Words to Live By

The Writing Life (Photo credit: Simply Bike)

I've never before worked in a place that had graffiti on the bathroom walls, but this one does. 

"How we spend our days," I read as I sit, "is, of course, how we spend our lives." Annie Dillard said it, possibly in The Writing Life. It's a beautiful wall. The woman who did it spends her days making walls beautiful, and those days add up to a life creating beautiful spaces for people to live and work in. 

We don't all have lots of choices in how we spend our days, but all of us have some choice. Choose wisely, when you can.

On Gratitude

joy! (Photo credit: atomicity)

I always feel funny talking to clients about gratitude, although I do it often. I worry that it sounds Pollyanna-ish, that flying in the face of their very real (and often truly insurmountable) difficulties, I am, in effect, advising them to whistle past the graveyard. I suspect that the only reason I'm able to do it is that I try to practice "an attitude of gratitude" myself and I know that it works. 

There are all sorts of How-To instructions out there. One of my favorites is Kathleen Adams's Pockets of Joy.  The expression comes from her childhood, when her mother would be emptying the pockets of her jeans before throwing them in the wash. There were always in them the cool things that kids collect during an adventurous day outside--pretty rocks, dead bugs and the like. And her mother would remark that she must have had another wonderful day, because she had her "pockets of joy" again. Adams advises journaling three things every day that you have in your Pockets of Joy. Sometimes when we think we've had a tough day, we can surprise ourselves, discovering that we actually had a pretty amazing one, too. And if we can hold those two views in our minds at once, we can feel better about ourselves and our days.

I've learned that there are dozens of things, often tiny ones, that we can be grateful for in any moment of a given day--or night. I may be lying awake anxious and frustrated because I'm not sleeping, worrying about the day gone by or the day to come, but I can be grateful that I have my nice warm waterbed with my nice soft sheets to lie and worry in. I can be grateful for a roof over my head, and central heating and air, and the dog at the foot of the bed and the partner by my side. And if I focus on those, then lying awake at 2 a.m. can actually become a pleasant experience.  

In a recent post on Tiny Buddha, guest blogger Alexandra Hope Flood advised listing things in your head that you are grateful for from your day as you lie in bed waiting to fall asleep every night. And in the morning, she says, while you're brushing your teeth, list ten things that you are grateful for to start your day. If you're having trouble thinking of anything, begin with having teeth to brush, and being able to stand there and brush them. From there, I might go on to being grateful for meaningful work to do, and a place to go and do it in.

I like that one, and I'm going to start prescribing it.  

The practice applies to far more serious problem states, too, than a little insomnia. Are you sick? injured? possibly even dying? Still. As Jon Kabat Zinn says in Full Catastrophe Living, "as long as you are breathing, there is more right with you than wrong with you, even if you are sick or troubled or in pain and things in your life feel dark and out of control." So start your gratitude list with the fact that you are breathing, if you can't think of anything else. And while you're at it you can send a smile, as Thich Nhat Hanh advises, to every body part that's working. This is something you can practice at any time throughout your day. Right now, for example, you can smile to your eyes that they see these letters, and to that part of your brain that comprehends the words. Smile to your eyelids that blink, to your tear ducts that moisturize, and to your lashes that keep junk out of your eyes. And then direct your attention back to your breathing. Put a half-smile on your face as you do, on the principle that "neurons that fire together wire together," to paraphrase Hebb. In this way, over time, you develop a habit of being happy.

Gratitude is one way I deploy Wood's Rule #4, and its corollary, #5. Focusing on what you can be grateful for in the moment is a mindfulness practice that is the perfect antidote to worry about what is not happening now, may never happen, in fact, and which, in any case, you can do nothing about right now. 

Now mind you, I'm not saying not to worry, period. That would be Pollyanna-ish. And it wouldn't do any good to try, because we're hard-wired for worry. I mean, think about it: The Pollyannas of the savannahs would have been eaten by sabre-toothed tigers before they ever got old enough to reproduce. What I am saying is that we are all so good at worrying that it tends to crowd other things out. We lose sight of the big picture. Cultivating an attitude of gratitude is just remembering to add our assets to our bottom line before we hit "Print" on the balance sheet of life. No matter what else is going on in my day, right now it's spitting snow, the birds are mobbing the feeders outside my window, my dog is lying beside my chair, and I am writing. There are problems, yes, and I am happy. No reason both can't be true for you, too. As one client said recently, "That's the power of 'and'."

When you are in a seriously foul mood, I think it's best to make a written list.  I advise people to use their journals for this, because you can look back over your  lists when you are making the cognitive error of thinking, "Oh, this has been such a bad week!" or some such. Read your lists and it will give you a more balanced perspective. Don't limit your list to a prescribed number, but keep writing until you run out of steam. It's ok to repeat things from previous lists: The dog and the sky and my mate go on nearly every list. And you can list the same thing multiple times from various points in time or points of view on the same list: Mine might, for example, include the way my dog's silky coat feels under my hand, the warmth of her body curled up next to mine during our afternoon nap, and something cute she did this morning, all on one day's list. I guarantee your mood will be improved when you're done, if only by a few percentage points. And that's good. At least while you are writing this list, you definitely feel better. So if nothing else, you've given yourself a break for five, or ten, or fifteen minutes from your unhappiness, and those breaks are essential for all of us. One thing we are often guilty of as humans is 100% thinking, as in "This is a bad day." Stopping and making a list proves to us that no day is 100% bad, including this one.

So hop to it. Unhappy? Get out your pen and paper!

Bullying

Physical bullying at school, as depicted in the film Rebecca of Sunnybrook Farm. (Photo credit: Wikipedia)

Bullied as a kid? Does it still bug you? Then you will be not the least surprised at the results of a study published in JAMA last week. This study is being touted in the media  as demonstrating that the effects persist into adulthood ("Scarred for life", says the Standard, a UK paper), which I suppose any adult bullied as a kid could have told you. After following over 1400 kids from 11 North Carolina counties for nearly 20 years, researchers found that victims had a higher prevalence of agoraphobia, generalized anxiety, and panic disorder in young adulthood than kids who were not bullied. 

A search of the American Psychological Association's database turned up only one--one!--other study of long-term effects, a retrospective study asking gay and lesbian adults about their experiences in school and checking for any correlations with mental health concerns in adulthood. Their results suggested that as many as 17% of gays and lesbians bullied in school might have at least some symptoms of posttraumatic stress disorder in adulthood.

An author of the first study has been quoted as being surprised by the results. I am not.  Therapists are exquisitely attuned to the verbal messages our clients received from their parents about who they were, their place in the family and in the world, their value as human beings. And we all know, and have known for nearly 100 years that clients who were told, just as one example, that they were stupid will continue to believe that right into their dotage. Anything smart they do will be seen either as a fluke, as dumb luck, or as not smart at all--something anyone could do. Our peers have less influence on us, but not by much. And they have nearly as much access to us, seeing us five days of every week, nine months out of every year, throughout some of the most formative years of our lives. They have plenty of opportunity to beat us down.

One very damaging aspect is the response of the people in charge. Bullying victims get doubly traumatized when teachers, administrators, and parents do nothing: This is experienced as a betrayal, an abandonment, or as further abuse--and sometimes, as all three. For example, a boy who was physically assaulted in front of a raft of teachers who did nothing reported it both the assault and the faculty's inaction to the principal. That worthy's response was that this would not have happened had the student not chosen to come out. In actual point of fact the boy had been outed by one of the bullies some months previously in a separate incident, and he had reported it at the time. So the victim gets the message that nobody cares, nobody's going to do anything, and it's his fault anyway. I suspect that, as studies of childhood sexual abuse have demonstrated, this kind of response on the part of adults is a risk factor for some of the more negative outcomes for the child.

Nor, as far as I can tell, are long-term effects limited to childhood experiences: I know one fellow, retired about four years now, who still has regular nightmares about workplace bullying he suffered. And I have worked with several veterans who count abuse by their superiors as among the worst experiences of their careers.

So am I surprised by the results of this study? Not hardly.

If Everybody Did

Image by swanksalot via Flickr

Tax day is coming, the W-2s and 1099s are rolling in, and in the midst of the usual bitching about paying them, I heard one fella actually brag that he did not report cash income. Which put me in mind of people I have known who claim bogus deductions. I myself, while reporting honestly, am more often late than not: Indeed, I would venture to say that I have probably filed nearly as many requests for extensions as I have actual returns. What is all this resistance about?

The tax complainers seem to see taxes as some kind of terrible, unfair imposition, as if (a) they had nothing to do with electing the governments that assess them, and (b) they never use the services the taxes pay for. They complain about how the money is spent, without much actual awareness of where it really goes. About a fifth, for example, goes for Social Security and Medicare, both of which these folks will apply for the day they become eligible. They elect a government that takes us on military excursions overseas and then resent ponying up their share (almost another fifth of the national budget, not including veterans' benefits) every April. These same people send their kids to public schools and will not hesitate to call the police if their office is burgled, while resenting paying their fair share for these services via sales, property, and other local taxes.

A couple of years ago, the IRS released results of a survey in which about 84% of us said it was never ok to lie on your returns. From that, researchers assumed that about 16% of us cheat. I would bet that there's another few percentage points at least comprised of those who say one thing and do another. Add those together, and you get at least a $345 billion (yes, that's billion) shortfall in any given year. Approximately 3/4 of government borrowing goes to make up this shortfall, adding to the deficit every year. Is it any wonder that early in the wars we saw stories about soldiers' parents having to purchase and ship body armor out of their own pockets? Or that programs and services are being cut or terminated because of lack of funding?

Besides being illogical and selfish, it's unethical to lie on your tax return.

When I was a little girl, someone gave me a book on ethics called If everybody did. The gist of it was that there were some things one person could do once that had small(ish) consequences, but if everybody did it, well, then. . .

 

Kant for short people

That question has been an ethical touchstone for me all my life. When I remember to ask the question and really listen to the answer, I rarely make a false step. When I don't,  the results are about what you'd expect.

I've been thinking a lot about that little book lately.

What if everybody who ever accepted cash for their work did not report it? What if everybody put their personal dry-cleaning bills, club memberships, and even church pledges down as business expenses? What if everybody claimed everything they bought at the drugstore, from magazines to shaving cream, as medical expenses in order to get the itemized deduction? And before you ask, yes, I've personally known people who've done every one of these things. Where do you think the the money would come from to treat injured veterans?  to pay for your Daddy's nursing home?  to upgrade the armor on that HUMVEE your cousin's riding around Afghanistan in?

When you cheat on your taxes, you are not cheating the IRS. You are, in effect, cheating your fellow citizens. Your coworkers. Your neighbors. Your children. Your parents.

The irony is that none of these people think of themselves as illogical, selfish, and unethical, or as liars, cheats, or criminals, despite the fact that they are every one of these things.

The whole system is based on self-reporting, on trust. If everybody lied and cheated, it would collapse. If everybody dragged their feet like I've been doing, we'd have to borrow even more every year to keep the government running (10% of the budget every year goes to interest payments as it is). The IRS would have to audit everybody, or maybe they would require all our patients, customers, clients, etc. to start issuing us 1099s at the end of the year. Or maybe we'd just go back to the system of old, when the government just showed up at your front door and took what it needed at the point of a spear. How would you like that?

So you just think about that the next time you are tempted, as a former colleague liked to put it, to "round things off at the corners". I know I'll be thinking about it this spring when the temptation to procrastinate arises.

What if everybody did?

Related articles by Zemanta

• Why we cheat on our taxes (msnbc.msn.com)

Doctor, get over thyself

Andreas Kisser - Hubris I & II (Photo credit: Pombinho)

One of the things I find least attractive about organized psychology is the zealousness with which we guard (and ceaselessly seek to expand) our turf. We forget, when we try to lock other well-trained and supervised people out of psychological assessment, for example, or when we set out to gain prescription privileges for ourselves, that we started out as a profession studying trivial crap like the eye-blink reflex. And for about the first 60 years psychiatry, which is where the power was, thought that's all we were good for. We were treated as little better than psychometricians and had to fight like hell to be allowed to diagnose mental illness, never mind treat it. (If World War II hadn't come along with a screaming shortage of providers bobbing in its wake, we probably wouldn't be there yet.) We're far too quick to at best condescend to, and at worst insult the abilities and character of, non-doctoral providers when we discover them doing something that we believe falls within our sole purview. We've lost our humility, traded it in somewhere along the line for hubris. And if you don't know where that will get you, go read some Greek tragedy. Or some Shakespeare. And then we'll talk.

I am disgusted by the alacrity with which we cry, "But that's bad for psychology!" and spring forth to organize and initiate yet another turf war when the real issue at hand is (or should be) the quality of services to clients. What does it say about our collective character when our first concern is our referral base and not the people--who depend on all mental health providers, not just us? Our greatest concern ought to be for them, but no. Our first instinct is to check our wallets. Our grasping nature probably does far more damage to the profession of psychology than any hard-working, well-trained, underpaid masters'-level practitioner could possibly inflict by--gasp!--performing a psychological assessment.

And while we're on that subject, I find it sublimely ironic that while a masters-level clinician who wishes to test must fill out a two-page questionnaire demonstrating specific proficiency before s/he's allowed to purchase many instruments, any psychologist with a doctorate and a license, no matter how poorly (or not at all) trained s/he may be in psychological assessment, can buy any test in the catalog, no questions asked. Of course it's unethical for one to administer and interpret tests one has never studied and practiced with, but not a few do. It's that hubris thing--too many psychologists think because they have the 'terminal degree' that they're qualified to do pretty much anything they take a fancy to. But that's another rant for another day.

New Georgia Child Abuse Reporting Law

Some of you who didn't used to be mandated reporters will be now, come July 1. Professionals like me have been required all along to make a report if we suspected abuse, but now just about anybody who comes into regular contact with kids in any organized fashion at any business, agency, or nonprofit is going to be covered. Parents helping out in the classroom, field trip chaperones, volunteers in Sunday Schools, soccer coaches, you name it, it's covered. So it would behoove you all to read the laws on what, exactly constitutes abuse.

While you're at it, pay careful attention to the wording of the law: You have 24 hours to report suspected abuse--which means if you think it might have happened, you have to report. It's not up to whether you believe the child, or think it might have been a one-time thing, or have no proof. It's not your job to investigate it, but  the State's. If the child asks you not to tell anybody, too bad. If you've been assured that it won't happen again, or hasn't happened in a long time, too bad.

It's very simple. If you suspect abuse, you must report.

If you don't, you can be charged with a misdemeanor which carries a $1,000 fine and up to a year in jail. Three professionals have been convicted since the current law took effect in 2009. There probably aren't going to be a whole slew of new arrests and prosecutions, but there certainly will be many more reports--which the state is hardly ready to handle. As it is now, many reports go uninvestigated.

Going Home; Finding Peace When Pets Die, by Jon Katz (Villard, 2011, 166pp., $22.00 US)

Going Home; Finding Peace When Pets Die, by Jon Katz (Villard, 2011, 166pp., $22.00 US) is a sort of manual for pet owners on pet death and grief, and when it’s necessary, on the decision to euthanize. It’s so much more than that, though—it’s also a paean to our pets and our relationships with them. Indeed, Katz characterizes the grief itself as an expression of our joy in the animal’s life.

Since the book covers both natural and assisted deaths, stressing the need for preparation, it makes useful reading for owners whose pets are still living and healthy as well as for those already grieving either form of loss. Katz includes sections on children’s experiences of pet death, and this is also covered thoroughly in Dr. Debra Katz’s Afterword (which the publisher’s notes refer to as a preface). 

Katz works three themes throughout the book. One, we are responsible for making choices that are in the animal’s best interests, not on the basis of what we want or what other people think we should do. Two, grief is normal and natural, and even a good thing, for it cleanses, heals, and stands as testimony to the love we had for our pet. Three, both the decision and the grief go best if we are prepared. What constitutes the animal’s best interests, and how do we tell? How do we grieve? And how do we prepare for deciding and grieving? The book addresses each in depth, including how to involve, prepare, and support the children. Katz approaches each task—which, as he points out, we commit to the moment we bring the animal into our homes and our lives—practically, spiritually, and compassionately. In doing so, Katz is incredibly generous, giving of himself in ways that few would have the courage to do in print. He shares his own grief, his personal failings, and his dreams (in chapters titled “Animal Dreams”).

Three of me read this book and we all loved it. The writer in me admired Katz’s ability to be both succinct and eloquent at the same time. This is the most eminently quotable book I have read in a long time—which is frustrating in a way because the publisher asks that nobody quote it yet as the ARCs are all uncorrected copy. (On which subject, this “uncorrected” copy is in better shape than some books I’ve seen in recent years that are in 2^nd and subsequent printings—and still riddled with a ridiculous number of errors. My hat’s off to the editors at Villard.) I have resolved that dilemma by quoting it anyway, as it is just too good to pass up. 

The clinical psychologist fell instantly and completely in love with the book. Its message of comfort, its exhortations to responsibility for our animals, its sweet photographs, and its moving stories all made me wish I could order a case of this book to hand out to grieving clients and friends. 

And finally, the dotty old woman who still mourns Rosie, who's been dead now for three years, hesitated to even start the book. When it arrived in the mail, I wondered what on earth I had been thinking when I requested it! But I was hooked on the first page. I read it in fits and starts, on lunch breaks and sometimes when I should have been doing paperwork, and I cried every time I picked it up. Sometimes for myself, sometimes for my Rosie, and sometimes for Katz or for whichever animal’s death the current chapter was about. But I found it tremendously comforting and anyway, as Katz put it, “I would hate to have a dog or cat for whom I did not grieve.”

The three of us have only a few, small quibbles with the book. One, and really the only substantive one, is the psychologist’s, and it has to do with the title: I’m uncomfortable with euphemisms like that, seeing them as a denial of the reality of death. The animal is not “going home”. It is dead, not somewhere else—gone. If clients’ personal spiritual beliefs include an afterlife or rebirth, fine. But I am not comfortable leading with that myself, preferring instead to follow the griever’s lead. Another, and I admit that this is so small it borders on petty, is the writer’s. Katz’s otherwise masterful story of The Perfect Day is marred, in my estimation, by the mention of a camera by brand name and model. I had that one myself once, and loved it, but really. That was just kind of jarring. And lastly, the dog owner found herself getting worked up over some of the folk (not Katz) in the book who let their animals run loose, but that’s not a quibble with the book per se. Just be forewarned that’s in there. 

Going Home will be available after September 27, 2011, and I highly recommend that if you have an animal, any kind of animal, to which you have become attached, you go out and get yourself a copy. Do it now, not when it gets sick or hurt or old. Buy one for a friend, too, while you are at it.