September 3rd

There is a buzz outside. Labourers work on condo construction but also nearby household renovations. Patios everywhere, sidewalks filling with people. The sun is out and it’s the peak of our sociability for this year, is it not? We all quietly know it’s only going to get colder from here, which means less people to seat on those patios, meaning eventually no patios, which means potentially no way for those businesses to stay in business.

That buzz is the sound of people whistling past the graveyard, wondering what’s going to happen when the kids go back to school. Wondering what the autumn will bring from the south.

That buzz is the necessary distractions we create for ourselves so that we don’t begin to feel like the world is caving in.

 

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A Different World

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I’m sometimes in the habit of cross-posting from this blog to my professional blog, but this time it’s the other way around. I think it fits.

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The COVID-19 pandemic has laid bare the human face behind our central idea of how an economy works — something we have long needed reminding of, lest those of us who are able to pay our rents and leases become too comfortable with abstract terms such as “supply chains” and “stakeholders”. We are reminded that we are a society of interdependent people — individuals, families, communities — and it’s overdue that we see our economies the same: people require support when tragedy makes their livelihood untenable.

And just as the pandemic has made us humbly pause to consider the society we have constructed (or, if I am feeling cynical, we have  allowed others to manage so long as it doesn’t affect our ability to pay too much for our livelihood), so too has the tragic, preventable deaths of George Floyd, and Breonna Taylor in the U.S. and in this country, Regis Korchinski-Paquet and Chantel Moore to name just two from each country in the last two months, forced us (and not without the persistence of the Black Lives Matter movement) to reckon with our society’s implicit racism and how that directly affects the lives (not just livelihoods) of Black and Indigenous individuals in particular.

We are reckoning not with the isolated actions of “a few bad apples” but with the concept of systemic racism, that is, when racist or white supremacist notions are baked into the very structure of certain communities, businesses, and government agencies. This is particularly evident within policing organizations.

I’ve previously written about the idea of social justice, and my own path from a place ignorance. There is a great sense of exhaustion I’ve heard from members of the BIPOC (that is, “Black, Indigenous, [and] People of Colour”) community. The exhaustion of having white friends and colleagues continually approach them to ask for resources to help them understand racism (imagine asking a victim of gun violence to help explain the problems with firearms licensing). The exhaustion that comes with wondering whether this will be yet another blip of media interest in which hopes are raised only to be let down.

A different world is possible, but the time is past due for white folk like myself to do the heavy lifting, to seek out and reference the many (many) resources out there already written by the BIPOC community that will help people like me contextualize and understand how racism is systemic, and — just as importantly — to help others like me better understand this situation. As a therapist and active member of society it’s the least I can do. 

For anyone who is curious, here are some resources I have no hesitation recommending:

Between the World and Me, by Ta-Nehisi Coates (book)

Black on Bay Street, by Hadiya Roderique (Globe and Mail essay)

The New York Times’ 1619 Project

The Inconvenient Indian, by Thomas King (book)

A last thought for you: there are no slow news days, only barriers to other peoples’ experience.

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Jean Vanier

Yesterday, I read the revelations concerning an internal report by L’Arche, an organization renowned for its work in changing the way society takes care of those with developmental and cognitive challenges. Its founder, Jean Vanier, has been accused by several women who worked with him of sexual assault. I was gutted to read this, as are many people around the world, I suspect. Let me be upfront, because I realize not everyone is going to follow the link I’ve posted (and sometimes I blog thinking that this will automatically be the case): these were women of faith who were working dedicatedly with his organization and/or directly with him, whom he coerced and pressured, sometimes over years, breaking so many personal and professional boundaries in the process, doing so much to hurt people while he was helping others.

Vanier, who passed away last year, was one of those people who, while I did not explicitly follow, I held in esteem. Ever since first learning about his work in my late 20s, his commitment to humanizing those who do not have a voice — which included the homeless, among other sectors of society — I’ve looked up to him as a high water mark of how to be a decent human being capable of walking the talk. And this makes the stories coming out all the more sickening, because of the extent of his abuse of power, how much harm he has done to his victims. 

So, what do we do?

I’m not on social media much but I can already imagine people dismissing everything to do with L’Arche, the organization. And while it would be healthy to see how the internal investigation evolved (in particular how quickly it responded to complaints), I am cognizant that the news is due to L’Arche’s internal investigation and not as a result (from what I can see) of an external journalistic exposé.

I want to continue to support the work of L’Arche in spirit, even if Vanier’s actions in private were so intoxicated and self-absorbed — in particular, for me, the accounts in which he justifies his actions to his victims as being in the spirit of God. While it appears that none of the people he cared for — the most vulnerable in society — were targeted, I am holding my breath on this last part. But there are already victims, women who trusted and believed in his work, in him, and who are scarred by their experience, and whose relationship with their religion I can only imagine must have exacted a great toll as well.

A question that is particularly relevant these days: is it possible to support the continuation of someone’s work despite their horrid private actions? Yes, I think it is, and I don’t think one requires a lawyer to parse out that logic, however I think in this particular instance L’Arche will need to gain the trust of the public, and to define themselves beyond (probably by expunging) Vanier’s image.

Incidentally, I’ve been reading Becoming Ethical, by Alan Jenkins, which provides ways for therapists and social workers to work with men who abuse. I appreciate Jenkins’ philosophy, part of what is called the invitational model, which is not to lock those who have abused into a permanent status of abuser, but allowing them an opportunity to represent themselves and find their own path through the pain they may have caused (as well as deep reflection on their own internal logic). I mention this because I deeply wish there had been a last act in Vanier’s career where he was able to recognize the damage he had done and at least had begun the work of transforming himself ethically.

I am so fucking angry at the man. And terribly saddened with yet another public figure – someone synonymous with raising the quality of the lives of others — has unveiled himself to be culpable of something so avoidable and destructive.

[For those who are curious, I’ve revised this piece many times. Why? The answer may be its own blog entry, but I feel I didn’t give as much space to the victims in the original post.]

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The “patchwork”

Note: this was originally a letter to the editor at The Globe & Mail, which in turn was published April 26th. It was in response to two articles posted in the G&M, the first a featured essay by Norman Doidge MD, a psychiatrist and psychoanalyst, and the second an op-ed by Ari Zaretsky, chief of the department of psychiatry at Sunnybrook Health Sciences Centre. Each of these were responding to cuts by the province of Ontario to the provision of psychotherapy. I have expanded upon my original letter, which was edited for publication.

Every few months I’m asked by someone seeking information on the process of finding a psychotherapist to describe what the landscape and rules are. The word “patchwork” is the first to come up in my attempt at an answer, what with it being a maze of publicly funded dead ends and privately available add-ons. But to call the mental health system in Canada a “patchwork” is to insult quilt-making. One only needs to scan the pieces by Norman Doidge and most recently Ari Zaretsky to discover how confusing this might be for the average person seeking support.

If this average person exists let’s attempt to make sense of the road ahead from their angle: a day devoted to research will show there are psychiatrists and psychologists, who, as it turns out, may or may not have extensive training in psychotherapy. Then you have psychotherapists, whose profession may or may not be regulated depending upon the province you live in. Assuming our average person isn’t privately wealthy we must then ask: which profession — psychiatrist, psychologist, psychotherapist, social worker — is covered by what public or private health plan, and for whom is this available? Imagine being in the midst of a panic attack then trying to find support when you most need it only to discover that, to use Ontario as an example, despite being the only profession covered by OHIP, more and more psychiatrists are less and less interested in delivering psychotherapy versus managing prescriptions where, coincidentally, they can see more clients in a day and make a larger income. Meanwhile social workers enjoy vastly more private health benefits coverage than do psychotherapists.

Both Doidge’s and Zaretsky’s pieces are coming from a perspective that seems to make things more about the therapist, justifying their modal belief system or cost benefit analysis over the basic needs of those who are not privately insured. They rightly hail the benefits and importance of psychotherapy, but in their own ways go on to mount a self-interested defence of their turf: psychodynamic vs cognitive delivery methods. This battle over which therapeutic approach is more quantitatively or qualitatively effective than the other reeks of the privilege of those who have probably never been in long-term individual therapy themself.

The cart before the horse is that there is too little public access to trained professionals — particularly those who don’t have the MD designation of psychiatrists or the PhD of a clinical psychologist, but nonetheless have specialized training in psychotherapy — while we are in the midst of a steadily growing demand, with grave consequences for some who aren’t able gain access to professional assistance. Let individuals decide on the right approach for them. To qualify for the College of Registered Therapists of Ontario (CRPO) I cannot practice psychotherapy in this province without qualifying for membership, which means being a graduate of (or currently in training with) one of the approved training institutes registered with the college. Given this thorough certification process why should we then disregard the diverse modalities the CRPO explicitly acknowledges and pretend that this can be boiled down to a binary choice between a conservative interpretation of psychoanalysis or the limitations of CBT? In my experience as both a therapist and someone who has been in long-term personal therapy as part of my training program’s ethos — an ethos I feel should be obligatory for anyone training to be a psychotherapist — therapy works best when the “fit” is good, not about which style is supposedly better than the other.

The most important point — and one lost in both Doidge’s or Zaretsky’s articles — is the primacy of allowing Canadians the ability to gain access to psychotherapy in the first place.

[I would also recommend reading Heather Weir’s contribution to the G&M letters to the editor]

 

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Pain

I have this weird, recurring thing. It starts with a dull soreness in my left glute, kinda like someone kicked it the day before and it feels bruised. Then, in a day or so, an odd stiffness and soreness stretching from the glute all the way down the back of my left leg, going down to my ankle. Within a day or so it reaches the zenith of its pathology: pain.

Two weeks ago yesterday I tried getting out of bed. I swung my legs over to the side of the mattress, and between that everyday action and my feet touching the floor I became a crumbled mess, bent over in agony. I was in so much pain I was crying. I was unable to stand. I was unable to sit. I was unable to do anything without experiencing the sort of intense, unrelenting pain that makes you realize in seconds why anyone would unhesitatingly reach for opiates.

What I have goes by two names: pseudo sciatica, or piriformis syndrome. The sciatic nerve travels from the spine and down the leg where it provides sensation to the skin of the foot and the lower leg. Unlike classic sciatica which involves irritation of the nerve from the spine via a disc, what I got is caused by the irritation via the piriformis muscle — something you’ve likely never hear of, but it’s a band of muscle in the core of your glutes. If the piriformis is aggravated it can bother the sciatic nerve in a similar way to classic sciatica. [Update: please see the follow-up post]

I’ve described the pain to people as like having your hamstring replaced with razor wire. It’s actually worse, because of how the pain “glows” all through the leg. At its worst, the pain cuts through your thoughts, your feelings. It takes priority over everything. It doesn’t care if you are happy or if you had plans to go somewhere that day. I’m always humbled by how quickly physical pain cuts through everything, taking priority, and how it terrorizes me with its power. I end up impatient with others, downright angry 24/7. I catastrophize: this is never going to end, I’m going to be like this forever.

I can afford physiotherapy, which makes me lucky. I don’t have health benefits because I’m self-employed, so anything not covered by provincial health care comes out of my wallet. I immediately checked myself into a physio clinic and I remember being furious: this again. This being physio. Physiotherapy (and related physical therapies) is something I have a good deal of experience with and I never hesitate to recommend it to people; the irony is that when I find myself being forced to return to physio it feels as if I’ve failed at something. Something tells me I’ve been irresponsible, which is silly.

Piriformis syndrome can happen to people who sit a lot. While I’m one of the most physically active people I know (I walk to work every day, I go to the gym, I run, I practice baguazhang) my job as a psychotherapist means I’m sitting for an hour at a time. Piriformis syndrome also prefers distance runners, which makes me a prime candidate.

For the last two weeks I’ve been doing physio exercises three times a day, combined with visits to a clinic, combined with acupuncture and Chinese medicine. Progress was very, very slow. The last time I had this it lasted all of a week or so, and I was able to work it out on my own with stretching and massage. This time it’s been remarkably more painful and long-lasting.

Yesterday, on the two week anniversary of not being able to stand out of bed, it felt like something had subtly changed. My mobility felt more easy, I didn’t have the feeling like I couldn’t extend my lower leg when I was walking on the sidewalk doing errands. I stayed outside, pushing myself a little, forcing myself to stay active. Today, for the first time in many weeks (partly because of the terrible weather we’ve had) I was able to practice ba gua outside on our terrace. I nearly cried.

My relationship with physical exercise is a personal one. It allows me to connect with my body. It is embodied movement, whether it’s running a 10K circuit or doing ape offers fruit. I’ve gone two weeks without any chance of significant exercise, and so the things that gave me internal relief — running, baguazhang, gym — were off-limits, which in turn made me miserable, feeling imprisoned.

I suppose I’m sharing this because it’s important to take a moment to reflect on the relationship between body and mental health. How it directly affects my spirit. The pain is slowly receding, I have my mobility, and I know that soon I’m going to be able to run outside and feel better. But my experience pales beside anyone with chronic pain, and I am humbled when I consider anyone who has to go through life under such conditions, be they due to injury or living conditions. Not to mention the fact that, when this has passed, I will have spent hundreds of dollars on physical therapies that many cannot access.

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A book, some photos

I swear I’m not a packrat, but sometimes you hold on to things for reasons that seem more intuitive than logical. Which brings me to a book on our shelf at home — The Chrysalids, by John Wyndham. This was from Grade 9 English class, if I’m not mistaken.

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Let’s get something out of the way, in case that book cover looks cool. It has absolutely nothing to do with the story, its characters, the themes. I am afraid to say there are no weapon-wielding anthropomorphic insects, which was a crushing blow as I turned the pages at the time. Don’t get me wrong, it’s a good book, and John Wyndham (The Midwich Cuckoos, The Day of the Triffids) was no slouch.

However, a couple of years ago, when I took it from the shelf to have a look, I found two photographs inserted. You see, back then I was a yearbook photographer, and these were a couple of photos I’d probably printed off at the time (this would have been 1985?) perhaps to give to one of the people pictured should I have seen them in the hallway between classes. It’s possible it was just a fancy bookmark. I don’t honestly remember, but I’m struck by the good condition of the paper (printed on glossy stock, which was verboten in the darkroom because of its cost and scarcity). If you look at the bottom margin of the upper photo below you can see that I didn’t square the cut.

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This is not a John Hughes film. At the end of the day, we’re looking at three teenagers standing at the rear (smokers’) entrance to Memorial Composite High School, in Stony Plain, Alberta. I sorta knew a couple of them. The guy in the middle was an asshole straight out of Stephen King’s Christine. I suppose I could grab my yearbook and look up their names, but all that’s going to give me are facts, right? What strikes me about the Wyndham book, the photographs, is how much of a time capsule it all is, as a somewhat complete package. Of a kid who was yanked from town to town, school to school, who didn’t get to have much say of where I went, what I had to endure along the way, who became more preoccupied with getting through it as opposed to (cue Hughes, whose movies I grew up watching) Having The Time Of My Life.

I suppose there’s a clever thing I could do: to connect the misrepresentation of the cover of The Chrysalids vs the more complex content, to the misrepresentation of how high school is sold to us vs the reality of growing up for many of us. So I will.

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Hello, world (2019 version)

For all intents and purposes, I abandoned this blog. Not willingly or intentionally. To be honest, I didn’t (and still somewhat don’t) know what to do with it. You see, it contains a lot of crap; this is what happens with any blog over time: you change, the world changes, your knowledge/opinions develop. You end up with a blog where you squint at parts, hoping nobody looks too closely at the early stuff. I’ve been doing this since 2006, so cut me some slack.

I’m here to say that I’m back. I just don’t know what form this is going to take. You see, at some points this blog has been philosophically driven, psychologically driven, artistically driven…and I always feel bad when I change the mandate.

Why can’t you be more consistent? Does that question sound familiar? For those of us who are outliers (not by choice but by design), there is a great deal of downward pressure on us by society to fit the fuck in. Because if you’re not consistent then you’re difficult, and difficult means people have to spend more time than they anticipated trying to figure you out. People who are difficult or inconsistent typically find themselves struggling to figure themselves out — why the hell am I taking a path that only makes things harder for me socially?

Often, there’s no choice. Because being consistent typically means disregarding complexity, and if you have an innate appreciation for complexity then this is going to be a problem. And so, getting back to this blog, I’m not going to sweat the inconsistencies. I’m not going to pretend to stand by everything I wrote in 2012 or 2009 — this is why most posthumous memoirs shouldn’t be published: if the author had an opportunity, they would probably throw them into a fireplace for fear of looking like an asshole/monster. Thankfully, I don’t think I come across that badly.

Kerry Clare has some interesting points to make about returning to blogging. For me, I can relate to wanting to shift away from the disposability of social media. Particularly as I’m wrapping up work on my next novel, I think I have time for this.

I hope you’ll stick around.

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The Brain & Science – The Problem With Wanting It All

As a psychotherapist, I have taken an interest in the rise of neurobiological research being applied to my field. At first, particularly upon hearing about “interpersonal neurobiology” (or IPNB), I was excited — I was seeing the intrapsychic and biological converge into what appeared to be a fascinating model of understanding human behaviour. But here’s the thing: while I have a deep reverence for the subjective life of the individual, I’m also interested in looking at things empirically, where applicable. Without this latter aspect, I feel we fall prey to magical thinking.

The more I looked into some of the new ideas permeating my field, I became aware of a few things. While certain concepts, such as the idea of neuroplasticity, were taken from science, the more I looked at who was writing about this, the more I noticed that the people applying these complicated concepts to psychotherapy weren’t neurologists or geneticists. One of the oft-referenced authors in the field of IPNB is Allan N. Schore, who is a psychologist and researcher. His books are popular with those looking to harmonize neurology and psychotherapy. And while I respect his multidisciplinary work, I have difficulty with binary conceptions of how the left and right brains work (whereas, supposedly, the right brain is responsible for emotional attunement, the left brain for insight and analysis). Why do I have difficulty with this? Because many neuroscientists would contend that this is too simplistic a way to look at the brain.

This is a blog post and not a long-form essay. I could go on. I suppose what irks me is the amount of material being written about a myriad of complex neurobiological research findings that skip over the necessary cautions that are the hallmarks of science. Correlation is not causation. How big was the sample size? Continue reading “The Brain & Science – The Problem With Wanting It All”

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Keep Moving / Being Wrong / Keep Moving

Sometimes I feel that I stand in-between too many things. Un-firm. Undecided. This is in part due to my fond appreciation for not only a lot of disparate topics but also disparate approaches. I believe in the vigour of an approach which involves good research. I also believe that we can lace “good research” with wishful thinking so that the evidence it produces is wishful thinking presented as fact. I believe that there are charlatans who willingly or naively provide a distraction that slows us down. I also believe that we dismiss many things as charlatanism not because they pose a danger but because they conflict with the politics of our personal or professional lives. I believe in intuition. I also believe intuition alone brings us too close to a raw reflexiveness which doesn’t serve long term needs.

So when someone asks me What do you think about x? I sometimes find myself considering a number of things and contexts to understand the question. The drawback is we’ve created a world where this sort of complexity is undesired. Certainly, in some industries and roles, complexity is unnecessary — a prime example would be assembly line work where the task is to simply crank out carbon copy iterations of something already conceived-of and revised to an acceptable standard. If you want to know what roles robots and AI are going to swallow up in the future, it’s those things. Complexity, on the other hand, keeps us guessing, reminds us that there are no set answers, or if there are they are kludges we developed until the next discovery forces us to revise our notions, our presumptions.

In an essay in this weekend’s New York Times Magazine, Ferris Jabr profiles someone turning to exotic flora in order to stave off our imminent depletion of effective antibiotics. The researcher in question turns to the lore of sometimes ancient civilizations, the extracts and tinctures from nature that one might rightly think come from fantasy, or from a presumably primitive culture. From some pharmaceutical industry perspectives, this is quackery. And yet, in one example, Continue reading “Keep Moving / Being Wrong / Keep Moving”

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The Trouble With The Trouble With Physics

I’m on my second attempt reading Lee Smolin’s 2006 book The Trouble With Physics. I am reminded of a similar situation with another book, Joyce’s Ulysses. And, similarly, my second attempt with The Trouble With Physics is not a reappraisal but a confirmation: this is hard to read.

Smolin’s book is making a case for the fact that string theory is a failure; a spectacular failure that its adherents defend with a most byzantine theoretical web; that, because string theory is de rigueur in so many of the top schools, with so many reputations at stake, no one wants to recognize the fact that string theory — an attempt to harmonize the ideas of quantum theory and relativity so that we might understand the foundation of the universe more clearly — is a dead end.

The problem I’m (still) having with the book is that Smolin is writing to an audience that is willing to take a steep (try 90 degrees upward) climb in order to understand the various concepts and theories which not only formed the foundation of string theory, but the issues that weren’t resolved through the original work of Newton, Einstein, etc. Smolin lays out in the beginning various fundamental aspects of how things work that we simply don’t know — instilling early that scientific inquiry is, if anything, about the need for curiosity. However, given Smolin’s densely described approach to get us ready to understand his arguments, and while I don’t doubt the necessity, I think he would need to double the length of his book to do so effectively for interested readers who are not physicists.

What is more successful, and the reason I continue to read it, is how Continue reading “The Trouble With The Trouble With Physics”

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