Archive for April 15th, 2011
never enough time
Case Study
Lisa was impatient. She had been impatient all of her life. Her father was impatient and so were her mother and brother. Now, at age 40, she was beginning to question the usefulness of her childish belief that faster is superior.
Therapist: “Lisa what does it mean to be impatient?”
Lisa: “It means I’m in a hurry.”
Therapist: “What would happen if you didn’t hurry?”
Lisa: “I’d be stupid. My father always used to say, ’What took you so long? If you were smarter you’d be done by now.’ So I started doing things faster so he wouldn’t put me down.”
Therapist: “To a child, it is easy see how perhaps you saw these comments as your father calling you stupid”
Lisa:”I did think that my dad looked at me as being stupid.”
Therapist: “To a child, stupid means worthless, unlovable and inferior. Those are very painful feelings. Your impatience may be a way of trying to keep those painful feelings from coming back to hurt you. Perhaps you are trying to prove that you are not stupid and inferior.”
Lisa: “What is wrong with that?”
Therapist: “Well it’s destructive, not constructive. The outcome cannot be positive. It is a good intention to show others that you are not stupid. But there opinion of you has got nothing to do with the demands of the real world. This desire to prove your case gets in the way; it slows you down and trips you up. It doesn’t make things better, it only makes them worse.”
Lisa: “I was only trying to do a good job.”
Therapist: “But how good is good enough? Your probably didn’t know what that meant. So some kids assume that it means perfect and if you weren’t perfectly good, perfectly smart, perfectly efficient, you were stupid.”
Lisa: “I thought I knew what he was talking about.”
Therapist: “When did you stop living on your father’s terms of good enough?”
Lisa: “I guess I’m still doing it.”
Therapist: “What would you like to do about it now?”
Lisa: “I’d like to feel more secure in my decisions, but I don’t know how.”
Therapist: “As an adult you are now entitled to two choices, the old and the new. You can choose to start living on your own terms as a worthwhile and successful person in your own right. To your father perhaps people were either smart or stupid. There is no middle ground in this childish all or nothing belief. Fortunately for you can decide to make a choice on your terms.”
Lisa: “So what do I have to do?”
Therapist: “You can take ownership over your choices. You can choose to stop being all or nothing. You can declare your independence from your role as a daughter. You are many things to many people, but the foundation of it all is Lisa. You get define yourself and your expectations base don what would make you happy.”
Lisa: “What does this have to do with managing my time better?”
Therapist: “Perhaps on some level you are still the obedient daughter, bound to seeking your father’s approval by working faster. You are obedient because you are afraid of disobeying and being criticized. This leaves you feeling guilty, hurt, and fearful that disapproval will leave to rejection.”
Lisa: “Isn’t it easier to be obedient?”
Therapist: “Yes, but that doesn’t mean its better. What is easy is familiar, but that is not always healthier. It is healthier to be independent and strengthen your adult judgment. Your self respect may be held hostage to this role from childhood. This role was needed at a time in place in your life, but you are now an adult and have choices you didn’t have then. Living in this role keeps you stuck and prevents you from growing up. This leads to impatience as you quickly try to offer enough evidence to prove your smarts, so then you can move on. But that never happens and you get angry. When you chose to manage you anger, you can begin by writing.”
Lisa: “How will this help?”
Therapist: “You’ll be able to stop mismanaging you time trying for perfectionism. You will be free to manage based on your judgment of the requirements of reality.”
Lisa did her homework. She wrote out her anger in a letter to her super-critical, ultra efficient father. He tried to help by criticizing what she did with the good intention of helping her to improve. But she just felt criticized. He made her feel inferior, inadequate and unlovable. His good intentions deprived her of the supportive, loving father that every child deserves. Her father’s help didn’t help; he made her feel unworthy of happiness and success. By mismanaging her time, she was silently plotting to fulfill her father’s negative expectations. As children, we assume that are parents are always right. So how can Lisa bear the terrible pain of proving her father wrong?
But she pushed her comfort zone and took a risk of writing anyways. As she wrote, she was able to see that she didn’t deserve her father’s criticism. It wasn’t fair. She was just a little kid, doing the best with what she knew at the time. Her father’s unfairness in demanding perfection made her angry because no matter what Lisa did it was never good enough to please him. She stuffed these feelings inside until there was no room left. She stuffs these feelings for fear of the consequences of facing them. Yet they were still down there. They never went away. She was living in fear and frustration due to the constant concern others would see her as her father saw her. It was time for a change.
After Lisa wrote her anger down and could concretely look at her feelings on a piece of paper, she felt relief from the years of pent up tension, pressure and stress. She wasn’t being controlled by her past. She was letting it go. She wasn’t rebelling against her father or submitting to his unrealistic standards either. Lisa is now acting like an adult. By writing out her feelings she was able to regain her self-respect. She could let go of the past and live on her own terms as an independent human being with a unique identity of her own. She was in control of her life; she was free to make choice at a time and place of her own choosing. She was free to use her adult judgment to determine how good was good enough. She could define how smart was smart enough. She could separate the act from the actor and allow herself top make mistakes without being a screw up.
Lisa learned to live on her own terms by seeing that ‘shoulds’ and ‘musts’ are not absolutes, but are preferences. There are no ‘have to’s’, only adult choices. She didn’t have to prove her worth or her intelligence to anyone. Lisa, having let go of her expectations based on her father’s perfectionism, could now chose to work at her own pace. No one was calling her stupid anymore. She began to replace her lifelong self doubt with self-respect. She was now able to get more done and feel a sense of accomplishment and success from her efforts.
Lisa did another homework task, more closely related to her impatience. When her old belief kicked in, “There won’t be enough time to get it all done.” And started to feel out of control, she could catch herself. She could catch herself self indulgently trying to prevent the disaster of displeasing and wasting time. She could ask herself a focusing question to identify this old belief for what it is, nonsense. She was able to ask herself, “What difference does it make?” As a child, we are what we do. If I do a good thing, then I am a good kid and if I do a bad thing then I am a bad kid. Everything made a difference. Everything was a test of her worth as a person, filled with potential disaster that her limitations will be exposed. This fear of being seen as lesser had to be predicted in advance and avoided at all costs, which is something she was rarely able to do.
The truth is her judgment was good enough. She has lived many years on this earth without ever knowing what was going to happen next and some how she has survived. She has survived by using her judgment to solve problems as they happen, rather then preventing what may or may not ever happen. Her judgment was not always a success or failure. She now was able to stop using this childish all or nothing thinking and could develop an appropriate view of herself. In this new perspective, she was able to let go of her worrying, impatience and frustration. She could listen to her boss yell and not take it personal. She wasn’t tearing herself apart over it, she let go of the emotional charge and she was more patient and at peace.
Read Full Post | Make a Comment ( None so far )Perceptions of Conflict
Freddie has the attitude: “I expect perfect fairness from my wife and it is her job to give it to me.” If his wife, Alice, had the attitude, “My husband expects me to be perfectly fair to him and I am only too happy to live up to his expectations,” there would be no clash. There would be perfect harmony. She would give and he would take. That is his definition of perfect fairness. He would criticize and she would accept his criticism, he would demand, she would obey, he would send her thought messages, for example, “I want an apple” and she would bring him the fruit bowl. Freddie would be happy at last.
Since Alice does not have this hypothetical attitude, this hardly ever happens. Freddie, therefore, cannot be “happy” in his marriage. He becomes very angry when his unreasonable, irrational expectations are not being fulfilled. When Alice is scrubbing the floor instead of tending to his “legitimate” needs, he says, “All you ever think of is yourself.” In his book, anyone who doesn’t think of his welfare constantly is selfish and guilty of irresponsibility. He feels deprived, and to be deprived is to be victimized. Since it isn’t “fair” to victimize nice persons like himself, he becomes very angry. His anger, then, has many facets that need to be identified before they can be properly relieved.
Freddie justifies and maintains his absurd expectations using the immature logic of a four year old: “If I am good to Alice, she is supposed to be good to me. That’s fair.” That sounds reasonable, but it is not. Freddie has his own definition of goodness. He feels that giving her ten dollars a week for food is “generous,” He is a “good” provider. When he doesn’t hit her as hard as he might, he feels that he has been “considerate” even “chivalrous,” and is entitled to compensation for his “gentlemanly restraint.” Alice, however, doesn’t see these actions as good. She does not understand his expectation that she will reciprocate by being good to him. He tries to make her understand that she is guilty of the crime of failure to reciprocate fairly. She tries to make him understand that his irrational behaviors are causing her pain. When she is in pain, she is in no mood to “appreciate” his fictitious goodness or to make him happy.
The truth is that neither one of them understands what is going on below the surface, nor wants to. Each one has the “good intention” to “improve” the other in ways that can only backfire. Alice, like many people, imagines that her marriage problems can be resolved by using rational thought processes. Her underlying attitude is, “I am rational, my husband is rational, we can talk things out like civilized human beings.” However, when she approaches Freddie to talk about the electric bill, Freddie is not listening to her with his brains, he is hearing her words through a dense fog of mistaken attitudes, perceptions and expectations. These mental elements are more powerful than his intellectual capabilities. It is like they are speaking foreign languages to each other without knowing it. He hears her statement of the problem as:
a) a criticism of his management skills,
b) a reflection on his masculinity,
c) an accusation that he is in the “wrong,”
d) an attempt at victimization by a potential enemy,
e) a power struggle for control of the marriage by controlling the money,
f) a failure to appreciate his goodness for the past ten years,
g) a good intention on her part to change him into a money manager,
h) the implication that she will not accept him as he is,
i) the implication that he is not perfect and, therefore, worthless.
In other words, he takes her critical comments personally, as if they were a reflection on his worth as a person. He doesn’t deserve this painful abuse. It’s not fair. This implication that he is worthless and unworthy of respect is painful, too. He is a veritable layer cake of anger upon anger. Freddie’s agenda is not to acquire money management skills, it is to relieve his pain as fast as he can. He overreacts and she overreacts to his overreaction. Each one is the prisoner of attitudes from the past, each one is recreating parental scenarios from childhood, each one is mismanaging their anger at the unfairness of it all. There can be no conflict resolution under these circumstances; there can be no problem solving, only one self-created crisis after another. There can be no happiness.
Read Full Post | Make a Comment ( None so far )Suicide Rate and Economy
The suicide rate increased 3 percent in the 2001 recession and has generally ridden the tide of the economy since the Great Depression, rising in bad times and falling in good ones, according to a comprehensive government analysis released Thursday.
Experts said the new study may help clarify a long-clouded relationship between suicide and economic trends.
While many researchers have argued that economic hardship can raise the likelihood of suicide in people who are already vulnerable — like those with depression or other mental illnesses — research has been mixed. Some studies have supported such a link, but others have found the opposite: that rates drop in periods of high unemployment, as if people exhibit resilience when they need it most.
Using more comprehensive data to nail down economic trends, the new study found a clear correlation between suicide rates and the business cycle among young and middle-age adults. That correlation vanished when researchers looked only at children and the elderly. It may not be the case that economic troubles cause suicide attempts, but they can be factors.
“They did a nice job of adding a piece to a very complex puzzle,” said Eve Moscicki, a researcher at the American Psychiatric Institute for Research and Education who was not involved in the study. “It may be that when people who are more vulnerable to suicide to begin with lose a job or get a pay cut, it adds one more stressor.”
In the study, which appears in The American Journal of Public Health, researchers at the federal Centers for Disease Control and Prevention examined suicide rates per 100,000 Americans for every year from 1928 to 2007.
The overall rate fell by more than a third in that time, to 11.2 from 18.0, with most of the decline occurring before 1945. It fluctuated in the mid-1950s, trended upward through the late 1970s, and back down between the mid-1980s and 2000. Over the years, researchers have attributed this general downward trend to improved access to care, rising standards of living and better drugs, among other things.
To investigate the effect of business cycles, the researchers calculated the average rate during periods when the economy contracted and compared it with the average during the years leading to downturns. The sharpest increase occurred at the start of the Great Depression, when rates jumped 23 percent — to 22.1 in 1932, from 18.0 in 1928. The study found smaller bumps during the oil crisis of the early 1970s and the double-dip recession of the early 1980s, among other economic troughs.
The suicide rate generally fell during periods of economic expansion, with some exceptions. Rates among people in their 30s and 40s went up during the booming 1960s and actually decreased among the elderly in the severe recession of the mid-1970s.
Cultural factors played a role, the authors argue. “The social unrest and tumult of the 1960s may have added to young people’s mental stress and therefore contributed to their continually rising suicide rates,” they wrote. “For the elderly groups, the rapid increase in Social Security benefits in the late 1960s may have provided a safety net in hard times.”
Feijun Luo, the lead author of the study, said, “The findings suggest the potential to see a big increase in the rates during this current recession.” His co-authors were Curtis S. Florence, Myriam Quispe-Agnoli, Lijing Ouyang, and Dr. Alexander E. Crosby, all of the C.D.C.
Suicide is impossible to predict, and rare even in the most dire circumstances, which is why prevention programs and early treatments have had mixed results. Most address specific problems like substance abuse, depression, isolation and troubled family relationships. But this study should give communities and doctors a better sense not only of when risk is high, but in whom — working-age adults, in this case.
“Once people age out of the work force, there seems to be no relationship between the business cycle and their vulnerability,” Dr. Florence said.
http://www.nytimes.com/2011/04/15/health/research/15suicide.html?_r=1
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