Apologizing

 It seems so easy to me, apologizing, or taking something back that I shouldn't have said. That sense of my bad is so jarring, so upsetting. There's baggage to it, triggers (if something feels bad it is because something else is at work). Someone is mad at me, someone doesn't like me. So to get rid of the baggage someone like me will be quick to own responsibility for messing up. It feels easy, like removing a finger from a hot burner on the stove. 

That's when we're aware. We're all like this to some degree. When we know, when we're aware of the feelings of others and that they will ricochet back to hurt us, we're motivated to reverse the damage. We'll say, I'm sorry.

But as the good doctor/rabbi Peter Rosenzweig likes to say, about 99% of what is happening around us isn't available to us, it's unconscious. 

Or maybe it was 95%.  You get the idea. 

The interesting thing about the subject of apologies is that we know there are people who cannot do it, cannot bring themselves to apologize, which makes doing couple therapy a bit of a challenge. Why? For some it feels like others should be apologizing to them, should be working harder to understand them, to feel their pain. Owning responsibility is exactly what some of us want others to do for us-- feel our pain. If only you would only empathize with me, you'd get it! You first. 

When I notice that going on (and it is sometimes even spoken) in therapy I might say:

(Name of pt). You have lived without that understanding this long, live without it a little longer just for today's visit. Let's get you into the position of modeling the behavior for your partner. One way to do that is to apologize first, say you are aware that you might have hurt her (him) and that you are sorry. See if it doesn't come back to you in a good way. 

We would call that secondary gain, There's just something about saying, I did that. It ends up feeling okay-- you aren't punished-- crazy, I know. You feel like there will be some kind of punishment, but there is not. 

This process is psycho-educational, and for some, it works. If therapists can help partners feel the pain of one another they are half-way there. 

We could call that an intervention, labeling the pain of the one who can't apologize. But it will not always work. There are other interventions, and we'll get to them in a second, but I'm wondering about the corollary of my first paragraph. Does what I wrote mean that people who don't take responsibility and/or don't apologize are not worried about social rejection? Does it mean that pride, a type of blinder, shields all of us from social rejection? As if  I'm right, so you must be wrong, nothing in-between. No need to apologize.

What's a therapist to do? Here are a few more thoughts, interventions:

(1) Chip away at the pride, or insecure narcissism-- that might be one option--The therapist says: Well what if you aren't correct? I think it would be helpful here, in the interest of empathizing and improving your relationship, for you to try on the idea of What if I'm not right? What happens then? 

This isa favorite intervention, although they're all good, because it forces people to face that catastrophic expectation, the consequences of being wrong, which in most situations are anything but catastrophic, and in fact, are benign.

(2) The therapist asks the partner to ask the other partner to do that-- that's good except that he or she has probably done it before without success, and that's the response I tend to get back

(3) The therapist explores the idea that they are both right and it is their challenge to find out how that could be true

(4) The therapist switches from content to feelings, simply do an emotional check-up-- how upset are you, and how upset are you, and what's weighing in on those feelings

(5) The therapist asks them who else they know who agrees with them and have they been talking about this topic with other people, and could that be affecting how strongly they are attached to being right or wrong

(6) The therapist asks, "In the past, how important was it for a parent or sibling to be right?"

(7) The therapist asks, "Has substance abuse made you feel either (a) always wrong, or (b) always right-- because according to the program. . . the program teaches. . . "

Not a complete list, for sure. But it's a start. 

Maybe I'm wrong about the whole thing. 

therapydoc

Measuring the Effects of Racism

 Everyone likes history these days, and January 6, 2021 was historic. Some say it will go down in infamy, a humiliation. Foreign leaders are saying that this is not America, meaning this is not democracy. But it is America. 

There have been marches on Washington before, the most effective perhaps in 1963, predating the Civil Rights Act of 1964. Look at these photographs for a second. Over 200,000 people attended the March on Washington for Jobs and Freedom to send a message: workplace inequality is unAmerican. 

March on Washington, 1963

Same march

Martin Luther King-- it's his birthday  pretty soon, know why the kids are off of school

Then, of course, we have pictures from Wednesday, Trump supporters barging the Capitol to take it back. This is ours, I heard one say. Another: This is a peaceful protest. 

Yet we see them breaking windows and bullying the Black guard at the door, terrorizing him as he backs off, farther and farther, up, up, up those wide stairs. There are hundreds of them, we're told by the newspapers, perhaps minimizing the count. Maybe not. It is their right to support the president. 

I want to give the benefit of the doubt, as always, to understand. They did not have any classes on narcissism or anger and follow him as a messiah. He is the only one, it seems, who has listened to the needs of this demographic and validated each of them, they feel, individually. They are not happy that he is no longer the president. They only see their pain and a country divided, us against them, and the impossibility of loss. The election had to have been stolen. How could Donald Trump have lost when he said he won? A dream, even if it is a confidence game, is very hard to lose.

Proud Boys apparently came in droves, proclaiming this the new 1776, the new revolution. We're all aware of armed militias in the back hills of America. It is a scary moment. We can put our heads in the sand or give them better paying jobs, a better education (for free). Isn't this the source of their malcontent? Having less than those who make a lovely passive income on Wall Street? It would be generous to say this, rather than to think that this is about racism and ethnocentrism, bringing one's self up by putting other people down.

I don't have any answers, am hoping that the younger generation, the new members of Congress will give it some thought.

Lets look at a few pictures. 

Destroying cameras and equipment 

The videos show protesters throwing camera equipment to the ground. 

Looking up at what I'm watching on television, FD says to me: Journalists love this stuff. 

WE love this stuff and we hate it. But some of us love it as a strange, surreal distraction. Anything not to have to think about Covid 19. 

FD is treating this stinking virus, you know, treating the community. I am beside myself and not vaccinated, yet I want to do Kincare- watch a new grandchild for a couple of days a week after my daughter goes back to work. She took off to have the baby, a good time to get out of healthcare, but worked the frontlines for six months last year. Oh this past year! That 350,000 Americans have died from Covid is devastating, and the numbers keep rising. The protesters call it a hoax. How death can be a hoax is confusing to me, and I wonder, which story will go away faster, the one about people dying from that hoax or the new revolution, the new 1776.

What drives people to break cameras? 

Many of us have had more time to read lately, and there are books strewn all over my living room about racism. The better ones are novels I get from the library, like Homegoing by Yaa Gyasi, and Americanah, the 2013 novel by the Nigerian author  Chimamanda Ngozi Adichie. Aaron Bady, a book blogger has a few other recommendations.

Scholars say the same thing, that race is a non-word. There are not separate races. We're all of the same race, the human race.  We have different skin-tone. That's pretty much it. 

Isabel Wilkerson, in CASTE: The Origins of Our Discontents (so good) speaks of a pecking order established before there even was a United States of America. In August 1629, a letter from early settler John Rolfe describes Africans sold to English colonists, people who looked different, who would be assigned by law to the bottom of an emerging caste system. Rolfe describes them as merchandise. 

In the decades to follow, writes Wilkerson, colonial laws herded European workers and African workers into separate and unequal queues and set in motion the caste system that would become the cornerstone of the social, political, and economic system in America. 

There's an obvious parallel to the caste system in India. 

An entire chapter of the book illustrates how Adolf Hitler learned how to institutionalize racism from the good old USA. He praised the near genocide of Native Americans and their exile to reservations, and found the American custom of lynching African-Americans and ritual torture/mutilation, impressive. Seeking alternative models in other white-dominated countries Hitler could find no other that punished interracial relationships, miscegenation. The best example of caste is the United States of America. 

Oh yes, he learned from the best. 

Let us look at Measuring the Effects of Racism: Guidelines for the Assessment and Treatment of Race-based Traumatic Stress Injury, just one more book, and a few take-aways. Unlike most social scientists, Robert T. Carter and Alex L. Pieterse immersed themselves in racial-cultural studies to present themselves as experts in biracial custody cases, equity issues in schools, racial discrimination and harassment, and consumer racial profiling. 

To impute the negative psychological consequences of trauma, experts in mental health are armed with the Diagnostic Statistical Manual, the DSM, the definitive judge of mental disorders. Features of the syndrome PTSD, or Post Traumatic Stress Disorder, identify the specific effects of  external events, some as intentional acts (beating a child), some not (hurricanes).  

Carter and Pieterse recognized racial trauma as different and constructed the Race-Based Traumatic Symptom Scale. 

This should be of interest to therapists, right? No matter our color, we work with people who have been excluded or bullied for no other reason than their skin color, and we feel the pain but are one-degree (at least) of separation to it-- unless we are also persons of that color. We know it is different from anything that we will ever experience, even if our parents did, perhaps, as concentration camp survivors. 

No matter how we are treated, white privilege is exactly this, the absence of race-based trauma. If someone slurs us racially, calls us a honky, gin jockey, gubba, pig or whatever the epithet, it is an unusual random event. It is not what people of color experience, always events. An example I like goes like this: 

An Black American tells her White American spouse that they will have to explain to their little girl that if she needs help on the street that she shouldn't go to the police. White skin-colored people don't think twice.  

We therapists have no idea how deeply our clients have been affected. Do we simply ask? How? Do we pull out the Race-Based Traumatic Stress Scale? There is much to be learned about treating racial trauma. I'll write more about it in another post.

Now what about the actions of the mob in Washington, the peaceful demonstrators who occupied a building in our capital, much like tree-lovers occupied the red-woods in the other Washington, and those who occupied Wall Street. Isn't possession nine-tenths of the law? Isn't that all they're saying? We are here, look at us. See us. We live here, too.

Sure, sure. We see you. Now you. Do the same. See everyone else, too. 

therapydoc 

What I Did on My Covid Vacation

This post is only tangentially about what I did during the Covid quarantine. We'll all be digging out of this in the next six months, processing the effects upon our children, parents, ourselves. But we're supposed to reflect this time of year, and we should reflect on the year gone by, or share our dreams for the future. An alternative post would be called, What I'd Like to Do When I'm Free to Move About the Cabin (when Covid is no longer a threat).

BALANCE BOARD, a metaphor? Nah

Hi FBI! 

Friends, I know that this is going to sound like I had a brief psychotic episode or symptoms of schizophrenia, you decide. It started about five years ago. 

Following someone's incarceration for a federal crime, a parent of this person, still positive that her kid would be freed one day, called me to chat. Not unusual, but as we're getting into it she says, "Oh, by the.way, the FBI is listening, just thought you should know. They tap all of our phones and because we're friends, they're tapping yours now, too!" 

We call that a snowball sample in research.

What do you say to that kind of news, that your conversations are now an open book? 

"Oh, good, no problem, no breach of HIPAA in that, me talking to patients fairly often. LOL." 

So every once in awhile we would pause and one of us would say, "Hi FBI! What's up?!! Everything good?  Great, now run along." 

Now. We've all watched enough television to know what that is like, how it works when the FBI is listening in. We're not talking some guy in a van and a bug planted in a telephone while you're out running an errand. We're talking two guys with headsets in a large room full of similar young men (never women) listening in on the conversations of every day Americans who might be planning a revolution to overthrow the government. Or they might be discussing the merits of buying the bedspread with the blue print over the one in white. 

I think the first time I saw the FBI listening in was on The Good Fight starring Christine Baranski, the sequel to The Good Wife, but it might have been The West Wing. The plot in The Good Fight took a dark turn and scared me, which isn't my thing, so I stopped watching and have no idea if they threw Christine into jail or what happened to the plot. Upset me, fine, like in Valley of Tears. But don't scare me.

Fast forward, we've learned quite recently, although the story has been scuttled to a large degree, that Russian intelligence has indeed hacked into all vital US governmental networks. I hope this isn't news to anyone reading. The upshot is that our identities are gone, our financial information is bare, and we should probably be learning Russian in our spare time. 

Why bring this up now? Because last night, reviewing all of the projects that I had time to work on these past ten months (not having to commute to work frees up a lot of time), I realized that although I had time to throw out old clothes, rearrange furniture, and indulge my hobbies, like buying a new aquarium and selling the old, I didn't do much writing. Except for scholarly stuff which is really difficult to finish because you're always sweating each sentence for a source. And then, in the process of looking things up, you find new things to learn and read about. So you could say that during the past ten months I learned, and learned, and learned, which is an accomplishment, but actually finishing anything to publish in an academic journal hasn't happened. Not that it won't, we're getting there; it just takes time. This is the reason so many begin their dissertations and never finish. 

But more than that, I wasn't in the mood to write for fun. Seven years ago when my mother passed away this blog took a downturn in content. I stopped writing, and now I get why. You need a certain flow in the serotonin to blog well. 

Meanwhile, and here's the exciting subplot, in 2017 it became clear that much traffic generated to this blog came here from Russia. That scared me out of blogging. Once you think somebody is reading your email, you get a little reluctant to use that account. There had always been a great deal of comfort in being an anonymous blogger, occasionally changing my so-called real name. Once the email address and feed were compromised, it simply felt dangerous to write and disseminate posts to those of you who subscribed.

Rationally, that's ridiculous. What in this blog is political? Nothing, nothing political, really, nothing subversive or anti-government. And believe me, the diagnosis of the 45th president of the United States did not escape this therapydoc from the get go. The Russians are not listening to us, we're not that important, or reading this blog. But in case they are, we can only hope they like whatever content is coming up this year. Because this year will be different from all others. The blog, and I say this in good faith, shall go on.

It could be about things that have happened, like two recent suicides in my community, or it could be about current events. But more likely I'll write about getting older, pretty sure, not that a lot of people will care. But getting older is shocking. You think back on the milestone birthdays like 16 (half of 32, a friend's mother told me way back when-- trying to get a reaction out of me at 16, which it did, turns out it's a snapshot memory). Forty and fifty are milestones, wrinkles, menopause, divorce, weddings, launching the kids. 

But you think to yourself, why did you stress about any of that, fifty being the new forty, blah, blah, blah. Then you round sixty and your senses change and the stress quadruples. You can't hear. You have to get hearing aids. You can't see, need cataract surgery. Your hair goes gray, seemingly over night. But you hate the smell of hair color, have distinct memories from your mother dyeing her hair and closing the bathroom door.

You become invisible except to others who are going through similar metamorphoses. You're strolling (with a mask, naturally) and you pass another silver-haired woman who is working on her lawn, raking, also wearing a mask. She's seemingly robust, and you silently nod to one another, acknowledging that the two of you could have been in high school together suggesting to the teacher that you would rather read anything by Jack Kerouac and Samuel Beckett than Silas Marner,* and now you're both thinking that the vision of getting the stinking virus is like looking death in the eye. You want to talk to her about that and ask, So how's it working for you, worrying about an early demise. But you nod and stroll on.

So yes, there's a lot to talk about. I feel like I could be back. I'm in a good mood, hoping for a vaccination, hoping to see people in real time, real space in a couple of months, maybe get on a plane. But even working on Zoom, there's much to talk about-- like how great it is to stand up while I'm working, stretch, balance on a balance board. You can't do that when you work in an office and a patient is sitting on the sofa across from you.

The Zoom blogging material is here. Like the patient who never stops telling me how she likes a blouse from decades ago, or how I look today or my haircut (naturally, my hair). The patient is a heterosexual female, not objectifying me in that way, but it bothers me. I've mentioned it to her but she can't help it. It's like people who always say that they are sorry when there's nothing to be sorry about, a hard habit to break. We could talk about that, that even the nicest people in the world can upset a therapist who gets impatient and has to call another therapist and vent. What the heck? But the patient has no idea that my sideline is sexual harassment prevention and objectification is a trigger.

Hey, FBI, we good?

therapydoc

*I'm ordering a copy from the library right now.