Tag: insults

Suicide, Perfectionism, and Criticism

Post author By Dr. Jeffrey Rubin
Post date October 20, 2014
7 Comments on Suicide, Perfectionism, and Criticism

Sometimes I’m asked why I write so much about dealing with criticism. The answer mostly has to do with the types of concerns that have been expressed to me over the years. Some involve the desire to be liked and respected. Others have to do with seeking to gain control over anger. And still others come from parents who find that how they go about disciplining their children has been a serious source of stress in their lives. Providing and responding to criticism in a pleasant, thoughtful manner involves skills that can be learned fairly quickly, and are clearly helpful when addressing these types of concerns.

Additionally, conflicts that bring forth negative criticism, if handled in an immature manner, can escalate and result in a destructive relationship between parent and child, the parting of a relationship between two valued friends, the loss of a job, serious injury, and prison time. And then there is the relationship between certain ways that people handle criticism and suicide.

In an earlier post, titled “Teenage Suicide and Cyberbullying: A Case Study,” I wrote about 12-year-old Rebecca Sedwick who had leaped to her death after more than a year of being incessantly criticized by a coterie of 15 middle-school children. Today, once again I take up the subject of the relationship between criticism and suicide because of an article I just read in this September’s Review of General Psychology by Gordon L. Flett, Paul L. Hewitt, and Marnin J Heisel titled, “The Destructiveness of Perfectionism Revisited: Implications for the Assessment of Suicide Risk and the Prevention of Suicide.” It’s written for research-minded people and has far more nuanced information than I can share in a single blog post designed for the general reader. Nevertheless, I’m going to summarize a few of its key points for I think they are very much worth considering as we move forward in our quest to become masters at dealing with name calling, insults and teasing.

Suicide and Criticism

The media is filled with stories about the Ebola virus, which has so far killed close to 4,000 people worldwide, and one person in North America. In contrast, it is estimated that over one million people worldwide, including 40,000 people in North America, kill themselves on an annual basis. Recent U.S. data indicate that suicide is the second leading cause of death among people who are under 40 years of age. For every person who commits suicide, several more attempt it, resulting in anguish for family and friends, and financial costs from emergency room and aftercare services that are estimated to be several billion dollars.

Of course, there are a number of reasons why people kill themselves, but the article I just read makes the following argument:

Chronic exposure to situations and contexts that place excessive pressure (or percieved pressure) on the individual to be perfect can have a destructive effect on most individuals and this is heightened among those people who are vulnerable and hypersensitive to criticism and social comparison feedback. Consider, for instance, the vulnerable perfectionist exposed regularly to a hypercritical parent, (boss/supervisor) or romantic partner who is ever-present and seemingly impossible to please. Alternatively, the vulnerable perfectionist may have a work environment where mistakes are simply not allowed and excessive standards are required by a tyrannical boss.

Now, I hasten to point out that most parents, bosses and supervisors who encourage quality performance don’t cause anyone to commit suicide. Moreover, the vast majority of people who may view themselves as perfectionists, even those who see themselves as particularly sensitive to criticism, don’t end up killing themselves. Nevertheless, the consistent evidence from studies that link suicide behavior with chronic exposure to external pressure to be perfect and the relationship between perfectionistic characteristics and an increased risk of lethal suicide behavior leads one to pause. Perhaps there may be some ways to encourage quality performance without increasing suicide risks.

Ideas about Prevention

Many people who view themselves as perfectionists tend to remain silent about any despair that they may experience. And those who demand that their children or workers be perfect don’t see anything wrong with this. So these people are unlikely to show up and ask to learn some skills to improve their behavior. Prevention programs, therefore, must be designed proactively and implemented broadly to reach these people. Schools, colleges and business organizations, if they are to impact people at risk, must provide education about these issues to their entire population. Thus, Flett and his colleagues recommend the following key themes be incorporated into school-based programs:

(a) fostering self-acceptance and compassion instead of experiencing shame and self-criticism; (b) promoting appropriate goal-setting and goal appraisal versus setting and maintaining impossible standards; (c) combating ambivalence about giving up the need to be perfect since the distressed perfectionist must be highly motivated to change; and (d) developing resilience to feelings of shame and ability to cope with interpersonal conflict and feelings of being rejected by others.

For the work environment, Flett and his colleagues state:

Prevention efforts should include an organizational focus on reducing pressures to be perfect. When perfectionism prevails as part of the culture and values of the workplace, it tends to promote poorer performance rather than superior performance (Gillett & Stenfert-Kroese, 2003) and it is linked with job dissatisfaction, poorer communication quality, role conflict, reduced likelihood of staying, and a poorer perceived fit between the person and the work environment (Balthazard, Cooke, & Potter, 2006; Rousseau, 1990).

Although, as a general statement, these ideas are worthwhile to think about, a far more detailed process is necessary to foster the goals of these researchers. For those who can afford counseling services designed to teach self compassion, along with addressing each individual’s concerns, I recommend working with either of the two counselors described HERE. For those who can’t access counseling services because of the financial costs, although not as ideal as direct one to one counseling, there is available for free a curriculum that teaches the necessary skills at this blog site (see below).

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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 Assessment of Suicide Risk, conflict management, conflict resolution, criticism, free social intelligence and emotional intelligence curriculum, Gordon L. Flett, insults, negative criticism, perfectionism, relationship, suicide, violence

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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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Name Calling by Psychiatrists: Is it Time to Put a Stop to it?

Post author By Dr. Jeffrey Rubin
Post date September 8, 2014
55 Comments on Name Calling by Psychiatrists: Is it Time to Put a Stop to it?

On one fine spring day, I was sitting on a Central Park bench and two women were sitting one bench just to my right reading their newspapers. Suddenly, one of them cried out, “Sophie, can you believe this! The story I’m reading here, oh my God! This young boy, seventeen years old mind you, the same age as my Jonathan, he’s struggling with ideas about suicide. Seventeen years old, his whole life before him and he wants to kill himself. What would lead a boy to this?”

“Such a young boy, Bessie?”

“Yes. My God.”

“He must have some type of mental illness.”

“Oh, you’re right, Sophie. I just glanced at the next paragraph, and a psychiatrist explains that the boy has a mental illness called major depressive disorder.”

With that explanation, the two women nodded to one another, and continued on to another story, seemingly satisfied that they now knew why the boy was dealing with this issue.

This notion that when a psychiatrist says someone has a mental illness, or some type of mental illness, that this offers a valid explanation for why the person is struggling with personal difficulties is, as far as I’m concerned, a bunch of nonsense. Just before the incident in the park, I had seen a performance of Shakespeare’s Hamlet, which tells the story of a boy about the same age as the one in the story Bessie was reading and is also struggling with feelings of committing suicide. As Shakespeare’s story unfolds, the audience is presented with a character that has motivations, conflicts, frustrations, disturbing situations and emotions. In the end, I left with some insights into why a character such as Hamlet might struggle with feelings of suicide.

In my opinion, even a play, which lasts but two or three hours, can only provide in its narrative a simplified account of what real life stories are all about. And yet, in today’s world, for many people a very different type of play is sufficient for providing the reason why someone is dealing with a challenging concern. This new type of play begins with the curtain rising. A character says to the audience he is struggling with feelings of suicide. A psychiatrist then proclaims the character has the mental disorder known as major depressive disorder, and then the curtain comes down. That’s the whole play. And people walk away fully satisfied that an adequate explanation has been provided.

When psychiatrists start calling people names, they get them from a book called The Diagnostic and Statistical Manual of Mental Disorders (DSM). They claim that they are not just calling people names, but, instead, they are making a diagnosis. Diagnosis, as it is defined in Wikipedia, “is the identification of the nature and cause of anything” (http://en.wikipedia.org/wiki/Diagnosis).

It would be reasonable to assume, therefore, that the DSM would assist in identifying the nature and causes of the types of personal concerns that come to be called mental disorder. But the DSM uses a descriptive approach that attempts to be neutral with respect to theories of the nature and cause of the various “disorders” that it describes. Therefore, referring to the DSM as a “diagnostic” manual is contrary to reason.

My Personal Understanding of the Nature of Diagnosis

When I was fifteen years old, I was tackled hard in a football game. After the pile of tacklers got off of me, I found that when I tried to put any weight on my left leg I felt excruciating pain. Shortly after this unwelcome discovery, I arrived at the Coney Island Hospital. A doctor asked a few questions and decided to take an x-ray of my left leg. Minutes later, he showed me the x-ray, and pointed to where a bone in my leg was broken. His “diagnosis” was that my left leg had a fractured fibula.

Now, what if the doctor did not take an x-ray, but instead just said to me after he asked me a few questions, “Your problem is that you have ‘Major Inability to Stand Disorder.’” Making such a statement, as far as I am concerned, is quite different from what the doctor did when he took an x-ray, looked it over, and declared that my left leg had a fractured fibula. To refer to both types of statements as examples of the same thing—that is, a diagnosis—makes it more difficult to see this difference.

Consider, if you will, another situation. A few years ago I had trouble starting my Ford Pinto. I brought the car in and the mechanic provided me a theory that perhaps I needed a new starter. This, it seemed to me, was his initial theoretical diagnosis. He then inspected the starter and found that it was in fine shape. Thus, his original theory of what was wrong proved incorrect. He then theorized that my spark plugs were dirty. He took a look and found that they were indeed dirty. He cleaned them up, put them back in their proper place, and the car started right up. In the end, as far as I was concerned, he “diagnosed” what was wrong with my car as having dirty spark plugs. If the mechanic had instead just asked me a few questions, and then told me that the problem with my car was that it had “Major Non-starting Disorder,” then this to me is something very different than “diagnosing” my car’s problem.

The DSM, by claiming it is a manual for making diagnoses, masks the difference between the following two statements:

1. “You have a fractured fibula.”
2. “You have ‘Major Inability to Stand Disorder.’”

Similarly, the DSM, by claiming it is a manual for making diagnoses, masks the difference between making the following two statements:

1. “My theory for why your car is not starting is it has dirty spark plugs.”
2. “Your car is not starting because it has ‘Major Non-starting Disorder.’”

In both of these examples, the number “1” statements offer some theory for understanding the cause for what we believe has gone wrong. The number “2” statements just restate the expressed concern about something we believe has gone wrong in some technical terminology. The DSM actually is just a classification system for expressed mental health concerns, and it would be far more accurate if it honestly said so.

Classification

A major reason why scientists classify is to speed up the process of obtaining useful information. The classification, when useful, is a labor-saving contrivance. Let’s look at an example that makes this vividly clear.

Biology Example

Suppose a biologist named Steve comes upon a whale for the first time. He has never seen such a creature before. He wants to learn more about it. He observes that it is a vertebrate, gives live birth to its offspring, and uses mammary glands to feed its offspring. Once this is observed, Steve can see if other biologists have collected any information on this creature by looking in a book that uses a certain classification system. By looking in the book under mammals, which has a pretty clear definition, he can save an enormous amount of time because he will not have to bother looking at all the insects, birds, and reptiles. This saves him from needlessly examining millions of specific listings—a clear time saver.

I hypothesize that there would be no significant difference between the so-called diagnosis system called the DSM and a classification system that simply classifies expressed personal concerns in retrieving valued scientific information. In an article that I published in The Journal of Humanistic Psychology, I fully explain this concern alternative (see HERE).

Briefly, with the concern approach individuals would not be classified, only their expressed concern. If I want to find out about any scientific studies that looked at different ways that addressed concerns about depression, in Google Scholar I can now simply put in the search engine— “depression, treatments.” Without adding the words “major” and “disorder” in the search engine, I can currently get numerous relevant hits. If the new concern classification system was adopted, soon the term “addressing concerns” would be receiving the same number of relevant hits that I now get by using the search term “treatment.” Thus, this scientific requirement would be amply fulfilled without using the search terms of “major depressive disorder” and “treatment.”

The DSM and the concern classification system would both serve a valuable scientific function—the retrieving of relevant scientific information in a time- saving manner. The accepted term for such a system in science is “classification,” not “diagnosis.” If “diagnosis” was clearly recognized as a perfect synonym for “classification” then it wouldn’t matter which term was used. But “diagnosis” indicates that something more than classification is being provided in the DSM, whereas the concern classification system would make no such claim. The concern system would not seek to present itself as something that it can’t back up as accurate. And it avoids the negative name calling of people that so many find offensive and stigmatizing.

Another Problem with Psychiatric Name Calling

Furthermore, when psychiatrists provide a so-called “diagnosis” of a mental disorder it indicates that there is something wrong with the person. This masks an alternative possibility. It is very possible that the experiences typically being diagnosed as mental disorders are more aptly construed as tools. That is, a hammer can be used to drive in nails in the construction of a life-preserving shelter or to bludgeon an innocent person to death. A car can be used to rush a child to an emergency room so that life-preserving treatment can be administered, or it can be used to tragically end a prom night. Similarly, there are numerous people who have had the experiences that are said to be diagnosed in the DSM as a mental disorder, who report that the experience ended up helping them to achieve enormous benefits; whereas, others became ambivalent, and others agree that they proved to be all bad. It may be very true that it is up to each one of us to find the wisdom to use these tools for good.

The percentage of people who report that the experiences now referred to in the DSM as mental disorders turned out to be good, bad or mixed is a question for science. Mental health practitioners when using the DSM participate in proclaiming that all of these experiences are all bad, thus masking these vitally important variations of experiences.

A scientific classification system is better when it helps us to see things of interest more clearly, rather than to mask them. The classification system of mental health concerns would serve to break us out of the DSM cloister of words and reopen us to the source of our experience.

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Tags criticism, DSM, insults, major depressive disorder, mental disorder, mental health concerns, mental illness, name calling, personal concerns, psychiatry, The Diagnostic and Statistical Manual of Mental Disorders

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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

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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.

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

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Fear, Cowardliness, and the Military

Post author By Dr. Jeffrey Rubin
Post date June 4, 2014
2 Comments on Fear, Cowardliness, and the Military

Last week my blog post asked, “Does Your Fearfulness Make You a Coward?” While attempting to answer this question, I pointed out that viewing yourself as a coward when you experience fear consumes time and energy. Moreover, it is way too simplistic. Fear is actually a highly valuable emotion. It motivates us to take some wise precautions. And the fact that some people can fearlessly perform a task that would make you quake actually indicates, when properly considered, that diversity in what people fear is helpful for the survival of our species. When it comes to fear, we are wiser to seek to learn to skillfully utilize it, rather than to seek to insult ourselves.

Within three days of my writing that post on fear, NBC Nightly News presented a video of Secretary of State John Kerry calling Edward Snowden, the NSA document leaker, a coward. I found this rather ironic because John Kerry, as a younger man, demonstrated against the Vietnam War. Such demonstrators were repeatedly called cowards by those who supported our military’s war efforts. And so I guess that makes both John Kerry and Edward Snowden cowards, at least in the eyes of some people who choose to use this name calling strategy when they believe it suits them.

John Kerry Protesting Against the Vietnam War

What’s up with this Name Calling?

When we call someone a coward, we are not making a scientifically objective distinction as we do when, for example, we call a snake a reptile rather than an insect. People use the word “coward” as a strategic move to actually increase fear in the hopes of achieving their personal desires. I know that this can seem counterintuitive at first, but with a little thought, this becomes simple to understand.

Many people are afraid to put themselves in a position in which others are publically calling them cowards. Thus, Sec. Kerry, by calling Mr. Snowden a coward on national television, sought to discourage others with access to secret government information from revealing what they know for fear that they, too, would be branded a coward. And those who called Sec. Kerry a coward when he was a younger man protesting against the Vietnam War sought to discourage others from doing likewise lest they, too, would be subjected to such name calling.

When we think of the military we often think about how it honors certain individuals who act fearlessly in the face of danger. Typically this is done in a ceremony during which medals are handed out and an inspiring speech is presented. It stirs our hearts to participate in these events.

Although we may think that courage and bravery is the driving force of the military, far more often utilized are strategies designed to actually increase fear. It is worth taking a good hard look at these strategies because when people become more aware of this, their simplistic kneejerk reaction of construing any fearfulness that they personally experience as a sign of their cowardliness can be dispelled. A more realistic understanding of these experiences can then take its place, thus aiding people to make better informed choices as they seek to achieve their most treasured desires.

The Military’s Use of Fear

When Japan attacked Pearl Harbor, it was the fear that our country would be conquered by another country that led men to enlist in the various branches of the military in record numbers. But even when our country is not actually attacked, those who seek military intervention artfully manipulate fear to achieve their ends.

Those of us who lived through the period during which the Vietnam War mounted, recall how our fear was heightened by repeated references to the “Domino Theory.” This theory claimed that if one country in a region came under the influence of communism, then the surrounding countries would follow in a domino effect. Thus, fear was aroused that if South Vietnam was to fall to the communists, other countries in the region would soon follow. And then these countries would enter into a vast policy of conquest. The Philippines, the Hawaiian Islands, and the whole of our coast west of the Sierra Passes would be swamped by the invaders in rapid succession. If we fail to act decisively in Vietnam, the rest of America would, in but a few short years, be enslaved by the conquerors, our women raped, and our children brainwashed.

A dismal forecast indeed! And yet, just plausible enough to rile up enough Americans to wage a terribly costly war.

In the end, the U.S abandoned its effort to keep South Vietnam from falling to the communists. And yet none of the fearful projections about our own country being swamped by foreign invaders came to pass. Among the effects of the fear campaign were approximately 58,000 US combat deaths and a million Vietnam combat deaths. Several million others were seriously wounded and according to Vietnam’s government, the U.S. herbicidal warfare program, Operation Ranch Hand, conducted during the Vietnam War, led to 400,000 people killed or maimed as a result of after effects, and 500,000 children born with birth defects. To this day, our own country continues to provide treatment to thousands of American veterans who were wounded in Vietnam battles or have been suffering from the effects of exposure to Agent Orange.

More recently, as a result of the military’s leadership that drummed up fear of “weapons of mass destruction” in Iraq, we fought a war costing billions of dollars, the lives of 4,486 U.S. soldiers, and approximately 100,000 Iraqis. Many more are still suffering from serious injuries.

Once people begin to serve in the military, fear is a dominant driver of carrying out one’s duties. Military personnel quickly become aware that insubordination can lead to prison time and various forms of name calling, including being branded a coward. Fear is further heightened by knowledge of the possibility of being disgraced with a dishonorable discharge, or shot for desertion. If soldiers don’t carry out their duties under fire, this can increase the likelihood of the enemy either killing them along with their fellow service personnel or to being captured and subjected to possible torture. All of these fears are strategically heightened by the military so that these fears, when combined, will be greater than the competing fear that comes from the sounds of bombs going off, bullets flying overhead and knowing that severe injury or death may come at any moment.

Now, of course the military doesn’t just rely on fear to achieve its ends. It provides training, initially under relatively easy conditions, and then under more and more arduous ones, eventually requiring trainees to perform with live bullets flying overhead. This increases the military personnel’s confidence that they can indeed perform under highly stressful conditions. Stories are told of simple soldiers who achieved great acts of bravery. Military personnel are provided with leaders who have distinguished themselves as individuals of great intelligence and character. And there are rewards for carrying out one’s duties—a salary, cheers from one’s comrades, an honorable discharge, veteran’s benefits, etc. Nevertheless, the idea that there is no place for fear in the military is a bunch of hogwash.

Conclusion

Bob, experiencing fear as he prepares to perform with his band in front of a large audience, initially observes his thoughts going off into a chain of insults. “I’m such a coward. Why can’t I be like a brave soldier, never experiencing any fear even in the face of bullets raining down from the enemy?”

But then it dawns on Bob that soldiers actually do experience fear. With this knowledge, he decides to let his thoughts continue for a few more minutes, but he simply nonjudgmentally observes them passing by without attaching any belief in them. Soon, they pass. He gets on with the work before him. He spends some time practicing his performance. He recalls some stories he heard about other performers who experienced fear before shows and yet managed to thrill their audiences. And, from time to time, he reminds himself that if it turns out that the life of a musician ends up not suiting him, there are other paths he can take to create a worthwhile life.

Tags armed services, conflict management, conflict resolution, cowardliness, criticism, dispute management, disrespectful, Edward Snowden, free social intelligence and emotional intelligence curriculum, insults, John Kerry, military, name calling, Secretary of State John Kerry, Vietnam War, wisdom

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Does Your Fearfulness Make You a Coward?

Post author By Dr. Jeffrey Rubin
Post date May 28, 2014
1 Comment on Does Your Fearfulness Make You a Coward?

As far back as I can remember, the first time I called myself a coward was when I was in fourth grade. The teacher gave the class an assignment requiring each student to get up in front of the class and give a speech about a book we had read. We were allowed to use some cue cards but were not permitted to read the speech word for word.

At home, when I thought about that assignment becoming due in a week, my heart pounded and I thought that I’d end up looking stupid. Then I thought to myself, I’m such a coward. I called myself a chicken for being scared and a number of other names as well. At the same time, I began to do some other things. I chose a book that I would report on, wrote out what I would say, and rehearsed in front of a mirror. In the end, my little speech turned out just fine.

Did viewing myself as a coward, and calling myself names help me in any way to get through this ordeal? It is indeed true that it was part of the process that led to a good outcome, and partly because of this, it became associated with what I needed to do to achieve success in other fearful situations–kind of like a superstition. But, in time, I learned to deepen my understanding of the nature of fear, and I no longer bother with framing myself as a coward or deliberately calling myself insulting names. Oh, from time to time, some of the old words still spring up in my mind during fearful moments, but I simply observe them passing by in a nonjudgmental manner, and they fade away in a few seconds.

What did I learn that led me to this understanding? Well, to get at this, I think a little parable might help.

The Parable of Mother Nature’s New Creation

Once upon a time, Mother Nature came up with a new creation—human beings. At first there were just a few of them.

In winter, the nearby lake iced up. To keep the food supply flowing, some bravely walked out on the lake and created ice fishing. Others refused to go out on the ice explaining that they were fearful the ice would break and they would end up all drowning in the frigid water.

Although the ice fishers were brave when it came to walking on the ice, some were fearful when it came to dealing with other situations. For example, some fishers refused to farm because they were fearful of the bugs and slimy creatures that were uncovered during the turning of the soil.

Barty, one of these early humans, was way too fearful to go on the ice to fish, so he tried to help out his little community by farming. The insects and slimy creatures scared him, so after about an hour, he left the field and returned to his little hut a bit shaken by what he had experienced.

Seeing her son looking fearful, Barty’s mother told him a story filled with rich images of how thankful the other humans were when the farmers showed up in the evening with wonderful fruits and vegetables. With those inspiring images, Barty went out a little longer the next day, and a little longer the next, and soon he got so used to the bugs and slimy creatures that they no longer scared him.

Some of these human beings who were fearful of either ice-fishing or farming tried to come up with other ways to be helpful. A few worked on coming up with techniques to preserve food that were grown in summer so that it would remain edible during winter. In time they created several approaches that allowed for a more varied winter food supply.

Then one day something terrible happened on the ice. It cracked and all of the fishers drowned in the freezing water. Some who were afraid to go out on the ice watched in horror. Barty, when he heard what happened, began to tremble. And then he thought to himself, it’s a good thing some of us were afraid to ice-fish or we would have all perished.

Parable Discussion

As it turned out in this parable, it was a good thing for this new creation of Mother Nature that some of the human beings were fearful of the ice. Otherwise all of the human beings would have died in this one horrible event. Because there were those who were fearful of the ice, this human characteristic was essential for keeping this new creation of Mother Nature thriving until this very day. Having some diversity in what people fear need not be a sign of cowardliness but helpful for survival.

In my view, when we experience fear, we are wise to spend some time embracing this feeling and deeply experiencing its physical sensations in a nonjudgmental manner. Then, some of the skills I discussed in my last two posts for transforming our fear into actions that lead to achieving our desires are employed (see posts titled Free of Fear and Overcoming Fear). These types of experiences are an essential part of who we are and lead us on to our most treasured accomplishments.

Tags conflict, conflict management, conflict resolution, cowardly, cowards, criticism, dispute management, fear, free social intelligence and emotional intelligence curriculum, human beings, insults, Mother Nature, name calling, negative criticism, respect, wisdom

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On Responding to the N-word

Post author By Dr. Jeffrey Rubin
Post date April 7, 2014
No Comments on On Responding to the N-word

Leonard Pitts, Jr. is a columnist, author of three novels and winner of numerous awards including the 2004 Pulitzer Prize for commentary. When I heard that he was speaking at Flagler College, having enjoyed reading his insightful column for many years, I eagerly went to see him.

Mr. Pitts’s formal presentation was well received. Then, he began to take questions from the audience. His responses to each were like a laser in that his answers were precisely on point–that is, until I asked my question.

My Question

When I first stepped up to the mike, I explained that I had worked with teenagers for many years, and sometimes a white student would seek to insult a black student by calling him the N-word.

Often the response was a physical fight that would lead to a school suspension.

Before returning to school, in some cases both students were asked to meet with me. I saw each separately at first and usually I’d discuss Martin Luther King, Jr. For the black students, at some point in our discussion I would ask, “Do you understand that Martin Luther King, Jr. was all about non-violence when dealing with injustice?”

“Sure, I know that, man!” was a common reply.

Then I would say something like, “When you were called the N-word, you started to physically attack the guy who called you that. That’s a violent approach to the injustice you had faced. If it happens again, can you think of some other way to deal with this, some way that would respect Martin Luther King, Jr.’s memory?”

I would then typically get the following type reply: “If Martin Luther King, Jr. lived in my neighborhood, he’d have realized that if anyone called him that, the only way to respond is to bloody the guy up good!”

Having had experiences like this, I asked Mr. Pitts, “As a respected black man, how would you respond to someone who called you the N-word, and how would you advise black people to respond in the event that someone called them the N-word?”

Mr. Pitts’s Response

As I had said before, prior to my question, Mr. Pitts’s answers to questions that were being presented to him were right on point. Now, his reply wandered off to related issues, never directly answering my question.

He spoke, for example, of how he objected to hip-hop’s embrace of the word. He related it to how many women in the women’s movement have now embraced the phrase, “She’s my bitch,” as a form of flattery, despite the fact that historically it was used in an unkind manner by sexist men seeking to put down women. And he spoke eloquently about why he personally found the N-word so offensive. I didn’t write down his exact words, but it seemed to closely match the words he used in some of his earlier newspaper columns. For example, in a column published on November 30th, 2013, he wrote:

The N-word is unique. It was present at the act of mass kidnap that created “black America,” it drove the ship to get here, signed the contracts at flesh auctions on Southern ports as mother was torn from child, love from love and self from self. It had a front row center seat for the acts of blood, rape, castration, exclusion and psychological destruction by which the created people was kept down and in its place. The whole weight of our history dictates that word cannot be used except as an expression of contempt for African Americans.

Now, I do want to avoid a too simplistic presentation of Mr. Pitts’s position on the N-word. He does believe that the word can be rightly used in certain situations. For example, in a column titled, “Don’t Censor Mark Twain’s N word” he defended how it is used in The Adventures of Huckleberry Finn:

It is, perhaps, the seminal moment in American literature.

Young Huck Finn, trying to get right with God and save his soul from a forever of fire, sits there with the freshly written note in hand. “Miss Watson,” it says, “your runaway nigger Jim is down here two mile below Pikesville and Mr. Phelps has got him and he will give him up for the reward if you send.”

Huck knows it is a sin to steal and he is whipped by guilt for the role he has played in helping the slave Jim steal himself from a poor old woman who never did Huck any harm. But see, Jim has become Huck’s friend, has sacrificed for him, worried about him, laughed and sung with him, depended upon him. So what, really, is the right thing to do?

“I was a-trembling,” says Huck, “because I’d got to decide, forever, betwixt two things and I knowed it. I studied a minute, sort of holding my breath, and then says to myself:

‘All right, then, I’ll go to hell’ — and tore it up.”

Mr. Pitts wrote this column in response to a publisher who had decided to put out a new edition of this classic story that replaced all 219 occurrences of the N-word with words such as “runaway slave.” Although Mr. Pitts acknowledges the publisher means well, he states that, “…it is troubling to think the state of reading comprehension in this country has become this wretched, that we have tweeted, PlayStationed and Fox Newsed so much of our intellectual capacity away that not only can our children not divine the nuances of a masterpiece, but that we will now protect them from having to even try.”

I liked what Mr. Pitts had said in reply to my question but as I left the auditorium, I wondered why he appeared to avoid answering my question more directly. And I wondered what he would say about the approach that I have been recommending for responding to insults (see for example, “Insulting Criticism: What Can We Do About It?”).

My Alternative to Violence When Responding to the N-word

Although I have given a number of different types of examples of people responding maturely to insults in past posts, I have never described specifically what my approach would look like in the type of a situation we have been discussing today. I, of course, recognize that since I am not an African-American, I lack much legitimacy in offering my opinion on this topic. Nevertheless, just to spur a deeper discussion, very tentatively I am tossing out one alternative to violence.

In the scenario presented below, this is the first time Fred is calling Leroy the N-word. In my view, Leroy’s response would be very different if Fred has begun to repeatedly taunt him. Concerns about how to handle taunting are addressed in my post titled “The Art of Playful Teasing”.

Leroy, an African-American teenager is called the N-word by Fred, a white teenager. Leroy replies by looking firmly into the eyes of Fred and says,”You just called me a nigger. I want to make certain you clearly understand that that word was used in the past by people who believed in slavery and that African-Americans are less than human. Is that what you are trying to say to me, that you believe in slavery, and I’m less than a human being?”

“Yeah, you nigger!” Fred replies.

Leroy pauses to think about this for a moment, looking down in a sad manner. Then, looking squarely into Fred’s eyes, he says firmly, “Why are you trying to insult me, Fred?”

“Because I hate niggers!”

“Fred, I’ve met some black guys who strike me as pretty hateful characters. But from my experience, there are a lot of great black guys out there. I hope in time you’ll change your mind. Anything else you want to say to me?

“Yeah, go to hell!”

“I understand that you’re trying to insult me, Fred. I’m always interested to hear you out. I’m sorry to hear how you feel about black people.”

Well, those are some thoughts I have for you this week. I encourage readers to continue the discussion by posting comments. I know these issues bring up for many of us some very strong emotions.

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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.