Category Archives: Cognitive biases

October 11, 2016 · 11:03 am

Ruminating: The Mental Health Killer


I teach a course on psychopathology. Each week we consider a different family of problems. We explore anxiety disorders, mood disorders (depression, mania), and anger/explosive disorders in the first few weeks in the class. Later on, we look at eating disorders, addictions, trauma, and psychosis.

While each of the presentations of problems vary widely from each other, there is ONE symptom that almost every person with a mental health problem experiences–repetitive, negative thought patterns. Rumination.

The content of the repetitive thoughts may change depending on the type of problem (i.e., anxious fears, depressive negative thoughts, illicit urges, fears of weight gain, hypervigilance, irritability, etc.) but the heart of the problem in most mental health challenges are negative thought patterns leading to an experience of either impulsivity or paralysis. These patterns can look like obsessional worries about germs (triggering ruminative “why” questions as to the root causes of the obsessions). The pattern can look like repeated negative self-attributions for perceived mistakes. Whatever the pattern, the person finds it difficult to break out of the negative thoughts and attempts at distractions seem futile since the thought or feeling returns in seconds to minutes.

Is there anything that helps?

Yes, there are things that you can do to reduce the “noise” level of these repetitive thoughts. It is important, however, to remember two important factors

  • patterns in place for years or decades are harder to change. Give yourself the grace to fail as you work to change them.
  • As with pain management, the goal should not be the complete elimination of negative thoughts and feelings. Realistically, anxious people will have some anxiety. Depressed people will feel darker thoughts. Addicts will have greater temptations. But lest you give up before you start, this does not mean that you must always suffer as you do now.

Consider the following three steps as a plan of action to address the problem of rumination.

  1. Build a solid foundation of health. Every house needs a foundation if it is going to  last. Your mental health foundation starts with your physical body: Exercise, diet, and sleep. Did you know that daily exercise, getting a good 8 hours of sleep each night, and eating a diet rich in protein supports good mental health and may even prevent re-occurrence of prior problems? Will this solve all your problems. No! But failing to get good sleep and eat a balanced diet of proteins will exacerbate your problems. Sleep is especially needed. The lack of it will multiply your problem. Of course, getting sleep is difficult when you are worrying or depressed. Thus, work to develop a different bed-time routine. Shut off your electronics, do mindless activities like Sudoku, develop rituals that help promote sleep. If you are having trouble with this or your diet or exercise, find a trusted person to review your situation. And avoid all/nothing thinking that often leaves us paralyzed when we can’t reach our goals. On this point, read the next step.
  2. Prepare for change by accepting your struggle. What, I thought this was helping me out of my struggle? Acceptance is the beginning of change. Consider this examples. You struggle with intrusive negative thoughts about your belly. You don’t like how it looks. You’ve tried dieting and exercise, but still it is flabby. Every time you look at yourself, every time your hand rests on your belly, you hear (and feel) that negative narrative. The first step in change is to accept the body you have and to find ways to like it, even love it. Sounds impossible but it is necessary to accept all your parts. This does not mean that you won’t continue to exercise and eat well. Marsha Linehan suggests that one part of change is to accept the problem as it is. In her Dialectical Behavior Therapy model she speaks of choosing willingness over willfulness. Willingness opposes the response “I can’t stand this belly” by saying, “my belly is not as I would like but it is not all of who I am.” “I can’t stand it…” becomes a willful and yet paralyzing response. Whereas acceptance acknowledges the reality and chooses goals that are within one’s power to achieve (e.g., healthy eating choices). Acceptance is not giving up but preparing for realistic change.
  3.  Start to move. Consider these action steps as the beginning movements you undertake in a long process towards the goal:
    1. “So what?” Our ruminations are often filled with interpretations and assumptions. There are times we can challenge them by attacking the veracity of the assumptions. But we can also ask, “so what?” So what if I have OCD? So what if have to fight every day to stay sober? So what if I have to manage my schedule so as to not trigger a bipolar episode? Challenge the worst thing that you are afraid of.
    2. Develop a counter narrative. Rumination is a narrative. Begin by writing and rehearsing a counter narrative. It won’t have much power at first compared to your internalized rumination but it will gain power over time. Work to refine it. Choose to repeat it as often as you see the trigger for the rumination. Make sure your counter narrative doesn’t include self-debasing or invalidating comments. If you have trouble writing one, use Scripture passages that speak of God’s narrative, through Christ, for you. Be encouraged that developing alternative storylines has shown capacity to alter chronic nightmares. If nightmares can be changed, then even more thoughts and feelings during the day.
    3. Practice being present. Much of our lives are run on auto-pilot. When we are in that mode, it is easy to fall into rumination. Work to stay present, to be mindful and attuned to your surroundings. Notice ruminations but let them slide on out of view and bring yourself back to the present. Use your senses that God gave you to enjoy the world he made. Smells, sounds, sights, taste, and touch all give you means to enjoy that world. Start practicing staying in tune with it, a few minutes at a time and build your capacity as you go.

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Filed under addiction, christian counseling, christian psychology, Cognitive biases, counseling skills, mental health, Mindfulness, Uncategorized

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July 2, 2013 · 1:05 pm

Can you teach children to think before acting violently


NPR’s Morning Edition has a piece this morning on the problem of impulsive acts of violence by adolescents with guns and an attempt at a prevention plan. You can read and/or listen to the segment here. The researchers discovered that most of the violent gun crimes by teens were not premeditated. Instead, the shooters were in possession of a gun and when the problem became heated, they made the choice to use their gun to solve the problem–they failed to consider the consequences as they “solved the problem” with a weapon.

The intervention used in Chicago schools is a form of Cognitive Behavior Therapy to increase prosocial decision-making strategies. These interventions are not particularly new. The basis of this type of intervention assumes that if a person would pause before acting, step back and make an evaluation of the problem and consider alternatives, then the person would likely make a better decision. In previous research, these interventions are found not to generalize well from session to real life.

But, the research discussed in this piece seemed to point less to impulsive decision-making and more to the base assumptions they assumed others would make of them if they used polite speech to ask for something they wanted.

In one exercise, Ludwig says, the students were grouped into pairs, and one member of each pair was given a ball. The other was told to get the ball out of his partner’s hand. This invariably led to a fight, Ludwig says, as the kids brawled over the ball. After watching the fight, the program leader would ask the student who was trying to get the ball a question: “Why didn’t you ask the other kid to give you the rubber ball?”

None of the adolescents, Ludwig says, ever thought to ask their partners for the ball.

“The kids will say things like, ‘Oh, if I would have asked, he would have thought I was a punk,’ ” Ludwig says. “Then the group leader will turn to the partner and ask, ‘What would you have done had this other kid asked you to give him the rubber ball?’ And usually this other kid will say, ‘I would have just given him the rubber ball. What do I care?’ ”

The goal of such exercises, Ludwig explains, is to help the teens understand that their strong, negative reactions during confrontations are often based on what they falsely imagine is happening in other people’s minds.

Does it work?

You can read in the linked essay that those who received the intervention were FAR less likely to engage in violent crime. But notice that on 1 year follow-up after the intervention, the differences between those who received the intervention and those who didn’t were insignificant. In other words, the intervention works while it is being received, but is not a permanent change. So, one wonders what makes the program work at all. Is it the positive relationship between the students and those doing the teaching leading to more gracious responses to others?

In the past, I’ve read about stop-think-observe-plan interventions and assumed they were worthless since the students didn’t retain the skills to make better decisions after the intervention concludes. But note that the essay concludes with the researching noting that the benefits during the program are worth it in terms of cost-benefit. Maybe it would be good to see a 5 year program and whether the benefits really do continue during a longer program.

 

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April 17, 2013 · 9:14 am

The “End of Worry” in a dangerous world?


In light of the recent bombing in Boston, I thought I would use today’s post as a timely book note. Will van der Hart (Anglican vicar) and Rob Waller (Psychiatrist) have written a small but helpful book entitled, The End of Worry: Why We Worry and How to Stop (2011, Howard Books). What makes this book interesting is the fact that Will freely discusses his own struggle with worry, made more evident after the 2005 bombings in his city of London. While the bombings were the final straw to panic attacks, Will also explores some of the early roots of worry in his life.

If you struggle with worry, there are several reasons why this little book might be a comfort to you.

  1. The authors write as if they know worry and fear.
  2. It is not, as they say, “triumphalistic.” Meaning, they do not believe the right beliefs/prayers/faith will automatically solve the problem
  3. Worry is portrayed not only as a spiritual problem but also explored through lenses of psychology, biology, and habit formation.
  4. It is written to the worrier, not about the worrier
  5. Each chapter gives you opportunity to engage in a few key exercises
  6. They differentiate between solvable worry and floating worry (and the tyranny of the “what ifs…”)
  7. Their solutions are practical but do not pretend to be simplistic. In fact, they devote some space to the notion that you should “stop trying not to worry.” Sound radical?
  8. A number of their solutions are helpful for those who ruminate (OCD, scrupulosity)

The book sits firmly in the cognitive behavioral model of intervention. Therefore, much of it encourages readers to explore belief systems about self and world and to begin challenging faulty thinking and to work to replace with more appropriate cognitions, meditations, and self-talk. CBT is not the only therapeutic model but offers anxious people something to do.

If you would like to work through a book that describes the process of worry and perfectionism and then gives you some ideas to examine and change your own struggle, this might be the book for you.

*I received a free copy of this book without any obligation to write this post.

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June 5, 2012 · 8:07 pm

Word choice matters!


Counselors often use what they call “additive” words to help flesh out the thoughts, feelings, and experiences of their clients. For example,

CLIENT: I feel so frustrated about how long it is taking for me to hear about the job I applied for.

COUNSELOR: You’re feeling anxious?

Certainly, my example is superficial and simple but you get the point. Frustrated doesn’t really adequately describe the true feelings of the client. We sometimes need help with defining what we really feel, think, or believe. This word addition happened to me today in a powerful way.

Today I was telling someone about a repeated discouragement I have experienced in recent months. In describing my experience I used the word “rumination” to describe the re-occurring thought pattern. She deftly said just one word.

“Grumbling?” [well, in fairness, that is what I remember]

That one word changes everything. When I choose to describe myself as having a repeating thought–a rumination–I am accurate if I am speaking only about the repeating part of the thought pattern. But notice that “rumination” doesn’t evaluate attitude or belief. What my trusted friend was trying to tell me was that I was allowing myself to have a pity party. I was accepting the disappointment feelings without any evaluation of what it was that I believed about the situation at hand. Truthfully, she was right. I was accepting the thoughts and feelings as accurate rather than interpretative of my situation.

Now, I am not arguing that those who have actual ruminations (a part of OCD) are all grumbling. But, it is a good reminder that the words we use do shape our perceptions of our life! We do not just respond to disappointments, we interpret them.

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November 10, 2011 · 5:22 am

Failures to act: Why we don’t always blow the whistle on abuse


Outrage. Befuddlement. Demands for the heads of leaders who probably knew something but didn’t appear to act. Righteous indignation against those who merely met legal obligations to report abuse but failed moral obligations to stop abuse.

Right now, in most of the country but especially in Philadelphia, you cannot turn on the television or listen to the radio without encountering such comments about the Sandusky/Penn State sexual abuse scandal. In my county, democrats control the county leadership for the first time in 140 years but no one seems to give that much time because of the outrage about this case. What people are talking about is, (a) why didn’t those who knew something was amiss do more to investigate abuse, and (b) what should happen to those people who failed to stop the abuse.

What would you have done?

If you are like me, you imagine that you would have acted to stop the abuse. You would have grabbed the boy out of the shower. You would have screamed bloody murder until someone took notice. You feel righteous indignation that no one seems to have had the moral fortitude to deal with this issue head on.

And you would be right to feel this way. But while we are holding leaders accountable for their failure to act and to protect (as well we should!) let us take a moment and address some of the reasons why we might not be quite as action oriented as we imagine ourselves. By doing so, we may make it more likely that we will respond correctly should we face the unfortunate situation of reporting someone we know to the authorities.

Here are some of the reasons we fail to intervene when intervention is needed:

Self protection

Worry about personal consequences can hinder our taking action. Thinking about how we will be treated, viewed, responded to can cause us to pause and not act. What if I get fired? What if this abusive person targets me? What if someone were to make an allegation about me? I wouldn’t like that so I don’t want to stir up trouble for this person.

Have you ever wondered why so many drivers flee the scene of a pedestrian/car accident–even when they were not at fault? We want to avoid facing the possibility that we might have done something wrong.

System protection

We sometimes worry about how the organization will be treated or viewed if abuse comes to light. Far too frequently individuals have covered up the sins of church leaders for fear of ruining the reputation of the congregation. This reason is also seen in the next two reasons. We don’t want people to turn away from God so we cover up what happened.

Groupthink

We’d like to think that with a larger group of individuals, sensibility will prevail. But my experience with institutions dealing with a sensitive issue suggests that once a group is deciding how to respond to abuse, it devolves into who has the loudest voice in what should be done next. Unfortunately, the loudest voice may be about liability (vs. morality) or outer reputation (vs. protection of victims). Also, groups often fail to address pertinent issues and alternative responses due to groupthink. Some of the reasons why this is the case can be found in Wikipedia’s definition.  One other thing about groups. We have ample evidence that individuals in a group setting are less likely to intervene when they witness violence happening to someone else. We’re more likely to act if we witness this when alone. Why is this? We may feel less responsibility when others are around.

Denial

We like to keep the good people good and the bad people bad. When those who are considered good do bad things, we can fall prey to denial. It is not possible. I know him. He couldn’t possibly do that. Thus, we deny what we have seen and that leads to the next reason.

Self doubt

Have you ever witnessed something troubling but then wondered if you really saw what you thought you saw? Maybe you catch a glimpse of an adult smacking a child in a parking lot as you drive by. Do you stop and confront? Well, maybe you didn’t really see that. Maybe there is some other explanation that might make this acceptable. When the abuse is done by someone we respect, it is easy to think we must have misconstrued it. And once we hesitate, it is that much harder to activate to do the right thing.

Winsomeness of the abusive person

It is important to remember that the most dangerous abuser is the person who is inter-personally winsome. The reason why a person can have access to others and can get away with abuse is often due to their capacity to put others at ease. Most abuse is not done by those who are revolting to others just because they don’t get opportunity. I know of individuals who were caught in acts of child abuse, questioned by authorities, and so winsome that the investigation was dropped before completed. They provide plausible even highly believable explanations that help the questioner feel at ease. They appear to be open and concerned. They are so good they convince most that such abuse could never happen by their hand. It takes a very expert examiner to catch them in the subtle lies they tell to themselves and to others. Check out Anna Salter’s book on predators if you want to see what she has learned from decades of interviewing known, convicted sex offenders.

It is easy for us to sit in the chair of judgment when we hear of cover-ups and failures to act. These failures to protect children do need to be judged and we ought not shrink back from administering restorative justice for abuse and for the inaction of others. However, let us remember that the work of being light in the midst of darkness has many enemies. Our own weaknesses plus the pressures of our community and the manipulative actions of offenders conspire to make inaction the easier choice.

May we take the high road as we encounter abuse in any form.

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Filed under Abuse, Christianity, church and culture, Cognitive biases, Cultural Anthropology, deception

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May 26, 2010 · 2:50 pm

Intractable conflict in marriage


The latest American Psychologist (65:4, 2010) has an interesting article on the topic of intractable conflicts. These can be seen in families, communities or whole country disputes like found recently in Rwanda and the Congo.

The authors make this point at the outset of the article,

Conflict resolution should be easy. Conventional wisdom…has it that conflict arises when people feel their respective interests or needs are incompatible….A conflict that has become intractable should be especially easy to resolve….After all, a conflict with no ed in sight serves the interests of very few people, drains both parties’ resources, wastes energy, and diminishes human capital in service of a futile endeavor. Even a compromise solution that only partially addresses the salient needs and interests of the parties should be embraced when they realize that such a compromise represents a far better deal than pursuing a self-defeating pattern of behavior that offers them nothing but aversive outcomes with a highly uncertain prospect of goal attainment.  (p. 262)

True, but since when does logic ever beat conflict? It doesn’t and these authors know it.

As a conflict becomes a primary focus of each party’s thoughts, feelings, and actions, even factors that are irrelevant to the conflict become framed in a way that intensifies or maintains the conflict. It is as though the conflict acts like a gravity well into which the surrounding mental, behavioral, and social-structural landscape begins to slide. Once parties are trapped in such a well, escape requires tremendous will and energy and thus feels impossible. (ibid, my emphasis)

This is EXACTLY why marriage counseling is so difficult. Everything is read through the lens of “He is so controlling,” or “She won’t respect me.”

Why does this happen? On the surface, an intractable conflict might seem to be about land (e.g., Palestinians vs. Israelis) or about ideological solidarity (republicans vs. democrats) or about bald desire for power. In marriage conflict may appear to be about respect, money, or power. But these authors suggest that conflict becomes intractable because the larger system is supported by the conflict and would more or less collapse if peace were to overtake it. Attractors, they say help maintain a coherent view of the world, a way of promoting unequivocal action without hesitation. Truth be told. We like living in a black/white world where our actions are always clear to us and the bad guys are always bad. A word about power. In conflict, we use power to get what we want (via direct use or manipulation). But there are always power differences between parties. Someone always has more power. In couples, one spouse will always want more sex than the other. This isn’t a bad thing. It only becomes bad when either party refuses to accept the differences or show any capacity to be influenced by the other.

When peaceful resolutions take place, it is because a new system has been developed; a new set of values and definers of reality.

How do you implement such a change? You cannot go directly after the thing that maintains the conflict. In other words, don’t say, “You, wife, stop believing your husband doesn’t love you”; or “You, husband, start loving your wife by…” Built into the maintainers of conflict is a strain of resistance. “I know you just did something nice for me but you really are just trying to get on my good side so you can [fill in the blank], but I’m on to you!”

The authors say, and I agree, that, “Attempts to challenge directly the validity or practicality of an attractor for intractable conflict are therefore often doomed to fail and in fact are likely to intensify people’s beliefs and energize their response tendencies.” (p. 273)

Again, how do we deal with these longstanding conflicts? How do we stop seeing the problem as a simple equation (you stink and I’m great) to something more complex (we’re both broken and here’s what I can do to make things better)?

1. Force self to step back to see the complexity of the situation. This sometimes happens when something blows our mind (we act in a way we THOUGHT we never would). To do this we have to believe that the simple answer is easy but ALWAYS wrong and desire to have a more nuanced view of self and other

2. Go back to see previous unity. So, a couple might go back to remember their first love. What affinities did they once have? Can they recover them? Some couples can. From here, they may find the power to fix problems that seem just a wee bit smaller because of a more powerful unifying narrative that was forgotten.

3. Focus on who we want to be in the midst of trials and tribulations. What kind of person do I want to be (that God empowers me to be) come what may?

Notice that only #2 has to work towards maintaining the marriage and living in close quarters. One can develop a more complex and realistic view of the problem (#1) or focus on character development (#3) and still choose to end a violent or destructive relationship. Both also require that we value something greater than self-interest. From a Christian point of view, love must be the reason for all three options–a love given to us by God alone.

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Filed under christian counseling, Cognitive biases, conflicts, counseling skills, Desires, marriage, Psychology, Relationships, Uncategorized

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May 7, 2010 · 11:23 am

Decisions by the numbers or by the gut?


We all make decisions every day. And most of us like to think that our decisions are based on adequate data. We consider going to college or grad school. Which school has the best degree, best profs? Which will give be the best options post graduation? We consider getting married. Will ____ be a good spouse? We consider buying a car. Should I buy a Toyota because their history of longevity and safety are well documented or do I skip them because of the gas pedal situation? We consider which counselor to use for our problems. Do I choose a christian or someone who is board certified (I know, I know, they can be both)?

We make decisions all the time but they are NEVER based on enough data. This is where faith or our gut is involved. For example, I didn’t know my wife would be the best wife to have. Well, I’ll tell you I did but I didn’t.

What I am aware of is how we have so much more data available to us these days to make our decisions. At times, the data can be helpful but it can also deceive us into thinking that we have more control over the outcome.

Consider these counseling related examples:

1. Home Sleep study devices. I saw an ad for a radio alarm clock sized device that records your time to sleep, your REM time, your number of awakenings and your wake point. Assuming the device works, you can really track your sleep in a much more accurate way (rather than just going by how it felt). There might be some benefit to this, especially if it helped you be more consistent in your bedtime rituals. But, data doesn’t stop anxiety nor does it alter sleep apnea.

2. Scales. I have a new scale at home that gives me all sorts of data. So, I weigh myself more frequently just to see what changes. Of course, it has yet to change my eating habits nor really tell me much that I didn’t already know.

3. Pop Psych treatments. I suppose some will challenge me here on this category. But there are a number of popular forms of treatments or assessments out there that purport to pinpoint your problem, remove your problem, or illustrate the healing you just received. Each of these forms of treatment have stories, anecdotes, even statistical data. But few have been researched in controlled studies. So, the data may be accurate and yet meaningless to you at the same time. These interventions may well be useful but often the promise outstrips what is really known at the present time.

I might sound like I’m down on data. I’m not at all. We have some wonderful tools now to track information. Data can give us direction. But, in the end, we have to decide and there are other kinds of “data” that we use to make these decisions: feelings, recent experiences (our own or others), first reactions, amount of energy, hope, etc. Let us not deceive ourselves that we truly live by the numbers.

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March 17, 2010 · 11:38 am

Infidelity: personality or opportunity?


On the way to work today I heard a radio personality muse about the rampant sexual infidelity among politicians and sports figures. They talked about how people (i.e., men as the stereotype goes)  in power have much more opportunity for sexual acting out because they have more women offering themselves to them. Probably true…

But, is it that they have more opportunity (and thus more chance to give in to temptation) or is it because they have a personality that sets themselves up for infidelity? And would  you have a different answer if we were talking about bribe taking or other financial temptations instead of sexual indiscretion?

I think they are the same AND I think every has opportunity (some more than others). What matters is one’s perceptions of self and others. While personality plays a part of our self awareness, the drive to win, be the best, to get the prize, listening only to one’s fans, the sense that you are better than others also is formed from self-talk. Thus, opportunity makes it possible but failure to be self-critical is the key feature that makes opportunity become reality.

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December 17, 2009 · 12:36 pm

Propaganda is in the eye of the beholder


What is the difference from selling truth to a population and selling propaganda? A razor’s edge so it seems. I suppose another response would be, “I know it when I see it”–the response made about pornography. But what may be truth to you is propaganda to another.

Why am I thinking about this? My recent trip to DC included a trip to the holocaust museum. There, the curator of the new propaganda exhibit took us through his amazing assemblage of Nazi propaganda. Let me give you a flavor:

Propaganda as defined in the museum is, “biased information designed to shape public opinion and behavior.” They go on to say that propaganda is identified as that which

  • plays on emotions
  • uses a combination of truths, half-truths, and lies
  • omits information that might counter its contentions
  • simplifies complex information into a slogan
  • Attacks opponents (blames them for all problems; negatively portrays them)
  • Advertises a cause and uses righteous approach to give the cause meaning
  • Targets desired audiences through contextual material

As we went through, here’s what I noticed as well. A propaganda machine works to re-write history; makes the enemy comical (caricatures of Jews evident); emphasizes oration skills; uses media, fine arts, art, color, pictures, emphasizes a logo; targets different audiences in different ways; doesn’t mind opposition but builds on it; keeps people terrified; encourages even demands grassroots involvement; gets the youth involved; portrays self as victim and minority; creates fictitious events (e.g., calls war by another name (retaliation for prior aggression); connects with known trusted and wise individuals or labels (Hitler was alluded to as the Great Physician!); encourages passivity so that the inner circle may act in their stead; and encourages skepticism and cynicism about the criticism they will receive (the Nazis told the people near the end of the war that the Allies would say evil things about them that were going to be untrue. Such activities plant seeds of doubt to encourage those to believe that the holocaust didn’t really happen).

Now, let me tell you about the reactions we had as we went though the exhibit. The Rwandans with us gasped and gaped at times. They realized that someone(s) masterminding the Rwandan genocide must have read the Nazi playbook. They reminded us that one such mastermind in Rwanda was a PhD in history and was behind the use of the Radio propaganda. They repeated over and over, “this is what happened to us.” Several of us also realized that in child sexual abuse, many of these same behaviors are used (whether consciously or not) to avoid detection. The perpetrator grooms the victim, rewrites history, tells half-truths, makes themself the victims, and even may try to plant seeds of doubt about the truth.

One more thought? Could we also say that sometimes Christian organizations use some of these tactics. Scare a population by making a caricature of the government, report only half the truth, make self as victim, excuse unchristian behavior as necessary.

While I don’t think the answer is that we ought to all become horrible skeptics in order to avoid propaganda, I do think we ought to be highly sensitive to those behaviors and attitudes that do not reflect the proper character of Christianity. We must not use tactics unbecoming of Christ–even if for a good end.

I leave you with this thought: Isn’t there a good use of propaganda? I believe so. Can you give some examples where you are getting “good” propaganda?

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December 8, 2009 · 1:54 pm

End of semester thoughts


Looking at a stack of papers I need to grade and yet not feeling the energy to do so. Late night classes take more out of me than I care to admit. My physiology class ended with student presentations and a look at bipolar disorder. As we concluded the class, I asked them to remember that,

  1. Even with all the advances in neuroscience, we must humbly admit we still know little how we are fearfully and wonderfully made.
  2. It is good for counselors to keep learning about the body and at the same time hold what they know lightly. Tomorrow may bring evidence to the contrary
  3. Yet, what we know about the body can be helpful. We ought not to look down upon our ignorance but remember that doctors do not always explain or walk with patients
  4. There are great medical interventions available, but (and that but shouldn’t diminish what I said before it),
  5. Over and over we saw that the basics (maintaining balance in life, self-care, mindfulness) are so important to health, perspective, etc. No, they aren’t magic interventions. Yes, they pay-off over time rather than immediately.

On this last point I am pondering a bit and so let me be hyperbolic. Most people who come to see me for paid counseling come because they think (naively) I have some expertise that will shed light on their situation and a solution to their problems. They want me to do something. Why else pay that kind of money? And yet much of what I have to offer isn’t rocket science. Beyond a few fun techniques, what I have to offer is a listening ear, a willingness to walk with the other person in their travail, and encouragement to keep going back to the basics. Most people like the first two but balk at the last one. Why do we balk at going back to the basics? Two reasons: (1) we want something that will fix the problem NOW, and (2) we’ve tried the basics and they didn’t seem to work (see reason 1).

Examples of what I mean.

  • If you are a parent and you go to a counselor to deal with your young child’s behavior problem. More than likely, you will get some counselor telling you to use some reinforcement strategies. And what do many parents say? “I tried that and it didn’t work.” Chances are they did try it and either they didn’t keep at it or they didn’t realize they were doing something that reinforced the wrong thing, or they had a misguided view of what success should look like
  • A couple is struggling with fighting. They go to the counselor who encourages them to return to the basics of respectful talk. Usually, they will feel like they have already tried it–and it didn’t work. Chances are… You get the picture.

In physiology, we see that care for the body includes mindful meditation (My friend and former professor says a substitute word would be “watchfulness”) on the world as God sees it, developing and maintaining good circadian rhythms, watching food intake, exercise, maintaining healthy relationships and social supports. In every mental illness, these things are shown to decrease the severity of symptoms and delay relapse.

Here’s the problem: we forget the basics and because they don’t give immediate results, we go searching for other fast-acting mechanisms. For example, I want to feel safe. Instead of engaging in centering prayer over the long haul, I fall prey to the temptation to act in such a way to avoid all possible danger–thereby increasing my fears of danger.

If I don’t exercise (and I don’t much) I rarely get immediate feedback that my body is falling apart. If I don’t eat right, I don’t immediately gain 10 pounds. If I don’t pray, I don’t immediately get embittered. So, I assume that these basics aren’t all that important. Or, I know they are important but since they don’t pay off now, I don’t do them. I only do what demands I do it to avoid a crisis.

How do we stay on track with the basics? We need another person(s) willing to keep us on a short leash. As a kid I ran because I had a friend who was going to wonder where I was. As a doctoral student, I played basketball at 6 am because my peers would  ask me where I was. I lost some weight a couple of years ago because my wife and I worked together. Notice that the social accountability is a key facet to help us build the disciplines long enough to see that the pay off is more than can be delivered by an exciting new technique.

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