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conflict resolution Mental Illness psychiatric drugs psychiatric medications psychiatry Thomas Szasz

My Radical Psychiatrist Friend Dr. Szasz

Welcome to From Insults To Respect. I’m Dr. Jeffrey Rubin.

Dr. Jeffrey Rubin

Typically, here on this blog I aim to write posts that suggest how we might deal with various intrapersonal and interpersonal conflicts in a manner that will enhance the respect that we have for ourselves, and others have for us. But today we will look at a set of circumstances that is a bit more complicated.

It just so happens that during the last 20 years of Dr. Thomas Szasz’s life I got to know and respect him. He passed away in 2012. During the period of time that I got to know him, I found that some people respected him as I did, but others didn’t. So, throughout this period, I had the following quandaries: If I let the people who didn’t respect him know I did, would that end up weakening the respect they have for me? Should I remain silent about my respect for him until I find out how the others I am with view him? Would I respect myself more if I spoke up about why I respect him even if I risked losing the respect of some? These are the questions that today I invite you to explore.

Learning About Dr. Szasz

Dr. Thomas Szasz

I first came to hear of Dr. Szasz back in 1971when I was taking an undergraduate Abnormal Psychology course at Brooklyn College. One of the assigned readings was Dr. Szasz’s article, published in the American Psychologist, titled, “The Myth of Mental Illness”.  Dr. Szasz also wrote a popular book with the same title, which I read a few years later.

In the article, Dr. Szasz put forth his belief that the behaviors and experiences that are considered “mental illnesses” are more accurately construed as problems in living. As someone whose family narrowly escaped the violent, inhumane actions of Hitler in 1938, he expressed a concern about society giving psychiatrists the authority to convert these problems into a language of illness. As he saw it, his own profession has a financial interest in converting more and more problems in living into illnesses that require its services to reach some vague harmonious state thought of as mental health. However, according to Szasz,

…it seems to me that—at least in our scientific theories of behavior—we have failed to accept the simple fact that human relations are inherently fraught with difficulties and that to make them even relatively harmonious requires much patience and hard work. I submit that the idea of mental illness is now being put to work to obscure certain difficulties which at present may be inherent—not that they need be unmodifiable—in the social intercourse of persons. If this is true, the concept functions as a disguise; for instead of calling attention to conflicting human needs, aspirations, and values, the notion of mental illness provides an amoral and impersonal “thing” (an “illness”) as an explanation for problems in living.

Of particular interest to my fellow students was Szasz’s argument that by converting these problems into something that sounds like a real illness, it creates a situation in which psychosocial, ethical, and/or legal deviations are claimed to be correctible by (so-called) medical action only doctors are licensed to provide, such as the prescribing of drugs. To Dr. Szasz, it is logically absurd to expect that it will help solve these types of problems by prescribing tranquilizers and other drugs as if they were like a bacterial infection, or the growth of a tumor. To be sure, people on their own have tried to deal with these problems by taking a wide range of drugs, such as alcohol, tobacco products, stimulants, and heroin. Such approaches, rather than promoting healthy outcomes, tend to lead to less healthy outcomes. To Szasz, changing to the drugs doctors prescribe to deal with these problems in living is like changing seats on the Titanic.

Upon reading the American Psychologist article, it seemed to me that Szasz made some valid, thought provoking points, and during the class discussions, although not everyone agreed with everything Dr. Szasz had written, none of the students, nor did the professor, seem upset with the author’s position.

As several years rolled by, I read several of Dr. Szasz’s books. The role of psychiatrists in social control, promoting conformity, lobotomizing, administering electrical currents to brains to cause convulsions, prescribing harmful drugs to children for behavior problems, stigmatizing adversaries, disqualifying citizens of their right to stand trial, and creating confusion by calling both voluntary medical interventions and coercive practices “treatment,” are the issues Dr. Szasz incisively analyzed.

Many of Dr. Szasz’s books received enormous praise. For example, a reviewer in The Atlantic wrote of his Myth of Mental Illness:

It is no exaggeration to state that Szasz’s work raises major social issues which deserve the attention of policy-makers and indeed of all informed and socially conscious Americans….Quite probably he has done more than any other man to alert the American public to the potential dangers of an excessively psychiatrized society.

Dr. Szasz’s book, Law, Liberty, and Psychiatry, also was met with high praise. In a review published in the New York Times, Edward de Grazia wrote;

This bold and iconoclastic work takes up most of the faults committed in the name of mental illness, and lays down short-run and long-run solutions.

Charles D. Aring, M.D., Professor of Neurology, University of Cincinnati, wrote:

It is likely to rank among the classics of psychiatry.

How We Met

Corning, NY

So, by the time I graduated from the University of Minnesota’s PhD program, and obtained a position as a psychologist in the Corning, New York school system, I was quite familiar with Dr. Szasz’s writings, but I had never met him. But then I began to notice that during my time in graduate school, there was an explosion in the number of students who were being prescribed psychiatric drugs. This began to alarm me more and more because of several of the cases referred to me.

One boy had recently become depressed. When I asked him why he thought he was depressed, he said that his mother was making him take Ritalin to treat his ADHD. The boy didn’t believe he had ADHD, and when the drug’s stimulant effects began to wear off each evening, he was left feeling awful, with waves of sadness, stomach aches, and difficulty falling asleep.

I checked his school record and found he had been consistently on the honor roll prior to taking Ritalin. His teacher reports never expressed any concerns about his having any trouble paying attention or being hyperactive. Instead, he was viewed as an excellent student.

When I asked the boy’s mother why he had begun to take the drug, she explained that he appeared to her to be having trouble paying attention to his homework. When she brought him to her doctor, he diagnosed him as having ADHD based on her concern about the homework issue and then prescribed the drug. When I informed her that the boy attributed his depression to the side effects of Ritalin, she got defensive, and told me she had faith in her son’s doctor, and she didn’t want my advice about what drugs her doctor was prescribing. I was, according to her, to keep my mouth shut about the drug and just treat her son’s depression.

I found this a very challenging situation.

At the same time, I had become concerned that so many of the kids referred to me who were in foster care were on drugs typically prescribed for people diagnosed as psychotic. These students typically were dealing with serious emotional challenges involving being taken from their parents’ home. A couple of these cases involved parental child abuse, others involved parents being sent to prison, and I had another case of a boy dealing with his parents dying in a car accident. My efforts to help these grieving kids became ever more difficult because of the side effects of the psychiatric drugs prescribed to them. Some of the side effects were known to be life threatening.

And then, in the spring of 1989, a 21-year-old man was found dead at a nearby psychiatric facility within 24 hours of being forcibly injected with the same type of drug these foster children were taking.

Prior to this incident, members in my community were already hotly debating the use of psychiatric drugs within schools. The death broadened and intensified the issues.

Lincoln-Douglas Debates

As a psychologist, my views were sought. Although forthright about my position, in my PhD program I had learned that when confronted with a controversial issue my primary obligation is not to propagandize but to teach; not to indoctrinate but to provide opportunities for citizens to hear a free exchange of opposing views.

To this end, I organized a full day debate in my community on this issue titled, “Psychiatric Drugs: Wonderful Revolution Or Ongoing Catastrophe?” There were two psychiatrists and a patient in favor of the current drug approach, and two psychiatrists and a former patient who were on the other side of the issue. Dr. Szasz was one of those psychiatrists. I served as the debate moderator.

The debate was so popular that people from other communities began to ask me to organize a similar event in their community. Consequently, I set them up in Washington, D.C., Binghamton University, Niagara Falls, and Baltimore, all of which were very well attended. As I went about planning these events, I started to hear from people who were vehemently opposed to them. For example, one woman wrote to one of the sponsors of the debate:

Regarding the October 3rd Binghamton Conference, I am writing in great dismay and utter incredulity that so much mental health money would be spent in this fashion. The money for the needed basic services has been so sharply reduced for our ill family members; plus with the number of mentally ill homeless ever increasing, then to see the large number of participants in such a program was definitely upsetting to me.

I am a member of the Finger Lakes Alliance for the Mentally Ill and have been involved with mental health issues at close range for many years. Firsthand, I can attest to the grief and destruction of lives which mental illness causes. To waste funds and not direct them toward research into the root causes is in my opinion, the wrong direction. To present fallacious viewpoints so flagrantly as was done October 3rd., can only cause more heartbreak to those least deserving of any more heartbreak.

No wonder so many health professionals are stumbling along trying to help our loved ones, but getting nowhere. This is not to say their motives are not right but such attitudes as Dr. Szasz, etc., expound upon cannot help but cloud their thinking.

It is my hope no such conferences will occur. However, if there are any other similar ones, family members should also be on the panel. Dr. Major and Dr. Feinstein were great, but there should be representation from the families who watch and suffer.

So, here we see that the person writing the letter acknowledges that some on the panel did a great job presenting her views but she objects to views with which she disagrees being expressed. Dr. Szasz is specifically named as among those who should be silenced.

By the way, the objection expressed by the critic of the debates, “that so much mental health money would be spent in this fashion” is very misleading. Those who attended came voluntarily and payed a fee for coming. There were some scholarships for those who wanted to attend but said they couldn’t afford the fee, but because so many attended, there were no substantial cost to mental health funded programs. The one exception was that one mental health department in New York State volunteered to print the brochure and send it out to all members of the state’s mental health workers. The cost to the department represented a pittance to their overall budget.

Shortly after receiving this letter, I was contacted by the Executive Director of the Mental Health Association in Niagra County, who asked me to work with her group, and several others in her area, to put on a similar debate for her community. This time I did add to the panel a family member who belonged to the local chapter of the National Alliance On Mental Illness. Despite that, I received a letter from the president of that organization’s New York State chapter asking that the debate be cancelled. In his letter, he specifically objects to Dr. Szasz expressing his views.

I am pleased to report that the debate in Niagra County went ahead as planned. Moreover, the Niagra New York chapter of the Alliance On Mental Illness formally welcomed the conference.

My involvement in the project led to Dr. Szasz and I becoming friends. I would go visit him at his home from time to time, and we would have lunch while discussing his views. At such times when I disagreed with him, I found his delightful sense of humor and cogent counter arguments were done in a manner that I deeply enjoyed and respected.

Over the years, I found his love for his two daughters particularly heartwarming. I could easily relate to his feelings toward them because I have two dear sons.

Whenever I visited him, he normally didn’t interrupt our conversation even when the phone rang, but if the answering machine indicated the call was from one of his daughters, the delight on his face was something to behold. And then he would quickly apologize to me and, like a little boy being invited to have some chocolate cake, he would rush over to take the call.

I remember being invited to his eightieth birthday party. Over a hundred people attended, and the enormous respect they all had for him was amazing.

How Best To Handle A Situation In Which It Becomes Apparent Someone Doesn’t Respect Your Friend?

So, what do you do in a situation like this, that is, a situation in which some people highly respect your friend, while others don’t? As for me, when I meet someone saying negative things about Dr. Szasz, I take some time to listen carefully, and I respectfully summarize the person’s position. I then gently say a few supportive things about Dr. Szasz, while bracing myself to deal with the person’s reaction. As the other person replies, I again listen, seeking to be as empathic as possible.

I recognize that I may lose a certain amount of respect from that person, but I hope, and seek, to win them back as time goes by with my other actions.

What are your thoughts about such challenging situations?

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Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on.  This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional and social intelligence.  To begin at the very first post you can click HERE.

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conflict resolution Preventing Community Violence Preventing mental illness Promoting peace

Fostering Peaceful Solutions To Conflicts In Communities

Welcome to From Insults to Respect.

What can we to do to foster peaceful solutions to conflicts in our communities? Well, currently, when young folks first begin to display a pattern of serious violence to themselves or others, they are typically placed together to provide some intervention in a group, such as a special education class or a correctional facility. Unfortunately, this often worsens these behavior patterns as the young folks in these programs begin to copy from one another a variety of harmful behaviors.

Mentoring programs, which provide one-on-one relationships, such as the Big Brother/Big Sister Program have demonstrated they can be helpful, but most communities find they have a severe shortage of mentor volunteers. In addition, it has become apparent that some who do manage to get mentors need significantly more time with a positive role model then the hour or two per week that mentoring programs typically provide.

So, after much thought on how to bolster the effectiveness of mentoring, and other helpful community programs, I drew up this idea I refer to as the  One-On-One Program. I got a school district and a college to agree to carry out the program if I could get funding for it, so I quickly wrote a grant without any experience in writing them. Reviewers indicted the program proposal has great potential but I need to have it written up by someone who knows how to write grants. When I got news of this, I was retiring, so I’m here describing the program in the hopes others will pick up this program idea and make it a reality.

Here’s How the One-On-One Program Would Work

It would begin with offering an elective course to high school and college students titled “An Introduction to Counseling and Conflict Resolution.” It would provide lessons on basic counseling skills such as empathic reflective listening. A major unit in the course would be on how to discipline children nonviolently, and another unit would be on how to teach skills for dealing with anger arousing situations.

For those students who master the course curriculum, they would be able to apply for a paid internship. These interns would serve as mentors for younger students at least four years younger than they. For their participation, mentors would receive an authentic sense of helping their community, a modest stipend of about $4 an hour, earn additional course credit, and have an opportunity to receive a sterling recommendation for any future job or advance education opportunity. Survey data that was administered at my school district and local college indicated there would be plenty of students who would agree to become mentors if the program became funded.

Starting when school lets out and lasting until 6:00 p.m., the mentors would work at their local high school one-on-one with their assigned mentee.

On site at each high school would be two adult supervisors, one of which would be a psychologist, the other, a volunteer senior citizen.

Additional supervision would be provided to mentors throughout their internship, by having them participate in a credit bearing course designed to help resolve peacefully conflicts that arise when working with their younger partner.

Because mentors will miss some days for sickness or personal reasons, a few alternate mentors would be on call to fill in when needed.

The daily activities each mentor-mentee pair would do together include:

  1. A mile walk during which the mentees would get to talk about whatever they want. During this time, their assigned mentor would employ the basic counseling skills of empathy and reflective listening that were mastered in the course that each had taken to qualify for the internship,
  2. When they return from their walk, each of the mentor-mentee pairs would sit down for a ten-minute meditation,
  3. Then they would work for twenty minutes doing homework.
  4. The next ten-minutes would be devoted to a lesson taught by the mentor to their mentee on how to handle anger arousing situations,
  5. The final hour would be devoted to an activity designed to develop some valued talent that both members of the mentor-mentee pair have shown an interest in working on.

So those are my suggestions for the daily 5 major activities.

The lessons that mentors would teach their mentee to deal with anger arousing situations, involve making video recordings. In these recordings the mentees would act out expertise in handling in a peace promoting manner some challenging event such as being teased or criticized.

Every 6 weeks, all of the parents of the mentees would be invited to an evening meeting. The focus of these meetings would be on seeing the little video shows that their sons and daughters had made that illustrate peacefully handling some conflict.

Now, this is an enormously important aspect of the program for the following reason: When I worked with youth at risk before I retired, there were times when I sought to have their parents show up to have problem solving discussions. I found many never came. But once I made these types of video recordings the focus of the parent meetings, not only did the parents show up, they often brought along grandparents, uncles, and aunts.  Apparently, parents and other family members love to see their kids in shows.  So, with this aspect of the One-On-One Program, not only would the mentors and mentees have an opportunity to learn and discuss peaceful, constructive ways to deal with challenging conflicts in a fun, engaging manner, so too would a large percentage of the mentees’ parents.

How would the program seek to enroll youths who can benefit from it? Teachers, counselors, police officers, and judges would be informed of the program’s existence and asked to refer young folks they view as in need of this community option.

So, there you have it, the raw basics of the One-On-One Program. Now, to give you a sense of the real heart of this program, I’m going to tell you two short parables. The first is:

The Parable of Tony

Our tale begins when Tony is 12-years old. Because of several fights that he has gotten into at the afterschool program, Tony has just been banned.

Tony’s mother is furious. While repeatedly swinging at him with her shoe, she screams, “If you get into any more trouble, I’ll beat the living daylights out of you!”

A few weeks go by and then Tony’s mother gets a call from the police and learns that he has been picked up by them for being a lookout for a gang while its members engaged in various illegal activities.  “What else could I do,” cries Tony, “it was the only way I could get the gang to stop doing mean things to me!”

At a judicial hearing, the judge refers Tony to the One-On-One Program.

Shortly afterwards, Nick, 17-years old, begins to mentor Tony every day after school. Nick had been bored before beginning to work with Tony, and without this constructive activity available, he could have easily gotten into trouble. But now he finds that the way Tony looks up to him very rewarding, and Nick gets great satisfaction knowing he’s helping his community. And he also likes the money that he’s earning from the stipend.

Meanwhile, with Nick’s help, Tony’s aggressive school behavior has clearly improved, more of his homework is getting done, and his behavior in the larger community has seized to be a problem.

For talent development, Tony showed an interest in the game of chess, so both he and Nick have begun to play every day after school.

The next school year, Nick has gone away to college, so Tony’s mother is planning on getting a new mentor for Tony.  But Tony has heard that his community has an afterschool chess club and he convinces his mother to let him give this a try.

To his delight, Tony finds that after a whole year of playing chess with his mentor, he has become pretty good.

Best of all, several of the players have begun to call Tony to play chess on the weekend or to go to a movie. Because of Tony’s training during the program on how to deal non-violently with anger arousing situations, he finds that he gets along with these students in a positive manner. Soon, he has, for the first time in his life, some real friends.

Well, there you have it, the Parable of Tony,

Here’s the other parable I want to share with you.

The Parable of June

June, 11-years old, is wearing a cute pink dress. She has been brought to see Dr. Shure, a psychologist.  Leaning forward on her desk, Dr Shure asks,“Do you know why your mother asked me to meet with you, June?”

“I’ve been awfully sad,” June replies, “and mom, well, she hates it when I cry out that I want to kill myself. I’m so terribly lonely.”

“Lonely,” says Dr. Shure, concerned and puzzled, “Hmmm.  You go to school where there’re lots of kids your own age. You could go to the afterschool program where you don’t have to be lonely, but your mother told me that you refuse to go.  What’s up with that?”

“At school and the afterschool center,” June replies, “I feel lonelier than when I’m alone.  The kids make fun of me.” Tears begin to form in June’s eyes.

“I see you are feeling sad,” says Dr. Shure softly.  “Are there any times when you don’t feel lonely?”

“Yeah, when my cousin Marissa comes for a visit.  She’s a few years older than me, but she really likes me.  And I play the flute and she plays the piano, so we play duets, and we love being together.  It’s just that she lives up in Rochester, so I only see her once every few months.”

Dr. Shure nods her head and says, “June, we have a program in this community called The One-On-One program.  If you join, someone a little older than you would do some fun stuff just with you every day after school including playing music together.  Would you like to give that a try?”

“Does the older person play the piano?” asks June.

“Hmm, let me look on this list.  Ummm, well we don’t have any piano players, but I see we do have a 17-year old named Rachel who plays the guitar.  She would love to do duets with you every day after school.”

“Really!” exclaims June. “She’d be like a big sister! I’d love to try something like that!”  A delightful smile is now lighting up June’s face.

As this parable illustrates, in addition to children and teenagers who are at an increased risk of becoming violent toward others, some are so lonely, so down on who they are as a person, they begin to display very concerning signs of harmful behavior toward themselves.

So, In Conclusion

In this One-On-One Program, the mentors would benefit because it would give them something constructive to do instead of getting embroiled with some harmful groups of bored students looking for trouble. They would learn useful skills taught in the counseling and conflict course and be given an opportunity to apply peace promoting skills in real life situations under supervision, skills that they would be able to use later in life and to a time when they become parents. They would also earn some money, and work daily on developing some valued skill.

For those who are mentored, the One-On-One Program would resolve the problem of a shortage of community mentors, relieve those who are suffering from loneliness and boredom, provide opportunities to develop valued talents, and engage them in healthy constructive activities in a supervised setting. And the program would also provide a forum for parents of at-risk youth to come together to observe peace promoting approaches to deal with conflict, and to participate in community problem solving discussions.

Now, as to the cost of the program? For thirty mentor-mentee pairs, the cost would be approximately the same as it would be to send one young person to a juvenile correctional facility or prison for one year. So, if the One-On-One Program was to succeed as a violent prevention program, with fewer folks going to residential programs or prisons, and fewer folks being rushed to the emergency room to be treated for a violent injury or attempted suicide, communities would actually end up saving hundreds of thousands of dollars. Of course it is my hope community members will think beyond the money that can be saved, and act to make the One-On-One Program a reality because this is in the best interest of our youth, and our entire community.

Categories
conflict resolution CSM Diagnostic and Statistical Manual of Mental Disorders-5 Mental Health mental health concern model

Alternatives to Psychiatric Diagnoses

Welcome to From Insults to Respect.

Dr. Jeffrey Rubin

From time to time I have written about the growing lack of respect for the current manner in which people seeking to obtain mental health services are treated. Particularly upsetting to many is the requirement that they be labeled as having a mental disorder.

This labeling process relies on descriptions provided in the Diagnostic and Statistical Manual of Mental Disorders–Fifth edition (DSM) and the International Classification of Diseases–Tenth edition (ICD). Both are manuals that are conceptually similar, utilizing as their core concept, mental disorders, and both share the same “diagnostic” codes. Because of their similarities, I will simply refer to them as the DSM/ICD approach.

Many professionals defending the use of this approach explain that it provides a common language for mental health professionals to communicate about those utilizing their services; its various classification terms, such as major depressive disorder, anxiety disorder, and so on, are short phrases that are convenient for placing into titles and search engines, and for efficient/streamlined communication in high-speed hospitals and clinics; third-party payers of mental health services have found that their coding system works well as part of a practical method for their record keeping; with the aid of these codes, people manage to access mental health services, mental health service providers manage to get paid, and for-profit health companies tend to make a profit.

Unfortunately, there are a number of serious weaknesses with this approach. It tends to be stigmatizing to mental health service users. The lack of reliability and validity of the various so called diagnoses violate basic principles of science. The process of coming up with a psychiatric label privileges the clinician’s perspective over that of the mental health service user. It ignores the fact that many people who have been labeled with these stigmatizing psychiatric terms come to realize that the experiences which led to their seeking services, rather than being an indication of a pathological condition, are really an essential element to their creative development. Many have also expressed concerns about the “mental illness” terminology which medicalizes mental health concerns, thus leading to an incredible number of people being prescribed psychiatric drugs, the use of which leads to numerous serious side effects.

Just as I was writing this post, major news outlets began to report that researchers found nearly a 50% increased odds of dementia for those taking the most popular drugs for treating depression and other mental health concerns. Although the study could not prove conclusively that these drugs caused the increased risk of developing dementia, because these same drugs had already been linked to confusion or memory issues, the new evidence is deeply troubling. The researchers expressed concerns that if this association is causal, it “would equate, for example, to around 20,000 of the 209,600 new cases of dementia per year in the United Kingdom.” With the population of the US being 6 times larger, this could mean that over 100,000 cases of dementia may be attributed to these drugs every year here in my own country.

Adding fuel to these types of concerns about negative effects of ingesting these drugs are the recent findings indicating that despite the fact that more Americans than ever are being prescribed so called antidepressants, the rate of suicide has climbed to an all-time high. Is the increased use of antidepressants causing this increased rate of suicide? Although definitive evidence is not yet available, it is a well known research finding that these drugs do increase the risk of suicidal thinking in many patients.

Meanwhile, the DSM/ICD approach has created a monolithically wealthy pharmaceutical industry, with all of the drawbacks associated with such institutions.

Given these problems, an international effort has been seeking to come up with some reasonable alternative that could provide all of the perceived practical benefits of the DSM/ICD approach, while having significantly fewer shortcomings. As part of this effort, I have come up with one alternative proposal which I discuss most extensively in a peer reviewed article published in a 2018 volume of the Journal of Humanistic Psychology (see HERE). Today, I shall summarize my approach, and then we’ll look at some of the published discussions on this topic that have come out after my article first appeared.

A Summary of My Approach

My proposed alternative to the DSM/ICD approach calls for the development of The Classification and Statistical Manual of Mental Health Concerns (CSM). In contrast to the DSM/ICD approach’s overarching concept of “mental disorders,” the CSM’s overarching concept is “mental health concerns.”

The CSM approach begins with a full recognition that individuality outruns any classification system. It is for this reason that the CSM does not classify anyone. Instead, it classifies the expressed concerns of individuals seeking to have their concerns addressed by a mental health service provider. A mental health concern occurs when a person seeking mental health services expresses to a mental health service provider a concern about any of these topics: behavior, emotion, mood, meaning of life, death, dying, managing chronic pain, addiction, work, relationships, education, eating, cognition, sleep, and challenging life situations.

Classifying the expressed concern would provide mental health service providers a common language that is helpful when communicating among other professionals. So, a professional might say to a colleague something like, “My 9:00 a.m. case is concerned about feeling depressed, my 10:00 case is concerned about his failing grades, my 11:00 case is concerned about how anxious she is in social situations.” Such communications are straightforward and easy to understand, not only for professionals, but for the general public as well.

Each expressed concern listed in the CSM would be a sufficiently short phrase so that it can be conveniently used in titles and search engines to retrieve valued relevant information. Along with each classified expressed concern, there would be a numerical code that would be convenient for third-party payer bureaucratic record keeping.

The CSM, in addition to coming up with a brief label for the expressed concern and a code for third party payers, describes a collaborative approach between the person expressing the concern and the mental health service provider for creating a psychological formulation narrative of a few paragraphs that eschews the DSM/ICD pathologizing jargon. This process involves a mental health service user and a mental health service provider co-constructing a hypothesis or “best guess” about the origins of the mental health service user’s concerns in the context of his or her relationships, social circumstances, cultural heritage, life events, and the sense that he or she has made of them. Once it has been established what the concerns are, the immediate next question is, “How do we jointly understand these experiences, why they arose, and how we might be able to address them?” This formulation is not something that is shared with third party payers of mental health services, but is utilized exclusively by the mental health service user and service provider.

With the CSM approach, no one is viewed as mentally ill, having a mental disorder, or having some psychopathological condition. Instead, it highlights that the progress of society is due to the fact that individuals naturally vary from the human average in all sorts of directions, that the originality is often useful, while, at the same time, being different can create a variety of concerns. Moreover, some people become concerned about how they are handling enormously stressful and traumatic experiences. Still others are living in unhealthy ways, such as making unhealthy choices in what they consume, or getting insufficient exercise. Mental health professionals, with the CSM approach, are viewed as seeking to address these types of concerns that arise from these conditions in a supportive setting while relying on a variety of wisdom traditions. Central to this approach, is an honoring of what Ralph Waldo Emerson referred to as the grand sweep of humanity.

Compared with the DSM/ICD approach, the use of the CSM would be less stigmatizing, more respectful to those seeking services, and more practical because of the ease of understanding the words and phrases that it utilizes. Moreover, it would be more consistent with principles of science because instead of using as its core concept the vaguely defined “mental disorders,” the CSM uses as its core concept “mental health concerns,” which is a clearly recognized event that occurs at a specific time and place. Finally, the CSM approach would provide a new choice to both mental health service users and providers, challenge old ideas, stimulate fresh perspectives, and open new avenues of research.

The Latest Discussions

Since my article on the CSM was published, the Journal of Humanistic Psychology (JHP), in its May 2019 issue, has several articles that discuss my approach as well as a few others. Let’s take a look at some of what was said, and as we do so, I’ll share a few thoughts about my reaction.

In an article titled, “What Might an Alternative to the DSM Suitable for Psychotherapists Look Like?” Jonathan D. Raskin notes that recent surveys of psychologists and counselors indicate they are dissatisfied with the DSM/ICD approach and are interested in coming up with alternatives better suited to their professions. Nevertheless, more that 90% said they will use the DSM/ICD; after all, that is how they get paid by third party payers.

What would be a better alternative for psychotherapists and counselors than the DSM/ICD approach? According to Dr. Raskin, it would have to be a system that allows them to contextualize psychosocial and biological aspects of human suffering in a more nuanced manner. And then he writes,

Dr. Jonathan D. Raskin

“Jeffrey Rubin (2018) has proposed that we classify concerns that clients bring to therapy, not disorders they have. Identifying concerns is very different from identifying disorders. Concerns are things such as feeling anxious about one’s job, unhappy about one’s marriage, emotionally distraught about past abuse, or unable to move past what one witnessed while fighting in a war. The current diagnosis system encourages clinicians to translate these concerns–which are clearly contextual and not reducible to biology alone–into disorders that afflict people. But therapists and counselors do not actually treat disorders. Instead, they talk to people about their concerns–some of which are quite serious and lead to extremely challenging and intransigent difficulties.”

To Dr. Raskin, any alternative to the DSM/ICD approach must be a better fit with what therapists and counselors actually do. The CSM approach admirably achieves this.

In a commentary on Dr. Raskin’s article that appears in the same JHP issue, Rachel Cooper, a senior lecturer in philosophy at the United Kingdom’s University of Lancaster, and author of Diagnosing the Diagnostic and Statistical Manual of Mental Disorders, puts in some of her own thoughts on this topic.

She begins by agreeing with Dr. Raskin that most psychologists and counselors would be keen for an alternative classification to be developed. She then reviewed research indicating that social workers should be included among the professionals unhappy with having to use the DSM/ICD approach. In surveys, most indicated they would not use it if it was not required for insurance purposes.

Despite this finding, Dr. Cooper expresses pessimism about any alternative becoming accepted for funding psychotherapy via health care insurance. Among the factors that make it particularly challenging is the marketing of psychopharmaceuticals, which heavily promotes the idea that certain drugs treat the specific conditions listed in the DSM and ICD. The sum of money being acquired with this approach, she points out, makes producing a competitor classification far beyond the reach of most organizations.

She then refers to my CSM approach, stating that I suggest that insurance companies could be persuaded to pay for “Mental Health Concerns,” as they would readily come to understand, with a little explaining, that mental health service providers now using the current DSM/ICD approach do not turn anyone away who has mental health insurance coverage and comes to their office expressing what the CSM refers to as a mental health concern. She then writes,

“I think that Rubin’s optimism is misplaced. The fact that some (but by no means all) therapists currently get away with recording DSM diagnoses to facilitate payment even in cases where a diagnostic criteria may not be met will not be news to insurance companies. It is a practice that insurers have long known about and usually try to prevent. I think it unlikely that insurers would easily agree to cover Rubin’s ‘Mental Health Concerns.'”

First of all, when Dr. Cooper says insurance companies usually try to prevent mental health providers from recording diagnoses to facilitate payment even in cases where a diagnosis criteria is not met, I strongly disagree with her. I’ve never in my entire career heard of an insurance company questioning a diagnosis, and on what basis could they possibly do so? Insurance funders are not present in the room when a so called diagnosis is made. All that they get as documentation for a given diagnosis is a code indicating the diagnosis.

Moreover, the ICD actually encourages mental health professionals to come up with a diagnosis when criteria are not met. Thus, it states, “When the requirements are only partially fulfilled, it is nevertheless useful to record a diagnosis for most purposes” (WHO, 1992, p. 8).

I do agree, however, with Dr. Cooper when she says that getting the change that I have been advocating for is not going to be easy. Nevertheless, I believe we–professionals, service users, and service users’ relatives and neighbors–have a responsibility to try. Moreover, I have been encouraged by the steady increase in the influence of mental health service user advocacy groups who are becoming more and more vocal about the need for their members to be treated respectfully. And whenever I am invited to speak to professional organizations about the CSM approach, the rousing applause that I receive at the end of my presentation, along with the positive comments from audience members afterwards, keep my hope alive.

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Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on. This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional and social intelligence. To begin at the very first post you can click HERE.

 

Categories
conflict resolution Good Grief support group Grief

Good Grief?

Welcome to From Insults to Respect. Today we’ll be taking an interesting look at the grief process.

Picture from tinybuddha.com

When we experience a major loss, such as the death of a loved one, financial ruin, losses from a natural disaster, or learning of a serious personal medical illness, our emotions can become pretty intense. Common reactions are waves of deep sadness, rumination about the loss, sleep difficulties, and reduced appetite.

A popular model of this process is known as the, “Seven Stages of Grieving.” They are:

– Shock or Disbelief
– Denial
– Anger
– Bargaining
– Guilt
– Depression
– Acceptance and Hope

Sometimes, rather than seven stages, five are used to capture the same basic model. This is accomplished by combining shock, disbelief, and denial into a single stage, and combining bargaining and guilt into a single stage.

These stages do not occur in the same sequence for all people, and they can last for a brief period or quite a bit longer; and during the process, more than one stage may occur at the same time. So, for example, someone may feel shock, anger, and waves of guilt all within a few seconds of one another, or they may all seem to merge together into one combined experience.

Beliefs that we learn from cultural norms can complicate the experience, making us feel at such times that we are acting in a manner that people may not respect. If we start to cry in front of others, will we be perceived as a weakling? If our bereavement lasts longer than what others may think is proper, will we be viewed as having some type of pathological condition?

In an extraordinary Feeling Deeply podcast, Emily Whyte Rubin, my daughter-in-law, interviews Jack Baxter, a guy from London who, having struggled with these issues, started a program to help others who are dealing with similar challenges. Called, “Good Grief,” the program essentially assists people to come together in small groups to share their experiences and to support one another. Let’s take a few minutes to look at some of that interview, and then I’ll express my views on this topic, and then invite those of you who are reading this post to weigh in.

The Feeling Deeply Podcast

This episode of Emily’s podcast can be listened to for free HERE. In introducing the interview, Emily explains that she chose to interview Jack Baxter because, “the human experience of grief is so prevalent, and something I believe many of us can use some more support around.”

After introducing Jack, she asks him what brought him to creating “Good Grief.” Jack’s reply, slightly abbreviated, follows:

“Sure. I’ll tell you a little bit about my story. It started with sadness, unfortunately. It started when I lost my father, Dave. He was 48. He was my best friend. You know, people talk about soulmates; I don’t believe you only have one soulmate, because, you know, I met someone else that I can label that. I’ve since met another soulmate, and I hope to continue to meet more, but my dad was very much my first soulmate; he connected with me in ways that I never connected with anyone. He was my best friend. I could tell him anything, and likewise, he would tell me anything–his advice, his wisdom, and I was lucky enough to have that man for twenty-two years.

“Sadly, he passed September 13th. He had skin cancer, which was, you know, tough for anyone to deal with, as you can imagine. I was only twenty-two at the time. It was like the center of my world had fallen out. It was a very tough time for me to deal with. I no longer had that support, and of course I had some friends and family, but no one like my dad who was, you know, who was there for me at times when I needed him most, and to be honest, I need him even now. You know, a young man needs his dad. And, well, we went on a journey of self discovery and I believe he was with me all that way as well. I made mistakes, ups and down, left and right, and, but, you know, I eventually sought some direction in “Good Grief” which, um, is a support group that I launched with some friends, Ben and James, and we offer support and advice for young people, in London at the moment, but we hope to venture out wider then that, for young people who have lost love ones, much like myself, and Ben, whose father died recently of brain cancer….

“To be honest with you, Emily, it was those people that I met whilst grieving, who understood my pain most. Ben was certainly one of those. I had two or three other friends who had all lost fathers themselves before, or shortly after mine, and they were the support group that I needed. I had lots of people telling me, ‘it will be OK and it will be all right, but it was those who experienced the same grief as me, they were the precious few who I really could listen to and I took strength from. And the group has been going from strength to strength ever since we launched in May, 2018.”

After Jack describes a little more of his grieving experiences, Emily asks him to describe in more detail what happens at these Good Grief meetings.

 “We first like to point out that it is not professional help, because, first off, there is professional help out there….But I think what we offer is, you know, just a group of understanding, empathetic young people. So we sit in a circle, or at least around a table. It’s all very informal; there are biscuits and cookies in the middle. We offer people to snack on them if they want to. Drinks are available, and it’s just a relaxed format. We sort of ask, that just by being there, you are acknowledging that you want to live a life with grief. You never beat grief, you know, you live with it. And just by being around that table, you are admitting to yourself that, well, enough is enough and I want to move forward carrying this weight with me. So we ask people to just introduce themselves. We go around the table clockwise, and we say, you don’t have to say anything tonight if you don’t wish, because this is a big do, it’s absolutely a big deal to sit in a room of strangers and to talk. You know, that’s hard enough. But to talk about some personal issues, that’s very hard. So we stress that you don’t have to talk if you don’t want to, but, at the very least, just say hello, and who it is that you miss…. And then, the person to the right of me would say, hello and it would go from there. And you find, Emily, that once people start saying their hellos, and start introducing themselves, questions just organically are asked by other participants, and there is this whole range of grief that at least one other person can identify with, be it a death from cancer, or a death from suicide, or a car accident. There will be someone else in that room that can identify. And that’s where the questions are asks, and that’s where the support is grown. And it’s a wonderful thing to be a part of.

Emily, then expresses how touched she is about how organic the process is, how simple, and yet, also, how vulnerable it is in its simplicity, to open up this space, and to go directly into that conversation.

Jack replies,

“It’s an amazing thing. You are right. It is so organic. There is no seminar leading up to it. This is what you can expect. You just jump in at the deep end, as they say. You know, you sit around the table and  there’s a brief hello, and…my name is Jack, this is Ben…. And then we just start a conversation…. It’s normalizing the grief, the confusion, and everything else that can come with death at a young age.”

At one point, Emily responds,

“Yes, and that reminder about not having to fix it, you never will be able to beat grief….That grief is something that we move in and out of our whole life. And to be able to have a space where that is welcome. It’s not like, ‘Well it’s okay, I’ll listen to you, but it’s welcoming you, that aspect.”

To this, Jack replies.

“That’s exactly right, Emily. You never complete grief. You never conquer it. It just becomes your new normal. You wake up one day and you realize my dad is not here anymore. But I will, to the day I die, carry that badge of honor that I miss my dad every day. But I got a new normal, a new focus, new responsibilities, new excitements. Also, new sadness. You know, other things have happened in my life since losing my dad that makes me sad, besides, so its acknowledging that you are normal feeling the way you do, and also continuing to feel that way whilst feeling happy, and whilst feeling sad. You don’t have to feel guilty about having a good day. It’s a safe space to be able to sit around with other people that could confirm that you are not a bad person for having a good day, or you are certainly not a bad person for having a bad day. It’s an incredible thing that I take no credit for, because it’s something so natural to me to facilitate a conversation about this.”

Well, there is so much more to this interview worth listening to, and I encourage my readers to take some time to give it a good listen to. But for now, let’s pause here and consider what was said up to this point in the conversation.

Some Thoughts

For me, personally, I tend to grieve internally, letting the experience flow through me, and I don’t feel a need to reach for a supplemental support group. In the past, when someone close to me died, I went to the funeral, spent a few days with people close to me, and then I processed the most challenging aspects of the experience that was, and is still, running through me mostly on my own. I have a supportive wife, and my children are a great source of comfort to me.

When my mom died, I had extended feelings of waves of guilt over whether I could have been more helpful to her when she was alive. I still do have these feeling from time to time, but I feel that I can deal with them without a special support group to help me through it, though I still miss her.

Although my personal approach is working for me, over the years I have met people who, it seems to me, really would benefit with the type of group Jack has put together. For example, a friend of mine whose wife died suddenly is now in his house all alone. It has been very rough on him. What a wonderful resource it would be for him if he could share what he has been going through, and offer support to others in a Good Grief type group. And I know others who, within their family structure, would meet with disrespect when showing any signs of tearfulness. “Man-up!” would be the demand they would face, or, “Don’t cry, it will all be okay.” For these folks, a more supportive group could be an enormous help.

Grief is a process that helps us to prepare for life after a serious loss. I respect that Jack is trying to be helpful and kind as he seeks a way to create something to honor his father’s life. In listening to the whole interview with Jack, I was left wondering if it makes sense to view grief as good, bad, it just is, some mixture of all three, or even something entirely different?

How do those of you who are reading this feel about what Jack has been doing, and grief in general? I’d love to hear from you.


Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on. This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional and social intelligence. To begin at the very first post you can click HERE.

Categories
conflict resolution dealing with negative emotions handling sadness parenting

Am I Bad for Being Sad?

Welcome to from Insults to Respect. Today we seek to answer the question, If we are experiencing sadness does that mean that we are bad? We’ll begin with a little parable to see what it might reveal. Then we’ll look at the real life example of Laura, a young woman who came to think there was something wrong with her because of her sadness.

The Parable of a Mother Disciplining Her Son

It’s a Sunday night. Eight-year-old Carl is playing a computer game. Suddenly, his mom cries out, “Time to head up to bed, tomorrow’s school.”

“Let me just finish my game, Mom!”

“Take another five minutes, and then it’s off to bed!”

 Five minutes later, Carl, still engrossed in his game, hears his mother cry out again, “Time to head up to bed.”

“My game isn’t over yet Mom.”

“Put the game away now.”

“But Mom!”

“Don’t ‘but mom’ me, let’s go,” and she takes Carl firmly by his arm and begins to guide him to his bedroom. Carl’s eyes tear up, which infuriates his mother, and she cries out, don’t you start with this crap or I’ll give you a real reason to cry! You’re acting like an infant!!! Now you stop this instant and get to bed!!!”

Parable Discussion

First of all, I can empathize with this mother. Perhaps she had a very trying day. Perhaps she has learned how to handle the bedtime situation from her own growing up experience, observing how her parents handled this type of situation. Much of our own parenting skills are indeed learned this way, observing how our parents raised us. This mother’s intention was good; she wanted Carl to get enough sleep so he could be ready to do his best the next day at school. I certainly respect what she was trying to do.

That said, I find myself wondering if there might be some better way to respond when Carl begins to express his sadness, instead of threatening him and saying he is acting like an infant. Here’s one alternative approach that comes to mind.

When Carl begins to shed some tears, she might have said in a caring way,

“I see you are feeling sad. That’s understandable. You were enjoying the game so much, and you’re disappointed about having to stop. You know, when we feel sad, it’s to help us figure out how to better handle what we do in the future. I wonder how we can better handle the going to bed situation in the future. Any ideas, Carl?”

“No Mom. I just want to keep playing.”

“I think, Carl, that in the future playing these computer games right before going to bed might not be a good idea. They are designed to keep you wanting to play more and more, and it doesn’t come to an end. You reach one level and there is always another more challenging level to get to. What might be a better thing to do before bedtime?

“I could watch a show that ends at bedtime.”

“That sounds like a good thing to try, as long as it’s not a scary show that will get you all wound up right before bedtime. We could also go to the library and pick out some books that have pleasant short stories, and you can read one right before bed. Short stories come to an end in a reasonable period of time, and the reader feels a sense of completion when it’s over, without making you feel like you have to read the next chapter to see what happens next. That might work also. So, in the future, why don’t we try having you each night choose one of these ideas. I’ll let you decide each night which approach feels right to you.”

From this alternative scenario you might surmise that I think it would be better to frame our sad experiences as something useful for planning our future, rather than an experience that means we are bad or that there is something wrong with us. And, actually you would be right. But there is some nuance to my thinking about this issue that I wish to bring to your attention.

Some Nuanced Thinking When It Comes to Dealing with Our Sad Feelings

Suppose a guy named Fred tends to be sad more than the average person. This might be due to some natural born tendency to experience life in a more sensitive manner than most, or because of some rough stuff going on in his life, or some trauma in the past has been leading to recurring anguishing memories. For whatever reason, Fred regularly comes to work expressing his sadness from the look on his face as he goes around doing his job. Co-workers often stop what they are doing to ask what is wrong, and offer help by taking time to listen to Fred in a caring way. This would be nice in some ways, but let’s say it happens so often, coworkers begin to find that their work at the end of the day doesn’t always get done on time and they end up having to stay late. Some resentment begins to arise. Moreover, in this scenario, the boss begins to dislike what has been going on partly because of the time being taken from the tasks that have to get done with top-notch efficiency in a competitive business environment, and she was brought up by parents who taught that there is something wrong with people who are sad more than average. In the end, Fred loses his job.

Upset about this, Fred begins to share with his friends and family members how he is feeling, but his frequent expressions of sadness over an extended period soon begins to wear on them.

The point that I am trying to make is that experiencing sadness is not something that makes us bad, but how we express sadness can increase the chances that some will view us in a bad way.

Perhaps Fred would have been better off putting on a happy face at work despite his internal experience. Perhaps Fred, if he could afford it, would be better off hiring a professionally trained personal counselor to help him work through his sad experiences in a positive manner so that he doesn’t put too much on the shoulders of friends and family members. There are, in most communities, some counselors available, and at the top of any of my blog post there is a link titled “Counseling Services” that when clicked on provides descriptions and contact information for two excellent personal counselors that I personally can recommend who conveniently provide services through Skype, Zoom, or your phone.

However, counseling services do cost money, and if it is too expensive for someone’s budget, an alternative is to set up via such internet resources like meetup.com, a support group that meets regularly for the specific purpose of sharing challenging emotional experiences. Of course, the members will be unlikely to have the expertise of a trained personal counselor, but with trial and error it is often very possible to find the right mix of caring, empathic participants.

For these types of peer run support groups, it helps to set up some ground rules at the start of such meetings. Here are the rules that make sense to me.

  1. We’re here to emotionally support one another.
  2. Our internal emotions are to be met by group members with empathic caring and the encouraging of self-compassion.
  3. When sad feelings are shared, it is worth considering how such feelings might help us to figure out how to better deal with the future.
  4. When a member thinks that the way a fellow member is expressing his or her emotions is less than ideal, rather than to use any name calling, like, “You are being stupid for acting like that,” members are to gently frame their opinions as tentative suggestions. Here’s a useful phrase to consider using at such time, “I’m wondering if you were to (state whatever the suggestion might be) if that might be worth considering.”

The Example of Laura

Sometimes, instead of interpreting our sad feelings as “we are bad,” we come to think that something is wrong with our physical make-up. If this leads to considering taking steps in the future to improve our diet, get more exercise, or spend more time in nature, that can lead to healthy outcomes. However, there is potentially a dark side to blaming the body.

Rachel Aviv, New Yorker Staff writer

In an eye opening April 8, 2019 New Yorker article by Rachel Aviv titled, “The Challenge of Going Off Psychiatric Drugs,” we learn about Laura Delano, a remarkably talented woman. Although she did have a number of problems in her youth, as most of us do, she functioned well enough to get accepted to Harvard University. Then, at one point, she was at a party where she began sobbing so hard that her escort had to put her in a cab.

Shortly afterwards, she saw a psychiatrist who declared she had a mental disorder and prescribed an antidepressant. Laura was relieved to hear the doctor say that her distress stemmed from an illness. “It was like being told, It’s not your fault. You are not lazy. You are not irresponsible.”

So, at this point, Laura has become convinced that she is not being a bad person for how she was experiencing her emotion, it was her body that was being bad in the form of an illness. Was this really an improvement?

As her story continues,

“When on the drugs,” Laura said, “I never had a baseline sense of myself.”

She began taking twenty milligrams of Prozac, an antidepressant; when she still didn’t feel better, her dose was increased to forty milligrams, and then to sixty. With each raised dose, she felt thankful to have been heard. “It was a way for me to mark to the world: this is how much pain I am in,” she said….

At parties, she flirted intently, but by the time she and a partner were together in bed, she said, “I’d kind of get hit with this realization that I was physically disconnected. And then I’d feel taken advantage of, and I would kind of flip out and start crying, and the guy would be, like, ‘What the heck is going on?’” Most antidepressants dampen sexuality—up to seventy per cent of people who take the medications report this response….

During her junior year, her pharmacologist raised her Prozac prescription to eighty milligrams, the maximum recommended dose. The Prozac made her drowsy, so he prescribed two hundred milligrams of Provigil, a drug for narcolepsy that is often taken by soldiers and truck drivers to stay awake during overnight shifts. The Provigil gave her so much energy that, she said, “I was just a machine.”….

The Provigil made it hard for Laura to sleep, so her pharmacologist prescribed Ambien, which she took every night. In the course of a year, her doctors had created what’s known as “a prescription cascade”: the side effects of one medication are diagnosed as symptoms of another condition, leading to a succession of new prescriptions.

Despite taking all of these drugs she felt so distressed that she thought every day about dying. So a new psychiatrist put her on a new combination of pills. Again, despite these drugs she experienced what John Teasdale, a research psychologist at the University of Oxford, named “depression about depression.” She interpreted each moment of lethargy or disappointment as the start of a black mood that would never end. Psychiatric diagnoses can ensnare people in circular explanations: they are depressed because they are depressed.

As Laura’s story continued, during a brief period she decided to see another psychiatrist who was also a psychoanalyst. He questioned the way that she’d framed what she had been experiencing. He doubted her early diagnosis, writing that “many depressions are given a ‘medical’ name by a psychiatrist, ascribing the problem to ‘chemistry’ and neglecting the context and specificity of why someone is having those particular life problems at that particular time.” Laura decided that “he wasn’t legit.” She stopped going to her appointments.

Soon afterwards, despite all of the drugs that she was taking, she attempted to take her life. She did manage to survive, and afterwards,

She was started on a new combination of medications: lithium, to stabilize her moods, and Ativan, a benzodiazepine, in addition to the antipsychotic Seroquel, which she had already been taking. Later, a second antipsychotic, Abilify, was added—common practice, though there was limited research justifying the use of antipsychotics in combination. “It is tempting to add a second drug just for the sake of ‘doing something,’ ” a 2004 paper in Current Medicinal Chemistry warns.

In May, 2010, Laura wandered into a bookstore.

Robert Whitaker

On the table of new releases was “Anatomy of an Epidemic,” by Robert Whitaker. The book explained to her that as more and more Americans have taken to psychiatric drugs to deal with their emotions, the number of Americans disabled by mental illness has risen. Whitaker argues that psychiatric medications, taken over the course of a lifetime, may be turning some episodic emotional experiences into chronic disabilities. As Whitaker explains what people like Laura are going through, they have “been prescribed one drug, and then a second, and a third, and they are put on this other trajectory where their self-identity changes from being normal to abnormal—they are told that, basically, there is something wrong with their brain, and it isn’t temporary—and it changes their sense of resilience and the way they present themselves to others.”

It was at this point that Laura decided to see what would happen if she stopped taking the drugs, and found that the process was an excruciating experience because of the medication withdrawal reactions. It took her many extremely rough months before her goal was achieved.

Internal records of pharmaceutical manufacturers show that the companies have been aware of this withdrawal problem for many years, and many doctors mislead their patients suggesting to them that the prescribed drugs were either not addictive, or withdrawal symptoms are mild.

Now off the psychiatric drugs, Laura began a relationship with a guy named Rob Wipond. Both of them became emotional when discussing Laura’s sexuality. “I felt like a newborn,” Laura confided. “I hadn’t ever figured out what my body was meant to be.” Rob said, “She was open and awake. Everything was new to her. We were, like, ‘Well, gee, what is this sexuality thing—what shall we do?’ ”

Prior to coming off the psychiatric drugs, Laura had been unable to have stable relationships. “I honestly thought that, because I was mentally ill, the numbness was just part of me.” Now she wondered about the other effects of the many medications she had been taking. “On this very sensory, somatic level, I couldn’t bond with another human being,” she said. “It never felt real. It felt synthetic.”

Laura felt as if she were learning the contours of her adult self for the first time. When she felt dread or despair, she tried to accept the sensation without interpreting it as a sign that she was defective and would remain that way forever, until she committed suicide or took a new pill. It felt like a revelation, she said, to realize that “the objective in being alive isn’t the absence of pain.” She remembered identifying with a sad little bubble pictured in a popular advertisement for Zoloft—the bubble is moping around, crying and groaning, until it takes the medication and starts to bounce while birds sing—and became increasingly aware that her faith in the drugs’ potential had been misplaced. “I never felt helped by the drugs in the sense that I have meaning, I have purpose, I have relationships that matter to me,” she said.

Perhaps we can all learn something essential from Laura’s experience.

Final Thoughts

From today’s post, I hope that you will consider the value of giving up any belief that you may have that feeling sad means you are bad. If, when you experience sadness, you find yourself saying such words like, “I can’t believe I’m feeling sad again, what an idiot I am,” consider how it may be far more helpful to view your sadness as a useful tool for helping us to better plan our future. If you are a parent, consider the value of teaching your children this “sadness is a helpful tool” idea.

Also worth considering is that there are ways in which to express our emotions publicly that can either hurt our reputation or enhance it. Over a half million people have been using this blog as a no financial cost method to learn skills that can enhance their reputation whenever they find themselves in various emotionally arousing situations. I’m hoping you consider the value of joining them.

Finally, the pharmaceutical industry, along with its allied psychiatrists, have enormous resources to convince people that the best way to deal with sadness is to take pills. Laura’s story provides us a cautionary sign to all those who are tempted to go down that road.

Well, that’s my post for today. Here’s hoping you’ll soon join us again right here at From Insults to Respect.

My Best,

Jeff

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Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on. This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional and social intelligence. To begin at the very first post you can click HERE.

Categories
conflict resolution Depression William James

William James’s Experience with Depression

Welcome to From Insults to Respect. Today we continue our exploration of famous people who, despite experiencing depression, managed to achieve an outstanding level of respect. In the recent past, the experiences of Joni Mitchell (see HERE), U.S. Grant (see HERE), Leo Tolstoy (see HERE), and Abraham Lincoln (see HERE) led us along their personal journey. We now turn to the master of all psychologists, William James, to be our guide.

Since we hear often enough from the pharmaceutical industry, with its enormous promotion machine, that it is crucial for people who have challenging experiences with depression to consume antidepressant pills, I have tried to offer a balance by providing examples of admired people who, in various ways, managed without them. For some, like Lincoln and Joni, their suffering never completely went away, but they, in a sense, made friends with it. They did so by coming to understand that experiencing challenges more deeply than people with a happy-go-lucky temperament has the potential to provide a motivating force to bring forth valued achievements. As Joni so beautifully expressed this, 

“Depression can be the sand that makes the pearl…. Most of my best work came out of it. If you get rid of the demons and the disturbing things, then the angels fly off, too. There is the possibility, in the mire, of an epiphany.”

Other people’s experience with depression takes a somewhat different course. At a certain point they find that their base notes of life are the result of living wrongly. Upon improving what they were doing and/or the situation that they were living in, they came to an understanding that the energy their depression provided for making changes led to a better life. Leo Tolstoy provided us the most vivid example. His depression stimulated a gnawing questioning that eventually led to one insight after another. His trouble had not been with life in general, not with the common life of common people, but with the life of the upper, intellectual, artistic classes, the life that he had personally always led, the cerebral life, the life of conventionality, artificiality, and personal ambition. By spending more time in nature and in a supportive community, “things cleared up within me and about me better than ever, and the light has never wholly died away.”  According to Tolstoy, his suicidal feelings disappeared, and he went on to live a productive life until he passed away at the age of 82 of natural causes.

William James’s story is more in line with this second type of depression experience, in that he, like Tolstoy, found that by making certain changes in how he was living and the situation in which he was living, his experiences of dealing with depression decreased to a point that he felt he was getting more out of life. I briefly reviewed these changes in an earlier post titled, “William James’s Personal Bout with a “’Mental Disorder’” (see HERE). I decided to delve a little deeper into this case because I happen to be reading The Letters of William James and came upon some additional information that I believe is worth reflection.

The Most Vivid Description of William James’s Experience with Depression

William James’s son, Henry, described his father’s struggle when he was in his 20s as follows:

William James’s father, Henry, on left, and young Will on right

“It was during this period that such doubts [about morality, his impotence to make any significant change, and the apparent meaningless of his life] invaded his consciousness in a way that was personal and intimate and, for the time being, oppressive. He was tormented by misgivings which almost paralyzed his naturally buoyant spirit. Bad health, a feeling of the purposelessness of his own particular existence, his philosophical doubts and his constant preoccupation with them, all these combined to plunge him into a state of morbid depression…. He even had an experience of that kind of melancholy which takes the form of panic fear.” 

William James, himself, described this fear in vivid detail:

“Whilst in this state of philosophic pessimism and general depression of spirits about my prospects, I went one evening into a dressing-room in a twilight, to procure some article that was there; when suddenly there fell upon me without any warning, just as if it came out of darkness, a horrible fear of existence. Simultaneously there arose in my mind the image of an epileptic patient whom I had seen in the asylum, a black-haired youth with greenish skin, entirely idiotic, who used to sit all day on the benches, or rather shelves, against the wall, with his knees drawn up against his chin, and the coarse gray undershirt, which was his only garment, drawn over them, inclosing his entire figure. He sat there like a sort of sculptured Egyptian cat or Peruvian mummy, moving nothing but his black eyes and looking absolutely non-human. This image and my fear entered into a species of combination with each other.

William in his early 20’s

“That shape am I, I felt, potentially. Nothing that I possess can defend me against that fate, if the hour for it should strike for me as it struck for him. There was such a horror of him, and such a perception of my own merely momentary discrepancy from him, that it was as if something hitherto solid in my breast gave way entirely, and I became a mass of quivering fear. After this the universe was changed for me altogether. I awoke morning after morning with a horrible dread at the pit of my stomach, and with a sense of insecurity of life that I never knew before, and that I have never felt since. It was a revelation; and although the immediate feelings passed away, the experience has made me sympathetic with the morbid feelings of others ever since. It gradually faded, but for months I was unable to go out into the dark alone.

“In general I dreaded to be left alone. I remember wondering how other people could live, how I myself had ever lived, so unconscious of that pit of insecurity beneath the surface of my life.”

Wow! That’s a pretty vivid description!

In that description, when William says that his disturbing experience gradually faded, from his letters it is clear to see that he continued to suffer through deep melancholy for a few years. Some of them included suicidal thoughts.

It is of special interest that William tells us that his experience “has made me sympathetic with the morbid feelings of others ever since.” For those of us who value people who can sympathize with those having such feelings, we see that something positive came out of William’s own experience. This theme that depression is often a tool to create something of value, runs throughout William’s writings for the rest of his life.

What Led to the Fading of William James’s Experience with Depression?

Initially, William, upon having his fearful experience believed that all mental health concerns now referred to as mental disorders are required to have a physical basis and that there was nothing anyone can willfully do about them. Today, short of taking a pill, many of today’s psychiatrists are promoting a similar view. Thus, their basic position is that these concerns are due to something within the patient’s physical makeup. This misses the overwhelming evidence that how people construe their past and current experiences, and their current social and work situations, are often the central causative factors.

Once William came to understand this, it provided the hope and motivation to do some things differently. As he explained to his father,

“Bless my soul, what a difference between me as I am now and as I was last spring at this time! Then so hypochondriacal, and now with my mind so cleared up and restored to sanity. It is the difference between death and life.”

One thing that he had decided to do was to spend more time than he had been on focussing on some uplifting life experiences. For example, he began to read poems by William Wordsworth. Consider Wordsworth’s poem, “I Wandered Lonely as a Cloud.”

I wandered lonely as a cloud
That floats on high o’er vales and hills,
When all at once I saw a crowd,
A host, of golden daffodils;
Beside the lake, beneath the trees,
Fluttering and dancing in the breeze.
Continuous as the stars that shine
And twinkle on the milky way,
They stretched in never-ending line
Along the margin of a bay:
Ten thousand saw I at a glance,
Tossing their heads in sprightly dance.
The waves beside them danced; but they
Out-did the sparkling waves in glee:
A poet could not but be gay,
In such a jocund company:
I gazed—and gazed—but little thought
What wealth the show to me had brought:
For oft, when on my couch I lie
In vacant or in pensive mood,
They flash upon that inward eye
Which is the bliss of solitude;
And then my heart with pleasure fills,
And dances with the daffodils.
For William, the delight that Wordsworth had for the beauty of nature was catching, and William began to spend more time in nature, especially in the Keene Valley area of the Adirondack Mountains. Also, of enormous help, was to find the right type of work for his temperament, as we see from a letter he wrote to his brother, the gifted novelist Henry James:

“The appointment to teach physiology is a perfect God-sent to me just now, an external motive to work, which yet does not strain me–a dealing with men instead of my mind, and a diversion from those introspective studies which bred a sort of philosophical hypochondria in me of late and which it will certainly do me good to drop…. It is a noble thing for one’s spirit to have responsible work to do.

On Left, Henry James, the novelist and brother to William

I enjoy my revived physiological reading greatly, and have in a corporeal sense been better for the past four or five weeks than I have been at all since you left…. I find the work very interesting and stimulating…. The authority is at first very flattering to one. So far, I seem to have succeeded in interesting them [his students], for they are admirably attentive, and I hear expressions of satisfaction on their part.”

Thus, finding something to do that was meaningful to him and placing him in an environment where those around him valued what he was contributing, played a huge part in improving how he was feeling.

Alice Gibbens

But there was an additional factor that perhaps made the shift in his life ever more extraordinary–his marriage to Alice Gibbens. As William explained this to his friend, Josiah Royce, “I have found in marriage a calm and repose I never knew before, and only wish I had done the thing ten years earlier.”

William’s son, Henry, describes the important support that his mother provided to his father, as follows:

“His wife, who entered into all of his plans and undertakings with unfailing understanding and high spirit, stood guard over his library door, protected him from interruptions and distractions, managed the household and the children and the family business, helped him to order his day and to see and entertain his friends at convenient times…and encouraged him to all his major undertakings, with a sustaining skill and cheer which need not be described to anyone who knew his household.”
Professor William James

There are, of course, numerous other aspects of William’s life that played a part in the lifting of his general spirits, some of which I cover in earlier posts. For remarkable suggestions for helping people who are considering suicide, consider taking a look at my post, “Is Life Worth Living? A William James Perspective” (see HERE).  But, for now, I leave the reader here hoping today’s post will serve to make the nature of depression at least a little more comprehensible.

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Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on.  This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional intelligence.  To begin at the very first post you can click HERE.

Categories
conflict resolution Congressional House Oversight Committee Disgraceful conduct of Republicans Lying Michael Cohen President Trump

Disgrace of Republicans During Cohen’s Hearing

Welcome to From Insults to Respect. Today, we take a hard look at what I view as the disgraceful actions of most of the Republican congresspersons who participated in the 2/27/19 Michael Cohen hearing, and, going forward, what they might do to regain my respect.

The Disgraceful Actions

Michael Cohen served as the president’s personal lawyer and was brought in to the hearing to answer questions by the Congressional House Oversight Committee about possible criminal conduct and unethical behavior on the part of his former client and others connected with him. Rather than to devote their time to the task at hand, Republican after Republican spent the vast amount of time insisting that the whole hearing was a waste of time and a scam by Democrats to do nothing more than to try to gain political points.

Notice that there are two parts of their position. The first indicates that the Democrats wanted to gain political points at the hearing. I take this to mean that they wanted to bring out information that would increase the chances that Democrats will be elected in future elections. This is true enough, though it would have been more true if they also mentioned that the Republicans were also there to try to win political points. Party politicians, Democrats and Republicans alike, are always trying to win political points. The second part of the statement tried to indicate that the Democrats were there to do nothing more than gain political points. I think that party politicians, including Democrats and Republicans, seek to do some other things besides win political points. The Republicans’ claim that the Democrats were seeking nothing more at the meeting was a superficial effort to hide the very real concerns that many of us citizens have with the current administration given the number of people connected with the administration that have been convicted of crimes.

Characteristic of the tone of the hearing by Republicans was Paul Gosar, a Republican representative from Arizona, who set up a sign behind his chair. The sign showed a picture of Mr. Cohen superimposed on flames, emblazoned with the words “LIAR, LIAR, PANTS ON FIRE!”

This was an attempt to discredit anything that Mr Cohen had to say at the hearing because he had lied in the past. Republicans repeated this attempt over and over again throughout the hearing, but it consistently appeared blatantly disingenuous given their continued support of the President who has a well documented history of lying on numerous occasions.

Rep. Jordan on Left and Rep. Cummings on Right
Rep. Jim Jordan on left, and Rep. Cummings on the right

Rep. Jim Jordan, Republican of Ohio, began the hearing by saying derisively to the Democratic Chairman of the Committee, Rep. Elijah Cummings,

“Here we go, your first announced witness, is Michael Cohen. I want everyone in this room to think about this, the first announced witness of the 116th Congress is a guy who is going to prison in two months for lying to Congress. Mr. Chairman, your chairmanship will be always identified with this hearing.”

To this claim, Rep. Cummings soon corrected the record by indicating the clearly documented fact that under his leadership during the 116th Congress the committee had already had three other hearings. At each, there were several announced witnesses. For example, at one such hearing, the high prices of pharmaceuticals, which is in the process of being investigated by the committee, had executives of the pharmaceutical industry called to answer questions.

Rep. Jordan went on from his untruthful statement, to claim that the present hearing was nothing more than to serve the Clintons, their loyalists, and operatives, as well as to harm the President. To defend his position, Rep. Jordan mentioned that the committee was limited to answer only certain questions. In making this statement, he failed to mention that the reason for these limits was to cooperate with the special counsel and the Southern District of New York that had asked for these limits because certain questions could interfere with their ongoing investigations. This is a standard requirement under this set of circumstances. No doubt Mr. Jordan is well aware of this, and nevertheless, he attempted to slip this by the public’s eye.

Throughout the hearing, when it came time for each of the other Republicans to have their five minutes to question Mr. Cohen, with little exception, they parroted, over and over again, what Rep. Jordan had done. Several of the Republicans asked no questions at all, and most of the others, after consuming the vast majority of their allotted time with insulting Chairman Cummings and the other Democrats for setting up this hearing, hastily asked a single question. This dramatically reduced the time to examine what Mr. Cohen replied.

Why the Republicans at the Hearing Had Clearly Acted Disgracefully

Consider the following facts that are all well known to all of the Republicans who participated in the Michael Cohen hearing:

  1. The United States Intelligence community has concluded that Russia, a US adversary, took illegal action during the last presidential election seeking to help President Trump win.
  2. President Trump, a Republican, nominated Rod Rosenstein to serve as Deputy Attorney General for the United States Department of Justice and was confirmed by the Republican majority U.S. Senate.
  3. Following the recusal of Attorney General Jeff Sessions over his misleading remarks he made to the Senate Committee on the Judiciary during his confirmation process and FBI Director Comey’s dismissal by President Trump, Rosenstein appointed Robert Mueller as special counsel to investigate alleged ties between the Trump campaign and Russia during the 2016 elections and related matters.
  4. During the special counsel’s investigation, several close associates to President Trump were convicted of lying about Russian government connections and/or other illegal matters, including his National Security Advisor Michael Flynn (plead guilty to a felony of willfully and knowingly making false, fictitious and fraudulent statements to the FBI), and his campaign chairman Paul Manafort (convicted on eight charges of tax and bank fraud, and repeatedly lying to investigators).
  5. Mr. Cohen had been President Trump’s personal attorney for about ten years, and in that role has probable first hand knowledge regarding possibly illegal actions over that period of time.
  6. Each and every one of the Republican participants know that skillful questioning by investigators of people with first hand knowledge of relevant events often leads to obtaining useful information from people even when the person being questioned had lied in the past.
  7. Information gathered from questioning such witnesses that is deemed as possibly helpful are not automatically assumed to be true, but are instead followed up to seek confirmation by other witnesses and documents.
  8. Mr. Cohen’s testimony before the special counsel had already been deemed helpful by the special counsel at the time of this hearing and the special counsel had recommended to the sentencing judge that Mr. Cohen’s cooperation be a factor in giving him a lighter sentence.
  9. Mr. Cohen, who is currently sentenced to three years in prison, if caught lying to Congress again would face far more years in prison, thus increasing the chances that he might provide further useful information if he is thoroughly and skillfully questioned.
  10. Millions of American citizens wanted to hear and see for themselves how Mr. Cohen would respond to questioning by the Congressional House Oversight Committee.

I contend that each of the ten facts listed above were well known to each of the Republican participants at the Cohen hearing. Together, they provide sound reasons to bring Mr. Cohen in for questioning by the Oversight Committee. Thus, by denying that there were any sound reasons, Republican participants were lying. In my opinion, those lies are even more harmful to Americans than the lies Mr. Cohen has been convicted of telling.

My best guess as to why those Republicans had lied at the hearing, wasted time repeating the lies over and over again, and insulting their Democratic colleagues, is that it was these same people who, when the Republicans were in the majority in the House of Representatives, had blocked a thorough oversight investigation in an effort to protect the President. If it was now admitted that going forward with the investigation is the right thing to do, these Republicans would be seen as guilty for having interfered with their committee’s obligations.

Going Forward

I well recognized the pressure these Republican representatives have for saying something supportive about the President whenever they appear in public. Each of them has in their districts a majority of voters who continue to support President Trump. Swimming against this type of tide is hardly to be expected of politicians. Nevertheless, this did not justify their conduct at the hearing.

Other witnesses are being called to be questioned before the same committee. To regain my respect, when going forward, they could find out from their constituents specific things that they believe the President is doing well. Then, at the hearing they could say in under a minute something like,

“We are here to investigate possible wrong doing that might have occurred, and some of President Trump’s associates have already been convicted of criminal activities. That said, I want all of us to keep firmly in mind that the President has been doing wonderful things. Under his leadership, unemployment has remained low, regulations and paper work for business folks have been dramatically reduced, and excellent people have been nominated for judgeships. I sit here today in full support of our President. Now, let me get down to questioning this witness.”

Although I respectfully disagree with much of this statement, I would understand the need for them to make it. If, after such a statement, they then proceeded to earnestly question the witness, while remaining civil to their colleagues, my level of respect for them would rise.

So, there you have it, today’s From Insults to Respect post. Until next time, may you find that all of our political leaders, Republicans and Democrats alike, are beginning to act more and more in an honest, respectful manner.

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Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on. This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional intelligence. To begin at the very first post you can click HERE.

 

Categories
Bob Dylan conflict resolution emotions kiss kissing romance romantic kissing

Bob Dylan On Romantic Kissing

Welcome to From Insults to Respect. Today’s topic, romantic kissing.

Concerned that your romantic partner’s respect for your kissing technique might not be all that you desire? Is it okay to offer a romantic kiss on a first date? Will your date think less of you if you accept a romantic kiss on the first date? A discussion of Bob Dylan’s Theme Time Radio Hour episode on kissing will enlighten us on these and other related topics.

Bob’s Introduction

Bob begins his show saying:

Today we are going to take a musical look at one of my favorite pastimes. It’s an act of intimacy, the thing that Mae West called a “man’s signature,” and I’m guessing she knows what she was talking about.

The first song that Bob plays for us is “It’s in His Kiss” by the magnificent Betty Everett. Here’s a bit of its lyrics:

Does she love me? I wanna know
How can I tell if she loves me so?

Is it in her eyes? (No no you’ll be deceived)
Is it in her sighs? (No no she’ll make believe)
If you wanna know if she loves you so
It’s in her kiss (That’s where it is)

Is it in her face? (No no that’s just her charms)
In her warm embrace? (No no that’s just her arms)
If you wanna know if she loves you so
It’s in her kiss (That’s where it is)
Oh yeah it’s in her kiss (That’s where it is)

So hold her and squeeze her tight
Tell her what you wanna know
If it’s love if it really is
It’s there in her kiss.

The unique communication that occurs during the romantic kiss is wonderfully captured in that song. However, I tend to doubt the we can be certain someone really loves us from a kiss. The kiss is an important form of communication, but there is far more to consider in just what it actually means.

The Varied Powerful Emotions That Come with Romantic Kisses

The next song Bob plays for us is sung by Lefty Frizzell, “Always Late with Your Kisses.” Here we learn that how someone handles romantic kisses can provide some hard to handle messages.

How long do you think that I can wait
When you know you’re always late
Always late with your kisses
Won’t you come to my arms sweet darlin’ and stay
You’re always late with your kisses
Why, oh why do you want to do me this way?

The song, sung in the most melancholy manner, suggests to me that if your romantic partner leans over to kiss you, if you are a little late in joining the kiss, it might be a signal that something isn’t quite right with the romance. Moreover, if instead of lingering in your arms during the kiss, she or he ends it a little too quickly, well, that may be another signal that something is wrong. Given how popular the song was, spending 12 weeks on the country charts, clearly indicates it touched something pretty sensitive in the heart of many a listener.

Bob goes on from here to songs that bring up such topics as passionate kissing, kissing in the dark, french kissing, finding lipstick on your collar, catching your woman kissing your best friend, making up after an argument kissing, and the fact that you don’t have to be rich to enjoy a wonderful kiss. He eventually gets back to our “romantic kissing” topic, with the Everly Brothers song, “Till I Kissed You.” Here’s a few lines of its romantic lyrics:

Never felt like this until I kissed ya’
How did I exist until I kissed ya’,
Never had you on my mind,
Now you’re there all the time,
Never knew what I missed till I kissed ya’, uh huh,
I kissed ya’, oh yeah…
You don’t realize what you doin to me,
and I didn’t realize what a kiss could be,
Mmm, you got a way about ya’,
Now I can’t live without ya’,

The song really captures how emotionally powerful a romantic kiss can have on a person.

A Specific Kissing Technique

Half way through the show, Bob checks his email and finds one of them perfect for today’s theme. Lawrence writes:

Dear Theme Time gang, I heard from the grapevine that you were doing a show about kissing. I can sure use your help. My girlfriend says I’m a bad kisser. We get along great but I’m afraid this one problem is going to ruin the whole thing. Please help.

Bob responds:

Well, Lawrence, kissing is an important part of a relationship. And it’s one of those things that you have to be relaxed to do. So the fact that you are getting anxious about it isn’t helping you one bit. However, I can give you a few tips. Armed with this knowledge you’ll feel a little more confident and be able to set things right. First of all, make sure your lips are moist. Run your tongue over your lips once before you kiss her. No one wants to kiss sandpaper. Stand close to your partner, you don’t want her to reach too far. Tilt your head slightly to one side. Close your eyes just before your lips meet. Just close them. Some people like to keep their eyes opened during a kiss, but until you understand your partner’s preference, better to play it safe and close your eyes. Open your lips slightly, not like you are about to swallow her whole head, just a little bit, and don’t hold your breath. Breath through your nose. Press your partner’s lips gently. Move your lips in a slow circular motion. Be gentle but firm. And finally, and I can’t stress this enough, have a pocketful of mints. There is no underestimating the fact of good breath. Good luck and happy kissing. I hope it won’t be long till you hear your girl say, “baby let me kiss ya just one more time.” 

That there is a pretty decent description of a decent kiss, but I would add one more suggestion for helping him. Why not encourage him to ask his girlfriend what she would like him to do differently when they kiss? For example, she might prefer to be held within his arms more firmly while they are kissing, or perhaps a little gentler approach would be more to her liking.

First Night Kisses

An issue sometimes comes up as to whether or not a guy will lose respect for a gal if she lets him kiss her on their first date. And what about a guy who tries to kiss a girl romantically on a first date? Would he be disrespectful to her for trying. To get into this topic, Bob plays us a recording of some guy taking the following position:

Jerry not only sees Margaret home, but opens the door for her, and then, well, they’ve been going steady for some time now, and there are some customs that are very enjoyable. But now Frank has a new problem, should he try on a first date to kiss his date. He sees her to her door, and thanks her for going out with him. No, he should not try to kiss her good night on a first date. But he does ask her for another date soon.

Bob doesn’t tell us who this guy is, but there is little doubt that there are people who agree with him that a kiss on the first date is a no no. There is also little doubt that people hold different positions on this topic. Take me, for example. I grew up in Brooklyn, and before I was married, and was dating back in the late 1960s and early 70s, when I asked a gal out, I did so because I had some romantic feelings for her. If, by the end of the evening, when we arrived back at her home, if I still felt romantic toward her, I would say I had a very pleasant time, and pause to see if she said something similar. If she did say something similar, I would very slowly and gently lean toward her, observing her reaction as I did so, and if I saw no sign of resistance, my eyes would close and our lips would join for a romantic kiss. If she seemed to get into it, I would feel a wonderful high sensation, not only during the kiss, but all the way home. I never had any sense of disrespect toward the gal for joining me in such a good night kiss.

I’m not saying my position is the correct one. I think it is a good idea to get a sense of the community standard before making a choice about how to respectfully act under such circumstances. Discuss the issue with friends and family members. I also believe that regardless of the community standard, using any force to get a good night kiss, or using any pressure is disrespectful and wrong.

Closing Words

Toward the close of the show, Bob gets back to the topic of the emotions that come from a romantic kiss by playing us a final song, and then reciting a poem. He introduces the song by inviting us to “listen to one of the old masters, the fountainhead from which all music flows, Louis Armstrong, and a song that was the centerpiece for his live performances in the later period of his life. This is a version that he recorded in 19 and 51, ‘A Kiss to Build a Dream on.'”

Here’s a few of that song’s wonderfully romantic lyrics:

Give me a kiss to build a dream on
And my imagination will thrive upon that kiss
Sweetheart, I ask no more than this
A kiss to build a dream on
Give me a kiss before you leave me
And my imagination will feed my hungry heart
Leave me one thing before we part
A kiss to build a dream on
And when I’m alone with my fancies, I’ll be with you
Weaving romances, making believe they’re true
Oh, give me your lips for just a moment
And my imagination will make that moment live
Give me what you alone can give
A kiss to build a dream on

A kiss to build a dream on–can there be a better way to capture the essence of a romantic kiss?

After this song, Bob recites a Robert Burns poem. It’s called “To A Kiss”:

Robert Burns

Humid seal of soft affections,
Tend’rest pledge of future bliss,
Dearest tie of young connections,
Love’s first snow-drop, virgin kiss.

Speaking silence, dumb confession,
Passion’s birth, and infants’ play,
Dove-like fondness, chaste concession,
Glowing dawn of brighter day.

Sorrowing joy, adieu’s last action,
Ling’ring lips, — no more to join!
What words can ever speak affection
Thrilling and sincere as thine!

Pretty fine words for me to close today’s post. Here’s hoping you’ll join us once again right here at From Insults to Respect, and may all of your romantic kisses be thrilling and sincere.

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Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on. This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional and social intelligence. To begin at the very first post you can click HERE.

Categories
Alcohol drinking problems Alcoholics Anonymous alcoholism Alcoholism as a disease conflict resolution responsibility

Alcoholism: No-Responsibility Illness?

Welcome to From Insults To Respect.

Over the years, I have met some pretty decent folks who spent a good part of their earlier life drinking way too much alcoholic beverages, and, at a certain point, found a way to get this under control. Some of these folks believe they took responsibility for their actions, and that was all that was needed. A very different group became engaged in a program, most typically Alcoholics Anonymous (AA), and came to believe the ongoing support that they receive from its peer members has been crucial in their management of this type of problem.

Some in such programs advocate that serious problem drinking be viewed as a no-responsibility illness. The topic is a useful vehicle for clarifying some confusion about the nature of “guilt,” “fault,” “blame,” and “responsibility.” Whether or not folks have a crystal clear understanding of these concepts can be the difference between whether or not others will regard them with respect.  

A Case Study

A useful way to get into this discussion is to take a look at a concrete example of someone who managed to gain control of a severe drinking problem. Mr. S. H. Hadley’s story, who after his recovery became an active helper of others with similar difficulties in New York, serves our purpose particularly well. His story appears in William James’s brilliant book, The Varieties of Religious Experience. I have slightly abridged Mr. Hadley’s account.

“One Tuesday evening I sat in a saloon in Harlem, a homeless, friendless, dying drunkard. I had pawned or sold everything that would bring a drink. I could not sleep unless I was dead drunk. I had not eaten for days, and for four nights preceding I had suffered with delirium tremens, or the horrors, from midnight till morning. I had often said, ‘I will never be a tramp. I will never be cornered, for when that time comes, if ever it comes, I will find a home in the bottom of the river.’ But the Lord so ordered it that when that time did come I was not able to walk one quarter of the way to the river. As I sat there thinking, I seemed to feel some great and mighty presence. I did not know then what it was. I did learn afterwards that it was Jesus, the sinner’s friend. I walked up to the bar and pounded it with my fist till I made the glasses rattle. Those who stood by drinking looked on with scornful curiosity. I said I would never take another drink, if I died on the street, and really I felt as though that would happen before morning. Something said, ‘If you want to keep this promise, go and have yourself locked up.’  I went to the nearest station-house and had myself locked up.

“I was placed in a narrow cell, and it seemed as though all the demons that could find room came in the place with me…. I was finally released, and found my way to my brother’s house, where every care was given me. While lying in bed the admonishing Spirit never left me, and when I arose the following Sabbath morning I felt that day would decide my fate, and toward evening it came to my head to go to Jerry M’Auley’s Mission. I went. The house was packed, and with great difficulty I made my way to the space near a platform. There I saw the apostle to the drunkard and the outcast–that man of God, Jerry M’Auley. He rose, and amid deep silence told his experience. There was a sincerity about this man that carried conviction with it, and I  found myself saying, ‘I wonder if God can save me?’  I listened to the testimony of twenty-five or thirty persons every one of whom had been saved from rum, and I made up my mind that I would be saved or die right there. When the invitation was given, I knelt down with a crowd of drunkards. Jerry made the first prayer. Then Mrs. M’Auley  prayed fervently for us. Oh, what a conflict was going on for my poor soul! A blessed whisper said, ‘Come’; the devil said, ‘be careful.’ I halted but a moment, and then, with a broken heart, I said, ‘Dear Jesus, can you help me?’ Never with mortal tongue can I describe that moment. Although up to that moment my soul had been filled with indescribable gloom, I felt the glorious brightness of the noonday sun shine into my heart. I felt I was a free man. Oh, the precious feeling of safety, of freedom, of resting on Jesus!…

“From that moment till now I have never wanted a drink of whiskey, and I have never seen money enough to make me take one. I promised God that night that if he would take away the appetite for strong drink, I would work for him all my life. He has done his part, and I have been trying to do mine.”

General Discussion

In this example, we see that Mr. Hadley had come to a pretty awful point in his drinking life. Rather than to kill himself, he chose another path.

He began by having himself voluntarily locked up at the station house. He then had a very supportive experience when he stayed with his brother, although throughout, it seemed to him he was beset by an admonishing spirit. 

That Mr. Hadley’s brother provided a place for him where every care was given to him may be viewed as a crucial step toward achieving his goal.

General Booth

General Booth, the founder of the Salvation Army, expressed the opinion that the first vital step in helping people to recover consists in making them feel that some decent human being cares enough for them to take an interest in the question whether they rise or sink. In counseling and psychotherapy research, this component is often referred to as empathic unconditional positive regard. Numerous studies have demonstrated it is a powerful ingredient for success when seeking to provide help.

When Mr. Hadley goes to Jerry M’Auley’s Mission he does not describe this as a choice that he made. Notice his wording. “It came into my head to go… I went.”

As the events unfold at the mission, Mr. Hadley continues to experience his actions, not based on choices that he is making, but a surrendering to what the mission might do to help him. Thus, at one point, he says to himself, “I found myself saying, ‘I wonder if God can save me?'”

As the experience continued, Mr. Hadley heard from many of his peers that they had struggled, like he had, but managed to recover. This, perhaps, provided a certain amount of hope that he, too, might recover. Perhaps, as well, some of his peers that he met at the mission came to provide some kind of support for him during his recovery process, and this too was an essential component for the recovery process.

Mr. Hadley ends up concluding that by surrendering to the will of God, God had taken away his appetite for strong drink and provided him the precious feeling of safety and freedom. At the very end of his shared experience, he does say that he has been “trying” to do his part in his recovery, suggesting that he did view applying some will or effort is, at least for him, part of his recovery process.

Clearly, there is a religious theme throughout Mr. Hadley’s story. A higher helper, as he viewed it, had been helping him. I can clearly see how someone who is religious minded can find some help by this way of construing events.

William James

That said, William James, as he discusses Mr. Hadley’s experience, hastens to point out that there are numerous “cases of drunkards’ conversions which are purely ethical, containing, as recorded, no theological beliefs whatever.” He gives, as an example, the case of John B. Gough, who was an atheist, and neither God nor Jesus is mentioned in his account of his recovery. A restaurant waiter, who had taken a kind interest in Mr. Gough, appears to be a crucial ingredient for that person gaining control over his drinking difficulties.

Some people just don’t have any religious inclinations. Nevertheless, some of these individuals may, as William James explains, “be excellent persons, servants of God in practical manners, but they are not children of his kingdom.”

For many people, in place of a God being the higher power, faith is placed in the “process” that is offered in the recovery plan. A surrendering of the will is still experienced as part of the process, fully knowing that regularly hearing stories of others who recovered, along with ongoing peer support, has worked for so many.

So, in this general discussion of Mr. Hadley’s experience, we can see the outlines of several components that may have been helpful to him. He recognized that he had come to a pretty awful situation as a result of his drinking. He found some people who took some kind interest in him. He began to hear, over and over again, stories of people who had gone through very similar experiences who did have success recovering. He surrendered, at least to some extent, his own will, replacing it in faith in God and the program he had entered into at the mission. He also began to help others who were struggling with similar problems.

Perhaps the reader might have noticed that in Mr. Hadley’s account of his experience, he does not try to make the case that his difficulty controlling his drinking is a no-responsibility disease. There is little doubt that heavy drinking is a risk factor for several diseases, and Mr. Hadley was clearly experiencing some toxic reactions to his heavy drinking. But to certain strict scientific minds, confirming that someone has a disease requires a pathological report that identifies the presence of a lesion, tumor, microbe infection, tissue tear, bone fracture, organ blockage, or physiological poison.

Now some argue that for alcoholics, alcohol is a poison, and therefore this makes it a legitimate disease. But in the disease model of alcoholism, even when a person designated as an alcoholic has not had any alcohol they still have the disease, and always will have the disease, even if they have refrained from drinking for years.

It may seem that whether or not some believe in this disease notion is of little import. However, some feel so very strongly about this issue that it has an effect on how much respect is afforded to people depending on what side they have come to accept. And because this blog is particularly interested in the nature of respect, let’s delve into this issue.

Guilt, Responsibility, and Drinking Problems As No-Responsibility Disease

Over the years, I have met AA members who refer to their drinking problem as a disease. I have also witnessed some members getting very angry and defensive when someone in front of them questioned whether or not their problem is a real disease.

Upon doing some research on this topic, I found a write-up in Wikipedia on AA, and a section within the write-up titled, “Disease Theory Of Alcoholism.” There I learned the following:

“More informally than not, AA’s membership has helped popularize the disease concept of alcoholism, though AA officially has had no part in the development of such postulates which had appeared as early as the late eighteenth century.[58] Though AA initially avoided the term ‘disease’, in1973 conference-approved literature categorically stated that “we had the disease of alcoholism.”[59][better source needed] Regardless of official positions, from AA’s inception most members have believed alcoholism to be a disease.[60]

“Though cautious regarding the medical nature of alcoholism, AA has let others voice opinions. The Big Book states that alcoholism “is an illness which only a spiritual experience will concur.” Ernest Kurtz says this is “The closest the book Alcoholics Anonymous comes to a definition of alcoholism.”[60] In his introduction to The Big Book, non-member William Silkworth said those unable to moderate their drinking have an allergy. Addressing the allergy concept, AA said “The doctor’s theory that we have an allergy to alcohol interests us. As laymen, our opinion as to its soundness may, of course, mean little. But as ex-problem drinkers, we can say that his explanation makes good sense. It explains many things for which we cannot otherwise account.”[61] AA later acknowledged that “alcoholism is not a true allergy, the experts now inform us.”[62] Wilson explained in 1960 why AA had refrained from using the term “disease.”

“Nevertheless the medical and scientific communities now join with AA’s 1930s disease hypothesis and use scientific criteria to confirm that alcoholism is an “addictive disease” (aka Alcohol Use Disorder, Severe, Moderate, or Mild)[64].”

Regarding this last sentence of the above Wikipedia quote, the claim that there now exists scientific criteria to confirm that alcoholism is an “addictive disease” is misleading. The sentence provides one citation that leads us to the two major mental and behavioral disorder classification systems. One of them (DSM-5) has been criticized by scientists for being heavily funded by the pharmaceutical industry seeking to classify as many psychological concerns as diseases to legitimize the prescribing of psychiatric drugs. Another one of the classification systems describes it as follows:

“Disorder” is not an exact term, but it is used here to imply the existence of a clinically recognizable set of symptoms or behaviour associated in most cases with distress and with interference with personal functions.”

Such classification systems too vaguely define their terms to be viewed as scientific. Relying on the descriptors of “distress” and “functioning” as central to the definition of disease simply doesn’t work. Distress is as natural a part of human life as breathing, and we all have levels of functioning that gets interfered with by numerous aspects of living. Accepting alcoholism as a scientifically validated disease requires that we accept it is as “disease” with no requirement that a valid test has identified a positive pathology result. Rather, a distressing behavior pattern becomes sufficient. For a complete description of the unscientific nature of these types of classifications systems, see HERE.

But outside of the strict scientific realm, if someone wants to view their alcohol drinking as a disease, why in the world would anyone really care? And why should anyone who believes that alcoholism is a disease get all worked up if they hear from someone who disagrees?

Delving Deeper Into This Issue

As I mentioned at the beginning of this post, there is a subgroup of folks who got there drinking problem under control and believe they did so because they took responsibility for their actions, and that was all that was needed. Some of these folks also believe there is a certain strength and dignity to handling their problems in this way, and those who don’t handle their problems in this way are weak, shameful, and maybe even deserving of punishment.

Some people, despite their efforts to handle their drinking problem by an act of will, find they have been unable to make it work. For them, they may have been spending substantial periods of time agreeing that they are indeed weak, shameful, deserving of punishment, that their negative drinking pattern is their fault, and the insults directed at them because of their drinking problem are well deserved and accurate.

The “sins” which they are eager to escape from almost exclusively engrosses their attention, so their efforts at recovery is a process of struggling away from the “sins,” rather than of striving for the positives that can be achieved. For William James, it would be far better for them to lay less stress on their various social miseries, the harm they are doing to their family, stomach, kidneys, and nerves, and far more on “the blessings of having an organism kept in lifelong possession of its full youthful elasticity by a sweet, sound blood, to which stimulants and narcotics are unknown, and to which the morning sun and air and dew comes as sufficiently powerful intoxicants.” 

When one’s will had done its uttermost toward bringing the drinking problem under control, oftentimes one becomes exhausted. This can be a time when suicide is considered, or one decides to surrender to a faith in a process that has worked for others. The personal will is given up, and the person ceases to resist. Sometimes this process includes religious or spiritual themes.

What value might this surrendering approach serve? William James explains it this way:

“You know how it is when you try to recollect a forgotten name. Usually you help the recall by working for it, by mentally running over the places, persons, and things with which the word was connected. But sometimes this effort fails: you feel then as if the harder you tried the less hope there would be, as though the name were jammed, and pressure in its direction only kept it all the more from rising. And then the opposite expedient often succeeds. Give up the effort entirely; think of something altogether different, and in half an hour the lost name comes sauntering into your mind, as Emerson says, as carelessly as if it had never been invited. Some hidden process was started in you by the effort, which went on after the effort ceased, and made the result come as if it came spontaneously.”

Depending on such a process is particularly valuable when individuals had been spending a great deal of time and effort insulting themselves and hearing insults from others. For such people, exercising their personal will has them living in the region where their imperfect self is the thing most emphasized.

Self-surrender is less tension provoking, thus providing for people with drinking problems more of their personal mental resources for doing the work necessary to make a valued change in their lives. This frees up the subconscious forces to take the lead for a period of time. Instead of trying to force themselves to become alcohol free, by falling back on some larger power, the work that had begun by their will is further worked on in this subconscious incubated process, and, if the soil is right, finally burst forth into flower!  

Returning to the Issue of Guilt, Responsibility and Drinking Problems As No-Responsibility Disease

To some folks, in addition to self-surrendering, there is another way for folks with drinking problems to put aside the notion that they are weak, shameful, deserving of punishment, that their negative drinking pattern is their fault. This other way has them becoming convinced that those with drinking problems have a no-responsibility disease. By framing drinking problems as a disease, it is hoped that people will respond altruistically toward those struggling with this issue in a manner analogous to what happens when a mother’s altruistic emotions spring up when her baby is stricken with an illness. With this line of thinking, instead of laying fault, guilt, insults, or punishment upon the drinker, the focus, it is hoped, is upon a plan to help the drinker deal with the disease.

This strategy, however, is far from perfect. By calling serious drinking problems a disease leads some people losing respect for you. Those who took responsibility for their drinking problems and managed, through an act of will, to free themselves from its clutches will feel you are dodging responsibility where it rightfully belongs.

Now I fully recognize that it is grossly unfair for people to assume that just because they managed to get control over their drinking problems by an act of will, everyone should be just like them. Their belief is self-centered, and they fail to recognize that not everyone is the same regarding biology and environmental life circumstances. Getting people with such self-centered views to better appreciate the grand sweep of humanity is a worthwhile goal, but seeking such a goal may be better advanced by avoiding the disease concept, and recognizing up front that you recognize that people with drinking problems are better off if they do take some responsibility for their problems.         

This view that people with drinking problems have at least some responsibility for their actions is common even for people who never gained control of their own drinking problem by their own act of will, and also for people who never had a drinking problem. A major reason for the conflict between those who are motivated to hang onto the no-responsibility disease concept, and those who insist on at least some responsibility, is the confusion about the concept of responsibility.  

The actor Will Smith, in his popular YouTube video titled “Fault Vs Responsibility” tries to clarify this (see HERE). He begins by telling us that he was having a debate with a friend of his on the difference between fault and responsibility. His friend kept saying, “It’s somebody’s fault!” He replied that it doesn’t matter if it’s somebody’s fault if it’s your responsibility to fix it. He goes on to say,

“If it’s somebody’s fault, we want them to suffer, we want them punished, we want them to pay…. As long as we are pointing the finger at whose fault it is, we’re jammed and trapped into victim mode. The road to power is in taking responsibility! Your heart, your life, your happiness is your responsibility and your responsibility alone…. taking responsibility is not admission of guilt. You are not admitting it is your fault. Taking responsibility is a recognition of the power that you see when you stop blaming people. It’s not like letting people who wronged you off the hook, but taking responsibility is an emotional self defense; it is taking your power back.”  

I largely agree with this statement, and if I had a direct conversation with Will Smith I suspect we would come to fully agree with one another. His statement in the video was brief, thus making it hard to get into any nuanced meanings of what he was trying to say in a simple, easy to understand manner. Nevertheless, let me point out two points that I at least appear to disagree.

First, when Mr. Smith says, “Your heart, your life, your happiness is your responsibility and your responsibility alone, I actually believe there is often a shared responsibility in the types of situations that he is referring to. That is, whenever those of us in our communities begin to see some folks getting into some serious trouble, it is a sign of wisdom if we take some responsibility to try to find ways, out of kindness, to be helpful in some way. For example, many communities, recognizing that problems with addiction is a problem for the whole community, have worked together to provide places for peer support groups to meet at no cost to the support groups.

Second, when Mr. Smith says, “It’s not like letting people who wronged you off the hook,” I’m not quite sure what he means by this. However, just to clarify my own position, I believe that there are times when a person who is having difficulty getting a drinking problem under control, and has tried all of the admonishments, and blaming that often goes along with the frustration of not succeeding, there may come a time when putting aside these negative approaches, and replacing them with something different, makes a world of sense. 

Now, I well understand that when someone has been self-admonishing and self-blaming for quite some time, to suddenly stop doing it is often difficult. Here’s a simple technique for learning to replace this habit with something far more helpful, and it does not cost even a penny.

As soon as you notice that you are saying to yourself insulting, self blaming words, if you happen to be alone, for a minute or so, observe in a nonjudgmental manner what words are coming to you. Observe them like you were a scientist objectively observing a flock of birds flying by, off in the distant sky.

After about a minute of this, for another minute, turn your attention to the physical sensations that you are experiencing as these words fly by. If you wish to linger, that’s fine. Then, for another minute, imagine what good things would come about if you did manage to solve your drinking problem.

By doing this exercise for two months, the old insulting, blaming habit will occur far less frequently. When it does occur, it will contain far less of an emotional sting. And, in the end, you will observe a new, more helpful pattern emerge. It is wonderfully freeing.

Of course, there will be times over the course of your two months of utilizing this approach when you will begin to notice that you are saying insulting, self blaming words about yourself while other people happen to be present. As soon as you notice you have begun to do this, excuse yourself, and find a place to be alone–even a bathroom will do. Once you are alone, do the practice session as described above. It only takes about three minutes. 

Well, in conclusion, I encourage you to consider whether or not it is wise for you to tell others that serious drinking problems is caused by the disease of alcoholism. It seems to me that even if you do believe that it is a disease, there are enough people promoting this idea so for those who are open to that belief, they already believe it is a disease and need no further push in that direction from you. However, each time you tell people you think it is a disease, you risk the possibility that some who hear will lose respect for you because they will view your attitude as a base attempt at eliminating essential responsibility from people who would be far better off accepting responsibility for their actions. 

Okay then, that’s my post today. I know some of what I’ve written is very controversial. Whether you agree or disagree, I encourage you to give me a piece of your mind in the comment section at the very bottom of this page. In any case, I hope you have found in what I have written some food for thought. And please do join us again right here at From Insults to Respect. 

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Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on. This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional and social intelligence. To begin at the very first post you can click HERE.

Categories
conflict resolution Jamal Khashoggi Responding to Criticism Saudi Crown Prince Mohammed bin Salman

Khashoggi, The Saudi Prince, and Managing Criticism

Welcome to From Insults to Respect. 

On this blog, I have been making the case that how we respond to criticism can have an enormous influence on how much respect others have for us. To support this position, from time to time I provide a tentative outline of five levels of maturity for responding to criticism, with level 1 being viewed as the most immature, I give specific examples of people using the different levels, and I discussed the consequences of responding at each level.

A very disturbing example of someone responding to criticism has now crashed upon the international stage. I am referring to the actions of Saudi Crown Prince Mohammed bin Salman. According to the US CIA and many others who have reviewed the evidence, the Prince ordered the murder of the Washington Post reporter Jamal Khashoggi because the reporter criticized him. The details are gruesome, with those who carried out the deed actually using a bone saw to cut him into pieces.

Today, in an effort to deepen our understanding about how to effectively manage criticism, we will quickly review the description of the five levels. Then we’ll take a look at how the Prince’s approach to dealing with criticism matches the lowest levels. Finally, I’ll discuss how he is being perceived as a result of his way of dealing with criticism.

The Five Levels of Responding to Criticism

Let’s begin this discussion by once again refreshing our memory of how all five levels are described. Level 1 is viewed, tentatively, as the most immature, and as we move to level 2, then 3, etc., more and more mature ways of responding to criticism is described.

1.  This level requires displaying one or more of the following:

  • Weeps or sobs with tears or pouts without also utilizing at least level 4 skills
  • Physically attacks the criticizer
  • Damages property

2.  This level requires displaying one or more of the following:

  • Insults the criticizer (either with words, hand gestures, the sticking out of a tongue, the rolling of the eyes, or smirks)
  • Glares at the criticizer
  • Threatens the criticizer
  • Punches, kicks, or throws an object without physically hurting someone or damaging anything
  • Criticizes the criticizer without first fully addressing the original criticism.

3.  This level requires displaying one or both of the following:

  • Displays defensiveness without directly insulting the criticizer (raising voice’s volume or pitch)
  • Displays a lack of interest either by verbally indicating this, or with nonverbal cues, or complete silence. 

4.  Level 4 individuals listen to the criticizer in a supportive, warm, friendly style, and then make it clear that they fully understand what was said.  Moreover, they put the criticizer at ease by making statements that indicate that the wise learn from criticism.  Some time is spent on showing that they are thinking about the criticism.  If, after thinking about the criticism the criticism is deemed to be correct, they make a statement frankly indicating, “I can see your ideas have merit and I intend to use them in the future.”  If they are not sure if they agree, they make a statement indicating that they are very interested in what was said, plan to think a little more about this over the next few days and then they will be ready to discuss this further.  If, after thinking about the criticism, the criticism is deemed to be incorrect, a statement is made designed to disagree without being disagreeable.  More specifically, a sense of humor, some listening in a caring way and a few smiles help to traverse rough terrain.  As the episode winds down, the criticizer is encouraged to feel comfortable communicating suggestions in the future.

5.  In addition to actions consistent with level 4, people responding to criticism in a manner consistent with level 5 seek ways to use, whenever they disagree with the criticism, a technique known as steering in the direction the criticizer would prefer to go.  That is, rather than just disagreeing without being disagreeable, the criticized person seeks to find a new choice of action that creatively utilizes some aspect suggested from the criticism.  Steering cannot be incorporated into all situations, but it is an additional goal of the most mature individuals.

Given these 5 level descriptions, if the Saudi Prince, because of being criticized, arranged to kill the criticizer, what level do you think best matches his actions?

Before I give my own judgment on this, let’s take a look at the Prince’s responses to criticism prior to the murder.

The Prince’s Previous Actions to Criticism

The Saudi Kingdom, an absolute monarchy, has long imprisoned its own citizens who criticize the government. However, entities outside of the Kingdom, when criticizing the Saudis, found that it was typically handled quietly, with the Saudis usually ignoring them. Things began to change when the Prince gained power.

Although King Salman did not appoint his son crown prince until June 21, 2017, the prince has been accumulating vast powers since January 2015, serving as defense minister, overseeing the state oil monopoly, working to overhaul the Saudi economy and building ties with foreign leaders.

Utilizing this power, the Prince recalled its ambassador to Sweden and stopped issuing business visas to Swedes in 2015 after human rights criticisms. Last year, under his influence, Saudi Arabia suspended deals with German firms and recalled its ambassador from Germany after the German foreign minister appeared to criticize Saudi foreign policy.

In August 2018, when Canada criticized the recent arrests of Saudi rights activists, the Prince threatened to break trade agreements with Canada and to break off trade with other Western countries if they, too, spoke out about political repression in the kingdom. An additional threat involved an unspecified, tit-for-tat response to further criticism, saying “any further step from the Canadian side in that direction will be considered as acknowledgment of our right to interfere in the Canadian domestic affairs.”

Besides these threats, the Prince expelled the Canadian ambassador, withdrew its ambassador from Canada, froze new business deals and investment with Canada, and announced plans to withdraw thousands of Saudi students and their families from Canadian schools and universities and place them elsewhere.

So, given these actions, along with the Prince’s order to murder Khashoggi, if you were to utilize the 5 levels of maturity described above, how would you rate these actions of the Prince? If you will, first come up with your own answer to this, and then compare it to my answer.

My Answer

The Prince’s threats, it seems to me, clearly results in a rating of 2 because it matches the level 2 phrase, Threatens the criticizer. His other actions clearly results in a rating of 1 because actions such as breaking off trade and withdrawing thousands of students are costly, thus they are a fairly good match with the level 1 phrase, Damages Property. The murder is clearly a level 1 response because it matches the level 1 phrase, Physically attacks the criticizer. Overall, I think the Prince deserves a rating of 1.