice Self-Care?

A teapot and a mug that says, "Write like a motherfucker."

90 degrees outside. No fucks given.

I’m going to give open threads a try! The folks who comment here seem to have a lot of interesting things to share, so I thought it’d be cool to have some threads where you can talk about yourself as much as you want.

The topic I’m starting with is self-care. Whether or not you have what could be called Mental Health Problems, everyone needs to calm down, unwind, or get their mind off of things sometimes. Different things work for different people, and sometimes something that seems really weird or counterintuitive will help someone.

Self-care is not a replacement or substitute for treatment (if you need it). It’s a way for people to cope with stress and jerkbrain, maintain recovery from a mental illness, or help manage mental illness symptoms if you have them. So none of these things are intended to cure or treat anything, and a lot of frustration tends to arise when people offer them up as “advice” for those with mental illnesses.

We each know best what helps us best. Here’s how I like to do self-care:

  • Hot tea. (Even in the summer. Must be because I’m Russian.)
  • Writing, even if it’s about something heavy.
  • Taking a hot shower, even if it’s just to have a place to cry in private.
  • Cleaning, organizing, doing dishes. My apartment tends to get cleaner the more life problems I’m having.
  • Going for a walk and listening to music. Unfortunately, I don’t get to do this so much now that I live in the city, where it wouldn’t be relaxing or necessarily pleasant. But my high school years, back in Ohio, were full of leisurely walks around the neighborhood.
  • Playing music. Now that I finally have a keyboard piano, I’ll finally be able to do that again.
  • Reading sci-fi novels or nonfiction articles. For some reason, it has to be one or the other. Nonfiction books don’t work, and short stories or poetry don’t work.
  • Watching something that tells a good story but doesn’t require careful attention. So, Star Trek and Doctor Who are in; West Wing and Damages are out.
  • Talking to a friend about something totally unrelated.

Some things that help lots of people but not me are: YouTube videos, animal photos, talking to someone about the thing I’m upset/stressed about, eating, video games (though I like them at other times), basically anything that’s supposed to be funny/uplifting. The first two are especially frustrating, because the first thing many people will do if I say I’m feeling down is send me YouTube videos and animal photos. Then I have to either pretend that it helped, or tell them that that doesn’t help. (Except sometimes. Hard to predict.)

 

What works for you? What doesn’t?