Essay in Humber Literary Review #6

I’m happy to say that the latest issue of Humber Literary Review (#6) is out, and I have an essay included. This is their first themed issue, and it’s about mental health. Because I’m a psychotherapist who is deeply reflective about the way in which we choose to see the world, I saw this as a golden opportunity to submit a pertinent perspective; my essay, On Madness Within Imagination, confronts a cultural blindspot – the depiction of madness in fiction.

 

 

 

 

 

 

 

 

 

 

It is available at the following Toronto bookstores:

Another Story (on Roncesvalles)
Book City on the Danforth
Book City on Queen
Book City on St Clair
Book City in the Village
Presse Internationale on Bloor
Presse Internationale in the Beaches
Type Books (on Queen)

It is available elsewhere, of course, but I have no clue where. You can also purchase a subscription from HLR.

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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

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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

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Book Review: The Therapy Industry, by Paul Moloney

I don’t have a lot of time or head space for reviews of any kind these days, however I try to make an exception for work which deserves attention, if only for sake of better exposure and discussion.

One of these works is the book The Therapy Industry, The Irresistible Rise of the Talking Cure and Why it Doesn’t Work by author Paul Moloney (Pluto Press). I came across this provocative title through Moloney’s recent curation of new book releases on the site New Left Project. What follows is a necessarily compressed review, certainly more so than what you would normally find for this sort of work, and perhaps more succinct than this book deserves.

Let’s stop the bus and draw your attention to the driver. My interest in this book is complex and certainly not unbiased: I’m a relational psychotherapist – it is a career I chose later in life and one whose practice and philosophy I have a deep, evolving respect for. However, increasingly I have found myself dissatisfied with the level of critical discussion about the array of available therapeutic modalities, the politics non-medical practitioners encounter with respect to recognition in an increasingly medicalized notion of mental health, and not least the pecking orders (particularly reinforced by those practitioners who receive provincial health care coverage, those who receive coverage via corporate health benefits plans, and those who receive neither).

I was drawn to this book not only for its stated critical approach but also, perhaps relievedly, that it was written by someone who is a counselling psychologist and lecturer. This is not, in other words, a journalistic view from the outside. Quite selfishly I thus figured that it must have some sort of a happy ending. And, in short, it does, though you need to swallow some hard medicine first.

The gist of The Therapy Industry is that there is a disconnect between the mainstream approach toward treating those with mental health issues and the realities of (at the very least Western) industrialized society which is becoming more and more demanding upon us, economically, socially, and – as a result – psychologically. The system generally available to the public – from awareness campaigns to the attitudes of medical and non-medical practitioners – goes to lengths to make those seeking help feel that the problems they are experiencing are the product of their genes or their own faulty reasoning about the world around them. Or, if the practitioner does recognize that there is a probable cause that is environmental rather than genetic, the prevailing course of treatment is, in essence, mind over matter. According to the book there is, in short, some denial about the more environmental causes in the marked rise of mental health-related issues over the last century. And worse still, if there is clinical – which is to say institutionalized – denial then that doubly disfavours those seeking help. Continue reading

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The Importance of Self Care

I was reading this article in the National Post, about a psychiatrist whose trained specialty is analyzing and working with violent sexual predators, who recently experienced a breakdown as a result of what is believed to be symptoms of PTSD (post-traumatic stress disorder). He has worked on cases involving Paul Bernardo, Robert Pickton, and most recently Russell Williams: all of them so-called sexual sadists, all of them convicted murderers.

To put this into context for those reading from outside Canada, each of these convicted – by virtue of the severity and depravity of their crimes – is a poster boy for reinstating capital punishment (which, for the record, I do not support). They have individually terrorized regions of the country when they were active. It’s important to understand all of this due to the nature of being a mental health professional – someone trained to see people as people no matter who they might be or what they might have done – working with people of this description.

The article describes how Dr. John Bradford simply lost his ability to keep the burden of content (and ostensibly the affect of said content) from seeping into his consciousness, whereas before he was able to separate the explicitly graphic information he worked with from getting to him. What stood out in the article for me was the following:

What he wouldn’t realize until he went into therapy was that the videos from his many cases had been gradually taking their toll and they rushed back to haunt him on that long drive home.”

 

In particular, the phrase “until he went into therapy”, which implies that he wasn’t seeing a therapist until this point. Assuming this conjunction isn’t sloppiness on behalf of the writer, I find it appalling that Dr. Bradford could have such a role and somehow not be mandated by his employer (or his governing professional society) to be in some form of regular personal therapy. It boggles my mind, actually.

We live in an odd time when the general public are being told (rightfully) the importance of mental health and not allowing toxic environments to fester within them and yet someone tasked with watching videos of killers’ victims doesn’t walk into a therapist’s office until he is exhibiting signs of PTSD and is forced to take a month off work?

Let me be clear: to my knowledge there is no explicit mandate for said procedure. I am not implying that Dr. Bradford was in any way professionally negligent. I am however suggesting that the past and current culture of psychiatry, with its “detached” experts, should reconsider its standards for those tasked with a specialty like Dr. Bradford. Self care goes both ways: it allows patients/clients/non-professionals to seek help and understanding for their issues; it also allows professionals an opportunity to explore how their work impacts their lives.

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About Blame, Shame, and the Sacred Altar of Individual Responsibility

[This originally started out as a post on my psychotherapy blog, but became so lengthy and opinion-laced that I figured I’d put it here.]

One comment I hear, particularly in op-ed sections of newspapers, is that as a society we are becoming “soft” (ostensibly because we are beginning to encourage children to discuss their emotions throughout public school life, and not just when they get in trouble or are victimized). Within this same argument is the contention that, thanks to people like me (mental health professionals), everything that is perceived to be wrong with the individual is to be blamed on other people or institutions. Thus, the contention is that individual responsibility is somehow being sapped of its strength.

I see no need to blame anyone for anything. If a client’s parents were too strict when they were growing up, it’s enough to explore it (and its effects) until such a time as the context of those events have a present-day meaning which will allow the client to lead a healthy, durable life and move on. My interest is with the client: their health, their well-being. I have no use for encouraging, casting, or redirecting blame. That is not within the philosophy of the modality of psychotherapy that I am trained in. It is certainly not within my personal philosophy. There’s not much to be gained from vilifying people and things.

Something to note is that many forms of victimization carry with it, primarily, shame (though other feelings may follow closely, like anger). The shame of not being able to avoid the caretaker who struck you. The shame of not being able to speak out about the racial discrimination you experienced in school. The shame of being sexually preyed upon by a coworker. Shame is a very deep hole to climb out of. Just talking about shameful experiences can retraumatize some clients – that is, put them right back in the original emotional context which first scarred them.

Survivors of abuse often feel responsible for their victimization, regardless of how little agency they had at the time they were victimized. In other words, if we are to talk about blame then we should talk about victims of abuse walking around blaming themselves. One of the tasks of therapy is to move the finger of blame away and to look at what has happened to a client with clarity, without an agenda. Then and only then can the process begin of assisting the client out of that deep hole I previously mentioned; assisting by paying close attention, sharing, talking. The client does the heavy work and I’m there to help in every way I can.

I cannot think of something which better defines individual responsibility than someone recognizing that something deep down within them needs to change, and undertaking the time and effort (and pain, and, yes, in the case of working with a therapist, money) to rework their understanding of themselves, to lift themselves to a higher point of view – and all that this entails both in the therapeutic space and in the outside world.

If by “soft” critics mean weak, then the individual who helps herself is not “soft” – she is not weak. She does not blame herself as she once did. She has taken control of herself and has worked hard to build awareness, and through awareness resiliency.

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The Pause Button

I don’t believe our identities ever settle, to become static. This isn’t to say that they fly willy-nilly like laundry in a windstorm. There are two great wheels: the one inside of us and the one outside. Both move forward regardless of our individual philosophies.

The outside wheel is time. It is the inevitable movement of progress, the passing-on of events, linking like the teeth of a sprocket on a bicycle chain. Whether we stand still or keep moving, this wheel keeps turning.

The inside wheel is our own development: our learning, the expansion of our comprehension of things, as well as our personal growth. It also keeps moving, again, whether we stand still or move.

Development is growth, and growth is sometimes painful, especially when we suspect we have been travelling on a path which does not intuitively serve our needs any longer. The temptation can be strong to “hit the pause button”; to stop looking at how the outer wheel affects the inner wheel, the learnings contained within their interplay. I’m not sure if it would be fair to call this wilful ignorance, but some would.

I’ve known people, particularly those from school, who seem to have “hit the pause button” at some point in their late teens or early twenties: they dress the same, they obsess about the same music, they ask the same questions they asked at that age – it can seem as if they are exist in a still photo of a past universe. I speculate that they see the larger wheel, the world, turning (one cannot wilfully blind oneself from seeing this), but don’t wish to acknowledge that the inner wheel, identity/personality, still turns and evolves also.

It makes me sad, and yes I realize that is a judgement. I don’t wish to categorize people since we live in a society which already puts such an emphasis on a divisive winners/losers binary. It makes me sad because I have a relational tether to those who are in this way: I know what it’s like. It’s also quite common.

I could speculate all day about whether this is fear-induced, shame-induced, whether (from a psychoanalytically informed perspective) there is a concern about narcissistic rupture at play in this. All I know is that it exists, and that the temptation for some to “keep things the way they are”, regardless that this is kind of impossible, has a strong lure.

 

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Mondays

For a number of reasons – one of which is gaining more diverse therapeutic experience – I have started a practicum with the Sutherland-Chan School & Teaching Clinic on Mondays, as one of three rotating in-house counsellors. Our purpose is to “be there” for students enrolled in the clinic.

I wasn’t sure, at first, what to expect. My home practice is moving along and my clientele growing modestly. Their needs for seeking a psychotherapist vary: some have acute issues, others less tangible (more existential). At the clinic, all of the students I counsel have the same thing in common: they are all training under the same roof and have the same tests put upon them. Yet, beneath the homogeneous surface stirs a diversity of thoughts, feelings, and reflexes. It’s not unlike a group of people making their way through an amusement park, who are each mandated to experience each ride on the midway, each game in the arcade: each person will have a particular skill-set, a particular threshold. The rides or games which do not lie within their sets of skills, which require resilience beyond their particular threshold – these are the events which differentiate, which personalize the common experience.

Even within a prescribed course of study, where one would expect common dips in personal performance to happen at certain compression points of time and workload, on their own our blindspots, our subconscious organizing principles come to the fore. Often in spite of us. It is here where I have people knock on my door at the school, and ask whether they could talk with me.

And we talk.

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Self-Consciousness and Self-Awareness

You’ve been leading recently. Leading yourself forward without hesitating when outward support isn’t there, without looking for the comfort that comes from the insular voice – the insular life – that no longer works.

You are switching gears, between the self-conscious and the self-aware. What’s the difference? Here’s an example to demonstrate:

You’re in a restaurant. You’ve been there before. The food is good – reliable. The service, however, has never been their strong suit. Eclectic, you have politely described it to others. You take your seat and the server takes your drink order. Sure enough, you find yourself waiting a long time for the drink to arrive – 10 minutes pass, 15 minutes. All you really want to do is have a meal and relax and not think about why you have to wait. When your drink comes, they take your food order. You hope the initial delay was just a snag – now that your food order was in the queue, it should go back to normal turnaround. And yet… 10 minutes pass… 15 minutes pass… 20 minutes pass… It was just a sandwich… At the point of exasperation, someone – not your server, but another staff member – brings your sandwich. It’s been nearly 30 minutes. You look down and notice that aside from the sandwich on your plate there isn’t a napkin.

Self-conscious you sighs. You don’t want to make a scene. For all you know the server is overworked or there are problems in the kitchen. You sit there, waiting to get his attention. You’re pissed off, but it’s just a sandwich. You eventually Continue reading

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Quote

“Delusional ideas [are] understood as a form of absolutism — a radical decontextualization serving vital restorative and defensive functions. Experiences that are insulated from dialogue cannot be challenged or invalidated.

– Robert D. Stolorow, “Trauma and Human Existence” (2007)

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