Being insane, college, and defining normal

Sometimes I'll be talking to patients and hear about how much shame they have attached to something they did at some insane time of life. They'll look at me with sincere remorse and ask, "Was I insane?"

Yes, you were.

Yes, you were, I want to say.

Yes, you were, I say.

Well, thanks. Thanks for the encouragement.

So insane is a little strong. But there are stages, and you ALL know it's true, when a person is less in control, has less desire to be disciplined, has no incentive for discipline. When a person does things that a person in their right mind would never do.

These behaviors (affairs, drug overdoses) can be triggered by stress and depression. They can happen mid-life, and most notably, during adolescence and young adulthood, which is where we're going on this page.

A wise man once said that Americans prolong adolescence with this business of college. At a time when able-bodied people should be working either to become self-sufficient or to pay back those who have sustained them throughout childhood, we send our children off to college.

Where they party.

Where they learn how to perfect their drinking and drug abuse.

Where they contract sexually transmitted diseases.

Where they get raped or rape.

(As an aside, if a person "consents" to sex while being under the influence it is not legally considered informed consent. Technically it's rape).

Okay, okay, I'll stop. Not everyone does these things.

But these things are brought to my attention in therapy at least once week, episodes folks wish they could forget. Most of us have at least one.

I'm very forgiving of college students partying, frankly. There seems no stopping them. It is the young married couples I see who are having trouble in their relationships due to alcohol consumption, drug use, and or nights "out" that I begin to label alcoholic or addicted.

By the mid-twenties a person should no longer be waking up with a hangover. That's my cut-off. The drinking and drugging has to stop there. Adulthood.

That may sound very liberal and even crazy, coming from a professional. Like I'm giving covert permission to teenagers to use substances. No way.

The professional party line, should the subject arise, is that alcohol IS the enemy, that women get sicker quicker, that it is EXCEEDINGLY RISKY to ever drink to the point where the room is spinning or one can't remember things, blacks out. It is exceedingly risky to smoke pot, use cocaine, enjoy designer drugs. These substances make the brain happy, and when the brain is happy, friends, it never forgets and looks to these sources for more happiness.

I'm not afraid to say that it is EXCEEDINGLY IRRESPONSIBLE (I try not to say stupid) to let oneself get dependent upon alcohol or drugs, especially of there's a family predisposition to addiction.

Enough preaching. You people know all this.

What I'm going to present here is the quick and dirty (YES DIRTY) on normal psychological development, something that unfortunately implies living, doing, and learning, EVEN MAKING MISTAKES.

Let’s look at Abraham Maslow's Hierarchy of Needs.

In my day it was a ladder, now it's a pyramid. Maybe it was always a pyramid. The idea is that we have various needs that change as we grow up and struggle to master the various developmental stages of our lives. Stay with me here.

The Maslovian pyramid looks like this:

1. As infants and toddlers we're all about getting physical survival needs met, as in

I'm HUNGRY, blank-it, WHY AREN'T YOU FEEDING ME??

2. Then in early childhood we get more into basic safety and security issues:

MOM, WHAT THE BLANK?? YOU'RE LEAVING ME AT SCHOOL ALL BY MYSELF?? ARE YOU NUTS???

3. At some point we get more into finding the kids at school interesting. Socializing meets the need for belonging. We get out of our own little autistic world.

Wow, these people are so cool! I want friends! I want to belong! I want to hang out. I’ll die if you don’t let me go on My Space!

4. Then there's a reevaluation of group-think and the shift towards inner focus and a need for self-esteem. We have a need to really like ourselves.

Oh, I don't HAVE to sleep with everyone I think is hot! I have boundaries! I can say, NO, or work on a RELATIONSHIP instead!

Developing boundaries, which requires a little (sometimes a lot) of self-discipline is only one way to raises self-esteem, but it's a good way.

Developing boundaries isn't as complicated as it sounds, and I'll write more about it another time, but the process sometimes starts with saying NO to something, someone or oneself. It starts with looking back at what we've done, taking responsibility and saying OH, (expletive) WHAT WAS I THINKING!

Are we our own worst enemies? Maybe, but I'd rather think that we're educable, we learn, we grow, and with that we develop a little self-respect, self-esteem on Maslow's pyramid. Second to the top tier.

So if after a slip, a set-back, a bad decision, A MOMENT OR SEVERAL MOMENTS OF TEMPORARY INSANITY, say an unexpected or expected sexual encounter, an unwanted pregnancy, maybe an abortion OR THREE, something that brings on shame, regret and remorse, IF THEN A PERSON FINALLY SETTLES DOWN?

I would say that's taking a monumental developmental step on the old pyramid, wouldn't you?


5. And finally, at some point, perhaps not until one is in his or her mid-thirties to forties or fifties there's a theoretical need to self-actualize, to be the best person one can be, to really stretch out and grow, do new things.

I say it's a theoretical need because in our world there's simply so much to do that's done for the sake of fun, because face it we work so hard, and we've already paid for cable and the shows have really improved, haven't they, over the years?

There are so many feel good things to do these days that striving to become a better, bigger person can be a real challenge. Becoming, growing, may be irrelevant.

Jury's out? Yeah, maybe.

Copyright 2006, TherapyDoc