Tag: disrespectful

The Mental Illness Construct: Does it Reduce Shame and Guilt?

Post author By Dr. Jeffrey Rubin
Post date February 29, 2016
8 Comments on The Mental Illness Construct: Does it Reduce Shame and Guilt?

Some people find that their actions are violating certain societal norms and feel guilty and ashamed about this. When they try to stop doing these actions, they may find they can’t just stop, and thus they end up feeling even more guilty and ashamed.

Some parents, when they see their offspring act in ways that violate certain societal norms, find that they feel guilty and embarrassed. These parents believe that they are to blame for the actions of their children, and they also feel ashamed because they believe others believe they are “bad” parents.

The idea that certain actions that violate societal norms are mental illnesses like any other illnesses is attractive to many people because they believe it helps to reduce this guilt and shame. To understand this a little better, let’s take a look at a quick parable:

The Parable of Rachel

Rachel, the mother of five-year old Jonathan, recently went through a very sad divorce. Now, at Jonathan’s parent-teacher conference, his Kindergarten teacher expresses some serious concerns. “Your son is very hyperactive and he has a great deal of difficulty paying attention. Have you considered taking him to a doctor? He may have ADHD.”

Upon leaving the meeting, Rachel begins to cry. “I feel so ashamed,” she thinks to herself. “It’s all my fault. I shouldn’t have been so critical of Ron (her former husband). That’s why he left me for a younger woman. Jonathan has been so upset since Ron left, and he blames me for the breakup. And it is all my fault! I’m a rotten mother.”

Later, Rachel takes Jonathan to a doctor who, after asking a few questions, states that he has diagnosed Jonathan as having ADHD and prescribes Ritalin.

“I’m so ashamed,” cries Rachel.

“There is no need to blame yourself,” the doctor explains. “ADHD isn’t caused by bad mothering. It is an illness very much like diabetes. Just like insulin is a drug that treats diabetes, the drug I’m prescribing for your son’s ADHD will treat his medical condition.”

As Rachel leaves the doctor’s office she feels a little less to blame. But when she tells her father what the doctor has said, he grumbles and says that the doctor is full of crap. “Jonathan is angry and upset because of the divorce and not having his father with him any more. Anyone can see that!”

“You think you know better than a doctor!” cries Rachel.

Her father waves his hand in disgust, but says nothing more. Rachel interprets his silence as meaning that she won the argument, but her father is not at all convinced.

Later, Rachel discusses what has been happening with her closest friend, Lora. “I felt so ashamed about how Jonathan has been acting at school, but the doctor explained that I’m not to blame, that Jonathan has ADHD, which is an illness.”

“Well, Rachel, I certainly don’t think you are to blame, but I don’t think Jonathan has an illness. I’m sorry to hear you are thinking about putting him on one of those ADHD drugs; they have a whole bunch of side effects.”

“If it’s not an illness, then I am to blame!” Tears start to roll down Rachel’s face. “I shouldn’t have criticized Ron so much. I should have been a better wife!”

“You did your best, Rachel. I think it makes sense that you take some responsibility for what has happened, but blaming yourself isn’t being fair, nor is it helpful. When people blame themselves a lot of the time they think they deserve some type of punishment. In my opinion, a better way to take responsibility for what went wrong is to accept the strong emotional experiences that go along with taking responsibility, accept that you played at least a part in what went wrong, and then set yourself on becoming determined to take steps to improve. The genuine sad, heartfelt feelings that come with taking responsibility leads us to do a search for making improvements.”

Does The “Mental Illness” Construct Help To Reduce Shame and Guilt

In the above parable, a doctor tries to reduce the shame and guilt that a mother is feeling about her son’s behavior by framing the behavior as an illness. Although this initially appears to help, she runs into some people who refuse to go along with this anti-shame/mental illness notion. Let’s explore this notion a little more thoroughly with the help of some of the writings of psychologist and philosopher, William James.

William James’s Letter to his brother, Henry James

In an earlier post, I discussed William James’s bout with a depression that many might refer to as a type of “mental illness.” There, we found that he came to believe he succeeded in overcoming his struggle with the help of his own will and effort, although he also recognized that as he went through the experience he received a great deal of support with the “will and effort” thinking from reading certain poets and philosophers.

Shortly after his recovery, James found that when he met other people who were struggling with their own bouts of depression, if he brought up the topic of will and effort it was not at all well received. James explains this type of reaction to his brother, Henry, in the following 1885 letter:

To suggest personal will and effort to one “all sicklied o’er” with the sense of weakness, of helpless failure, and of fear, is to suggest the most horrible of things to him. What he craves is to be consoled in his very impotence, to feel the Powers of the Universe recognize and secure him, all passive and failing as he is.

Why would one believe that framing one’s difficulties as an illness would lead to the Powers of the Universe providing some type of help? Perhaps it stems from a related experience.

Anyone with even an ounce of maternal feeling is familiar with the altruistic emotions that spring up when a baby is stricken with an illness. Generalizing from such experiences might lead to the belief that an illness is especially worthy of altruism.

Although this may make sense to some, others just don’t buy the illness notion, and feel that it is an excuse to avoid responsibility. Thus, the “mental illness” construct comes with it some pluses and minuses.

From my discussions with people in Alcoholic Anonymous, it seems to me that many of its members found themselves in a state similar to what James describes in his letter. The program seems to provide them a way to stop blaming themselves by using the “I have a real sickness” idea. It also offers a sense that they could put themselves in the hands of a higher power, while, at the same time, they receive a great deal of support from peers who have managed to recover.

I think the real active ingredients in the program are the reduction of blame that is experienced by becoming a member of a group that stops the blaming rhetoric while also providing peer support to its members to work toward their common goal. However, for people who have a religious background, perhaps the additions of the “real illness” and “higher power” ingredients do offer some added benefits, but they come with negative reactions from those who believe in taking responsibility for one’s actions. Some of those who believe in responsibility think mainly that certain actions are “deserving of punishment.” In my view, it is much better if we come to understand responsibility as a strong emotion that spurs us on to actively pursue better ways to deal with the present and the future.

Now, to further our thinking of these issues, let’s turn our attention to something else that James wrote on this topic.

James’s Talk to Teachers

In James’s book titled Talk to Teachers he tells us, “The teacher often is confronted in the school with an abnormal type of will, which we may call the ‘balky will.’ He then explains what he means by this: “Certain children, if they do not succeed in doing a thing immediately, remain completely inhibited in regard to it.”

James then tells us that “Such children are usually treated as sinful, and are punished; or else the teacher pits his or her will against the child’s will, considering that the latter must be ‘broken.’

Clearly, James opposes this approach. “Such will breaking is always a scene with a great deal of nervous wear and tear on both sides, a bad state of feeling left behind it and the victory not always with the would-be will-breaker.”

In his next paragraph, which I quote in its entirety, the theory that pathology as a concept is used by James to protect individuals can be seen rather clearly.

When a situation of the kind is once fairly developed, and the child is all tense and excited inwardly, nineteen times out of twenty it is best for the teacher to apperceive the case as one of neural pathology rather than as one of moral culpability. So long as the inhibiting sense of impossibility remains in the child’s mind, he will continue unable to get beyond the obstacle. The aim of the teacher should then be to make him simply to forget. Drop the subject for the time, divert the mind to something else: then, leading the pupil back by some circuitous line of association, spring it on him again before he has time to recognize it, and as likely as not he will go over it now without any difficulty. It is in no other way that we overcome balkiness in a horse: we divert his attention, do something to his nose or ear, lead him around in a circle, and thus get him over a place where flogging would only have made him more invincible.

Note that James doesn’t say that the child actually has a neural pathology, only that it would be helpful for the teacher to apperceive the child as having this condition. By apperceiving the case as neural pathology, what does James hope to gain? He does not explicitly say. The technique that he describes of dropping the subject, diverting the mind, then springing it on the pupil later, is stated plainly enough so that many individuals can employ it without first apperceiving the case as neural pathology. I have done so, myself, on numerous occasions.

James appears to feel that some individuals who are prone to apperceive the case as one of moral culpability are likely to use will-breaking and flogging. If, instead, they can apperceive the case as neural pathology, it would be easier to use the technique that leads to a good state of feeling.

Viewing someone as “sick” can elicit altruistic behavior for some people. Feelings of caring, as if for a child with an illness, are conjured up. Such a chain of reactions is more commensurate with James’s circuitous technique than the clashing-wills technique.

Here again, we are faced with the dilemma–whether it is wiser to use the “mental illness” construct to promote caring, which may short circuit the habit of blaming someone in the sense of seeking to punish someone, or is it wiser to promote notions of responsibility that leaves out the desire to punish, while constructively seeking to make personal improvements? Today, I leave this dilemma in the hands of my readers.

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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.

Tags ADHD, Alcohol Anonymous, blame, disrespectful, guilt, mental disorders, mental illness, responsibility, shame, William James

anger Bullied bullying conflict resolution emotional maturity insults interpersonal conflicts Name calling providing negative criticism social skills sports coaching

Abusive Criticism In Big Time Sports

Post author By Dr. Jeffrey Rubin
Post date September 30, 2015
No Comments on Abusive Criticism In Big Time Sports

It’s the bottom of the eighth inning. The talented star, Bryce Harper, front runner for the National League Most Valuable Player Award, hits a pop fly to left field that a professional outfielder is very likely to catch. However, there are times when such fielders do lose the ball in the sun or the stadium lights, and the ball ends up being dropped, allowing the batter to safely reach base if he had bothered to run. It is for this reason that Mr. Harper is supposed to hustle down to first base even if he has a pretty good reason to think that the ball he hit is, in all likelihood, going to be caught. Instead of sprinting down to first, Mr. Harper slowly steps out of the batter’s box and then heads to the dugout where he runs into a very angry teammate, Jonathan Papelbon.

According to several sports reporters, Mr. Papelbon, an incredibly talented pitcher, began to criticize Mr. Harper about his lack of hustle, and after a very brief exchange, he charged into Mr. Harper, putting his hands on his throat and shoving him into the back wall of the Washington dugout. Fortunately, Mr. Harper was still wearing his batting helmet because his head smacked hard into the wall, and his helmet came flying off. Several Nationals players and coaches responded immediately and physically separated the two.

How Mature was Mr. Papelbon’s Style of Providing Negative Criticism in this Situation?

Regular readers of this blog know that when it comes to providing negative criticism, we are encouraged to consider a tentative model that describes five levels of maturity. Level one is viewed as the most immature, and each higher level is viewed as a little more mature. Let’s take a quick look at these levels, and as we do so, let’s see if we can figure out which of the five levels best describes Mr. Papelbon’s approach.

PROVIDING NEGATIVE CRITICISM: FIVE LEVELS OF MATURITY

1. The criticizer displays one or more of the following behaviors:

Cries without stating what the crying is about
Physically attacks the person being criticized
Damages property

2. Those who are at this level display one or both of the following behaviors:

The criticizer does not explain what the offending behavior is, but instead expresses displeasure with glares, insults, shouting, silence, or threats that do not involve bodily harm. (For example, someone might be making too much noise and the criticizer might turn to the noise maker and glare, or cry out, “Jerk!”)
Threatens bodily harm regardless of what else is said.

3. Those who are at this level clearly state the criticism with enough detail so the criticized person, if he or she wills, can improve the behavior, idea, or appearance, but couple it with glares, insults, shouts, or threats that are not about bodily harm.

4. Those who are at this level state the criticism without bodily attacks, damaging property, glares, insults, threats, or shouts, and with enough details so that the criticized person, if he or she wills, can improve the behavior, idea, or appearance. If the person receiving the criticism becomes defensive or angry, these criticizers empathize without returning glares, insults, threats, or shouts.

5. Those who are at this level provide criticism in a manner very similar to a level four style of criticism but beforehand, they consider the person who is the target of the criticism, and the situation that he or she is in. As a result of such considerations, they may decide to alter the criticism.

According to the Above Model, What Level of Maturity Best Describes Mr. Papelbon’s Form of Negative Criticism?

While criticizing Mr. Harper’s lack of hustle to first base, Mr. Papelbon physically attacked him. Of the five levels described in the above model, level one, the most immature level, best describes what he had done.

Why is such a style considered immature? Well, one reason is that when people respond at the more mature levels, it demonstrates that they can consider the consequences of their actions before they choose what actions to take. In this case, the consequences for Mr. Papelbon has been a suspension for the rest of the season, a fine of thousands of dollars, and he has been displayed on national news in a negative light, thus tarnishing his reputation. A little forethought would have led to avoiding these clearly negative consequences.

Now, it is important to note that the specific negative criticism that Mr. Papelbon wanted to deliver to Mr. Hudson, was, according to my own value system, correct. Mr. Hudson does owe it to his teammates to hustle down to first base in these situations. However, I disagree with how Mr. Papelbon provided the criticism.

Mr. Papelbon, center, after lunging at Mr. Harper.

What would have been a more mature response? A little forethought would have led to realizing that Mr. Harper was very frustrated with his own pop out in the game. Thus, to wait until the next day would give both parties time to calm down.

Moreover, providing negative criticism to someone in front of lots of other people is often a huge mistake. Face-saving actions tend to increase defensiveness for both parties. Asking to discuss such matters in private is often a kinder, wiser approach.

Finally, Mr. Papelbon would have been wise to first consider if he was the best person to present the criticism. Usually managers of a team are the ones who are considered to have the legitimate authority to bring these types of issues up to a player. If Mr. Papelbon felt he had a particularly close relationship with Mr. Harper, or an established mentor relationship, there could be some exceptions to this general rule. Otherwise, Mr. Papelbon might have been wise to privately discuss his displeasure about his teammate’s lack of hustle with his manager and urge him to take firm action.

Sports Illustrated Article on “Abusive Coaches”

In big time sports, Mr. Papelbon is in no way the only one who provides negative criticism in a manner that matches the most immature levels of our model. In a special report of the September 28, 2015 issue of Sports Illustrated, Alexander Wolff (with reporting by Lauren Shute) writes:,

“Why do college coaches continue to yell, demean and demoralize? That’s yesterday’s tactic. Today’s athletes can’t-and won’t-take it. What’s more, it doesn’t work: Study after study shows the benefits of a more positive approach.” (p. 51)

What are the negative consequences of providing negative criticism in these low maturity level styles? The Sports Illustrated writer tells us about excellent players leaving their teams, and in rare cases, committing suicide.

Many coaches have lost their jobs after an athletic director’s investigation. Over the past 28 months at least seven Division I schools have had an investigation, and then parted ways with coaches following player complaints of mistreatment.

Moreover, some colleges end up getting sued. In one case, seven former players have filed a $10 million civil suit that charges the school and coaches were fostering a racially hostile environment.

There is some relatively good news in the Sports Illustrated article. Apparently, most players are not being treated in a demeaning manner judging from one recent NCAA survey. Of Division I players, 31% of men’s basketball players and 22% of football players reported that a coach “puts me down in front of others.” Although this indicates that there is still plenty of room for improvement, it can nevertheless be viewed as a hopeful sign that most coaches are finding more positive ways to bring out quality performances in their players.

Why Do Many Coaches Continue to Use Abusive Tactics?

As reported in the Sports Illustrated article, according to Ramogi Huma, executive director to the National College Players Association, which often hears from abused athletes:

“I believe this is a cultural problem. A lot of coaches, they were hollered at and abused when they were players.” (p. 52)

There is also undoubtedly a great deal of pressure on the coaches. If they don’t win, they are very likely to be replaced.

But perhaps the major reason is that coaches are not provided enough inspiring stories about how successful coaches find ways to win by fostering bonding, loyalty, and commitment to a team in a positive manner. Dramatic enthusiasm when explaining to players what specifically they can do to improve, rather than belittling them about what they did wrong, is one such positive approach. Celebrating each step toward improvement is another.

Conclusion

Thinking about what happens when immature styles of criticism occur in the world of big time sports can provide us an important lesson with regards to how we provide criticism to others in non-athletic situations. The five levels of maturity provides guidance not only to big time athletic teammates and their coaches, but also to the rest of us.

Real change from lower levels of maturity to higher levels rarely occurs from reading a single article. More typically, it requires bringing examples of people utilizing the higher level skills before one’s consciousness at least weekly for several months, and, on each of these occasions, an effort must be put forth to consider how these skills can be specifically applied to one’s own life. Following this blog is a no cost way to help make this happen.

I hope you join us again real soon.

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 intelligence. To begin at the very first post you can click HERE.

Tags anger, bullies, bullying, disrespectful, insults, maturity levels, negative criticism, sports coaching

Bullied bullying conflict resolution criticism fairness incivility at work mean bosses mean employers respect

Mean Bosses

This blog has frequently advocated that it is beneficial for all if we treat others respectfully. At times we focussed on a respectful way to provide negative criticism–no glares, insults, threats, or shouts, and with enough details so that the criticized person, if he or she wills, can improve the behavior, idea, or appearance. At other times, we focussed on the best way to respond to negative criticism–listen in a supportive, warm, friendly style, and then make it clear that we fully understand what was said by providing a summary.

Although posts like these were generally well received, some comments argued that they didn’t apply to work settings. “A good boss doesn’t have time to be nice!” claimed one person. Another argued that “A boss has to be tough or he or she will be taken advantage of, and the whole organization will end up suffering.”

Well, an excellent article once appeared in the New York Times that delves into this issue. Titled “No Time to Be Nice,” the author, Christine Porath, tells us that how we treat one another at work matters. “Insensitive interactions have a way of whittling away at people’s health, performance and souls.”

Early in the article, Ms. Porath reviews research demonstrating that stressful jobs increase the risk of a cardiovascular event by 38 percent, and a major source of work related stress is how the boss treats employees.

Bosses produce demoralized employees through a string of actions: walking away from a conversation because they lose interest; answering calls in the middle of meetings without leaving the room; openly mocking people by pointing out their flaws or personality quirks in front of others; reminding their subordinates of their “role” in the organization and “title”; taking credit for wins, but pointing the finger at others when problems arise.

Although in surveys people say they are afraid they will not rise in an organization if they are really friendly and helpful, research evidence indicates the opposite is true–behavior involving politeness and regard for others in the workplace pays off. Those seen as civil were twice as likely to be viewed as leaders.

Ms. Porath tells us:

Civility elicits perceptions of warmth and competence….these two traits drive our impressions of others, accounting for more than 90 percent of the variation in the positive or negative impressions we form of those around us. These impressions dictate whether people will trust you, build relationships with you, follow you and support you.

The reason that some people don’t believe the research findings is that they see mean bosses who seem to succeed despite being rude and thoughtless. Whereas it is true that some bosses can be highly successful while being mean, it is not being mean that makes them successful. They succeed despite their incivility, not because of it. If they happen to have highly talented people working for them, or their company is particularly profitable because their product is much better than the competition, the boss may get the credit. But studies reviewed by Ms. Porath demonstrate that the No. 1 characteristic associated with an executive’s failure is an insensitive, abrasive or bullying style.

Power can force compliance. But insensitivity or disrespect often sabotages support in crucial situations. Employees may fail to share important information and withhold efforts or resources. Sooner or later, uncivil people sabotage their success — or at least their potential. Payback may come immediately or when they least expect it, and it may be intentional or unconscious.

There is far more in the “No Time to Be Nice” article worth studying, and I highly recommend giving it a thorough read. Ms. Porath’s article is a breath of fresh air to all of us who advocate that treating people respectfully is in all of our best interests.

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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.

Tags bullying, disrespectful, disrespectful bosses, insults, mean bosses, mean employers, respect, stress

anger conflict management conflict resolution criticism insults interpersonal conflicts negative criticism respect Responding to Criticism Uninvited criticism Unsolicited criticism

A Conversation About Unsolicited Criticism

Post author By Dr. Jeffrey Rubin
Post date March 30, 2015
6 Comments on A Conversation About Unsolicited Criticism

A while back, I published on this blog a post titled, “Unsolicited Criticism: Good or Bad?” Regular readers may recall that it begins as follows:

Illustration by Aviva Maltin

“Judy, it’s so nice to see you,” I say as she comes into my office and sits down on my couch.

“I’ve been reading your blog again, Dr Rubin. It’s filled with a bunch of hogwash.”

“Hmmm, it sounds like there are some ideas in it that you don’t care for.”

“I read last night two of your blog posts–Is Criticism Bad and Criticism and Wisdom. What a bunch of nonsense!”

“I’m very interested in your point of view, Judy. Please tell me more specifically about what you disagree with in those posts.”

John Stewart Mill

“Well, you talk about this John Stuart Mill. According to him, if people criticize us, even for holding an opinion we are very sure of, we should thank them for it, open our minds to listen to them, and rejoice. That’s ridiculous! If you don’t have something nice to say to somebody you should keep your stupid mouth shut! And, as far as I’m concerned, unless I give someone permission to criticize me, that person has no right to inflict it upon me!”

The rest of that post provides my response to Judy. As brilliant as that response is, it is my considered opinion that my readers and I benefit from hearing a variety of views on these types of issues. And so, with that in mind, I went about seeking these views by introducing the post to the Facebook groups that I belong to. Thus, I wrote for each group the following:

Some say that unless you are invited to provide criticism, you should keep your mouth shut. How wise is that?

Then I provided the link to my post. It led to quite a few excellent insightful discussions. My favorite happened to appear on the wonderful group, The Brain Cafe. To our good fortune, several of its participants graciously granted permission to use their comments for the current post. These permissions do not mean they are providing a blanket endorsement of this blog or its writers. And, with that, let’s take a look at the discussion that had taken place.

The Brain Cafe Discussion

Brad Esau, prior to reading my blog post wrote: Uninvited “advice” makes me go thermo nuclear. Uninvited criticism is courting death. Perhaps I should read this.

I, Jeffrey Rubin, replied: Please do read it, Brad Esau, and then let me know what you think.

Barry Kort: I suppose the context matters. As a retired academic, I hang out in Internet venues where my fellow academics schmooze with each other and with interested lay people who are arm-chair aficionados of the subjects on the table. In academia, we have a scholarly culture such that we routinely peer-review each other’s work in a collegial and congenial manner. I view this culture as being characterized by an informal tacit social contract that defines a scholarly culture.

There is, on the other hand, the unscientific (or non-scientific) political culture which has its own inscrutable ground rules which admit of some rather dicey and sleazy practices.

What is the lay person to do in these Social Networks? Clearly we find a mix of behavior that spans the spectrum.

I don’t mind conscientious scholarly criticism of the sort one would expect in academia. I’m not fond of the kind of snarky or mean-spirited dismissals that one finds in our ofttimes toxic political culture….

Brad Esau: This seems to be a cultural thing. I’ve noticed Americans (I’m Canadian) seem to have this notion that they have the “right” to speak out about anything at any time. This is much different than most cultures.

I happen to believe a) I – or anyone – absolutely has the right to deny anyone’s “right” to offer “criticism” or “input” and b) through much, much, much hard won experience, I learned that most people’s “criticism” was largely invalid and of poor construct. In other words, they had no idea what they were talking about.

I am very, very open to critique – if it’s from someone whose expertise or experience I trust and they’ve *earned* my trust. Otherwise, I have no time to waste on most people’s hot air.

So while I think your approach is valid for within American culture, it should be limited to that.

E. C.: Well said Brad! (also a “fellow” Canadian). Love your courage for taking this on Jeffrey. And Brad, you make me THINK

Brad Esau: Thanks, E. C. After growing up in polite Canada and spending a decade and a half around Asians (Japanese, Taiwanese and Chinese) where this kind of “right” to openly criticize is unthinkable, I still find this jarring. Most of my online exchanges are with our friends south of the 49th. Just could never get used to their unrestrained forwardness.

And thank you for the compliment.

Barry Kort: What stood out for me in that vignette was that Judy was enacting a practice that she abhorred when the roles were reversed. About the only scenario where that’s kosher is in scripted psychodrama as a theatrical performance.

Brad Esau: Thinking on this further, I think unsolicited criticism is warranted in cases where intervention is needed. Somebody is clearly going about things in ways that will harm their future or… their chances at their goals, and then I think it’s quite correct to voice some well founded constructive criticism….

The thing with most people, they’re not nearly as “smart” or “wise” or “expert” as they believe themselves to be and most of their “criticism” or “advice” is nothing more than egotistical bluster and hot air.

After some time had passed, Brad added: I now just sort of have this iron clad rule for when anyone – and I mean anyone – offers “advice” or “criticism” I ask for or dig into their credentials and poke into what their motivation might be. 98% of people don’t pass those simple tests.

Of course the trick then is to learn to check one’s own premises and to see if whatever criticism or feedback they might have had to offer was warranted.

There are so many variables at work here!

I could fill a city with people crippled by the criticism they received all their lives from their mothers. Hell, maybe a whole continent. I’d have to say raising motherly criticism is invalid.

Judges are different – you purposely go there to be judged. The topic here is *unsolicited* criticism and how to deal with it.

E. C.: No one wants or needs to hear “bad things” about themselves. That is not constructive criticism. What is helpful is solicited advice on how I can improve on something. That is entirely different, and it requires the “advice giver” to have to actively listen to what it is I am asking and what information I am giving as far as what I need advice or help with.

Lyra Alves: I agree that it is highly determined by our cultural background, but we surely can work our way out of having it as “taboo” and adapt to it. I find criticism, from whatever source it comes, from people who know me or not, who have something interesting to say or not, an incredible gift for my personal growth. I trust much more people who are straight forward than those who are over-polite. I also tend to feel that often those who resist to criticism or those who only accept it if it comes from certain “certified” sources may have self-confidence issues, some hidden insecurities to be sorted out. Every chance we receive some criticism is a chance we have to review various concepts we have about ourselves, about what is the best or not. I think it is always a valuable chance to expand our view on the world and increase our ability to empathize.

Susan Clemens: I have a Facebook rule: Your wall; your opinion.
Other than that, constructive criticism can be offered if you have a relationship with the person, if the person is otherwise at risk of injury, or if you are approaching a business from the customer perspective.
“Pat them-poke them-pat them” works best. I have a few friends who welcome criticism and others who can’t stand it. I try to respect them and vice versa.

Brad Esau <irony>

I’ve recently posted a piece critical of America and Americans along with my own well founded views.

Going by the universal angry responses and denial I’ve gotten so far, it seems like the people who enjoy criticizing the most and defend their “right” to do so, are most uncomfortable with criticism of themselves.

</irony>

Jeffrey Rubin: Brad Esau, I’ve noticed the same thing–that many people who hate to be criticized are among the quickest to criticize, and often are the ones who are the nastiest criticizers as well.

E. C.: I wonder, am I the only one who kind of “bristles” at the word “Criticism?” I am all for constructive feedback but for some reason framing it as “criticism” feels far less helpful and like others have said does become more about the person giving it than about the person needing it. Jeffrey Rubin – do you see a difference? If so, why or why not?

Jeffrey Rubin: Hi E. C. I see the difference that you are trying to make, and it is an important and worthwhile distinction to make. I don’t see that that difference has to be made by using the word “feedback” for one and “criticism” for the other. However, if I am in a conversation just with you, I wouldn’t object to an understanding that we would use the words to mean whatever you would like.

That said, people have a variety of conceptions of these two words (criticism and feedback) and therefore typically it is a good idea to use more than just those words to explain what we mean. Defining our terms beforehand is a good strategy.

For future reference, to me and Daniel Webster, criticism is an evaluation. If you have evaluated something, then you have formulated a criticism of it; and if you tell someone your evaluation, you are providing the person criticism or a critique of something. It can be done in a way so that it is designed to be helpful to someone. Sometimes it is expressed in a manner that is designed to punish someone, or to just hurt someone for a variety of reasons, e.g., because of jealousy or because the person is stressed and irritable.

Concluding Comment

Well, I hope you enjoyed this discussion as much as I did. I hate to end it here, for there is so much more to say, but rest assured that there will be more on this emotionally packed conversation in coming weeks. Until then, here’s hoping that kindness accompanies all of the criticisms that come our way.

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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.

Tags conflict management, dispute management, disrespectful, insults, uninvited criticism, unsolictied criticism

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Insults By Jews As Works Of Art

Post author By Dr. Jeffrey Rubin
Post date February 1, 2015
2 Comments on Insults By Jews As Works Of Art

Recently I visited Philadelphia’s National Museum of American Jewish History. Some of the floors were devoted to a single theme. For example, there was a floor devoted to “Chasing Dreams,” which celebrated baseball and the many fans, players, and characters from minority groups who helped shape our American story. And there was a floor devoted to Jews as immigrants coming to America. Each exhibit was great, but the museum director has to be a putz for neglecting to devote a floor to classic insults by Jews.

To be fair, I, myself, didn’t come up with this idea until last night when I happened to be listening to Bob Dylan’s “Theme Time Radio” show. Bob happened to have Tom Waits as a guest and here’s what he had to say:

Hi, Bob. It’s Tom. Here’s a little morsel of information. The Jewish people have always had a penchant for colorful cursing. Here are some of the most famous Jewish curses:

May God call the tune and may your enemies play the music.

May you lose your faith and marry a pious woman.

May all your teeth fall out but one which should remain for a toothache.

May you grow like an onion with your head in the ground and your feet in the air.

May you have a good long sleep, dreaming only of your troubles.

May you be the proof that man can endure anything.

May your wife eat matzohs in bed and may you roll all night in the crumbs.

So there.

It was upon hearing this, that I first came up with this great idea for a separate floor at the museum.

A Separate Museum Floor Devoted to Classic Insults By Jews

For your consideration, here are some ideas for this museum addition. There could be several sections on the floor. Of course, one of them would have to be devoted to the great insults that spilled forth from the many comedians who performed during the heyday of the Borscht Belt.

For those not familiar with the term, “Borscht Belt,” it refers to the mostly defunct summer resorts of the Catskill Mountains that would cater to many of their guests who happened to be Jewish. The word, “borscht” refers to one of the traditional Jewish items found on their menus (sour cream and beets).

The long list of the Borscht Belt stars include Woody Allen, Jack Benny, Billy Crystal, Rodney Dangerfield, Henny Youngman, Jerry Lewis, Don Rickles, Joan Rivers and Jerry Stiller. Some of these stars specialized in insulting themselves.

Perhaps the greatest of all within this group was Rodney Dangerfield who continually complained about getting no respect:

“My doctor said I was in terrible shape. I told him, ‘I want a second opinion.’ He said, ‘All right, you’re ugly too!'”

Some specialized in insulting their spouses:

“My wife dresses to kill. She cooks the same way.” (Henny Youngman)

And, for some, their favorite schtick was insulting hecklers in the audience:

“Oh my God, look at you. Anyone else hurt in the accident?” (Don Rickles)

In addition to a section on Jewish Borscht Belt comedians, I think there could be one set aside for Seinfeld characters seeking to come up with the perfect insult to reply to an insult.

George Costanza character from the Seinfeld TV show

“Hey George, the ocean called and they’re running out of shrimp.”

“Oh yeah!” replies George, “Well, the jerk store called and they’re running out of you!”

Another section could be devoted to Chelm, a real Polish town that according to Jewish folklore is inhabited by Jewish fools whose antics kept Jews amused for generations.

The great sage of Chelm went out for a walk with his trusted young assistant, Shlermo, by his side. Suddenly it began to pour.
“Quick,” said Shlermo, “open your umbrella. You’re getting soaked.”
“Don’t be ridiculous,” exclaimed the great sage, “it wouldn’t do any good. My umbrella has more holes than a sieve.”
“Then why did you bring it?”
“I didn’t think it would rain!”

Well, there you have it, just a few ideas from off of the top of my head for a museum floor devoted to classic insults by Jews. It would be great!

Now, at this point, I’m imagining that some of my readers might be scratching their heads, wondering why I would want to support any idea that might encourage people to insult anyone. So let’s take a moment to look at this issue.

What Possible Value Could There Be To Having a Section In A Museum Devoted To Insults?

If done well, this section could delve into the more serious issues surrounding the nature of insults as used in our society. For example, as I pointed out in an earlier post titled THE ART OF PLAYFUL TEASING, insults are used in a playful game called teasing. You are judged in part on the quality of your insults and also how well you keep your cool on being insulted.

Even the most mature people may like to play the teasing game, for they enjoy the duel of wits and the occasional humorous comeback.

Mature people are distinguished from immature people by their lack of desire to hurt somebody in this game. Their empathy helps them to realize that the smiles and the lighthearted tone they try to set throughout the game sometimes mask real tensions. Thus, they keep their senses tuned to the subtleties of the repartee, and know when to back off when things begin to get too serious.

Less mature people, partly because of their lower levels of empathy, may think that the more awful they can make someone feel during this game, the better they are at it. When the criticizers have themselves been humiliated by other immature people, they may come to be even more motivated to humiliate others as a way to take out their own pain on others.

So, there you have it, my post for this week. I hope that in addition to a few laughs you found within it some food for thought.

Until next time, may you find some ways to bring a little peace into this cockeyed crazy world of ours.

Jeff

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Tags bullying, disrespectful, Don Rickles, insults, Jewish Comedians, Jews, National Museum of American Jewish History, Phyllis Diller, Rodney Dangerfield, Tom Waits

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Women and Criticism

On this blog, I often discuss immature and mature ways to deal with criticism. The advice that I offer is designed to be helpful to males and females alike. But recently, in an Op-Ed piece in the New York Times, Tara Mohr argues that when it comes to criticism, women can benefit from advice specifically targeted to the unique cultural situation that they find themselves in.

The New York Times Article

Ms Mohr, in her thoughtful article titled “Learning to Love Criticism,” tells us:

Criticism stings for all of us, but women have been socialized to not rock the boat, to be, above all else, likable. By the time a girl reaches adolescence, she’ll most likely have watched hundreds of films, television shows and advertisements in which a woman’s destiny is determined not by her own choices but by how she is perceived by others. In those hundreds of stories, we get the message: What other people think and say about us matters, a lot.

In addition to these messages in the media, for centuries women have had less rights than men. Being likable, or at least acceptable to stronger, more powerful men, became a primary survival strategy. For many women around the world, this is still the reality.

Given this history, we might think that women have mastered the skills to insure that they are liked, but in the business world there is some evidence that problems exist.

A Recent Survey

In a recent survey that looked at 248 performance reviews from 28 different companies, both men and women gave more negative feedback to the women being reviewed. Here are a few examples:

“You can come across as abrasive sometimes. I know you don’t mean to, but you need to pay attention to your tone.”

“Your peers sometimes feel that you don’t leave them enough room. Sometimes you need to step back to let others shine.”

“The presentation ultimately went well. But along the way, we discovered many areas for improvement. You would have had an easier time if you had been less judgmental about R—‘s contributions from the beginning.”

This kind of negative criticism showed up twice in the 83 critical reviews received by men. It showed up in 71 of the 94 critical reviews received by women.

There are three possibilities that present themselves here:

1. The women received more negative criticism despite not acting in any distinctively different way than the men because of distinctively different expectations of how women “should” act;

2. The women who received more negative reviews actually acted distinctly different in certain ways than the men and it is these differences that led to the additional negative criticism;

3. It is a little of both.

An Informal Survey

Interestingly, from my perspective, are the results of an informal survey of someone I know who was intimately involved in evaluating and promoting personnel. Here, early criticism was about equal between men and women, but more women took the negative criticism they received to heart and made changes prior to their following evaluation. This ultimately led to their promotions. The majority of the men who got negative feedback seemed uninterested in making any changes and subsequently lost their opportunity for promotion.

From this, I think that it is not only possible, but perhaps even probable, that despite the pattern suggested in the more thorough survey, there is great variability across settings.

Some bosses may have an archtype that a great leader is a tough, no nonsense person who only projects a demanding sense of profits. Such an attitude will provoke a very different style of criticism around the office than one that supports the idea working for profits doesn’t have to mean that we must abandon basic principles of human dignity.

Let me just add that the person involved in providing and promoting personnel in the informal survey happened to be a master at providing very specific feedback. Consider the example provided above in which someone stated in a review:

“You can come across as abrasive sometimes. I know you don’t mean to, but you need to pay attention to your tone.”

Such a statement potentially can be helpful as one looks within and seeks to come up with a less abrasive way to respond in situations. However, the feedback would be far better if a supervisor, let’s call him Bill, invited a subordinate, let’s call her Mary, to a one-on-one meeting shortly after an abrasive incident occurred. At that meeting, Bill does several things. He gently explains that he is about to imitate how Mary had acted, using her tone of voice and what was said. Then, after imitating for her how she acted, he displays for her in a role-play how he would prefer she act when a similar incident arises. He then proceeds to ask Mary to imitate what he just acted out. Then he goes through this process with Mary until she can actually copy the less abrasive style to his satisfaction. If Bill provided this level of specific feedback, it would be potentially far more helpful then the two-sentence feedback that was actually provided.

Advice

I very much support the recommendations that Ms Mohr provides in her New York Times piece. For example, at one point she writes,

If a woman wants to do substantive work of any kind, she’s going to be criticized — with comments not just about her work but also about herself. She must develop a way of experiencing criticism that allows her to persevere in the face of it.

How can this be done? “A woman,” says Ms Mohr, “can identify another woman whose response to criticism she admires. In challenging situations, she can imagine how the admired woman might respond, and thereby see some new possible responses for herself.”

I won’t go into all of the recommendations of Ms Mohr, suffice it to say her article is well worth reading. But I do think it is essential to point out that a single article will not do the trick for most of us, women or men, who want to learn to become a master at dealing with criticism. It takes several months of regularly bringing before our minds examples of criticism, followed by a discussion of how to transform each specific example into something better. My blog provides one way to go about doing just this. Readers can begin with the introduction to this blog, and move forward at their own pace by clicking on the next newer entry post. Additionally, by reading the trilogy of novels that I’ve written, people become immersed for a few months in adventures that illustrate the struggle to seek respect even under the most trying circumstances.

Well, that’s this week’s edition of From Insults to Respect. Here’s to hoping you’ll join us again real soon.

Jeff

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Tags conflict, conflict management, criticism, dispute management, disrespectful, insults, negative criticism, negative feedback, New York Times Op Ed, psychological maturity, respect, Tara Mohr, types of criticism, women and criticism

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Psychiatric Name Calling: Is Science to Blame?

Post author By Dr. Jeffrey Rubin
Post date September 22, 2014
14 Comments on Psychiatric Name Calling: Is Science to Blame?

A couple of weeks ago I raised the question, “Name Calling by Psychiatrists: Is it Time to Put a Stop to it?” In response, some blamed the insurance companies and other third party payers for the name calling. Because it is true that these payers do require the pathologizing of people seeking mental health services, in last week’s article, I took a close look at that issue.

Others responding to my question argued that diagnosing mental illness is based on the principles of science. So, let’s look at this line of thought.

The Nature of Science

Science enquires what is the nature of something? what is its constitution, origin, and history? Human beings also make enquires of a different sort, What is the object’s importance, meaning, significance, or value now that it is once here? Neither judgment can be deduced immediately from the other. They proceed from diverse intellectual preoccupations, and the mind combines them only by making them first separately and then adding them together.

As Steven Jay Gould, professor of zoology and geology at Harvard University, explains it:

“The net of science covers the empirical realm: what is the universe made of (fact) and why does it work this way (theory). The net of religion extends over questions of moral meaning and value. These two magisteria do not overlap, nor do they encompass all inquiry (consider, for starters, the magisterium of art and the meaning of beauty). To cite the usual clichés, we get the age of rocks, and religion retains the rock of ages; we study how the heavens go, and they determine how to go to heaven.”

In the natural sciences there is a branch called pathology that classifies tumors, lesions, bone fractures, tissue tears, toxic reaction to a chemical, blockage of blood flow within the circulation system, blockage within or to an organ, and microbe infections. Pathologists have reliable ways of identifying and categorizing these naturally occurring entities. When we take a science view of each of these entities of interest to pathologists, it is not a value judgment if they exist or not. If ten pathologists look at a tumor, they can all see it, describe its color, density, weight and what each of the tumor’s cells look like under a microscope.

Pathologists, as scientists, have been studying these entities and sometimes they found that some of them are associated with certain physical complaints. For example, some people complain about headaches and vision problems. When they died, autopsies were carried out and often a tumor was present that was pressing against the optic nerve.

This finding led to a theory that for people who expressed this type of physical complaint, if an operation was carried out while the patients were still alive and this type of tumor was indeed pressing on the optic nerve, perhaps removing it would alleviate the complaint. Studies were carried out and it led eventually to a valued treatment.

The connections between the research findings of pathologists gave doctors some understanding of what was causing some of the physical complaints of their patients. But often doctors could not find evidence that any of the entities of interest to pathologists were the cause of the complaint. When this occurred, most doctors merely changed the expressed complaint into some medical jargon that sounded somewhat like those concerns that had been shown to be due to a pathological condition. In such cases, they offered some treatment that was often based more on the commercial art of medicine rather than science.

These doctors usually called both types of physical complaints (those with pathological findings and those without) “illnesses” or “disorders.” By doing so, the science of medicine and the art of medicine became blurred. And then, business interests became wrapped up in the various treatment options and principles of science began to become more and more murky when applied to the medical world.

Disorders and Psychiatry

In a book titled Psychiatric Persuasion by Elizabeth Lunbeck, there is considerable documentation that back at the turn of the 20th century when the main job of psychiatrists was running insane asylums their professional organization decided to expand their market by doing two things. 1. Persuade the public that more and more normal behaviors are pathologies that require psychiatric treatment, and 2. Develop a category system that converts all psychological concerns that a person might want to get help for into a language that sounds like a pathological condition. This would legitimize the treatment of anyone who came to their office, thus the argument that the current psychiatric “diagnosis” system has become a business tool while being promoted as science.

Now, it is certainly possible to create a categorical system consistent with science for the problems that come to the attention of psychiatrists and other mental health service providers that don’t confuse conditions that are associated with pathological findings and those that are not. Such a system would classify “mental health concerns,” rather than calling people names. A mental health concern occurs when a person seeking mental health services expresses to a mental health service provider a concern about any of the following topics: behavior, emotion, mood, meaning of life, managing chronic pain, work, relationships, education, eating, cognition and sleep. Two classes of mental health concerns are concerns expressed about oneself and concerns expressed about someone else.

One benefit of classifying “mental health concerns” rather than “mental disorders” has to do with inter-rater reliability. Consider being in a room with 100 psychologists, or even 100 average Joes and Jills, and a person in front of the room says she has been feeling depressed. A questioner asks the client, “Are you concerned about feeling depressed?” and the person says, “Yes.” If you asked for a survey of how many people in the room thinks the person has expressed a concern about being depressed, you would get, I believe, 100 percent agreement. Expressing a mental health concern is a specific action that people do, and therefore it is clearly observable.

Research on the inter-rater reliability of the mental disorders classification system has demonstrated that its inter-rater reliability is very problematic.

Science is Not to Blame

It is not science that is to blame for psychiatric name calling; it is the psychiatric business tool that is cleverly designed to capitalize on the public’s respect for science.

When we begin to use a classification system that does not clearly separate principles of science from values involved in business interests, other values start to slip into the classification process as well. Early on when the pathologizing of human experience was just getting underway, William James made a number of relevant comments about this.

James argued that experiences that are commonly viewed as unhealthy or morbid are really “an essential part of every character” and give life “a truer sense of values.” To support his contention, James first provided three examples of famous individuals who expressed concerns about melancholy. Such experiences today, if expressed to a psychiatrist, would probably be converted into a so-called “diagnosis” of “major depressive disorder.” St. Paul, the religious figure of the New Testament, Cesare Lombrosa, a late 19th-century Italian criminologist, and Immanual Kant, the 18th-century German philosopher, became, according to their biographies, better as a result of their troubling experiences.

Although hallucinations can mean madness to some, James presented the case of Socrates who “once stood motionless for many hours in the cold and spoke of having a guiding demon.” Attempting to counter the association between pathologies and hallucinations, James stated, “Even if this demon [of Socrates] were really meant hallucinations of hearing, we know now that one in eight or ten of the population has had such an experience and that for insanity we must resort to other tests than these.”

James stated that there is no end to the possible types of obsessions that we see all around us. What benefit can such experiences have? James wrote about Henry Borg, founder of the American Society for the Prevention of Cruelty to Animals in 1866; Charles Henry Parkhurst, a Presbyterian clergyman and reformer who held a New York City pastorate from 1880 to 1918 and who launched a furious attack on organized crime in state government that led to an official investigation; Dorothea Dix, a mid-19th-century humanitarian who visited the insane asylums and successfully advocated for legislation to improve the care for those labeled mentally ill.

Later, James stated, “Individuals are types of themselves and enslavement to conventional names and their associations is only too apt to blind the student to the facts before him.”

James concluded that,

“Any peculiarity that is of use to a man is a point of soundness in him, and what makes a man sound for one function may make him unsound for another. Moreover we are all instruments for social use, and if sensibilities, obsessions and other… peculiarities can so combine with the rest of our constitution as to make us the more useful to our kind, why, then, we should not call them in that context points of unhealthiness, but rather the reverse . . . The trouble is that such writers [pathologizers]. . . use the descriptive names of symptoms merely as an artifice for giving objective authority to their personal dislikes. The medical terms become mere appreciative clubs to knock a man down with. . . . The only sort of being, in fact, who can remain as the typical normal man, after all the individuals with degenerative symptoms have been rejected, must be a perfect nullity… Who shall absolutely say that the morbid has no revelations about the meaning of life? That the healthy minded view so-called is all?”

To illustrate what James means here, consider an article in the American Journal of Psychiatry (May, 2004), titled “Virginia Woolf (1882-1941).” Although she is described by psychiatrists as having bipolar disorder, her diaries and letters, document movingly, her emotional extremes and her capacity to savor the “ordinary rhythms of life.” At times Woolf railed against her distressing emotional experiences, felt frustrated and impeded by them, and at other times she felt it was essential to her. In diaries and letters, she returned to the question repeatedly without reaching a resolution: were her emotional experiences a terrible obstacle to her art, or were they the necessary condition for it?

For those trying to sell psychiatric drugs, a simplistic answer to this question is eagerly promoted. Science has not provided a definitive answer to this question as far as I am concerned, and throwing around phrases such as “the brain is malfunctioning in depression,” or “the brain has a chemical imbalance in depression” goes way beyond the available evidence.

Psychiatric labels are like masks held on by rubberband straps. They hide some of the characteristics of an individual. Wearing such masks may serve some purposes, but after a while they start to get uncomfortable for many, particularly around the ears. Let those who want to wear these masks be free to do so. But let those who want to meet us face to face, also be free to do so.

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Tags disrespectful, DSM, free social intelligence and emotional intelligence curriculum, insults, mental disorders, mental health, mental health concerns, mental health services, mental illness, name calling, psychiatry, science, Steven Jay Gould, William James

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Psychiatric Name Calling: Are the Insurance Companies to Blame?

Post author By Dr. Jeffrey Rubin
Post date September 16, 2014
5 Comments on Psychiatric Name Calling: Are the Insurance Companies to Blame?

Last week, I posted an article titled “Name Calling by Psychiatrists: Is it Time to Put a Stop to it?” It created quite a stir and it’s currently challenging my two previous most popular posts—“Teaching Children How to to Deal with Criticism” and “Is it Wise to be Assertive?”—for the number one spot.

The article points out that by using the term “diagnosis” in psychiatric terminology it misleads people in a variety of ways. For example, when psychiatrists provide their patients a so-called diagnosis many people believe there is now a valid explanation for why they are struggling with their personal difficulties. Instead, all that has really happened is that the psychiatrist has converted the expressed concern of the patient into pathologizing language.

The manual that psychiatrists use when deciding which words to use when converting concerns to “diagnoses” is called The Diagnostic and Statistical Manual of Mental Disorders (DSM). Of course as this manual was developed there was a huge financial interest to utilize language that encourages the perception that an expressed concern is a very, very serious life-long condition that requires medical treatment for a lifetime. Consequently, when patients express a concern about being depressed, the psychiatrist informs them that they have “major depressive disorder,” and often couple this with statements such as, “This is a serious lifetime condition that must be managed for a lifetime.” Any language that suggests that there is substantial evidence that most people recover even without treatment runs counter to the psychiatric business plan.

Among the many comments that I received about the name calling article are those that point out that most of the doctors who are using the psychiatric terminology provided in the DSM are not psychiatrists. Pediatricians, general practitioners, internists, psychologists, and neurologists daily call people these names. Other comments present the argument that it is the pharmaceutical companies that promote the pathologizing of human concerns in order to convince people to ingest their drugs.

I’ll be exploring these issues in coming weeks. But today, let’s focus in on the argument that the real group of people at fault for this type of name-calling is the third party payers such as insurance companies, Medicaid, Medicare, and Social Security. After all, by far, the DSM terms are used most by these types of entities.

The DSM and Third Party Payers

Most people in the United States who seek mental health services don’t directly pay for them. Instead, they have insurance policies that cover some, or all, of the fees; or they qualify for Medicaid, Medicare, or Social Security benefits. Insurance companies and these other agencies are called third party payers.

Third party payers currently have a form that must be filled out whenever someone seeks mental health services under their plan. That form has boxes for the name of the person seeking services, his or her contact information, policy number, some information about who is being asked to provide services, and then, imbedded in all of this, is a little box that currently says, “Diagnosis.” In that box, mental health professionals must fill in the DSM code that corresponds to their “diagnosis” of the person seeking services.

Third party payers initially developed their form for people who were seeking medical services for physical complaints. Physicians would fill in the diagnosis box with a code that corresponded to a list of diagnoses in their pathology manuals based on a visual inspection of a tissue tear, the results of x-rays, blood test, or a pathologist examining a tissue sample of a tumor under a microscope. Sometimes it was based on a report from a toxicologist because it was theorized that the patient had been exposed to some toxic substance. In each of these cases, the diagnosis that was provided actually did provide some understanding for why patients were struggling with their expressed physical complaints.

However, I hasten to point out that in many cases physicians were unable to uncover the reason for the physical complaint. At such times they often did pretty much what psychiatrists do today—they converted the physical complaint into medical jargon, typically using Latin derived syllables, and then stuck them into the third party payer’s “diagnosis” box on the third party payer forms, prescribed some treatment, and low and behold, third party payers paid the doctors just like they did when a real diagnosis was provided.

A physician once confided in me that for the majority of his cases he was unable to identify the reason for the physical complaint but he nevertheless provided some diagnosis and a prescription for a pill. “If I didn’t,” he said, “my patients would feel that they wasted their money by coming to see me.” I then asked him how he felt about misleading his patients in this way. “Well,” he replied, “if my patients feel that I have made a real diagnosis and prescribed some pills, they feel a sense of being reassured and the pills can have a placebo effect which may be very curative in its own way.”

“The pills that you prescribe,” I replied, “are not simply substances with no physical effects beside the placebo effect, they have a number of real serious side effects associated with their use. Is that really ethical?”

“Well, the physical side effects often help the placebo effect because the patient feels something is really physically happening. It is part of what reassures them that what was prescribed has a powerful effect. When weighing the risk of serious side effects versus the minor side effects that can be helpful, I make my decisions on what to prescribe.”

And so, that’s a little of my understanding of the reasoning behind this type of misleading name-calling and prescribing practices of physicians dealing with physical complaints. I prefer honesty. However, for those who prefer this fatherly treatment that is mixed with huge financial interests, I’m advocating that they continue to get what they want.

Now, once third party payers began to provide coverage for mental health services, their administrative forms didn’t have to be changed. There was already a precedent for placing in the “diagnosis” box on the form fake diagnoses, and psychiatrists seeing that this business model was a source of a great deal of money created the DSM.

What would be a Reasonable Alternative to the DSM?

For those who prefer to be treated honestly, can an alternative to the DSM be developed?

The alternative I’ve been working on is called The Classification and Statistical Manual of Mental Health Concerns, or, for short, the CSM. With this approach, no individuals would be classified, only their expressed concerns.

With the CSM proposal, all that we would be asking insurance companies to do differently in order to add value to their customers, is to slightly change that little box that currently requires a diagnosis or a word pretending to be a diagnosis. Instead of just saying “Diagnosis” as it currently says, that box would just add two little words, so it would end up saying “Diagnosis or Concern.” Then, when mental health professionals fill in the box, they would be given the choice to either write in the letters DSM and its code number that corresponds to its so- called diagnosis, or they would write the letters CSM and its code number that corresponds to the expressed concern.

The cost and efforts for insurance companies would be minimal, and we would have numerous testimonials from customers that documents that this change would be viewed as a significant improvement.

Now, some of the insurance company executives might pause and say, “Wait a minute. You’re asking us to permit the use of the CSM as an alternative to the DSM. Just wait a minute. The DSM has been developed by mental health experts and is backed by a major mental health professional organization—the American Psychiatric Association. Does the CSM have that type of authority to back it up?”

If we prepared for this, we will be able to answer that the CSM was also developed by mental health experts and does have several mental health professional organizations backing up its use as an alternative to the DSM. I believe this can be achieved. We have in our alternatives group several people who would qualify as mental health experts, and I think we can get some more involved as well. And when the latest edition of the DSM was released several professional organizations expressed a strong desire that an alternative to the DSM be developed. I think it’s reasonable to assume that at least some of them would agree to back this alternative, especially if we involve them in its development.

In short, the creation of the CSM would permit us to present to insurance company executives and other third party payer administrators a real alternative to the DSM. It would be virtually cost free for them to permit its use, it would have the authority of being developed by experts in the mental health field, the backing of mental health professional organizations, and it adds value for a significant number of their customers.

The CSM Would also Help Mental Health Service Providers

Now, besides the insurance companies and other third party payers, the other big group of people in America that is currently using the DSM is mental health services providers. How would they react to being given the choice to replace the DSM code with the CSM code on third party payer forms when they felt in their professional judgment that it was appropriate? Well, we get a little sense of what their reaction would be from a survey Paula Caplan tells us about in her book, They Say You’re Crazy. According to this survey, over 70 percent of those practitioners who responded to the survey said that the only way they use the DSM is to fill out the insurance form. Other than that, it doesn’t help them at all.

To those who believe that the use of the current DSM terminology helps to enhance the placebo effect of treatment, keep in mind that this is a testable theory. We can arrange for studies that compare the outcomes of service providers that utilize the DSM coding system with service providers that employ the CSM coding system. But that would be an approach that employs basic principles of science, rather than unsupported claims backed by enormous financial interests.

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Tags disrespectful, DSM, insults, insurance companies, mental disorders, mental health, mental health services, mental illness, name calling, psychiatric disorders, psychiatry

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Internet Meanies

One day I happened to be flipping through the New York Times when I came upon a story titled Dealing With Digital Cruelty by Stephenie Rosenbloom. It had been a year since I had written a post about a particularly sad incident of internet cruelty. Back then, 12-year-old Rebecca Sedwick had leaped to her death after being cyberbullied by a coterie of 15 middle-school children who urged her to kill herself. Upon reading the Times story, I decided to revisit this issue.

The Times article begins, “Anyone who has ever been online has witnessed, or been virtually walloped by, a mean comment.”

Because communication on the internet can provide anonymity and invisibility it can lead many to feel uninhibited. If someone is sitting right in front of you, there is a chance that a mean comment could lead to the insulter ending up with a fat lip or witnessing streams of tears running down a sweet face. Not so when all you see is some letters.

The Times article offers us some advice. “One way to become proactive is to ask yourself if those barbs you can’t seem to shrug off have an element of truth.” An example is provided by a writer, Mr. Pozen, who became particularly upset upon reading that his book was too “U.S.-centric.” Mr. Pozen considered that idea — and decided that the reader, despite not having put it particularly nicely, might be right. “So I thought, ‘Well, if I ever write another version of this book I ought to take that into account,’ ” he said.

While I was doing some research on this topic, I came upon another good example of this:

The writer, Gina Trapani, tells us how she would handle the following type of internet comment,

“Hey asshat, way to waste my time with a stupid article that has no original information in it whatsoever. I wish you and your web site would drop dead, dry up and blow away.”…Once I got over the name-calling and the death wish, I might ask myself: Was this article unoriginal? Could it have been more in-depth or relevant? If nothing else make a mental note of the core problem minus the meanness, learn from it and move on. Put your critics to good use instead of letting them make you feel bad.

It’s not always possible, of course, to learn something from a nasty comment. Some are baseless; some are crass.

Illustration by Credit Kristian Hammerstad — Illustration by
Kristian Hammerstad

The Times article tells us that it helps to keep in mind that some people think of their online life as a kind of game with rules and norms that don’t apply to everyday living, a game for which they do not feel responsible. If bloggers and people who use social networks keep this concept in mind, he said, they will see the psychology of aggressors, and their comments may be easier to take — and possibly ignore.

Moreover,

Harsh comments can also be made to feel less potent by directly disputing to yourself what was said. If, for example, someone writes, “You’re an idiot and no one likes you,” you can marshal evidence against it by reminding yourself, Stuart Smalley-style, of the obvious: You have an education, a job, more friends than you have time to see in a week.

Speaking of time, be mindful of when you choose to glance at your blog or social media feeds. Researchers have discovered that feeling blue or even being in a so-called neutral mood makes people more vulnerable to nasty comments. In other words: Stay off Twitter if you just bombed a presentation.

These are just a few of the thoughtful advice the article provides. If you find yourself troubled by this type of experience, I highly recommend that you give it a thorough read.

Have a great week!

Jeff

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Tags anger, bullies, bullying, conflict management, disrespectful, insults, internet, negative criticism, New York Times, types of criticism

army child discipline confiict management conflict management conflict resolution fairness free social intelligence and emotional intelligence curriculum interpersonal conflicts military discipline psychological maturity relationships respect threats

Providing Criticism with Shouting, Insults and Threats: Is There a Place for It?

Post author By Dr. Jeffrey Rubin
Post date June 13, 2014
7 Comments on Providing Criticism with Shouting, Insults and Threats: Is There a Place for It?

“Left turn!” hollers the drill sergeant to his new recruits.

Private Smith begins to turn right, but catches his mistake as he notices the other recruits turning in the correct manner. He manages, although a bit clumsily, to end up turning left.

“Boy, don’t you know your left from your right?” the drill sergeant shouts in Private Smith’s face.

“Yes, Drill Sergeant.”

“I’m so glad to hear that, boy!” shouts the drill sergeant. “Now listen-up you stupid maggot! If I order you to turn left, you turn left! Do you got that, boy?!”

Yes, Drill Sergeant.”

“If I catch you turning right again when I order you to turn left I’m going to have you scrubbing the latrine with a toothbrush for a week. Do you got that, boy?!”

“Yes, Drill Sergeant!”

In the above scenario, we see an example of a sergeant providing criticism, and as he does so, he shouts, insults and threatens Private Smith. The army leadership believes that for this type of situation this style of providing negative criticism is helpful.

How does the army’s views on providing negative criticism compare to mine?

Providing Negative Criticism: Comparing My Approach with that of the Army’s

Regular readers of this blog know that I have presented a post titled, “Providing Negative Criticism: Five Levels of Maturity.” If you check that post out, you will see that the sergeant’s style appears to most closely match the level 3 description, which is as follows:

3. The criticizer clearly states the criticism with enough detail so the criticized person, if he or she wills, can improve the behavior, idea, or appearance, but couples it with glares, insults, shouts, or threats that are not about bodily harm.

Here’s an example of a style of providing negative criticism that matches level 3:

A level 4 style of providing criticism, that is, one level more mature than level 3, is described as:

4. The criticizer states the criticism without bodily attacks, damaging property, glares, insults, threats, or shouts, and with enough details so that the criticized person, if he or she wills, can improve the behavior, idea, or appearance. If the person receiving the criticism becomes defensive or angry, the criticizer empathizes without returning glares, insults, threats, or shouts.

Here’s an example of a level 4 style of providing negative criticism:

You are not likely to see anything that looks like a level 4 style of providing negative criticism coming out of a drill sergeant’s mouth during a training situation if he or she is speaking to a private.

And so, it looks like my level 5 model for providing negative criticism runs counter to the army’s view, at least in some situations. But before we conclude this, let’s first take a quick look at how a level 5 style is described:

5. When the criticizer provides criticism, he or she does so in a manner very similar to a level four response, but beforehand, the criticizer considers the person who is the target of the criticism, and the situation that he or she is in. As a result of such considerations, the criticizer may decide to alter the criticism.

As we can see, people who provide criticism in a manner consistent with level 5 are apt to do so in a manner that is very similar to the level 4 description. However, before they actually provide the criticism, they consider the person who is the target of the criticism, and the situation that he or she is in.

In this regard, I think it’s worthwhile to point out that as tough as sergeants may be on privates, they act very differently when speaking to someone who has a higher military rank, such as a lieutenant or general.

That is, sergeants first consider who they are speaking to before deciding on how they will provide negative criticism. This is one of the hallmarks of a person who tends to provide negative criticism in a manner that is consistent with level 5.

The Army’s Reasons for Supporting the Drill Sergeant’s Style of Providing Negative Criticism

The army’s leadership believes that those who hold a higher military rank are better qualified to make tough military decisions than those who hold a lower rank. They based this belief on their process for selecting who is invited to get training for a higher rank, the quality of the training that is provided, and the fact that only those who successfully complete the training are promoted. Those who do not perform well after they are promoted are demoted.

In a number of military situations, quick decisions are necessary to achieve military objectives while minimizing the number of casualties. If platoon leaders see enemy troops rapidly advancing, with their guns blasting and bombs going off, there simply is not a lot of time to discuss how to respond. Those with the most training for dealing with this situation rapidly cry out orders and those with a lower rank rapidly obey.

Now, with all of the gun firing and bombs going off, military leaders are probably going to shout out their orders to be heard. If some of the privates suddenly feel offended because their leader has yelled at them in a tone of voice that strikes them as unfair criticism, without proper training perhaps they might start yelling back, “How dare you talk that way to me!” Perhaps they might even physically attack the leader for the perceived insult. Such actions would seriously delay the carrying out of orders and thereby risk the military objectives and the lives of the soldiers.

During battles, there are times when even the best trained personnel may become irritable. Perhaps a captain might have lost a soldier she was very close to. If the captain, in her irritable state, was to slip up and accidentally speak to someone who is at a lower rank with a tone of voice that seems a bit disrespectful, would valuable time be lost because of an argument over the perceived insult? To avoid wasting time on these types of arguments, the army leaders have come to support training soldiers to respond immediately to orders even if it comes with criticism that might not be viewed as ideal in more typical situations. I think their position is reasonable.

Applying a Drill Sergeant’s Style of Negative Criticism to Situations Beyond the Military

Many people who have been in the army, having experienced basic training, come to believe that what worked well in the army should work just as well in all other situations. And so they begin to provide negative criticism in a style that matches that of a drill sergeant.

Some parents try this with their kids, and when the kids are young it often seems to work. But too often the drill sergeant approach leads to a building up of bitter resentment. Some teenagers end up running away from home, while others essentially end their relationships with their parents as soon as they are old enough to live on their own.

I know someone who was given the job to coach a women’s college basketball team. He had in the past, coached a boys college team and found the drill sergeant approach had worked, in his estimation, fairly well. Occasionally a good player would quit the team, but he felt that this was just the cost of maintaining good discipline. But when he tried the same technique with the women’s team, more than half quit. In order to field any team at all, he had to go to the women who had quit and apologize. In the end, he found that there were alternative ways to provide negative criticism in his new situation that worked much better for him. The incident reminds me of a great scene in the movie, “A League of Their Own.”

In the army, if someone thinks about quitting, there are very serious consequences. The army can put the quitter in prison for a time, give him or her a dishonorable discharge, etc. Moreover, there are a number of positives for hanging in there even under the most trying of circumstances. There is the honor that comes from helping your country, a military salary, VA benefits, etc. When we raise children or coach a team, the consequences for quitting or staying in the relationship are very different.

And so, for those who think it makes a great deal of sense to use a drill sergeant’s approach for providing negative criticism in non-military situations, I urge caution. People have strong desires to be liked and to escape from situations in which someone seeks to interfere with their freedom to make their own decisions. A drill sergeant’s approach runs counter to these desires. It is only in rare situations where rapid action is required, the available leadership is well trained, and other desires are so strong that shouting, insults and threats may make sense.

Tags conflict management, conflict resolution, criticism, dispute management, disrespectful, drill sergeant, drill sergeants, insults, name calling, negative criticism, respect, threats, wisdom